2026-04-14T07:09:10Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/135392025-10-24T10:40:15Zcom_2072_378070com_2072_378040col_2072_378092

External fixation to intramedullary nailing for femoral and tibial fractures: an eleven-year cohort study at a level I trauma center Fabado-Tortajada, Paula González-Morgado, Diego Nomdedeu Sancho, Josep Teixidor Serra, Jordi Tomás-Hernández, Jordi Joshi Jubert, Nayana Minguell-Monyart, Joan Andrés Peiró, José Vicente Institut Català de la Salut [González Morgado D, Nomdedéu J, Teixidor Serra J, Joshi-Jubert N, Minguell-Monyart J, Andrés-Peiró JV] Department of Surgery, Universitat Autònoma de Barcelona, Bellaterra, Spain. Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Fabado Tortajada P, Tomàs Hernández J] Vall d’Hebron Hospital Universitari, Barcelona, Spain Vall d'Hebron Barcelona Hospital Campus Fèmur - Fractures Tíbia - Fractures Osteosíntesi externa Dispositius de fixació ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Equipment and Supplies::Surgical Equipment::Orthopedic Equipment::Orthopedic Fixation Devices::External Fixators DISEASES::Wounds and Injuries::Fractures, Bone::Tibial Fractures Other subheadings::Other subheadings::Other subheadings::/surgery ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Orthopedic Procedures::Fracture Fixation::Fracture Fixation, Internal::Fracture Fixation, Intramedullary DISEASES::Wounds and Injuries::Fractures, Bone::Femoral Fractures TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::equipos y suministros::equipo quirúrgico::equipos ortopédicos::dispositivos de fijación ortopédica::fijadores externos ENFERMEDADES::heridas y lesiones::fracturas óseas::fracturas de la tibia Otros calificadores::Otros calificadores::Otros calificadores::/cirugía TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::procedimientos ortopédicos::fijación de fractura::fijación interna de fractura::fijación intramedular de fractura ENFERMEDADES::heridas y lesiones::fracturas óseas::fracturas del fémur External fixation; Femur fracture; Intramedullary nailing Fixació externa; Fractura de fèmur; Enclavament intramedul·lar Fijación externa; Fractura de fémur; Enclavado intramedular Purpose: To identify factors that contribute to the incidence of postoperative complications following staged treatment of femoral and tibial fractures with external fixation (EF) and intramedullary nailing (IMN). Methods: This retrospective cohort study involved patients with tibial and/or femoral fractures temporarily immobilized using EF, followed by IMN. Patient characteristics, types of injury, treatments, and outcomes were recorded. Primary outcomes were pin tract infection (PTI) and fracture-related infection (FRI). Results: The study had 103 patients involving 119 fractures: 73 tibial (61.3%) and 46 femoral (38.7%). Of these, 44.5% were open. 31.1% of the EFs were implanted by an orthopedic trauma (OT) specialist. In femoral fractures, OT specialists placed the pins a mean 78.2 mm from the fracture site, versus just 37.3 mm by non-OT surgeons (p < 0.01). This difference was not observed in the tibia. The average time of EF was 12.6 ± 7.8 days. PTI occurred in seven cases (5.9%), on average 14.9 ± 10.9 days after EF placement. FRI occurred in nine patients (7.6%): two in the femur (4.5%) and seven in the tibia (10.6%). All FRIs occurred in cases where the EF had been implanted by a surgeon without specialization in OT (p = 0.03). FRI was more frequent in patients with prior PTI than in those without (57.1% vs. 4.5%, respectively; p < 0.01). Conclusion: PTI was a risk factor for FRI after IMN of tibial and femoral fractures. Surgeon specialization in OT was a protective factor against FRI, probably related to pin placement further from the fracture site. Open Access Funding provided by Universitat Autonoma de Barcelona. 2025-08-19T10:13:32Z 2025-08-19T10:13:32Z 2025-05-27 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion González-Morgado D, Fabado-Tortajada P, Nomdedéu J, Teixidor-Serra J, Tomàs-Hernández J, Joshi-Jubert N, et al. External fixation to intramedullary nailing for femoral and tibial fractures: an eleven-year cohort study at a level I trauma center. Eur J Orthop Surg Traumatol. 2025 May 27;35:219. 1432-1068 http://hdl.handle.net/11351/13539 10.1007/s00590-025-04282-9 40423840 001497719500003 http://hdl.handle.net/11351/13539 eng European Journal of Orthopaedic Surgery & Traumatology;35 https://doi.org/10.1007/s00590-025-04282-9 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess application/pdf Springer Scientia