Search results for "Intramedullary"

Locked Plate Fixation and Intramedullary Nailing for Proximal Humerus Fractures: A Biomechanical Evaluation

2005

Background Internal fixation of proximal humeral fractures is associated with a considerable secondary malalignment rate. Fixed-angle implants have been suggested to increase the stability of fixation. Methods The biomechanical properties of four different implants were tested. These included an internal fixator with semi-elastic properties (reference), the Synthes T-plate, a locked plate with rigid properties and a spiral blade locked intramedullary nail (PHN). These implants were assessed in twenty-four osteotomized pairs of human cadaveric humeri. Specimens were subjected to two-hundred cycles of axial loading and torque followed by load to failure. Results The PHN had greater axial stif…

Isolated Pediatric Intramedullary Schwannoma: Case Report and Review of Literature

2018

Background: Intramedullary (IM) schwannomas are rare entities representing 0.3%−1% of intramedullary tumors and 1.1% of spinal schwannomas. Beside many theories proposed, their rare occurrence might be related to the absence of Schwann cells in the spinal cord. Pediatric IM schwannomas are uncommon, and in the absence of neurofibromatosis they are extremely rare. To date, few cases have been reported in the literature. Case Description: We describe the case of an 8-year-old female affected by a progressive paraparesis. Neuroradiologic investigations showed an oval-shaped mass at the level of T10-T11. The patient underwent surgery, performed under neurophysiologic monitoring. The patient was…

Callus distraction of the femur and tibia. Experience with the Monofixator - indications for reosteosynthesis

1998

In a 4-year period, 18 patients underwent callus distraction of the femur or tibia with the use of a unilateral external fixator. Twelve patients had post-traumatic bone loss resulting from complex lower-limb fractures. The bony defect was located in the tibia in 11 cases and in the femur in one case. All patients had major associated soft-tissue lesions. The length of the bony defect averaged 6.25 cm. Eight fractures were infected at the beginning of treatment. Six other patients underwent callus distraction for reasons of limb shortening. Five femora and one tibia were lengthened. The average increase in length was 6.5 cm. There were no fixator-related complications during distraction. Th…

Ergebnisse nach primärer ungebohrter Tibianagelung von Unterschenkelfrakturen mit schwerem offenem oder geschlossenem Weichteilschaden

1996

Primary stabilization was performed in 72 tibial fractures with sever open (n = 37) or closed (n = 35) soft tissue injury using unreamed interlocking nails. In 60 (83%) cases the fractures healed without additional procedures. There were 2 cases of osteitis, but both these fractures healed after removal of the nail or after reamed nailing. In 9 patients with delayed union reamed nailing (n = 8) or bone grafting (n = 1) led to healing. In 1 patient with hypertrophic pseudarthrosis, union was achieved after substitution of a reamed nail for the anreamed nail. The infection rate was similar to that observed with external fixation. More secondary procedures, such as bone grafting or a change of…

Spinal Intradural Intramedullary Dissemination in the Absence of Intracranial Relapse of a Previously Radically Treated Temporal Lobe Glioblastoma Mu…

2017

Intracranial glioblastoma multiforme (GBM) constitutes the most frequent and unfortunately aggressive primary central nervous system malignancy. Despite the high tendency of these tumors to show local relapse within the brain after primary therapy, dissemination into the spinal axis is an infrequent event. If spinal metastases occur they are leptomeningeal in the vast majority of cases and always in the context of intracranial progressive disease. Spinal intramedullary metastases of intracranial GBM have rarely been described to date. We report the unique case of a young woman with subacute progressive paraparesis due to spinal intramedullary metastases of a temporal lobe GBM despite the re…

Giant enchondroma recurrence of the proximal phalanx of the fifth finger: A case report

2020

Enchondroma (EC) is a benign and cartilage-forming tumor that causes intramedullary lesions. Moreover, EC is the most common bone tumor in the phalanges and metacarpal bones of the hand, deforming the structure and causing pain and functional limitation. The management of this neoplasia is the surgical treatment and the approach that is well-accepted consists in the curettage followed by the void augmentation with biological or synthetic fillers. The results from surgery are usually good and the recurrence rate is low (2-15%). In this article we report a case of EC recurrence of the proximal phalanx of the fifth finger of the hand after curettage and grafting. The patient was treated with t…

Internal Fixation of Proximal Humeral Fractures: Current Concepts

2003

Fractures of the proximal humerus are an increasingly common type of injury. Mainly elderly patients with osteoporotic bone are affected. Whereas non-displaced and stable fractures are managed successfully with conservative treatment, there is no general agreement on the surgical strategy for displaced and unstable two- to four-part fractures. The clinical outcome is influenced by the fracture type and concomitant injury to the rotator cuff. Extensive surgical manipulation of the soft tissues, non-anatomic and/or unstable fixation as well as technical errors are important contributing factors to poor clinical results. Goals of surgical treatment are to restore anatomy, to achieve fixation t…

Nonreamed flexible locked intramedullary nailing in tibial open fractures

1998

Thirty-nine open unstable tibial shaft fractures were treated with a nonreamed flexible locked intramedullary nail between 1992 and 1995. There were 23 Grade I, 12 Grade II, three Grade IIIA, and one Grade IIIB fractures. The average time of followup assessment was 24 months. The average time to fracture union was 24 weeks. Complications were related in most cases to fractures with highly unstable patterns and extensive soft tissue lesions. There were five (12.5%) delayed unions and one (2.5%) nonunion. Deep infections developed in three (7.7%) patients. One patient required an additional procedure to correct a varus malunion. There were no implant failures. It was concluded that nonreamed …

2014

Currently, antegrade intramedullary nailing and minimally invasive plate osteosynthesis (MIPO) represent the main surgical alternatives in distal tibial fractures. However, neither choice is optimal for all bony and soft tissue injuries. The Retrograde Tibial Nail (RTN) is a small-caliber prototype implant, which is introduced through a 2-cm-long incision at the tip of the medial malleolus with stab incisions sufficient for interlocking. During this project, we investigated the feasibility of retrograde tibial nailing in a cadaver model and conducted biomechanical testing. Anatomical implantations of the RTN were carried out in AO/OTA 43 A1-3 fracture types in three cadaveric lower limbs. B…

Biomechanical evaluation of a new treatment method for distal tibia fractures

2015

Distal tibial fractures are often the result of high-energy impacts combined with excessive soft tissue injury. Treatment options include either open reduction and internal fixation usually as a mi...