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At least 19 recordsLinked to original sources

The use of a combination nail elevator and hemostat clamp. New instruments for nail avulsion.

Nail avulsion surgery is frequently accomplished using a hemostat clamp with or without a nail elevator device. Two new instruments have been developed that combine the useful design specifications of the hemostat clamp with the nail elevator device. Specifically, one blade of the hemostat is replaced with either a nail elevator spatula or a Freer septum elevator allowing nail elevation, clamping, and removal with a single instrument. Use of either device is more efficient because nail avulsion is completed using a single instrument thereby reducing procedural steps and handling and sterilization costs. Furthermore, these instruments may reduce the risk of trauma to the nail bed and matrix during nail avulsion. The instruments and their use are described.

Humans

[A new intramedullary nailing system for long bone fractures--biomechanical evaluation and animal study of a new intramedullary nail].

Interlocking intramedullary nails have expanded their application to the fixation of long bones especially for unstable or comminuted fractures. However, there are certain drawbacks in this method: prolongation of operative time and increased radiation hazard to the patient as well as to the surgical staff, the latter of which is especially a problem in the distal interlocking under fluoroscopic control. In order to solve the problem a new intramedullary nail (J-type) was developed and tested in vitro with Hiprox femur models as well as in vivo using canine models. The nail made of Ti-6Al-4V alloy is composed of an inner nail and an outer cylinder. The proximal portion is transversely fixed with two screws, while the distal portion is fixed into the cancellous bone with four expandable blades. The strength of fixation with this nail was compared to those with four other commercially available interlocking nails as to bending, tortional and compression stiffness as well as to the durability against repeated compression. In the present in vitro and in vivo experiments, a newly developed intramedullary nail (J-type) provides evidence for satisfactory mechanical strength. The use of J-type nail also contributes to shorter operative time and reduction of radiation hazard.

Animals

Pulmonary damage after intramedullary femoral nailing in traumatized sheep--is there an effect from different nailing methods?

Stabilization of femoral shaft fractures is a controversial issue in the management of patients with multiple trauma. Intramedullary nailing usually is preferred primarily; in recent years, however, pulmonary complications (e.g., ARDS) have been reported that were attributed to the reaming procedure. To study the effects of different nailing methods in a model of severe trauma, hemorrhagic shock and lung contusion were created at day 1 in sheep prepared by the method described by Staub. After recuperation (day 3) the animals in the study group (group 1) underwent intramedullary nailing of a closed femur without prior reaming; group 2 was treated with reaming and nailing according to AO standards. The reaming procedure led to an acute increase of pulmonary arterial pressure only in group 2 (19.8 +/- 2.1 to 31.0 +/- 4.6 mm Hg). Pulmonary triglyceride levels increased at parallel time points from 18.27 +/- 2.3 to 33.04 +/- 7.37 mg/dL only in group 2. Stimulatory capacity of polymorphonuclear leukocytes (PMNL) increased in the study group and decreased in controls (group 1: 2.652 +/- 0.23 x 10(6) cpm to 3.387 +/- 1.34 x 10(6) cpm; group 2: 2.699 +/- 0.34 x 10(6) cpm to 2.460 +/- 0.187 x 10(6) cpm). Intramedullary nailing caused an increase of lung capillary permeability in both groups; in the study group less damage was seen (group 1: 0.390 +/- 0.0006 to 0.354 +/- 0.011; group 2: 0.391 +/- 0.0004 to 0.336 +/- 0.015; p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylglucosaminidase

[Ascending bipolar nailing using elastic nails in the treatment of fractures of the upper end of the humerus (author's transl)].

In the treatment of non-impacted fractures of the upper end of the humerus, the tendency of many surgeons is to use nailing with the fracture site closed, from the supra-olecranon fossa. This would seem to merit certain criticisms. Following reduction of the fracture, we use Ender elastic nails and two modified nails of a smaller calibre, one inserted via the epicondyle and the other via the epitrochlea. The technique of this ascending bipolar nailing using elastic nails is carried out in a horizontal supine position, which facilitates manoeuvres of reduction and facilitates anaesthesia. Apart from non-impacted fractures of the upper end of the humerus, other indications exist.

Fracture Fixation, Internal

Two families with congenital nail anomalies: Nail formation in ectopic areas.

Two families with congenital nail anomalies are reported. The nail covered not only the dorsal but also some of the palmar aspect of the distal phalanx. The ungual phalanges of the affected fingers were lacking in the crescent-shaped cap and had a blunt Y-shaped bony projection. The anomalies may have been transmitted by an autosomal recessive gene.

Child

The use of porcine xenografts on nail beds following total nail avulsion and phenol chemomatrixectomy.

The success of applying split-thickness porcine xenografts to nail beds after nail avulsion with matrix chemocauterization depends on the adherence of the graft to the underlying tissue. When this was obtained, the authors found that porcine xenografts contribute markedly toward reducing postoperative pain and drainage. Further investigation is being undertaken to determine whether total healing time following chemomatrixectomy has been reduced by utilizing xenografts.

Animals

[The value of Ender nailing in hip para-articular femoral fractures in gerontologic traumatology. Ender nailing--hip para-articular femoral fractures--gerontologic traumatology].

Nailing according to Ender is one of several competing methods of osteosynthesis for treating per- and subtrochanteric fractures of the femur in geronto-traumatology. Within 5 years we have treated 62 geriatric patients by this procedure. The average-age of our patients was about 76 years. Only 20 of them were able to be examined after a time of ca. 37 months post operationem. Intraoperative complications were backing out of the femur corticalis at the entry hole, followed by perforations of the head or neck of the femur. In one case we saw a supracondylar fracture. In the postoperative period we mostly found dislocations of the nails to cranial or caudal. Moreover there were one wound infect and one pseudarthrosis. The mortality rate came to 6.5% and was never caused by the method. When leaving the hospital the majority of the elderly patients was mobilized and able to walk. In spite of reduction of function of hip and knee and external rotation deformity and shortened legs the patients declared to be content with the result of the operation. Important geronto-traumatological aspects of the Endernailing-method could be seen in the simple procedure, the short operating time, a minimal surgical trauma and a diminishing of the risk of the mostly multi-morbid patients. Regarding the great number of specific complications competing methods are going on to be preferred. Meanwhile the application of Endernails is an exception in geronto-traumatology.

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