Intramedullary nails (IMNs) are the most frequent surgical fixation method for femur fractures. Although IMNs provide good healing outcomes and low complication rates, concerns persist regarding potential complications such as malunion, nonunion, and infections. This multicenter retrospective study aims to assess the epidemiology and outcomes of IMNs for diaphyseal femoral fractures. Data from 91 patients who underwent IMN fixation at two Brazilian hospitals between 2020 and 2024 were analyzed, with a mean age of 33.3 years (SD ± 12.7) and 76.9%% of male patients. Traffic accidents were the most common mechanism of trauma (84.61%). The bone healing rate was 96.7% within six months, and 98.9% within one year, with a complication rate of 3.26%, including two cases of pseudoarthrosis, one case of pseudoarthrosis and infection, and two reoperations. There was a significant association between previous external fixation and fracture type (open/closed) (χ²(1) = 17.5, p_Fischer < 0.001). Previous external fixation was also associated with lower consolidation rates six months post-surgery (χ²(1) = 9.83, p_Fischer = 0.031), but not after one year (χ²(1) = 8.19, p_Fischer = 0.11). The retrograde approach was associated with a lower consolidation rate after six months (χ²(1) = 6.98, p_Fischer = 0.027), but no significant association was found after one year (χ²(1) = 2.27, p_Fischer = 0.308). Only one patient with pseudoarthrosis did not consolidate after one year. The outcomes support the efficacy of IMNs in achieving bone consolidation with low complication rates.

Introduction: Most transplanted organs are obtained from brain-dead donors. Inflammation results in a higher rate of rejection. Objectives: The objective of this animal model of brain death (BD) was to evaluate the effect of the progressive institution of volume expansion, norepinephrine, and combined hormone therapy on clinical, laboratory, and histological aspects. Methods: Twenty rabbits were divided: A (control), B (induction of BD + infusion of crystalloid), C (BD + infusion of crystalloid and noradrenaline (NA)), and D (BD + infusion of crystalloid + vasopressin + levothyroxine + methylprednisolone + NA). The animals were monitored for four hours with consecutives analysis of vital signs and blood samples. The organs were evaluated by a pathologist. Results: In Group D, we observed fewer number and lesser volume of infusions (p = 0.032/0.014) when compared with groups B and C. Mean arterial pressure levels were higher in group D when compared with group B (p = 0.008). Group D had better glycemic control when compared with group C (p = 0.016). Sodium values were elevated in group B in relation to groups C and D (p = 0.021). In Group D, the organ perfusion was better. Conclusion: The optimized strategy of management of BD animals is associated with better hemodynamic, glycemic, and natremia control, besides reducing early signs of ischemia.