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Original Article
- Three-Dimensional Analysis of the Morphological Features in the Femur of Atypical Fracture and Practical Implications of Intramedullary Nailing
- Yong Uk Kwon, Kyung-Jae Lee, Joo Young Choi, Gu-Hee Jung
- J Korean Fract Soc 2020;33(2):87-95. Published online April 30, 2020
- DOI: https://doi.org/10.12671/jkfs.2020.33.2.87
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Abstract
PDF - Purpose
This study analyzed the morphological features of the contralateral femur without an atypical fracture by constructing a three-dimensional model with an actual size medullary canal.
Materials and Methods
Lateral and anterior bowing of the shaft were measured for 21 models, and the shape of the medullary canal was analyzed. To eliminate the projection error, the anteroposterior (AP) femur was rotated internally to the extent that the centerline of the head and neck, which is the ideal position of cephalomedullary nail screw, was neutral, and the lateral femur matched the medial and lateral condyle exactly.
Results
The lateral bowing and anterior bowing was an average of 5.5° (range, 2.8°-10.7°; standard deviation [SD], 2.4°) and 13.1° (range, 6.2°-21.4°; SD, 3.2°), respectively. In the area where lateral bowing increased, the lateral cortex became thicker, and the medullary canal was straightened. On the lateral femur, the anterior angle was increased significantly, and the diameter of curvature averaged 1,370.2 mm (range, 896-1,996 mm; SD, 249.5 mm).
Conclusion
Even if the anterolateral bowing increases in the atypical femur, the medullary canal tends to be straightened in the AP direction. So, it might be considered as a reference to the modification of an intramedullary nail to increase the conformity.
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Case Report
- Repeated Metal Breakage in a Femoral Shaft Fracture with Lateral Bowing: A Case Report
- Dong Soo Kim, Yong Min Kim, Eui Sung Choi, Hyun Chul Shon, Kyoung Jin Park, Byung Ki Cho, Ji Kang Park, Hyun Cheol Lee, Kyung Ho Hong
- J Korean Fract Soc 2012;25(2):136-141. Published online April 30, 2012
- DOI: https://doi.org/10.12671/jkfs.2012.25.2.136
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Abstract
PDF
- Fractures of the femoral shaft with marked bowing face some obstacles in fixation of the fracture such as difficulty in insertion of the intramedullary nail (IM nail) or exact contouring plate. Locking compression plates (LCP) are an option to manage this problem. However, we experienced consecutive breakage of LCP twice and IM nail once in an 80-year-old female. Finally, union of the fracture was achieved after fixation of the IM nail and additional plate together. Fractures of the femur shaft with marked bowing are thought to have different biomechanical properties; therefore, we present this case with a review of the literature.
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Citations
Citations to this article as recorded by
- Comparative analysis of operation time and intraoperative fluoroscopy time in intramedullary and extramedullary fixation of trochanteric fractures
Milan Mitkovic, Sasa Milenkovic, Ivan Micic, Predrag Stojiljkovic, Igor Kostic, Milorad Mitkovic
Vojnosanitetski pregled.2022; 79(2): 177. CrossRef - Pre-operative planning for fracture fixation using locking plates: device configuration and other considerations
Alisdair R. MacLeod, Pankaj Pankaj
Injury.2018; 49: S12. CrossRef - Letter: Repeated Metal Breakage in a Femoral Shaft Fracture with Lateral Bowing - A Case Report -
Hae Seok Koh
Journal of the Korean Fracture Society.2012; 25(3): 240. CrossRef
- Comparative analysis of operation time and intraoperative fluoroscopy time in intramedullary and extramedullary fixation of trochanteric fractures
- 163 View
- 3 Download
- 3 Crossref
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