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Online ISSN 1827-1707
95° CONGRESS OF THE PIEDMONTESE-LIGURIAN-LOMBARD SOCIETY OF ORTHOPEDICS AND TRAUMATOLOGY (SPLLOT) (La Spezia, September 04-05, 1998)
Sala F., Fezzi P., Lovisetti G., Lovisetti L.
Background. The concept of ''Biological healing'' of fractures has progressively become established, both in closed and surgical treatment. The non-exposure of the fracture site and the non-rigid or ''elastic'' internal fixation of the fracture, determine the ''biologicity'' of a surgical treatment. This results in an increased use of closed intramedullary nails.
Methods. In the period November 1992-May 1998, 140 patients, with 66 femoral and 74 tibial fractures, were treated with the Marchetti-Vicenzi intramedullary bundle nail. The authors have studied 35 high energy fractures (22 femoral and 13 tibial) type B3 and C ''AO'' classification. Clinical and radiological reviews were performed on all patients except for one who went abroad.
Results. Complications included: 3 non-union (1 femoral and 2 tibial), that were treated, and 2 femoral shortening (<1.5 cm). Bone healing took 16 and 12.5 weeks in femoral and tibial fractures respectively.
Conclusions. These results suggest that flexible intermedullary nails give adequate rotatory stability, require a minimum exposure to radiation and do not require reaming. The nail must be ''locked'' proximally in comminuted fractures with delayed weight bearing in femoral fractures and with the use of external support in tibial fractures.