A Follow-up Study of Intramedullary Fixation with Wiring for Lower Extremity Fractures.

概要

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We used both wiring with intramedullary nailing to treat cases such as long oblique fractures or comminuted fractures of the lower extremities to obtain accurate alignment and stability of bone fragments.Intramedullary nails were used in thirty-seven fractures of the lower extremities for the last three years (20 males and 13 females, 22 femoral and 15 tibial fractures). Supplemental wire fixation was performed in seven of these cases (wiring group), while the other 30 cases had no additional material except interlocking screws of an intramedullary nail (control group). Wiring group (4 males and 3 females) consisted of 6 femoral and one tibial fracture, 4 long oblique and 3 comminuted fractures, and 4 cases operated on using Russell-Taylor intramedullary nails and 3 cases with Ender nails.Comparing the two groups, blood loss and operative time tended to be slightly increased in the wiring group but this was not significant. The initiation of rehabilitation and mean period required for bone union were similar for both groups. Wiring can be available as a form of supplemental fixation of the intramedullary nail for treatment of unstable fractures. However preparation against bleeding is needed in exposing the fracture site if vascular damage is suspected.