Femur malunion treated with open osteotomy and intramedullary nailing in developing countries
- Orthopaedics and traumatology : surgery and research , 2012 (98) : 784-787
Résumé
Introduction. — In developing countries, malunion following untreated femoral shaft fractures is not uncommon. The difficulty of managing these cases contrasts with the limited technical resources available.
Patients and methods. — Our prospective study, conducted over a one-year period, reports on 16 open-wedge osteotomies fixed with Kuntscher intramedullary nails in patients with femoral shaft malunion. Twelve men and four women (mean age 34.5 years [range: 18–67]) were treated after a mean delay of eight months (range: 4–14). All patients had initially sought treatment from a traditional bonesetter. The mean limb-length discrepancy was 3 cm (range: 2–6), and the mean limitation of knee flexion was 90° (range: 10–120°). Rotational stability was achieved through the obliquity of the osteotomy cut. No bone grafting was performed, but reaming and decortication were routinely carried out. Clinical and radiographic evaluations were performed at 21, 45, 90, and 120 days, assessing limb-length discrepancy, range of motion, and union. Rotational deformities were not analyzed.
Mots-clés
Diaphyseal malunion femur; nailing