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At least 19 recordsLinked to original sources
PubMed1991

Itraconazole penetrates the nail via the nail matrix and the nail bed--an investigation in onychomycosis.

Nail-matrix kinetics were studied in 21 patients (19 with onychomycosis, two with tinea corporis) as soon as taking itraconazole (Sporanox) 100 mg daily for up to 7 months. Itraconazole was detected in the distal nail as soon as 1 month after the start of therapy (42 ng/g in fingernails and 16 ng/g in toenails). During the course of treatment, this concentration rose and reached a mean of 160 ng/g in fingernail clippings and 197 ng/g in toenail clippings. Moreover, in fingernails of 12 out of 21 patients and in toenails of six out of 20 patients, itraconazole was detected in the distal nail clippings before full outgrowth of the fastest-growing nail. In most patients, itraconazole was detected in the distal nail clippings earlier than would be expected if the drug were incorporated only via the nail matrix, indicating that in addition to the nail matrix, a second route of penetration into the nail exists, i.e. the nail bed.

Adult↗
PubMed1992

The use of a combination nail elevator and hemostat clamp. New instruments for nail avulsion.

Nail avulsion surgery is frequently accomplished using a hemostat clamp with or without a nail elevator device. Two new instruments have been developed that combine the useful design specifications of the hemostat clamp with the nail elevator device. Specifically, one blade of the hemostat is replaced with either a nail elevator spatula or a Freer septum elevator allowing nail elevation, clamping, and removal with a single instrument. Use of either device is more efficient because nail avulsion is completed using a single instrument thereby reducing procedural steps and handling and sterilization costs. Furthermore, these instruments may reduce the risk of trauma to the nail bed and matrix during nail avulsion. The instruments and their use are described.

Humans↗
PubMed1992

[A new intramedullary nailing system for long bone fractures--biomechanical evaluation and animal study of a new intramedullary nail].

Interlocking intramedullary nails have expanded their application to the fixation of long bones especially for unstable or comminuted fractures. However, there are certain drawbacks in this method: prolongation of operative time and increased radiation hazard to the patient as well as to the surgical staff, the latter of which is especially a problem in the distal interlocking under fluoroscopic control. In order to solve the problem a new intramedullary nail (J-type) was developed and tested in vitro with Hiprox femur models as well as in vivo using canine models. The nail made of Ti-6Al-4V alloy is composed of an inner nail and an outer cylinder. The proximal portion is transversely fixed with two screws, while the distal portion is fixed into the cancellous bone with four expandable blades. The strength of fixation with this nail was compared to those with four other commercially available interlocking nails as to bending, tortional and compression stiffness as well as to the durability against repeated compression. In the present in vitro and in vivo experiments, a newly developed intramedullary nail (J-type) provides evidence for satisfactory mechanical strength. The use of J-type nail also contributes to shorter operative time and reduction of radiation hazard.

Animals↗
PubMed1992

Pulmonary damage after intramedullary femoral nailing in traumatized sheep--is there an effect from different nailing methods?

Stabilization of femoral shaft fractures is a controversial issue in the management of patients with multiple trauma. Intramedullary nailing usually is preferred primarily; in recent years, however, pulmonary complications (e.g., ARDS) have been reported that were attributed to the reaming procedure. To study the effects of different nailing methods in a model of severe trauma, hemorrhagic shock and lung contusion were created at day 1 in sheep prepared by the method described by Staub. After recuperation (day 3) the animals in the study group (group 1) underwent intramedullary nailing of a closed femur without prior reaming; group 2 was treated with reaming and nailing according to AO standards. The reaming procedure led to an acute increase of pulmonary arterial pressure only in group 2 (19.8 +/- 2.1 to 31.0 +/- 4.6 mm Hg). Pulmonary triglyceride levels increased at parallel time points from 18.27 +/- 2.3 to 33.04 +/- 7.37 mg/dL only in group 2. Stimulatory capacity of polymorphonuclear leukocytes (PMNL) increased in the study group and decreased in controls (group 1: 2.652 +/- 0.23 x 10(6) cpm to 3.387 +/- 1.34 x 10(6) cpm; group 2: 2.699 +/- 0.34 x 10(6) cpm to 2.460 +/- 0.187 x 10(6) cpm). Intramedullary nailing caused an increase of lung capillary permeability in both groups; in the study group less damage was seen (group 1: 0.390 +/- 0.0006 to 0.354 +/- 0.011; group 2: 0.391 +/- 0.0004 to 0.336 +/- 0.015; p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylglucosaminidase↗
PubMed1991

Subtrochanteric femur fractures: a comparison of the Zickel nail, 95 degrees blade plate, and interlocking nail.

Seventy-nine nonconsecutive patients with subtrochanteric femur fractures were divided into three groups based on the method of fracture fixation. Group I consisted of 21 patients treated with a Zickel nail, Group II comprised 25 patients treated with a 95 degrees blade plate, and Group III included 33 patients treated with an interlocking nail. All patients in Group I and Group II had open reduction and internal fixation of their fractures. Ninety-four percent of the patients in Group III were treated by closed intramedullary nailing. The average operating times for Groups I, II, and III were 212, 272, and 181 min, respectively, while blood loss averaged 900, 1,500, and 600 ml for each group, respectively. Group I had one infection, ten malunions, and one nonunion. Group II had one infection, six malunions, and two nonunions. Group III had no infections, two malunions, and one nonunion. We conclude that closed interlocking nailing is the treatment of choice for acute nonpathologic subtrochanteric femur fractures in adults. There is decreased blood loss, reduced operating time, and fewer complications than with either the Zickel nail or the 95 degrees blade plate regardless of the fracture pattern or the degree of fracture comminution.

Adult↗
PubMed1978

[Ascending bipolar nailing using elastic nails in the treatment of fractures of the upper end of the humerus (author's transl)].

In the treatment of non-impacted fractures of the upper end of the humerus, the tendency of many surgeons is to use nailing with the fracture site closed, from the supra-olecranon fossa. This would seem to merit certain criticisms. Following reduction of the fracture, we use Ender elastic nails and two modified nails of a smaller calibre, one inserted via the epicondyle and the other via the epitrochlea. The technique of this ascending bipolar nailing using elastic nails is carried out in a horizontal supine position, which facilitates manoeuvres of reduction and facilitates anaesthesia. Apart from non-impacted fractures of the upper end of the humerus, other indications exist.

Fracture Fixation, Internal↗
PubMed1992

Nail bed reconstruction with split-thickness nail bed grafts.

The results of reconstruction of chronic post-traumatic nail deformities are thought to be unpredictable. We have reviewed eight patients treated by split-thickness nail bed grafts for deformities arising from defects in the sterile matrix. Appearance, adherence and function were improved in all cases, with no significant morbidity of the donor area.

Esthetics↗
PubMed1978

Two families with congenital nail anomalies: Nail formation in ectopic areas.

Two families with congenital nail anomalies are reported. The nail covered not only the dorsal but also some of the palmar aspect of the distal phalanx. The ungual phalanges of the affected fingers were lacking in the crescent-shaped cap and had a blunt Y-shaped bony projection. The anomalies may have been transmitted by an autosomal recessive gene.

Child↗
PubMed1977

The use of porcine xenografts on nail beds following total nail avulsion and phenol chemomatrixectomy.

The success of applying split-thickness porcine xenografts to nail beds after nail avulsion with matrix chemocauterization depends on the adherence of the graft to the underlying tissue. When this was obtained, the authors found that porcine xenografts contribute markedly toward reducing postoperative pain and drainage. Further investigation is being undertaken to determine whether total healing time following chemomatrixectomy has been reduced by utilizing xenografts.

Animals↗
PubMed1992

[The value of Ender nailing in hip para-articular femoral fractures in gerontologic traumatology. Ender nailing--hip para-articular femoral fractures--gerontologic traumatology].

Nailing according to Ender is one of several competing methods of osteosynthesis for treating per- and subtrochanteric fractures of the femur in geronto-traumatology. Within 5 years we have treated 62 geriatric patients by this procedure. The average-age of our patients was about 76 years. Only 20 of them were able to be examined after a time of ca. 37 months post operationem. Intraoperative complications were backing out of the femur corticalis at the entry hole, followed by perforations of the head or neck of the femur. In one case we saw a supracondylar fracture. In the postoperative period we mostly found dislocations of the nails to cranial or caudal. Moreover there were one wound infect and one pseudarthrosis. The mortality rate came to 6.5% and was never caused by the method. When leaving the hospital the majority of the elderly patients was mobilized and able to walk. In spite of reduction of function of hip and knee and external rotation deformity and shortened legs the patients declared to be content with the result of the operation. Important geronto-traumatological aspects of the Endernailing-method could be seen in the simple procedure, the short operating time, a minimal surgical trauma and a diminishing of the risk of the mostly multi-morbid patients. Regarding the great number of specific complications competing methods are going on to be preferred. Meanwhile the application of Endernails is an exception in geronto-traumatology.

Aged↗
PubMed1991

[Does covered tibial intramedullary nailing promote formation of a compartment syndrome? Perioperative and intraoperative continuous monitoring of compartmental pressure in covered tibial intramedullary nailing].

Between October 1988 and October 1989 we performed a continuously pressure monitoring with the infusion technique in the tibialis anterior and deep posterior compartment of the lower leg during the nailing of the tibia in complete fractures of the lower leg in 16 patients. We set up 2 groups of patients because of different pathophysiological conditions: patients, who were operated on a few days after trauma (Group A) and patients operated on months after the trauma (Group B) because of non-union of the tibia. The effects of the preoperative, intraoperative, and postoperative manipulations were recorded. In no case we saw a beginning compartmental syndrome, although very high pressures of 100 mmHg in Group A and 55 mmHg in Group B in the deep posterior compartment during reduction of the fracture were registrated. The registrated pressures correlated very well with the manipulations during the operation and were absolutely reversible after the ending of these manipulations. In our observation the closed tibia nailing does not favorize the development of a compartmental syndrome, if not done during the vulnerable phase after the first days after trauma, in blunt multiple trauma patients and during bleeding complications.

Adult↗
PubMed1991

Intramedullary locking femoral nails. Experience with the AO nail.

The AO interlocking nail was introduced to the Ulster Hospital, Dundonald in 1988 and since then has been used in over 50 patients with femoral shaft fractures. We have reviewed 45 patients with 46 femoral shaft fractures treated between June 1988 and April 1990. These included four compound fractures and 13 comminuted fractures. The results compare favourably with other series. The union rate was 98% and there were no instances of deep infection. The alternative treatment methods available are discussed along with a review of the relevant literature.

Adult↗