Uncorrected bony deformity or stiffness resulting from a metacarpal shaft fracture can produce a significant functional or cosmetic deficit. Intramedullary fixation of metacarpal shaft fractures using small flexible rods can provide stable internal fixation while minimizing the extent of soft tissue trauma that is associated with more extensive surgical techniques such as plate or screw fixatio...

INTRODUCTION The basic principle of non-surgical fracture treatment is to restore the original anatomical position of fractured fragments by different techniques, without direct access to the bone and without further traumatizing of tissues. Intramedullary nailing is synthesis and consolidation of fracture fragments with the main goal to gain strength and permanent placement of the implants. Tw...

In a frail elderly patient a pathological fracture of the femur at the lower end of a loose femoral stem was treated by the retrograde insertion of an intramedullary nail over the tip of the prosthesis.

BACKGROUND The treatment of an infected intramedullary nail is a challenging and serious complication. Normally, treatment involves the removal of metalwork, followed by washout and debridement of the infected bone. This can leave the bone and any fracture unsupported. We promote using a threaded Ilizarov rod encased with antibiotic impregnated Palacos® cement (Heraeus, Wehrheim, Germany) to ac...

We report four patients who sustained secondary fractures of the posterior wall of the tibial shaft during the removal of one pattern of intramedullary nail after fracture healing. The cause of this complication is discussed.

We report a patient who sustained massive catastrophic pulmonary fat embolism while undergoing surgery for intramedullary nail of femur. Application of percutaneous cardiopulmonary support, in our view, saved the patient from cardiopulmonary collapse.

Intramedullary nailing with expandable nails is one of the techniques available for the treatment of fractures of long bones. Concerns regarding bony union have been reported in medical literature, but no case of femoral nail breakage secondary to delayed union has been reported to date. We present a case of a broken expandable femoral nail secondary to delayed union, and we describe the techni...

Proper ligament balancing, restoration of the mechanical axis and component alignment are essential for the success and longevity of a prosthesis. In conventional total knee arthroplasty (TKA), an intramedullary guide is used to improve the alignment. An extramedullary guide can be used in cases of severe femoral bowing or intramedullary nailing but its use is more subjective and relies on the ...

The radius of curvature of femoral intramedullary nails does not match the average radius of curvature of the human femur. Anterior cortical breach of the distal femur during nail placement has been reported in certain fracture patterns, in femora with a smaller radius of curvature, and at the starting point of the nail. The authors describe a novel technique used to prevent anterior cortical d...