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Intramedullary nailing

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https://www.readbyqxmd.com/read/27914027/the-role-of-guided-growth-as-it-relates-to-limb-lengthening
#1
REVIEW
Peter M Stevens
For decades, the classic indication for limb lengthening has been reserved for anisomelia that was expected to reach or exceed 5 cm at maturity. Epiphysiodesis was reserved for discrepancies in the 2-5 cm range. With the increasing sophistication of fixators, including rail, hexapod, and hybrid, complex deformities may be corrected simultaneously while moderate to extreme lengthening is achieved. More recently, iterations of telescoping intramedullary rods have further strengthened our armamentarium. Meanwhile, permanent epiphysiodesis techniques, both open and percutaneous, have yielded to more versatile and reversible tethering of one (angle) or both (length) sides of a physis...
December 2, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27914012/biomechanical-investigation-of-titanium-elastic-nail-prebending-for-treating-diaphyseal-long-bone-fractures
#2
Yen-Nien Chen, Pei-Yuan Lee, Chih-Wei Chang, Yi-Hung Ho, Yao-Te Peng, Chih-Han Chang, Chun-Ting Li
This study numerically investigated the deformation of titanium elastic nails prebent at various degrees during implantation into the intramedullary canal of fractured bones and the mechanism by which this prebending influenced the stability of the fractured bone. Three degrees of prebending the implanted portions of the nails were used: equal to, two times, and three times the diameter of the intramedullary canal. Furthermore, a simulated diaphyseal fracture with a 5-mm gap was created in the middle shaft portion of the bone fixed with two elastic nails in a double C-type configuration...
December 2, 2016: Australasian Physical & Engineering Sciences in Medicine
https://www.readbyqxmd.com/read/27911364/an-intramedullary-locking-nail-for-standardized-fixation-of-femur-osteotomies-to-analyze-normal-and-defective-bone-healing-in-mice
#3
Tina Histing, Michael D Menger, Tim Pohlemann, Romano Matthys, Tobias Fritz, Patric Garcia, Moritz Klein
Bone healing models are essential to the development of new therapeutic strategies for clinical fracture treatment. Furthermore, mouse models are becoming more commonly used in trauma research. They offer a large number of mutant strains and antibodies for the analysis of the molecular mechanisms behind the highly differentiated process of bone healing. To control the biomechanical environment, standardized and well-characterized osteosynthesis techniques are mandatory in mice. Here, we report on the design and use of an intramedullary nail to stabilize open femur osteotomies in mice...
November 13, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27904933/-metastatic-disease-in-long-bones-review-of-surgical-treatment-options
#4
Franz Liska, Philipp Schmitz, Norbert Harrasser, Peter Prodinger, Hans Rechl, Rüdiger von Eisenhart-Rothe
Surgery in metastatic bone disease is currently the most frequent type of surgery in orthopedic oncology. Improved survival rates and an increasing incidence of bone metastasis have led to an increase in complications caused by metastatic disease, such as pathological fractures or hardware failure after operative treatment. Although surgery of metastatic lesions remains a palliative therapy concept, because of sufficient therapy for the primary carcinomas, tumor-specific-oriented follow-up protocols and a variation in the prognosis for the individual entities, an individually adapted treatment strategy is necessary...
November 30, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27904734/recurrence-of-a-unicameral-bone-cyst-in-the-femoral-diaphysis
#5
Hyun Se Kim, Kyung Sup Lim, Sung Wook Seo, Seung Pil Jang, Jong Sup Shim
Diaphyseal unicameral bone cysts of the long bone are generally known to originate near the growth plate and migrate from the metaphysis to the diaphysis during skeletal growth. In the case of unicameral bone cysts of diaphyseal origin, recurrence at the same location is extremely rare. We report a case of recurrence of a unicameral bone cyst in the diaphysis of the femur that developed 8 years after treatment with curettage and bone grafting. We performed bone grafting and lengthening of the affected femur with an application of the Ilizarov apparatus over an intramedullary nail to treat the cystic lesion and limb length discrepancy simultaneously...
December 2016: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/27904730/intramedullary-nailing-for-pathological-fractures-of-the-proximal-humerus
#6
Eun-Seok Choi, Ilkyu Han, Hwan Seong Cho, In Woong Park, Jong Woong Park, Han-Soo Kim
BACKGROUND: Endoprosthetic reconstruction is widely applied for pathological fractures of the proximal humerus; however, functional impairment is usually unsatisfactory. The aims of the current study are to evaluate the reliability of interlocking intramedullary (IM) nailing with cement augmentation as a fixation method in proximal humeral lesions and to assess functional outcomes. METHODS: We reviewed 32 patients with pathological fractures of the proximal humerus who underwent interlocking IM nailing and cement augmentation...
December 2016: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/27904716/is-anterior-bridge-plating-for-mid-shaft-humeral-fractures-a-suitable-option-for-patients-predominantly-involved-in-overhead-activities-a-functional-outcome-study-in-athletes-and-manual-laborers
#7
Abhishek S Mahajan, Young Gun Kim, Jae Hwa Kim, Prashanth D'sa, Azhar Lakhani, Hyun Soo Ok
BACKGROUND: To assess the functional and radiological outcomes of minimally invasive anterior bridge plating (ABP) for mid-shaft humerus fractures in patients predominantly involved in overhead activities (athletes and manual laborers). METHODS: Forty-eight patients fulfilling inclusion criteria were treated with ABP at a level-I trauma center using a 4.5-mm dynamic/locking compression plate and followed for a period of 1 year. Functional outcome was assessed using the Constant, Mayo elbow, and Disabilities of the Arm, Shoulder and Hand (DASH) scores...
December 2016: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/27902166/is-intramedullary-nailing-applicable-for-distal-tibial-fractures-with-ankle-joint-extension
#8
Ozan Beytemür, Cem Albay, Oktay Adanır, Serdar Yüksel, Mehmet Akif Güleç
OBJECTIVES: This study aims to evaluate the functional and radiographic results and treatment complications of AO/OTA (Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopaedic Trauma Association) type 43C1 and C2 fractures treated with intramedullary nailing. PATIENTS AND METHODS: We retrospectively evaluated 35 AO/OTA type 43C1 and C2 patients (26 males, 9 females; mean age 39.8±16.9 years; range 19 to 82 years) treated with intramedullary nailing. Two interfragmentary screws out of nail were applied in 10 patients (29%), while one interfragmentary screw out of nail was applied in 17 patients (49%)...
December 2016: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/27895371/rotational-mal-alignment-after-reamed-intramedullary-nailing-for-tibial-shaft-fracture
#9
Sher Baz Khan, Yasir Mohib, Rizwan Haroon Rashid, Haroonur Rashid
Intra-medullary (IM) nailing is standard of care for unstable tibial shaft fractures. Malrotation is very common but it is under-recognised, inpart because of variation in normal anatomy and partly due to difficulty in accurately assessing rotation. This study was planned to evaluate the frequency of rotational mal-alignment after reamed tibia IMnailing. This cross-sectional study was conducted at Aga khan University Hospital, Karachi, and comprised patients with tibia shaft fractures managed with IMnailing from January to December 2014...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27878549/fluoroscopic-freehand-and-electromagnetic-guided-targeting-system-for-distal-locking-screws-of-humeral-intramedullary-nail
#10
P Persiani, M Gurzi, O Moreschini, G Di Giacomo, C Villani
PURPOSE: The current techniques used to lock distal screws for the nailing of long bone fractures expose the surgeons, radiologists and patients to a hearty dose of ionizing radiation. The Sureshot™ Distal Targeting System is a new technique that, with the same results, allows for shorter surgery times and, consequently, less exposure to radiation. MATERIALS AND METHODS: The study was performed on 59 patients (34 males and 25 females) with a simple humerus fracture diagnosis, type 1...
November 22, 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27875489/femoral-medialization-fixation-failures-and-functional-outcome-in-trochanteric-hip-fractures-treated-with-either-a-sliding-hip-screw-or-an-intramedullary-nail-from-within-a-randomized-trial
#11
Christopher P Bretherton, Martyn J Parker
OBJECTIVES: The aim of this study was to determine if femoral medialization influences residual pain and mobility and to determine if fixation method or fracture pattern influences the tendency to medialize. DESIGN: This study used data from within a randomized controlled trial. SETTING: Peterborough City Hospital, UK. PATIENT/PARTICIPANTS: Eight hundred forty-four patients presenting with a trochanteric hip fracture were randomized...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27872519/the-inflatable-intramedullary-nail-for-humeral-shaft-fractures
#12
Fırat Ozan, Kaan Gürbüz, Erdal Uzun, Sefa Gök, Fatih Doğar, Fuat Duygulu
BACKGROUND: We assessed the results of humeral shaft fracture fixation using the inflatable intramedullary nail using radiological and clinical findings. METHODS: From 2012 to 2015, we treated 14 patients with humeral shaft fractures using inflatable intramedullary nail after closed reduction. RESULTS: The mean follow-up time was 14.1 months. The mean time to bone union was 4.5 months. None of the patients had major perioperative mechanical complications or postoperative complications, except for the occurrence of fixation loss and non-union in one patient...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/27865312/an-overview-of-internal-and-external-fixation-methods-for-the-diabetic-charcot-foot-and-ankle
#13
REVIEW
Crystal L Ramanujam, Thomas Zgonis
Diabetic Charcot neuroarthropathy (DCN) of the foot and ankle is a challenging disease with regard to clinical presentation, pathogenesis, and prognosis. Its surgical management is equally difficult to interpret based on the wide array of options available. In the presence of an ulceration or concomitant osteomyelitis, internal fixation by means of screws, plates, or intramedullary nailing needs to be avoided when feasible. External fixation becomes a great surgical tool when managing DCN with concomitant osteomyelitis...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27861604/effectiveness-and-safety-of-interventions-for-treating-adults-with-displaced-proximal-humeral-fracture-a-network-meta-analysis-and-systematic-review
#14
Long Chen, Fei Xing, Zhou Xiang
PURPOSE: Network meta-analysis (NMA) is a comparatively new evidence-based technique in medical disciplines which compares the relative benefits associated with multiple interventions and obtains hierarchies of these interventions for various treatment options. We evaluated the effectiveness and safety of open reduction and internal fixation (ORIF), hemiarthroplasty (HA), reverse shoulder arthroplasty (RSA), intramedullary nailing (IN) and non-operative treatment (NOT) of displaced proximal humeral fractures in adults using Bayesian NMA of data from clinical trials...
2016: PloS One
https://www.readbyqxmd.com/read/27859357/postoperative-ambulatory-performance-status-significantly-affects-implant-failure-rate-among-surgical-treatment-strategies-in-patients-with-proximal-femur-metastasis
#15
Shang-Wen Tsai, Po-Kuei Wu, Cheng-Fong Chen, Ming-Chau Chang, Wei-Ming Chen
Surgical treatment strategies for proximal femur metastasis have been reported with mixed results. Little is known about risk factor for implant failure except for longer patient survival. Therefore, we determined whether implant survivorship differed among treatment strategies, as well as risk factors for implant failure. We retrospectively reviewed a consecutive 106 patients with proximal femur metastasis treated with prosthesis replacement (n = 38), intramedullary nail (n = 32), and dynamic hip screw (DHS) (n = 36)...
November 8, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27858886/fixator-assisted-tibial-lengthening-over-a-plate-in-a-patient-with-sequelae-of-poliomyelitis
#16
Haci Bayram Tosun, Sancar Serbest, Abuzer Uludag, Seyitali Gumustas, Suat Celik
There are many techniques for limb lengthening. Lengthening over a plate is an alternative choice of fixation in children or when nailing is difficult. We present a new technique for tibial lengthening with using a monolateral external fixator over a lengthening plate.Lengthening over an intramedullary nail is a commonly used method in patients with short stature or limb-length discrepancy. However, in patients with a narrow and excessively sclerotic intramedullary cavity in the pediatric age group where the skeletal system has not yet fully developed, difficulties have been observed in lengthening methods with nailing...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27855049/-evaluation-of-patients-with-humeral-midshaft-fractures-treated-with-dcp-plate-vs-intramedullary-nail-uhn
#17
Jonathan Guzmán-Guevara, Gerardo López-Cázares, Rodolfo Gregorio Barragán-Hervella, José Saúl Alejandro Villegas-Rosas, Iván Alvarado-Ortega, Álvaro José Montiel-Jarquín
BACKGROUND: Humeral midshaft fractures should be surgically managed, so the knowledge of functionality, bone healing and pain of these treatments is required to obtain the expected results. The aim of this paper is to compare the results of patients with humeral midshaft fracture operated with intramedullary nails UHN vs. DCP plate. METHODS: Comparative study, conducted during the period of June 2014 to June 2015, in patients with humeral midshaft fracture, incidents, operated with intramedullary nails UHN vs...
2016: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/27848194/intramedullary-lengthening-nails-can-we-also-correct-deformities
#18
REVIEW
U Lenze, A H Krieg
Unlike external fixators, the use of solid intramedullary lengthening nails is restricted to defined anatomical preconditions, such as an adequate bone length. Furthermore, all deformity corrections except the lengthening procedure have to be implemented intraoperatively and cannot be adjusted postoperatively. Conversely, even complex deformity corrections can be performed using intramedullary devices after a thorough preoperative planning. For preparation of the intramedullary cavity as well as positioning of the lengthening nail according to the preoperative planning, reaming the medullary canal with rigid reamers which don't follow the line of least resistance is inevitable...
November 15, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27846358/-subtrochanteric-fracture-in-children-treated-with-minimally-invasive-surgery-case-report
#19
R Guzmán-Vargas, D F Rincón-Cardozo, J A Camacho-Casas
Subtrochanteric fractures in children are rare events that occur in only 4% of all femur fractures; most injuries occur as a result of high-energy trauma, being young male patients the most affected. The management of this type of injury is controversial; there are many forms of treatment, including the use of plaster spica 90-90, closed reduction and use of elastic or rigid intramedullary nails, open reduction and plate placement, and the use of external fixators. Most suggest that for children under 10 a nonoperative approach should be preferred and that older ones should be managed surgically, but it is between six and 12-year-olds that most of the controversy exists...
March 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/27843272/open-intramedullary-nailing-for-segmental-long-bone-fractures-an-effective-alternative-in-a-resource-restricted-environment
#20
Olasunkanmi M Babalola, Gbadebo Hakeem Ibraheem, Bola A Ahmed, Ayokunle Olawepo, Samuel B Agaja, Adebowale Adeniyi
BACKGROUND: Closed, locked intramedullary nailing has been accepted as the gold standard in the care of femoral fractures, with reported union rates as high as 98-100%. Closed, locked intramedullary nailing often requires expensive equipment which is a challenge in developing countries. Segmental long bone fractures are often a result of high-energy trauma and hence often associated with a lot of injuries to the surrounding soft tissues. This consequently results in higher rates of delayed or nonunion...
July 2016: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
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