Intramedullary nailing in elderly patients.
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Biomedical subjects
Publications and source records attributed to Michael Zlowodzki.
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Evidence-based medicine differs from the traditional approach to health care in that in addition to relying on clinical experience, expert opinion, and knowledge of pathophysiology for clinical decision-making, clinicians identify important knowledge gaps and information needs, formulate answerable questions, identify potentially relevant research, assess the validity of evidence and results, and apply research evidence to individual patients in a way that takes into account the patients' particular experiences, expectations, and values. It is becoming increasingly important that physicians learn the concepts of EBM because many EBM-related concepts have become a part of daily clinical practice. This article uses examples from orthopedics to outline EBM principles and methods and the advantages of EBM over traditional approaches. It also discusses challenges in implementing EBM and suggests EBM-related resources for physicians.
The treatment of femoral shaft fractures has become safe and reproducible since the advent of popularization of intramedullary nailing, however, many femoral shaft fractures are complicated by associated fractures, extensive comminution, extensive contamination, and arterial injury compartmental syndrome. Other conditions associated with the use of femoral nailing include femora nonunions, broken hardware, acute fractures with prior implants, and infections. The management of these complex femoral shaft fractures demands special techniques for successful outcome.