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Results for “Fracture Fixation, Intramedullary”

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At least 793 records · Page 44Linked to original sources
PubMed1997

Heterotopic ossification: a comparison between reamed and unreamed femoral nailing.

Heterotopic ossification in the abductor region of the hip following reamed intramedullary femoral nailing has an incidence as high as 68 per cent. A definitive triggering factor for heterotopic ossification remains obscure, but it has been suggested that there may be both local and systemic influences. Previous work has only been able to show a statistical correlation with systemic factors. Sixty antegrade femoral nailings were performed in 58 patients, of which 32 were unreamed. There was no significant difference between the two groups for systemic risk factors known to have statistical correlation with the formation of heterotopic bone. The incidence of heterotopic ossification in the reamed nail group was 35.7 per cent and 9.4 per cent in the unreamed nail group (P = 0.01). The difference in the incidence of heterotopic bone formation seems to be due to local factors, in particular the generation of osteogenic reaming debris, which are important in the pathophysiology of heterotopic ossification seen in femoral intramedullary nailing.

Adolescent↗
PubMed1994

Midshaft clavicle nonunions treated with intramedullary Steinman pin fixation and onlay bone graft.

The current literature tends to favor rigid internal fixation with plates for symptomatic midclavicular nonunions. From 1985 to 1992, 14 patients with clavicular nonunions were treated by open reduction and intramedullary Steinman pin fixation with onlay iliac crest bone grafting. The average age of patients was 36 years (range 18-62). The majority of nonunions occurred after high-energy injuries to the clavicle. Three patients had failed previous plating and one initial fracture was pathological through irradiated bone. At an average follow-up of 4 years, all nonunions healed uneventfully and all were satisfied with the result of surgery. There were no infections or pin migrations. All hardware was removed at an average of 12.7 weeks (7-24 weeks). The most significant complications were two refractures occurring through osteopenic bone. We have found this technique to be as effective as plating procedures, yet it maintains the great advantage of ease of hardware removal. It allows early motion and has been useful in those whose previous plating procedures have failed.

Adolescent↗
PubMed1997

Fracture on removal of the ACE tibial nail.

We report four patients who sustained secondary fractures of the posterior wall of the tibial shaft during the removal of one pattern of intramedullary nail after fracture healing. The cause of this complication is discussed.

Adolescent↗
PubMed2004

[Intramedullary osteosynthesis of the ulna in revision surgery].

The exact and adequate management of diaphyesal fractures of the forearm is necessary to ensure forearm motion. Unsatisfactory treatment can lead to loss of function and disability of forearm and hand movement, resulting in severe patient morbidity. Since the rotational and angulatory stresses at the fracture site are the superior factors which influence the outcome of the forearm fracture healing after surgical treatment, the implants must fulfill some general prerequisites including high biomechanical stability, less invasive surgical approach and adequate biological features. However, less clinical studies are known for cases of complicated ulnar fractures when additional revision surgery is necessary to restore form and function. Thus, the choice of implant in such difficult situations requires a profound knowledge and experience. In a series of seven clinical cases we report about the successful use of the ForeSight-nail in revision surgery of complicated ulnar fractures. The series include cases with refractures after plate removal, in-situ plate brokerage and a critical size bone non-union which were treated with interlocking intramedullary osteosynthesis technique.

Adult↗
PubMedDate not supplied

[Intramedullary bundle nailing for stabilization of pathologic humerus fractures in malignant tumors].

Pathological fractures of the humerus are mostly due to skeletal metastases or to malignant bone tumours. In most of the cases fracture stabilization as a palliative measurement is the only possible therapy. Our own collective during 1980 through 1987 includes 77 pathological fractures of the long bones, 23 of them located in the humerus. In eight of 15 fractures of the humeral shaft intramedullary nailing was performed, in two cases bone cement was used in addition.

Bone Neoplasms↗
PubMed2002

Retrograde intramedullary nailing of supracondylar femoral fractures: design and development of a new implant.

Since 1992 we have developed an implant in which the distal (condylar) screws have a diagonal configuration so that the screws can be closer to the distal end of the nail, allowing more distal fractures to be fixed. It also utilises the denser bone of the posterior condyles for more secure fixation in osteoporotic patients. The new implant was used for 24 extra-articular fractures from September 1994 to September 1997, and for 14 articular fractures from February 1995 to December 2000. There was no significant difficulty with obtaining fixation in very distal fractures and in osteoporotic bone. Early weightbearing was encouraged in those with extra-articular fractures. All fractures united within 3 months except one which required a bone graft (but no revision of implant) at 6 months. Average knee flexion at final followup was 101 degrees for extra-articular fractures and 106 degrees for articular fractures. Complications included quadriceps adhesions requiring further surgery in two patients who had open fractures, and malunion in one patient who had an early design of the implant and a 4.5mm condylar screw broke. Nine patients required late removal of condylar screws due to local soft tissue irritation.

Adult↗
PubMed1981

The treatment of unstable fractures of the tibia and fibula with flexible medullary wires. A review of two hundred and thirty-five fractures.

A retrospective study was done of the treatment of closed and open unstable fractures of the tibia and fibula with flexible intramedullary wires in 223 patients with 235 fractures. The surgical procedure is relatively atraumatic to the tibia, can be learned easily by the surgeon, and does not require complicated or expensive instrumentation. The flexible intramedullary wires permit stabilization of the fractures in a functional position. External support by a long cast in the initial phase of treatment is necessary, but full weight-bearing is usually allowed during the third to fourth week. This has proved to be a beneficial method of treatment for bilateral fracture of the tibia and fibula and for combined femoral and ipsilateral tibiofibular fractures. Of the 235 fractures, fifty-seven (24.3 per cent) were closed and 178 (75.7 per cent) were open. Primary healing of soft tissue and bone occurred in fifty-three (92.9 per cent) of the closed fractures and in 117 (65.7 per cent) of the open fractures. The complication rate in closed fractures was 7.1 per cent, primarily due to delayed bone union. There was a 34.3 per cent complication rate in the open fractures, of which thirty-one (17.4 per cent) showed delayed soft-tissue healing, ten (5.6 per cent) had delayed bone union, and eight (4.4 per cent) resulted in deep infection with osteomyelitis. There were eight non-unions in the open, uninfected fractures, five of which healed after bone-grafting. Flexible intramedullary wiring of the tibia should be considered as an alternate method of treatment in the presence of an unstable fracture.

Adolescent↗
PubMed1998

Tissue perfusion after intramedullary nailing of tibial shaft fracture.

BACKGROUNDS AND AIMS: To measure noninvasively the effect of circulative changes caused by fracture and intramedullary nailing on tibialis posterior (TPA), dorsalis pedis (DPA) and sum (TPA + DPA) arterial peak signals, transcutaneous oxygen tension (PtcO2) as well as local skin temperature (T) in patients with tibial shaft fractures. PATIENTS, MATERIAL AND METHODS: A total of thirty tibias consisting of ten closed, reamed, intramedullary nailed simple tibial shaft fractures (Type AO A), ten contralateral tibias and as controls, ten intact tibias of healthy volunteers. The measurements took place one day before and immediately after nailing, six hours later and during five days postoperatively. The values were compared to those of contralateral legs and to control legs. RESULTS: In the nailed legs the mean TPA and PtcO2 remained at a significantly lower level compared to the contralateral legs throughout the study (p < 0.003 in both cases). However, the alterations in DPA and TPA + DPA were not statistically significant. Additionally, skin temperature on the fracture site was averagely 3 degrees C warmer than that of the contralaterals (p < 0.001). All the measured parameters were statistically significantly higher in control legs compared to contralateral legs. There were no statistically significant differences between pre- and postoperative values in any measured parameters. CONCLUSION: The changes in the local tissue perfusion variables measured in the present study reflect rather the injury mechanism itself than the effect of reaming and intramedullary nailing in simple tibial fractures. Additionally, arterial circulation was reduced in the contralateral legs.

Adult↗
PubMed2000

Development of small diameter intramedullary nails made from ISO 5832-9 stainless steel.

BACKGROUND: In order to improve strength in small diameter intramedullary nails, a system was designed in which the implants were manufactured from 30% coldworked ISO 5832-9 stainless steel. METHODS: Nail diameters were 9 and 10 mm for the femur, and 8 and 9 mm for the tibia. The nails were solid rods and the screws were partially threaded. Pre-clinical bending yield tests established that the 8-, 9- and 10-mm diameter rods had strengths comparable, respectively, with 10-, 12- and 14-mm diameter Grosse-Kempf nails. Forty-eight femoral and 98 tibial shaft acute fractures were treated with this system. Postoperatively, patients were allowed to gently bear weight as tolerated. RESULTS: There was one broken nail, occurring 10 months after femoral nailing. There were six broken screws, occurring between 3 and 6 months postoperatively in two patients and after more than 6 months in four patients. The broken screws had no adverse clinical effect. Five patients required late bone grafting or exchange nailing, and 15 patients required dynamization. CONCLUSION: This design of small diameter locked intramedullary nails was strong enough to allow early weightbearing.

Adolescent↗
PubMed2007

Endoscopic controlled intramedullary fracture reduction. A case report about closed fracture reduction under visual control.

Intramedullary bone endoscopy (IBE) was introduced as a new endoscopic technique in the year 2002 to achieve and manipulate the medullary canal of long bone under direct visual control. We report on a patient with a proximal femur fracture, where the new technique of IBE was used for intramedullary fracture reduction under visual control for the first time. Thus, the intraoperative use of an image intensifier was reduced.

Endoscopes↗
PubMed1993

Intramedullary nailing of femoral shaft fractures in adolescents.

Twenty-two femoral shaft fractures in 20 patients aged 10-14 years with open physes treated with closed reamed intramedullary nailing were studied retrospectively. Follow-up averaged 26.7 months in 18 of 20 patients. Eleven additional patients with 11 femoral shaft fractures treated with casting and traction were included for comparison of hospitalization time, cost, and time to mobilization. All of the fractures treated with an intramedullary nail healed without malunion or leg length inequality, and there was no evidence of growth plate arrest. The patients treated with an intramedullary nail had statistically significant shorter hospitalizations and shorter times to mobilization, and treatment had an estimated cost of less than half of traction treatment. Results of this study suggest that closed intramedullary nailing of femur fractures in adolescents is an effective treatment option.

Adolescent↗