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At least 307 records · Page 17Linked to original sources
PubMed2006

[Intramedullary locked nailing in the treatment of proximal femoral fractures].

INTRODUCTION: The aim of the study is evaluation of results of operative treatment the proximal femoral fractures with intramedullary locked nailing. MATERIAL AND METHOD: In years 1996-2004 44 patients were treated because of proximal femoral fractures with closed reduction and stabilization with intramedullary locked nailing. There were 15 women and 29 men in average age 60 years (18-95 years). There were 2 femoral neck fractures and 42 peritrochanteric fractures. The fracture of femoral shaft in 2 patients accompanied the fracture of proximal part of femur. The morphology of fractures was estimated according to AO classification. Clinical results were evaluated with Harris hip score (HHS). RESULTS: The average follow up is 8 months (from 6 to 24 months). There was good reduction of 27 fractures on postoperative radiograms. The average 15 degrees of varus lack of reduction was noted in 17 peritrochanteric fractures (from l0 to 35 degrees). There were mainly 31.A.3 unstable fractures according to AO classification. 3 patients died during three postoperative months from causes not connected with operative treatment. 39 fractures united in the period from 10 to 16 weeks. Delayed union--after 6 months occurred in 2 persons. Fatigue fracture of intramedullary rods occurred to both of this patients. The average Harris Hip Score was 86 points (from 70 to 100 points) after union of fractures. CONCLUSIONS: (1) The use of intramedullary locked nailing in the treatment of fractures of proximal part of femur leads to union without additional immobilization. (2) Closed intramedullary locked nailing in the treatment of unstable intertrochanteric fractures is connected with the risk of varus malalignment of fragments, which does not delay union, but decreases functional outcome. (3) Proper operative technique decreases the number of intra- and postoperative complications.

Adolescent↗
PubMed2005

Non-union in osteogenesis imperfecta.

A retrospective study of 44 patients with osteogenesis imperfecta treated over a 14-year period was undertaken to determine the frequency and pattern of non-unions of long bones in these patients. Nine non-unions were encountered in eight patients. Four of these non-unions developed at sites of osteotomies performed at the time of intramedullary rodding. These children have remained asymptomatic, however, without appreciable limitations in spite of the non-union. Five atrophic or gap non-unions that occurred in the humerus were following inadequately treated fractures. These children were disabled on account of the non-unions. In three patients all attempts at obtaining union failed. The other two patients were braced. We conclude that non-union in osteogenesis imperfecta is not a very rare phenomenon. We also recommend that all fractures in children with osteogenesis imperfecta must be treated with appropriate immobilization to prevent a gap non-union developing, since gap non-unions are exceedingly difficult to treat.

Adolescent↗
PubMed1995

Proximal third tibial shaft fractures. Should they be nailed?

Thirty-two extraarticular fractures of the proximal third of the tibia were treated with locked intramedullary nails. There were 10 closed and 22 open injuries. Treatment consisted of a reamed nail in each of the 5 closed fractures, and an unreamed nail in the remaining 27 fractures. Thirty of the 32 fractures eventually healed; however, 9 (28%) underwent exchange nailing and 4 (13%) required bone grafting. At final followup, 27 of 32 fractures (84%) had angulation of 5 degrees or greater in the frontal or sagittal plane. Nineteen of the 32 fractures (59%) had 1 cm or more of displacement at the fracture site. In 8 fractures (25%), there was loss of fixation, most commonly associated with placement of a single proximal locking screw. Fractures of the proximal third of the tibial shaft do not appear to respond as favorably to intramedullary nailing as do fractures in the distal 2/3 of the tibia. Valgus, apex anterior angulation, and residual displacement at the fracture site are common after nailing. Surgical errors of a medialized nail entry point and a posteriorly and laterally directed nail insertion angle contributed to malalignment. Based on their findings, the authors have limited the use of intramedullary nailing for proximal third tibial shaft fracture and consider alternate forms of fixation (plate or external fixation).

Adolescent↗
PubMed2003

[Are the terms "biology" and "osteosynthesis" contradictory?].

Biology and Osteosynthesis may, at first glance, appear to be contradictory. The disadvantages of the surgical procedure are offset by improved recovery of blood supply across a fracture zone and by stimulation of callus formation due to (controlled and slight) instability (elastically flexible fixation). Biological internal fixation is a principle in its own right; its technique is to some extent incompatible with conventional compression fixation. Locked screws provide better anchorage of the implant in both biological and compression internal fixation techniques. This generally offers improved potential in the treating fractures in osteoporotic bone. Because locked screws offer improved anchorage, the use of unicortical screws is made possible with the effect that the medullary circulation is damaged less. Locked unicortical screws, especially if they are self-drilling and self-cutting, offer important surgical advantages in minimally invasive percutaneous osteosynthesis (MIPO) whereas bicortical screws are required for epi- and metaphyseal anchorage.

Adolescent↗
PubMed2003

[Innovative implants -- a prerequisite for biological osteosynthesis].

Biological osteosynthesis is a new paradigm in fracture fixation. In contrast to the conservative mechanical operative period, where exact anatomical and rigid fracture fixation was the ultimate ambition, the new perception in fracture management attaches more importance to the conservation of bone perfusion than to the exact anatomical reduction. Because soft tissue condition and local blood circulation are most important for bone reconstruction and healing of fractures, additional damage of soft tissue caused by operation should ideally be avoided. Consequently surgeons aim at minimally invasive operating techniques using no-touch bone implants. This shift in point of view has also been accommodated by a rapid progress in development of innovative bone implants. Solid medullar nails, novel designs and applications of plates, locking screws and biocompatible titanium implants are some of the implantation techniques which pushed the new concept of biological fracture fixation.

Adult↗
PubMed2005

[Mistakes in the diagnosis and treatment of the complete dislocation and fractures of the acromial end of the clavicle].

The analysis of the mistakes in the operative treatment of the sick with such a trauma was conducted. Two typical examples were given. The mistakes were stipulated non-diagnosis of the simultaneous break of the coracoclavicular ligament and not taking measures for its recovery. The radiodiagnosis based on N. Z. Shmidt's method is considered to be inevitable for this category of the sick. After the confirmation of the diagnosis the operation of choice can be the operation of Yotkins-Leochuk for the sick with the complete dislocation of the acromial end of the clavicle, and the operation of Yotkins for the sick with fractures of the acromial end of the clavicle with the break of the coracoclavicular ligament. By means of these methods 43 sick men with the dislocation and 7 sick men with fractures of the acromial end of the clavicle have been operated since 1973. No cases had complications, relapses or unsatisfactory results.

Acromioclavicular Joint↗