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Intramedullary nailing

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https://www.readbyqxmd.com/read/28216756/outcome-of-anatomic-locking-plate-in-extraarticular-distal-humeral-shaft-fractures
#1
Deepak Jain, Gurpreet S Goyal, Rajnish Garg, Pankaj Mahindra, Mohammad Yamin, Harpal S Selhi
BACKGROUND: Extraarticular fractures of distal humerus are challenging injuries to treat because of complex anatomy and fracture patterns. Functional bracing may not provide adequate stability in these injuries and operative treatment with intramedullary nails or conventional plates also has the limitation of inadequate fixation in the short distal fragment. The 3.5 mm precontoured single column locking plate (extraarticular distal humerus plate [EADHP]) has been introduced to overcome this problem...
January 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28216752/management-of-gustilo-anderson-iii-b-open-tibial-fractures-by-primary-fascio-septo-cutaneous-local-flap-and-primary-fixation-the-fix-and-shift-technique
#2
P R Ramasamy
BACKGROUND: Open fractures of tibia have posed great difficulty in managing both the soft tissue and the skeletal components of the injured limb. Gustilo Anderson III B open tibial fractures are more difficult to manage than I, II, and III A fractures. Stable skeletal fixation with immediate soft tissue cover has been the key to the successful outcome in treating open tibial fractures, in particular, Gustilo Anderson III B types. If the length of the open wound is larger and if the exposed surface of tibial fracture and tibial shaft is greater, then the management becomes still more difficult...
January 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28202370/to-evaluate-the-role-of-platelet-rich-plasma-in-healing-of-acute-diaphyseal-fractures-of-the-femur
#3
Roop Singh, Rajesh Rohilla, Jeetesh Gawande, Paramjit Kumar Sehgal
PURPOSE: New research is focusing on the use of autologous growth factors to increase the effect of bone fracture healing while decreasing the amount of healing time for the patient. Platelets have been demonstrated to be the natural storage vessel for several growth factors and cytokines that promote blood coagulation, tissue repair, and the process of bone mineralization. The present study aims to evaluate the role of platelet-rich plasma (PRP) in healing of acute femoral shaft fractures radiologically...
January 20, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28199292/management-of-open-tibial-shaft-fractures-does-the-timing-of-surgery-affect-outcomes
#4
Oscar A Duyos, David Beaton-Comulada, Ariel Davila-Parrilla, Jose Carlos Perez-Lopez, Krystal Ortiz, Christian Foy-Parrilla, Francisco Lopez-Gonzalez
BACKGROUND: Open tibial shaft fractures require emergent care. Treatment with intravenous antibiotics and fracture débridement within 6 to 24 hours is recommended. Few studies have examined outcomes when surgical treatment is performed >24 hours after occurrence of the fracture. METHODS: This retrospective study included 227 patients aged ≥18 years with isolated open tibial shaft fractures in whom the time to initial débridement was >24 hours. The statistical analysis was based on time from injury to surgical débridement, Gustilo-Anderson classification, method of fixation, union status, and infection status...
March 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28196033/thromboembolic-disease-in-patients-with-metastatic-femoral-lesions-a-comparison-between-prophylactic-fixation-and-fracture-fixation
#5
Arun Aneja, Jimmy J Jiang, Anna Cohen-Rosenblum, Hue L Luu, Terrance D Peabody, Samer Attar, T David Luo, Rex C Haydon
BACKGROUND: We are not aware of any previous studies that have compared the rate of venous thromboembolic events in patients who underwent prophylactic intramedullary nailing because of an impending fracture with the rate in patients who underwent intramedullary nailing after a pathological fracture. The objective of the present study was to determine if the rate of venous thromboembolic events varies between patients who are managed with prophylactic fixation and those who are managed with fixation after a pathological fracture...
February 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28194386/femur-lengthening-with-monoplanar-external-fixator-associated-with-locked-intramedullary-nail
#6
Henrique Paradella Alvachian Fernandes, Danilo Gabriel do Nascimento Silva Barronovo, Fabio Lucas Rodrigues, Marcos Hono
OBJECTIVE: This study aimed to demonstrate that the lengthening technique of an external fixator associated with locked intramedullary nail is an efficient method that decreases the duration of the external fixation and improves the rehabilitation period. METHODS: From January of 2005 to May of 2014, 31 patients with mean lower limb discrepancy of 5.31 cm were treated. The etiologies of the deformity were femur fracture sequelae, infection, hip development dysplasia, polio, and congenital short femur...
January 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28194379/reliability-of-the-radiographic-union-scale-in-tibial-fractures-rust
#7
Fernando Antonio Silva de Azevedo Filho, Ricardo Britto Cotias, Matheus Lemos Azi, Armando Augusto de Almeida Teixeira
OBJECTIVE: This study aimed to evaluate the inter- and intra observer reproducibility of the radiographic score of consolidation of the tibia shaft fractures. METHODS: Fifty-one sets of radiographs in anteroposterior (AP) and profile (P) of the tibial shaft treated with intramedullary nail were obtained. The analysis of X-rays was performed in two stages, with a 21-day interval between assessments by a group of nine evaluators. To evaluate the reproducibility of RUST score between the evaluators, the intra-class correlation coefficient (ICC) with a 95% confidence interval was used...
January 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28193138/removal-of-interlocking-intramedullary-nail-for-relieve-of-knee-pain-after-tibial-fracture-repair
#8
Shaodong Zhang, Xiaotao Wu, Lei Liu, Chen Wang
OBJECTIVE: To investigate the effects of intramedullary nail removal after tibial fracture repair. METHODS: Sixty patients at our hospital were enrolled in a prospective study and divided into moderate/severe knee pain (visual analog scale (VAS) ≥ 4) and mild/no knee pain (VAS < 4) groups after interlocking intramedullary nailing. Variables studied included the distance from the tip of the nail to the tibial plateau and the front of the tibia on a normalized lateral X-ray, the VAS score of knee and ankle pain, the range of motion of the knee and ankle, and Johner-Wruhs criteria before, 6 weeks after operation, and at the last follow-up...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28188129/enhancement-of-fracture-healing-in-the-rat-modulated-by-compounds-that-stimulate-inducible-nitric-oxide-synthase-acceleration-of-fracture-healing-via-inducible-nitric-oxide-synthase
#9
R A Rajfer, A Kilic, A S Neviaser, L M Schulte, S M Hlaing, J Landeros, M G Ferrini, E Ebramzadeh, S-H Park
OBJECTIVES: We investigated the effects on fracture healing of two up-regulators of inducible nitric oxide synthase (iNOS) in a rat model of an open femoral osteotomy: tadalafil, a phosphodiesterase inhibitor, and the recently reported nutraceutical, COMB-4 (consisting of L-citrulline, Paullinia cupana, ginger and muira puama), given orally for either 14 or 42 days. MATERIALS AND METHODS: Unilateral femoral osteotomies were created in 58 male rats and fixed with an intramedullary compression nail...
February 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28184364/tibial-lengthening-using-a-fixator-assisted-lengthening-plate-a-new-technique
#10
Haci Bayram Tosun, Ismail Agir, Seyitali Gumustas, Sancar Serbest, Abuzer Uludag, Suat Celik
BACKGROUND: There are many techniques that are used for limb lengthening. Lengthening a limb over a plate is an alternative choice used in children or when using an intramedullary nail is difficult. OBJECTIVES: In this study, we presented a new technique for tibial lengthening using a monolateral external fixator over a lengthening plate. MATERIALS AND METHODS: For tibial lengthening, a monolateral external fixator was attached to the composite bone model medially...
November 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28183211/3d-optical-investigation-of-2-nail-systems-used-in-tibiotalocalcaneal-arthrodesis
#11
Julia Evers, Martin Lakemeier, Dirk Wähnert, Martin Schulze, Martinus Richter, Michael J Raschke, Sabine Ochman
BACKGROUND: Although retrograde intramedullary nails for tibiotalocalcaneal arthrodesis (TTCA) are an established fixation method, few studies have evaluated the stability of the available nail systems. The purpose of this study was to compare biomechanically the primary stability of 2 nail-systems, A3 (Small Bone Innovations) and HAN (Synthes), in human cadavers and analyze the exact point of instability in TTCA by means of optical measurement. METHODS: In 6 pairs of lower legs (n = 12) of fresh-frozen human cadavers with osteoporotic bone structure, bone mineral density (BMD) was determined...
February 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28176597/the-risk-of-iatrogenic-injury-to-anterior-tibial-artery-variations-during-tibial-nail-distal-interlocking
#12
Nathan J Fanter, Sandra E Inouye, Christopher W Beiser
INTRODUCTION: Tibial intramedullary nailing remains a common tibial fracture fixation method. Tibial nailing indications continue to expand. Neurovascular complications from tibial nailing have been described; however, the proximity of distal tibial locking bolts to the anterior tibial artery (ATA) variants has not. MATERIALS AND METHODS: 52 cadaveric legs were dissected identifying three common ATA variants. Each ATA variant received an intraluminal wire to facilitate fluoroscopic identification...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28169938/percutaneous-or-open-reduction-of-closed-tibial-shaft-fractures-during-intramedullary-nailing-does-not-increase-wound-complications-infection-or-nonunion-rates
#13
Darryl A Auston, Jordan Meiss, Rafael Serrano, Thomas Sellers, Gregory Carlson, Timothy Hoggard, Michael Beebe, Jonathan Quade, David Watson, R Bruce Simpson, Brian Kistler, Anjan Shah, Roy Sanders, Hassan Mir
OBJECTIVE: To compare the incidence of complications (wound, infection, nonunion) among those patients treated with closed, percutaneous, and open intramedullary nailing for closed tibial shaft fractures. DESIGN: Retrospective Review. SETTING: Multiple trauma centers. PATIENTS: Skeletally mature patients with closed tibia fractures amenable to treatment with an intramedullary device. INTERVENTION: Intramedullary fixation with closed, percutaneous, or open reduction...
December 26, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28168640/3d-computer-graphical-anatomy-study-of-the-femur-a-basis-for-a-new-nail-design
#14
Beat Schmutz, Stanley Kmiec, Martin E Wullschleger, Martin Altmann, Michael Schuetz
BACKGROUND: Current intramedullary nails with a radius of curvature (ROC) of 1500-2000 mm sometimes cause distal anterior cortical encroachment. Furthermore, clinical data indicate that the proximal nail end is too long for some Asian patients. The objective of our study was to develop a comprehensive 3D measurement protocol that measures both the anatomy of the canal and the proximal region. The protocol was used to obtain measurements from Caucasian and Asian (Japanese and Thai) specimens...
March 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28164068/fracture-diaphyseal-femur-in-a-case-of-ipsilateral-excision-arthroplasty-of-hip-report-of-two-cases-with-description-of-an-unusual-injury-pattern-mechanism-and-clinical-decision-making-in-management
#15
Kunal Shah, Tushar Ubale, Rahematullah Abdul, Vaibhav Kasodekar, Ashish Assudani, Kiran Makwana
INTRODUCTION: Although fracture diaphyseal femur is commonly seen in orthopedic practice, its association with ipsilateral resection arthroplasty of hip/pseudarthrosis of neck is rare. The technique of excision arthroplasty has undergone modification with emphasis on preserving as much bone as possible. However, it is not always possible to preserve bone while removing the earlier prosthesis and cement. This often leads to extensive proximal bone loss. Associated ipsilateral fracture femur presents a unique scenario...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28164053/long-term-bisphosphonate-therapy-induced-periprosthetic-femoral-stress-fracture-in-a-sliding-hip-screw-implant-a-unique-case-report
#16
Mark R Adams, Conor Dunn, Michael S Sirkin, Mark C Reilly
INTRODUCTION: Long-term bisphosphonate therapy for osteoporosis is associated with an increased risk of low-to-no energy atypical subtrochanteric and femoral shaft fractures with characteristic radiologic findings. There are few reports of patients with long-term bisphosphonate-induced periprosthetic fractures, all of them had a hip arthroplasty prosthesis. In this report, we present a unique case of a 90-year-old Caucasian female on long-term bisphosphonate therapy with a sliding hip screw implant who sustained a periprosthetic fracture of the femoral shaft at the distal aspect of the plate...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28164049/a-case-report-of-bisphosphonate-induced-bilateral-osteoporotic-subtrochanteric-fracture-femurii-review-of-literature
#17
Rajendra Uppin, Srinath Gupta, Shivank Prakash
INTRODUCTION: Osteoporosis is a significant health-care problem characterized by excessive skeletal fragility, susceptibility to low-trauma fractures in men as well as women. Any abnormality of the bone that reduces the strength of the bone predisposes it to mechanical failure during normal activity or with minimum trauma. The mechanical failure manifests itself as a fracture, and this fracture must be recognized as a pathological fracture if the patient is to be treated properly. Osteoporosis is one of the leading causes of such pathological fractures and accounts for 1...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28155822/treatment-of-displaced-intra-articular-calcaneal-fractures-by-intramedullary-nail-preliminary-report
#18
Mirosław Falis, Krystian Pyszel
BACKGROUND: Open reduction and plate stabilisation is a recognised method of treatment of intra-articular calcaneal fractures. The surgical approach to the calcaneal bone used in these procedures is associated with a high risk of complications. The aim of this paper is to present the author's experience with a new surgical method and analyse early outcomes of the treatment of calcaneal fractures by Calcanail intramedullary nailing. MATERIAL AND METHODS: The study encompassed 17 patients (5 women and 12 men) with 18 calcaneal fractures (5 in the right foot and 13 in the left foot)...
March 23, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28153480/radiographic-predictors-of-symptomatic-screw-removal-after-retrograde-femoral-nail-insertion
#19
Max Hamaker, Nathan N O'Hara, W Andrew Eglseder, Marcus F Sciadini, Jason W Nascone, Robert V O'Toole
INTRODUCTION: Removal of symptomatic implants is a common procedure performed by orthopaedic trauma surgeons. No guidance is available regarding which factors contribute to the likelihood of an implant becoming symptomatic. Our objective was to determine whether radiographic parameters associated with distal interlocks in retrograde femoral nails are associated with the rate of symptomatic screw removal. PATIENTS AND METHODS: We conducted a retrospective review at a Level I trauma center...
January 6, 2017: Injury
https://www.readbyqxmd.com/read/28149195/non-unions-after-fixation-of-humeral-fractures-using-hackethal-s-bundle-nailing-technique
#20
Petr Obruba, Stefan Rammelt, Lubomir Kopp, Karel Edelmann, Jakub Avenarius
OBJECTIVE: The aim of the study was to identify factors contributing to the development of non-union after fixation of diaphyseal humeral fractures using Hackethal's intramedullary nailing technique. METHODS: In the time period from 2001 to 2010 156 patients with diaphyseal humeral fractures were treated surgically using Hackethal's technique. Six of them (3.8%) developed non-union. This group included three women and two men aged 63-69 years and one woman aged 37 years...
September 2016: Acta Ortopedica Brasileira
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