Failure of medullary tubes

Taub, Marc B.; Wera, Glenn D.; Dauskardt, Reinhold H.; Mohler, David G.

doi:10.1016/s0020-1383(03)00307-3

Cited by 5 publications

(5 citation statements)

References 3 publications

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“…Material analysis demonstrated that medullary tubes with more than 100 autoclave cycles are more likely to break. 6 Unused tubes are white in colour, whereas tubes with repeated autoclave cycles progresses from yellow to brown. 6 In our case, we suspect that our Teflon tube was used more than 200 times.…”

Section: Discussionmentioning

confidence: 99%

“…6 Unused tubes are white in colour, whereas tubes with repeated autoclave cycles progresses from yellow to brown. 6 In our case, we suspect that our Teflon tube was used more than 200 times. Therefore, prior to beginning the surgery, we recommend checking the Teflon tube by inspecting it for colour changes and damages, as well as testing its flexibility.…”

Section: Discussionmentioning

confidence: 99%

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A Novel Closed Method to Retrieve Broken Teflon Tube during Intramedullary Nailing in Proximal Humeral Fracture

Lau

Chan

Koo

et al. 2017

Journal of Orthopaedics, Trauma and Rehabilitation

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Broken medullary tubes have been used for intramedullary (IM) nailing of femoral and tibial fractures. In these reported cases, fragments of the medullary tube were retrieved by opening the fracture sites or left in situ, which might jeopardize periosteal blood supply. We herein present the case of a 58-year-old woman who underwent IM nailing for proximal humeral fracture, which was complicated by breakage of the medullary tube intraoperatively. Different instruments including guide rods, straight forceps, and cement extract hook were used to retrieve the retained fragments from the medullary canal, but these attempts were unsuccessful. Finally, the fragments were successfully removed using an anterior cruciate ligament (ACL) ENDOBUTTON depth gauge. This case highlights that medullary tubes can break during humeral IM nailing, which could be minimized by ensuring integrity of the medullary tube prior to surgery and disposing medullary tubes with more than 100 exposures. A novel method of using ACL ENDOBUTTON depth gauge to retrieve retained tube fragments is recommended because of its long and slim design.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Novel Closed Method to Retrieve Broken Teflon Tube during Intramedullary Nailing in Proximal Humeral Fracture

Lau

Chan

Koo

et al. 2017

Journal of Orthopaedics, Trauma and Rehabilitation

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“…4 The appearance and mechanical properties of the medullary tube change over time. 5 When the medullary tube is new, it is white and flexible, which allows bending into a semicircle. With repeated autoclaving, the medullary tube becomes yellowish.…”

Section: Discussionmentioning

confidence: 99%

“…The presence of surface flaws and degradation of the surface finish act as stress risers and nucleation points for crack propagation. 5 When the bent ball-tipped reaming guide wire is forced through the opening of the medullary tube, cracks along the surface flaw of the medullary tube propagate along the direction of pull of the reaming guide wire. This breaks the radiopaque wire.…”

Section: Discussionmentioning

confidence: 99%

“…The medullary tube should also be replaced before 100 exposures to autoclaving. 5 Excessive acute bending should be avoided in the ball-tipped reaming guide wire, and its smooth passage through the medullary tube should be checked before it is placed into medullary canal. If an acute bend is necessary to cross the fracture site or whenever difficulty is felt in retrieving the ball-tipped reaming guide, the medullary tube should not be used to exchange the guide wire.…”

Section: Discussionmentioning

confidence: 99%

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