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At least 181 records · Page 10Linked to original sources
PubMed1986

Yellow nail syndrome--the triad of yellow nails, lymphedema and pleural effusions. A review of the literature and a case report.

The yellow nail syndrome, combination of yellow discoloured nails, lymphedema and pleural effusions, is a rare clinical condition. A review of the literature, including 97 patients, is presented. Most patients developed yellow nail syndrome in early middle age, and the overall male:female ratio was 1.1.6. The etiology of the syndrome is obscure, while the pathogenesis seems to involve impaired lymphatic drainage. A patient, whose recurrent pleural effusions were effectively controlled by chemical pleurodesis, is also presented.

Diagnosis, Differential↗
PubMed2005

Tibiotalocalcaneal (hindfoot) arthrodesis by retrograde intramedullary nailing using a curved locking nail. The results of 52 procedures.

BACKGROUND: The purpose of this study was to report the results of 52 combined subtalar and ankle arthrodesis using an intramedullary nail. METHODS: Retrospective review identified 49 patients who had 52 combined ankle and subtalar arthrodeses with an ACE retrograde locked intramedullary humeral nail (DePuy-Ace), Warsaw, IN). Most procedures included bone grafts from the fibula, proximal tibia, or iliac crest or femoral head allograft. Intraoperative complications included one fractured tibia and one fractured medial malleolus. The procedure was done mainly for the treatment of combined ankle and subtalar arthritis (31) or complex hindfoot deformities (12). Outcome was assessed by a combination of chart review, clinical examination, and telephone questionnaire. Followup averaged 34 (8 to 73) months. RESULTS: At followup 82% of patients were satisfied with the results of surgery, 82% reported improvements in pain levels, and 67% reported improved foot function. The average postoperative American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score was 63. Postoperative complications included deep infection, amputation, stress fracture, nonunion, and prominent hardware. CONCLUSION: Hindfoot arthrodesis with intramedullary nailing is an effective technique for treating complex foot deformities and often is the only alternative to amputation. Patient satisfaction is high, but the procedure is demanding and complications are frequent.

Adult↗
PubMedDate not supplied

Allergic onycholysis and paronychia caused by cyanoacrylate nail glue, but not by photobonded methacrylate nails.

Artificial acrylic nails may induce side effects such as fingertip dermatitis, periungual dermatitis, onycholysis, paresthesiae, Raynaud's phenomenon, ectopic facial involvement, and allergic contact dermatitis. We present a patient who developed allergic onycholysis from a cyanoacrylate used in a nail adhesive. She was able to use photobonded sculptured nails because they contain methacrylates that do not cross-react with cyanoacrylates.

Adult↗
PubMed2004

Treatment of unstable trochanteric fractures. Randomised comparison of the gamma nail and the proximal femoral nail.

The proximal femoral nail (PFN) is a recently introduced intramedullary system, designed to improve treatment of unstable trochanteric fractures of the hip. In a multicentre prospective clinical study, the intra-operative use, complications and outcome of treatment using the PFN (n = 211) were compared with those using the gamma nail (GN) (n = 213). The intra-operative blood loss was lower with the PFN (220 ml v 287 ml, p = 0.001). Post-operatively, more lateral protrusion of the hip screws of the PFN (7.6%) was documented, compared with the gamma nail (1.6%, p = 0.02). Most local complications were related to suboptimal reduction of the fracture and/or positioning of the implant. Functional outcome and consolidation were equal for both implants. Generally, the results of treatment of unstable trochanteric fractures were comparable for the PFN and GN. The pitfalls and complications were similar, and mainly surgeon- or fracture-related, rather than implant-related.

Aged↗
PubMedDate not supplied

Basal cell carcinoma of the nail unit treated with Mohs micrographic surgery: superficial multicentric BCC with jagged borders--a histopathological hallmark for nail unit BCC.

We present a case of basal cell carcinoma (BCC) of the nail unit with a special emphasis on superficial multicentric histopathologic type with jagged borders that was treated with Mohs micrographic surgery. Nail unit BCCs may not be as rare as previously believed and jagged borders in the superficial neoplastic buds may be a hallmark for superficial BCCs of the nail unit.

Aged↗
PubMed1990

Problems associated with longitudinal fractures of the femoral shaft in adults. A comparison between intramedullary nailing, interlocking intramedullary nailing and plating.

The results of 64 operatively treated patients with longitudinal femoral shaft fracture are presented. Twenty-four fractures were treated with an intramedullary nail, six with an interlocking intramedullary nail and 34 with plating. The functional end results were good and the anatomical result satisfactory in all groups although treatment with plate caused several failures. We conclude that intramedullary nailing is a good and safe method to treat non-comminuted fractures of the femoral shaft.

Adolescent↗
PubMed1987

Ender nailing of acute fractures of the humerus. A study of closed fixation by intramedullary nails without reaming.

A prospective study of closed intramedullary fixation of fractures of the shaft of the humerus, using Ender nails, was performed over a six-year period. Eighty-nine fractures in eighty-eight patients were treated with no immobilization postoperatively. Three patients were lost to follow-up. Eighty-five of the remaining eighty-six fractures healed, the average time to clinical union being 7.2 weeks. Non-union of one fracture occurred and there were no infections or malunions. Six of the nine preoperative and two postoperative radial-nerve palsies were lesions in continuity and healed spontaneously. The remaining three radial nerves that had been severed by a missile needed further attention. One of the nails backed out in eight patients, requiring revision in five. The average lack of complete extension of the elbow was 4 degrees and flexion of the elbow was 132 degrees. Abduction of the shoulder averaged 91 degrees; external rotation, 54 degrees; and internal rotation, 68 degrees. We conclude that closed intramedullary Ender nailing can be performed safely and effectively in selected fractures of the humeral shaft. However, only fractures that are recalcitrant to closed reduction and immobilization or fractures in the non-compliant patient should be considered for this form of operative treatment.

Acute Disease↗
PubMed1984

[Sandy nails and twenty-nail dystrophy of childhood. Apropos of 2 cases].

2 apparently idiopathic cases of twenty-nail dystrophy of childhood are reported with follow-ups of 4 and 16 years, respectively. The associated koilonychia appears to be only fortuitous and related to the fragility of the nail. Trachyonychia should be considered as a symptom often related to external traumatism or dermatoses, particularly alopecia areata or lichen planus, of which it could be a specific isolated location. Within the spectrum of apparently idiopathic trachyonychies , the twenty-nail dystrophy of childhood appears to be a real entity on the basis of its clinical features and course.

Adolescent↗
PubMed1980

Closed retrograde intramedullary nailing of peritrochanteric fractures of the femur with a new nail.

Two hundred and forty patients with intertrochanteric and subtrochanteric fractures were treated by closed intramedullary nailing with a new nail inserted retrograde via the medial condyle. After insertion, the alignment of the nail is nearly parallel to the line of load-bearing. Early weight-bearing was achieved for most patients with intertrochanteric and stable subtrochanteric fractures. A review of the 176 fractures that had at least an eight-month follow-up revealed loss of reduction in 2.3 per cent. There were no cases of implant failure, delayed union, non-union, or infection. The six-week mortality rate was 3.7 per cent and the eight-month rate, 10.4 per cent.

Aged↗
PubMed1989

Tumors of the nail and nail bed.

This article reviews the tumors that most frequently affect the nail and nail bed. Clinical appearance, histopathology, differential diagnosis, and treatment are discussed.

Diagnosis, Differential↗
PubMed1996

[Retrograde interlocking nailing of distal femoral fractures with the intramedullary supracondylar nail].

Between June 1993 and September 1995, 18 distal femoral fractures were treated using the supracondylar intramedullary nail. There were 8 type A fractures and 10 type C fractures (AO classification). The operative technique involved retrograde insertion of an unreamed supracondylar nail through the intercondylar notch. Follow-up was available on all patients and averaged 18.3 months (range 6-32 months). All fractures healed with an average time to union of 12.4 weeks (range 8-16 weeks). Bone grafting was not necessary in any case. Sixteen patients achieved almost the same ROM as they had had before the injury. One patient developed a varus malignant and underwent correction with a supracondylar osteotomy 20 months post trauma. There were no infections or nonunions. The retrograde supracondylar nail is an excellent alternative to plate osteosynthesis in the management of dia- and supracondylar femoral fractures.

Adult↗
PubMed1985

[Treatment of tibial shaft fracture in the area of the large medullary cavity--an indication for intramedullary nailing? Results of intramedullary nailing and comparison with concurrent treatment procedures].

Nailing has become the major method of treating lower leg fractures: though there are still different opinions how to treat lower leg fractures localized between the proximal-middle and middle-distal third as well as in the second and fifth/sixth. Following our own experiences with 192 lower leg nailings in that sphere we report the results in order to demonstrate the efficiency of nailing in comparison with the traditional way of conservative treatment and plate osteosynthesis.

Female↗
PubMed1994

[Current status of surgical technique for unreamed nailing of tibial shaft fractures with the UTN (unreamed tibia nail)].

Nailing technique has changed in recent years in some important aspects which are not limited to the omitted reaming procedure. These changes concern patient positioning, reduction technique, the use of temporary stabilizers such as the 'Pinless', and determination of implant length and diameter. Approach and exposure techniques have been modified to new, less invasive procedures, in order to fulfill technical, functional and aesthetic requirements. Techniques and tricks have been developed for avoidance of fragment diastasis and axial and torsional malalignment. Finally, simple algorithms are described for the management of large bone defects, bilateral tibia shaft or ipsilateral femoral shaft fractures, number and location of locking bolts, the 'when and how' of patient mobilization and load bearing, and primary and secondary dynamization. These algorithms, techniques and procedures were developed in a series of 152 tibia shafts, which were stabilized with the AO unreamed tibia nail (UTN) in a prospective study between March 1989 and June 1994. Of these, 75 cases with a mean follow-up of 19.4 +/- 6.3 (range 11-37) months after trauma were reviewed. Fractures were classified according to Müller (1990): 14 type A, 37 type B and 24 type C. Closed soft tissue damage was categorized according to our classification: C0/1, n = 5; C2, n = 12; C3, n = 9 (Tscherne 1982). Among 49 open fractures 8 were OI, 18 OII, 10 OIIIA and 13 OIIIB (Gustilo 1976). The main minor intraoperative complication was drill bit breakage (n = 10), most frequently at the proximal locking holes. The main postoperative complication was breakage of locking bolts (n = 16), mainly between weeks 6 and 20. Minor secondary reinterventions were, in most cases, secondary dynamization under local anaesthesia. Major reintervention were: soft tissue reconstructions (n = 5), isolated cancellous bone graft (n = 6), and change of treatment (n = 12). There were nine changes to a reamed nail, two changes, in very proximal fractures, to plate osteosyntheses. There were three deep infections. Mean time to union was 23.9 weeks (range 10-48 weeks, n = 73); in two cases non-union was observed. The overall result was judged with the Karlström-Olerud score, which was applicable in 66 of 75 cases; excellent, n = 2; good, n = 22; satisfactory, n = 24; fair, n = 9; poor, n = 9. In the remaining nine cases no scoring was attempted because of severe injuries around the knee or ankle.

Adolescent↗
PubMed1996

[Development and initial clinical use of an aiming device for distal boring in interlocking nailing without roentgen image intensifier for the unreamed tibial nail].

An aiming technique for an unreamed tibial nail was developed, which uses the relatively constant distance between the first transverse distal nail hole and the anterior aspect of the tibia. This aiming device is set at a distance of 12.3 mm from the anterior cortex, and fine tuning is finally resolved by use of a "working channel" with a 10 mm diameter from the medial side. The aiming system was tested in 20 cases in a video-documented prospective study using the unreamed tibial nail (UTN, Synthes) between July 1993 and March 1995. In all cases (100%) distal locking could be performed without image intensification. With a high percentage (55%) of open fractures (3 O3B fractures) the total operation time was 108 min (median, range 60-180 min). The time for distal locking (always 3 bolts) was 15.5 min (median, range 8.0-39.0 min), while the time for proximal locking (average 1.6 +/- 0.7 bolts) was 4.5 min (median, range 3.0-15.0 min). There were no major intra- or postoperative complications related to the aiming system. The major advantages are that it is not necessary to have image intensification for distal locking, there is a reduction in radiation exposure for the surgeon, and the drill holes are very precise.

Adolescent↗
PubMed1998

[Importance of blade geometry for stability of fixation with short intramedullary nailing systems for the proximal end of the femur (gliding nail)].

Three biomechanical examinations of the double-T blade of the gliding nail were performed. Under alternating load, also after 100,000 cycles and 2000 N load, no instability occurred after gliding nail osteosynthesis. The best relationship between the introduction forces of the blade (1.771-1.329 N) and the extraction forces (1.474-477 N) was seen after glass pearl treatment of the blade surface. Displacement of the plate in a sow bone femor head after 1000 cycles at 1500 N was 1.0-4.00 mm for a double-T blade, but 4.0-8.0 mm for a 10 mm screw like the gamma-nail screw.

Aged↗
PubMed1992

Nail bed reconstruction with split-thickness nail bed grafts.

The results of reconstruction of chronic post-traumatic nail deformities are thought to be unpredictable. We have reviewed eight patients treated by split-thickness nail bed grafts for deformities arising from defects in the sterile matrix. Appearance, adherence and function were improved in all cases, with no significant morbidity of the donor area.

Esthetics↗