Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “NAILS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources
PubMed2005

The fixion proximal femur nailing system: biomechanical properties of the nail and a cadaveric study.

The treatment of choice for early mobilization of hip fracture is surgery, which traditionally employs side plates and screws or intramedullary nails. We examined the biomechanical properties of a new proximal femoral nail system. The new expandable Fixion proximal femur nailing (PFN) system, made of stainless-steel alloy, consists of a nail, a peg and an anti-rotation pin. Upon positioning, the nail and peg are expanded to their maximal diameter. The current biomechanical study investigated: nail bending strength and stiffness, fatigue properties and hip peg strength. A cadaveric study that determined the effect of the expandable peg on the femoral head included subsidence testing, pull and torsion testing and intra-osseous pressure (IOP) measurements before and after expansion. Biomechanical properties of the new nail met ASTM F384 guideline requirements. The cadaver study yielded equivalent results for the pullout test between the peg and the hip screw, but found the peg superior in the torsion strength test. IOP during peg insertion and expansion was substantially lower than the threshold pressure that causes avascular necrosis. The biomechanical tests found the new system to be safe and able to provide good abutment of the nail to the bone. We conclude that the Fixion PFN system proved to be an effective proximal femur fracture fixation device.

Alloys↗
PubMed2002

[Treatment of post-traumatic nail bed deformities with split-thickness nail bed grafts].

INTRODUCTION: Split-thickness nail bed graft have been proposed for treatment of post-traumatic nail bed dystrophies. Only three papers reported good results in 60 to 90% of cases. We report our experience. MATERIAL AND METHODS: We reviewed 18 cases of split-thickness nail bed grafts from operative and consultation files and photographs. Evaluation was made using criteria as the nail plate shape, its adhesion on the nail bed, patient satisfaction and possible sequelae on the donor finger. RESULTANTS: Thirteen patients have been reviewed with a sufficient follow-up to assess the results. In 13 cases, the graft was taken from the hallux. The nail-bed graft was used for hallux reconstruction two times, the thumb six times, index six times, middle and ring finger one each, and the little finger two times. In every patient the graft was molded using either the patient nail or the nail plate from the donor finger. Clinical results were excellent in five cases, good in three and poor in five cases. Five failures were due to wrong indications in three cases in which matrix problem has been underestimated, and infectious failures in two cases. Fifteen per cent of our patients had some sequelae on the donor finger.

Adolescent↗
PubMed1996

Ipsilateral fractures of the femur and tibia: treatment with retrograde femoral nailing and unreamed tibial nailing.

Between 1989 and 1995 a total of 47 patients with 50 fractures of the ipsilateral femoral and tibial shafts without significant articular involvement were treated at Tampa General Hospital. Within this group were 24 patients with 26 fractures who were treated with intramedullary fixation of both bones using a technique of retrograde insertion of a femoral nail and unreamed insertion of an interlocking tibial nail. Information concerning the injuries, treatments, and much of the follow-up was gleaned from a trauma registry. Five of the femoral fractures (19%) and 14 of the tibial fractures (54%) were open. Associated injuries were present in 18 of the 24 patients (75%) with injuries of the pelvis, other extremities, and head being most prevalent. The average Injury Severity Score was 14 (range 9-32). The femoral nails were placed either through the medial femoral condyle (n = 14) or the intercondylar notch of the distal femur (n = 12). Twenty patients with 22 extremities had sufficient follow-up at an average of 20 months (range 4-60) postinjury to be included in the review. One patient had died, and three were completely lost to follow-up. Both fractures in 14 extremities had healed or were healing uneventfully at final review. Seven of the tibiae and three of the femora had complications after initial hospitalization. Two patients developed problems in both bones. Three patients had electrical stimulation of a tibia fracture, one of which underwent simultaneous nail dynamization. A total of 18 additional operative procedures were necessary after the primary treatment in six problematic extremities. Thirteen additional operative procedures were required in five complicated tibiae (one nail dynamization, six debridement procedures, five bone grafts, and one muscle flap) after the initial hospitalization. Five additional operative procedures were required in the three complicated femora (two nail dynamizations, one bone graft, and two exchange nailing procedures). Functional results were good or excellent in 13 of the 20 patients (65%) and 15 of the 22 extremities (68%) available at final review. No significant knee problem related to the femoral nailing technique was identified. This method of treatment can be performed using a standard radiolucent table and a single medial parapatellar incision. It is expedient and allows other procedures to be performed simultaneously in this group of severely injured patients.

Adolescent↗
PubMed1990

Nail abrasion: a new treatment for ingrown toe-nails.

A simple new method for the treatment of ingrown toe-nails was devised and applied to 33 toe-nails in 22 patients. The entire nail surface, except for the margin, was abraded until the nail became flexible with a Schreu's skin grinder equipped with a steel bar. When there was infection or granulation of the nail wall, the imbedded nail corner was trimmed before abrasion. The patients underwent additional treatments when one treatment was not enough to achieve cure or when discomfort appeared, which was the first symptom of recurrence. The average number and duration of treatments was 2.9 times and 16 months, respectively. Relief from pain occurred in all patients soon after abrasion was performed. Recurrence of infection and granulation was observed in only one patient. Five patients (23%) remained problem-free for more than one year without any additional treatment, because their incurved nail was gradually improved in shape by repetition of this procedure. This therapy was particularly effective in patients with severely incurved nails.

Adult↗
PubMed1992

The use of a combination nail elevator and hemostat clamp. New instruments for nail avulsion.

Nail avulsion surgery is frequently accomplished using a hemostat clamp with or without a nail elevator device. Two new instruments have been developed that combine the useful design specifications of the hemostat clamp with the nail elevator device. Specifically, one blade of the hemostat is replaced with either a nail elevator spatula or a Freer septum elevator allowing nail elevation, clamping, and removal with a single instrument. Use of either device is more efficient because nail avulsion is completed using a single instrument thereby reducing procedural steps and handling and sterilization costs. Furthermore, these instruments may reduce the risk of trauma to the nail bed and matrix during nail avulsion. The instruments and their use are described.

Humans↗
PubMed2000

Comparison of ender nails, dynamic hip screws, and Gamma nails in the treatment of peritrochanteric femoral fractures.

Three hundred seventy-six patients with peritrochanteric fractures treated over a 10-year period were reviewed. In 85 patients treated with Ender nailing, the most frequent complications were leg shortening (34), external rotation failure (21), and postoperative distal gliding of the nails (7). In 183 patients treated with dynamic hip screws or a 95 degree condylar or a 130 degree blade plate, 3 presented with infection, 5 with instability, and 4 with femoral head necrosis. In 105 patients treated with Gamma nailing, the most serious complications were infections (3), inward rotation failure (2), postoperative bleeding at the insertion site (2), and shaft fracture (1). Because of its inherent instability, Ender nailing is no longer used. The implantation technique for the dynamic hip screw is safer and simpler than the various models of the ASIF blade plate. However, the dynamic hip screw has been superseded by the Gamma nail because of its absolute stability. In the beginning, Gamma nailing was technically more demanding with a higher number of intraoperative complications. In this study, the number of malalignments did not differ significantly between the dynamic hip screw (14) and the Gamma nail (11), but was high with Ender nailing (56).

Activities of Daily Living↗
PubMed1999

[Elastic intramedullary nailing of the tibia with the Marchetti-Vicenzi nail. 43 treated cases].

PURPOSE OF THE STUDY: The purpose of this study was to analyse the results of tibial intramedullary nailing using an unreamed "Universal Elastic Bundle Nail". MATERIAL AND METHODS: Forty-three intramedullary nailing of tibial shaft were done in 43 patients with recents fractures, from May 1993 and May 1996. There were 36 males and 7 females. The average age was 31.5 years (range 17-68 years). Thirty-three were injured in a traffic accident (20 motorcycles, 5 pedestrians and 8 car passengers), seven were injured in a home accident (fall) and three had a sport injury. There were 13 open fractures according to Gustilo: 5 grade I, 7 grade II and one grade III B. Eight fractures involved the proximal metaphyseal part of the tibia, 16 the distal metaphyseal part and 14 the tibial shaft; in five cases there were segmental fractures. According to AO classification there were: 10 fractures type A, 24 fractures type B and 9 fractures type C (5 segmental fractures). In 5 cases there were associated femoral fractures: three ipsilaterals and two controlaterals. All were treated in the same time: four by UEBN device and one by AO's nail. All the patients with type B and C fractures were positioned on a Maquet table with a boot traction or transcalcaneal pin traction (in the distal fractures). The nail was introduced after closed reduction through a vertical transpatellar tendon incision, without reaming procedure. RESULTS: Forty one fractures healed after an average time of 96 days (60-120). In 11 open fractures bone union occurred after 98 days (85-120). The distal fractures healed after a mean time of 86 days (60-120), proximal fractures in 123 days and mid shaft fractures in 98 days. In type A fractures bone union occurred after an average time of 68 days, while bone union occurred after a mean time of 100 days in type B and C fractures. Two patients with an open proximal type B fracture, had a delayed union: both healed after proximal screws removal. Two fractures healed with a valgus angulaton 5 degrees and 10 degrees. No infection, no loss of reduction and no bundle migration has been noted. DISCUSSION: The Marchetti-Vicenzi's nail (UEBN) permitted a stable fixation in tibial fractures. The use of this unreamed nailing coupled with an automatic distal locking in the metaphyseal cancellous bone, reduced operative time and shortened X Ray's radiation exposure. At the follow-up fracture healing occurred in 41 cases 95.3 p. 100 at four months. Two delayed union occurred after four months, the two cases were open fractures grade II. All the two cases healed after secondary procedure without any loss of function. Malunion occurred in two patients (in only one case there was a major valgus angulation 10 degrees), the two cases were related to technical error. We had no cases of infection or leg shortening or bundle migration in the ankle joint. CONCLUSION: We believe that Universal Elastic Bundle Nail allows a stable and safety fixation in open or closed tibial fractures without pseudarthrosis and without infection (in our series).

Accidents↗
PubMed2002

[A new locking nail for proximal humerus fractures: the Telegraph nail, technique and preliminary results].

We present a new nail, the telegraph nail, designed for the treatment of proximal fractures of the humerus. This nail has a new locking system providing a self-stabilization of the cancelous screws inserted in small fragments. We discuss the surgical technique and present preliminary results. The anterolateral approach and nail insertion through the medial and well vascularized part of the cuff is described for simple fractures. With the cup and ball technique, this nail can also be used for complex fractures of the proximal humerus with three or four fragments and major displacement. With this method, the nail is inserted before reduction and locked in the distal humerus before fixation of the head and tuberosities around the head once the targeting device removed. We report results for the first 64 nails inserted in our unit during the first year (1998-1999). Outcome was assessed at 11 months mean follow-up using the Constant score. Outcome was favorable, including in patients with complex fractures involving 3 or 4 separate displaced fragments. Besides providing an anatomically stable reconstruction, the telegraph nail has the advantage of allowing early mobilization of the shoulder joint. This method is a useful alternative to prosthetic reconstruction for traumatic fractures of the proximal humerus.

Adolescent↗
PubMed1992

[A new intramedullary nailing system for long bone fractures--biomechanical evaluation and animal study of a new intramedullary nail].

Interlocking intramedullary nails have expanded their application to the fixation of long bones especially for unstable or comminuted fractures. However, there are certain drawbacks in this method: prolongation of operative time and increased radiation hazard to the patient as well as to the surgical staff, the latter of which is especially a problem in the distal interlocking under fluoroscopic control. In order to solve the problem a new intramedullary nail (J-type) was developed and tested in vitro with Hiprox femur models as well as in vivo using canine models. The nail made of Ti-6Al-4V alloy is composed of an inner nail and an outer cylinder. The proximal portion is transversely fixed with two screws, while the distal portion is fixed into the cancellous bone with four expandable blades. The strength of fixation with this nail was compared to those with four other commercially available interlocking nails as to bending, tortional and compression stiffness as well as to the durability against repeated compression. In the present in vitro and in vivo experiments, a newly developed intramedullary nail (J-type) provides evidence for satisfactory mechanical strength. The use of J-type nail also contributes to shorter operative time and reduction of radiation hazard.

Animals↗
PubMed1990

Twenty-nail dystrophy. A clinical manifestation of spongiotic inflammation of the nail matrix.

Twenty-nail dystrophy is a distinctive pattern of nail changes, in which all 20 nails are uniformly affected with excessive longitudinal ridging and loss of luster. Because of the rarity of this disorder, and controversy surrounding its cause and pathogenesis, we share our experience with five patients whose clinical diagnoses were consistent with 20-nail dystrophy. Histologically, all patients showed distinctive changes of spongiotic inflammation of the nail matrix. The cause and pathogenesis of these changes are still unknown. We suggest the concept that they represent a subgroup of endogenous eczema with a predilection for the nail matrix. A second, and less likely, hypothesis is that these lesions represent an autoimmunologic response to the nail matrix.

Adolescent↗
PubMed2004

Modulation of linear nail growth to treat diseases of the nail.

Diseases affecting the nail can cause significant distress and interfere with an individual's self-esteem, personal relationships, and professional life. Often, hand and foot function is adversely affected. Certain diseases are characterized by accelerated nail growth while others show a decrease. In this review, drugs known to influence the growth rate of nails are examined, highlighting their potential use as adjunctive therapy in the treatment of nail disease. This approach, described recently in the context of the yellow nail syndrome,(1) may be extended to other common disorders such as nail psoriasis, brittle nails, and onychomycosis.

Humans↗
PubMed1994

Acquired nail beading in patients receiving itraconazole--an indicator of faster nail growth? A study using optical profilometry.

Nail surfaces of toe-nail fragments were analysed by optical profilometry in patients treated with two different dosages of itraconazole: 200 mg continuous dosing for 12 weeks, or a pulse-dose regimen of 1 week per month of 400 mg itraconazole daily for 3-4 months. The use of the latter regimen seemed clinically to increase nail growth, which was accompanied in several patients by the occurrence of nail surface irregularities. This aspect was studied by computerized optical profilometry. Nail beading was characterized by a higher number of peaks and a larger mean roughness value (Ra). Such findings are reminiscent of other nail alterations resulting from a faster matrix turnover. A substantially greater number of peaks and larger Ra were found in the patients receiving the pulse treatment than in those receiving the continuous-dose regimen. Pulse therapy with itraconazole therefore appears to modify the structure of the nail plate, probably as a result of, or in association with, an increased rate of growth.

Dose-Response Relationship, Drug↗
PubMed1995

Incurvated nail. Does the phalanx determine nail plate shape?

This study examines the relationship between the shape of the nail plate of the hallux and the base of its distal phalanx. Twenty-three cadaver specimens were examined anatomically for nine variables. These variables represented the following: height and width of the distal phalanx base; height and width of the proximal aspect of the nail plate; distal shape of the nail plate; ratio of the nail plate height and width and structural index of the nail plate. Statistics for the variables are presented using correlation coefficients between nail structural index and bone structural index. The study shows a high and significant correlation between the shape of the proximal aspect of the nail plate and that of the phalangeal base.

Hallux↗
PubMed1998

[Treatment of humeral shaft fracture with intramedullary procedures (Seidel nail, Marchetti-Vicenzi nail, Prevot pins)].

Humeral shaft fractures can be treated either conservatively or operatively. Plating of the humerus is the established operative method, but recently interest has also been focussed on intramedullary nailing. Fifty-nine cases of humeral fractures treated with intramedullary nailing (Seidel/Marchetti-Vicenzi/Prévot) from January 1991 to December 1995 (44 fractures after trauma, 11 pathological fractures, 3 pseudarthroses, 1 re-fracture). Closed reduction in 55/59 cases. One infection (soft tissue); 2/48 pseudarthrosis (indication for nailing: pseudarthrosis!). No iatrogenic palsy of the radial nerve. Functional postoperative treatment in all 44 cases of humeral fractures after adequate trauma. One poor functional result: periarticular ossification after retrograde nailing, possibly connected with long-term respiratory treatment after trauma. Treatment of humeral shaft fractures by intramedullary nailing is favoured in our clinic (low complication rates, excellent or good functional results, limited approaches, small scars). Proximal fractures should be treated by the Seidel nail (stable interlocking of the proximal fragment); very distal fractures need Prévot nailing (reaming of condylar canals). All other fractures of the humeral shaft can be treated by each of the implants used in our clinic. Pathological fractures are an excellent indication for intramedullary stabilization. These patients benefit from stable fixation without intense surgical trauma. Pseudarthrosis, according to our limited experience, seems to require plating plus bone grafting. Plating is also recommended if revision of the radial nerve becomes necessary.

Adolescent↗
PubMed2001

Intramedullary nailing in humeral shaft fractures. Mechanical behavior in vitro after osteosynthesis with three different intramedullary nails.

The aim of this in vitro study was to compare the mechanical behavior of fixation by the Russell-Taylor nail with the more recent Polarus nail. Fixation with an experimental nail made from polyacetal polymer was also included in the study. Thirty humeri were fractured and randomized to receive one of the three nail types. A four-point nondestructive bending test was performed, as well as torsional testing to failure. The torsional test was designed to record the amount of 'play' (uncontrolled rotation) in the bone/implant construct. The Polarus nail gave higher rigidity of the nail/bone construct than the two other types. The Russell-Taylor nailing exhibited a high degree of 'play' (uncontrolled rotation). The polyacetal nails allowed a large elastic deformation before failure.

Biomechanical Phenomena↗
PubMed1989

External fixation of injured nail bed with the INRO surgical nail splint.

The use of the nail as a splint is desirable in the management of acute nail bed injuries. However, when the nail plate is destroyed and during secondary reconstruction of the nail bed, the nail is not available for use as a splint. Several substitutes, notably silicone sheet have been used, but without much success. The INRO surgical nail, with qualities similar to the nail splint was developed for use as a substitute. During the period of study from 1983 to 1985, 89% of patients had good results.

Adolescent↗
PubMed2006

Nail diseases related to nail cosmetics.

The use of nail care products and procedures to beautify and groom the nails is extremely common. Unfortunately, when improperly used, nail cosmetics can lead to nail diseases, such as paronychia, onycholysis, and brittle nails. Understanding the pathophysiology behind these conditions is an essential step toward better treatment and future prevention allowing patients to enjoy nail adornments while maintaining healthy nails.

Cosmetics↗
PubMed2003

Distal replantation, nail bed, and nail problems in musicians.

Nails enhance pulp sensibility, increase pulp stability and are necessary for fine prehension. A finger without a nail will compromise a musician's career if the finger involved is necessary to play a note (strings, keyboards) or hold a position (winds). Salvage of the nail is then a very important part of any surgical procedure in musicians with distal finger trauma. Surgical techniques will depend on the level and type of nail injury. Replantation is by far the best technique in distal finger amputation but, when not feasible, reposition-flap repair may be used. In isolated nail lesions, sutures, split-thickness nail bed graft, or nail matrix flaps are used according to the level and severity of the lesion.

Finger Injuries↗