comminuted segmental fracture of femur shaft
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This document discusses a 25-year-old male who presented with a communited segmental fracture of the femur shaft following a road traffic accident 6 hours prior. The fracture extends from the subtrochanteric region to the distal fourth of the femur shaft. The document then provides information on femoral shaft fractures, including that they are usually high-energy injuries associated with conditions like motor vehicle accidents in younger patients. It describes classification systems for femoral fractures and details treatment options like intramedullary nailing or plating, as well as potential complications.
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comminuted segmental fracture of femur shaft
- 1. Communited Segmental Fracture of Femur Shaft Prep By DR BADAL KHAN PGR1 ORTHO UNIT 3 BMCH
- 3. Patient particularies • NAME Muhammad husain • AGE 25 Yrs • Sex male • Resident of quetta
- 4. • Presented to us As a case of Road traffic Accident after 6 hours of injury. • Closed Fracture of shaft that is extending from subtroch to the distal fourth of femur shaft …
- 5. Pre op
- 6. Pre op
- 7. Pre op
- 9. 12.10.2016
- 10. 12.10.2016
- 11. 12.1.2017
- 12. 12.01.2017
- 13. 18.09.2017
- 14. 18.09.2017
- 16. Introduction • High energy injuries Associated with life-threatening conditions incidence • 37.1 per 100,000 person-years
- 17. Mechanism • TRAUMATIC • high-energy most common in younger population often a result of high-speed motor vehicle accidents • low-energy more common in elderly often a result of a fall from standing
- 18. CLASSIFICATION • Classification • Winquist and Hansen Classification • Type 0 No comminution • Type I Insignificant amount of comminution • Type II Greater than 50% cortical contact • Type III Less than 50% cortical contact • Type IV Segmental fracture with no contact between proximal and distal fragment
- 19. CLASSIFICATION
- 20. OTA CLASSIFICATION • 32A - Simple • A1 - Spiral • A2 - Oblique, angle > 30 degrees • A3 - Transverse, angle < 30 degrees • 32B - Wedge • B1 - Spiral wedge • B2 - Bending wedge • B3 - Fragmented wedge • 32C – Complex • C1 - Spiral • C2 - Segmental • C3 - Irregular
- 22. • Symptoms pain in thigh Physical exam • inspection tense, swollen thigh affected leg often shortened tenderness about thigh • Document distal neurovascular status • ROM painfull
- 23. Radiographs • AP and lateral views of entire femur • AP and lateral views of ipsilateral hip • important to rule-out coexisting femoral neck fracture • AP and lateral views of ipsilateral knee
- 24. CT SCAN • may be considered in midshaft femur fractures to rule-out associated femoral neck fracture
- 25. Treatment
- 26. • Nonoperative • long leg cast • nondisplaced femoral shaft fractures in patients with multiple medical comorbidities
- 27. Operative • Antegrade intramedullary nail with reamed technique • Retrograde intramedullary nail with reamed technique • External fixation with conversion to intramedullary nail within 2-3 weeks • ORIF with plate
- 28. Complications • Heterotopic ossification • Pudendal nerve injury • Femoral artery or nerve injury • Malunion • Delayed union • Nonunion
- 29. Complications • Infection • Weakness • Mechanical axis deviation • Rotational malalignment