The internal mammary artery perforator (IMAP) flap represents the evolution from axially pedicled flaps (deltopectoral flap) to perforator flaps. Both flaps are typically used for neck and tracheostoma reconstruction in male patients. We present the case of a 68-year-old obese female patient with a right upper thoracic radionecrosis secondary to ...

A 44-year-old woman presented with ulcerating stage IV breast cancer involving the chest wall. En bloc resection of the second to seventh ribs on the right side, parts of the second to eighth ribs on the left side, the sternum, the chest wall muscles, and skin was completed with immediate ...

BACKGROUND: The classical DIEP-flap is considered state-of-the-art in microsurgical autologous breast reconstruction. Some patients may require additional volume to match the contralateral breast. This quality control study prospectively evaluates the feasibility and outcome of a surgical technique, which pursues the volumetric augmentation of the DIEP-flap by harvesting of additional subscarpal ...

BACKGROUND: Two work-horse approaches to postmastectomy breast reconstruction are the deep inferior epigastric perforator flap and the superior gluteal artery perforator (SGAP) flap [and its variation, the lateral septocutaneous superior gluteal artery perforator flap]. Our purpose was fourfold: 1) to analyze our experience with the SGAP flaps for simultaneous bilateral ...

Background: Prolactin-raising antipsychotics, risperidone (antidopaminergic activity), may be associated with low bone mass. On the other hand, risperidone may cause an increase in body weight thought to be favorable for bone. Objectives: (1) To determine bone remodeling parameters and bone mass in patients with schizophrenia on long-term treatment with long-acting ...

Second generation antipsychotics (SGAs) have been linked to metabolic and bone disorders in clinical studies, but the mechanisms of these side effects remain unclear. Additionally, no studies have examined whether SGAs cause bone loss in mice. Using in vivo and in vitro modeling we examined the effects of risperidone, the ...

Intra-articular distal radial fractures are frequently accompanied by a scapholunate interosseous ligament injury, which may adversely affect the outcomes. Arthroscopy may not be appropriate as a first-line evaluation method to diagnose these injuries because of time, expense, and availability issues. The purpose of this study was to evaluate the effectiveness ...

Mechanically activated intramedullary lengthening nails are advantageous over external fixator. However, difficulties with the control of the distraction rate are the main drawbacks, which may in turn cause insufficient bone regenerate. A total of 57 lengthening procedures were performed using intramedullary skeletal kinetic distractor (ISKD) nail in 53 patients (femoral ...

Intramedullary nailing is the accepted treatment of femoral and tibial shaft fractures. Improvements in surgical techniques and implant designs have extended indications for nailing to metaphyseal fractures of the proximal tibia, distal tibia and the distal femur. Malalignment can still occur with intramedullary nailing of these fractures. Among many techniques ...

: Unstable distal tibia fractures are challenging injuries that require surgery. Increasingly, intramedullary nails are being used. However, fracture site anatomy may cause distal-fragment stabilization and fixation problems and lead to malunion/nonunion. We studied the influence of angle-stable nail locking on fracture gap movement and other biomechanical parameters. : Eight ...

The deep inferior epigastric artery perforator flap is an option for women desiring autologous tissue breast reconstruction. If this reconstruction fails, other autologous tissue flaps, including the gluteal artery perforator and latissimus dorsi flaps, may be used for salvage. The anterolateral thigh (ALT) flap offers adequate tissue volume for breast ...

Pedicle transverse rectus abdominus myocutaneous (pTRAM) flaps remain the most common method of autologous tissue breast reconstruction. Using pTRAM flaps, complications often arise postoperatively, secondary to inadequate circulation. Tissues from distant angiosomes are associated with poorer perfusion, but this differs among patients. Many modalities have been used to reduce the ...

After reamed nailing in long bones, there is a negligible amount of reaming debris at the fracture gap of A2 and A3 fractures. The aim of this study was to show whether there are differences between reamed nailing and reamed nailing with controlled intramedullary application of reaming debris at the ...

In 2004, we modified our technique for the stabilization of femoral shaft fractures so that all fractures were stabilized using a reconstruction nail with proximal locking screws oriented into the femoral head. The rationale for this was twofold: first, potentially "missed" associated femoral neck fractures would be stabilized. Second, hip ...

Midclavicular fractures are common clinically, accounting for about 76% of all clavicular fractures. Recent studies have revealed a previously unrecognized incidence of nonunion and malunion after conservative treatment of more severe midclavicular fractures. Our aim was to evaluate the clinical outcomes of midclavicular fractures treated with titanium elastic nails. From ...

An 83-year-old female patient was referred to the emergency room with progressive pain on mobilization. Three weeks before presentation, she had been treated with a gamma nail for an unstable right intertrochanteric fracture. Pelvic x-ray showed an intra-abdominally migrated lag screw. No evidence of intra-abdominal lesions was visible on computed ...

The aim of this study is to evaluate the influence of the external fixation associated with flexible intramedullary nailing (FIN) on the healing index (HI) in limb lengthening. We compared the healing index between 2 groups of children undergone the lengthening of upper and lower limbs carried out with the ...

We compare the use of plate and screws versus intramedullary nails in the operative management of patients with displaced midclavicular fractures. Between March 2006 and June 2007, we performed a retrospective comparison of a demographically balanced sample of 110 patients (aged 16-65 years) who had received either plates or nails ...

Infection of the long bones after intramedullary nailing is a troublesome condition and management of the infection remains challenging to orthopedic surgeons. Associated infection can be more problematic and more diffuse in intramedullary bone fixation, since it may spread along the nail. Surgical treatment choices are also difficult especially in ...

We present two cases of metastatic lung cancer which occurred at the site of a previously united tibial fracture. Both patients were treated with a locked intramedullary nail. The patients presented with metastases at the site of their initial fracture approximately 16 and 13 months after injury respectively. We discuss ...

The intramedullary nailing of a femoral shaft metastatic fracture or an impending fracture has been complicated by hemodynamic accidents in up to 13% of patients. In previous studies, otherwise healthy patients pulled well through the nailing despite high pulmonary shunting and vascular tone and right ventricular strain. We hypothesized that ...

The aim of this study was to determine the difference in displacement of a newly designed intramedullary olecranon fracture fixation device compared with multifilament tension band wiring after 4 cycles and 300 cycles of dynamic continuous loading. In eight pairs of fresh-frozen cadaver ulnae, oblique olecranon fractures were created and ...

Retrograde nailing of open femoral fractures has presumed increased risk of knee sepsis. Our hypothesis was that the incidence of secondary knee infection after retrograde nailing of open femoral fractures is low. Retrospective, multicenter. Four Level I trauma centers. A retrospective review of prospective trauma registries and fracture databases identified ...

Intramedullary nailing is a widely accepted technique for the stabilization of unstable diaphyseal tibia fractures. When this method of stabilization is applied to proximal and distal metadiaphyseal fractures, achieving and maintaining fracture reduction is more difficult. The intramedullary nailing of proximal metadiaphyseal fractures in semiextension has been advocated to make ...

The healing outcome of long bone fractures is strongly influenced by the mechanical environment. High interfragmentary movement at the fracture site is detrimental to the fracture healing process. Long bone fractures stabilized with thin intramedullary nails commonly used for unreamed intramedullary nailing might be very flexible in shear direction and ...

The objective of this study was to investigate primary stability of the proximal femoral nailing antirotation for the indication of unstable medial femoral neck fractures. The device was compared to the dynamic hip screw blade, which is a "gold standard" in the treatment of proximal femoral fractures. Six pairs of ...

A Galeazzi fracture is defined as a fracture of the radius associated with dislocation of the distal radio-ulnar joint (DRUJ). The conventional surgical technique of nailing does not give enough stability and open reduction, internal fixation with the plate is associated with numerous complications. The stacked nailing for the management ...

Procurvatum or anterior bow deformity is a potential complication after treatment of femur fractures with flexible titanium nails (FTNs). This article reports on a clinical evaluation of angulation after treating pediatric femur fractures with FTNs. The article also reports on a complementary investigation of potential causes of these deformities using ...

Intramedullary nailing has become the gold standard to treat femoral shaft fractures. It is unknown which nailing technique orthopedic surgeons prefer. The goal of this study was to determine current techniques and perioperative complications of intramedullary nailing of diaphyseal femoral fractures. Fifty-one institutions in 26 countries participated in an international ...

BACKGROUND: Intramedullary reaming and nailing increases intramedullary pressure. This may cause intravasation of bone marrow contents, leading to bone marrow embolization and altered cardiopulmonary function. Possible beneficial effects of attenuation of the intramedullary pressure increase by the use of a reamer-irrigator-aspirator (RIA) system were studied with the hypothesis that the ...

Closed reduction and percutaneous pinning using Zifko nails offer the advantage of a minimal soft-tissue dissection but have been criticised for limited stability and secondary fracture dislocation. Angular stable plate osteosynthesis enables anatomic reduction, but carries the risk of soft tissue traumatisation and consecutive humeral head necrosis. The present study ...

The surgical methods for treatment of femoral neck fractures and trochanteric hip fractures vary. We describe the changes in Sweden over the period 1998–2007 and the regional differences in treatment. Patients and methods Data on 144,607 patients were drawn from the National Patient Register. The proportion of femoral neck fractures ...

To report use of an ulnar interlocking intramedullary nail for repair of an open highly comminuted fracture of the proximal third of the antebrachium in a dog, caused by gunshot. Case report. 1.5-year old, 60 kg, neutered male Mastiff. An ulnar interlocking intramedullary nail was used to stabilize an open ...

To determine whether reamed or unreamed intramedullary nailing of femoral fractures results in higher incidence of pulmonary fat embolism, three different methods of intramedullary nailing were compared in sheep. To analyze the presence of bone marrow fat embolism in pulmonary arteries, histological evaluation was undertaken using a quantitative computer-assisted measurement ...

Femoral intramedullary nailing is currently one of the most frequent surgical treatments for extracapsular hip-fracture fixation. Cutting-out of the lag screw is the main complication of this technique, but only few studies have approached the cutting-out focussed on femoral nailing. The aim of this study was to confirm in patients ...

This study evaluates different operative treatment options for patients with metastatic fractures of the humerus focusing on surgical procedures, complications, function, and survival rate. From January 2003 to January 2008, 87 pathological fractures of the humerus in 85 cancer patients were surgically treated in our institutions. Histotypes were breast (n=21), ...

Trochanteric fractures are commonly stabilized either by intramedullary nailing or plate and screw fixation after reduction on the orthopaedic surgical table under radiological guidance. Closed trochanteric fracture anatomic reduction is difficult in the transversal plane. The objective of this prospective study was to assess the rotational malalignment induced after reduction ...

Using antegrade exchange locked nailing to treat femoral supracondylar aseptic nonunion may sometimes have some limitations. Using retrograde locked nailing to treat such situations may achieve great advantages. The feasibility of such a technique was investigated. Fifteen consecutive adult patients were treated. Indications for this technique were an aseptic nonunion ...

Fractures of the tibia and femoral diaphysis are commonly repaired by intramedullary (IM) nails, which are currently composed of either electropolished stainless steel (EPSS) or standard, non-polished titanium-aluminum-niobium (TAN). Once the fracture has fully healed, removal of IM nails is common, but the strong adhesion of bone to standard TAN ...

Proximal femoral fractures, especially in elderly persons with osteoporosis, present a challenge for the traumatologist. While the dynamic hip screw (DHS) became the implant of choice for the treatment of stable fractures, the ideal implant for the treatment of unstable fractures remains an issue. In our experience, Proximal Femoral Nail ...

To develop percutaneous osteoplasty with the use of a bone marrow nail for fixation of long-bone fractures, and to evaluate its feasibility and safety in vivo and in vitro. Six long bones in three healthy swine were used in the in vivo study. Acrylic cement was injected through an 11-gauge ...

Bone metastasis is a severe complication for patients with cancer. Not only does it cause intractable pain and other clinical problems such as fracture after trivial injury, it also signifies that the malignant process is incurable. Since life expectancy of metastasised cancer patients has improved due to advanced oncological treatment ...

Intramedullary (IM) nailing is the classical treatment for diaphyseal fractures of the tibia. Stabilizing fractures of the distal quarter is recognized as being delicate. We report a continuous, multicenter prospective study of distal tibia-fibula fractures treated with anterograde intramedullary nailing. The working hypothesis was to identify the problems encountered with ...

We describe a technique for preventing varus malreduction of intertrochanteric hip fractures during fixation with a cephalomedullary nail. When the entry reamer guidewire is positioned in the fracture line, passage of the entry reamer may simply push the proximal fragment medially and the distal fragment laterally rather than ream the ...

With industrial societies getting older the incidence of femoral fractures is increasing. Complication rates up to 20% have led to a continuous improvement of intramedullar nailing systems and the third generation of implants is in clinical application. They seem superior to the second generation. But as clinical data is still ...

We studied if a static or dynamic mode of nail fixation influenced the healing of segmental defect reconstructions in long bones. Defects in the femur of goats were reconstructed using a cage filled with firmly impacted morsellised allograft mixed with a hydroxyapatite paste (Ostim). All reconstructions were stabilised with an ...

To assess the value of venous serum bicarbonate as an endpoint of resuscitation and guide to timing of femoral nailing in multi-system trauma patients. Retrospective cohort study. Academic Level 1 Trauma Centre. Seventy-two consecutive adult multi-system trauma patients (Injury Severity Score≥15) with femoral shaft fracture (Orthopaedic Trauma Association Class 32-A ...

The objective of this study comparing the proximal femoral nails Targon PF (Aesculap, Tuttlingen, Germany) and Proximal Femoral Nail Antirotation (PFNA; Synthes. Oberdorf, Switzerland) was to observe the complications and postoperative results following pertrochanteric femoral fracture fixation, with special attention devoted to the dynamic properties of both implants under physiological ...

To retrospectively analyse the clinical outcome of emergency treatment of senile intertrochanteric fractures with proximal femoral nail antirotation (PFNA). From September 2008 to March 2009, 35 senile patients with intertrochanteric fracture, aged from 65 to 92 years with an average age of 76.5 years, were treated with PFNA within 24 ...

The optimal treatment method for displaced proximal humeral fractures continues to be under debate. There are a variety of fixation techniques, none of which has been proven to be more effective. We retrospectively studied 24 patients with displaced proximal humerus fractures, treated with the Polarus intramedullary nail. All patients were ...