title: [Change in procedure and re-osteosynthesis of the femur. Definition and retrospective analysis].
abstract: The change of treatment modality in osteosynthesis is based on two principles. On one hand, one can exchange the implant as part of a two step procedure to reduce side effects of stabilizing fractures. On the other hand, a reosteosynthesis may be required for treatment of complications. A retrospective analysis was undertaken to differentiate the situation of indication, technique and results of patients with fractures of the femur. Indications for two step procedure of therapy at the femur are limited to fractures of polytraumatized patients and fractures with severe soft tissue damage. External fixator devices have been used for stabilization of long bone fractures with severe soft tissue damage using the two step procedure in the past decades; nowadays unreamed nailing is commonly preferred. Reosteosynthesis may be appropriate for the treatment of failing of osteosynthesis; they can also be used due to delayed union or nonunion of fractures, osseous deficiency or infection. In the case of failing osteosynthesis, the reasons for failing have to be studied thoroughly and a variety of subsequent procedures has to be taken into consideration for successful treatment.
authors.affiliation: Universitätsklinik für Unfallchirurgie des Allgemeinen Krankenhauses Wien, Osterreich.
authors.forename: J
authors.initials: J
authors.lastname: Erhart
authors.forename: M
authors.initials: M
authors.lastname: Mousavi
authors.forename: R
authors.initials: R
authors.lastname: Schuster
authors.forename: A
authors.initials: A
authors.lastname: Kolonja
authors.forename: G
authors.initials: G
authors.lastname: Bockhorn
authors.forename: V
authors.initials: V
authors.lastname: Vécsei
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004868:Equipment Failure; D005260:Female; D005264:Femoral Fractures / Q000401:mortality / Q000601:surgery*; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000295:instrumentation*; D006620:Hip Fractures / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery*; D011542:Pseudarthrosis / Q000401:mortality / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate