PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Fracture Fixation, Intramedullary”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources
PubMed1997

[Healing modalities in unstable tibial fractures treated by locked flexible intramedullary fixation].

PURPOSE OF THE STUDY: This clinical study aimed specifically to evaluate the role of flexibility in aseptic consolidation of unstable tibial fractures on compact bones. The device employed was made of intramedular nails placed separately and locked together using an original proximal system. MATERIAL: 125 unstable compact bone fractures of the tibial shaft were treated by this method for almost 6 years. 110 cases were included in this study. 30 per cent of the fractures were open. The topographical breakdown of fracture sites on the diaphysis was 6 times, in the upper third (Sector I), 23 times in Sector II and 66 times in the lower third (Sector III). In 13 cases, there were sequential fractures of which the upper site was in Sector I. 57 cases were simple sites (A), 27 were sites with edges greater than 50 per 100 of the diaphyseal circumference (B), and 26 per 100 of comminuted sites (C). The distance measured in the fracture sites after osteosynthesis were 66 times within 3 mm, 24 cases from 4 to 10 mm, 12 cases from 11 to 15 mm, and 8 cases over 16 mm. METHODS: 110 cases were followed for more than 6 months. Consolidation was established on standard clinical and radiological criteria. The value of parameters affecting consolidation and the time period recorded were validated by a precise statistical evaluation using Stat. View II software, and Fisher and Yates tables. RESULTS: Complications due to implants were rare and minor. There were only 4 cases of nonunion resulting from secondary desaxation of two pins apparatus. 16 cases of nonunion (14.5 per 100) were recorded but 3 were forseeable nonunions, because of a traumatic bone loss. 8 cases were Sector I fractures of which 7 were Sector I unsequental fractures. 7 cases had a gap of 10 to 15 mm, and 5 of 16 to 20 mm. Thus 42.1 per 100 of cases in Sector I were not consolidated compared to only 6.1 per 100 of cases in Sector III. Primary consolidation of the 94 cases was achieved in an average of 11.08 +/- 3.19 weeks (minimum 6 weeks, maximum 20 weeks). Time for consolidation did not appear to be affected by anatomical type, opened fracture (degree 1 or 2) nor number of nails used. But, there were significant differences according to topography and postoperative gap at the fracture site. Sector II fractures took 15 days less than Sector I fracture: average 10.5 as compared to 12.6 weeks. The cases with a gap of 0 to 3 mm consolidated at an average of 10.6 weeks, those with 4 to 10 mm: 11.39 weeks, with a gap of 11 to 15 mm: 14.4 weeks, and the cases superior to 16 mm: 14.8 weeks. DISCUSSION: Compared to the interlocking nail, this procedure gave an average shortening of consolidation delay of 1 month for closed and degree 1 and 2 open fractures. This rapidity of consolidation can only be explained by the flexibility parameter. Thus it is only the flexibility of the device which can explain that even with a gap of 11 to 15 mm left within the fracture site, consolidation occurred 1 time out of 2 and 9 times out of 10 when the gap was 4 to 10 mm. Finally, this mechanical parameter can explain that consolidation is by far the shortest for low fractures although these are reputed to be the least osteogenic.

Adult↗
PubMedDate not supplied

Treatment of proximal humeral fractures with Polarus nail fixation.

A chart review of 20 patients who sustained acute proximal humeral fractures and who were treated by surgical stabilization with locked antegrade humeral intramedullary nails (Polarus nails) was undertaken. The clinical outcome measurements were fracture healing, infection, and neurologic injury. Radiologic outcome measurements included fracture alignment, loosening, fixation and hardware failure, and malunion and nonunion. Of 20 fractures, 11 healed without complications. The mean immediate postoperative and final radiographic valgus neck/shaft angulation measured 131 degrees. Of the 20 implants, 3 had proximal fixation screw loosening. Of the 20 implants, 2 underwent revision surgery for proximal fixation failure. With certain fracture types, the Polarus intramedullary humeral nail can be an effective implant. In fracture cases involving an unstable or comminuted lateral metaphyseal fracture, if the starting point extends into the greater tuberosity, fixation failure or fracture displacement may result.

Adolescent↗
PubMed1982

Treatment of pathologic fractures or impending fractures of the humerus with Rush rods and methylmethacrylate. Experience with 55 cases in 54 patients, 1968-1977.

A retrospective study of 54 patients with established or impending pathologic humeral fractures was done to evaluate the technique of intramedullary fixation with a Rush rod, during the period from 1968 to 1977. Breast carcinoma, multiple myeloma, and hypernephroma were the most common metastatic tumors. Primary tumors included Ewing's sarcoma and a low-grade chondrosarcoma, in which case the patient refused any other form of treatment. An anterolateral incision was used to expose the fracture site and a deltoid-splitting incision to introduce the Rush rod. Thirty-eight of the 55 procedures utilized methylmethacrylate to help stabilize the fracture. All patients had relief of their preoperative pain after the procedure. Seven patients subsequently experienced pain: four had proximal migration of the Rush rod with impingement, three of which required removal of the Rush rod; three other patients had discomfort two years postoperatively. All patients except one had good functional motion. Six patients had complications: three with proximal migration of the Rush rod, two with transient subluxation of the humeral head, and one with limited glenohumeral motion secondary to a technical error. This procedure provides significant pain relief and maintains function.

Adolescent↗
PubMedDate not supplied

Telescoping intramedullary rodding with Bailey-Dubow nails for recurrent pathologic fractures in children without osteogenesis imperfecta.

We reviewed four children with multiple, recurrent, pathologic fractures caused by bone disease, excluding osteogenesis imperfecta, and in whom multiple osteotomies with telescoping intramedullary stabilization had been performed. The diagnoses were myelomeningocele in two children and Rett syndrome and fibrous dysplasia in one child each. Five long bones were stabilized; four femora and one tibia. The average age at surgery was 6 years 6 months; the average number of fractures that had occurred in the involved bone before surgery was 3.0 per bone. At an average follow-up of 2 years 4 months, the average number of fractures that had occurred after surgery in the stabilized bones was 0.2 per bone. There were no infections, nonunions, or rod complications. We believe that in the carefully selected patient, multiple osteotomies with intramedullary telescoping rod stabilization can be quite successful in solving the problem of recurrent fractures in children with diseases other than osteogenesis imperfecta.

Bone Nails↗
PubMed2001

Simultaneous ipsilateral diaphyseal fractures of the femur and tibia: treatment and complications.

We present our experience of intramedullary nailing (IM) and external fixation in the treatment of 54 patients with ipsilateral diaphyseal fractures of the femur and tibia. Eight femoral and 24 tibial fractures were open. They were classified into three groups: IM nailing of both fractures (group A, 19 patients); IM nailing of the femoral and external fixation of the tibial fracture (group B, eight patients); and external fixation of both fractures (group C, 27 patients). In group C (which included all but one grade III open fracture), two patients died and four underwent amputation. Femoral fractures treated with external fixation had significantly more complications and reoperations than those treated with IM nailing. In tibial fractures this difference was also present but not statistically significant. We believe that IM nailing is the method of choice for femoral fractures and is preferable for tibial fractures, with the exception probably of grade III B and C open injuries.

Adolescent↗
PubMed2004

Treatment of ipsilateral hip and femoral shaft fractures with reconstructive intramedullary interlocking nail.

OBJECTIVE: To evaluate the results of reconstructive intramedullary interlocking nail in the treatment of ipsilateral hip and femoral shaft fractures. METHODS: From August 1997 to November 2001, 13 patients were treated with the reconstructive intramedullary interlocking nail. Nine patients were associated with ipsilateral femoral neck fractures, three with ipsilateral intertrochanteric fractures, and one with subtrochanteric fracture. RESULTS: The follow-up time was from 6 to 38 months with an average of 14 months. All the femoral shaft and hip fractures healed up well. There was no nonunion of the femoral neck, and only one varus malunion. No patient had avascular necrosis of the femoral head. The average healing time for femoral neck fracture was 4.6 months and for shaft fracture 5.8 months. The joint movement and other functions were fairly resumed. CONCLUSIONS: The reconstructive intramedullary interlocking nail, with less trauma, reliable fixation, and high rate of fracture healing, is an ideal method of choice in the treatment of ipsilateral hip and femoral shaft fractures.

Adolescent↗