EFFECTS OF INTRAMEDULLARY FEMORAL FRACTURE FIXATION: WHAT IS THE IMPACT OF EXPERIMENTAL STUDIES IN REGARDS TO THE CLINICAL KNOWLEDGE?
EFFECTS OF INTRAMEDULLARY FEMORAL FRACTURE FIXATION: WHAT IS THE IMPACT OF EXPERIMENTAL STUDIES IN REGARDS TO THE CLINICAL KNOWLEDGE?
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DOI：
10.1097/00024382-200210000-00001
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发表时间：
2002-10
期刊：
影响因子：
3.1
通讯作者：
H. Pape;P. Giannoudis;K. Grimme;M. van Griensven;C. Krettek
中科院分区：
文献类型：
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作者：
H. Pape;P. Giannoudis;K. Grimme;M. van Griensven;C. Krettek
这篇综述文章总结了关于髓内（IM）扩髓和非扩髓内钉的局部和全身效应的动物研究的现有文献。它关注的问题是，大量的研究是否有助于我们了解其对灌注、骨折愈合的影响以及全身副作用的临床相关性。由于扩髓和髓内钉固定，髓内内容物被挤出髓腔进入静脉和体循环的影响一直是一个主要问题。此外，在过去十年中，外科手术的影响和股骨骨折手术等重大手术的时机一直是争论的主要来源。调查外科手术影响程度和伴随损伤影响的相关研究的汇编取决于动物模型的设计和类型。如果考虑到这一事实，并且如果选择的模型反映了与临床情况相当的全身影响，则动物研究是有价值的信息来源。在这方面，脂肪栓塞代表了附加的手术影响，并且如果辅因子（例如，胸部创伤、严重休克和多发性创伤），这些都是术后并发症的诱因。
This review manuscript summarizes the available literature on animal studies dealing with the local and systemic effects of intramedullary (IM) reamed and unreamed nailing. It focuses on the question of whether the large numbers of studies have contributed to our clinical knowledge about its impact on perfusion, fracture healing, and about the clinical relevance of systemic side effects. The effects of IM contents that are squeezed out of the medullary canal into the venous and the systemic circulation due to reaming and nailing has been a major issue. In addition, the impact of the surgical procedure and the timing of such a major operation as femoral fractures surgery has been a major source of debate within the last decade. The compilation of relevant studies investigating the degree of impact of a surgical procedure and the influence of concomitant injuries depends on the design and the type of the animal model. If this fact is considered and if a model is selected that reflects the systemic impact comparable with the clinical situation, animal studies represent a valuable source of information. In this respect, fat embolization represents an additive surgical impact and can cause clinically relevant side effects if cofactors (e.g., thoracic trauma, severe shock, and polytrauma) are present that set the individual up for postoperative complications.