My Orthopaedic Surgeon

OTA paper 2004: Improvement by Using a Standard Protocol in Cases of Femoral Shaft Fractures:
The purpose of this study was to describe a program of quality improvement and a subsequent protocol that have resulted in a reduction of missed femoral neck fractures in patients with femoral shaft fractures

AONA posting of the AO Classification of Long Bone Fractures

OTA Poster 2004
The purpose of this study was to look at specific trochanteric entry sites to examine whether there is a "perfect" universal starting point. In addition, we examined the insertion angle, the trochanteric angle, the proximal bend, and the radius of curvature of four commonly used implants. Three different starting points were employed.

Mitkovic 2001 Facta Universitatis Vol. 8, No 1, 2001 pp. 50 - 53 Abstract -> Full Text
New internal fixator that provides fixation while application can be performed by minimally invasive method with no contact between the implant and bone fragment in fracture area. The device is selfdynamisible.

OTA Paper 1998 Robert F. Ostrum, MD; Animesh Agarwal, MD; Ronald Lakatos, MD; Attila Poka, MD
The purpose of this study was to prospectively and critically examine a consecutive series of femur fractures treated with either antegrade or retrograde intramedullary nailing.

OTA Paper 2004 Archdeacon et al
The purpose of this study was to prospectively analyze hip abductor function at two discrete time points after a femur fracture treated with intramedullary nailing.

OTA paper 1998 Randomized Clinical Trial: The objective of this clinical trial was to determine if the type of intramedullary nail fixation (IMN) in acute femoral shaft fractures affects pulmonary function.

OTA paper 2004: We investigated whether the presence of head injury is associated with accelerated bone healing in patients with femoral shaft fractures.

OTA paper 2004: A Prospective Randomized Evaluation: Purpose: We compared anterograde with retrograde nailing of isolated femoral shaft fractures.
Conclusions: Anterograde and retrograde nailing are both acceptable treatments for femoral shaft fractures.

Reports from Medscape Orthopaedics and Sports Medicine 1999
Ipsilateral femoral neck and shaft fractures
Fracture Healing in Tibia Fractures With an Associated Vascular Injury
The Treatment of Lisfranc Injuries
Open Fractures of the Patella: Long-term Functional Outcome

Medscape Conference Coverage from American Academy of Orthopaedic Surgeons Annual Meeting Day 4 - Saturday, March 18. Overview of the controveries of intramedullary nailing in femoral shaft fractures and severe open tibial fractures.

OTA Paper 1998:
Purpose: To evaluate the safety and efficacy of this two-stage treatment, we retrospectively reviewed the records of 63 polytrauma patients with 69 femoral fractures treated with conversion of external fixation to IM nailing from 1989 to 1997 at our institution.

OTA Paper 2004: Risk of Local Infection?
We aimed to determine the rate of wound infection after use of DCO procedures and primary IMN for femoral fracture stabilization in severely injured patients.
Conclusion: The results of this study demonstrate that infection rates after DCO for femoral fractures are not significantly different than those observed after primary IMN.

eMedicine article on diaphyseal femur fractures.
Orthopedic surgeons often encounter diaphyseal femur fractures. Because these fractures most often result from high-energy trauma, one must have a high index of suspension for complications or other injuries.

- account for approx 5% of all physeal fractures;
- displacement in sagittal plane is assoc with Neuro/Vascular injury in popliteal fossa and instability on closed reduction;
- common mechanism is hyperextension causing anterior displacement of epiphysis;
- displacement in coronal plane is not assoc with other injuries, & joint may be stable after closed reduction.
Wheeless' Textbook of Orthopaedics