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Transesophageal echocardiography in quantification of emboli during femoral nailing: reamed versus unreamed techniques.

Publication ,  Journal Article
Coles, RE; Clements, FM; Lardenoye, JW; Wermeskerken, GV; Hey, LA; Nunley, JA; Levin, LS; Pearsall, AW
Published in: J South Orthop Assoc
2000

We quantified the embolic load to the lungs created with two different techniques of femoral nailing. Eleven patients with 12 traumatic femur fractures were randomized to reamed (7 fractures) and unreamed (5 fractures) groups. Intramedullary nailing was with the AO/ASIF* universal reamed or unreamed nail. Transesophageal echocardiography (TEE) was used to evaluate the quantity and quality of emboli generated by nailing. Data were analyzed using software that digitized the TEE images and quantified the area of embolic particles in each frame. The duration of each level of embolic phenomena (zero, moderate, severe) was used to determine total embolic load with various steps (fracture manipulation, proximal portal opening, reaming, and nail passage). Manual grading of emboli correlated highly with software quantification. Our data confirm the presence and similarity of emboli generation with both methods of intramedullary nailing. Unreamed nails do not protect the patient from pulmonary embolization of marrow contents.

Duke Scholars

Published In

J South Orthop Assoc

ISSN

1059-1052

Publication Date

2000

Volume

9

Issue

2

Start / End Page

98 / 104

Location

United States

Related Subject Headings

  • Pulmonary Embolism
  • Male
  • Intraoperative Complications
  • Humans
  • Fracture Fixation, Intramedullary
  • Femoral Fractures
  • Female
  • Embolism, Fat
  • Echocardiography, Transesophageal
  • Adult
 

Citation

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ICMJE
MLA
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Coles, R. E., Clements, F. M., Lardenoye, J. W., Wermeskerken, G. V., Hey, L. A., Nunley, J. A., … Pearsall, A. W. (2000). Transesophageal echocardiography in quantification of emboli during femoral nailing: reamed versus unreamed techniques. J South Orthop Assoc, 9(2), 98–104.
Coles, R. E., F. M. Clements, J. W. Lardenoye, G. V. Wermeskerken, L. A. Hey, J. A. Nunley, L. S. Levin, and A. W. Pearsall. “Transesophageal echocardiography in quantification of emboli during femoral nailing: reamed versus unreamed techniques.J South Orthop Assoc 9, no. 2 (2000): 98–104.
Coles RE, Clements FM, Lardenoye JW, Wermeskerken GV, Hey LA, Nunley JA, et al. Transesophageal echocardiography in quantification of emboli during femoral nailing: reamed versus unreamed techniques. J South Orthop Assoc. 2000;9(2):98–104.
Coles, R. E., et al. “Transesophageal echocardiography in quantification of emboli during femoral nailing: reamed versus unreamed techniques.J South Orthop Assoc, vol. 9, no. 2, 2000, pp. 98–104.
Coles RE, Clements FM, Lardenoye JW, Wermeskerken GV, Hey LA, Nunley JA, Levin LS, Pearsall AW. Transesophageal echocardiography in quantification of emboli during femoral nailing: reamed versus unreamed techniques. J South Orthop Assoc. 2000;9(2):98–104.

Published In

J South Orthop Assoc

ISSN

1059-1052

Publication Date

2000

Volume

9

Issue

2

Start / End Page

98 / 104

Location

United States

Related Subject Headings

  • Pulmonary Embolism
  • Male
  • Intraoperative Complications
  • Humans
  • Fracture Fixation, Intramedullary
  • Femoral Fractures
  • Female
  • Embolism, Fat
  • Echocardiography, Transesophageal
  • Adult