Use of a Nancy nail to remove a broken intramedullary nail: A technical note

Injury ◽  
2015 ◽  
Vol 46 (12) ◽  
pp. 2498-2501 ◽  
Author(s):  
Young-Mo Kim ◽  
Yong-Bum Joo ◽  
Ki-Young Lee
2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0012
Author(s):  
Alessio Bernasconi ◽  
Shelain Patel ◽  
Karan Malhotra ◽  
Dishan B. Singh ◽  
Matthew J. Welck ◽  
...  

Category: Ankle; Ankle Arthritis Introduction/Purpose: End-stage ankle arthritis may be managed with ankle arthrodesis or total ankle replacement (TAR). Failure of these procedures results in a challenging clinical situation. Revision in these scenarios is technically demanding, and if associated with subtalar degeneration, conversion to tibiotalocalcaneal (TTC) arthrodesis may be required. Bone grafting may be necessary to maintain length and reduce disability, and fibular strut grafting in form of ‘pillars’ or ‘columns’ may be used in association with intramedullary TTC nailing. In our experience, fibular column autograft may be supplemented with tricortical and cancellous iliac crest graft and stabilised with cannulated screws and either an intramedullary nail or a lateral plate. In this technical note, we review the history of this technique and report indications, surgical approach, results and complications. Methods: A distal J-shaped lateral approach is performed over the posterior edge of the distal fibula. An oblique fibular cut is made with a saw at 8- 12 cm from the fibular tip. Careful removal of the implant, previous cement spacer or metalwork is performed then articular surfaces are prepared. After assessment of the articular gap, the autograft is prepared by removing the tip of the fibula from the fibular block, then sectioning it in to either three or four columns which are positioned into the gap and stabilised either in a press-fit fashion or using 1.6mm K-wires. Six patients (4M, 2F; mean age: 69.8 years (range, 51 to 83)) were treated between December 2018 and March 2019 (5 failed TAR and 1 was symptomatic tibiotalar non-union) at our institution. Fixation was achieved in 5 cases with a locked intramedullary nail and in 1 case with a lateral locking plate. Results: At a mean follow up of 10 months (range, 6 to 11 months), 4 patients had clinically and radiologically united and were satisfied with the outcome of surgery. Two patients remained dissatisfied having not united: one patient with a background of chronic kidney disease had raised inflammatory blood markers at 10 months and is undergoing investigation to exclude infection whilst one other patient with no obvious risk factors for non-union has started low intensity pulsed ultrasound treatment at 6 months. No other complications were observed. Conclusion: Tibiotalocalcaneal fusion augmented with fibular columns and iliac crest autograft is an option to treat combined ankle and the subtalar joint pathologies with significant talar bone loss. However larger studies with longer follow-up are required to define the rates of success and failure with future research directed to better understand which factors may predict the outcome.


1998 ◽  
Vol 69 (6) ◽  
pp. 638-639 ◽  
Author(s):  
Ahsan A F Maleh ◽  
Kasper Saxtrup Nielsen

2020 ◽  
Vol 7 (4) ◽  
pp. 124-126
Author(s):  
Matheus Levy Almeida Taveira de Souzaa ◽  
Hugo Bertani Dressler ◽  
Bruno Jannotti Padua ◽  
Anderson Humberto Gomes ◽  
João Murilo Brandão Magalhães ◽  
...  

Ankle fractures are common and represent approximately a quarter of all lower limb fractures. The general concepts for osteosynthesis techniques for deviated and unstable fractures have undergone little change since the 1960s. The presence of comorbidities and poor soft tissue conditions, especially in elderly patients, is associated with a higher rate of postoperative complications. Intramedullary implants have the advantage of using smaller incisions, which minimizes skin damage allowing for early loading. The present technical note describes the use of the fibular intramedullary nail with a minimally invasive approach to deviated and unstable ankle fractures.


2020 ◽  
Vol 83 ◽  
pp. 100-101
Author(s):  
George J.M. Hourston ◽  
Sriram H. Srinivasan ◽  
Steven Cutts

2012 ◽  
Vol 21 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Susan Fager ◽  
Tom Jakobs ◽  
David Beukelman ◽  
Tricia Ternus ◽  
Haylee Schley

Abstract This article summarizes the design and evaluation of a new augmentative and alternative communication (AAC) interface strategy for people with complex communication needs and severe physical limitations. This strategy combines typing, gesture recognition, and word prediction to input text into AAC software using touchscreen or head movement tracking access methods. Eight individuals with movement limitations due to spinal cord injury, amyotrophic lateral sclerosis, polio, and Guillain Barre syndrome participated in the evaluation of the prototype technology using a head-tracking device. Fourteen typical individuals participated in the evaluation of the prototype using a touchscreen.


1998 ◽  
Vol 47 (3) ◽  
pp. 153-160
Author(s):  
Wang ◽  
Park ◽  
Kang ◽  
Oh
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