Imaging Evaluation of Insertion Point Accuracy in Retrograde Intramedullary Femoral Nailing.

Objective. When compared with visual retrograde intramedullary nail placement in the femur, fluoroscopic retrograde intramedullary nail placement in the femur improved the accuracy of insertion. Methods. Ninety-six patients treated with retrograde intramedullary nailing of the femur for femoral frac...

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Published in:BioMed Research International pp. 1 - 8
Main Authors: He, Miao, Tian, Shanshan, Liu, Jian, Deng, Xu, Xiang, Jiangxia
Format: diagnostic images research tables/charts Journal Article
Published: Wiley-Blackwell 10/28/2022
Online Access:View this record in EBSCOhost
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      dt: 10/28/2022
      pid: 480
      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        159929993
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        10.1155/2022/6068490
        159929993
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        atl: Imaging Evaluation of Insertion Point Accuracy in Retrograde Intramedullary Femoral Nailing.
      aug:
        au:
          He, Miao
          Tian, Shanshan
          Liu, Jian
          Deng, Xu
          Xiang, Jiangxia
        affil: Department of Orthopedic Surgery, Chongqing Emergency Medical Center (Chongqing University Central Hospital), No. 1 Jiankang Road, Chongqing 400010., China
      sug:
        subj:
          Femoral Fractures Surgery
          Fracture Fixation Methods
          Insertion Site Selection Evaluation
          Femur Radiography
          Fluoroscopy Methods
          Outcome Assessment
          Human
          Male
          Female
          Adult
          Middle Age
          Aged
          Record Review
          Retrospective Design
          Case Control Studies
          Comparative Studies
          Univariate Statistics
          Linear Regression
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Objective. When compared with visual retrograde intramedullary nail placement in the femur, fluoroscopic retrograde intramedullary nail placement in the femur improved the accuracy of insertion. Methods. Ninety-six patients treated with retrograde intramedullary nailing of the femur for femoral fracture were included in this retrospective case-control study, including 48 patients treated with nailing under direct vision and 48 patients treated with nailing under fluoroscopy. Influencing factors potentially associated with the deviation of the needle insertion point on the coronal and sagittal planes (including the needle insertion method, use of limited open reduction, side, intramedullary nail diameter, mechanism of injury, and fracture classification) were analyzed univariately; then, the variables with a p value < 0.20 on univariate analysis were included in the linear regression equation to assess the independent factors associated with needle insertion point deviation. Results. On the coronal plane, the insertion point deviation in the visual nail placement group (1.11 ± 4.08 mm) was not significantly different (p = 0.13) from that in the fluoroscopic nail placement group − 0.44 ± 3.48 mm ; on the sagittal plane, the insertion point deviation in the visual nail placement group (4.91 ± 4.67 mm) was significantly greater than that in the fluoroscopic nail placement group (2.08 ± 2.97 mm) (p < 0.01). Visual nail placement was a risk factor for insertion point deviation on the sagittal plane compared with fluoroscopic nail placement (β = − 0.84 , p < 0.01). Conclusion. Compared with visual nail placement, fluoroscopic nail placement improves the accuracy of insertion on the sagittal plane, with no difference between the two methods on the coronal plane. These findings indicate that surgeons should exercise more caution when placing nails under direct vision.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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