Cases reported "Femoral Fractures"

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1/6. Broken Ender nails after fixation of concomitant ipsilateral fractures of the femoral neck and shaft.

    Concomitant ipsilateral fractures of the upper part and shaft of the femur are uncommon injuries. Because of the small number of cases reported and the diversity of devices used, no single type of internal fixation stands out as the best treatment for both of these fractures. This report describes a case of concomitant ipsilateral fractures of the femoral neck and shaft that is further distinguished by a rare complication: breakage of Ender nails after fixation.
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2/6. Locking compression plate loosening and plate breakage: a report of four cases.

    The Locking Compression Plate (LCP) system offers a number of advantages in fracture fixation combining angular stability through the use of locking screws with traditional fixation techniques. This makes the implant particularly suitable for use in poor bone stock and complex joint fractures, especially in the epimetaphyseal area. However, the system is complex, requiring careful attention to biomechanical principles, and a number of potential pitfalls need to be considered. These pitfalls are illustrated in the 4 cases described herein, in which treatment was unsuccessful due to implant breakage or loosening. In each case, treatment failure could be attributed to the choice of an inappropriate plate and/or fixation technique, rather than to the features of the Locking Compression Plate system itself. Such experiences highlight the importance of detailed understanding of the biomechanical principles of plate fixation as well as careful preoperative planning for the successful use of the Locking Compression Plate system.
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3/6. Breakage of the Kuntscher nail in fractures of the femur after healing has occurred.

    Four cases of breakage of Kuntscher intramedullary nails (AO model) are presented. All 4 nails broke after fracture healing had occurred and all 4 presented breakage of the stem in the same site. In these cases breakage of the nails is not due to instability of the fracture, but always derives from superficial micro-cracks, technologically inevitable, due to defects or irregularities in the metal that expand during load application.
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4/6. Difficulties during removal of fluted femoral intramedullary rods.

    The difficulties that were encountered during removal of a fluted intramedullary femoral rod from six patients were reviewed. The mechanisms of failure included metal breakage at three different locations along the rod or the rod extractor. Three of the six rods were left in place due to difficulties in removal. The design of the fluted intramedullary rod appears to be the main cause of the problem.
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5/6. Mechanical failure of intramedullary nails after fracture union.

    The case reports of four patients with breakage of the intramedullary nail of the femur are presented. In all four patients the nail broke after consolidation of the fracture of the femoral shaft. All the nails broke at the same place: the junction between the round cross-section and the cloverleaf cross-section.
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6/6. First experience with the use of compression cerclage Gundolf in orthopaedic and trauma surgery. A preliminary report.

    In this prospective study we describe our experience with a new method of osteosynthesis of fissures, spiral and comminuted fractures of long bones of the extremities using the titanium compression cerclage of Gundolf (CCG). The operative technique is described in detail, and the results are presented for 50 operated patients who were followed up until fracture consolidation. The technique of application of the CCG is simple and quick and according to the results obtained ensures a permanent fixation at the site of the fracture. No cerclage-related complications such as stress shielding, corrosion, breakage of the band and impairment of the superficial cortical blood supply were radiologically observed in this series. We recommend the use of this titanium band in difficult cases of fractures of the long bones as well as in selected cases of primary and particularly revision hip arthroplasty.
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