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Nail bitting

Susan Osborne
Bit by bit, government meddling with the health service is diminishing the nurse's role.
July 6, 2016: Nursing Standard
Andreas F Mavrogenis, Georgios N Panagopoulos, Panayiotis D Megaloikonomos, Vasilios G Igoumenou, Ioannis Galanopoulos, Christos T Vottis, Panayiotis Karabinas, Panayiotis Koulouvaris, Vasilios A Kontogeorgakos, John Vlamis, Panayiotis J Papagelopoulos
Pertrochanteric fractures in elderly patients represent a major health issue. The available surgical options are fixation with extramedullary devices, intramedullary nailing, and arthroplasty. Intramedullary nailing for hip fractures has become more popular in recent years. Advantages of intramedullary nailing for hip fracture fixation include a more efficient load transfer due to the proximity of the implant to the medial calcar, less implant strain and shorter lever arm because of its closer positioning to the mechanical axis of the femur, significantly less soft tissue disruption and periosteal stripping of the femoral cortex, shorter operative time and hospital stay, fewer blood transfusions, better postoperative walking ability, and lower rates of leg-length discrepancy...
January 2016: Orthopedics
Shi-Min Chang, Ying-Qi Zhang, Zhuo Ma, Qing Li, Jens Dargel, Peer Eysel
PURPOSE: To introduce the concept of fracture reduction with positive medial cortical support and its clinical and radiological correlation in geriatric unstable pertrochanteric fractures. METHODS: A retrospective analysis of 127 patients (32 men and 95 women, with mean age 78.7 years) with AO/OTA 31A2.2 and 2.3 hip fractures treated with cephalomedullary nail (PFNA-II or Gamma-3) between July 2010 and June 2013 was performed. They were classified into three groups according the grade of medial cortical support in postoperative fracture reduction (positive, neutral, and negative)...
June 2015: Archives of Orthopaedic and Trauma Surgery
Sithombo Maqungo, Anria Horn, Brian Bernstein, Marius Keel, Stephen Roche
OBJECTIVES: To compare the free-hand (FH) technique of placing interlocking screws to a commercially available electromagnetic (EM) targeting system in terms of operating time, radiation dose, and accuracy of screw placement. METHODS: Between September 2011 and July 2012, we prospectively randomized 100 consecutive femur shaft fractures in 99 patients requiring intramedullary nails to either FH using fluoroscopy (n = 43) or EM targeting (n = 38; Sureshot). SETTING: Single Level 1 University Hospital Trauma Center...
December 2014: Journal of Orthopaedic Trauma
P Nenoff, I Winter, A Winter, C Krüger, J Herrmann, Y Gräser, N Rangno, T Maier, J C Simon
BACKGROUND: In 1969, Kolipp and Hoffmann isolated Trichophyton (T.) thuringiense spec. nov. Koch when they performed their thesis dealing with the distribution and epidemiology of dermatophytes and keratinophilic fungi in mice and other small mammals. At that time, T. thuringiense was detected as saprophytic fungus of the skin of different mice species (e.g. Mus musculus) both in rural and urban settings in the area of Thuringia in Germany. There were no further reports on this dermatophyte species until now, neither in animals, nor in man...
March 2014: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Ritesh Kumar Soni, Surender Mohan Mehta, Bhanu Awasthi, Janith Lal Singh, Amit Kumar, Lokesh Thakur, Sujit Kumar Tripathy
BACKGROUND: Distal interlocking screw insertion in intramedullary nailing of long-bone fracture is a challenging task for orthopedic surgeons. It is difficult particularly when the surgeon is in his learning stage or when image intensifier is not available. We describe a radiation-free technique of distal interlocking screw insertion which is easy and practicable. MATERIALS AND METHODS: In this technique, a same length nail is placed over the skin (outer nail) and through its distal-most screw hole, a 3...
January 2012: Journal of Surgical Technique and Case Report
D Höntzsch, M Blauth, R Attal
OBJECTIVE: Greater stability in intramedullary osteosynthesis using angle-stable fixation with intramedullary nails and proximal locking screws. A novel screw-and-sleeve system (ASLS®, Synthes GmbH, Oberdorf, Switzerland) is applied using normal cannulated nails. Decisions can be made intraoperatively. INDICATIONS: This technology widens the range of indications for intramedullary nailing: The smaller and less stable the fragment requiring fixation, the greater the indication for angular stable fixation of the proximal and/or distal fragment...
December 2011: Operative Orthopädie und Traumatologie
B K Moor, M Ehlinger, Y Arlettaz
BACKGROUND: During the last decades, intramedullary nailing has become the standard treatment for diaphyseal fractures of long bones. Numerous innovative techniques and devices have been proposed to simplify distal locking. Each has its own limitations and, as a result, the fluoroscopy-dependent "free-hand technique" remains the most popular method. However, radiation exposure to the patient and operating room staff remains a concern. METHODS: Before the development of a new radiation-independent, nail-mounted targeting system, we mathematically analyzed the aiming accuracy that such a system has to achieve...
February 2012: Orthopaedics & Traumatology, Surgery & Research: OTSR
V Smekal, R Attal, C Dallapozza, D Krappinger
OBJECTIVE: To restore alignment and length of the clavicle, to relieve typical symptoms of malunion, and to improve functional outcome and aesthetic results. INDICATIONS: Symptomatic malunion after clavicular fractures, including local pain and tenderness, weakness and rapid fatigability of the shoulder girdle muscles, impairment of overhead mobility, numbness, parasthesia, and pain of the arm and fingers during overhead movements due to brachial plexus irritation (thoracic outlet syndrome), and dissatisfaction with the appearance of the shoulder girdle...
December 2011: Operative Orthopädie und Traumatologie
Mohammad Taghi Peivandi, Amir Reza Kachooei, Zohreh Nazemian
Removing a broken guide wire is difficult and challenging. This article reports a method that was used to successfully remove a broken guide wire in 3 patients who underwent operative treatment for intertrochanteric fractures of the femur. Under general anesthesia, the first patient was placed on the orthopedic fracture table, and closed reduction of the hip fracture was performed under the image intensifier. A 2-mm non-threaded pin was used in the center of the femoral neck, and the amount of reaming required was determined...
October 2011: Orthopedics
Mervyn Singer, David Brealey
Blood pressure saggy? Cardiac output low? Oliguria? Increasing acidosis? Peripheries a bit cool? Poor cardiac history? No problem. Just start some dobutamine and watch the numbers improve. And if the patient happens to die, that is their fault. Or is it? Catecholamines are long-established drugs that have never undergone formal testing of long-term outcomes and safety. Their use requires re-evaluation in the light of a wide range of deleterious actions and retrospective studies suggesting harm.
2011: Critical Care: the Official Journal of the Critical Care Forum
Bryce M Fincham, Todd Jaeblon
Successful penetration of bone is dependent on several factors, including bone quality, drill bit and pin design, and drilling technique. Wires are also used in bone drilling, and the tip configuration can affect the efficiency of bone penetration. Incorrect use of drill bits, pins, and wires may result in complications such as thermal necrosis and hardware breakage.
September 2011: Journal of the American Academy of Orthopaedic Surgeons
Sreenivasulu Metikala, Riazuddin Mohammed
BACKGROUND: Extracting broken segments of intramedullay nails from long bones can be an operative challenge, particularly from the distal end. We report a case series where a simple and reproducible technique of extracting broken femoral cannulated nails using a ball-tipped guide wire is described. This closed technique involves no additional equipment or instruments. MATERIALS AND METHODS: Eight patients who underwent the described method were included in the study...
July 2011: Indian Journal of Orthopaedics
Cory Collinge, Frank Liporace, Kenneth Koval, George T Gilbert
OBJECTIVES: In 2004, we modified our technique for the stabilization of femoral shaft fractures so that all fractures were stabilized using a reconstruction nail with proximal locking screws oriented into the femoral head. The rationale for this was twofold: first, potentially "missed" associated femoral neck fractures would be stabilized. Second, hip fractures that might occur later in life above the intramedullary nail might be avoided. The purpose of this study therefore was to determine whether there were any risks to patients treated for femoral shaft fractures with antegrade nails using cephalomedullary proximal locking screws...
December 2010: Journal of Orthopaedic Trauma
J Bartonícek, P Dousa, M Krbec
UNLABELLED: Based on the analysis of their group of 75 patients treated for the fracture of proximal femur by means of the Gamma nail and on the analysis of data from the literature the authors present a comprehensive list of all complications resulting from this technique: inadequate reduction, -jamming of nail, fracture displacement by nail isertion, perforation of the head, incorrect length of the lag screw, problems with distal locking, fracture of the femoral shaft, rotation of head on the lag screw, rotation of diaphysis on the nail, failure of the healing of the wound and infection, breaking of the nail, non-union, healing in the varus position, aseptic necrosis of the head, incorrect rotational position of the limb, unequal length of lower limbs, problems with the set of instruments, migration of the set screw...
1998: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
K A Bubeck, J García-López, L S Maranda
OBJECTIVES: To compare heat generation and time to finish between a new step drill and sequential drilling in order to create a 6.2 mm pilot hole for insertion of a positive profile transfixation pin into the equine third metacarpal bone. METHODS: Nine pairs of equine third metacarpal bones from cadavers of adult horses were used. Maximum temperature rise of the bone was measured continuously at the cis- and trans-cortices 1, 2 and 3 mm from the final pilot hole during creation of a 6...
2009: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
J Bartonícek
Injury to femoral vessels in trochanteric fractures is a rare but a severe complication. Most often it involves the profunda femoris artery, less often the (superficial) femoral artery. This injury may be caused by different mechanisms; most frequently by pressure of a sharp bone fragment (the lesser trochanter), the tip of protruding cortical screws (extramedullary implant) or the distal locking screw (Gamma nail). Less often it is caused by the drill bit or incorrectly placed elevators. Pressure of a sharp bone fragment or contact with protruding tips of screws results in a gradual erosion of vessels and consequently in development of false aneurysm...
April 2009: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Alvin J Detterline, Christian Lattermann, Bernard R Bach
Transosseous patellar tunnels commonly are used in the repair of acute or chronic patellar tendon or quadriceps tendon ruptures. Commonly, a small diameter (2.0-3.5 mm) drill bit is used to create these drill tunnels. However, drill bits are relatively brittle and susceptible to breakage. The use of a larger diameter smooth Steinmann pin (3/32") is recommended to create transosseous patellar tunnels to eliminate this potential complication.
July 2007: Journal of Knee Surgery
S J Matthews, R E Landsmeer, T L Thomas
No abstract text is available yet for this article.
May 2006: Annals of the Royal College of Surgeons of England
Tim Ivor Williams, Rebecca Rose, Sarah Chisholm
OBJECTIVE: To compare the frequency of nail biting in 4 settings (interventions) designed to elicit the functions of nail biting and to compare the results with a self-report questionnaire about the functions of nail biting. DESIGN: Randomised allocation of participants to order of conditions. SETTING: University Psychology Department. SUBJECTS: Forty undergraduates who reported biting their nails. INTERVENTIONS: Left alone (boredom), solving maths problems (frustration), reprimanded for nail biting (contingent attention), continuous conversation (noncontingent attention)...
May 2007: Behaviour Research and Therapy
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