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MINERVA ORTOPEDICA E TRAUMATOLOGICA

A Journal on Orthopedics and Traumatology


Official Journal of the Piedmontese-Ligurian-Lombard Society of Orthopedics and Traumatology
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  95° CONGRESS OF THE PIEDMONTESE-LIGURIAN-LOMBARD SOCIETY OF ORTHOPEDICS AND TRAUMATOLOGY (SPLLOT) (La Spezia, September 04-05, 1998)


Minerva Ortopedica e Traumatologica 2000 February;51(1):21-4

language: Italian

Indications to the use of ''non-standard'' assemblies of compression-distraction devices in the management of ''high energy'' open femoral shaft fractures

Mora R., Pedrotti L., Belluati A., Gaudio A., Porta M., Martinelli R., Piovani L.


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Background. Versatility and stability of compression-distraction systems (or circular external fixators) have favoured their diffusion in the management of tibial fractures. Indications in the treatment of femoral fractures are more limited, owing to the painful intolerance, the difficulty in achieving effective reduction and stable fixation, and the frequent knee joint stiffness. In order to take advantage of circular external fixation in the management of ''high energy'' open femoral fractures, some types of ''non-standard'' assembly were developed by means of special techniques (use of half-pins instead of wires, variations of the distal part of the device, association with internal osteosynthesis, Novikov reduction pins, double-threaded screws).
Methods. Between 1986 and 1996, 10 ''high energy'' open fractures of the femoral shaft were treated with compression-distraction devices. In 9 cases a ''non-standard'' assembly was employed.
Results. Healing was obtained in all cases but one, in a mean time of 6 months; in 1 case nonunion was observed. In 3 cases, after the removal of the external fixation device, a knee joint contracture required mobilization under general anesthesia.
Conclusions. Good results achieved in this series confirm that compression-distraction devices with the use of some types of ''non-standard'' assembly are very effective in the management of ''high energy'' open femoral shaft fractures.

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