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European Journal of Orthopaedic Surgery... Jul 2023Surgical fixation of distal femur fractures in geriatric patients is an evolving topic. Unlike hip fractures, treatment strategies for distal femur fractures are... (Review)
Review
Surgical fixation of distal femur fractures in geriatric patients is an evolving topic. Unlike hip fractures, treatment strategies for distal femur fractures are ill-defined and lack substantive high-quality evidence. With an increasing incidence and an association with significant morbidity and mortality, it is essential to understand existing treatment options and their supporting evidence. Current fixation methods include the use of either retrograde intramedullary nails, or plate and screw constructs. Due to the variability in fracture patterns, the unique anatomy of the distal femur, and the presence or absence or pre-existing implants, decision-making as to which method to use can be challenging. Recent literature has sought to describe the advantages and disadvantages of each, however, there is currently no consensus on a standard of care, and little randomized evidence is available that directly compares intramedullary nails with plating. Future randomized studies comparing intramedullary nails with plating constructs are necessary in order to develop a standard of care based on injury characteristics.
Topics: Humans; Aged; Bone Nails; Femoral Fractures, Distal; Fracture Fixation, Internal; Fracture Fixation, Intramedullary; Bone Screws; Bone Plates; Femoral Fractures; Femur
PubMed: 35895117
DOI: 10.1007/s00590-022-03337-5 -
Ugeskrift For Laeger Jan 2023Fractures in the lower leg are common in children and are most often due to accidental falls. A significant part of the fractures involves the growth plates. This review... (Review)
Review
Fractures in the lower leg are common in children and are most often due to accidental falls. A significant part of the fractures involves the growth plates. This review describes a broad range of techniques for treatment ranging from immobilization in a cast to open reduction and fixation with K-wires, screws, or flexible intramedullary nails. Premature growth arrest is relatively common following the physeal fractures in proximal or distal tibia. We recommend early consultation with a tertiary care centre for guidance and planning of the best treatment.
Topics: Humans; Child; Leg; Bone Nails; Tibial Fractures; Lower Extremity; Growth Plate
PubMed: 36760152
DOI: No ID Found -
International Orthopaedics May 2021To summarize the evolution of intramedullary nailing, highlight important milestones, introduce the atmosphere of the era concerning the first uses and development of... (Review)
Review
PURPOSE
To summarize the evolution of intramedullary nailing, highlight important milestones, introduce the atmosphere of the era concerning the first uses and development of intramedullary nailing, and present the status of nailing in modern international orthopaedics and traumatology.
METHOD
A thorough literature search was undertaken in PubMed and Google Scholar as well as in physical books in libraries to summarize the literature on the history and evolution of intramedullary nailing.
RESULTS
The first use of an intramedullary device was attested in ancient Egypt; however, the first use of intramedullary nailing was reported in 1524 in Mexico, and the first medical journals reported on intramedullary nailing around the mid-1800s. The evolutions of intramedullary nailing including approach, material, cross-section and shape, and reaming technique occurred in the twentieth century. During the 1960s, intramedullary nailing was abandoned in favour of plate and screws osteosynthesis; however, in the 1970s, 1980s, and 1990s, a surge of novelties including flexible reaming, interlocking, and use of image intensification and titanium nails led to the advent of the second-generation intramedullary nailing. Today, intramedullary nailing has become the standard treatment of long bone fractures with low infection rates, small scars, excellent stabilization of the fractures, and immediate mobilization of the patients.
CONCLUSION
Intramedullary nailing has revolutionized the treatment of long bone fractures. However, with numerous nail designs, a lot of information on their efficacy is lacking. Considerably more work will need to be done to determine the optimal nail specifications.
Topics: Bone Nails; Bone Plates; Fracture Fixation, Internal; Fracture Fixation, Intramedullary; Fractures, Bone; Humans
PubMed: 33575858
DOI: 10.1007/s00264-021-04973-y -
Journal of Orthopaedic Trauma Mar 2022Multiple studies have described retrograde nailing as a treatment of periprosthetic supracondylar femoral fractures (OTA/AO type 33A-C) above total knee replacements...
Periprosthetic Supracondylar Femoral Fractures Above a Total Knee Replacement: An Updated Compatibility and Technique Guide for Fixation With a Retrograde Intramedullary Nail.
BACKGROUND
Multiple studies have described retrograde nailing as a treatment of periprosthetic supracondylar femoral fractures (OTA/AO type 33A-C) above total knee replacements (TKRs). It is often difficult to discern which TKRs will be compatible with intramedullary nailing because the femoral component design and intercondylar distance is highly variable among total knee designs. The goal of our study is 3-fold: (1) Review and update previous work of intercondylar distances of all currently available prostheses in the United States. (2) Review retrograde nails currently on the market and associated driving end to nail shaft diameter mismatch and opening reamer sizing. (3) Review technical tricks for executing a retrograde femoral nail for the treatment of periprosthetic supracondylar femur fractures.
METHODS
Data for the intercondylar distance of the femoral components, diameter of retrograde nails and reamers, and notch compatibility were gathered.
RESULTS
The results were compiled and recorded. A "technical tricks" section was included that highlights reduction and fixation techniques.
CONCLUSIONS
This update further empowers surgeons to use all the tools available when treating periprosthetic femur fractures and allows efficient identification of the compatibility of different TKR designs with various intramedullary nails.
LEVEL OF EVIDENCE
Therapeutic Level V. See Instructions for Authors for a complete description of levels of evidence.
Topics: Arthroplasty, Replacement, Knee; Bone Nails; Femoral Fractures; Fracture Fixation, Intramedullary; Humans; Periprosthetic Fractures; Treatment Outcome
PubMed: 34270521
DOI: 10.1097/BOT.0000000000002236 -
The Veterinary Clinics of North... Jan 2020Reviews of clinical outcomes led to the foundation of a new approach in fracture management known as biological osteosynthesis. As intramedullary rods featuring... (Review)
Review
Reviews of clinical outcomes led to the foundation of a new approach in fracture management known as biological osteosynthesis. As intramedullary rods featuring cannulations and locking devices at both extremities, interlocking nails are well suited for bridging osteosynthesis. Unique biological and mechanical benefits make them ideal for minimally invasive nail osteosynthesis and an attractive, effective alternative to plating, particularly in revisions of failed plate osteosynthesis. Thanks to a new angle-stable locking design, interlocking nailing indications have been expanded to osteosynthesis of epi-metaphyseal fractures, including those with articular involvement and angular deformities such as distal femoral varus and associated patellar luxations.
Topics: Animals; Biomechanical Phenomena; Bone Nails; Fracture Fixation, Internal; Fractures, Bone; Minimally Invasive Surgical Procedures
PubMed: 31668598
DOI: 10.1016/j.cvsm.2019.09.003 -
The Bone & Joint Journal May 2015Implant-associated infection is a major source of morbidity in orthopaedic surgery. There has been extensive research into the development of materials that prevent... (Review)
Review
Implant-associated infection is a major source of morbidity in orthopaedic surgery. There has been extensive research into the development of materials that prevent biofilm formation, and hence, reduce the risk of infection. Silver nanoparticle technology is receiving much interest in the field of orthopaedics for its antimicrobial properties, and the results of studies to date are encouraging. Antimicrobial effects have been seen when silver nanoparticles are used in trauma implants, tumour prostheses, bone cement, and also when combined with hydroxyapatite coatings. Although there are promising results with in vitro and in vivo studies, the number of clinical studies remains small. Future studies will be required to explore further the possible side effects associated with silver nanoparticles, to ensure their use in an effective and biocompatible manner. Here we present a review of the current literature relating to the production of nanosilver for medical use, and its orthopaedic applications.
Topics: Animals; Anti-Bacterial Agents; Bacterial Infections; Bone Nails; Durapatite; Humans; Nanoparticles; Orthopedic Procedures; Postoperative Complications; Prosthesis Design; Prosthesis-Related Infections; Silver
PubMed: 25922449
DOI: 10.1302/0301-620X.97B5.33336 -
Der Unfallchirurg Nov 2018
Topics: Bone Lengthening; Bone Nails; Femur; Fracture Fixation, Intramedullary; Leg Length Inequality; Treatment Outcome
PubMed: 30430225
DOI: 10.1007/s00113-018-0551-2 -
Injury Aug 2019
Topics: Bone Nails; Fracture Fixation, Intramedullary; Fracture Healing; Fractures, Bone; Humans; Lower Extremity
PubMed: 31378547
DOI: 10.1016/j.injury.2019.07.007 -
Journal of Surgical Orthopaedic Advances 2021The objective of this study is to report operative time and associated complications of six types of implants and to determine if surgeons are adequately compensated....
The objective of this study is to report operative time and associated complications of six types of implants and to determine if surgeons are adequately compensated. Hardware removals were analyzed from 2014-2019. Implants were flexible nails, intramedullary rigid nails, long plates, screw(s), single guided-growth plates, and multiple guided-growth plates. Patient demographics, operative time, blood loss, complications, and relative value units (RVU)/min were collected. RVU/min was used to maximize rate. In total, 392 patients were analyzed. Long plate removals took significantly longer than screw removal, therefore RVU/min was significantly lower (p < 0.001). Long plate removals also took significantly longer, and RVU/min was significantly lower compared to guided-growth plate removal (p < 0.001). Intramedullary nails took significantly longer compared to flexible nails, nearly double the RVU/min (p = 0.02). The results from this study indicate that the RVU/ minute for these six different types of implant removals are not equal. Surgeons can use this data to set up their schedule to ensure maximum utilization. (Journal of Surgical Orthopaedic Advances 30(1):020-023, 2021).
Topics: Bone Nails; Bone Plates; Bone Screws; Fracture Fixation, Internal; Fracture Fixation, Intramedullary; Humans; Reoperation
PubMed: 33851909
DOI: No ID Found -
Zhongguo Xiu Fu Chong Jian Wai Ke Za... May 2021To review the research progress of intramedullary lengthening nail technology. (Review)
Review
OBJECTIVE
To review the research progress of intramedullary lengthening nail technology.
METHODS
The foreign literature on the development history, types, advantages and disadvantages, indications and contraindications, complications, and effectiveness of intramedullary lengthening nail were reviewed and analyzed.
RESULTS
The intramedullary lengthening nail system mainly includes mechanical type, electric motor drive type, and magnetic drive type. Compared with traditional external fixation and lengthening technology, the intramedullary lengthening nail technology has certain advantages in incidence of complications, bone healing, postoperative functional rehabilitation, incision aesthetics, convenience, and patient satisfaction. However, there are also shortcomings, such as pain, uncontrollable distraction rate, device failure, etc. In the clinical application of intramedullary lengthening nails for limb lengthening, the indications should be grasped reasonably, and the related complications should be prevented and treated.
CONCLUSION
Intramedullary lengthening nails provide a new option for limb lengthening, and the initial effectiveness is good. It is one of the development direction of limb lengthening technology.
Topics: Bone Lengthening; Bone Nails; Femur; Fracture Fixation, Intramedullary; Humans; Leg Length Inequality; Technology; Treatment Outcome
PubMed: 33998220
DOI: 10.7507/1002-1892.202012084