Reaming and the healing of fractures
AbstractOBJECTIVE: We quantified fracture healing response in the intramedullary nailed fractures of femur.
PATIENTS AND METHOD: By a simple method of measuring size and mass of callus formation radiologically in 30 patients who had undergone open retrograde intramedullary Kuntscher nailing. We then compared the callus formation in the reamed and unreamed.
RESULTS: 17 patients had reamed kuntscher nailing (RKN) and 13 had unreamed nailing (UKN). The mass of callus formed as seen on radiographs taken at 12 weeks of none weight bearing and at 20 weeks of some or total weight bearing was measured by the method described by Spencer.
There was no significant difference in the rate of union or healing between RKN and UKN at 12 weeks, 1.65 and 1.39 respectively (P>0.05). However at 20 weeks, RKN showed significantly more callus mass 2.11 and compared to 1.62 in UKN groups (t-test: 0.06629). Fractures treated with the reamed method tended to stimulate faster healing response with more prolific callus mass, only when subjected to stress by loading or by weight bearing.
CONCLUSION: Quantitative radiological assessment of callus formation is recommended not only for objective documentation but also for ease of comparison.
Key Words: Reaming, Intramedullary nailing, healing fracture, callus.
Nigerian Journal of Orthopaedics and Trauma Vol.3(1) 2004: 6-9