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Results for “Fracture Fixation, Intramedullary”

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At least 1,063 records · Page 59Linked to original sources
PubMed1999

Fixation of femoral shaft osteotomy with an intramedullary composite rod: an experimental study on dogs with a two-year follow-up.

A novel composite material with an ultra-high strength and a low elastic modulus called carbon fibre-reinforced liquid crystalline polymer (LCP/CF) has been developed. An experimental diaphyseal osteotomy of the proximal femur in fourteen Beagle dogs was fixed with an intramedullary LCP/CF rod of 4.5 mm in diameter and 80 mm in length. The radiological follow-up intervals were 1, 3, 6, 12, 24, 52, and 104 weeks. Five dogs were killed at 1 year and three dogs at 2 years for histological studies; six dogs were retained for longer follow-up. Radiographs showed an uncomplicated healing of the diaphyseal osteotomy with an external callus formation in all dogs in 12 weeks. Histological analysis revealed a benign host tissue response with few inflammatory cells. Both bone and fibrous tissue were seen at the LCP/CF-host tissue interface. The cross-sectional cortical area of the operated femur was slightly greater than that of the control femur in the 2-year follow-up. LCP/CF showed promising properties for high-load applications.

Animals↗
PubMedDate not supplied

Deformity in flexion of proximal tibia secondary to bifocal fracture and anterior instability of knee (deformity in flexion of tibia and ACL reconstruction).

We present a clinical case of anterior instability of the knee due to chronic rupture of the ACL; where there was also proximal deformity of the tibia, secondary to consolidation in flexion of the proximal fragment in a bifocal fracture of the tibia, treated by non-reamed intramedullary nailing, which consolidated in flexion of the proximal fractured segment, causing a marked increase in the angle of the tibial slope. The patient refers an articular instability, which prevented her from walking correctly and causing her frequent falls. We repaired under same chirurgical act, all the problems of the patient, her vicious consolidation and her articular instability. The result is perfect.

Adult↗
PubMed1991

Flexible intramedullary pins in the treatment of unstable proximal humeral fractures.

A series of 35 proximal humeral fractures treated with flexible intramedullary pins between 1986 and 1988 are presented. Special design features of the pins include a proximal 15 degrees angulated 20 mm tip and a 20 mm curve distally. The method is suitable for fractures in the surgical neck with displacement of bone width (AO-type A2/2). In cases of fracture-dislocation or three- or four-part fractures it is only suitable when the fragments can be reduced satisfactorily. Complications are minimal with 95 per cent bone union.

Bone Nails↗
PubMed1989

Interlocked intramedullary nailing of the humerus.

Indications for use of the intramedullary interlocked humeral nail are: pathologic fractures, including those with severe osteopenia alone; nonunions, especially those with bone atrophy and/or marked osteopenia; and humeral shaft fractures with comminution, bone loss, or other causes of instability not controlled by conventional treatment methods. In this series, eight patients were treated by intramedullary interlocked humeral nail. Follow up ranged up to 30 months, with an average of 12 months. Five of six patients in this series who had the potential to unite their fractures did so. The remaining patient had a painless fibrous union. While the two patients with pathologic fractures of the humeral shaft caused by malignant tumors did not unite their fractures, the pain relief, functional recovery, and lack of postoperative morbidity justified the operative procedure.

Adult↗
PubMed1999

Effect of intermittent administration of parathyroid hormone on fracture healing in ovariectomized rats.

To evaluate the potential use as a therapeutic agent for osteoporotic fractures, we examined the effects of intermittent administration of parathyroid hormone on fracture healing in ovariectomized rats. At three months post-ovariectomy, bilateral tibial shaft fractures were induced and stabilized by intramedullary nailing with Kirschnerwires. Saline, 17-estradiol, or recombinant human PTH(1-84) was given once a day for 30 consecutive days during fracture healing. Fracture healing was assessed by morphometric and mechanical analysis of fracture callus. Intermittent parathyroid hormone administration increased the morphometric and mechanical parameters in a dose-dependent manner. 17-estradiol, a bone-resorption inhibiting agent, did not offer advantage in terms of fracture healing in ovariectomized rats. Our findings suggest that intermittent parathyroid hormone administration may benefit osteoporosis and fracture.

Animals↗
PubMed1998

Treatment of clavicular aseptic nonunion: comparison of plating and intramedullary nailing techniques.

OBJECTIVE: The aim of this retrospective study was to investigate and compare the effects of plating and intramedullary nailing in the treatment of clavicular aseptic nonunion. METHODS: Thirty-three consecutive patients with middle-third clavicular aseptic nonunions with previous nonoperative treatment were treated by plating (13 patients) and intramedullary nailing (20 patients) with supplementary cancellous bone grafting. The indications for such treatment were middle-third aseptic nonunions without previous operative treatment and with local pain or tenderness, deformity, or neurologic complaint. The choice of plating or intramedullary nailing was according to the surgeon's individual preference. RESULTS: Twenty-nine patients were followed for at least 1 year (range, 1-7 years; median, 3 years; plating, 11; intramedullary nailing, 18). The union rate was 81.8% (9 of 11) for plating and 88.9% (16 of 18) for intramedullary nailing (p = 0.35, Fisher's exact test). The union period was 4.0 +/- 1.3 months for plating and 4.1 +/- 1.1 months for intramedullary nailing (p = 0.80, unpaired Student's t test). The complication rate was 27.3% (3 of 11) for plating and 11.1% (2 of 18) for intramedullary nailing (p = 0.21, Fisher's exact test). There were no significant differences in other parameters. CONCLUSION: Intramedullary nailing may have a higher union rate with a lower complication rate than plating (p > 0.05). At least in common situations, it is not inferior to plating. Whenever possible, therefore, intramedullary nailing should be used preferentially to treat clavicular aseptic nonunion without previous operative treatment. Nevertheless, both techniques have relatively higher nonunion rates in the treatment of clavicular nonunion than in the treatment of other long-bone nonunions. Gentle handling of surrounding soft tissues to reduce bony fragments should be strictly executed.

Adult↗
PubMed1990

Treatment of tibial malunions and nonunions with reamed intramedullary nails.

Reamed intramedullary nailing is an effective, relatively low-risk technique for the management of delayed union, nonunion, and malunion of the tibia. Closed technique should be used where possible and open realignment, when necessary, should be executed with minimal dissection. Bone grafting is rarely indicated. The use of interlocking nails provides an added degree of security in the control of rotation.

Adult↗
PubMed1986

Transfixion intramedullary nail.

The Modny transfixion intramedullary nail has been used in 261 cases of complex femoral fractures with excellent results. Proximal, medial, and distal comminutions of all sizes were accurately transfixed by this open method. Transfixion screws and biologic ingrowth fixed the fragments rapidly, resulting in no measurable shortening or rotational deformity, and rapidity of healing was enhanced. The nail was also used in five knee fusions.

Adult↗
PubMed1999

Rushpin fixation for midshaft clavicular nonunions: good results in 13/14 cases.

We treated 14 patients having a symptomatic mid-shaft clavicular nonunion with intramedullary Rushpin fixation and autogenous bone grafting. 13 nonunions healed within 4 months. There were no complications related to the operation. After a mean follow-up of 40 (4-156) months, shoulder function (Constant-Murley score) was 90 (44-100)%, compared to the contralateral shoulder. Rushpin fixation with autogenous bone grafting is a simple and reliable method for treating nonunions of the midshaft of the clavicle.

Activities of Daily Living↗
PubMed1975

Intramedullary nailing in the treatment of open fractures of the tibia and fibula.

Intramedullary nailing of thirty acute displaced open fractures of the tibia and fibula resulted in union with only one superficial infection. The low incidence of sepsis is attributed to the use of the curved malleable Hodgkinson tibial nail which requires no reaming, renders the operation less difficult and traumatic, and interferes minimally with bone vascularity. Fibular nailing was an effective means of stabilizing nine of the twelve fractures close to the ankle joint.

Adolescent↗
PubMed1995

[Treatment of supracondylar femoral fracture proximal to a knee joint endoprosthesis by retrograde interlocking nailing].

A case of a supracondylar femoral fracture proximal to a total knee prosthesis is reported. This difficult fracture was managed with retrograde intramedullary locked nailing. The time to union was 6 weeks. Cancellous bone grafting was not necessary. At final follow up the patient had a knee score of 90 and a functional score of 80 points. This was equal to the result after joint replacement prior to the injury.

Aged↗
PubMed2001

Cigarette smoking and open tibial fractures.

Complication rates were compared in 140 smoking and 133 non-smoking patients with open tibial fractures. Both the groups were evenly matched demographically and in terms of primary fracture treatment. Flap failure complicated 7 (20%) patients in the smoking group and 4 (14%) in the non-smoking group. The mean time to union was 32 weeks for smokers and 28 weeks for non-smokers (P<0.05). Bone grafting to stimulate union was required in 36 (26%) smoking patients compared with 24 (18%) non-smoking patients. In patients treated by intramedullary nailing exchange, nailing to achieve union was carried out in 24 (38%) smoking cases compared with 13 (26%) of non-smoking cases. Smoking is associated with an increased risk of complications in patients with open tibial fractures. There is an increased rate of flap failure, delayed union and non-union. We recommend patients with open tibial fractures should be advised to stop smoking to minimise these complications.

Adolescent↗
PubMed1998

Nonreamed flexible locked intramedullary nailing in tibial open fractures.

Thirty-nine open unstable tibial shaft fractures were treated with a nonreamed flexible locked intramedullary nail between 1992 and 1995. There were 23 Grade I, 12 Grade II, three Grade IIIA, and one Grade IIIB fractures. The average time of followup assessment was 24 months. The average time to fracture union was 24 weeks. Complications were related in most cases to fractures with highly unstable patterns and extensive soft tissue lesions. There were five (12.5%) delayed unions and one (2.5%) nonunion. Deep infections developed in three (7.7%) patients. One patient required an additional procedure to correct a varus malunion. There were no implant failures. It was concluded that nonreamed flexible locked nailing provides effective control of axial and rotational stability in unstable Grades I to IIIA open fractures with acceptable union rates and a low incidence of complications secondary to the fixation system.

Adolescent↗
PubMed1991

Treatment of open tibial shaft fractures by delayed closed intramedullary nailing.

Forty-seven open tibial fractures in 43 patients were internally fixed by delayed closed nailing after reaming the medullary canal. The procedure was usually undertaken after complete healing of the wound. Early mobilization was encouraged in all cases. In 37 patients (86%) the fractures were caused by road traffic accidents; 21 patients (49%) had other skeletal and soft tissue injuries. All fractures united with a mean of 19 weeks, but five had delayed union. Most patients had a full range of knee and ankle movements. No infection was encountered in the series.

Adult↗
PubMed1997

A technique for intramedullary nailing of proximal third tibia fractures.

Twelve of 14 proximal third tibial shaft fractures were successfully treated with a new technique for intramedullary nailing of these fractures. The average anterior displacement was 3.0 mm (range 0-17). The average coronal plane alignment was 2.0 degrees valgus (range 2 degrees varus to 12 degrees valgus). There was one nonunion. The technique's success is dependent on neutralizing the primary factors causing malreduction: wide effective diameters of tibial nails, narrow diameter of the medial tibial metaphysis, and a posteriorly directed sagittal plane entrance angle.

Adolescent↗
PubMedDate not supplied

Ulnar nerve palsy following fracture of the shaft of the humerus.

We present an unusual case of ulnar nerve palsy associated with humeral shaft fracture. Initial examination showed swelling and tenderness. No mention of neurological deficit was found in the patient's file. Radiography showed a displaced midshaft fracture. Closed reduction and intramedullary nailing were performed. Ulnar nerve palsy was noted by the attending physician afterward, and, after four months of nonoperative treatment without any obvious improvement, the patient was referred to our center. During surgery, the nerve was found to be transected and an end-to-end repair was performed. Five months after surgery, signs of motor recovery were present. This case demonstrates that ulnar nerve injury can occur with a closed fracture of the humeral shaft.

Adult↗
PubMed2001

Proximal tibial fractures--should we nail them?

Intramedullary nails (IMNs) are the treatment of choice for diaphyseal tibial fractures. Its use has been expanded both distally and proximally to cover metaphyseal fractures at both ends of the tibia. Several authors have stated that IMN use in proximal tibial fractures (extra-articular) can become problematic, leading to a significantly increased rate of malunion. Different strategies for solving this problem have been reported in recent years, but no strategy is fault-free. We review the causes of and solutions for increased malunion following use of IMNs for proximal tibial fractures.

Fracture Fixation, Intramedullary↗