• Title/Summary/Keyword: Intramedullary Fixation Nail

Search Result 23, Processing Time 0.026 seconds

Humeral intramedullary nail bending following trauma: a case report

  • Siem A. Willems;Alexander P. A. Greeven
    • Journal of Trauma and Injury
    • /
    • v.36 no.1
    • /
    • pp.65-69
    • /
    • 2023
  • The surgical approach for humeral implant failure can be challenging due to neurovascular anatomy and the possible necessity of osteosynthesis removal. We present a rare case of humeral nail bending after secondary trauma in a patient with preexistent nonunion of the humerus after intramedullary nailing. During revision surgery, the nail was sawed in half and the distal part was removed, followed by plate osteosynthesis with cable fixation to achieve absolute stability. The patient regained a full range of motion 1 year after surgery, and complete healing of the fracture was seen on imaging.

Arthrodesis of the Knee Using a Retrograde Femoral Intramedullary Nail: Technical Report (역행성 대퇴부 골수강 내 금속정을 이용한 슬관절 고정술: 술기 보고)

  • Wang, Lih;Kim, Sun Hyo
    • Journal of the Korean Orthopaedic Association
    • /
    • v.56 no.2
    • /
    • pp.183-189
    • /
    • 2021
  • Arthrodesis is one of the last options available to obtain a stable, painless knee in patients who are unable to undergo reconstructive surgery due to a damaged knee joint. A variety of techniques have been used, including external fixation, internal fixation by compression plates, intramedullary fixation through the knee with a modular nail, and antegrade nailing through the piriformis fossa. Another option is the use of a short nail such as the Neff nail, the Wichita nail, or the Huckstep nail, but there are no commercial short nails available for use in Korea. This technical report describes a technique for knee arthrodesis using a retrograde femoral intramedullary nail.

The Effect of Fibular Fixation on Ankle Function in Intramedullary Nailing for Distal Tibiofibular Fractures (원위 경비골 골절에 대한 골수강내 금속정술에서 비골 고정이 족근 관절 기능에 미치는 영향)

  • Suh, Byung-Ho;Lee, Soo-Won;Kong, Gyu-Min;Kim, Dong-Jun;Oh, Hyun-Keun
    • Journal of Korean Foot and Ankle Society
    • /
    • v.13 no.2
    • /
    • pp.169-174
    • /
    • 2009
  • Purpose: To evaluate the clinical results between interlocking intramedullary nail with fibular fixation and nail only for treating distal tibiofibular diaphyseal fractures. Materials and Methods: From March 2003 to September 2006, 19 distal tibiofibular fractures were antegrade nailed after anatomical reduction and fixation of fibular fractures, and another 37 fractures fixed with nails only. Average age of patients was 48.6 years. These two groups were compared by VAS (visual analogue scale) & ankle ROM according to degree of comminution and fracture configuration. The statistical analysis was evaluated by t-test. Results: There was no statistical difference between fibular fixation group and non-fixation group in VAS score according to fracture comminution and configuration (p>0.05). However, compared according to fracture configuration, mean ankle eversion of fibular fixation group in oblique fractures was 18.3 degrees, and that of non-fixation group was 12.5 degrees (p<0.05). In addition, mean ankle plantar flexion, dorsiflexion, inversion and total ankle ROM of fibular fixation group in spiral fractures was 40.0, 20.0, 30.0 and 108.3 degrees of each and that of non-fixation group was 38.3, 18.5, 27.0 and 101.7 degrees (p<0.05). Conclusions: In oblique and spiral fractures of distal tibiofibular diaphysis, interlocking intramedullary nail with fibular fixation had the advantage in postoperative ankle ROM. So, it can be a worthy method for the treatment of distal tibiofibular diaphyseal fractures.

  • PDF

A Study on Development of Humeral Intramedullary Fixation Nail based on Korean Cadaver Tests (한국인 Cadaver Test에 대한 상완골 골수정 개발에 관한 연구)

  • Chon, Chang-Soo;Lee, Jae-Won;Ko, Cheol-Woong;Oh, Jong-Keon;Woo, Soo-Heon;Lee, Sung-Jae
    • Journal of the Korean Society for Precision Engineering
    • /
    • v.28 no.8
    • /
    • pp.984-991
    • /
    • 2011
  • The aim of this study is to develop a humeral Intramedullary fixation nail (HIFN) suitable for Korean people. In this study, CT images were obtained from 72 Korean cadaveric humeral bones and 3D Korean humeral bone models were reconstructed based on the CT images to investigate anatomical characteristics. Major design parameters of HIFN were selected using the morphological measurement information of the Korean humeral bone models. Through finite element analysis and mechanical tests, the developed HIFN prototype was compared with the Polarus HIFN ($ACUMED^{(R)}$, USA), and it was found that the HIFN prototype showed similar and/or superior mechanical performance compared to the Polarus HIFN. Also, clinical validation for the HIFN prototype was carried out to check predictable troubles in surgical operations. Finally, optimal design modification was proposed to prevent the possible axillary nerve injury due to the locking screw system of the HIFN prototype.

Comparison between Intramedullary Nailing and Percutaneous K-Wire Fixation for Fractures in the Distal Third of the Metacarpal Bone

  • Moon, Sung Jun;Yang, Jae-Won;Roh, Si Young;Lee, Dong Chul;Kim, Jin Soo
    • Archives of Plastic Surgery
    • /
    • v.41 no.6
    • /
    • pp.768-772
    • /
    • 2014
  • Background To compare clinical and radiographic outcomes between intramedullary nail fixation and percutaneous K-wire fixation for fractures in the distal third portion of the metacarpal bone. Methods A single-institutional retrospective review identified 41 consecutive cases of metacarpal fractures between September 2009 and August 2013. Each of the cases met the inclusion criteria for closed, extra-articular fractures of the distal third of the metacarpal bone. The patients were divided by the method of fixation (intramedullary nailing or K-wire). Outcomes were compared for mean and median total active motion of the digit, radiographic parameters, and period until return to work. Complications and symptoms were determined by a questionnaire. Results During the period under review, 41 patients met the inclusion criteria, and the fractures were managed with either intramedullary nailing (n=19) or percutaneous K-wire fixation (n=22). The mean and median total active range of motion and radiographic healing showed no statistically significant difference between the two groups. No union failures were observed in either group. The mean operation time was shorter by an average of 14 minutes for the percutaneous K-wire fixation group. However, the intramedullary nailing group returned to work earlier by an average of 2.3 weeks. Complications were reported only in the K-wire fixation group. Conclusions Intramedullary nailing fixation is advisable for fractures in the distal third of the metacarpal bone. It provides early recovery of the range of motion, an earlier return to work, and lower complication rates, despite potentially requiring a wire removal procedure at the patient's request.

Comparison of the Results between Intramedullary Nailing and Plate Fixation for Distal Tibia Fractures (원위 경골 골절에서 금속정 및 금속판 고정술의 결과 비교)

  • Kim, Jung-Han;Gwak, Heui-Chul;Lee, Chang-Rack;Jung, Yang-Hwan
    • Journal of Korean Foot and Ankle Society
    • /
    • v.19 no.3
    • /
    • pp.86-90
    • /
    • 2015
  • Purpose: We analyzed and compared the clinical and radiologic results between minimally invasive plate osteosynthesis and internal fixation using intramedullary (IM) nail in the treatment of distal tibia fractures. Materials and Methods: From March 2005 to June 2013, 65 cases of distal tibia fractures treated with either plate fixation or IM nail fixation were analyzed retrospectively by clinical and radiologic evaluations. The clinical results were compared using the American Orthopaedic Foot and Ankle Society (AOFAS) score, Olerud-Molander ankle score (OMAS), and visual analogue scale (VAS) score at the last follow-up. The radiologic results were compared by time to bone union, complications such as nonunion, delayed union, and malunion. Results: The clinical results (according to OMAS, AOFAS score, and VAS score) were 77.47, 84.76, and 1.75, respectively, in the plating group, and 90.21, 91.00, and 1.25, respectively, in the nailing group, and there was no statistically significant difference. Plating group showed earlier union than the nailing group and the nailing group showed higher frequency of non-union and delayed union than plating group. Conclusion: In treatment of distal tibia fractures, two methods showed appropriate results. Therefore, thorough investigation of the types of fracture, state of soft tissues, and advantages and disadvantages of the two methods should be conducted in the treatment of distal tibia fractures.

Tibiotalocalcaneal Arthrodesis Using Retrograde Compressive Intramedullary Nail (역행성 압박 골수내 금속정을 이용한 경골거골종골 관절 유합술)

  • Song, Moo Ho;Kim, Bu Hwan;Ahn, Seong Jun;Kang, Suk Woong;Kim, Young Jun;Kim, Dong Hwan;Yoo, Seong Ho
    • Journal of Korean Foot and Ankle Society
    • /
    • v.18 no.4
    • /
    • pp.202-207
    • /
    • 2014
  • Purpose: The purpose of this study was to evaluate the radiological and clinical outcomes of tibiotalocalcaneal arthrodesis using retrograde compressive intramedullary nail for patients with complex hindfoot problems, including Charcot arthropathy, osteonecrosis of talus, combined arthritis of the ankle and subtalar joint, failure of previous ankle arthrodesis, and failed total ankle arthroplasty. Materials and Methods: Eighteen consecutive patients (10 men and 8 women) with an average age of 54 years (range, 42~72 years) underwent tibiotalocalcaneal arthrodesis using retrograde compressive intramedullary nail fixation. The mean duration of follow-up was 16 months (range, 12~23 months). Radiological evaluation included assessment of the union status of ankle and subtalar joints. Clinical evaluations included visual analogue scale (VAS) for pain and patient satisfaction, and postoperative complications were analyzed. Results: Radiological union was achieved in 14 ankle joints (77%) and 16 subtalar joints (88%) at an average of 16 weeks (range, 14~40 weeks) and 14 weeks (range, 12~24 weeks), respectively. The preoperative VAS were 4.6 (range, 4~8) at rest and 8.2 (range, 7~10) during walking, and the postoperative VAS were 2.2 (range, 0~3) and 4.6 (range, 4~6), respectively (p<0.05). There were 6 nonunions (4 ankle joints and 2 subtalar joints), 3 tibia fractures, 2 delayed union of ankle joints, and 2 breakage of the implant. Conclusion: Tibiotalocalcaneal arthrodesis using retrograde compressive intramedullary nail may be considered as a viable option in patients with complex hindfoot problems.

Comparing the Use of Single and Double Interlocking Distal Screws on a Polarus Intramedullary Nail for Humeral Shaft Fractures

  • Yang, Hee Seok;Kim, Jeong Woo;Kang, Hong Je;Park, Jung Hyun;Lee, Yong Chan;Kim, Kwang Mee
    • Clinics in Shoulder and Elbow
    • /
    • v.18 no.2
    • /
    • pp.91-95
    • /
    • 2015
  • Background: Our aim was to make a comparative analysis of radiological and clinical outcomes of using either one or two interlocking distal screws on a Polarus intramedullary nail for the internal fixation of humeral shaft fractures. Methods: From January 2008 to March 2014, we enrolled 26 patients with humeral shaft fractures who were operated on using intramedullary nails. The patients were divided into 2 groups according to how many interlocking distal screws were used to lock the Polarus nail: in group 1, a single interlocking distal screw was used in 12 patients; and in group 2, double interlocking distal screws, in 14 patients. We compared the degree of recovery of the displaced fracture fragments between the two groups. To compare the nonunion and shoulder function, we assessed each patient's modified American Shoulder and Elbow Surgerns (ASES) score. Results: We found that 10 of 12 fractures achieved union in group 1, and 13 of 14 fractures, in group 2. We did not find a meaningful difference in the time to bone union between the two groups. The percentage of recovery of displaced fracture fragments until union was 66.9% for group 1 and 59.41% for group 2. At the final follow-up, we found that the scores for shoulder joint modified ASES was 78.7 for group 1 and 80.7 for group 2. Conclusions: Our results show that if locked appropriately, even a single screw on a Polarus nail can provide satisfactory radiological union and improved clinical outcome after intramedullary nailing of humeral shaft fractures.