Clinical and radiological midterm results from using the Fixion expandable intramedullary nail in transverse and short oblique fractures of femur and tibia (original) (raw)
Related papers
The Role of Intramedullary Nailing in Modern Treatment of Open Fractures of the Tibia and Femur
Military Medicine, 1994
The increasing incidence of open tibial and femoral fractures causes great suffering by patients and is an enormous economic burden, necessitating improved treatment. The current treatment of these fractures is reviewed, as well as the evolving role of intramedullary nailing in this treatment. Intramedullary nailing seems to give better results than external fixation in Gustilo type I and II fractures, and is at least as good in type III. The introduction of the non-reamed interlocking intramedullary nail may bring about even better outcomes. Any improvements in treatment should be based on thorough understanding of the biologyand biomechanics of the injury.
Journal of Orthopaedic Trauma, 2006
Setting: Two level-1 trauma centers-University teaching hospitals. Methods: Fifty-four consecutive patients were treated by this nail system for acute tibial shaft fracture. Two nail diameters were used, 8.5 mm and 10 mm. Operation, hospitalization and healing times, reaming versus nonreaming, isolated versus multiple injuries, and reoperations were recorded and analyzed statistically. Results: Follow-up was obtained either until fracture healing or for a minimum of 1 year with an average of 14 months (12 to 24). All fractures healed in an average time of 72 days (21 to 204). The average healing times for patients treated with 8.5-mm and 10-mm nails were 77.2 days (27 to 204) and 63.4 days (21 to 121), respectively. Average operative time was 103 minutes (40 to 185) if reamed and 56 minutes (30 to 80) if unreamed. Average healing times were 65.4 days (21 to 190) if reamed and 79.5 days (42 to 204) if unreamed. There were 11 complications (20.4%) related to the nailing: 3 deep infections, 2 superficial infections, 2 bone shortenings of 1 cm secondary to nail protrusion in the knee, 1 compartment syndrome, 1 fracture propagation, 1 distal malalignment, and 1 delayed union. Hardware was removed in 6 patients (3 infections, 2 patients' request and 1 protrusion into the knee), and 1 additional patient underwent exchange nailing due to a delayed union. Conclusions: The expandable nail offers the theoretical advantages of improved load sharing and rotational control without the need for interlocking screws. This study demonstrates satisfactory healing and alignment for the treatment of tibial shaft fractures using this device. However, caution must be exercised when using this nail in cases of significant comminution and in cases where the fracture pattern involves the more proximal or distal aspect of the tibial shaft.
Results of angular-stable locked intramedullary nails in the treatment of distal tibia fractures
Orthopaedics & traumatology, surgery & research : OTSR, 2014
Intramedullary nailing in distal tibial fracture is controversial because of a lack of stability. The present study sought to assess radiological and clinical results for a new "angular-stable" locking system in difficult indications for intramedullary nailing. A prospective study recruited 41 patients (41 tibias) with distal tibial fracture consecutively managed using angular-stable locked intramedullary nails. Radiologic assessment comprised AP and lateral lower-limb views, taken postoperatively and through to last follow-up. The mean distance was measured between fracture and joint line. Fusion, with or without malunion, primary reduction defect, non-union and secondary displacement were recorded, as were all complications. Mean follow-up was 18 ± 5 months; 3 patients were lost to follow-up. Mean fracture distance from the joint line was 63 ± 25 mm. Fusion was achieved within 3 months in 29 cases (76%); delayed fusion in 7 patients (18%) required secondary dynamization ...
Blade expandable intramedullary nails for fixation of tibial shaft fractures
2019
This study is aimed to compare the clinical and radiological differences between classic locked intra- medullary nailing (LIN) and blade expandable intra- medullary nailing (BEIN) at tibia shaft fractures. Operation time, exposing of radiation time and fracture healing times were recorded. Pain visual anolog scale (VAS), shortening of tibia and angulation of fracture line were compared. All patients healed. In LIN group operation time, exposing of radiation time was longer (statistically significant). Because of shorter operation time and lower radiation exposure we recommend the BEIN technique as a preferable technique in tibia intramedullary nailing.
Fractures of the tibia shaft treated with locked intramedullary nail
ARS Medica Tomitana, 2013
Background: The gold standard treatment for complex fractures of tibial shaft is the reamed interlocking intramedullary nail. There has been some controversies about dynamization of statically locked nail, and some authors recommend routine dynamization for promotion of healing. This study evaluates the treatment of complex fractures of tibia shaft with static and dynamic interlocking intramedullary nail method. Methods: In this retrospective study, we studied 100 patients treated in Clinical Emergency Hospital Constanta between April 2012 - July 2013 diagnosed with tibia and fibula shaft fractures. They were treated by external fixation, and intramedullary nail. The intramedullary nail was blocked distally static or dynamic. Results: All patients achieved union during 12-18 weeks. The need of dynamization was required at 23 patients after 10 weeks from osteosynthesis. No significant complication was observed in our patients. Alignment of tibial fracture was perfect in all patients ...
Tibial fractures were the most common long bone fracture. These were treated by intramedullary nailing. Treatment of reamed versus unreamed intramedullary nailing was still controversial. This comparative study was conducted in the department of orthopaedic surgery in Mahatma Gandhi Memorial Hospital, Warangal, Telangana state, India with an aim to know the efficacy of both treatments. In this study the average duration of surgery was 72±12 min, the average time to full weight-bearing was 9.2 weeks and the average time to union of the fracture was 14 weeks. The unreamed intramedullary nailing group demonstrated a significantly higher rate of fracture non-union (R 3%, U 6%) and malunion (R 6%, U 9%). The significantly higher incidences of implant exchange, a higher risk of screw failure and dynamization were noticed in the unreamed intramedullary nailing group. Regarding the adverse effects like infection, compartment syndrome and knee pain there was no significant difference between two groups.
Reamed locked intramedullary nailing for studying femur fracture and its complications
European Cells and Materials
Morbidity associated with femur fractures in polytrauma patients is known to be high. The many unsolved clinical questions include the immunological effect of the fracture and its fixation, timing of fracture fixation, management of fracture non-union, effect of infection and critical size of bone defects. The aim of this study was to establish a clinically-relevant and reproducible animal model with regards to histological, biomechanical and radiological changes during bone healing. A custom-designed intramedullary nail with interlocking system (RabbitNail, RISystem AG, Davos Platz, Switzerland) was used for fixation, following femur fracture. New Zealand White rabbits were assigned to two groups: 1. closed fracture model (CF; non-survival model: n = 6, survival model: n = 3) with unilateral mid-shaft femur fracture created by blunt force; 2. osteotomy model (OT; survival model: n = 14) with unilateral transverse osteotomy creating femur fracture. There were no intraoperative complications and full-weight bearing was achieved in all survival rabbits. Significant periosteal reaction and callus formation were confirmed from 2 weeks postoperatively, with a significant volume formation (739.59 ± 62.14 mm 3) at 8 weeks confirmed by micro-computed tomography (µ-CT). 2 months after fixation, there was no difference between the osteotomised and contralateral control femora in respect to the maximum torque (3.47 ± 0.35 N m vs. 3.26 ± 0.37 N m) and total energy (21.11 ± 3.09 N m × degree vs. 20.89 ± 2.63 N m × degree) required to break the femur. The data confirmed that a standardised internal fixation technique with an intramedullary nail for closed fracture or osteotomy produced satisfactory bone healing. It was concluded that important clinically-relevant studies can be conducted using this rabbit model.
Prospective Study on Unreamed Interlocking Nail for Open Tibial Fractures
IOSR Journals , 2019
The tibial shaft is one of the most common sites of open fractures. The specific methods of skeletal stabilization and soft tissue treatment of open fractures continue to be topics of debate in the orthopaedic traumatology. The aim of the study is to evaluate the results of the undreamed intramedullary nailing in the open fractures of the tibia. Unreamed nailing in open fractures can avoid known complications of reamed nailing in an open fracture.
Intramedullary nailing of tibial fractures: An analysis of 54 cases
European Surgery
Background. Tibial fracture treatment developed from nonoperative approach to a variety of operative techniques. Introduction of interlocking nails has shown good results and became a standard of care for most displaced dlaphyseal tibial fractures. This case series evaluates early outcome of tibial nailing. Methods. We prospectively followed 54 consecutive adults with 55 tibial fractures [9 open) who were treated with locked IM nail on our department between Jan. 1 2006 and June 30 2009. All fractures were classified by the AO and Gustillo-Andersen classiflcation. Results. Thirty-four fractures were treated by static and 21 by dynamic reamed locking nail. We report the dynamics of union rate and associated complications using this techtnique. There were 43 males and 11 females with an average age of 46.1 years (range 17 - 74 years). Thirty-four patients were treated in the emergency, 17 5-12 days after initiai injury, 3 due to nonunion. Fibuia fixation was done in 15 cases. Average ...
Far Proximal and Far Distal Tibial Fractures: Management with Intramedullary Nails
Tibia Pathology and Fractures, 2020
Operative treatment of tibial fractures located at the proximal metaphysealepiphyseal and distal metaphyseal-epiphyseal areas, including those with articular extensions, is a technical challenge. Common methods for surgical management include plates (locking and nonlocking), external fixation devices, and intramedullary nails. All these methods have shown satisfactory results in terms of quality of reduction and clinical and radiological outcomes. The authors present some technical methods and strategies that have been useful for the surgical approach, reduction, and fixation of these lesions with the use of locked nails.