整形外科とリハビリテーションのジャーナル

抽象的な

Accelerated callus formation and fracture union in patients with femoral or tibial shaft fracture and traumatic head injuries.

Hee-Gon Park, Yong-Eun Shin

Aim and Purpose: The purpose of this study is to reveal whether the patients with femoral or tibial shaft fracture and traumatic head injuries accelerates callus formation, as well as fracture union periods. In advance, it allows orthopedic surgeons to predict earlier fracture union period and reassure the patients and their family.

Methods: 291 patients who underwent closed reduction and intramedullary nail fixation for the femoral or tibial shaft fractures and followed up at least 1 year were analyzed retrospectively. Callus formation and fracture union were quantified by serial radiographic images. The level of consciousness and Glasgow Coma Scale, location and severity of head injuries were evaluated by neurosurgeon at the time of admission. Cases were subdivided into two groups; group A consisted of the patients who had concomitant traumatic head injuries, and group B consisted of the patients who had not concomitant traumatic head injuries.

Results: The mean callus ratio and volume were significantly greater in group A than group B. The fracture union period was shorter in group A than group B. There was no statistically difference for gender and age between two groups. The level of consciousness, Glasgow coma scale, location and severity of head injuries, and experience of neurosurgical intervention were not significant factors in predicting the rate of bone healing and the extent of callus formation in group A.

Conclusion: Femoral or tibial shaft fractures with concomitant traumatic head injuries regardless of the severity or location of injuries were demonstrated to enhance bone healing with increased callus formation and decreased fracture union period. Orthopedic surgeons should evaluate traumatic head injuries prudently with assistance of neurosurgeons if needed even though the patient was alert consciousness state.

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