Objective: To study the biomechanical characteristics of antegrade intramedullary fixation for metacarpal fractures.
Methods: From March to May 2008, both the 4th and 5th metacarpals from 25 formalin embalmed cadaver hands had three-point bending test after transverse osteotomy followed by randomly fixation with one of the following three methods: plate and screw, antegrade intramedullary K-wire, crossed K-wire. While, both the 2nd and 3rd metacarpals had torsional loading test after the same management as the 4th and 5th metacarpal had undergone.
Results: In the three-point bending test, both the maximum bending moment (M(max)) and bending rigidity (EI) of the antegrade intramedullary K-wire were comparable with those of the plate and screw, and were significantly larger than those of the crossed K-wire. In the torsional loading test, the antegrade intramedullary K-wire had a statistically smaller maximum torque (T(max)) than the plate and screw, and had a comparable T(max) with the crossed K-wire; while, the torsional rigidity (GJ) of the intramedullary K-wire was statistically weaker than that of both the plate and screw and the crossed wire.
Conclusions: One single antegrade intramedullary K-wire can provide a satisfactory M(max) and EI for metacarpal fixation and shows relatively weak in the torsional loading test. The injured finger should be well protected to avoid torsional deformity in clinical practice.
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Cureus
November 2024
Orthopaedics, Virginia Commonwealth University School of Medicine, Richmond, USA.
Distal femoral anterior cortical perforation is a rare complication of intramedullary nailing for proximal femur fractures. Awareness and intraoperative preventive measures are key to minimizing the risk of this complication. We report a case of a patient who experienced an anterior cortical breach of the distal femur during routine antegrade nailing for an intertrochanteric fracture, which was attributed to a sclerotic lesion in the distal femur.
View Article and Find Full Text PDFJ Med Case Rep
December 2024
Department of Internal Medicine, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
Introduction: Traumatic obturator-type anterior dislocation of the hip with an ipsilateral subtrochanteric fracture is rarely encountered in clinical practice. This case presentation described a trauma patient with such a rare scenario.
Case Report: This paper reports a case of a 20-year-old Amhara ethnic male patient who had a traumatic anterior dislocation of the hip associated with an ipsilateral subtrochanteric femur fracture after a truck rolled over.
OTA Int
March 2025
Department of Orthopedic Surgery, Detroit Medical Center, Detroit, MI.
Introduction: Intramedullary femoral nails (IMFNs) need to be removed for subsequent joint replacement, refracture, nonunion, or infection. The tools used to extract newer IMFNs may not be suited for removal of older implants, especially if broken. The purpose of this study was to describe a novel technique in femoral nail extraction when primary measures fail and a report on 6 cases where it was used.
View Article and Find Full Text PDFMalays Orthop J
November 2024
Department of Orthopaedic Surgery, Japanese Red Cross Ashikaga Hospital, Tochigi, Japan.
Introduction: Antegrade intramedullary nail fixation for humeral shaft fractures yields satisfactory union rates. However, one of the related concerns is damage to the rotator cuff during nail insertion, which may affect long-term outcomes. The effect of a rotator cuff lesion on mid- and long-term shoulder outcomes remains unknown.
View Article and Find Full Text PDFKurume Med J
November 2024
Department of Orthopaedic Surgery, Saiseikai Fukuoka General Hospital.
Background: The purpose of this study was to investigate the effect of the main fragment fracture type (oblique or transverse) on the union rate of femoral shaft fractures.
Methods: Patients who underwent surgical treatment with an antegrade intramedullary nail for femoral shaft fracture (Arbeitsgemeinschaft für Osteosynthesefragen / Orthopaedic Trauma Association; AO/OTA type 32 type B or C) between January 2009 and March 2021 were included in this study. Patients with oblique fractures of the two main fragments on radiographs immediately after surgery were classified into the oblique fracture group.
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