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Submitted: 12 December 2012 Modified: 22 January 2013
HERDIN Record #: R04A-DLSHSI-12121209364643

Estimating femoral nail length using forearm referencing.

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Background: Intramedullary nailing is currently the standard of treatment of diaphyseal femoral fractures (3,7,14,17,18,19). Proper nail length is imperative for satisfactory outcomes. Several methods of estimating femoral nail length have been described. Our paper illustrates a simple technique in predicting the length of the femur to ensure the availability of a suitable intramedullary nail preoperatively.

Objective: To determine the effectiveness of forearm referencing as a predictor of femoral length.

Design: Experimental Study.

Setting: De La Salle University Medical Center (DLSUMC), Dasmarinas, Cavite, Philippines

Participants: Adult Filipino volunteers from DLSUMC.

Intervention: Forearm referencing (Distance from tip of olecranon to tip of little finger)

Outcome measures: Anthropometric measurements obtained using forearm referencing (Measurement 1) and greater trochanter and lateral joint line distance (Measurement 2).

Results: Our study generated a total of 100 volunteers, with equal ratio of male and female, aged 19-72 years old (mean age = 44.66 SD = 14.96). Scatter plot of our data revealed a linear relationship between measurement 1 and measurement 2. The Bland-Altman plot clearly demonstrates that measurement 1 tend to give values that are higher than measurement 2. With a standard deviation of the differences of 15.04 mm, perhaps measurement 1 could be of practical use provided a small downward adjustment was applied to the measurement. Since, the two techniques are not absolutely comparable we used linear regression analysis to formulate a regression equation. We came up with the formula: Measurement 2 = 14.70 + 0.924 (Measurement 1).

Conclusions: Results show that the two measuring techniques cannot be used interchangeably, but perhaps measurement 1 could be of practical use provided a small downward adjustment was applied to the measurement. Adjustments were done using the linear equation that we formulated so that we can predict the length of the femoral canal which in turn can provide us with a range of nails that we can prepare preoperatively so that the proper set of nails are available during the surgery.

FUNDING: No funding was solicited and all of the expenses were shouldered by the authors.

Objectives

To determine the effectiveness of forearm referencing as a predictor of femoral length.

LocationLocation CodeAvailable FormatAvailability
3/F Room 6301 De La Salle Angelo King Medical Research Center 2011-A.5 Fulltext Print Format

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