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Results for “Fracture Fixation, Intramedullary”

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PubMed2004

[Research on the expression of some immune markers after reamed and unreamed femoral nailing].

OBJECTIVE: To investigate on the expression of some cytokines and other immunity makers right after the operation, the effect of femoral nailing on systemic immunity and sought to differentiate any differences between reamed and unreamed IMN. METHODS: Fifty-nine patients presenting with acute femoral fractured including 55 male and 4 female, 32.1 years old on average, are divided into 2 group depend on ISS. All patients were treated by close reduction and intramedullary nail for fixation. In group 1, 23 reamed and 23 unreamed; in group 2, 7 reamed and 6 unreamed. Venous blood samples were taken at 24 hr pre-operationally, and 1 hr, 24 hr, 48 hr post operationally. Serum TNF, IL-6, IL-8, IL-10 were measured by enzyme-linked immunosorbent assay. CRP was measured by protein assay apparatus. We also collected venous samples from 22 healthy uninjured volunteers, which formed control group. RESULTS: All immune marks were elevated post operation, for IL-6, IL-8, IL-10, this elevation began at 1 hr after operation, reached to the peak at 24 hr, and then down but never to the normal at 48 hr. For TNF and CRP, the level were raised at 24 hr, and then fallen at 48 hr. All mediators were raised significantly above the control group (< 0.05). Between reamed and unreamed patients both in group 1 and group 2, Although there was a trend towards higher levels of TNF, IL-6, IL-8, IL-10 and CRP in RFN than in the URFN, no significant difference was found except that there was a greater release of serum IL-10 in RFN than in URFN at 24 hr post operation (P = 0.047). Two patients have become SIRS, but the markers have shown no significant difference with those that have no SIRS symptoms. CONCLUSIONS: To the patient not injured severely, using IMN for treatment will make the inflammatory mediators re-released on higher level than normal, which will be balanced by immunity itself soon, so IMN won't make any damage severely. And no significant difference were found between reamed and unreamed nail. But the changing of IL-10 show us that after IMN, especially the reamed nailing, the level of anti-inflammatory mediators will show the difference more apparently between RFN and URFN while the patient got injured more severely. Under this condition, the RFN will aggravate the restrain of immunity.

Adult↗
PubMed1994

[Results of treating fractures of the femur and tibia with closed intramedullary fixation].

The paper presents the technique and results of treatment of 450 fractures of the femur or tibia. Closed intramedullar fixation has been employed. There was no surgical approach to the fracture site. The intramedullar nail was inserted through small incision remote from the fracture. Flexible reamers were used to prepare the medullar cavity. X-ray intensifier was used to monitor the procedure. If the fracture was located outside the middle third the nail was interlocked. Fixation achieved was stable, no additional immobilization was needed. Mobilization was started at the first post-operative day. No wound infection or osteomyelitis occurred. Weight bearing was allowed after 2 months for 80 per cent of the patients. In all cases the union was achieved before the end of the third month.

Adult↗
PubMed1993

[Secondary management of tibial fractures with plate osteosynthesis--applications of an old, but reliable procedure].

During the time period from May 1990 through October 1992, a total of 70 tibia fractures were treated in the Department of Traumatology of the University of Bonn. 35 patients with 37 tibial fractures were treated according to a regimen including primary stabilization, usually in an external fixateur, soft tissue reconstruction and delayed open reduction and internal fixation using an AO-plate. A majority of the patients were involved in motor vehicle accidents leading to multiple injuries in 22 instances. An open fracture was seen 16 times. The complication rate of 19% is comparable to the reports following intramedullary stabilisation. Only one infection, following a grade 2 open fracture, was seen. Bony union was achieved after 15.7 weeks. Considering the complications associated with nailing such as fat or air embolism, heterotopic ossification and non- or malunions, the use of the tibial plate seems not only to offer logistic advantages but is a viable alternative for the delayed stabilization of tibial fractures.

Adult↗
PubMed1976

Küntscher intramedullary reaming and nail fixation for nonunion of the humerus.

Thirteen cases of nonunion of the humerus were treated by intramedullary reaming and nail fixation. Rigid stabilization which was usual after operating upon other long bones was not always secured in these cases, and supplementary plaster immobilization was necessary. Seven fractures healed and 3 fractures required re-nailing before healing. Three fractures did not heal in spite of reoperation, but in 2 of these cases the nail provided stability and controlled pain and motion at fracture site. Nonunion of the humerus is a difficult problem, irrespective of the method of treatment.

Adult↗
PubMed2004

Osteoporotic pertrochanteric hip fractures: management and current controversies.

The treatment of intertrochanteric hip fractures has evolved over the past 80 years because of a better understanding of fracture anatomy, application of biomechanical principles, and novel technologic advances. Surgical treatment of intertrochanteric hip fractures is the current standard of care, with short-term goals of fracture stabilization and early patient mobilization and the long-term objective of restoring patients to their previous level of independence and function. Treatment for stable intertrochanteric hip fractures includes use of percutaneous intramedullary devices and open reduction and internal fixation using a sliding hip screw. To date, none of these devices has shown any clear clinical advantage over the dynamic hip screw. Intramedullary fixation has multiple theoretical advantages for the treatment of unstable fracture patterns; however, it remains unclear if ultimate functional outcome warrants the added expense of such treatment. For patients with a reverse obliquity fracture pattern, the advantage of the intramedullary construct has been shown.

Aged↗