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 91 records · Page 5Linked to original sources
PubMed1988

Intramedullary nailing of femoral shaft fractures. Part II: Fracture-healing with static interlocking fixation.

A consecutive, prospective series of ninety-seven patients who had 100 fractures of the femoral shaft that were treated with static interlocking nailing was analyzed to determine the incidence of union of the fracture without planned conversion from static to dynamic intramedullary fixation as a technique to stimulate healing of the fracture. Eighty-four patients (eighty-seven fractures) were studied through union of the fracture (average follow-up, fourteen months). Eighty-five (98 per cent) of the eighty-seven fractures healed with static interlocking fixation. Two patients needed conversion from static to dynamic interlocking fixation because of inadequate fracture-healing; both progressed to uneventful union. The time to full weight-bearing (average, eleven weeks) was individualized for each patient and depended on the cortical contact of the major fragments, the presence of bridging callus as seen on radiographs, and the extent of other injuries of the ipsilateral lower extremity. No deformation or failure of the static interlocking device developed after early walking with weight-bearing, but fatigue failure of one nail occurred in a non-ambulatory patient who had an intracranial injury. Pain related to soft-tissue irritation by the prominent heads of the interlocking screws, clinically presenting as bursitis or snapping of the iliotibial band, was severe enough in six patients to necessitate removal of either the proximal or the distal screw after union of the fracture. We concluded that static interlocking of intramedullary nails in femoral shaft fractures does not appreciably inhibit the process of healing of the fracture, and that routine conversion to dynamic intramedullary fixation, although occasionally necessary, need not be performed.

Adolescent↗
PubMed2004

Biomechanical evaluation of intramedullary nail versus tension band fixation for transverse olecranon fractures.

OBJECTIVES: To compare the biomechanical stability of an alternative custom-designed intramedullary nail (IMN) fixation with that of traditional tension band wiring (TBW), the gold standard for stabilizing transverse olecranon fractures. DESIGN: Ex vivo biomechanical study. SETTING: Biomechanical laboratory. MATERIALS: Six pairs of elderly cadaver elbows. INTERVENTION: A simulated transverse olecranon fracture was created in each elbow after it had been denuded of most of its soft tissue. The right and left olecranons of each pair were alternately assigned to the IMN or TBW group. A tensile force was applied via the triceps tendon while the elbow was secured in 90 degree of flexion. MAIN OUTCOME MEASUREMENTS: Displacement at the simulated fracture segment was measured optically. Fixation failure was defined as >2 mm of fracture displacement. The differences in stiffness and maximum load to failure between the two treatments were analyzed for significance (P < 0.05) using a one-tailed paired t test. RESULTS: IMN fixation was significantly stiffer and stronger than TBW fixation. CONCLUSIONS: The locked IMN provided stronger and stiffer fixation than did TBW. Theoretically the IMN fixation would require less surgical exposure and would be expected to require fewer revisions than TBW fixation. IMN fixation warrants consideration as a clinical alternative to TBW.

Aged↗
PubMed1981

A comparison of the effect of open intramedullary nailing and compression-plate fixation on fracture-site blood flow and fracture union.

UNLABELLED: We compared the effects of compression-plating and open intramedullary nailing after reaming on the vascular supply to a standard fracture site, on the rate of fracture union, and on the biomechanical quality of bone after union, and on the biomechanical quality of bone after union in dogs. The proper location of a compression plate in relation to the periosteum also was investigated. Bone blood flow reached higher levels and remained elevated longer in fractures that were fixed with a rod than in those fixed with a plate. Rod-fixed fractures healed by periosteal callus, whereas plate-fixed fractures healed by endosteal callus. The fracture gained mechanical strength more slowly in the rod-fixed group than in the plate-fixed group. Subperiosteal or extraperiosteal placement of a plate revealed similar effects on bone-healing. CLINICAL RELEVANCE: Decisions to use intramedullary rods or compression plates for internal fixation of fractures should be based on knowledge of the biological effects of these procedures on blood flow at the fracture site and on the mechanical strength of the healing fracture. This study defines in quantitative terms the advantages and disadvantages of intramedullary rods compared with compression plates in the internal fixation of fractures.

Animals↗
PubMed2006

[Treatment of comminuted inferior femoral fractures with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy].

OBJECTIVE: To investigate the advantages and the clinical outcomes of the treatment of comminuted inferior femoral fractures with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy. METHODS: From June 2002 to December 2004, 12 cases of comminuted inferior femoral fractures were treated (9 males, 3 females). Of them, 5 cases were classified as type B and 7 cases as type C according to AO classification. All cases were treated with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy. In 12 cases of one-stage bone grafting, there 5 of autologous cancellous bone grafting and 7 allo-freeze drying bone grafting. RESULTS: With a follow-up of 6 to 18 months, all fractures healed within 3 to 6 months. There were no infection and nonunion. The function of all the knees joint was excellent. According to Noye's criterion for knee scoring, the results were excellent in 9 cases and good in 3 cases; the excellent and good rate was 100%. CONCLUSION: It is a good method to treat comminuted inferior femoral fractures with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy. It has many advantages of less injury to knee joint, good anatomic reduction and reliable fixation.

Adult↗
PubMed1990

Performance of retrieved Kuntscher intramedullary rods: improved corrosion resistance with contemporary material design.

Eighteen Kuntscher-type intramedullary rods were obtained after human implantation periods ranging from 1 to 23 years. A clinical evaluation, metallurgical and chemical analyses of each implant were performed. Idiopathic, implant-related pain was the most common reason for removal, but was not related to extent of implant corrosion. When classified as early versus contemporary material compositions, a significant increase in surface corrosion, inclusion content and carbon content were demonstrated in rods made of the earlier composition of stainless steel. Intergranular corrosion was associated with structural design, rather than material microcleanliness or composition. While contemporary intramedullary fracture fixation provides excellent clinical results, the present investigation suggests that the performance of stainless steel implants may be improved through continued refinement of steel composition, careful consideration of structural design and fabrication techniques, and by routine removal of implants at the earliest opportunity.

Biocompatible Materials↗
PubMed1991

Rotational disorders in intramedullary fixation of the lower limbs.

The routine employment of intramedullary fixation in fractures of the femur and tibia has led the authors to thoroughly evaluate malunions. With the aid of CT scan, precise multilevel quantification of residual rotational deformity was possible by comparison with the contralateral limb after fracture healing. The results of this study confirm the effectiveness of the method, filling an interpretative gap in the literature.

Adolescent↗
PubMedDate not supplied

Intramedullary nailing of pediatric femoral fractures.

This retrospective study reviews our results with intramedullary nail fixation of 37 fractures of the femur in 35 skeletally immature patients. Five of these fractures were open. Twenty-two patients (average age 12 + 9 years) were treated with reamed intramedullary nails. Fifteen patients (average age 9 + 6 years) were treated with nonreamed nails. All fractures united in 6-12 weeks. There were no infections, delayed or nonunions, nor were there any incidences of avascular necrosis. There were very few significant complications. One patient required excision of heterotopic bone to restore hip motion. When surgical treatment of pediatric femur fractures is indicated, we prefer intramedullary nail fixation (either reamed or nonreamed) depending on age, fracture pattern (level, degree of comminution), and size of femoral canal. Experience and careful surgical judgment are required to appropriately individualize treatment for these patients.

Adolescent↗
PubMed2001

Management of midclavicular fractures: comparison between nonoperative treatment and open intramedullary fixation in 80 patients.

BACKGROUND: The aim of this study was to compare the results achieved in two groups of 40 patients, treated for uncomplicated midclavicular fractures. METHODS: Group 1 (mean age, 37.2 years) underwent nonoperative treatment with a figure-of-8 bandage, whereas group 2 (mean age, 30.2 years) underwent open reduction and intramedullary fixation with a 2.5-mm threaded pin. The groups were similar with respect to fracture type. RESULTS: A high rate of complications occurred in group 2, including eight superficial infections, three refractures, two delayed unions with pin breakage, and two nonunions. Return to daily activities was undertaken after an average of 16.7 days from trauma in group 1, and after 40.7 days in group 2 (p = 0.00). Also, return to heavy and sport activities was more rapid for patients treated conservatively: 2.6 months versus 3.2 months (p = 0.014). At follow-up, which averaged 63.7 months, clinical evaluation according to the Constant rating scale did not show significant differences between the two groups. The absolute score averaged 84.8 in group 1 and 82.9 in group 2, whereas the mean relative scores were 94.9% and 95%, respectively. Thirty patients of each group were completely satisfied with the treatment received. The most common cause of dissatisfaction was represented by the unaesthetic appearance of the clavicle, because of subcutaneous bone prominence or dystrophic surgical scars. CONCLUSION: According to our experience, we conclude that nonoperative treatment appears more advantageous than open intramedullary fixation for the management of most midclavicular fractures.

Adolescent↗
PubMed2000

[Orthograde Kirschner wire osteosynthesis. Experiences with intramedullary fixation of the distal metacarpal V fracture].

Dislocated metacarpal V fractures, fixed by percutaneous Kirschner wires or other implants near the metacarpophalangeal joint, often show impaired movement despite excellent radiologic findings. We therefore chose an alternative method using intramedullary Kirschner wire osteosynthesis according to Foucher. Twenty-five patients were operated on in a 3-year period and movement of the fingers and complications were examined. Six weeks after operation all fractures were consolidated in anatomical reduction. One patient suffering from an early stage of Sudeck's dystrophy was healed, and no other complications appeared. Three months after treatment all patients achieved free movement of the fingers with anatomical alignment. We therefore recommend intramedullary Kirschner wire osteosynthesis in distal metacarpal V fractures.

Adolescent↗
PubMedDate not supplied

Immediate percutaneous intramedullary fixation and functional bracing for the treatment of pediatric femoral shaft fracture.

Fifty-three consecutive children ages 6 to 14 with femur fractures treated with early percutaneous intramedullary fixation were evaluated retrospectively. The operation was performed within 24 hours in 50 patients and in the remainder after 48 hours. All patients were mobilized and allowed full weight-bearing in a functional brace in the early postoperative period. The average hospital stay was 4 days. The average follow-up was 24 months. There were no significant intra- or postoperative complications. An average overgrowth of 1.8 mm was measured using scanogram 24 months after surgery. In the authors' experience, this technique is highly effective for the treatment of children 6 to 14 years old with femur fractures. The main advantages of this method are early weight-bearing, immediate mobilization, short hospitalization, and fewer complications.

Adolescent↗
PubMed2003

[Fixation of humeral head fractures with antegrade intramedullary nailing].

The new method of antegrade intramedullary fixation of humeral head fractures is based on a straight proximal humeral nail with special head fixation screws and conventional interlocking screws at the proximal end of the shaft fragment leaving an axillary nerve shelter space in between. The nail acts as a central load carrier. The head fixation screws run through threaded holes in the proximal end of the nail thus being held in a stiff angle and without gliding. The entry points of these screws correspond to the anatomical main portions of the lesser and greater tubercle. They allow a three-dimensional screw grip to the subchondral bony layer of the head fragment. The purpose of this intramedullary construct is to keep the fracture stable at a grade which allows instant postoperative active exercise and which corresponds to the needs of mechanical tranquility in a predominantly endosteal healing area. In a prospective clinical study 45 patients could be followed up after 3, 6 and 12 months. We found an ongoing improvement of the postoperative results up to an average Constant Score of 85.7 pts after one year. The complication rate was 16 %. The main complication was the screw protrusion into the joint.

Aged↗
PubMed1993

[The closed method of intramedullary fixation of forearm fractures].

The authors demonstrate a group of 27 patients subjected to intramedullary osteosynthesis of the forearm by means of Kirschner wires, using closed surgery. They prefer the described method in patients suffering from multiple injuries who have devastated soft parts of the forearm and in unstable fractures in children. The authors draw attention to the fact that they have achieved very good results by the simple surgical method they described.

Adult↗
PubMed2007

Fractured neck of femur in a child after femoral fracture fixation by intramedullary flexible nails: a case report.

Since the introduction of flexible intramedullary nails, the treatment of femoral shaft fractures in adolescents has been revolutionized and this has become the routine treatment in most units, with minimal complications. We report a rare complication of an ipsilateral fractured neck of femur in a fit and healthy 12-year-old girl 6 months after treatment of a traumatic fractured femoral shaft; this was treated effectively with cannulated screws and the patient was successfully discharged without any further complication.

Bone Nails↗