Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Fracture Fixation, Intramedullary”

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 919 records · Page 51Linked to original sources
PubMed2006

Elastic stable intramedullary nailing for midclavicular fractures in athletes: indications, technical pitfalls and early results.

This prospective consecutive case series was done to evaluate indications, technical pitfalls and functional outcome of elastic stable intramedullary nailing of displaced midclavicular fractures in 14 athletes. Constant score and radiographs were evaluated after 1 and 6 weeks, 3 months and 6 months in 13 patients. Mean age was 28 years. The average follow-up was 17 months. Mean operation time was 62 minutes. Open reduction through an additional small incision was necessary for 7 fractures. Mean hospital stay was 1.2 days. Secondary fracture displacement was observed in 1 patient. The Constant score averaged 81 after 1 week, 96 after 6 weeks and 98 after 6 months. Compared to the contralateral side, average shortening of the clavicle was 1.7 mm. Overall, elastic stable intramedullary nailing provided good restoration of the length of the clavicle and allowed immediate active mobilisation with early return to normal activity. Functional results were excellent.

Adolescent↗
PubMed1990

Problems associated with longitudinal fractures of the femoral shaft in adults. A comparison between intramedullary nailing, interlocking intramedullary nailing and plating.

The results of 64 operatively treated patients with longitudinal femoral shaft fracture are presented. Twenty-four fractures were treated with an intramedullary nail, six with an interlocking intramedullary nail and 34 with plating. The functional end results were good and the anatomical result satisfactory in all groups although treatment with plate caused several failures. We conclude that intramedullary nailing is a good and safe method to treat non-comminuted fractures of the femoral shaft.

Adolescent↗
PubMed2001

Prospective randomized comparison between a dynamic hip screw and a mini-invasive static nail in fractures of the trochanteric area: preliminary results.

OBJECTIVES: This study aimed at comparing the results obtained with a sliding screw plate and an experimental device including a small-diameter nail that can be placed with a mini-invasive approach and provides a stable fixation. DESIGN: Randomized prospective study. SETTING: University hospital. PATIENTS: The study included two groups with thirty fractures of the trochanteric area. INTERVENTIONS: In both groups, the surgical procedure was carried out on patients placed on a traction table in a supine position, under an x-ray amplifier. Sliding screw plates (THS) were set in place according to the usual open technique. Nails were placed through a twenty-millimeter supratrochanteric cutaneous incision. This experimental system comprised a locked intramedullary nail with two nonparallel seven-millimeter cervicocephalic screws. MAIN OUTCOME MEASURES: The comparison between the two groups was based on the surgical procedure (time, duration of x-ray irradiation, and total blood loss); the initial postoperative period (complications, duration of hospital stay, and the time before returning home); the time before full weight bearing became effective; the functional and social recovery; mortality; and the quality of immediate and final anatomic restitution and healing. RESULTS: Operating time (p < 0.001) and blood loss (p < 0.001) were lower in the nail group, and no blood transfusion was required. Postoperative pain (p < 0.01), time necessary to support full weight bearing (p < 0.02), and time before returning home (p < 0.05) were reduced in the nail group. All fractures healed in the same amount of time, with good anatomic results in the nail group, whereas ten impactions beyond ten millimeters occurred in the plate group. No difference was found between the two groups in walking ability and autonomy recovery, but hip function (p < 0.05) was better in the nail group. CONCLUSION: This preliminary clinical study has shown the advantages of this mini-invasive technique. It could not evaluate all the possible disadvantages inherent in the method. These points will be evaluated in a multicenter study justified by these preliminary results.

Aged↗
PubMed1996

Fasciculated intramedullary pinning of metacarpal fractures.

We reviewed 20 patients with 23 displaced extraarticular fractures of the distal end of the long metacarpals, treated by fasciculated pinning. At a mean follow-up of 5 years, all the patients were subjectively satisfied with the result. All the patients but one, who fractured four metacarpals, had a normal range of motion. The average grip strength was 43.4 kg for the operated side compared to 43.4 kg for the uninjured hand. Radiologically, the fractured fifth metacarpal had a shortening of 2.2 mm compared to a control group, whereas the volar angulation was 16.6 degrees (13.2 degrees for the control group). The technique of intramedullary fasciculated pinning is a reliable alternative when conservative treatment of fractures of the metacarpal neck has failed or is inappropriate. The procedure provides sufficient stability to allow early mobilization and a good functional result.

Adolescent↗
PubMed2002

[LOCKED INTRAMEDULLARY NAlLlNG OF HUMERAL SHAFT FRACTURES].

BACKGROUND: Clinical and radiological results ofthe patients with humeral shaftfractures who underwent Iocked intramedullary nailing are retrospectively evaluated in this study. METHODS: 29 patients (17 males, 12 females; mean age 43.6; range 26 to 68 years) who underwent Iocked intramedullary nailing were evaluated retrospectively. 17 patients had major and seven patients had minor traumas. ln three patients the fractures were, pathological and also two patients had additional hypertrophic non-union. Closed intramedullary nailing was performed in 21 patients. Three patients (two with non-union) were treated by using autogenous graft. Nine patients were nailed antegradely and 20 retrogradely. RESULTS: The meanfollow-up period was 16.2 months (range 8 to 47 months). The mean time ofunion was 18 weeks (range 8 to 36 weeks) in 26 patients (% 90) but non-union occured in three patients.Functional end results ofshoulderand elbow were excellent in 23 (%79) patients, moderate infour (%13) patients and bad in two %8) patients. Postoperative complications included radial nerve palsy, breakaie of the distal locking screw and superficial infection in one patient each. Nail migration also occured in an osteoporotic patient. CONCLUTIONS: Locked intramedullary nailing is the treatment ofchoicefor humeral shaftfractures in osteopenic bone, pathological fractures, comminuted or segmentalfractures and also for humeral shaftfractures in polytraumatised patients who may need to use the injured armfor early rehabilitation and mobilization.

Fracture Fixation, Intramedullary↗
PubMedDate not supplied

Elastic intramedullary nailing: a minimally invasive concept in the treatment of unstable forearm fractures in children.

The standard treatment in forearm fractures in children is usually conservative. Unstable fractures of the proximal parts of the forearm often show poor results after nonoperative management so that these fractures usually require surgical intervention. We report 30 children (ages, 4-14 years) who were treated by elastic intramedullary nailing. Sixteen patients were treated by intramedullary splinting immediately after their accident; 14 children required intramedullary nailing after failure of conservative treatment and fracture redisplacement. At the time of follow-up 6 months later, functional results were excellent in 24 children, good in five children, and fair in one child. There were no serious complications other than one delayed union. According to these results intramedullary nailing can be recommended for the treatment of unstable fractures of the proximal and middle thirds of the forearm in children.

Adolescent↗
PubMed2003

Subtrochanteric metastatic lesions treated with the long gamma nail.

From 1996 to 2002, 39 consecutive intramedullary reconstructions (three bilateral) in 36 patients were performed in a group of subtrochanteric femoral metastatic bone disease using the long gamma nail (LGN). Reconstruction was performed prophylactically in 28 femurs and, for actual fractures in 11. All patients achieved good functional results with pain relief and improved mobility. No major intraoperative complication or long-term mechanical failures were observed. Minor technical, medical and implant related complications were seen in 14 patients. The LGN is a valuable intramedullary reconstruction device with good functional outcome for the treatment of subtrochanteric femoral metastatic bone disease.

Adult↗
PubMed1980

[Operative and conservative treatment of fractures of the femur (author's transl)].

82 cases with fractures of the thigh bone were seen at the Surgical Department of the Charité Hospital in Berlin. 5 selected cases were chosen to demonstrate problems of treating these fractures in a different way. Surgical and conservative treatment are no longer adverse. Whereas in compound fractures surgery is the exception, it is the method of choice in fractures of the shaft by intramedullary nailing. Plate-osteosynthesis is only performed in cases which cannot be stabilized by intramedullary nailing. Additional injuries, such as those of skull and brain especially, will complicate surgery in a way, which until now has not been completely elucidated.

Adolescent↗
PubMed2006

Physical and technical aspects of intramedullary reaming.

Intramedullary pressure during reaming is influenced by various factors, including those of the patient, such as bone morphology and location and type of fracture, and those related to reaming technique and instruments. Through intensive research, technical developments and the use of modern materials, intramedullary pressure caused by modern reaming systems can be reduced to a minimum and, perhaps, completely avoided through use of the reaming-irrigation-aspiration system.

Bone Nails↗
PubMed1996

[Efficacy of intramedullary stabilization of pathologic femoral shaft fractures].

We report here on the treatment with intramedullary nailing or gamma nailing of 23 pathological femoral shaft fractures, 14 patients having tumors or metastases. Thirteen (13/14) tumor patients were treated palliatively and one patient radically. The results were that 10 patients were able to walk after the operation, all patients gained considerable relief from pain and nursing was facilitated. Intramedullary nailing or gamma nailing offers, in the given indications, a good alternative to the other osteosynthesis procedures.

Activities of Daily Living↗
PubMed2006

Treatment of diaphyseal forearm nonunions with interlocking intramedullary nails.

UNLABELLED: Fifteen patients with 26 nonunions of diaphyseal forearm fractures were treated with interlocking intramedullary nails and iliac bone grafts. The purpose of our study was to evaluate the rate of successful healing and complications that developed after using this technique. The mean followup was 31 months (range, 25-38 months). The average length of bone loss after freshening the bone ends was 20 mm (range, 10-30 mm). Radiographic union was achieved in 14 patients (96%). Compared with the uninjured contralateral arm, the mean loss of flexion and extension motion at the wrist was 27 degrees. The mean loss of the arc of motion at the elbow was 18 degrees, and the mean loss of rotation of the forearm was 39 degrees. In seven patients, the amount and location of the maximum radial bow on the injured side were significantly different from those of the contralateral arm. Using the rating system of Anderson et al, two patients (13%) had excellent results, six patients (40%) had satisfactory results, six patients (40%) had unsatisfactory results, and one patient (7%) had a failed result. The mean Disabilities of the Arm and Shoulder Score was 35 points (range, 16-56 points), indicating moderate residual impairment. There were three postoperative complications (an incidence of 12%). Our results showed that interlocking intramedullary nailing of nonunions of the diaphysis of the radius or ulna with an open reaming technique should not be considered an adequate alternative to plate fixation of these injuries. LEVEL OF EVIDENCE: Therapeutic study, Level IV (case series no, historical control group).

Adult↗
PubMed1997

Operative treatment of humeral shaft fractures.

The results of the operative treatment of 27 humeral shaft fractures treated at the University of Louisville during a 2-year period were reviewed. The aim of this study was to analyze 1) the indications and results of surgical treatment, 2) the indications for nailing versus plating, and 3) the failures and their treatment (especially surgical nonunions). Indications for surgery were polytrauma patients (including open fractures, associated neurovascular injuries, associated ipsilateral forearm injuries) and isolated unstable fractures in which closed reduction failed. Plate and screw osteosynthesis was used in patients with proximal and distal fractures, in the presence of neurovascular injuries, progressive radial nerve palsy and failure of closed reduction due to interposition of soft tissue. Intramedullary antegrade nailing was preferentially used in polytrauma patients. Seven patients (25%) needed further surgery because of nonunion. The frequency was higher after plating (30%) than after nailing (20%), it was more common in comminuted fractures, middle third fractures and after insufficient distal locking. Exchange nailing resulted in union in 5 of the 7 cases. Although excellent results with low complication rates are reported in the recent literature following plate and screw osteosynthesis or locked intramedullary nailing, we found that operative treatment of difficult humeral shaft fractures is still fraught with a high complication rate.

Bone Nails↗
PubMed2004

Factors affecting rates of infection and nonunion in intramedullary nailing.

We report a retrospective study over five years to determine the incidence of infection and nonunion after intramedullary nailing in fractures of 214 long bones; 122 femoral, 75 tibial and 17 humeral. The indications for nailing were trauma (n = 161), pathological fracture (n = 30) and nonunion (n = 23). There were 30 open fractures. The overall rates of deep infection and nonunion were 3.8% and 14.2%, respectively. Using multiple logistic regression analysis, we determined the relationships between deep infection and nonunion and the pre- and peri-operative factors of age, ASA score, indication for nailing, the use of reaming, the use of antibiotics, whether the fracture was open and the operating time. Open fractures were found to be significantly associated with deep infection. The length of the operation may also affect the outcome. Opening of the fracture at the time of surgery and the ASA score were found to be significantly associated with the development of nonunion after intramedullary nailing. We have compared our findings with previously published data from large teaching hospital units.

Adolescent↗
PubMed1990

Intramedullary nailing with interlocking.

The locked or unlocked intramedullary nail is considered today in most institutions the first choice for stabilisation of the majority of closed diaphyseal fractures of the femur and tibia. In 1st and 2nd degree open fractures of the tibia, the unreamed locked nail may perhaps become the preferred implant. In spite of very favourable results with nailing, not all fracture problems of long bone will be solved with this device. The plate and external fixator will remain indicated in most fractures with meta- and epiphyseal extension as well as in situations in which the intraoperative fluoroscopy is not available. Our experience with the new AO universal femur and tibia nails are being reported.

Bone Nails↗
PubMed1995

[Risk of infection in centro-medullary locking nailing of open fractures of the femur and tibia].

Intramedullary reamed locking nail of open fractures remains controversial because of the risk of infection. 1,474 closed reamed locked nailings were performed between 1974 and 1989 for femoral (744 cases) or tibial (730 cases) fractures. 349 fractures were open: 100 femoral fractures (51 Gustilo and Anderson Grade I and 49 Grade II) and 249 tibial fractures (140 Grade I, 99 Grade II et 10 Grade III). 24 femoral (3.2%) and 46 tibial (6.3%) nails were followed by infection. This difference is significant (p < 0.01). Reoperations for infection occur more frequently for femoral than tibial fractures (p < 0.05). There is no difference between the results of infection treatment between femoral or tibial fractures. Traumatic opening of the femoral fracture site does not affect the occurrence of an infection, its severity or the results of its treatment. Traumatic opening of the tibial fracture site significantly increases the infection rate (p < 0.001), and the incidence of infection increases with the severity of the soft tissue lesions; but the severity of the infection and the results of its treatment are not modified. Acute closed reamed intramedullary locking nail is the best treatment for open femoral or tibial fractures with respect to the bone healing and infection rate for Grade I and II fractures. For Grade III fractures, nailing must be followed by a coverage flap.

Femoral Fractures↗
PubMed2000

[Unstable pediatric femoral and forearm shaft fractures. Comparison between conservative treatment and stable intramedullary nailing].

Elastic intramedullary nailing represents a new surgical concept in the treatment of unstable shaft fractures in children. The present case control study wanted to examine the superiority of intramedullary nailing in comparison to conservative therapeutic concepts which had been applied so far. 13 children with forearm fractures who were treated initially by conservative measures were compared to 13 other children who received a primary intramedullary nailing. With femoral fractures, 12 children were included in each group. In each patient pair age, type and localisation of the fracture were comparable. During the observation period (until the termination of final therapeutic measures or until the third year after injury) we examined clinical variables and subjective findings. Both therapeutic concepts led to comparably good functional results. Also subjective judgement of the therapeutic success did not differ between groups. However, with intramedullary nailing of shaft fractures of the femur the mean hospital length of stay (7.0 +/- 3.5 days) was significantly shorter than with initial conservative treatment (36.5 +/- 2.2 days, P < 0.05). Irrespective of the localisation of the fracture intramedullary nailing required significantly less x-ray examinations during the observation period. These results suggest intramedullary nailing to be the procedure of choice to treat unstable forearm and femoral fractures in children.

Adolescent↗