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Intramedullary nailing

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https://www.readbyqxmd.com/read/28746061/lengthening-with-monolateral-external-fixation-versus-magnetically-motorized-intramedullary-nail-in-congenital-femoral-deficiency
#1
Vivian L Szymczuk, Ahmed I Hammouda, Martin G Gesheff, Shawn C Standard, John E Herzenberg
BACKGROUND: Limb lengthening for congenital femoral deficiency (CFD) with or without fibular hemimelia can be performed with both external and internal devices. The purpose of this study is to compare clinical outcomes of femoral lengthening utilizing monolateral external fixation versus a magnetically motorized intramedullary nail in patients with CFD with or without fibular hemimelia. METHODS: This retrospective review included 62 patients with femoral lengthening, 32 patients had monolateral external fixation (group A), 30 patients had internal lengthening nail (group B)...
June 25, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28742786/proper-distal-placement-of-tibial-nail-improves-rate-of-malalignment-for-distal-tibia-fractures
#2
Konstantinos Triantafillou, Eric Barcak, Arturo Villarreal, Cory Collinge, Edward Perez
OBJECTIVES: We hypothesize that the anatomic center of the distal tibia is just lateral and anterior to the center of the distal tibia articular surface in the coronal and sagittal planes respectively, and that placement of the nail along this axis results in improved rates of malalignment when treating distal tibia fractures. DESIGN: Retrospective study SETTING:: One level I and one level II trauma center PATIENTS/PARTICIPANTS:: 203 distal tibia fractures treated with IMN (primary cohort) whose main fracture line extended within 5 cm of the plafond to evaluate the rate of malalignment with distal nail placement...
July 24, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28740524/a-comparison-of-two-fixation-methods-for-femoral-trochanteric-fractures-a-new-generation-intramedullary-system-vs-sliding-hip-screw
#3
Christian Carulli, Federico Piacentini, Tommaso Paoli, Roberto Civinini, Massimo Innocenti
INTRODUCTION: Trochanteric fractures are frequent and generally associated with bone fragility. There is still debate on the best fixation device to treat stable or rather stable trochanteric fractures: we report our clinical and radiological results of fixation with Proximal Femoral Nail "antirotation" (PFNa) in a population of patients compared to a control group treated by Sliding Hip Screw (SHS). MATERIALS AND METHODS: A prospective study was conducted in 71 consecutive patients treated by PFNa (group A), and 69 by a SHS (group B), with a mean age of 81...
January 2017: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/28736125/minimally-invasive-treatment-of-displaced-femoral-shaft-fractures-with-a-teleoperated-robot-assisted-surgical-system
#4
Qing Zhu, Bin Liang, Xingsong Wang, Xiaogang Sun, Liming Wang
BACKGROUND: Minimally invasive surgical operation of intramedullary (IM) nailing is a standard technique for treating diaphyseal fractures. However, in addition to its advantages, there are some drawbacks such as the frequent occurrence of malalignment, physical fatigue and high radiation exposure to medical staff. The use of robotic and navigation techniques is promising treatments for femoral fractures. MATERIALS AND METHODS: This paper presents a novel robot-assisted manipulator for femoral shaft fracture reduction with indirect contact with the femur...
July 12, 2017: Injury
https://www.readbyqxmd.com/read/28735655/an-intramedullary-nail-coated-with-antibiotic-and-growth-factor-nanoparticles-an-individualized-state-of-the-art-treatment-for-chronic-osteomyelitis-with-bone-defects
#5
Roberto Berebichez-Fridman, Pablo Montero-Olvera, Ricardo Gómez-García, Enrique Berebichez-Fastlicht
Among various infections, chronic osteomyelitis is one of the most challenging in terms of treatment. This infection is more common among patients with open fractures and those who have undergone elective orthopedic procedures. The treatment of osteomyelitis requires high antibiotic doses and an aggressive and multifaceted surgical approach. The use of parenteral antibiotics alone, without debridement, is not sufficiently effective, due to the formation of sequestra and the low vascularity of the affected area...
August 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28734495/clinical-experiences-in-the-use-of-a-gentamicin-coated-titanium-nail-in-tibia-fractures-and-revisions
#6
G Schmidmaier, M Kerstan, P Schwabe, N Südkamp, M Raschke
Despite the improvement of surgical techniques surgical site infections (SSIs) still remain a significant clinical burden in high risk patients undergoing osteosynthesis for tibia fractures. The use of an antibiotic coated implant might reduce the adhesion of bacteria on the implant surface and could therefore reduce the rate of implant-related infection or osteomyelitis. In this prospective multicenter study the use of a gentamicin-coated tibia nail for the treatment of open and closed tibia fractures and non-union revision cases was evaluated in 100 patients (99 treated) followed for 18 months...
July 10, 2017: Injury
https://www.readbyqxmd.com/read/28723755/comparison-of-free-hand-fluoroscopic-guidance-and-electromagnetic-navigation-in-distal-locking-of-femoral-intramedullary-nails
#7
Bing Han, Zhigang Shi, Yu Fu, Yong Ye, Juehua Jing, Jun Li
BACKGROUND: Although the method has been used widely, one of the greatest challenges for intramedullary nailing is to position the distal locking screw. A new technology, the electromagnetic navigation system, is a radiation-free way to locate the position of the drill bit and provide 3-dimensional real-time feedback of location and orientation of the drill bit relative to the locking holes. The purpose of our study was to evaluate the reliability and efficiency of the free-hand technique compared to the new electromagnetic navigation system...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28721484/a-comparison-of-external-fixation-and-locked-intramedullary-nailing-in-the-treatment-of-femoral-diaphysis-fractures-from-gunshot-injuries
#8
G Polat, H I Balci, O N Ergin, A Asma, C Şen, Ö Kiliçoğlu
INTRODUCTION: We studied the safety and incidence of complications from the treatment of gunshot-induced femur diaphysis fractures with locked intramedullary nailing in comparison to external fixation. METHODS: Patients who had femoral diaphysis fracture operations due to gunshot injuries (107 femurs of 99 patients) between 2003 and 2014 were retrospectively reviewed, and 66 femurs of 60 patients were place into two groups (Group A: intramedullary nailing-38 femurs of the 36 patients; Group B: external fixator-28 femurs of 24 patients)...
July 18, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28720982/single-incision-pediatric-flexible-intramedullary-tibial-nailing
#9
John G Coury, Zachary C Lum, Nicholas P O'Neill, Joseph A Gerardi
BACKGROUND: There has been a trend towards flexible intramedullary nailing for unstable tibial shaft fractures in the pediatric population, traditionally, utilizing a 2-incision technique with passage of one nail medially and one nail laterally. Our study aims to compare a single incision approach for flexible nailing of unstable tibial shaft fractures in pediatric patients to the traditional 2-incision approach. METHODS: Patients were selected for operative fixation if they had a length unstable tibial shaft fracture confirmed by fluoroscopy...
September 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28719990/radiographic-and-clinical-assessment-of-intramedullary-nail-fixation-for-the-treatment-of-unstable-metacarpal-fractures
#10
Ather Mirza, Justin Mirza, Chris Healy, Vishaaq Mathew, Brian Lee
BACKGROUND: The purpose of the article was to evaluate clinical and radiographic outcomes in a case series of unstable metacarpal fractures treated with flexible intramedullary nail (IMN) fixation. METHODS: A total of 55 patients with unstable metacarpal fractures between 2003 and 2010 were treated with IMN fixation and followed for a minimum of 1 year. The outcomes were assessed via a radiological study of longitudinal and angular collapse, Disabilities of the Arm, Shoulder, and Hand (DASH) score, total active range of motion (ROM) of the wrist, and grip strength testing...
March 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28719546/fracture-table-application-for-pediatric-femur-fractures-incidence-and-risk-factors-associated-with-adverse-outcomes
#11
Brian A Kelly, Manahil Naqvi, Emily S Rademacher, Patricia E Miller, Daniel J Hedequist, Michael P Glotzbecker, Travis H Matheney, Benjamin J Shore
BACKGROUND: Flexible elastic nails, submuscular plating, and rigid locked intramedullary nails are common methods of fixation for pediatric femur fractures (PFF) in which the fracture table is used to aid reduction. Little is known about complications associated with fracture table application in PFF. The purpose of this study was to determine the incidence and risk factors associated with adverse outcomes related to fracture table application for the treatment of PFF. METHODS: A retrospective chart review of all children (younger than 18 y) treated for a femur fracture with the use of the fracture table between 2004 and 2015 at a single tertiary pediatric hospital was performed...
July 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28719401/antibiotic-coated-interlocking-intramedullary-nail-for-the-treatment-of-long-bone-osteomyelitis
#12
James Barger, Austin T Fragomen, S Robert Rozbruch
No abstract text is available yet for this article.
July 18, 2017: JBJS Reviews
https://www.readbyqxmd.com/read/28717066/a-heart-shaped-sleeve-simplifies-intramedullary-tibial-nail-insertion-when-using-the-suprapatellar-approach
#13
Kosuke Tajima, Chikako Shimizu, Soichiro Ohno, Yusho Nishida, Kazuhiko Udagawa, Junichi Sasaki
The suprapatellar approach for intramedullary tibial nailing has become widely accepted over the past decade. A round sleeve is passed beneath the patella to protect the surface of the patellofemoral joint (PFJ). However, the round sleeve cannot be easily stabilized in the PFJ because it does not conform to the shape of the patellar apex. Consequently, we produced a heart-shaped sleeve to simplify the insertion of the entry sleeve during the suprapatellar approach. Using the new sleeve, the following procedure is used: (1) make a longitudinal 4 cm skin incision proximal to the patella to reach the PFJ, (2) insert the guide pin manually to the ventral edge of the tibial plateau, (3) insert the cannulated trocar along the guide pin, (4) insert the heart-shaped sleeve along the cannulated trocar, (5) remove the cannulated trocar, (6) ream the entry point through the heart-shaped sleeve...
July 15, 2017: Keio Journal of Medicine
https://www.readbyqxmd.com/read/28702383/a-retrospective-study-of-titanium-elastic-stable-intramedullary-nailing-in-displaced-mid-shaft-clavicle-fractures
#14
Rajesh Govindasamy, Saravanan Kasirajan, Jimmy Joseph Meleppuram, Fawas Thonikadavath
OBJECTIVE: The aim of this study is to analyze the functional outcome following titanium elastic stable intra-medullary nailing (ESIN) for displaced mid-shaft clavicular fractures (DMCF). METHODS: A retrospective study of 60 patients between March 2009 and March 2015 was conducted. Patients were selected based on the inclusion criteria. Six patients were lost during follow up. Out of the remaining 54 patients, there were 39 males and 15 females. The mean age was 30...
May 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28697089/fixation-of-a-proximal-humerus-fracture-with-an-intramedullary-nail
#15
Andrew D Sobel, Kalpit N Shah, E Scott Paxton
Proximal humerus fractures (PHFs) are common injuries seen mostly in elderly patients. Although nonoperative management is acceptable for most patients, surgical fixation is often advocated for younger patients or active, elderly patients with reconstructable fractures. A variety of fixation methods exist: percutaneous pinning, open reduction and internal fixation with locking plates, and intramedullary nailing are viable options. Modern intramedullary nails serve as excellent options for the fixation of many operative PHFs...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28697085/humeral-shaft-fracture-intramedullary-nailing
#16
Sanjit R Konda, Hesham Saleh, Nina Fisher, Kenneth A Egol
INTRODUCTION: This video demonstrates the technique of intramedullary nailing for a humeral shaft fracture. METHODS: The patient is a 30-year-old man who sustained a gunshot wound to his right arm. The patient was indicated for humeral nailing given the comminuted nature of the diaphysis and to allow for minimal skin incisions. Other relative indications include soft-tissue compromise about the arm precluding a large surgical exposure. RESULTS: This video presents a case of a comminuted humeral shaft fracture treated with an intramedullary nail...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28697079/exchange-nailing-for-hypertrophic-femoral-nonunion
#17
Alejandro Marquez-Lara, T David Luo, Rebecca Senehi, Arun Aneja, Hoyt Randy Beard, Eben A Carroll
Exchange nailing has proven to be a reliable surgical technique for the management of aseptic femoral shaft nonunions. Similar to primary intramedullary nail fixation for femur fractures, exchange nailing for aseptic hypertrophic nonunions of the femur relies on successful navigation of the starting point and proper nail trajectory to minimize coronal and sagittal plane deformities. Compared with the supine position, the lateral decubitus position has the advantage of allowing gravity to displace the soft tissue around the piriformis start site to facilitate nail entry...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28697077/femoral-nonunion-with-iliac-crest-bone-graft
#18
Sanjit R Konda, Anthony Christiano, Nina Fisher, Philipp Leucht, Kenneth A Egol
PURPOSE: Fracture nonunion is a common problem for today's orthopaedic surgeon. However, many techniques are currently available for the treatment of long-bone nonunion. This video demonstrates the use of iliac crest bone graft and plate stabilization in the setting of a hypertrophic femoral nonunion. METHODS: Treatment of femoral nonunion after intramedullary nail fixation using compression plating and bone grafting is a reliable technique for reducing pain, improving function, and achieving radiographic union...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28697070/retrograde-femoral-nailing-using-percutaneous-reduction-techniques
#19
Brett J Pettett, Matthew C Avery, Robert F Ostrum
Femoral shaft fractures are commonly treated with closed reduction and reamed intramedullary nailing. However, some reductions are difficult to obtain or maintain, especially in muscular or large patients. When closed methods fail to achieve reduction, percutaneous techniques are extremely useful. In addition, the use of either permanent or temporarily placed blocking implants offer a minimally invasive option for improving sagittal and coronal plane alignment. In the accompanying video, we describe our method of percutaneous reduction techniques in the setting of a comminuted femoral shaft fracture treated with a retrograde femoral intramedullary nail...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28693817/investigation-of-perioperative-hidden-blood-loss-of-unstable-intertrochanteric-fracture-in-the-elderly-treated-with-different-intramedullary-fixations
#20
Xu Yang, Qiang Wu, Xin Wang
OBJECTIVE: Our aim was to investigate perioperative hidden blood loss (PHBL) of unstable intertrochanteric fracture (UIF) in the elderly treated with different intramedullary fixations. PATIENTS AND METHODS: 120 consecutive elderly patients with UIF treated by intramedullary nails between January 2013 and September 2016 were enrolled in the retrospective study, including 52 patients (mean age 79.6±6.3) for the Third generation Gamma Nail (TGN), 51 patients (mean age 79...
June 24, 2017: Injury
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