Sa4.9 Technique to achieve appropriate reduction with provisional K wires instead of poller screws for diametaphyseal fractures of distal femur, proximal and distal tibia

Clinical and Radiographic Comparisons of Distal Tibia Shaft Fractures Stabilized with an Intramedullary Nail: Blocking Pin Versus Blocking Screw

“…In the BS group, it requires an additional intraoperative procedure to replace the temporary Steinmann pins with screws, but in the BP group, the temporary Steinmann pins can be pulled out directly. This explains why the operating time was signi cantly shorter in the BP group [15,16,28]. The Steinmann pin was used during reduction in both groups, and no intraoperative adverse event occured.…”

“…To overcome these issues, Shahulhameed et al [12] proposed to use a smooth and elastic Steinmann pin to facilitate fracture reduction, and nally replace it with a permanent BS. With the development of modern IMN, Wang et al [15] and Poyanlı et al [16] found that when the metaphyseal fracture was reduced with a temporary Kirschner wire, the fracture reduction could be well maintained even if the Kirschner wire was removed directly rather than replaced with a permanent BS. This new technique can reduce the operating time and avoid permanent soft tissue irritation.…”

Does using different entrance points for intramedullary nails affect clinical outcomes for femoral shaft fractures? A retrospective clinical comparative study

“…Using Poller screws or after proper reduction via locking the nail in at least two planes can prevent initial malreduction and further deterioration of the reduction. Also using a retrograde intramedullary nail specifically designed for distal oblique fractures can prevent this complication [ 20 ].…”

Cat’s eye screws for nailing distal tibial fractures

“…An even earlier account of a blocking-type screw can be seen in the second edition of Campbell’s Operative Orthopaedics 5 where a “snub screw” is used to help guide an intramedullary implant. Over the years, other methods of blocking screw technique have been described, including the use of alternative blocking devices such as Kirschner wires or the use of Steinmann pins for provisional blocking prior to placing a blocking screw 6,7. Regardless, the basic principles remain that blocking screws assist with reducing a fracture and centralizing a nail and, of particular interest here, stabilizing a nail in the medullary canal.…”