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At least 397 records · Page 22Linked to original sources
PubMed1998

[Treatment of humeral shaft fracture with intramedullary procedures (Seidel nail, Marchetti-Vicenzi nail, Prevot pins)].

Humeral shaft fractures can be treated either conservatively or operatively. Plating of the humerus is the established operative method, but recently interest has also been focussed on intramedullary nailing. Fifty-nine cases of humeral fractures treated with intramedullary nailing (Seidel/Marchetti-Vicenzi/Prévot) from January 1991 to December 1995 (44 fractures after trauma, 11 pathological fractures, 3 pseudarthroses, 1 re-fracture). Closed reduction in 55/59 cases. One infection (soft tissue); 2/48 pseudarthrosis (indication for nailing: pseudarthrosis!). No iatrogenic palsy of the radial nerve. Functional postoperative treatment in all 44 cases of humeral fractures after adequate trauma. One poor functional result: periarticular ossification after retrograde nailing, possibly connected with long-term respiratory treatment after trauma. Treatment of humeral shaft fractures by intramedullary nailing is favoured in our clinic (low complication rates, excellent or good functional results, limited approaches, small scars). Proximal fractures should be treated by the Seidel nail (stable interlocking of the proximal fragment); very distal fractures need Prévot nailing (reaming of condylar canals). All other fractures of the humeral shaft can be treated by each of the implants used in our clinic. Pathological fractures are an excellent indication for intramedullary stabilization. These patients benefit from stable fixation without intense surgical trauma. Pseudarthrosis, according to our limited experience, seems to require plating plus bone grafting. Plating is also recommended if revision of the radial nerve becomes necessary.

Adolescent↗
PubMed1988

Comparative mechanical properties of various Kirschner wire configurations in transverse and oblique phalangeal fractures.

A biomechanical study assessed the comparative mechanical properties of various wire configurations used in transverse and oblique phalangeal fractures. The configurations included crossed, oblique, and intramedullary wire techniques using 0.028-inch diameter (d) or 0.035-inch d Kirschner (K) wires. Six different configurations were tested in both the oblique fracture pattern and in the transverse fracture pattern. The mechanical properties were determined after either oblique or transverse osteotomy and fixation of the proximal phalanx. Each fixation technique was tested in apex palmar, apex dorsal, and lateral bending, as well as in torsion and distraction. The results showed that of the configurations tested, four crossed 0.028-inch d Kirschner wires obtained the highest rigidity in the transverse fracture pattern and three oblique 0.035-inch d Kirschner wires obtained the highest rigidity in the oblique fracture pattern.

Aged↗
PubMed1989

[Treatment of patients with multiple and associated fractures of the long bones].

The authors have studied 266 patients with multiple and associated injuries, 31 of whom were performed a one-stage osteosynthesis in fractures of the bones of the femur (36), the crus (23), the humerus (5) and the forearm (3). Before 1985 the main method of surgical treatment was open intramedullary osteosynthesis with Küntscher-type nails with drilling out of the medullary canal. This method was applied in operating 21 patients with fractures of the femur, 5 patients with fractures of the bones of the crus and 2 patients with fractures of the humerus. Osteosynthesis with Ilizarov's apparatus was performed in 11 patients with fractures of the femur, in 13 patients with fractures of the bones of the crus and in 3 patients with fractures of the humerus. Since 1985 a method of closed intramedullary osteosynthesis has been worked out which was used in fractures of the femur (5 patients) and of the bones of the crus (5 patients). In the postoperative period a reposition-fixation device was used for the reposition of the bone fragments. The results of the treatment are reported.

Adult↗
PubMed1995

A sequential protocol for management of severe open tibial fractures.

Fifty consecutive open fractures of the tibia, including 22 Grade IIIB and 4 Grade IIIC, were treated using a protocol of debridement, immediate wound coverage, and intramedullary nailing. Fasciocutaneous flaps were used extensively to cover areas of exposed bone. The severity of the soft tissue injury dictated the timing of definitive fixation. Fracture location determined implant selection and nailing technique. Patients were observed for an average of 21 months. Ninety-eight percent of the fractures united < 6 months postoperatively. There was 1 infection (2%), 2 malunions (4%), and 1 case of partial flap necrosis. Locking screws broke in 1 patient (2%); the fracture united with < 5 mm of shortening. Immediate postdebridement wound coverage, and intramedullary nailing after reconstruction of the soft tissue envelope facilitate fracture healing in these complex open injuries. Intramedullary nailing can be performed safely to include all grades of open tibial fractures from the proximal to distal metaphysis.

Adolescent↗
PubMedDate not supplied

The role of early internal fixation in the management of open fractures.

A series of 101 victims of multiple trauma and open fractures were treated by early open reduction and internal fixation. Some of the fractures included associated vascular injury. Some of the patients had extensive intraarticular fractures. Femur fractures in the elderly were included. All wounds were left open. In 94 patients, the early infection rate was 1.9% in small clean open (type I) wounds, 8% in large open (type II) wounds, and 41% in extensively contused large open (type III) wounds. In 94 cases the overall infection rate was 10.6%. In only one infection (1%) a long-term chronic osteomyelitis ensued; there were no non-unions in long bone fractures. Open fractures with type I wounds have the same infection rate as reported for closed fractures. In fractures with types II and III wounds salvage of limb, life, or joint function must justify the high risk of infection. Immediate plate fixation of severe open fractures of the tibia could save a limb from amputation. Closed intramedullary nailing of open fractures of the femur carries a high rate of success.

Adolescent↗
PubMed2004

[Treatment results of aseptic non-unions of long bones with medullary canal reaming followed by intramedullary nailing].

This paper presents results of treatment of 46 consecutive patients with pseudoarthroses of the long bones treated with closed intramedullary reaming followed by intramedullary nailing. There were 22 nonunions of the tibia, 15 of the femur, 3 of the humerus and 6 of the forearm. The union occurred in 40 cases, among them in 3 of 4 treated atrophic, that gives 87% success. None of treated pseudoarthrosis of the humerus united.

Adult↗
PubMed2001

Intramedullary nailing in humeral shaft fractures. Mechanical behavior in vitro after osteosynthesis with three different intramedullary nails.

The aim of this in vitro study was to compare the mechanical behavior of fixation by the Russell-Taylor nail with the more recent Polarus nail. Fixation with an experimental nail made from polyacetal polymer was also included in the study. Thirty humeri were fractured and randomized to receive one of the three nail types. A four-point nondestructive bending test was performed, as well as torsional testing to failure. The torsional test was designed to record the amount of 'play' (uncontrolled rotation) in the bone/implant construct. The Polarus nail gave higher rigidity of the nail/bone construct than the two other types. The Russell-Taylor nailing exhibited a high degree of 'play' (uncontrolled rotation). The polyacetal nails allowed a large elastic deformation before failure.

Biomechanical Phenomena↗
PubMed2004

Comparison of a sliding hip screw with a trochanteric lateral support plate to an intramedullary hip screw for fixation of unstable intertrochanteric hip fractures: a cadaver study.

BACKGROUND: The lateral trochanteric support plate (LSP) was developed to prevent excessive sliding of unstable intertrochanteric femur fractures fixed with a sliding hip screw (SHS). This study compared the fracture stability and screw sliding characteristics of unstable intertrochanteric femur fractures fixed with either an SHS and LSP or an Intramedullary Hip Screw (IMHS). METHODS: Six matched pairs of cadaveric human femurs with simulated, unstable intertrochanteric femur fractures were stabilized with either an IMHS or a 135-degree SHS with an attached LSP. Inferior and lateral head displacements and lag screw sliding distances were measured for applied static loads of 750 N, before and after cycling. RESULTS: Four-part unstable intertrochanteric femur fractures showed comparable screw sliding characteristics and stability whether instrumented with an SHS and LSP or an IMHS. CONCLUSION: A sliding hip screw with an attached lateral support plate provides stability and ability to resist medial displacement of the femoral shaft similar to that seen with the IMHS.

Biomechanical Phenomena↗