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Results for “Fracture Fixation, Intramedullary”

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PubMed2003

[Ipsilateral femoral fracture and anterior hip dislocation in a 15-year-old girl: case report].

Operative management of concomitant ipsilateral femur fracture and anterior hip dislocation has not been previously described in the literature. We report the case of a 15-years-old girl who was injured in a motorcycle accident and presented with a femoral shaft fracture and a concomitant ipsilateral anterior hip dislocation. Operative management consisted of an attempted closed reduction of the femoral fracture, which was unsuccessful; thus, an external fixator was temporarily applied. Subsequently, the hip dislocation was treated by open reduction through an anterolateral approach. Finally, the femoral fracture was securely stabilized using an unreamed femoral intramedullary nail. The postoperative course was uneventful. MRI follow-up after 6 weeks did not reveal any sign of mangled vascularization of the femoral head and radiographs demonstrated normal bony healing of the shaft fracture. Due to the fact that there is no definitive surgical strategy for this rare combination of injuries, concomitant ipsilateral femoral fracture and anterior hip dislocation is an interesting and challenging situation for the trauma surgeon which requires a subtle and exact surgical technique in order to achieve satisfying results.

Aged↗
PubMed2003

[Metal removal after osteosyntheses. Indications and risks].

This paper presents guidelines for indications, risks, and technical aspects of removal of metal works. The indications comprise the general condition of patient, age, location of the implant, risks and disadvantages of the procedure. Problems concerning removal of metal are for example: lesions to nerves and re-fracture. Problems concerning maintaining the implant are for example: a compromise concerning necessary diagnostic procedures and late infections. In order to aid the decision making process two distinct groups of indications were applied. First, the definite indications, as for example disturbing implants as well as implants in the growing individual. Second, debatable indications, as for example removing screws from the femoral head, or implant-tissue-interactions. The issue of obtaining the consent of a patient to an operation, often not an operation for novice, may not be neglected. Lesions to nerves are amongst the most common complications. The technical guidelines refer to the specific locations and to the problem of broken intramedullary nails.

Aged↗
PubMed2004

[First clinical experience with nonreamed intramedullary nailing in Lithuania].

Long bone diaphyseal fractures are very common. Limited choice of implants for treatment of these fractures in Lithuania often leads to unsatisfactory treatment results and complications. Unreamed intramedullary nailing is relatively simple and effective method for treatment of severely injured patients. Using this method early stabilization and rehabilitation, decreased number of complications, and shortened stay in hospital can be ensured. Indications, technique and early results of first fifty intramedullary fixations with unreamed nails performed in the Clinic of Orthopedics and Traumatology, Kaunas University of Medicine are presented.

Adolescent↗
PubMed1988

Treatment of open tibial-shaft fractures. External fixation and secondary intramedullary nailing.

Between 1979 and 1986, sixteen of 369 open fractures of the tibial shaft were treated by external fixation followed by intramedullary nailing. These fractures comprised one Type-I, two Type-II, and thirteen Type-III injuries. This method of treatment was the original treatment plan in nine patients (56 per cent), for delayed union while the external fixator was still in place in four patients (25 per cent), for loss of reduction in a plaster cast in two patients (13 per cent), and for osteomyelitis and a segmental defect in one patient (6 per cent). The average duration of external fixation was 8.5 weeks; the average time between removal of the external fixator and intramedullary nailing, three weeks; and the average time between injury and nailing, twelve weeks. All sixteen patients were followed until either the fracture had united (eleven patients) or there was an established non-union (five patients). At that time, seventeen additional procedures were performed, including bone-grafting, fibulectomy, and re-nailing. Only five of the sixteen fractures healed without additional surgical procedures or major complications. The five fractures that progressed to a non-union were all Type III, and all were complicated by a deep infection. Over-all, the complications included seven deep infections (an intramedullary infection in four patients, osteomyelitis in two, and a chronic draining sinus associated with a ring sequestrum in one); five minor infections during external fixation, which developed into five of the seven deep infections that occurred after the secondary intramedullary nailing; and eight non-unions, three of which progressed to union after multiple procedures. The over-all incidence of non-union was 50 per cent and that of deep infection, 44 per cent. On the basis of the high incidence of complications in both the present series and the few reports in the literature, we concluded that alternative treatment options should be carefully considered before electing this sequential method of fixation.

Adolescent↗
PubMed1987

Compartment syndrome of the thigh complicating surgical treatment of ipsilateral femur and ankle fractures.

A 26-year-old man presented with ipsilateral femur and ankle fractures. The patient was treated with interlocking nail of his femur fracture, followed by open reduction and internal fixation of his ankle fracture under tourniquet control. Postoperatively, the patient developed compartment syndrome of his thigh with elevated pressures, requiring decompressive fasciotomies. This case illustrates the possible complication of treating a femur fracture with intramedullary nailing and then immediately applying a tourniquet to treat an ipsilateral extremity fracture. Because of the complication with this patient, we feel the procedure should be staged, or a tourniquet should be avoided if possible.

Adult↗
PubMed1996

Stabilization of ulnar carpometacarpal dislocations or fracture dislocations.

For the management of ulnar carpometacarpal dislocations or fracture dislocations, various authors have suggested closed reduction and percutaneous pin fixation, or open reduction and internal fixation with the use of transversely oriented pins. The methods can be problematic with failure of fixation or injury to tendons or nerves. A stable internal fixation alternative uses intramedullary metacarpal Steinmann pins or Kirschner wires, passed across the carpometacarpal joint into the hamate. If the fixation devices exit through the triquetrum and the lunate, then the finger metacarpal phalangeal joints may be left with full active motion. This method has provided ease of placement, stability, and no loss of fixation in 9 cases. An associated coronal fracture of the hamate may be fixed with small Kirschner wires or with a small lag screw, which can be placed through the same incision.

Adolescent↗