BACKGROUND Lengthening nails have been used to correct limb length discrepancy caused by different etiologies, as well as for post-traumatic reasons. Two important lengthening nail-related complications are damage to the distraction mechanism and femoral fractures around the nail tip. As a result of the curved anatomy of the femur, straight nails impinge on the anterior cortex. Therefore, prope...

BACKGROUND Intramedullary (IM) nailing is the treatment of choice among orthopaedic surgeons for tibial shaft fractures. However, because of the close proximity of the nail's insertion site to the anterior medial (AM) meniscal root on the tibial plateau, there is increased risk of iatrogenic injury to the meniscal root during nailing. PURPOSE To quantify the area of the AM meniscal root footp...

INTRODUCTION Many studies have been conducted to determine the different effects that reaming or intramedullary nailing have on fracture healing, but there is no evidence in the literature of the effect of intramedullary reaming on osteogenesis. We performed a prospective study to analyse the effect of intramedullary reaming and nailing on the production of growth factors during the process of ...

The development of intramedullary nailing, introduced in 1939 by Küntscher, 1 revolutionised the treatment of fractures of the long bones. Initially, this mechanism of stabilisation consisted of the maintenance of close contact and friction between the implant and the inner cortex by a cloverleaf nail. The technique was limited to simple fractures of the midshaft only. Once established, reaming...

The tibial nutrient artery supplies 62% of cortical blood flow in the diaphysis and normal blood flow is centrifugal (Willans 1987). Intramedullary reaming destroys the nutrient artery and injures the endosteal surface of the cortex. Trueta (1974) suggested that the direction of blood flow can reverse from centrifugal to centripetal after loss of the endosteal supply. We examined this hypothesi...

INTRODUCTION: Historically, tibial tunnel creation in ACL reconstruction was performed by antegrade insertion of a tibial guide pin followed by antegrade reaming from the anteromedial tibial metaphysis (distal aperture) to the tibial plateau (proximal aperture). In the last few years retrograde reaming has been introduced.[1, 2] It has been theorized that the retrograde tibial tunnel drilling t...

BACKGROUND The effect of intramedullary reaming on diaphyseal tibial defects has not been examined in the literature. The present aim was to relate the extent of reaming to angiogenesis and bone formation occurring around a critical-sized defect in the tibia for two scenarios, namely, when the bone defect is left empty and when the bone defect is treated with autograft. METHODS Eleven canines...

We examined the roles of methylmethacrylate (MMA) monomer and cementing technique in the formation, and haemodynamic outcome, of pulmonary fat emboli. The preparation of the femoral canal and the cementing technique were studied in four groups of adult dogs as follows: control (no preparation); lavage; cement pressurisation; and cement pressurisation after lavage. We measured the intramedullary...