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At least 1,099 records · Page 61Linked to original sources
PubMed1998

Indications for use of the long Gamma nail.

A retrospective analysis of 42 patients treated by intramedullary nailing with the Gamma nail with a mean followup of 22.4 months is reported. The indications for the use of this nail were subtrochanteric fractures in 31 cases, diaphyseal femoral fractures in 10 cases, and segmental fracture in one case. Seven cases of the diaphyseal fractures were renailings for a previously placed nail. There was one pathologic fracture in the subtrochanteric group and three in the diaphyseal group. The indications of this new technique and its complications are analyzed.

Adult↗
PubMed2000

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

The effects of intermittent administration of parathyroid hormone on fracture healing in ovariectomized rats were examined to evaluate its potential use as a therapeutic agent for osteoporotic fractures. Three months postovariectomy, bilateral tibial shaft fractures were induced and stabilized by intramedullary nailing with Kirschner wires. Saline, 17beta-estradiol (Sigma Chemical Corp, St Louis, Mo), or recombinant human parathyroid hormone (1-84) (Korean Green-Cross Pharm Corp, Seoul, Korea) 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. A bone-resorption inhibiting agent, 17beta-estradiol did not offer advantage in terms of fracture healing in ovariectomized rats. Findings suggest intermittent parathyroid hormone administration may benefit osteoporosis and fracture.

Animals↗
PubMed1995

Retrograde locked nailing of humeral shaft fractures. A review of 39 patients.

We treated 39 patients with fractures of the humeral shaft by closed retrograde locked intramedullary nailing, using Russell-Taylor humeral nails. The mean healing time of all fractures was 13.7 weeks. After consolidation, shoulder function was excellent in 92.3% and elbow function excellent in 87.2%. Functional end-results were excellent in 84.6% of patients, moderate in 10.3% and bad in 5.1%. One patient had a postoperative radial nerve palsy, which recovered within three months. There was additional comminution at the fracture site in three patients (7.7%) which did not affect healing, and slight nail migration in two older patients (5.1%). Two patients (5.1%) needed a second procedure because of disturbed fracture healing. One screw breakage was seen in a patient with delayed union. Retrograde locked humeral nailing appears to be a better solution for the stabilisation of fractures of the humeral shaft than anterograde nailing or plate and screw fixation. We found the complication rate to be acceptable and shoulder and elbow function to recover rapidly in most cases.

Adolescent↗
PubMedDate not supplied

[The biomechanical basis for the number of blocking screws in the intramedullary metal-polymer osteosynthesis of comminuted longitudinally unstable fractures of the femoral diaphysis].

A technique is submitted for finding the minimum number of blocking screws in carrying out a blocking intramedullary metallopolymeric osteosynthesis of comminuted longitudinal unstable fractures of the femoral diaphysis. It has been shown that to ensure stability of the system of injury "bone-clamp" under conditions of dynamic loads it is necessary that four blocking screws be passed in age groups I and II, with six blocking screws being used in age group III.

Adult↗
PubMed1993

Bone healing following two methods of non-rigid tibial osteotomy repair in the dog.

Bone healing was assessed after stabilisation of transverse tibial osteotomies in adult Beagles (n = 6) with intramedullary pins, in conjunction with modified Mennen clamp-on plates to counteract rotation. Post-operative return to full limb function was compared to that after use of a two-pin, uniplanar (Type I) external skeletal fixator and an intramedullary pin combination (n = 6). Additional external splinting was not used. The dogs were graded weekly after exercise, according to a functional performance grading scale. All of the clamp-on plates were well tolerated. Bony periosteal callus incorporated the crimp arms and the mean time required for full limb function was 7 weeks. The clinical performance of the dogs, with the external skeletal fixators and intramedullary pins, was consistently lower during the initial 4 weeks. Soft tissue swellings with pin-tract drainage occurred, but resolved following removal of the transcortical fixation pins. These dogs returned to full limb function with bony bridging callus after 8 to 9 weeks. Quantitative assessment of the bone activity, using sequential scintigraphy at weekly intervals, suggested consolidation of the callus 6 weeks after the operation for the clamp-on plate and pin combination, and at 7 weeks for the external skeletal fixator and pin combination.

Animals↗
PubMed1998

Treatment of femoral fractures after irradiation.

Twelve fractures of the femur occurred after irradiation in 12 patients during the past 15 years. All 12 patients had excision of a soft tissue sarcoma of the thigh. The periosteum was stripped in every case. The fractures had a deceptively innocuous radiographic appearance, which showed minimal comminution, displacement, and shortening. Treatment of the fractures was difficult and demanding. At a mean followup of 37 months, bony union was achieved in only four patients, and in all four cases union was delayed beyond 12 months. Because fracture healing typically is delayed, a loadsharing device such as an intramedullary nail may be preferable in treating these fractures. Primary or delayed bone grafting may be necessary, for no fracture united without bone graft. For elderly patients with low supracondylar fractures, primary endoprosthetic replacement may effect quicker rehabilitation. The possibility of local recurrence of tumor should be ruled out before definitive surgical treatment of the fracture. Closed, antegrade nailing in the presence of recurrent tumor may contaminate the flap for a salvage procedure such as hemipelvectomy and may compromise chances for cure.

Bone Transplantation↗
PubMed1987

Flexible intramedullary nailing of tibial shaft fractures.

At the author's institution, flexible intramedullary nailing of long bones is most commonly used in tibial fractures. The 4.0-mm nails are most frequently used and are supplemented with the 3.5-mm nails. Over 95% of the nailed tibial fractures are stabilized in the antegrade method directed from the proximal tibia into the distal fragment. Retrograde nailing is done most often to supplement the stability of fractures in the distal third. Surgery can be performed on a standard fracture table with the patient placed on a radiotranslucent board; a biplanar image intensifier is required. Functional bracing is used four to six weeks after surgery. Early solid union is obtained even in comminuted fractures.

Bone Nails↗
PubMed2005

The use of traction to simplify intramedullary fixation of paediatric forearm fractures.

A minority of paediatric and early adolescent diaphyseal forearm fractures require operative fixation. The method of closed reduction and intramedullary stabilisation of such fractures using stainless steel pins or flexible titanium nails has well documented success rates. The literature proposing their use advises the wires are inserted with the forearm resting free on a radiolucent arm table. In our experience, this technique is demanding; the fracture sites are unstable, often with soft tissue interposition, and the proximal radial fragment is difficult to control by closed means because of the overlying muscle mass. The technique, we describe, employs a standard Maquet Orthostar traction table (Maquet, Colima Ave, Hylton Riverside, Sunderland, UK) to effect a stable closed reduction of diaphyseal forearm fractures to simplify the procedure of passing the radial wire. The traction is then released to allow elbow flexion and the ulna wire to be passed, the ulna fracture having been reduced by the traction and stabilised by the radial wire. In summary, the use of traction to reduce and stabilise the radial fracture has simplified the surgery and reduced operative time.

Bone Wires↗
PubMed2003

Difficulties in removing ACE tibial intramedullary nail.

We experienced three cases of refracture and two cases of failure to remove the nail while trying to take out ACE tibial nails from healed tibial fractures. In order to determine the risk factors associated with difficulties in nail removal, these five patients were compared in the parameters of age, gender, duration of nail in situ, nail diameter, nail length, and level of fracture with 30 patients who had uneventful removal. Younger age of the patient was significantly associated with the difficulty in nail removal.

Adolescent↗
PubMed2001

Antegrade locked intramedullary nailing in humeral shaft fractures.

Thirty-three humeral nailings were carried out using the Russell-Taylor nail. Twenty-two acute fractures and one non-union united, gave an overall union rate of 70%. Eighteen patients (56%) experienced pain in the shoulder or at the fracture site. Thirteen patients (41%) had poor shoulder function. Only 17 (51%) of the patients were satisfied with the outcome. Fourteen patients (42%) needed further surgery. We conclude that antegrade intamedullary nailing of humeral shaft fractures leads to a substantial risk of non-union and impairment of shoulder function. There was no significant correlation between fracture comminution and fracture healing in our study.

Adult↗
PubMed1994

[Callus distraction with the AO tubular fixator--principles, techniques and clinical examples].

Callus distraction in segmental transport for closure of traumatic or operative bone defects can be performed with the AO tubular fixator in various ways. Depending on the soft tissue situation and personal preference segmental shifting may either be achieved by tension wires running through the soft tissues (Augsburg model) or by percutaneous Schanz' screws (Basel model). Transportation along an intramedullary nail has certain advantages but also specific draw-backs. To be able to apply the optimal technique to a given situation it is necessary to be familiar with each of these methods. A hybrid system under development at this moment will facilitate anchorage in short epiphyseal segments. We are also going to have a clamp which can turn in itself for correction of axial malalignment.

Adult↗
PubMed1986

Intramedullary nailing and reaming for delayed union or nonunion of the femoral shaft. A report of 105 consecutive cases.

One hundred five consecutive patients with a diagnosis of delayed union (61 patients) or nonunion (44 patients) of the femoral shaft from February 1968 to November 1983 were managed by intramedullary reaming and nailing. The procedure was accomplished by closed techniques in 82 of the cases. Adequate follow-up study was obtained in 101 patients; all but four showed clinical and radiologic union at an average of 20 weeks following the procedure, with an overall union rate of 96%. The four patients whose fractures failed to consolidate with this treatment had repeat procedures with placement of thicker nails, and all subsequently healed.

Adult↗
PubMed1993

Open adult femoral shaft fracture treated by early intramedullary nailing.

In two hospitals, 115 consecutive open femoral shaft fractures were treated by meticulous wound excision and early locked (97) or unlocked (18) intramedullary nailing. All the fractures united; union was delayed in four, three of which required bone grafting. The average range of knee flexion at follow-up was 134 degrees (60 to 148). Five patients had a final range of less than 120 degrees, but three of these improved after manipulation under general anaesthesia. Three patients developed staphylococcal infections and required further surgical treatment. All eventually healed.

Adolescent↗
PubMed1995

Femoral neck fracture: a complication of femoral nailing.

A fracture of the shaft of the femur in adults is common after road traffic accidents. Until recently it was not known that a fracture of the femoral neck can occur while fixing the femoral shaft fracture with an intramedullary nail. We report three patients in whom femoral neck fractures occurred during femoral nailing. Fractures of the femoral neck were detected by routine postoperative radiographs of the hip joint. All the three patients were treated non-operatively and the fractures healed without complication. The cause of the femoral neck fracture seems to be forceful use of an awl in the wrong direction or multiple entry points in the trochanteric region which weaken the femoral neck; subsequent hammering of the nail completes the fracture.

Adult↗
PubMed1994

Intramedullary interlocking nailing for humeral fractures: experiences with the Russell-Taylor humeral nail.

The Russell-Taylor intramedullary interlocking nail has been used on 39 patients with fractures that occurred at various levels of the humerus. Thirty patients had acute fractures and nine had pathological fractures. Twenty-five patients with acute fractures were re-examined after their fractures had united and assessed according to Neer's classification of shoulder function. Twenty-two (88 per cent) had excellent and satisfactory shoulder function. Pain relief was achieved in all pathological fractures. Shoulder pain encountered in a few patients in this series, where nailing was performed by the antegrade route, was mainly due to problems associated with the proximal interlocking screw.

Adolescent↗
PubMed1992

Treatment of humeral diaphyseal fractures with Hackethal stacked nailing: a report of 33 cases.

Hackethal's technique of stacked intramedullary (IM) nailing was used to treat 43 consecutive acute fractures of the humeral diaphysis. Of these, 6 were lost to follow-up and 4 additional patients were excluded for pathologic fractures. All of the remaining 33 traumatic fractures were followed until union. The average age was 34 years. Mean operative time was 90 min. Usually four or five 2- or 3-mm IM Kirschner wires were introduced in a retrograde manner, through a posterior unicortical window under radioscopic control. Closed reductions were performed in 28 patients, and open reductions were performed in the other five. Time to follow-up averaged 3 years 5 months (range 8 months to 13 years). There were no infections. There were three nonunions (9%), and two nails in 1 patient penetrated the greater tuberosity and one nail migrated distally in another patient. This method of internal fixation is not complicated and causes minimal trauma. It provides good stability at the fracture site and permits early mobilization of patients with excellent functional results.

Adolescent↗
PubMed1994

Muscle contraction increases the strength of healing tibial fracture in the rat.

Tibial fractures in 7-week-old rats were fixed with intramedullary nails. After 25 days of healing the nails were removed and the tibiae loaded in vivo with intact soft tissues until refracture. The animals were tested in three-point anterior cantilever bending either during muscle contraction (n 8) or with relaxed muscles (n 8). Muscle contraction increased the ultimate bending moment by 84 percent, energy absorption by 108 percent, bending stiffness by 21 percent, and ultimate deflection by 49 percent.

Animals↗
PubMed2004

Exclusion of a crural pseudoaneurysm with a PTFE-covered stent-graft.

PURPOSE: To describe the successful endovascular treatment of an iatrogenic anterior tibial artery pseudoaneurysm with a polytetrafluoroethylene-covered stent-graft. CASE REPORT: A 58-year-old man was admitted to our hospital with pseudoarthrosis and malunion of the right distal tibia. Fibulotomy and intramedullary fixation were performed, which was complicated by a pseudoaneurysm of the anterior tibial artery. Under local anesthesia, a 4x31-mm Symbiot covered stent was successfully placed over the origin of the pseudoaneurysm. At 12 months, the pseudoaneurysm remained excluded, and the anterior tibial artery was patent. CONCLUSIONS: Endovascular treatment of a crural artery pseudoaneurysm seems to be a feasible treatment option. Further experience with this technique is needed to validate its safety and long-term patency.

Aneurysm, False↗