Clinical criteria to rule out cervical-spine injury.
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Biomedical subjects
Publications and source records attributed to R Lanfranchi.
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The "Eiffel Tower" method of nailing has not attracted the interest in Italy that it deserves, both because its utilisaton in fractures is difficult when closed reduction of the fragments is difficult, and because the attention of surgeons has been progressively directed towards osteosynthesis by open reduction. Our experience over many years, however, has convinced us that, in the diaphysis, only the intramedullary nail can provide the quick recovery that is not always forthcoming in the case of plating. We need only think of comminuted fractures, where the possible necrosis of one or more fragments demands a certain amount of prudence in allowing direct weight bearing. Therefore, in adopting the double Rush system, we extended its application to the intramedullary osteosynthesis of metaphyseal fractures. It was a short step from this to the surgical treatment of pseudarthrosis impacted in good position or retarded union, the results of which were encouraging, as demonstrated by the eighty-one cases reported in this paper.
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The results obtained with delayed closed endomedullary osteosynthesis in 230 cases are considered. This method greatly extends the use of endomedullary nailing to open fractures and those in which controindications of a mechanical nature (multiple fractures, or at several levels) rule out the immediate use of implants. The techniques proposed (osteosynthesis with triflanged nail in fractures of the diaphysis and osteosynthesis with double Rush nails in metaphysio-diaphysis fractures) have two advantages. Due to the non opening of the fracture focus there is minimal risk of infection and early restoration of function.
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