Retrograde intramedullary nailing of supracondylar femoral fractures: design and development of a new implant.

Since 1992 we have developed an implant in which the distal (condylar) screws have a diagonal configuration so that the screws can be closer to the distal end of the nail, allowing more distal fractures to be fixed. It also utilises the denser bone of the posterior condyles for more secure fixation in osteoporotic patients. The new implant was used for 24 extra-articular fractures from September 1994 to September 1997, and for 14 articular fractures from February 1995 to December 2000.

Percutaneous intramedullary fixation of trochanteric fractures of the femur. Clinical trial of a new hip nail.

Since 1992, we have developed an implant which can be inserted percutaneously without reaming the femoral shaft. In the final design, the intramedullary nail is 13 mm diameter proximally and 11 mm distally. The femoral head is fixed with two screws of 6.

Development of small diameter intramedullary nails made from ISO 5832-9 stainless steel.

Background: In order to improve strength in small diameter intramedullary nails, a system was designed in which the implants were manufactured from 30% coldworked ISO 5832-9 stainless steel.

Methods: Nail diameters were 9 and 10 mm for the femur, and 8 and 9 mm for the tibia. The nails were solid rods and the screws were partially threaded.

Locked intramedullary nailing of humeral shaft fractures. Implant design, surgical technique, and clinical results.

We report our experience with a modified implant and a new technique for locked intramedullary nailing of the humerus in 41 patients. Locking was by cross-screws placed from lateral to medial in the proximal humerus, and anteroposteriorly in the distal humerus. Early in the series, 11 nails were inserted at the shoulder, but we found that rehabilitation was faster after retrograde nailing through the olecranon fossa, which was used for the other 30.

A comparison between innominate osteotomy and hip spica in the treatment of Legg-Perthes' disease.

Thirty-eight cases of Legg-Perthes' disease treated by innominate osteotomy have been reviewed and compared with 33 cases, matched for age and severity, treated in recumbency in plaster hip spicas. The results were similar in the two groups, the radiologic results in the innominate osteotomy group being marginally worse. There was a high incidence of poor results in both groups in those over the age of eight years at the onset of symptoms, especially if femoral "head at risk" signs were present.