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Analysis of the Changes in Femoral Varus Bowing and the Factors Affecting Nonunion for the Treatment of Femoral Shaft Fractures over 60 Years Old Using Piriformis Fossa Insertion Intramedullary Nailing
Yonghan Cha, Chan Ho Park, Jun-Il Yoo, Jung-Taek Kim, WooSuk Kim, Ha-Yong Kim, Won-Sik Choy
J Korean Fract Soc 2020;33(2):65-71.   Published online April 30, 2020
DOI: https://doi.org/10.12671/jkfs.2020.33.2.65
AbstractAbstract PDF
Purpose
This study examined the bony morphological changes to analyze the factors affecting bony union in the treatment of elderly femoral shaft fractures with varus bowing using piriformis fossa insertion intramedullary nailing.
Materials and Methods
This study included 26 patients over 60 years of age, who were admitted for femoral shaft fractures between January 2005 and December 2014 and treated with piriformis fossa insertion intramedullary nailing. Age, sex, height, weight, bone mineral density, injury mechanism, fracture type, diameter and length of the nail, postoperative lengthening of the femur, postoperative change in varus angle, contact between the lateral and anterior cortex, and the gap between the fracture line and the bony union were checked. The patients were divided into a varus group and nonvarus group, as well as a bone union group and nonunion group. Logistic regression analysis was performed to analyze the factors affecting nonunion.
Results
The patients were classified into 11 in the varus group and 15 in the non-varus group and 24 in the union group and 2 in the nonunion group. The varus group showed a larger increase in leg length and varus angle reduction than the non-varus group (p<0.05). The union group had more contact with the lateral cortical bone than that of the nonunion group (p<0.05). The factor affecting bone union in regression analysis was contact of the lateral cortical bone (p<0.05).
Conclusion
Treatment of a femoral shaft fracture in elderly patients with a varus deformity of the femur using piriformis fossa insertion intramedullary nail increases the length of the femur and decreases the varus deformity. For bony union, the most important thing during surgery is contact of the lateral cortical bone with the fracture site.

Citations

Citations to this article as recorded by  
  • Straight nail insertion through a laterally shifted entry for diaphyseal atypical femoral fractures with bowing: good indications and limitations of this technique
    Seong-Eun Byun, Young-Ho Cho, Young-Kyun Lee, Jung-Wee Park, Seonguk Kim, Kyung-Hoi Koo, Young Soo Byun
    International Orthopaedics.2021; 45(12): 3223.     CrossRef
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Supracondylar Osteotomy for Cubitus Vnrus Deformity by Using Plate in Adults
Hyun Ki Yoon, Sung Seok Soe, Young Ku Lee
J Korean Soc Fract 1992;5(2):319-324.   Published online November 30, 1992
DOI: https://doi.org/10.12671/jksf.1992.5.2.319
AbstractAbstract PDF
Cubitus varus deformity is the most common complication of supracondylar fractures of the humerus in children. For the correction of this deformity, three basic types of osteotomies were known. Among them, the lateral closing wedge osteotomy is the easiest, safest and the most stable method. After osteotomy, the methods of fixation are plate fixation, crossed kirschner wires, staple, and French techniques. Between 1987 and 1991, 15 corrective supracondylar osteotomy of the humerus in adults were perromed at department of orthopaedic surgery inje University, Paik hoshpital Pusan, Korea. All were fixed with plate and screws. From this small series of retrospective study, the authors concluded that plate fixation is good method for the prevention of complication after osteotomy and results are satisfactory.
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