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Results for “Fracture Fixation, Intramedullary”

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At least 613 records · Page 34Linked to original sources
PubMed1997

[Treatment of pathological fractures caused by metastatic bone cancer].

The diagnosis of metastatic bone cancer is usually easy but in some cases the metastatic lesion is found before primary lesion is diagnosed. In such cases, the diagnosis is essential before treatment is begun. For these cases, bone scintigraphy and MRI are useful. Since curative treatment for metastatic bone cancer is impossible in most cases, it is important to decide the purpose of the treatment before starting. The aims are elongation of the life, decrease of pain, recovery from paralysis, attainment of stability, treatment and prophylaxis of the pathological fracture, and improvement of QOL. As for treatment of the pathological compression fracture of the spine combined with paralysis, the decompression operation should be done as early as possible, because at 48 hours after the paralysis is completed, recovery can not be expected even if complete decompression is performed. The decompression operation is performed with complete resection of the affected vertebrae anteriorly and then by rigid fixation with instrumentation posteriorly. As for the treatment of the pathological fracture of the extremities, in most cases operative treatments are indicated. Most pathological fractures of the extremities occur in the femur and humerus. In case of a proximal femur and humerus, wide excision of the tumor combined with the affected bone is performed, and the defect is then replaced with the prosthesis. When the shaft of the bone is affected, segmental resection of the bone is done in most cases and the defect is then replaced with ceramics and bone cement and fixed with intramedullary nails.

Bone Cements↗
PubMedDate not supplied

Surgical management of diaphyseal humeral nonunion after intramedullary nailing: Wave-plate fixation and autologous bone grafting without nail removal.

Six patients with a nonunion of the humeral diaphysis after intramedullary nailing were treated with a wave plate and autologous bone graft but without removal of the intramedullary implant. The mean duration of the nonunion was 19 months (range, 6-36 months). At a mean follow-up of 12 months (range, 6-18 months), all six nonunions had healed, and patient satisfaction was high. Five patients had regained full shoulder function. One patient, who was treated for a rotator cuff tear before the humeral fracture, had a satisfactory functional outcome. Elbow motion was full in all but one patient. One patient had a postoperative radial nerve palsy, which recovered partially but did not require further surgery. This report suggests that healing of humeral nonunions can be achieved in the presence of intramedullary hardware.

Adult↗
PubMed2005

Flexible intramedullary nailing of displaced diaphyseal forearm fractures in children.

INTRODUCTION: This study analyses the results of 50 displaced diaphyseal forearm fractures in children treated with flexible intramedullary nailing. METHODS: Between 1999 and 2002 we treated 50 children aged between 5 and 15 years, with diaphyseal fractures of the forearm using Flexible intramedullary nailing (FIN). Both bones were fractures in 45 patients, radius only in 4 and ulna only in 1. The indications for fixation were instability (26), re-displacement (20), and open fractures (4). RESULTS: 24 patients were reduced closed, followed by nailing, while 26 fractures required open reduction of either one bone(16 cases) or both bones(10 cases) prior to nailing. Bony union of all fractures was achieved by an average of 7 weeks (range 6 weeks to 4 months) with one delayed union. Pronation was restricted by an average of 20 degrees in 9 patients. Two patients developed post operative compartment syndrome requiring fasciotomy. Three patients were lost to follow-up. INTERPRETATION: FIN led to early bony union with acceptable bony alignment in all 47 patients available at final follow-up. We therefore recommend FIN for the treatment of unstable diaphyseal forearm fractures in children.

Adolescent↗
PubMed1996

[Role of intramedullary nailing in pseudarthrosis and malalignment].

Intramedullary stabilization can provide fast bone consolidation in cases of delayed fracture healing and hypertrophic non-unions. The indication for intramedullary nailing must be exactly adapted to the individual situation. An analysis of our own cases revealed bony healing in hypertrophic non-unions of femoral shaft fractures in 93% and in 94% of tibial shaft fractures after reamed intramedullary nailing. In selected cases of axial or rotational deformities or length discrepancy of the femur and the tibia, a correction osteotomy can be performed with intramedullary nailing. If it is necessary to expose the non-union and in axial or rotational deformities a rotation-stabilizing plate can be applied in addition to the intramedullary nail.

Adult↗
PubMed1977

Management of open fractures of the tibial shaft.

In a retrospective study of 98 open fractures of the tibial shaft, the end result was found to be most closely correlated with the severity of the initial injury. Comparison of six different forms of treatment (external immobilization, external immobilization with early weight bearing, pins and plaster immobilization, intramedullary fixation, multiple screw fixation and plate and screw fixation) did not indicate a superiority of any one method of management.

Accidents, Traffic↗
PubMed2000

Treatment of nonunion around the olecranon fossa of the humerus by intramedullary locked nailing.

Nonunion of fractures of the olecranon fossa of the humerus presents a difficult surgical problem. The distal fragment is usually small and osteoporotic and stable fixation is not easy to achieve. We describe a modification of the technique of locked nailing by which the distal aspect of the nail is placed in the subchondral region of the trochlea. Good results were obtained in seven out of eight patients with this technique.

Adult↗
PubMed1996

Skeletal fixation of grade IIIB tibial fractures. The potential of metaanalysis.

Contemporary management of Grade IIIB open tibial fractures has evolved to include intravenous antibiotics, thorough interval surgical debridement, rigid skeletal fixation, early local or free tissue myoplasty, and liberal use of autogenous bone graft beneath a clean, stable wound. External fixation has been the skeletal stabilization of choice with the lowest reported deep sepsis rates. Pin tract infection, malunion, and nonunion have complicated its use. Static unreamed locked nailing is an alternative treatment that has been successfully used in lower grade open tibial fractures. A metaanalysis of the literature was undertaken to determine whether there was evidence favoring 1 method of skeletal fixation. Inclusion criteria were restricted to studies that were randomized to either external fixation or unreamed intramedullary nail methods and that used a strict definition of Grade IIIB to include muscle transfer for soft tissue coverage. Two studies were identified and combined to show no difference in deep sepsis rate. Intramedullary nailing significantly shortened union time whereas external fixation showed a trend toward a higher incidence of malunion and superficial sepsis. More well designed randomized studies would add to this initial effort and yield more compelling evidence for either form of fixation.

Adolescent↗