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Intramedullary nailing

Matthew Aizpuru, Christopher Staley, William Reisman, Michael B Gottschalk, Mara L Schenker
OBJECTIVES: To investigate the determinants of length of stay (LOS) for patients surgically treated for femur fractures. DESIGN: Retrospective medical record review. SETTING: Urban Level I Trauma Center. PARTICIPANTS: Three hundred twenty-one patients operatively treated for femur fractures between July 12, 2015 and July 12, 2016. INTERVENTION: Intramedullary nailing, open reduction internal fixation, arthroplasty, or other (percutaneous screw or multiple hardware/technique) definitive fixation of femur fracture...
April 2018: Journal of Orthopaedic Trauma
Chaowei Guo, Jianxiong Ma, Xinlong Ma, Ying Wang, Lei Sun, Bin Lu, AiXian Tian, Yan Wang, BenChao Dong
BACKGROUND: Intramedullary nailing (IMN) and plate have been reported as two effective devices for treating distal extra-articular fractures. However, reports of complications after fractures with use of different tibial fixation techniques in literatures are controversial. Thus, we performed a meta-analysis of randomized controlled trials (RCTs) to compare IMN with plate for evaluating the safety and efficacy. METHODS: The studies were searched from PubMed, Embase, Web of science and the Cochrane Central Register of Controlled Trials by two reviewers up to August 2017...
March 16, 2018: International Journal of Surgery
Emanuel Rivera-Rosado, David Beaton-Comulada, Eric Hernandez-Ortiz, Pablo V Marrero-Ortiz
Fibrous dysplasia is a benign developmental disorder of bone in which fibrous connective tissue containing abnormal bone with irregular trabeculae replaces normal cancellous bone. It may affect 1 (monostotic) or multiple bones (polyostotic). Polyostotic disease is the less common of the 2, occurring in only 20 to 25% of fibrous dysplasia patients and tending to affect those who are younger than 10 years of age; patients having this form tend to experience bone enlargement beyond normal skeletal maturation, which can cause pain, progressive damage, and increased risk of pathological fracture...
March 2018: Puerto Rico Health Sciences Journal
J S Palmer, P Ward
No abstract text is available yet for this article.
March 15, 2018: Annals of the Royal College of Surgeons of England
Richard Yoon, Frank Liporace
Today intramedullary nails (IMN) are the gold standard in the treatment of femur fractures. Since its inception, improved design and understanding of the surrounding anatomy has exponentially increased successful patient treatment and outcomes by promoting early mobilization and reliable union. In this review, we provide an in-depth look into the evolutionary process that has led IMN to becoming today's gold standard in femur fractures.
March 2018: Bulletin of the Hospital for Joint Diseases
Sherif Galal
OBJECTIVES: The best fixation method for open tibial fractures has long been a matter of debate, many studies have recommended the use of intramedullary nails over external fixation for treating such fractures, recent studies also showed favorable results for the use of plates in managing open tibial fractures. However, there are very few (if any) reports in the literature comparing the use of minimally invasive plate osteosynthesis to reamed intramedullary nails in the fixation of open tibial fractures...
March 8, 2018: Injury
Anas Nooh, Krista Goulding, Marc H Isler, Sophie Mottard, Annie Arteau, Norbert Dion, Robert Turcotte
BACKGROUND: Bone metastases represent the most frequent cause of cancer-related pain, affecting health-related quality of life and creating a substantial burden on the healthcare system. Although most bony metastatic lesions can be managed nonoperatively, surgical management can help patients reduce severe pain, avoid impending fracture, and stabilize pathologic fractures. Studies have demonstrated functional improvement postoperatively as early as 6 weeks, but little data exist on the temporal progress of these improvements or on the changes in quality of life over time as a result of surgical intervention...
March 2018: Clinical Orthopaedics and related Research
Mohammed Saquib Hussain, Steven Kyle Dailey, Frank R Avilucea
With an aging population, treatment of interprosthetic femur fractures continues to pose a challenge to the orthopedic surgeon. Retrograde IMN combined with open reduction internal fixation utilizing a tissue-preserving plating technique was used in our series of 9 patients with non-comminuted, distal femur fractures. No interfragmentary screws, cables, cerclage wires, or supplemental bone grafts of any type were used. Each patient initiated weight-bearing as tolerated following operative intervention. Every fracture healed at an average of 20 weeks (range 18 to 24 weeks)...
February 23, 2018: Journal of Orthopaedic Trauma
Jakub J Słowiński, Konrad Kudłacik
Introduction: The treatment of femoral diaphyseal fractures by intramedullary nailing has become a common procedure in orthopaedic surgery. The purpose of this numerical simulation was to present how the changes in configuration of the stabilisation system can affect the stress and displacement state in the bone tissue and implanted device. Material and Methods: The numerical comparison of the stabilisation variants for the type 32-A2 femoral diaphyseal fracture (according to the AO classification) performed by using the Charfix2 (ChM®) anatomical nail locked in a number of chosen ways...
2018: Applied Bionics and Biomechanics
Megan E Cain, Job N Doornberg, Robin Duit, Jock Clarnette, Ruurd Jaarsma, Bhavin Jadav
BACKGROUND: Intramedullary-nails (IMN) are the treatment of choice for most tibial shaft fractures due to their minimally-invasive nature and non-demanding surgical technique. However, a potential iatrogenic pitfall is intra-articular interlocking screw positioning within the proximal (PTFJ) and distal (DTFJ) tibiofibular joints that may go unrecognized. OBJECTIVE: To evaluate the incidence of intra-articular screw penetration of the PTFJ and DTFJs after interlocking of IMN for tibial fractures...
March 1, 2018: Injury
Leo Nherera, Paul Trueman, Alan Horner, Tracy Watson, Alan J Johnstone
BACKGROUND: Intertrochanteric hip fractures are common and devastating injuries especially for the elderly. Surgical treatment is the optimal strategy for managing intertrochanteric fractures as it allows early rehabilitation and functional recovery. The relative effects of internal fixation strategies for intertrochanteric fracture after operation remain limited to relatively small studies which create uncertainty in attempts to establish evidence-based best practice. METHODS: We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) and observational studies to assess the clinical effectiveness of two commonly used intramedullary devices: a twin screw integrated cephalomedullary nail (InterTAN) versus a single screw cephalomedullary nail (proximal femoral nail antirotation) in patients with intertrochanteric fractures...
March 2, 2018: Journal of Orthopaedic Surgery and Research
Christopher A Iobst, S Robert Rozbruch, Scott Nelson, Austin Fragomen
INTRODUCTION: Patients with limb-length discrepancies often have concomitant deformity. We describe the outcomes of acute, fixator-assisted deformity correction with gradual lengthening using the retrograde femoral Precice nail (NuVasive). METHODS: We analyzed a retrospective series of 27 patients in whom an external fixator was combined with a Precice nail to correct angular or rotational deformity and limb-length discrepancy. The fixator was applied temporarily to restore normal alignment...
February 27, 2018: Journal of the American Academy of Orthopaedic Surgeons
Iftikhar H Wani, Naseem Ul Gani, Mohammad Yaseen, Adil Bashir, Mohammad Shahid Bhat, Munir Farooq
BACKGROUND: The ideal treatment of distal tibial extra articular fractures remains controversial. Minimally invasive percutaneous plate osteosynthesis and intramedullary nailing are the two most commonly used methods. We did a prospective randomized controlled study to assess the functional outcome of distal tibial extra articular tibial fractures by comparing these treatment methods. MATERIALS AND METHODS: Sixty patients with distal tibial extra articular fractures were randomly assigned to an IMN (intramedullary nailing) group and a MIPPO (minimally invasive percutaneous plate osteosynthesis) group...
December 30, 2017: Ortopedia, Traumatologia, Rehabilitacja
Antti Stenroos, Jenni Jalkanen, Juha-Jaakko Sinikumpu, Sauli Palmu, Eeva Koskimies-Virta, Topi Laaksonen, Yrjänä Nietosvaara
BACKGROUND:  Surgical treatment of pediatric tibia shaft fractures has gained popularity despite closed reduction and cast-immobilization providing good long-term results. There is no consensus about optimal methods and satisfactory quality of treatment. MATERIALS AND METHODS:  During 2010 to 2014, 226 pediatric patients were treated under anesthesia for tibia shaft fractures in Finland's five university hospitals. A total of 164 (73%) patients had closed fractures of the tibia or both tibia and fibula without other injuries (62 tibia only and 102 both tibia and fibula)...
February 28, 2018: European Journal of Pediatric Surgery
Justin J Fleming
The reamed intramedullary (IM) technique has many benefits. However, open plating is the most commonly used technique. Previously, IM stabilization was reserved for fibular fractures, which were given lower priority, and generally associated with injuries to the distal tibia or instances in which the soft tissue envelope was unsuitable for an open approach. This article reviews the literature and the level of evidence, and presents case examples and operative technique.
April 2018: Clinics in Podiatric Medicine and Surgery
Ted C Lai, Justin J Fleming
Surgical treatment of distal tibia fractures can present as a difficult task. Intramedullary nailing (IMN), external fixation, and open reduction internal fixation (ORIF) have displayed various complications ranging from a high rate of knee morbidity with IMN to wound complications and infection with ORIF. Minimally invasive plate osteosynthesis (MIPO) has been used to decrease development of these complications. MIPO respects the soft tissue envelope along with maintaining the biological environment needed for proper osseous healing...
April 2018: Clinics in Podiatric Medicine and Surgery
Florian Sevelda, Wenzel Waldstein, Joannis Panotopoulos, Alexandra Kaider, Philipp Theodor Funovics, Reinhard Windhager
BACKGROUND: The majority of metastatic bone lesions to the femoral bone can be treated without surgery or with minimally invasive intramedullary nailing. In rare patients with extensive metastatic disease to the femur, total femur replacement may be the only surgical alternative to amputation; however, little is known about this approach. QUESTIONS/PURPOSES: In a highly selected small group of patients with metastatic carcinoma of the femur, we asked: (1) What was the patient survivorship after this treatment? (2) What was the implant survivorship free from all-cause revision and amputation, and what complications were associated with this treatment? (3) What functional outcomes were achieved by patients after total femur replacement for this indication? METHODS: Eleven patients (three men, eight women) with a mean age of 64 years (range, 41-78 years) received total femur replacements between 1986 and 2016; none were lost to followup...
February 14, 2018: Clinical Orthopaedics and related Research
William T Kent, Trevor J Shelton, Jonathan Eastman
PURPOSE: Floating knee injuries are relatively uncommon injuries. We report the prevalence, location, and severity of heterotopic ossification (HO) around the knee in patients treated with antegrade tibial intramedullary nailing and ipsilateral antegrade versus retrograde femoral intramedullary nailing as well as how the severity of HO around the knee affects knee range of motion (ROM). METHODS: From 2004 to 2014, 26 floating knee injuries were included. Radiographs were reviewed to determine presence, location, and severity of HO...
February 22, 2018: International Orthopaedics
Michele Bisaccia, Andrea Cappiello, Luigi Meccariello, Giuseppe Rinonapoli, Gabriele Falzarano, Antonio Medici, Cristina Ibáñez Vicente, Luigi Piscitelli, Verdiana Stano, Olga Bisaccia, Auro Caraffa
INTRODUCTION: Distal tibial fractures are the most common long bone fractures. Several studies focusing on the methods of treatment of displaced distal tibial fractures have been published. To date, locked plates, intramedullary nails and external fixation are the three most used techniques. The aim of our study was to compare intramedullary nail (IMN) and locked plate (LP) for treatment of this kind of fracture. MATERIALS AND METHODS: We collected data on 81 patients with distal tibial fractures (distance from the joint between 40 and 100 mm) and we divided into two groups: IMN and LP...
2018: SICOT-J
C Hierholzer, J Friederichs, P Augat, A Woltmann, O Trapp, V Bühren, C von Rüden
Key factors for successful osteosynthetic fracture stabilization are anatomical fracture reduction, restoration of axis and torsion alignment as well as tissue-preserving operative techniques. In long bone fractures, the use of intramedullary long bridging nailing offers ideal conditions for bone healing, as axial and rotational stability is provided by canal-filling nails and locking screws. In addition, the tissue in the fracture region is protected as the intramedullary nail insertion is distant from the fracture...
February 20, 2018: Der Unfallchirurg
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