R Krishnakumar1, G Thiruvenkitaprasad1, Dayanand Kaliaperumal1, Nandkumar Sundaram2. 1. Associate Consultant, Department of Orthopaedic Surgery and Trauma, Nova Specialty Surgery, Velachery, Chennai, Tamil Nadu 600020, India. 2. Prof, HOD, Department of Orthopaedic Surgery and Trauma, Nova Specialty Surgery, Velachery, Chennai, Tamil Nadu 600020, India.
Abstract
BACKGROUND: Neglected trauma is a common problem faced by Orthopaedic surgeons practicing in developing countries. Nothing much in English literature is available regarding the practical difficulties and guidelines for treating neglected trauma of long bones. METHODS: In our institution from November 2003 to October 2009 we treated 25 cases of neglected fracture of shaft of femur. Patients underwent either of three types of management protocols depending upon the preoperative manual traction radiographs. The fracture was fixed with open interlocking nail. Primary bone grafting and bone shortening procedures were not performed in any of the patient. RESULTS: The fractures united in all patients at an average duration of 17 weeks. Two patients had limb length discrepancy. CONCLUSION: Careful preoperative evaluation is mandatory for good results. Preoperative skeletal traction and two stage surgical procedure may be required to avoid limb length discrepancy and neurovascular complication.
BACKGROUND: Neglected trauma is a common problem faced by Orthopaedic surgeons practicing in developing countries. Nothing much in English literature is available regarding the practical difficulties and guidelines for treating neglected trauma of long bones. METHODS: In our institution from November 2003 to October 2009 we treated 25 cases of neglected fracture of shaft of femur. Patients underwent either of three types of management protocols depending upon the preoperative manual traction radiographs. The fracture was fixed with open interlocking nail. Primary bone grafting and bone shortening procedures were not performed in any of the patient. RESULTS: The fractures united in all patients at an average duration of 17 weeks. Two patients had limb length discrepancy. CONCLUSION: Careful preoperative evaluation is mandatory for good results. Preoperative skeletal traction and two stage surgical procedure may be required to avoid limb length discrepancy and neurovascular complication.