Leg length discrepancies can occur despite successful union of femur fractures after intramedullary nailing (IMN). Often, the leg length discrepancy can result in significant disability to the patient, altered gait biomechanics, pelvic obliquity, and pain. Therefore, a successful clinical result for such deformities after IMN involves addressing the leg length inequality. Femoral reconstruction...

OBJECTIVE The humerus is a common site for metastasis. Intramedullary nail fixation has been reported to be the best form of fixation for this disease but complications occur. This study aimed to assess the use of a new humeral nail to treat pathological fractures and impending pathological fractures of the humerus. METHODS 29 patients received 31 Austofix locked intramedullary humeral nails:...

Background: Surgeons agree on the benefits of operative treatment of tibial fractures – the most common of long bone fractures – with an intramedullary rod or nail. Rates of re-operation remain high – between 23% and 60% in prior trials – and the two alternative nailing approaches, reamed or non-reamed, each have a compelling biological rationale and strong proponents, resulting in ongoing cont...

OBJECTIVE To determine the outcome of intramedullary interlocking surgical implant generation network (SIGN) nail in diaphyseal tibial fractures in terms of union and failure of implant (breakage of nail or interlocking screws). STUDY DESIGN Case series. PLACE AND DURATION OF STUDY Orthopaedics and Spinal Surgery, Ghurki Trust Teaching Hospital, Lahore Medical and Dental College, Lahore, fr...

We describe a patient with insufficient bone regeneration of the tibia after bone transport over an intramedullary nail, in whom union was ultimately achieved after exchange nailing and intramedullary application of rh-bone morphogenetic protein-7 at the site of distraction.

Compression was evaluated in an intramedullary hindfoot arthrodesis cadaver model using an external fixator and a "second generation" intramedullary compression nail. Four cadaver specimens were used. Four trials were done with each specimen. Trial 1: manual compression with the 1st generation nail. Trial 2: external fixator for compression with the 1st generation nail. Trial 3: external fixato...

BACKGROUND It has been observed clinically that the Z-effect is a potential cause of failure of an intramedullary nail with two cephalic screws. It describes the migration behavior of the cephalic screws in the femoral head. The primary objective was to examine different cephalic screw configurations and test the load distribution between them as a function of their relative placement and their...

Patients with in situ intramedullary nails sustaining a second distal femoral fracture following high-velocity trauma are infrequently reported in the literature. We report 5 such patients who sustained a second injury after 6 to 24 months, resulting in another fracture at the nail-tip level. These second fractures severely comminuted the femoral condyles. These patients required removal of the...

We reviewed 46 leg-shortening operations (37 femoral and nine tibial), performed by different methods, to assess the incidence of complications and permanent disability. Shortening of as much as 7.5 cm in the femur and 5 cm in the tibia was achieved in men of normal height without any loss of function. Complications were seen with all surgical techniques despite the use of modern implants. Most...

OBJECTIVE We describe a new technique for removing the distal fragments of broken intramedullary femoral nails without disturbing the nonunion site. METHODS This technique involves the application of an AO distractor prior to the removal of the nail fragments, with subsequent removal of the proximal nail fragment in an anterograde fashion and removal of the distal fragment through a medial pa...