Vigorous Endosteal Reaming across Fracture Site to Aid Union in Atypical Femur Fractures

• 作者: Mayank Vijayvargiya Prashant Pandey Sanjay Agarwala
• 来源期刊: 矫形学期刊(英文)
• 学科: 数学
• 关键词: Atypical Femur Fracture Vigorous Reaming BISPHOSPHONATES Intramedullary Nail
• 年，卷（期）: 2020,（12）
• 页码范围: 412-418
• 页数: 7页
• 分类号: O17

摘要

<b><span>Background</span></b><b><span>: </span></b><span>Bisphosphonate abuse is associated with atypical femur fractures, which despite different fixation methods have increased non-union, delayed union, and re-operation rates. Therefore, there is a need for a surgical technique that may enhance union in such cases. Herein we are introducing a novel technique of sequential multiple vigorous reaming across the fracture site to introduce reaming debris/endosteal bone graft around the fracture site.</span><span> </span><b><span>Materials and Methods</span></b><b><span>: </span></b><span>We present a retrospective analysis of five prospectively treated patients with atypical diaphyseal femur fracture who presented to us from January 2015 to August 2019.</span><span> </span><span>All the patients were followed up at regular intervals and assessed both clinically and radiologically.</span><span> </span><b><span>Results</span></b><b><span>: </span></b><span>All 5 cases operated with our technique showed union at a mean follow-up of 16 weeks (12</span><span> </span><span>-</span><span> </span><span>20 weeks). There were no complications reported in our study at the last mean follow-up of 25 months (12</span><span> </span><span>-</span><span> </span><span>51 months).</span><span> </span><b><span>Conclusion</span></b><b><span>: </span></b><span>This technique of multiple vigorous reaming at and around the fracture site provides a new paradigm in the management of AFF. The autograft around the outer cortex promotes the formation of bridging callus and results in the early union.</span>