نویسنده
* ارتوپد، دانشگاه علوم پزشکی جهرم، ایران.
چکیده
نقطه عطف میلهگذاری بهصورت نوین به جرارد کونچر برمیگردد. وی در سال 1940در کشور آلمان، میلهگذاری نوین را معرفی کرد و به دو اصل کلی اعتقاد داشت: فیکساسیون پایدار و فیکساسیون شکستگیها بدون بازکردن محل شکستگی. در ابتدا از میلههایی ابتدایی با نقاط ضعف متعدد و تنها در شکستگیهای تنه استخوانهای بلند از میلهگذاری استفاده میشد. به مرور زمان، تغییرات تأثیرگذاری در طراحی و کارگذاری میلههای استخوانی ایجاد گردید. هدف از این مقاله مروری بر تکامل طراحی میلهها و اصول ساده ولی بسیار مهم میلهگذاری استخوانهای بلند میباشد که در صورت عدم رعایت همین اصول ساده توسط جراحان، باعث عدم رسیدن به فیکساسیون دلخواه میشود.
کلیدواژه‌ها
عنوان مقاله [English]
Principles of Fixation with Interlocking Nailing
نویسنده [English]
- Masoome Pourmokhtari
* Orthopedist, Jahrom University of Medical Sciences, Iran.
چکیده [English]
The history of the new nailing method dates back to Gerhard Küntscher, who introduced this concept in Germany in 1940. He believed in two general principles: Stable fixation and fixation of fractures without opening the fracture site. In the beginning, primary nails with various weaknesses were only used in fractures of femur. Over time, effective changes were made in the design and insertion of bone nails. This article aimed to review the evolution of the design of nails and simple but significantly important principles of inserting nails in long bones. In any case, lack of adherence to these simple principles by surgeons leads to lack of desirable fixation.
کلیدواژه‌ها [English]
- Keywords: Nailing
- Locking
- Long Bones
1.Vecsei V, Hajdu S, Negrin LL. Intramedullary nailing in fracture treatment: history, science and Kuntscher's revolutionary influence in Vienna, Austria. Injury. 2011;42 Suppl 4:S1-5.
2.Cameron CD, Meek RN, Blachut PA, O'Brien PJ, Pate GC. Intramedullary nailing of the femoral shaft: a prospective, randomized study. J Orthop Trauma. 1992;6(4):448-51.
3.Rosa N, Marta M, Vaz M, Tavares SMO, Simoes R, Magalhaes FD, et al. Recent developments on intramedullary nailing: a biomechanical perspective. Ann N Y Acad Sci. 2017;1408(1):20-31.
- Speitling A. Intramedullary nail systems. In Kempf I, Leung KS, Grosse A, Haarman HJTM, Seidel H, Taglang G, editors: Practice of intramedullary locked nails. Berlin; Springer; 2002. p.51-9.
5.Bong MR, Kummer FJ, Koval KJ, Egol KA. Intramedullary nailing of the lower extremity: biomechanics and biology. J Am Acad Orthop Surg. 2007;15(2):97-106.
6.Yuan H, Acklin Y, Varga P, Gueorguiev B, Windolf M, Epari D, et al. A cadaveric biomechanical study comparing the ease of femoral nail insertion: 1.0- vs 1.5-m bow designs. Arch Orthop Trauma Surg. 2017;137(5):663-71.
7.Pfister U. Reamed intramedullary nailing. Orthopade. 2010;39(2):171-81.
8.Pfeifer R, Barkatali BM, Giannoudis P, Pape HC. Physiologic effects associated with intramedullary reaming. In Rommens P, Hessmann M, editors: Intramedullary nailing. London; Springer; 2015. p. 27-37.
9.Blachut PA, O'Brien PJ, Meek RN, Broekhuyse HM. Interlocking intramedullary nailing with and without reaming for the treatment of closed fractures of the tibial shaft. A prospective, randomized study. J Bone Joint Surg Am. 1997;79(5):640-6.
10.Finkemeier CG, Schmidt AH, Kyle RF, Templeman DC, Varecka TF. A prospective, randomized study of intramedullary nails inserted with and without reaming for the treatment of open and closed fractures of the tibial shaft. J Orthop Trauma. 2000;14(3):187-93.
- Hildebrand F, Andruszkow H, Barkatali BM, Pfeifer R, Lichte P, Kobbe P, et al. Animal models to assess the local and systemic effects of nailing: review of the literature and considerations for future studies. J Trauma Acute Care Surg. 2014;76(6):1495-506.
- Penzkofer R, Maier M, Nolte A, von Oldenburg G, Puschel K, Buhren V, et al. Influence of intramedullary nail diameter and locking mode on the stability of tibial shaft fracture fixation. Arch Orthop Trauma Surg. 2009;129(4):525-31.
- Brumback RJ, Reilly JP, Poka A, Lakatos RP, Bathon GH, Burgess AR. Intramedullary nailing of femoral shaft fractures. Part I: Decision-making errors with interlocking fixation. J Bone Joint Surg Am. 1988;70(10):1441-52.
- Wähnert D, Gehweiler D. Complications of intramedullary nailing—Evolution of treatment. Injury. 2017;48:S59-S63.
- Sadowski C, Lubbeke A, Saudan M, Riand N, Stern R, Hoffmeyer P. Treatment of reverse oblique and transverse intertrochanteric fractures with use of an intramedullary nail or a 95 degrees screw-plate: a prospective, randomized study. J Bone Joint Surg Am. 2002;84-a(3):372-81.
- Handolin L, Pajarinen J, Lindahl J, Hirvensalo E. Retrograde intramedullary nailing in distal femoral fractures--results in a series of 46 consecutive operations. Injury. 2004;35(5):517-22.
- Shahulhameed A, Roberts CS, Ojike NI. Technique for precise placement of poller screws with intramedullary nailing of metaphyseal fractures of the femur and the tibia. Injury. 2011;42(2):136-9.
- Gautschi OP, Frey SP, Zellweger R. Bone morphogenetic proteins in clinical applications. ANZ J Surg. 2007;77(8):626-31.
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