The introduction of the strong clover-leafed nail combined with the principle of reaming out the medullary canal and the development of image intensifiers has been extended the indications of the in tramedullary nailing. In this report, an attempt was made to introduce the method and to verify the indications and advantage of retrograde intramedullary nailing of humeral shaft fractures, as compared with the conventionally accepted methods.
Fracture Fixation, Intramedullary ; Humerus ; Methods

Background: Leg bone fracture is common seen in orthopedic trauma. Currently, the trend of treatment is using a less invasive technique. Especially, with application of C-Arm in surgery, closed Kuntscher nailing technique has made the treatment of leg bone fractures achieving more new improvements. Objectives: To summarize the experiences in the technical implementation process and to assess results of treatment. Subjects and method: A descriptive, retrospective study was conducted on 112 patients was confirmed diagnosed with leg bone fractures (81 males, 31 females, the average aged 29\xb15.3), were operated in Da Nang General Hospital from January, 2004 to June, 2006. All of them were performed with Kuntscher intramedullary nail in tibia without opening fracture cavity, in condition of without C-Arm. Results: The patients with combined injuries included 5 cases of 2 legs fracture, 2 cases of hip fracture, 5 cases of leg fracture in 2 stages, 1 case of collabone fracture. Postoperative observations: no case of infection, patients were discharged after 2-7 days, the average length of hospitalization was 3\xb12.4 days. Complication: 1 case of secondary deviation, no case of any delay to heal bone, broken nails. Recording a case of nail was rise up to cause painfully and synovial capsule inflammation of knee joint. Conclusion: The implementation of this less invasive technique should be orderly done. The most ideal indication was tibial shaft fractures in stage of middle 1/3. Because of a minimally invasive technique so patients were less painful, fracture healing quickly, early mobilization could be set, surrounding joints were not affected.
Tibial Fractures/surgery ; Fracture Fixation ; Intramedullary/ methods ;

OBJECTIVETo discuss the curative effect of bone graft from trochanter with interlocking intramedullary nail for comminute fracture of femur.

METHODSFrom January of 2009 to January of 2010, fifty patients with comminute fracture of femur were treated by the therapy of bone graft from trochanter with interlocking intramedullary nail, included 35 males and 15 females with an average age of 38.4 years old ranging from 28 to 50 years. According to AO/ASIF classification system, there were 15 cases of type B1, 20 of type B2, 8 of type B3, 7 of type C1.

RESULTSAll the patients were followed up for 12 to 24 months, averaged 14.4 months. All the broken femurs knitted in 4 to 6 months, the average period of knit was 5.6 months. The injured legs with normal movement in knees,which had no infection, vascellum-nerve injury and anchylosis in knees. According to Merchan knee rating scale, the results were excellent in 25 cases, good in 20, fair in 3 and poor in 2, and the excellent and good rate was 90%.

CONCLUSIONBone graft from trochanter with interlocking intramedullary nail, which has a virtue of small injury, less blood loss, high rate of bone knit, perfect functional recovery, is a preferable therapy of fresh fracture of femur.

Adult ; Bone Transplantation ; methods ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Intramedullary ; methods ; Humans ; Male ; Middle Aged

Bone Nails ; Bone Plates ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Humans ; Tibial Fractures ; surgery

OBJECTIVETo investigate the treatment of femoral neck fractures after the fixation of ipsilateral femoral shaft fracture by antegrade intramedullary nail.

METHODSA retrospective study on 12 patients with femoral neck fractures after the fixation of ipsilateral femoral shaft fracture by antegrade intramedullary nail, which were identified intraoperatively or postoperatively from January 2000 to January 2010. All the patients were treated with 2 supplemental screws placed anteriorly and posteriorly to intramedullary nail seperately. All the patients were periodic followed-up, fractures union and functional recovery were evaluated.

RESULTSAll the patients were followed up, and the duration ranged from 10 to 36 months (averaged 16.5 months). The mean healing time was 3.6 months in femoral neck fractures and 5.4 months in femoral shaft fractures. No osteonecrosis of femoral head was found. According to Harris scoring system for hip function, 7 patients got an excellent result, 3 good, 2 fair.

CONCLUSIONTreatment of femoral neck after the fixation of ipsilateral femoral shaft by antegrade intramedullary nail with 2 screws placed anteriorly and posteriorly to intramedullary nail separately is feasible, and has the advantages of reliable fixation, less trauma and high rate of fracture healing.

Adult ; Female ; Femoral Neck Fractures ; surgery ; Femur ; surgery ; Fracture Fixation, Intramedullary ; methods ; Humans ; Male ; Middle Aged

OBJECTIVETo study the clinical efficacy of semiextended intramedullary nailing of the tibia using a suprapatellar approach for proximal tibial fractures.

METHODSFrom January 2013 to January 2014, a total of 16 patients with unilateral proximal tibial fractures, 14 males and 2 females, underwent closed reduction and internal fixation with TRIGEN™ META-NAIL™ via the suprapatellar approach. The average age was 42.2 years old (ranged, 26 to 57 years old). Radiographic and clinical follow-up examinations were performed at a minimum of 1 year after surgery. Measurements included surgery time, complications, bone healing time, tibial alignment, knee range of motion, pain scoring (visual analogue scale) and functional outcome (Lysholm knee score).

RESULTSThe average surgery time was (75.7±8.3) minutes (ranged, 65 to 95 minutes). No obvious complications were recorded. Average duration of follow-up was (15.6±8.1) months (ranged, 12 to 24 months). Fifteen patients attained radiological bone union for a mean time of (3.6±1.8) months (ranged, 3 to 5 months). At the final follow-up, all tibial alignments were good, and no patients complained of anterior knee pain. Mean arc of knee motion was (124.4±18.8) degrees for the affected extremity compared with (127.5±16.7) degrees for the contra-lateral knee. The total scores of Lysholm knee score ranged from 77 to 92, average 86.4±12.3.

CONCLUSIONFor proximal tibial fractures,the semiextended intramedullary nailing technique via a suprapatellar approach can obtain satisfactory clinical outcomes with simplicity in reduction and fixation, minimal complications, and good recovery of limbs function.

Adult ; Female ; Fracture Fixation, Intramedullary ; methods ; Humans ; Male ; Middle Aged ; Tibia ; surgery ; Tibial Fractures ; surgery

OBJECTIVETo study the biomechanical characteristics of Ni-Ti shape-memory alloy-enclosed interlocking intramedular nail Ni-Ti En for clinical application.

METHODSSix transverse fractures were induced in 6 fresh humeral shafts and fixed with Ni-Ti En, plate, interlocking intramedullary nail, and Ender nail, respectively. The specimens then underwent stress analysis for comparison of the bending strength, twisting force, and flexibility.

RESULTSThe bending strength of Ni-Ti En was not significantly different from that of the plate and better than ender's nail; the twisting force of the interlocking intramedullary nail was comparable with the plate, but better than Ender nail.

CONCLUSIONNi-Ti Enpossess good biomechanical property to meet the demand of osteosynthesis, and its less stress protection, freedom of distant nail locking, flexibility and stable fixation may accelerate fracture healing.

Biomechanical Phenomena ; Bone Nails ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Humans ; Humeral Fractures ; physiopathology ; surgery ; Nickel ; Titanium

Adolescent ; Adult ; Child ; Female ; Fracture Fixation, Intramedullary ; methods ; Humans ; Male ; Radius Fractures ; surgery

OBJECTIVETo analyze the clinical effects of intramedullary fixation of Kirschner pin for the treatment of distal fibula fractures.

METHODSFrom April 2007 to June 2010, thirty patients with the distal fibula fractures were treated with intramedullary fixation of Kirschner pin. There were 22 males and 8 females with an average age of 35.6 years old (22 to 60 years), length of hospital stay was 10 to 30 days (means 15.8 days). There were 20 cases of Transverse fracture and 10 cases of oblique fracture. Evaluation of the function of the ankle joint is based on the American Orthopaedic Foot and Ankle Society (AOFAS) standard evaluation systems.

RESULTSAll the cases were followed up. The mean followed-up time was 15.5 months (3 to 30 months). All fractures were bone healed, no case suffered infection and nonunion, no case suffered nervus fibularis superficialis injury. According to the AOFAS (American Orthopaedic Foot and Ankle Society) evaluation systems, the total scores after operation was 96.1 +/- 4.3 (the pain was 39.0 +/- 4.0, the fracture force line was 10, the function was 47.1 +/- 2.1. Twenty-eight patients obtained excellent results, 2 good.

CONCLUSIONThis method can be easily operated with the advantages of less pain and safety. It can effectively attenuate the financial burden of the patients. Thus worth being popularized in clinicic and basic level hospital.

Adult ; Female ; Fibula ; injuries ; Fracture Fixation, Intramedullary ; methods ; Humans ; Male ; Middle Aged

BACKGROUNDNowadays pediatric femoral fractures are more commonly managed with operative treatment rather than conservative treatment because of more rapid recovery and avoidance of prolonged immobilization. Children between the ages of 5-13 years are treated either by traction plus hip spica and flexible/elastic stable retrograde intramedullary nail, or external fixators in the case of open fractures. The aim of this study is to evaluate the outcome of pediatric femoral shaft fractures treated by stainless steel flexible intramedullary nail in children between 5 and 13 years of age.

METHODSThere were 32 cases of femoral shaft fractures which were all fixed with stainless steel flexible intramedullary nail under fluoroscopy. Long leg cast was applied at the time of fixation. Partial weight bearing was started 2 weeks after surgery. Patients were evaluated in follow-up study to observe the alignment of fracture, infection, delayed union, nonunion, limb length discrepancy, motion of knee joint, and time to unite the fracture.

RESULTSWe were able to follow up 28 out of 32 patients. The patients were 8.14 years of age on average. The mean hospital stay after operation was 4 days and fracture union time was 9.57 weeks. There were 3 cases of varus angulation, 2 cases of anterior angulation, and 4 cases of limb lengthening.

CONCLUSIONPatients aged between 5 and 13 years treated with flexible intramedullary nail for closed femoral shaft fracture have rapid union and recovery, short rehabilitation period, less immobilization and psychological impact, and cost-effective.

Adolescent ; Child ; Child, Preschool ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Intramedullary ; methods ; Fracture Healing ; Humans ; Male