What nobody told you about femur fractures.
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Published:
May 11, 2016
Keywords:
femur, fracture, complications, surgical tools, nail, claim.
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Abstract
Surgical expertise permits our surgeons to handle intraoperative difficulties related to a deffectuous set of surgical instruments when dealing with femur fracture intramedullary nailing . This paper intends to co- relate data obtained from different orthopedic surgical- teams and literature on this topic.GoalsTo define frequent surgical situations arising from a deffectuous set of surgical tools, when an orthopedic surgical team is operating on femur fractures. To perform an Orthopedic Surgeons survey . Estimation of possible ways to a solution. Methods31 surgical interventions with intramedullary femoral nailing were practiced from January 2008 to Aug 2013.18 cases of surgical tools defficiencies were registered in 14 surgical procedures. Main problems were related to femoral drill bits and guide wires. A retrospective, observational study on clinical records, and radiologic files from our Institution was practiced. An On- line survey form was sent by e-mail to Orthopedic surgeons. A query was sent to ANMAT IRAM, and National Ministry of Health and Ministry of Health from Buenos Aires City asking about possible ways of solution to these claims.ResultsThere were 270 forms filled up by Surgical teams: National response involved 19 provinces from Argentina. There were also responses from Colombia, Ecuador, Italy, Australia and Bolivia.180 belonged to private institutions of Health, and 90 to public Hospitals. Possible ways to a solution were deemed to be Technovigilance Program of ANMAT, Inobservance of IRAM ISO 9001 rules, Inobservance of Basic Law of Health art 12, items k and l and resolution 255, and denunciation to AAOT Implants Sub-Commitee.ConclusionsA clear cut difference was established among public and private Services, the latter doing better on these subjects. Information in labour field only defined prevalence of technical situations but problems themselves, seemed to be the same. There are legal and administrative tools to deal with these problems.
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How to Cite
Ricciardi, G. A., Ricciardi, G. D., Perez, M. A., Bustos, A. A., Soliz, V., Locaso, F., Mucci, F., García Tornadú, E., & Ricciardi, D. O. (2016). What nobody told you about femur fractures. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 81(2), 99-109. https://doi.org/10.15417/436
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Clinical Research
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References
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10. Removal of a broken intramedullary femoral nail with an unusual pattern of breakage: a case report Juan Pretell Mazzini Æ Juan Rodriguez Martin Æ Carlos Resines ErasunStrat Traum Limb Recon (2009) 4:151–155
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13. Cristiani Díaz G, Galicia Cornejo MI, Pérez Viquez AF, Galindo Soto SE, Gómez Espíndola C. Complicaciones de fracturas diafisarias de fémur tratadas con clavos centromedulares bloqueados. Experiencia en el Centro Médico Naval, Acta Ortopédica Mexicana 2006; 20(1): Ene.-Feb: 6-12.
14. Sharma AK , Kumar A, Joshi GR , John T. Retrospective study of Implant Failure in Orthopaedic Surgery. MJAFI 2006 ; 62 ; 70-72.
15. Sekimpi P1, Okike K, Zirkle L, Jawa A. Femoral fracture fixation in developing countries: an evaluation of the Surgical Implant Generation Network (SIGN) intramedullary nail. J Bone Joint Surg Am. 2011 Oct 5;93(19):1811-8.
16. Chi-Chuan Wu . Zhon-Liau Lee.Low success rate of non-intervention after breakage of interlocking nails. International Orthopaedics (SICOT) (2005) 29: 105–108
17. Bone LB, Johnson KD, Weigelt J, Scheinberg R. Early versus delayed stabilization of femoral fractures. A prospective randomized study J Bone Joint Surg Am. 1989 Mar;71(3):336-40.
18. Gosselin R, and Lavaly D. Perkins traction for adult femoral shaft fractures: a report on 53 patients in Sierra Leone. Int Orthop. 2007 October; 31(5): 697–702.
19. Carroll EA, Koman LA. External fixation and temporary stabilization of femoral and tibial trauma. J Surg Orthop Adv. 2011 Spring;20(1):74-81.
20. Krettek C, Stephan C, Schandelmaier P, Richter M, Pape HC, Miclau T. The use of Poller screws as blocking screws in stabilising tibial fractures treated with small diameter intramedullary nails. J Bone Joint Surg Br. 1999 Nov;81(6):963-8.
21. Undre S, Healey AN, Darzi A, Vincent CA. Observational assessment of surgical teamwork: a feasibility study. World J Surg. 2006 Oct;30(10):1774-83.
22. Catchpole K, Mishra A, Handa A, McCulloch P. Teamwork and error in the operating room: analysis of skills and roles. Ann Surg. 2008 Apr;247(4):699-706.
23. Gawande AA, Zinner MJ, Studdert DM, Brennan TA. Analysis of errors reported by surgeons at three teaching hospitals. Surgery. 2003 Jun;133(6):614-21.
24. Technique for precise placement of poller screws with intramedullary nailing of metaphyseal fractures of the femur and the tibia. University of Louisville, Department of Orthopaedic Surgery, 210 East Gray Street, Suite 1003, Louisville, KY 40202, USA.
2. Smith WR; Stahel PF; Ziran BH; Anglen, JO. Locking Plates: Tips and Tricks. J Bone Joint Surg Am. 2007 Oct;89(10):2298-307.
3. García OG, Mombiela FL, De La Fuente CJ, Aránguez MG, Escribano DV, Martín JV.The influence of the size and condition of the reamers on bone temperature during intramedullary reaming. J Bone Joint Surg Am. 2004 May;86-A(5):9949.
4. Sekimpi P, Okike K, Zirkle L, Jawa A. Femoral fracture fixation in developing countries: an evaluation of the Surgical Implant Generation Network (SIGN) intramedullary nail. J Bone Joint Surg Am. 2011 Oct 5;93(19):1811-8.
5. Wong, Hing-Cheong et al.Removal of a Broken Intramedullary Femoral Nail by Transarticular Retrograde Technique—A Case Report and Review of Literature. Journal of Orthopaedics, Trauma and Rehabilitation , Volume 15 , Issue 2 , 65 - 67
6. Russell GV Jr, Kregor PJ, Jarrett CA, Zlowodzki M. Complicated femoral shaft fractures. Orthop Clin North Am. 2002 Jan;33(1):127-42, viii-ix.
7. Sakellariou VI, Kyriakopoulos S, Kotoulas H, Sofianos IP. Bent intramedullary femoral nail: surgical technique of removal and reconstruction. Case Rep Orthop. 2011;2011:614509.
8. Campbell B. Originality in the technical section. TECHNICAL NOTES AND TIPS Ann R Coll Surg Engl. 2012 Jan;94(1):61.
9. Karadimas EJ, Papadimitriou G, Theodoratos G, Papanikolaou A, Maris J. The effectiveness of the antegrade reamed technique: the experience and complications from 415 traumatic femoral shaft fractures. Strat Traum Limb Recon (2009) 4:113–121.
10. Removal of a broken intramedullary femoral nail with an unusual pattern of breakage: a case report Juan Pretell Mazzini Æ Juan Rodriguez Martin Æ Carlos Resines ErasunStrat Traum Limb Recon (2009) 4:151–155
11. Sancineto CF, Rubel IF, Seligson D, Vasquez Ferro G. Technique for Removal of Broken Interlocking Screws. Journal of Orthopaedic Trauma, no. 2. p. 132, 2001
12. Fogarty AB1, Yeates HA. Intramedullary locking femoral nails. Experience with the AO nail. Ulster Med J. 1991 Oct;60(2):129-36.
13. Cristiani Díaz G, Galicia Cornejo MI, Pérez Viquez AF, Galindo Soto SE, Gómez Espíndola C. Complicaciones de fracturas diafisarias de fémur tratadas con clavos centromedulares bloqueados. Experiencia en el Centro Médico Naval, Acta Ortopédica Mexicana 2006; 20(1): Ene.-Feb: 6-12.
14. Sharma AK , Kumar A, Joshi GR , John T. Retrospective study of Implant Failure in Orthopaedic Surgery. MJAFI 2006 ; 62 ; 70-72.
15. Sekimpi P1, Okike K, Zirkle L, Jawa A. Femoral fracture fixation in developing countries: an evaluation of the Surgical Implant Generation Network (SIGN) intramedullary nail. J Bone Joint Surg Am. 2011 Oct 5;93(19):1811-8.
16. Chi-Chuan Wu . Zhon-Liau Lee.Low success rate of non-intervention after breakage of interlocking nails. International Orthopaedics (SICOT) (2005) 29: 105–108
17. Bone LB, Johnson KD, Weigelt J, Scheinberg R. Early versus delayed stabilization of femoral fractures. A prospective randomized study J Bone Joint Surg Am. 1989 Mar;71(3):336-40.
18. Gosselin R, and Lavaly D. Perkins traction for adult femoral shaft fractures: a report on 53 patients in Sierra Leone. Int Orthop. 2007 October; 31(5): 697–702.
19. Carroll EA, Koman LA. External fixation and temporary stabilization of femoral and tibial trauma. J Surg Orthop Adv. 2011 Spring;20(1):74-81.
20. Krettek C, Stephan C, Schandelmaier P, Richter M, Pape HC, Miclau T. The use of Poller screws as blocking screws in stabilising tibial fractures treated with small diameter intramedullary nails. J Bone Joint Surg Br. 1999 Nov;81(6):963-8.
21. Undre S, Healey AN, Darzi A, Vincent CA. Observational assessment of surgical teamwork: a feasibility study. World J Surg. 2006 Oct;30(10):1774-83.
22. Catchpole K, Mishra A, Handa A, McCulloch P. Teamwork and error in the operating room: analysis of skills and roles. Ann Surg. 2008 Apr;247(4):699-706.
23. Gawande AA, Zinner MJ, Studdert DM, Brennan TA. Analysis of errors reported by surgeons at three teaching hospitals. Surgery. 2003 Jun;133(6):614-21.
24. Technique for precise placement of poller screws with intramedullary nailing of metaphyseal fractures of the femur and the tibia. University of Louisville, Department of Orthopaedic Surgery, 210 East Gray Street, Suite 1003, Louisville, KY 40202, USA.