{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:52:10Z","timestamp":1789401130021,"version":"build-2803163510"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2024,5,18]],"date-time":"2024-05-18T00:00:00Z","timestamp":1715990400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,18]],"date-time":"2024-05-18T00:00:00Z","timestamp":1715990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005774","name":"Universitat de Barcelona","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005774","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["International Orthopaedics (SICOT)"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Femoral fractures are common in low and middle-income countries (LMIC), predominantly caused by high-energy trauma. The surgical implant generation network (SIGN\u00ae) program offers two different intramedullary nails in LMIC which are designed to be used without image intensifier free of charge for the patients: the SIGN standard nail (SSN\u00ae) and the SIGN Fin nail (SFN\u00ae). This study aimed to compare the results of the SSN\u00ae and the SFN\u00ae for the treatment of middle and distal shaft femoral fractures through a retrograde approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>This was a retrospective, descriptive, and non-experimental study including all consecutive patients who underwent surgical management of middle or distal shaft femoral fracture between January 2017 and May 2022 in an NGO hospital located in Freetown, Sierra Leone. The duration of surgery, type of reduction, complications like screw loosening, implant migration, anterior knee pain and non-union rate at six\u00a0months of follow up were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 122 patients were included in the study. Group A: 60 patients were managed with SSN\u00ae and Group B: 62 patients with SFN\u00ae. The mean operative time was 104\u00a0min with SSN\u00ae and 78 with SFN\u00ae (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Open reduction of the fracture was necessary in ten (16.7%) patients with SSN\u00ae and 12 (19.4%) patients treated with SFN\u00ae (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.69). Non-union was observed in one (1.7%) patient with SSN\u00ae and two (3.2%) patients with SFN\u00ae (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.57).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both options seem equally effective in treating midshaft and distal femoral shaft fractures. The SFN\u00ae reduces the surgical time, due to this fact, in polytraumatized patients, patients with bilateral femur fracture or patients with ipsilateral tibia fracture, it can be considered as the best option to be used. There was no statistical difference in the complications presented by the two groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00264-024-06192-7","type":"journal-article","created":{"date-parts":[[2024,5,18]],"date-time":"2024-05-18T01:02:08Z","timestamp":1715994128000},"page":"2179-2187","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Standard or Fin SIGN\u00ae nail? which option is better for the treatment of femoral fractures in low and middle-income countries?"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8884-431X","authenticated-orcid":false,"given":"Juan Carlos","family":"Perdomo-Lizarraga","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennys J.","family":"Andrade-Arellano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Necchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Zavatta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8316-2803","authenticated-orcid":false,"given":"Marcella","family":"Ryan-Coker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richmond","family":"Dixon-Cole","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2260-1117","authenticated-orcid":false,"given":"Ernesto","family":"Mu\u00f1oz-Mahamud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1035-9469","authenticated-orcid":false,"given":"Andr\u00e9s","family":"Combalia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,18]]},"reference":[{"issue":"5","key":"6192_CR1","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1007\/s00264-015-3081-3","volume":"40","author":"EJ Kramer","year":"2016","unstructured":"Kramer EJ, Shearer D, Morshed S (2016) The use of traction for treating femoral shaft fractures in low- and middle-income countries: a systematic review. 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