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At least 91 records · Page 5Linked to original sources
PubMed1987

[Congenital pseudarthrosis of the tibia and fibula in children. Results of the treatment of 18 cases with nails and bone grafts].

Eighteen cases of congenital pseudarthrosis of the leg in 17 children were treated by nailing and tibio-fibular graft with a mean follow-up of six years (from one to twelve years). Six patients had reached the end of growth. Primary union was obtained in 17 cases in a mean time of 6.5 months (from 3.5 to 18 months), but one case developed a new pseudarthrosis at the level of an associated upper tibial osteotomy. Only one case required a supplementary graft. Walking was usually achieved without any apparatus after five-and-a-half months, the tibia being protected by a nail which was left in place until the end of growth. In two cases, a fracture produced by trauma occurred in the limb long after consolidation. These two fractures healed in the normal time. Inequality of limb length was present in all the cases, but its progress varied. On three occasions it was treated by femoral lengthening. Stiffness of the ankle and subtaloid joints resulted from nailing of the hindfoot in nine cases and improved very little after freeing of the joints. The use of telescopic rods avoids the need for further operations to change the rod during growth. We consider that this is a reliable method but that, in certain cases, the effects on growth and on the foot can be diminished by appropriate modifications of technique.

Bone Transplantation↗
PubMed1988

[Palliative surgical therapy of pathologic fractures].

From 1971 through 1985, 97 patients with pathological fractures were operated at the Giessen University Hospital for Accident Surgery. The palliative operations were intended to relief pain, to prevent long periods of bed rest for the patients, to restore the loading capacity of the lower extremity as well as the mobility of the upper extremity. The preservation or restoration of the patients general mobility in everyday life and the psychological aid for the patients had to be considered as well. In case of primary tumors, pathological fractures as a result of formation of metastases are most frequently induced by mammary carcinomas, followed by bronchial carcinomas, hypernephromas, colon carcinomas, and plasmocytomas. The preferential sites of metastases are the proximal femur area, the femur shaft, the humerus, and the pelvis. In our palliative operations, we applied 43 compound osteosyntheses, 23 endoprostheses, 17 resections, 10 marrow nailings, 4 Ender nailings or multiple bone nailings, respectively. One patient underwent a stabilization of the femur neck by means of a strap nail and another patient a stabilization of the spine by spondylodesis. Excisions were performed in 7 cases. The average survival was between 24 and 52 weeks.

Adult↗
PubMed1986

Bone dependent nail formation.

Two sporadic cases with congenital anonychia and hypoplastic nails combined with ectrophalangia or hypoplastic phalanges are reported. It is suggested that congenital anonychia and hyponychia may be 'bone territory' dependent disorders.

Abnormalities, Multiple↗
PubMed1997

Improving the distal fixation of intramedullary nails in osteoporotic bone.

Twenty-four mildly osteoporotic human femurs were used to examine the fixation stability of several types of distal locking screws in osteoporotic femoral condylar segments. The fixated femurs were axially loaded to 1000 N at a rate of 100 N/sec to assess the locking screws' resistance to motion and then sinusoidally cycled to 10,000 cycles with a 500 N load to assess axial stability. Of the four screw configurations tested, the standard screws and the standard screws placed at a 30 degree crossing angle were significantly more stable (p < 0.05) than the step screw and osteoporotic bolt.

Bone Nails↗
PubMed2004

Five years' clinical experience with the unreamed humeral nail in the treatment of humeral shaft fractures.

With the development of interlocking nail systems especially designed for the upper arm, standards for the operative treatment of humeral shaft fractures have appeared to change. The trumpet-like shape of the medullary cavity does not allow stable splinting with a nail alone, and therefore the bone--nail complex is commonly stabilized with interlocking bolts. Between June 1996 and June 2001, 51 fractures of the humeral shaft were treated operatively at the BG Unfallklinik Ludwigshafen with the unreamed humeral nail (UHN; Synthes). All nails were inserted by the retrograde technique. Ninety-five percent of the patients showed excellent or good shoulder function at follow-up examinations. For elbow function, 91.4% of the patients showed excellent or good results. Three out of four patients with poor elbow function had suffered from an additional injury to the brachial plexus; one patient developed heterotopic ossification. Intraoperative complications were: one iatrogenic lesion of the radial nerve, two intraoperative shaft fractures, one split at the insertion point, and one supracondylar fracture. As implants we used 7.5 mm nails in 36 cases and 6.7 mm nails in 15 cases. Among the 47 patients undergoing follow-up examinations, we found two cases of non-union. All patients were pain-free. Thirty-seven patients were very satisfied, six satisfied and four dissatisfied with the therapy. Decisive criteria for the use of a new implant are a high safety standard and simple reproducibility; these appear to be fulfilled by retrograde nailing of humeral fractures with the UHN. Interlocking nailing with the UHN enriches the range of therapeutic options for humeral shaft fractures.

Adolescent↗
PubMed1998

[Ankle para-articular tibial fracture. Is osteosynthesis with the unreamed intramedullary nail adequate?].

In a prospective study, 53 fractures of the distal fifth of the tibia were stabilized by unreamed nailing. Additional involvement of the ankle joint occurred in 18 patients. 50 patients returned for follow-up. In 30 patients tibia and fibula were fractured at the same (distal) level; in 20 patients the fracture of the fibula was located more proximally. In 12 patients the fractures extended into the tibial pilon. Severe soft tissue damage was seen in 24 fractures (18 open, 6 closed). Ninety percent of all fractures healed uneventfully without further surgical intervention after unreamed nailing. In two patients the unreamed nail had to be exchanged for a reamed tibial nail. Bone grafting and secondary dynamization of the nail by removal of a proximal interlocking bolt were performed in one case each. Thirty-one fractures healed in anatomical position. Valgus or varsus angulation of less than 5 degrees occurred in 18 patients. One fracture healed with rotatory angulation of 15 degrees. The highest rate of complications (22%) was seen in patients with distal fractures of the fibula without additional plating (of the fibula). There was no deep infection. Tibial fractures close to the ankle joint can be managed by unreamed nailing. Distal fractures of the fibula should be stabilized by additional plating. Because of the unreamed technique of implantation this procedure can also be used in grade II or III open fractures.

Adult↗
PubMedDate not supplied

Multiple fracture of medullary tube during intramedullary nailing of long bone fractures.

Intramedullary nailing is an accepted treatment for the fixation of femoral and tibial shaft fractures. There is a low but significant incidence of intraoperative complications during intramedullary nailing. During this procedure, a medullary tube may be used to exchange the bent olive-tipped reaming guidewire for the straight guidewire. A review of the literature found only one report of a fracture of the medullary tube. Two cases in which the medullary tube fractured into multiple pieces are presented.

Adult↗