Intramedullary Nailing of Metaphyseal Fractures of the Lower Extremity.

Intramedullary Nailing of Metaphyseal Fractures of the Lower Extremity.
Acta Chir Orthop Traumatol Cech. 2017;84(5):330-340
Authors: Rommens PM, Küchle R, Hofmann A, Hessmann MH
Abstract
Intramedullary nailing is a worldwide accepted technique for stabilization of fractures of long bones. Technique, instruments and implants primarily have been developed for the fixation of short (transverse and oblique) diaphyseal fractures. First generation nails were hollow and slotted, which gave them some elasticity. When the tip of the nail passed the fracture gap, picked up the opposite fracture fragment and was driven further down, the longitudinal axis of the bone was restored and the extremity realigned. Bone length was restored by closure of the fracture gap. The tight connection between the deformable hollow nail and the inner cortex at the isthmus realized a press-fit, which achieved a very stable bone-implant construct. The nail had the function of a weight-shearing implant. Interlocked nails represent the second-generation nails. They changed the spectrum of indications for nailing considerably. Not only short middle-third shaft fractures, but shaft fractures of all types (from transverse to comminuted) and all localizations can be stabilized with an interlocked nail. Due to interlocking, length and rotation are controlled. The nail bridges the area of instability, being a weight-bearing implant. Small diameter, solid nails formed the ...

Source: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca - January 20, 2018 Category: Orthopaedics Tags: Acta Chir Orthop Traumatol Cech Source Type: research