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Tibial nailing

Jong Woong Park, Yong-Il Kim, Hyun Guy Kang, June Hyuk Kim, Han Soo Kim
OBJECTIVE: For symptomatic metastasis of the long bones, intramedullary nailing has been the most accepted fixation method. Intramedullary nailing has effective control of pain, perioperative bleeding, and local tumor progression by augmentation with bone cement around the nail. Here, we report the preliminary results of a new surgical implant that allows for simultaneous injection of bone cement while inserting a percutaneous, flexible intramedullary nail. MATERIALS AND METHODS: We performed palliative surgeries for long-bone metastasis using a multi-hole injection nail (MIN) with multiple side holes in the distal one third...
June 21, 2018: Skeletal Radiology
Atsushi Kogure, Yu Mori, Hidetatsu Tanaka, Masayuki Kamimura, Naoya Masahashi, Shuji Hanada, Eiji Itoi
Intramedullary nailing is widely performed for internal fixation of fractures. The applicable elasticity of materials composing intramedullary nails remains unclear. The present study aimed to evaluate the effects of the elastic property of β-type titanium alloy nails on fracture healing compared with conventional Ti-6Al-4V alloy nails using a rabbit tibial osteotomy model. Two types of intramedullary nails composed of β-type Ti-Nb-Sn alloy (Young's modulus: 37 GPa) or Ti-6Al-4V alloy (Young's modulus: 110 GPa) were used for osteotomy fixation in the tibiae of rabbits...
June 19, 2018: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
Gabriele Falzarano, Giuseppe Pica, Antonio Medici, Giuseppe Rollo, Michele Bisaccia, Raffaele Cioffi, Mario Pavone, Luigi Meccariello
The aim of our study was to investigate which technique among hybrid external fixation, plate and screws, and intramedullary nailing produces better outcomes in foot loading when treating type 43.A1, 43.A2, and 43.A3 fractures, according to the AO classification. From November 2011 to December 2014, 34 patients, including 25 (73.5%) males and 9 (26.5%) females with an average age of 32.3 (range 16 to 67) years, with a type A tibia fracture were treated with intramedullary nailing, plate and screws, or hybrid external fixation...
June 15, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Patrick B Horrigan, Monica J Coughlan, Malcolm DeBaun, Blake Schultz, Julius A Bishop, Michael J Gardner
Use of percutaneous clamps are often helpful tools to aid reduction and intramedullary nailing of distal tibial spiral diaphyseal fractures. However, the anterior and posterior neurovascular bundles are at risk without careful clamp placement. We describe our preferred technique of percutaneous clamp reduction for distal spiral tibial fractures with a distal posterolateral fracture spike, with care to protect the adjacent neurovascular structures. We also investigated the relationship between these neurovascular structures and the site of common percutaneous clamp placement...
June 4, 2018: Journal of Orthopaedic Trauma
Zhixue Gao, Wei Han, Haigang Jia
BACKGROUND AND OBJECTIVE: The aim of this study was to compare the outcome of using tibial nails inserted by the suprapatellar approach with tibial nails inserted by the infrapatellar approach in a meta-analysis of randomized controlled trials (RCTs). METHODS: The following electronic databases were searched: PubMed (1966 to January 2018), EMBASE (1974 to January 2018), Cochrane Library (January 2018), Web of Science (1990 to January 2018). We also used Google Search Engine to search more potentially eligible studies until January 2018...
June 2018: Medicine (Baltimore)
Liqing Yang, Yuefeng Sun, Ge Li
BACKGROUND: Optimal surgical approach for tibial shaft fractures remains controversial. We perform a meta-analysis from randomized controlled trials (RCTs) to compare the clinical efficacy and prognosis between infrapatellar and suprapatellar intramedullary nail in the treatment of tibial shaft fractures. METHODS: PubMed, OVID, Embase, ScienceDirect, and Web of Science were searched up to December 2017 for comparative RCTs involving infrapatellar and suprapatellar intramedullary nail in the treatment of tibial shaft fractures...
June 14, 2018: Journal of Orthopaedic Surgery and Research
Ke-Jie Fan, Ke Chen, Wen-Long Ma, Ke-Wei Tian, Ye Ye, Hong-Gan Chen, Yan-Feng Tang, Hong-Min Cai
OBJECTIVE: To investigate the effect of minimally invasive mini-incision and instrumented reduction combined with interlocking intramedullary nailing in the treatment of patients with multi-segment fracture of complex femoral shaft. METHODS: From January 2013 to January 2016, 32 patients with multiple fractures segments of femoral shaft were treated with instrumentation-assisted reduction combined with interlocking intramedullary nailing, including 22 males and 10 females with an average age of 45 years old ranging 17 to 68 years old...
May 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Iulia Tevanov, Dan Mircea Enescu, Madalina Carp, Andrei Dusca, Alin Ladaru, Alexandru Ulici
Open fractures of the leg with large loss of tissue require extensive reconstructive methods that can injure the donor area. The use of negative pressure wound therapy (NPWT) may minimise the impact of these reconstructive methods because of its capacity to create granulation tissue that will form a wound bed for the skin graft, thus reducing the volume of soft tissue defect and saving the donor region. This case study describes the effectiveness of NPWT in the treatment and reconstruction of an open fracture of the leg, with massive loss of soft tissue, associated with elastic intramedullary nailing in a 10-year-old female patient, who was a victim of a car accident...
June 1, 2018: Journal of Wound Care
Kazuhiko Udagawa, Yasuo Niki, Kengo Harato, Shu Kobayashi, So Nomoto
Retrograde intramedullary nailing (RIMN) has been used for periprosthetic fracture of the distal femur after total knee arthroplasty (TKA), yielding good fracture union rates and satisfactory outcomes. However, RIMN for posterior-stabilized- (PS-) TKA risks malpositioning the entry point and disturbing the post of the tibial insert, and the surgeon therefore usually requires knee joint arthrotomy. We report a case of a 79-year-old male who was involved in bicycle accident resulting in periprosthetic fracture of the distal femur after PS-TKA...
2018: Case Reports in Orthopedics
Jialei Chen, Zhaokui Yan, Gang Zhong, Yue Fang
Objective: To discuss the efficacy of skin stretcher applied for repair of postoperative skin and soft tissue defects in tibial fractures. Methods: Between April 2016 and March 2017, 15 cases with skin and soft tissue defects after tibial fractures fixation were treated with the skin stretcher. There were 11 males and 4 females with an age of 24-59 years (mean, 37.5 years). The causes of injury included traffic accident in 7 cases, bruise in 3 cases, falling from height in 3 cases, and falling in 2 cases; without nerve and vascular injury in all patients...
May 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Antti Stenroos, Tuomas Brinck, Lauri Handolin
BACKGROUND: The removal of implants such as intramedullary nails is one of the most common operations in orthopedic surgery. The indications for orthopedic implants removal will always remain a subject of conversation and hardly supported by literature. The aim of this study to report injuries of treatment in tibial nail removal and to determine if there are fracture characteristics, patient demographics, or surgical details that may predict a complication. METHODS: This is a retrospective seven-year (2010-2016) study including a total of 389 tibial intramedullary nail removals at the Helsinki University Hospital's orthopedic unit...
May 21, 2018: Injury
Peng Jia, Feng-Cheng Lu, Kifayat Ullah, Man Zhang, Yan-Sheng Dong, Chao Xiong, Zhi-Hui Zhao, Jin-Feng Wang, Ju-Wen Chen, Yong-Qing Wang
OBJECTIVE: Angle stable interlocking intramedullary nail (ASIN), a novel technique, has rarely been used for treatment of tibial plateau fractures (TPF). This retrospective study was designed to introduce this novel technique, ASIN, as well as to describe the initial experience and verify the effectiveness when ASIN was used for the management for TPF. METHODS: A cohort of 19 cases with closed TPF aged from 18-70 years with at least 23 months follow-up from November 2008 to September 2013 was analyzed retrospectively...
May 16, 2018: Orthopaedic Surgery
Cyril Mauffrey, David J Hak, Peter Giannoudis, Volker Alt, Christoph Nau, Ingo Marzi, Peter Augat, J K Oh, Johannes Frank, Andreas Mavrogenis, Xavier Flecher, Jean-Noel Argenson, Ashok Gavaskar, David Rojas, Yehia H Bedeir
OBJECTIVE: The lack of universally accepted treatment principles and protocols to manage infected intramedullary (IM) nails following tibial fractures continues to challenge us, eliciting a demand for clear guidelines. Our response to this problem was to create an ORS/ISFR taskforce to identify potential solutions and trends based on published evidence and practices globally. MATERIALS AND METHODS: A questionnaire of reported treatment methods was created based on a published meta-analysis on the topic...
May 3, 2018: International Orthopaedics
M Maredza, S Petrou, M Dritsaki, J Achten, J Griffin, S E Lamb, N R Parsons, M L Costa
No abstract text is available yet for this article.
May 1, 2018: Bone & Joint Journal
Yu Zhang, Xiaodong Qin, Lijun Song, Xiang Li
BACKGROUND: For a distal tibial spiral fracture combined with a non-displaced posterior malleolar fragment (PMF), we proposed a hypothesis that the treating surgeon could assess the size of the PMF to determine the need for stabilizing that structure first before rodding the tibia. MATERIALS AND METHODS: Fifty 3-D models (22 females) of combined distal tibial and posterior malleolar fractures from one trauma center were reconstructed. In each case, a virtual tibial intramedullary nail (vIM nail) with three distal anteroposterior (AP) locking screws (S13 , S15 and S37 , the number indicating the distance from the screw to the nail tip) were inserted into the center of the tibial canal and ended on top of the distal tibial physeal scar...
April 19, 2018: BMC Musculoskeletal Disorders
Hannah L Dailey, Katherine A Wu, Ping-Shi Wu, Margaret M McQueen, Charles M Court-Brown
OBJECTIVE: To determine factors associated with nonunion of adult tibial fractures. DESIGN: Retrospective review with data collection for logistic regression and survival analysis. SETTING: Scottish Level I trauma centre, 1985 to 2007. PATIENTS: During this period, 1,590 adult tibial fractures were treated by reamed nailing and 1,003 met all inclusion criteria for the chosen analysis. INTERVENTION: Reamed intramedullary nailing...
April 3, 2018: Journal of Orthopaedic Trauma
Vignesh Ramachandran, Lee S Haruno, Theodora S Browne, Laila E Woc-Colburn, Scott B Rosenfeld, Vinitha R Shenava
CASE: A 14-year-old boy presented with a pathologic fracture of the distal aspect of the tibia and a remote history of a dog bite near the injury site. Imaging studies, biopsy, and presentation corroborated the diagnosis of chronic osteomyelitis. Multiple diagnostic methods were negative until an open biopsy identified Haemophilus parainfluenzae, a fastidious oropharyngeal bacterium, with polymerase chain reaction analysis. The patient underwent extensive debridement, placement of external fixation, and a year-long antibiotic therapy regimen...
January 2018: JBJS Case Connector
Jong Ho Noh, Sung Jun Koh, Kee Haeng Lee
Antibiotic cement-coated intramedullary nails maintain a locally high antibiotic concentration while contributing to bone stability. We present a case of femoral subtrochanteric fracture in a patient with an infected nonunion who was successfully treated for an infection and nonunion using an antibiotic cement-coated tibial intramedullary nail. A 79-year-old woman with a right femoral subtrochanteric fracture underwent internal fixation using proximal femoral nail antirotation (PFNA). She developed osteomyelitis with nonunion at the surgical site 10 months postoperatively...
March 2018: Hip & Pelvis
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 literature 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...
May 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
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