Unreamed tibia nail (UTN) bending: case report and problem solution

Kelsch, G.; Kelsch, Reiner; Ulrich, C.

doi:10.1007/s00402-003-0576-y

Cited by 17 publications

(8 citation statements)

References 7 publications

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“…The distal Various mechanisms have been described as potential causes of intramedullary nail failure [10]. Bending of an intramedullary nail is most commonly linked to trauma, while breakage of the nail primarily occurs in cases of nonunion and unstable or pathologic fractures due to metal fatigue [11,12]. This condition is generally the result of repetitive cycles of stress.…”

Section: Discussionmentioning

confidence: 99%

Humeral intramedullary nail bending following trauma: a case report

Willems

Greeven

2023

J Trauma Inj

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The surgical approach for humeral implant failure can be challenging due to neurovascular anatomy and the possible necessity of osteosynthesis removal. We present a rare case of humeral nail bending after secondary trauma in a patient with preexistent nonunion of the humerus after intramedullary nailing. During revision surgery, the nail was sawed in half and the distal part was removed, followed by plate osteosynthesis with cable fixation to achieve absolute stability. The patient regained a full range of motion 1 year after surgery, and complete healing of the fracture was seen on imaging.

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Section: Discussionmentioning

confidence: 99%

Humeral intramedullary nail bending following trauma: a case report

Willems

Greeven

2023

J Trauma Inj

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“…The next technique is to extract the nail by cutting the nail by a saw dental drill high-speed burr [16,17]. This technique with saw and drill has some disadvantages include: heat burn, debris formation In this technique, continuous irrigation is mandatory to prevent heat damage and debris formation [18].…”

Section: Discussionmentioning

confidence: 99%

How to Remove a Bent Intramedullary Nail from Long Bones

Shojaei

2020

OROAJ

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The gold standard treatment for femoral, tibial and humeral shaft fractures in most circumstances is intramedullary nailing. Sometimes the nail continuity fails before a complete union, rarely the nail construct becomes bend due to high energy trauma. These circumstances are big challenges for orthopaedic surgeons. We are going to have a mini review for this condition and available technique in the literature.

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“…15 In addition to hardware toggle, the implant and/or bone may fail owing to early, excessive loading or excessive lighter loading over a prolonged period. 16,17 The latter scenario represents a fatigue loading condition in which the bone, screw, or nail are vulnerable to breakage 18 especially in cases of complex fractures. 19 These data highlight the need for fatigue testing of emerging nail designs to ensure that the stability is maintained over time.…”

Section: Introductionmentioning

confidence: 99%

A modified intramedullary nail interlocking design yields improved stability for fatigue cycling in a canine femur fracture model

Garlock

Donovan

LeCronier

et al. 2012

Proc Inst Mech Eng H

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Intramedullary nailing has evolved to become the standard of care for most diaphyseal femoral and tibial fractures, as well as an expanding number of metaphyseal fractures. Owing to the unstable nature of some fractures, the intramedullary device may be subjected to significant stresses owing to a lack of solid cortical contact after nailing. In such cases, excessive interfragmentary motion (due to construct toggle) has been shown to occur. Such motion increases the likelihood of a non- or delayed-union. In the current study, two versions of a modified, angle stable interlocking design were subjected to fatigue testing in a segmental defect fracture model representing a canine femur. As a control, a third group of constructs were stabilized with a traditional nail that allowed a small amount of toggle. All constructs were subjected to 50,000 fatigue cycles representing 12 weeks of cage activity at physiologic levels of combined axial-torsional loading. Torsional testing pre- and post-fatigue revealed 4.6 +/- 1.3 degrees of toggle in the traditional nail and no toggle with the angle stable nail designs. The stable nails were also significantly stiffer in axial compression and torsion before and after cycling. These data indicate that the enhanced stability of the modified interlocking designs can be maintained throughout fatigue cycling in a challenging fracture model.

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Unreamed tibia nail (UTN) bending: case report and problem solution

Abstract: Our analysis shows that modification of the arrangement of the locking holes by 45 degrees increases bending load capacity of the UTN, which can minimize the probability of the occurrence of a bent nail.

Cited by 17 publications

References 7 publications

Humeral intramedullary nail bending following trauma: a case report

Humeral intramedullary nail bending following trauma: a case report

How to Remove a Bent Intramedullary Nail from Long Bones

A modified intramedullary nail interlocking design yields improved stability for fatigue cycling in a canine femur fracture model

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