Summary
We report on 71 severely comminuted femoral shaft fractures that were operated on between 1980 and 1984 at the Berufsgenossenschaftliche Unfallklinik Duisburg-Buchholz. The method of operative stabilization was plate osteosynthesis in two variations: In one group 39 fractures (ten open) were stabilized by plate osteosynthesis after anatomical reduction of the fractured area. The other group comprised 32 fractures (six open) fixed with a bridging-plate osteosynthesis, without preparation of the fracture zone. The rate of postoperative complications was strikingly diminished after bridging-plate osteosynthesis. Fracture healing occurred within 23 (16–32) weeks after bridging-plate osteosynthesis and within 36 (32–40) weeks after anatomical reduction. No special instrumentation or equipment is necessary to perform a bridging-plate osteosynthesis. The patient rests in a supine position. There is no need for intraoperative image-intensifier control. For operative treatment of severely comminuted femoral fractures we consider the technique of bridging-plate osteosynthesis advantageous, especially in multiply injured patients.
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References
Harper MC (1985) Fractures of the femur treated by open and closed intramedullary nailing using the fluted rod. J Bone Joint Surg [Am] 67:699
Heitemeyer U, Hierholzer G (1985) Die überbrückende Osteosynthese bei geschlossenen Stückfrakturen des Femurschaftes. Aktuel Traumatol 15:205
Heitemeyer U, Hierholzer G, Terhorst J (1986) Der Stellenwert der überürtickenden Plattenosteosynthese bei Mehrfragmentbruchschädigungen des Femur im klinischen Vergleich. Unfallchirurg 89:533
Jahna H, Witlich H (1976) Konservative und operative Behandlung der Mehrfragmentbrüche am Oberschenkel. Unfallheilkunde 79:165
Johnson KD, Johnson DWC, Parker B (1984) Comminuted femoral-shaft fractures: treatment by roller traction, cerclage-wires and an intramedullary nail, or an interlocking intramedullary nail. J Bone Joint Surg [Am] 66:1222
Kempf I, Grosse A, Beck G (1985) Closed locked intramedullary nailing. J Bone Joint Surg [Am] 67:709
Kleining R, Hax PM (1981) Die interne Überbrückungsosteosynthese ohne Reposition des Stückbruchbereiches als Alternative zur internen Fragmentfixation von Stückbrüchen nach anatomischer Reposition. Hefte Unfallheilkd 153:213
Müller ME, Allgöwer M, Schneider R, Willenegger H (1971) Manual der Osteosynthese. Springer, Berlin Heidelberg New York
Muhr G, Tscherne H, Trentz O, Haas N (1976) Die Osteosynthese mit zusätzlicher Drahtumschlingung bei Oberschenkelschaftbriichen. Aktuell Traumatol 6:387
Schenk RK (1986) Histophysiology of bone remodelling and bone repair. In: Lin OCC, Eys Chao (eds) Perspectives on biomaterials. Elsevier Science Publishers BV, Amsterdam, p 75
Thoresen BO, Alho A, Ekeland A (1985) Interlocking intramedullary nailing in femoral-shaft fractures. J Bone Joint Surg [Am] 67:1313
Tscherne H, Trentz O (1977) Operationstechnik und Ergebnisse bei Mehrfragment- und Trümmerbrüchen des Femurschaftes. Unfallheilkunde 80:221
Willenegger H (1975) Verplattung und Marknagelung bei Femur- und Tibiaschaftfrakturen: Pathophysiologische Grundlagen. Chirurg 46:145
Willenegger H, Perren SM, Schenk R (1971) Primäre und sekundäre Knochenbruchheilung. Chirurg 42:241
Winquist RA, Hansen ST (1980) Comminuted fractures of the femoral shaft treated by intramedullary nailing. Orthop Clin North Am 11:633
Winquist RA, Hansen ST, Clausen DK (1984) Closed intramedullary nailing of femoral fractures. J Bone Joint Surg [Am] 66:529
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Heitemeyer, U., Kemper, F., Hierholzer, G. et al. Severely comminuted femoral shaft fractures: Treatment by bridging-plate osteosynthesis. Arch. Orth. Traum. Surg. 106, 327–330 (1987). https://doi.org/10.1007/BF00454343
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DOI: https://doi.org/10.1007/BF00454343