Femur fractures in chest-injured patients: is reaming contraindicated?

Journal of Orthopaedic Trauma
D W CarlsonM Misinski

Abstract

To determine if reamed femoral intramedullary nailing increases the pulmonary complications seen in chest-injured patients. Retrospective review of prospectively collected trauma database data from January 1991 to October 1994. Methodist Hospital, Indianapolis, Indiana, Level I Trauma Center. Group I: Chest-injured patients [chest Abbreviated Injury Score (AIS) > or = 2] without femur or tibia fractures. Group II: Chest-injured patients (chest AIS > or = 2) with femoral reamed intramedullary fixation. Group III: Chest-injured patients (chest AIS > or = 2) with femoral shaft fixation using nonreamed fixation (rush rods, plating, or external fixation). Group IV: Non-chest-injured patients (chest AIS < 2) with femoral reamed intramedullary fixation. MAIN OUTCOME MEASUREMENT/HYPOTHESIS: Reamed femoral intramedullary nailing does not alter pulmonary outcomes, even in chest-injured patients. Groups I and II had a very similar incidence of adult respiratory distress syndrome (ARDS), pneumonia, and number of ventilator days. Group III had a significantly higher incidence of ARDS and number of ventilator days than did Group I or II. Group III did not have a chest AIS score significantly different than Groups I and II. Group II had signi...Continue Reading

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Citations

Jan 13, 2010·Der Orthopäde·R Attal, M Blauth
Jan 8, 2000·The Surgical Clinics of North America·B D BrownerD J Mastella
Jan 8, 2000·The Surgical Clinics of North America·E A Deitch, E R Goodman
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Jun 13, 2006·Journal of Orthopaedic Trauma·Robert N Meek
Mar 16, 2021·Journal of Clinical Orthopaedics and Trauma·H C Pape, L Leenen

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