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

Journal Article (Clinical Trial;Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Coles, RE; Clements, FM; Lardenoye, JW; Wermeskerken, GV; Hey, LA; Nunley, JA; Levin, LS; Pearsall, AW

Published Date

  • 2000

Published In

Volume / Issue

  • 9 / 2

Start / End Page

  • 98 - 104

PubMed ID

  • 10901647

International Standard Serial Number (ISSN)

  • 1059-1052


  • eng

Conference Location

  • United States