Patient positioning for closed locked tibial nailing

Hill, Ruaraidh; Albert, J. S.

doi:10.1016/0020-1383(90)90099-g

Cited by 7 publications

(3 citation statements)

References 2 publications

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“…One of the frequently discussed benefits of the semi-extended position for IM nailing is that the limb positioning allows for a more reliable reduction and maintenance of reduction, and easier intraoperative fluoroscopy evaluation. 43–45 This is supported by the significant decrease in fluoroscopy time reported in the SP group. One explanation for this may be that the SP approach allows for a more consistent method to establish the tibial insertion point.…”

Section: Discussionmentioning

confidence: 66%

Comparison of Patient-Reported Outcomes After Suprapatellar Versus Infrapatellar Nailing Techniques for Tibial Shaft Fractures: A Systematic Review and Meta-analysis

Sepehri

You

Lobo

et al. 2022

Journal of Orthopaedic Trauma

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Section: Discussionmentioning

confidence: 66%

Comparison of Patient-Reported Outcomes After Suprapatellar Versus Infrapatellar Nailing Techniques for Tibial Shaft Fractures: A Systematic Review and Meta-analysis

Sepehri

You

Lobo

et al. 2022

Journal of Orthopaedic Trauma

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“…Other advantages of the intraoperative OTT and skeletal traction are the consistency of traction and the ability to perform the surgery with a single assistant [32,33]. However, reported complications associated with the use of trans-calcaneal traction, though rare, include subtalar encroachment, hemorrhage and pain at entry point secondary to neuroma [34].…”

Section: Discussionmentioning

confidence: 99%

Displaced diaphyseal tibia fractures managed by elastic stable intramedullary nailing with or without the use of intraoperative traction table during nail insertion: a comparative analysis of 160 patients

Alberghina

Andreacchio

Cravino

et al. 2020

Journal of Pediatric Orthopaedics B

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The use of an orthopedic traction table (OTT) during elastic stable intramedullary nailing (ESIN) in the management of displaced diaphyseal tibia fractures (DTFs) is controversial. The aim of this study was to evaluate the clinical and radiological outcome of children with displaced DTF managed by ESIN with and without the use of an OTT. Medical records were retrospectively reviewed for all pediatric patients sustaining DTF managed by ESIN from 2011 to 2019 at two different institutions. In all, 160 consecutive children with displaced DTF were recorded, of whom 80 underwent operative treatment by ESIN without OTT (group A), and 80 by ESIN with the use of an OTT and skeletal traction (group B). ESIN outcome measure scale, Beaty radiologic criteria and Radiographic Union Scale for Tibia fractures (RUST) score were used to evaluate the results. Average patient age at time of injury was 10.8 years (range 7-15). The mean follow-up was 55.8 months (range 12-96). All complications (2.5%) and poorer results according to ESIN outcome measure scale and Beaty radiological criteria were recorded among children managed with OTT. No complications related to pin insertion for skeletal traction were observed. Mean RUST score, length of surgery and cumulative time of radiation exposure were comparable between the two groups. Children with a displaced DTF treated by ESIN without the use of OTT showed superior results as there are no additional procedures (traction wire insertion and removal) decreased theater time and no complications with similar radiation dose.

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“…Zur Lagerung des Patienten bei der Unterschenkelmarknagelung galt bis vor kurzem der Extensionstisch als Standard [9]. Der Aufbau des Tisches erfordert aber geschultes Personal und kann je nach Situation bis zu 30 min in Anspruch nehmen [2,3]. Zusätzlich müssen Extensionsdrähte durch das Fersenbein geschossen oder der Fuß in einen Lagerungsschuh eingespannt werden, was einen zusätzlichen invasiven Eingriff erfordert und sich bei Begleitverletzungen des Fußes zum Teil verbietet.…”

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Einfache Lagerungshilfe zur Unterschenkelmarknagelung

Prokop¹,

Isenberg²,

Hahn³

et al. 2004

Akt Traumatol

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EinleitungDie Marknagelung gilt heutzutage als Therapie der ersten Wahl bei Unterschenkelfrakturen in den mittleren drei Fünfteln des Schaftes [4,9]. Die Osteosynthesen sind frühzeitig belastbar und ersparen dem Patienten lange Immobilisationszeiten. Bei den offenen Frakturen sowie bei polytraumatisierten Patienten und beim schweren Thoraxtrauma werden ungebohrte Nägel empfohlen, ansonsten werden gebohrte Marknägel eingesetzt, die je nach Frakturform belastungsstabil sind [4,9]. An den Metaphysen sind Marknagelungen nur mit ergänzenden Schrauben-und Plattenosteosynthesen sicher möglich und bleiben dem versierten Traumatologen vorbehalten [7]. Hier haben die neuen winkelstabilen Plattensysteme, die weichteilschonend unter Erhalt des Periostes eingebracht werden, die erste Priorität [8]. ZusammenfassungUnterschenkelfrakturen in den mittleren drei Fünfteln werden in der Regel durch Marknagelung behandelt. Die Lagerung des Patienten auf einem Extensionstisch erfordert einen erheblichen zeitlichen Mehraufwand bei erhöhten intramedullären Drucken. Eine alternative Lagerung auf einem Normaltisch erfordert einen zusätzlichen Assistenten zur Fixierung des Beines und führt unwillkürlich zu ungewollten Bewegungen im Bein. Dadurch werden unnötig Ressourcen im OP gebunden. Eine einfache variable Lagerung des Beines auf einem Rahmen aus 4 Fixateur-Karbonstangen ermöglicht hingegen eine einfache Reposition und Nagelung mit einem Operateur und bei Bedarf einen zusätzlichen Assistenten. 50 Unterschenkelfrakturen wurden seit 1996 mit dieser Lagerungshilfe genagelt. Die durchschnittliche Operationszeit betrug bei gebohrten Nägeln 63 min und bei ungebohrten Nägeln 55 min. Zusätzliche Lagerungszeiten wurden vermieden. AbstractLower leg fractures localised in the middle three fifths of tibial shaft are stabilised by intramedullary nailing. Patients' positioning on an extension table involves a loss of time and causes an increase of intramedullary pressure. The alternative positioning on a normal table requires an additional assistant to hold the leg and is associated with spontaneous and unwanted movements in the leg. Furthermore, there is a unnecessary need for personal capacities. A variable positioning of the leg can be easily reached by means of a frame made of carbon fixateur rods. Reduction and nailing can be performed by a single operator without help of a further surgeon. Fifty lower leg fractures have been operated since 1996 by means of this positioning aid. Mean operation time was 63 min for reamed and 55 min for unreamed nailing.

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Patient positioning for closed locked tibial nailing

Cited by 7 publications

References 2 publications

Comparison of Patient-Reported Outcomes After Suprapatellar Versus Infrapatellar Nailing Techniques for Tibial Shaft Fractures: A Systematic Review and Meta-analysis

Comparison of Patient-Reported Outcomes After Suprapatellar Versus Infrapatellar Nailing Techniques for Tibial Shaft Fractures: A Systematic Review and Meta-analysis

Displaced diaphyseal tibia fractures managed by elastic stable intramedullary nailing with or without the use of intraoperative traction table during nail insertion: a comparative analysis of 160 patients

Einfache Lagerungshilfe zur Unterschenkelmarknagelung

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