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Intramedullary nailing

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https://www.readbyqxmd.com/read/28453556/characterization-of-interfragmentary-motion-associated-with-common-osteosynthesis-devices-for-rat-fracture-healing-studies
#1
Nicholaus Meyers, Matthias Sukopp, Rudolf Jäger, Malte Steiner, Romano Matthys, Bernd Lapatki, Anita Ignatius, Lutz Claes
Rat models are widely used in preclinical studies investigating fracture healing. The interfragmentary movement at a fracture site is critical to the course of healing and therefore demands definition in order to aptly interpret the experimental results. Estimation of this movement requires knowledge of the fixation stiffness and loading. The characteristic loading for the rat femur has been estimated, but the stiffness of fixation used in rat studies has yet to be fully described. This study aimed to determine the 6 degree of freedom stiffness of four commonly used implants, two external fixators (RatExFix and UlmExFix), a locking plate, and a locking intramedullary nail, in all degrees of freedom and estimate the interfragmentary movement under specific physiological loads...
2017: PloS One
https://www.readbyqxmd.com/read/28448704/-retrograde-intramedullary-nail-fixation-for-charcot-neuroarthropathy
#2
E López-Gavito, N A Gómez-Fuentes, P Parra-Téllez, M Lezama-Peniche, J Vázquez-Escamilla, S R León-Hernández
Charcot arthropathy is defined as an articular degenerative, chronic, progressive disease that affects one or more peripheral joints, develops as a result of a failure in the normal sensory perception (pain and proprioception) in the innervation of joints located in the foot and ankle, is characterized by destructive bone lesions without the presence of infection. Neuropathy is directly associated with diabetes mellitus type 1 and 2. Surgery is indicated when there is severe involvement of soft tissue, foot joints are unstable, at the presence of chronic or recurrent ulcers or when the foot and ankle can not fit to a normal shoe, and had limitation to perform activities of daily living...
September 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28442207/tibio-talo-calcaneal-fusion-after-limb-salvage-procedures-a-retrospective-study
#3
Lukas Zak, Gerald E Wozasek
BACKGROUND: The treatment of limb threatening trauma on the distal tibia or hindfoot often results in posttraumatic osteoarthritis requiring tibiotalocalcaneal (TTC) arthrodesis. The purpose of this study was to present a case series of patients undergoing various techniques of joint fusion after bone reconstruction and deformity correction as a salvage procedure. The study should help trauma surgeons making decisions in limb salvage and deformity correction in complex lower leg and foot injuries by presenting options and treatment strategies...
April 15, 2017: Injury
https://www.readbyqxmd.com/read/28439819/lengthening-of-the-humerus-with-intramedullary-lengthening-nails-preliminary-report
#4
Julian Fürmetz, Søren Kold, Nikola Schuster, Florian Wolf, Peter H Thaller
Distraction osteogenesis of the humerus with fully implantable lengthening is now possible since the diameter of the available nails was reduced to 10 mm and below. We report on the first intramedullary lengthening cases of the humerus with two different lengthening devices (FITBONE and PRECICE). Two different approaches and implantation techniques were used. We retrospectively reviewed clinical and radiographic data and pointed out results, pitfalls and complications of the procedure. Four adult patients with relevant length discrepancy of the humerus were treated with fully implantable systems in two centers between 2012 and 2015...
April 24, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28439311/treatment-of-shepherd-s-crook-deformity-in-patients-with-polyostotic-fibrous-dysplasia-using-a-new-type-of-custom-made-retrograde-intramedullary-nail-a-technical-note
#5
F Hefti, L Donnan, A H Krieg
AIMS: The severe form of coxa vara, the 'shepherd's crook deformity', is always a consequence of a locally extensive form of polyostotic fibrous dysplasia (or McCune-Albright syndrome). Treatment of this deformity is a challenge. The soft bone does not tolerate any implant that depends on the stability of the cortical bone (like plates or external fixators). Intramedullary nails are the most appropriate implants for stabilisation, but if they are inserted from the greater trochanter, they cannot correct the varus deformity enough...
2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28437500/removal-of-the-distal-aspect-of-a-broken-tibial-nail
#6
Joseph A Gil, Philip McClure, Christopher T Born
Nail breakage is a known complication of intramedullary nail (IMN) fixation of tibial fractures. Several case reports have described unique methods used to facilitate removal of broken IMNs. In this article, we describe an efficient technique for extracting broken tibial IMNs-a technique that can be used before attempting more invasive extraction methods.
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28435571/outcome-of-skeletal-reconstructive-surgery-for-metastatic-bone-tumours-in-the-femur
#7
N H Mohamed-Haflah, Y Kassim, I Zuchri, W Zulmi
INTRODUCTION: The role of surgery in skeletal metastasis is to reduce morbidity and improve the quality of life in terminally ill patients. We report our experience with patients who underwent skeletal reconstructive surgery for metastatic bone tumour of the femur. MATERIALS AND METHODS: Twenty nine operations for skeletal metastasis of the femur performed in our centre between 2009 and 2015 were included in this study. We evaluated the choice of implant, complications, survival rate and functional outcome...
March 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28435556/anterior-knee-pain-after-tibial-intra-medullary-nailing-is-it-predictable
#8
P C Soraganvi, B S Anand-Kumar, R Rajagopalakrishnan, B A Praveen-Kumar
Introduction: Intramedullary nailing has been used frequently for the treatment of tibial diaphyseal fractures. Chronic anterior knee pain has been considered the most frequent post-operative complication of this technique. We investigated the relationship between anterior knee pain and position of nail tip in proximal tibia. Methods: 103 patients were selected among patients who underwent interlocking nailing in our institution. Patients with other factors that might cause anterior knee pain were excluded...
July 2016: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28435555/the-radial-bow-following-square-nailing-in-radius-and-ulna-shaft-fractures-in-adults-and-its-relation-to-disability-and-function
#9
M B Dave, K D Parmar, B A Sachde
One of the points made against nailing in radius and ulna shaft fractures has been the loss of radial bow and its impact on function. The aims of the study were to assess the change in magnitude and location of the radial bow in radius and ulna shaft fractures treated with intramedullary square nails and to assess the impact of this change on functional outcome, patient reported disability and the range of motion of the forearm. We measured the magnitude of radial bow and its location in the operated extremity and compared it to the uninjured side in 32 adult patients treated with intramedullary square nailing for radius and ulna shaft fractures at our institute...
July 2016: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28422876/low-complication-rate-of-elastic-stable-intramedullary-nailing-esin-of-pediatric-forearm-fractures-a-retrospective-study-of-202-cases
#10
Christiane Kruppa, Pamela Bunge, Thomas A Schildhauer, Marcel Dudda
Elastic stable intramedullary nailing (ESIN) has been established as state of the art treatment for forearm fractures in children, if operative stabilization is required. Their use has been expanded to single bone shaft fractures, and also more complex injuries such as Monteggia fractures or Monteggia-like lesions. A wide range of complications has been reported in the literature, up to 70% in certain investigations. The purpose of this study was to assess the complication rate after ESIN treatment of forearm fractures in children and adolescents in a representative cohort of patients from a level 1 trauma center in Germany...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28416833/-diagnosis-and-treatment-for-the-basicervical-fractures-of-the-trochanteric-region
#11
T C Zhang, Z S Zhang, F Zhou, Y Tian, H Q Ji, Y Guo, Y Lv, Z W Yang, G J Hou
OBJECTIVE: To evaluate the rate of basicervical fractures and document their diagnosis and treatment. METHODS: From January 2005 to May 2016, 28 basicervical fractures of the 832 trochanteric fractures were collected and evaluated. The patients were treated with multiple screws, dynamic hip screw (DHS), intramedullary nail. Via the operation time, postoperative hospitalization, loss of blood duration the operation, hidden blood loss, total blood loss, mean union time and the final follow-up Harris hip score, the characteristics of different internal fixations were compared and analyzed...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28415456/osteoinductive-composite-coatings-for-flexible-intramedullary-nails
#12
E N Bolbasov, A V Popkov, D A Popkov, E N Gorbach, I A Khlusov, A S Golovkin, A Sinev, V M Bouznik, S I Tverdokhlebov, Y G Anissimov
This work presents composite coatings based on a copolymer of vinylidene fluoride with tetrafluoroethylene (VDF-TeFE) and hydroxyapatite (HA) for flexible intramedullary nails (FIN). The effect of the proportion of VDF-TeFE (100-25% wt.) on physicochemical and biological properties of the composite coatings was investigated. It was shown that a decrease of VDF-TeFE in the coating hinders its crystallization in β and γ forms which have piezoelectric properties. The decrease also reduces an adhesive strength to 9...
June 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28414721/a-novel-smart-navigation-system-for-intramedullary-nailing-in-orthopedic-surgery
#13
Jaesuk Choi, Jihun Kim, Jae Youn Hwang, Minkyu Je, Jun-Young Kim, Shin-Yoon Kim
This paper proposes a novel smart surgical navigation system for intramedullary nailing in orthopedic surgery. Using a handle-integrated laser guidance module, the system can target a drill insertion point onto skin, indicating an accurate target position to perpendicularly access an invisible distal hole. The proposed handle-integration-based fixation of the laser guidance module precisely defines the relative position of the module with respect to the distal hole. Consequently, unlike conventional systems, the proposed system can indicate the target insertion point without any help from bulky and costly external position-tracking equipment that is usually required for compensating disturbances generated by external impacts...
2017: PloS One
https://www.readbyqxmd.com/read/28413494/preoperative-qct-assessment-of-femoral-head-for-assessment-of-femoral-head-bone-loss
#14
Chen Yi, Manyi Wang, Jie Wei, Jun Wang, Ling Wang, Xiaoguang Cheng
We quantified differences in trabecular volumetric bone mineral density (BMD) of the femoral head between patients with proximal femoral fractures and healthy subjects in the control group by using quantitative computed tomography (QCT) with the purpose of providing guidance for the choice of head screw in the intramedullary nail fixation. Participants suffering from intertrochanteric fractures (n=536 patients) were recruited. In addition, 497 fracture-free, age-matched cases were considered as the control group...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28409214/-fractures-of-the-upper-limbs-in-childhood-and-adolescence
#15
P P Schmittenbecher
Fractures of the upper limbs are frequent and often need operative treatment in addition to a well-indicated conservative management. This depends on the maturity of the nearest growth plate and the local remodeling potential, which is dependent on age. Following conventional x‑ray imaging an individual prognostic growth analysis leads to the therapeutic decision. Around the elbow and the shaft of the forearm, criteria are stricter than near the shoulder or wrist. Gilchrist or Desault bandages as well as braces are adequate for most subcapital and humeral shaft fractures...
April 13, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28408084/semiextended-approach-for-intramedullary-nailing-via-a-patellar-eversion-technique-for-tibial-shaft-fractures-evaluation-of-the-patellofemoral-joint
#16
Tomohiro Yasuda, Shu Obara, Junji Hayashi, Masayuki Arai, Kaoru Sato
Intramedullary nail fixation is a common treatment for tibial-shaft fractures, and it offers a better functional prognosis than other conservative treatments. Currently, the primary approach employed during intramedullary nail insertion is the semiextended position is the suprapatellar approach, which involves a vertical incision of the quadriceps tendon Damage to the patellofemoral joint cartilage has been highlighted as a drawback associated with this approach. To avoid this issue, we perform surgery using the patellar eversion technique and a soft sleeve...
March 25, 2017: Injury
https://www.readbyqxmd.com/read/28405221/assessment-of-the-restriction-of-arm-elevation-after-intramedullary-fixation-for-proximal-humeral-fractures
#17
Hiroaki Inui, Katsuya Nobuhara
BACKGROUND: Nail protrusion is suspected as a reason for the restriction of arm elevation after antegrade nailing of proximal humeral fractures, although assessment of the restriction of the glenohumeral joint during arm elevation has been insufficient. METHODS: In this retrospective study, 30 shoulders with proximal humeral fractures in 29 cases were treated with Polarus short nails (Acumed, Beaverton, OR, USA). At a mean final follow-up of 14 months, clinical outcomes, bony union, alignment including retroversion of the head and entry points of the nails were evaluated...
April 2017: Shoulder & Elbow
https://www.readbyqxmd.com/read/28399048/pediatric-femoral-shaft-fractures-a-multicenter-review-of-the-aaos-clinical-practice-guidelines-before-and-after-2009
#18
John D Roaten, Derek M Kelly, Joseph L Yellin, John M Flynn, Micaela Cyr, Sumeet Garg, Alexander Broom, Lindsay M Andras, Jeffrey R Sawyer
BACKGROUND: To determine if the AAOS clinical practice guidelines (CPG) for the treatment of pediatric femoral shaft fractures (2009) changed treatment, we analyzed pediatric femoral shaft fractures at 4 high-volume, geographically separated, level-1 pediatric trauma centers over a 10-year period (2004 to 2013). METHODS: Consecutive series of pediatric femoral shaft fractures (ages, birth to 18 y) treated at the 4 centers were reviewed. Treatment methods were analyzed by age and treatment method for each center and in aggregate...
April 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28396949/factors-influencing-radiation-exposure-during-internal-fixation-of-hip-fractures
#19
G A Kelly, F E Rowan, C Hurson
The use of fluoroscopy is of great importance for operative fixation of fractures. Previous studies have shown an increased fluoroscopy time for intramedullary nails and with junior surgeons in comparison with more experienced surgeons. We examined the impact of operation length on fluoroscopy dose, cumulative fluoroscopy time between consultant and registrar surgeons and cumulative fluoroscopy time between dynamic hip screw and intramedullary nailing. We performed a retrospective cohort study of all patients admitted to our centre over the period of 1 year...
April 10, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28394845/im-nail-fixation-of-atypical-femur-fractures-with-bone-marrow-aspirate-concentrate-leads-to-faster-union-a-case-control-study
#20
Andrew J Lovy, Jun S Kim, John Di Capua, Sulaiman Somani, Stephanie Shim, Aakash Keswani, Rohit Hasija, Yangguan Wu, David Joseph, Richard Ghillani
OBJECTIVES: High rates of implant failure and nonunion in atypical femur fractures (AFF) have been reported. The aim of this study was to evaluate bone marrow aspirate concentrate (BMAC) use in the treatment of AFF. DESIGN: Retrospective Case Control SETTING:: Level 1 Trauma Center PATIENTS:: Complete AFF, defined according to American Society of Bone and Mineral Research (ASBMR) criteria, from September 2009 to April 2015 with minimum 1 year follow up. INTERVENTION: Operative treatment with anterograde intramedullary (IM) nails...
April 7, 2017: Journal of Orthopaedic Trauma
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