Advances in Tibial Nailing

Hsu, Joseph R.; Dickson, Kyle

doi:10.1007/3-540-32345-7_8

Cited by 4 publications

(8 citation statements)

References 52 publications

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“…In the materials field, a strong novelty was also introduced in the 1990s with the adoption of titanium, a new material competing with the until then commonly used AISI 136 LVM ASTM F138 stainless steel (generally known as medical‐grade stainless steel) . Today, both materials are widely accepted; however, there is a preferential tendency for titanium alloy owing to its attractive mechanical properties (see Table ), such as Young's modulus closer to the intact diaphyseal cortical bone, higher fatigue strength and yield strength, and the fact that it is biocompatible and shows less magnetic resonance imaging interference than that observed for stainless steel implants . Today, the increased preference for limited reaming or “ream‐to‐fit” techniques allowed the adoption of anatomically smaller diameter nails, which in static locked mode provide a sufficiently large interfragmentary motion that favors callus development .…”

Section: The Evolutionary Biomechanical Landmarksmentioning

confidence: 99%

“…3,14,[29][30][31][32] Today, the increased pref-erence for limited reaming or "ream-to-fit" techniques allowed the adoption of anatomically smaller diameter nails, which in static locked mode provide a sufficiently large interfragmentary motion that favors callus development. 10,21,32 Despite its effectiveness and reliability as a stabilization system, intramedullary nailing is still subject to constant upgrades that aim to improve the time and quality of the callus formation, as described below.…”

Section: The Evolutionary Biomechanical Landmarksmentioning

confidence: 99%

“…Today, both materials are widely accepted; however, there is a preferential tendency for titanium alloy owing to its attractive mechanical properties (see Table ), such as Young's modulus closer to the intact diaphyseal cortical bone, higher fatigue strength and yield strength, and the fact that it is biocompatible and shows less magnetic resonance imaging interference than that observed for stainless steel implants . Today, the increased preference for limited reaming or “ream‐to‐fit” techniques allowed the adoption of anatomically smaller diameter nails, which in static locked mode provide a sufficiently large interfragmentary motion that favors callus development . Despite its effectiveness and reliability as a stabilization system, intramedullary nailing is still subject to constant upgrades that aim to improve the time and quality of the callus formation, as described below.…”

Section: The Evolutionary Biomechanical Landmarksmentioning

confidence: 99%

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Recent developments on intramedullary nailing: a biomechanical perspective

Rosa

Marta

Vaz

et al. 2017

Annals of the New York Academy of Sciences

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Combining contributions from engineering and medicine, we highlight the biomechanical turning points in the historical evolution of the intramedullary nailing stabilization technique and discuss the recent innovations concerning increase in bone-implant system stability. Following the earliest attempts, where stabilization of long bone fractures was purely based on intuition, intramedullary nailing evolved from allowing alignment and translational control through press-fit fixation to current clinical widespread acceptance marked by the mechanical linkage between nail and bone with interlocking screws that allow alignment, translation, rotation, and length control. In an attempt to achieve an optimum interfragmentary mechanical environment, recent improvements considered the impact of different biomaterials on bone-implant stiffness. Another strategy considered the increase in the structural stability through the reduction of the number of movements between the different components that constitute the bone-implant system. Intramedullary nail improvements will most likely benefit from merging mechanics and fracture-healing biology by combining surface engineering with sensor tools associated with the innovative progress in wireless technology and with bone-healing biological active agents. Future research should aim at better understanding the ideal mechanobiological environment for each stage of fracture healing in order to allow for intramedullary nail design that satisfies such requirements.

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Section: The Evolutionary Biomechanical Landmarksmentioning

confidence: 99%

Section: The Evolutionary Biomechanical Landmarksmentioning

confidence: 99%

Section: The Evolutionary Biomechanical Landmarksmentioning

confidence: 99%

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Recent developments on intramedullary nailing: a biomechanical perspective

Rosa

Marta

Vaz

et al. 2017

Annals of the New York Academy of Sciences

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“…Closed intramedullary nailing has become the ''gold standard'' in the treatment of displaced fractures of the tibial shaft. [1][2][3][4][5][6][7][8][9] Due to their nature, intramedullary nails require high mechanical performance compared to their dimensions. Such occurrence has in turn driven a steadily growing request for high performance materials in terms of mechanical properties.…”

Section: Introductionmentioning

confidence: 99%

Experimentally validated structural finite element method analysis of a tibial intramedullary nail: Optimal choice of the contact settings

Croccolo

Agostinis

Fini

et al. 2018

Proc Inst Mech Eng H

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This article focuses on the static structural analysis of a tibial intramedullary nail, carried out by the finite element method. The investigated subject is concerned with the issue of frictional contacts that, generating a non-linear problem, play an important role in numerical analyses. Experimental tests were also developed on tibial intramedullary nail specimens. The experimental results, in terms of force-displacement, were used to calibrate and validate the finite element analysis, by tuning the contact parameters available in the software.

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“…[1] Kanal içi çivileme hem kilitli hem de kilitsiz olarak uygulanabilen, yüksek stabilite sağlaması ve erken yük vermeye izin vermesi gibi avantajlara sahip bir yöntemdir. [2][3][4] Kilitli kanal içi çivileme, stabil ve minimal invaziv bir yöntem olmakla birlikte gelişen teknolojiye rağmen yüksek ameliyat sırası ve sonrası komplikasyon riski, uzun cerrahi süre-si ve aşırı radyasyona maruz kalma gibi dezavantajlara sahiptir. [2,5] Diğer yandan, kilitsiz kanal içi çivileme, uygulama kolaylığı, kısa cerrahi süresi, daha düşük radyasyona maruz kalma gibi avantajlara sahipken özellikle rotasyonel instabilite, çivinin proksimale yer değiştirmesi, kötü kaynama (malunion) ve bazen alçı gibi ek tespit gerektirmesi bu yöntemin dezavantajları-nı oluşturmaktadır.…”

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Unlocked using of interlocked intramedullary nails in tibial shaft fractures

Saruhan¹

2013

Eklem Hastalik Cerrahisi

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Amaç: Bu çalışmada tibia cisim kırıklarında, kilitli kanal içi çivilerin kilitsiz kullanımının incelemesi ve sonuçlarının kilitli çivilerle karşılaştırılması amaçlandı. Hastalar ve yöntemler: Aralık 2006 -Temmuz 2011 tarihleri arasında kliniğimizde tibia cisim kırığı nedeniyle kilitli (n=15) ve kilitsiz kanal içi çivi uygulanan (n=15) toplam 30 hastanın tıbbi kayıtları geriye dönük olarak incelendi. Her iki grup da cinsiyet dağılımları, yaş ortalaması, yaralanma mekanizması, kırık yeri ve şekli, açık kırık tipi ve taburcu süreleri açısından benzerdi. Radyolojik ve fonksiyonel değerlendirme Johner-Wruhs kriterlerine uygun olarak gerçekleştirildi. Bulgular: Kilitsiz grupta bütün hastalardan mükemmel ve iyi fonksiyonel sonuç elde edilirken, kilitli grupta 11 hastada mükemmel ve iyi sonuç, dört hastada ise orta ve kötü sonuç vardı. Bu grupta dört hastaya dinamizasyon uygulandı. Kaynama açısından her iki grup benzerdi. Fonksiyonel sonuç-larda istatistiksel olarak anlamlı fark yoktu. Sonuç: Tibia cisim kırıklarında öncelikli tedavi yöntemi kilitli kanal içi çivileme olmakla beraber, uygun hastalarda kilitsiz çivilemenin de travmatolojik cerrahi pratiğinde yer bulabileceği kanaatindeyiz.Anahtar sözcükler: Kırık sabitlenmesi; intramedüler; tibia kırıkları. Objectives:This study aims to investigate unlocked using of locked intramedullary nails in tibial shaft fractures and to compare the results to those of locked nails. Patients and methods: Between December 2006 and July 2011, medical records of a total of 30 patients who underwent locked (n=15) or unlocked intramedullary nails (n=15) due to tibial shaft fracture in our clinic were retrospectively analyzed. Gender distribution, mean age, injury mechanism, location and morphology of the fracture, type of open fracture and time of discharged from hospital were similar in both groups. Radiological and functional evaluation was carried out according to Johner-Wruhs criteria. Results: Excellent and good functional results were obtained in unlocked group of all patients, while there were 11 excellent and good, four fair and poor results in locked group. Dynamization was performed on four patients in this group. It was similar in terms of union between the groups. There was no statistically significant difference in functional results. Conclusion: We concluded that unlocked nailing would be taken place in practice of traumatologic surgery at appropriate cases, although primary treatment method is locked intramedullary nailing in tibial shaft fractures.

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Advances in Tibial Nailing

Cited by 4 publications

References 52 publications

Recent developments on intramedullary nailing: a biomechanical perspective

Recent developments on intramedullary nailing: a biomechanical perspective

Experimentally validated structural finite element method analysis of a tibial intramedullary nail: Optimal choice of the contact settings

Unlocked using of interlocked intramedullary nails in tibial shaft fractures

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