BACKGROUND: The Surgical Implant Generation Network (SIGN) intramedullary nailing system was designed to treat femoral fractures in developing countries where real-time imaging, power equipment, and fracture tables are often not available. We performed a retrospective analysis of prospectively collected data on femoral shaft fractures treated with the SIGN intramedullary nailing system. METHODS: Seventy consecutive patients with a closed diaphyseal femoral fracture were treated with the SIGN intramedullary nail at Mulago National Hospital in Uganda between February 2007 and March 2008, and fifty of these patients (the study cohort) were followed for at least six months or until fracture-healing. RESULTS: The mean time to surgery was 13.2 days (range, zero to thirty-three days). All fractures healed, although two required dynamization for treatment of delayed union. No hardware failures occurred. An interlocking screw missed the nail in two patients, but both fractures healed without complications. One superficial and one deep infection developed; the latter required nail removal after fracture union. Including these patients, complications requiring further treatment occurred in 14% (seven) of the fifty patients. CONCLUSIONS: The SIGN intramedullary nailing system promotes predictable healing of femoral fractures in settings with limited resources including lack of real-time imaging, lack of power reaming, and delayed presentation to the operating room.
BACKGROUND: The Surgical Implant Generation Network (SIGN) intramedullary nailing system was designed to treat femoral fractures in developing countries where real-time imaging, power equipment, and fracture tables are often not available. We performed a retrospective analysis of prospectively collected data on femoral shaft fractures treated with the SIGN intramedullary nailing system. METHODS: Seventy consecutive patients with a closed diaphyseal femoral fracture were treated with the SIGN intramedullary nail at Mulago National Hospital in Uganda between February 2007 and March 2008, and fifty of these patients (the study cohort) were followed for at least six months or until fracture-healing. RESULTS: The mean time to surgery was 13.2 days (range, zero to thirty-three days). All fractures healed, although two required dynamization for treatment of delayed union. No hardware failures occurred. An interlocking screw missed the nail in two patients, but both fractures healed without complications. One superficial and one deep infection developed; the latter required nail removal after fracture union. Including these patients, complications requiring further treatment occurred in 14% (seven) of the fifty patients. CONCLUSIONS: The SIGN intramedullary nailing system promotes predictable healing of femoral fractures in settings with limited resources including lack of real-time imaging, lack of power reaming, and delayed presentation to the operating room.
Authors: Trina Stephens; Alexander Mezei; Nathan N O'Hara; Jeffrey Potter; Rodney Mugarura; Piotr A Blachut; Peter J O'Brien; Tito Beyeza; Gerard P Slobogean Journal: World J Surg Date: 2017-06 Impact factor: 3.352
Authors: Iain S Elliott; Reinou S Groen; Thaim B Kamara; Allison Ertl; Laura D Cassidy; Adam L Kushner; Richard A Gosselin Journal: Clin Orthop Relat Res Date: 2014-10-25 Impact factor: 4.176
Authors: Erik Woelber; Audrey Martin; Douglas Van Citters; Craig Luplow; Michael Githens; Charlotte Kohn; Yong Jun Kim; Heang Oy; Jim Gollogly Journal: Int Orthop Date: 2018-05-28 Impact factor: 3.075
Authors: Daniel B Sonshine; Jesse Shantz; Raphael Kumah-Ametepey; R Richard Coughlin; Richard A Gosselin Journal: World J Surg Date: 2013-07 Impact factor: 3.352