Intramedullary nailing has become the gold standard in surgical treatment for long bones shaft fractures. Many intraoperative complications may occur. We report an unusual complication of trapped bone fragments between the reamer and the cortex during intramedullary nailing of a simple femur shaft fracture. All Attempts to withdraw the reamer were unsuccessful. The fragments had to be removed through an open incision. This complication was probably caused by a migrated chip of cortical bone fragment from the inner cortex which caused incarceration of the reamer. If a loose intramedullary fragment is noted during nailing, it must absolutely not be ignored.
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http://dx.doi.org/10.1016/j.tcr.2023.100909 | DOI Listing |
Int J Surg
January 2025
Department of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Purpose: Congenital pseudarthrosis of the tibia (CPT) is a rare condition typically manifesting within the first decade of life. The primary objectives of surgical intervention for CPT include achieving long-term bony union of the tibia, preventing or minimizing limb length discrepancies (LLD), avoiding mechanical axis deviations of the tibia and adjacent joints, and preventing refracture. This study aims to conduct a systematic review of current treatment methods for CPT to determine the most effective non-surgical and surgical management strategies for pediatric patients with this condition.
View Article and Find Full Text PDFCureus
December 2024
Trauma and Orthopaedics, Northwick Park Hospital, London, GBR.
Distal fibula fractures involving the ankle are one of the most common fractures, often requiring open reduction and internal fixation with plates and screws. The increased incidence of potential wound complications arising from open reduction methods led to a rejuvenated interest in the application of minimally invasive methods like intramedullary nailing of the fibula in the management of ankle fractures and isolated distal fibular fractures. A literature search was performed using Medline, Cochrane, and Embase from 1993 to 2023.
View Article and Find Full Text PDFPLoS One
January 2025
Çukurova University Faculty of Medicine, Department of Orthopedics and Traumatology, Adana, Türkiye.
Background: This study aimed to analyze the files of patients treated using PFN-A or INTERTAN intramedullary nails to reveal additional superiorities or disadvantageous factors for selecting the better intramedullary fixation method in patients presenting with intertrochanteric femur fractures.
Methods: In this retrospective study, the files of the patients who were operated on for intertrochanteric femur fractures using intramedullary fixation methods between September 2010 and June 2015 in the Orthopedics and Traumatology Clinic, Çukurova University Faculty of Medicine, were reviewed. The data including age, gender, chronic diseases, causes of fractures, fracture classification based on Arbeitsgemeinschaft für Osteosynthesefragen (AO), the nail type (long or short), the interval between trauma and surgery, duration of anesthesia and surgery, hospitalization duration, amount of blood transfusion, the Tip-Apex Distance (TAD) in postoperative radiographs, functional outcomes according to Harris Hip Score (HHS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), postoperative complications, need for revision, and mortality was noted.
Background: Intramedullary screw (IMS) fixation for metacarpal fractures is a relatively new fixation technique in comparison to plate and screw constructs. Our hypothesis evaluated whether IMS fixation for metacarpal fractures results in lower overall health care-associated costs in comparison to open reduction and internal fixation (ORIF).
Methods: A retrospective review of patients undergoing IMS fixation for metacarpal fractures at a single center during 2018 to 2022 was conducted.
J Orthop Surg Res
January 2025
Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China.
Background: Finite element analysis (FEA) could advance the understanding of fracture fixation and guide the choice of surgical treatment. This study aimed to compare two internal fixation methods in the treatment of displaced proximal humeral fracture (PHF) through FEA.
Methods: Three-dimensional FEA model based on the left shoulder joint of a 67-year-old female patient with PHFs and osteoporosis was adopted, in order to analyze the fixation effect and load stress distribution of internal fixation plates with open reduction and intramedullary nails without opening the fracture in the treatment of Neer III-VI PHF.
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