scholarly journals Comparitive Study of Reamed vs Unreamed Interlocking Intra Medullary Nailing for Fracture Shaft of Tibia

2021 ◽  
pp. 417-422
Author(s):  
N. Mathivanan ◽  
S. V. Satyanarayana
Keyword(s):  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Medullary Canal ◽  
Open Fractures ◽  
Tibial Shaft ◽  
Advantages And Disadvantages ◽  
Interlocking Nailing ◽  
Open Injury ◽  
Radiological Union

Tibia is the commonest bone to sustain open injury because of subcutaneous position. Treatment of open fractures requires simultaneous management of both skeletal and soft tissue injury. Intramedullary nailing with reaming is generally considered to be contraindicated for open fractures tibia, because it damages the endosteal blood supply which will lead to non-union, deep infection. However, recent studies with or without reaming in open fracture tibia shows no influence in healing of fracture. Purpose: To compare the clinical and radiological results of intramedullary interlocking nailing of open fractures of the tibial shaft after reaming versus unreamed medullary canal. The aim and objective is a comparative study on the technique, outcome and time taken for clinical and radiological union in either of the reamed or unreamed interlocking nailing in tibial shaft fractures. The operative technique, advantages and disadvantages, follow up, time taken for bony and radiological union and complications if any and overall functional outcome will be evaluated in patients. The follow up of patients will be done in the immediate post operative period and  subsequently  at periodic intervals both clinically and radiologically and the result so obtained will be compared.

Role of Reamed and Unreamed Interlocking Intermedullary Nailing in the Management of Compound Fracture of Shaft Tibia

2014 ◽  
Vol 23 (Number 2) ◽  
pp. 21-26
Author(s):  
Md. F Ahmed ◽  
Md. M Rahman ◽  
K Dipu ◽  
Md. N Islam
Keyword(s):  
Soft Tissue ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Deep Infection ◽  
Medullary Canal ◽  
Open Fractures ◽  
Soft Tissue Coverage ◽  
Non Union ◽  
Interlocking Nailing ◽  
Open Injury

Tibia is the commonest bones to sustain open injury because of subcutaneous position. Treatment of open fractures requires simultaneous management of both skeletal and soft tissue injury. Intramedullary nailing with reaming is generally considered to be contraindicated for open fractures tibia, because it damages the endosteal blood supply which will lead to non-union, deep infection. The study was done to compare the clinical and radiological results of intramedullary interlocking nailing of open fractures of the tibial shaft after reaming versus unreamed medullary canal. Open fractures of shaft of tibia treated with unreamed/reamed interlocking nailing gave excellent results. In present series, 19 fractures (95%) treated by unreamed and 19 (95%) fractures treated by reamed technique, united within 6 months of injury. Delay in union was noticed in one patient treated by unreamed technique who had segmental and extensive soft tissue injury and in reamed nailing there was one patient with deep infection, which was treated with antibiotic coated nail. Time to complete union was similar in both groups. Adequate debridement of wound and adequate soft tissue coverage is the key to minimize deep infection irrespective of whether the bone is reamed or not.

scholarly journals Primary interlocking nailing for open fractures of tibial shaft: a clinical study

2019 ◽  
Vol 5 (5) ◽  
pp. 811
Author(s):  
Talluri V. G. Krishna
Keyword(s):  
Intramedullary Nailing ◽  
Open Fractures ◽  
Type I ◽  
Type Ii ◽  
Tibial Shaft ◽  
Non Union ◽  
Interlocking Nailing ◽  
Type Iiia ◽  
Open Injury ◽  
Closed Intramedullary Nailing

<p class="abstract"><strong>Background:</strong> The excellent method for treating fractures of the tibial shaft was the closed intramedullary nailing technique. But because of limited references related to the results, incidence of infection, non-union of open injury. Hence, it was decided to analyse open tibial fractures treatment by primary interlocking nailing.</p><p class="abstract"><strong>Methods:</strong> 50 Patients with open fractures of the tibial shaft which were treated with primary interlocking nail were studied in the period of 14 months.<strong></strong></p><p class="abstract"><strong>Results:</strong> In present study 18 (36%) type I, 22 (44%) type II and 10 (20%) type IIIA Gustilo open fractures were treated. The average duration of time between injury and nailing was 3.5 hours (range was 1.5 hours to 4 hours). After reaming, 40 (80%) fractures were fixed, without reaming, 10 (20%) of fractures were fixed. The average time to union was 27 weeks for type I fractures, 30 weeks for type II fractures and 33 weeks for type IIIA fractures. There was 1 non-union. There were 4 deep infections.</p><p class="abstract"><strong>Conclusions:</strong> The best mode of therapy was primary interlocking intramedullary nailing for open fractures.</p>

Acute Compartment Syndrome of Upper Extremities with Tendon Ruptures

2017 ◽  
Vol 22 (04) ◽  
pp. 411-415
Author(s):  
Taku Suzuki ◽  
Eiko Yamabe ◽  
Takuji Iwamoto ◽  
Katsuji Suzuki ◽  
Harumoto Yamada ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Compartment Syndrome ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Skin Grafting ◽  
High Energy ◽  
Acute Compartment Syndrome ◽  
Mechanism Of Injury ◽  
Sensory Disturbances

Background: It is well known that acute compartment syndrome is associated with fracture of the forearm, while involvement of soft tissue injury including musculotendinous injury remains unclear. The purpose of this study was to evaluate the soft tissue involvement, including musculotendinous ruptures, in acute compartment syndrome of the upper limb. Methods: We retrospectively enrolled 16 patients who underwent surgical treatment for acute compartment syndrome of the upper extremity. The average age of the patients was 47 years (range, 14 to 79) and the mean follow-up period after the surgery was 15 months (range, 12 to 29). Complications included at least one presentation at the final follow up of sensory disturbances or motor disturbances. We examined the presence of musculotendinous injury mechanism of injury, presence of fracture, the performance of skin grafting, and complications. Results: Mechanism of injury of “caught in a machine” was found in six cases. Three of these patients had musculotendinous ruptures and all muscle tears were revealed by intraoperative findings. No patients had muscle ruptures with other injury mechanisms. Seven out of 16 patients (44%) developed complications at final follow-up. Skin grafting was performed in six patients, and five of these patients developed complications. Only one of the nine patients without complications underwent skin grafting. Conclusions: In cases of high-energy injuries, the surgeon should suspect the presence of a musculotendinous injury prior to surgery.

scholarly journals Застосування екстракортикального остеосинтезу за діафізарних переломів кісток кінцівок у собак

2017 ◽  
Vol 19 (77) ◽  
pp. 15-17
Author(s):  
V.S. Dmytriev ◽  
N.M. Khomyn
Keyword(s):  
Soft Tissue ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Axial Deformation ◽  
Advantages And Disadvantages ◽  
Injured Area ◽  
Different Types ◽  
Diaphyseal Fractures ◽  
Orthopedic Diseases ◽  
Methods Of Treatment

The article presents an analysis of research results of domestic and foreign veterinary scientists concerning different treatments for dogs fractures of extremities. The researchers recommend to apply both conservative and radical treatment of orthopedic diseases, consisting in the use of different types of stable functional osteosynthesis (intramedullary, extra cortical and perosseous), creating conditions for early functioning of the injured area and the process of bone regeneration in the area of the fracture. It was established advantages and disadvantages of extra cortical osteogenesis and the feasibility of its application for diaphyseal fractures of extremities fractures in dogs. So, preference of closed intramedullary osteosynthesis consist in insignificant soft tissue injury. The downside is that that operation is performed blindly; is possible the injury of main nerves by pin, blood vessels, bones cracking. It is widely used open intramedullary drawback – destruction of bone marrow, vessels, circulatory disorders around the metal; reoperation is required to remove the metal holder. Extra cortical method provides reliable fixation of debris, especially for complex comminuted fracture. The disadvantage is the trauma during the imposition and removal of plates, infection of wounds. Perosseous allows to treat fractures of various localization, limb elongation, eliminate axial deformation and defects in bone and soft tissue of any origin and location, particularly complicated by osteomyelitis. But for its application requires special expensive equipment. Therefore becomes important the improvement of radical methods of treatment of fractures in order to stimulate regenerative processes and elimination of complications in the postoperative period.

Fractures of the Central Metatarsal

1996 ◽  
Vol 17 (4) ◽  
pp. 200-203 ◽  
Author(s):  
E. Sánchez Alepuz ◽  
V. Vicent Carsi ◽  
P. Alcántara ◽  
A. J. Llabrés
Keyword(s):  
Traffic Accidents ◽  
Sagittal Plane ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Functional Results ◽  
Work Related ◽  
Metatarsal Fractures ◽  
Plane Displacement ◽  
Anatomic Localization

We reviewed the evolution and final results of 57 patients with central metatarsal fractures treated in Hospital “La Fe” in Valencia between 1982 and 1993. The treatments were nonsurgical in 36 cases and surgical in 21 cases. The most frequent etiologies were traffic accidents, followed by work-related accidents. The fractures were classified according to their anatomic localization and whether they were closed (44 cases) or open (13 cases). Poor functional results manifested by metatarsalgia were present most often when one or two of the following were present: comminution, sagittal plane displacement, open fracture, or severe soft tissue injury. The mean follow-up was 5 years.

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