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At least 163 records · Page 9Linked to original sources
PubMed1989

[Claw nails. Apropos of 16 cases treated by nail recession flap].

16 patients (75% women) were operated for a claw nail involving one of the three middle fingers. In 14 cases out of 16, a traumatic amputation, treated by directed healing in 60% of cases, was responsible for the deformity. The average loss of bone substance was 49% (range: 0-90%). The average shortening was 5 mm. The loss of substance was repaired by a local flap in 14 cases. Two early recurrences led to one failure and one good result after a second recession flap. One case of arthritis of the distal interphalangeal joint and one case of septic necrosis of the nail bed were also observed. Eleven subjects were reviewed with a mean follow-up of 4 years (1-7 years). The range of movement of the distal interphalangeal joint was always normal. The pinch force and the growth of the nail were normal in 75% of cases. The finger was cumbersome in one half of cases and 60% of patients complained of pain. Recurrences were observed in 50% of cases and the patients were disappointed in 64% of cases. This is a minor operation in terms of vascular elements, but it is associated with a high rate of recurrence and leaves a short finger. Its indications should be limited to losses of bone substance less than 50%.

Adolescent↗
PubMed1980

Combination urea and salicyclic acid ointment nail avulsion in nondystrophic nails: a follow-up observation.

Following the initial report by Farber and South on nonsurgical nail avulsion with urea ointment and their emphasis that the therapy was not helpful in treating nondystrophic nails, we utilized a similar therapy to treat a sixty-seven year old patient who had severe arteriosclerotic cardiovascular disease and relatively nondystrophic but symptomatic large toenail disease. Because their formulation was ineffective on nondystrophic nails, a formulation with an additive, 20 percent urea and 10 percent salicylic acid preparation was used. After a period of two weeks of occlusive paplication, painless nonsurgical avulsion was achieved. Moderate maceration of surrounding skin was temporary and relatively asymptomatic.

Aged↗
PubMed2006

[Intramedullary locked fixation and compression nail (IP-XS-Nail): treatment of ankle joint fractures].

OBJECTIVE: Reconstruction of the anatomy of the ankle joint while protecting the soft tissue, and osteosynthesis to maintain stability for function and weight bearing. INDICATIONS: Distal fractures of the fibula, bimalleolar fractures, and isolated fractures of the medial malleolus. CONTRAINDICATIONS: Very small (< 5 mm) distal fragments (if fixation of the fragments is not possible using a small XXS nail) and very narrow (< 2.5 mm) medullary cavity (conversion to plate fixation). SURGICAL TECHNIQUE: With displaced fibula fractures, open reduction should be performed with fracture retention using wide-armed reduction forceps, insertion of a central guide wire into the medullary cavity, use of a cannulated drill bit, introduction of the nail using an aiming arm and locked fixation with threaded wire. After checking the position using X-ray, the wire should be shortened using the bolt cutters. POSTOPERATIVE MANAGEMENT (Depending on the Weber classification): Full weight bearing for all isolated distal fractures of the fibula (Weber types A and B) and isolated fractures of the medial malleolus. For distal fractures of the fibula (Weber types A and B) with additional fracture of the medial malleolus or involvement of the medial ligament partial weight bearing of 20 kp for 4 weeks, followed by full weight bearing. For all Weber C fractures and/or additional Volkmann fracture only 10 kp of partial weight bearing with a rocker-sole orthosis should be allowed for 6 weeks followed by full weight bearing. No weight bearing for 6 weeks until the screws are removed is only recommended, if positioning screws have been used for Weber C fractures. RESULTS: In the period from 05/2000 to 01/2002, 194 ankle fractures were treated with the IP-XS-Nail((R)). Follow-up examinations were conducted on 162 patients with an average age of 51.2 years after an average of 15 months. 62 Weber B fractures (38.3%) and 45 Weber C fractures (27.7%) were evaluated. There were bimalleolar fractures in 55 cases (34.0%). According to the Olerud Score (clinical and radiologic score), 95 patients (58.6%) had an excellent, 54 (33.3%) a good, nine (5.5%) a moderate, and four (2.4%) an unsatisfactory result.

Adolescent↗
PubMed2002

[Retrograde locking nail osteosynthesis of distal femoral fractures with the distal femoral nail (DFN)].

Non-operative treatment with immobilization or isometric traction has been abandoned as treatment for fractures of the distal femur at the end of the 1960ies. The technique of open reduction and internal fixation with a condylar plate as suggested by the AO has been the golden standard since the 1970ies. However, anatomic reconstruction of the condylar region with interfragmentary screw fixation and axial realignment of the femur shaft with a plate are challenging procedures especially in the presence of severely compromised soft tissues and put periosteal blood supply at risk. Soft tissue complications, axial malalignment and delayed fracture healing times led to the consideration of alternative techniques, such as intramedullary nailing which has been practiced with success since the 1940ies by Gerhard Küntscher and colleagues for femoral shaft fractures with minimal complication rates and improved results after closed reduction. The era of retrograde femoral nailing began with the systematic approach through the intercondylar notch by Green. This paper reviews the biomechanical properties, indication, technique as well as potential hazards and pitfalls of fracture management with the AO "distal femoral nail" (DFN). With appropriate application this technique is suitable for all fractures of the distal third of the femoral shaft including highly instable bicondylar fractures without damage to the soft tissues and the knee joint.

Biomechanical Phenomena↗
PubMed2005

Humeral shaft fractures treated by dynamic compression plates, Ender nails and interlocking nails.

Between January 1991 and December 2002, we treated 92 acute, displaced, closed humeral shaft fractures (AO classification type A). We used three fixation methods: dynamic compression plates (DCP) in 36 patients, Ender nails (EN) in 32 patients and interlocking nails (ILN) in 24 patients. The patients were followed for a minimum of 24 months. At one year, all fractures except two (one DCP/one ILN) had united. Patients treated with EN had shorter mean operation time, 51 (35-110) min; less mean blood loss, 70 (30-170) ml and shorter mean hospital stay, 5.8 (3-12) days. There were three iatrogenic radial nerve palsies: two in the DCP group and one in the ILN group. There was one wound infection. There were three cases with impingement of the shoulder but range of motion was restored after nail removal. For patients with multiple trauma or high operative risk, EN fixation served as a safer and faster procedure. ILN fixation offered a stable fixation via a smaller incision but more fracture comminution might happen.

Adult↗
PubMed1999

Prospective randomized comparison of gliding nail and gamma nail in the therapy of trochanteric fractures.

In a prospective randomized study, we compared the new intramedullary implant of the gliding nail to the gamma nail in the fixation of 80 unstable trochanteric fractures in elderly patients. The preconditions of both groups were comparable. We found no differences concerning the operation time, blood loss, period of stationary treatment or social situation. Also, the anatomic reconstruction and the long-term function according to the Merle d'Aubigne score were comparable. Regarding postoperative complications, the gliding nail showed a minor tendency of cutting out; this we attribute to the special design of the dynamic blade and regard it as the most favourable advantage of this new implant.

Aged↗
PubMed1982

Nail relocation by nail flap in digital injuries.

In circumstances where the nail complex is intact and undamaged it may be wiser to relocate the nail as a flap based on its vascular supply rather than resort to pulp replacement procedures such as a cross-finger flap or similar techniques which leave a hyposensitive pulp and a "parrot-beak" deformity of the nail. In "acute" finger injuries this procedure is decidedly preferable to amputation through the head of the middle phalanx.

Adult↗
PubMed2004

The use of chloramphenicol ointment as an adhesive for replacement of the nail plate after simple nail bed repairs.

Fingertip injuries are common and are often repaired. The nail plate is replaced to protect the repair and maintain the alignment of the nail bed edges after repair. Once replaced, this can be secured by any means and often a suture is used. We advocate that a small bleb of chloramphenicol provides a simple method of securing the nail plate. It is fast, easy and secure. In addition it provides an antibacterial effect, which may be of some benefit.

Adhesives↗
PubMed2000

Closed intramedullary tibial nailing using the Marchetti-Vicenzi nail.

We present the results of using the Marchetti-Vicenzi nail in the management of 41 closed and 16 type I-III open tibial fractures in 56 patients. The treatment goals were to achieve stability and fracture alignment allowing early functional treatment of the knee and ankle by immediate partial or full weight-bearing. Early callus formation and rapid mobilisation were obtained in 84% of the patients. The mean time to clinical union was 9.8 weeks (radiological union 28.4 weeks) for closed fractures and also 9.8 weeks for open fractures (radiological union 28.7 weeks). No late rotational deformities were observed. We argue that intramedullary nailing with a Marchetti-Vicenzi nail is a quick and excellent method of treating selected closed and open tibial fractures.

Adolescent↗
PubMed2000

[Intramedullary nailing of humeral shaft fractures--initial experiences with an unreamed humerus nail]].

Interlocking intramedullary nailing has become the preferred method of internal fixation for diaphyseal fractures of the lower extremity. In shaft fractures of the humerus however open reduction and internal fixation with plates and screws is still considered the gold standard for operative treatment. The unreamed humerus nail (UHN) is a new implant for interlocking intramedullary nailing, which allows for stable fixation of humerus shaft fractures and immediate functional after treatment. The UHN could thus become an equal alternative to plate osteosynthesis. From this point of view we analyzed retrospectively 19 shaft fractures of the humerus, which have been treated at our institution with an UHN. Infections and iatrogenic nerve lesions did not occur. One patient with a rotational malalignment of 45 degrees underwent a secondary procedure. In two out of ten fresh fractures the bone healing failed and resulted in a non-union. In all cases of pathological fractures a good palliation could be achieved. With exception of two patients the range of motion of the shoulder and elbow was symmetric. We conclude that the UHN is a real alternative to plate osteosynthesis. Compared with most series of plate osteosynthesis published in the literature the risk for iatrogenic lesions of the radial nerve appears to be lower. Even in this small series we found however a rather high rate of non-unions.

Adult↗
PubMed2000

Radical surgery for ingrown nails by partial resection of the nail plate and matrix using a carbon dioxide laser.

BACKGROUND: We report here on the successful surgical treatment of ingrown nails by partial resection of the nail plate and matrix using a carbon dioxide laser. MATERIALS AND METHODS: The subjects of this study were 28 patients (37 cases) who visited our outpatient clinic with the chief complaint of ingrown nails of the great toe between October 1995 and October 1999. They included 12 males and 25 females. Patient age ranged from six to 72 years (mean 26.5 years), and the post operative follow-up period ranged from eight to 48 months (mean 23.2 months). RESULTS: Clinically, this treatment was excellent in terms of operating time reduction, mitigation of mid-operative and post-operative bleeding and pain, and treatment period reduction. Furthermore, no recurrences were observed during the study period. CONCLUSIONS: Judging from the good therapeutic results and improved quality of life of patients, this treatment is expected to be commonly used in the future.

Adolescent↗
PubMed2003

Elastic stable intramedullary nailing of midclavicular fractures with a titanium nail.

This study presents the results of a minimally invasive operative treatment for markedly displaced midclavicular fractures. In all patients a flexible titanium nail was inserted in an unreamed technique from the sternal end of the clavicle. The result of surgery was determined with clinical and radiographic controls. The clinical outcome was evaluated 12 months after hardware removal using the scoring system of Constant and Murley. Fifty-eight fractures in 55 patients were treated with intramedullary fixation. Postoperatively on Day 3, the mean subjective pain was significantly lower and range of motion was improved compared with the day before surgery. One nonunion occurred. There was no infection and no implant displacement or refracture. Intramedullary nailing of midclavicular fractures with a flexible titanium nail is a safe minimally invasive surgical technique with excellent functional and cosmetic results compared with plate fixation or conservative treatment. Marked pain reduction along with early restoration of shoulder function and early mobilization are advantageous for patients. This technique can be used as an alternative treatment to conservative procedures or plate fixation in patients with markedly displaced midclavicular fractures, multiple trauma, fractures of the lower extremities, or associated shoulder girdle injuries.

Adolescent↗
PubMed1988

A comparison of nail-plate fixation and Ender's nailing in pertrochanteric fractures.

A randomized comparison was made of condylocephalic (Ender) nails and a nail-plate technique (McLaughlin) for fixation of trochanteric fractures, to evaluate the consumption of acute hospital bed-days, number of reoperations, peroperative blood loss, and operation time. Reoperations were performed in 30% of the Ender group and in 10% of the McLaughlin group and blood loss was doubled for the McLaughlin method. Our study has shown, that in our hands, patients operated on with Ender nails had more reoperations, but in spite of this the total cost, in the form of days in hospital or operation time was not increased.

Aged↗
PubMed2002

Functional outcome after intramedullary nailing of humeral shaft fractures: comparison between retrograde Marchetti-Vicenzi and unreamed AO antegrade nailing.

BACKGROUND: We compared anesthesia time, complications, fracture healing, as well as shoulder and elbow function after retrograde and antegrade nailing of humeral shaft fractures or impending fractures. METHODS: Thirty retrograde Marchetti-Vicenzi nails (MVN) and 22 antegrade locked AO unreamed humeral nails (AO-UHN) were inserted in 52 patients. Forty-three fractures were followed up until healing, and three required reoperation for nonunion (two MVN, one AO-UHN). Nineteen MVN and 17 AO-UHN patients were evaluated according to Constant's shoulder score and HSS elbow score after an average of 2 years (0.5-3.4 years). RESULTS: Anesthesia time did not differ significantly in both groups. Differences in Constant's shoulder score between healthy and affected side were more important in the AO-UHN group due to limitation in ROM and loss of abduction power. Differences in HSS elbow score were similar in both groups, although four supracondylar fractures occurred in the MVN group. CONCLUSION: The retrograde approach to the humeral medullary cavity using a MVN resulted in better shoulder function and similar elbow function compared with the antegrade approach using an AO-UHN.

Adolescent↗
PubMed1995

Follow-up study of patients treated for ingrown nails with the nail matrix phenolization method.

In the past 7 years, a total of 537 ingrown nail lesions were treated with the nail matrix phenolization method (NMP). A study was performed based on follow-up examinations and a questionnaire survey regarding recurrence rate, degree severity, duration of postoperative pain, and other relevant factors. The major advantages of the NMP revealed by our study were: (1) The surgical procedure is easy to perform and does not require specialized equipment; (2) total time requirement for surgery is minimal; (3) the operation can be performed in the presence of a concomitant infection; (4) the recurrence rate is low (1.1%); and (5) postoperative pain and postoperative bed rest is minimized. These results indicate that NMP is an extremely effective method for treatment of ingrown nails.

Adolescent↗
PubMed2004

Tibial lengthening over nails in children using modified Ender nails: preliminary results of a new treatment.

Tibial lengthening over nails, using modified Ender nails, was performed in nine children whose mean age at surgery was 12.8 years. The prerequisite for using this technique was the absence of axial malalignment and an indication for tibial lengthening only. Lengthening was not performed in one case due to the development of a compartment syndrome after the tibial osteotomy. Breakage of one interlocking screw without loss of alignment or length was observed in one case. Superficial pin tract infections were observed in two cases. An average of 4.1 cm (range 3-4.5 cm) lengthening of the tibia was achieved in eight of the nine cases. The modified Ender nails used permitted locking at both ends after achieving the desired distraction and permitted early removal of the external fixator. The advantage of this technique is that it permits early removal of the fixator and thus decreases the incidence of fixator related problems and facilitates early rehabilitation.

Adolescent↗