Iatrogenic Splitting in Femur During Nailing
Author Information
Author(s): Papadakis Stamatios A, Zalavras Charalampos, Mirzayan Raffy, Shepherd Lane
Primary Institution: Department of Orthopaedics, Keck School Of Medicine, LAC+USC Medical Center, University of Southern California
Hypothesis
The study aims to report the observation of undetected radiographically iatrogenic longitudinal splitting in the anterior cortex during intramedullary nailing of the femur.
Conclusion
Longitudinal splitting in the anterior cortex during intramedullary nailing of the femur cannot be detected radiographically.
Supporting Evidence
- Five of 18 cadaver femora showed longitudinal splitting macroscopically.
- No splitting was detectable in radiographic control.
- The average length of the longitudinal split was 30.7 mm.
- All cases of longitudinal splitting were nondisplaced cracks.
Takeaway
When doctors put a rod in the thigh bone, they might accidentally create tiny cracks that can't be seen on X-rays.
Methodology
Cadaveric study using nine pairs of fresh-frozen femora from adult cadavers to detect iatrogenic lesions after standardized intramedullary nailing.
Potential Biases
Potential bias in measurements due to the order of femur inspection.
Limitations
Findings may not replicate in live surgical practice due to the use of cadaveric bones, which are harder and less compliant than live bone.
Participant Demographics
Adult cadavers.
Statistical Information
P-Value
p < 0.001
Statistical Significance
p = 0.029
Digital Object Identifier (DOI)
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