scholarly journals Biomechanical Performance of BoneHelix® Compared with Elastic Stable Intramedullary Nailing (ESIN) in a Pediatric Tibia Fracture Model

Life ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1189
Author(s):  
Laura Leonie Brandes ◽  
Luis Fernando Nicolini ◽  
Johannes Greven ◽  
Philipp Lichte ◽  
Thomas Thaddäus Stopinski ◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Fatigue Testing ◽  
Weight Bearing ◽  
Cyclic Fatigue ◽  
Elastic Stable Intramedullary Nailing ◽  
Tibia Fracture ◽  
Fracture Model ◽  
Maximal Load ◽  
Intramedullary Device ◽  
Load To Failure

Tibial shaft fractures are common injuries in the pediatric and adolescent populations. Elastic stable intramedullary nailing (ESIN) is the treatment of choice for cases that require surgical stabilization. A new intramedullary device, BoneHelix® (BH), may be an alternative for use with fractures that cannot be satisfactorily stabilized with ESIN. This study aimed to assess the biomechanical performance of BH compared with ESIN in a porcine tibia fracture model, observing cyclic fatigue and load to failure. Computed tomography was used to monitor the implant position and to rule out unintended damage. No implant or bone failure occurred during the fatigue testing. An increase in the cumulative plastic displacement was observed in both test groups over the loading cycles applied. Both implant–bone constructs displayed a trend toward closure of the osteotomy gap. During the load-to-failure test, the average loads at failure in specimens instrumented with ESIN and BH were 5364 N (±723) and 4350 N (±893), respectively, which were not statistically significant (p = 0.11). The values of both groups were two to three times higher than the estimated maximal load (2000 N) during physiological weight bearing. The biomechanical results thus indicate equivalent performance and stability by the implants tested.

Unlocked and locked elastic stable intramedullary nailing in an ovine tibia fracture model: A biomechanical study

2014 ◽  
Vol 40 ◽  
pp. 267-274 ◽  
Author(s):  
Leopold Berger ◽  
Stefan Fischerauer ◽  
Barbara Weiß ◽  
Anna Celarek ◽  
Christoph Castellani ◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Biomechanical Study ◽  
Elastic Stable Intramedullary Nailing ◽  
Tibia Fracture ◽  
Fracture Model

scholarly journals The advent of elastic stable intramedullary nailing for the treatment of long bone fractures in skeletally immature patients

2021 ◽  
Vol 27 (4) ◽  
pp. 406-412
Author(s):  
A. Andreacchio ◽  
◽  
F. Alberghina ◽  
F. Canavese ◽  
◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Bone Fractures ◽  
Weight Bearing ◽  
Surgical Techniques ◽  
Early Mobilization ◽  
Elastic Stable Intramedullary Nailing ◽  
Long Bone ◽  
Long Bones ◽  
Skeletally Immature ◽  
Fractures In Children

Introduction Management of pediatric long bones fractures is a complex and rapidly evolving field. Traditionally, casting and conservative techniques played a key-role in the management of fractures in skeletally immature patients. However, the surgical approach has evolved steadily over the past four decades or so and increasing evidence has been published supporting the advantages of fixation techniques over conservative methods. The purpose of this narrative review is to outline how innovations in orthopedic surgery have changed the rationale of treating long bones fractures in children and adolescents with focus on surgical techniques, particularly elastic stable intramedullary nailing (ESIN). Material and methods We aimed to describe the main trends in pediatric long bones fractures management and to identify its specificities and difficulties as well as the best standard of care. Results The introduction of ESIN has profoundly influenced the management of pediatric upper and lower extremity fractures. Overall, in comparison to conservative techniques, advantages of ESIN include minimally invasiveness, short hospital stay, primary bone union, early mobilization and progressive weight bearing, and good outcome with low complication rate. Moreover, the flexible nail can be used as a closed reduction tool itself. Conclusions Irrespective of the technique performed, the key-concepts remain 1) the proper understanding of the injury to treat; 2) the identification the main characteristics of the patient; 3) the pros and cons of each technique; and 4) the potential complications.

scholarly journals Functional outcome of elastic stable intramedullary nailing of diaphyseal fractures of paediatric long bones

2016 ◽  
Vol 2 (4) ◽  
pp. 359
Author(s):  
Arun Vashisht ◽  
Gaurav Dev Sharma
Keyword(s):  
Conservative Treatment ◽  
Functional Outcome ◽  
Intramedullary Nailing ◽  
Weight Bearing ◽  
Elastic Stable Intramedullary Nailing ◽  
Personal Hygiene ◽  
Long Bones ◽  
Forearm Bones ◽  
Diaphyseal Fractures ◽  
Partial Weight

<p class="abstract"><strong>Background:</strong> After the advent of titanium elastic nails (TENs) and gratifying results of elastic stable intramedullary nailing (ESIN) in diaphyseal fractures of paediatric long bones, not only the parents of patients are opting surgical treatment over conservative, but also more and more orthopaedicians are offering ESIN with TENs to obviate the inherent problems of conservative treatment. We took up this study to evaluate the functional outcome of ESIN with TENs<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> 44 patients aged 5-15 years suffering from diaphyseal fractures of femur, tibia, humerus, and forearm bones were treated by ESIN with TENs.<strong></strong></p><p class="abstract"><strong>Results:</strong> All 44 patients showed uneventful union, femur in an average period of 8.3 weeks, tibia in 7.3 weeks, forearm bones within 7 weeks and humerus in 7.5 weeks. Commonest complication was pain at insertion site. 1 femur patient had lengthening of 1.5 cm. 1 femur and 1 forearm patient showed joint stiffness. No patient had delayed/non-union, sagittal/coronal/rotational mal-union, and deep infection. Partial weight bearing (PWB) started from 2<sup>nd</sup>/3<sup>rd</sup> day attaining full weight bearing (FWB) in 6-10 weeks<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> ESIN with TENs appears logical and safe to obviate the inherent problems of conservative treatment, as ESIN is least invasive and allows early PWB/FWB leading to early independence of personal hygiene/toilet use with early social integration/return to school<span lang="EN-IN">.</span></p>

scholarly journals Comparative Study between Intra-medullary Nailing and Minimally Invasive Plate Osteosynthesis (MIPO) in Closed Distal Tibia Fracture in a District Hospital in Bangladesh

2021 ◽  
Vol 12 (1) ◽  
pp. 33-37
Author(s):  
Md Asjadur Rahman ◽  
Md Shahidullah Kaiser ◽  
SM Roknuzzaman ◽  
Nadim Ahmed
Keyword(s):  
Intramedullary Nailing ◽  
Weight Bearing ◽  
Distal Tibia ◽  
Tibia Fracture ◽  
Tibial Fractures ◽  
Distal Tibia Fracture ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Tibia Fractures ◽  
Distal Tibia Fractures

Introduction: Tibia fractures are the most common long bone fractures encountered by the orthopedic surgeons and distal tibia fractures have the second highest incidence of all tibia fractures after the middle third of tibia the distal tibial fractures are unique and are considered as most challenging fractures to treat due to its proximity to the ankle joint and its superficial nature. The objective of this study is to compare two osteosynthesis systems developed for surgical treatment of distal tibia fractures: the intramedullary nailing and the MIPO technique. Methods: The study was conducted between Jan 2018 to Dec 2019. 30 patients with extraarticular distal tibia fracture treated with intramedullary nailing and MIPO technique were reviewed retrospectively and clinical outcome was evaluated according to American Orthopaedic Foot and Ankle Score. Results: 15 patients were treated with intramedullary nail and 15 with MIPO technique. Fibular fixation was done in cases where fibular fracture was at or below the level of tibial fractures. We found no difference in terms of time for fracture union, mal-union, non-union, duration of surgery and amount of blood loss. But there was significant difference in terms of infection and duration of hospital stay. Also weight bearing was possible much earlier in intramedullary group as compared to the MIPO group. Conclusion: Thus we conclude that intramedullary nailing is better choice of implant in patients with extra- articular distal tibia fractures and helps in early weight bearing and ambulation of patient with fewer complications. J Shaheed Suhrawardy Med Coll, December 2020, Vol.12(1); 33-37

Mechanical evaluation of a tapered thread-run-out half-pin designed for external skeletal fixation in small animals

2011 ◽  
Vol 24 (04) ◽  
pp. 257-261 ◽  
Author(s):  
J. P. Toombs ◽  
D. G. Bronson ◽  
J. D. Ross ◽  
R. H. Browne ◽  
H. Griffin
Keyword(s):  
External Fixation ◽  
Static Loading ◽  
Cyclic Load ◽  
Fatigue Testing ◽  
Maximum Load ◽  
Cyclic Fatigue ◽  
Small Animals ◽  
Mechanical Study ◽  
Load To Failure

SummaryAn in vitro mechanical study was performed to compare the stiffness, maximum load, and cyclic load-to-failure of a new external fixation half-pin design utilizing a tapered thread-run-out (TRO) feature with currently available positive profile thread (PP) half-pins. Five different sizes of each of the two pin types were evaluated. Under static loading, TRO pins were significantly stiffer and had a higher maximum load compared to the similar sized PP pins (p ±0.0001 for all comparisons). In cyclic fatigue testing, TRO pins lasted 2.3- to 4.9-fold more cycles than PP pins of similar size (p ±0.0001 for all comparisons). The increased pin stiffness and improved cyclic lifespan provided by TRO pins may be especially valuable in the stabilization of biologically and mechanically challenging fracture cases where healing is prolonged.

PHYSIOTHERAPY AFTER SURGICALLY STABILIZED PROXIMAL TIBIA FRACTURE

2020 ◽  
Vol 18 (2) ◽  
pp. 156-160
Author(s):  
R. Tasheva
Keyword(s):  
Proximal Tibia ◽  
Weight Bearing ◽  
Lateral Compartment ◽  
Recovery Phase ◽  
Knee Extension ◽  
Tibia Fracture ◽  
Extension Deficit ◽  
Proximal Tibia Fracture ◽  
Ao Classification ◽  
Correct Function

THE AIM OF THIS STUDY is to present the physiotherapy for overcoming the substitution movements and to restore the correct function in the phase of relative protection after surgical stabilized proximal tibia fracture. Material and method Seven patients after fracture in the proximal lateral compartment of the tibia (type b1 in AO classification) with an average age of 42, 9 years were treated. After surgery, an average of 30 days of the brace was used for relative protection. The aim of the physiotherapy was to overcome muscle imbalance to achieve proper movement in the respective planes. Emphasis on recovery was the proper weight bearing on the operated lower limb. RESULTS The results of the first recovery phase demonstrated very limited knee flexion in range of 22, 7º, and knee extension deficit in the range of -15º. After two weeks the results progressed to 115, 5º flexion and full restoration of the extension. Control of edema and hypotrophy of the thigh were proven by circumference. CONCLUSION The adequate physiotherapy provides overcoming of the substitution movements and to restore the correct knee function in the phase of relative protection after surgical stabilized fracture in the proximal tibia.

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