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Femur fractures and lung complications: a prospective randomized study of reaming.

Publication ,  Journal Article
Anwar, IA; Battistella, FD; Neiman, R; Olson, SA; Chapman, MW; Moehring, HD
Published in: Clin Orthop Relat Res
May 2004

Reaming the intramedullary canal during fixation of femoral shaft fractures may contribute to pulmonary morbidity in patients with trauma. The purpose of our study was to compare acute and late pulmonary complications after reamed or nonreamed nailing of femur fractures. Patients who had femoral shaft fractures were randomized prospectively to a reamed (n = 41) or nonreamed (n = 41) femoral nailing group. Arterial blood gases were measured before and after femur fixation. Ratios of PaO2/FiO2 and alveolar arterial gradients were calculated. Pulmonary complications (acute respiratory distress syndrome) (ARDS), pneumonia, and respiratory failure) were monitored. Age, gender, fracture site, fracture type, time to nailing, length of operation, Injury Severity Score, and Abbreviated Injury Scale-thorax were similar for the two groups. No significant differences were observed in the ratio of PaO2/FiO2 ratios or alveolar arterial (A-a) gradients before and after nailing. The overall incidence of pulmonary complications was 14.6% (eight patients who had reamed nailing and four patients who had nonreamed nailing), and given the sample size, definitive conclusions could not be reached because of inadequate statistical power. We were unable to document differences in pulmonary physiologic response or clinical outcome between patients having reamed and nonreamed femoral nailing. This study may serve as a pilot investigation for other clinical investigations.

Duke Scholars

Published In

Clin Orthop Relat Res

ISSN

0009-921X

Publication Date

May 2004

Issue

422

Start / End Page

71 / 76

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Risk Assessment
  • Respiratory Function Tests
  • Respiratory Distress Syndrome
  • Radiography
  • Prospective Studies
  • Probability
  • Postoperative Complications
  • Pneumonia
  • Orthopedics
 

Citation

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ICMJE
MLA
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Anwar, I. A., Battistella, F. D., Neiman, R., Olson, S. A., Chapman, M. W., & Moehring, H. D. (2004). Femur fractures and lung complications: a prospective randomized study of reaming. Clin Orthop Relat Res, (422), 71–76.
Anwar, Iqbal A., Felix D. Battistella, Rafael Neiman, Steven A. Olson, Michael W. Chapman, and H David Moehring. “Femur fractures and lung complications: a prospective randomized study of reaming.Clin Orthop Relat Res, no. 422 (May 2004): 71–76.
Anwar IA, Battistella FD, Neiman R, Olson SA, Chapman MW, Moehring HD. Femur fractures and lung complications: a prospective randomized study of reaming. Clin Orthop Relat Res. 2004 May;(422):71–6.
Anwar, Iqbal A., et al. “Femur fractures and lung complications: a prospective randomized study of reaming.Clin Orthop Relat Res, no. 422, May 2004, pp. 71–76.
Anwar IA, Battistella FD, Neiman R, Olson SA, Chapman MW, Moehring HD. Femur fractures and lung complications: a prospective randomized study of reaming. Clin Orthop Relat Res. 2004 May;(422):71–76.

Published In

Clin Orthop Relat Res

ISSN

0009-921X

Publication Date

May 2004

Issue

422

Start / End Page

71 / 76

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Risk Assessment
  • Respiratory Function Tests
  • Respiratory Distress Syndrome
  • Radiography
  • Prospective Studies
  • Probability
  • Postoperative Complications
  • Pneumonia
  • Orthopedics