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The Bone & Joint Journal
Vol. 99-B, Issue 6 | Pages 834 - 840
1 Jun 2017
Long-term survival and risk factors for failure of the native hip joint after operatively treated displaced acetabular fractures
Clarke-Jenssen J Røise O Storeggen SAØ Madsen JE
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Aims

Our aim in this study was to describe the long-term survival of the native hip joint after open reduction and internal fixation of a displaced fracture of the acetabulum. We also present long-term clinical outcomes and risk factors associated with a poor outcome.

Patients and Methods

A total of 285 patients underwent surgery for a displaced acetabular fracture between 1993 and 2005. For the survival analysis 253 were included, there were 197 men and 56 women with a mean age of 42 years (12 to 78). The mean follow-up of 11 years (1 to 20) was identified from our pelvic fracture registry. There were 99 elementary and 154 associated fracture types. For the long-term clinical follow-up, 192 patients with complete data were included. Their mean age was 40 years (13 to 78) with a mean follow-up of 12 years (5 to 20). Injury to the femoral head and acetabular impaction were assessed with CT scans and patients with an ipsilateral fracture of the femoral head were excluded.

Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_I | Pages 156 - 156
1 Mar 2009
THE INFLUENCE OF A ONE STEP REAMER-IRRIGATOR-ASPIRATOR TECHNIQUE ON THE INTRAMEDULLARY PRESSURE IN THE PIG FEMUR.
Husebye E Lyberg . Madsen J Eriksen M Røise O
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Background: Increased intramedullary pressure in the femoral cavity causes intravasation of bone marrow content to the circulation which may lead to occlusion of pulmonary vessels and cardiorespiratory dysfunction. A one-step reamer-irrigator-aspirator (RIA) technique has been developed to reduce the intramedullary pressure (IMP) during the reaming procedure.

Material and method: In a randomized study in 19 Nor-wegian landrace pigs reamed intramedullary nailing was performed with two different reamer devices. Nine animals were operated with a traditional reamer and ten animals with RIA. One animal in the RIA group was excluded due to a perioperative femoral fracture, and three animals in the traditional group due to a perforation of the distal medial femoral cortex. The intramedullary pressure was registrated with a transducer-tipped pressure monitoring catheter during reaming.

Results: The highest intramedullary pressure during reaming was mean 33 mm Hg in the RIA group and 188 mm Hg in the traditional reamer group. This difference was significant (P < 0.05). Intramedullary pressures recorded before surgery, at the opening of the femoral cavity with an awl, by insertion of a guide wire, at insertion of the intramedullary nail, and ten minutes after nail insertion showed no significant differences between the groups.

Conclusion: The use of a one-step reamer-irrigator-aspirator technique in the pig femur induced less intramedullary pressure increase than the use of a traditional reamer.