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Results for “Fracture Fixation, Intramedullary”

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At least 361 records · Page 20Linked to original sources
PubMed2005

Periprosthetic fractures after total knee arthroplasty.

Fractures around total knee arthroplasties are challenging clinical problems and include the following: stress fractures of the pelvis and femoral neck, supracondylar femur fractures, fractures of the proximal tibial metaphysis and diaphysis, and patellar fractures. Treatment focuses on restoration of the patient's prefracture functional status. The etiology of supracondylar femur fractures is multifactorial and treatment includes immobilization, retrograde intramedullary nailing, open reduction and internal fixation, and revision arthroplasty. The "Less Invasive Stabilization System" plate has recently been added to the list of viable fixation options. Tibial metaphyseal and diaphyseal fractures are less common and usually treated with revision arthroplasty. In the absence of maltracking or component loosening, vertical patellar fractures often respond to immobilization. Disruption of the extensor mechanism may require cerclage wiring or even extensor mechanism allografting if chronic. Conventional tension band wiring usually fails. Patellar fractures are controversial and problematic.

Arthroplasty, Replacement, Knee↗
PubMed1984

Infra-isthmal fractures of the femur: a review of 82 cases.

Eighty-two infra-isthmal fractures of the femur were reviewed in order to develop a fracture classification, to determine the results of treatment, and to define the best treatment methods for certain specific fracture patterns. Type I (transverse or short oblique) fractures were seen in 36 patients (mean age, 33 years). They had a 25% complication rate when treated by open reduction, and a high malunion rate when treated by closed means. Type II (spiral or long oblique) fractures were generally caused by falls, and were seen in 36 patients (mean age, 56 years). Most patients treated by operation had an unsatisfactory result. Malunion was seen in 29% of the patients treated by closed means. The remaining ten patients had either severely comminuted (Type III), or pathological (Type IV) fractures. Intramedullary nail fixation should be used wherever possible in these fractures since many of the complications in the operative group were related to rigid plate fixation. Closed treatment resulted in an unacceptably high incidence of malunion in this study, particularly in Type I fractures. Conventional methods of internal fixation were not successful in dealing with Type II fracture, and alternative methods are proposed.

Adolescent↗
PubMed1990

Closed intramedullary pinning of metacarpal and phalanx fractures.

The surgical technique for closed intramedullary pinning of metacarpal and phalanx fractures is described. Commonly available 0.045 K-wires are used in a manner similar to Ender or Rush nailing of long bone fractures. This technique avoids impaling soft tissue structures--a drawback to more commonly used percutaneous K-wire techniques--and provides sufficient stability to allow early, protected motion.

Bone Nails↗
PubMed1993

[What does the new solid unreamed tibia nail (UTN) contribute in open fractures?].

In the field of trauma surgery open fractures of the lower leg remain an injury with a high complication rate. Bone and soft tissues must be treated carefully to avoid further damage, so that uncomplicated healing results. In the past, treatment of open fractures of the lower leg was done primarily by external fixation. Medullary nailing with reaming of the medullary canal has been widely used for shaft fractures without soft tissue damage, but when used in open fractures, the infection rate remained high. Intramedullary nailing without reaming required the development of new implants (i.e. the solid unreamed tibia nail (UTN) by AO). These new implants allow us to perform the nailing technique in open fractures of the lower leg with a low complication rate. This can be done primarily or secondarily after initial treatment with external fixation. Even patients with lower-leg open fractures may benefit from the advantages of early mobilization and partial weight-bearing after osteosynthesis with intramedullary nailing.

Bone Nails↗
PubMed1994

Anterograde interlocked nailing of distal femoral fractures after gunshot wounds.

Standard treatment for distal femoral fractures has been with blade plate or condylar screw plate devices. Excellent fixation is obtained, but bone grafting is required and the procedure exposes the fracture site. More recently, indirect methods of reduction have been initiated to limit the devascularization of the fracture site. Anterograde interlocked nailing has the advantage of using an incision far from the fracture site, and the technique is familiar to most surgeons. It can be performed regardless of the degree or length of comminution. Thirty-eight patients 16-50 years of age who underwent anterograde interlocked nailing for fractures of the distal femur were retrospectively studied. Follow-up averaged 24 months. All patients sustained their injury from a gunshot wound (GSW). Thirty-one had angiograms. The distance from the fracture to the distal screws was < 5 cm in all cases. There were five Winquist 2, eight Winquist 3, and 25 Winquist 4 type fractures. In five patients the rod tip was cut off to place the screw holes more distally, and in four patients only three corticies were obtained by the distal locking screws. Early motion was obtained in all patients. Fractures healed at an average of 8.6 weeks. No primary or secondary bone grafts were performed. Three of the six patients positioned laterally had 5 degrees or more of valgus angulation, and five of the 34 patients positioned supine had > or = 5 degrees of posterior angulation. A method of using smooth Steinman pins as joysticks to control the distal fragment is presented. Anterograde interlocked intramedullary (IM) nailing is an effective means of fixation for distal femur fractures.

Adolescent↗
PubMed1998

Operative management of diaphyseal fractures of the humerus. Plate versus nail.

Although nonoperative treatment is indicated and successful for the majority of diaphyseal humeral fractures, operative intervention is indicated in several situations. Either intramedullary nail or plate fixation commonly is used for the operative management of this problem. Familiarity with the surgical techniques and application of both types (and subtypes) of implants is necessary to allow optimal treatment for the widest range of fracture patterns. In most indications for operative management, internal fixation with plates is preferred. Stable fixation, sparing adjacent joints from iatrogenic injuries, and direct visualization and protection of the radial nerve are of critical importance in maximizing postoperative function and in most cases outweight the potential advantages of a loadsharing implant inserted through a more limited incision.

Biomechanical Phenomena↗
PubMed2003

Cardiopulmonary complications of intramedullary fixation of long bone metastases.

Intramedullary fixation of long bone metastases is an effective method of treating or preventing pathologic fractures. An important complication of this technique is the development of pulmonary embolism, which may occur at any number of steps during bone manipulation. Passage of normal marrow contents or tumor into the pulmonary circulation is thought to cause various biochemical, hemodynamic, or physical responses that lead to hypotension, arrythmia, and O2 desaturation. Death is a known risk of this procedure. Numerous surgical and anesthetic strategies have been developed to prevent or treat pulmonary embolic phenomena; however, the most important prophylaxis may be a heightened awareness of this possibility during any procedure that involves intramedullary manipulation of tumor containing bone.

Blood Coagulation Disorders↗
PubMed1992

Compartment pressures of the leg following intramedullary fixation of the tibia.

A prospective study was performed to determine whether compartment pressures of the leg were affected by intramedullary fixation of the tibia. Ten of the 11 patients studied had surgery for acute diaphyseal fractures and 1 for tibial nonunion. Compartment pressures were measured immediately prior to the procedure and at 12 hours after the procedure. There was no difference between the preoperative and postoperative compartment pressures. Our data suggest that intramedullary stabilization of the tibia does not predictably increase compartment pressures.

Adolescent↗
PubMed2001

Retrograde fixation of fractures of the neck and shaft of the humerus with the 'Halder humeral nail'.

The Halder humeral nail is a new intramedullary device designed for displaced two part humeral neck and shaft fractures. It is inserted retrograde from the olecranon fossa and a unique trio wire is inserted through the nail to provide good proximal fixation. This avoids the use of proximal screws and damage to the rotator cuff thereby ensuring good rotator cuff function. The results of 100 cases are presented. At 6 weeks, 95 patients could perform the majority of daily tasks. There were four non-unions, one following a deep infection.

Adult↗
PubMed1998

Intramedullary versus extramedullary fixation for the treatment of intertrochanteric hip fractures.

One hundred thirty-one patients (135 fractures) who sustained an intertrochanteric fracture were assigned randomly to treatment with either a sliding hip screw or an intramedullary hip screw and followed up prospectively. In patients with unstable intertrochanteric fractures, the intramedullary device was associated with 23% less surgical time and 44% less blood loss; however, use of the intramedullary hip screw in patients who had a stable fracture pattern required 70% greater fluoroscopic time. Intraoperative complications occurred exclusively in patients in the intramedullary hip screw group. There were no differences in the rates of functional recovery between the two fixation groups.

Activities of Daily Living↗