[Initial experience with the treatment of diaphyseal fractures of the leg by an intramedullary nail.].
The authors present an account on their clinical experience with the treatment of diaphyseal fractures of the leg using an intramedullary nail not drilled in advance. During the period between May 1994 and August 1995 they treated at the Orthopaedic Clinic of IPVZ in Prague Bulovka hospital a total of 28 patients, 22 men and 6 women, mean age 36 years, follow up period six months. The final clinical evaluation comprised 26 patients with 27 fractures. In 93% the authors recorded complete cure of the fracture of the leg, on average within five months after operation. The group of patients comprised 7 (25%) patients with multiple injuries and 5 (17%) with open fractures of the crus. According to the AO classification of skeletal injuries type B fractures were most frequent -18 (64%). The operation was implemented on average on the seventh day after the accident. In 8 (28%) the authors recorded bending or breaking of the nails, in all instances without any effect on the healing of the fracture. As to local complications the authors recorded four times instability of the nail -three times proximal and once distal instability. The position was successfully managed in all instances by application of a plaster bandage of the Sarmient type. There was only one typical deep infection. The final clinical evaluation was made in 26 patients, where minimal axial deviations were found, minimal restructions as regards the mobility of the knee or talar joint, and the majority of patients were satisfied with the operation. Initial experience with treatment of diaphyseal fractures of the leg using an intramedullary nail without previous drilling revealed a high percentage of completely healed fractures with a minimal number of local or systemic complications. Key word: intramedullary nailing without previous drilling.
Soukup
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B
Ortopedická klinika IPVZ FN Bulovka, Praha.
Malkus
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T