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At least 865 records · Page 48Linked to original sources
PubMed2005

Versatile sterile field for nail surgery using a sterile glove.

Nail surgery is frequently done by dermatologists. Post-operative complications of nail surgery include infection, bleeding, pain, pyogenic granuloma, and nail dystrophy. Infectious complications after nail surgery can be prevented with proper aseptic techniques. Standard fenestrated surgical drapes used for a sterile field during nail surgery are cumbersome and difficult to keep in place during surgery. We present a versatile sterile field for nail surgery using a sterile glove that will facilitate nail surgery and concomitantly decrease the risk of infection.

Gloves, Surgical↗
PubMed2006

[Biomechanical evaluation of nickel-titanium shape-memory alloy enclosed interlocking intramedular nail].

OBJECTIVE: To study the biomechanical characteristics of Ni-Ti shape-memory alloy-enclosed interlocking intramedular nail Ni-Ti En for clinical application. METHODS: Six transverse fractures were induced in 6 fresh humeral shafts and fixed with Ni-Ti En, plate, interlocking intramedullary nail, and Ender nail, respectively. The specimens then underwent stress analysis for comparison of the bending strength, twisting force, and flexibility. RESULTS: The bending strength of Ni-Ti En was not significantly different from that of the plate and better than ender's nail; the twisting force of the interlocking intramedullary nail was comparable with the plate, but better than Ender nail. CONCLUSION: Ni-Ti Enpossess good biomechanical property to meet the demand of osteosynthesis, and its less stress protection, freedom of distant nail locking, flexibility and stable fixation may accelerate fracture healing.

Biomechanical Phenomena↗
PubMed1991

[The Gamma Nail in per- and intertrochanteric femoral fractures--alternative or supplement to the dynamic hip screw? A prospective randomized study of 100 patients with per- and intertrochanteric femoral fractures in the surgical clinic of the City Hospital of Triemli, Zurich, September 1989 - June 1990].

In a prospective randomised trial between September 89 and June 90 one hundred patients with per- and subtrochanteric fractures were consecutively treated by Gamma-nail or DHS. The average age of both groups was about 80 years. The operation time for Gamma-nailing was longer than for DHS-implantation and also the postoperative blood loss was higher in the Gamma-nail-group. We found no difference of intraoperative blood loss, of perioperative letality and in duration of hospital care. 90% of Gamma-nail-patients and 80% of DHS-patients were successfully able to walk four days after operation with full weight bearing on the operated limb. Six patients (12%) with DHS had to be reoperated within 6 weeks. Three patients with unstable fractures got cranial perforation of the cephalic screw after mobilisation. The other three patients had soft tissue complications. Five patients (10%) of the Gamma-nail-group were reoperated, one case because of missed distal locking, one because of cranial perforation of the cephalic screw after varus dislocation of the proximal fragment. One patient suffered intraoperatively a proximal femur shaft fracture which was corrected during operation. In one case a wound hematoma was evacuated, an other patient needed secondary wound closure. Despite technical imperfection of implant and instruments, we conclude that the Gamma-nail allows a very high percentage early and full weight bearing immediately after operation. So we consider that in the treatment of unstable pertrochanteric fractures of geriatric patients, the Gamma-nail has proven to be more efficient than the DHS.

Adult↗
PubMed1992

Intramedullary nailing of femoral shaft fractures. Part III: Long-term effects of static interlocking fixation.

The results of treatment of fractures of the femoral shaft with static interlocking nailing were reviewed retrospectively to determine the clinical importance of any stress-riser or stress-shielding properties of the nail. These properties, if relevant, would have been manifested by refracture of the femur, either through a hole used for a locking screw or through the original site of fracture after extraction of the device. Two hundred and fourteen fractures that had been treated with static interlocking nailing and that had healed without conversion to dynamic intramedullary fixation were divided into two groups. In Group I, which comprised 111 fractures, the static interlocking-fixation device was retained and in Group II, which comprised 103 fractures, the static interlocking-fixation device was removed during one operative procedure at an average of fourteen months after the injury. The average duration of follow-up was thirty months from the time of the original fixation in both groups. All patients in Group II were followed for a minimum of six months after removal of the nail. No femur in Group I, in which the static interlocked nail remained in situ, refractured. No femur in either group fractured through the proximal or the distal holes used for the locking screws. No locking screws or nails broke. One patient (1 per cent) in Group II had a refracture of the femoral shaft through the site of the original fracture six weeks after removal of the nail.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Quantitation of calcium levels in the nails of psoriasis patients by energy dispersive X-ray microanalysis.

Energy dispersive X-ray microanalysis was used to study the calcium levels in the involved and uninvolved nails of patients with psoriasis, and in the nails of healthy controls. A significant difference was found between the involved and uninvolved psoriatic nails. Calcium levels were higher in the dystrophic nails than in the normal nails of the same patients, patients without nail lesions, and healthy controls. No difference was noted in the calcium levels of normal nails between psoriasis patients and healthy controls. Calcium depletion from the horny layer may play a role in the formation of psoriatic skin lesions.

Adult↗
PubMed1991

Biomechanical characteristics of interlocking femoral nails in the treatment of complex femoral fractures.

Interlocking intramedullary (IM) nails allow more comminuted and proximal or distal femoral fractures to be successfully treated than previously possible with routine IM nailing. Autopsy specimens were prepared to evaluate the effectiveness of different locking mechanisms on fracture site stability. Grosse-Kempf (GK) and Brooker-Wills (BW) IM nails were inserted in anatomic specimen femurs with transverse fractures and 1-, 2-, and 3-cm defects. The femurs were loaded in four-point bending, and bending stiffness was calculated. The femurs were also loaded in torsion, and the amount of slippage between the nail and bone (at 10 Nm of applied torque) was measured. The GK nail, fully interlocked, had the lowest amount of rotational slip, followed by the BW and the GK noninterlocked nail. Bending stiffness was not significantly different for these IM nails.

Biomechanical Phenomena↗
PubMed1990

Nail re-growth in fingertip injuries.

One hundred and fifty-five fingertip injuries were treated over a one-year period. Seventy-six patients with 90 fingertip injuries attended for follow-up. Sixty-four of these injuries were suitable for study. In ten cases, the nail was either trimmed and left in-situ, or cleaned and replaced (Group A). In the remaining 54 cases, the nail was either missing, or had been removed at operation (Group B). The two groups were compared in terms of nail re-growth and nail appearance, but no statistically significant difference was found. There was a direct correlation between final outcome and the degree of crush injury. We conclude that it is the severity of the original injury and the accuracy of the primary repair of the nailbed which are the main determinants of the outcome of a nailbed injury. Non-replacement of the nail did not appear to adversely affect nail re-growth and nail appearance.

Adolescent↗
PubMed1990

A comparison of the Brooker-Wills and Russell-Taylor nails for treatment of patients who have fractures of the femoral shaft.

Seventy-three fractures of the femoral shaft (seventy patients) were randomized to treatment with interlocked nailing with either the Brooker-Wills femoral nail (thirty-nine fractures) or the Russell-Taylor femoral nail (thirty-four fractures). Sixty-one patients (sixty-four fractures) were prospectively followed from admission until healing of the fracture. Specific attention was paid to recording operative details, including technical difficulties associated with insertion of the nails. Technical difficulties were encountered in insertion of the proximal screw, distal screw, and nail, and in deployment of the fins. Insertion of the Russell-Taylor nail was associated with less technical difficulty, operative time, and estimated loss of blood. The two nails differ in their biomechanical properties, methods of fixation, and instrumentation. These differences did not affect the clinical outcome; the fractures in both groups of patients healed with excellent functional results.

Biomechanical Phenomena↗
PubMedDate not supplied

The Gamma nail. A preliminary note.

The Gamma nail is a new device used in the treatment of pertrochanteric fractures in the elderly in which the principles of locked intramedullary nailing are applied. It is constituted by an intramedullary nail crossed in the proximal segment by a cervico-cephalic screw, by which compression of the fracture segments may be obtained. It is furthermore possible to obtain distal locking by means of two screws, such as for Grosse-Kempf nailing. It constitutes an alternative to Ender nailing, screw-plate, and nail-plate. Our experience with 31 cases did not reveal any differences as compared to what occurs with Ender nailing with regard to surgical stress. Instead, a shorter amount of time seems to be required for functional recovery, as the stability of the assembly allows for early weight-bearing.

Age Factors↗
PubMed1989

Intramedullary nailing of open fractures of the femoral shaft.

The cases of eighty-six patients in whom eighty-nine open fractures of the femoral shaft had been treated by intramedullary nailing with reaming were retrospectively reviewed. Twenty-seven fractures were classified as grade-I open fractures; sixteen, as grade-II open fractures; and forty-six, as grade-III open fractures. Immediate intramedullary nailing was done for fifty-six fractures, and delayed stabilization (five to seven days after delayed closure of the wound) was done for thirty-three fractures. A prerequisite for immediate intramedullary nailing was that irrigation and debridement of the open wound be done within eight hours after injury. All fractures healed in an average of 5.2 months. No infections occurred in the sixty-two grade-I, grade-II, or grade-IIIA open fractures, regardless of whether immediate or delayed intramedullary nailing was performed. Of the twenty-seven grade-IIIB fractures, infection developed in three: in one after immediate intramedullary nailing and in two after delayed intramedullary nailing. We concluded that, if a thorough and timely debridement can be accomplished, immediate intramedullary nailing of grade-I and grade-II open fractures of the femoral shaft does not increase the risk of postoperative infection. Selected patients who have a grade-III open fracture may be candidates for immediate intramedullary stabilization, depending on the degree of the patient's associated injuries and the extent of disruption and contamination of the soft tissues of the thigh.

Adolescent↗
PubMed1985

Anatomy and physiology of the nail.

The nail plate lies under the proximal nail fold and over the matrix, nail bed, and hyponychium. The nail plate is made by the matrix. Although the few cells the nail bed contributes to the nail plate do not increase the bulk of the plate, they are important in attaching the plate to the bed. The interrelationships of the components of the nail and knowledge about their normal function are reviewed.

Female↗
PubMed1985

Closed locked intramedullary nailing. Its application to comminuted fractures of the femur.

For many fractures of the femoral shaft, closed intramedullary nailing will not control rotation or telescoping of the fragments. Locked intramedullary nailing combines closed nailing with the percutaneous insertion of screws that interlock the bone and nail. This method permits static locking that controls rotation and telescoping and subsequently conversion to dynamic locking when weight-bearing is started after approximately twelve weeks. By providing greater stability, this method extends the indications for intramedullary nailing to severely comminuted, oblique, and spiral fractures as well as to fractures complicated by loss of bone and fractures in the proximal and distal ends of the femoral shaft. Of fifty-two patients with forty-nine severely comminuted fractures of the femoral shaft and three fractures that were complicated by loss of bone, forty-seven patients had uneventful consolidation of the fracture, with a mean time of 4.5 months for the severely comminuted fractures and seven months for the fractures that had a loss of bone. At follow-up, all forty-seven patients had normal motion of the hip, and forty-five had normal motion of the knee. Of the remaining five patients, four had a non-union that eventually healed (three after a second locked nailing and one after a third) and one had a septic non-union that eventually healed after removal of the nail and screws, débridement, and immobilization with an external fixator. Based on this experience, we concluded that this form of treatment has many advantages. The risk of infection and non-union is low, the incidence and severity of malunion are reduced, the hospital stay is short, and early mobilization of the patient is possible.

Adult↗
PubMed1979

[Fascicular nailing of the femur and tibia. 14 years' experience. Report of 275 cases (author's transl)].

The use of the fascicular four-pin nail has been introduced to correct certain inadequacies revealed by the rigid nailing according to Kuntscher's method; made up of four tiny pins soldered at each end, it fits the curve of the bone; its elasticity allows a much greater resistance to repeated strain as compared to other nails; an experimental study which compares the stability of fresh femurs cut then nailed according to different methods, reveals a definite superiority for the fascicular nail. The clinical use for 14 years (275 nailings among which 92 cases werefresh closed fractures of the femur) confirms that such a method provides the advantage of nailing without reaming as well as the possibility of immediate weight bearing ambulation for most patients (75% in the cases of resh femur or tibia fractures).

Biomechanical Phenomena↗
PubMed1979

[Yellow-nail syndrome from d-penicillamine].

The yellow nail syndrom consists of the triad of scleronychia (yellow nails), lymphedema and respiratory tract involvement. The nail changes include symmetrical involvement of finger and toe nails with regression of the nail sheath, paling of the half-moon, arrest of longitudinal growth, thickening, yellow coloration, increased transverse convexity, ridging and partial separation of the nail. This report describes a case of drug-induced yellow nail syndrom due to penicillamin.

Adult↗
PubMed1983

Yellow nail syndrome associated with penicillamine therapy.

A patient is described in whom the nail changes of the yellow nail syndrome developed whilst she was taking penicillamine. Stopping the drug was associated with resolution of the nail changes. The yellow nail syndrome was first described in 1964 (Samman and White), but the cause is still unknown. Impaired lymphatic drainage is thought to be a factor in the pathogenesis, and lymphoedema is often an accompanying feature. We describe a case in which nail changes, typical of those described in the yellow nail syndrome, occurred in a patient treated with d-penicillamine, and in whom the nails reverted to normal on withdrawing the drug. (Received March 15, 1983.)

Adult↗
PubMedDate not supplied

Heberden's nodes' nails.

Heberden's nodes lie close to the matrix of the nails and may impinge on them causing nail changes. This occurs particularly when the nodes become inflamed, cystic or grow distally from the joint. The affected nail often shows a ridge that delimits the area where the disturbance occurs. The surface of the nail distal to the lesion on the nail matrix usually becomes concave. These changes may regress spontaneously, after antiinflammatory treatment or not at all. Depigmentation of the affected area of the nail may remain as a sequela. We illustrate the various modalities of Heberden's nodes' nails with 4 case reports.

Female↗
PubMed1995

Diagnosis and management of infection after tibial intramedullary nailing.

A series of 20 patients with infection after intramedullary nailing of the tibia is discussed. The most common pathogen was Staphylococcus aureus, which was found in 14 patients (64%). Eleven nails were originally inserted without reaming, and 9 were reamed. Treatment protocols were based on the time of onset of infection (acute, subacute, and chronic) and the status of bone healing. In eight patients, the fractures (6) and nonunions (2) were healed at diagnosis of infection and were treated by debridement, nail removal, and antibiotics. Twelve patients had fractures (8) and nonunions (4) that were not healed. Four were treated with debridement, nail removal, and external fixation, and four with debridement and nail retention. The overall success rate for eradicating infection was 90%. Infection after unreamed nailing had fewer complications and a higher success rate for infection control than did reamed nailing. Risk factors identified in this study for infection are previous external fixation, severe open fracture, and substance abuse.

Adolescent↗
PubMed1996

[Ascending intramedullary nailing of the femur. Technique. Initial results. Indications].

Some fractures of the distal third of the femur are not good indications for the centromedular locked nailing technique where the nail in inserted through the greater trochanter. Indeed, unsatisfactory reduction and stabilization are often obtained. Inversely, when the nail is inserted upwardly from the knee joint after drilling an orifice in the trochlea and the condyles, the mechanical locking is very close to the knee joint and, when the subtrochanter region is reached, the nail automatically aligns the fracture. The implant temporarily used was a centromedular tibial nail rotated by 180 degrees and mechanically locked near the knee under fluoroscopic control near the lesser trochanter. Five trauma cases were treated with this technique. Early results have been encouraging, similar to those obtained for nailing with closed surgery. These results would suggest that upward nailing should be conceived for particular indications: fractures of the supracondyle area, spiral and comminutive fractures of the distal third of the femur, certain fractures of the supra and inter condyle area.

Adult↗