[ @entity73 after Surgery for XXXX ].

@entity1 @entity174 @entity4422 @entity73 @entity1230 @entity3330 @entity130 @entity1516
UNASSIGNED: PURPOSE OF THE STUDY The aim of the study was to analyse causes of impaired @entity174 and to present options of their management. MATERIAL AND METHODS This is a retrospective study of the data on complications prospectively collected between 2008 and 2013. The @entity1 admitted for primary treatment at the @entity130 Centre of the Faculty of Medicine in Hradec Kralove from January 2008 to December 2013 included 1186 @entity1 with @entity130 ( @entity130 ) > 15 and 1340 @entity1 with new @entity130 (NISS) >15, all older than 16 years. With the exception of two @entity1 , the primary treatment involved the application of an external fixator as part of damage control surgery. Definitive surgery, regardless of the site of @entity174 , was performed using unreamed femoral nails (UFN) in 51, distal femoral nails (DFN) in 33, plates in 26, long proximal femoral nail antirotation (PFNA-long) in 14 and nails combined with dynamic hip screw (DHS) plates in five @entity174 . The analysis revealed both mechanical and biological causes of poor bone healing. RESULTS Of the 124 @entity1 whose @entity1230 included a @entity174 of the femur, 11 died within 24 hours in spite of intensive resuscitation. In the remaining 113 @entity1 there were 16 bilateral @entity174 , 20 @entity174 of the proximal femur (extraarticular), 72 @entity174 and 26 @entity174 . Nine @entity1 sustained segmental femoral shaft @entity174 . Ten diaphyseal and 14 distal femur @entity130 were @entity4422 (13.5% and 54%, respectively). @entity1516 developed in a total of 12 @entity174 (9.3%); six (7.2%) were diaphyseal @entity174 , of which three were @entity4422 , and six (21.4%) were @entity174 with two initially open @entity130 . All proximal femur @entity174 healed completely. DISCUSSION The frequency of non-union femoral diaphyseal @entity174 in our @entity1 treated by unreamed intra-medullary nailing is in agreement with the literature data. The frequency of non-union @entity174 in our group was slightly higher than is published in the literature. This can be accounted for by the characteristics of our group consisting of @entity1 with multiple severe @entity130 in whom @entity174 are due to high-energy @entity130 ; the overall severity of @entity130 negatively affects the biological potential of a @entity1 organism for bone healing. CONCLUSIONS A successful outcome of @entity3330 repair is based on an understanding of the biomechanical principle, i.e., correct @entity174 reduction and stable osteosynthesis fitting the morphology of the @entity174 . @entity3330 heal well with the use of a narrow long nail whose working length allows for even distribution of movement at a @entity174 line amongst the fragments and thus @entity174 motion load does not exceed 20%. On the other hand, short oblique and transverse @entity174 are examples of problematic @entity174 which require maximum possible stability provided by a thick nail with a short working length; this is achieved by reaming the medullary cavity or adding lag screws. In our group of @entity1 these @entity174 were also the most problematic ones. Generally, nailing remains the golden standard in the management of @entity3330 . Key words: @entity1230 , @entity3330 , surgical treatment, @entity73 .
