Medullary Canal Widening Effect on Insertion of Tibial Intramedullary Nail bent anteriorly at distal portionJong Min Sohn

2000 ◽  
Vol 13 (2) ◽  
pp. 267
Author(s):  
Hyung Kwan Kim ◽  
Juhae Jahng ◽  
Dae Hyun Baek ◽  
Nan Kyoung Ha ◽  
Hyuk Je Lee
Keyword(s):  
Intramedullary Nail ◽  
Medullary Canal

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.

scholarly journals EARLY OUTCOMES OF FLEXIBLE INTRAMEDULLARY NAILING IN PEDIATRIC SHAFT OF FEMUR FRACTURES

2021 ◽  
Vol 71 (6) ◽  
pp. 2157-60
Author(s):  
Muhammad Umair Hashmi ◽  
Muhammad Nadeem Ahsan ◽  
Babar Bakht Chughtai ◽  
Saqib Majeed
Keyword(s):  
Intramedullary Nailing ◽  
Intramedullary Nail ◽  
Femur Fracture ◽  
Fracture Site ◽  
Medullary Canal ◽  
Femur Fractures ◽  
Flexible Intramedullary Nailing ◽  
Mean Diameter ◽  
Flexible Intramedullary Nail ◽  
Age Range

Objective: To study the early outcomes and complications of fixation of pediatric shaft of femur fractures using flexible intramedullary nail. Study Design: Prospective observational study. Place and Duration of Study: Orthopedic Department, Bahawal Victoria Hospital Bahawalpur, from Jan to Jun 2021. Methodology: Children between the ages of 5-11 years with shaft of femur fractures were included in the study. Fixation of fracture was done using elastic intramedullary nail. Final outcomes of fixation were observed using Flynn and Schwend Scoring System. Six-month follow-up was done in all cases. Data was analyzed using SPSS-20. Results: Total 70 cases having shaft of femur fracture were included in the study. Age range of cases was 5-11 years with mean age of 7.75 ± 1.66 years and mean weight of 24.44 ± 4.77 kilograms. Mean diameter of femur medullary canal was 7.48 ± 0.63 millimeters and mean diameter of flexible nail was 3.03 ± 0.26 millimeters. Mean post-operative period of radiological union of fracture was 8.57 ± 1.05 weeks. Per-operatively, fracture site was approached in 4 (5.7%) cases. Migration of nail was not seen in any case. Final outcomes according to Flynn and Shwend Score were excellent in 62 (88.5%), satisfactory in 7 (10%) and poor in 1 (1.4%) case. Conclusion: Fixation of shaft of femur fracture using flexible intramedullary nailing technique is safe and reliable with good outcomes among children between 5-11 years of age.

scholarly journals Design and numerical investigation of an adaptive intramedullary nail with a novel interlocking mechanism

2020 ◽  
Vol 7 (6) ◽  
pp. 722-735
Author(s):  
Mohammad Ali Bagheri ◽  
Gholamreza Rouhi
Keyword(s):  
Finite Element ◽  
Finite Element Model ◽  
Intramedullary Nail ◽  
Adaptive Design ◽  
Stress Shielding ◽  
Element Model ◽  
Fracture Site ◽  
Medullary Canal ◽  
Bone Ash ◽  
Intramedullary Canal

Abstract Malalignment is a common complication in the treatment of distal fractures of the tibia. Numerous efforts have been made to reduce the malalignment ratio. However, the reported cases with this disorder are still high. This study aimed at investigating an adaptive design of an intramedullary nail with a novel interlocking mechanism (AINIM), as an alternative for the customary nailing, in reducing malalignment ratio. A verified finite element model was employed to compare the performance of AINIM with the customary nail. The finite element model of the tibia follows the exact shape of the medullary canal, and nonhomogeneous material properties were assigned to the bone from bone ash density. It was assumed that the nails were implanted and interlocked in the tibia according to surgical protocols, and physiological-like loading was applied to finite element models. The results of this study showed that AINIM reduces the mean shear interfragmentary strains by about 30%, and the axial interfragmentary strain by 55%, also it increases the uniformity in the interfragmentary movements, compared to the customary nail. It was also found that AINIM caused a reduction of the stress on the nail by 60%, and an increase of 25% on the bone, compared to the customary nail. Moreover, average compressive principal strains in the tibia fixed by AINIM increased by 40% from 485 to 678 με, compared to the tibia fixed by the customary nailing method. The results of this work also showed that AINIM causes an increase in the contact area with the intramedullary canal, particularly at the fracture site, and it also escalates the magnitude of contact pressure. Results of this work indicate that, from the biomechanical standpoint, the adaptive nail, i.e. AINIM, with an innovative interlocking mechanism, compared to the customary nailing, can lessen intra- and post-operative malalignment occurrence, and it also mitigates the side effects of stress shielding, and thus better conserves neighboring bone density in a long period.

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

T1.12 Humerus diaphyseal fractures treatment with intramedullary nail in adults

Injury ◽  
2013 ◽  
Vol 44 ◽  
pp. S4
Author(s):  
T. Kurtulmus ◽  
G. Saka ◽  
N. Saglam ◽  
F. Kücükdurmaz ◽  
U. Öztürk
Keyword(s):  
Intramedullary Nail ◽  
Diaphyseal Fractures

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.

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