title: Interlocking intramedullary nail fixation with additional bone grafting from trochanter via a femoral hollow trephine in the treatment of femoral shaft fractures: design and clinical application.
abstract: The purpose of this study was to describe and evaluate the clinical application of the technique of interlocking intramedullary (IM) nailing via an entry point at the tip of greater trochanter using a specially designed femoral hollow trephine to stabilize diaphyseal fractures of the femur.
  
  
  
  From February 2010 to April 2014, 35 consecutive patients with femoral shaft fractures were treated by the therapy of bone grafting from trochanter region with interlocking IM nail. The average age of these 23 male and 12 female patients was 37.5 years (range, 22-67 years). Fractures were classified according to AO classification system (15 type A, 17 type B, 3 type C). Femoral canal reaming and the collection of cancellous bone were simultaneously performed in a single step with the specially designed femoral hollow trephine, followed by regular IM nailing procedure.
  
  
  
  Of the 35 cases, the mean volume of spongy bone obtained was 5.63 cm3(range, 3.0-7.0 cm3). Thirty-five patients with femoral shaft fractures had a mean follow-up period of 16.2 months (range, 12-22 months). All patients achieved bony union, at a mean of 5.4 months (range, 4-6 months). No patient developed a delayed union or a nonunion. There were no complications such as infections, injury of vascular and nerve, or heterotopic ossification in hip.
  
  
  
  These results indicate that the technique of use of IM nailing with the femoral hollow trephine significantly decreases the occurrence of nonunion in femoral shaft fractures.
authors.affiliation: Department of Orthopaedic and Traumatology, Shuguang Hospital affiliated to Shanghai TCM University, No. 528 Zhangheng Road, Shanghai, 201203, China.
authors.forename: Yinwen
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Orthopaedic and Traumatology, Shuguang Hospital affiliated to Shanghai TCM University, No. 528 Zhangheng Road, Shanghai, 201203, China.
authors.forename: Yuxin
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Department of Orthopaedic and Traumatology, Shuguang Hospital affiliated to Shanghai TCM University, No. 528 Zhangheng Road, Shanghai, 201203, China.
authors.forename: Ziliang
authors.initials: Z
authors.lastname: Shen
authors.affiliation: Department of Orthopaedic and Traumatology, Shuguang Hospital affiliated to Shanghai TCM University, No. 528 Zhangheng Road, Shanghai, 201203, China.
authors.forename: Shuqiang
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic and Traumatology, Shuguang Hospital affiliated to Shanghai TCM University, No. 528 Zhangheng Road, Shanghai, 201203, China.
authors.forename: Xiaoen
authors.initials: X
authors.lastname: Wei
authors.affiliation: Department of Orthopaedic and Traumatology, Shuguang Hospital affiliated to Shanghai TCM University, No. 528 Zhangheng Road, Shanghai, 201203, China.
authors.forename: Xinfeng
authors.initials: X
authors.lastname: Gu
authors.affiliation: Department of Orthopaedic and Traumatology, Shuguang Hospital affiliated to Shanghai TCM University, No. 528 Zhangheng Road, Shanghai, 201203, China. zhhongshengzhan@126.com.
authors.forename: Hongsheng
authors.initials: H
authors.lastname: Zhan
authors.affiliation: Department of Orthopaedic and Traumatology, Shuguang Hospital affiliated to Shanghai TCM University, No. 528 Zhangheng Road, Shanghai, 201203, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Kuang
mesh_terms: D000328:Adult; D000368:Aged; D001858:Bone Nails / Q000009:adverse effects*; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005269:Femur / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult
keywords: Bone graft; Femoral shaft fracture; Hollow trephine; Intramedullary nailing