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H Tscherne

Publications and source records attributed to H Tscherne.

At least 55 records · Page 3Linked to original sources
PubMed1999

[Optimal duration of primary surgery with regards to a "Borderline"-situation in polytrauma patients. Arbeitsgemeinschaft "Polytrauma" der Deutschen Gesellschaft für Unfallchirurgie].

Primary stabilization of major fractures in polytrauma patients is known to represent an important principle of treatment and has been shown to reduce the incidence of posttraumatic complications and of organ failure. However, in critically injured patients it has been discussed that extensive primary definitive treatment may also cause adverse effects due to its systemic burden by blood loss, loss of temperature etc. Patients who deteriorated unexpectedly following primary surgery have been named "borderline patients". In these patients it appears necessary to limit the amount of operative procedures, e. g. by performing temporary fixation of major fractures primarily. The threshold beyond which surgical procedures may cause more harm than good has not been well defined. This holds true especially for the duration of primary surgery. We investigated the clinical outcome in a large number of prospectively documented multiple trauma patients with respect of the duration of primary fracture stabilization. If a primary surgical procedure exceeded 6 hours in multiple trauma patients with an ISS of 25 points, patients demonstrated a significantly elevated ventilation time, an increased mortality, and a higher incidence of death from MOF in comparison with patients that were injured comparably, but were submitted to shorter primary operative procedures.

Adult↗
PubMed1999

Medium-term results of the operative treatment of recurrent patellar dislocation by Insall proximal realignment.

Between 1984 and 1991, 36 patients with the diagnosis of recurrent patellar dislocation were treated operatively using the proximal realignment procedure. Thirty patients were available for follow-up. The average follow-up period was 6.3 years (range 2-9.6 years). The average age at injury was 21.3 years with a predominance of female patients. At follow-up all knees were physically examined. The results were evaluated using the score of Larsen and Lauridsen as well as the Tegner score and subjective assessment. Radiographs from 19 patients (63%) were available for review. At follow-up one patient suffered from a recurrence of patellar dislocation. All patients had stable knee joints and a full range of motion. There was no statistically significant difference between pre- and postoperative sports activity level. Seven patients (23.3%) had excellent results, 12 patients (39.9%) good results and 1 a poor result using the Larsen and Lauridsen score. Subjective assessment revealed the operative result as very good, good or satisfactory in 90%. Patellofemoral osteoarthritis was seen in 7 of 19 patients (36.8%). With a proximal realignment procedure good clinical results can be achieved for recurrent patellar dislocation. Subjective satisfaction with this procedure is rated as good. It is successful in preventing redislocation.

Adolescent↗
PubMed1999

Parameters of multiple organ dysfunction fail to predict secondary amputation following limb salvage in multiply traumatized patients.

OBJECTIVE: The purpose of this retrospective analysis was to evaluate whether systemic parameters that are used to characterize multiple organ dysfunction could also be used to predict the optimal time for amputation in patients failing limb salvage surgery following severe extremity injury. METHODS: The principal criterion for the study group was a lower limb amputation following a type IIIb or IIIc open tibial shaft fracture in multiply traumatized patients. This group was then divided into one group of primary amputation (group A) and one group of secondary amputation (group B). Beside these groups a third group of total traumatic lower limb amputation was recruited (group C). Data analysis included demographics, injury severity according to the ISS, evaluation of the limb injury by three different salvage scores (HFS, MESS and NISSSA) and organ function monitoring by the Denver MOD Score over a 14-day period posttrauma or up to 7 days after secondary amputation. RESULTS: Within the period 1987-1997 a total of 15 patients were recruited for group A (primary amputation), 10 patients for group B (secondary amputation) and nine patients for group C (traumatic amputation). The MOD score was only positive for pulmonary dysfunction, also reflected by the Horovitz quotient, in those patients that died later in either group. Mortality was higher in group A (three out of 15) compared with group B (one out of 10), which may be due to a higher ISS in group A (mean ISS 28.2 vs. 21.0 of group B). Although the MOD score of all recovered patients revealed no significant difference between group A and B, secondary amputation resulted in significantly longer demand of mechanical ventilation. According to our results secondary amputation may lead to transiently decreased pulmonary function but does not necessarily end in multiple organ dysfunction. The need for amputation in failed limb salvage was not indicated by systemic parameters. CONCLUSION: The right time for secondary amputation in order to prevent subsequent pulmonary dysfunction cannot be predicted by parameters otherwise indicating organ dysfunction. As the risk of secondary amputation for developing pulmonary dysfunction apparently cannot be estimated the decision for amputation or limb salvage should be made initially after trauma and should be the definite one.

Adolescent↗
PubMed1999

A mechanical distal aiming device for distal locking in femoral nails.

Although the free hand technique remains the most popular method for distal interlocking screw insertion, proximally mounted radiation independent devices that compensate for implant deformation recently have been developed for the femur. However, the benefits of such systems have not been determined. This study prospectively compared the duration of the nailing procedure, the length of radiation time, and the accuracy of interlocking screw placement when using a radiation independent distal aiming system with those using the free hand technique. In 20 paired intact anatomic specimen femurs, one surgeon experienced only in the free hand technique performed statically locked intramedullary nailing using the two methods. For the aiming system and free hand technique, respectively, the total operation time was 19.1 +/- 8.4 minutes versus 20.9 +/- 11.3 minutes, the distal locking time was 6.6 +/- 2.4 minutes versus 4.8 +/- 1.5 minutes, the total fluoroscopy time was 23 +/- 17 seconds versus 69 +/- 34 seconds, and the distal locking fluoroscopy time was 0 versus 37 +/- 15.5 seconds. There were no failures in either group. Drill nail contact and distal screw damage were greater with the free hand technique. This study suggests that the main advantages of the aiming arm compared with the free hand technique include the elimination of radiation during distal interlocking and more precise screw placement with decreased insertion related hardware damage.

Aged↗
PubMed1999

Minimally invasive plate osteosynthesis: does percutaneous plating disrupt femoral blood supply less than the traditional technique?

OBJECTIVES/HYPOTHESIS: Proximal and distal femur fractures have traditionally been treated with open reduction and internal fixation through a standard lateral approach. New, "minimally invasive" internal fixation techniques, however, have been developed in an effort to devascularize the bone less than the traditional method. The purpose of this study was to determine whether a minimally invasive percutaneous plating technique better preserves bone vascularity relative to the traditional method by comparing the effect of the two approaches on the blood supply of the distal femur using silicone arterial dye injection in a cadaveric model. STUDY DESIGN/METHODS: Ten fresh human cadavers underwent lateral conventional plate osteosynthesis (CPO) through a standard lateral approach on one side and minimally invasive plate osteosynthesis (MIPO) through two three-centimeter incisions on the contralateral side. After injection of silicone dye, a dissection was performed bilaterally to identify the femoral perforating and nutrient arteries. RESULTS: All MIPO specimens showed intact perforating and nutrient arteries, whereas the CPO specimens had a variable incidence of vessel disruption. The MIPO group demonstrated better periosteal perfusion in each of the cadavers and improved medullary perfusion in 70 percent of the MIPO specimens compared with the CPO specimens. CONCLUSION: A percutaneous minimally invasive plating technique disrupts the femoral blood supply less than the traditional open method. Such minimally invasive methods may be more advantageous biologically than the traditional method.

Aged↗
PubMed1999

Closed reduction/percutaneous fixation of tibial plateau fractures: arthroscopic versus fluoroscopic control of reduction.

OBJECTIVE: To evaluate arthroscopic versus fluoroscopic reduction and percutaneous fixation of lateral tibial plateau fractures of AO/OTA Types 41.B1 to 41.B3. DESIGN: Prospective study. SETTING: University hospital. PATIENTS AND INTERVENTION: One hundred sixty-eight patients underwent operative treatment for a tibial plateau fracture from 1988 to 1995. Thirty-three of these patients had monocondylar fractures of the lateral plateau that were treated by percutaneous reduction and fixation techniques. In the first ten cases, arthroscopic control of reduction was used. The following twenty-three consecutive cases were treated by reduction and fixation solely under fluoroscopic control. The arthroscopy group was followed for a mean of fifty-two months and the fluoroscopy group for thirty-eight months. RESULTS: Nine of ten cases of the arthroscopy group had an excellent or good result in Rasmussen's knee score at follow-up. One patient with an unreduced anterolateral depression zone despite arthroscopic surgery required a total knee prosthesis after eighteen months. Sixteen cases in the fluoroscopy group met the follow-up criteria. Fifteen were graded good or excellent in Rasmussen's clinical score; sixteen were excellent or good in the radiological score. One patient claimed chronic medial joint line pain after a lateral split fracture and had arthroscopy revealing chondral degeneration on the medial side but had no pathological findings in the lateral compartment. No secondary meniscus or ligament surgery was performed in the follow-up period. CONCLUSIONS: Percutaneous treatment of fractures of the tibial plateau can be performed using arthroscopy as well as image intensification to control reduction of the joint surface. We were not able to demonstrate any significant benefit from arthroscopy compared with fluoroscopic reduction. Reduction under image intensification is technically easier in our practice, especially in serial fractures and multiply injured patients. We reserve arthroscopy for cases with significant ligament injuries and for children with fractures of the median eminence.

Adolescent↗
PubMed1999

The mechanical effect of blocking screws ("Poller screws") in stabilizing tibia fractures with short proximal or distal fragments after insertion of small-diameter intramedullary nails.

OBJECTIVES/HYPOTHESIS: To evaluate the mechanical effects of medial and lateral blocking screws in supplementing intramedullary nail fixation of high proximal and low distal tibial fractures treated with small-diameter intramedullary nails. STUDY DESIGN: Intact fresh human cadaveric tibiae were sectioned to provide ten distal segments measuring seventy millimeters and ten proximal segments measuring ninety millimeters. In the distal segments, stainless steel solid eight-millimeter tibial nails were advanced to eight millimeters from the ankle joint. Two transverse and one anterior-posterior (AP) locking screw were inserted using a custom-made jig. The same jig was used for the placement of a medial and a lateral blocking screw (BS) in the AP direction, nine millimeters above the superior most interlocking screw and eight millimeters distal to the lower end of the segment. In the proximal segments, two interlocking screws (both static and dynamic screws) were placed in a medial-lateral direction with the use of the insertion handle. A jig was used for placement of a medial and a lateral BS in the AP direction, nine millimeters below the lower transverse interlocking screw and sixteen millimeters proximal to the lower end of the segment. The bone-implant construct (BIC) was embedded and fixed in a materials testing machine. The BICs were loaded in the medial-lateral direction at a distance of 185 millimeters from the nail ends with loads from -150 newtons to + 150 newtons. Force-displacement curves were recorded before and after insertion of the BSs. RESULTS: In proximal BICs, the addition of BSs decreased the deformation of the BICs 25 percent, from 8.9 +/- 1.9 degrees [mean +/- standard deviation (SD)] in the control group to 6.8 +/-1.1 degrees in the BS group (mean +/- SD) (p < 0.0001). In distal BICs, the addition of BSs decreased the deformation of the BICs 57 percent, from 9.5 +/- 1.4 degrees (mean +/- SD) in the control group to 4.0 +/- 1.0 degrees in the BS group (mean +/- SD) (p < 0.0001). CONCLUSIONS: The study suggests that medial and lateral blocking screws can increase the primary stability of distal and proximal metaphyseal fractures after nailing and can be an effective tool for selected cases that exhibit malalignment and/or instability.

Aged↗
PubMed1999

Long-term outcome in children with fractures of the proximal femur after high-energy trauma.

BACKGROUND: Fractures of the femoral head and neck in children have a risk of severe complications, especially femoral head necrosis. We performed a long-term follow-up study of patients treated at our institution. METHODS: Patients were reexamined at least 3 years after trauma and were included if they were younger than 17 years old at the time of injury, if there was no history of previous fracture, and if there was no history of underlying bone disease. Fractures were classified according to Delbet, and outcome was graded according to Ratliff. Anterior capsulotomy was not performed, and stabilization devices were placed short of the epiphysis except for type I fractures. RESULTS: Of 32 patients, 28 were reexamined. Among these patients, the mean age at the time of injury was 11.8 years and the mean follow-up time was 11.1 years (range, 3-21 years). There were 3 patients with type I fractures, 8 patients with type II fractures, 12 patients with type III fractures, and 5 patients with type IV fractures. Thirteen patients had Injury Severity Scores > 18. At last follow-up, 20 patients presented with good function, 5 with fair outcome, and 3 with poor results; all of the latter suffered type I fractures. Eighteen patients had no restrictions in activities of daily living or during sports activities. In six other patients, the inability to participate in sports was attributable to head trauma, amputation, or peripheral neurologic damage. CONCLUSION: We found favorable long-term outcome in type II to type IV fractures. In these patients, restrictions of function were usually caused by other associated injuries. All patients with type I fractures presented with poor outcome secondary to their proximal femoral fractures, and not because of other associated injuries. Type I fractures during childhood and adolescence represent an unsolved problem.

Accidents↗
PubMed1999

Levels of antibodies to endotoxin and cytokine release in patients with severe trauma: does posttraumatic dysergy contribute to organ failure?

BACKGROUND: We conducted a prospective study in patients with multiple injuries investigating the time course of trauma-related changes of systemic immunologic defense mechanisms. METHODS: Patients with multiple injuries with Injury Severity Scores of more than 20 were included if they survived for more than 4 days after injury. Further inclusion criteria were no local or systemic infection (pneumonia, sepsis, soft-tissue infection, acquired immunodeficiency syndrome, tuberculosis, etc.) at the time of injury and no history of liver disease, bowel disease, or abdominal surgery. Serum endotoxin levels were measured from peripheral venous blood, as were the immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies against lipid A and against the core polysaccharide of endotoxin (lipopolysaccharide [LPS]), during the course of intensive care management. Serial central venous levels of interleukin-6 were determined as a marker of the inflammatory response. RESULTS: The patients were grouped according to their survival, with the survivors belonging to group S (48 patients) and the nonsurvivors belonging to group N (16 patients). The time of death for the nonsurvivors was between days 10 and 32 after the initial trauma. Thirteen of these patients (81%) died of multiple organ failure between days 12 and 17, two died of head trauma, and one died of sepsis. In patients who died of multiple organ failure, a significantly lower production of the IgM and IgG antibodies (AB) against lipid A and LPS was found before death (lipid A IgM-AB, day 11: group N, 29 +/- 11 U/mL; group S, 106 +/- 16 U/mL; p = 0.008; lipid A IgG-AB, day 11: group N, 18 +/- 9 U/mL; group S, 57 +/- 18 U/mL; p = 0.007; LPS IgM-AB, day 11: group N, 36 +/- 14 U/mL; group S, 122 +/- 23 U/mL; p = 0.009; LPS IgG-AB, day 11: group N, 17 +/- 12 U/mL; group S, 56 +/- 19 U/mL; p = 0.03). Interleukin-6 levels were significantly increased in the nonsurvivors (day 1: group N, 1,095 +/- 112 pg/mL; group S, 393 +/- 67 U/L; p = 0.008). CONCLUSION: In patients who died of severe trauma and in whom the cause of death was multiple organ failure, a significantly lower production of antiendotoxin antibodies was measured shortly before death. An insufficient immune defense (dysergy) may be involved in the pathomechanisms leading to the development of organ dysfunction.

Adult↗
PubMed1999

Adenosine-triphosphate in trauma-related and elective hypothermia.

BACKGROUND: In trauma patients, hypothermia is a frequent event. According to the literature, the majority of trauma patients are presenting a core temperature of less than 34 degrees C at admission. In contrast to the benefit of hypothermia in elective surgery, clinical experience with hypothermia in trauma patients has identified hypothermia to be one major cause of severe posttraumatic complications. It was hypothesized that this diverse effect of hypothermia is related to depletion of high-energy phosphates like adenosine triphosphate (ATP) in trauma patients. To verify this hypothesis, the relation of ATP plasma levels and hypothermia was examined in a clinical study. METHODS: Three different groups of patients were under study. The first group (group A, normothermic control group) included patients (n = 15) undergoing elective surgery of the lower limb with a mean operation time of 113 minutes. The second study group (group B, hypothermic control) was composed of patients (n = 15) who were subjected to elective coronary artery bypass operation under hypothermia (31 degrees C for 48 minutes, mean total operation time being 205 minutes). The third study group (group C) included trauma patients (n = 23, mean Injury Severity Score [ISS] of 24.7). At the time of admission, 10 patients presented a core temperature more than or equal to 34 degrees C (group C1, mean ISS, 25.2; mean T(A), 34.5 degrees C), 13 patients presented a T(A) less than 34 degrees C (group C2, mean ISS, 26.0; mean T(A), 32.9 degrees C). In both groups of surgical patients, the ATP plasma level was measured preoperatively, at 2, 4, and 24 hours postoperatively. For trauma patients, this measurement was performed at admission and 24 hours later. Within the same schedule, body core temperature was recorded and the clinical course was documented as well. RESULTS: Elective limb surgery in normothermic patients resulted only in a transient decrease in ATP plasma levels (preoperative, 87.8 micromol/dL; 4 hours postoperative, 52.0 micromol/dL). At 24 hours, the ATP plasma level (62.6 +/- 10.0 micromol/dL) has increased toward baseline level. Elective hypothermia in patients subjected to coronary bypass also resulted only in a transient decrease in ATP plasma levels. During the operation period, including hypothermia, the ATP plasma level was comparable (50.4 micromol/dL) to group A and also returned back toward normal values at 24 hours (58.2 micromol/dL). All trauma patients revealed a significant low ATP plasma level at admission compared with both control groups. Looking at subdivided groups the most significant drop in ATP plasma level (28.5 micromol/dL) was noted in patients presenting an initial core temperature less than 34 degrees C and ISS more than 30. Even 24 hours later, the ATP level of this subgroup was significantly diminished, despite a rise up to 44.4 micromol/dL. In contrast, only a moderate drop in ATP plasma concentration (59.2 micromol/dL) was noted in the group of T(A) more than or equal to 34 degrees C and ISS less than 20. This group revealed almost normal values (68.3 micromol/dL) 24 hours after trauma. In addition to hypothermia, the metabolic state, reflected by the plasma lactate levels, significantly influenced the ATP plasma levels, as high lactate levels were paralleled by low ATP levels. Also, the overall outcome was related to injury severity and hypothermia. CONCLUSION: Hypothermia in elective surgery, established by active cooling, preserves the ATP storage and maintains an aerobic metabolism, which both contribute to the beneficial effect of hypothermia in ischemia/reperfusion in cardiovascular surgery. However, in trauma patients hypothermia is caused by insufficient heat production due to utilization of ATP under anaerobic metabolic conditions. Low ATP plasma levels combined with hypothermia seem to be a predisposition for post-traumatic complications like organ failure.

Adenosine Triphosphate↗
PubMed1999

Long-term results of subtalar fusions after operative versus nonoperative treatment of os calcis fractures.

From 1984 to 1994, 40 patients with a subtalar fusion were reexamined in long-term follow-up. The evaluation of the overall results was carried out with three different scoring systems. The calcaneal fractures were primarily treated nonsurgically in 23 patients (57.5%), and 17 patients (42.5%) had undergone ORIF. Complete pain relief was achieved in 52.5% of patients; 65% revealed a restriction in a range of motion in the ankle joint, and in 62% a grade 1 arthritis of the ankle joint was found. The statistical analysis could only reveal a tendency for a better outcome in the operative group compared with the nonsurgical group, although within the operated group, the majority of the os calcis fractures were more severe than in the nonsurgical group.

Adult↗
PubMed1999

[Process fractures. A diagnostic problem in ankle injuries].

Peripheral talar fractures are frequently overlooked and should be considered in the differential diagnosis of patients with acute and chronic ankle pain. Early diagnosis allows specific treatment options to prevent long-term complications and enables better overall results. Computertomography is obligatory for definite evaluation of the pathology and to determine the need for conservative or operative treatment. Conservatively treated displaced fractures lead to pain and decreased range of motion from ongoing arthrosis of the subtalar joint. Large or displaced fragments require, according to the scare literature, open reduction and internal fixation. Comminution or small fragments are best addressed by surgical excision, although alteration in the biomechanics of the subtalar joint may occur.

Ankle Injuries↗
PubMed1999

[Role of adenosine triphosphate (ATP) in trauma-induced and elective hypothermia].

BACKGROUND: In trauma patients hypothermia is a frequent event. According to the literature the majority of trauma patients are presenting a core temperature of less than 34 degrees C at admission. In contrast to the benefit of hypothermia in elective surgery, clinical experience with hypothermia in trauma patients has identified hypothermia to be one major cause of severe posttraumatic complications. It was hypothetized that this diverse effect of hypothermia is related to depletion of high energy phosphates like adenosine-tri-phosphate (ATP) in trauma patients. To verify this hypothesis the relation of ATP plasma levels and hypothermia was examined in a clinical study. METHODS: Three different groups of patients were under study. The first group (group A, normothermic control group) included patients (n = 15) undergoing elective surgery of the lower limb with a mean operation time of 113 minutes. The second study group, hypothermic control (group B), comprised patients (n = 15) that were subjected to elective coronary artery bypass operation under hypothermia (31 degrees C for 48 minutes, mean total operation time being 205 minutes). The third study group (group C) included trauma patients (n = 23, mean ISS of 24.7). At the time of admission 10 patients presented a core temperature > or = 34 degrees C (group C1, mean ISS 25.2, mean TA 34.5 degrees C), 13 patients presented a TA < 34 degrees C (group C2, mean ISS 26.0, mean TA 32.9 degrees C). In both groups of surgical patients the ATP plasma level was measured preoperatively, at 2 hr, 4 hr and 24 hr postoperatively. In trauma patients this measurement was performed at admission and 24 hours later. Within the same schedule body core temperature was recorded and the clinical course was documented as well. RESULTS: Elective limb surgery in normothermic patients resulted only in a transient decrease in ATP plasma levels (preoperative: 87.8 mumol/dl, 4 hr postoperative: 52.0 mumol/dl). At 24 hours the ATP plasma level (62.6 +/- 10.0 mumol/dl) has increased towards baseline level. Elective hypothermia in patients subjected to coronary bypass also resulted only in a transient decrease in ATP plasma levels. During the operation period, including hypothermia, the ATP plasma level was comparable (50.4 mumol/dl) to group A and also returned back towards normal values at 24 hours (58.2 mumol/dl). All trauma patients revealed a significant low ATP plasma level at admission as compared to both control groups. Looking at subdivided groups the most significant drop in ATP plasma level (28.5 mumol/dl) was noted in patients presenting an initial core temperature < 34 degrees C and ISS > 30. Even 24 hours later the ATP level of this subgroup was significantly diminished despite a rise up to 44.4 mumol/dl. In contrast an only moderate drop in ATP plasma concentration (59.2 mmol/dl) was noted in the group of TA > or = 34 degrees C and ISS < 20. This group revealed almost normal values (68.3 mmol/dl) 24 hours after trauma. Beside hypothermia the metabolic state, reflected by the plasma lactate levels, significantly influenced the ATP plasma levels, as high lactate levels were paralleled by low ATP levels. Also the over all outcome was related to injury severity and hypothermia. CONCLUSION: Hypothermia in elective surgery, established by active cooling, preserves the ATP storage and maintains an aerobic metabolism, which both contribute to the beneficial effect of hypothermia in ischemia/reperfusion in cardiovascular surgery. However, in trauma patients hypothermia is caused by insufficient heat production due to utilization of ATP under anaerobic metabolic conditions. Low ATP plasma levels combined with hypothermia seem to be a predisposition for posttraumatic complications like organ failure.

Adenosine Triphosphate↗
PubMed1999

The topography of the perforating vessels of the deep femoral artery.

This study evaluated the anatomic relationship between the femur and the vessels that arise from the deep femoral artery, that is, the perforating arteries and the nutrient artery. Blue silicone dye was injected through the common femoral artery in 20 fresh human cadavers. An anteromedial and a posterolateral dissection were performed to identify the femoral perforating arteries and the nutrient artery of the femur. The length of the femur and the distances between the tip of the greater trochanter and the perforating arteries and nutrient artery were measured. This study showed that a reliable, clinically applicable topographic relationship exists between the femur and the perforating arteries and the nutrient artery.

Aged↗
PubMed1998

Deformation of femoral nails with intramedullary insertion.

Current methods of distal interlocking of intramedullary femoral nails are dependent on image intensification. However, radiation exposure to the patient, the operating room staff, and the surgeon remains a concern. Proximally mounted, radiation-free aiming systems for distal interlocking of femoral nails have reportedly failed because of nail deformation with insertion. To better understand this deformation, a three-dimensional magnetic motion tracking system was used to determine the position of the distal interlocking hole following nail insertion. The amount and direction of deformation of commercially available small-diameter implants (unslotted 9-mm nails inserted without reaming) and large-diameter implants (slotted 13-mm nails inserted with reaming) from a single manufacturer were analyzed. Measurements of deformation (three translations and three angles), based on the center of the distal transverse locking hole, were performed on 10 paired intact human cadaveric femora before and after insertion. The technique produced the following results for the small and large-diameter nails, respectively: lateral translations of 18.1+/-10.0 mm (mean+/-SD, range: 47.8 mm) and 21.5+/-7.9 mm (range: 26.4 mm), dorsal translations of -3.1+/-4.3 mm (range: 15.2 mm) and 0.4+/-9.8 mm (range: 30.1 mm), and rotation about the longitudinal axes of -0.1+/-0.2 degrees (range: 0.7 degrees) and 10.0+/-3.1 degrees (range: 7.8 degrees). This technique is useful for measuring insertion-related femoral nail deformation. The data for the nails tested suggest that a simple aiming arm, mounted on the proximal end of the femoral nail alone, will not sufficiently provide accurate distal aiming.

Bone Nails↗
PubMed1998

[Not Available].

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Journal Article↗