Comparison of RIA and conventional reamed nailing for treatment of femur shaft fractures

Philipp N. Streubel, Pratik Desai, Michael Suk

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

The standard of care for femoral diaphysis fractures is sequentially reamed, locked, intramedullary nails. However, in the polytraumatized patient perioperative complications such as fat embolism syndrome (FES) and acute respiratory distress (ARDS) are well chronicled. The reamer irrigator aspirator (RIA)has been theorized to minimize such phenomena. A retrospective study comparing conventional reamed nailing for femur fractures versus those treated with the RIA was conducted. From January 2005 to September 2006, 156 patients treated at our institution with an intramedullary nail met inclusion criteria. There were sixty-six patient treated with conventional reaming (group A) and ninety patients treated with the RIA (group B). The main outcome measures included length of hospital stay, rate of ARDS, pneumonia, ventilatory failure, overall pulmonary complications, healing rate and death. No significant differences were found between groups with regard to patient demographics, injury severity and the incidence of head/chest trauma. In addition, no differences were found in length of hospital stay, length of ICU stay or mechanical ventilation. Overall pulmonary complications occurred in 11 (group A) and 16 (group B) respectively (p = 0.48). No fatalities were found in group A while there were four in group B, 4 (p = 0.14). No significant differences were found in delayed union versus nonunion rate between groups, while overall healing complications were seen in 7 and 14 of patients (p = 0.35) in groups A and B respectively. No statistical significance was reached with regard to pulmonary complications, healing rates or death. However, we were unable to demonstrate favorable physiologic lung parameters with RIA use compared to conventional reaming as has been described in previous animal studies. We found a trend toward more healing complications in the RIA group, but this was not statistically significant. Further study is warranted.

Original languageEnglish (US)
Pages (from-to)S51-S56
JournalInjury
Volume41
Issue numberSUPPL. 2
DOIs
StatePublished - Nov 1 2010

Fingerprint

Femur
Length of Stay
Lung
Nails
Therapeutics
Fat Embolism
Diaphyses
Femoral Fractures
Mortality
Standard of Care
Respiratory Rate
Craniocerebral Trauma
Artificial Respiration
Pneumonia
Thorax
Retrospective Studies
Demography
Outcome Assessment (Health Care)
Incidence
Wounds and Injuries

Keywords

  • ARDS
  • Femur
  • Fracture healing
  • Intramedullary nail
  • Reaming

ASJC Scopus subject areas

  • Emergency Medicine
  • Orthopedics and Sports Medicine

Cite this

Comparison of RIA and conventional reamed nailing for treatment of femur shaft fractures. / Streubel, Philipp N.; Desai, Pratik; Suk, Michael.

In: Injury, Vol. 41, No. SUPPL. 2, 01.11.2010, p. S51-S56.

Research output: Contribution to journalArticle

Streubel, Philipp N. ; Desai, Pratik ; Suk, Michael. / Comparison of RIA and conventional reamed nailing for treatment of femur shaft fractures. In: Injury. 2010 ; Vol. 41, No. SUPPL. 2. pp. S51-S56.
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