scholarly journals Refracture of the tibia 6 years after bilateral tibia nail removal in a patient later diagnosed with osteopetrosis

2010 ◽  
pp. 93 ◽  
Author(s):  
van Linge
Keyword(s):  
Nail Removal

scholarly journals Removal of a Broken Cannulated Intramedullary Nail: Review of the Literature and a Case Report of a New Technique

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Amr A. Abdelgawad ◽  
Enes Kanlic
Keyword(s):  
Case Report ◽  
Intramedullary Nail ◽  
Small Diameter ◽  
New Technique ◽  
Long Bones ◽  
Review Of The Literature ◽  
Tibial Nail ◽  
A New Technique ◽  
Nail Removal ◽  
Real Challenge

Nonunion of long bones fixed with nails may result in implant failure. Removal of a broken intramedullary nail may be a real challenge. Many methods have been described to allow for removal of the broken piece of the nail. In this paper, we are reviewing the different techniques to extract a broken nail, classifying them into different subsets, and describing a new technique that we used to remove a broken tibial nail with narrow canal. Eight different categories of implant removal methods were described, with different methods within each category. This classification is very comprehensive and was never described before. We described a new technique (hook captured in the medulla by flexible nail introduced from the locking hole) which is a valuable technique in cases of nail of a small diameter where other methods cannot be used because of the narrow canal of the nail. Our eight categories for broken nail removal methods simplify the concepts of nail removal and allow the surgeon to better plan for the removal procedure.

Radiographs of 366 removed limb lengthening nails reveal differences in bone abnormalities between different nail types

2021 ◽  
pp. 1-5
Author(s):  
Christopher A. Iobst ◽  
Markus Winther Frost ◽  
Jan Duedal Rölfing ◽  
Ole Rahbek ◽  
Anirejuoritse Bafor ◽  
...  
Keyword(s):  
Case Series ◽  
Limb Lengthening ◽  
Retrospective Case ◽  
High Prevalence ◽  
Nail Insertion ◽  
Radiological Changes ◽  
Low Prevalence ◽  
Nail Removal ◽  
Mean Time ◽  
Bone Abnormalities

Aims Limb lengthening nails have largely replaced external fixation in limb lengthening and reconstructive surgery. However, the adverse events and high prevalence of radiological changes recently noted with the STRYDE lengthening nail have raised concerns about the use of internal lengthening nails. The aim of this study was to compare the prevalence of radiological bone abnormalities between STRYDE, PRECICE, and FITBONE nails prior to nail removal. Methods This was a retrospective case series from three centres. Patients were included if they had either of the three limb lengthening nails (STYDE, PRECICE, or FITBONE) removed. Standard orthogonal radiographs immediately prior to nail removal were examined for bone abnormalities at the junction of the telescoping nail parts. Results In total, 306 patients (168 male, 138 female) had 366 limb lengthening nails removed. The mean time from nail insertion to radiological evaluation was 434 days (36 to 3,015). Overall, 77% of STRYDE nails (20/26) had bone abnormalities at the interface compared with only 2% of FITBONE (4/242) and 1% of PRECICE nails (1/98; p < 0.001). Focal osteolysis in conjunction with periosteal reaction at the telescoping interface was only observed in STRYDE nails. Conclusion Bone abnormalities at the interface of telescoping nail parts were seen in the majority of STRYDE nails, but only very rarely with FITBONE or PRECICE nails. We conclude that the low prevalence of radiological changes at the junctional interface of 242 FITBONE and 98 PRECICE nails at the time of nail removal does not warrant clinical concerns.

Nail Removal

2010 ◽  
pp. 854-856
Author(s):  
Andrew Moore ◽  
Robert E. Meehan
Keyword(s):  
Nail Removal

Femoral Nail Removal Should Be Restricted in Asymptomatic Patients

2004 ◽  
Vol 423 ◽  
pp. 222-226 ◽  
Author(s):  
Thomas G??sling ◽  
Tobias Hufner ◽  
Stefan Hankemeier ◽  
Boris A Zelle ◽  
Assia Muller-Heine ◽  
...  
Keyword(s):  
Femoral Nail ◽  
Asymptomatic Patients ◽  
Nail Removal

scholarly journals Treatment of FRI after intramedullary nailing of tibia fractures: assessment of nail retention and nail removal

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Jenna Jones ◽  
Brian Mullis ◽  
Bree Weaver ◽  
Roman Natoli
Keyword(s):  
Intramedullary Nailing ◽  
Delayed Union ◽  
Bone Union ◽  
Additional Patient ◽  
Multiple Parameters ◽  
Initial Fixation ◽  
Significant Difference ◽  
Primary Bone ◽  
Primary Union ◽  
Nail Removal

Objectives: Fracture related infection (FRI) is a severe, potentially limb-threatening complication after fracture fixation. Dilemma exists with regard to removing or retaining implants while treating the infection. The purpose of this study was to compare primary bone union and infection clearance in patients who had an infection following intramedullary nailing of the tibia treated either by retaining the implant or by removing the implant.    Methods: Patients from two level-I trauma centers were identified through billing registries and retrospectively reviewed between January 2013 and December 2020. We identified 44 patients who had a diagnosis of FRI within 90 days of their initial fixation and returned to the OR for operative treatment of the infection. The incidences of both primary union and infection clearance were calculated for both groups and multiple parameters that may be associated with success or failure were assessed.     Results: Four patients did not have complete records and were excluded. Of the remaining patients, 20 (50%) achieved infection clearance. Twenty-three (59%) patients achieved primary union whereas 16 (41%) had a primary outcome of either delayed union, nonunion, or amputation (one additional patient excluded as healing status unknown). Further analysis showed no significant difference (X2 (39) = 1.13, p < .29) in infection clearance between patients treated with nail retention (64%) versus nail removal (68%). No significant difference was seen in primary bone union (X2 (39) = 3.24, p < .07) with 36% of patients treated with nail retention and 68% of patients treated with nail removal reaching primary union; however, this does trend toward an association. Fewer surgeries performed for infection and complication after initial fixation was positively associated with infection clearance (p < .04, M=4.6, SD=2.13, df=39) and primary union (p < .001, M=4, SD=2, df=38).    Conclusion: Infection clearance seems similarly possible with both nail retention and nail removal strategies, with fewer number of surgeries performed for infection and complication improving the likelihood of infection clearance and bone union. This may suggest that more severe FRI’s are less likely to unite and clear infection. Nail removal may play a role in increasing primary bone union; however, a larger sample size is needed for more definitive assessment.  

scholarly journals Intramedullary reaming and irrigation and antibiotic-loaded calcium sulfate implantation for the treatment of infection after intramedullary nailing: a retrospective study of 19 cases

2020 ◽  
Author(s):  
Hong-An Zhang ◽  
Chun-Hao Zhou ◽  
Xiang-Qing Meng ◽  
Jia Fang ◽  
Cheng-He Qin
Keyword(s):  
Intramedullary Nailing ◽  
Distraction Osteogenesis ◽  
Intramedullary Nail ◽  
Calcium Sulfate ◽  
Bone Fractures ◽  
Weight Bearing ◽  
Bone Transport ◽  
Complication Rates ◽  
Nail Removal

Abstract Background: The incidence of intramedullary infection is increasing with increased use of intramedullary fixation for long bone fractures. However, appropriate treatment for infection after intramedullary nailing is unclear. The purpose of this study was to report the results of our treatment protocol for infection after intramedullary nailing: intramedullary nail removal, local debridement, reaming and irrigation, and antibiotic-loaded calcium sulfate implantation with or without segmental bone resection and distraction osteogenesis. Methods: We retrospectively reviewed the records of patients with an infection after intramedullary nailing treated from 2014 to 2017 at our center. Patients with follow-up of less than 24 months, received other treatment methods, or those with serious medical conditions were excluded from the analysis. Patients met the criteria were treated as described above, followed by distraction osteogenesis in 9 cases to repair bone defect. The infection remission rate, infection recurrence rate, and post-operative complication rates were assessed. Results: A total of 19 patients were included in the analysis. All of patients had satisfactory outcomes with an average follow-up of 38.1 ± 9.4 months (range, 24 to 55months). Eighteen patients (94.7%) achieved infection remission; 1 patient (5.3%) developed a reinfection that resolved after repeat debridement. Nine patients with bone defects (average size 4.7 ± 1.3 cm; range, 3.3 to 7.6 cm) were treated with bone transport which successfully restored the length of involved limb. The mean bone transport duration was 10.7 ± 4.0 months (range, 6.7 to 19.5 months). The majority of patients achieved full weight bearing and became pain free during the follow-up period. Postoperative complications mainly included prolonged aseptic drainage (7/19; 36.8%), re-fracture (1/19; 5.3%) and joint stiffness, which were successfully managed by regular dressing changes and re-fixation, respectively. Conclusion: Intramedullary nail removal, canal reaming and irrigation, and antibiotic-loaded calcium sulfate implantation (with or without distraction osteogenesis) is effective for treating infections after intramedullary nailing.

scholarly journals Intramedullary reaming and irrigation and antibiotic-loaded calcium sulfate implantation for the treatment of infection after intramedullary nailing: a retrospective study of 19 cases

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Hong-An Zhang ◽  
Chun-Hao Zhou ◽  
Xiang-Qing Meng ◽  
Jia Fang ◽  
Cheng-He Qin
Keyword(s):  
Intramedullary Nailing ◽  
Distraction Osteogenesis ◽  
Intramedullary Nail ◽  
Calcium Sulfate ◽  
Bone Fractures ◽  
Weight Bearing ◽  
Bone Transport ◽  
Complication Rates ◽  
Nail Removal

Abstract Background The incidence of intramedullary infection is increasing with increased use of intramedullary fixation for long bone fractures. However, appropriate treatment for infection after intramedullary nailing is unclear. The purpose of this study was to report the results of our treatment protocol for infection after intramedullary nailing: intramedullary nail removal, local debridement, reaming and irrigation, and antibiotic-loaded calcium sulfate implantation with or without segmental bone resection and distraction osteogenesis. Methods We retrospectively reviewed the records of patients with an infection after intramedullary nailing treated from 2014 to 2017 at our center. Patients with follow-up of less than 24 months, received other treatment methods, or those with serious medical conditions were excluded from the analysis. Patients met the criteria were treated as described above, followed by distraction osteogenesis in 9 cases to repair bone defect. The infection remission rate, infection recurrence rate, and post-operative complication rates were assessed. Results A total of 19 patients were included in the analysis. All of patients had satisfactory outcomes with an average follow-up of 38.1 ± 9.4 months (range, 24 to 55 months). Eighteen patients (94.7%) achieved infection remission; 1 patient (5.3%) developed a reinfection that resolved after repeat debridement. Nine patients with bone defects (average size 4.7 ± 1.3 cm; range, 3.3 to 7.6 cm) were treated with bone transport which successfully restored the length of involved limb. The mean bone transport duration was 10.7 ± 4.0 months (range, 6.7 to 19.5 months). The majority of patients achieved full weight bearing and became pain free during the follow-up period. Postoperative complications mainly included prolonged aseptic drainage (7/19; 36.8%), re-fracture (1/19; 5.3%) and joint stiffness, which were successfully managed by regular dressing changes and re-fixation, respectively. Conclusion Intramedullary nail removal, canal reaming and irrigation, and antibiotic-loaded calcium sulfate implantation (with or without distraction osteogenesis) is effective for treating infections after intramedullary nailing.

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