scholarly journals Closing the medullary canal after retrograde nail removal using a bioabsorbable bone plug: technical tip

2012 ◽  
Vol 132 (6) ◽  
pp. 801-803
Author(s):  
T. Schepers ◽  
L. M. M. Vogels
Keyword(s):  
Medullary Canal ◽  
Retrograde Nail ◽  
Nail Removal ◽  
Bone Plug

scholarly journals Intramedullary reaming and irrigation in associated with antibiotic-loaded calcium sulfate implantation in the treatment of infection after intramedullary nailing: A retrospective study of 19 cases.

2020 ◽  
Author(s):  
Hong-An Zhang ◽  
Chun-Hao Zhou ◽  
Xiang-Qing Meng ◽  
Jia Fang ◽  
Cheng-He Qin
Keyword(s):  
Intramedullary Nailing ◽  
Distraction Osteogenesis ◽  
Intramedullary Nail ◽  
Calcium Sulfate ◽  
Bone Fractures ◽  
Weight Bearing ◽  
Medullary Canal ◽  
Nail Removal ◽  
Treatment Of Infection

Abstract Background The incidence of intramedullary infection is increasing with the frequent application of intramedullary fixations on long bone fractures in latest decades. However, appropriate treatment for those special infection remains a challenge. The aims of this study were to assess the efficiency of our treatment protocols: intramedullary nail removal, medullary canal reaming and irrigation, followed by antibiotic-loaded calcium sulfate implantation with or without distraction osteogenesis, for the treatment of infection after intramedullary nailing. Methods From 2014 to 2017, a total of 19 patients with intramedullary infection were treated in our center, with means of intramedullary nail removal, distal diaphysis fenestration, medullary canal reaming and irrigation, antibiotic-loaded calcium sulfate implantation, followed by distraction osteogenesis in 9 cases to repair bone defect. The infection remission rate, infection recurrence rate and post-operative complications rate were assessed during the follow-up. Results All of patients gained satisfactory outcomes with an average follow-up of 38.1 (24 to 55months). 94.7% (18/19) patients achieved infection remission after surgical treatment. 5.3% (1/19) patient developed reinfection, but healed at the end of follow up with re-debridement. 9 patients with surgery-related bone defects received bone transport and successfully restored the length of involved limbs, with a mean transport duration of 10.7 months (range, 6.7 to 19.5months). Majority of patients achieved pain free and full weight bearing during the follow-up. Postoperative complications mainly included prolonged aseptic draining (36.8%, 7/19) and refracture (5.3%, 1/19), which were successfully managed by regular dressing and refixation. Conclusion Intramedullary nail removal, canal reaming and irrigation in associated with antibiotic-loaded calcium sulfate implantation (with or without distraction osteogenesis) were effective in the treatment of infection after intramedullary nailing.

Atypical Femoral Fracture in McCune-Albright Syndrome

2020 ◽  
Vol 7 (3) ◽  
pp. 147-152
Author(s):  
Salman Ghaffari ◽  
◽  
Mehran Razavipour ◽  
Parastoo Mohammad Amini ◽  
◽  
...  
Keyword(s):  
Femoral Fracture ◽  
Dynamic Compression ◽  
Plate Fixation ◽  
Medullary Canal ◽  
Mccune Albright Syndrome ◽  
Café Au Lait Spots ◽  
History Of ◽  
Albright Syndrome ◽  
Mccune Albright

McCune-Albright Syndrome (MAS) is characterized by endocrinopathies, café-au-lait spots, and fibrous dysplasia. Bisphosphonates are the most prescribed treatment for reducing the pain but their long-term use has been associated with atypical fractures of cortical bones like femur in patients. We present a 23-year-old girl diagnosed with MAS. She had an atypical mid-shaft left femoral fracture that happened during simple walking. She also had a history of long-term use of alendronate. Because of the narrow medullary canal, we used 14 holes hybrid locking plate for the lateral aspect of the thigh to fix the fracture and 5 holes dynamic compression plate (instead of the intramedullary nail) in the anterior surface to double fix it, reducing the probability of device failure. With double plate fixation and discontinuation of alendronate, the complete union was achieved five months after surgery

scholarly journals Graphene-Doped Poly (Methyl-Methacrylate) (Pmma) Implants: A Micro-CT and Histomorphometrical Study in Rabbits

2021 ◽  
Vol 22 (3) ◽  
pp. 1441
Author(s):  
Antonio Scarano ◽  
Tiziana Orsini ◽  
Fabio Di Carlo ◽  
Luca Valbonetti ◽  
Felice Lorusso
Keyword(s):  
Methyl Methacrylate ◽  
Dental Implant ◽  
Animal Studies ◽  
White Male ◽  
Biological Response ◽  
Medullary Canal ◽  
Poly Methyl Methacrylate ◽  
Titanium Surfaces ◽  
Dental Applications

Background—the graphene-doping procedure represents a useful procedure to improve the mechanical, physical and biological response of several Polymethyl methacrylate (PMMA)-derived polymers and biomaterials for dental applications. The aim of this study was to evaluate osseointegration of Graphene doped Poly(methyl methacrylate) (GD-PMMA) compared with PMMA as potential materials for dental implant devices. Methods—eighteen adult New Zealand white male rabbits with a mean weight of approx. 3000 g were used in this research. A total of eighteen implants of 3.5 mm diameter and 11 mm length in GD-PMMA and eighteen implants in PMMA were used. The implants were placed into the articular femoral knee joint. The animals were sacrificed after 15, 30 and 60 days and the specimens were evaluated by µCT and histomorphometry. Results—microscopically, all 36 implants, 18 in PMMA and 18 in DG-PMMA were well-integrated into the bone. The implants were in contact with cortical bone along the upper threads, while the lower threads were in contact with either newly formed bone or with marrow spaces. The histomorphometry and µCT evaluation showed that the GP-PMMA and PMMA implants were well osseointegrated and the bone was in direct contact with large portions of the implant surfaces, including the space in the medullary canal. Conclusions—in conclusion, the results suggest that GD-PMMA titanium surfaces enhance osseointegration in rabbit femurs. This encourages further research to obtain GD-PMMA with a greater radiopacity. Also, further in vitro and vivo animal studies are necessary to evaluate a potential clinical usage for dental implant applications.

scholarly journals Bone Marrow Adipocytes—Role in Physiology and Various Nutritional Conditions in Human and Animal Models

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1412
Author(s):  
Katarzyna Piotrowska ◽  
Maciej Tarnowski
Keyword(s):  
Bone Marrow ◽  
Adipose Tissue ◽  
Anorexia Nervosa ◽  
Animal Models ◽  
Diabetes Mellitus Type 1 ◽  
Medullary Canal ◽  
Dietary Interventions ◽  
Nutritional Conditions ◽  
Heterogeneous Tissue

In recent years, adipose tissue has attracted a lot of attention. It is not only an energy reservoir but also plays important immune, paracrine and endocrine roles. BMAT (bone marrow adipose tissue) is a heterogeneous tissue, found mostly in the medullary canal of the long bones (tibia, femur and humerus), in the vertebrae and iliac crest. Adipogenesis in bone marrow cavities is a consequence of ageing or may accompany pathologies like diabetes mellitus type 1 (T1DM), T2DM, anorexia nervosa, oestrogen and growth hormone deficiencies or impaired haematopoiesis and osteoporosis. This paper focuses on studies concerning BMAT and its physiology in dietary interventions, like obesity in humans and high fat diet in rodent studies; and opposite: anorexia nervosa and calorie restriction in animal models.

scholarly journals Removal of a Broken Cannulated Intramedullary Nail: Review of the Literature and a Case Report of a New Technique

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Amr A. Abdelgawad ◽  
Enes Kanlic
Keyword(s):  
Case Report ◽  
Intramedullary Nail ◽  
Small Diameter ◽  
New Technique ◽  
Long Bones ◽  
Review Of The Literature ◽  
Tibial Nail ◽  
A New Technique ◽  
Nail Removal ◽  
Real Challenge

Nonunion of long bones fixed with nails may result in implant failure. Removal of a broken intramedullary nail may be a real challenge. Many methods have been described to allow for removal of the broken piece of the nail. In this paper, we are reviewing the different techniques to extract a broken nail, classifying them into different subsets, and describing a new technique that we used to remove a broken tibial nail with narrow canal. Eight different categories of implant removal methods were described, with different methods within each category. This classification is very comprehensive and was never described before. We described a new technique (hook captured in the medulla by flexible nail introduced from the locking hole) which is a valuable technique in cases of nail of a small diameter where other methods cannot be used because of the narrow canal of the nail. Our eight categories for broken nail removal methods simplify the concepts of nail removal and allow the surgeon to better plan for the removal procedure.

Fifth Metatarsal Jones Fractures in the Athlete

2017 ◽  
Vol 39 (2) ◽  
pp. 250-258 ◽  
Author(s):  
David A. Porter
Keyword(s):  
Screw Fixation ◽  
Nonoperative Treatment ◽  
Fracture Site ◽  
Medullary Canal ◽  
Return To Sports ◽  
Stress Reactions ◽  
Current Standard ◽  
Level Of Evidence ◽  
Metatarsal Fractures ◽  
Intramedullary Screw

Fifth metatarsal fractures, otherwise known as “Jones” fractures, occur commonly in athletes and nonathletes alike. While recent occurrence in the popular elite athlete has increased public knowledge and interest in the fracture, this injury is common at all levels of sport. This review will focus on all three types of Jones fractures. The current standard for treatment is operative intervention with intramedullary screw fixation. Athletes typically report an acute episode of lateral foot pain, described as an ache. Radiographic imaging with multiple views of the weightbearing injured foot are needed to confirm diagnosis. If these images are inconclusive, further magnetic resonance imaging (MRI) or computed tomography (CT) is used. Nonoperative treatment is not commonly used as the sole treatment, except when following reinjury of a stable screw fixation. While screw selection is still controversial, operative treatment with intramedullary screw fixation is the standard approach. Technical tips on screw displacement are provided for Torg (types I, II, III) fractures, cavovarus foot fractures, recurrent fractures, revision surgery, occult fractures/high-grade stress reactions, and Jones’ variants. Excellent clinical outcomes can be expected in 80% to 100% of patients when using the intramedullary screw fixation to “fit and fill” the medullary canal with threads across the fracture site. Most studies show the timing for return to sports with optimal healing to be seven to twelve weeks after fixation. Level of Evidence: Level V, expert opinion.

scholarly journals Custom-Made Antibiotic Cement Nails in Orthopaedic Trauma: Review of Outcomes, New Approaches, and Perspectives

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Marcin K. Wasko ◽  
Rafal Kaminski
Keyword(s):  
Failure Mechanisms ◽  
Medullary Canal ◽  
Bone Infection ◽  
Long Bone ◽  
Current Evidence ◽  
Orthopaedic Trauma ◽  
Antibiotic Cement ◽  
Custom Made ◽  
Trauma Surgeons ◽  
Technique Failure

Since the first description in 2002 by Paley and Herzenberg, antibiotic bone cement nails (ACNs) have become an effective tool in the orthopaedic trauma surgeons’ hands. They simultaneously elute high amounts of antibiotics into medullary canal dead space and provide limited stability to the debrided long bone. In this paper, we perform a systematic review of current evidence on ACNs in orthopaedic trauma and provide an up-to-date review of the indications, operative technique, failure mechanisms, complications, outcomes, and outlooks for the ACNs use in long bone infection.

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