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Sample records for broken femoral nails

  1. Anterograde removal of broken femoral nails without opening the nonunion site: a new technique

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    Henrique Antônio Berwanger de Amorim Cabrita

    2010-01-01

    Full Text Available OBJECTIVE: We describe a new technique for removing the distal fragments of broken intramedullary femoral nails without disturbing the nonunion site. METHODS: This technique involves the application of an AO distractor prior to the removal of the nail fragments, with subsequent removal of the proximal nail fragment in an anterograde fashion and removal of the distal fragment through a medial parapatellar approach. Impaction of the fracture site is then performed with a nail that is broader than the remaining fragmented material. RESULTS: Nails were removed from five patients using the technique described above without any complications. After a mean follow-up period of 61.8 months, none of these patients showed worsened knee osteoarthritis. CONCLUSION: The original technique described in this article allows surgeons to remove the distal fragment of fractured femoral intramedullary nails without opening the nonunion focus or using special surgical instruments.

  2. Closed retrograde retrieval of the distal broken segment of femoral cannulated intramedullary nail using a ball-tipped guide wire

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    Sreenivasulu Metikala

    2011-01-01

    Full Text Available Background: Extracting broken segments of intramedullay nails from long bones can be an operative challenge, particularly from the distal end. We report a case series where a simple and reproducible technique of extracting broken femoral cannulated nails using a ball-tipped guide wire is described. This closed technique involves no additional equipment or instruments. Materials and Methods: Eight patients who underwent the described method were included in the study. The technique involves using a standard plain guide wire passed through the cannulated distal broken nail segment after extraction of the proximal nail fragment. The plain guide wire is then advanced distally into the knee joint carefully under fluoroscopy imaging. Over this wire, a 5-millimeter (mm cannulated large drill bit is used to create a track up to the distal broken nail segment. Through the small knee wound, a ball-tipped guide wire is passed, smooth end first, till the ball engages the end of the nail. The guide wire is then extracted along with the broken nail through the proximal wound. Results: The method was successfully used in all eight patients for removal of broken cannulated intramedullary nail from the femoral canal without any complications. All patients underwent exchange nailing with successful bone union in six months. None of the patients had any problems at the knee joint at the final follow-up. Conclusion: We report a technique for successful extraction of the distal fragment of broken femoral intramedullary nails without additional surgical approaches.

  3. Retrieval of a broken guide wire transfixing the hip through the proximal femoral nail hole

    Institute of Scientific and Technical Information of China (English)

    Saurabh Jain; Abhishek Pathak; Rajeev Kant Pandey

    2014-01-01

    Retrieval of a broken guide wire transfixing the acetabulum or with intrapelvic migration is challenging and frustrating for surgeons.We here present a case report on a method to remove a broken guide wire transfixing the acetabulum through the proximal hole of recon nail using a grasping forceps.This method is little invasive,easy,time-saving and without need for changing the inital fixation.

  4. Retrieval of a broken guide wire transfixing the hip through the proximal femoral nail hole

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    Jain Saurabh

    2014-02-01

    Full Text Available 【Abstract】Retrieval of a broken guide wire transfixing the acetabulum or with intrapelvic migration is challenging and frustrating for surgeons. We here present a case report on a method to remove a broken guide wire transfixing the acetabulum through the proximal hole of recon nail using a grasping forceps. This method is little invasive, easy, time-saving and without need for changing the inital fixation.

  5. Femoral midshaft fractures: expandable versus locked nailing.

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    Zhou, Zhen-Tao; Song, Yu-Chen; Zhou, Xiao-Zhong; Zhou, Hai-Bin; Luo, Zong-Ping; Dong, Qi-Rong

    2015-04-01

    Femoral midshaft fracture is one of the most common clinical injuries and is often caused by high-energy traffic accidents. Intramedullary nailings, plates, and external fixators are all used as treatment alternatives for a variety of patients depending on fracture location, displacement, comminution, soft tissue condition, and local tradition. Locked intramedullary nailing is currently the preferred treatment method for most diaphyseal fractures and has good clinical results. The goal of this study was to compare expandable and locked intramedullary nailing for the treatment of AO type 32A and 32B1 femoral midshaft fractures. The authors performed a retrospective analysis of 46 patients (33 men and 13 women; mean age, 32.3 years; range, 22-52 years) with femoral midshaft fractures who were divided into 2 groups-one treated with an expandable intramedullary nailing method and the other with a conventional locked intramedullary nailing. The 2 groups were compared with respect to operation time, fluoroscopic time, amount of estimated blood loss, hospitalization time, healing time, and complications. Patients were followed for at least 1 year. The results of this study showed that all of the patients achieved bone union within 12 to 24 months. Expandable nailing performed better than locked nailing in operation time, fluoroscopic time, amount of estimated blood loss, and healing time (P<.001). There was no difference in hospitalization time and no visible shortening or severe complications were observed in either group. Based on the results of this study, the expandable intramedullary nailing is an easy and effective treatment for AO type 32A and 32B1 diaphyseal femoral fractures. PMID:25901625

  6. Retained portion of latex glove during femoral nailing. Case report.

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    Sadat-Ali, M; Marwah, S; al-Habdan, I

    1996-11-01

    A case of retained glove during Kuntscher intramedullary nailing is described. An abscess around the glove could have lead to osteomyelitis. One need to be cautious feeling the top end of the nail while femoral nailing to avoid such a complication.

  7. Persistent knee complaints after retrograde unreamed nailing of femoral shaft fractures

    NARCIS (Netherlands)

    El Moumni, Mostafa; Schraven, Pim; ten Duis, Henk Jan; Wendt, Klaus

    2010-01-01

    Retrograde nailing is an attractive method for stabilisation of femoral shaft fractures in cases of polytrauma, ipsilateral pelvic, acetabular, tibial and femoral neck fractures, bilateral femoral fractures, obese and pregnant patients. However, retrograde nailing may result in complaints about the

  8. Femoral nailing in adults : doctor and patient reported outcomes

    NARCIS (Netherlands)

    El Moumni, Mostafa

    2016-01-01

    The treatment of traumatic femoral shaft fractures using an unreamed nail is associated with good results. Both antegrade and retrograde unreamed nailing techniques result in high union rates and low rates of complications, such as non-union, deep infection and septic arthritis. These results are co

  9. Inadvertent advancement of guide wire across the knee caused by incarcerated bone fragment at the nail tip during femoral nailing

    Institute of Scientific and Technical Information of China (English)

    Dhananjaya Sabat; Tsering Wangchuk; Anil Dhal

    2014-01-01

    Fracture of femoral shaft in adults is common and mostly managed with intramedullary interlocking nails.Complications during closed intramedullary femoral nailing are uncommon,and mostly of them are caused by technical reasons.We describe a case of closed nailing for a femoral shaft fracture in which a jammed intramedullary guide wire,due to an incarcerated bone fragment at the nail tip,was inadvertently advanced across the knee.Forceful attempt of nail insertion caused this complication,which was probably attributed to nail design.

  10. Pediatric femoral shaft fractures treated by flexible intramedullary nailing

    Institute of Scientific and Technical Information of China (English)

    K.C.Kapil Mani; R.C.Dirgha Raj; Acharya Parimal

    2015-01-01

    Background:Nowadays pediatric femoral fractures are more commonly managed with operative treatment rather than conservative treatment because of more rapid recovery and avoidance of prolonged immobilization.Children between the ages of 5-13 years are treated either by traction plus hip spica and flexible/elastic stable retrograde intramedullary nail,or external fixators in the case of open fractures.The aim of this study is to evaluate the outcome of pediatric femoral shaft fractures treated by stainless steel flexible intramedullary nail in children between 5 and 13 years of age.Methods:There were 32 cases of femoral shaft fractures which were all fixed with stainless steel flexible intramedullary nail under fluoroscopy.Long leg cast was applied at the time of fixation.Partial weight bearing was started 2 weeks after surgery.Patients were evaluated in follow-up study to observe the alignment of fracture,infection,delayed union,nonunion,limb length discrepancy,motion of knee joint,and time to unite the fracture.Results:We were able to follow up 28 out of 32 patients.The patients were 8.14 years of age on average.The mean hospital stay after operation was 4 days and fracture union time was 9.57 weeks.There were 3 cases of varus angulation,2 cases of anterior angulation,and 4 cases of limb lengthening.Conclusion:Patients aged between 5 and 13 years treated with flexible intramedullary nail for closed femoral shaft fracture have rapid union and recovery,short rehabilitation period,less immobilization and psychological impact,and cost-effective.

  11. A blocking-wire technique for removal of a broken hollow intramedullary nail.

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    Zheng, Xuan-Lin; Park, Young-Chang; Kang, Dong-Hyun; Seok, Sang-Ok; Yoon, Yeo-Kwon; Yang, Kyu-Hyun

    2016-07-01

    We present a simple method to remove the distal portion of the broken nail just using the bulb-tipped guide pin and a blocking Kirschner wire. At first, we removed the proximal part of the broken nail and all interlocking screws. Next, we introduced the bulb-tipped guide wire into the distal part of the nail with fluoroscopic guidance until it passed the interlocking hole that would be used. After snugly fitting the blocking Kirschner wire into the interlocking hole of the nail, the bulb-tipped guide wire is then pulled to engage the blocking wire complex in the interlocking hole. The bulb-tipped guide wire and broken nail are removed by sequential stroke using a ram. PMID:27170540

  12. Titanium elastic nailing in pediatric femoral diaphyseal fractures

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    Singh Roop

    2006-01-01

    Full Text Available Background: The need for operative fixation of pediatric femoral fractures is increasingly being recognised in the present decade. The conventional traction and casting method for management of pediatric femoral fractures is giving way for the operative stabilisation of the fracture. Methods : Thirty five pediatric patients in age group 6-14 years with diaphyseal femoral fractures were stabilised with two titanium nails. Patients were followed up clinically and radiologically for two years. The final results were evaluated using the criteria of Flynn et al. Technical problems and complications associated with the procedure were also analysed. Results : Overall results observed were excellent in 25, satisfactory in 8 and poor in 2 patients. Hospital time averaged 12.30 days in the series. All the fractures healed with an average time to union of 9.6 (6-14.4 weeks. Return to school was early with an average of 7.8 weeks. The soft tissue discomfort near the knee produced by the nails ends was the most common problem encountered. Shortening was observed in three cases and restriction of knee flexion in 5 patients. There was no delayed union, infection or refractures. Per operative technical problems included failure of closed reduction in 2 cases and cork screwing of nails in one case. Conclusion : We believe that with proper operative technique and aftercare TENs may prove to be an ideal implant for pediatric femoral fracture fixation. The most of the complication associated with the procedure are infact features of inexact technique and can be eliminated by strictly adhering to the basic principles and technical aspects.

  13. Retrograde interlocking intramedullary nailing under arthroscopy for supracondylar femoral fracture

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To evaluate the therapeutic effects of retrograde interlocking intramedullary nailing under arthroscopy on supracondylar femoral fractures.   Methods: From June 1999 to December 2000, 17 patients with supracondylar femoral fracture were treated with arthroscopically assisted implantation of retrograde interlocking intramedullary nail and close reduction.   Results: More than 6-month follow-up study after operation in 11 patients revealed that the average healing time was 3 months. Average range of the knee motion for all the patients was more than 90 degrees. There was no implant breakage and infection.   Conclusions: This new method, combining the advantage of arthroscope and retrograde interlocking intramedullary nail, can provide a stable and reliable fixation, and meanwhile is less invasive to the soft tissue and knee, less operative time and blood loss, minimal disruption of the blood supply in fracture site. It is conducive to the fracture healing and the functional recovery of the knee joint and worthwhile to be recommended.

  14. Long-term functional outcome following intramedullary nailing of femoral shaft fractures

    NARCIS (Netherlands)

    el Moumni, Mostafa; Voogd, Emma Heather; ten Duis, Henk Jan; Wendt, Klaus Wilhelm

    2012-01-01

    Background: The management of femoral shaft fractures using intramedullary nailing is a popular method. The purpose of this study was to evaluate the long-term functional outcome after antegrade or retrograde intramedullary nailing of traumatic femoral shaft fractures. We further determined predicto

  15. Interlocking versus kuntscher nails in the management of femoral shaft fractures

    International Nuclear Information System (INIS)

    To compare the outcome of Femoral shaft fractures managed with Interlocking and Kuntscher intramedullary nails, in terms of healing time, full weight bearing and post-operative complications. A total of 200 cases of Femoral shaft fractures. Half (100) the cases of Femoral shaft fractures were treated with Kuntscher intramedullary nails and the other half (100) with Interlocking nails, the cases being assigned randomly. The detailed data of the patients was recorded, computed and analyzed using Chi-square test and Students t-test. The main parameters compared included fracture healing time, full weight bearing time and post-operative complications. There was no significant difference between the two groups in terms of demographic data, fracture type and associated co-morbidities. The average operating time was 110+-25 minutes for the Interlocking nail and 80+-15.8 mins for the K-nail. All patients of K-nail group needed blood transfusion, while only 17 patients of interlocking group needed blood transfusion. The full weight bearing time was significantly shorter (p<0.005) in cases of Inter- locking nail. Out of 200 fractures 182 (91%) healed with in six months while 18 (9%) did not. The latter included 6 (3%) cases treated with Interlocking nails and 12 (6%) with Kuntscher nails, p<0.005. Interlocking intramedullary nailing is better than Kuntscher nailing in every respect. (author)

  16. ROLE OF SUPRACONDYLAR NAILING IN DISTAL FEMORAL FRACTURES

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    Abhishek

    2014-08-01

    Full Text Available : BACKGROUND: Fractures of distal femur are complex injuries that can be difficult to manage. Due to poor bone stock, less cortical bone in this region, wide medullary cavity and frequently associated severe soft tissue damage. METHODS: From June 2008 to April 2012, a prospective study of 46 patients, with distal femoral fractures, including supracondylar and inter condylar fractures, treated with intramedullary supracondylar nail, was done to evaluate its results and final functional outcome and its applicability in open as well as closed distal femoral fractures. Four cases were lost to follow up; six had followed up for less than six months. These ten cases were excluded from the study hence effectively the study included total thirty six cases. Average age of patients was 41.7 yrs. with Male: Female ratio of 2.6:1. Among 36 fractures 16.6% were of type A1, 44.4% were of type A2, 27.7% were of type A3 and 11.1% were of type C1. 27.7% fractures were open and associated injuries were present in 22.2% of cases. Second generation supracondylar nail was used for definitive fixation in all eighteen cases, through percutaneous patellar tendon splitting approach in 26 patients and medial parapatellar arthrotomy approach in ten patients. RESULTS: At an average follow up of 9 months, final functional outcome was evaluated as per Neer’s criteria (1967. Average time of union was 17.5 weeks, with an average range of movement being 101.38. Functional results were excellent in 20 (55.5% cases, satisfactory in 10 (27.7% cases, unsatisfactory in 2 (5.5% and poor in 4 (11.1% cases. No significant correlation was observed in this study between the age of the patient, fracture type and the final functional outcome achieved. Similarly no significant difference was observed between the final functional outcomes achieved in open versus closed fracture. However patients treated with medial parapatellar arthrotomy approach were found to be associated with increased

  17. Outcomes of trochanteric femoral fractures treated with proximal femoral nail: an analysis of 100 consecutive cases

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    Korkmaz MF

    2014-04-01

    Full Text Available Mehmet Fatih Korkmaz,1 Mehmet Nuri Erdem,2 Zeliha Disli,3 Engin Burak Selcuk,4 Mustafa Karakaplan,1 Abdullah Gogus5 1Department of Orthopedics and Traumatology, Inonu University School of Medicine, Malatya, Turkey; 2Department of Orthopedics and Traumatology, Nisantasi University School of Medicine, Istanbul, Turkey; 3Department of Anesthesiology, Malatya Government Hospital, Malatya, Turkey; 4Department of Family Medicine, Inonu University School of Medicine, Malatya, Turkey; 5Department of Orthopedics and Traumatology, Florence Nightingale Hospital, Istanbul, Turkey Purpose: In this study, we aimed to report the results of a retrospective study carried out at our institute regarding cases of patients who had suffered proximal femoral fractures between January 2002 and February 2007, and who were treated with a proximal femoral nail. Materials and methods: One hundred consecutive cases were included in the study. A case documentation form was used to obtain intraoperative data including age, sex, mechanism of injury, type of fracture according to Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF classification and the American Society of Anesthesiologists' (ASA physical status classification (ASA grade. Clinical and radiographic examinations were performed at the time of admission and at the 6th week; subsequent visits were organized on the 3rd month, 6th month, and 12th month, and in patients with longer follow-up and annually postoperatively. The Harris score of hip function was used, and any change in the position of the implants and the progress of the fracture union, which was determined radiologically, was noted. Results: The mean age of the patients was 77.66 years (range: 37–98 years, and the sex distribution was 32 males and 68 females. Seventy-three fractures were reduced by closed means, whereas 27 needed limited open reduction. The mean follow-up time for the study group was 31.3 months (range

  18. Treatment of Pediatric Open Femoral Fractures with External Fixator Versus Flexible Intramedullary Nails

    OpenAIRE

    Hossein Aslani; Ali Tabrizi; Ali Sadighi; Ahmad R Mirbolook

    2013-01-01

      Background: In children, inappropriate treatment of open femoral fractures may induce several complications. A few studies have compared the external fixator with flexible intramedullary nails in high-grade open femoral fractures of children. The present study aims at comparing results of these two treatment methods in open femoral fractures. Methods: In this descriptive analytical study, 27 patients with open femoral fractures, who were treated using either the external fixator (n=14) or T...

  19. UNSTABLE FEMORAL FRACTURES TREATED WITH TITANIUM ELASTIC INTRAMEDULLARY NAILS, IN CHILDREN

    OpenAIRE

    Soni, Jamil Faissal; Schelle, Gisele; Valenza, Weverley; Pavelec, Anna Carolina; Souza, Camila Deneka Arantes

    2015-01-01

    Objective: To evaluate the indications, epidemiology, associated lesions, complications and prognosis among children with unstable femoral diaphysis fractures who were treated with titanium elastic intramedullary nails. Method: This was a retrospective analysis on 24 patients aged 5-12 years with unstable femoral diaphysis fractures who underwent surgical treatment with elastic titanium intramedullary nails at the Cajuru University Hospital, Curitiba-PR, between April 2002 and March 2008, wit...

  20. Removal of a Broken Cannulated Intramedullary Nail: Review of the Literature and a Case Report of a New Technique

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    Amr A. Abdelgawad

    2013-01-01

    Full Text Available Nonunion of long bones fixed with nails may result in implant failure. Removal of a broken intramedullary nail may be a real challenge. Many methods have been described to allow for removal of the broken piece of the nail. In this paper, we are reviewing the different techniques to extract a broken nail, classifying them into different subsets, and describing a new technique that we used to remove a broken tibial nail with narrow canal. Eight different categories of implant removal methods were described, with different methods within each category. This classification is very comprehensive and was never described before. We described a new technique (hook captured in the medulla by flexible nail introduced from the locking hole which is a valuable technique in cases of nail of a small diameter where other methods cannot be used because of the narrow canal of the nail. Our eight categories for broken nail removal methods simplify the concepts of nail removal and allow the surgeon to better plan for the removal procedure.

  1. Flexible intramedullary nailing in paediatric femoral fractures. A report of 73 cases

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    Lohiya Ramprakash

    2011-12-01

    Full Text Available Abstract Background Flexible intramedullary nailing has emerged as an accepted procedure for paediatric femoral fractures. Present indications include all patients with femoral shaft fractures and open physis. Despite its excellent reported results, orthopaedic surgeons remain divided in opinion regarding its usefulness and the best material used for nails. We thus undertook a retrospective study of paediatric femoral fractures treated with titanium or stainless steel flexible nails at our institute with a minimum of 5 years follow up. Material and methods We included 73 femoral shaft fractures in 69 patients treated with retrograde flexible intramedullary nailing with a minimum follow up of 5 years. Final limb length discrepancy and any angular or rotational deformities were determined. Results Mean age at final follow up was 15.5 years (10-21 years. Mean follow up was 7.16 years (5.0-8.6 years. Titanium and stainless steel nails were used in 43 and 30 cases respectively. There were 51 midshaft, 17 proximal, and 5 distal fractures. All fractures united at an average of 11 weeks but asymptomatic malalignment and LLD were seen in 19% and 58% fractures respectively. LLD ranged from -3 cm to 1.5 cm. Other complications included superficial infection(2, proximal migration of nail(3, irritation at nail insertion site(5 and penetration of femoral neck with nail tip(1. There were 59 excellent, 10 satisfactory and 4 poor results. Conclusion Flexible intramedullary nailing is reliable and safe for treating paediatric femoral shaft fractures. It is relatively free of serious complications despite asymptomatic malalignment and LLD in significant percentage of fractures.

  2. New Technique: A Novel Femoral Derotation Osteotomy for Malrotation following Intramedullary Nailing

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    S. Jagernauth

    2012-01-01

    Full Text Available A 19-year-old female patient sustained a closed spiral midshaft femoral fracture and subsequently underwent femoral intramedullary nail insertion. At followup she complained of difficulty in walking and was found to have a unilateral in-toeing gait. CT imaging revealed 30 degrees of internal rotation at the fracture site, which had healed. A circumferential osteotomy was performed distal to the united fracture site using a Gigli saw with the intramedullary femoral nail in situ. The static distal interlocking screws were removed and the malrotation was corrected. Two further static distal interlocking screws were inserted to secure the intramedullary nail in position. The osteotomy went on to union and her symptoms of pain, walking difficulty, and in-toeing resolved. Our paper is the first to describe a technique for derotation osteotomy following intramedullary malreduction that leaves the intramedullary nail in situ.

  3. Pelvic migration of the helical blade after treatment of transtrochanteric fracture using a proximal femoral nail

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    Pedro Luciano Teixeira Gomes

    2016-08-01

    Full Text Available ABSTRACT Proximal femoral nails with a helical blade are a new generation of implants used for treating transtrochanteric fractures. The blade design provides rotational and angular stability for the fracture. Despite greater biomechanical resistance, they sometimes present complications. In the literature, there are some reports of cases of perforation of the femoral head caused by helical blades. Here, a clinical case of medial migration of the helical blade through the femoral head and acetabulum into the pelvic cavity is presented.

  4. Pelvic migration of the helical blade after treatment of transtrochanteric fracture using a proximal femoral nail.

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    Gomes, Pedro Luciano Teixeira; Castelo, Luís Sá; Lopes, António Lemos; Maio, Marta; Miranda, Adélia; Dias, António Marques

    2016-01-01

    Proximal femoral nails with a helical blade are a new generation of implants used for treating transtrochanteric fractures. The blade design provides rotational and angular stability for the fracture. Despite greater biomechanical resistance, they sometimes present complications. In the literature, there are some reports of cases of perforation of the femoral head caused by helical blades. Here, a clinical case of medial migration of the helical blade through the femoral head and acetabulum into the pelvic cavity is presented.

  5. Comparison of two kinds of intramedullary nails in the treatment of femoral shaft fractures in adults

    Institute of Scientific and Technical Information of China (English)

    CHEN Wei; WANG Juan; SU Yan-ling; ZHAGN Qi; WANG Bo; LI Zhi-yong; ZHANG Ying-ze

    2011-01-01

    Background Intramedullary nails have been widely used in treating femoral shaft fractures.However,end caps falling into soft tissue intraoperatively may cause trouble to surgeons,prolong operative time and increase radiation exposure.Additionally,difficulties may be encountered when removing nails because of callus formation over the nail tip.We performed a prospective study to compare two types of nails in managing femoral shaft fractures.Methods Group I consisted of seventy-four patients with unilateral femoral shaft fractures treated with cannulated interlocking anatomical femoral intramedullary nails.Group Ⅱ consisted of seventy-eight patients treated with cannulated interlocking anatomical femoral intramedullary nails with tail wires.The patients' ages,fracture severity,duration of operation,fluoroscopy time,blood loss and falls of end caps into soft tissue were recorded.Nails were removed after fracture healing.The duration of operation and blood loss during nail removal were recorded.Results There were no significant differences between groups with respect to age and fracture severity (P>0.05).End caps fell into soft tissue 17 times in 15 cases in group Ⅰ and 21 times in 16 cases in group Ⅱ.An average of seven minutes was spent recovering a lost cap in group Ⅰ.In group Ⅱ,all lost caps were recovered immediately.The duration of operation and fluoroscopy time in group Ⅱ was significantly less than in group Ⅰ (P <0.05).Asymptomatic palpable nodules were detected in 4 cases in group Ⅱ.Nail removals were performed on 58 patients in group Ⅰ and 69 patients in group Ⅱ.The duration of operation,blood loss and complications in group Ⅱ were less than in group Ⅰ (P<0.05).Conclusion Intramedullary nails with tail wires facilitate both fracture fixation and nail removal,which can be used to treat femoral shaft fractures with less radiation exposure,shorter surgical time and fewer complications.

  6. Femoral shaft fractures in children: elastic stable intramedullary nailing in 31 cases

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    Houshian, Shirzad; Gøthgen, Charlotte Buch; Pedersen, Niels Wisbech;

    2004-01-01

    We report our experience with elastic stable intramedullary titanium nailing (ESIN) of femoral shaft fractures in children. From 1998 to 2001, we treated 31 children (20 boys), median age 6 (4-11) years, with ESIN for 29 closed and 2 grade I open femoral shaft fractures. We reviewed 30 children...... clinically after median 1.5 (1-3) years. Their median hospital stay was 6 (2-20) days. All fractures were radiographically united at a median of 7 (5-9) weeks. The nails were removed in 29 children after a median of 22 (6-38) weeks postoperatively. At follow-up, we found a leg-length discrepancy up to 1 cm...... in 6 children and 10 degrees of internal rotational deformity in 1 child. No angular deformity had occurred. Elastic stable intramedullary nailing seems to be a safe method for the treatment of femoral shaft fractures in children between 4 and 11 years of age....

  7. Correlation of Trochanter-Shaft Angle in Selection of Entry Site in Antegrade Intramedullary Femoral Nail

    OpenAIRE

    Lakhwani, O.P.

    2012-01-01

    Background. Selection of entry point for nail insertion is controversial and lack firm anatomical basis. The study is done to analyze the proximal anthropometry of femur and measure the Trochanter-Shaft Angle to find its relation and significance in selection of entry point for antegrade uniplanar femoral nail. Materials and Methods. Study involves the measurement of trochanter-shaft angle and other anthropometric measurements on 50 dry femora and on digital radiogram. Results. Trochanter-Sha...

  8. Heterotopic ossification in the reaming tract of a percutaneous antegrade femoral nail: a case report

    OpenAIRE

    Botolin, Sergiu; Mauffrey, Cyril; Hammerberg, E Mark; Hak, David J; Stahel, Philip F.

    2013-01-01

    Introduction Heterotopic ossification is a rare complication of musculoskeletal injuries, characterized by bone growth in soft tissues. Percutaneous antegrade intramedullary nailing represents the ‘gold standard’ for the treatment of femur shaft fractures. Minor bone growth is frequently seen around the proximal end of reamed femoral nails (so-called ‘callus caps’), which are asymptomatic and lack a therapeutic implication. The occurrence of excessive, symptomatic heterotopic ossification aro...

  9. Failure of intramedullary femoral nail with segmental breakage of distal locking bolts: a case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Sameer Aggerwal; Nitesh Gahlot; Uttam C. Saini; Kamal Bali

    2011-01-01

    Breakage of locking bolts is an important cause of interlocking nail failure in femoral fractures. It usually occurs in the form of single breakage in one of the distal bolts of the nail or nail breakage around the distal locking hole. Here we report an unusual case of intramedullary femoral nail failure with segmental breakage of both the distal locking bolts. Such a scenario usually complicates further management. We successfully managed this case with exchange nailing without bone grafting. Here we briefly reviewed the literature regarding such an unusual presentation and discussed in detail the possible etiology of such a presentation and the management options when facing such a complex situation.

  10. Treatment of ipsilateral hip and femoral shaft fractures with reconstructive intramedullary interlocking nail

    Institute of Scientific and Technical Information of China (English)

    吴立东; 吴琼华; 严世贵; 潘志军

    2004-01-01

    Objective: To evaluate the results of reconstructive intramedullary interlocking nail in the treatment of ipsilateral hip and femoral shaft fractures. Methods: From August 1997 to November 2001, 13 patients were treated with the reconstructive intramedullary interlocking nail. Nine patients were associated with ipsilateral femoral neck fractures, three with ipsilateral intertrochanteric fractures, and one with subtrochanteric fracture. Results: The follow-up time was from 6 to 38 months with an average of 14 months. All the femoral shaft and hip fractures healed up well. There was no nonunion of the femoral neck, and only one varus malunion. No patient had avascular necrosis of the femoral head. The average healing time for femoral neck fracture was 4.6 months and for shaft fracture 5.8 months. The joint movement and other functions were fairly resumed. Conclusions: The reconstructive intramedullary interlocking nail, with less trauma, reliable fixation, and high rate of fracture healing, is an ideal method of choice in the treatment of ipsilateral hip and femoral shaft fractures.

  11. Treatment of Pediatric Open Femoral Fractures with External Fixator Versus Flexible Intramedullary Nails

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    Hossein Aslani

    2013-12-01

    Full Text Available   Background: In children, inappropriate treatment of open femoral fractures may induce several complications. A few studies have compared the external fixator with flexible intramedullary nails in high-grade open femoral fractures of children. The present study aims at comparing results of these two treatment methods in open femoral fractures. Methods: In this descriptive analytical study, 27 patients with open femoral fractures, who were treated using either the external fixator (n=14 or TEN nails (n=13 method from 2006-2011, were studied. Some patients were treated with a combination method of TEN and pin. The results were evaluated considering infection, union, malunion, and refracture and the patients were followed up for two years. Results: Mean time required for fracture union was 3.89 (range: 2-5.8 and 3.61 (range: 2-5.6 months for the external fixator and TEN groups, respectively. The difference was not statistically significant and there was not any significant difference between the two groups considering infection of the fractured area. Osteomyelitis was not observed in any group. There was an infection surrounding the external fixator pin in 4 cases (28.5% and so this required changing the location of the pin. In the TEN group, one case (7.6% of painful bursitis was observed at the entry point of TEN and so the pin was removed earlier than usual. There were two cases (14.2% of femoral refracture in the external fixator group. Malunion requiring correction was not observed in any of the groups. There were no complications observed in five patients treated with a combined method of pin and flexible intramedullary nails. Conclusion: Both external fixator and intramedullary nail methods are effective ways in treating high grade open femoral fractures in children and final treatment results are similar. Combining pins and flexible intramedullary nails is effective in developing more stability and is not associated with more

  12. STUDY OF OUTCOME FOLLOWING NAIL DYNAMIZATION FOR TREATING DELAYED HEALING FEMORAL SHAFT FRACTURES

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    Vidya Bhushan

    2015-11-01

    Full Text Available : BACKGROUND: Dynamisation of a previously interlocked intramedullary nail is believed to stimulate an osteogenic response and accelerate union due to increased load across the fracture site. OBJECTIVE: This retrospective study evaluated the role of dynamization of interlocking nails to treat the delayed heeling femoral fractures. MATERIAL AND METHODS: Eighteen static femoral interlocking nails were dynamized after 4 months (Range 3-6 months because of poor fracture healing. The clinical and radiographic healing processes were recorded. All the cases were followed up to monitor the progress of fracture healing till their end results in the form of union or non-union. RESULTS: The time between interlocking nailing and nail dynamization was ranging between 3 to 6 (Mean 4 months. After the dynamization cases were followed for at least 6 months (Range, 4-8 months twelve patients (66.6% achieved a solid union, within a union period of 5.4 months (Range, 3-8 months after dynamization. One patient achieved union with more than 2 cm of femoral shortening. CONCLUSION: Not all cases achieve union after dynamization. It should be reserved for delayed healing axially stable fractures

  13. The Holland nail: a universal implant for fractures of the proximal femur and the femoral shaft.

    NARCIS (Netherlands)

    Krastman, P.; Welvaart, W.N.; Breugem, S.J.; Vugt, A.B. van

    2004-01-01

    OBJECTIVE: To study the possibilities and outcomes for hip and femoral fractures treated with the universal Holland nail((R)). DESIGN: Retrospective study from November 1998 to December 2001. SETTING: Department of Traumatology, Erasmus Medical Centre, Rotterdam. SUBJECTS: 112 patients with 115 frac

  14. The incidence of non-union following unreamed intramedullary nailing of femoral shaft fractures

    NARCIS (Netherlands)

    el Moumni, M.; Leenhouts, P. A.; ten Duis, H. J.; Wendt, K. W.

    2009-01-01

    Introduction: Stabilisation. of fractures with an intramedullary nail is a widespread technique in the treatment of femoral shaft fractures in adults. To ream or not to ream is still debated. The primary objective of this Study was to determine the incidence of non-union following unreamed intramedu

  15. Femoral Condyles Tangential Views: An Effective Method to Detect the Screw Penetration of Femoral Condyles After Retrograde Nailing

    Institute of Scientific and Technical Information of China (English)

    Zhan-Le Zheng; Xian Yu; Wei Chen; Yue-Ju Liu; Kun-Lun Yu; Tao Wu; Ying-Ze Zhang

    2015-01-01

    Background: Postoperative knee soft tissue irritation is a common complication after retrograde nail fixation of femoral fractures.Distal locking screw prominence is one of the causes for soft tissue irritation.This study aimed to determine whether the use of the femoral condyles tangential views improve the diagnostic accuracy compared with anteroposterior (A-P) view in detecting distal locking screw penetrations during retrograde femoral nailing.Methods: The angle between the sagittal plane and lateral aspect of the condyle and the angle between the sagittal plane and medial aspect of condyle were measured on computed tomography (CT) images.After the angles were measured and recorded, cadaveric femurs were used in a simulated surgical procedure.The retrograde femoral nail was inserted into the femur and placed distal locking screws, which were left 2, 4, and 6 mm proud of the medial and lateral condyles for each femur.A-P view, lateral condyle tangential view and medial condyle tangential view were obtained.All fluoroscopic images were recorded and sent to three observers blinded to the experimental procedure to determine whether screws penetrated the condyle cortex or not.Results: According to the results of CT scan, the lateral condyle view was 20.88 ± 0.98° and the medial condyle view was 40.46 ± 3.14°.In the A-P view, we detected 0% at 2 mm penetration, 16.7% (lateral condyle screw) and 25.0% (medial condyle screw) at 4 mm, and 41.7% (lateral condyle screw) and 58.3% (medial condyle screw) at 6 mm.In the lateral tangential view, we detected 91.7% at 2 mm penetration of the lateral condyle and 100% at 4 mm and 6 mm.In the medial tangential view, we detected 66.7% at 2 mm penetration of the medial condyle and 100% at 4 mm and 6 mm.The femoral condyle tangential views provided significant improvement in detecting screw penetrations at all lengths (2, 4, and 6 mm) compared with the A-P view (P < 0.05).Conclusions: The femoral condyles

  16. Femoral Condyles Tangential Views: An Effective Method to Detect the Screw Penetration of Femoral Condyles After Retrograde Nailing

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    Zhan-Le Zheng

    2015-01-01

    Full Text Available Background: Postoperative knee soft tissue irritation is a common complication after retrograde nail fixation of femoral fractures. Distal locking screw prominence is one of the causes for soft tissue irritation. This study aimed to determine whether the use of the femoral condyles tangential views improve the diagnostic accuracy compared with anteroposterior (A-P view in detecting distal locking screw penetrations during retrograde femoral nailing. Methods: The angle between the sagittal plane and lateral aspect of the condyle and the angle between the sagittal plane and medial aspect of condyle were measured on computed tomography (CT images. After the angles were measured and recorded, cadaveric femurs were used in a simulated surgical procedure. The retrograde femoral nail was inserted into the femur and placed distal locking screws, which were left 2, 4, and 6 mm proud of the medial and lateral condyles for each femur. A-P view, lateral condyle tangential view and medial condyle tangential view were obtained. All fluoroscopic images were recorded and sent to three observers blinded to the experimental procedure to determine whether screws penetrated the condyle cortex or not. Results: According to the results of CT scan, the lateral condyle view was 20.88 ± 0.98° and the medial condyle view was 40.46 ± 3.14°. In the A-P view, we detected 0% at 2 mm penetration, 16.7% (lateral condyle screw and 25.0% (medial condyle screw at 4 mm, and 41.7% (lateral condyle screw and 58.3% (medial condyle screw at 6 mm. In the lateral tangential view, we detected 91.7% at 2 mm penetration of the lateral condyle and 100% at 4 mm and 6 mm. In the medial tangential view, we detected 66.7% at 2 mm penetration of the medial condyle and 100% at 4 mm and 6 mm. The femoral condyle tangential views provided significant improvement in detecting screw penetrations at all lengths (2, 4, and 6 mm compared with the A-P view (P < 0.05. Conclusions: The femoral condyles

  17. A sonography assisted technique for the removal of a femoral interlocking nail – a technical note

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    Shen Po-Wen

    2005-10-01

    Full Text Available Abstract Background Open methods for removal of femoral interlocking nails involve an incision (up to 10 cm over the trochanter to find the tip of the nail. The distal locking screws are some times difficult to palpate and an incision (up to about 5 cm is often needed for exposure. Intra-operative fluoroscopy is often used as an adjunct technique to minimize the surgical wound. However, patients and surgeons are exposed to a radiation hazard. Sonography can provide a real-time and efficient alternative to fluoroscopy. Methods Sonography of soft tissue has been established to identify a foreign body. A metallic implant has a hyperechoic image; therefore, we can identify the correct position of the screws preoperatively and intraoperatively. Results We have developed a technique using sonography and minimal incisions for the removal of a femoral interlocking nail. The proximal wound is 2.5 cm in length and the wound is 0.5 cm in length for each distal locking screw. Conclusion The sonography can be used to minimize the length of incision and prevent radiation exposure in the removal of intramedullary femoral nails.

  18. An Effective Approach for Optimization of a Composite Intramedullary Nail for Treating Femoral Shaft Fractures.

    Science.gov (United States)

    Samiezadeh, Saeid; Tavakkoli Avval, Pouria; Fawaz, Zouheir; Bougherara, Habiba

    2015-12-01

    The high stiffness of conventional intramedullary (IM) nails may result in stress shielding and subsequent bone loss following healing in long bone fractures. It can also delay union by reducing compressive loads at the fracture site, thereby inhibiting secondary bone healing. This paper introduces a new approach for the optimization of a fiber-reinforced composite nail made of carbon fiber (CF)/epoxy based on a combination of the classical laminate theory, beam theory, finite-element (FE) method, and bone remodeling model using irreversible thermodynamics. The optimization began by altering the composite stacking sequence and thickness to minimize axial stiffness, while maximizing torsional stiffness for a given range of bending stiffnesses. The selected candidates for the seven intervals of bending stiffness were then examined in an experimentally validated FE model to evaluate their mechanical performance in transverse and oblique femoral shaft fractures. It was found that the composite nail having an axial stiffness of 3.70 MN and bending and torsional stiffnesses of 70.3 and 70.9 N⋅m², respectively, showed an overall superiority compared to the other configurations. It increased compression at the fracture site by 344.9 N (31%) on average, while maintaining fracture stability through an average increase of only 0.6 mm (49%) in fracture shear movement in transverse and oblique fractures when compared to a conventional titanium-alloy nail. The long-term results obtained from the bone remodeling model suggest that the proposed composite IM nail reduces bone loss in the femoral shaft from 7.9% to 3.5% when compared to a conventional titanium-alloy nail. This study proposes a number of practical guidelines for the design of composite IM nails. PMID:26458035

  19. Exchanging reamed nailing versus augmentative compression plating with autogenous bone grafting for aseptic femoral shaft nonunion: a retrospective cohort study

    OpenAIRE

    Jiang-ying, Ru; Yun-fei, Niu; Yu, Cong; Wen-bo, Kang; Hai-bin, Cang; Jian-ning, Zhao

    2015-01-01

    Objective: The purpose of this study was to compare the outcomes of exchanging reamed nailing (ERN) and augmentative compression plating (ACP) with autogenous bone grafting (BG) for the treatment of aseptic femoral shaft nonunion secondary to the treatment of intramedullary nailing (IMN).Methods: A multicenter retrospective study was performed for 178 patients (180 cases) of aseptic femoral shaft nonunion secondary to first treatment of IMN. All cases were fixed with either ERN (n=87) or ACP ...

  20. Avascular necrosis associated with nailing of femoral neck fracture

    International Nuclear Information System (INIS)

    Two patients with femoral neck fractures, one displaced and one undisplaced, are presented. Preoperative intravital staining with tetracycline and Tc-MDP scintimetry both showed intact femoral head circulation while Tc-MDP-scintimetry 1 week after operation showed pronounced circulatory deficiency. SR85-scintimetry performed at the same time was inconclusive. Segmental collapse was observed radiographically, 8 and 12 months postoperatively. The major vascular injury resulting in avascularity most probably occured during the procedure of osteosynthesis, and Tc-MDP-scintimetry was found suitable for early postoperative recognition of avascular necrosis in both fractures. (author)

  1. Radiographic and functional results of osteosynthesis using the proximal femoral nail antirotation (PFNA) in the treatment of unstable intertrochanteric femoral fractures

    OpenAIRE

    Sahin, Suner; Erturer, Erden; Ozturk, Irfan; Toker, Serdar; Seckin, Faik; Akman, Senol

    2004-01-01

    Objectives: We evaluated the radiographic and functional results of the proximal femoral nail antirotation (PFNA) system in patients with unstable intertrochanteric femoral fractures. Methods: The study included 45 patients (25 women, 20 men; mean age 72 years; range 27 to 97 years) who underwent osteosynthesis using the PFNA for unstable intertrochanteric femoral fractures. The fractures were in the right hip in 25 patients, and in the left hip in 20 patients. The fractures were classifie...

  2. Results of titanium elastic nailing in paediatric femoral diaphyseal fractures-report of 30 cases

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    Jalan Divesh

    2013-04-01

    Full Text Available 【Abstract】 Objective: Fractures of the femur are the most incapacitating fractures. For children aged 6-14 years, there is no clear consensus as to the preferred treatment. The conventional treatment of traction and cast-ing is no longer recommended. We report our experience in titanium elastic nailing for treatment of paediatric femoral diaphyseal fractures. Methods: Thirty patients in the age group of 6-16 years with displaced diaphyseal femoral fractures were sta-bilized with titanium elastic nails. Patients were followed up clinically and radiologically for a minimum period of 1 year. The final results were evaluated using Flynn’s criteria. Tech-nical difficulties and complications associated with the pro-cedure were also analysed. Results: Overall results were excellent in 20 cases and satisfactory in 10 cases. No patient had poor result. The average hospital stay was 9 days. All the fractures healed with an average time to union of 6.86 weeks. The most com-mon complication encountered was soft tissue irritation at the nail entry site seen in 6 cases. Clinically, lengthening was noticed in 4 cases, while no patient had shortening. Malalignment was seen in only 6 cases. Perioperative diffi-culties encountered were failure of closed reduction seen in 6 cases and corkscrewing of nails in one case. Conclusion: Titanium elastic nails are a relatively easy to use, minimally invasive, physeal-protective implant sys-tem with high rate of good and excellent outcomes in chil-dren aged 6-16 years. Technical pitfalls can be eliminated by adhering to the basic principles. Key words: Titanium; Nails; Fractures, bone; Femur; Paediatrics

  3. Acute closed traumatic sciatic nerve injury: a complication of heterotopic ossification and prominence of the femoral nail: a case report.

    Science.gov (United States)

    Niempoog, Sunyarn; Chumchuen, Sukanis

    2014-08-01

    The report of a 27-years-old man with presence of heterotopic ossification (HO) after femoral nailing 7years ago who developed foot drop afterfalling to the ground on his buttocks. Radiographs revealed a prominence ofthefemoral nail with HO in his right hip. EMG confirmedperoneal nerve injury ofthe hip region. Femoral nail and the HO were removed and external neurolysis was performed. At 9 months after surgery, he had not regain motor power thus posterior tibialis tendon transfer was performed to restore ankle dorsiflexion. Finally, at 2 years follow-up, he could ambulate well but did not regained sensation, extensor digitorum communis and peroneal muscle function. PMID:25518317

  4. Results of titanium elastic nailing in paediatric femoral diaphyseal fractures— report of 30 cases

    Institute of Scientific and Technical Information of China (English)

    Divesh Jalan; Rajesh Chandra; VK Sharma

    2013-01-01

    Objective:Fractures of the femur are the most incapacitating fractures.For children aged 6-14 years,there is no clear consensus as to the preferred treatment.The conventional treatment of traction and casting is no longer recommended.We report our experience in titanium elastic nailing for treatment of paediatric femoral diaphyseal fractures.Methods:Thirty patients in the age group of 6-16 years with displaced diaphyseal femoral fractures were stabilized with titanium elastic nails.Patients were followed up clinically and radiologically for a minimum period of 1 year.The final results were evaluated using Flynn's criteria.Technical difficulties and complications associated with the procedure were also analysed.Results:Overall results were excellent in 20 cases and satisfactory in 10 cases.No patient had poor result.The average hospital stay was 9 days.All the fractures healed with an average time to union of 6.86 weeks.The most common complication encountered was soft tissue irritation at the nail entry site seen in 6 cases.Clinically,lengthening was noticed in 4 cases,while no patient had shortening.Malalignment was seen in only 6 cases.Perioperative difficulties encountered were failure of closed reduction seen in 6 cases and corkscrewing of nails in one case.Conclusion:Titanium elastic nails are a relatively easy to use,minimally invasive,physeal-protective implant system with high rate of good and excellent outcomes in children aged 6-16 years.Technical pitfalls can be eliminated by adhering to the basic principles.

  5. Femoral shaft fractures in children, treaties with elastic nails of titanium - TENs

    International Nuclear Information System (INIS)

    Femoral shaft fractures are a common and temporarily disabling injury in children. Recent advances in orthopedic traumatology have led us at the Hospital Universitario del Valle, in Cali, Colombia, to perform a case series observational study with the use of a more aggressive approach with the new endomedullar titanium nails (TENs) in children suffering femur shaft fractures, in a closed procedure performed under image intensification. The main purpose of this study was to evaluate the outcome of 30 children treated with these nails. Pediatric femoral shaft fractures are more common in males with approximately a 2.75:1 male to female ratio. The age distribution is bimodal, with peaks in the younger than 5 years and mid-teenage groups (10-14 years) because of the increased incidence of high-energy trauma in teenage children (mean age: 9 years). Overall, TENs allowed rapid mobilization with few complications. The results were excellent or satisfactory in our cases. No child lost rotational alignment in the postoperative period. Irritation of the soft tissue near the knee by the nail tip occurred in one patient. As indications, implantation technique, and aftercare are refined, TENs may prove to be the ideal implant to stabilize most pediatric femur shaft fractures, avoiding the prolonged immobilization and complications of traction and spica cast

  6. Scintimetric evaluation of nailed femoral neck fractures with special reference to type of osteosynthesis

    International Nuclear Information System (INIS)

    With the aid of Tc-MDP-scintimetry 1-2 weeks after nailing of femoral neck fractures, it is possible to distinguish fractures liable to complications. Due to the suspicion that frequent peroperative vascular damage was caused by the fourflanged nail a less traumatizing cylindric nail with an insertion instrument was used. In a prospective investigation in January 1981-February 1982, which included all intracapsular femoral neck fractures, the two above-mentioned methods of osteosynthesis were used randomly. Intravital staining with tetracycline showed the peroperative circulation equivalent in Rydell and Hansson groups. A significant difference in postoperative isotope uptake could be noted between the two groups in 37 patients with undisplaced fractures. In 34 of 45 displaced fractures in the Rydell group evidence of circulatory deficiency appeared in the postoperative scintimetry but in only 23 of 52 of the displaced fractures in the Hansson group, a statistically significant difference. The latter figure corresponds well to the incidence of peroperatively registered severe vascular injury evaluated by tetracycline labelling. (author)

  7. Role of Russell - Taylor delta reconstruction nail in the management of complex proximal femoral fractures

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    Raj D

    2005-01-01

    Full Text Available Background: Complex proximal femoral fractures are challenging problem. Methods: Forty-one patients had Russell- Taylor Delta reconstruction nailing done during the period from March 1992 to December 1996. 38 patients could be followed both clinically and radiologically either up to the fracture union or death. Clinical outcome was assessed by Kyle′s criteria. Out of 13 patients with high-energy comminuted fractures, 12 were rated excellent or good. There was one death due to poly trauma. Results: Out of six elderly subtrochanteric fractures, 4 had excellent or good results. There was one poor result and one death. Out of 11 elderly interochanteric fractures with subtrochanteric extension, 8 had excellent or good results. There was 1 fair, 1 poor result and 1 death. In the elderly groups, the poor results were due to poor pre- existing medical conditions of the patients. In all the seven cases of pathological lesions, excellent or good results were achieved either till fracture union or death because of their malignant pathology. Conclusion: Russell- Taylor Delta reconstruction nail is a very useful device in high-energy comminuted proximal femoral fractures, in elderly low energy proximal femoral fractures and also in pathological lesions. The implant provides bio-mechanically stable fixation. The relatively high complication rate in elderly patients is because of their poor medical condition. In cases of pathological lesions, it is always preferable to fix the bone at the stage of impending fracture.

  8. Management of Femoral Shaft Fractures with Elastic Titanium Nails in Pediatric Patients

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    Yunus Güzel

    2016-06-01

    Full Text Available Objective: The aim of this study was to evaluate the func­tional and radiological results of the application of intra­medullary fixation with elastic titanium nails in unstable femoral fractures and to determine the factors affecting these results. Methods: A total of 32 patients aged 4-17 years treated with intramedullary elastic nails for a femoral diaphysis fracture between 2001 and 2014 were included. The frac­ture was left side in 12 cases, right side in 18 and bilateral in 2. The fracture pattern was determined as fragmented in 11 cases, short oblique in 11, transverse in 8 and spi­ral in 4. The same surgical technique and postoperative care was applied to all the patients. Sagittal and coronal angle measurements were made from postoperative and follow-up anterior-posterior and lateral radiographs. The mean follow-up period was 54 months (12-156 months. Positive union criteria were accepted as pain-free weight-bearing and callus bridging in at least 3 cortices seen on direct radiographs. Results: Union was achieved in all except one patient. They were able to return to previous activities with full knee and hip joint range of movement. Radiologically, the mean time to union was determined as 9 weeks (range, 6-16 weeks. Limb shortness was determined in 5 (14% patients. No significant association was detected be­tween shortness and fracture pattern. No varus or valgus angulation of >10˚ was determined in any patient. Conclusion: Application of titanium elastic nails in pe­diatric femoral diaphysis fractures is a comfortable, eco­nomic, and reliable method which is allows early weight-bearing.

  9. SURGICAL MANAGEMENT OF INTERTROCHANTERIC FRACTURES : A STUDY USING DYNAMIC HIP SCREW AND PROXIMAL FEMORAL NAIL

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    Venkateswara Rao

    2015-08-01

    Full Text Available OBJECTIVES: The aim of this study was to compare the outcome of intertrochanteric fractures treated with Dynamic Hip Screw and Proximal Femoral nail. METHODS: This study was conducted on 80 cases of Intertrochanteric fractures of femur treated by a dynamic hip screw and proximal femoral nail. Patients were operated on standard fracture table under image intensifier control. RESULTS: The average age of the patient was 63.2 years. Most common mechanism of fracture was domestic fall. The unstable pattern was more common in old aged patients with higher grade of osteoporosis. The average blood loss was 240 and 320ml in PFN and DHS group respectively. In PFN there were more no. of radiation exposure intraoperatively. The average operating time for the patients treated with PFN was 100min as compared to 80 min in patients treated with DHS. No complications of non - union and infection. In the PFN group the amount of sliding on X - rays was less as compared to DHS. The patients treated with PFN started early ambulation as they had better Harris Hip Score in the early period (at 1 and 3 month. In the long term both the implant had almost similar functional outcomes. CONCLUSION: From the study, we concluded PFN is better alternative to DHS in management of intertrochanteric fractures but is technically difficult procedure and requires more expertise compared to DHS.

  10. Retrograde intramedullary nailing in treatment of diaphysical femoral fractures in patients between 6 and 12 years

    International Nuclear Information System (INIS)

    A descriptive, prospective, longitudinal study was carried out, with the object of determine the clinical evolution and surgical timing of treatment of diaphysical femoral fractures in patients between 6 and 12 years of age using retrograde flexible intramedullary nailing. We followed 62 fractures in 62 patients (46 boys and 16 girls). The average follow-up time was 6 months (range 4 to 20 months). Average age of patients was 8.3 years. The time of duration for the surgical procedure averaged 52.6 minutes. Average in-hospital stay was 7.8 days. We did not have any cases of deep infection. There were 4 cases of superficial skin infection and 3 patients required reoperation due to protrusion of the medial nail under the skin. None of the patients had complications such as loss of range of motion, non-union, hardware failure, injury to the neither distal femoral physis nor heterotopic ossification. In conclusion we recommend this method as an excellent treatment modally for diaphyseal fractures of the femur in patients between 6 and 12 years of age

  11. Treatment of femoral shaft fractures in young children by Ender's nail: indications AND complications

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    Sunil Nikose

    2015-10-01

    Results: All the 42 stable femoral fractures showed bridging callus in a mean time of 3.83 weeks (2.5 to 6.5 weeks. Full weight bearing was possible in a mean time of 4.19 weeks. Radiological union was seen in a mean time of 9.4 weeks. 34 fractures were evaluated by scanogram one year after injury and they revealed lengthening of 0.3cms. All the children returned to their previous level of activities. All the 19 unstable femoral fractures showed bridging callus in a mean time of 5.53 weeks (4 and ndash; 8 weeks. Full weight bearing was possible in a mean time of 6.21weeks. Radiological union was seen in a mean time of 12 weeks. 8 patients were readmitted for adjunctive procedures like nail impaction, traction and cast immobilization. 20% patients with unstable group had shortening of 1.3cms and 20% had external rotation of lower limb. Conclusions: Ender's nailing is simple, cost-effective and minimally invasive procedure in 6-12 years of age. It offers stable fixation with rapid healing. There is prompt return of child to normal activity. [Int J Res Med Sci 2015; 3(10.000: 2613-2617

  12. OUTCOME ANALYSIS OF PROXIMAL FEMORAL NAIL IN STABLE INTERTROCHANTERIC FEMUR FRACTURES

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    Suneet

    2015-02-01

    Full Text Available BACKGROUND: Proximal femoral nail is commonly recommended as treatment of choice for unstable and reverse oblique intertrochanteric fracture in view of superior biomechanics and prevention of varus collapse associated with Dynamic hip scre w. Although in stable fracture types DHS is still being preferred as the treatment modality of choice. Proximal femoral nail owing to better biomechanics , less complications can still be used as the method of choice in stable fracture pattern as well. The aim of this study is to evaluate the results of PFN nail in stable intertrochanteric fracture and include evaluation of the mean operative time , amount of blood loss , complications and functional status of the patient . MATERIALS AND METHODS : In this study 30 patients presented to Orthopedics Department Hamidia Hospital Bhopal with stable intertrochanteric fracture were treated with p roximal femoral nail. All patients were followed up for a period of 1 year and functional outcome assessment including amount of shortening , neck - shaft angle , Harris hip score was noted. RESULTS : At the time of final follow - up , all 30 patients showed union with average Harris hip score of 86.6 (range 62 - 94 . 14 patients had excellent score , 9 patients had good score , 5 patients ha d fair score and 2 patients had poor outcome . Mean neck shaft angle achieved post - reduction was 131.4 degrees and at final follow - up was 128.4 degrees. Limb length discrepancy was assessed in the final follow - up with average shortening of 5 mm and 4 patien ts had shortening above 1.5 cm. Average blood loss was 80 ml , the mean operative time was 65 minutes. Complications w ere seen in 3 cases with one case of local wound infection, one of screw cut - out and one of screw penetration. CONCLUSION : With proper tech nique PFN gives excellent results with less blood loss and shorter incision with less soft tissue trauma are added advantages which ultimately lead to less morbidity and

  13. RETROGRADE INTRAMEDULLARY INTERLOCKING NAIL: AN OPTIMAL TOOL FOR THE TREATMENT OF SUPRACONDYLAR FEMORAL FRACTURES

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    Kamareddy

    2014-10-01

    Full Text Available : BACKGROUND: This prospective consecutive case series was done to evaluate indications, technical pearls and pitfalls and functional outcomes of distal femoral supracondylar fractures treated with retrograde intramedullary nailing. METHODS: The surgical outcome of 80 patients (59 males and 21 females who were treated with retrograde intramedullary nailing for. Patients were followed-up both clinically and radiologically every 6 weeks for a mean duration of 20 (12 – 24 months. The patients were assessed based on Schatzker and Lambert criteria. RESULTS: The mechanism of injury was motor vehicle accident in 48 (60% patients and fall in 32 (40% patients. Sixty four (80% fractures were closed and 16 (20% fractures were compound. Average operation time was 2 hours and average blood loss was 300 ml. The mean union time was 5.6 months (5 – 7 months. Knee flexion of more than 120 degree was achieved in 60 patients, 110 degree in 16 patients and 100 degree in 2 patients. Six patients had anterior knee pain of transient nature which subsided within one year after rehabilitation, full weight bearing and self exercises. By the end of 1 year, overall outcome was excellent in 59 patients (74%, good in 12 patients (15% and fair in 8 (10% patients. CONCLUSION: Retrograde intramedullary femoral nailing is an optimal tool in the treatment of AO/ASIF type A and type C distal femur (supracondylar fractures. It provides rigid fixation in a region of femur where, wide canal, thin cortices and frequently poor bone stock make fracture fixation difficult. It also provides excellent results in selected comminuted fractures of the distal femur with a low complication rate.

  14. A biomechanical evaluation of proximal femoral nail antirotation with respect to helical blade position in femoral head: A cadaveric study

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    Jin-Ho Hwang

    2012-01-01

    Full Text Available Objective: Despite new developments in the management of osteoporotic fractures, complications like screw cutout are still found in the fixation of proximal femur fractures even with biomechanically proven better implants like proximal femoral nail antirotation (PFNA. The purpose of this cadaveric study was to investigate the biomechanical stability of this device in relation to two common positions (center-center and inferior-center of the helical blade in the femoral head in unstable trochanteric fractures. Materials and Methods: Eight pairs of human cadaveric femurs were used; in one group [center-center (C-C group], the helical blade of PFNA was fixed randomly in central position both in anteroposterior and lateral view, whereas in the other group it was fixed in inferior one-third position in anteroposterior and in central position in lateral view [inferior-center (I-C group]. Unstable intertrochanteric fracture was created and each specimen was loaded cyclically till load to failure Results: Angular and rotational displacements were significantly higher within the C-C group compared to the I-C group in both unloaded and loaded condition. Loading to failure was higher in the I-C group compared to the C-C group. No statistical significance was found for this parameter. Correlations between tip apex distance, cyclic loading which lead to femoral head displacement, and ultimate load to failure showed a significant positive relationship. Conclusion: The I-C group was superior to the C-C group and provided better biomechanical stability for angular and rotational displacement. This study would be a stimulus for further experimental studies with larger number specimens and complex loading protocols at multicentres.

  15. A novel method of removal of a broken drill bit in the femoral medullary canal during internal fixation of a type C distal femoral fracture: a case report

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    Mounasamy Varatharaj

    2012-11-01

    Full Text Available 【Abstract】 Breakage of surgical instruments and implants during operative procedures is not uncommon in any surgical discipline. The need for removal and the out-come of leaving the broken instruments and implants in the surgical area have not been described in detail. Few studies have suggested removal if they are lying loosely in the tis-sues or joint, close to neurovascular structures. Challenges and the amount of time spent in the retrieval of broken in-struments and implants are well known among surgeons, so most choose to leave them in situ. We reported a novel method of retrieval of a broken drill bit in the femoral medul-lary canal during internal fixation of a type C distal femoral fracture. Key words: Fracture fixation, internal; Femoral fractures; Surgical instruments

  16. Development and mechanical testing of a short intramedullary nail for fixation of femoral rotational osteotomy in cerebral palsy patients

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    Volpon Jose B

    2011-06-01

    Full Text Available Abstract Background Rotational osteotomy is frequently indicated to correct excessive femoral anteversion in cerebral palsy patients. Angled blade plate is the standard fixation device used when performed in the proximal femur, but extensile exposure is required for plate accommodation. The authors developed a short locked intramedullary nail to be applied percutaneously in the fixation of femoral rotational osteotomies in children with cerebral palsy and evaluated its mechanical properties. Methods The study was divided into three stages. In the first part, a prototype was designed and made based on radiographic measurements of the femoral medullary canal of ten-year-old patients. In the second, synthetic femoral models based on rapid-prototyping of 3D reconstructed images of patients with cerebral palsy were obtained and were employed to adjust the nail prototype to the morphological changes observed in this disease. In the third, rotational osteotomies were simulated using synthetic femoral models stabilized by the nail and by the AO-ASIF fixed-angle blade plate. Mechanical testing was done comparing both devices in bending-compression and torsion. Results The authors observed proper adaptation of the nail to normal and morphologically altered femoral models, and during the simulated osteotomies. Stiffness in bending-compression was significantly higher in the group fixed by the plate (388.97 ± 57.25 N/mm than in that fixed by the nail (268.26 ± 38.51 N/mm as torsional relative stiffness was significantly higher in the group fixed by the plate (1.07 ± 0.36 Nm/° than by the nail (0.35 ± 0.13 Nm/°. Conclusions Although the device presented adequate design and dimension to fit into the pediatric femur, mechanical tests indicated that the nail was less stable than the blade plate in bending-compression and torsion. This may be a beneficial property, and it can be attributed to the more flexible fixation found in intramedullary devices.

  17. Treatment of distal femoral nonunion and delayed union by using a retrograde intramedullary interlocking nail

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To analyze the causes of distal femoral nonunion and delayed union and assess the outcome of the corresponding treatment, retrograde intramedullary interlocking nail (RIIN).   Methods: From June 1995 to December 1998, 15 patients (9 males and 6 females) with distal femoral nonunion and delayed union were treated with RIIN. The average age of the patients was 34.5 years (23-46 years). Bone grafting was performed in 10 patients, closed reaming was done in the other 5 patients. Correction osteotomy was performed in 2 patients, and intra-articular release of knee adhesion in 11 patients. X-ray examination and knee society clinical rating system (KSS) were used to evaluate the results.   Results: All fractures were followed up for at least 9 months with average follow-up duration of 14.5 months (9-33 months). Solid union was documented in all patients at 6.4 months on average. There were no infections or malunions in this series. Based on the final follow-up data, acceptable functional range of motion (ROM) of over 90° was achieved in most patients. The average ROM was 93.5° with significant improvement of 28° (42.7%, P<0.05) compared with the preoperative ROM. The average knee score was 96. Excellent ROM emerged in 13 patients. The knee function score was 90.5 on average.   Conclusions: The main causes of distal femoral nonunion and delayed union are improper indications and improper use of the implants. RIIN is an effective alternative for treatment of distal femoral nonunion and delayed union because it can provide a stable and reliable fixation which is beneficial for early functional exercise of knee. Bone grafting, closed reaming and intra-articular release of knee adhesion should be considered in order to enhance the bone healing and improve ROM and the knee function.

  18. A STUDY OF MANAGEMENT OF SUBTROCHANTERIC FRACTURE FEMUR BY PROXIMAL FEMORAL NAILING

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    Venkateswara Rao

    2015-08-01

    Full Text Available Numerous variations of intramedullary nails have been devised to achieve a stable fixation and early mobilisation of pertrochanteric fracture, among which is the proximal femoral nail (PFN. We report here the results of a prospective study carried out at our institute on 60 consecutive patients who had suffered high subtrochanteric fracture between May 2011 and October 2014 and were subsequently treated with a PFN. Close t o anatomical reduction of the fracture fragments was achieved in 54 patients, while limited open reduction was required in 3 patients. In the present series, 3.33(2 of cases had superficial infection and no deep infections were recorded. Cut of the anti - r otational screw was noted in 1 patient. Fracture of the shaft with breakage of the nail was noted 1.66% (1 of patients. In the current series, the mean Harris Hip score was 80.76 and it was ranging from 100 - 29. In this series all the patients between 20 – 3 0 years had excellent result irrespective of the type of fracture. Older age group patients had relatively poor results and 50% (5 of them had poor results and another 50% (5 had good to fair results. In this study excellent outcome was not seen in the o lder age group patients.Our results indicate the necessity of a careful surgical technique and modifications that are specific to the individual fracture pattern in order to reduce complications. Osteosynthesis with the PFN offers the advantages of high ro tational stability of the head - neck fragment, an unreamed implantation technique and the possibility of static or dynamic distal locking.

  19. Analysis of using antirotational device on cephalomedullary nail for proximal femoral fractures☆☆☆

    Science.gov (United States)

    Takano, Marcelo Itiro; de Moraes, Ramon Candeloro Pedroso; de Almeida, Luis Gustavo Morato Pinto; Queiroz, Roberto Dantas

    2014-01-01

    Objective To analyze the influence of femoral neck diameter in the positioning of the sliding screw in cefalomedulares nails for treatment of unstable transtrochanteric fractures. Methods Prospectively throughout 2011, patients with unstable fractures transtrochanteric undergoing osteosynthesis with cephalomedullary nail using antirotacional device. They were evaluated for sex, age and fracture classification according to Tronzo. Through digital radiographs angle reduction, tip apex distance (TAD), stem diameter and measures between the positioning of the screws and the limits of the cervix were measured. Results Of the 58 patients, 42 (72.4%) were female and 16 (27.6%) were male. 33 patients were classified as Tronzo III (56.9%), 6 patients as Tronzo IV (10.4%) and 19 as Tronzo V (19.8%). The majority were in between the eighth and ninth decade of life. The average reduction in the angle was 130.05° for females and 129.4° for males. The TAD average was 19.7 mm for females and 21.6 for males. The average diameter of the neck and head vary with statistical significance between men and women. In 19 patients the placement of the sliding bolt can be optimal. If the ideal positioning was not possible, the mean displacement for non‐infringement of higher cortical neck was 4.06 mm. Conclusion The optimal placement would not be possible for the majority of the population, for the average diameter of the neck of the sample. PMID:26229767

  20. Biomechanical analysis of a synthetic femoral spiral fracture model: Do end caps improve retrograde flexible intramedullary nail fixation?

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    Wessel Lucas M

    2011-09-01

    Full Text Available Abstract Background Elastic Stable intramedullary Nailing (ESIN of dislocated diaphyseal femur fractures has become an accepted method for the treatment in children and adolescents with open physis. Studies focused on complications of this technique showed problems regarding stability, usually in complex fracture types such as spiral fractures and in older children weighing > 40 kg. Biomechanical in vitro testing was performed to evaluate the stability of simulated spiral femoral fractures after retrograde flexible titanium intramedullary nail fixation with and without End caps. Methods Eight synthetic adolescent-size femoral bone models (Sawbones® with a medullar canal of 10 mm and a spiral fracture of 100 mm length identically sawn by the manufacturer were used for each group. Both groups underwent retrograde fixation with two 3.5 mm Titanium C-shaped nails inserted from medial and lateral entry portals. In the End Cap group the ends of the nails of the eight specimens were covered with End Caps (Synthes Company, Oberdorf, Switzerland at the distal entry. Results Beside posterior-anterior stress (4.11 Nm/mm vs. 1.78 Nm/mm, p Conclusion In this biomechanical study the use of End Caps did not improve the stability of the intramedullary flexible nail osteosynthesis.

  1. Failure of intramedullary femoral nail with segmental breakage of distal locking bolts: a case report and re- view of the literature

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    Aggerwal Sameer

    2011-06-01

    Full Text Available 【Abstract】Breakage of locking bolts is an impor- tant cause of interlocking nail failure in femoral fractures. It usually occurs in the form of single breakage in one of the distal bolts of the nail or nail breakage around the distal locking hole. Here we report an unusual case of intramedul- lary femoral nail failure with segmental breakage of both the distal locking bolts. Such a scenario usually complicates further management. We successfully managed this case with exchange nailing without bone grafting. Here we briefly reviewed the literature regarding such an unusual presenta- tion and discussed in detail the possible etiology of such a presentation and the management options when facing such a complex situation. Key words: Femoral fractures; Bone screws; Frac- ture fixation, intramedullary; Fracture healing

  2. Preliminary effect of proximal femoral nail antirotation on emergency treatment of senile patients with intertrochanteric fracture

    Institute of Scientific and Technical Information of China (English)

    TANG Xin; LIU Lei; YANG Tian-fu; TU Chong-qi; WANG Guang-lin; FANG Yue; DUAN Hong; ZHANG Hui; PEI Fu-xing

    2010-01-01

    Objective: To retrospectively analyse the clinical outcome of emergency treatment of senile intertrochanteric fractures with proximal femoral nail antirotation (PFNA).Methods: 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 hours after injury. There were 10 type Ⅰ fractures, 19 type Ⅱ and 6 type Ⅲ according to upgraded Evans-Jensen classification system. All patients were complicated with osteoporosis, and 19 patients had preexisting internal medical diseases. According to the rating scale of disease severity by the American Society of Anesthesiologists (ASA), there were 9 grade Ⅰ, 14 grade Ⅱ, 8 grade Ⅲ, and 4 grade Ⅳ.Results: The duration for operation ranged from 45 to 73 minutes with an average of 57.6 minutes. The volume of blood loss during operation ranged from 50 to 120 ml with an average of 77.5 ml. Patients could ambulate 2-4 days after operation (mean 3.5 days). Hospital stay was 4-7 days (mean 5.3 days). Full weight bearing time was 10-14 weeks (mean 12.8 weeks). During hospitalization period, there was no regional or deep infection, hypostatic pneumonia, urinary tract infection and bedsore except for 2 cases of urine retention. All cases were followed up with an average period of 12.3 months, and bone healing achieved within 15-18 weeks (mean 16.6 weeks). No complications such as delayed union, coxa vara or coxa valga, screw breakage or backout occurred and only 2 cases had trochanter bursitis because of thin body and overlong end of the antirotated nail. According to the Harris grading scale, the results were defined as excellent in 21 cases, good in 9 cases and fair in 5 cases, with the excellent and good rates of 85.7%.Conclusion: The emergency treatment of senile intertrochanteric fracture with proximal femoral nail antirotation has the advantages of minimal invasion, easy manipulation,less blood loss

  3. Mechanical failures after fixation with proximal femoral nail and risk factors

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    Koyuncu S

    2015-12-01

    Full Text Available Şemmi Koyuncu,1 Taşkın Altay,2 Cemil Kayalı,2 Fırat Ozan,3 Kamil Yamak2 1Department of Orthopedics and Traumatology, Bayburt State Hospital, Bayburt, 2Department of Orthopedics and Traumatology, İzmir Bozyaka Training and Research Hospital, İzmir, 3Department of Orthopedics and Traumatology, Kayseri Training and Research Hospital, Kayseri, Turkey Background: This study aims at assessing the clinical results, radiographic findings, and associated complications after osteosynthesis of trochanteric hip fractures with proximal femoral nail (PFN.Methods: A total of 152 patients with hip fractures who underwent osteosynthesis with PFN were included. The hip fracture types in the patients included in the study were classified according to the American Orthopedic/Orthopedic Trauma Association (AO/OTA. AO/OTA A1, A2, and A3 type fractures were found in 24 (15.8%, 107 (70.4%, and 21 (13.8% patients, respectively. The Baumgaertner scale was used to assess the degree of postoperative reduction. The Salvati–Wilson hip function (SWS scoring system was used to evaluate functional results. After a follow-up period, clinical and radiographic results were evaluated and complications were assessed. The relationship between the complications and SWS score, age, sex, fracture type, reduction quality, and time from the fracture to surgery was evaluated.Results: Eighty-five (55.9% female patients and 67 (44.1% male patients were enrolled in the study. Seventy-nine (51.9% patients had left hip fractures, and 73 (48.1% had right hip fractures. The mean age was 76 (range 21–93 years, and the mean follow-up duration was 23.6 (range 7–49 months. Postoperatively, one patient (0.6% had a poor reduction, 16 patients (10.5% had an acceptable reduction, and 135 patients (88.9% had a good reduction according to the above criteria. The SWS scores were excellent, good, moderate, and poor in 91 (59.8%, 45 (29.6%, 15 (9.8%, and one (0.6% patients, respectively. Late

  4. A novel method of removal of a broken drill bit in the femoral medullary canal during internal fixation of a type C distal femoral fracture: a case report

    Institute of Scientific and Technical Information of China (English)

    Varatharaj Mounasamy; Pingal Desai; Satya Mallu; Senthil Sambandam

    2012-01-01

    Breakage of surgical instruments and implants during operative procedures is not uncommon in any surgical discipline.The need for removal and the outcome of leaving the broken instruments and implants in the surgical area have not been described in detail.Few studies have suggested removal if they are lying loosely in the tissues or joint,close to neurovascular structures.Challenges and the amount of time spent in the retrieval of broken instruments and implants are well known among surgeons,so most choose to leave them in situ.We reported a novel method of retrieval of a broken drill bit in the femoral medullary canal during internal fixation of a type C distal femoral fracture.

  5. Comparative endurance testing of the Biomet Matthews Nail and the Dynamic Compression Screw, in simulated condylar and supracondylar femoral fractures

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    Davies Benjamin M

    2008-01-01

    Full Text Available Abstract Background The dynamic compression screw is a plate and screws implant used to treat fractures of the distal femur. The Biomet Matthews Nail is a new retrograde intramedullary nail designed as an alternative surgical option to treat these fractures. The objective of this study was to assess the comparative endurance of both devices. Method The dynamic compression screw (DCS and Biomet Matthews Nail (BMN were implanted into composite femurs, which were subsequently cyclically loaded using a materials testing machine. Simulated fractures were applied to each femur prior to the application of load. Either a Y type fracture or a transverse osteotomy was prepared on each composite femur using a jig to enable consistent positioning of cuts. Results The Biomet Matthews Nail demonstrated a greater endurance limit load over the dynamic compression screw in both fracture configurations. Conclusion The distal locking screws pass through the Biomet Matthews Nail in a unique "cruciate" orientation. This allows for greater purchase in the bone of the femoral condyle and potentially improves the stability of the fracture fixation. As these fractures are usually in weak osteoporotic bone, the Biomet Matthews Nail represents a favourable surgical option in these patients.

  6. SURGICAL OUTCOMES OF SUBTROCHANTERIC FRACTURES OF FEMUR TREATED WITH PROXIMAL FEMORAL NAIL (PFN

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    Jenson

    2016-06-01

    Full Text Available BACKGROUND AND OBJECTIVES Subtrochanteric fractures of the femur remain one of the most challenging fractures facing orthopaedic surgeons. Most of the fractures in the elderly results from trivial fall from standing or walking, while in the younger age group it is mainly due to road traffic accidents. Closed management of these subtrochanteric fractures thus poses difficulties in obtaining and maintaining a reduction, making operative management the preferred treatment. Hence, this study is intended to determine the effectiveness of intramedullary fixation of subtrochanteric fractures with the proximal femoral nail and the complications involved in the management of subtrochanteric fractures. METHODOLOGY This is a prospective study of 90 cases of Subtrochanteric fracture admitted to Tagore Medical College and Hospitals between October 2013 and Jan 2016 treated with the proximal femoral nail. Cases were taken according to inclusion and exclusion criteria, i.e. fresh Subtrochanteric fracture in adults. Pathologic fractures, multiple fractures, fractures in children, old neglected fractures were excluded from the study. RESULTS In our study of 90 cases, there were 75 male and 15 female patients with age ranging from 17 years to 75 years with most patients in between 21-40 years; 67% of the cases admitted were road traffic accidents, 23% due to fall from height and 10% due to trivial fall with right side being more common side affected. Russell and Taylor type IA fracture accounted for 40% of cases. Mean duration of hospital stay was 12 days and mean time of full weight bearing was 14 weeks in our patients. Out of 90 cases, 9 cases were lost in follow-up and 3 cases died. Good-to-excellent results were seen in 80% of cases in our study. CONCLUSION From our study, we conclude that PFN is a reliable implant for subtrochanteric fractures leading to high rate of bone union and minimal soft tissue damage. Intramedullary fixation has biological and

  7. A comparison of effi cacy of femoral and tibial fractures healing treated by static and dynamic intramedullary nails

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    Đemil Omerović

    2012-12-01

    Full Text Available Introduction: Intramedullary nailing is synthesis and  consolidation of fracture fragments with the main goalto gain strength and permanent placement of the implants. Two techniques of intramedullary osteosynthesis are used: with dynamic or with static intramedullary nail. Dynamization include conversion of static nail by removing screws from the longest fragment. The aim of this study is to determine whether there is a difference in the speed and quality of healing of the type A and B fractures of the femur and tibia treated by static or dynamic intramedullary nails and to compare the results.Methods: The study was conducted on a total of 129 patients with closed fractures of the diaphysis of the femur and tibia type A and type B. Patients were divided into two groups, based on the applied operating method, static or dynamic intramedullary osteosynthesis.Results: The average number of weeks of healing femoral and tibial fractures was slightly in advantage of static intramedullary osteosynthesis, it was 17.08 weeks (SD=3.382. The average number of weeks of healing in 23 patients with fractures of the femur, treated by dynamic intramedullary osteosynthesis was 17.83 (SD=2.978.Conclusion: We can conclude that static intramedullary nailing osteosynthesis unable movements between fragments which directly stimulates bone formation and formation of minimal callus. Static intramedullary ostesinthesys resolve the problem of stabilizing the fracture, limb shortening and rotation of fragments.

  8. Treatment options for unstable trochanteric fractures: Screw or helical proximal femoral nail

    Institute of Scientific and Technical Information of China (English)

    Jeetendra Bajpai; Rajesh Maheshwari; Akansha Bajpai; Sumit Saini

    2015-01-01

    Purpose: To compare treatment outcome of screw proximal femoral nail (PFN) system with that of a helical PFN.Methods: The study included 77 patients with closed unstable intertrochanteric fracture classified as AO 31A2 & 31A3, between June 2008 to August 2011.Inclusion criteria were: all mature skeletons above 50 years of age;closed unstable trochanteric fracture classified as AO 31A2 & A3.Exclusion criteria were: immature skeleton, pathological fracture of any cause other than osteoporosis, inability to walk independently prior to injury.Patients were randomized to 2 treatment groups based on admission sequence.Forty patients were treated with screw PFN and thirty seven were treated with helical PFN.Results: Both groups were similar in respect of time of surgery, blood loss and functional assessment and duration of hospitalization.In screw PFN group 2 patients had superficial wound infection, 1 patient had persistent hip pain and 1 patient had shortening >1 cm but <2 cm, while in helical PFN group 1 patient had superficial wound infection.Conclusion: Both screw and helical PFN are very effective implants in osteoporotic and unstable trochanteric fractures even in Indian patients where the bones are narrow and neck diameter is small.It is an implant of choice for osteoporotic and unstable trochanteric fractures.

  9. Augmentation plating in hypertrophic non-union after nail fixation of femoral shaft fracture compared with exchange plating

    Institute of Scientific and Technical Information of China (English)

    Jiang Liangjun; Pan Zhijun; Zheng Qiang

    2014-01-01

    Background Augmentation plating has been used successfully to treat hypertrophic non-union after nail fixation.This study compared the efficacy of augmentation plating and exchange plating for treating hypertrophic non-union of femoral shaft fracture after intramedullary nail fixation.Methods A total of 12 patients received augmentation plating and 15 patients received exchange plating as treatment for femoral shaft hypertrophic non-union.The procedures were conducted at our medical centre between January 2005and January 2012.Clinical follow-up was conducted at 2 weeks,1 month and then monthly until union was achieved to compare union time,operation time,bleeding and complications between the two groups.Results All patients underwent follow-up examinations until fracture union was achieved.The average length of followup time after the second treatment was (18.37±3.28) months.The time needed for union was (4.17±0.94) months in the augmentation plating group and (5.33±1.72) months in the exchange plating group.The operation time was (90.00±17.58) minutes in the augmentation plating group and (160.00±25.35) minutes in the exchange plating group.The amount of blood loss during the operation was (270.00±43.32) ml in the augmentation plating group and (530.00±103.65) ml in the exchange plating group.Both groups showed significant difference (P <0.05) in their results.No complications were reported after the second operation.Conclusions Augmentation plating after nail fixation could remove local rotation instability,facilitate simple operation,create minimal damage and enable exercise for early functional recovery.Therefore,augmentation plating is excellent for treating hypertrophic non-union after nail fixation in femoral shaft fracture.

  10. Quality of life after pertrochanteric femoral fractures treated with a gamma nail: a single center study of 62 patients

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    Giessauf Christian

    2012-10-01

    Full Text Available Abstract Background Intramedullary nailing of pertrochanteric femoral fractures has grown in popularity over the past 2 decades likely because this procedure is associated with a low risk for postoperative morbidity and a fast recovery of function. The evaluation of outcomes associated with pertrochanteric nailing has mainly been based on objective measures. The purpose of the present study is to correlate patients’ health-related quality of life results after intramedullary nailing of pertrochanteric fractures with objective outcome measures. Methods We conducted a single-center study including 62 patients (mean age 80 ± 10 years with pertrochanteric fractures treated with a Gamma 3 Nail. Health related quality of life was measured using the Short Form-36. These results were compared to both US and Austrian age and sex-adjusted population norms. The objective outcome measures studied at one year postoperatively included Harris Hip Score, range of motion, leg length, body mass index, neck-shaft angle and grade of osteoarthritis. Results According to the Harris Hip Score 43 patients (67% had excellent or good results. There was no significant difference in the average neck-shaft angle comparing affected hip to non-affected hip at 12 months postoperatively. The average osteoarthritis score, for both the injured and uninjured hip, did not differ significantly. We found significant differences between the bodily pain, social functioning and mental health subscales and two summary scores of the Short-Form 36 in comparison to Austrian population norms. Complication rate was 8%. Conclusions The results of this study confirm that intramedullary nailing with the use of a Gamma Nail is a safe treatment option for stable and unstable pertrochanteric fractures. Despite good functional and radiographic results we noticed a substantial fall off in patients’ quality of life up to 12 months after operation.

  11. EARLY FUNCTIONAL RESULTS OF UNSTABLE PERTROCHANTERIC FRACTURES TREATED WITH PROXIMAL FEMORAL NAILS IN A PERIPHERAL TERTIARY CARE CENT RE

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    Bharath Kumar

    2015-05-01

    Full Text Available BACKGROUND : Pertrochanteric fractures forms a major share of proximal femoral fractures in young and old . Proper implant selection and surgical planning plays a pivotal role in providing fracture union and early rehabilitation of patients to prevent complications due to recumbency . AIM : The aim of this retrospective study is to assess the results of proximal femoral nails in unstable pertrochanteric f ractures . MATERIALS AND METHODS : This study was performed in the Department of Orthopaedic Surgery , Chettinad hospital and research institute , Kelambakkam between November 2012 and December 2014 . 15 patients with pertrochanteric fractures were retrospectively followed . Among the fifteen 9 were male and 6 were female with an average age of 43 . Eleven patients sustained Intertrochanteric fractures , 8 of A2 type and 3 of A3 type according to AO classification . 4 patients had subtroch anteric fractures of seinseimer Type 5 . RESULTS : Short PFN was used in all the 11 Intertrochanteric fractures and long PFN was used in the 4 subtrochanteric fractures . All fractures healed by around 3 . 5 months . There is one case of varus malunion and one c ase of screw pullout which required implant removal . The limitations of this study are its retrospective nature , small sample size and short follow up . CONCLUSION : Our results show that proximal femoral nails being load sharing implants form an ideal choic e for stabil ising pertrochanteric fractures . Minimally invasive technique of insertion with less blood loss make it an ideal choice in such complex scenarios .

  12. Type II Intertrochanteric Fractures: Proximal Femoral Nailing (PFN Versus Dynamic Hip Screw(DHS

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    Cyril Jonnes

    2016-01-01

    Full Text Available Background: Intertrochanteric fracture is one of the most common fractures of the hip especially in the elderly with osteoporotic bones, usually due to low-energy trauma like simple falls. Dynamic Hip Screw (DHS is still considered the gold standard for treating intertrochanteric fractures by many. Not many studies compare the DHS with Proximal femoral nail (PFN, in Type II intertrochanteric fractures (Boyd and Griffin classification. This study was done to compare the functional and radiological outcome of PFN with DHS in treatment of Type II intertrochanteric fractures.   Methods: From October 2012 to March 2015, a prospective comparative study was done where 30 alternative cases of type II intertrochanteric fractures of hip were operated using PFN or DHS. Intraoperative complications were noted. Functional outcome was assessed using Harris Hip Score and radiological findings were compared at 3, 6, and 12 months postoperatively. Results: The average age of the patients was 60 years. In our series we found that patients with DHS had increased intraoperative blood loss (159ml, longer duration of surgery (105min, and required longer time for mobilization while patients who underwent PFN had lower intraoperative blood loss (73ml, shorter duration of surgery (91min, and allowed early mobilization. The average limb shortening in DHS group was 9.33 mm as compared with PFN group which was only 4.72 mm. The patients treated with PFN started early ambulation as they had better Harris Hip Score in the early post-op period. At the end of 12th month, there was not much difference in the functional outcome between the two groups. Conclusion: PFN is better than DHS in type II inter-trochanteric fractures in terms of decreased blood loss, reduced duration of surgery, early weight bearing and mobilization, reduced hospital stay, decreased risk of infection and decreased complications.

  13. Decreased muscle strength is associated with impaired long-term functional outcome after intramedullary nailing of femoral shaft fracture

    DEFF Research Database (Denmark)

    Larsen, Peter; Elsøe, Rasmus; Graven-Nielsen, Thomas;

    2015-01-01

    -up with clinical examination of 48 patients treated with intramedullary nailing after femoral shaft fracture between 2007 and 2010. The patients underwent a clinical examination and assessment of walking ability, maximal muscle strength during knee flexion and extension and hip abduction. Hip disability...... and Osteoarthritis Outcome Score (HOOS) and questionnaire evaluating QOL (Eq5D-5L) were completed by patients.RESULTS:Fourty-eight patients agreed to participate. Mean time for follow-up was 4.7 years. The mean HOOS scores were 84.9 (Pain), 86.6 (ADL), 85.0 (Symptoms), 72.6 (QOL), and 69.1 (Sport). The mean muscle...

  14. Proximal Femoral Nail Antirotation Versus Reverse Less Invasive Stabilization System-distal Femur for Treating Proximal Femoral Fractures: A Meta-analysis.

    Science.gov (United States)

    Jiang, Xuan; Wang, Ying; Ma, XinLong; Ma, JianXiong; Wang, Chen; Zhang, ChengBao; Han, Zhe; Sun, Lei; Lu, Bin

    2016-04-01

    The aim of this study was to compare the effectiveness and safety of 2 surgical techniques that are used to treat proximal femoral fractures.A systematic literature search (up to December 2014) was conducted in Medline, Embase, PubMed, and The Cochrane Central Register of Controlled Trials to screen for studies comparing proximal femoral nail antirotation (PFNA) with less invasive stabilization system-distal femur (LISS-DF) for proximal femoral fractures. Two authors independently assessed the methodological quality of the included studies and extracted data. Surgical information and postoperative outcomes were analyzed.A total of 7 studies with 361 patients who satisfied the eligibility criteria included 3 randomized controlled trials and 4 case-controlled trials associated with PFNA versus LISS in treating proximal femoral fractures. Our results demonstrated that there was a significant reduction in hospital stay and time to weight-bearing ambulation and bone healing for PFNA compared with LISS (odds ratio [OR] -1.48, 95% confidence interval [CI] -2.92 to -0.05; OR -7.08, 95% CI -8.32 to -5.84; OR -2.71, 95% CI -4.76 to 0.67). No statistically significant difference was observed between the 2 groups for operative time, blood loss volume, Harris hip score, and incidence of complications.Based on the results of this analysis, we inferred that PFNA is safer and more effective than reverse LISS-DF in patients undergoing osteosynthesis for proximal femoral fractures, and that PFNA is associated with reduced hospital stays and reduced time to weight-bearing ambulation and bone healing. Nonetheless, in certain cases in which PFNA is not suitable due to abnormal structure of the proximal femur or particularly unstable fractures, the LISS plate technique could be a useful alternative. PMID:27057840

  15. Intramedullary nailing of femoral shaft fractures in polytraumatized patients. a longitudinal, prospective and observational study of the procedure-related impact on cardiopulmonary- and inflammatory responses

    OpenAIRE

    Husebye Elisabeth E; Lyberg Torstein; Opdahl Helge; Aspelin Trude; Støen Ragnhild Ø; Madsen Jan Erik; Røise Olav

    2012-01-01

    Background Early intramedullary nailing (IMN) of long bone fractures in severely injured patients has been evaluated as beneficial, but has also been associated with increased inflammation, multi organ failure (MOF) and morbidity. This study was initiated to evaluate the impact of primary femoral IMN on coagulation-, fibrinolysis-, inflammatory- and cardiopulmonary responses in polytraumatized patients. Methods ...

  16. Early intramedullary nailing for femoral fractures in patients with severe thoracic trauma: A systemic review and meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Xiao-Yuan Liu; Meng Jiang; Cheng-La Yi; Xiang-Jun Bai; David J.Hak

    2016-01-01

    Purpose:Early intramedullary nailing (IMN) within the first 24 h for multiply injured patients with femoral fracture and concomitant thoracic trauma is controversial.Previously published studies have been limited in size and their outcomes have been inconclusive.A meta-analysis was conducted to evaluate the available data in order to guide care and help improve the outcomes for these patients.Methods:We searched the literature up to December 2011 in the main medical search engines and identified 6 retrospective cohort studies that explored the safety of early IMN in patients with both femoral fracture and chest injury.Our primary outcome was the rates of pulmonary complication (pneumonia,adult respiratory distress syndrome,fat embolism syndrome),multiple organ failure (MOF) and mortality.Results:We found no statistically significant difference in the rate of pulmonary complications,MOF or mortality in the patients treated with early IMN.Conclusion:Early IMN for femoral fractures does not increase the mortality and morbidity in chestinjured patients in the studies analyzed.

  17. Outcome analysis of retrograde nailing and less invasive stabilization system in distal femoral fractures: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Christian Hierholzer

    2011-01-01

    Full Text Available Background: Two major therapeutic principles can be employed for the treatment of distal femoral fractures: retrograde intramedullary (IM nailing (RN or less invasive stabilization on system (LISS. Both operative stabilizing systems follow the principle of biological osteosynthesis. IM nailing protects the soft-tissue envelope due to its minimally invasive approach and closed reduction techniques better than distal femoral locked plating. The purpose of this study was to evaluate and compare outcome of distal femur fracture stabilization using RN or LISS techniques. Materials and Methods: In a retrospective study from 2003 to 2008, we analyzed 115 patients with distal femur fracture who had been treated by retrograde IM nailing (59 patients or LISS plating (56 patients. In the two cohort groups, mean age was 54 years (17-89 years. Mechanism of injury was high energy impact in 57% (53% RN, 67% LISS and low-energy injury in 43% (47% RN, 33% LISS, respectively. Fractures were classified according to AO classification: there were 52 type A fractures (RN 31, LISS 21 and 63 type C fractures (RN 28, LISS 35; 32% (RN and 56% (LISS were open and 68% (RN and 44% (LISS were closed fractures, respectively. Functional and radiological outcome was assessed. Results: Clinical and radiographic evaluation demonstrated osseous healing within 6 months following RN and following LISS plating in over 90% of patients. However, no statistically significant differences were found for the parameters time to osseous healing, rate of nonunion, and postoperative complications. The following complications were treated: hematoma formation (one patient RN and three patients LISS, superficial infection (one patient RN and three patients LISS, deep infection (2 patients LISS. Additional secondary bone grafting for successful healing 3 months after the primary operation was required in four patients in the RN (7% of patients and six in the LISS group (10% of patients

  18. Comparative biomechanical study of reversed less invasive stabilization system and proximal femoral nail antirotation for unstable intertrochanteric fractures

    Institute of Scientific and Technical Information of China (English)

    Chen Ying; Liu Shouyao; Lin Peng; Wang Yunting; Wang Jinhui; Tao Jianfeng; Cai Rongrong

    2014-01-01

    Objective Unstable intertrochanteric fractures (ITFs) are mostly treated by proximal femoral nail antirotation (PFNA),Inter-Tan,Asian Hip,and other new internal fixation devices.But for complex unstable fractures,such as crushed lateral wall of the greater trochanter,the loss of fixation point on lateral wall slightly reduces the fixing effect.This study aimed to compare the biomechanical strengths between reversed less invasive stabilization system (LISS) and PFNA for treatment of unstable ITFs.Methods Forty synthetic femurs were used to simulate unstable ITFs in vitro and were fixed using the reversed LISS or PFNA.These fractures were divided into two groups depending on whether the lateral wall of the greater trochanter is intact or not (AO classification:31-A2.3 and 31-A3.3,respectively).The load-displacement of femur,stiffness,ultimate load,and cyclic fatigue resistance were detected using an incremental load test and a dynamic fatigue test through an MTS 858 test system.Results For both 31-A2.3 and 31-A3.3,the vertical sinking displacement (VSD) of the femoral head under 500 N load was insignificantly smaller after treatment with reversed LISS than with PFNA,and when the displacement was 5 mm,the femoral head bore insignificantly greater load.The fixation with reversed LISS resulted in greater axial stiffness of the femur but smaller ultimate load.During the same cycle in the dynamic fatigue test,the VSD was insignificantly smaller with the fixation of reversed LISS.Conclusion Reversed LISS and PFNA have similar biomechanical strength for unstable ITFs.This conclusion should be supported by additional large-size research on basic biomechanics and clinical application.This is the first comparative biomechanical study comparing reversed LISS and PFNA for unstable ITFs.

  19. Application of Küntscher nail technique with screws on the femoral fractures

    OpenAIRE

    Cakmak, Mehmet; Taser, Omer; Domanic, Unsal; Hamzaoglu, Azmi; Ozturk, Irfan

    2004-01-01

    Küntscher nail with screws was applied in two subtrochanteric and one supracondylar femur fractures which were believed no sufficient stabilization would be obtained with usual application of Küntscher. The results of these cases which have been followed-up at least for one year were presented. The method of screwed Küntscher with its indications and application techniques was discussed under the light of literature.

  20. Periprosthetic supracondylar femoral fractures following total knee arthroplasty: clinical comparison and related complications of the femur plate system and retrograde-inserted supracondylar nail

    OpenAIRE

    Gondalia, Viral; Choi, Duck Hyun; Lee, Su Chan; Nam, Chang Hyun; Hwang, Bo Hyun; Ahn, Hye Sun; Ong, Alvin C.; Park, Ha Young; Jung, Kwang Am

    2014-01-01

    Background The purpose of this study is to analyze the clinical results and related complications of the femur plate system (FP) and the retrograde-inserted supracondylar nail (RISN). Materials and methods The study included 42 cases of periprosthetic supracondylar femoral fractures (PSF) proximal to posterior stabilized total knee arthroplasty between 2005 and 2009. Twenty-four cases of PSF were treated with the FP, and the other 18 cases were treated with the RISN. This study cohort was div...

  1. A new, lateral, continuous, combined, femoral–sciatic nerve approach via a single skin puncture for postoperative analgesia in intramedullary tibial nail insertion

    OpenAIRE

    Imbelloni, Luiz; Rava,; Gouveia,

    2013-01-01

    Luiz Eduardo Imbelloni,1,2 Carlos Rava,1,3 Marildo A Gouveia21Faculdade de Medicina Nova Esperança, 2Institute for Regional Anesthesia, 3Complexo Hospitalar de Mangabeira Governador Tarcisio Burity, João Pessoa, BrazilBackground: The prevalence of anterior knee pain following intramedullary tibial nail insertion is high. Continuous peripheral nerve blockade is an alternative method of pain control to opiods. This case illustrates the use of femoral nerve and sciatic nerv...

  2. INTRA MEDULLARY FIXATION OF SUB TROCHANTERIC FRACTURERS WITH LONG PROXIMAL FEMORAL NAIL & STAINLESS STEEL WIRE FIXATION: A STUDY

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    Sree Krishna

    2015-01-01

    Full Text Available INTRODUCTION: The objective of this study was to prospectively evaluate the clinical outcome of traumatic subtrochanteric fractures fixed with long proximal femoral nail (PFN & Stainless s te e l wire banding Fixation with particular emphasis on our experience of surgical techniques. Materials and Methods: We reviewed the results of 49 consecutive patients who had undergone intramedullary fixation specifically with a long PFN with S.S wire banding fixation for traumatic subtrochanteric fractures in our hospital during a 2 - year period from January 2013 to December 2014. The average age of the patients was 53 years. Clinical and radiographic analyses were performed when follow - up was made at 6 weeks, 12 weeks, 6 months, 1 year and 2 years. Results: All the 49 traumatic subtro chanteric fractures healed uneventfully except 1 case of delayed union. Walking and squatting ability was completely restored in every case at follow - up examination 6 months postoperatively. Among them, 32 fractures were successfully reduced with traction on a fracture table under fluoroscopy & cerclage wiring or bandage with S.S wire of various diameters (1.6, 1.8 etcthrough a small incision near the fragment to be fixed. The average operative time was 70 minutes (range, 45 to 120. Seventeen Seinsheimer type II fractures were left unlocked distally, and static distal interlocking with 1 bolt was carried out in the other 31 cases. No complications such as cutout or breakage of the implants were encountered. Conclusions: The objective of this study was to evaluate the clinical and radiological outcome of traumatic subtrochanteric fractures with trochanteric exten sion treated with long proximal femoral locking nail (PFNL & S.S wire. This study suggests that long PFN is a reliable implant for subtrochanteric fractures, leading to high rate of bone union and minimal soft tissue damage. Intramedullary fixation has bi ological and biomechanical advantages, but the operation

  3. COMPARATIVE STUDY BETWEEN TITANIUM ELASTIC NAILING (TENS AND DYNAMIC COMPRESSION PLATING (DCP IN THE TREATMENT OF FEMORAL DIAPHYSEAL FRACTURES IN CHILDREN

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    Ramasubba Reddy

    2015-08-01

    Full Text Available BACKGROUND : Orthopaedic surgeons have long maintained that all children who have sustained a diaphyseal fracture of femur recover with c onservative treatment, given the excellent remodeling ability of immature bone in children. Angulations, shortenings and malrotations are not always corrected by conservative treatment. Of many surgical options, titanium elastic nailing has been the newer implant which is being used regularly. Although good results have been reported with elastic intramedullary nails, plate fixation continues to be a viable alternative in surgical treatment of femoral shaft fractures. However there are not many studies comp aring the efficiency of titanium elastic nailing and plating for femoral diaphyseal fractures in pediatric age group. AIM : The present study aims to compare the surgical management of diaphyseal fractures of femur in children with Dynamic Compression Plati ng versus Titanium Elastic Nailing. DESIGN : This is a prospective study . MATERIALS AND METHODS : This prospective study was conducted in a tertiary hospital. Patients who presented to the out - patient department and casualty of the hospital with femoral diap hyseal fractures during April 2012 to June 2014 were considered for the study. Subjects fulfilling the predetermined inclusion and exclusion criteria were included in the study. STATISTICAL METHODS : Fisher Exact test, Chi - Square Test, Student t test (Two t ailed, independent . RESULTS : Patients in the age group of 6 - 14 years were considered for the study, Patients were divided into two groups and treated with DCP/TENS. The duration of surgery, hospital stay, and, amount of blood loss was minimal in TENS grou p. Callus was seen early in TENS group. Radiological union was early in TENS group by 2 - 3 weeks. Outcome was better in patients treated with TENS (Excellent - 70%; Satisfactory – 30%; Poor - 0% in comparison to DCP (Excellent - 70%; Satisfactory - 25%; Poor - 5%. CO NCLUSION : TENS

  4. Using Three-Dimensional Computational Modeling to Compare the Geometrical Fitness of Two Kinds of Proximal Femoral Intramedullary Nail for Chinese Femur

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    Sheng Zhang

    2013-01-01

    Full Text Available Objective. The aim of this study was to use three-dimensional (3D computational modeling to compare the geometric fitness of these two kinds of proximal femoral intramedullary nails in the Chinese femurs. Computed tomography (CT scans of a total of 120 normal adult Chinese cadaveric femurs were collected for analysis. With the three-dimensional (3D computational technology, the anatomical fitness between the nail and bone was quantified according to the impingement incidence, maximum thicknesses and lengths by which the nail was protruding into the cortex in the virtual bone model, respectively, at the proximal, middle, and distal portions of the implant in the femur. The results showed that PFNA-II may fit better for the Chinese proximal femurs than InterTan, and the distal portion of InterTan may perform better than that of PFNA-II; the anatomic fitness of both nails for Chinese patients may not be very satisfactory. As a result, both implants need further modifications to meet the needs of the Chinese population.

  5. Soft tissue injury related to choice of entry point in antegrade femoral nailing : piriform fossa or greater trochanter tip

    NARCIS (Netherlands)

    Moein, CMA; Verhofstad, MHJ; Bleys, RLAW; van der Werken, C

    2005-01-01

    Intramedullary nailing through the piriform fossa results in some cases in toss of abduction strength and persistent pain. Nail insertion at the tip of the greater trochanter may be favourable. The aim of this study was to assess (possible) iatrogenic injury to the abductor and external rotator musc

  6. Three-dimensional finite element analysis on intramedullary controlled dynamic nailing for femoral shaft fracture%髓内持骨动力性髓内钉固定股骨干骨折的三维有限元分析

    Institute of Scientific and Technical Information of China (English)

    王国栋; 姜海波; 张元民; 赵晓伟; 潘滔

    2014-01-01

    背景:交锁髓内钉并发症诸如锁钉弯曲或断裂、退出,钉尾或锁钉孔处再骨折仍然存在,基于此,作者所在课题组设计了一种新型的髓内持骨动力性髓内钉。  目的:检验髓内持骨动力性髓内钉设计和强度的合理性与安全性,并就其临床应用和改进提出合理建议。  方法:分别建立全股骨及髓内持骨动力性髓内钉固定股骨干横形骨折三维有限元模型。对全股骨模型和骨折模型进行垂直加载及步态分析,了解各模型的应力分布和动力加压特点。  结果与结论:在承重载荷下,全股骨模型的股骨颈部及股骨干内外侧缘存在较明显应力集中,骨折模型的应力集中部位位于髓内钉顶端及锁钉周围;步态中,全股骨模型的股骨远端1/2前内侧及股骨颈部存在应力集中,骨折模型的应力集中部位位于髓内钉顶端及锁钉周围;髓内持骨动力性髓内钉有断端动力性加压功能。说明这种髓内持骨动力性髓内钉结构合理,具有良好的生物力学性能。%BACKGROUND:Interlocking intramedul ary nail complications contain nail bent or broken, exit, re-fracture at spiketail or nail hole. Thus, our team designs a novel intramedul ary control ed dynamic nail. OBJECTIVE:To evaluate the rationality and safety of intramedul ary control ed dynamic nail design and strength, and to give rational proposal for its clinical application. METHODThe three-dimensional finite element models of composite femur, transverse fractures of the femoral shaft were constructed with intramedul ary control ed dynamic nailing. The stress and strain were detected under vertical loads and gait cycle. RESULTS AND CONCLUSION:The maximum stress of the intact femur under the compression load was at femoral neck and the medial and lateral aspects of the femoral shaft;while the stresses of fractured femur were at the interface between screw and screw hole. In

  7. Functional outcome in treatment of elderly unstable proximal femoral fractures with PFNA or Gamma nails%PFNA和Gamma钉治疗老龄患者不稳定股骨近端骨折的对照研究

    Institute of Scientific and Technical Information of China (English)

    邱志杰; 徐红革; 王良恩; 杨勇; 杨斌

    2011-01-01

    Objective To compare outcome of elderly patients with unstable proximal femoral fractures treated by the proximal femoral nail (PFNA) and the Gamma nail. Methods This study was a retrospective clinical study in which 69 patients with an unstable proximal femoral fracture treated by proximal femoral nail antirotation or Gamma nail. Follow-up visits occurred at 6 weeks, 12weeks, 6 months and 12 months. Results were measured by perioperative data, functional outcome, pain score, living conditions, fracture healing and main complications. Results The ability to walk at 12 weeks was significantly better in the PFNA group compared to the Gamma nail group ( P < 0. 05 ). More delay fracture healing and nonunion were found in Gamma nails than in PFNA group (P < 0. 05 ). The PFNA group had more major complications and reoperations rate compared to the Gamma nail group ( P < 0. 05 ). Conclusion Unstable proximal femoral fracture could be treated successfully by the two methods. Advanta ges with the PFNA were the lower reoperation rate, femoral head cut out and refracture, and the PFNA group was prior to Gamma nail group in early rehabilitation period.%目的 比较股骨近端抗旋转髓内钉(PFNA)和Gamma钉治疗老龄患者不稳定股骨近端骨折的疗效.方法 回顾分析采用PFNA或Gamma钉固定治疗的69例不稳定股骨近端骨折患者,术后4周、12周、6个月、12个月定期随访.评价指标有围手术期资料、功能和疼痛评估、生活状况、骨折愈合情况和主要并发症等.结果 在12周时行走能力PFNA组明显优于Gamma钉组(P <0.05).Gamma钉组延迟愈合和骨不连发生率高于PFNA组(P<0.05).PFNA组并发症和再手术率低于Gamma钉组(P<0.05).结论 两种治疗方法都能取得良好的手术疗效,PFNA的优点为较低的再手术率、股骨头切出率、再骨折率,在早期康复阶段有优势.

  8. Comparison of Outcome of Femoral Shaft Fracture Fixation with Intramedullary Nail in Elderly Patient and Patients Younger than 60 Years Old

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    Asgar Elmi

    2014-06-01

    Full Text Available Background:   Although intramedullary nailing (IMN is an established and accepted operative treatment for femoral shaft fracture in patients younger than 60, there is a lack of data on the results of this treatment on those over 60. The purpose of this study was to determine if the outcome of IMN for femoral shaft fracture in elderly patients is also acceptable. Particular challenges in this group of patients included osteopenia and other associated multiple medical problems frequently observed. Methods: The outcome of 84 patients who had IMN for femoral shaft fracture was reviewed and the results were compared between two groups of patients (younger than 60 and over 60 year old patients. Complications and mortality was analyzed for each group, and then compared between the two groups by testing the null hypothesis that the outcome of treatment in the two groups are similar (P>0.05. Results: The mean duration of follow up was 57.3 months (range: 10-94 months. Incidence of malunion, nonunion, infection, DVT, and dependence on walker/crutch in the groups were similar and differences were not significant (P>0.05. However, incidence of mortality (P

  9. Biomechanical properties of a structurally optimized carbon-fibre/epoxy intramedullary nail for femoral shaft fracture fixation.

    Science.gov (United States)

    Samiezadeh, Saeid; Fawaz, Zouheir; Bougherara, Habiba

    2016-03-01

    Intramedullary nails are the golden treatment option for diaphyseal fractures. However, their high stiffness can shield the surrounding bone from the natural physiologic load resulting in subsequent bone loss. Their stiff structure can also delay union by reducing compressive loads at the fracture site, thereby inhibiting secondary bone healing. Composite intramedullary nails have recently been introduced to address these drawbacks. The purpose of this study is to evaluate the mechanical properties of a previously developed composite IM nail made of carbon-fibre/epoxy whose structure was optimized based on fracture healing requirements using the selective stress shielding approach. Following manufacturing, the cross-section of the composite nail was examined under an optical microscope to find the porosity of the structure. Mechanical properties of the proposed composite intramedullary nail were determined using standard tension, compression, bending, and torsion tests. The failed specimens were then examined to obtain the modes of failure. The material showed high strength in tension (403.9±7.8MPa), compression (316.9±10.9MPa), bending (405.3±8.1MPa), and torsion (328.5±7.3MPa). Comparing the flexural modulus (41.1±0.9GPa) with the compressive modulus (10.0±0.2GPa) yielded that the material was significantly more flexible in compression than in bending. This customized flexibility along with the high torsional stiffness of the nail (70.7±2.0Nm(2)) has made it ideal as a fracture fixation device since this unique structure can stabilize the fracture while allowing for compression of fracture ends. Negligible moisture absorption (~0.5%) and low porosity of the laminate structure (flexible axially while being relatively rigid in bending and torsion and is strong enough in all types of physiologic loading, making it a potential candidate for use as an alternative to the conventional titanium-alloy intramedullary nails. PMID:26703226

  10. Biomechanical properties of a structurally optimized carbon-fibre/epoxy intramedullary nail for femoral shaft fracture fixation.

    Science.gov (United States)

    Samiezadeh, Saeid; Fawaz, Zouheir; Bougherara, Habiba

    2016-03-01

    Intramedullary nails are the golden treatment option for diaphyseal fractures. However, their high stiffness can shield the surrounding bone from the natural physiologic load resulting in subsequent bone loss. Their stiff structure can also delay union by reducing compressive loads at the fracture site, thereby inhibiting secondary bone healing. Composite intramedullary nails have recently been introduced to address these drawbacks. The purpose of this study is to evaluate the mechanical properties of a previously developed composite IM nail made of carbon-fibre/epoxy whose structure was optimized based on fracture healing requirements using the selective stress shielding approach. Following manufacturing, the cross-section of the composite nail was examined under an optical microscope to find the porosity of the structure. Mechanical properties of the proposed composite intramedullary nail were determined using standard tension, compression, bending, and torsion tests. The failed specimens were then examined to obtain the modes of failure. The material showed high strength in tension (403.9±7.8MPa), compression (316.9±10.9MPa), bending (405.3±8.1MPa), and torsion (328.5±7.3MPa). Comparing the flexural modulus (41.1±0.9GPa) with the compressive modulus (10.0±0.2GPa) yielded that the material was significantly more flexible in compression than in bending. This customized flexibility along with the high torsional stiffness of the nail (70.7±2.0Nm(2)) has made it ideal as a fracture fixation device since this unique structure can stabilize the fracture while allowing for compression of fracture ends. Negligible moisture absorption (~0.5%) and low porosity of the laminate structure (carbon-fibre/epoxy intramedullary nail is flexible axially while being relatively rigid in bending and torsion and is strong enough in all types of physiologic loading, making it a potential candidate for use as an alternative to the conventional titanium-alloy intramedullary nails.

  11. Early results of reverse less invasive stabilization system plating in treating elderly intertrochanteric fractures: a prospective study compared to proximal femoral nail

    Institute of Scientific and Technical Information of China (English)

    YAO Chen; ZHANG Chang-qing; JIN Dong-xu; CHEN Yun-feng

    2011-01-01

    Background Intertrochanteric femur fracture is common in elderly population. Though multiple treatment options are available, the choice of implant remains controversial. The reverse less invasive stabilization system (LISS) plating was introduced for treatment of a patient with ipsilateral intertrochanteric and midshaft femoral fractures. The aim of this research was to compare such technique to intramedullary nailing (proximal femoral nail, PFN) for intertrochanteric fractures.Methods Fifty-six patients with an age of at least sixty-five years and an AO/OTA type-A1 or A2 fractures were included and divided into LISS and PFN treatment group. Background parameters, fracture and surgery details were documented. Follow-up time was at least 12 months. Radiology, complication, Harris Hip Score and Rapid Disability Rating Score (RDRS) were recorded to evaluate fixation status and hip function for each patient during follow-up.Results There was no significant difference between the two groups in surgical time ((48.0±8.6) minutes, vs.(51.8±10.8) minutes, P=0.3836) and intraoperative blood loss ((149.1±45.1) ml vs. (176.4±25.4) ml, P=0.0712). The LISS group had less postoperative haemoglobin (Hb) reduction ((10.2±4.5) g/L Hb, vs. (15.1~5.9) g/L Hb, P=0.0475). There was no complication observed in PFN group. All 31A1 type fracture in LISS group showed 100% maintenance of reduction. One nonunion with locking screw breakage and 2 varus union were found in the LISS group. Postoperative hip function was similar between the two groups.Conclusions Though reverse LISS plating may not be recommended as a routine fixation method for elderly unstable intertrochanteric fractures compared to PFN, it may possibly be reserved for rapid fixation and damage control in polytrauma patients and ORIF of subtrochanteric and reverse oblique intertrochanteric fractures.

  12. Intramedullary nailing of femoral shaft fractures in polytraumatized patients. a longitudinal, prospective and observational study of the procedure-related impact on cardiopulmonary- and inflammatory responses

    Directory of Open Access Journals (Sweden)

    Husebye Elisabeth E

    2012-01-01

    Full Text Available Abstract Background Early intramedullary nailing (IMN of long bone fractures in severely injured patients has been evaluated as beneficial, but has also been associated with increased inflammation, multi organ failure (MOF and morbidity. This study was initiated to evaluate the impact of primary femoral IMN on coagulation-, fibrinolysis-, inflammatory- and cardiopulmonary responses in polytraumatized patients. Methods Twelve adult polytraumatized patients with femoral shaft fractures were included. Serial blood samples were collected to evaluate coagulation-, fibrinolytic-, and cytokine activation in arterial blood. A flow-directed pulmonary artery (PA catheter was inserted prior to IMN. Cardiopulmonary function parameters were recorded peri- and postoperatively. The clinical course of the patients and complications were monitored and recorded daily. Results Mean Injury Severity Score (ISS was 31 ± 2.6. No procedure-related effect of the primary IMN on coagulation- and fibrinolysis activation was evident. Tumor necrosis factor alpha (TNF-α increased significantly from 6 hours post procedure to peak levels on the third postoperative day. Interleukin-6 (IL-6 increased from the first to the third postoperative day. Interleukin-10 (IL-10 peaked on the first postoperative day. A procedure-related transient hemodynamic response was observed on indexed pulmonary vascular resistance (PVRI two hours post procedure. 11/12 patients developed systemic inflammatory response syndrome (SIRS, 7/12 pneumonia, 3/12 acute lung injury (ALI, 3/12 adult respiratory distress syndrome (ARDS, 3/12 sepsis, 0/12 wound infection. Conclusion In the polytraumatized patients with femoral shaft fractures operated with primary IMN we observed a substantial response related to the initial trauma. We could not demonstrate any major additional IMN-related impact on the inflammatory responses or on the cardiopulmonary function parameters. These results have to be interpreted

  13. Gamma钉、PFNA及股骨重建钉治疗老年股骨粗隆间骨折的临床对比分析%Clinical comparative analysis of gamma nail,PFNA and reconstruction interlocking nail in the treatment of intertrochanteric femoral frac-ture in elderly

    Institute of Scientific and Technical Information of China (English)

    赵苛棋; 周维锋; 徐建桥

    2015-01-01

    目的:探讨Gamm钉、PFNA及股骨重建钉治疗老年股骨粗隆间骨折的临床疗效对比。方法选取2013年1月至2013年12月收治的老年股骨粗隆间骨折患者78例,根据手术方法将其分为3组,PFNA组56例,Gamma钉治疗组12例,股骨重建钉组10例。比较两组患者的临床指标、髋关节功能及术后并发症情况。结果 PFNA组及股骨重建钉组手术时间、术中出血量、骨折愈合时间均明显小于股骨Gamma钉组,差异有统计学意义(P0.05)。Parker髋关节功能评定结果显示,Gamma钉组、PFNA组及股骨重建钉组3组术后总优良率分别为75%、92.8%、90%,PFNA组及股骨重建钉组高于Gamma钉组(P<0.05);术后并发症的发生率PFNA组低于其他两组(P<0.05)。结论 PFNA、Gamma钉及股骨重建钉均是治疗不稳定型股骨粗隆间骨折的有效方法,股骨重建钉及PFNA具有创伤小、手术方法简单、术后恢复快、并发症少等优点,更适合于临床应用。%Objective To investigate the clinical efficacies of gamma nail, PFNA and reconstruction interlocking nail in the treatment of in-tertrochanteric femoral fracture. Methods 78 aged patients with intertrochanteric femoral fracture admitted in our hospital from January 2013 to Decem-ber 2012 were divided into three groups:gamma nail group(n=12), PFNA group(n=56), and reconstruction interlocking nail group (n=10),according to the operation method. Clinical indexes, hip joint function and complications of the three groups were compared. Results The operation time and healing time both in PFNA and reconstruction interlocking nail group were significantly shorter than those of the gamma nail group, intraoperative blood loss was less than that of the gamma nail group, and the differences were statistically significant ( P<0.05). The hospital time of the PFNA and reconstruction interlocking nail group was both shorter than that of the gamma nail group, the total

  14. Elastic stable intramedullary nailing of femoral shaft fractures in children: Particularities and results at Sylvanus Olympio teaching hospital of Lomé, Togo

    Directory of Open Access Journals (Sweden)

    Akakpo-Numado Gamedzi Komlatsè

    2014-01-01

    Full Text Available Introduction: The elastic stable intramedullary nailing (ESIN presently seems the best technique in the surgical treatment of femoral shaft fractures (FSF in >6-year-old children. We hereby report technical difficulties and therapeutic results after our first 8 years of experience. Patients and Methods: It′s a retrospective study over a period of 8 years from January 2005 to December 2012 in the Paediatric Surgery Department of Sylvanus Olympio Teaching Hospital of Lomé. Indications, technical particularities and results were studied. Results: There were 32 patients, 17 were boys and 15 were girls, with a mean age of 11 years old. The mean time to surgery was 21 days (range: 14 and 51 days. A callus was always removed before reduction. The osteosynthesis was stable in 22 cases, but in 10 others, it had been completed with a cast immobilisation. The operation needed a blood transfusion in 18 cases. With a mean follow-up of 3.5 years, the results were excellent in 29 patients (90.63% and good in 3 patients (9.37%. Conclusion: Although undertaking an ESIN can be difficult, due to the lack of adequate equipment the procedure produces satisfactory outcome.

  15. Nail abnormalities

    Science.gov (United States)

    ... nails include systemic amyloidosis , malnutrition, vitamin deficiency, and lichen planus . Skin cancers near the nail and fingertip ... the nail bed. Chemotherapy medicines can affect nail growth. Normal aging affects the growth and development of ...

  16. Nail dyschromias

    Directory of Open Access Journals (Sweden)

    Vibhu Mendiratta

    2011-01-01

    Full Text Available Nail dyschromias have a wide variety of presentation. There are numerous causes of discoloration of the nail affecting the nail plate, nail attachments, or the substance of the nail. The chromonychia may also be caused due to the exogenous deposition of pigments over the nail plate. Careful examination of the nail and few bed side tests may help in identifying the root cause of the nail dyschromia and many a times unravels some underlying systemic disorder too.

  17. Clinical assessment of femoral malrotation following intramedullary nailing of the femur intertrochanric fractures with proximal femoral nails%股骨转子间骨折行股骨近端髓内钉内固定术后旋转畸形的临床评估

    Institute of Scientific and Technical Information of China (English)

    徐华中; 施克勤; 朱国兴; 杨玉生; 钱科军; 于光荣; 陶波

    2013-01-01

    Objective To analyze cause for postoperative femoral malrotation after treatment of the femur intertrochan-teric fractures with proximal femoral nails. Methods An retrospective study was done on 26 patients with intertro-chanteric fracture treated with proximal femoral nail (PFN). The cause for postoperative malalignment were analyzed through the CT-scanzed method. Results All patients were followed up for 12~36 months. Of all, 7 patients (26. 9% ) had rotational deformities beyond 15°. Conclusions Treatment of the femur intertrochanteric fracture with PFN can lead to malalignment of femur to some extent. Irregular performance and bad reduction are the important causes which lead to malrotation of femur. To avoid its development requires good qualities of reduction. Intraoperatively careful attetion to details is important to reduce malalignment of femur and to improve function of hip.%目的 分析股骨近端髓内钉(PFN)内固定治疗股骨转子间骨折术后发生旋转畸形的原因,探讨预防措施.方法 对26例单一股骨转子间骨折患者应用PFN钉治疗.术后CT扫描成像获得相关测量数据,评估骨折远近端旋转畸形的程度,分析术后发生旋转对线不良的原因并进行临床评估.结果 26例患者均得到门诊随访,时间12~36个月.7例患者(26.9%)术后有15°以上旋转畸形.结论 应用PFN髓内固定治疗股骨转子间骨折,术中操作不规范和复位不理想是发生旋转畸形的主要原因.精细操作、良好复位可减少旋转畸形的发生,改善术后关节功能.

  18. Avaliação do emprego da haste femoral curta na fratura trocantérica instável do fêmur Evaluating the use of a proximal femoral nail in unstable trochanteric fracture of the femur

    Directory of Open Access Journals (Sweden)

    João Antonio Matheus Guimarães

    2008-09-01

    , devido a uma redução inadequada em varo, ocorreu um cutout que necessitou de revisão cirúrgica. Outro caso de fratura do tipo 31A2, evoluiu para necrose avascular da cabeça femoral, após consolidação da fratura. Por fim, um caso de fratura do tipo 31A3, devido a redução inadequada no plano sagital, evoluiu para retarde de consolidação, com quebra da haste após 13 meses da cirurgia. CONCLUSÃO: A osteossíntese com haste proximal, como tratamento da fratura trocantérica instável do fêmur realizada em pacientes com idade superior a 60 anos, resultou na consolidação da maioria dos casos. As complicações foram distintas nos dois subgrupos estudados. A redução adequada da fratura antes da introdução da haste intramedular é fundamental para o sucesso do procedimento.OBJECTIVE: Identifying the rate of healing of unstable trochanteric fractures submitted to osteosynthesis with a proximal femoral nail (PFN® - AO/ASIF, in patients operated on between November 1999 and March 2004. METHODS: 45 patients were analyzed, ages ranging from 60 to 93, with unstable trochanteric fractures of the femur submitted to osteosynthesis with short PFN®, with indirect reduction in a traction device guided by radioscopy. The fractures were classified according to the AO/OTA classification. Bone quality was evaluated by the Singh index in the post-operative radiographic routine. The quality of the reduction achieved and the positioning of the implant were evaluated by post-operative anteroposterior and profile X-ray of the proximal femur, with analysis of the cervicodiaphyseal angle and the distance between the tip of the sliding nail and the center of the femoral head, the so-called "tip apex distance" (TAD. RESULTS: The mean age of patients studied was 80.8 years (60-93. Females prevailed, with 37 cases (82.2%. The right side was involved in 22 cases (48.89% and the left side, in 23 (51.1%. All fractures were unstable, 22 of them of the type 31A2 (48.8%, and 23, of the

  19. The observation of the effect of elastic intramedullary nail in the treatment of femoral fractures in children%弹性髓内针治疗小儿股骨骨折的疗效观察

    Institute of Scientific and Technical Information of China (English)

    刘忠; 伍峰; 代宗涛; 曾浩; 孟炼

    2014-01-01

    Objective:To investigate the effect of elastic intramedullary nail in the treatment of femoral fractures in children. Methods:26 cases with femoral fractures were selected from September 2009 to October 2012.They were treated with elastic intramedullary nailing,observated its curative effect.Results:Postoperative function of all cases was excellent,and did not occured infection,nonunion,elastic intramedullary needle,epiphyseal injury or other complications.1 cases occurred the phenomenon of local skin “provocation”,the self-healing after removal of intramedullary needle.Conclusion:Elastic intramedullary nail in the treatment of femoral fractures in children can fixed fully,safe,and easy to be operated and removed.It also has fewer complications. So it is worthy of clinical application.%目的:探讨弹性髓内针治疗儿童股骨骨折的效果。方法:2009年9月-2012年10月收治股骨干骨折患儿26例,使用弹性髓内针进行治疗,观察其治疗效果。结果:所有患儿术后功能均达优,未发生感染、骨不连、弹性髓内针折断、骨骺损伤等并发症,1例患儿出现局部皮肤“激惹”现象,拔除髓内针后自愈。结论:弹性髓内针治疗儿童股骨骨折,固定充分、安全、易于操作和拔除、并发症少,值得临床广泛应用。

  20. Nail cosmetics

    Directory of Open Access Journals (Sweden)

    Nina A Madnani

    2012-01-01

    Full Text Available The nail as an anatomic structure protects the terminal phalanx of the digit from injury. Historically, it has served as a tool for protection and for survival. As civilizations developed, it attained the additional function of adornment. Nail beautification is a big industry today, with various nail cosmetics available, ranging from nail hardeners, polishes, extensions, artificial/sculpted nails, and nail decorations. Adverse events may occur either during the nail-grooming procedure or as a reaction to the individual components of the nail cosmetics. This holds true for both the client and the nail technician. Typically, any of the procedures involves several steps and a series of products. Separate "nail-bars" have been set up dedicated to serve women and men interested in nail beautification. This article attempts to comprehensively inform and educate the dermatologist on the services offered, the products used, and the possible/potential adverse effects related to nail-grooming and nail cosmetics.

  1. Your Nails

    Science.gov (United States)

    ... lunula is easiest to see on your thumbnails. Nail Care You might need an adult to help you ... mom or dad. But infections and more serious nail injuries need a doctor's care. Signs of a nail infection include pain, redness, ...

  2. Nail Hygiene

    Science.gov (United States)

    ... clipping or grooming nails, all equipment (for example, nail clippers and files) should be properly cleaned. Sterilizing equipment before use is especially important when nail tools are shared among a number of people, ...

  3. Nursing Care for the Children with Femoral Fracture Treated by Titanium Elastic Intramedullary Nail%弹性钛制髓内钉治疗儿童股骨干骨折的护理

    Institute of Scientific and Technical Information of China (English)

    许丽芬; 董亚萍

    2013-01-01

    Objective: To introduce Nursing care methods of the children femoral fracture treated by Tianium elastic intramedullary nail. Methods:Nursing care for 43 cases of children with femoral fracture treated by Titanium elastic intramedullary nail. Results:43 cases obtained bony union; the excellent and good rate was 100%. Conclusion: This method is an operation with low damage, low physiological influence for fracture, short hospitalization time, easy care, less complications. The proper nursing care and rehabilitation training during perioperative period is the essential important guarantee.%目的:介绍弹性钛制髓内钉治疗儿童股骨干骨折的护理方法。方法:通过对43例弹性钛制髓内钉治疗儿童股骨干骨折的护理。结果:43例皆获骨性愈合,优良率为100%。结论:该方法是一种损伤小、对骨折处生理影响小、住院时间短、易于护理、并发症少的手术,同时做好手术前后护理、术后康复训练是患儿全面恢复的重要保证。

  4. Therapeutic effect of proximal femoral nail antirotation combining with integrated Chinese and western nurs-ing in the treatment of femoral intertrochanteric fracture in aged%股骨近端抗旋髓内钉治疗老年股骨粗隆间骨折的中西医结合护理

    Institute of Scientific and Technical Information of China (English)

    吕华

    2014-01-01

    目的:观察股骨近端抗旋髓内钉( PFNA)联合中西医结合护理对老年股骨粗隆间骨折的治疗效果。方法将72例老年股骨粗隆间骨折患者随机分为2组。 PFNA组36例予PFNA治疗,PFNA+护理组36例在PFNA组基础上加中西医结合护理。术后每月随访2~3次,均随访18个月,观察2组并发症发生情况,比较2组髋关节功能疗效。结果2组并发症发生率比较差异有统计学意义(P<0.05),PFNA+护理组并发症较少。2组优良率比较差异有统计学意义(P<0.05),PFNA+护理组髋关节功能疗效优于PFNA组。结论 PFNA是治疗老年股骨粗隆间骨折较理想的内固定物,同时应用中西医结合护理明显缩短住院时间,减少并发症的发生。%Objective To observe the therapeutic effectiveness of proximal femoral nail antirotation com-bined with integrated Chinese and western nursing in treatment of femoral intertrochanteric fracture .Methods 72 cases of femoral intertrochanteric fracture were randomly divided into two groups:36 cases were treated with proximal femoral nail antirotation only , 36 cases were treated with integrated Chinese and western nursing besides proximal femoral nail antirotation.After surgery, patients were followed up for 2 to 3 times per month, were followed up for 18 months , the incidence of complications was observed two groups , and two groups were compared for the efficacy of hip function.Results There was significant difference between two groups on the incidence of complications ( P <0.05).The numbers of postoperative complications of patients in integrative care group were markedly reduced .There was significant difference between two groups on the good rate ( P<0.05).The curative effect of integrative care group was obviously superior to that of proximal femoral nail antirotation surgery group .Conclusion Proximal femo-ral nail antirotation is an ideal internal fixation in the treatment of

  5. Biomechanics study on the femoral neck with side hole hollow nail combined with bone cement%股骨颈带侧孔空心钉添加骨水泥的生物力学实验探究

    Institute of Scientific and Technical Information of China (English)

    闫作

    2014-01-01

    objective To study the healing effects by applying femoral neck with side hole hollow nail combined with bone cement for the promotion of fracture.Methods 58 adult femoral neck specimens were seletced based on the maximum axial pull output (F-Max) in experimental group, 12 femoral neck in bored after the hollow screw directly into the center of the axial, the other 12 femoral neck in the center of the axial drilling will polymethacrylate again after infusion of bone cement into side holes with hollow screw. To pull out the experiment, the hollow nail pulling power of the maximum axial and screw in the process of cycle resistance to bending experiment in loose could withstand the maximum load were determined.Results In PMMA bone cement injection hole hollow nail was signiifcantly higher than that of the maximum axial force ,which was higher than pure hollow nail maximum axial pull output, the difference was statistically signiifcant (P<0.05). Conclusion For hip osteoporosis fracture, the side holes by using methyl methacrylate hollow nail ifxed the fracture end, can signiifcantly reduce the risk of femoral head loose, falling off, and improve the stability of the ifxed the fracture end, accelerate fracture healing.%目的:探讨股骨颈带侧孔空心钉添加骨水泥对骨折愈合的促进效果。方法选取58具成人尸体股骨颈标本,依据最大轴向拔出力(F-max)进行实验分组,12个股骨颈在轴向正中钻孔后将空心钉直接置入,另12个股骨颈在轴向正中钻孔将聚甲基丙烯酸酯骨水泥输注后再置入带侧孔空心钉。进行拔出实验,对空心钉最大轴向的拔出力及周期抗屈实验过程中螺钉在松动时所能承受的最大负荷进行测定。结果注入PMMA骨水泥侧孔空心钉最大轴向力显著高于高于单纯空心钉最大轴向拔出力,对比差异有统计学意义(P<0.05)。结论对于髋部骨质疏松骨折来说,采用加入聚甲基丙烯酸甲酯侧孔

  6. Fraturas instáveis do fêmur em crianças tratadas com hastes intramedulares elásticas de titânio Unstable femoral fractures treated with titanium elastic intramedullary nails, in children

    Directory of Open Access Journals (Sweden)

    Jamil Faissal Soni

    2012-10-01

    Full Text Available OBJETIVO: Avaliar as indicações, epidemiologia, lesões associadas, complicações e prognóstico das fraturas diafisárias instáveis do fêmur na criança tratadas com hastes intramedulares elásticas de titânio. MÉTODO: Estudo retrospectivo composto por 24 pacientes com fraturas diafisárias instáveis do fêmur com idade entre cinco e 12 anos, submetidos a tratamento cirúrgico com hastes intramedulares elásticas de titânio no Hospital Universitário Cajuru - Curitiba, PR. Pacientes atendidos no período de abril de 2002 a março de 2008, com seguimento mínimo de 36 meses, submetidos à avaliação de dados epidemiológicos, desvios angulares, encurtamento e consolidação óssea. RESULTADOS: Foram reavaliados os prontuários de 113 casos operados de abril de 2002 a março de 2008, destes, incluídos no estudo 24 casos com fraturas de fêmur diafisárias instáveis tratadas com hastes intramedulares elásticas de titânio com inserção retrógrada. Apresentando duas fraturas bilaterais, duas fraturas expostas, sete pacientes do sexo feminino e 17 masculinos, com idade média de 8,3 anos. Apresentaram, ao final do estudo: encurtamento, desvios em varo ou valgo, retrocurvato ou antecurvato final igual a zero, não havendo ainda presença de retardo de consolidação ou pseudartrose. CONCLUSÕES: As hastes intramedulares elásticas de titânio são de fácil colocação e remoção. Consideramos a utilização das hastes intramedulares elásticas de titânio uma boa opção para a fixação de fraturas instáveis do fêmur em crianças.OBJECTIVE: To evaluate the indications, epidemiology, associated lesions, complications and prognosis among children with unstable femoral diaphysis fractures who were treated with titanium elastic intramedullary nails. METHOD: This was a retrospective analysis on 24 patients aged 5-12 years with unstable femoral diaphysis fractures who underwent surgical treatment with elastic titanium intramedullary

  7. Analysis the effect of retrograde intramedullary nail and distal femoral condyle steel plate in the treat-ment of femoral supracondylar fractures%倒打髓内钉与股骨远端髁钢板治疗股骨髁上骨折效果分析

    Institute of Scientific and Technical Information of China (English)

    刘烈东; 高军红

    2015-01-01

    ObjectiveTo investigate the effects of retrograde intramedullary nail and distal femoral condyle steel plate in the treatment of femoral supracondylar fractures.Method104 patients with femoral supracondylar fractures in our hospital were chose from March 2011 to November 2013, which were randomly divided into retrograde intramedullary nail fixation operation group (group A) and distal femoral condyle steel plate ifxation operation group (group B), 52 cases in each group. Compared two groups of patients with operation time, intraoperative blood loss, length of incision, fracture healing time and curative effects.Result Group A of patients with operation time, intraoperative blood loss and length of incision were signiifcantly lower than group B (P0.05). Fine rate and curative effect evaluation of group A were 86.54%, 85.67 points, group B were 88.46% and 86.12 points, there were no signiifcant differences between the two groups (P>0.05).ConclusionThe retrograde intramedullary nail and distal femoral condyle steel plate in the treatment of femoral supracondylar fractures respectively are effective, but the retrograde intramedullary nail ifxation operation is signiifcantly superior to the distal femoral condyle steel plate ifxation operation in the biomechanical aspects, and in order to attain the best treatment effects, the ifxed method should be selected according to the situation of the patients in clinical treatment.%目的:探讨倒打髓内钉与股骨远端髁钢板治疗股骨髁上骨折的效果。方法选取2011年3月至2013年11月本院治疗的股骨髁上骨折患者104例为研究对象,随机分为两组,分别行倒打髓内钉固定术(A组)和股骨远端髁钢板固定术(B组),每组各52例,比较两组患者手术时间、术中出血量、切口长度、骨折愈合时间及疗效。结果 A组患者手术时间、术中失血量及切口长度均显著低于B组(P<0.05)。两组患者骨折愈合时间

  8. Comparison effects of unstable intertrochanteric fractures fixed with proximal femoral nail anti-rotation and Gamma nail in elderly%股骨近端防旋髓内钉和 Gamma 钉治疗老年不稳定型股骨转子间骨折疗效比较

    Institute of Scientific and Technical Information of China (English)

    杨建伟; 唐坚; 孙月华; 俞超; 龚伟华; 史定伟

    2014-01-01

    Objective To compare the clinical effects of proximal femoral nail antirotation ( PFNA) and Gamma nail in the treatment of unstable intertrochanteric fractures. Methods 133 cases with unstable intertrochanteric fractures were treated with the PFNA(55 cases) and Gamma nail (78 cases)respectively. The following aspects were collected for statistical analysis on,including skill of operation,postoperative complications,fracture healing and the function of hip joint. Results All cases were followed up for 6~18 months. The differences of operation time,blood loss,clini-cal healing time and post-operative restored function ( Harris score,the latest follow-up) between the two groups were not of statistical significant (P>0. 05). Two cases with cut-out, one with internal fixation failure, one with fracture of femoral shaft were found in the Gamma nail group. No complications were found in the PFNA group. Conclusions Both PFNA and Gamma nail are effective treatment for unstable femoral intertrochanteric fractures. Compared to Gamma nail,PFNA fixation has advantages of less interference with less post-operative complications of internal fixa-tion, it is more effective in senile patients.%目的:比较股骨近端髓内钉和Gamma钉治疗老年不稳定股骨转子间骨折的疗效。方法将133例老年不稳定股骨转子间骨折患者按内固定方法分为股骨近端髓内钉( PFNA)组55例和Gamma钉组78例。比较两组的手术技巧、术后并发症、骨折愈合情况和髋关节功能。结果两组患者均获随访,时间6~18个月。两组在手术时间、术中出血量、骨折愈合情况及髋关节功能(末次随访Harris 评分)比较差异均无统计学意义(P>0.05)。 Gamma钉组出现2例髋螺钉切割,1例远端锁钉断裂,1例股骨干骨折;PFNA组无相关并发症发生。结论 PFNA和Gamma钉均是治疗老年不稳定型股骨转子间骨折的理想方法。与Gamma钉相比,PFNA显著降低了术后并发症,更适用于

  9. Prospective study of Gamma nail and DHS for the treatment of elder femoral intertrochanteric fracture%Gamma钉与DHS微创治疗老年股骨转子间骨折的前瞻性研究

    Institute of Scientific and Technical Information of China (English)

    杜浩; 郭锐; 张晓强; 吴涛; 扈延龄; 裴国献

    2008-01-01

    Objective To evaluate and compare the outcome of Gamma nail and DHS for the treatment of elder femoral intertrochanteric fracture by minimally invasive surgery.Methods From January 2004 to December 2006.58 elder patients suffered femoral intertrochanteric fracture were treated with Gamma nail(30 patients)and DHS(28 patients)respectively,which were classified into Al(n=21)and A2(n=37)according to the AO system.The difference between the 2 groups was not significant in preoperative evaluation and comparability existed.The clinic data of surgical trauma,postoperative function and complications of the 2 groups of patients were statistically compared in our study.Results There was no statistical significance on average incision length and postoperative pain score at 6 d.DHS group resulted in a lower blood loss and less surgery time than Gamma nail group(statistically significant),consequently the former Was superior to the latter about two aspects.Compared with the DHS group,Gamma nail group had better early functional recovery.Neither union of fracture nor prospective efficacy had significant difierence between the 2 groups.Femoral fracture had a high occurrence in Gamma nail group.coxa adduction and failure of internal fixation appeared in DHS group.There were no significant differences between the two groups with regard to infection,deep venous thrombosis,nonunion.Conclusion The principles are simple-operation,microtrauma.less-complication for treatment of the elder femoral intertrochanteric fractures.DHS had better be used in A0 type A1.Gamma nail should be recommended for type A2 accompanied with osteoperosis.beneficial to do functional exercise earlier.At the same time reaming should less used to the limit.If the site of the fracture is Hear to the point of entry of Gamma nail.DHS is advised to be used.%目的 对应用Gamma钉和DHS微创治疗老年股骨转子间骨折患者的疗效进行分析比较.方法 对2004年1月至2006年12月收入院的58例股骨

  10. Comparison of Gamma nail and proximal femoral nail antirotation in the treatment for femo- ral intertrochanteric fracture%Gamma钉和股骨近端防旋髓内钉治疗股骨转子间骨折的疗效比较

    Institute of Scientific and Technical Information of China (English)

    蒋毅; 范勇; 李玉军; 许庆利; 周建伟; 刘磊; 张传寅

    2015-01-01

    目的:比较Gamma钉、股骨近端防旋髓内钉( PFNA)治疗股骨转子间骨折的疗效。方法对162例接受髓内钉系统治疗的股骨转子间骨折患者的临床资料进行回顾性分析,其中Gamma钉治疗82例,PFNA治疗80例。对两组术中出血量、手术时间、骨折复位和骨折愈合情况及髋关节功能进行比较。结果两组的手术时间、术中出血量比较差异均无统计学意义( P>0.05)。死亡及失访30例,132例获得随访,时间6~48个月。两组骨折愈合时间及髋关节功能优良率比较差异均无统计学意义( P>0.05);骨折复位情况 Gamma 钉组优于 PFNA 组(P0. 05). 30 cases got death or lost to follow-up. 132 cases were followed up for 6~48 months,two groups of fracture healing time and hip function were no statistical different (P>0. 05). The fracture re-duction for Gamma nail group was better than PFNA group ( P<0. 05 ) . Conclusions Among two intramedullary nail systems,PFNA and Gamma nail are effective methods for treatment of femoral intertrochanteric fracture.

  11. The curative effect of the treatment with proximal femoral nail anti-rotation and Gamma nail to intertrochanteric fractures of the aged patients%防旋型股骨近端髓内钉与Gamma钉治疗老年股骨转子间骨折的疗效观察

    Institute of Scientific and Technical Information of China (English)

    郭震; 姚勐炜; 杨安礼

    2011-01-01

    目的 比较防旋型股骨近端髓内钉(PFNA)与Gamma钉治疗老年股骨转子间骨折的疗效.方法 99例老年股骨转子间骨折患者,53例使用PFNA固定,46例使用Gamma钉固定,对两组手术时间、术中出血量、骨折愈合时间、并发症和髋关节功能等进行临床随访分析.结果 平均手术时间和出血量PFNA组均少于Gamma组,差异有统计学意义(P0.05);并发症发生率PFNA组低于Gamma组,差异有统计学意义(P0.05).结论 PFNA设计合理,微创操作,出血少,固定可靠,是治疗老年股骨转子间骨折的理想方法之一,尤其适用于骨质疏松性股骨转子间骨折.%Objective To discuss the characters of proximal femoral nail anti-rotation ( PFNA ) and Gamma nail for treating intertrochanteric fractures of the aged patients.Methods Among 99 cases of aged intertrochanteric fractures,53 cases were treated with PFNA and 46 cases were treated with Gamma nail.Operative time , volume of blood loss,fracture healing time, complications, and postoperative function were observed and compared.Results Average operation time and blood loss in PFNA group were less than Gamma group, the difference was statistically significant( P < 0.01 ) ; There was no significant difference in the fracture healing time( P > 0.05 ) ; There was significant difference in the complications( P < 0.05 ) ; the rate of complications was lower in PFNA.Excellent and good rate was 90.57% in PFNA, and 86.96% in Gamma nail, and there was no significant difference hetween them( P > 0.05 ).Conclusions PFNA is reasonably designed , which has advantages of small trauma and hleeding with reliahle fixation.For senile people , it is one of ideal treatment of intertrochanteric fractures, especially for people who has osteoporosis.

  12. Uncoiling of reamer during intramedullary nailing for fracture shaft of femur

    OpenAIRE

    Meena, Sanjay; Trikha, Vivek; Singh, Vivek; Mittal, Samarth; Kishanpuria, Tanmay S.

    2013-01-01

    Intramedullary nailing is considered the standard of care for closed femoral shaft fractures. Several studies have shown that reamed intramedullary nailing is a safe procedure in fracture shaft femur with lower nonunion rates than unreamed nailing. Reamed intramedullary nailing provides better stability because of increased contact between the nail and medullary canal. However, careful attention to reaming techniques as well good instrumentation is necessary while undertaking such a procedure...

  13. Nail infections.

    Science.gov (United States)

    Jules, K T; Bonar, P L

    1989-04-01

    Nail infections are and will continue to be a diagnostic and therapeutic challenge to all foot physicians. Attention to basic concepts of accurate detailed history and physical examination will aid in the determination of the etiology of these infections. Following basic guidelines of incision and drainage, gram stain, soaks, and antibiotics will be the cornerstone of initial treatment of pyogenic infections. Upon resolution of the acute infection a permanent treatment plan can be constituted based on the etiology. Nail infections of mycotic nature require an understanding by both patient and doctor as to the difficulty and resistance to treatment of this problem. It is the authors' opinion that aggressive persistent treatment will provide the best long-term result when dealing with mycotic infections. This may require nail removal, local and systemic treatment as well as change in shoe environment. As we have seen and is stated throughout this text, the nail and its pathologic processes can be a mirror of systemic disease. Many times a dystrophic infected nail may be the initial clinical presentation of a much more involved disease process. It is the responsibility and duty of all foot physicians to have a total understanding of knowledge of normal and pathologic process that affect the nail plates, nail bed, and surrounding nail proper. I hope this article will stimulate the foot physician to approach the disease of the nail with a high index of suspicion and respect. PMID:2650850

  14. Rotary self-locking intramedullary nail for long tubular bone fractures

    Institute of Scientific and Technical Information of China (English)

    HUANG Zhong-lian; YANG Hai-long; XU Jian-kun; XIA Xue; WANG Xin-jia; SONG Jian-xin; HU Jun

    2013-01-01

    Background Intramedullary nails had been widely used in the treatment of long-bone fractures because of less interference of fractures and center bearing biomechanical advantage.However,it had been also found many shortcomings such as broken nails,delayed healing and was modified in order to achieve better efficacy and reduce complications.The aim of the present study is to compare the efficacy of rotary self-locking intramedullary nails (RSIN) with that of interlocking intramedullary nails (IIN) in the treatment of long-bone fractures.Methods A retrospective study investigated 129 cases with long-bone fractures (36 with femoral fracture,81 with tibial fracture,and 12 with humeral fracture).The fractures were fixed using either an RSIN or IIN.All patients underwent followup for 12-30 months.Results All patients in both groups achieved a clinical fracture healing standard and the postoperative affected limb muscle strength and joint function were well restored.The RSIN group required a shorter operative time and the fracture healed faster.There was no significant difference in the hospital stay,intraoperative blood loss or postoperative complications between the two groups.Conclusions RSIN is used to treat long-bone fractures.Its healing efficacy is equivalent to the IIN.Moreover,the RSIN method is simpler and causes less tissue damage than the IIN,therefore having the advantage of accelerated healing.

  15. Nursing care on interlocking intramedullary nail internal fixation for femoral shaft fracture%股骨干骨折交锁髓内钉内固定术后的护理

    Institute of Scientific and Technical Information of China (English)

    李肖媚; 罗东斌; 唐东鸣; 叶间欢

    2014-01-01

    Objective To explore the nursing method and effect of interlocking intramedullary nail fixation.Methods We randomly divided 96 cases of femoral shaft fracture with interlocking intramedullary nail fixation into two groups.The control group received routine nursing after the operation,while the experimental group,based on routine nursing,was added the therapy of Wax associating with TDP lamp irradiation.The we observed and recorded the complications and nursing problems within 1 week in the operation.Result There was significant difference in the treatment efficiency of two therapies (P < 0.05).Conclusion The therapy of Wax associating with TDP lamp irradiation has a significant effect on the prevention of nursing problems such as edema,pain and so on caused by interlocking intramedullary nail fixation,without affecting infection,deep vein thrombosis.%目的 探讨交锁髓内钉内固定术后的护理方法和效果.方法 将96例股骨干骨折行交锁髓内钉内固定术后的患者随机分为两组,对照组48例按术后常规护理,实验组48例在常规护理的基础上,增加患肢蜡疗联合TDP神灯照射疗法,观察并记录术后1周内并发症及护理问题.结果 术口疼痛Ⅱ度以上对照组33例,实验组12例;术口水肿(++)以上对照组33例,实验组12例;两组患者在术口疼痛、水肿、感染及深静脉血栓等方面比较差异具有统计学意义(P<0.05).结论 蜡疗联合TDP神灯照射疗法,对预防交锁髓内钉内固定术后水肿、疼痛等护理问题效果显著,对预防术后感染、深静脉血栓等护理无影响.

  16. Proximal femoral nail antirotation for treatment of intertrochanteric fractures: an analysis of 112 patients%股骨近端防旋髓内钉治疗老年股骨转子间骨折112例

    Institute of Scientific and Technical Information of China (English)

    李慧武; 孙月华; 史定伟; 唐坚; 俞超; 龚伟华; 朱振安; 王友; 戴尅戎

    2011-01-01

    目的 探讨股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)治疗老年股骨转子间骨折的手术疗效.方法 自2007年4月至2009年7月应用PFNA治疗股骨转子间骨折112例,其中男34例,女78例;平均年龄76岁.AO分型:31 -A2型80例,31 -A3型32例.Singh指数分类:Ⅰ级4例,Ⅱ级21例,Ⅲ级70例,Ⅳ级15例;骨折前2例跛行.低能量损伤97例,高能量损伤15例.采用Salvati - Wilson评分对髋关节功能进行评估.结果 112例患者中90例接受12 ~24个月随访,平均18.6个月.Salvati - Wilson评分为(29.98±5.18)分:优41例,良40例,可6例,差3例,优良率为90%.术中主要问题为插钉困难22例,其中3例患者在插钉过程中导致股骨近端外侧皮质破裂.敲击螺旋刀片过程中造成骨折断端不同程度的移位或分离34例,远端锁钉困难9例.术后并发症中局部并发症包括髋部疼痛21例,股部疼痛4例,明显髋内翻2例,延迟愈合7例.无论Singh指数为何种类型均未见螺旋刀片切出或穿透股骨头,也未见股骨干骨折发生.全身并发症包括心脑血管疾病1例,肺部感染4例,深静脉栓塞1例,会阴部淤血或肿胀17例.结论 PFNA是治疗股骨转子间骨折特别是骨质疏松性骨折的有效方法,但骨折延迟愈合以及髓内钉与股骨近端形态的不匹配还有待进一步解决.%Objective To investigate the clinical value of proximal femoral nail antirotation ( PFNA) in treatment of intertrochanteric fractures.Methods From April 2007 to July 2009,112 patients with intertrochanteric fractures were treated by using PFNA.There were 34 males and 78 females,at mean age of 76 years.Of all,80 patients were with type 31-A2 fracture and 32 with type 31-A3 fractures according to AO classification.According to Singh index classification,there were 4 patients at grade Ⅰ,21 at grade Ⅱ,70 at grade Ⅲ and 15 at grade Ⅳ.The fracture was caused by low-energy injury in 97 patients and by high

  17. Fungal nail infection

    Science.gov (United States)

    Nails - fungal infection; Onychomycosis; Infection - fungal - nails; Tinea unguium ... the hair, nails, and outer skin layers. Common fungal infections include: Athlete's foot Jock itch Ringworm on the ...

  18. Onychomycosis nailed

    OpenAIRE

    Leelavathi, M; Noorlaily, MN

    2014-01-01

    Fungal infection of the nail is a common condition that causes much concern because of its disfiguring appearance. Although specific treatment is available for this condition, treatment outcome is variable and persistent nail dystrophy post-treatment may cause distress to both the patient and the physician. This article describes the current available treatment options for onychomycosis, management approach and the expected treatment outcome to enhance primary care physicians’ confidence in m...

  19. 股骨近端防旋髓内钉治疗股骨反转子间骨折%Proximal femoral nail antirotation for the treatment of reverse intertrochanteric fractures

    Institute of Scientific and Technical Information of China (English)

    成俊

    2012-01-01

    目的 评估股骨近端防旋髓内钉(PFNA)治疗股骨反转子间骨折的临床疗效.方法 21例反转子间骨折采用PNFA内固定,牵引床牵引复位.不暴露骨折断端,微创植入PFNA.结果 21例均获随访,时间12~36个月.骨折均愈合,愈合时间13~28周.1例诉髋部疼痛,1例10°内翻愈合,2例双下肢不等长;无螺钉切割及内固定失败等并发症发生.结论 PFNA是治疗股骨反转子间骨折的有效方法,软组织损伤小,固定稳定,并发症少.%Objective To evaluate the clinical effect of proximal femoral nail antirotation( PFNA ) for the treatment of reverse intertrochanteric fractures. Methods 21 cases of reverse intertrochanteric fractures were treated with PFNA fixation. All cases were reduced through longitudinal traction on the traction table, without exposing of the fracture section during the operation. Results 21 cases were followed up for 12 ~ 36 months. All fractures healing time was 13 ~ 28 weeks. One patient complained of hip pain. One case healed up with 10° varus deformity. Two cases had limb length discrepancy. No complications such as cut-out or breakage of the implants occurred. Conclusions PFNA is an effective treatment method for reverse intertrochanteric fractures with less tissue damage, more stable fixation and less complications.

  20. Comparison of clinical efficacy of proximal femoral nail anti-rotatio and locking plate for proximal femoral fractures%髓内钉与近端锁定钢板治疗股骨近端骨折的对比研究

    Institute of Scientific and Technical Information of China (English)

    叶庆林; 邹华章; 罗春强; 梁桂泉; 卢志文

    2016-01-01

    目的探讨股骨近端螺旋刀片抗旋髓内钉( PFNA)和股骨近端锁定钢板( PFLCP)治疗股骨近端骨折患者的临床疗效并进行对比分析。方法笔者回顾性分析2010年3月~2014年3月采用PFNA和PFLCP法治疗股骨近端骨折70例的病例资料,PFNA内固定治疗40例,PFLCP内固定治疗30例。观察比较两组患者手术时间、术中透视时间、术中失血量、术后引流量以及Parker-Palmer评分的差异。结果所有患者随访6~9个月,平均8.9个月。末次随访时两种方法的Parker-Palmer评分差异无统计学意义( P>0.05)。两种方法的手术时间、术中透视时间、术中失血量、术后引流量以及Parker-Palmer评分的差异均无统计学意义(P>0.05),但PFNA组的术中透视时间明显短于PFLCP组。结论 PFNA和PFLCP均是治疗股骨近端骨折较好的内固定材料。%Objective To compare and analyze the clinical efficacy of proximal femoral nail anti-rotation (PFNA) and proximal femoral locking compression plate (PFLCP) in the treatment of proximal femoral fracture . Methods From Mar.2010 to Mar.2014,70 patients with proximal femoral fracture treated with PFNA and PFLCP were collected.All of these patients were randomly divided into PFNA group (40 cases) and PFLCP group (30 ca-ses).The operation time,intraoperative fluoroscopy time,intraoperative blood loss,postoperative drainage volume and Parker-Palmer score between these two groups were compared .Results All patients were followed up for 6-9 months,averaging 8.9 months.There was no significant difference in the intraoperative blood loss ,operative time, postoperative drainage volume and Parker-Palmer score between the two groups .But intraoperative fluoroscopy time of the PFNA group was shorter than that of the PFLCP group .Conclusion PFNA and PFLCP were both good in-ternal fixation materials for the treatment of proximal femoral fractures .

  1. Causes analysis and handling of postoperative complications of femoral shaft fracture treated with intramedullary interlocking nails%股骨干骨折交锁髓内钉固定所致并发症的原因分析及处理

    Institute of Scientific and Technical Information of China (English)

    黄彦; 王胜标

    2001-01-01

    目的探讨交锁髓内钉治疗股骨干骨折术后并发症的原因,并提出防治措施。方法对我院1994~1999年116例交锁髓内钉治疗股骨干骨折病人进行回顾分析,其中对14例延迟愈合者采取拔除锁钉,变静力固定为动力固定;对6例骨不连者,全部取钉、换钉并植骨;对4例骨感染者进行病灶清除加拔钉,适度的外固定。结果骨延迟愈合14例,随访1年全部愈合;骨不连6例,其中二次手术4例,三次手术2例,随访1年半均愈合;骨感染4例,3例愈合,1例未愈。总有效率95.8%。结论交锁髓内钉治疗股骨干骨折,虽比其他内固定具有较明显的优势,但产生骨延迟愈合、骨不连、骨感染、断钉等并发症并不少见。严格掌握手术指征、适当选材、适时掌握静力固定与动力固定、第二次手术扩髓与不扩髓、彻底清创与严格的无菌操作是减少并发症的有效措施。%Objective To investigate the causes and preventive methods of postoperative complications of femoral shaft fracture treated with intramedullary interlocking nails.  Methods A total of 116 patients with femoral shaft fractures admitted to our hospital from 1994 to 1999 were retrospectively studied in this article. They were all treated with intramedullary interlocking nails. The locking nails were removed from the 14 patients with delayed union to convert the fixation from static to dynamic. For the 6 patients with bone nonunion, the locking nails were removed, and new locking nails and bone grafts were employed. And for the 4 patients with bone infection, the foci were cleaned and the locking nails were removed, then certain external fixation was applied. Results Followed up for 1 year, the fractures of 14 patients with delayed union were completely healed. For the 6 patients with bone nonunion, reoperation was needed in 4 patients and a third operation needed in 2 patients, and they all healed after

  2. Stabilization of Fractures with the Use of Veterinary Interlocking Nails

    Directory of Open Access Journals (Sweden)

    Adam Piórek*, Zbigniew Adamiak, Hubert Matyjasik and Yauheni Zhalniarovich

    2012-01-01

    Full Text Available Interlocking nails (ILN are effective tools for the fixation of long bone fractures, including humeral, femoral and tibial fractures. An interlocking nails are a steel rods which are placed in medullary canal of fractured bone. They have transverse openings which are use to put inside a transcortical screws. Those screws block the nail relative to the main bone fragments. Interlocking nails counteract all forces at the fractured site, thus they are an alternative to bone plates. Simultaneously, the intramedullary nail is placed in a natural position relative to the bone's biomechanical axis and neutralizing bending forces across bone fragments. Unlike bone plates that are eccentrically positioned, the nail has an intramedullary position which makes it much more resistant to compressive, torsional and bending force. This technique requires a relatively low surgical approach to compare with plate osteosynthesis. Most importantly, interlocking nails support biological osteosynthesis and fracture management with minimal surgical intervention. The first application in veterinary medicine of the interlocking nail was at the late 1980s. Since this moment, the technique still evolves providing the next generations of interlocking nails. At these days we have several generations of it. This paper discusses the use of interlocking nails in fracture stabilization in veterinary practice and overviews the development of nail implants and their applications. The advantages of the analyzed technique and the associated complications are discussed.

  3. Effects of PFNA and Gamma nail in treatment of femoral shaft fracture combined with ipsilateral fractures of the proximal femur%PFNA与Gamma钉治疗股骨干骨折合并同侧股骨近端骨折的比较研究

    Institute of Scientific and Technical Information of China (English)

    张帆; 罗晓东; 叶茂; 汪志忠; 李宝丰

    2012-01-01

    Objective To study the effects of PFNA and Gamma nail in treatment of femoral shaft fracture combined with ipsilateral fractures of the proximal femur. Methods 22 patients with femoral shaft fracture combined with ipsilateral fractures of the proximal femur were collected and randomly divided into observation group given extended PFNA fixation and control group given extended Gamma II fixation. Then the curative effect, negative emotions, activities and the function of hip joint were observed. Results The total efficiency of PFNA was significantly better than Gamma nail ( 100. 0% vs 64. 3% , P 0.05);观察组VAS疼痛评分、HAMA评分、HAMD评分均明显低于对照组(P<0.05);Barthel评分、Harris评分均明显高于对照组(P<0.05).结论 股骨干合并股骨颈骨折应用PFNA,较Gamma II型钉治疗更具积极意义.

  4. Treatment of long-segment fracture in middle-up part of femoral shaft with long proximal femoral nail antirotation of AO/ASIF%加长型股骨近端螺旋刀片抗旋髓内钉治疗股骨中上段长节段骨折的临床研究

    Institute of Scientific and Technical Information of China (English)

    林焱斌; 李仁斌; 张怡元; 冯尔宥; 熊国胜; 王武练; 林任; 庄研

    2010-01-01

    Objective To investigate the operative method and evaluate the clinical outcomes of long proximal femoral nail ant-rotation(PFNA-long)in treating long-segment fracture in middle-up part of femoral bone.Methods From June 2006 to December 2009,32 cases of long-segment fracture in middleup part of femoral shaft were treated by closed reduction or limited open reduction and fixation with PFNA-long,including 30 males and 2 females with an average age of 3.8.8 years(range,20-69).All patients had closed fractures in shaft of femur.The average time from injury to operation was 4.2 days(range,3 hours to 12 days).All fractures were fixed with the PFNA-long.The patients were followed at 1,2,3,6,9,12 month after surgery,respectively,and next time at least once per year.The clinical outcomes were evaluated according to Harris criteria and radiological examinations.Results The mean operating time of all cases was 55 minutes(range,35-90),and the mean blood loss during surgery was 75.6 ml(ranged,30-150 ml).All patients walked with walking aid 4-7 days after surgery.They were followed up for 9-37 months.All fractures healed after 3.1-5.4 months(mean 3.7 months).No complications such as infection,lower limb vein infarction,cut-out or breakage of the implants occurred.But 2 cases had hip internal reverse-lamb shortening malformation,According to Harris criteria,the clinical results were excellent in 23 cases,good in 7,and moderate in 2,and the excellent and good rate was 93.75%(30/32).Conclusion PFNA-long is an effective and minimally invasive method for long-segment fracture in middle-up part of femoral shaft,with minimally invasive,high fixation-strength and accord with biomechanics characteristics;and with a high rate of bone union,early functional recovery and less complications.%目的 评价采用国际内固定研究学会(association for the study of internal fixation,AO/ASIF)加长型股骨近端螺旋刀片抗旋髓内钉(proximal femoral nail anti-rotation,PFNA)治疗股

  5. Double-level osteotomy and one-stage reconstruction with long intramedullary femoral nail to correct a severe proximal and diaphyseal femur deformity in a patient with polyostotic fibrous dysplasia: case report and literatures review

    OpenAIRE

    Chen, FeiYan; Wei, Yibing; Xia, Jun; Wu, Jianguo; Wang, Siqun; Huang, Gangyong; Chen, Jie; Shi, JingSheng

    2015-01-01

    Proximal femur is often involved with varus and retroversion deformity in polyostotic fibrous dysplasia (PFD). Multiple corrective osteotomies with intramedullary nails in two stages is recommended procedure as some authors described. We report a case using double-level osteotomy and one-stage reconstruction with intramedullary nail in a patient with painful proximal femur and diaphysis varus deformity, the neck-shaft angle was corrected from 95° pre-operatively to 125° post-operatively, the ...

  6. Digital design and clinical application of intramedullary nailing fixation for femoral shaft fracture based on accurate three-dimensional measurement%基于精确三维测量股骨干骨折髓内钉内固定的数字化设计及临床应用

    Institute of Scientific and Technical Information of China (English)

    陈宣煌; 林海滨; 余正希; 陈旭; 郑锋; 张国栋

    2015-01-01

    背景:传统的髓内钉手术的局限性在于依赖医生的个人经验,而且扩髓会导致髓腔内生物学环境的破坏,影响骨的愈合。目的:观察数字化技术辅助髓内钉内固定治疗股骨干骨折的疗效分析。方法:2010年1月至2014年1月莆田学院附属医院骨科收治股骨干骨折患者80例,均应用数字化技术辅助治疗,术前建立股骨干骨折的三维数字模型,对三维数字骨折端进行虚拟复位,测量髓腔的直径,按测量数据选取合适规格的髓内钉,然后按照数字化技术制定的手术方案进行闭合复位髓内钉内固定治疗。结果与结论:80例患者随访12-24个月,骨折全部获得骨愈合,随访12个月时按骨科临床疗效标准评价,优62例,良15例,可3例,优良率为96%。无感染、内固定物断裂或松动等并发症发生。提示,数字化技术辅助髓内钉内固定治疗股骨干骨折疗效确切,能明显缩短手术时间,减少手术创伤,减少患者和医护人员术中透视的放射量。%BACKGROUND:The limitation of the traditional intramedulary nailing relies on the personal experience of the doctor. Moreover, the enlargement of the bone marrow causes the destruction of the biological environment of the marrow cavity and affects the healing of bone. OBJECTIVE:To observe therapeutic effect of digital technology assisted intramedulary nail fixation for femoral shaft fracture. METHODS:A total of 80 patients with femoral shaft fracture, who were treated in the Department of Orthopedics, Affiliated Hospital of Putian University from January 2010 to January 2014, were enroled. Digital technology was used to assist treatment. Three-dimensional digital model of femoral shaft fracture was established before treatment. Virtual reduction was conducted in the three-dimensional digital fractures. The diameter of medulary cavity was measured. Appropriate specification of intramedulary nailing was

  7. Retrograde nailing for distal femur fractures in the elderly

    Directory of Open Access Journals (Sweden)

    Giddie Jasdeep

    2015-01-01

    Full Text Available Introduction: We report the results of treating a series of 56 fractures in 54 elderly patients with a distal femur fracture with a retrograde femoral nail. Methods: Fifty-four of the nails were inserted percutaneously with a closed reduction. After surgery all patients were allowed to weight bear as tolerated. Four fractures were supported in a temporary external splint. Results: The mean age of patients was 80.6 years (range 51–103 years, 52/54 (96% were females. There were no cases of nail related complications and no re-operations were required. One patient was lost to follow up. The 30-day mortality was 5/54 (9.3% and the one year mortality was 17/54 (31.5%. Conclusions: Distal femoral nail fixation provides a good method of fixation allowing immediate mobilisation for this group of patients.

  8. Clinical outcomes of proximal femur intramedullary nails of InterTan in the elderly patients with femoral intertrochanteric comminuted fractures%股骨近端髓内钉InterTan治疗老年粉碎性股骨转子问骨折疗效观察

    Institute of Scientific and Technical Information of China (English)

    王嘉; 梁朝革; 于荣华; 王奕; 曹德良; 唐献忠; 徐志英

    2011-01-01

    Objective To estimate the clinical outcomes of proximal femur intramedullary nails of InterTan in the elderly patients with femoral intertrochanteric comminuted fractures. Methods 30 elderly patients with femoral intertrochanteric comminuted fractures were treated with InterTan nails. Their surgical data, Harris hip score, union time and complications were retrospectively analyzed. Results Among the 30 cases, 28 patients were followed up except 2 cases 6 months after the treatment. The healing time of fractures was 2 ~ 6 months, average (2.6±0.8) months. Postoperative Harris hip score evaluation results: 10 patients had excellent results, 14 good, 3 medium and 1 poor. The excellent and good rate was 85.7%. No collapse of the neck, nocoxavara, or no implant failure was observed. Conclusion The proximal femur intramedullary nails of InterTan is the better clinical treatment for elderly patients with femoral intertrochanteric comminuted fractures with high union rate and rare complications.%目的 评估InterTan治疗老年粉碎性股骨转子间骨折的临床疗效.方法 采用InterTan治疗老年粉碎性股骨转子间骨折30例,对患者术中情况、术后Harris髋关节评分、骨折愈合时间、术后并发症等情况进行评估.结果 30例患者中除2例失访,28例患者术后获平均6m随访,骨折均获愈合,愈合时间2~6m,平均愈合时间为(2.6±0.8)m.术后Harris髋关节评分评定结果:优10例,良14例,中3例,差1例,优良率为85.7%,未出现股骨颈颈部短缩,髋内翻,内固定断裂等并发症.结论 股骨近端髓内钉INTERTAN是治疗老年粉碎性股骨转子间骨折较好的方法,其骨愈合率高,并发症少.

  9. Nursing experience on proximal femoral nail anti-rotation for intertrochanteric fractures%PFNa 内固定治疗股骨粗隆间骨折的护理体会

    Institute of Scientific and Technical Information of China (English)

    谭凤珍; 李淑桂

    2011-01-01

    Objective To explore the preoperative nursing methods of proximal femoral nail anti-rotation(PFNA)treatment of intertrochanteric fractures.Methods 35 Cases of PFNA treatment of intertrochanteric fractures were analyzed retrospectively from June 2006 to June 2010,establishing good care relation with patients before operation,postoperative closely monitoring patients'vital signs,positive complications associated with patients,as well as the rehabilitation training.Care methods of 35 PFNA patients was summarized.Results During the follow-up of 4-24 months,all patients'fracture healed,and Can completely walk bearing load,the average fracture healing time was about 14.5 weeks.With good hip activities function.there were 30 excellent cases and 5 good cases according Harris efficacy evaluation criterion.Conclusion The operation is simple,easy and suitable for application of PFNA minimally invasive operation,less trauma,reliable internal fixation,it is a kind of treatment for intertrochanteric fractures,good care can effectively prevent complications and promote the patients'recover.%目的 探讨防旋型股骨近端髓内钉(PFNa)治疗股骨粗隆间骨折的围手术期护理.方法 对2006年6月-2010年6月间我院采用PFNa治疗股骨粗降间骨折35例的临床资料进行回顾性分析,35例患者行PFNa内固定治疗,术前与患者建立良好的护患关系,术后密切观察患者生命体征,积极预相关并发症,配合患者进行康复训练.总结35例应用PFNA手术治疗的患者围手术期护理的方法.结果 术后随访4~24个月,全部病例骨折均愈合,且能完全负重行走,平均骨折愈合时间约14.5周.患髋关节活动功能良好,按Harris疗效评分标准,优30例,良5例.结论 应用PFNa操作简单,适合微创操作,创伤少,内固定可靠,是一种治疗股骨粗隆间骨折,良好的护理可有效的预防并发症,促进患者康复.

  10. 缝线锚钉修复肾功能衰竭伴自发性股四头肌腱断裂的临床研究%Clinical Research of Suture Anchor Nail Repair Renal Failure Associated with Spontaneous Femoral Quadriceps Tendon Rupture

    Institute of Scientific and Technical Information of China (English)

    杨瑞; 陈祥云; 颉朝阳; 韩晓军; 刘志鹏; 宋矿朋

    2015-01-01

    目的:评估缝线锚钉修复肾功能衰竭伴自发性股四头肌腱髌骨止点断裂的临床疗效。方法:2007年1月-2012年1月,对本院收治的21例肾功能衰竭伴自发性股四头肌腱断裂患者采用缝线锚钉行股四头肌腱髌骨止点修补缝合。术前常规实验室检查,拍摄患侧膝关节X线片及MRI;术后6周内支具保护,6周后行屈膝练习,术后2年测量患者屈膝角度。结果:21例患者均获得随访。随访结束,均未发生锚钉松动及脱出。术前术后均采用Lysholm和Kujala膝关节评分标准,评分差异有统计学意义(P<0.05)。结论:选择适当的病例,应用缝线锚钉是修复肾功能衰竭伴自发性股四头肌腱髌骨止点断裂的有效方法。%Objective: To assess the clinical efficacy of suture anchor nail repair renal failure associated with spontaneous femoral quadriceps tendon patellar check point of fracture.Method: From January 2007 to January 2012, 21 renal failure patients with spontaneous femoral quadriceps tendon rupture were given the nail line of patella femoral quadriceps tendon suture anchor check point repair suture. Preoperative routine laboratory examination was taken by lateral knee X-ray films and MRI. With a protection within 6 weeks, after 6 weeks bend knees practice was taken, and knees angle was measured 2 years later.Result: 21 patients were all followed up and in the end they were not loose bolts and emergence. The effect was evaluated by Kujala and Lysholm knee scoring standards and showed significant difference before and after operation (P<0.05).Conclusion: Selecting appropriate cases and using suture anchors is renal failure associated with spontaneous femoral quadriceps tendon patellar fracture effective method of check point.

  11. Single cortical locking plate combined intramedullary nail and bone grafting in the treatment of femoral nonunion with clinical analysis%单皮质锁定钢板联合髓内钉加植骨治疗股骨骨不连临床分析

    Institute of Scientific and Technical Information of China (English)

    米宁

    2012-01-01

      目的:观察单皮质锁定板联合髓内钉加植骨治疗股骨骨不连临床疗效并对影响因素加以分析.方法:2008年5月至2012年5月对使用单皮质锁定板联合髓内钉固定加植骨治疗的股骨骨不连患者34例进行回顾性分析.抽取同期单纯使用带锁髓内钉加植骨治疗股骨骨不连29例进行对比分析并进行疗效评定,HSS评分检验膝关节功能恢复情况.结果:所有患者均在4~8个月内获得性骨愈合,两组优良率分别为88.23%和86.02%.术后对患者膝关节功能进行HSS评分两组患者平均(85.14±5.14)和(82.4±4.52).结论:单皮质锁定板联合髓内钉加植骨治疗股骨骨不连效果较好,有利于肢体早期功能恢复,可作为股骨骨不连治疗的一种有效方法.%  Objective:Observation of single cortical locking plate combined with intramedullary nail and bone grafting in the treatment of femoral nonunion with clinical efficacy and influence factors analysis. Methods:2008 May to 2012 May on the use of single cortical locking plate combined with intramedullary nail fixation and bone grafting for the treatment of nonunions of the femur in 34 cases were retrospectively analyzed. Extraction compared with use of interlocking intramedullary nail and bone grafting for the treatment of femoral nonunion in 29 cases were analyzed and the curative effect was studied, HSS score test knee joint function recovery. Results:All patients were in the 4 to 8 months of acquired bone healing, two groups of the excellent and good rate respectively is 88.23% and 86.02%. On postoperative patients with knee joint function of two groups of patients the mean HSS score ( 85.14± 5.14 ) and ( 82.4 ±4.52). Conclusion:Single cortical locking plate combined with intramedullary nail and bone grafting in the treatment of femoral nonunion with good effect, is beneficial to early limbs function recovery of femoral nonunion, can be used as an effective method to treat.

  12. Distal nail embbeding

    Directory of Open Access Journals (Sweden)

    Patricia Chang

    2014-01-01

    Full Text Available Male patient, 35 years old who came to dermatological consultation due to contact dermatitis on back, during his clinical examination alterations of his digits was seen. Dermatological examination reveals a rim of tissue at the distal edge of the nail of both big toenails and thickened nails (Fig.1a – c, 2a, b. Both big toenails were removed due to ingrown nails two times. Diagnosis of distal nail embedding was done. Distal nail embedding is a rim of tissue at the distal edge of the nail. Causes can de acquired or congenital.

  13. Intramedullary compression interlocking nail in treatment of non-union and delayed union of femoral and tibial fractures%加压交锁髓内钉治疗下肢长骨干骨折不愈合及延迟愈合

    Institute of Scientific and Technical Information of China (English)

    马克; 徐健; 张新宁; 杨帆; 马建东

    2009-01-01

    Objective To investigate the cause of non-union and delayed union of femoral and tibia] fractures and assess the clinical outcome after treatment with intramedullary compression interlocking nail (ICIN). Methods From February 1998 to December 2006, 21 patients with non-union and delayed union of femoral and tibial fractures (13 patients with femoral fractures and 8 with tibial fractures) were treated by ICIN. Bone grafting was performed in 18 patients, and the other three patients only rocoived reamed compression nailing. Five patients received bone grafting combined with knee adhesion release operation. Results All patients were followed up for 11.4-36 months (mean 13.6 months). Solid bone union was observed in all patients, with mean bone union time of 8.7 months and without malunion, infection or refracture. According to the Klemm grading, the clinical outcome was graded excellent in 19 patients and good in 2. Conclusions The main causes for non-union and delayed union of femoral and tibial fractures are improper indication selection and incorrect use of implants, which may result in bieenvironment disruption. ICIN shortens the time of functional recovery of knee and ankle joint. ICIN has advantages of stable fixation, early exercise of the knee and ankle as well as early weight loading and hence is one of effective alternatives in treatment of non-union and delayed union of femoral and tibial fractures. ICIN can accelerate the healing of bone and improves the function of knee joint when combined with bone grafting, reamed compression nailing and knee adhesion release.%目的 分析下肢长骨干骨折不愈合及延迟愈合的原因,评价加压交锁髓内钉治疗下肢长骨干骨折不愈合及延迟愈合的效果. 方法 1998年2月-2006年12月,对21例股骨和胫骨干骨折不愈合及延迟愈合者采用加压交锁髓内钉治疗.其中股骨13例,胫骨8例,3例未植骨,仅扩髓加压,5例同时行膝关节松解. 结果 随访11.4~36

  14. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... hair, and nail care Skin care Hair care / hair loss Injured skin Nail care Younger skin Kids’ zone ... hair, and nail care Skin care Hair care / hair loss Injured skin Nail care Artificial nails Healthy nails ...

  15. Femoral hernia

    International Nuclear Information System (INIS)

    A retrospective study of 18 patients with femoral hernia assessed by herniography is presented. Although a palpable lump was present in 11 patients (61%), the diagnosis of a femoral hernia was not made before herniography. Surgical exploration was performed in 12 patients and a femoral hernia was found and repaired with beneficial outcome in 9 of them. In conclusion: herniography is of value for the diagnosis of a femoral hernia in patients with obscure groin pain. (author). 14 refs.; 2 figs

  16. The efficacy comparison between hollow screw fixation and head and tail nail fixation treatment for the elderly femoral neck fractures%空心拉力螺钉内固定与首尾钉内固定治疗老年人不同类型股骨颈骨折疗效比较

    Institute of Scientific and Technical Information of China (English)

    郝应文; 唐军伟

    2014-01-01

    Objective To analyze and compare the efficacies of internal fixation by the cancellous bone screw and by the head and tail nail in the treatment of femoral neck fracture of the elderly. Methods 103 cases of elderly femoral neck fractures who were followed up for more than one year accepted the retrospective analysis. They were divided into group A(n=55)and group B(n=48)according to the treatment they received. Group A was treated by cancellous bone screw,and group B was treated by head and tail nail. The efficacy was evaluated by Harris score. Results There was no statistical difference in the efficacy of the treatment between two groups( P >0. 05)and Harris score was improved in each type of femoral neck fracture. However,the excellent rate was higher in group A than in group B(91. 2% vs. 62. 5%)for subcapital type ( P 0. 05),and lower in group A than in group B(66. 7% vs. 95. 0%) ( P 0.05)。两组患者不同类型术后髋关节Harris评分均有不同程度的改善。头下型骨折:A组优良率为91.2%,B组优良率为62.5%,A组优良率高于B组( P 0.05);基底型骨折:A组优良率为66.7%,B组优良率为95.0%,B组优良率高于A组( P <0.05)。结论空心拉力螺钉内固定与首尾钉内固定治疗老年人股骨颈骨折,都可以达到良好的骨折复位效果,头下型骨折空心拉力螺钉内固定效果更优,基底型骨折首尾钉内固定效果更优。

  17. Nail care for newborns

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001914.htm Nail care for newborns To use the sharing features on ... finger or toe instead of the nail. Baby's nails grow quickly, so you may have to cut the fingernails at least once a week. You may only need ... SG, Bedwell C, Cork MJ. Neonatal skin care and toxicology. In: Eichenfield LF, Frieden IJ, Mathes ...

  18. Diaphyseal humeral fractures and intramedullary nailing: Can we improve outcomes?

    Directory of Open Access Journals (Sweden)

    Christos Garnavos

    2011-01-01

    Full Text Available While intramedullary nailing has been established as the treatment of choice for diaphyseal fractures of the femur and tibia, its role in the management of diaphyseal humeral fractures remains controversial. The reasons include not only the complicated anatomy and unique biomechanical characteristics of the arm but also the fact that surgical technique and nail designs devised for the treatment of femoral and tibial fractures are being transposed to the humerus. As a result there is no consensus on many aspects of the humeral nailing procedure, e.g., the basic nail design, nail selection criteria, timing of the procedure, and the fundamental principles of the surgical technique (e.g., antegrade/retrograde, reamed/unreamed, and static/dynamic. These issues will be analyzed and discussed in the present article. Proposals aiming to improve outcomes include the categorization of humeral nails in two distinct groups: "fixed" and "bio", avoidance of reaming for the antegrade technique and utilization of "semi-reaming" for the retrograde technique, guidelines for reducing complications, setting the best "timing" for nailing and criteria for selecting the most appropriate surgical technique (antegrade or retrograde. Finally, suggestions are made on proper planning and conducting clinical and biomechanical studies regarding the use of intramedullary nailing in the management of humeral shaft fractures.

  19. Effect of lag screw auxiliary interlocking intramedullary nail for complicated fracture of femoral shaft on callus content%拉力螺钉辅助交锁髓内钉治疗股骨干复杂骨折对骨痂含量的影响

    Institute of Scientific and Technical Information of China (English)

    王胜强; 何兴川; 胡黔粤; 王攀

    2012-01-01

    BACKGROUND: Biomechanical studies and clinical cases observation discovers that using interlocking intramedullary nail for the treatment of complicated fracture of femoral shaft and using lag screw assisted fixation of comminuted fracture piece, can optimize fracture conductivity and promote fracture healing.OBJECTIVE: To explore the effect of lag screws fixation for comminuted fractures of block fixation on the significance of fracture healing during interlocking intramedullary nail fixation for the treatment of complicated fracture of femoral shaft in operation.METHODS: Totally 60 cases with interlocking intramedullary nail internal fixation for the treatment of femoral shaft were divided into pulling nail group and exclusion group. Digital X-ray posteroanterior films at 1 and 12 weeks after internal fixation in each group were randomly selected. Gray-scale density of callus area, normal bone area and normal soft tissue area was detected.Comparative analysis of callus area self control gray rate in intragroup and intergroup.RESULTS AND CONCLUSION: There was no significant difference of the gray-scale density in the normal bone area and normal soft tissue area (P < 0.01), but gray-scale density at 12 weeks after internal fixation was higher than that at 1 week after I nternal fixation in callus area (P < 0.01). At 12 weeks after internal fixation, gray-scale density of the pulling nail group was obviously higher than that of the exclusion group (P < 0.01). Self control gray rate of the pulling nail group was obviously higher than that of the exclusion group (P < 0.01). The lag screw fixation for comminuted fractures after auxiliary block can contribute to the formation of callus, and bone callus content in the pulling nail group is higher than that in the exclusion group.%背景:生物力学研究及临床病例观察发现,用交锁髓内钉治疗股骨干复杂骨折,使用拉力螺钉辅助固定粉碎骨折块,能优化骨折的力学传导,促进骨折愈

  20. Elastic intramedullary nail for treatment of extremity fractures in children

    Institute of Scientific and Technical Information of China (English)

    MA Hong-ru; MA Shu-lin; ZHANG Wen-lu; YANG Jin-chang; CUI Hou-xuan

    2008-01-01

    Objective: To assess the clinical therapeutic effects of elastic intramedullary nail on extremity fractures in children. Methods: From June 2005 to March 2008, 40 children with extremity fractures were treated by elastic intramedullary nail, in whom femoral shaft fractures occurred in 26 cases, tibiofibular fractures in 8 cases, radial capitular fractures in 4 cases, ulnoradial fractures in 2 cases. All patients were treated by closed reduction and elastic intramedullary nail fixation. Results: All the fractures gained satisfactory reduc-tion and healing. The average duration needed for fracture healing was 1-2 months. Postoperative follow-up confirmed a sound functional recovery. Conclusions: The elastic intramedullary nail is a minimally invasive and effective surgical approach for treatment of extremity fractures in children. It allows early functional exercises after operation and secures a satisfactory bone union and functional recovery.

  1. Nursing of nail fixation combined with bone cement replantation treatment of femoral shaft nonunion.%交锁髓内钉固定结合骨泥回植治疗股骨干骨折不愈合的护理

    Institute of Scientific and Technical Information of China (English)

    柯阳芳; 邓月兴; 李文英; 黄瑞生; 樊仕才

    2009-01-01

    目的:探讨交锁髓内钉固定结合扩髓之骨泥回植治疗股骨干骨折不愈合的围手术期护理特点.方法:交锁髓内钉固定并将扩髓时产生的骨泥回植于骨折端治疗股骨干骨折不愈合29例,其中男23例,女6例.年龄26~54岁,平均39.5岁.术后48 h拔引流管,使用抗生素预防感染3 d,所有患者均未行外固定,摄X线片根据骨折稳定情况进行关节功能锻炼.结果:29例平均骨性愈合时间为47周,膝关节功能较术前明显改善,无感染、肢体短缩、旋转或成角畸形,无内固定断裂等并发症.结论:交锁髓内钉固定结合扩髓之骨泥回植治疗股骨干骨折不愈合,术前心理辅导、术前准备、术中配合监护、术后康复训练等环节护理对手术成功至关重要.%Objective:Discussion the characteristics of perioperative nursing of locked reamed intramedullary nailing for replantation of the bone cement treatment of femoral shaft fracture nonunion. Methods:Care line locked intramedullary reaming and nailing of the bone cement when replantation in the treatment of femoral shaft fracture nonunion in 29 cases, male 23 cases, six cases of women; age 26-54 years old, average 39.5 years old.After surgery 48h the drainage tube out, the use of antibiotics to prevent infection in 3 d, not all patients with external fixation line, taken X-ray conducted in accordance with the stability of articular fracture functional exercise.Results:Average of 29 cases of bone healing time for 47 weeks, pre-operative knee function improved significantly compared with no infection, limb shortening, rotation or angulation deformity, no complications such as fracture fixation. Conclusion:Locked reamed intramedullary nailing for replantation of the bone cement treatment of femoral shaft fracture nonunion of perioperative nursing, with emphasis on pre-operative psychological, preoperative preparation, intraoperative with guardianship, such as postoperative rehabilitation

  2. STUDY OF TITANIUM ELASTIC NAILING FOR FRACTURE SHAFT FEMUR IN CHILDREN BETWEEN 3 TO 13 YEARS OF AGE

    Directory of Open Access Journals (Sweden)

    Rajesh

    2015-03-01

    Full Text Available Treatment of Displaced diaphyseal femoral shaft fracture in children between 3 to 13 years is controversial. Various methods are available for treatment. Titanium elastic nailing is one of the methods for treatment of femur shaft fracture in children. In our study we have assessed the outcome of titanium elastic nailing for fracture shaft femur in children. We have found that titanium elastic nailing has excellent results in treatment of femur shaft fracture in children. Also it is less time consuming

  3. Anatomic observation and clinical application of identifying the entry point in the greater trochanter for antegrade femoral intramedullary nailing without the fluoroscopic guidance%非透视下确定顺行股骨髓内钉大转子进钉点的解剖观察及临床应用

    Institute of Scientific and Technical Information of China (English)

    李云飞; 高生; 张秋琴; 沈宝良

    2016-01-01

    目的:探讨非透视下确定顺行股骨髓内钉大转子进钉点的技术方法。方法2007年12月—2008年6月选取10%甲醛溶液固定的成人髋部湿标本8具,男5例、女3例,观察股骨大转子解剖特征,标记大转子上臀中肌、梨状肌的附着情况,观察股骨大转子嵴拐点凹陷、髓腔中轴线与梨状窝的解剖关系。2010年1月—2012年12月对收治的44例股骨转子间及股骨干骨折患者进行前瞻性研究。其中男20例,女24例;年龄25~85岁,平均(66.9±15.7)岁。患者均行顺行髓内钉固定术,术中根据标本解剖中发现大转子嵴拐点凹陷和梨状窝的关系,非透视下通过手法触摸确定髓内钉开口位置。结果尸体标本解剖研究发现,股骨大转子在与股骨颈结合部形成一个向外侧凸出类似“C”形的山嵴样结构。股骨大转子嵴呈后方高、前方平坦下降似斜坡样结构,中间凭借手指就可以感觉有一个类似拐点的凹陷切迹。臀中肌附着在大转子嵴的外侧部分,梨状肌腱附着在大转子嵴拐点切迹的内侧部分。梨状窝就是梨状肌附着点的骨质凹陷,梨状窝基本位于髓腔中轴线上、大转子嵴拐点凹陷的内侧。44例患者中,1例患者术中无法满意确定骨折近端髓腔朝向,开口过程中采用X线透视检查髓腔开口器的方向;43例均在非透视的情况下将髓内钉导针置入髓腔,髓内钉均置入良好。术后随访时间9~28个月,平均18.4个月;除1例股骨干骨折愈合迟缓,动力化后愈合外,其他患者均愈合良好;随访期间所有患者无髓内钉松动、股骨头切出等并发症。结论在股骨干和股骨转子区骨折采用顺行髓内钉固定治疗术中,非透视下通过手法触摸,可以利用大转子嵴拐点凹陷切迹代替梨状窝参考定位,确定髓内钉开口位置,避免反复透视,降低辐射损害。%Objective To identify the entry points for antegrade femoral nailing

  4. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... Common coding issues ICD-10 Audits, fraud, and abuse Test your knowledge Derm Coding Consult AAD coding ... Injured skin Nail care Artificial nails Healthy nails Child nail care Manicure safety Nail biting Younger skin ...

  5. Nail Deformities and Injuries.

    Science.gov (United States)

    Tucker, James Rory J

    2015-12-01

    A variety of nail deformities commonly presents in the primary care office. An understanding of nail anatomy coupled with inspection of the nails at routine office visits can reveal undetected disorders. Some problems are benign, and treatment should be attempted by the primary care provider, such as onychomycosis, paronychia, or ingrown toenails. For conditions such as benign melanonychia, longitudinal ridges, isolated Beau lines, and onycholysis, clinicians may offer reassurance to patients who are concerned about the change in their nails. For deformities such as early pterygium or clubbing, a thorough evaluation and referral to an appropriate specialist may be warranted. PMID:26612379

  6. 右美托咪定复合腰骶丛阻滞在老年患者股骨近端防旋髓内钉内固定术中的应用%The application of dexmedetomidine combined with lumbosacral plexus block in senile intertrochanteric fractures treated with proximal femoral nail antirotation

    Institute of Scientific and Technical Information of China (English)

    赵若光; 龚灿生; 廖燕凌; 林莹; 陈彦青

    2015-01-01

    目的 比较右美托咪定复合超声引导下腰骶丛阻滞或硬膜外腔阻滞用于老年患者股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)内固定术的效果. 方法 选择股骨粗隆间骨折择期行PFNA内固定术的老年患者60例,美国麻醉医师协会(ASA)分级Ⅱ或Ⅲ级,年龄65岁~75岁,按随机数字表法分为2组,硬膜外腔阻滞组(E组)和腰骶丛阻滞组(L组),每组30例.E组经L3~L4隙行硬膜外穿刺,局部麻醉药为0.5%罗哌卡因10 ml~15 ml;L组在超声引导下行L2~L3间隙旁腰丛阻滞及骶丛阻滞,各注射0.5%罗哌卡因12 ml.15 min后两组患者均经静脉泵入右美托咪定,负荷剂量0.8 μg/kg,维持泵速1.0 μg· kg-1·h-1.术中若出现疼痛不适,予静脉注射芬太尼20 μg/次.比较两组患者麻醉手术过程中的平均动脉压、心率、芬太尼用量、麻黄碱用量、术中输液量及副作用情况,记录术后随访患者的感觉、运动阻滞维持时间. 结果 阻滞15 min后,两组患者阻滞效果相似.L组感觉阻滞维持时间及运动阻滞维持时间明显长于E组(P<0.05),同时L组感觉阻滞维持时间明显长于运动阻滞维持时间(P<0.05).与L组比较,E组血压明显降低,心率明显增快(P<0.05);E组输液量[(1 360±240)m1]明显多于L组[(865±180) ml](P<0.05). 结论 右美托咪定辅助超声引导下腰骶丛神经阻滞用于老年患者PFNA内固定术效果良好,血流动力学平稳,副作用少,较硬膜外阻滞具有更大的优势.%Objective To compare the effects of intravenous dexmedetomidine combined with ultrasound guided lumbosacral plexus block and epidural block in intertrochanteric femoral fracture treated with proximal femoral nail antirotation (PFNA) in elderly patients.Methods Sixty patients of ASA Ⅰ-Ⅱ,aged 65 y-75 y,suffering from intertrochanteric femoral fracture and undergoing elective PFNA fixation,were included in this study and randomly divided into 2 groups

  7. Facts about Broken Bones

    Science.gov (United States)

    ... White House Lunch Recipes The Facts About Broken Bones KidsHealth > For Kids > The Facts About Broken Bones ... through the skin . continue What Happens When a Bone Breaks? It hurts to break a bone! It's ...

  8. Treatment of ipsilateral femoral neck and shaft fractures

    Institute of Scientific and Technical Information of China (English)

    WANG Hai-qiang; HAN Yi-sheng; LI Xin-kui; LI Ming-quan; WEI Yi-yong; WU Zi-xiang

    2008-01-01

    Objective: To investigate the clinical characteristics, treatment options and causes of misdiagnosis of ipsilateral femoral neck and shaft fractures. Methods: Among 20 patients with ipsilateral femoral neck and shaft fractures, 19 were treated operatively and 1 was treated conservatively. Sixteen cases of femoral shaft fractures were treated by open reduction and internal fixation with compressive plate, and 2 cases were treated with interlocking intramedullary nailing. Eighteen femoral neck fractures were treated with cannulated screws. Another patient was treated with proximal femoral nail to fix both the neck and shaft. Delayed diagnosis for femoral neck frac tures occurred in 2 cases preoperatively. Results: A total of 19 patients were followed up. The follow up period ranged from 5 to 48 months with an average of 15 months. All the fractures were healed. Conclusion: For case of femoral shaft fracture caused by high energy injury, an AP pelvic film should be routinely taken. Once the femoral neck fracture is recognized, operative reduction and fixation should be performed in time. Femoral neck and shaft fractures should be fixed separately.

  9. Yellow nail syndrome

    Directory of Open Access Journals (Sweden)

    Dixit Ramakant

    2007-01-01

    Full Text Available A case of yellow nail syndrome is described in a forty year old male patient who presented with classical triad of this syndrome i.e. deformed yellow nails, lymph-edema and chronic recurrent pleural effusion. The practical problems in the di-agnosis are also briefly discussed with emphasis on awareness of this rare clinical entity.

  10. Trimming Your Baby's Nails

    Science.gov (United States)

    ... However, if you're hesitant to try baby nail scissors or clippers and your baby will stay still long enough to cooperate, you can use an emery board to file the nails down without the risk of giving your little ...

  11. Hair and nail relationship.

    NARCIS (Netherlands)

    Baran, R.; Dawber, R.P.; Haneke, E.

    2005-01-01

    Hair and nails are often stated to have much in common in relation to their origin, anatomical structures, and common involvement in many diseases. Hair and nails are predominantly epithelial structures derived from primitive epidermis and made up of keratinous fibrils embedded in a sulfur-rich matr

  12. Nail changes after carbamazepine

    Directory of Open Access Journals (Sweden)

    Chopra Adarsh

    2000-01-01

    Full Text Available Antiepileptics are known to produce different types of side effects including nail changes. A 20-year-old epileptic man had yellowish discolouration followed by dystrophy and onycholysis of his 15 nails after taking carbamazepine for 3 months which cleared within six months after discontinuation of the drug. This type of change has not been reported earlier with carbamazepine

  13. Carbon fiber intramedullary nails reduce artifact in postoperative advanced imaging

    Energy Technology Data Exchange (ETDEWEB)

    Zimel, Melissa N. [Memorial Sloan Kettering Cancer Center, Orthopaedic Surgery Service, Department of Surgery, New York, NY (United States); Hwang, Sinchun [Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY (United States); Riedel, Elyn R. [Memorial Sloan Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY (United States); Healey, John H. [Memorial Sloan Kettering Cancer Center, Orthopaedic Surgery Service, Department of Surgery, New York, NY (United States); Weill Medical College of Cornell University, Department of Orthopaedic Surgery, New York, NY (United States)

    2015-09-15

    This study assessed whether radiolucent carbon fiber reinforced-polyetheretherketone (CFR-PEEK) intramedullary nails decreased hardware artifact on magnetic resonance imaging (MRI) and computed tomography (CT) in vitro and in an oncologic patient population. In vitro and clinical evaluations were done. A qualitative assessment of metal artifact was performed using CFR-PEEK and titanium nail MRI phantoms. Eight patients with a femoral or tibial prophylactic CFR-PEEK nail were retrospectively identified. All patients had postoperative surveillance imaging by MRI, CT, and were followed for a median 20 months (range, 12-28 months). CFR-PEEK images were compared to images from a comparative group of patients with titanium femoral intramedullary nails who had a postoperative MRI or CT. A musculoskeletal-trained radiologist graded visualization of the cortex, corticomedullary junction, and bone-muscle interface, on T1-weighted (T1W), STIR, and contrast-enhanced T1-weighted fat-saturated (T1W FS) sequences of both groups with a five-point scale, performing independent reviews 4 months apart. Statistical analysis used the Wilcoxon rank-sum test and a weighted kappa. Substantially less MRI signal loss occurred in the CFR-PEEK phantom than in the titanium phantom simulation, particularly as the angle increased with respect to direction of the static magnetic field. CFR-PEEK nails had less MRI artifact than titanium nails on scored T1W, STIR, and contrast-enhanced T1W FS MRI sequences (p ≤ 0.03). The mean weighted kappa was 0.64, showing excellent intraobserver reliability between readings. CFR-PEEK intramedullary nail fixation is a superior alternative to minimize implant artifact on MRI or CT imaging for patients requiring long bone fixation. (orig.)

  14. Femoral head vitality after intracapsular hip fracture

    International Nuclear Information System (INIS)

    Femoral head vitality before, during and at various intervals from the operation was determined by tetracycline labeling and/or 99 sp (m)Tc-MDP scintimetry. In a three-year follow-up, healing prognosis could be determined by scintimetry 3 weeks from operation; deficient femoral head vitality predicting healing complications and retained vitality predicting uncomplicated healing. A comparison between pre- and postoperative scintimetry indicated that further impairment of the femoral head vitality could be caused by the operative procedure, and as tetracycline labeling prior to and after fracture reduction in 370 fractures proved equivalent, it was concluded that the procedure of osteosynthesis probably was responsible for capsular vessel injury, using a four-flanged nail. The four-flanged nail was compared with a low-traumatic method of osteosynthesis, two hook-pins, in a prospective randomized 14 month study, and the postoperative femoral head vitality was significantly better in the hook-pin group. This was also clearly demonstrated in a one-year follow-up for the fractures included in the study. Parallel to these investigations, the reliability of the methods of vitality determination was found satisfactory in methodologic studies. For clinical purpose, primary atraumatic osteosynthesis, postoperative prognostic scintimetry and early secondary arthroplasty when indicated, was concluded to be the appropriate approach to femoral neck fracture treatment. (Author)

  15. External fixation of complex femoral shaft fractures

    OpenAIRE

    Zlowodzki, M; Prakash, J. S.; Aggarwal, N. K.

    2006-01-01

    Conversion of temporary external fixation to an intramedullary nail within the first 2 weeks after a femoral shaft fracture is standard practice. However, due to financial constraints, in large parts of the world external fixation of femoral shaft fractures is often the definitive treatment. Out of 60 fractures, 47 were followed-up for a minimum period of 39 weeks. The average follow-up time was 75 weeks. Fourteen fractures were closed, and 33 open. Forty-four fractures united at an average o...

  16. Interventions for nail psoriasis (Review)

    NARCIS (Netherlands)

    Vries, A.C. de; Bogaards, N.A.; Hooft, L.; Velema, M.; Pasch, M.C.; Lebwohl, M.; Spuls, P.I.

    2013-01-01

    BACKGROUND: Psoriasis is a common skin disease that can also involve the nails. All parts of the nail and surrounding structures can become affected. The incidence of nail involvement increases with duration of psoriasis. Although it is difficult to treat psoriatic nails, the condition may respond t

  17. A STUDY OF CLOSED INTERLOCKING NAILING FOR FRACTURES OF SHAFT OF FEMUR IN ADULTS

    Directory of Open Access Journals (Sweden)

    Ashwin

    2013-06-01

    Full Text Available ABSTRACT: BACKGROUND:-This study is to determine the clinical course and results after interlocking nailing for femoral shaft fractures , merits and demerits of interlocking nailing, achieving the final goals of femoral shaft fracture management with special references to time for radiological union, knee stiffness, limb length discrepancy, ambulation and return to work. Femur is the strongest and heaviest bone in the human skeleton. It is also the longest bone contributing 26% to height of an individual. Fractures of the shaft of the femur are among the most common fractures encountered in orthopaedic practice, can cause prolong morbidity and extensive disability unless treatment is appropriate. Many treatment modalities were described; with many surgeons advocating different methods of treatment .At present Interlocking nailing of the femur seems to be the ideal method of treatment for complex femoral fractures.

  18. 股骨干骨折闭合复位髓内钉固定术中大转子倾斜指数的应用%Application of the greater trochanter tilting index in close reduction and intramedullary nail fixation of a femoral shaft fracture

    Institute of Scientific and Technical Information of China (English)

    付世杰; 高海军; 张建志; 董天华; 吴希瑞; 郑占乐; 张国川

    2013-01-01

    Objective To assess the usage of the greater trochanter tilting index in the close reduction and intramedullary nail fixation of femoral shaft fracture for correction of rotational deformity.Methods From January 2011 to January 2012 we treated 24 patients with one-sided and closed femoral shaft fracture.They were 20 men and 4 women,aged from 17 to 61 years (average,36.5 years).By AO classification,11 cases were of 32A2,8 of 32B2 and 5 of 32C2.After the anteroposterior radiograph of the proximal femur was taken,its rotational angle was calculated according to the greater trochanter tilting index.When the external rotation angle of the proximal femur was ≥ 15°,the Schanz pin skill was used to rectify the extorsion before inserting the main intramedullary nail; when the angle was < 15°,the main intramedullary nail was inserted and the proximal locking screws were locked before the rotational deformity was corrected.The anteversion angles of both healthy and affected sides were measured and compared to judge the rotation reduction quality using CT scans.Results In the 24 patients,the anteversion angle was 15.36°± 7.91° at the affected side and 14.54° ± 7.44° at the healthy side,showing no statistically significant difference (t =0.958,P =0.348).The mean value of D-values between the affected and healthy sides (deformity degrees) was 3.58°± 2.26°.The deformity degrees of all patients averaged less than 9°.Fifteen cases had internally rotational deformity at the distal fracture end,8 externally rotational deformity and one no deformity.The 24 patients were followed up for 8 to 20 months (average,13 months).All fractures obtained union after an average of 5.1 months (from 3 to 7 months).No complications like bone nonunion or knee stiffness were found.Conclusion The greater trochanter tilt index can be used as an aid in close reduction and intramedullary nail fixation of femoral shaft fracture because it can help judge the rotational state of the proximal

  19. 股骨近端螺旋刀片抗旋髓内钉治疗股骨转子间骨折的并发症原因分析%Complications of intertrochanteric fractures treated with proximal femoral nail anti-rotation (PFNA) system

    Institute of Scientific and Technical Information of China (English)

    李仁斌; 林焱斌; 庄研; 张怡元; 熊国胜; 林任

    2012-01-01

    Background: Although the therapcutic effects are satisfactory by proximal femoral nail anti-rotation (PFNA) in treatment of intertrochanteric fractures, there are still intraoperative and postoperative complications. Objective: The purpose of the study is to investigate the complications of the PFNA system in treatment of intertrochanteric fractures. Methods: From June 2006 to June 2011, 229 patients with intertrochanteric fracture underwent osteosynthesis with PFNA. There were 132 males and 97 females with a mean age of 65.5 years (range 48 to 103 years). The fractures affected 127 right hips and 102 left hips. The fractures were classified according to the AO system. The mean duration from injury to surgery was 5d (range 3 to 16 d). The mean hospital stay was 13.5 d (range 4 to 23 d). Surgical results were assessed clinically (Harris hip score) and radiographically. Perioperative and postoperative complications were recorded. Results: The mean operation time was 39.8 min (range 19 to 112 min) and the mean blood loss was 47ml (range 20 to 250 ml). Reduction was poor in 14 patients, acceptable in 78, and good in 137. The tip-apex distance was Iess than 25 mm in 187 patients, and 25 mm and more than 25 mm in 42 patients. The mean neck-shaft angle was 135.7°(range 125°to 148°). During the surgery, femoral shaft fracture occurred in 3 patients, and gTeater trochanter fracture occurred in 12 patients. Postoperative complications included pressure sore in 2 cases, poor healing in 6, secondary varus in 5, lateral hip pain in 4, thigh pain in 11, screw cut-out in 2, femoral shortness in 9, nail breakage in 2, and screw lateral displacement in 7. The mean Harris hip score was 83.8 (range 67 to 96). The outcomes were excellent in 152 patients, good in 48, fair in 23, and poor in 6. No heterotopic ossification, venous embolism and deep infection occurred. The mean follow-up lasted for 22.4 months (range 18-28 months). Conclusions: The clinical outcome of PFNA is good in

  20. Skin or nail culture

    Science.gov (United States)

    Mucosal culture; Culture - skin; Culture - mucosal; Nail culture; Culture - fingernail; Fingernail culture ... There, it is placed in a special dish (culture). It is then watched to see if bacteria, ...

  1. Femoral fractures : indications an[d] biomechanics of external fixation

    NARCIS (Netherlands)

    A.H. Broekhuizen (Tom); B. van Linge

    1988-01-01

    textabstractInternal fixation can be carried out in various ways. For femoral shaft fractures, an (interlocking) nail is becoming increasingly popular, instead of open realignment of the fracture. External fixation, which has become a generally accepted method of treating fractures of the lower leg,

  2. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... care & guidelines Clinical guidelines Appropriate use criteria Patient safety Choosing Wisely Quality measures Outcomes in Dermatology Pilot ... Artificial nails Healthy nails Child nail care Manicure safety Nail biting Younger skin Kids’ zone Video library ...

  3. [Nail involvement in leprosy].

    Science.gov (United States)

    Belinchón Romero, I; Ramos Rincón, J M; Reyes Rabell, F

    2012-05-01

    Leprosy, a disease caused by Mycobacterium leprae, primarily affects the skin and nerves, but the nails are also involved in as many as 3 out of 4 patients .The factors that trigger nail changes in leprosy are numerous and include repeated trauma, neuropathy, vascular impairment, infections, lepra reactions, and the drugs used to manage the disease. The changes most often reported include subungual hematomas, onycholysis, onychauxis, onychogryphosis, pterygium unguis, and onychoheterotopia, most of which can be attributed to nerve damage and trauma. Furthermore, the acro-osteolysis that occurs in the advanced stages of the disease may present with brachyonychia, racquet nails, or even anonychia. Infections of the nail bed leading to paronychia and onychomycosis should also be taken into account in leprosy. Other typical changes include longitudinal striae, pitting, macrolunula, Terry nails, leukonychia, hapalonychia, and Beau lines. In this review, we describe the principal nail changes associated with leprosy. These changes, which are highly varied and diverse in origin, are in fact a reflection of the significant morbidity caused by M. leprae infection.

  4. Early experience with titanium elastic nails in a trauma unit.

    LENUS (Irish Health Repository)

    Shah, M H

    2012-02-03

    The Titanium Elastic Nail (TEN) offers a number of potential advantages over traditional ways of treating long bone fractures particularly in the paediatric population. These advantages include earlier mobilisation and shorter hospital stay and less risk of loss of fracture position. These advantages are most apparent and significant when treating femoral fractures in children where the length of hospital stay is reduced from several weeks to a typical period of 5 to 8 days. We have reviewed our early experience of using these implants over the past 2 years. Patients were assessed clinically and radiologically. 13 patients were treated using the TEN during this period. There were 2 femoral fractures, 4 humeral fractures, 1 tibial and 6 forearm fractures treated using the Titanium Elastic Nail. All fractures united during the study period. However 1 humeral fracture required a secondary bone grafting and plating for delayed union and 1 fracture lost position during follow-up. Insertion point pain was a problem in 4 patients but this resolved after nail removal in all. There was 1 superficial wound infection which resolved with antibiotics and 1 superficial wound infection of an open fracture wound which resolved following nail removal and antibiotics. There were no cases of deep infection. There were no limb length discrepancy or rotational or angular malalignment problems. Biomechanical principles and technical aspects of this type of fixation are discussed.

  5. PEADIATRIC LONG BONES FRACTURE IN LOWER LIMBS TREATED BY TENS (TITANIUM ELASTIC NAILING SYSTEM NAIL: A SURGICAL OUTCOME

    Directory of Open Access Journals (Sweden)

    Suresh

    2014-08-01

    Full Text Available In the last two decades, there was an increased interest in the operative treatment of pediatric fractures, although debate persisted over its indications. There is a little disagreement concerning the treatment of long bone fractures in children less than 6 years (POP cast and adolescents, older than 16 years (locked intramedullary nailing. 1 Controversy persists regarding the age between 6 to 16 years, with several available options: traction followed by hip Spica, external fixation, flexible, stable intramedullary nails, plate fixation, and locked intramedullary nailing. As no clear guidelines have been available until now despite efforts done initially by French surgeons, later on by European surgeons and recently by the Paediatric Orthopaedic Society of North America (POSNA2Titanium elastic nail (TEN fixation was originally meant as an ideal treatment method for femoral fractures, but was gradually applied to other long bone fractures in children, as it represents a compromise between conservative and surgical therapeutic approaches with satisfactory results and minimal complications3. Hence we have undertaken a prospective study of 30 cases in our institution about the outcome and efficacy of paediatric femoral and tibial diaphyseal fracture between age 6 to 16 years.

  6. OPTIMAL DISTAL SCREW ALIGNMENT IN THE GAMMA NAIL

    Institute of Scientific and Technical Information of China (English)

    Ching-KongChao; Chun-ChingHsiao; Po-QuangChen

    2002-01-01

    The effect of stress distribution due to the changes of the distal screw alignment in relation to the Gamma nail and the femoral shaft is thoroughly studied in this paper. Failure of the Gamma nail composite occurs through the cranial aperture of the distal screws and the insertion hole for the lag screw due to nonunion, delayed-union and continued weight-bearing. A three-dimensional finite element model was used to study the fractured femur, the Gamma nail, the lag screw and the distal locking screws. The first and the second distal screws were inserted into the Gamma nail in four different configurations. We found that the stress of the Gamma nail composite was substantially reduced with the two screws configured in the anterior to posterior direction. This alignment can bear greater loading in the more demanding fracture types. In the subtrochanteric fracture or the comminuted fractures at the proximal femur, the optimal alignment of the two distal screws was in the anterior to posterior direction.

  7. 可膨胀股骨近端髓内钉与PFN治疗老年股骨转子间骨折的比较分析%A comparative study on the outcome of expandable intramedullary nailing system and proximal femoral nail for treatment of peritrochanteric fractures in aged patients

    Institute of Scientific and Technical Information of China (English)

    李晓林; 于晓雯; 罗从风; 张长青; 曾炳芳

    2007-01-01

    目的 比较可膨胀股骨近端髓内钉(Fixion PF)与股骨近端髓内钉(proximalfemoral nail,PFN)治疗老年股骨转子间骨折的临床效果.方法 自2005年3月~2006年9月用PFN与Fixion PF治疗老年股骨转子间骨折48例,其中PFN治疗组27例,Fixion PF钉组21例.比较项目包括手术时间、出血量、术中X线照射时间、并发症以及功能恢复情况.结果 所有病例均获得随访,平均随访9个月(3~22个月),骨折均愈合.Fixion PF组平均手术时间和手术切口长度小于PFN组(P<0.05),术中X线透视次数、出血和引流量、离床和弃拐时间、骨愈合时间及Harris髋关节功能评分两组差异无统计学意义.结论 PFN与Fixion PF治疗老年股骨转子间骨折均有较好疗效,但Fixion PF钉固定后的应力分布均匀,远端不需锁定,近端加用股骨头栓钉能增加股骨头松质骨密度和固定强度,增加抗旋转能力,较适合于老年骨质疏松性股骨近端骨折的治疗,但对严重骨质疏松者慎用.

  8. Titanium, Sinusitis, and the Yellow Nail Syndrome

    OpenAIRE

    Berglund, Fredrik; Carlmark, Björn

    2010-01-01

    Yellow nail syndrome is characterized by nail changes, respiratory disorders, and lymphedema. In a yellow nail patient with a skeletal titanium implant and with gold in her teeth, we found high levels of titanium in nail clippings. This study aims to examine the possible role of titanium in the genesis of the yellow nail syndrome. Nail clippings from patients with one or more features of the yellow nail syndrome were analyzed by energy dispersive X-ray fluorescence. Titanium was regularly fou...

  9. Yellow Nail Syndrome (Case report

    Directory of Open Access Journals (Sweden)

    Mustafa Haki Sucaklı

    2011-09-01

    Full Text Available Yellow nail syndrome, usually autosomal dominant transition and occurs with yellow nails, lymph edema and pleural effusion triad. In this article, a girl, 13 months, who was diagnosed as yellow nail syndrome and followed with pericardial effusion and lymph edema from her birth, has been presented. Yellow nail syndrome has been diagnosed lately due to the occurrence of clinical symptoms which are often more obvious after the puberty. However, neonatal or infant period of pericardial effusion in patients with lymphedema and yellow nail syndrome should be kept in mind.

  10. Nail Problems (Toenails)

    Science.gov (United States)

    ... Ingrown toenail may be caused by: ◆ Improperly trimmed nails (Trim then straight across, not longer than the tip of the toes. Do not round off corners. Use toenail clippers.) ◆ Heredity ◆ Shoe pressure; crowding of toes ◆ Repeated trauma ...

  11. Titanium exposure and yellow nail syndrome

    Directory of Open Access Journals (Sweden)

    Ali Ataya

    2015-01-01

    Full Text Available Yellow nail syndrome is a rare disease of unclear etiology. We describe a patient who develops yellow nail syndrome, with primary nail and sinus manifestations, shortly after amalgam dental implants. A study of the patient's nail shedding showed elevated nail titanium levels. The patient had her dental implants removed and had complete resolution of her sinus symptoms with no change in her nail findings. Since the patient's nail findings did not resolve we do not believe titanium exposure is a cause of her yellow nail syndrome but perhaps a possible relationship exists between titanium exposure and yellow nail syndrome that requires further studies.

  12. OUTCOME STUDY OF TITANIUM AND STAINLESS STEEL ELASTIC NAIL FIXATION OF PAEDIATRIC FRACTURE SHAFT OF FEMUR

    Directory of Open Access Journals (Sweden)

    Saubhik

    2014-09-01

    Full Text Available INTRODUCTION: Femoral shaft fractures are common fractures in paediatric age group. There are various methods to treat them. Elastic stable intramedullary nailing is one of them and an established and reliable method for treating these fractures. Ideal treatment of femoral shaft fractures in the age group of 5 to 14 years is still a matter of debate as no consensus has been achieved till now. We have done a study to know whether elastic stable intramedullary nails can be used reliably in this age group. So, purpose of the present study is to evaluate the outcome of titanium and stainless steel elastic nail in paediatric femoral fractures in 5-14 years of age group. METHODS: A group of forty two children with femoral fractures that were treated with elastic nails (which includes both titanium and stainless steel nails- both nail types were of similar design and outcome was evaluated. Twenty children (16 boys, four girls in the age group of 5-14 years (average 9.3 years with femoral shaft fractures (16 closed, two Grade- I and two Grade- II compound were stabilized with Titanium Elastic Nail (TEN, while twenty-two (16 boys, six girls in the age group of 5-14 years (average 9.1 years with femoral shaft fractures (18 closed, two Grade- I and two Grade- II compound were stabilized with Stainless Steel Elastic Nail (SSEN between June 2009 and October 2011. A familiar retrograde insertion technique was used. Major complications were defined as malunion with sagittal angulation of >15° and coronal angulation of >10°, nail irritation requiring revision surgery, infection, delayed union, and rod breakage. Minor complications were defined as nail irritation or superficial infection not requiring surgery. RESULTS: Radiological union was achieved in all cases in a mean time of 7.7 weeks (6-12 weeks in TEN groups while that took 7.9 weeks in SSEN group. Full weight bearing was possible in a mean time of 7.7 weeks (6-12 weeks in TEN groups and a mean of 7

  13. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... hair, and nail care Nail care Nail biting public SPOT Skin Cancer™ Diseases and treatments Skin, hair, ... Member resources Practice Tools Education Meetings & events Advocacy Public & patients AAD Resources For: Dermatologists in the US ...

  14. Burns and beauty nails

    Science.gov (United States)

    Bélanger, Richard E; Marcotte, Marie-Eve; Bégin, François

    2013-01-01

    A case involving a five-month-old girl brought to the emergency department with burns over her abdomen is described. The child was reported to have spilled two small bottles of beauty nail adhesive on her clothes while her mother was preparing dinner. After undressing the infant, the mother discovered several lesions on the child’s abdomen and quickly sought medical attention. Given the unusual circumstances of the presentation, the child was hospitalized for both treatment and supervision. The beauty nail adhesive contained cyanoacrylate. In addition to its well-appreciated adhesive capacity, cyanoacrylate, in the presence of cotton or other tissues, is known to produce an exothermic reaction that may cause burns. Cyanoacrylate-based products, due to their possible adverse effects, should be kept away from children as advised. Odd injuries should always raise concerns about the possibility of inflicted injury. PMID:24421671

  15. Burns and beauty nails

    OpenAIRE

    Richard E. Bélanger; Marcotte, Marie-Eve; Bégin, François

    2013-01-01

    A case involving a five-month-old girl brought to the emergency department with burns over her abdomen is described. The child was reported to have spilled two small bottles of beauty nail adhesive on her clothes while her mother was preparing dinner. After undressing the infant, the mother discovered several lesions on the child’s abdomen and quickly sought medical attention. Given the unusual circumstances of the presentation, the child was hospitalized for both treatment and supervision. T...

  16. EVALUATION OF RESULT OF TITANIUM ELASTIC NAILING IN PAEDIATRICS DIAPHYSEAL FRACTURE

    Directory of Open Access Journals (Sweden)

    Abhijit

    2016-03-01

    Full Text Available BACKGROUND The management of paediatric femoral shaft fractures has evolved towards a more operative approach in the present decade. It has been noticed that problems such as angulations, malrotation and limb length discrepancy cannot be effectively tackled by nonoperative treatment all the time. AIMS AND OBJECTIVES This is a prospective study to show titanium classic nailing in femoral fractures in children, is a single procedure and at the same time effective in perspective of early weight bearing, short hospital stay and better control of angulations, malrotation and leg length discrepancy. MATERIALS AND METHODS 22 children (18 boys and 4 girls aged 6-16 years with recent femoral diaphyseal fracture were stabilized with titanium elastic nail. All the nails were introduced through retrograde approach under image intensifier. Patients were evaluated using Flynn’s scoring criteria. 1 Statistical analysis was done using Fisher’s exact test. RESULTS All 22 patients were evaluated after a mean 26 months (14-36 months of followup. Radiological unions were achieved in a mean time of 8.2 weeks. Full weight bearing was possible in a mean time of 8.7 weeks. Mean duration of stay in hospital was 9.7 days. The results were excellent in 15 patients, good in 6 patients and poor in 1 patient. CONCLUSION Intramedullary fixation of diaphyseal fracture in children of 6-16 years with titanium elastic nail is a simple and effective method with low complication rate.

  17. A PROSPECTIVE STUDY OF TREATMENT OF INTERTROCHANTERIC FRACTURE FEMUR WITH TROCHANTERIC ENTRY NAIL IN ADULTS

    Directory of Open Access Journals (Sweden)

    Pereddy Somashekhara

    2016-02-01

    Full Text Available In the current series, we have done a randomized study of 50 cases of intertrochanteric fracture femur treated by minimally invasive intramedullary fracture fixation technique using trochanteric entry femoral nail. All the cases have been operated by senior Orthopaedic surgeons or have been operated under their guidance and supervision. All the cases have been followed up for a minimum period of 4-12 months. Average follow-up is 4 months. The results have been evaluated on the basis of Harris Hip Score. The results of this study have been compared to the I. B. Schipper series Gamma Nail and Proximal Femoral Nail in 424 cases of peritrochanteric fractures are done. The stable variety of intertrochanteric fractures (AO Type 31A.1 have good-to-excellent results in all the patients in the present series. The unstable variety (AO Type 31A.2 and A.3 in the current series have good to excellent results in 79% cases and fair results in 17.64% cases. However, various studies with extramedullary implants have shown only 59% good results. In the reverse oblique type of fracture as well as with subtrochanteric extension, Trochanteric entry femoral nail has given consistently good results, whereas studies with extramedullary implants have shown only 36% good results. So there is distinct advantage of intramedullary fixation in unstable varieties. The present study shows that trochanteric entry femoral nail has definite clear advantage over extramedullary implants in unstable fractures. At the same time, the implant that has good results in unstable fractures can always be used for stable fractures also.

  18. 亚洲型股骨近端防旋髓内钉治疗老年股骨转子间骨折体会%Initial experience of using proximal femoral nail antirotationⅡ to treat intertrochanteric femoral fractures in elderly patients

    Institute of Scientific and Technical Information of China (English)

    王华; 樊仕才; 叶书熙; 杨成亮; 曾参军; 李涛; 金大地

    2012-01-01

    目的 评价亚洲型股骨近端防旋髓内钉(PFNA-Ⅱ)治疗老年股骨转子间骨折手术策略及临床疗效,总结相关的经验体会.方法 2009年5月~2010年4月,我院共收治并行PFNA-Ⅱ固定的老年股骨转子间骨折21例,所有患者均于入院后72h内在全麻下完成手术;手术在骨科牵引床上进行,患者取平卧位,C型臂X线机透视下,患髋内收内旋屈曲30°牵引,骨折解剖复位后,自转子尖打入合适规格的PFNA-Ⅱ固定.统计手术时间和出血量,术后常规预防感染及预防深静脉血栓(DVT)治疗,并对内科疾病进行对症治疗,合并骨质疏松患者行抗骨质疏松治疗.结果 本组21例均顺利完成手术,术中透视及术后髋关节正侧位X线片显示骨折复位固定好.手术时间28~51min,平均35min;出血量30~110ml,平均50ml;愈合时间平均9周.根据Harris功能评分:优18例,良2例,可1例;优良率95.2%.结论 PFNA-Ⅱ是PFNA的亚洲型,更适合国人股骨近端的解剖特点,在手术操作、固定的稳定性方面优于PFNA-Ⅰ型.Ⅱ固定.统计手术时间和出血量,术后常规预防感染及预防深静脉血栓(DVT)治疗,并对内科疾病进行对症治疗,合并骨质疏松患者行抗骨%O b jective To evaluate tie surgical strategy and clinical effect of proxinal fanoral nail antirota-tion II ( PFNA-II ) to treat elderly patients with intertrochanteric fenoral fractures and sun up the relevant experience M ethods Fran May 2009 to Apr 2010,21 elderly patients with intertrochanteric fanoral fractures were fixed with PFNA under general anesthesia within72 h after admission Surgery was perfomed in the orthopedic traction bed in supine position Hip was placed in30c of flexion, and then the adduction and internal rotation of hips was applied underG-am fluoroscopy Then patients were fixed with the suitable FFNA II following achieving anatomical reduction The operative tine and blood loss were assessed Conventional treatnentwas perfomed

  19. Injuries Associated with Femoral Shaft Fractures with Special Emphasis on Occult Injuries

    Directory of Open Access Journals (Sweden)

    E Carlos Rodriguez-Merchan

    2013-12-01

    Full Text Available Background: Fractures of the femoral shaft are mostly the result of high-energy accidents that also cause multiple trauma injuries, in particular ipsilateral knee and hip injuries. The purpose of this study was to investigate the incidence of injuries associated with femoral shaft fractures and how many of them were undetected. Methods: We studied 148 patients (150 femoral shaft fractures with an average age of 52 (range: 18-97. Femoral shaft fractures were treated with antegrade intramedullary nailing in 118 cases (78.7%, and with open reduction and internal fixation in 32 cases (21.3%. Unlocked reamed intramedullary nailing was performed in Winquist type I and type II fractures, while statically locked unreamed intramedullary nailing was carried out in Winquist type III and type IV fractures. Results: There were 70 patients with associated injuries (46.4%. The associated injuries went undetected in 18 out of 70 patients (25.5%. Six femoral nonunions (4% occurred in patients under 70 years of age (high-energy accidents treated by open reduction and internal fixation. Conclusion: Injuries associated with femoral shaft fractures were very frequent (46.4% in our series, with 25.5% undetected. Open reduction and internal fixation was a poor prognostic factor of nonunion in these fractures.

  20. Injuries Associated with Femoral Shaft Fractures with Special Emphasis on Occult Injuries

    Directory of Open Access Journals (Sweden)

    E Carlos Rodriguez-Merchan

    2013-12-01

    Full Text Available   Background: Fractures of the femoral shaft are mostly the result of high-energy accidents that also cause multiple trauma injuries, in particular ipsilateral knee and hip injuries. The purpose of this study was to investigate the incidence of injuries associated with femoral shaft fractures and how many of them were undetected. Methods: We studied 148 patients (150 femoral shaft fractures with an average age of 52 (range: 18-97. Femoral shaft fractures were treated with antegrade intramedullary nailing in 118 cases (78.7%, and with open reduction and internal fixation in 32 cases (21.3%. Unlocked reamed intramedullary nailing was performed in Winquist type I and type II fractures, while statically locked unreamed intramedullary nailing was carried out in Winquist type III and type IV fractures. Results: There were 70 patients with associated injuries (46.4%. The associated injuries went undetected in 18 out of 70 patients (25.5%. Six femoral nonunions (4% occurred in patients under 70 years of age (high-energy accidents treated by open reduction and internal fixation. Conclusion: Injuries associated with femoral shaft fractures were very frequent (46.4% in our series, with 25.5% undetected. Open reduction and internal fixation was a poor prognostic factor of nonunion in these fractures.

  1. Risk of septic knee following retrograde intramedullary nailing of open and closed femur fractures

    Directory of Open Access Journals (Sweden)

    Halvorson Jason J

    2012-02-01

    Full Text Available Abstract Background One potential complication of retrograde femoral nailing in the treatment of femur fractures is the risk of septic knee. This risk theoretically increases in open fractures as a contaminated fracture site has the potential to seed the instrumentation being passed in and out of the sterile intraarticular starting point. There are few studies examining this potential complication in a relatively commonly practiced technique. Methods All patients who received a retrograde femoral nail for femur fracture between September 1996 and November 2006 at a Level 1 trauma center were retrospectively reviewed. This yielded 143 closed fractures, 38 open fractures and 4 closed fractures with an ipsilateral traumatic knee arthrotomy. Patient follow-up records were reviewed for documentation of septic knee via operative notes, wound culture or knee aspirate data, or the administration of antibiotics for suspected septic knee. Results No evidence of septic knee was found in the 185 fractures examined in the dataset. Utilizing the Wilson confidence interval, the rate of septic knee based on our population was no greater than 2%, with that of the open fracture group alone being 9%. Conclusions Based on these results and review of the literature, the risk of septic knee in retrograde femoral nailing of both open and closed femoral shaft fractures appears low but potentially not insignificant. Funding There was no outside source of funding from either industry or other organization for this study.

  2. Weakly broken galileon symmetry

    Energy Technology Data Exchange (ETDEWEB)

    Pirtskhalava, David [Scuola Normale Superiore, Piazza dei Cavalieri 7, 56126 Pisa (Italy); Santoni, Luca; Trincherini, Enrico [Scuola Normale Superiore, Piazza dei Cavalieri 7, 56126 Pisa (Italy); INFN, Sezione di Pisa, Piazza dei Cavalieri 7, 56126 Pisa (Italy); Vernizzi, Filippo [Institut de Physique Théorique, Université Paris Saclay, CEA, CNRS, Gif-sur-Yvette cédex, F-91191 (France)

    2015-09-01

    Effective theories of a scalar ϕ invariant under the internal galileon symmetryϕ→ϕ+b{sub μ}x{sup μ} have been extensively studied due to their special theoretical and phenomenological properties. In this paper, we introduce the notion of weakly broken galileon invariance, which characterizes the unique class of couplings of such theories to gravity that maximally retain their defining symmetry. The curved-space remnant of the galileon’s quantum properties allows to construct (quasi) de Sitter backgrounds largely insensitive to loop corrections. We exploit this fact to build novel cosmological models with interesting phenomenology, relevant for both inflation and late-time acceleration of the universe.

  3. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... break the habit. Try to stop biting one set of nails, such as your thumb nails, first. When that’s successful, eliminate your pinky nails, pointer nails, or even an entire hand. The goal is to get to the point where you ...

  4. Teaching Your Child Healthy Nail Care

    Science.gov (United States)

    ... as beaches, pools, locker rooms, camps, and hotel bathrooms (including showers and tubs). 8. Check your nails. Children's nails are usually healthy, but teaching them to check their nails at a young age develops a healthy habit. Checking nails is important because the first sign ...

  5. Yellow Nail Syndrome - a Case Report

    Directory of Open Access Journals (Sweden)

    Paravina Mirjana

    2015-06-01

    Full Text Available Yellow nail syndrome is a rare disease of unknown etiology. It is clinically characterized by a triad of yellow nails, lymphedema at one or more sites, and chronic respiratory disease (bronchitis, bronchiectasis and rhinosinusitis. All nails may be affected, but some may be spared. The nail plates are yellowish green, thickened, occasionally with transverse ridging and onycholysis, with increased longitudinal and transversal over-curvature, with partial or complete separation of the nail plate from the nail bed, without lunula and cuticle and slow nail growth rate. The lymphedema is usually peripheral, affecting the lower limbs, or in the form of pleural effusion.

  6. Blood flow and microdialysis in the human femoral head

    DEFF Research Database (Denmark)

    Bøgehøj, Morten; Emmeluth, Claus; Overgaard, Søren

    2007-01-01

    BACKGROUND: If it would be possible to detect lack of flow and/or the development of ischemia in bone, we might have a way of predicting whether a broken bone will heal. We established microdialysis (MD) and laser Doppler (LD) flow measurement in the human femoral head in order to be able to detect...

  7. How Cryptosystems Get Broken

    Institute of Scientific and Technical Information of China (English)

    Adi Shamir

    2009-01-01

    @@ It's all us pleasure to come to China.a great deal of cheerful times already.I hope that we have additional opportunity to meet,talk about cryptography and other components.Today I am going to give a general talk which is not designed for special lists,about how could the systems get broken like this.I think I don't assume you know much about cryptography and some of the basics.Cryptography deals with issue how to send secret information from a sender which is usually called Alice.to a receiver which is usually called Bob.The usual way how to encrypt data is to use an encryption box that accepts the plaintext,the plaintext is the message that you would like to send encrypted.It could be just"Good morning".By using a secret cryptographic key K,you put ciphertext which looks very very strange."zqvkj…".

  8. Yellow nail syndrome, pincer nails, colon cancer and polyps in a 76 year-old-woman

    Directory of Open Access Journals (Sweden)

    Vitorino Modesto dos Santos

    2015-11-01

    Full Text Available The yellow nail syndrome is a scarcely described condition characterized by dystrophic yellowish nails, respiratory disturbances and lymphedema; while the pincer nail deformity is characterized by thickening and excessive transverse curvature of the nail plate. The objective of this case study is to report a 76-year-old Japanese descent woman with yellow nail syndrome and pincer nails, intestinal polyps, and sigmoid colon adenocarcinoma. Both the yellow nail syndrome and pincer nails may develop in association with malignancies, either by chance or by some etiopathogenic mechanism not well-known.

  9. Influence of Lateral Muscle Loading in the Proximal Femur after Fracture Stabilization with a Trochanteric Gamma Nail (TGN)

    Science.gov (United States)

    Sitthiseripratip, Kriskrai; Mahaisavariya, Banchong; Suwanprateeb, Jintamai; Bohez, Erik; Vander Sloten, Jos

    The purpose of this study was to investigate the influence of lateral muscle loading on the stress/strain distributions of the trochanteric Gamma nail (TGN) fixation within the healed, trochanteric and subtrochanteric femoral fractures by means of a finite element method. The effect of three muscle groups, the abductors (ABD), the vastus lateralis (VL) and the iliotibial band (ITB), were investigated. The analytical results showed that addition of lateral muscle forces, iliotibial band and vastus lateralis, produced compensation of forces and reduction of bending moments in the bone and in the trochanteric Gamma nail especially in the lateral aspect. The iliotibial band produced a higher impact as compared to the vastus lateralis. Therefore in the finite element analysis of the proximal femur with the trochanteric Gamma nail fracture fixation should include the lateral muscle forces to simulate load condition with maximal physiological relevance to the closed nailing technique.

  10. Radiation exposure to the surgeon during closed interlocking intramedullary nailing

    Energy Technology Data Exchange (ETDEWEB)

    Levin, P.E.; Schoen, R.W. Jr.; Browner, B.D.

    1987-06-01

    During interlocking intramedullary nailing of twenty-five femoral and five tibial fractures, the primary surgeon wore both a universal film badge on the collar of the lead apron and a thermoluminescent dosimeter ring on the dominant hand to quantify the radiation that he or she received. When distal interlocking was performed, the first ring was removed and a second ring was used so that a separate recording could be made for this portion of the procedure. At the conclusion of the study, all of the recorded doses of radiation were averaged. The average amount of radiation to the head and neck during the entire procedure was 7.0 millirems of deep exposure and 8.0 millirems of shallow exposure. The average dose of radiation to the dominant hand during insertion of the intramedullary nail and the proximal interlocking screw was 13.0 millirems, while the average amount during insertion of the distal interlocking nail was 12.0 millirems. Both of these averages are well within the government guidelines for allowable exposure to radiation during one-quarter (three months) of a year. Precautions that are to be observed during this procedure are recommended.

  11. A study on the surgical treatment of ingrowing toe nail with nail excision with chemical matricectomy versus nail excision alone

    Directory of Open Access Journals (Sweden)

    Ashutosh Talwar

    2013-01-01

    Full Text Available An in growing toenail develops when the proper fit of the nail plate in the lateral nail groove is altered. We selected 30 patients of ingrowing toe nail for the study. The patients were divided into two groups of 15 patients each. In group I patients, nail avulsion with chemical matrictectomy with 88%phenol was done. In group II only nail avulsion was done. In group I patients the surgical success rate was 98% and in group II, the surgical success rate was 86.6%. No patient complained about the cosmetic appearance of toe nail after the operation.

  12. Additive manufacturing in the development of an intramedullary nail: study of clinical case

    OpenAIRE

    Fernandes, Maria; Lino, Jorge; Fonseca, E.M.M.

    2015-01-01

    The additive manufacturing is currently an indispensable tool in different areas. Its application in orthopaedic area has been essential in the development of surgical procedures, visualization of anatomical structures and especially in the new implants design to improve the conditions for patients’ treatment. The present study considered different techniques of additive manufacturing applied in design, diagnosis and planning of a locked intramedullary nail used in the femoral diaphysis fract...

  13. Atypical femoral fracture in an osteogenesis imperfecta patient successfully treated with teriparatide

    DEFF Research Database (Denmark)

    Holm, Jakob; Eiken, Pia; Hyldstrup, Lars;

    2014-01-01

    : This is a case report of an AFF treated with teriparatide. RESULTS: The patient was treated with hormone replacement therapy for 18 years and bisphosphonates for 9 years before suffering a spontaneous AFF in the form of a dislocated noncomminute transverse fracture of the right femoral shaft, and an open......OBJECTIVE: We report a case of a successfully healed atypical femoral fracture (AFF) following treatment with teriparatide in a patient with osteogenesis imperfecta (OI). To our knowledge, no successful treatment of AFFs with teriparatide in this subpopulation has ever been described. METHODS...... reduction and internal fixation (ORIF) with a T2 Femoral Nail was done. Due to nonunion and another fracture distal to the nail, the patient was reoperated on with exchange ORIF and off-label treatment with teriparatide 20 μg/day was started. An X-ray 1 month later showed early signs of fracture healing...

  14. The affordances of broken affordances

    DEFF Research Database (Denmark)

    Grünbaum, Martin Gielsgaard; Simonsen, Jakob Grue

    2015-01-01

    important: how users may (i) achieve their goals in the presence of such broken affordances, and may (ii) repurpose or otherwise interact with artefacts with broken affordances. We argue that (A) thorough analyses of breakdowns of affordances and their associated signifiers and feedbacks have implication...

  15. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... hair loss Injured skin Nail care Younger skin Kids’ zone About skin: Your body's largest organ About ... More important than you think Questions lots of kids ask about their skin, hair, and nails. Amazing ...

  16. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... Common coding issues ICD-10 Audits, fraud, and abuse Test your knowledge Derm Coding Consult AAD coding ... from biting their nails. Get regular manicures: Spending money to keep your nails looking attractive may make ...

  17. Femoral hernia repair

    Science.gov (United States)

    Femorocele repair; Herniorrhaphy; Hernioplasty - femoral ... During surgery to repair the hernia, the bulging tissue is pushed back in. The weakened area is sewn closed or strengthened. This repair ...

  18. Yellow Nail Syndrome: Dystrophic Nails, Peripheral Lymphedema and Chronic Cough

    Directory of Open Access Journals (Sweden)

    Christian Dornia

    2011-01-01

    Full Text Available A case involving a 41-year-old man with yellow nail syndrome (YNS is reported. YNS is a rare disorder characterized by yellow, dystrophic nails, peripheral lymphedema and bronchiectasis with recurrent lower respiratory tract infections. YNS is often misdiagnosed because the syndrome is not well known. An interdisciplinary approach is required to recognize and collate the components of the syndrome accurately. Correct diagnosis is of utmost clinical importance because YNS can occur secondary to malignancies and autoimmune disorders. Hence, the diagnosis of YNS must prompt further investigation.

  19. Nail abnormalities in patients with vitiligo*

    Science.gov (United States)

    Topal, Ilteris Oguz; Gungor, Sule; Kocaturk, Ozgur Emek; Duman, Hatice; Durmuscan, Mustafa

    2016-01-01

    Background Vitiligo is an acquired pigmentary skin disorder affecting 0.1-4% of the general population. The nails may be affected in patients with an autoimmune disease such as psoriasis, and in those with alopecia areata. It has been suggested that nail abnormalities should be apparent in vitiligo patients. Objective We sought to document the frequency and clinical presentation of nail abnormalities in vitiligo patients compared to healthy volunteers. We also examined the correlations between nail abnormalities and various clinical parameters. Methods This study included 100 vitiligo patients and 100 healthy subjects. Full medical histories were collected from the subjects, who underwent thorough general and nail examinations. All nail changes were noted. In the event of clinical suspicion of a fungal infection, additional mycological investigations were performed. Results Nail abnormalities were more prevalent in the patients (78%) than in the controls (55%) (p=0.001). Longitudinal ridging was the most common finding (42%), followed by (in descending order): leukonychia, an absent lunula, onycholysis, nail bed pallor, onychomycosis, splinter hemorrhage and nail plate thinning. The frequency of longitudinal ridging was significantly higher in patients than in controls (p<0.001). Conclusions Nail abnormalities were more prevalent in vitiligo patients than in controls. Systematic examination of the nails in such patients is useful because nail abnormalities are frequent. However, the causes of such abnormalities require further study. Longitudinal ridging and leukonychia were the most common abnormalities observed in this study. PMID:27579738

  20. Expandable self-locking nail in the management of closed diaphyseal fractures of femur and tibia

    Directory of Open Access Journals (Sweden)

    Kapoor Sudhir

    2009-01-01

    Full Text Available Background : Intramedullary fixation is the treatment of choice for closed diaphyseal fractures of femur and tibia. The axial and rotational stability of conventional interlocking nails depends primarily on locking screws. This method uses increased operating time and increased radiation exposure. An intramedullary implant that can minimize these disadvantages is obviously better. Expandable intramedullary nail does not rely on interlocking screws and achieves axial and rotational stability on hydraulic expansion of the nail. We analyzed 32 simple fractures of shaft of femur and tibia treated by self-locking expandable nail. Materials and Methods: Intramedullary fixation was done by using self-locking, expandable nail in 32 patients of closed diaphyseal fractures of tibia (n = 10 and femur (n = 22. The various modes of injury were road traffic accidents (n = 21, fall from height (n = 8, simple fall (n = 2, and pathological fracture (n = 1. Among femoral diaphyseal fractures 16 were males and six females, average age being 33 yrs (range, 18- 62 yrs. Seventeen patients had AO type A (A1 (n = 3, A2 (n = 4, A3 (n = 10 and 5 patients had AO type B (B1 (n = 2, B2 (n = 2, B3 (n = 1 fractures. Eight patients having tibial diaphyseal fractures were males and two were females; average age was 29.2 (range, 18- 55 yrs. Seven were AO type A (A1 (n = 2, A2 (n = 3, A3 (n = 2 and three were AO type B (B1 (n = 1, B2 (n = 1, and B3 (n = 1. We performed closed (n = 27 or open reduction (n = 5 and internal fixation with expandable nail to stabilize these fractures. The total radiation exposure during surgery was less as no locking screws were required. Early mobilisation and weight-bearing was started depending on fracture personality and evidences of healing. Absence of localised tenderness and pain on walking was considered clinical criteria for union, radiographic criteria of union being continuity in at least in three cortices in both AP and lateral views

  1. Broken Bones, Sprains, and Strains (For Parents)

    Science.gov (United States)

    ... 5 Things to Know About Zika & Pregnancy Broken Bones, Sprains, and Strains KidsHealth > For Parents > Broken Bones, ... home. What to Do: For a Suspected Broken Bone: Do not move a child whose injury involves ...

  2. Broken toe - self-care

    Science.gov (United States)

    Fractured toe - self-care; Broken bone - toe - self-care; Fracture - toe - self-care; Fracture phalanx - toe ... often treated without surgery and can be taken care of at home. Severe injuries include: Breaks that ...

  3. Job loss and broken partnerships

    DEFF Research Database (Denmark)

    Kriegbaum, Margit; Christensen, Ulla; Lund, Rikke;

    2008-01-01

    The aim of this study was to investigate the effects of the accumulated number of job losses and broken partnerships (defined as the end of cohabitation) on the risk of fatal and nonfatal events of ischemic heart disease (IHD).......The aim of this study was to investigate the effects of the accumulated number of job losses and broken partnerships (defined as the end of cohabitation) on the risk of fatal and nonfatal events of ischemic heart disease (IHD)....

  4. Nail Disease for the Primary Care Provider.

    Science.gov (United States)

    Biesbroeck, Lauren K; Fleckman, Philip

    2015-11-01

    Nail disorders are a common presenting complaint for both the primary care physician and the dermatologist. Nail diagnoses are broad in scope and include infectious, inflammatory, and neoplastic conditions. Onychomycosis is an especially common nail condition, and treatment should always be preceded by appropriate fungal studies for confirmation of diagnosis. Inflammatory conditions of the nail unit can mimic onychomycosis, and a dermatologist can assist with diagnosis and treatment recommendations. Likewise, subungual tumors often require biopsy, and should be evaluated by a dermatologist who is experienced in nail evaluation and treatment. PMID:26476249

  5. Atherosclerotic femoral artery aneurysms

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Schroeder, T V

    1996-01-01

    Based on a clinical suspicion of an increase in the proportion of deep femoral aneurysms, we reviewed the case records of patients who underwent reconstructive procedures for femoral aneurysms to investigate if this could be confirmed and explained by selection of patient or modality of diagnosis...

  6. Nail psoriasis: The journey so far

    Directory of Open Access Journals (Sweden)

    Alka Dogra

    2014-01-01

    Full Text Available Nail involvement is an extremely common feature of psoriasis and affects approximately 10-78% of psoriasis patients with 5-10% of patients having isolated nail psoriasis. However, it is often an overlooked feature in the management of nail psoriasis, despite the significant burden it places on the patients as a result of functional impairment of manual dexterity, pain, and psychological stress. Affected nail plates often thicken and crumble, and because they are very visible, patients tend to avoid normal day-to-day activities and social interactions. Importantly, 70-80% of patients with psoriatic arthritis have nail psoriasis. In this overview, we review the clinical manifestations of psoriasis affecting the nails, the common differential diagnosis of nail psoriasis, Nail Psoriasis Severity Index and the various diagnostic aids for diagnosing nail psoriasis especially, the cases with isolated nail involvement. We have also discussed the available treatment options, including the topical, physical, systemic, and biological modalities, in great detail in order to equip the present day dermatologist in dealing with a big clinical challenge, that is, management of nail psoriasis.

  7. Onycholysis induced by nail hardener.

    Science.gov (United States)

    Helsing, Per; Austad, Joar; Talberg, Hans Jørgen

    2007-10-01

    Nail hardeners appeared in the market during the 1960s. They were basically solutions of formaldehyde. The first adverse effects were published in 1966 (1). Reactions were onycholysis, chromonychia, subungual haemorrhage, and hyperkeratosis. Onycholysis may be non-inflammatory or inflammatory, and is accompanied by throbbing pain. Inflammatory reactions are followed by paronychia and occasional dermatitis on the digital pulpa. PMID:17868227

  8. [Key messages in nail disease].

    Science.gov (United States)

    Goettmann, Sophie

    2014-11-01

    Nail diseases are varied, and their diagnosis is often difficult. Misdiagnosis can result in failure to recognize a severe disease in urgent need of treatment and in the prescription of treatments that are inappropriate, long, ineffective, and expensive. Acute paronychia must be managed rapidly, treated with antiseptics several times a day, and closely monitored. Nail lichen must be recognized early and treated rapidly and appropriately to prevent permanent scarring. All chronic pain (to shocks or cold) of the tip of a finger or toe should suggest a glomus tumor. Any unexplained persistent single-finger onychopathy should in principle cause the physician to suspect a tumor, carcinoma, or melanoma and to order a histologic examination. An onychopathy must not be treated as an onychomycosis without diagnostic certainty. Repeated microtraumas of the toenails cause injuries that absolutely must be differentiated from onychomycosis. In growth of the big toenail can often be avoided by appropriate cutting of the nails, leaving in place the lateral parts of the nail plate. PMID:25451634

  9. Total Hip Arthroplasty for Implant Rupture after Surgery for Atypical Subtrochanteric Femoral Fracture

    Directory of Open Access Journals (Sweden)

    Yu Ozaki

    2016-01-01

    Full Text Available Treatment methods for delayed union and nonunion of atypical femoral fracture are still controversial. Moreover, no treatment method has been established for implant rupture caused by delayed union and nonunion. We encountered a 74-year-old female in whom nonunion-induced implant rupture occurred after treatment of atypical subtrochanteric femoral fracture with internal fixation using a long femoral nail. It was unlikely that sufficient fixation could be obtained by repeating osteosynthesis alone. Moreover, the patient was elderly and early weight-bearing activity was essential for early recovery of ADL. Based on these reasons, we selected one-stage surgery with total hip arthroplasty and osteosynthesis with inverted condylar locking plate as salvage procedures. Bone union was achieved at 6 months after surgery. This case illustrated that osteosynthesis-combined one-staged total hip arthroplasty could be considered as one of the options for nonunion-induced implant rupture of atypical femoral subtrochanteric fracture.

  10. 7 CFR 51.2717 - Broken.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Broken. 51.2717 Section 51.2717 Agriculture... Standards for Shelled Runner Type Peanuts Definitions § 51.2717 Broken. Broken means that more than one-fourth of the peanut kernel is broken off....

  11. 7 CFR 51.2759 - Broken.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Broken. 51.2759 Section 51.2759 Agriculture... Standards for Shelled Virginia Type Peanuts Definitions § 51.2759 Broken. Broken means that more than one-fourth of the peanut kernel is broken off....

  12. 46 CFR 9.8 - Broken periods.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Broken periods. 9.8 Section 9.8 Shipping COAST GUARD... § 9.8 Broken periods. In computing extra compensation where the services rendered are in broken periods and less than 2 hours intervene between such broken periods the time served should be...

  13. 7 CFR 51.2737 - Broken.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Broken. 51.2737 Section 51.2737 Agriculture... Standards for Grades of Shelled Spanish Type Peanuts Definitions § 51.2737 Broken. Broken means that more than one-fourth of the peanut kernel is broken off....

  14. A STUDY OF EXCHANGE OF FAILED IMPLANT WITH INTRAMEDULLARY INTERLOCKING NAIL IN FRACTURES OF FEMUR AND TIBIA

    Directory of Open Access Journals (Sweden)

    Rapaka

    2015-09-01

    Full Text Available The aim of the fracture treatment is to achieve union with timely functional recovery. Internal fixation with adherence to strict biomechanical principles is often required to achieve this. However, a fixation device may fail to hold a redu ced fracture until union, giving rise to non - union or delayed union with implant failure. The aim of this study was to see the efficacy of exchange of failed implant with an intra - medullary interlocking nail. PATIENTS AND METHODS: 18 cases of long bone f ractures (Femur and Tibia, who had the problem of poor fracture healing because of the fracture pattern or the implant were studied. Their failed implants were exchanged with an intra - medullary interlocking nail. RESULTS: In our study 89 percent were male s and majority of the patients were in the age group of 18 - 35 years. Femur (11 cases was more frequently involved than Tibia (7cases. Dynamic compression plates were exchanged in 2 cases, external fixator of Tibia was exchanged with interlocking nail of Tibia (secondary interlocking nailing in 4 cases, 1 External Fixator of Femur was exchanged with Interlocking nail Femur. Mean duration of hospital stay was 25 days. Overall Functional Result was Excellent in 33.33%, good in 55.55% and Poor in 11.11% of cases. CONCLUSION: In case of an earlier implant failure, intramedullary interlocking nail is a better choice for fixation of fractures i n long bones. Thorough reaming of the medullary canal should be done to remove endosteal fibrous tissue in all cases of exchange nailing. In properly selected cases, bone grafting is not necessary akin to our series as the endosteal reamings provide suffic ient osteogenic material. Exchange nailing is an excellent choice for aseptic nonunions of non - comminuted diaphyseal femoral and tibial fractures.

  15. Lateral decubitus for treating pertrochanteric fractures using cephalomedullary nails

    Directory of Open Access Journals (Sweden)

    Elton João Nunes de Oliveira

    2015-08-01

    Full Text Available ABSTRACTOBJECTIVE: To perform a retrospective radiographic evaluation on the fracture reduction and implant position in the femoral head among patients with pertrochanteric fractures who had been treated using a cephalomedullary nail in lateral decubitus; and to assess factors that might interfere with the quality of the fracture reduction and with the implant position in using this technique. METHODS: Nineteen patients with a diagnosis of pertrochanteric fractures of the femur who had been treated using cephalomedullary nails in lateral decubitus were evaluated. For outpatient radiographic evaluations, we used the anteroposterior view of the pelvis and lateral view of the side affected. We measured the cervicodiaphyseal angle, tip-apex distance (TAD, spatial position of the cephalic element in relation to the head, and the bispinal diameter. To make an anthropometric assessment, we used the body mass index. Two groups of patients were created: one in which all the criteria were normal (TAD ≤25 mm, cervicodiaphyseal angle between 130° and 135° and cephalic implant position in the femoral head in the central-central quadrant; and another group presenting alterations in some of the criteria for best prognosis. RESULTS: Female patients predominated (57.9% and the mean age was 60 years. Seven patients presented a central-central cephalic implant position. One patient present a cervicodiaphyseal angle >135° and the maximum TAD was 32 mm; consequently, 12 patients presented some altered criteria (63.2%. None of the characteristics evaluated differed between the patients with all their criteria normal and those with some altered criteria, or showed any statistically significant association among them ( p> 0.05. CONCLUSION: The technique described here enabled good reduction and good positioning of the implant, independent of the anthropometric indices and type of fracture.

  16. Effect of reaming medullary cavity on femoral fracture healing

    International Nuclear Information System (INIS)

    To study the effect of reaming medullary cavity on blood supply of femoral fracture and fracture healing. Methods: Animal model was developed through breaking the femur and nailing the fracture in twenty mature rabbits, half of them with medullary reamed cavity. Authors injected model 185 MBq of 99Tcm on the third day, the first, second and fourth week after operation, then conducted observation of blood supply through ECT. Authors also made histological and EM observation in different stages 1 week, 2 weeks, 4 weeks and 8 weeks after fracture. Results: Three days after operation, the ratio of 99Tcm uptaken amount was significantly decreased in the reaming medullary group. Immunohistochemistry study also revealed the processing of fracture healing was slower. Conclusion: After reaming of medullary cavity, the blood supply of femoral fracture is reduced, and fracture healing is delayed

  17. [Onychomatricoma, a rare lesion of the nail].

    Science.gov (United States)

    Pommepuy, Isabelle; Roblet, Denis; Blaise, Sophie; Delage-Corre, Manuela; Bonnetblanc, Jean-Marie; Fayol, Jacqueline; Labrousse, François

    2004-09-01

    Onychomatricoma is a rare fibroepithelial lesion of the nail matrix with peculiar clinical and histological features. Clinically, it is characterized by a longitudinal band of yellow thickening of the nail plate with transverse overcurvature and splinter hemorrhages. Nail avulsion exposes a villous tumor of the matrix with filamentous digitations extending into multiple holes of the nail plate. Histologically, a thick keratogenous zone forms a thickened nail plate. The lesion in its proximal portion is characterized by deep epithelial invaginations and by a stroma organized in two layers. The distal zone corresponds to multiple fibroepithelial projections extending into the nail plate. The diagnosis can be difficult in the presence of misleading clinical features or when the specimen is incomplete or examined with an improper orientation. Surgical resection is the recommended treatment. PMID:15567955

  18. Nail-Gun Injuries to the Hand

    OpenAIRE

    Pierpont, Yvonne N.; Pappas-Politis, Effie; Naidu, Deepak K.; Salas, R. Emerick; Johnson, Erika L.; Payne, Wyatt G.

    2008-01-01

    Background: The nail gun is a commonly utilized tool in carpentry and construction. When used properly with appropriate safety precautions, it can facilitate production and boost efficiency; however, this powerful tool also has the potential to cause serious injury. The most common site of nail-gun injuries in both industrial and nonoccupational settings is the hand. Materials and Methods: We report on two patients with nail-gun injuries to the hand. A review of the literature and discussion ...

  19. Dramatic Response of Nail Psoriasis to Infliximab

    OpenAIRE

    Gilles Safa; Laure Darrieux

    2011-01-01

    Nail psoriasis, affecting up to 50% of psoriatic patients, is an important cause of serious psychological and physical distress. Traditional treatments for nail psoriasis, which include topical or intralesional corticosteroids, topical vitamin D analogues, photochemotherapy, oral retinoids, methotrexate, and cyclosporin, can be time-consuming, painful, or limited by significant toxicities. Biological agents may have the potential to revolutionize the management of patients with disabling nail...

  20. Yellow Nails, Lymphedema and Chronic Cough: Yellow Nail Syndrome in an Eight-Year-Old Girl

    OpenAIRE

    Ishita Siddiq; Daniel Hughes

    2012-01-01

    Yellow nail syndrome is a rare disease and reported mainly in adults. A case of yellow nail syndrome involving an eight-year-old girl with associated discoloured yellowish nails on the fingers and toes, lymphedema and chronic cough, and sputum production is reported.

  1. Yellow Nails, Lymphedema and Chronic Cough: Yellow Nail Syndrome in an Eight-Year-Old Girl

    Directory of Open Access Journals (Sweden)

    Ishita Siddiq

    2012-01-01

    Full Text Available Yellow nail syndrome is a rare disease and reported mainly in adults. A case of yellow nail syndrome involving an eight-year-old girl with associated discoloured yellowish nails on the fingers and toes, lymphedema and chronic cough, and sputum production is reported.

  2. Application of Quality Control in Treatment of femoral intertrochanteric fracture in the elderly with Insertion of DHS system%DHS系统置入质量控制在老年股骨粗降间骨折治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    杨克敏; 孔维云; 王宇飞

    2013-01-01

    fluoroscopy, and the plate was placed in the standard position on the middle line of the proximal of the femoral. Result:The nails were in the standard position in 23 cases, and were too short in 4 cases with the distance over 10mm from the edge of the head of the femoral. The nails were not in the standard position and too short in 3 cases, and was too short in 1 case. The plates of DHS were not on the middle line of the proximal of the femoral because the start points were in the front of the standard point. The nail was out of the neck of the femoral post operation, and had to revision after 8 days post operation. 30 cases of fractures were union without broken of the nails and plate with fol owed 12 months, and the nail was out of the neck of the femoral. Conclusion:The quality control in the nail placement with the guide needle is the key point to the quality control in the DHS system placement.

  3. Cosmetically Induced Disorders of the Nail with Update on Contemporary Nail Manicures

    Science.gov (United States)

    Tosti, Antonella

    2016-01-01

    The nail carries a significant cosmetic impact and plays an integral role in the multi-billion dollar salon industry. This review focuses on nail disorders that are induced by nail cosmetics via procedures, equipment, or materials that are intended to beautify or adorn the nail. The authors give specific attention to clinical presentations that are common, novel, and underreported, but may be misdiagnosed easily by the competent dermatologist. They also provide an update on the controversies surrounding contemporary nail cosmetic procedures, such as acrylic and gel manicures. PMID:27462387

  4. Comparison of nail-plate fixation and Ender's nailing for intertrochanteric fractures.

    Science.gov (United States)

    Hall, G; Ainscow, D A

    1981-02-01

    Two comparable groups of patients with fractures of the trochanteric region of the femur were studied. One hundred and sixty-five fractures had been fixed with conventional nail-plates and 132 with Ender's nails. Ender's nails gave superior results in the treatment of trochanteric fractures. The operation was quicker and less traumatic than that using conventional nail-plates and both the mortality rate and the time in hospital were reduced. More patients in the group with Ender's nails who were initially independent returned to an independent existence.

  5. Sistemas osso-implante ex vivo utilizando haste intramedular polimérica para imobilização de fraturas femorais em bovinos jovens Ex vivo bone-implant systems using polymeric intramedullary nails for fixation of femoral fractures in young calves

    Directory of Open Access Journals (Sweden)

    Odael Spadeto Junior

    2011-02-01

    Full Text Available O desenvolvimento de novos aparatos usando materiais disponíveis e de baixo custo pode ser uma alternativa viável para o tratamento cirúrgico de fraturas em ossos longos de bovinos. O objetivo deste estudo foi avaliar a resistência mecânica de fêmures de bovinos jovens com fratura diafiseal, imobilizados com hastes intramedulares bloqueadas, compostas por diferentes polímeros. Para tanto, testes físicos de compressão e flexão, por meio de uma máquina universal de ensaios foram realizados em quatro grupos distintos de seis fêmures obtidos de bovinos jovens. Em um dos grupos, os ossos foram mantidos íntegros (grupo controle, enquanto que os outros os ossos, foram fraturados e imobilizados com uma haste intramedular bloqueada, composta por polipropileno, poliacetal ou poliamida (uma para cada grupo. Independente do polímero utilizado, nenhuma das hastes estudadas ofereceu aos fêmures fraturados resistência comparável ao osso íntegro, quando consideradas em conjunto as forças de flexão e compressão. A concordância desses achados com resultados in vivo previamente publicados, demonstra que a metodologia utilizada para testes ex vivo pode ser útil na seleção de materiais mais resistentes para confecção de novos modelos.The development of new devices using available and low cost materials may be an useful alternative for the treatment of long bone fractures in large animals. The aim of this study was to evaluate the mechanical strength of young bovine femur with diaphyseal fracture fixed with different polymeric intramedullary nails. Bending and compression tests using a universal machine were carried out in 4 distinct groups of 6 femurs from young calves. In one of the groups bones were intact while in the other three fractured bones were fixed using an intramedullary nail made of polypropylene, polyacetal or polyamide (one for each group. Considering bending and compression tests together, none of the used polymers offered

  6. Broken Ergodicity in MHD Turbulence

    Science.gov (United States)

    Shebalin, John V.

    2010-01-01

    Ideal magnetohydrodynamic (MHD) turbulence may be represented by finite Fourier series, where the inherent periodic box serves as a surrogate for a bounded astrophysical plasma. Independent Fourier coefficients form a canonical ensemble described by a Gaussian probability density function containing a Hermitian covariance matrix with positive eigenvalues. The eigenvalues at lowest wave number can be very small, resulting in a large-scale coherent structure: a turbulent dynamo. This is seen in computations and a theoretical explanation in terms of 'broken ergodicity' contains Taylor s theory of force-free states. An important problem for future work is the case of real, i.e., dissipative flows. In real flows, broken ergodicity and coherent structure are still expected to occur in MHD turbulence at the largest scale, as suggested by low resolution simulations. One challenge is to incorporate coherent structure at the largest scale into the theory of turbulent fluctuations at smaller scales.

  7. Opto-thermal radiometry for in-vivo nail measurements

    International Nuclear Information System (INIS)

    We have developed a new method for in-vivo human nail characterization by using opto-thermal transient emission radiometry (OTTER) and condenser-chamber TEWL (trans-dermal water loss) method - AquaFlux. With OTTER, we can measure nail water content, nail water concentration depth profiles, as well as topically applied solvent penetration through nail. With AquaFlux, we can measure nail transonychial water loss (TOWL). Combining the water content results with TOWL results, we can get the water diffusion coefficient of nail. Measuring the water diffusion coefficients of nail at different nail water concentration levels can also yield information on how nail diffusion coefficients change with water content. We will present the theoretical background, and experimental results on water concentration depth profile in nail, as well as topically applied solvent penetration through nail.

  8. Nail Involvement in Frontal Fibrosing Alopecia

    OpenAIRE

    Macpherson, Melanie; Hohendorf-Ansari, Parinaz; Trüeb, Ralph Michel

    2015-01-01

    A case of frontal fibrosing alopecia with nail involvement is presented. Nail involvement provides evidence for underlying lichen planus, and that the disease represents a rather generalized than localized process. Favorable response of the scalp condition to oral dutasteride points to an inflammatory reaction on the background of androgenetic alopecia.

  9. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... you’ve repeatedly tried to quit and the problem persists, consult a doctor. If you bite your nails and develop a skin or nail infection, consult a board-certified ... & patients AAD Resources For: Dermatologists in the US ...

  10. Mycobacteria in nail salon whirlpool footbaths, California.

    Science.gov (United States)

    Vugia, Duc J; Jang, Yvonne; Zizek, Candi; Ely, Janet; Winthrop, Kevin L; Desmond, Edward

    2005-04-01

    In 2000, an outbreak of Mycobacterium fortuitum furunculosis affected customers using whirlpool footbaths at a nail salon. We swabbed 30 footbaths in 18 nail salons from 5 California counties and found mycobacteria in 29 (97%); M. fortuitum was the most common. Mycobacteria may pose an infectious risk for pedicure customers.

  11. Nail psoriasis: a questionnaire-based survey

    NARCIS (Netherlands)

    Klaassen, K.M.G.; Kerkhof, P.C.M. van de; Pasch, M.C.

    2013-01-01

    BACKGROUND: Skin manifestations are the most characteristic finding of psoriasis. However, nail involvement is also a clinical feature of disease although it is often overlooked. The documented prevalence of nail psoriasis varies between 10.0% and 81.1%. OBJECTIVES: The aim of this investigation is

  12. Femoral shaft fractures

    International Nuclear Information System (INIS)

    The femur is the longest, largest, and strongest bone in the body. Because of its length, width, and role as primary weight-bearing bone, it must tolerate the extremes of axial loading and angulatory stresses. Massive musculature envelopes the femur. This masculature provides abundant blood supply to the bone, which also allows great potential for healing. Thus, the most significant problem relating to femoral shaft fractures is not healing, but restoration of bone length and alignment so that the femoral shaft will tolerate the functional stresses demanded of it

  13. Nail changes and disorders among the elderly

    Directory of Open Access Journals (Sweden)

    Singh Gurcharan

    2005-01-01

    Full Text Available Nail disorders are frequent among the geriatric population. This is due in part to the impaired circulation and in particular, susceptibility of the senile nail to fungal infections, faulty biomechanics, neoplasms, concurrent dermatological or systemic diseases, and related treatments. With aging, the rate of growth, color, contour, surface, thickness, chemical composition and histology of the nail unit change. Age associated disorders include brittle nails, trachyonychia, onychauxis, pachyonychia, onychogryphosis, onychophosis, onychoclavus, onychocryptosis, onycholysis, infections, infestations, splinter hemorrhages, subungual hematoma, subungual exostosis and malignancies. Awareness of the symptoms, signs and treatment options for these changes and disorders will enable us to assess and manage the conditions involving the nails of this large and growing segment of the population in a better way.

  14. Interlocked Intramedullary Nail Without Fluoroscopy.

    Science.gov (United States)

    Zirkle, Lewis G; Shahab, Faseeh; Shahabuddin

    2016-01-01

    Surgical Implant Generation Network (SIGN) was founded 15 years ago to create equality of fracture care throughout the world. This is done by education and supply of the appropriate implants and instruments to implement the education. SIGN implants have been used in 150,000 long bone fractures in developing countries. The same implants and instruments are used to provide intramedullary nail interlocking screw fixation in the tibia, femur, and humerus. The design of SIGN implants and the surgical technique are described. PMID:26614921

  15. Severe Onychodystrophy due to Allergic Contact Dermatitis from Acrylic Nails.

    Science.gov (United States)

    Mattos Simoes Mendonca, Marcela; LaSenna, Charlotte; Tosti, Antonella

    2015-09-01

    Acrylic nails, including sculptured nails and the new ultraviolet-curable gel polish lacquers, have been associated with allergic contact dermatitis (ACD). We report 2 cases of ACD to acrylic nails with severe onychodystrophy and psoriasiform changes including onycholysis and subungual hyperkeratosis. In both cases, the patients did not realize the association between the use of acrylate-based manicures and nail changes. One patient had been previously misdiagnosed and treated unsuccessfully for nail psoriasis. The informed clinician should elicit a history of acrylic manicure in patients with these nail changes, especially in cases of suspected nail psoriasis refractory to treatment. Patch testing is a useful tool in confirming diagnosis. PMID:27170940

  16. Proximal femoral fractures

    DEFF Research Database (Denmark)

    Palm, Henrik; Teixidor, Jordi

    2015-01-01

    searched the homepages of the national heath authorities and national orthopedic societies in West Europe and found 11 national or regional (in case of no national) guidelines including any type of proximal femoral fracture surgery. RESULTS: Pathway consensus is outspread (internal fixation for un...

  17. Open intramedullary nailing for segmental long bone fractures: An effective alternative in a resource-restricted environment

    Directory of Open Access Journals (Sweden)

    Olasunkanmi M Babalola

    2016-01-01

    Full Text Available Background: Closed, locked intramedullary nailing has been accepted as the gold standard in the care of femoral fractures, with reported union rates as high as 98-100%. Closed, locked intramedullary nailing often requires expensive equipment which is a challenge in developing countries. Segmental long bone fractures are often a result of high-energy trauma and hence often associated with a lot of injuries to the surrounding soft tissues. This consequently results in higher rates of delayed or nonunion. This study was proposed to review the outcome of management of segmental fractures with locked intramedullary nails, using an open method of reduction. Methods: A retrospective analysis was made of data obtained from all segmental long bone fractures treated with intramedullary nailing over a 1-year period. Records were retrieved from the folders of patients operated on from January 2011 to December 2011. Patients were followed up for a minimum of 1 year after the surgery. Results: We managed a total of 12 segmental long bone fractures in 11 patients. Eight of the 12 fractures were femoral fractures and 10 of the fractures were closed fractures. All but one fracture (91.7% achieved union within 4 months with no major complications. Conclusions: Open method of locked intramedullary nailing achieves satisfactory results when used for the management of long bone fractures. The method can be used for segmental fractures of the humerus, femur, and tibia, with high union rates. This is particularly useful in low-income societies where the use of intraoperative imaging may be unavailable or unaffordable. It gives patients in such societies, a chance for comparable outcomes in terms of union rates as well as avoidance of major complications. Larger prospective studies will be necessary to conclusively validate the efficacy of this fixation method in this environment.

  18. Early Stage Disease Diagnosis System Using Human Nail Image Processing

    Directory of Open Access Journals (Sweden)

    Trupti S. Indi

    2016-07-01

    Full Text Available Human’s hand nail is analyzed to identify many diseases at early stage of diagnosis. Study of person hand nail color helps in identification of particular disease in healthcare domain. The proposed system guides in such scenario to take decision in disease diagnosis. The input to the proposed system is person nail image. The system will process an image of nail and extract features of nail which is used for disease diagnosis. Human nail consist of various features, out of which proposed system uses nail color changes for disease diagnosis. Here, first training set data is prepared using Weka tool from nail images of patients of specific diseases. A feature extracted from input nail image is compared with the training data set to get result. In this experiment we found that using color feature of nail image average 65% results are correctly matched with training set data during three tests conducted.

  19. Complications of close interlock nailing in the management of close tibial fracture

    International Nuclear Information System (INIS)

    Objective: The objective of this study is to find out the frequency of complications of locally made interlock nailing in tibia after nine months of surgery. Material and Method:. This case series study was done from March 2004 to February 14 in the Department of Orthopedic and Trauma Postgraduate Medical Institute Hayatabad Medical Complex Peshawar. A total of 58 adults ( after the closure of epiphysis) patients were randomly selected provided that they have; Close diaphysial fracture of tibia which is located 7 cm below the knee joint and 4 cm above the ankle joint and fracture less than one week old. Results: Total numbers of patients were 58. Anterior Knee pain was observed in 14(24.1%), delayed union in 10(17.2%), external of 100 rotation in 4(6.9%) and internal rotation of 50 in 1(1.7%), non union in 4(6.9%), intramedullay infection in 3(5.2%), shortening of 1 centimeter (cm) in 2(3.4), 2 cm in 1(1.7%) and 1.5 cm in 3(5.2%) cases, distal screw broken in 2(3.4%), proximal screw broken in 1(1.7%), Nail broken in 2(3.4), infection at proximal screw in 2(3.4%) and at distal screw was 2(3.4%), Restriction of knee flexion in 1(1.7%), Restricted ankle movements in 1(1.7%), varus angulation of 100 in 1(1.7%), valgus angulation of 100 in 1(1.7%), Ankle pain in 1(1.7%) and deep vein thrombosis in 1(1.7%). Conclusion: interlocking nail is considered to be the gold standard for management of tibial fracture but it is not free of complication especially knee pain and angular rotation. (author)

  20. Unstable Pelvic Fractures Associated with Femoral Shaft Fractures: A Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    Chun-Liang Wu

    2013-04-01

    Full Text Available Background: Both pelvic fractures and femoral shaft fractures are caused by high-energy injuries. When unstable pelvic fractures and femoral shaft fractures occur concomitantly, the optimal treatment method is controversial. The aim of this study was to establish a reasonable principle for treating such complicated injuries. Methods: Forty patients sustaining unstable pelvic fractures and concomitant femoral shaft fractures were treated in a 7-year period. The initial management of the fractures was started at the emergency service according to the Advanced Trauma Life Support protocol. Unstable pelvic fractures were wrapped by cloth sheets and femoral shaft fractures were immobilized with a splint. Angiography was performed on patients with unstable hemodynamic status. The definitive treatment for combined fractures was performed after stabilizing the hemodynamics. Closed nailing was used for femoral shaft fractures, and pelvic fractures were treated with various techniques. Results: The mortality rate was 12.5% (5/40 during admission. Thirty-three patients were followed up for an average of 32 months (range, 12-76 months. There were 33 cases of unstable pelvic fractures and 36 instances of femoral shaft fractures. The union rate for pelvic fractures was 100% (33/33, while femoral shaft fractures had a 94.4% (34/36 union rate. The average healing time was 3.3 months (range, 1.6-8.1 months and 4.1 months (range, 2.5-18.2 months for pelvic and femoral shaft fractures, respectively. After fracture, 34 hips (94% achieved a satisfactory result in the Harris hip score and 30 knees (83% achieved a satisfactory result in the Mize knee score. Conclusions: Stabilization of the hemodynamics in patients with combined fractures should be the first aim. Angiography to stop arterial bleeding in the pelvis is often life-saving. The definitive treatment for combined fractures, such as pelvic fractures and femoral shaft fractures, should wait until hemodynamics

  1. NAIL AS A PROMISING DRUG DELIVERY SYSTEM FOR CONTROLLED RELEASE

    OpenAIRE

    G. Sai Krishna*, P. Prem Kumar, K. Bala Murugan

    2013-01-01

    ABSTRACT: The effectiveness of topical therapies is limited by minimal drug permeability through the nail plate. Nail permeability is however quite low and limits topical therapy to early/mild disease states such as onychomycosis (fungal infections of the nail). Current research on nail permeation that focuses on altering the nail plate barrier by means of chemical treatments, penetration enhancers as well as physical and mechanical methods is reviewed also the recent research into ungual dru...

  2. Ultrasound-mediated nail drug delivery system.

    Science.gov (United States)

    Abadi, Danielle; Zderic, Vesna

    2011-12-01

    A novel ultrasound-mediated drug delivery system has been developed for treatment of a nail fungal disorder (onychomycosis) by improving delivery to the nail bed using ultrasound to increase the permeability of the nail. The slip-in device consists of ultrasound transducers and drug delivery compartments above each toenail. The device is connected to a computer, where a software interface allows users to select their preferred course of treatment. In in vitro testing, canine nails were exposed to 3 energy levels (acoustic power of 1.2 W and exposure durations of 30, 60, and 120 seconds). A stereo -microscope was used to determine how much of a drug-mimicking compound was delivered through the nail layers by measuring brightness on the cross section of each nail tested at each condition, where brightness level decreases coincide with increases in permeability. Each of the 3 energy levels tested showed statistical significance when compared to the control (P permeability factor of 1.3 after 30 seconds of exposure, 1.3 after 60 seconds, and 1.5 after 120 seconds, where a permeability factor of 1 shows no increase in permeability. Current treatments for onychomycosis include systemic, topical, and surgical. Even when used all together, these treatments typically take a long time to result in nail healing, thus making this ultrasound-mediated device a promising alternative. PMID:22124008

  3. Ultrasound-mediated nail drug delivery system.

    Science.gov (United States)

    Abadi, Danielle; Zderic, Vesna

    2011-12-01

    A novel ultrasound-mediated drug delivery system has been developed for treatment of a nail fungal disorder (onychomycosis) by improving delivery to the nail bed using ultrasound to increase the permeability of the nail. The slip-in device consists of ultrasound transducers and drug delivery compartments above each toenail. The device is connected to a computer, where a software interface allows users to select their preferred course of treatment. In in vitro testing, canine nails were exposed to 3 energy levels (acoustic power of 1.2 W and exposure durations of 30, 60, and 120 seconds). A stereo -microscope was used to determine how much of a drug-mimicking compound was delivered through the nail layers by measuring brightness on the cross section of each nail tested at each condition, where brightness level decreases coincide with increases in permeability. Each of the 3 energy levels tested showed statistical significance when compared to the control (P permeability factor of 1.3 after 30 seconds of exposure, 1.3 after 60 seconds, and 1.5 after 120 seconds, where a permeability factor of 1 shows no increase in permeability. Current treatments for onychomycosis include systemic, topical, and surgical. Even when used all together, these treatments typically take a long time to result in nail healing, thus making this ultrasound-mediated device a promising alternative.

  4. Broken Windows and Collective Efficacy

    Directory of Open Access Journals (Sweden)

    Aldrin Abdullah

    2015-01-01

    Full Text Available The broken windows thesis posits that signs of disorder increase crime and fear, both directly and indirectly. Although considerable theoretical evidence exists to support the idea that disorder is positively related to fear of crime, the empirical literature on examining the indirect effect of the individual’s perception of incivilities on fear of crime is limited, especially in developing countries. This research was conducted to assess the indirect relationship between perceived disorder and fear of crime through collective efficacy. A total of 235 households from Penang, Malaysia, participated in this study. Results reveal that high perception of disorder is negatively associated with collective efficacy. High collective efficacy is associated with low fear of crime. Moreover, a significant and indirect effect of disorder on fear of crime exists through collective efficacy. The results provide empirical support for the broken windows theory in the Malaysian context and suggest that both environmental conditions and interactions of residents play a role in the perceived fear of crime.

  5. Physicochemical characterization of the human nail: I. Pressure sealed apparatus for measuring nail plate permeabilities.

    Science.gov (United States)

    Walters, K A; Flynn, G L; Marvel, J R

    1981-02-01

    Diffusion characteristics of the nail plate are necessary in providing the baselines for rational topical management of nail infections. In order to develop such baselines a unique stainless steel diffusion cell has been designed. The cell permits the exposure of 0.38 cm2 of nail plate to a bathing medium which is stirred by small motors mounted above the cell. The diffusion of water, methanol and ethanol at constant temperature (37 degrees C), has been examined over periods up to 4 h. Average permeability coefficients of water, methanol and ethanol were determined as 16.5 +/- 5.9 X 10(-3) cm hr-1, 5.6 X 10(-3) cm hr-1 and 5.8 +/- 3.1 X 10(-3) cm hr-1 respectively. Moreover rates of diffusion across the nail were inversely proportional to nail thickness. Based on methanol data, nail plate barrier property appears stable for long periods of aqueous immersion.

  6. Estimation of pretraumatic femoral antetorsion in bilateral femoral shaft fractures

    Energy Technology Data Exchange (ETDEWEB)

    Citak, Musa; Jagodzinski, Michael; Krettek, Christian; Huefner, Tobias [Hannover Medical School, Trauma Department, Hannover (Germany); Citak, Mustafa [BG-University Hospital Bergmannsheil, Department of Surgery, Bochum (Germany); Kendoff, Daniel; O' Loughlin, Padhraig F. [Hospital for Special Surgery, Orthopaedic Department, New York, NY (United States); Tavassol, Frank [Hannover Medical School, Department of Oral and Maxillofacial Surgery, Hannover (Germany)

    2009-12-15

    To describe a system for measurement of the pretraumatic femoral antetorsion angle post-bilateral femoral shaft fracture with the use of new imaging software which allows segmentation and three dimensional (3D) reconstruction of DICOM (digital imaging and communications in medicine) images. This case involved a 20-year-old patient with bilateral femoral shaft fractures. Following initial clinical examination, CT scans of both femurs were performed. Subsequently, the DICOM datasets were uploaded to the new software tool. Following segmentation and 3D reconstruction, pretraumatic femoral antetorsion angles were determined. Femoral antetorsion was described and assessed in two ways by referring to the intersection of the posterior condylar plane and (1) a line drawn between the center of the femoral head and femoral neck, (2) a line drawn between the centers of the femoral head and greater trochanter. Using these definitions, values for femoral antetorsion were found to be, respectively, 20 at the right fracture site and 19 on the left site, and 33 bilaterally. The investigators describe in this current technical report the use of new imaging software which enables the calculation of femoral AV following reduction of virtual fracture fragments which are created from standard DICOM images. We believe that this 3D reconstruction method of measuring the antetorsion angle can be integrated into a regular treatment algorithm and may potentially optimize clinical outcomes. (orig.)

  7. Estimation of pretraumatic femoral antetorsion in bilateral femoral shaft fractures

    International Nuclear Information System (INIS)

    To describe a system for measurement of the pretraumatic femoral antetorsion angle post-bilateral femoral shaft fracture with the use of new imaging software which allows segmentation and three dimensional (3D) reconstruction of DICOM (digital imaging and communications in medicine) images. This case involved a 20-year-old patient with bilateral femoral shaft fractures. Following initial clinical examination, CT scans of both femurs were performed. Subsequently, the DICOM datasets were uploaded to the new software tool. Following segmentation and 3D reconstruction, pretraumatic femoral antetorsion angles were determined. Femoral antetorsion was described and assessed in two ways by referring to the intersection of the posterior condylar plane and (1) a line drawn between the center of the femoral head and femoral neck, (2) a line drawn between the centers of the femoral head and greater trochanter. Using these definitions, values for femoral antetorsion were found to be, respectively, 20 at the right fracture site and 19 on the left site, and 33 bilaterally. The investigators describe in this current technical report the use of new imaging software which enables the calculation of femoral AV following reduction of virtual fracture fragments which are created from standard DICOM images. We believe that this 3D reconstruction method of measuring the antetorsion angle can be integrated into a regular treatment algorithm and may potentially optimize clinical outcomes. (orig.)

  8. Utility of gel nails in improving the appearance of cosmetically disfigured nails: Experience with 25 cases

    OpenAIRE

    Soni Nanda; Chander Grover

    2014-01-01

    Background: Gel nails are a commonly used cosmetic procedure, though their use by dermatologists has not been evaluated. These can be used to improve the appearance of cosmetically disfigured nails where other treatment options have failed; the condition is self-limiting or irreversible; or to camouflage the dystrophy until healing. Materials and Methods: A prospective, uncontrolled, open-label study on 25 participants presenting with cosmetically disfigured nails was undertaken. Mycologicall...

  9. MRI of broken bioabsorbable crosspin fixation in hamstring graft reconstruction of the anterior cruciate ligament

    Energy Technology Data Exchange (ETDEWEB)

    Bakhru, Prashant [Department of Radiology Jacobi Medical Center, Bronx, NY (United States); Park, Brian [Albert Einstein College of Medicine, Bronx, NY (United States); Umans, Hilary [Department of Radiology Jacobi Medical Center, Bronx, NY (United States); Lenox Hill Radiology and Imaging Associates, P.C., New York, NY (United States); DiFelice, Gregory S. [Hospital for Special Surgery, New York, NY (United States); Tobin, Keith [Lenox Hill Radiology and Imaging Associates, P.C., New York, NY (United States)

    2011-06-15

    To report seven cases of broken bioabsorbable femoral crosspins identified by MRI in evaluation of hamstring grafts of the anterior cruciate ligament. Seven cases of broken bioabsorbable crosspins utilized in femoral fixation of ACL hamstring grafts were identified prospectively and retrospectively from our PACs database during a period from 9/1/08 to 8/31/09. All imaging was performed using 1.5 or 3.0 Tesla MRI and were evaluated for T2 signal within and surrounding the crosspin, osteolysis surrounding the fragments, displacement of fragments, and graft integrity. Time from surgery was also recorded. Seven cases of hamstring grafts with broken bioabsorbable crosspins were imaged 4 months to 3 years following grafting. There was osteolysis surrounding the crosspin in all but one case in which the graft was intact but a pin fragment was displaced into the joint. One graft failed due to aseptic foreign-body reaction to the fixation with aggressive osteolysis at 9 months post surgery. In the remaining five, the ACL graft was either completely torn, partially torn, lax, or degenerative and frayed. Of these, the crosspins were broken and angulated with osteolysis surrounding the apex of the angulated fragment or demonstrated lateral extrusion of the peripheral fragment. Bioabsorbable crosspins utilized in femoral fixation of hamstring graft reconstruction of the ACL may become fractured. While the natural history of osteo-integration of these devices as demonstrated by MRI has not been defined, osteolysis surrounding the fragments, extrusion or displacement of the fragments, and graft laxity or failure would suggest that these are abnormal findings that should be reported. (orig.)

  10. A Case of Yellow Nail Syndrome with Dramatically Improved Nail Discoloration by Oral Clarithromycin

    Directory of Open Access Journals (Sweden)

    Manabu Suzuki

    2011-11-01

    Full Text Available An 80-year-old woman was admitted to our hospital with pneumonia and exacerbation of sinobronchial syndrome (SBS. She presented with yellow discoloration of the nail beds of all fingers and toes, and her nails were recognized as growing slowly. Chest X-ray revealed bronchiectasis in the bilateral lower lobe and bilateral pleural effusion. We diagnosed her as having yellow nail syndrome (YNS, based on the triad of yellow nails, lymphedema, and lung disease. After treatment with antibiotics [ampicillin/sulbactam and clarithromycin (CAM] for pneumonia and SBS, her general condition improved, and the yellow nails disappeared in some fingers. When she was previously treated with 200 mg CAM for SBS, her yellow nails had not shown improvement. This time, her yellow nails improved after treatment with 400 mg CAM. The literature reports vitamin E, zinc, and topical corticosteroid plus active vitamin D3 to be effective in the treatment of yellow nails. Two studies have reported treatment for YNS using CAM, though they found a lack of efficacy. Thus, the present case is the first to report improved yellow nails using CAM alone. We conclude that not only SBS and lung disease but also YNS were improved by treatment with 400 mg CAM.

  11. Nails

    Science.gov (United States)

    ... resources Meet our partners Español Donate Diseases and treatments Acne and rosacea Bumps and growths Color problems Contagious skin diseases Cosmetic treatments Dry / sweaty skin Eczema / dermatitis Hair and scalp ...

  12. Acute femoral neck fracture

    International Nuclear Information System (INIS)

    Ten patients with traumatic femoral neck fracture were studied with MR imaging (0.5 T, Magnetom, Siemens): unenhanced (multiecho, TR/TE = 1,600/30--240 [repetition time/echo time, msec]; gradient echo, TR/TE = 315/14, θ = 90 degrees) and Gd-DTPA enhanced (0.1 mM/kg body weight, Magnevist, Schering; gradient echo, TR/TE = 315/14, θ = 90 degrees). MR images were compared with clinical-radiographic findings. Digital subtraction angiography of the femoral head (FH) in five patients showed complete interruption of blood supply to the FH in three patients (signal intensity of FH did not increase on postcontrast images) and intact FH arteries in two patients (FH signal increased on postcontrast images, as did the healthy-side signal)

  13. Proximal Focal Femoral Deficiency

    Directory of Open Access Journals (Sweden)

    Vishal Kalia, Vibhuti

    2008-01-01

    Full Text Available Proximal focal femoral deficiency (PFFD is a developmental disorder of the proximal segment of thefemur and of acetabulum resulting in shortening of the affected limb and impairment of the function. It isa spectrum of congenital osseous anomalies characterized by a deficiency in the structure of the proximalfemur. The diagnosis is often made by radiological evaluation which includes identification and descriptionof PFFD and evaluation of associated limb anomalies by plain radiographs. Contrast arthrography orMagnetic Resonance Imaging is indicated when radiological features are questionable and to disclose thepresence and location of the femoral head and any cartilagenous anlage. The disorder is more commonlyunilateral and is apparent at birth. However, bilateral involvement is rarely seen. Therapy of the disorder isdirected towards satisfactory ambulation and specific treatment depending on the severity of dysplasia.

  14. Broken links and black boxes

    DEFF Research Database (Denmark)

    Sindbæk, Søren Michael

    2013-01-01

    Long-distance communication has emerged as a particular focus for archaeological exploration using network theory, analysis, and modelling. Initial attempts to adapt methods from social network analysis to archaeological data have, however, struggled to produce decisive results. This paper argues...... that the archaeological study of communication networks in the past calls for radically different analytical methods from those employed by most other forms of social network analysis. The fragmentary archaeological evidence presents researchers with the task of reconstructing the broken links of a ruined network from...... observable distributions and patterns of association in the archaeological record. In formal terms this is not a problem of network analysis, but network synthesis: the classic problem of cracking codes or reconstructing black-box circuits....

  15. [Pleuritis in yellow nail syndrome].

    Science.gov (United States)

    Kossakowski, C A; Schmiegelow, P; Müller, K-M

    2012-03-01

    A 76-year-old man presented clinically with coughing and shortness of breath and was diagnosed radiologically to have massive pleural effusion as a combined feature of yellow nail syndrome. A lung biopsy was taken and revealed histologically: chronic non-specific inflammation in the pleuropulmonary border, intrapleural edema with eightfold pleural thickening in comparison to normal, angiogenesis in both the nutritive and functional intrapleural blood vessels, no abnormalities of lymphatic vessels with normal topographical distribution as detected by immunohistochemistry for antibody D2-40, granulomatous chronic foreign body reaction as a consequence of pleural effusion therapy by talcum pleurodesis.The histopathological findings of chronic non-specific pleuritis with angiogenesis and increased permeability of blood vessels led to massive intrapleural edema with pleural effusion. Abnormalities of lymphatic vessels could not be confirmed. Considering the features of this disease, they are probably secondary to chronic r infectious or immunological inflammation or paraneoplastic complications with angiogenesis (in about 19%). PMID:22048329

  16. [Pleuritis in yellow nail syndrome].

    Science.gov (United States)

    Kossakowski, C A; Schmiegelow, P; Müller, K-M

    2012-03-01

    A 76-year-old man presented clinically with coughing and shortness of breath and was diagnosed radiologically to have massive pleural effusion as a combined feature of yellow nail syndrome. A lung biopsy was taken and revealed histologically: chronic non-specific inflammation in the pleuropulmonary border, intrapleural edema with eightfold pleural thickening in comparison to normal, angiogenesis in both the nutritive and functional intrapleural blood vessels, no abnormalities of lymphatic vessels with normal topographical distribution as detected by immunohistochemistry for antibody D2-40, granulomatous chronic foreign body reaction as a consequence of pleural effusion therapy by talcum pleurodesis.The histopathological findings of chronic non-specific pleuritis with angiogenesis and increased permeability of blood vessels led to massive intrapleural edema with pleural effusion. Abnormalities of lymphatic vessels could not be confirmed. Considering the features of this disease, they are probably secondary to chronic r infectious or immunological inflammation or paraneoplastic complications with angiogenesis (in about 19%).

  17. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... information Housing & travel Education FAQs Mobile app Exhibit hall 2017 Annual Meeting Derm Exam Prep Course Essentials ... and can continue through adulthood, and the side effects can be more than cosmetic. Repeated nail biting ...

  18. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... develop a skin or nail infection, consult a board-certified dermatologist . Explore AAD Member resources Practice Tools Education Meetings & events Advocacy Public & patients AAD Resources For: ...

  19. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... ICD-10 Audits, fraud, and abuse Test your knowledge Derm Coding Consult AAD coding manuals and webinars ... and nails Skin dictionary Camp Discovery Good Skin Knowledge lesson plans and activities Video library Find a ...

  20. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... like biting your nails, try playing with a stress ball or silly putty instead. This will help ... of hangnails, or other triggers, such as boredom, stress, or anxiety. By figuring out what causes you ...

  1. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... a derm practice EHR & meaningful use ACOs & medical homes Teledermatology Compliance Medicare fee schedule MACRA resource center ... plans and activities Video library Find a dermatologist Home Public and patients Skin, hair, and nail care ...

  2. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... Structure Program SPOTme® Skin Cancer Screening Program Volunteer Recognition Program AAD and AADA Historian Leadership Institute Programs ... your fingers and from your nails to your face and mouth. To help you stop biting your ...

  3. Nail involvement in mycosis fungoides: brief report

    Directory of Open Access Journals (Sweden)

    Amir Houshang Ehsani

    2014-11-01

    Conclusion: We found about 30% prevalence that is a little higher than previously shown. It seems that nail changes in CTCL have no relationship to CTCL staging or other specifications including demographic specifications.

  4. PREVALENCE OF NAIL ABNORMALITIES IN PATIENTS WITH PSORIASIS

    Directory of Open Access Journals (Sweden)

    Nermina Ovcina-Kurtovic

    2013-07-01

    Full Text Available Introduction: Psoriasis is a chronic inflammatory skin disease that affects about 2% of general population. Cllinicaly, disease can present with cutaneous and nails lesions. Nail abnormalities can be seen in up to two-thirds of patients with psoriasis and both fingernails and toenails may be affected.Objective: The objectives of our study were to evaluate the frequency and clinical presentations of nail abnormalities in patients with psoriasis. Also, we aimed to find correlation between nail changes and some clinical parameters.Methods: One hundred and ten patients with psoriasis were included in this study. A detailed history and examination was recorded for all study subjects, including the age and gender of the patients, type of psoriasis, duration, and extent of disease. Finger and toe nails were clinically examined and nail changes were noted. In the case of clinicaly suspected of fungal infection, further mycological investigations were performed.Results: Nail abnormalities were present in 67 patients (60.9% with psoriasis. Nail pitting was the most common lesion observed on fingernails, followed by discoloration of nail plate. Subungual hyperkeratosis of nail plates were significantly more frequent on the toenails. Positive mycological culture was in 14 (20.8% psoriatic patients with nail involvement. Also, positive correlation between nail abnormalities and duration of psoriasis was found.Conclusions: Nail involvement is common in patients with psoriasis and accompanies skin lesions on the body surface. Pitting and subungual hyperkeratosis are the most frequent nail abnormality in psoriatic patients.

  5. Onychomatricoma: A Rare Tumor of Nail Matrix

    OpenAIRE

    Joo, Hong Jin; Kim, Mi Ri; Cho, Baik Kee; Yoo, Gyeol; Park, Hyun Jeong

    2016-01-01

    Onychomatricoma is a rare tumor of the nail matrix. Until now, few cases of onychomatricoma have been reported in the literature. Immunohistochemically, CD10, a marker of the onychodermis, is expressed in the stroma of the onychomatricoma. In the present case, a 27-year-old woman presented with an 8-year history of a yellowish, thickened, and overcurved nail plate of the right index finger, mimicking onychomycosis. She had been treated for 4 years with antifungal agents by general physicians,...

  6. Nail involvement in mycosis fungoides: brief report

    OpenAIRE

    Amir Houshang Ehsani; Fatemeh Gholamali; Mahboubeh Sadat Hosseini; Mojgan Nouri; Pedram Noormohammadpour

    2014-01-01

    Background: Mycosis fungoides (MF) is the commonest T-Cell lymphoma (CTCL) involving skin and its appendages to variable degrees. Nail involvement is one of multiple dermatologic manifestation of this disorder and could have negative impact on psychological status of patients and producing therapeutic challenge to physician. We aimed to evaluate prevalence and subtypes of nail involvement in MF patients attending dermatology clinic, Razi Hospital in Tehran, Iran. Methods: All patients havi...

  7. Expandable intramedullary nail - experimental biomechanical evaluation

    OpenAIRE

    A. Kajzer; W. Kajzer; J. Marciniak

    2010-01-01

    Purpose: The paper presents results of experimental analysis of femur and femur – expandable intramedullary nail system. The aim of the work was to determine displacement in three models. In addition, the torsion of the system aiming at determining the moments depending on the torsional angle of the bone was carried out.Design/methodology/approach: Three femurs were selected for studies. The analysis was carried out on the femur – expandable intramedullary nail system. The influence of the lo...

  8. Nail disorders in children, a clinical study

    Directory of Open Access Journals (Sweden)

    Ayşe Akbaş

    2016-04-01

    Full Text Available Introduction: Aims of the study to investigate the frequency and the nature ofnail disorders in children significant clinical data is available. Nail disorders although common in children in some parts of our country. This study was carried out to document the clinical and demographic pattern of nail disorders in a dermatology outpatient clinic of a pediatric hospital in Ankara, Turkey. Material and Methods: All consecutive patients a total of 3000 children from age 0-16 were admitted to dermatology outpatient clinic of Ankara Pediatric Hematology and Oncology Education and Research Hospital during January 2011 to December 2011 were studied and retrospectively evaluated for age, gender, drug use, diseases, systemic or genetic disorders and demographic features. Diagnostic evaluation results were noted and patients were categorized for demographic features and diagnosis. Results: These 133 patients (M: F 58:75, %44 vs 56, respectively were under 16 years of age and have 17 different dermatological disorders related with nail symptoms. Fifty three of (39,8% these patient were under 2 years of age, 31 (23.3% were between 3-5 years, 30 (22.5% were between 6-11 years old, 19 of 133 (14%, 2 were between 11-16 years of age. Through all of ages and independent of gender the most etiologies of nail disorders were, onychomadesis, paronychia, onycholysis, onychomycosis and systemic nail presentation of systemic dermatosis. Conclusion: Nail disorders are different in children than in adults. In our study, the first 5 years of age was found in 53% of nail disorders. Nail disorders are uncommon but may be seen as a part of a systemic disease and may be associated with cosmetic and psychologic problem.

  9. Utility of gel nails in improving the appearance of cosmetically disfigured nails: Experience with 25 cases

    Directory of Open Access Journals (Sweden)

    Soni Nanda

    2014-01-01

    Full Text Available Background: Gel nails are a commonly used cosmetic procedure, though their use by dermatologists has not been evaluated. These can be used to improve the appearance of cosmetically disfigured nails where other treatment options have failed; the condition is self-limiting or irreversible; or to camouflage the dystrophy until healing. Materials and Methods: A prospective, uncontrolled, open-label study on 25 participants presenting with cosmetically disfigured nails was undertaken. Mycologically negative, consenting patients with various nail plate surface abnormalities like trachyonychia (n =8; superficial pitting (n =6; onychorrhexis (n =4; superficial pitting with onychoschizia (n =3; Beau′s lines (n =3 and pterygium (n =1 were included. The patients received gel nail application using Ranara gel nail kit ® . Extra care was taken to avoid any damage to cuticle. Standard pre- and post-treatment photographs were taken to assess improvement. Patient satisfaction score (1-10; Global assessment score of improvement (no improvement to excellent improvement and any side effects reported were recorded. Results: The average age of treated patients was 30.44±11.39 years (range 18-60 years. A total of 69 nails were treated (average of 2.76 per patient. Post-procedure, the average patient satisfaction score was 9.08 ± 0.86 (range 7-10. The Global assessment showed excellent improvement (40% cases; good improvement (56% cases and mild improvement in the single case of pterygium treated. Conclusions: The use of Gel nails in patients with cosmetically disfiguring nail plate surface abnormalities (like trachyonychia, onychoschizia, pitting, etc. was found to produce good to excellent improvement in most of the cases. The patient satisfaction with the procedure was rated as high. This, coupled with absence of side effects, make gel nails a valuable tool in improving cosmesis and satisfaction among patients presenting with nail plate surface abnormalities

  10. Transungual delivery of terbinafine by iontophoresis in onychomycotic nails.

    Science.gov (United States)

    Nair, Anroop B; Vaka, Siva Ram Kiran; Murthy, S Narasimha

    2011-10-01

    Trans-nail permeability is limited due to the innate nature of the nail plate and the recent investigations indicated the potential of iontophoresis in enhancing the transungual drug delivery in normal nails. However, the onychomycotic nails differ from the normal nails with respect to the anatomical and biological features. The current study investigated the effect of iontophoresis (0.5 mA/cm(2) for 1 h) on the transungual delivery of terbinafine in onychomycotic finger and toe nails. The presence of fungi in the onychomycotic nails was diagnosed by potassium hydroxide (KOH) microscopy. Passive and iontophoretic delivery of terbinafine across the infected nail was studied in Franz diffusion cell. Further, the release profile of terbinafine from the drug-loaded nails was investigated by agar diffusion method. KOH microscopy confirmed the presence of fungi in all the nails used. The amount of drug permeated across the nail plate was enhanced significantly during iontophoresis over passive delivery, that is, by 21-fold in case of finger and 37-fold in case of toe nails. Further, the total drug load in the onychomycotic nail was enhanced by ~12-fold (in both finger and toe nails) due to iontophoresis. Release of terbinafine from the iontophoresis-loaded nails into agar plates exhibited two phases, a rapid phase followed by a steady release, which extended >2 months. This study concluded that the drug delivery in onychomycotic nails did not differ significantly when compared with normal nails, although the extent of drug permeation and drug load differs between finger and toe nails. PMID:21457120

  11. Transungual delivery of terbinafine by iontophoresis in onychomycotic nails.

    Science.gov (United States)

    Nair, Anroop B; Vaka, Siva Ram Kiran; Murthy, S Narasimha

    2011-10-01

    Trans-nail permeability is limited due to the innate nature of the nail plate and the recent investigations indicated the potential of iontophoresis in enhancing the transungual drug delivery in normal nails. However, the onychomycotic nails differ from the normal nails with respect to the anatomical and biological features. The current study investigated the effect of iontophoresis (0.5 mA/cm(2) for 1 h) on the transungual delivery of terbinafine in onychomycotic finger and toe nails. The presence of fungi in the onychomycotic nails was diagnosed by potassium hydroxide (KOH) microscopy. Passive and iontophoretic delivery of terbinafine across the infected nail was studied in Franz diffusion cell. Further, the release profile of terbinafine from the drug-loaded nails was investigated by agar diffusion method. KOH microscopy confirmed the presence of fungi in all the nails used. The amount of drug permeated across the nail plate was enhanced significantly during iontophoresis over passive delivery, that is, by 21-fold in case of finger and 37-fold in case of toe nails. Further, the total drug load in the onychomycotic nail was enhanced by ~12-fold (in both finger and toe nails) due to iontophoresis. Release of terbinafine from the iontophoresis-loaded nails into agar plates exhibited two phases, a rapid phase followed by a steady release, which extended >2 months. This study concluded that the drug delivery in onychomycotic nails did not differ significantly when compared with normal nails, although the extent of drug permeation and drug load differs between finger and toe nails.

  12. Biomechanical investigation of a novel ratcheting arthrodesis nail

    Directory of Open Access Journals (Sweden)

    Billiar Kristen L

    2010-10-01

    Full Text Available Abstract Background Knee or tibiotalocalcaneal arthrodesis is a salvage procedure, often with unacceptable rates of nonunion. Basic science of fracture healing suggests that compression across a fusion site may decrease nonunion. A novel ratcheting arthrodesis nail designed to improve dynamic compression is mechanically tested in comparison to existing nails. Methods A novel ratcheting nail was designed and mechanically tested in comparison to a solid nail and a threaded nail using sawbones models (Pacific Research Laboratories, Inc.. Intramedullary nails (IM were implanted with a load cell (Futek LTH 500 between fusion surfaces. Constructs were then placed into a servo-hydraulic test frame (Model 858 Mini-bionix, MTS Systems for application of 3 mm and 6 mm dynamic axial displacement (n = 3/group. Load to failure was also measured. Results Mean percent of initial load after 3-mm and 6-mm displacement was 190.4% and 186.0% for the solid nail, 80.7% and 63.0% for the threaded nail, and 286.4% and 829.0% for the ratcheting nail, respectively. Stress-shielding (as percentage of maximum load per test after 3-mm and 6-mm displacement averaged 34.8% and 28.7% (solid nail, 40.3% and 40.9% (threaded nail, and 18.5% and 11.5% (ratcheting nail, respectively. In the 6-mm trials, statistically significant increase in initial load and decrease in stress-shielding for the ratcheting vs. solid nail (p = 0.029, p = 0.001 and vs. threaded nail (p = 0.012, p = 0.002 was observed. Load to failure for the ratcheting nail; 599.0 lbs, threaded nail; 508.8 lbs, and solid nail; 688.1 lbs. Conclusion With significantly increase of compressive load while decreasing stress-shielding at 6-mm of dynamic displacement, the ratcheting mechanism in IM nails may clinically improve rates of fusion.

  13. Heat profiles of laser-irradiated nails.

    Science.gov (United States)

    Paasch, Uwe; Nenoff, Pietro; Seitz, Anna-Theresa; Wagner, Justinus A; Kendler, Michael; Simon, Jan C; Grunewald, Sonja

    2014-01-01

    Onychomycosis is a worldwide problem with no tendency for self-healing, and existing systemic treatments achieve disease-free nails in only 35 to 76% of cases. Recently, treatment of nail fungus with a near-infrared laser has been introduced. It is assumed that fungal eradication is mediated by local heat. To investigate if laser treatment has the potential to eradicate fungal hyphae and arthrospores, laser heat application and propagation needs to be studied in detail. This study aimed to measure nail temperatures using real-time videothermography during laser irradiation. Treatment was performed using 808- and 980-nm linear scanning diode lasers developed for hair removal, enabling contact-free homogeneous irradiation of a human nail plate in one pass. Average and peak temperatures increased pass by pass, while the laser beam moved along the nail plates. The achieved mean peak temperatures (808 nm: 74.1 to 112.4°C, 980 nm: 45.8 to 53.5°C), as well as the elevation of average temperatures (808 nm: 29.5 to 38.2°C, 980 nm: 27.1 to 32.6°C) were associated with pain that was equivalent to that of hair removal procedures and was not significantly different for various wavelengths. The linear scanning laser devices provide the benefits of contact-free homogeneous heating of the human nail while ensuring adequate temperature rises.

  14. Heat profiles of laser-irradiated nails

    Science.gov (United States)

    Paasch, Uwe; Nenoff, Pietro; Seitz, Anna-Theresa; Wagner, Justinus A.; Kendler, Michael; Simon, Jan C.; Grunewald, Sonja

    2014-01-01

    Onychomycosis is a worldwide problem with no tendency for self-healing, and existing systemic treatments achieve disease-free nails in only 35 to 76% of cases. Recently, treatment of nail fungus with a near-infrared laser has been introduced. It is assumed that fungal eradication is mediated by local heat. To investigate if laser treatment has the potential to eradicate fungal hyphae and arthrospores, laser heat application and propagation needs to be studied in detail. This study aimed to measure nail temperatures using real-time videothermography during laser irradiation. Treatment was performed using 808- and 980-nm linear scanning diode lasers developed for hair removal, enabling contact-free homogeneous irradiation of a human nail plate in one pass. Average and peak temperatures increased pass by pass, while the laser beam moved along the nail plates. The achieved mean peak temperatures (808 nm: 74.1 to 112.4°C, 980 nm: 45.8 to 53.5°C), as well as the elevation of average temperatures (808 nm: 29.5 to 38.2°C, 980 nm: 27.1 to 32.6°C) were associated with pain that was equivalent to that of hair removal procedures and was not significantly different for various wavelengths. The linear scanning laser devices provide the benefits of contact-free homogeneous heating of the human nail while ensuring adequate temperature rises.

  15. In vitro permeation of several drugs through the human nail plate: relationship between physicochemical properties and nail permeability of drugs.

    Science.gov (United States)

    Kobayashi, Yoichi; Komatsu, Tsunehisa; Sumi, Machiko; Numajiri, Sachihiko; Miyamoto, Misao; Kobayashi, Daisuke; Sugibayashi, Kenji; Morimoto, Yasunori

    2004-03-01

    The objectives of the present study are to clarify the relationship between the physicochemical properties and the nail permeability of drugs through human nail plates. Homologous p-hydroxybenzoic acid esters were used to investigate the relationship between the octanol/water partition coefficient and the permeability coefficient of several drugs. The nail permeability was found to be independent of the lipophilicity of a penetrating drug. However, the nail permeability of several model drugs was found to markedly decrease as their molecular weights increased. The nail permeability of an ionic drug was found to be significantly lower than that of a non-ionic drug, and the nail permeability of these drugs markedly decreased as their molecular weights increased. The permeation of a model drug, 5-fluorouracil (5-FU), through healthy nail plates was also determined and compared with that through nail plates with fungal infections. The drug permeation through a nail plate decreased with an increase in nail plate thickness. Nail plates with fungal infections exhibited approximately the same 5-FU permeation as healthy nail plates. We suggest that the permeability of a drug is mainly influenced by its molecular weight and permeability through nails with fungal infection can be estimated from data on healthy nail permeability.

  16. Prospective evaluation of femoral head viability following femoral neck fracture

    International Nuclear Information System (INIS)

    The bone scans of 33 patients (pts) with recent subcapital fractures (fx) of the femur were evaluated prospectively to determine their value in predicting femoral head visability. Each of the 33 pts (ll men, 22 women, age range 30-92) had a pre-operative bone scan within 72 hrs of the fx (23 pts within 24 hrs). Anterior and posterior planar views of both hips and pinhole views (50% of pts) were obtained 2 hrs after administration of Tc-99m HDP. The femoral head was classified as perfused if it showed the same activity as the opposite normal side or if it showed only slightly decreased activity. Femoral heads showing absent activity were classified as nonperfused. Overall, 20 of the 33 pts showed a photopenic femoral head on the side of the fx. Only 2 pts showed increased activity at hte site of the fx. Internal fixation of the fx was performed in 23 pts, 12 of whom had one or more follow-up scans. Five of these 12 pts showed absent femoral head activity on their initial scan, but 2 showed later reperfusion. The other 7 pts showed good perfusion initially, with only 1 later showing decreased femoral head activity. The other 10 pts (7 of whom had absent femoral head activity) had immediate resection of the femoral head and insertion of a Cathcart prosthesis. The results suggest that femoral head activity seen on a bone scan in the immediate post-fx period is not always a reliable indicator of femoral head viability. Decreased femoral head activity may reflect, in part, compromised perfusion secondary to post-traumatic edema, with or without anatomic disruption of the blood supply

  17. Infiltration of soft tissue by myeloma after internal fixation of pathologic femoral fracture; Infiltracion de partes blandas por mieloma, tras la fijacion interna de una fractura patologica femoral

    Energy Technology Data Exchange (ETDEWEB)

    Martinez, J.; Escape, I.; Bastart, F.; Solduga, C. [Hospital de Barcelona. Barcelona (Spain)

    2002-07-01

    a 75-year-old man with multiple myeloma presented with a pathologic fracture of distal right femoral diaphysis, which was fixed with Ender nails. Two and a half months later, the patients was readmitted with rapidly progressive swelling of right thigh. Ultrasound computed tomography and magnetic resonance imaging revealed infiltration of anterior right thigh muscles, extending upward to the iliopsoas muscle and retroperitoneal space, above ipsilateral renal vein. Ultrasound-guided biopsy of the soft tissue of the thigh revealed diffuse myelomatous infiltration by plasma blasts. (Author) 9 refs.

  18. [A new locking nail for proximal humerus fractures: the Telegraph nail, technique and preliminary results].

    Science.gov (United States)

    Cuny, C; Pfeffer, F; Irrazi, M; Chammas, M; Empereur, F; Berrichi, A; Metais, P; Beau, P

    2002-02-01

    We present a new nail, the telegraph nail, designed for the treatment of proximal fractures of the humerus. This nail has a new locking system providing a self-stabilization of the cancelous screws inserted in small fragments. We discuss the surgical technique and present preliminary results. The anterolateral approach and nail insertion through the medial and well vascularized part of the cuff is described for simple fractures. With the cup and ball technique, this nail can also be used for complex fractures of the proximal humerus with three or four fragments and major displacement. With this method, the nail is inserted before reduction and locked in the distal humerus before fixation of the head and tuberosities around the head once the targeting device removed. We report results for the first 64 nails inserted in our unit during the first year (1998-1999). Outcome was assessed at 11 months mean follow-up using the Constant score. Outcome was favorable, including in patients with complex fractures involving 3 or 4 separate displaced fragments. Besides providing an anatomically stable reconstruction, the telegraph nail has the advantage of allowing early mobilization of the shoulder joint. This method is a useful alternative to prosthetic reconstruction for traumatic fractures of the proximal humerus. PMID:11973536

  19. 股骨颈骨折内固定手术的研究历程与展望%History and prospect of internal fixation operation of femoral neck fracture

    Institute of Scientific and Technical Information of China (English)

    梅炯

    2015-01-01

    Femoral neck fracture is one of the major damages to health and life in the elderly population. But man has had his own understanding of that damage for only 600 years. The following research efforts had their milepost signiifcance in the development of the internal ifxation operation on femoral neck fracture. In 1858, a German surgeon, Von Langenbeck, did the ifrst internal ifxation of femoral neck fracture. But the patient unfortunately died of septicemia. In 1875, Franz König succeeded in the same operation with metal screws on disinfection. In 1883, Nicholass Senn, an American Surgeon, suggested that all femoral neck fractures should be treated with operation based on his animal experiments, but his proposal was not widely accepted. In 1931, Smith-Petersen etc. from the USA ifrst published the results of open reduction and internal ifxation of femoral neck fracture with the use of triifn nail. In 1938, an American doctor, Henderson, publisized his results of the treatment of femoral neck fracture with cannulated screws in Mayo Clinic. In 1941, American Academy of Orthopaedic Surgeons ( AAOS ) advocated the technique of triifn nail, which was pointed out to be unsuitable for the displaced femoral neck fracture by British Medical Research Council in 1976. Asnis cannulated screws appeared in 1980, which is still in use today. Fairly good effects have been achieved in the treatment of femoral neck fracture with internal ifxation, but in some patients it still results in the necrosis of the femoral head. Thus, people are still making different choices between arthroplasty or internal ifxation for the femoral neck fracture, depending largely on the surgeon’s judgment on the degree of the impairment on blood supply to femoral head after the fracture and the influence of the impairment on its healing. The individualized choice of operation method, the maximal retainability of the femoral head blood supply, and the retaining of the residual blood supply from the

  20. 儿童股骨干骨折的规范化治疗%Standardized treatment of pediatric femoral shaft fractures

    Institute of Scientific and Technical Information of China (English)

    张立军

    2015-01-01

    Femoral shaft fracture is the most common pediatric injury. Several methods of treatment of femoral shaft fracture can be used in children. In general, nonoperative therapy should be used in a 3 years or younger child, such as Pavlik harness, skin traction, spica casting, or spica casting followed skin traction. Femoral shaft fracture caused by birth trauma in neonate even with serious angulation deformity will turn to normal within one year after remolding. Operative therapy should be performed above 3 years old. Elastic Stabilized Intramedullary Nailing ( ESIN ) is the main operative treatment. ESIN with small incision and minimally invasive is suitable for transverse fracture and short oblique fracture. ESIN is not suitable for long oblique fracture, comminuted fracture and overweight ( > 45 kg ). The plate ifxation is suitable for inferior femoral lesser trochanter fracture and distal femoral metaphyseal fracture. The disadvantages of plate ifxation include the long incision, severe injury, and removal of the internal ifxator. The plate ifxation is decreasing in the modern treatment for the femoral shaft fracture in children. Submuscular bridge plating ifxation is applied to the long oblique fracture, spiral fracture, especially comminuted fracture. External ifxation is suitable for the infection of bone or soft tissue and open fracture. When the patient is older than 10 years ( or less ), especially with the weight of more than 50 kg, rigid locked intramedullary nail should be considered.

  1. Drug delivery to the nail following topical application.

    Science.gov (United States)

    Murdan, Sudaxshina

    2002-04-01

    The absorption of drugs into the nail unit, following topical application to the nail plate, is highly desirable to treat nail disorders, such as onychomycosis (fungal infections of the nail). Nail permeability is however quite low and limits topical therapy to early/mild disease states. In this paper, the recent research into ungual drug delivery is reviewed. The nail unit and the two most common diseases affecting the nail--onychomycosis and nail psoriasis--are briefly described to set the scene and to give an overview of the nature and scope of the problem. The factors, which affect drug uptake and permeation through the nail plate such as solute molecular size, hydrophilicity/hydrophobicity, charge, and the nature of the vehicle, are then discussed, followed by ways of enhancing drug transport into and through the nail plate. Finally, drug-containing nail lacquers which, like cosmetic varnish, are brushed onto the nail plates to form a film, and from which drug is released and penetrates into the nail, are reviewed.

  2. 49 CFR 230.39 - Broken staybolts.

    Science.gov (United States)

    2010-10-01

    ..., DEPARTMENT OF TRANSPORTATION STEAM LOCOMOTIVE INSPECTION AND MAINTENANCE STANDARDS Boilers and Appurtenances Staybolts § 230.39 Broken staybolts. (a) Maximum allowable number of broken staybolts. No boiler shall be... inside the firebox or combustion chamber on a straight line. No boiler shall be allowed to remain...

  3. Femoral shaft fracture osteosynthesis in a critically ill patient under Extracorporeal Membrane Oxygenation (ECMO

    Directory of Open Access Journals (Sweden)

    Calvo Cristobal

    2016-01-01

    Full Text Available Introduction: Extracorporeal Membrane Oxygenation (ECMO is an invasive procedure used in critically ill patients with catastrophic pulmonary failure or cardiogenic shock in which conventional management has failed. These patients are managed with permanent anticoagulation, with increased bleeding risk. Hemorrhage is the main reported complication. Case: A 25-year-old polytraumatized woman, both lower limbs amputated and a left femoral shaft fracture with catastrophic pulmonary failure (Murray score 4 that required intensive management care with ECMO. During her evolution definitive femoral shaft osteosynthesis with a nail as required and the medical team decided to operate on the patient under ECMO. She recovered with fluctuations in her hematocrit, but was hemodynamically stable. The patient recovered satisfactorily, was weaned from ECMO and commenced her rehabilitation program. At 16 months, she was almost autovalent, and full consolidation was achieved, with no complication of the implants. Discussion: ECMO is a life-saving support, but requires permanent anticoagulation, which implies a high risk of hemorrhages, specially for surgical treatment. This patient underwent an osteosynthesis surgery satisfactorily. Hematoma was the only complication of her intramedullary femoral nail, without compromising hemodynamics. This case shows that patients on ECMO can undergo a major orthopedic surgery in selected cases.

  4. Transonychial water loss in healthy and diseased nails.

    Science.gov (United States)

    Krönauer, C; Gfesser, M; Ring, J; Abeck, D

    2001-01-01

    The objective of this study was to determine the transonychial water loss (TOWL) in both healthy and affected nails in different diseases and to compare it with the transepidermal water loss (TEWL). TOWL was measured by a new evaporimetric method: Plasticine was used to fix the protection cover of the evaporimeter probe to the nails. The TOWL behaved contrary to the TEWL. Affected nails in patients with atopic eczema (p <0.01), psoriasis (p<0.05) and onychomycosis (p<0.001) showed a significantly lower TOWL than did nails of healthy test subjects. The decrease in TOWL in diseased nails in comparison to healthy nails could be due to the formation of a stratum granulosum in atopic, psoriatic or fungus-affected nails, as this layer is normally absent in healthy nails. PMID:11558871

  5. Complications Using Bioabsorbable Cross-Pin Femoral Fixation: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Saqib Hasan

    2011-01-01

    Full Text Available The use of bioabsorbable cross-pin transcondylar fixation has remained a viable option for femoral fixation in anterior cruciate ligament reconstruction. Although numerous biomechanical studies have demonstrated high fixation strength and minimal slippage with use of this method of fixation, there have been increasing reports of a variety of clinical complications associated with these implants. We reviewed the literature for all complications associated with the Bio-TransFix implant and present a case report of a patient status after ACL reconstruction using Bio-TransFix cross-pin femoral fixation with iliotibial band friction syndrome from a broken cross-pin four month post-operatively.

  6. Femoral pseudoaneurysms in drug addicts

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Rørdam, Peter; Jensen, L P;

    1997-01-01

    OBJECTIVE: To evaluate the outcome of treatment of femoral pseudoaneurysms in drug addicts. METHODS: The records of eight patients undergoing vascular surgery for femoral pseudoaneurysms from substance abuse identified from a vascular database were reviewed. RESULTS: Were good in four out of five...

  7. Heavy Metal Contamination of Popular Nail Polishes in Iran

    OpenAIRE

    Golnaz Karimi; Parisa Ziarati

    2015-01-01

    Background: Toxic and hazardous heavy metals like arsenic, lead, mercury, zinc, chromium and iron are found in a variety of personal care products, e.g. lipstick, whitening toothpaste, eyeliner and nail color. The nails absorb the pigments of nail polishes and vaporized or soluble metals can easily pass it. The goal of this survey was to assess whether the different colors of nail polishes comply with maximum concentrations of heavy metals in the EPA’s guidelines. Methods: 150 samples of d...

  8. Clinical and Educational Gaps in Diagnosis of Nail Disorders.

    Science.gov (United States)

    Hare, Anna Q; Rich, Phoebe

    2016-07-01

    Dermatologists care for skin, hair, and nails, yet many dermatologists find nail disorders challenging. Practice gaps in knowledge, skill, and attitude in clinical practice and resident education are sometimes impediments to timely medical and surgical diagnosis of nail disorders. Limited resident exposure to diagnosis and management of complicated nail disorders and lack of experience performing diagnostic and surgical procedures impairs progress toward surmounting these gaps. PMID:27363883

  9. Unusual nail pigmentation following cyclophosphamide-containing chemotherapy regimen

    OpenAIRE

    Kumar Santosh; Dixit Rakesh; Karmakar Saurabh; Paul Sayan

    2010-01-01

    Cyclophosphamide therapy may rarely cause pigmentation of the nails which is of different patterns. We report a patient who developed pigmentation of nails after six cycles of cyclophosphamide, methotrexate, and 5-flourouracil chemotherapy, each repeated after 28 days for breast cancer. The patient developed nail pigmentation that started proximally and spread distally and involved all the nails of both hands and feet except the second and third toenails of right foot. Using Naranjo ADR Proba...

  10. Femoral shaft fracture fixed with intramedullary nailing in a child resulting in femoral neck narrowing deformity and fracture

    Institute of Scientific and Technical Information of China (English)

    WAN Lin; ZHAO Lin; LIU Yan-qing; WANG Xu; LIU Jing-sheng

    2008-01-01

    @@ Treatment of factures in children is different from that of adults because improper internal fixation,including selection of internal fixation device and epiphysis approaching,may cause epiphysis injury,which may result in a series of secondary lesions in bone development,such as growth arrest,limb length discrepancy, osteonecrosis, and other deformities.

  11. Unusual manifestation of the yellow nail syndrome - Case report *

    OpenAIRE

    Papaiordanou, Francine; Epstein, Marina Gabrielle; Miyaoka, Mariana Yumi; Yang, Jeane Jeong Hoon; Pires, Mario Cezar

    2014-01-01

    The yellow nail syndrome is a rare disorder characterized by the classic triad of yellow and dystrophic nails, lymphedema and pleural effusion. We report in this paper a case of yellow nail syndrome, presenting the classic triad of the disease, associated with an unusual lymph accumulation in the abdomen region.

  12. Radiologic findings of nail-pateIIa syndrome: case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sung Bin [Seoul Regional Military Manpower Office, Seoul (Korea, Republic of); Yoo, Jeong Su [Military Manpower Administration, Daejeon (Korea, Republic of)

    2004-09-01

    Nail-patella syndrome is a rare autosomal dominant pleiotropic disorder characterized by dysplasia of the nails, pateller aplasia or hypoplasia, iliac horns, and dysplasia or dislocation of the elbow. We experienced a case of nail-patella syndrome. NPS is a relatively uncommon disease; however, an understanding of the typical radiologic findings is useful in establishing the diagnosis and guiding the treatment.

  13. Drug-induced nail disorders: incidence, management and prognosis.

    Science.gov (United States)

    Piraccini, B M; Tosti, A

    1999-09-01

    A large number of drugs of different classes, ranging from antibacterials to chemotherapeutic agents to psoralens, can be responsible for the development of nail changes. Drug-induced nail changes usually involve several or all 20 nails and appear in temporal correlation with drug intake. Some nail changes are asymptomatic and only cause cosmetic problems, while others cause pain and discomfort and impair manual activities or deambulation. Drug-induced nail abnormalities are usually transitory and disappear with drug withdrawal, but sometimes persist in time. The pathogenesis of the nail changes is usually a toxic effect of the drug on the different nail constituents, but other mechanisms can be involved. Drugs that are well known to produce nail abnormalities include cancer chemotherapeutic agents, psoralens, retinoids, tetracyclines, antimalarials and zidovudine. Arsenic poisoning is also always associated with nail changes that have medico-legal importance. Some drugs taken during pregnancy may impair nail development of the fetus, and nail hypoplasia or other nail dystrophies will be evident in the newborn.

  14. Scintigraphical observation of femoral head in femoral neck fractures

    International Nuclear Information System (INIS)

    In IO cases of femoral neck fracture treated with prosthetic replacement, the preopera tive sup(99m)Tc-MDP scintigraphs were investigated and then compared with each histological findings of the extracted femoral head. The appearances of the scintigraphs were classified into following 3 patterns; increased activity pattern of sup(99m)Tc-MDP uptake in the overall femoral head (type I) in 4 cases, deficient activity pattern at the lateral side correspond to weight-bearing area (type II) in 2 cases and considerably deficient activity pattern in the whole femoral head (type III) in remaining 4 cases. Histological examination of the extracted femoral heads revealed the narrow part of ischemic necrosis in type I. However type II showed extensive necrosis in the portion of deficient activity by scintigraphs and in type III, the femoral heads except articular cartilage were entirely necrotic. This classification of sup(99m)Tc-MDP scintigraphy is correlated with the degree of femoral head necrosis and it can be emphasized that the preoperative scintigraphy is a useful method to select osteosynthesis or prosthetic replacement treatment, etc. (author)

  15. Juvenile xanthogranuloma of the proximal nail fold.

    Science.gov (United States)

    Piraccini, Bianca Maria; Fanti, Pier Alessandro; Iorizzo, Matilde; Tosti, Antonella

    2003-01-01

    An 18-month-old Caucasian boy presented with a firm 0.5 mm nodule, pink-red in color, with a yellow hue and some telangiectases on the surface, localized on the right thumbnail. The nodule involved all of the proximal nail fold and covered the proximal third of the nail. Pathology showed a dense dermal infiltrate of histiocytes, some of which had foamy nuclei, and multinucleated Touton giant cells. The lesion progressively decreased in size and had completely disappeared after 3 years. Periodic follow-up was important not only to monitor evolution of the juvenile xanthogranuloma, but also to avoid excessive growth of the lesion with possible definitive nail matrix damage.

  16. SUPRACONDYLAR FRACTURE FEMUR T REATED WITH INTRAMEDULLARY NAIL : A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Venkateswara Rao

    2015-08-01

    Full Text Available BACKGROUND: Supracondylar fractures are one of the commonest fractures encountered in high velocity trauma which are associated with high morbidity and mortality . 1 Isolated fracture can itself lead to complications such as ARDS and pulmonary embo lism 1 . This necessitates early stabilization of fractures. Internal fixation is the choice of treatment in supracondylar fractures (AO type – A . 2 Retrograde supracondylar nail has shown to give one of the best results in terms of recovery, fracture union, r eturn to work and the functional outcome. METHODS: 20 patients with supracondylar fracture femur were studied (AO type - A. Supracondylar fractures femur were treated by closed or open reduction and internal fixation by Retrograde supracondylar nail inserte d through inter - condylar notch between July 2012 to September 2014 at our institution. The patients were evaluated clinically and radiologically for outcomes. All patients were followed up for an average of 12 months. Outcome was assessed using NEER’S SCOR E . 3 RESULTS: Supracondylar femoral extra - articular fractures in 20 patients were treated in this study with retrograde intramedullary supracondylar nail after closed or open reduction. The AO - ASIF fracture classification was used. All extra - articular fractures were selected for study. Six were compound fractures according to the Gustilo - Anderson classification , 4 the fracture was stabilized with the chosen system at an average of 6.9 days post - trauma, with an average operative time of 65. 9 minutes. In 15 cases closed reduction was possible while 5 required open reduction. Post - operatively all patients were shifted to continuous passive mobilization with early toe touch walking and gradually progressive weight bearing with appearance of clinical and radi ological signs of union. Evaluation was done according to Neer’s rating system . 3 65% excellent results were found. In the present study, road traffic accidents

  17. Infiltration of soft tissue by myeloma after internal fixation of pathologic femoral fracture

    International Nuclear Information System (INIS)

    a 75-year-old man with multiple myeloma presented with a pathologic fracture of distal right femoral diaphysis, which was fixed with Ender nails. Two and a half months later, the patients was readmitted with rapidly progressive swelling of right thigh. Ultrasound computed tomography and magnetic resonance imaging revealed infiltration of anterior right thigh muscles, extending upward to the iliopsoas muscle and retroperitoneal space, above ipsilateral renal vein. Ultrasound-guided biopsy of the soft tissue of the thigh revealed diffuse myelomatous infiltration by plasma blasts. (Author) 9 refs

  18. Subtrochanteric Femur Fracture after Slipped Capital Femoral Epiphysis Pinning: A Novel Treatment

    Directory of Open Access Journals (Sweden)

    Michael Paloski

    2011-01-01

    Full Text Available Slipped capital femoral epiphysis is a common injury suffered by adolescents worldwide. Treatment of most slips can be accomplished by percutaneous screw fixation, as this is an accepted and proven method associated with minimal morbidity. Complications, although limited, can be problematic for both the patient and treating physician. These include avascular necrosis, chondrolysis, infection, and fracture. We report a case of an individual who sustained a subtrochanteric femure fracture three weeks after in situ pinning of his left hip treated with a reconstruction intramedullary nail. This option allowed both the subtrochanteric fracture and SCFE to be treated concomitantly with minimized morbidity.

  19. Treatment of a femoral shaft fracture in a patient with congenital hip disease: a case report

    Directory of Open Access Journals (Sweden)

    Koutsostathis Stefanos D

    2010-07-01

    Full Text Available Abstract Introduction We present a rare case of two concomitant morbidities treated in one operation. To our knowledge, this is the first report of its kind in the literature. Case presentation A 57-year-old Greek woman was admitted to the emergency department having sustained a spiral mid-shaft femoral fracture. She also suffered from an ipsilateral hip congenital dysplasia with ankylosed hip joint due to severe arthritis. She was treated with a total hip arthroplasty using a long stem performing as an intramedullary nail. Conclusion We undertook a complex operative treatment of both co-morbidities in a one stage procedure with a satisfactory clinical result.

  20. NAIL AS A PROMISING DRUG DELIVERY SYSTEM FOR CONTROLLED RELEASE

    Directory of Open Access Journals (Sweden)

    G. Sai Krishna*, P. Prem Kumar, K. Bala Murugan

    2013-03-01

    Full Text Available ABSTRACT: The effectiveness of topical therapies is limited by minimal drug permeability through the nail plate. Nail permeability is however quite low and limits topical therapy to early/mild disease states such as onychomycosis (fungal infections of the nail. Current research on nail permeation that focuses on altering the nail plate barrier by means of chemical treatments, penetration enhancers as well as physical and mechanical methods is reviewed also the recent research into ungual drug delivery is reviewed, a new method of nail sampling is examined. Topical therapy is worth pursuing however, as local action is required in many nail disorders. Drug transport into the nail plate can be assisted by filing the nail plate before topical application of drug formulations as well as by the use of chemical enhancers. Finally limitations of current ungual drug permeability studies are briefly discussed and the factors, which affect drug uptake and permeation through the nail plate such as solute molecular size, hydrophilicity/hydrophobicity, charge, and the nature of the vehicle, are then discussed, and drug-containing nail lacquers which, like cosmetic varnish, are brushed onto the nail plates to form a film, and from which drug is released and penetrates into the nail are reviewed. The nail plate behaves like a concentrated hydrogel to permeating molecules and diffusion of molecules through the nail plate has been compared to the diffusion of non-electrolytes through polymer gels. Thus, for optimal ungual permeation and uptake, drug molecules must be of small size and be uncharged.

  1. Ingrowing Toe Nail : Results of Surgical Matricectomy

    Directory of Open Access Journals (Sweden)

    Sanjay Sadhu, Kiran Bhat

    2004-07-01

    Full Text Available Ingrowing toenail is a common problem causing lot of discomfort and morbidity. Though a variety ofmethods have been adopted including conservative treatment, nail excision, partial/completematricectomy and even amputation of distal part of big toe, but to date no ideal treatment exists. Inthis study 50 patients with ingrowing toenail were treated by nail excision with surgical segmentalmatricectomy. The patients were mobile by 24 hrs, were able to perform normal activities by the endof second week and showed complete healing by the end of fourth week. There was no recurrence.The method was found satisfactory for treatment of ingrowing toenail.

  2. Focal femoral condyle resurfacing.

    LENUS (Irish Health Repository)

    Brennan, S A

    2013-03-01

    Focal femoral inlay resurfacing has been developed for the treatment of full-thickness chondral defects of the knee. This technique involves implanting a defect-sized metallic or ceramic cap that is anchored to the subchondral bone through a screw or pin. The use of these experimental caps has been advocated in middle-aged patients who have failed non-operative methods or biological repair techniques and are deemed unsuitable for conventional arthroplasty because of their age. This paper outlines the implant design, surgical technique and biomechanical principles underlying their use. Outcomes following implantation in both animal and human studies are also reviewed. Cite this article: Bone Joint J 2013;95-B:301-4.

  3. Nobel Prize for work on broken symmetries

    CERN Multimedia

    2008-01-01

    The 2008 Nobel Prize for Physics goes to three physicists who have worked on broken symmetries in particle physics. The announcement of the 2008 Nobel Prize for physics was transmitted to the Globe of Science and Innovation via webcast on the occasion of the preview of the Nobel Accelerator exhibition.On 7 October it was announced that the Royal Swedish Academy of Sciences had awarded the 2008 Nobel Prize for physics to three particle physicists for their fundamental work on the mechanisms of broken symmetries. Half the prize was awarded to Yoichiro Nambu of Fermilab for "the discovery of the mechanism of spontaneous broken symmetry in subatomic physics". The other half is shared by Makato Kobayashi of Japan’s KEK Institute and Toshihide Maskawa of the Yukawa Institute at the University of Kyoto "for the discovery of the origin of the broken symmetry which predicts the existence of at least three families of quarks in Nature". At th...

  4. 1st meeting on topical drug delivery to the nail.

    Science.gov (United States)

    Murdan, Sudaxshina

    2007-07-01

    The first ever symposium dedicated solely to drug delivery to the nail following topical application was held on the 2nd April 2007, in London, UK, organised by Dr Clive Roper (Charles River Laboratories, Scotland) and Dr Sudaxshina Murdan (School of Pharmacy, University of London, UK), under the auspices of Skin Forum. The 1-day meeting was attended by approximately 35 delegates from industry, academia and hospitals, and provided a much-needed forum for the presentation and discussion of research and problems in this emerging field. Topical drug delivery is especially suitable for onychomycosis (fungal infections of the nail plate and/or nail bed) and nail psoriasis, which affect 2 - 13 and 1 - 3% of the general population, respectively, and make up the bulk of nail disorders. Topical therapy would avoid the adverse events and drug interactions of systemic antifungal agents and the pain of injection when antipsoriatic agents are injected into affected nail folds. However, successful topical therapy is extremely challenging due to the very low permeability of the nail plate. Five speakers spoke about various aspects of topical drug delivery to the nail, including review of the nail plate structure, function, diseases, their existing therapies (systemic and topical), limitations and global sales. The need for effective topical drug delivery to the nail to overcome the problems associated with present treatment, and the fact that there are few topical formulations available for the treatment of nail fungal infections and psoriasis, and the even fewer effective formulations, was highlighted. PMID:17683257

  5. 1st meeting on topical drug delivery to the nail.

    Science.gov (United States)

    Murdan, Sudaxshina

    2007-07-01

    The first ever symposium dedicated solely to drug delivery to the nail following topical application was held on the 2nd April 2007, in London, UK, organised by Dr Clive Roper (Charles River Laboratories, Scotland) and Dr Sudaxshina Murdan (School of Pharmacy, University of London, UK), under the auspices of Skin Forum. The 1-day meeting was attended by approximately 35 delegates from industry, academia and hospitals, and provided a much-needed forum for the presentation and discussion of research and problems in this emerging field. Topical drug delivery is especially suitable for onychomycosis (fungal infections of the nail plate and/or nail bed) and nail psoriasis, which affect 2 - 13 and 1 - 3% of the general population, respectively, and make up the bulk of nail disorders. Topical therapy would avoid the adverse events and drug interactions of systemic antifungal agents and the pain of injection when antipsoriatic agents are injected into affected nail folds. However, successful topical therapy is extremely challenging due to the very low permeability of the nail plate. Five speakers spoke about various aspects of topical drug delivery to the nail, including review of the nail plate structure, function, diseases, their existing therapies (systemic and topical), limitations and global sales. The need for effective topical drug delivery to the nail to overcome the problems associated with present treatment, and the fact that there are few topical formulations available for the treatment of nail fungal infections and psoriasis, and the even fewer effective formulations, was highlighted.

  6. 动力髁螺钉治疗股骨近端不稳定骨折%Dynamic Condylar Screw for Treatment of Unstable Proximal Femoral Fractures

    Institute of Scientific and Technical Information of China (English)

    李明辉; 刘洋

    2011-01-01

    Objective To evaluate the efficacy of operative treatment for the Proximal femoral fracture with dynamic condyle screw (DCS). Methods From January 2004 to June 2009,37 cases of patients with Proximal femoral fracture (Reverse intertrochanteric femur fractures in 16 cases, 21 cases of intertrochanteric fracture ;Male 15,Female 22) was treated by DCS. 34 cases were followed up by 6 to 60 months in average age. The body mass index,operative time,blood loss,X ray projection times,the number of postoperative blood transfusion,postoperative wound drainage,postoperative neck-shaft angle,fracture healing time (patient began full weight bearing time) was statistics,and make Harris score. Results All patients were healed and there are no complications such as broken nails,broken boards,and other nonunion take place. 32 patients were followed up for 11~24 months time,with an average of 13 months.According to Harris score,the result was excellent in 15 cases,good in 12 cases, fair in4 and not satisfied with3. The excellent rate is 79. 41%. Conclusion Dynamic condylar screw is effective methods in treating unstable proximal femoral fractures. Application of DCS should be considered in elderly,obese patients. If you have to use the DCS,full weight-bearing should be extended.%目的 探讨应用动力髁螺钉(dynamic condylar screw,DCS)治疗股骨近端不稳定骨折的方法,评价其术中、术后情况及临床疗效.方法 自2004年1月至2009年6月采用闭合复位动力髁螺钉内固定治疗股骨近端骨折37例,其中男15例,女22例;股骨逆粗隆间骨折16例,股骨粗隆下骨折21例.在患者平均年龄、体重指数、手术时间、术中失血量、X线投照次数、术中及术后输血量、术后伤口引流量、术后颈于角、骨折愈合时间(患者开始完全负重时间)等方面进行统计,并进行Harris评分.结果 37例中34例得到6~60个月的随访,骨折全部愈合,无断钉、断板、骨

  7. How to Stop Biting Your Nails

    Medline Plus

    Full Text Available ... your mouth. Identify your triggers: These could be physical triggers, such as the presence of hangnails, or other triggers, such as boredom, stress, or anxiety. By figuring out what causes you to bite your nails, you can figure ...

  8. Expandable intramedullary nail - experimental biomechanical evaluation

    Directory of Open Access Journals (Sweden)

    A. Kajzer

    2010-01-01

    Full Text Available Purpose: The paper presents results of experimental analysis of femur and femur – expandable intramedullary nail system. The aim of the work was to determine displacement in three models. In addition, the torsion of the system aiming at determining the moments depending on the torsional angle of the bone was carried out.Design/methodology/approach: Three femurs were selected for studies. The analysis was carried out on the femur – expandable intramedullary nail system. The influence of the loads and displacements on the bone – nail system on the results of experimental analysis was analysed. In order to carry out calculations, three models were selected: model I – bone without fracture gap, model II and III – femur with expansion intramedullary nails – fracture gap was located 100 mm under greater trochanter. The studies were performed on femur models produced by Swedish company Sawbones. The intramedullary „Fixion IM” nails (Ti-6Al-4V alloy were implanted into the bone. Displacements of determinated models were being recorded from the sensors every 100 N from 10 N to 2000 N.Findings: The analyses showed the difference in displacements, depending on the selected models.Research limitations/implications: The limitations were connected with simplification of boundary conditions during analysis which were the result of the simplification of the models. While studying, muscles and ligaments supporting the bone in anatomic position were not taken into consideration. Instead, the system has been loaded with the axial force (compression.Practical implications: The obtained results can be useful in clinical practice. They can be applied in selection of stabilization methods or rehabilitation as well as in describing the biomechanical conditions connected with type of bone fracture obtained from medical imaging.Originality/value: . The work compares the values of displacement of characteristic points of femur (healthy – model I with the

  9. A study of nail changes in various dermatosis in Punjab, India

    OpenAIRE

    Neerja Puri; Tejinder Kaur

    2012-01-01

    Nails act as a window to diagnosis of skin diseases. Various dermatosis affect the nails and the severity of the skin disorder is reflected in the nails. Nail changes are seen in various dermatosis like psoriasis, lichen planus, onychomycosis, collagen vascular disorders, vescicobullous disorders and other papulosquamous disorders. We will discuss in detail regarding nail changes in various dermatosis.

  10. A study of nail changes in various dermatosis in Punjab, India

    Directory of Open Access Journals (Sweden)

    Neerja Puri

    2012-07-01

    Full Text Available Nails act as a window to diagnosis of skin diseases. Various dermatosis affect the nails and the severity of the skin disorder is reflected in the nails. Nail changes are seen in various dermatosis like psoriasis, lichen planus, onychomycosis, collagen vascular disorders, vescicobullous disorders and other papulosquamous disorders. We will discuss in detail regarding nail changes in various dermatosis.

  11. Coexistence of onychomycosis in psoriatic nails: A descriptive study

    Directory of Open Access Journals (Sweden)

    Natarajan Vidhya

    2010-01-01

    Full Text Available Background: Psoriatic nail changes predispose to onychomycosis because it becomes easier for fungi to penetrate an already compromised nail plate. Moreover, some of the psoriatic nail changes closely resemble onychomycosis. Aim: To investigate cases of nail psoriasis for any evidence of onychomycosis. Methods: Seventy-two patients with psoriasis were included in the study. The patients were selected from the psoriasis clinic and dermatology in-patient ward. Direct microscopic examination with 20% KOH and culture were carried out in all patients showing psoriatic nail changes. Histopathological examination with Periodic Acid-Schiff (PAS stain was done in cases negative by KOH examination and culture. Results: Nail changes were seen in 66.66% (48/72 of psoriasis patients. The most common fingernail changes observed were pitting, onycholysis and subungual hyperkeratosis, and the most common toenail changes were onycholysis and subungual hyperkeratosis. Nail changes were significantly more common in males. The duration of skin lesions of psoriasis and Psoriasis Area Severity Index scores were significantly higher in patients with nail changes. Out of 48 patients with psoriatic nail change, 23 (47.91% had investigative evidence of onychomycosis. The fungal isolates on culture were non-dermatophytic molds in nine patients (18.75% and yeast like fungi also in nine patients (18.75%. Conclusion: Coexistent onychomycosis in psoriatic nails does occur.

  12. RESULTS OF SURGICAL TREATMENT OF PAEDIATRIC DIAPHYSEAL FRACTURES OF LONG BONES USING INTRAMEDULLARY ELASTIC NAIL

    Directory of Open Access Journals (Sweden)

    Arun Kumar

    2015-12-01

    Full Text Available BACKGROUND Among the various methods of treating the long bone fractures in children less than 5yrs (POP cast and adolescents 16yrs (IMN, flexible intramedullary nail has gained importance because of its stability, not violating the physis and less complications and early rehabilitation. Irrespective of mode of treatment, goal shall be to achieve union at fracture site, control length and alignment, minimize the morbidity and complications for patient and their family. MATERIALS AND METHODS A prospective study was conducted on children of both sexes, between the age group of 5-15yrs with diaphyseal fractures of long bones, meeting the inclusion and exclusion criteria during the study period at RRMCH (September 2012 to September 2014. Totally, 30 cases were evaluated clinically and radiologically and followed up at 3, 6, 12, 24 weeks after surgery. Final outcome was assessed using Flynn’s criteria for Tens Scoring System. RESULTS Results of entire, 30 patients were followed up for an average of 6 months, was excellent in 19(63% cases and satisfactory in 11(37% cases and no poor outcome. CONCLUSION Based on this study and result, we found that intramedullary elastic nailing technique is an ideal method for treatment of pediatric femoral and tibial diaphyseal fractures.

  13. X-ray-based machine vision system for distal locking of intramedullary nails.

    Science.gov (United States)

    Juneho, F; Bouazza-Marouf, K; Kerr, D; Taylor, A J; Taylor, G J S

    2007-05-01

    In surgical procedures for femoral shaft fracture treatment, current techniques for locking the distal end of intramedullary nails, using two screws, rely heavily on the use of two-dimensional X-ray images to guide three-dimensional bone drilling processes. Therefore, a large number of X-ray images are required, as the surgeon uses his/her skills and experience to locate the distal hole axes on the intramedullary nail. The long-term effects of X-ray radiation and their relation to different types of cancer still remain uncertain. Therefore, there is a need to develop a surgical technique that can limit the use of X-rays during the distal locking procedure. A robotic-assisted orthopaedic surgery system has been developed at Loughborough University to assist orthopaedic surgeons by reducing the irradiation involved in such operations. The system simplifies the current approach as it uses only two near-orthogonal X-ray images to determine the drilling trajectory of the distal locking holes, thereby considerably reducing irradiation to both the surgeon and patient. Furthermore, the system uses robust machine vision features to reduce the surgeon's interaction with the system, thus reducing the overall operating time. Laboratory test results have shown that the proposed system is very robust in the presence of variable noise and contrast in the X-ray images.

  14. Softly Broken Supersymmetric Gauge Theories through Compactifications

    CERN Document Server

    Takenaga, K

    1998-01-01

    Effects of boundary conditions of fields for compactified space directions on the supersymmetric gauge theories are discussed. For general and possible boundary conditions the supersymmetry is explicitly broken to yield universal soft supersymmetry breaking terms, and the gauge symmetry of the theory can also be broken through the dynamics of non-integrable phases, depending on number and the representation under the gauge group of matters. The 4-dimensional supersymmetric QCD is studied as a toy model when one of the space coordinates is compactified on $S^1$.

  15. 75 FR 40820 - City of Broken Bow, Oklahoma; Project No. 12470-001-Oklahoma Broken Bow Re-Regulation Dam...

    Science.gov (United States)

    2010-07-14

    ... Energy Regulatory Commission City of Broken Bow, Oklahoma; Project No. 12470-001--Oklahoma Broken Bow Re... included in, or eligible for inclusion in, the National Register of Historic Places at the Broken Bow Re..., 2010, for the Broken Bow Re-Regulation Dam Hydroelectric Project No. 12470 is revised to add...

  16. 75 FR 33802 - City of Broken Bow, OK; Broken Bow Re-Regulation Dam; Hydropower Project; Notice of Proposed...

    Science.gov (United States)

    2010-06-15

    ... Energy Regulatory Commission City of Broken Bow, OK; Broken Bow Re-Regulation Dam; Hydropower Project... eligible for inclusion in, the National Register of Historic Places at the Broken Bow Re-Regulation Dam... the Broken Bow Re-Regulation Dam Hydropower Project would be fulfilled through the...

  17. Sarcoidosis: radiographic manifestations in the nails and distal phalanges

    International Nuclear Information System (INIS)

    Sarcoidosis is a granulomatous disease which can affect multiple organ systems. Clinical and radiologic manifestations depend on the organ system involved and the chronicity of disease. Nail involvement in sarcoidosis is rare, but is clinically relevant as it indicates chronic systemic disease. Nail abnormalities can be identified radiographically, and when seen in patients with known or suspected sarcoidosis, should prompt careful evaluation of the underlying bone for osseous involvement. We describe a case of sarcoidosis with radiographic findings in the nails and distal phalangeal tufts, which were indicative of nail and osseous sarcoid involvement and strongly supported the presence of chronic systemic disease. Although the nail findings resolved clinically and on radiographs after treatment, the osseous findings showed only minimal improvement. To our knowledge, the radiographic findings of nail sarcoidosis have not been previously addressed in the literature. (orig.)

  18. Sarcoidosis: radiographic manifestations in the nails and distal phalanges

    Energy Technology Data Exchange (ETDEWEB)

    Albers, Brittany K.; Garner, Hillary W. [Mayo Clinic, Department of Radiology, Jacksonville, FL (United States); Sluzevich, Jason C. [Mayo Clinic, Department of Dermatology, Jacksonville, FL (United States)

    2016-05-15

    Sarcoidosis is a granulomatous disease which can affect multiple organ systems. Clinical and radiologic manifestations depend on the organ system involved and the chronicity of disease. Nail involvement in sarcoidosis is rare, but is clinically relevant as it indicates chronic systemic disease. Nail abnormalities can be identified radiographically, and when seen in patients with known or suspected sarcoidosis, should prompt careful evaluation of the underlying bone for osseous involvement. We describe a case of sarcoidosis with radiographic findings in the nails and distal phalangeal tufts, which were indicative of nail and osseous sarcoid involvement and strongly supported the presence of chronic systemic disease. Although the nail findings resolved clinically and on radiographs after treatment, the osseous findings showed only minimal improvement. To our knowledge, the radiographic findings of nail sarcoidosis have not been previously addressed in the literature. (orig.)

  19. Radiographic findings in the nail-patella syndrome

    OpenAIRE

    West, James A.; Louis, Thomas H.

    2015-01-01

    Nail-patella syndrome is a rare disorder characterized classically by the tetrad of nail hypoplasia or aplasia, aplastic or hypoplastic patellae, elbow dysplasia, and the presence of iliac horns. Iliac horns are considered pathognomonic, and the presence of hypoplastic or aplastic patellae in conjunction with nail abnormalities is a cardinal feature of diagnosis. Elbow dysplasia is present in most cases and can exhibit features typical of the syndrome. Herein we present the radiographic findi...

  20. Iontophoretically Enhanced Ciclopirox Delivery into and Across Human Nail Plate

    OpenAIRE

    HAO, JINSONG; Smith, Kelly A; Li, S. Kevin

    2009-01-01

    Transungual delivery of antifungal drugs is hindered by the low permeability of human nail plates, and as such, repeated dosing over a long period of time is necessary for effective treatment. The objectives of this study were to explore the possibilities of (a) enhancing the delivery of ciclopirox (CIC) across human nail plates and (b) sustaining CIC delivery from the larger resultant drug depot in the nail plates with constant voltage iontophoresis. In vitro passive and 9 V cathodal iontoph...

  1. MANAGEMENT OF PERIPROSTHETIC DISTAL FEMORAL FRACTURE AFTER TOTAL KNEE ARTHROPLASTY USING MINIMALLY INVASIVE PLATE OSTEOSYNTHESIS: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Reddy

    2015-07-01

    Full Text Available CONTEXT: The approximate incidence of periprosthetic supracondylar femur fractures after total knee arthroplasty ranges from 0.3 to 2.5 percent. Various methods of treatment of these fractures have been suggested in the past, such as conservative management, open reduction and plate fixation and intramedullary nailing. However, there were complications like pain, stiffness, infection and delayed union. Minimally invasive plate osteosynthesis (MIPO is a relatively newer technique in the treatment of distal femoral fractures, as it preserves the periosteal blood supply an d bone perfusion as well as minimizes soft tissue dissection. AIM: To evaluate the effectiveness of MIPO technique in the treatment of periprosthetic distal femoral fracture. SETTINGS AND DESIGN : In this study, we present a case report of a 54 year old female patient who sustained type 2 (Rorabeck et al. classification periprosthetic distal femoral fractures after TKA. Her fracture fixation was done with distal femoral locking plates using minimally invasive technique. METHODS AND MATERIAL : We evaluated the clinical (using Oxford knee scoring system and radiological outcomes of the patient till six months post - operatively. Radiologically, the fracture showed complete union and she regained her full range of knee motion by the end of three months. CONCLUSION: We conclude that MIPO can be considered as an effective surgical treatment option in the management of periprosthetic distal femoral fractures after TKA

  2. Monopoles and strings in broken symmetry

    International Nuclear Information System (INIS)

    When a U(1) gauge theory is spontaneously broken, work has shown that a monopole cannot exist isolated but must be attached to a string carrying both energy and a quantized magnetic flux. The authors wish to consider whether and how this result can be generalized to non-abelian theories. (author)

  3. Broken windows, mediocre methods, and substandard statistics

    NARCIS (Netherlands)

    J.M. Wicherts; M. Bakker

    2013-01-01

    Broken windows theory states that cues of inappropriate behavior like litter or graffiti amplify norm-violating behavior. In a series of quasi-experiments, Keizer, Lindenberg, and Steg altered cues of inappropriate behavior in public places and observed how many passersby subsequently violated norms

  4. Responses to Broken Promises: Does Personality Matter?

    Science.gov (United States)

    Ho, Violet T.; Weingart, Laurie R.; Rousseau, Denise M.

    2004-01-01

    This paper examined the effects of personality traits on individuals' reactions to broken promises. We studied the effects of Neuroticism and Agreeableness on emotive and cognitive responses to breach and investigated whether these effects varied across different types (economic vs. social) and severity (high vs. low) of breach. We collected data…

  5. PERIODIC-SOLUTIONS IN SPONTANEOUSLY BROKEN THEORIES

    NARCIS (Netherlands)

    BRIHAYE, Y; KUNZ, J

    1992-01-01

    A class of spontaneously broken field theories is proposed, and the occurrence of their periodic, classical solutions is investigated in detail. The emergence of multiple solutions is observed, their normal modes of oscillation are studied, and the bifurcations of the classical energy functional are

  6. Broken Scale Invariance and Anomalous Dimensions

    Science.gov (United States)

    Wilson, K. G.

    1970-05-01

    Mack and Kastrup have proposed that broken scale invariance is a symmetry of strong interactions. There is evidence from the Thirring model and perturbation theory that the dimensions of fields defined by scale transformations will be changed by the interaction from their canonical values. We review these ideas and their consequences for strong interactions.

  7. Ratchet device with broken friction symmetry

    DEFF Research Database (Denmark)

    Norden, Bengt; Zolotaryuk, Yaroslav; Christiansen, Peter Leth;

    2002-01-01

    An experimental setup (gadget) has been made for demonstration of a ratchet mechanism induced by broken symmetry of a dependence of dry friction on external forcing. This gadget converts longitudinal oscillating or fluctuating motion into a unidirectional rotation, the direction of which is in...

  8. HEMATOMA OF THE PROXIMAL NAIL FOLD. REPORT OF 41 CASES

    OpenAIRE

    Chang Patricia; Rodas Diaz Cecilia

    2011-01-01

    Background: The proximal fold is an important part of the nail apparatus it contributes to the formation of the nail plate and through the cuticle acts as an impermeable barrier protecting it from any cause.Objective: To know the proximal nail fold hematoma caused by the use of pulse oximeter.Material and Methods: A descriptive study was conducted in 41 patients with proximal nail hematoma secondary to the use of oximetry in patients hospitalized in the Intermediate and Intensive Care Unit at...

  9. In vitro human nail penetration and kinetics of panthenol.

    Science.gov (United States)

    Hui, X; Hornby, S B; Wester, R C; Barbadillo, S; Appa, Y; Maibach, H

    2007-08-01

    The in vitro absorption of panthenol into and through the human nail was examined in this study. Panthenol, the alcohol form of pantothenic acid (vitamin B5), is believed to act as a humectant and improve the flexibility and strength of nails. A liquid nail treatment formulated with panthenol (2%) was compared to a solution of panthenol (2%) in water. Fingernail specimens were dosed daily for 7 days with either the nail treatment (non-lacquer film forming) formulation or aqueous solution with sampling performed every 24 h. Panthenol concentrations were determined in the dorsal surface, interior (by drilling and removal) and in the supporting bed under the human nail. Panthenol levels in the dorsal nail (R(2) = 0.87; P panthenol was delivered into the interior nail and supporting bed by a nail treatment formulation than from an aqueous solution. The film acts not only as a reservoir of panthenol, but also acts to increase the hydration of the nail and the thermodynamic activity of panthenol as well, thereby enhancing diffusion. PMID:18489355

  10. Yellow nail syndrome: does protein leakage play a role?

    Science.gov (United States)

    D'Alessandro, A; Muzi, G; Monaco, A; Filiberto, S; Barboni, A; Abbritti, G

    2001-01-01

    Yellow nail syndrome is characterized by primary lymphoedema, recurrent pleural effusion and yellow discoloration of the nails. Although mechanical lymphatic obstruction is assumed to be the underlying pathology, it cannot explain the common finding of high albumin concentration in the pleural space. This paper describes a case of yellow nail syndrome presenting with the classical triad of lymphoedema, recurrent pleural effusion and yellow discoloration of the nails, associated with persistent hypoalbuminaemia and increased enteric loss of albumin. Based on the findings in this case and those in the literature, it is speculated that increased microvascular permeability may contribute to the pathogenesis of this syndrome.

  11. Unusual nail pigmentation following cyclophosphamide-containing chemotherapy regimen

    Directory of Open Access Journals (Sweden)

    Kumar Santosh

    2010-01-01

    Full Text Available Cyclophosphamide therapy may rarely cause pigmentation of the nails which is of different patterns. We report a patient who developed pigmentation of nails after six cycles of cyclophosphamide, methotrexate, and 5-flourouracil chemotherapy, each repeated after 28 days for breast cancer. The patient developed nail pigmentation that started proximally and spread distally and involved all the nails of both hands and feet except the second and third toenails of right foot. Using Naranjo ADR Probability Scale, the case revealed a "probable" association with cyclophosphamide.

  12. Yellow nail syndrome following thoracic surgery: A new association?

    Directory of Open Access Journals (Sweden)

    Banta D

    2009-01-01

    Full Text Available An 80-year-old man presented with the characteristic triad of yellow nail syndrome (chronic respiratory disorders, primary lymphedema and yellow nails in association with coronary artery bypass graft surgery. Treatment with mechanical pleurodesis and vitamin E resulted in near complete resolution of the yellow nails, pleural effusions, and lower extremity edema. The etiology of the yellow nail syndrome has been described as an anatomical or functional lymphatic abnormality. Several conditions have previously been described as associated with this disease. This is the first report of the association of this syndrome with thoracic surgery.

  13. Pseudopathologic fracture of the femoral neck

    International Nuclear Information System (INIS)

    We have seen two cases of traumatic subcapital fractures of the femoral neck which resembled pathologic fractures on plain radiography. We have named this entity pseudopathologic fracture of the femoral neck and offer suggestions for why it occurs. (orig.)

  14. Femoral neck shortening after internal fixation

    OpenAIRE

    LIU, YUE; AI, Zi Sheng; Shao, Jin; Yang, Tieyi

    2014-01-01

    Objective: The aim of this study was to assess the factors affecting femoral neck shortening after internal fixation of femoral neck fractures. Methods: Eighty-six patients with femoral neck fractures were treated using three parallel cannulated screws between May 2004 and January 2011. The shortening of the femoral neck in the horizontal (X), vertical (Y), and along the resultant along the (Z) vector (XÆ, YÆ, ZÆ) was measured on anteroposterior radiographs corrected by screw diameter and ...

  15. A new, lateral, continuous, combined, femoral–sciatic nerve approach via a single skin puncture for postoperative analgesia in intramedullary tibial nail insertion

    Directory of Open Access Journals (Sweden)

    Imbelloni LE

    2013-02-01

    Full Text Available Luiz Eduardo Imbelloni,1,2 Carlos Rava,1,3 Marildo A Gouveia21Faculdade de Medicina Nova Esperança, 2Institute for Regional Anesthesia, 3Complexo Hospitalar de Mangabeira Governador Tarcisio Burity, João Pessoa, BrazilBackground: The prevalence of anterior knee pain following intramedullary tibial nail insertion is high. Continuous peripheral nerve blockade is an alternative method of pain control to opiods. This case illustrates the use of femoral nerve and sciatic nerve peripheral catheters with an elastomeric infusion pump for major intramedullary nailing surgery.Case report: A 36-year-old male with fractures to the left leg bones presented for placement of an intramedullary nail under spinal anesthesia. At the end of the procedure, access to the lateral femoral and sciatic continuous nerve block was achieved by using a stimulator connected to a 110 mm 18G Tuohy needle. Postoperative analgesia was provided with a 40-hour infusion of 0.1% bupivacaine (400 mL at a rate of 10 mL hour-1 with an elastomeric pump. Anesthetic dispersion and contrast were investigated. The analog scale remained with scores below 3 during the 40 hours after surgery, and boluses were not necessary.Conclusion: The use of a femoral and sciatic nerve peripheral catheter offered an alternative to conventional pain control. Continuous femoral–sciatic peripheral blockade via a skin puncture with an infusion of 0.1% bupivacaine with elastomeric pumps is a safe and effective procedure in adults.Keywords: local anesthetic, bupivacaine, continuous peripheral nerve block, orthopedic surgery, tibia, elastomeric pump

  16. Nail bed expansion: A new technique for correction of multiple isolated congenital micronychia

    Directory of Open Access Journals (Sweden)

    Gholamhossein Ghaffarpour

    2014-01-01

    Full Text Available Congenital micronychia may involve big toes or may involve other nails. The etiology of micronychia is not clear but amniotic bands, teratogens (drugs, alcohol, Nail Patella Syndrome etc. A 44-year-old woman with multiple isolated congenital micronychia over her hands and feet was selected. The major affected nails were thumbs and Index fingers. Surgical method were done step by step: Anesthesia of the area, extraction of short nail, elevation of nail bed, longitudinal nail bed incisions, suturing the lateral nail bed to the nail wall, covering the nail bed by a splint of plastic suction tube, bandage with gauze Vaseline. Finally, we hypnotized that in congenital micronychia, the main pathology is in nail bed; through this theory by nail bed expansion better outcomes are coming.

  17. Femoral Reconstruction Using External Fixation

    Directory of Open Access Journals (Sweden)

    Yevgeniy Palatnik

    2011-01-01

    Full Text Available Background. The use of an external fixator for the purpose of distraction osteogenesis has been applied to a wide range of orthopedic problems caused by such diverse etiologies as congenital disease, metabolic conditions, infections, traumatic injuries, and congenital short stature. The purpose of this study was to analyze our experience of utilizing this method in patients undergoing a variety of orthopedic procedures of the femur. Methods. We retrospectively reviewed our experience of using external fixation for femoral reconstruction. Three subgroups were defined based on the primary reconstruction goal lengthening, deformity correction, and repair of nonunion/bone defect. Factors such as leg length discrepancy (LLD, limb alignment, and external fixation time and complications were evaluated for the entire group and the 3 subgroups. Results. There was substantial improvement in the overall LLD, femoral length discrepancy, and limb alignment as measured by mechanical axis deviation (MAD and lateral distal femoral angle (LDFA for the entire group as well as the subgroups. Conclusions. The Ilizarov external fixator allows for decreased surgical exposure and preservation of blood supply to bone, avoidance of bone grafting and internal fixation, and simultaneous lengthening and deformity correction, making it a very useful technique for femoral reconstruction.

  18. Partial-limb salvage after persistent infection in the distal femoral prosthesis: straight-plasty - a novel technique

    International Nuclear Information System (INIS)

    A 35 years old female had giant cell tumour (GCT) of the distal femur for which wide resection and distal femoral endoprosthetic replacement was performed. Massive infection of prosthesis required removal and replacement of the prosthesis with nail antibiotic cement spacer, which also proved to be futile. Ultimately the whole of the infected thigh had to be excised. The limb could be preserved partially using straight-plasty instead of amputation. Patient is well rehabilitated and doing well at a follow-up of 3 years. (author)

  19. Broken Ergodicity in Ideal, Homogeneous, Incompressible Turbulence

    Science.gov (United States)

    Morin, Lee; Shebalin, John; Fu, Terry; Nguyen, Phu; Shum, Victor

    2010-01-01

    We discuss the statistical mechanics of numerical models of ideal homogeneous, incompressible turbulence and their relevance for dissipative fluids and magnetofluids. These numerical models are based on Fourier series and the relevant statistical theory predicts that Fourier coefficients of fluid velocity and magnetic fields (if present) are zero-mean random variables. However, numerical simulations clearly show that certain coefficients have a non-zero mean value that can be very large compared to the associated standard deviation. We explain this phenomena in terms of broken ergodicity', which is defined to occur when dynamical behavior does not match ensemble predictions on very long time-scales. We review the theoretical basis of broken ergodicity, apply it to 2-D and 3-D fluid and magnetohydrodynamic simulations of homogeneous turbulence, and show new results from simulations using GPU (graphical processing unit) computers.

  20. Iontophoretically enhanced ciclopirox delivery into and across human nail plate.

    Science.gov (United States)

    Hao, Jinsong; Smith, Kelly A; Li, S Kevin

    2009-10-01

    Transungual delivery of antifungal drugs is hindered by the low permeability of human nail plates, and as such, repeated dosing over a long period of time is necessary for effective treatment. The objectives of this study were to explore the possibilities of (a) enhancing the delivery of ciclopirox (CIC) across human nail plates and (b) sustaining CIC delivery from the larger resultant drug depot in the nail plates with constant voltage iontophoresis. In vitro passive and 9 V cathodal iontophoretic transport experiments of CIC across human nails were performed. Transungual CIC delivery with Penlac was the control. The amounts of CIC released from and deposited in the nails were determined in drug release and extraction experiments, respectively. Iontophoresis increased the flux of CIC permeated across the nail approximately 10 times compared to passive delivery from the same formulation or from Penlac. A significant amount of CIC was loaded into and released from the nails; the CIC concentrations were estimated to be above the minimum inhibitory concentrations of CIC for dermatophytic molds. The apparent transport lag time decreased in iontophoretic transport. The results demonstrate that iontophoresis was able to deliver an effective amount of CIC into and across the nails, and this suggests the feasibility of a constant voltage battery-powered transungual iontophoretic device. PMID:19117048

  1. Iontophoretically enhanced ciclopirox delivery into and across human nail plate.

    Science.gov (United States)

    Hao, Jinsong; Smith, Kelly A; Li, S Kevin

    2009-10-01

    Transungual delivery of antifungal drugs is hindered by the low permeability of human nail plates, and as such, repeated dosing over a long period of time is necessary for effective treatment. The objectives of this study were to explore the possibilities of (a) enhancing the delivery of ciclopirox (CIC) across human nail plates and (b) sustaining CIC delivery from the larger resultant drug depot in the nail plates with constant voltage iontophoresis. In vitro passive and 9 V cathodal iontophoretic transport experiments of CIC across human nails were performed. Transungual CIC delivery with Penlac was the control. The amounts of CIC released from and deposited in the nails were determined in drug release and extraction experiments, respectively. Iontophoresis increased the flux of CIC permeated across the nail approximately 10 times compared to passive delivery from the same formulation or from Penlac. A significant amount of CIC was loaded into and released from the nails; the CIC concentrations were estimated to be above the minimum inhibitory concentrations of CIC for dermatophytic molds. The apparent transport lag time decreased in iontophoretic transport. The results demonstrate that iontophoresis was able to deliver an effective amount of CIC into and across the nails, and this suggests the feasibility of a constant voltage battery-powered transungual iontophoretic device.

  2. NAIL KERATIN AS MONITOR-TISSUE FOR SELENIUM EXPOSURE

    NARCIS (Netherlands)

    VANNOORD, PAH; MAAS, MJ; DEBRUIN, M

    1992-01-01

    Nail clippings might provide a way to monitor exposure to selenium in the recent past of an individual, since a clipping collected from a toe would reflect exposures months before actual clipping date. The relation between levels of exogenous selenium exposure and selenium levels in nail keratin was

  3. Theory of broken gauge symmetry of families

    International Nuclear Information System (INIS)

    A theoretical scheme is considered, based on the gauge spontaneously-broken SU(3)H symmetry of families. The generation of quark and lepton masses is induced by their mixing with hypothetical superheavy fermions, providing a relationship of the observed mass hierarchy and mixing of quarks and leptons with the structure of horizontal symmetry breaking. The model predicts the existance of invisible axion, being simultaneously familon and Majoron, as well as the existence of neutrino Majorana mass hierarchy

  4. Broken Heart Syndrome: A Typical Case.

    Science.gov (United States)

    Therkleson, Tessa; Stronach, Shona

    2015-12-01

    This case describes a combination external treatment for "Broken Heart Syndrome" that includes a lavender footbath, massage using moor extract, and oxalis ointment to the abdomen applied by an Anthroposophic nurse for a specific personality type. Lavender footbaths have been used since ancient times for relaxation and calming, while moor extract has been used medicinally in Europe since the middle ages for warmth and environmental protection. Rhythmical massage using moor extract and oxalis ointment poultice to the abdomen are part of the tradition of Anthroposophic nursing when managing stress induced by emotional and physical trauma. An elderly lady with specific characteristics diagnosed as Broken Heart Syndrome received one treatment a week for 4 weeks given by an Anthroposophic nurse at an integrative medical center. Between treatments, education was given to enable self-treatment in the home. The nursing treatments, each using lavender footbaths, moor extract massage, and oxalis ointment poultice to the abdomen, proved very effect, and no negative effects were reported. External applications need to be considered by nurses caring for specific personality types with Broken Heart Syndrome. PMID:25673580

  5. Green Nail Syndrome (Pseudomonas aeruginosa Nail Infection: Two Cases Successfully Treated with Topical Nadifloxacin, an Acne Medication

    Directory of Open Access Journals (Sweden)

    Simon Müller

    2014-07-01

    Full Text Available Green nail syndrome (GNS caused by Pseudomonas aeruginosa is the most common bacterial nail infection. The treatment of GNS is challenging in many cases and recommendations based on clinical trials are lacking. We report two cases with GNS successfully treated with off-label use of topical nadifloxacin, a fluoroquinolone approved for acne and bacterial skin infections in some countries.

  6. The pattern of femoral diaphyseal fractures in children admitted in Sarawak General Hospital.

    Science.gov (United States)

    Rasit, A H; Mohammad, A W; Pan, K L

    2006-02-01

    Trend towards changing the face of management for pediatric femoral fractures tends to advocate operative treatment. This study was undertaken to review our current practice in the wake of recent progress in the management of pediatric femoral fractures. Fifty patients with femoral diaphyseal fracture treated in Sarawak General Hospital were reviewed retrospectively after an average follow-up of 2.6 years. There were 36 boys and 14 girls, with a mean age of 6.2 years (range five months to 14 years). Children under six years of age constituted the majority of the patients. Half of the fractures were caused by road traffic accident. Nine patients had associated injuries. The most common site of fracture was at the middle third (N=31). The treatment regimens were delayed hip spica (DHS) in 16, immediate hip spica (IHS) in 24, plate osteosynthesis (PO) in five, titanium elastic nailing (TEN) in five, and external fixation (EF) in one. The minimum hospital stay was two days, and the maximum 33 days (mean, 9.7 days). Malunion was the commonest complication. Conservative treatment is the preferred option for children under six years of age. It is cost-effective with minimal complication. The other treatment options are reserved for specific indication in older children. Diaphyseal fractures of the femur in children can be adequately managed non-operatively.

  7. Onychophagia (Nail biting, anxiety, and malocclusion

    Directory of Open Access Journals (Sweden)

    Avesh Sachan

    2012-01-01

    Full Text Available Nail biting is a stress removing habit adopted by many children and adults. People usually do it when they are nervous, stressed, hungry, or bored. All of these situations are having a common phenomenon between them is anxiety. Onychophagia is also a sign of other emotional or mental disorders. It is a habit that is not easy to quit and reflection of extreme nervousness or inability to handle stressful conditions. This abnormal habit may cause various malocclusions associated with dentoalveolar segment of the oral cavity. Crowding and rotations of incisors are common with this habit.

  8. 7 CFR 868.254 - Broken kernels determination.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Broken kernels determination. 868.254 Section 868.254 Agriculture Regulations of the Department of Agriculture (Continued) GRAIN INSPECTION, PACKERS AND STOCKYARD... Governing Application of Standards § 868.254 Broken kernels determination. Broken kernels shall...

  9. 46 CFR 9.9 - Two hours between broken periods.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Two hours between broken periods. 9.9 Section 9.9... COMPENSATION FOR OVERTIME SERVICES § 9.9 Two hours between broken periods. Where 2 hours or more intervene between broken periods, one-half day's extra pay will be allowed for each distinct 2-hour period or...

  10. 7 CFR 868.304 - Broken kernels determination.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Broken kernels determination. 868.304 Section 868.304 Agriculture Regulations of the Department of Agriculture (Continued) GRAIN INSPECTION, PACKERS AND STOCKYARD... Application of Standards § 868.304 Broken kernels determination. Broken kernels shall be determined by the...

  11. 7 CFR 51.2125 - Split or broken kernels.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Split or broken kernels. 51.2125 Section 51.2125... STANDARDS) United States Standards for Grades of Shelled Almonds Definitions § 51.2125 Split or broken kernels. Split or broken kernels means seven-eighths or less of complete whole kernels but which will...

  12. Assessment of the geometry of proximal femur for short cephalomedullary nail placement: An observational study in dry femora and living subjects

    Directory of Open Access Journals (Sweden)

    Devendra Pathrot

    2016-01-01

    Full Text Available Background: Intramedullary devices have increasingly become popular and are widely used for fixation of unstable intertrochanteric and subtrochanteric fractures as well. These implants have been designed taking into consideration the anthropometry of the western population whose anthropometry varies from those of other ethnic groups. This study was carried out to assess the geometry of proximal femur for the placement of short cephalomedullary nails in our subset of patients and suggest suitable design modifications based on these parameters. Materials and Methods: The study was conducted in the following three groups: (1 Anthropometric study of 101 adult human dry femora, (2 radiographs of the same femora, and (3 radiographs of the contralateral uninjured limb of 102 patients with intertrochanteric or subtrochanteric fractures. In Group 1, standard anthropometric techniques were used to measure neck shaft angle (NSA, minimal neck width (NW, trochanteric offset, and distance from the tip of greater trochanter (GT to the lower border of lesser trochanter on the femoral shaft axis (distance X. In Group 2 and 3, the NSA, minimal NW, NW at 130° and 135°, trochanteric shaft angle (TSA, trochanteric offset, distance X, distance between the tip of GT and the point where the neck axis crosses the line joining the tip of the GT to the lower border of the lesser trochanter on the femoral shaft axis (distance Y, and canal width at 10, 15, and 20 cm from tip of GT were measured on standard radiographs. The values obtained in these three groups were pooled to obtain mean values. Various parameters of commonly used short cephalomedullary nails available for fixation of pertrochanteric fractures were obtained. These were compared to the results obtained to suggest suitable modifications in the nail designs for our subset of patients. Results: The mean parameters observed were as follows: NSA 128.07° ± 4.97 (range 107°–141°, minimum NW 29.0 ± 2.8 mm

  13. Enhancing the nail permeability of topically applied drugs.

    Science.gov (United States)

    Murdan, Sudaxshina

    2008-11-01

    The topical therapy of nail diseases, especially of onychomycosis, and to a smaller extent, of nail psoriasis, is desirable to avoid the side effects associated with their systemic therapy, to increase patient compliance and reduce the cost of treatment. Systemic therapy is however the mainstay of treatment due to the poor permeability of the nail plate to topically applied drugs. For effective topical therapy, ungual drug permeation must be enhanced. This can be achieved by disrupting the nail plate using physical techniques or chemical agents. Alternatively, drug permeation into the intact nail plate may be encouraged, for example, by iontophoresis or by formulating the drug within a vehicle which enables high drug partition out of the vehicle and into the nail plate. The physical techniques (manual and electrical nail abrasion, acid etching, ablation by lasers, microporation, application of low-frequency ultrasound and electric currents) and chemicals (thiols, sulphites, hydrogen peroxide, urea, water, enzymes) that have shown ungual enhancer activity are discussed in this review. Optimal drug formulation, while crucial to ungual drug delivery, is only briefly reviewed due to the limited literature. PMID:18976136

  14. Enhancing the nail permeability of topically applied drugs.

    Science.gov (United States)

    Murdan, Sudaxshina

    2008-11-01

    The topical therapy of nail diseases, especially of onychomycosis, and to a smaller extent, of nail psoriasis, is desirable to avoid the side effects associated with their systemic therapy, to increase patient compliance and reduce the cost of treatment. Systemic therapy is however the mainstay of treatment due to the poor permeability of the nail plate to topically applied drugs. For effective topical therapy, ungual drug permeation must be enhanced. This can be achieved by disrupting the nail plate using physical techniques or chemical agents. Alternatively, drug permeation into the intact nail plate may be encouraged, for example, by iontophoresis or by formulating the drug within a vehicle which enables high drug partition out of the vehicle and into the nail plate. The physical techniques (manual and electrical nail abrasion, acid etching, ablation by lasers, microporation, application of low-frequency ultrasound and electric currents) and chemicals (thiols, sulphites, hydrogen peroxide, urea, water, enzymes) that have shown ungual enhancer activity are discussed in this review. Optimal drug formulation, while crucial to ungual drug delivery, is only briefly reviewed due to the limited literature.

  15. HEMATOMA OF THE PROXIMAL NAIL FOLD. REPORT OF 41 CASES

    Directory of Open Access Journals (Sweden)

    Chang Patricia

    2011-04-01

    Full Text Available Background: The proximal fold is an important part of the nail apparatus it contributes to the formation of the nail plate and through the cuticle acts as an impermeable barrier protecting it from any cause.Objective: To know the proximal nail fold hematoma caused by the use of pulse oximeter.Material and Methods: A descriptive study was conducted in 41 patients with proximal nail hematoma secondary to the use of oximetry in patients hospitalized in the Intermediate and Intensive Care Unit at the Hospital General de Enfermedades from December 1, 2007 to December 31, 2010.Results: We studied 41 patients with proximal nail fold hematoma secondary to the use of oximeter, 30 (73.1% were males and 11 (26.8% females. The numbers of fingers affected by pulse oximeter were in one digit. 30 (73.1% cases, in two digits 6 (14.6%, in three digits 3 (7.3%, in 4 digits 1 (2.4% and in 5 digits 1 (2.4% case. The most affected proximal nail fold was right index: 24 (58.5%, right middle 11 (26.8%, right ring 6 (14.6%, left index 12 (29.2%, and left middle 6 (14.6% cases.Conclusions: Hematomas of the proximal nail fold may be caused by different traumatisms. The use of pulse oximeter is one of them.

  16. Effective theories with broken flavour symmetry

    International Nuclear Information System (INIS)

    The work of Ovrut and Schnitzer on effective theories derived from a non Abelian Gauge Theory is generalised to include the physically interesting case of broken flavour symmetry. The calculations are performed at the 1-loop level. It is shown that at an intermediate stage in the calculations two distinct renormalised gauge coupling constants appear, one describing gauge field coupling to heavy particles and the other describing coupling to light particles. Appropriately modified Slavnov-Taylor identities are shown to hold. A simple alternative to the Ovrut-Schnitzer rules for calculating with effective theories is also considered

  17. Broken Lifshitz invariance, spin waves and hydrodynamics

    CERN Document Server

    Roychowdhury, Dibakar

    2016-01-01

    In this paper, based on the basic principles of thermodynamics, we explore the hydrodynamic regime of interacting Lifshitz field theories in the presence of broken rotational invariance. We compute the entropy current and discover new dissipative effects those are consistent with the principle of local entropy production in the fluid. In our analysis, we consider both the parity even as well as the parity odd sector upto first order in the derivative expansion. Finally, we argue that the present construction of the paper could be systematically identified as that of the hydrodynamic description associated with \\textit{spin waves} (away from the domain of quantum criticality) under certain limiting conditions.

  18. Rotating optical microcavities with broken chiral symmetry

    CERN Document Server

    Sarma, Raktim; Wiersig, Jan; Cao, Hui

    2014-01-01

    We demonstrate in open microcavities with broken chiral symmetry, quasi-degenerate pairs of co-propagating modes in a non-rotating cavity evolve to counter-propagating modes with rotation. The emission patterns change dramatically by rotation, due to distinct output directions of CW and CCW waves. By tuning the degree of spatial chirality, we maximize the sensitivity of microcavity emission to rotation. The rotation-induced change of emission is orders of magnitude larger than the Sagnac effect, pointing to a promising direction for ultrasmall optical gyroscopes.

  19. Neutrino masses and spontaneously broken flavor symmetries

    Energy Technology Data Exchange (ETDEWEB)

    Staudt, Christian

    2014-06-16

    We study the phenomenology of supersymmetric flavor models. We show how the predictions of models based on spontaneously broken non-Abelian discrete flavor symmetries are altered when we include so-called Kaehler corrections. Furthermore, we discuss anomaly-free discrete R symmetries which are compatible with SU(5) unification. We find a set of symmetries compatible with suppressed Dirac neutrino masses and a unique symmetry consistent with the Weinberg operator. We also study a pseudo-anomalous U(1){sub R} symmetry which explains the fermion mass hierarchies and, when amended with additional singlet fields, ameliorates the fine-tuning problem.

  20. Superselective intra-arterial DSA in patients with femoral head necrosis and femoral neck fracture

    International Nuclear Information System (INIS)

    The prospective study includes 25 patients without pathology of the femoral head for the evaluation of the normal femoral head perfusion. In addition 34 patients with femoral head necrosis underwent i.a. DSA preoperatively before pedicled pelvic bone grafting. 15 patients after pelvic bone graft operation and 7 patients with medial femoral head fracture were also examined via superselective DSA. In cases with femoral head necrosis a rarefaction or interruption of the rami nutricii proximales, or an occlusion of the medial circumflex femoral artery were observed. Patients with medial femoral neck fracture showed an interruption of the rami nutricii proximales of the femoral head. Postoperative DSA - after pedicled pelvic bone graft - revealed a regular arterial graft perfusion in 82%. (orig.)

  1. Dose-Effect Relationships for Femoral Fractures After Multimodality Limb-Sparing Therapy of Soft-Tissue Sarcomas of the Proximal Lower Extremity

    Energy Technology Data Exchange (ETDEWEB)

    Pak, Daniel; Vineberg, Karen A. [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Griffith, Kent A. [Biostatistics Unit, Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI (United States); Sabolch, Aaron [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Chugh, Rashmi [Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan, Ann Arbor, MI (United States); Ben-Josef, Edgar [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Biermann, Janet Sybil [Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI (United States); Feng, Mary, E-mail: maryfeng@umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States)

    2012-07-15

    Purpose: We investigated the clinical and dosimetric predictors for radiation-associated femoral fractures in patients with proximal lower extremity soft tissue sarcomas (STS). Methods and Materials: We examined 131 patients with proximal lower extremity STS who received limb-sparing surgery and external-beam radiation therapy between 1985 and 2006. Five (4%) patients sustained pathologic femoral fractures. Dosimetric analysis was limited to 4 fracture patients with full three-dimensional dose information, who were compared with 59 nonfracture patients. The mean doses and volumes of bone (V{sub d}) receiving specified doses ({>=}30 Gy, 45 Gy, 60 Gy) at the femoral body, femoral neck, intertrochanteric region, and subtrochanteric region were compared. Clinical predictive factors were also evaluated. Results: Of 4 fracture patients in our dosimetric series, there were three femoral neck fractures with a mean dose of 57.6 {+-} 8.9 Gy, V30 of 14.5 {+-} 2.3 cc, V45 of 11.8 {+-} 1.1 cc, and V60 of 7.2 {+-} 2.2 cc at the femoral neck compared with 22.9 {+-} 20.8 Gy, 4.8 {+-} 5.6 cc, 2.5 {+-} 3.9 cc, and 0.8 {+-} 2.7 cc, respectively, for nonfracture patients (p < 0.03 for all). The femoral neck fracture rate was higher than at the subtrochanteric region despite lower mean doses at these subregions. All fracture sites received mean doses greater than 40 Gy. Also, with our policy of prophylactic femoral intramedullary nailing for high-risk patients, there was no significant difference in fracture rates between patients with and without periosteal excision. There were no significant differences in age, sex, tumor size, timing of radiation therapy, and use of chemotherapy between fracture and nonfracture patients. Conclusions: These dose-volume toxicity relationships provide RT optimization goals to guide future efforts for reducing pathologic fracture rates. Prophylactic femoral intramedullary nailing may also reduce fracture risk for susceptible patients.

  2. Dose–Effect Relationships for Femoral Fractures After Multimodality Limb-Sparing Therapy of Soft-Tissue Sarcomas of the Proximal Lower Extremity

    International Nuclear Information System (INIS)

    Purpose: We investigated the clinical and dosimetric predictors for radiation-associated femoral fractures in patients with proximal lower extremity soft tissue sarcomas (STS). Methods and Materials: We examined 131 patients with proximal lower extremity STS who received limb-sparing surgery and external-beam radiation therapy between 1985 and 2006. Five (4%) patients sustained pathologic femoral fractures. Dosimetric analysis was limited to 4 fracture patients with full three-dimensional dose information, who were compared with 59 nonfracture patients. The mean doses and volumes of bone (Vd) receiving specified doses (≥30 Gy, 45 Gy, 60 Gy) at the femoral body, femoral neck, intertrochanteric region, and subtrochanteric region were compared. Clinical predictive factors were also evaluated. Results: Of 4 fracture patients in our dosimetric series, there were three femoral neck fractures with a mean dose of 57.6 ± 8.9 Gy, V30 of 14.5 ± 2.3 cc, V45 of 11.8 ± 1.1 cc, and V60 of 7.2 ± 2.2 cc at the femoral neck compared with 22.9 ± 20.8 Gy, 4.8 ± 5.6 cc, 2.5 ± 3.9 cc, and 0.8 ± 2.7 cc, respectively, for nonfracture patients (p < 0.03 for all). The femoral neck fracture rate was higher than at the subtrochanteric region despite lower mean doses at these subregions. All fracture sites received mean doses greater than 40 Gy. Also, with our policy of prophylactic femoral intramedullary nailing for high-risk patients, there was no significant difference in fracture rates between patients with and without periosteal excision. There were no significant differences in age, sex, tumor size, timing of radiation therapy, and use of chemotherapy between fracture and nonfracture patients. Conclusions: These dose–volume toxicity relationships provide RT optimization goals to guide future efforts for reducing pathologic fracture rates. Prophylactic femoral intramedullary nailing may also reduce fracture risk for susceptible patients.

  3. Unusual Contents of the Femoral Hernia

    OpenAIRE

    Ahmed Alzaraa

    2011-01-01

    Different contents in the femoral hernia have been reported in the literature, but herniation of the fallopian tube in a femoral hernia is very rare due to its normal anatomical position. Case Presentation. A female patient was admitted to the surgical ward for a lump in the right groin. Clinical examination confirmed a right femoral hernia. The patient underwent surgery to repair the hernia. Intraoperatively, the right uterine tube was found in the hernia. The tube was reduced back into the ...

  4. Computer tomography after medullary nailing of the tibia

    Energy Technology Data Exchange (ETDEWEB)

    Schild, H.; Mueller, H.A.; Menke, W.

    1982-11-01

    Computer tomographic examination of the tibia was carried out in ten patients two days to four years after removal of an intramedullary nail. Sclerosis of the marrow cavity and cortex and bone formation in the nail track are characteristic findings. They have been correlated with the appearances on conventional X-rays. Changes in the density of the marrow cavity, which is normally increased around the previous nail tract, do not necessarily indicate the presence of infection. In the absence of complications, the increased marrow space density may return to normal negative values corresponding with fat density.

  5. Evaluation of perfusion of the femoral head after femoral neck fracture using bone scintigraphy

    International Nuclear Information System (INIS)

    We treated 13 patients for femoral neck fracture. They consisted of 2 males and 11 females, and were classified according to Garden stage classification; Stage I, 3 cases; Stage II, 2 cases; Stage III, 2 cases; Stage IV, 4 cases. Two trochanteric fracture cases were used by control. We evaluated perfusion of the femoral head after femoral neck fracture using bone scintigraphy, which is considered useful for evaluation of perfusion of the femoral neck before operation. (author)

  6. Absorption of solar radiation in broken clouds

    Energy Technology Data Exchange (ETDEWEB)

    Zuev, V.E.; Titov, G.A.; Zhuravleva, T.B. [Institute of Atmospheric Optics, Tomsk (Russian Federation)

    1996-04-01

    It is recognized now that the plane-parallel model unsatisfactorily describes the transfer of radiation through broken clouds and that, consequently, the radiation codes of general circulation models (GCMs) must be refined. However, before any refinement in a GCM code is made, it is necessary to investigate the dependence of radiative characteristics on the effects caused by the random geometry of cloud fields. Such studies for mean fluxes of downwelling and upwelling solar radiation in the visible and near-infrared (IR) spectral range were performed by Zuev et al. In this work, we investigate the mean spectral and integrated absorption of solar radiation by broken clouds (in what follows, the term {open_quotes}mean{close_quotes} will be implied but not used, for convenience). To evaluate the potential effect of stochastic geometry, we will compare the absorption by cumulus (0.5 {le} {gamma} {le} 2) to that by equivalent stratus ({gamma} <<1) clouds; here {gamma} = H/D, H is the cloud layer thickness and D the characteristic horizontal cloud size. The equivalent stratus clouds differ from cumulus only in the aspect ratio {gamma}, all the other parameters coinciding.

  7. The changes of nitric oxide and hemorheology in steroid-induced avascular necrosis of femoral head

    Institute of Scientific and Technical Information of China (English)

    WANG Guo-yu; HE Xi-jing; LI Yi; ZHANG Zhen-ni

    2006-01-01

    Objective: To explore the pathogenesis of avascular necrosis of femoral head (ANFH), the early diagnosis index and the treatment effective index of ANFH in clinical practice. Methods: Twenty-four Japanese rabbits were divided into 2 groups: model group and control group. ANFH models were produced by intramuscular injection of large dosage of steroid to rabbits for 8 weeks. On the 4 th, 8 th week after the injection, two rabbits each time from each group were taken to observe the structure of femoral head by light microscope and scanning electron microscope. Four other stomach-empty rabbits from each group were also used to test the contents of Nitric Oxide (NO), contents of the hemorheology indexes. Results: Compared with the control group, the rabbits in the model group exhibited osteoporosis of femoral head and more bone lacuna and more fat cells through light microscope. Through scanning electron microscope observation bone trabecula were broken and sunk, and collagen fibers on the surface of bone matrix became loosen and broken,more osteocyte had pyknosis, adipocyte in the medullary cavity were enlarged and subchondral arterioles and capillaries of the femoral head were pressed by adipocyte. Compared with the control group, the model rabbits contained less NO and obvious increase of the plasma viscosity (PV), low blood viscosity (LBV), erythrocyte hematocrit (HCT), indices of erythrocyte rigidity (TK) and indices of erythrocyte aggregation (AI), plasma fibrin level (PFL) (P<0.01) and an increase of erythrocyte electrophoresis rate (ERT) (P<0.05). High blood viscosity (HBV), and erythrocyte sedimentation rate (ESR) were unchanged. Conclusion: The steroid-induced ANFH might be related to less NO and the abnormal hemorheology; and NO and hemorheology should be considered as an early diagnosis index for ANFH in clinical practice.

  8. Femoral rotation unpredictably affects radiographic anatomical lateral distal femoral angle measurements

    DEFF Research Database (Denmark)

    Miles, James Edward

    2016-01-01

    Objective: To describe the effects of internal and external femoral rotation on radiographic measurements of the anatomical lateral distal femoral angle (a-LDFA) using two methods for defining the anatomical proximal femoral axis (a-PFA). Methods: Digital radiographs were obtained of 14 right...

  9. Foreign body reaction after PLC reconstruction caused by a broken PLLA screw.

    Science.gov (United States)

    Kim, Tae-Kwon; Jeong, Tae-Wan; Lee, Dae-Hee

    2014-12-01

    Foreign body reactions may occur in patients who receive bioabsorbable implants during orthopedic surgery for fractures and ligament repair. The authors describe a 34-year-old man who presented with a palpable tender mass on the lateral aspect of the left knee of 1 month's duration. He underwent posterior cruciate ligament and posterolateral corner reconstruction 3 years earlier. Physical examination showed a 1×1-cm soft, nontender mass without localized warmth on the lateral epicondyle of the distal femur. Magnetic resonance imaging showed a broken screw fragment surrounded by a cyst-like mass. Under general anesthesia, the surgeon excised the screw fragment and the fibrotic mass, enclosing it in the subcutaneous tissue at the lateral epicondyle, the site at which a poly-L-lactic acid bioabsorbable screw had been inserted to fix the graft for posterolateral corner reconstruction. Histologic evaluation showed a foreign body reaction to the degraded screw particles. To the authors' knowledge, this report is the first description of a patient presenting with a delayed foreign body reaction to a broken poly-L-lactic acid bioabsorbable screw at the lateral femoral epicondyle after posterolateral corner reconstruction. Because delayed foreign body reactions can occur at any site of poly-L-lactic acid bioabsorbable screw insertion, care should be taken to avoid screw protrusion during ligament reconstruction because it can lead to screw breakage and delayed foreign body reaction.

  10. Foreign body reaction after PLC reconstruction caused by a broken PLLA screw.

    Science.gov (United States)

    Kim, Tae-Kwon; Jeong, Tae-Wan; Lee, Dae-Hee

    2014-12-01

    Foreign body reactions may occur in patients who receive bioabsorbable implants during orthopedic surgery for fractures and ligament repair. The authors describe a 34-year-old man who presented with a palpable tender mass on the lateral aspect of the left knee of 1 month's duration. He underwent posterior cruciate ligament and posterolateral corner reconstruction 3 years earlier. Physical examination showed a 1×1-cm soft, nontender mass without localized warmth on the lateral epicondyle of the distal femur. Magnetic resonance imaging showed a broken screw fragment surrounded by a cyst-like mass. Under general anesthesia, the surgeon excised the screw fragment and the fibrotic mass, enclosing it in the subcutaneous tissue at the lateral epicondyle, the site at which a poly-L-lactic acid bioabsorbable screw had been inserted to fix the graft for posterolateral corner reconstruction. Histologic evaluation showed a foreign body reaction to the degraded screw particles. To the authors' knowledge, this report is the first description of a patient presenting with a delayed foreign body reaction to a broken poly-L-lactic acid bioabsorbable screw at the lateral femoral epicondyle after posterolateral corner reconstruction. Because delayed foreign body reactions can occur at any site of poly-L-lactic acid bioabsorbable screw insertion, care should be taken to avoid screw protrusion during ligament reconstruction because it can lead to screw breakage and delayed foreign body reaction. PMID:25437089

  11. Nailed timber beams with I composed section

    Directory of Open Access Journals (Sweden)

    Jorge Luís Nunes de Góes

    2003-01-01

    Full Text Available The employment of built-up timber beams, made of commercial dimensions pieces, is becoming increasingly important in timber structures in Brazil, mainly due to the ever-growing scarcity of timber elements in larger sizes. The built-up system has vast application, from beams for residential buildings to girders for small bridges. The objective of this work is the theoretical and experimental study of nailed timber beams with composed cross section I. The design procedure of EUROCODE 5/93 and NBR 7190/97 are shown and evaluated, as well as the theory about the subject matter. The experimental evaluation of the theoretical models was made by means of bending tests in prototypes of built-up timber beams. The obtained results shows that the EUROCODE 5/93 procedure is the most indicated for evaluating effective bending stiffness, normal and shear stresses as well as the load on fasteners.

  12. Penetrating Cardiac Nail Gun Injury in a Child.

    Science.gov (United States)

    Kulaylat, Afif N; Chesnut, Charles H; Patel, Sunil; Rocourt, Dorothy V; Clark, Joseph B

    2016-08-01

    Nail gun injuries primarily occur in the extremities of adult males as a consequence of accidental occupational trauma. Such injury involving the thorax is much less common, and penetrating cardiac injury secondary to pneumatic nail gun discharge is rare. Although potentially lethal, most cases with cardiac trauma are survivable with expedient surgical intervention. Despite improvements in engineered safety mechanisms, the incidence of nail gun injuries has risen as use of the devices has increased. The widespread availability of these tools to nonprofessional consumers exposes a broader population to the potential hazards associated with these devices. We describe the presentation and successful management of the first reported case of penetrating cardiac nail gun injury in a young child. PMID:27018525

  13. Fracture Union in Closed Interlocking Nail in Humeral Shaft Fractures

    Directory of Open Access Journals (Sweden)

    Ramji Lal Sahu

    2015-01-01

    Conclusions: The results of the present study indicates that in the presence of proper indications, reamed antegrade intramedullary interlocked nailing appears to be a method of choice for internal fixation of osteoporotic and pathologic fractures.

  14. Biomechanics – Elastic Foundation Applied in Modelling of Calcaneal Nails

    Directory of Open Access Journals (Sweden)

    Sejda František

    2015-12-01

    Full Text Available This paper presents a strength analysis of a calcaneal nail (material Ti6Al4V and stainless steel which is used to treat complex heel fractures. The application focuses on a unique calcaneal nail, the C-NAIL, produced by Medin a.s. (Nové Město na Moravě, Czech Republic. The paper first presents an analysis of fracture types, treatment methods and loading of the calcaneus. It then presents an analysis of limit conditions and loading. Calculations (displacement and stress are performed for 6 and 7 fixing screws using FEM (Ansys Workbench 14 software. The calculation involves a new, original application of an elastic foundation, which effectively replaces the complex interaction of the calcaneal nail and the heel bone.

  15. Reference values for the nickel concentration in human finger nails

    DEFF Research Database (Denmark)

    Gammelgaard, Bente; Peters, K; Menné, T

    1991-01-01

    A reference value for the nickel concentration in finger nails from people who are not occupationally exposed to nickel was determined on the basis of nail samples from 95 healthy individuals. The mean +/- standard deviation was 1.19 +/- 1.61 mg/kg and the median was 0.49 mg/kg (range 0.042-7.50 mg....../kg). The 95% confidence interval of the population mean was 0.51-1.26 mg/kg and the 95% confidence interval of the population median was 0.39-0.74 mg/kg. The random sample consisted of 59 women and 36 men. No significant difference between the nickel levels in finger nails from men and women could...... be demonstrated. The age of the subjects varied from 16 to 66 years. There was no correlation between age and nickel concentration in finger nails....

  16. The functional results of tibial shaft fractures treated with intramedullary nail compressed by proximal tube.

    Science.gov (United States)

    Karaarslan, Ahmet Adnan; Acar, Nihat; Aycan, Hakan; Sesli, Erhan

    2016-04-01

    Nailing of tibial shaft fractures is considered the gold standard surgical method by many surgeons. The aim of this retrospective study was to investigate and compare the clinical outcome of tibial shaft fractures treated with intramedullary nails compressed by proximal tube and conventional intramedullary interlocking nails. Fifty-seven patients with tibial shaft fractures, treated with intramedullary nails compressed by proximal tube (n = 32) and the conventional interlocking nails (n = 25), were reviewed. All fractures except for one were united without any additional surgical intervention in the proximal compression tube nail group, whereas in the conventional interlocking nail group, six patients needed dynamization surgery (p = 0.005) and three cases of nonunion were recorded. In the proximal compression tube nail group, faster union occurred in 20 ± 2 (16-24) weeks (mean ± SD; range) without failure of locking screws and proximal nail migration, whereas in the conventional interlocking nail group, union occurred in 22 ± 2.5 (17-27) weeks (p = 0.001) with two failures of locking screws and two proximal nail migration. The proximal compression tube nail system is safer than the conventional nailing methods for the treatment for transverse and oblique tibial shaft fractures with a less rate of nonunion, proximal locking screw failure and proximal nail migration. PMID:26837377

  17. Osteonecrosis of Femoral Head Occurred after Stent Placement of Femoral Artery

    Directory of Open Access Journals (Sweden)

    Akiyoshi Shimatani

    2014-01-01

    Full Text Available We present a case of osteonecrosis of femoral head (ONFH that occurred after stent angiography of femoral artery for the treatment of arteriosclerosis obliterans (ASO of left inferior limb in a 76-year-old woman. No case of late collapse of femoral head as a complication of endovascular procedure such as stent placement has been previously documented. We considered that ONFH occurred after detaining stent at a junction of left deep femoral artery for the treatment of the ischemia of left lateral and medial femoral circumflex artery.

  18. Estimation and Control of Distraction Osteogenesis Using an Intramedullary Nail

    OpenAIRE

    Tumelius, Simo

    2016-01-01

    Modern limb lengthening techniques involve fully implantable intramedullary lengthening nails. Compared to conventional lengthening methods using external fixators, intramedullary nails are more patient friendly and easier to integrate to day-to-day living. However, a common challenge encountered in these types of lengthenings is insufficient distraction rate control. Two algorithms for estimation and distraction rate control of limb lengthening were developed. The lengthening system, for...

  19. Dermoscopy and Onychomycosis: guided nail abrasion for mycological samples*

    Science.gov (United States)

    Bet, Diego Leonardo; dos Reis, Ana Lucia; Chiacchio, Nilton Di; Belda Junior, Walter

    2015-01-01

    Mycological examination is still the cornerstone for the diagnosis of onychomycosis for many dermatologists, but sampling technique interferes on its sensitivity and specificity. Nail abrasion may be used to reach the most proximal part of the lesion and can be easily accomplished with an electric abrasor. We suggest nail plate dermoscopy to identify the best location for localized abrasion to obtain adequate samples for mycological examination. PMID:26734877

  20. Effective Action of Softly Broken Supersymmetric Theories

    CERN Document Server

    Nibbelink, S G; Nibbelink, Stefan Groot; Nyawelo, Tino S.

    2007-01-01

    We study the renormalization of (softly) broken supersymmetric theories at the one loop level in detail. We perform this analysis in a superspace approach in which the supersymmetry breaking interactions are parameterized using spurion insertions. We comment on the uniqueness of this parameterization. We compute the one loop renormalization of such theories by calculating superspace vacuum graphs with multiple spurion insertions. To preform this computation efficiently we develop algebraic properties of spurion operators, that naturally arise because the spurions are often surrounded by superspace projection operators. Our results are general apart from the restrictions that higher super covariant derivative terms and some finite effects due to non-commutativity of superfield dependent mass matrices are ignored. One of the soft potentials induces renormalization of the Kaehler potential.

  1. Restoring broken entanglement by injecting separable correlations

    CERN Document Server

    Pirandola, Stefano

    2012-01-01

    The distribution of entanglement is central in many protocols of quantum information and computation. However it is also known to be a very fragile process when loss and noise come into play. The inevitable interaction of the quantum systems with the external environment induces effects of decoherence which may be so strong to destroy any input entanglement, a phenomenon known as "entanglement breaking". Here we study this catastrophic process in a correlated-noise environment showing how the presence of classical-type correlations can restore the distribution of entanglement. In particular, we consider a Gaussian environment whose thermal noise is strong enough to break the entanglement of two bosonic modes of the electromagnetic field. In this scenario, we show that the injection of separable correlations from the same environment is able to reactivate the broken entanglement. This paradoxical effect happens both in schemes of direct distribution, where a third party (Charlie) broadcasts entangled states to...

  2. Effects of broken affordance on visual extinction.

    Science.gov (United States)

    Wulff, Melanie; Humphreys, Glyn W

    2015-01-01

    Previous studies have shown that visual extinction can be reduced if two objects are positioned to "afford" an action. Here we tested if this affordance effect was disrupted by "breaking" the affordance, i.e., if one of the objects actively used in the action had a broken handle. We assessed the effects of broken affordance on recovery from extinction in eight patients with right hemisphere lesions and left-sided extinction. Patients viewed object pairs that were or were not commonly used together and that were positioned for left- or right-hand actions. In the unrelated pair conditions, either two tools or two objects were presented. In line with previous research (e.g., Riddoch et al., 2006), extinction was reduced when action-related object pairs and when unrelated tool pairs were presented compared to unrelated object pairs. There was no significant difference in recovery rate between action-related (object-tool) and unrelated tool pairs. In addition, performance with action-related objects decreased when the tool appeared on the ipsilesional side compared to when it was on the contralesional side, but only when the tool handle was intact. There were minimal effects of breaking the handle of an object rather than a tool, and there was no effect of breaking the handle on either tools or objects on single item trials. The data suggest that breaking the handle of a tool lessens the degree to which it captures attention, with this attentional capture being strongest when the tool appears on the ipsilesional side. The capture of attention by the ipsilesional item then reduces the chance of detecting the contralesional stimulus. This attentional capture effect is mediated by the affordance to the intact tool.

  3. Effects of broken affordance on visual extinction

    Directory of Open Access Journals (Sweden)

    Melanie eWulff

    2015-09-01

    Full Text Available Previous studies have shown that visual extinction can be reduced if two objects are positioned to afford an action. Here we tested if this affordance effect was disrupted by breaking the affordance – if one of the objects actively used in the action had a broken handle. We assessed the effects of broken affordance on recovery from extinction in eight patients with right hemisphere lesions and left-sided extinction. Patients viewed object pairs that were or were not commonly used together and that were positioned for left- or right-hand actions. In the unrelated pair conditions, either two tools or two objects were presented. In line with previous research (e.g., Riddoch et al., 2006, extinction was reduced when action-related object pairs and when unrelated tool pairs were presented compared to unrelated object pairs. There was no significant difference in recovery rate between action-related (object-tool and unrelated tool-tool pairs. In addition, performance with action-related objects decreased when the tool appeared on the ipsilesional side compared to when it was on the contralesional side, but only when the tool handle was intact. There were minimal effects of breaking the handle of an object rather than a tool, and there was no effect of breaking the handle on either tools or objects on single item trials. The data suggest that breaking the handle of a tool lessens the degree to which it captures attention, with this attentional capture being strongest when the tool appears on the ipsilesional side. The capture of attention by the ipsilesional item then reduces the chance of detecting the contralesional stimulus. This attentional capture effect is mediated by the affordance to the intact tool.

  4. Modified broken rice starch as fat substitute in sausages

    Directory of Open Access Journals (Sweden)

    Valéria Maria Limberger

    2011-09-01

    Full Text Available The demand for low-fat beef products has led the food industry to use fat substitutes such as modified starch. About 14% of broken rice is generated during processing. Nevertheless, this by-product contains high levels of starch; being therefore, great raw material for fat substitution. This study evaluated the applicability of chemically and physically modified broken rice starch as fat substitute in sausages. Extruded and phosphorylated broken rice was used in low-fat sausage formulation. All low-fat sausages presented about 55% reduction in the fat content and around 28% reduction in the total caloric value. Fat replacement with phosphorylated and extruded broken rice starch increased the texture acceptability of low-fat sausages, when compared to low-fat sausages with no modified broken rice. Results suggest that modified broken rice can be used as fat substitute in sausage formulations, yielding lower caloric value products with acceptable sensory characteristics.

  5. Role of nail biopsy as a diagnostic tool

    Directory of Open Access Journals (Sweden)

    Chander Grover

    2012-01-01

    Full Text Available Nail biopsy (NB is an investigation that is not routinely resorted to by most of the dermatologists. The commonly cited reasons are the complexity of the procedure, risk of scarring and the reluctance of the patient. However, in cases with isolated nail psoriasis, isolated nail lichen planus, onychomycosis not confirmed on direct microscopy and culture, or longitudinal melanonychia, the treating dermatologist is left with no choice but to resort to this procedure. Nail as a unit, is capable of projecting only a limited number of clinical manifestations. This is responsible for the more or less similar clinical presentation of many different nail disorders. Hence, a practical knowledge of the indications, appropriate patient selection, procedural details and histopathological interpretation of a NB is a must-have for any practicing dermatologist. The risk of scarring is none to minimal if appropriate type of biopsy is performed, not to mention the wealth of histopathological data that can be retrieved from the nail unit. This article aims to explore the various practical do′s and don′ts for the NB and tells us what to expect from of the procedure.

  6. COEXISTENCE YELLOW NAIL SYNDROME WITH SYSTEMIC SYMPTOMS - PRESENTATION OF CASES

    Directory of Open Access Journals (Sweden)

    Brzeziński Piotr

    2010-10-01

    Full Text Available Nail changes can accompany many systemic diseases and very often indicate the ongoing systemic process of illness. The yellow nail syndrome (YNS is very rare clinical entity characterized by marked thickening and yellow to yellow-green discoloration of the nails. Congenitally hypoplastic lymphostasis plays a major role in the clinical manifestation of that disease. Syndrome includes pleural effusions, lymphedema and yellow dystrophic nails. The pathogenesis stays still unknown.Aim: Presentation the coexistence of YNS with the systemic symptoms by analyzing cases of 3 patients.Material and methods: The analysis involved 3 patients with YNS (2 women and 1 man aged from 43 to 48 years.Results: We confirmed 3 cases of YNS, with the characteristic nails changes (yellow-greenish discoloration, absence of lunula, etc.. None of the patients had a family history of YNS. All suffered from chronic diseases: the first patient suffered from lymphedema and diabetes mellitus, second - from rheumatoid arthritis and the third complained of a chronic caught and sinusitis. All YNS`s symptoms occurred in the patients` forties. We observed fingers and toes involvement on 7-8 nails in each patient.Conclusions: The YNS offen associated with systemic disease, most commonly lymphedema and bronchiectasis. However, the literature describes some connections with carcinoma and autoimmune diseases. Therefore, each patient with YNS should be examined for cancer detection and stay under periodic medical control.

  7. Heavy Metal Contamination of Popular Nail Polishes in Iran

    Directory of Open Access Journals (Sweden)

    Golnaz Karimi

    2015-06-01

    Full Text Available Background: Toxic and hazardous heavy metals like arsenic, lead, mercury, zinc, chromium and iron are found in a variety of personal care products, e.g. lipstick, whitening toothpaste, eyeliner and nail color. The nails absorb the pigments of nail polishes and vaporized or soluble metals can easily pass it. The goal of this survey was to assess whether the different colors of nail polishes comply with maximum concentrations of heavy metals in the EPA’s guidelines. Methods: 150 samples of different popular brands of nail polishes in 13 colors (yellow, beige, silver, pink, white, violet, brown, golden, green, black, colorless, red and blue were randomly purchased from beauty shops in Tehran City, Iran, in 2014. Microwave digestion EPA method 3051 was used by a microwave oven to determine the amount of 5 heavy metals; Nickel, Chromium, Lead, Arsenic and Cadmium. One-way ANOVA, Two-way ANOVA, hierarchical cluster, and principal component analyses were applied by Statistica 7.0 software. Results: The concentrations of chrome, lead, nickel and arsenic showed significant differences between the colors (p<0.05. In all studied samples, the level of cadmium was beyond the safe maximum permissible limit (MPS, but no significance difference in the cadmium content was identified. Conclusion: Due to the high concentrations of toxic metals in many brands of nail polishes, meticulous quality control is recommended for these beauty products.

  8. The femoral sulcus in total knee arthroplasty.

    Science.gov (United States)

    Lingaraj, Krishna; Bartlett, John

    2009-05-01

    The position of the femoral sulcus relative to the midline of the distal femoral resection in total knee arthroplasty (TKA) was studied to determine if centralized placement of the femoral component on the distal femur was justified in terms of aligning the prosthetic sulcus with the native femoral sulcus. The location of the femoral sulcus was studied in 112 consecutive patients undergoing TKA. The mean sulcus position was 0.7 mm lateral to the midline of the distal femoral resection (SD 1.4, 95% CI, 0.5-1.0 mm). However, the variation in sulcus positions ranged from 4 mm medial to 4 mm lateral to the midline. The mean sulcus position in valgus knees was 1.0 mm lateral to the midline (SD 1.8), and that in varus knees was 0.7 mm lateral to the midline (SD 1.2) (P = 0.501). It appears prudent to centre the femoral component on the native sulcus rather than the midline of the distal femoral resection, so as to ensure accurate alignment of the prosthetic sulcus with the native sulcus and to encourage normal patella tracking.

  9. Effect of dynamic hip system blade on the treatment of femoral neck fractures in elderly patients with osteoporosis

    Institute of Scientific and Technical Information of China (English)

    Zhao Wenbo; Liu Lei

    2014-01-01

    Objective:To discuss the curative effect of the dynamic hip system blade (DHS-blade) on the treatment of femoral neck fractures in elderly patients with osteoporosis.Methods:A retrospective study was conducted to analyse the clinical data of 60 elderly patients with osteoporosis who had been treated for femoral neck fractures with DHS-blade in our department between September 2012 and February 2014.There were 22 males and 38 females with a mean age of (66.8±3.2) years.According to the Singh Index Classification,all the patients' Singh index was below level 3.The Harris criterion and function recovery after operation were analysed.Results:All patients were followed up for 12-17 months (mean 14 months).No femoral head necrosis,femoral neck shortening,internal fixation loosening or backing out of the nails occurred.Bone nonunion was found in one case and he had a good recovery after total hip arthroplasty.The time for fracture healing ranged from 3-6 months (average 3.5 months).According to Harris criterion,35 cases were rated as excellent,22 good,2 fair and 1 poor.The Harris scale was significantly improved from 28.46±2.35 preoperatively to 91.98±3.26 at 6 months postoperatively (P<0.05).Conclusion:DHS-blade,being minimally invasive,allowing earlier postoperative exercise and avoiding the complications elicited by traditional internal fixation,is advisable for treatment of femoral neck fractured patients with osteoporosis.

  10. Subchondral insufficiency fractures of the femoral head

    International Nuclear Information System (INIS)

    The aim of this study was to increase awareness of, and to show the variable clinical and radiological features of, subchondral insufficiency fractures of the femoral head. The clinical and radiological findings in 7 patients with subchondral insufficiency fractures of the femoral head were reviewed retrospectively. The diagnosis was confirmed histologically in 4 patients. Radiographs were performed in all patients, MRI in 5 and scintigraphy in 4 patients. Radiographs showed varying degrees of femoral head collapse in 4 patients. In the remaining 3 patients radiographs showed a normal femoral head, regional osteoporosis and focal sclerosis, respectively. Magnetic resonance imaging showed a low-signal band on T1- and T2-weighted images in the subchondral bone adjacent or parallel to the articular surface associated with bone marrow oedema. Scintigraphy showed increased uptake in the femoral head. Insufficiency fractures of the femoral head are easily overlooked or confused with avascular necrosis and, when there is significant joint destruction, osteoarthritis. Unsuspected insufficiency fracture of the femoral head can lead to significant and rapid loss of bone stock in osteoporotic patients waiting for arthroplasty for osteoarthritis. Increased awareness of this condition will hopefully lead to earlier diagnosis and a successful outcome of conservative treatment. (orig.)

  11. Tension free femoral hernia repair with plug

    Institute of Scientific and Technical Information of China (English)

    Milivoje Vukovi; Neboja Moljevi; Sinia Crnogorac

    2013-01-01

    Objective: To investigate the conventional technique involves treatment of femoral hernia an approximation inguinal ligament to pectineal ligament. In technique which uses mesh closure for femoral canal without tissue tension. Method: A prospective study from January 01. 2007-May 30. 2009. We analyzed 1 042 patients with inguinal hernia, of which there were 83 patients with 86 femoral hernia. Result: Femoral hernias were present in 7.96% of cases. Males were 13 (15.66%) and 70 women (84.34%). The gender distribution of men: women is 1:5.38. Urgent underwent 69 (83%), and the 14 election (17%) patients. Average age was 63 years, the youngest patient was a 24 and the oldest 86 years. Ratio of right: left hernias was 3.4:1. With bilateral femoral hernias was 3.61% of cases. In 7 patients (8.43%) underwent femoral hernia repair with 9 Prolene plug. Conclusions: The technique of closing the femoral canal with plug a simple. The plug is made from monofilament material and is easily formed. This technique allows the reduction of recurrence and can be used safely, quickly and easily in elective and emergency situations.

  12. Lateral femoral cutaneous neuralgia: an anatomical insight.

    Science.gov (United States)

    Dias Filho, L C; Valença, M M; Guimarães Filho, F A V; Medeiros, R C; Silva, R A M; Morais, M G V; Valente, F P; França, S M L

    2003-07-01

    A detailed anatomic study was carried out on the lateral femoral cutaneous nerve to better understand the etiology and treatment of lateral femoral cutaneous neuralgia. As it passed from the pelvis into the thigh, the lateral femoral cutaneous nerve ran through an "aponeuroticofascial tunnel," beginning at the iliopubic tract and ending at the inguinal ligament; as it passed through the tunnel, an enlargement in its side-to-side diameter was observed, suggesting that the fascial structures proximal to the inguinal ligament may be implicated in the genesis of lateral femoral cutaneous neuralgia. The finding of pseudoneuromas at this location, distant from the inguinal ligament, supports this hypothesis. The anterior superior iliac spine is located approximately 0.7 cm from the lateral femoral cutaneous nerve and serves as the bony landmark for nerve localization. Within the first 3 cm of leaving the pelvis, the lateral femoral cutaneous nerve was observed deep to the fascia lata; therefore, surgical dissection within the subcutaneous fascia may be conducted with relative impunity near the anterior superior iliac spine just inferior to the inguinal ligament. In 36% of cases there was no posterior branch of the nerve, which is correlated to lateral femoral cutaneous neuralgia symptoms often being limited to the anterior branch region. An accessory nerve was found in 30% of cases. PMID:12794914

  13. Variations of femoral condyle shape.

    Science.gov (United States)

    Biscević, Mirza; Hebibović, Mujo; Smrke, Dragica

    2005-12-01

    The aim of this study is to mathematically approximate the shape of the femoral articulating line and compare radiuses of condylar curves within and between males and females. Ten male and ten female participants were included in the study. Radiuses of medial and lateral condylar curves were calculated from the side view knee X-ray by original mathematical equation. Average radiuses of condylar curves were between 4.5 and 1.7 cm medially, and between 3.2 and 1.8 cm laterally, for 0 degrees and 90 degrees flexion contact point respectively. Males had longer curve radiuses of both condyles (p knee geometry, and other ellipsoidal structures in human body, like wrist, scull segments, dental arches, etc.

  14. Gluons as Goldstone Bosons when Flavor Symmetry is Broken Spontaneously

    CERN Document Server

    Törnqvist, N A

    1997-01-01

    The mechanism where flavor symmetry is broken spontaneously is discussed within a scalar QCD model with effective three-meson couplings. For sufficiently large coupling the model is unstable with respect to quantum loops from mesonic vacuum polarization. It is argued that color and gluons naturally can account for the Goldstone degrees of freedom expected when flavor symmetry is spontaneously broken.

  15. Planck driven by vision, broken by war

    CERN Document Server

    Brown, Brandon R

    2015-01-01

    Planck's Law, an equation used by physicists to determine the radiation leaking from any object in the universe, was described by Albert Einstein as "the basis of all twentieth-century physics." Max Planck is credited with being the father of quantum theory, and his work laid the foundation for our modern understanding of matter and energetic processes. But Planck's story is not well known, especially in the United States. A German physicist working during the first half of the twentieth century, his library, personal journals, notebooks, and letters were all destroyed with his home in World War II. What remains, other than his contributions to science, are handwritten letters in German shorthand, and tributes from other scientists of the time, including his close friend Albert Einstein. In Planck: Driven by Vision, Broken by War, Brandon R. Brown interweaves the voices and writings of Planck, his family, and his contemporaries-with many passages appearing in English for the first time-to create a portrait of...

  16. A Cosmological Mass Function with Broken Hierarchy

    CERN Document Server

    Lee, J

    2006-01-01

    We construct an analytic formalism for the mass function of cold dark matter halos, assuming that there is a break in the hierarchical merging process. According to this {\\it broken-hierarchy} scenario, due to the inherent nature of the gravitational tidal field the formation of massive pancakes precedes that of dark halos of low-mass. In the framework of the Zel'dovich approximation which generically predicts the presence of pancakes, we first derive analytically the conditional probability that a low-mass halo observed at present epoch was embedded in an isolated pancake at some earlier epoch. Then, we follow the standard Press-Schechter approach to count analytically the number density of low-mass halos that formed through anti-hierarchical fragmentation of the massive pancakes. Our mass function is well approximated by a power-law dN/dM = M^{-l} in the mass range 10^{6}M_{sun}/h < M < 10^{10}M_{sun}/h with the slope l=1.86 shallower than that of the currently popular Sheth-Tormen mass function l = 2...

  17. Embracing fixator for treating periprosthetic femoral fractures

    Institute of Scientific and Technical Information of China (English)

    张先龙; 章玮; 眭述平; 将垚; 曾炳芳

    2001-01-01

    @@Femoral fractures in the presence of other intramedullary implants are uncommon. These fractures are difficult to manage and the presence of other intramedullary implants creates a complex problem. The rate of these fractures has increased due to an increase in the number of patients having total hip arthroplasty (THA) and the use of various new techniques for femoral fractures.1-5 Literature on the treatment of femoral fractures with other intramedullary implants is rare.2,3 From 1995 to 1998, we reduced these fractures openly and fixed them with a shape memory alloy sawtooth-arm embracing fixator (EF), and the outcomes were satisfactory.

  18. Preoperative determination of tibial nail length: An anthropometric study

    Institute of Scientific and Technical Information of China (English)

    Renjit Thomas Issac; Hitesh Gopalan; Mathew Abraham; Cherian John; Sujith Mathew Issac; Diju Jacob

    2016-01-01

    Objective:To assess the correlation between five anthropometric parameters and the distance from tibial tuberosity to medial malleolus in 100 volunteers.Methods:Six anthropometric parameters were measured in 50 male and 50 female medical students using a metallic scale:medial knee joint line to ankle joint line (K-A),medial knee joint line to medial malleolus (K-MM),tibial tuberosity to ankle joint (TT-A),tibial tuberosity to medial malleolus (TT-MM),olecranon to 5th metacarpal head (O-MH) and body height (BH).Nail size predicted based upon TT-MM measurement was chosen as ideal nail size.A constant was derived for each of the six anthropometric parameters which was either added or subtracted to each measurement to derive nail size.A regression equation was applied to BH measurements.Nail sizes calculated were compared with that obtained from TT-MM measurement and accuracy was evaluated.Accuracy of O-MH and BH regression equations recommended by other authors were calculated in our data.Results:Adding 11 mm to TT-A distance had highest accuracy (81%) and correlation (0.966) in predicting nails correctly.Subtracting 33 mm from K-MM measurement and 25 mm from K-A distance derived accurate sizes in 69% and 76% respectively.Adding 6 mm to O-MH distance had a poor accuracy of 51%.Nail size prediction based upon body height regression equation derived correct nail sizes in only 34% of the cases.Regression equation analysis by other authors based on O-MH and BH distances yielded correct sizes in 11% and 5% of the cases respectively.Conclusion:TT-A,K-A and K-MM measurements can be used simultaneously to increase accuracy of nail size prediction.This method would be helpful in determining nail size preoperatively especially when one anatomic landmark is difficult to palpate.

  19. Could percutaneous femoral head arthroplasty using calcium phosphate cement be a novel therapeutic method for late-stage Legg-Calvé-Perthes disease?

    Directory of Open Access Journals (Sweden)

    Jun Wan

    2009-05-01

    Full Text Available "nLegg-Calvé-Perthes disease (LCPD belongs to the category of aseptic osteochondroses of childhood which is characterized by idiopathic avascular osteonecrosis of the femoral head which can cause severe deformity of hip joint such as coxa plana and ‘flattening femoral head'. As the harmonious structural relation of hip joint was broken, osteoarthritis of hip joint could be always observed in patients about 50 years old which finally needs to be treated with total hip replacement. In present most methods yield markedly to achieve good clinical results when dealing with late-stage of LCPD mainly because of inability of reconstruction of spherical shape of femoral head. So the direct urgent thing should be to find one way out to completely reconstruct the spherical shape of femoral head. By the enlightenment of percutaneous vertebroplasty (PKP and biological properties of calcium phosphate cement (CPC, we hypothesize that percutaneous femoral head arthroplasty using CPC can solve the problem of reconstruction of spherical framework of femoral head in late-stage LCPD and pave a brand-new way to achieve excellent clinical results in patients of late-stage LCPD.  

  20. Systematic investigation of different formulations for drug delivery through the human nail plate "in vitro"

    OpenAIRE

    Vejnoviċ, Ivana

    2010-01-01

    Human nails do not have only protective and decorative role, but can also be considered as an alternative pathway for drug delivery, especially in nail diseases such as onychomycosis or psoriasis. These nail diseases are widely spread in the population, particularly among elderly and immunocompromised patients. Oral therapies are accompanied by systemic side effects and drug interactions, while topical therapies are limited by the low permeation rate through the nail plate. For the successful...

  1. Diffusion of uncharged solutes through human nail plate.

    Science.gov (United States)

    Baswan, Sudhir M; Li, S Kevin; Kasting, Gerald B

    2016-01-01

    Passive diffusion data for uncharged solutes in hydrated human nail plate are collected and compared to the predictions of two theories for diffusion of uncharged solutes in dense keratin matrices. Quantitative agreement between the experimental data and the theories examined is poor. Concerns with both the experiments and the theories are identified and discussed. It is evident from the analysis that magnitude of the experimental nail permeability data may be questioned, as may the extrapolation procedures used to estimate the properties of dense fiber arrays from more dilute systems. Despite these caveats, it can be inferred that the microstructure of the nail plate is more complex than that assumed in the described models. The influence of residual lipids is implicated. More rigorous experiments and theoretical analysis of mass transport in the nail plate system are warranted. Successful completion of these tasks could lead not only to better predictions of transungual drug delivery, but also to better models of skin permeability, if hydrated nail plate can indeed serve as a model for the corneocyte phase of (partially hydrated) stratum corneum. PMID:25518727

  2. Diffusion of uncharged solutes through human nail plate.

    Science.gov (United States)

    Baswan, Sudhir M; Li, S Kevin; Kasting, Gerald B

    2016-01-01

    Passive diffusion data for uncharged solutes in hydrated human nail plate are collected and compared to the predictions of two theories for diffusion of uncharged solutes in dense keratin matrices. Quantitative agreement between the experimental data and the theories examined is poor. Concerns with both the experiments and the theories are identified and discussed. It is evident from the analysis that magnitude of the experimental nail permeability data may be questioned, as may the extrapolation procedures used to estimate the properties of dense fiber arrays from more dilute systems. Despite these caveats, it can be inferred that the microstructure of the nail plate is more complex than that assumed in the described models. The influence of residual lipids is implicated. More rigorous experiments and theoretical analysis of mass transport in the nail plate system are warranted. Successful completion of these tasks could lead not only to better predictions of transungual drug delivery, but also to better models of skin permeability, if hydrated nail plate can indeed serve as a model for the corneocyte phase of (partially hydrated) stratum corneum.

  3. Elastoplasticity analysis of the nails used in long bone fractures

    International Nuclear Information System (INIS)

    Elastoplastic endomedullary nail-insertion system in long bone fractures is a method which allows generating forces, moments, frictions and stress states in parts of the bone previously selected. Adding previous knowledge on the distribution of forces and acting moments over the bone fragments to be threaded, as well as on the elastoplastic and mechanical properties of the nails to be inserted (designing a special, specific structure for each case), the results, coming from 26 years of applying this technique, have been promising. It is from this perspective that we call this threading and anchoring procedure 'Selective Tension System' (STS). Physicochemical analyses and mechanical trials on elastoplastic nails used in the osteosynthesis in long bone fractures are presented. The magnitude of the forces produced by flattening the nails and the reacting forces at both ends are measured. It is expected that the evidence provided on the elastic variability of these nails will be useful as guidance on the availability and choice of the elastoplastic combinations that best fit each patient.

  4. Intramedullary nailing of the proximal humerus: evolution, technique, and results.

    Science.gov (United States)

    Dilisio, Matthew F; Nowinski, Robert J; Hatzidakis, Armodios M; Fehringer, Edward V

    2016-05-01

    Proximal humerus fractures are the third most common fracture in the elderly. Although most fractures can be treated conservatively with acceptable outcomes, certain fracture patterns are at high risk for progression to humeral malunions, nonunions, stiffness, and post-traumatic arthrosis. The goal of antegrade humeral nailing of proximal humerus fractures is to provide stability to a reduced fracture that allows early motion to optimize patient outcomes. Certain technical pearls are pivotal in managing these difficult fractures with nails; these include rotator cuff management, respect of the soft tissues, anatomic tuberosity position, blood supply maintenance, knowledge of the deforming forces on the proximal humerus, fracture reduction, and rehabilitation strategies. Modern proximal humeral nail designs and techniques assist the surgeon in adhering to these principles and have demonstrated promising outcomes. Humeral nail designs have undergone significant innovation during the past 40 years and now can provide stable fixation in the humeral shaft distally as well as improved stability in the head and tuberosity fragments, which were the common site of fixation failure with earlier generation implants. Compared with other fixation strategies, such as locking plate fixation, no compelling evidence exists to suggest one technique over another. The purpose of this review is to describe the history, results, new designs, and techniques that make modern intramedullary nailing of proximal humerus fractures a viable treatment option. PMID:26895601

  5. The treatment of femoral bone loss by axial external fixation and susbequent locking plate application: a case report.

    Science.gov (United States)

    Boero, Emanuele; Mogollo, Maria del Amparo Paredes

    2015-12-01

    A 20-year-old man was admitted to our hospital having sustianed bilateral high-energy femoral fractures. The right femoral fracture was an open grade 3B with OTA grade 3 bone loss. The patient had also a brain contusion with a subdural haematoma and a closed fracture of the left clavicle. Initial management included temporarily stabilisation of the femoral fractures wth external fixators and prompt transfer to the intensive care unit. Three weeks later the external fixator of the right femur was converted to an hybrid system, and the fixator of the left side was removed and a reamed intramedullary locking nail was applied. Two months after the accident the patient underwent bone transport (11 cm long) of the right femur with an monolateral external fixation. When the final length was achieved there were knee stiffness (ROM 0° to 30°) and non-union of the docking site. Therefore, the patient underwent a Judet's procedure to treat the knee stiffness and stabilisation of the non united femur with a locking plate (LISS). After the operation the patient started progressive weight bearing. A year after trauma and following union of the femur, the patient underwent soft tissue reconstruction of the anterior side of the thigh with a free vascularised flap. At final follow upo the patient had a good functional recovery with return to his previous occupation. PMID:26738458

  6. A PROSPECTIVE STUDY ON THE OUTCOMES FOLLOWING LCP CONDYLAR PLATE FIXATION IN AO TYPE C DISTAL FEMORAL FRACTURES

    Directory of Open Access Journals (Sweden)

    Vikas

    2015-11-01

    Full Text Available : Fractures of the distal third of the femur especially AO type C are a treatment challenge despite new fixation options. Fixed angle locking plates have become the most commonly used device for this indication replacing intramedullary nails, blade plates and condylar screws. In this study we analyze the functional outcome of open reduction and rigid internal fixation using LCP condylar plate in AO type C distal femoral fractures. METHODOLOGY: We studied the results of LCP Condylar plate fixation in 30 patients with AO type C distal femoral fractures over a period of 22 months at our institution. Functional outcome is measured with Neer`s criteria. RESULTS: Out of 30 patients, 11 patients (36.7% achieved excellent and 11 patients (36.7% achieved satisfactory outcome. 3 patients (10% achieved unsatisfactory and 5 patients (16.6% achieved poor outcome. We found that, open fractures, articular comminution, infection, lack of rigid internal fixation and malalignment are the major culprits for a poor functional outcome. CONCLUSION: The LCP condylar plate is an acceptable surgical option for treatment of AO type C distal femoral fractures by achieving early mobility due to primary stability of the construct

  7. A SURVEY OF NAIL INFECTION AND AWARENESS AMONG NON-DIABETIC PATIENTS IN MAURITIUS

    Directory of Open Access Journals (Sweden)

    Jeewon Rajesh

    2013-07-01

    Full Text Available Introduction: Nail infection like onychomycosis is mainly caused by dermatophytes and account for almost half of all nail disorders. Prevalence of nail infection has been attributed to several factors such as age, gender, socioeconomic status and predisposition to diabetes amongst others. This study aims at determining the prevalence and level of awareness of non-diabetics towards nail infections in Mauritius.Material and Methods: A survey was carried out among 471 participants of the non-diabetic population of Mauritius. Data on socio demographic factors, awareness, level of hygiene, family history and quality of life were obtained via questionnaire based studies. Data was analysed using the SPSS software.Results: Results show almost the same ratio of female to male was affected with nail infection but varies gender wise. Participants within the age group 20-60 with less than US 500 monthly income had a higher incidence of nail infection. No significant relation was obtained between nail infection and education level. A significant relationship was obtained between nail infection and occupation as well as quality of life. More than half of participants did not know about the routes of nail infections or the precautions needed to avoid spreading. However, good level of hygiene was observed among the participants.Conclusion: Factors like age, gender and socio economic status had a significant relationship on nail infection. Nail infection affects the Quality of Life (QoL and manual workers or even professionals are prone to nail infections.

  8. Preoperative estimation of tibial nail length--because size does matter.

    LENUS (Irish Health Repository)

    Galbraith, J G

    2012-11-01

    Selecting the correct tibial nail length is essential for satisfactory outcomes. Nails that are inserted and are found to be of inappropriate length should be removed. Accurate preoperative nail estimation has the potential to reduce intra-operative errors, operative time and radiation exposure.

  9. Femoral anteversion measured by ultrasonography and radiography

    International Nuclear Information System (INIS)

    Radiographic and real-time ultrasound measurements of femoral anteversion were compared in an anatomic study of 20 dried adult femurs. The real anteversion (AV) angle was determined by biplanar radiography. In four ultrasound measurements, the linear transducer was kept either horizontal or tilted. The measuring lines were either the anterior tangent of the femoral head-greater trochanter or the anterior tangent of the femoral neck. With the tilted transducer, the correlation between the head-trochanter AV angle and the real AV angle was high (r=0.9452), and slightly less when the anterior neck AV angle was used (r=0.9142). The clinical relevance is that the tilted transducer technique with the head-trochanter tangent is recommended for AV screening in patients with clinical signs of increased femoral anteversion. In adults 8.50 has to be subtracted in order to obtain an approximation of the real AV angle. (orig.)

  10. Internal derangement of the knee after ipsilateral femoral shaft fracture: MR imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Blacksin, M.F.; Zurlo, J.V. [Department of Radiology, University of Medicine and Dentistry of New Jersey, Newark, NJ (United States); Levy, A.S. [Department of Orthopedic Surgery, University of Medicine and Dentistry of New Jersey, University Hospital, Newark, NJ 07103-2426 (United States)

    1998-08-01

    Objective. This study uses magnetic resonance (MR) imaging to delineate the types and frequencies of injuries seen in the knee after ipsilateral femoral shaft fracture. We also compare the results of the orthopedic knee examination with the MR findings. Design and patients. MR imaging of the ipsilateral knee was performed on 34 patients with closed femoral shaft fractures. Indications for knee MR imaging included knee pain at the time of fracture, soft tissue swelling or an effusion of the knee, or a positive knee examination under anesthesia. The patients had a mean age of 27 years and all were stabilized with intramedullary nails. Imaging was performed a mean time of 2.5 days after surgery. All patients had knee examinations done under anesthesia, and the MR results were compiled and compared with the clinical examinations. Results. Ninety-seven percent of patients demonstrated knee effusions. Twenty-seven percent of patients demonstrated meniscal tears, with the posterior horn of the medial meniscus most frequently torn. The medial collateral ligament was the most frequent site of ligamentous injury (38%) followed by the posterior cruciate ligament (21%). Fifty percent of patients had injuries of the extensor mechanism. Bone bruises were noted in 32% of patients. Articular cartilage injuries were confined to the patella in four cases. One occult tibial plateau fracture and one meniscocapsular separation were seen. Conclusions. There is a common incidence of both ligamentous and meniscal injury to the knee after ipsilateral femoral shaft fracture. MR imaging can be useful in assessing the extent of injury, and may reveal findings unsuspected after clinical examination of the knee. (orig.) With 4 figs., 2 tabs., 13 refs.

  11. Internal derangement of the knee after ipsilateral femoral shaft fracture: MR imaging findings

    International Nuclear Information System (INIS)

    Objective. This study uses magnetic resonance (MR) imaging to delineate the types and frequencies of injuries seen in the knee after ipsilateral femoral shaft fracture. We also compare the results of the orthopedic knee examination with the MR findings. Design and patients. MR imaging of the ipsilateral knee was performed on 34 patients with closed femoral shaft fractures. Indications for knee MR imaging included knee pain at the time of fracture, soft tissue swelling or an effusion of the knee, or a positive knee examination under anesthesia. The patients had a mean age of 27 years and all were stabilized with intramedullary nails. Imaging was performed a mean time of 2.5 days after surgery. All patients had knee examinations done under anesthesia, and the MR results were compiled and compared with the clinical examinations. Results. Ninety-seven percent of patients demonstrated knee effusions. Twenty-seven percent of patients demonstrated meniscal tears, with the posterior horn of the medial meniscus most frequently torn. The medial collateral ligament was the most frequent site of ligamentous injury (38%) followed by the posterior cruciate ligament (21%). Fifty percent of patients had injuries of the extensor mechanism. Bone bruises were noted in 32% of patients. Articular cartilage injuries were confined to the patella in four cases. One occult tibial plateau fracture and one meniscocapsular separation were seen. Conclusions. There is a common incidence of both ligamentous and meniscal injury to the knee after ipsilateral femoral shaft fracture. MR imaging can be useful in assessing the extent of injury, and may reveal findings unsuspected after clinical examination of the knee. (orig.)

  12. Airborne contact dermatitis and asthma in a nail art operator

    Directory of Open Access Journals (Sweden)

    Mario Vaccaro

    2014-02-01

    Full Text Available Nail art (creation and decoration of artificial nails is a growing fashion trend. Proportionally to its popularity, the number of allergic reactions to the materials used has recently increased. We report the case of a nail art operator who developed occupational allergy to acrylates, manifested with the unusual simultaneous presence of asthma and dermatitis. Cutaneous lesions only affected areas not covered by individual protection devices or clothes, even if such areas were not in direct contact with acrylates, suggesting airborne allergic contact dermatitis. While respiratory problems were solved with the correct use of a mask at the workplace, facial dermatitis proved impossible to avoid or control and, for this reason, the patient had to change her work.

  13. Solitary eccrine syringofibroadenoma with nail involvement: A rare entity

    Directory of Open Access Journals (Sweden)

    Pooja Arora

    2015-01-01

    Full Text Available Eccrine syringofibroadenoma (ESFA is a rare, benign tumor of eccrine sweat gland origin that usually presents as a nodule on the extremities of an elderly person. It can also present as an ulcerative plaque, verrucous lesion, papular or nodular lesion or as palmoplantar keratoderma. Although the clinical features are variable, histology is characteristic in the form of anastomosing strands, cords and columns of epithelial cells embedded in a fibrovascular stroma. We report the case of a 62-year-old male with a nodular lesion on the extremity that caused secondary involvement of the nail in the form of complete nail dystrophy. The histology showed features consistent with ESFA. Nail involvement by ESFA is a rare presentation and is rarely described in the literature.

  14. Nail Assessment in Psoriasis and Psoriatic Arthritis (NAPPA)

    DEFF Research Database (Denmark)

    Augustin, M; Blome, C; Costanzo, A;

    2013-01-01

    BACKGROUND: Existing tools for nail psoriasis are complex and may not adequately measure outcomes that are important to patients. OBJECTIVES: We have developed and validated a new tool, the Nail Assessment in Psoriasis and Psoriatic Arthritis (NAPPA), with three components: a questionnaire...... assessing quality of life (NAPPA-QoL), a two-part questionnaire assessing patient-relevant treatment benefits (the Patient Benefit Index, NAPPA-PBI) and a psoriasis Clinical Assessment of Severity (NAPPA-CLIN). METHODS: Development of the questionnaires involved multiple steps: (i) collection of items about...... nail psoriasis-related impairments and treatment goals; (ii) selection of 48 items by an expert panel, including patients; (iii) translation into eight languages; (iv) feasibility testing and (v) longitudinal validation in six countries. RESULTS: Patients found the questionnaires clear (84...

  15. Primary unreamed intramedullary locked nailing in open fractures of tibia

    Directory of Open Access Journals (Sweden)

    Jain Vineet

    2005-01-01

    Full Text Available Background: Fractures of tibia are among the commonest fractures sustained in road traffic accidents. They are frequently open and contaminated. Unreamed nails are considered superior to external fixator in the management of open fractures of tibia. Method: Forty patients with open fractures of tibia, grade I, II, IIIa, IIIb were included in the study. They were managed by primary unreamed intramedullary nailing with adequate soft tissue management. Results: Functional results were excellent in 26 cases, good in 10 cases and fair in 4 cases. Four cases had delayed union. Average time of union was 16.9 weeks. Conclusion: Primary unreamed intramedullary nailing offers advantage of rigid fixation, low incidence of infection, non-union, good functional results and early return to work. An adequate soft tissue management is mandatory in treatment of these fractures.

  16. Distal Humeral Fixation of an Intramedullary Nail Periprosthetic Fracture

    Directory of Open Access Journals (Sweden)

    Hiren M. Divecha

    2013-01-01

    Full Text Available Distal humeral periprosthetic fractures below intramedullary nail devices are complex and challenging to treat, in particular due to the osteopenic/porotic nature of bone found in these patients. Fixation is often difficult to satisfactorily achieve around the intramedullary device, whilst minimising soft tissue disruption. Descriptions of such cases in the current literature are very rare. We present the case of a midshaft humeral fracture treated with a locking compression plate that developed a nonunion, in a 60-year old female. This went on to successful union after exchange for an intramedullary humeral nail. Unfortunately, the patient developed a distal 1/5th humeral periprosthetic fracture, which was then successfully addressed with a single-contoured, extra-articular, distal humeral locking compression plate (Synthes with unicortical locking screws and cerclage cables proximally around the distal nail tip region. An excellent postoperative range of motion was achieved.

  17. Limited Quadricepsplasty for Contracture during Femoral Lengthening

    OpenAIRE

    Khakharia, Saurabh; Fragomen, Austin T.; Rozbruch, S. Robert

    2009-01-01

    Extension contracture of the knee is a common complication of femoral lengthening. Knee flexion exercises to stretch the contracture with physical therapy can be effective but take a prolonged amount of time to work and place increased stress across the patellofemoral joint. We developed a minimal-incision limited quadricepsplasty surgical technique to treat knee extension contracture secondary to femoral lengthening and retrospectively reviewed 16 patients treated with this procedure. The me...

  18. Laparoscopic repair of an incarcerated femoral hernia

    OpenAIRE

    Yagan Pillay

    2015-01-01

    Introduction: A femoral hernia is a rare, acquired condition, which has been reported in less than 5% of all abdominal wall hernias, with a female to male ratio of 4:1. Presentation of case: We report a case in a female patient who had a previous open inguinal herniorrhaphy three years previously. She presented with right sided groin pain of one month duration. Ultrasound gave a differential diagnosis of a recurrent inguinal hernia or a femoral hernia. A transabdominal preperitoneal repair...

  19. Mini-mesh repair for femoral hernia

    OpenAIRE

    Hakan Kulacoglu

    2014-01-01

    INTRODUCTION: Femoral hernia consists only 4% of all primary groin hernias. It is described as “the Bête Noire of Hernias” because of its nature and anatomy which is difficult to understand for the surgeons and tendency to recurrence. Although there is some large series of femoral hernia in the literature, few studies prospectively comparing repair techniques especially for this type of hernia has been published. A new technique named mini-mesh repair is described here. PRESENTATION OF CAS...

  20. Hygroma following endovascular femoral aneurysm exclusion

    DEFF Research Database (Denmark)

    Wad, Morten; Pedersen, Brian Lindegaard; Lönn, Lars;

    2013-01-01

    Endovascular treatment of aneurysms in the superficial femoral artery (SFA) and popliteal segments is a suggested alternative to open surgical repair. Careful selection of patients for endovascular treatment of SFA aneurysms is mandatory.......Endovascular treatment of aneurysms in the superficial femoral artery (SFA) and popliteal segments is a suggested alternative to open surgical repair. Careful selection of patients for endovascular treatment of SFA aneurysms is mandatory....

  1. Clinical experience of ioxaglate in femoral angiography

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, S.; Mine, H.; Iwai, T. (Tokyo Medical and Dental Univ. (Japan). School of Medicine)

    1982-01-01

    Painless femoral angiography could be performed in patients under slight analgesic premedication by using ioxaglate (320 mg I/ml). Slower flow of ioxaglate resulted in longer segments of the arteries being filled by the contrast column than by using iothalamate, which was confirmed by serial whole-limb angiography. The dynamic characteristics of ioxaglate, in addition to marked reduction of pain, fulfilled the requirements for its use as a contrast medium in femoral or peripheral angiography.

  2. Femoral Bone Plug in Total Knee Replacement.

    Science.gov (United States)

    Vulcano, Ettore; Regazzola, Gianmarco M V; Murena, Luigi; Ronga, Mario; Cherubino, Paolo; Surace, Michele F

    2015-10-01

    The intramedullary alignment guides used in total knee replacement disrupt the intramedullary vessels, resulting in greater postoperative blood loss. The use of an autologous bone plug to seal the intramedullary femoral canal has been shown to be effective in reducing postoperative bleeding. The authors present a simple technique to create a bone plug from the anterior chamfer femoral cut to perfectly seal the intramedullary canal of the femur. PMID:26488774

  3. A novel intramedullary nail for micromotion stimulation of tibial fractures.

    LENUS (Irish Health Repository)

    Dailey, Hannah L

    2011-09-20

    BACKGROUND: Animal studies and clinical trials have suggested that early application of controlled axial micromotion can accelerate healing of long bone fractures compared to rigid fixation. However, experimental investigations of micromotion constructs have been limited to external fixators, which have a higher incidence of complications than intramedullary nails. The purpose of this study was to assess whether a novel intramedullary nail design can generate stimulatory micromotion under minimal weight-bearing loads typical of the early healing period. METHODS: Eight cadaver tibiae were reamed, osteotomised, and implanted with commercially-available IM nails fitted with a custom insert that allowed 1mm of axial micromotion after proximal\\/distal interlocking. Specimens were mounted in a materials testing machine and subjected to cyclic axial loading while interfragmentary motion was measured using an extensometer. Implants were also tested in standard statically-locked mode. FINDINGS: The average force required to cause distraction of the fracture gap in micromotion mode was 37.0 (SD 21.7) N. The mean construct stiffness was 1046.8 (SD 193.6) N\\/mm in static locking mode and 512.4 (SD 99.6) N\\/mm in micromotion mode (significantly different, P<0.001). INTERPRETATION: These results support the development of a micromotion-enabled IM nail because the forces required to cause interfragmentary movements are very low, less than the weight of the hanging shank and foot. In contrast to rigid-fixation nails, which require significant weight-bearing to induce interfragmentary motion, the micromotion-enabled nail may allow movement in non-weight-bearing patients during the early healing period when the benefits of mechanical stimulation are most critical.

  4. ELASTIC INTRAMEDULLARY NAILING IN PAEDIATRIC DIAPHYSEAL FOREARM FRACTURES

    Directory of Open Access Journals (Sweden)

    Amit Kumar

    2016-03-01

    Full Text Available BACKGROUND The majority of paediatric diaphyseal fractures of the radius and ulna can be treated well with closed reduction and cast immobilization. The most common indications for surgery are failure of closed reduction, open fractures and fracture instability. Over recent years the forearm fractures are increasingly being treated with intramedullary elastic nails to prevent displacement during the healing phase. OBJECTIVE Recently, there has been an increased interest in determining which method provides superior results, but the optimal treatment remains controversial. This article analyses the results of 22 diaphyseal forearm fractures in children who underwent flexible intramedullary nail fixation. MATERIAL AND METHODS A prospective study was conducted from January 2012 to December 2015, on the patients with both-bone forearm fractures. Inclusion criteria of study were age between 5 and 15 years, closed displaced fractures, unacceptable closed reduction and open displaced fractures (Type 1 and 2. A single nail was used for each forearm bone. RESULTS The results of the 22 patients (16 males and 6 females who were treated in our institution with closed elastic nails were studied systematically with a follow-up period from 4 months to 15 months. At follow-up clinics, all patients went on to osseous union and regained a full range of movement after rehabilitation. There were no cases of delayed union, non-union or mal-union. All implants were routinely removed within average time of 8 months (Range: 6-10 after nailing. There were no complications after implant removal in our patients. CONCLUSION Conservative management is still the first line of treatment for paediatric forearm fractures, especially in children less than 10 years old. Treatment with an elastic intramedullary nail is indicated for unstable, irreducible or open fractures when non-operative management fails.

  5. Bilateral femoral neck fractures following pelvic irradiation

    International Nuclear Information System (INIS)

    Over 300 cases of femoral neck fractures following radiotherapy for intrapelvic malignant tumor have been reported in various countries since Baensch reported this disease in 1927. In Japan, 40 cases or so have been reported, and cases of bilateral femoral neck fractures have not reached to ten cases. The authors experienced a case of 75 year-old female who received radiotherapy for cancer of the uterus, and suffered from right femoral neck fracture 3 months after and left femoral neck fracture one year and half after. As clinical symptoms, she had not previous history of trauma in bilateral femurs, but she complained of a pain in a hip joint and of gait disturbance. The pain in left femoral neck continued for about one month before fracture was recognized with roentgenogram. As histopathological findings, increase of fat marrow, decrease of bone trabeculae, and its marked degeneration were recognized. Proliferation of some blood vessels was found out, but thickness of the internal membrane and thrombogenesis were not recognized. Treatment should be performed according to degree of displacement of fractures. In this case, artificial joint replacement surgery was performed to the side of fracture of this time, because this case was bilateral femoral neck fractures and the patient had received artificial head replacement surgery in the other side of fracture formerly. (Tsunoda, M.)

  6. MANAGEMENT OF DISEASES OF LONG BONES WITH KUNTSCHER NAILS

    Directory of Open Access Journals (Sweden)

    Ravikant

    2015-07-01

    Full Text Available BACKGROUND: AIMS: SETTINGS AND DESIGN : The aim of this study was, to devise economical, easy, simple, quick method of fixation of diseased long bones, so that pathological fracture could be prevented and to provide rigid fixation, in those cases which have already developed pathological fractu re, and to achieve arthrodesis. Ten, cases of long bone diseases were managed with the help of K nails, in the Department of Orthopaedics, in CIMS, between, December 2002 to January 2005, and cases were followed for about ten years for recurrence, relapse and complications or deterioration of the underlying disease process. METHODS AND MATERIAL : K nailing was done by standard procedure of nailing, applying A O Principles of internal fixation with due emphasis on exact length and thickness of the nail, so as to span the whole length of the bone and should occupy the entire medullary cavity at isthmus, and should achieve three point fixation of the nail in the bone, in order to provide complete rotational stability of the bone and fracture. RESULT : All the cases healed within three to six months of operation. The results were similar to internal fixation done with interlocking nailing or plating, in all the parameters including, knee and hip range of movement, both active and passive, thigh and leg girth, muscle wasting, extensor lag and time of union, but the operative time was half that of interlocking. CONCLUSION : By this study we came to the conclusion that, K nailing is still indispensable implant, and should not be discarded completely. It shou ld be an important inclusion in the inventory of implants in Orthopaedic surgeon basket. Especially in management diseases of long bones, a surgeon has to take care of so many surgical steps that the surgeon is left with very little, anaesthesia and surgic al time to put in complicated lengthy processed implant. In such a situation a K nail serves the purpose. Therefore it should be the most preferred

  7. Retrospective dosimetry of nail by Electron Paramagnetic Resonance

    International Nuclear Information System (INIS)

    The purpose of this study is to characterize samples of human nails, subjected to irradiation of high doses through Technical Electron Paramagnetic Resonance (EPR). The goal is to establish a dose/response relationship in order to assess dose levels absorbed by individuals exposed in radiation accidents situations, retrospectively. Samples of human nails were irradiated with gamma radiation, and received a dose of 20 Gy. EPR measurements performed on samples before irradiation identified EPR signals associated with defects caused by the mechanical action of the sample collection. After irradiation other species of free radicals, associated with the action of gamma radiation, have been identified

  8. Nail in the Fence%栅栏上的钉子

    Institute of Scientific and Technical Information of China (English)

    张顺生

    2006-01-01

    @@ There once was a little boy who had a bad temper. His father gave him a bag of nails and told him that every time he lost his temper, he must hammer a nail into1 the back of the fence. The first day the boy had driven 37 nails into the fence. Over the next few weeks, as he learned to control his anger, the number of nails hammered daily gradually dwindled down2. He discovered it was easier to hold his temper than to drive those nails into the fence. Finally the day came when the boy didn't lose his temper at all.

  9. Randomized controlled trial of a water-soluble nail lacquer based on hydroxypropyl-chitosan (HPCH, in the management of nail psoriasis

    Directory of Open Access Journals (Sweden)

    Cantoresi F

    2014-05-01

    Full Text Available Franca Cantoresi,1 Maurizio Caserini,2 Antonella Bidoli,1 Francesca Maggio,1 Raffaella Marino,1 Claudia Carnevale,1 Paola Sorgi,1 Renata Palmieri21Department of Dermatology, Sapienza University, Rome, Italy; 2Scientific Department, Polichem SA, Lugano, Switzerland Background: Nail psoriasis occurs in up to 50% of patients affected by psoriasis, with a significant impact on quality of life that leads to a real clinical need for new therapeutic options. Aim: To confirm whether the strengthening and hardening properties of the hydroxypropyl-chitosan (HPCH nail lacquer could improve the structure of the nail plates on psoriatic nails. Materials and methods: A randomized, double-blind, placebo controlled, parallel-group trial was carried out to evaluate the efficacy and tolerability of a hydrosoluble nail lacquer containing HPCH, Equisetum arvense, and methylsulfonylmethane on nail psoriasis. The test product or a placebo was applied once daily for 24 weeks to all fingernails. Efficacy assessments were performed on the target fingernail by means of the modified Nail Psoriasis Severity Index score. A cut-off score of 4 was considered to define the clinical cure rate (ie, Cure ≤4, Failure >4. Results: After 24 weeks, the clinical cure rate showed the statistically significant superiority of the HPCH nail lacquer compared to placebo in both the intention-to-treat (Fisher's exact test, P=0.0445 and the per protocol population (Fisher's exact test, P=0.0437. This superiority was already present after 16 weeks of treatment. Moreover, the analysis of the modified Nail Psoriasis Severity Index-50 showed a statistically significant clinical improvement after 12 weeks of treatment in comparison to the results obtained after 8 weeks (Fisher's exact test, P<0.05. Conclusion: The trial showed that HPCH nail lacquer could be a new, valid, effective, and safe option for decreasing the signs of nail dystrophy in psoriatic patients. Keywords: nail psoriasis

  10. Comparison of mechanical rigidity between plate augmentation leaving the nail in situ and interlocking nail using cadaveric fracture model of the femur

    OpenAIRE

    Park, Kyungho; Kim, Kwanwoo; Choi, Y. S.

    2010-01-01

    Thirteen matched pairs of cadaveric femurs were placed into two groups. In each group, a transverse fracture was created at a point 70% distal between the lesser trochanter and the adductor tubercle. One femur out of each matched pair was then stabilised with an interlocking intramedullary nail (nail only group) and the other femur was stabilised with plate augmentation after interlocking intramedullary nailing (plate augmentation group). The bending load to promote 5-mm displacement showed s...

  11. Biomechanical changes after implant fixation for femoral condyle fracture%股骨髁骨折植入物内固定后的生物力学变化

    Institute of Scientific and Technical Information of China (English)

    谭林强; 崔泳; 张华

    2014-01-01

    BACKGROUND:Clinical treatment of epicondyle fractures and intercondylar comminuted fractures is quite tricky due to instability and spread to the articular surface. Common complications contained bone delayed union, nonunion, broken nails and broken boards. Internal fixation for fractures is various, but reasonable choice for clinical fixation plays a decisive role for repair of fractures. OBJECTIVE:To explore the repair effects of various fixation methods on femoral condyle fracture from different aspects such as fracture type, bone healing, functional recovery and biomechanics. METHODS:First author searched PubMed database and China National Knowledge Infrastructure for articles about various fixation methods in repair of femoral condyle fracture published from January 2000 to April 2014. Key words were“femoral condyle fracture, internal fixation, biomechanics, load-displacement, axial stiffness, horizontal shear stiffness”. Total y 142 articles were retrieved, but 39 articles met the inclusion criteria. RESULTS AND CONCLUSION:Femoral condyle fracture caused the damage to normal anatomic structure of knee join, changed normal anatomical axis and the mechanical axis of knee joint. Therefore, anatomic reduction and rigid internal fixation are necessary. During treatment, the advantages and disadvantages of various fixation methods should be known. It is necessary to ful y evaluate the type of intercondylar fractures of the femoral condyle and soft tissue injury. According to biological characteristics of the human body and mechanical property, internal fixation device should be reasonably used. Individual treatment programs should be provided. Thus, the occurrence of postoperative complications should be reduced utmostly, resulting in a satisfactory repair outcome.%背景:髁上骨折、髁间骨折常因粉碎不稳定和波及关节面,临床处理相当棘手,常见的并发症有骨延迟愈合、骨不连、断钉及断板等,骨折内固定方法

  12. Early diagnosis for segmental collapse of the femoral head after femoral neck fracture by scintigraphy

    International Nuclear Information System (INIS)

    In order to obtain an early prediction for segmental collapse of the femoral head after femoral neck fracture, we have studied in 53 cases of the femoral neck fracture using 99mTC-MDP scintimetry. According to the radionuclide uptake ratio of the femoral heads, we can estimate the gravity of the avascular necrosis of the femoral head after fracture and recognize the repair process in the necrotic head. Fifty-three cases of fresh fracture were examined by sequential scintigraphy before operation and during follow up examinations after operation. The radionuclide uptake were all increased in 3 to 4 months after operation as comparing with that done before operation. The uptake ratios in 37 cases decreased gradually and approached 1 in 12 months after operation. All of them have an excellent result during follow up examination 36 months after surgery. The uptake ratios in 19 cases were also increased after operation, but still maintained at a high level in 6 to 12 months. They all showed radiographical signs of segmental collapse 18 to 24 months after operation. These results showed that uptake ratio of the radionuclide bone imaging is able to predict the occurrence of segmental collapse of the femoral head after femoral neck fracture. The time of the diagnosis by scintigraphy for segmental collapse of the femoral head is earlier than that by radiography. (authors). 5 refs., 1 tab

  13. Evaluation of a pig femoral head osteonecrosis model

    Directory of Open Access Journals (Sweden)

    Kim Harry

    2010-03-01

    Full Text Available Abstract Background A major cause of osteonecrosis of the femoral head is interruption of a blood supply to the proximal femur. In order to evaluate blood circulation and pathogenetic alterations, a pig femoral head osteonecrosis model was examined to address whether ligature of the femoral neck (vasculature deprivation induces a reduction of blood circulation in the femoral head, and whether transphyseal vessels exist for communications between the epiphysis and the metaphysis. We also tested the hypothesis that the vessels surrounding the femoral neck and the ligamentum teres represent the primary source of blood flow to the femoral head. Methods Avascular osteonecrosis of the femoral head was induced in Yorkshire pigs by transecting the ligamentum teres and placing two ligatures around the femoral neck. After heparinized saline infusion and microfil perfusion via the abdominal aorta, blood circulation in the femoral head was evaluated by optical and CT imaging. Results An angiogram of the microfil casted sample allowed identification of the major blood vessels to the proximal femur including the iliac, common femoral, superficial femoral, deep femoral and circumflex arteries. Optical imaging in the femoral neck showed that a microfil stained vessel network was visible in control sections but less noticeable in necrotic sections. CT images showed a lack of microfil staining in the epiphysis. Furthermore, no transphyseal vessels were observed to link the epiphysis to the metaphysis. Conclusion Optical and CT imaging analyses revealed that in this present pig model the ligatures around the femoral neck were the primary cause of induction of avascular osteonecrosis. Since the vessels surrounding the femoral neck are comprised of the branches of the medial and the lateral femoral circumflex vessels, together with the extracapsular arterial ring and the lateral epiphyseal arteries, augmentation of blood circulation in those arteries will improve

  14. Brushes and picks used on nails during the surgical scrub to reduce bacteria: a randomised trial.

    Science.gov (United States)

    Tanner, J; Khan, D; Walsh, S; Chernova, J; Lamont, S; Laurent, T

    2009-03-01

    Though brushes are no longer used on the hands and forearms during the surgical scrub, they are still widely used on the nails. The aim of this study was to determine whether nail picks and nail brushes are effective in providing additional decontamination during a surgical hand scrub. A total of 164 operating department staff were randomised to undertake one of the following three surgical hand-scrub protocols: chlorhexidine only; chlorhexidine and a nail pick; or chlorhexidine and a nail brush. Bacterial hand sampling was conducted before and 1h after scrubbing using a modified version of the glove juice method. No statistically significant differences in bacterial numbers were found between any two of the three intervention groups. Nail brushes and nail picks used during surgical hand scrubs do not decrease bacterial numbers and are unnecessary. PMID:19162371

  15. Nickel in nails, hair and plasma from nickel-hypersensitive women

    DEFF Research Database (Denmark)

    Gammelgaard, Bente; Veien, Niels

    1990-01-01

    The concentrations of nickel in finger-nails, toe-nails, hair and plasma from 71 nickel-hypersensitive women and 20 non-hypersensitive women were determined. Nickel concentrations in finger-nails were significantly higher than in toe-nails in both the nickel-hypersensitive group and the control...... group. Nickel-sensitive women had significantly higher levels of nickel in toe-nails, hair and plasma than had control subjects, whereas there was no significant difference in nickel concentration in finger-nails between the two groups. No correlation could be demonstrated between nickel levels in any...... combination of nails, hair and plasma in the nickel-hypersensitive or in the control group....

  16. Removal of a bent tibial intramedullary nail: a rare case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Sameer Aggerwal; Ashwani Soni; Uttam C. Saini; Nitesh Gahlot

    2011-01-01

    Intramedullary interlocking nailing is a gold standard for treatment of tibial shaft fractures. Bending of a nail secondary to trauma is a rare complication,which may be encountered in healed or unhealed tibial shaft fractures. Removal of such bent nail is always a challenge.We reported this case to discuss various techniques for removal of bent nails and to share our experience in removing a bent tibial intramedullary nail in a 30-year-old man,who was admitted in our department with re-fracture of the right tibial shaft due to a roadside accident two years after the initial surgical treatment. The intramedullary nail, bent by 30 degrees and visible on anterioposterior as well as on lateral radiographs, was firstly weakened by partially cutting the convex wall, then straightened by applying extemal force,and finally removed by using the standard nail removal method.

  17. Elastoconductivity as a probe of broken mirror symmetries

    OpenAIRE

    Hlobil, Patrik; Maharaj, Akash V.; Hosur, Pavan; Shapiro, M. C.; Fisher, I. R.; Raghu, S.

    2015-01-01

    We propose the possible detection of broken mirror symmetries in correlated two-dimensional materials by elastotransport measurements. Using linear response theory we calculate the shearconductivity $\\Gamma_{xx,xy}$, defined as the linear change of the longitudinal conductivity $\\sigma_{xx}$ due to a shear strain $\\epsilon_{xy}$. This quantity can only be non-vanishing when in-plane mirror symmetries are broken and we discuss how candidate states in the cuprate pseudogap regime (e.g. various ...

  18. Broken Images : Eliot, Lorca, Neruda and the discontinuity of Modernism

    OpenAIRE

    Young, Howard T.

    1998-01-01

    T. S. Eliot's powerful trope in The Waste Land ("a heap of broken images"), which may derive in part from Tennyson's Idylls of the King, has overflowed into Lorca's Poeta en Nueva York and Neruda's Residencia en la tierra. What these three poets see while "walking around" is the detritus of urban life, broken and abandoned objects. With values fractured and icons turned into shards, Eliot's image relates as well to the discontinuity that underlines many examples of modern...

  19. Parameter Sensitivity Analysis on Deformation of Composite Soil-Nailed Wall Using Artificial Neural Networks and Orthogonal Experiment

    OpenAIRE

    Jianbin Hao; Banqiao Wang

    2014-01-01

    Based on the back-propagation algorithm of artificial neural networks (ANNs), this paper establishes an intelligent model, which is used to predict the maximum lateral displacement of composite soil-nailed wall. Some parameters, such as soil cohesive strength, soil friction angle, prestress of anchor cable, soil-nail spacing, soil-nail diameter, soil-nail length, and other factors, are considered in the model. Combined with the in situ test data of composite soil-nail wall reinforcement engi...

  20. Broken Ergodicity in Two-Dimensional Homogeneous Magnetohydrodynamic Turbulence

    Science.gov (United States)

    Shebalin, John V.

    2010-01-01

    Two-dimensional (2-D) homogeneous magnetohydrodynamic (MHD) turbulence has many of the same qualitative features as three-dimensional (3-D) homogeneous MHD turbulence.The se features include several ideal invariants, along with the phenomenon of broken ergodicity. Broken ergodicity appears when certain modes act like random variables with mean values that are large compared to their standard deviations, indicating a coherent structure or dynamo.Recently, the origin of broken ergodicity in 3-D MHD turbulence that is manifest in the lowest wavenumbers was explained. Here, a detailed description of the origins of broken ergodicity in 2-D MHD turbulence is presented. It will be seen that broken ergodicity in ideal 2-D MHD turbulence can be manifest in the lowest wavenumbers of a finite numerical model for certain initial conditions or in the highest wavenumbers for another set of initial conditions.T he origins of broken ergodicity in ideal 2-D homogeneous MHD turbulence are found through an eigen analysis of the covariance matrices of the modal probability density functions.It will also be shown that when the lowest wavenumber magnetic field becomes quasi-stationary, the higher wavenumber modes can propagate as Alfven waves on these almost static large-scale magnetic structures

  1. Psoriatic nail involvement and its relationship with distal interphalangeal joint disease.

    Science.gov (United States)

    Lai, T L; Pang, H T; Cheuk, Y Y; Yip, M L

    2016-08-01

    Psoriatic nail disease and distal interphalangeal (DIP) arthritis both are common manifestations of psoriatic arthritis (PsA). Several clinical characteristics are allegedly associated with DIP joint damage, particularly nail psoriasis. However, there is little evidence to substantiate this phenomenon. The purpose of this study is to investigate the relationship between DIP involvement, nail psoriasis and other parameters. A cross-sectional study involved 45 patients from local rheumatology clinic. Four hundred fifty psoriatic fingernails scored, and the radiographs of all these fingers were reviewed to define PsA DIP arthritic changes. 64.4 % patients had nail psoriasis and 35.6 % had DIP arthritis. Univariate analysis identified that swollen joint-count, digits with chronic dactylitis, HLA-B27 status and nail psoriasis were associated with DIP arthritis. Regression model supported that nail disease was the most significant associated factor of DIP arthritis (OR 9.7, p = 0.05). Nail psoriasis was identified in 40.2 % of digits. Pitting (29.6 %), onycholysis (15.1 %), crumbling (8.2 %), nail bed hyperkeratosis (2.0 %) were noted with the mean modified Nail Psoriasis Severity Index of 0.95 +/-1.68. Among all digits, 57 had DIP arthritis while 393 did not. Within DIP joints with PsA radiological change, 59.6 % had nail disease. Chi-square test with the Bonferroni correction further supported an association between nail psoriasis and DIP involvement with p value of 0.001. Two specific nail subtypes-crumbling and onycholysis-were found to be significantly associated with DIP disease. A significant proportion of PsA patients had nail involvement and DIP arthritis. PsA patients with nail changes may be more susceptible to DIP disease. PMID:27251673

  2. Drug permeation through the three layers of the human nail plate.

    Science.gov (United States)

    Kobayashi, Y; Miyamoto, M; Sugibayashi, K; Morimoto, Y

    1999-03-01

    The in-vitro permeation characteristics of a water soluble model drug, 5-fluorouracil, and a poorly water soluble model drug, flurbiprofen, were investigated through three layers of the human nail plate (namely, the dorsal, intermediate and ventral nail plates), using a modified side-by-side diffusion cell. The dorsal-filed nail plate, the ventral-filed nail plate and the dorsal-and-ventral-filed nail plate were prepared to known thicknesses and then used with the full-thickness nail plate to investigate the permeation characteristics of each single layer. Most of the lipids in the human nail plate were found in the dorsal and ventral layers. The rank orders of the permeation fluxes for 5-fluorouracil and flurbiprofen were both: dorsal-and-ventral-filed nail plate > dorsal-filed nail plate > ventral-filed nail plate > full-thickness nail plate. With respect to 5-fluorouracil permeation through each single layer, the permeability coefficient of the intermediate layer was higher than those of other single layers. However in the case of flurbiprofen, the permeability coefficient of the ventral layer was higher than other single layers. The diffusion coefficients of 5-fluorouracil and flurbiprofen in the dorsal layer were the lowest of any single layer. The drug concentration in each layer was estimated using each respective permeation parameter. The drug concentration in the nail plate was observed to be dependent on the solubility and the flux of the drug. From these findings, we suggest that the human nail plate behaves like a hydrophilic gel membrane rather than a lipophilic partition membrane and that the upper layer functions as the main nail barrier to drug permeation through its low diffusivity against the drugs.

  3. Use of the gamma3™ nail in a teaching hospital for trochanteric fractures: mechanical complications, functional outcomes, and quality of life

    Directory of Open Access Journals (Sweden)

    Buecking Benjamin

    2012-11-01

    Full Text Available Abstract Background Trochanteric fractures are common fractures in the elderly. Due to characteristic demographic changes, the incidence of these injuries is rapidly increasing. Treatment of these fractures is associated with high rates of complications. In addition, the long-term results remain poor, with high morbidity, declines in function, and high mortality. Therefore, in this study, complication rates and patients’ outcomes were evaluated after fixation of geriatric trochanteric fractures using the Gamma3™ nail. Methods Patients aged 60 years old or older, with pertrochanteric and subtrochanteric femoral fractures, were included. Patients with polytrauma or pathological fractures were excluded. Age, sex, and fracture type were collected on admission. In addition, data were recorded concerning the surgeon (resident vs. consultant, time of operation, and local or systemic perioperative complications. Complications were also collected at the 6- and 12-month follow-ups after trauma. Barthel Index, IADL, and EQ-5D measurements were evaluated retrospectively on admission, as well as at discharge and during the follow-up. Results Ninety patients were prospectively included between April 2009 and September 2010. The patients’ average age was 81 years old, and their average ASA score was 3. The incision/suture time was 53 min (95% CI 46–60 min. Hospital mortality was 4%, and overall mortality was 22% at the 12-month follow-up. Eight local complications occurred (4 haematomas, 1 deep infection, 1 cutting out, 1 irritation of the iliotibial tract, 1 periosteosynthetic fracture. The incidence of relevant systemic complications was 6%. Forty-two percent of the patients were operated on by residents in training, without significant differences in duration of surgery, complication rate, or mortality rate. The Barthel Index (82 to 71, p p = .0195 and EQ-5-D (0.75 to 0.66, p = .068 values did not reach pre-fracture levels during the follow

  4. Ingrown toenails (unguis incarnatus): Nail braces/bracing treatment

    OpenAIRE

    Chiriac, Anca; Solovan, Caius; Brzezinski, Piotr

    2014-01-01

    Nail bracing is a safe, simple, and inexpensive treatment option that avoids surgery, requires no anesthetic, requires no recovery period, allows wearing the existing shoes, offers immediate relief from pain, and allows the practice of daily activities. Braces can be used for prolonged periods of times. If recurrence occurs, reapplication of bracing is usually required.

  5. 78 FR 78382 - Steel Nails From China; Determination

    Science.gov (United States)

    2013-12-26

    ... The Commission instituted this review on July 1, 2013 (78 FR 40172) and determined on October 21, 2013 that it would conduct an expedited review (78 FR 68472, November 14, 2013). The Commission completed... COMMISSION Steel Nails From China; Determination On the basis of the record \\1\\ developed in the subject...

  6. The SIGN nail for knee fusion: technique and clinical results

    Directory of Open Access Journals (Sweden)

    Anderson Duane Ray

    2016-01-01

    Full Text Available Purpose: Evaluate the efficacy of using the SIGN nail for instrumented knee fusion. Methods: Six consecutive patients (seven knees, three males with an average age of 30.5 years (range, 18–50 years underwent a knee arthrodesis with SIGN nail (mean follow-up 10.7 months; range, 8–14 months. Diagnoses included tuberculosis (two knees, congenital knee dislocation in two knees (one patient, bacterial septic arthritis (one knee, malunited spontaneous fusion (one knee, and severe gout with 90° flexion contracture (one knee. The nail was inserted through an anteromedial entry point on the femur and full weightbearing was permitted immediately. Results: All knees had clinical and radiographic evidence of fusion at final follow-up and none required further surgery. Four of six patients ambulated without assistive device, and all patients reported improved overall physical function. There were no post-operative complications. Conclusion: The technique described utilizing the SIGN nail is both safe and effective for knee arthrodesis and useful for austere environments with limited fluoroscopy and implant options.

  7. Probabilistic assessment of exposure to nail cosmetics in French consumers.

    Science.gov (United States)

    Ficheux, A S; Morisset, T; Chevillotte, G; Postic, C; Roudot, A C

    2014-04-01

    The aim of this study was to assess probabilistic exposure to nail cosmetics in French consumers. The exposure assessment was performed with base coat, polish, top coat and remover. This work was done for adult and child consumers. Dermal, inhalation and oral routes were taken into account for varnishes. Exposure evaluation was performed for the inhalation route with polish remover. The main route of exposure to varnishes was the ungual route. Inhalation was the secondary route of exposure, followed by dermal and oral routes. Polish contributed most to exposure, regardless of the route of exposure. For this nail product, P50 and P95 values by ungual route were respectively equal to 1.74 mg(kg bw week)(-1) and 8.55 mg(kg bw week)(-1) for women aged 18-34 years. Exposure to polish by inhalation route was equal to 0.70 mg(kg bw week)(-1) (P50) and 5.27 mg(kg bw week)(-1) (P95). P50 and P95 values by inhalation route were respectively equal to 0.08 mg(kg bw week)(-1) and 1.14 mg(kg bw week)(-1) for consumers aged 18-34 years exposed to polish remover. This work provided current exposure data for nail cosmetics, and a basis for future toxicological studies of the uptake of substances contained in nail cosmetics in order to assess systemic exposure.

  8. An electrochemical modeling of lithium-ion battery nail penetration

    Science.gov (United States)

    Chiu, Kuan-Cheng; Lin, Chi-Hao; Yeh, Sheng-Fa; Lin, Yu-Han; Chen, Kuo-Ching

    2014-04-01

    Nail penetration into a battery pack, resulting in a state of short-circuit and thus burning, is likely to occur in electric car collisions. To demonstrate the behavior of a specific battery when subject to such incidents, a standard nail penetration test is usually performed; however, conducting such an experiment is money consuming. The purpose of this study is to propose a numerical electrochemical model that can simulate the test accurately. This simulation makes two accurate predictions. First, we are able to model short-circuited lithium-ion batteries (LIBs) via electrochemical governing equations so that the mass and charge transfer effect could be considered. Second, the temperature variation of the cell during and after nail penetration is accurately predicted with the help of simulating the temperature distribution of thermal runaway cells by thermal abuse equations. According to this nail penetration model, both the onset of battery thermal runaway and the cell temperature profile of the test are obtained, both of which are well fitted with our experimental results.

  9. Multiple intramedullary nailing of proximal phalangeal fractures of hand

    Directory of Open Access Journals (Sweden)

    Patankar Hemant

    2008-01-01

    Full Text Available Background: Proximal phalangeal fractures are commonly encountered fractures in the hand. Majority of them are stable and can be treated by non-operative means. However, unstable fractures i.e. those with shortening, displacement, angulation, rotational deformity or segmental fractures need surgical intervention. This prospective study was undertaken to evaluate the functional outcome after surgical stabilization of these fractures with joint-sparing multiple intramedullary nailing technique. Materials and Methods: Thirty-five patients with 35 isolated unstable proximal phalangeal shaft fractures of hand were managed by surgical stabilization with multiple intramedullary nailing technique. Fractures of the thumb were excluded. All the patients were followed up for a minimum of six months. They were assessed radiologically and clinically. The clinical evaluation was based on two criteria. 1. total active range of motion for digital functional assessment as suggested by the American Society for Surgery of Hand and 2. grip strength. Results: All the patients showed radiological union at six weeks. The overall results were excellent in all the patients. Adventitious bursitis was observed at the point of insertion of nails in one patient. Conclusion: Joint-sparing multiple intramedullary nailing of unstable proximal phalangeal fractures of hand provides satisfactory results with good functional outcome and fewer complications.

  10. Laparoscopic repair of an incarcerated femoral hernia

    Science.gov (United States)

    Pillay, Yagan

    2015-01-01

    Introduction A femoral hernia is a rare, acquired condition, which has been reported in less than 5% of all abdominal wall hernias, with a female to male ratio of 4:1. Presentation of case We report a case in a female patient who had a previous open inguinal herniorrhaphy three years previously. She presented with right sided groin pain of one month duration. Ultrasound gave a differential diagnosis of a recurrent inguinal hernia or a femoral hernia. A transabdominal preperitoneal repair was performed and the patient made an uneventful recovery. Discussion Laparoscopic repair of a femoral hernia is still in its infancy and even though the outcomes are superior to an open repair, open surgery remains the standard of care. The decision to perform a laparoscopic trans abdominal preperitoneal (TAPP) repair was facilitated by the patient having previous open hernia surgery. The learning curve for laparoscopic femoral hernia repair is steep and requires great commitment from the surgeon. Once the learning curve has been breached this is a feasible method of surgical repair. This is demonstrated by the fact that this case report is from a rural hospital in Canada. Conclusion Laparoscopic femoral hernia repair involves more time and specialized laparoscopic skills. The advantages are a lower recurrence rate and lower incidence of inguinodynia. PMID:26581083

  11. A STUDY ON THE PATTERNS OF CIRCUMFLEX FEMORAL ARTERIES

    Directory of Open Access Journals (Sweden)

    R. Chitra

    2015-09-01

    Full Text Available Context: Many different patterns have been described to classify the origins of circumflex femoral arteries by many authors since from 1860.The aim of the present study was to classify the circumflex femoral arteries in 100 lower limbs of adult cadavers of both sexes following the recent classification and to compare with the previous studies. Materials and Methods: A total of 100 lower limbs of 50 embalmed human adult cadavers (Male: 37, Female: 13 were dissected and observed for the origins of circumflex femoral arteries in femoral triangle in routine educational dissection in the period of 2005-2009 Results: The medial and lateral circumflex femoral arteries have been classified into three different patterns based on the levels of their origin. Pattern I: Both arteries arose from the profunda femoris artery (56%. Type Ia, medial circumflex femoral artery origin was proximal to the lateral circumflex femoral artery origin (69%; Type Ib, lateral circumflex femoral artery origin was proximal to medial circumflex femoral artery origin (16 %; Type Ic, both arteries arose from a common trunk or at same level (14%. Pattern II: One of the arteries arose from the femoral artery and the other from the profunda femoris artery (36%. Type IIa, the medial circumflex femoral artery arose from the femoral artery (75% and Type IIb, the lateral circumflex femoral artery arose from the femoral artery (25%.Pattern III: Both arteries arose from the femoral artery (7%. The medial circumflex femoral artery was absent in a female cadaver on right side. Conclusion: In every pattern or type, there was significantly unilateral higher occurrence than bilateral occurrence. A precise knowledge of the circumflex femoral arteries in relation to the profunda femoris artery is important in surgical interventions of the hip region

  12. 99mTc-MDP scintigraphy of femoral head necrosis following femoral neck fracture

    International Nuclear Information System (INIS)

    Secondary ischemic necrosis of femoral head due to loss of blood supply following to femoral neck fracture is well known. The regional distribution of bone-seeking radiopharmaceuricals in the skeleton can depend on a number of factors, but bone blood flow is a major physiological determinant of regional skeletal uptake of Tc-99m polyphosphate and bone imaging may thus be used for the evaluation of vascularity of the femoral head. The authors made a comparative study of scintigraphic findings and operative findings of 28 cases of femoral neck fracture treated at Kyung Hee University Hospital from April 1980 to May 1984. The results were as follows: 1. In 16 cases of proven avascular necorsis of femoral head, scintigraphy showed absent or decreased activity in 14 cases (87.5%), while radiography showed increased density in 10 cases (62.5%). 2. In 12 cases of proven vital femoral head, scintigraphy showed increased activity in 9 cases (75%) and radiography showed decreased density in 9 cases (75%). 3. 99mTc-MDP scintigraphy was an excellent and useful method for assessing bone vitality of femoral head

  13. Emergency intravenous access through the femoral vein.

    Science.gov (United States)

    Swanson, R S; Uhlig, P N; Gross, P L; McCabe, C J

    1984-04-01

    A study was undertaken to assess the efficacy and safety of femoral venous catheterization for resuscitation of critically ill patients in the emergency department setting. From May 1982 to April 1983, 100 attempts were made at percutaneous insertion of a large-bore catheter into the femoral veins of patients presenting to our emergency department in cardiac arrest or requiring rapid fluid resuscitation. Eighty-nine attempts were successful. Insertion was generally considered easy, and flow rates were excellent. The only noted complications were four arterial punctures and one minor groin hematoma. This study suggests that short-term percutaneous catheterization of the femoral vein provides rapid, safe, and effective intravenous access. PMID:6703430

  14. Participation of osteoporosis in femoral neck fracture

    International Nuclear Information System (INIS)

    Quantitative computed tomography (QCT) was used to measure bone mineral contents of the proximal femur. First, 62 specimens of cancellous bones of the proximal femur obtained at operation were burnt for mineral determination after preoperative QCT measurement to evaluate the relationship between QCT values and ash weight. The findings indicated that QCT measurement of proximal femur was as useful as that of the lumbar spine. Next, 10 groups of 50 men and 50 women ranging in age from the 5th to the 9th decade were tested to define the control mean and range of QCT mineral content of proximal femur, to compare with 32 cases of femoral neck fracture. In women with femoral neck fracture, QCT values of the femoral neck were less than those of the same normal age group except for cases of medial fracture in the 9th decade. This measurement might provide an index for fracture risk. (author)

  15. Selective arteriography in femoral head fractures

    International Nuclear Information System (INIS)

    The choice between conservative and radical operation in case of femoral neck fractures is very important because it is the determining factor for a successfull therapy. In case of epiphysial necrosis, an endoprosthesis as well as an osteosynthesis will be carried out. Selective arteriography of the medical circumflex artery represents the most reliable study to establish, immediately after the fractures, the possible presence of a post-traumatic ischemic necrosis. Angiography, as a reliable diagnostic tool, has to be carried out in the most selective way and needs the image subtraction technique. The authors report their preliminary results on the reliability of angiography in the femoral epiphyseal ischemic necrosis diagnosed by comparing the results of angiography with the wood light test carried out on the surgically removed femoral head

  16. Optimizing Stability in Femoral Neck Fracture Fixation.

    Science.gov (United States)

    Ye, Ye; Hao, Jiandong; Mauffrey, Cyril; Hammerberg, E Mark; Stahel, Philip F; Hak, David J

    2015-10-01

    Optimizing stability of femoral neck fracture fixation is important in obtaining a successful outcome. The mechanical problems and strategies for achieving optimal stability differ depending on patients' age and degree of osteoporosis. Femoral neck fractures in younger adults usually result from high-energy trauma and have a vertical fracture pattern. Strategies for optimizing fixation stability in this group include placing additional screws at right angles to the fracture plane and medial buttress plate augmentation. In elderly patients, screw position relative to the intact cortical femoral neck bone is of critical importance. Additional strategies for optimizing fixation stability in this group include the concept of length stable fixation, use of adjunctive calcium phosphate cement, and use of novel fixed angle fixation implants. PMID:26488776

  17. Micromotion of cemented and uncemented femoral components.

    Science.gov (United States)

    Burke, D W; O'Connor, D O; Zalenski, E B; Jasty, M; Harris, W H

    1991-01-01

    We evaluated the initial stability of cemented and uncemented femoral components within the femoral canals of cadaver femurs during simulated single limb stance and stair climbing. Both types were very stable in simulated single limb stance (maximum micromotion of 42 microns for cemented and 30 microns for uncemented components). However, in simulated stair climbing, the cemented components were much more stable than the uncemented components (76 microns as against 280 microns). There was also greater variation in the stability of uncemented components in simulated stair climbing, with two of the seven components moving 200 microns or more. Future implant designs should aim to improve the initial stability of cementless femoral components under torsional loads; this should improve the chances of bony ingrowth. PMID:1991771

  18. Comparison of cutout resistance of dynamic condylar screw and proximal femoral nail in reverse oblique trochanteric fractures: A biomechanical study

    Directory of Open Access Journals (Sweden)

    Gursimrat Singh Cheema

    2012-01-01

    Results: The bending moment of the PFN group was approximately 50% less than that of the DCS group (P<0.0001. The PFN group resisted more number of cycles than the DCS group (P=0.03 and showed lesser number of component failures as compared with the DCS group (P=0.003. Conclusions: The PFN is biomechanically superior to DCS for the fixation of reverse oblique trochanteric fractures of femur.

  19. Osteochondritis dissecans in bilateral lateral femoral condyle in knees

    Directory of Open Access Journals (Sweden)

    Ari Zekcer

    2013-12-01

    Full Text Available The osteochondritis dissecans (OCD is a disease of unknown cause that classically affects the knee lateral border of the medial femoral condyle. We present a rare case of OCD in bilateral lateral femoral condyle.

  20. Femoral lipectomy increases postprandial lipemia in women.

    Science.gov (United States)

    Hernandez, Teri L; Bessesen, Daniel H; Cox-York, Kimberly A; Erickson, Christopher B; Law, Christopher K; Anderson, Molly K; Wang, Hong; Jackman, Matthew R; Van Pelt, Rachael E

    2015-07-01

    Femoral subcutaneous adipose tissue (SAT) appears to be cardioprotective compared with abdominal SAT, possibly through better triglyceride (TG) sequestration. We hypothesized that removal of femoral SAT would increase postprandial TG through a reduction in dietary fatty acid (FA) storage. Normal-weight (means ± SD; BMI 23.9 ± 2.6 kg/m(2)) women (n = 29; age 45 ± 6 yr) were randomized to femoral lipectomy (LIPO) or control (CON) and followed for 1 yr. Regional adiposity was measured by DEXA and CT. A liquid meal labeled with [(14)C]oleic acid was used to trace the appearance of dietary FA in plasma (6-h postprandial TG), breath (24-h oxidation), and SAT (24-h [(14)C]TG storage). Fasting LPL activity was measured in abdominal and femoral SAT. DEXA leg fat mass was reduced after LIPO vs. CON (Δ-1.4 ± 0.7 vs. 0.1 ± 0.5 kg, P fat area (-39.6 ± 36.6 vs. 4.7 ± 14.6 cm(2), P fat mass and CT visceral fat area were unchanged. Postprandial TG increased (5.9 ± 7.7 vs. -0.6 ± 5.3 × 10(3) mg/dl, P fat remained reduced 1 yr following lipectomy and was accompanied by increased postprandial TG and reduced femoral SAT LPL activity. There were no changes in storage of meal-derived FA or visceral fat. Our data support a protective role for femoral adiposity on circulating TG independent of dietary FA storage and visceral adiposity. PMID:25968576

  1. Nail unit in collagen vascular diseases: A clinical, histopathological and direct immunofluorescence study

    Directory of Open Access Journals (Sweden)

    Nabil P

    2006-01-01

    Full Text Available Background: Abnormalities of the nail unit are common in patients with connective tissue diseases. Clinical examination of the nail unit, coupled with biopsy of proximal nail fold offers an additional advantage in the diagnosis. Purpose: Our aim was to record clinical changes of the nail unit in connective tissue diseases and to study the histopathological (both H and E and periodic acid Schiff and direct immunofluorescence (DIF findings of nail-fold biopsy. Materials and Methods: Thirty-eight confirmed cases connective tissue diseases attending skin OPD were enrolled in the study. After detailed clinical examination of the nail unit, a crescentric biopsy was taken from the proximal nail fold (PNF. Histopathological and DIF studies were was carried out. Findings: Nail changes could be demonstrated in 65% connective tissue diseases. Specific histopathological (H and E and immunofluorescence findings were also encountered in many patients. Conclusion: Clinical examination of the nail unit offers additional clue in the diagnosis of connective tissue diseases. Though DIF of PNF biopsy is useful in the diagnosis, it is not an ideal site for H and E study, as the yield is very low. Limitations: Lack of adequate comparison group and non-utilization of capillary microscopy for the detection of nail fold capillary abnormalities.

  2. Cephalomedullary fixation for femoral neck/intertrochanteric and ipsilateral shaft fractures: surgical tips and pitfalls

    Institute of Scientific and Technical Information of China (English)

    Kamal Bali; Nitesh Gahlot; Sameer Aggarwal; Vijay Goni

    2013-01-01

    Objective:Surgical management options for femoral shaft fracture and ipsilateral proximal femur fracture vary from single-implant to double-implant fixation.Cephalomedullary fixation in such fractures has relative advantages over other techniques especially because of less soft tissue dissection and immediate postoperative weight beating with accelerated rehabilitation.However,the surgery is technically demanding and there is a paucity of literature describing the surgical techniques for this fixation.The aim of the study was to describe the surgical technique of cephalomedullary fixation for femoral shaft fracture and ipsilateral proximal femur fracture.Methods:Sixteen cases (10 males and 6 females with a mean age of 41.8 years) ofipsilateral proximal femur and shaft fractures were treated by single-stage cephalomedullary fixation at tertiary level trauma center in northern India.The fractures were classified according to AO classification.An intraoperative record of duration of surgery as well as technical challenges unique to each fracture pattern was kept for all the patients.ResuRs:The most common proximal femoral pattern was AO B2.1 observed in 9 of our patients.The AO B2.3 fractures were seen in 4 patients while the AO A1.2 fractures in 3 patients.Four of the AO B2.1 and 2 of the AO B2.3 fractures required open reduction with Watson-Jones approach.The mean operative time was around 78 minutes,which tended to decrease as the surgical experience increased.There was only one case of malreduction,which required revision surgery.Conclusion:Combination of ipsilateral femoral shaft fracture and neck/intertrochanteric fracture is a difficult fracture pattern for trauma surgeons.Cephalomedullary nail is an excellent implant for such fractures but it requires careful insertion to avoid complications.Surgery is technically demanding with a definite learning curve.Nevertheless,a majority of these fractures can be surgically managed by singleimplant cephaiomedullary

  3. A correlation between femoral neck shaft angle to femoral neck length

    OpenAIRE

    gujar, subhash moolchand; Vikani, Sanjay; Parmar, Jigna; Bondre, K V

    2013-01-01

    Knowledge of the anatomy of proximal end of femur is a prerequisite for a complete understanding of the mechanics of the hip joint and serves as a basis for the treatment of pathological condition of the hip and femur. A total of 250 adult femora were used to  measure femoral neck shaft angle, femoral neck length & femoral total length at S.B.K.S Medical institute, Vadodara. The neck shaft angle range from 116o to 150o with means of 136.3o & no significant side difference. The neck le...

  4. Femoral component loosening after hip resurfacing arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Zustin, Jozef; Sauter, Guido [University Medical Centre Hamburg-Eppendorf, Institute of Pathology, Hamburg (Germany); Hahn, Michael [University Medical Centre Hamburg-Eppendorf, Center for Biomechanics and Skeletal Biology, Hamburg (Germany); Morlock, Michael M. [TUHH Hamburg University of Technology, Biomechanics Section, Hamburg (Germany); Ruether, Wolfgang [University Medical Centre Hamburg-Eppendorf, Department of Orthopaedics, Hamburg (Germany); Amling, Michael [University Medical Centre Hamburg-Eppendorf, Center for Biomechanics and Skeletal Biology, Hamburg (Germany); University Medical Centre Hamburg-Eppendorf, Department of Trauma, Hand and Reconstructive Surgery, Hamburg (Germany)

    2010-08-15

    Before the re-introduction of the current generation of total hip resurfacing arthroplasty, component loosening and osteolysis were of great concern to the orthopaedic community. Early, mid- and long-term clinical results are encouraging, but component loosening still exists. Macroscopic, contact radiographic and histopathological analyses after undecalcified preparation of bone tissue specimens were performed. To investigate the frequency and morphological patterns of the loosening of the femoral component, we analysed a series of 190 retrieved femoral remnants that were revised for aseptic failures. Thirty-five (18.4%) hips were revised for clinical and/or radiographic loosening of the femoral component. Pseudoarthrosis (n = 17; median in situ time: 16 weeks, interquartile range [IQR]: 9 to 34), collapsed osteonecrosis (n = 5; median in situ time: 79 weeks, IQR: 63 to 97), cement-socket debonding (n = 3; median in situ time: 89 weeks, IQR: 54 to 97) and at later follow-up bone-cement loosening (n = 10; median in situ time: 175 weeks; IQR 112 to 198; p =0.005) were distinct patterns of the femoral remnant-implant loosening. Fibrocartilaginous metaplasia of interface bone trabeculae (n = 38; median in situ time: 61 weeks, IQR: 32 to 138) was strongly associated with femoral component loosening (p = 0.009). Both the trabecular hyperosteoidosis (n = 32; median in situ time: 71 weeks, IQR 50 to 129) and excessive intraosseous lymphocyte infiltration (n = 12; median in situ time: 75 weeks, IQR 51 to 98) at the bone-cement interface correlated strongly with fibrocartilaginous metaplasia (p = 0.001 and p = 0.016 respectively) and all three lesions were associated with the female gender (p = 0.021, p = 0.009, and p = 0.051). Femoral component loosening at early follow-up was mostly caused by pathological changes of the femoral remnant bone tissue: pseudoarthrosis and collapsed osteonecrosis. Fibrocartilaginous metaplasia was frequently observed in hips with femoral

  5. Occult, massive hematomas following antegrade femoral angioplasty

    International Nuclear Information System (INIS)

    Small groin hematomas are not uncommon after percuatenous antegrade femoral angioplasty (PAFA) and are usually apparent clinically. The authors describe three patients of 235 who underwent PAFA, in whom occult, massive hemorrhage was detected after the procedure. All patients underwent fluoroscopically guided antegrade punctures, with adequate hemostasis achieved after the procedure. CT revealed extraperitoneal hematomas in two patients. One patient required surgical intervention with ligation of the inferior epigastric artery. The authors postulate that these hematomas arose due to inadvertent injury to a branch of the common femoral artery during the puncture. The radiologist should be aware of the chance occurrence of this occult, potentially life-threatening complication

  6. Proton-neutron correlations in a broken-pair model

    International Nuclear Information System (INIS)

    In this thesis nuclear-structure calculations are reported which were performed with the broken-pair model. The model which is developed, is an extension of existing broken-pair models in so far that it includes both proton and neutron valence pairs. The relevant formalisms are presented. In contrast to the number-non-conserving model, a proton-neutron broken-pair model is well suited to study the correlations which are produced by the proton-neutron interaction. It is shown that the proton-neutron force has large matrix elements which mix the proton- with neutron broken-pair configurations. This occurs especially for Jsup(PI)=2+ and 3- pairs. This property of the proton-neutron force is used to improve the spectra of single-closed shell nuclei, where particle-hole excitations of the closed shell are a special case of broken-pair configurations. Using Kr and Te isotopes it is demonstrated that the proton-neutron force gives rise to correlated pair structures, which remain remarkably constant with varying nucleon numbers. (Auth.)

  7. Bifurcation and catastrophe of seepage flow system in broken rock

    Institute of Scientific and Technical Information of China (English)

    MIAO Xie-xing; LI Shun-cai; CHEN Zhan-qing

    2009-01-01

    The study of dynamical behavior of water or gas flows in broken rock is a basic research topic among a series of key projects about stability control of the surrounding rocks in mines and the prevention of some disasters such as water inrush or gas outburst and the protection of the groundwater resource. It is of great theoretical and engineering importance in respect of promo-tion of security in mine production and sustainable development of the coal industry. According to the non-Darcy property of seepage flow in broken rock dynamic equations of non-Darcy and non-steady flows in broken rock are established. By dimensionless transformation, the solution diagram of steady-states satisfying the given boundary conditions is obtained. By numerical analysis of low relaxation iteration, the dynamic responses corresponding to the different flow parameters have been obtained. The stability analysis of the steady-states indicate that a saddle-node bifurcaton exists in the seepage flow system of broken rock. Consequently, using catastrophe theory, the fold catastrophe model of seepage flow instability has been obtained. As a result, the bifurcation curves of the seepage flow systems with different control parameters are presented and the standard potential function is also given with respect to the generalized state variable for the fold catastrophe of a dynamic system of seepage flow in broken rock.

  8. Neutrino mixing: from the broken μ-τ symmetry to the broken Friedberg–Lee symmetry

    International Nuclear Information System (INIS)

    I argue that the observed flavor structures of leptons and quarks might imply the existence of certain flavor symmetries. The latter should be a good starting point to build realistic models towards deeper understanding of the fermion mass spectra and flavor mixing patterns. The μ-τ permutation symmetry serves for such an example to interpret the almost maximal atmospheric neutrino mixing angle (θ23 ~ 45°) and the strongly suppressed CHOOZ neutrino mixing angle (θ13 < 10°). In this talk I like to highlight a new kind of flavor symmetry, the Friedberg–Lee symmetry, for the effective Majorana neutrino mass operator. Luo and I have shown that this symmetry can be broken in an oblique way, such that the lightest neutrino remains massless but an experimentally-favored neutrino mixing pattern is achievable. We get a novel prediction for θ13 in the CP-conserving case: sinθ13 = tanθ12|(1 - tanθ23)/(1 + tanθ23)|. Our scenario can simply be generalized to accommodate CP violation and be combined with the seesaw mechanism. Finally I stress the importance of probing possible effects of μ-τ symmetry breaking either in terrestrial neutrino oscillation experiments or with ultrahigh-energy cosmic neutrino telescopes. (author)

  9. A Longitudianl Study of the Link Between Broken Homes and Criminality.

    Science.gov (United States)

    McCord, Joan

    Possible explanatory theories of the relationship between broken homes and crime include the following: (1) broken homes lead to crimes if there are "catalytic agents"; (2) broken homes lead to crime if these homes fail to provide certain conditions which promote socialization; and (3) broken homes and crime have a common source, but not a causal…

  10. Strongly broken Peccei-Quinn symmetry in the early Universe

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Fuminobu [Department of Physics, Tohoku University,Sendai, Miyagi 980-8578 (Japan); Kavli IPMU (WPI), TODIAS, The University of Tokyo,Kashiwa, Chiba 277-8583 (Japan); Yamada, Masaki [Kavli IPMU (WPI), TODIAS, The University of Tokyo,Kashiwa, Chiba 277-8583 (Japan); Institute for Cosmic Ray Research, ICRR, The University of Tokyo,Kashiwa, Chiba 277-8582 (Japan)

    2015-10-06

    We consider QCD axion models where the Peccei-Quinn symmetry is badly broken by a larger amount in the past than in the present, in order to avoid the axion isocurvature problem. Specifically we study supersymmetric axion models where the Peccei-Quinn symmetry is dynamically broken by either hidden gauge interactions or the SU(3){sub c} strong interactions whose dynamical scales are temporarily enhanced by the dynamics of flat directions. The former scenario predicts a large amount of self-interacting dark radiation as the hidden gauge symmetry is weakly coupled in the present Universe. We also show that the observed amount of baryon asymmetry can be generated by the QCD axion dynamics via spontaneous baryogenesis. We briefly comment on the case in which the PQ symmetry is broken by a non-minimal coupling to gravity.

  11. Misunderstanding that the Effective Action is Convex under Broken Symmetry

    CERN Document Server

    Asanuma, Nobu-Hiko

    2016-01-01

    The widespread belief that the effective action is convex and has a flat bottom under broken global symmetry is shown to be wrong. We show spontaneous symmetry breaking necessarily accompanies non-convexity in the effective action for quantum field theory, or in the free energy for statistical mechanics, and clarify the magnitude of non-convexity. For quantum field theory, it is also explicitly proved that translational invariance breaks spontaneously when the system is in the non-convex region, and that different vacua of spontaneously broken symmetry cannot be superposed. As applications of non-convexity, we study the first-order phase transition which happens at the zero field limit of spontaneously broken symmetry, and we propose a simple model of phase coexistence which obeys the Born rule.

  12. Early roentgenological grading of femoral shortening is correlated to the late outcome after femoral neck fractures

    International Nuclear Information System (INIS)

    Using orthoradiography, the distance between the centre of the femoral head and the intercondylar notch was assessed at regular intervals in 144 patients who were followed for a 2-year period after osteosynthesis of a femoral neck fracture. Late complications, such as segmental collapse and non-union, occurred in 27% of the patients. The degree of femoral shortening was significantly correlated to the incidence of late complications. At 1 month, femoral shortening of more than 5 mm was observed in 85% of patients who developed late complications, and in only 5% of patients without such complications. Thus, the observation of a shortening of more than 5 mm predicted a greater than 6-fold increase of the incidence of late complications. The prognostic accuracy of this observation 1 month after treatment was 92%. (orig.)

  13. Management of a Low-Energy Penetrating Brain Injury Caused by a Nail

    Science.gov (United States)

    Aguiar, G. B.; Vitorino-Araujo, J. L.; Badke, G. L.; Veiga, J. C. E.

    2016-01-01

    Low-energy penetrating nail injury to the brain is an extremely rare neurosurgical emergency. The most common cause of nail gun injury is work related accidents; other causes result from accidental firing of a nail gun, suicide attempts by firing nail guns into the brain, and bomb blasts containing pieces of nails. Neurosurgical treatment performed by craniotomy still seems to be the safest one; there are reports of complications such as subdural hematoma and intraparenchymal hemorrhages following the blind removal of foreign bodies leading to suggestions that all penetrating foreign bodies should be removed under direct vision. We report a rarely described neurosurgical approach for removal of a penetrating nail from the brain and skull without evidence of associated hematoma and other brain lesions.

  14. Comparison of clozapine in nail and hair of psychiatric patients determined with LC-MS/MS.

    Science.gov (United States)

    Chen, Hang; Xiang, Ping; Sun, Qi-Ran; Shen, Min

    2012-09-01

    As a keratinized material, nail recently has attracting researchers' attention in the pharmaceuticals analysis. There are comparatively limited studies concerning nail's xenobiotic determination and its mechanism. This article reported the development of a sensitive, specific and reproducible LC-MS/MS method, which could be as a foundation of other studies on drug determination in nail. It can also be regarded as the first report on organic drug in mainland China. Sixteen nail samples from volunteers, who were ingested clozapine for more than nine months, are confirmed positive after being analyzed by the method. It is found that contents of clozapine in the patients' nails are above the nanogram level. Besides, a comparative study of clozapine concentration in nails and hair was made, with a result that there exists a correlation between the two materials in terms of clozapine concentration. PMID:23227550

  15. Management of a Low-Energy Penetrating Brain Injury Caused by a Nail

    Directory of Open Access Journals (Sweden)

    V. R. Ferraz

    2016-01-01

    Full Text Available Low-energy penetrating nail injury to the brain is an extremely rare neurosurgical emergency. The most common cause of nail gun injury is work related accidents; other causes result from accidental firing of a nail gun, suicide attempts by firing nail guns into the brain, and bomb blasts containing pieces of nails. Neurosurgical treatment performed by craniotomy still seems to be the safest one; there are reports of complications such as subdural hematoma and intraparenchymal hemorrhages following the blind removal of foreign bodies leading to suggestions that all penetrating foreign bodies should be removed under direct vision. We report a rarely described neurosurgical approach for removal of a penetrating nail from the brain and skull without evidence of associated hematoma and other brain lesions.

  16. Full thickness burns caused by cyanoacrylate nail glue: A case series.

    Science.gov (United States)

    Kelemen, Noemi; Karagergou, Eleni; Jones, Sarah L; Morritt, Andrew N

    2016-06-01

    Artificial (acrylic) nails are popular cosmetic enhancements that provide the user with the appearance of manicured nails, do not chip or crack, and are generally considered very safe to apply. We report three cases where full thickness thermal burns were sustained from nail glue adhesive (cyanoacrylate) during the application of artificial nails. All three cases underwent surgical debridement and split skin graft reconstruction. We carried out an experiment to characterize the exothermic reaction between nail glue and cotton leggings. The average high temperature produced was 68°C which was sustained for 12.2s which is more than sufficient to cause full thickness burns on skin. We report these cases to increase both professional and public awareness of this serious potential complication associated with the application of artificial nails. PMID:26777605

  17. Femoral neck version affects medial femorotibial loading.

    Science.gov (United States)

    Papaioannou, T A; Digas, Georgios; Bikos, Ch; Karamoulas, V; Magnissalis, E A

    2013-01-01

    The aim of this study was to provide a preliminary evaluation of the possible effect that femoral version may have on the bearing equilibrium conditions developed on the medial tibiofemoral compartment. A digital 3D solid model of the left physiological adult femur was used to create morphological variations of different neck-shaft angles (varus 115, normal 125, and valgus 135 degrees) and version angles (-10, 0, and +10 degrees). By means of finite element modeling and analysis techniques (FEM-FEA), a virtual experiment was executed with the femoral models aligned in a neutral upright position, distally supported on a fully congruent tibial tray and proximally loaded with a vertical only hip joint load of 2800 N. Equivalent stresses and their distribution on the medial compartment were computed and comparatively evaluated. Within our context, the neck-shaft angle proved to be of rather indifferent influence. Reduction of femoral version, however, appeared as the most influencing parameter regarding the tendency of the medial compartment to establish its bearing equilibrium towards posteromedial directions, as a consequence of the corresponding anteroposterior changes of the hip centre over the horizontal tibiofemoral plane. We found a correlation between femoral anteversion and medial tibiofemoral compartment contact pressure. Our findings will be further elucidated by more sophisticated FEM-FEA and by clinical studies that are currently planned. PMID:24959355

  18. Femoral fractures in the extremely elderly

    Science.gov (United States)

    Guido, Giulio; Giannotti, Stefano; Bottai, Vanna; Ghilardi, Marco; Bianchi, Maria Giulia; Ceglia, Michael James

    2011-01-01

    Summary At the Trauma Unit of Pisa we performed an observational study reviewing nineties that about 200 patients were treated and underwent surgery for femoral neck fracture from 1998 to 2005. The clinical and radiographic results obtained were discrete, with a mortality of 42.5%, the survivors are still having a good quality of life. PMID:22461814

  19. Sequential changes in the femoral head after intracapsular fracture of the femoral neck. MRI findings

    International Nuclear Information System (INIS)

    Authors obtained T1-weighted MRI images of the femoral head after fracture of the femoral neck and classified the signals into four patterns to investigate the sequential changes of the femoral head. The T1-weighted MRI images obtained initially after femoral neck fracture showed a normal pattern in 10 of the 15 hip joints studied. MRI images obtained subsequently still showed the normal signal pattern in eight of the 10 hip joints which had shown the normal pattern in the first MRI, while two of the 10 joints subsequently showed a band pattern. The joint with the homogeneous pattern in the first MRI subsequently showed a band pattern. Of the three joints with an inhomogeneous pattern in the first MRI, two joints showed a subsequent band pattern, and the other a normal pattern. The joints which showed a band pattern continued to show a similar band pattern. Eventually, all hip joints studied showed a normal or band pattern within six months after intracapsular fracture of the femoral neck. The joints which showed a band pattern in the first MRI continued to show a similar band pattern in the subsequent MRI, without any change. Collapse occurred in one hip joint which showed an extensive band pattern. Plain X-rays showed collapse of one of the joints with a band pattern in the MRI image. It was therefore suggested that necrosis may be present histologically in the femoral head after fracture of the femoral neck even when no abnormalities are present in plain X-rays. Based on the above results, it is considered necessary to follow-up patients with femoral neck fracture with MRI for at least six months until the normal or band pattern is observed. (K.H.)

  20. Early prediction of avascular necrosis of the femoral head following femoral neck fractures

    International Nuclear Information System (INIS)

    The treatment of acute fracture of the femoral neck remains an unsolved problem. Fifty-three patients are presented using 99mTc phosphate scintigraphy with quantitative computer interpretation to predict the viability of the femoral head following acute fracture. The accuracy of prediction was 92.5%; the scans were incorrect in four patients. Armed with a safe, simple diagnostic procedure and a greater than 90% accurate prognosis, a rational program of treatment can be prescribed for the individual patient

  1. Rotational Position of Femoral and Tibial Components in TKA Using the Femoral Transepicondylar Axis

    OpenAIRE

    Aglietti, Paolo; Sensi, Lorenzo; Cuomo, Pierluigi; Ciardullo, Antonio

    2008-01-01

    Proper femoral and tibial component rotational positioning in TKA is critical for outcomes. Several rotational landmarks are frequently used with different advantages and limitations. We wondered whether coronal axes in the tibia and femur based on the transepicondylar axis in the femur would correlate with anteroposterior deformity. We obtained computed tomography scans of 100 patients with arthritis before they underwent TKA. We measured the posterior condylar angle on the femoral side and ...

  2. Electromagnetic media with Higgs-type spontaneously broken transparency

    International Nuclear Information System (INIS)

    In the framework of standard electrodynamics with linear local response, we construct a model that provides spontaneously broken transparency. The functional dependence of the medium parameter turns out to be of the Higgs type. - Highlights: • We study a class of electrodynamics models endowed with a symmetric-type skewon field. • We describe a spontaneous broken transparence phenomenon in some subclass of these models. • The phenomenon is turned out to be of the Higgs-type known from particle physics. • We construct a simple explicit 1-parametric skewon model and calculate the corresponding dispersion relation

  3. Hematoma of the proximal nail fold due to oximeter in a child

    OpenAIRE

    Patricia Chang; Monica Vanesa Vásquez Acajabón

    2014-01-01

    Boy 4 years old, hospitalized due to hemorrhagic chickenpox and sepsis during his clinical examination besides hemorrhagic crust, vesicles and bullous he has also a cutaneous red lesion localized at the right proximal nail fold of the big toenail (Fig. 1), dermatoscopic view of the lesion (Fig. 2). The diagnosis of hematoma of the proximal nail fold due to oximeter was done. The proximal nail fold hematomas due to oximeter are uncommon dermatoses at this level that are caused for the pressure...

  4. Human Nail Plate Modifications Induced by Onychomycosis: Implications for Topical Therapy

    OpenAIRE

    Baraldi, A.; Jones, S A; Guesné, S.; Traynor, M. J.; McAuley, W. J.; Brown, M.B.; Murdan, S.

    2014-01-01

    Purpose Through the characterisation of the human onchomycotic nail plate this study aimed to inform the design of new topical ungual formulations. Methods The mechanical properties of the human nail were characterised using a Lloyd tensile strength tester. The nail’s density was determined via pycnometry and the nail’s ultrastructure by electron microscopy. Raman spectroscopy analysed the keratin disulphide bonds within the nail and its permeability properties were assessed by quantifying wa...

  5. The Investigation of Nail Disorders in Patients with Chronic Renal Failure Undergoing Hemodialysis

    Directory of Open Access Journals (Sweden)

    Perihan Öztürk

    2012-06-01

    Full Text Available Objective: Nail changes are often observed in patients with end-stage renal disease. These changes may occur due to chronic renal failure itself or to the treatment. This study aims to investigate the frequency of nail findings in patients undergoing hemodialysis therapy and to compare with healthy controls. Methods: One hundred and four patients with chronic renal failure treated with hemodialysis, and 104 healthy controls without any dermatological and sistemic diseases, were examined for nail signs. Groups were compared for the incidence of nail findings. Results: 74.4% of hemodialysis patients, and 51.9% of controls had at least one nail finding. The most common signs in hemodialysis patients were (58.7% absence of lunula, (40.5% streaking, (15.7% terry nail and (14.9% half and half nail. In the control group, the most common signs were vertical streaking (36.5%, absence of lunula (8.7% and coilonichi (2.9%. In hemodialysis patients, absence of lunula, beau lines, onycomycosis, terry nail, half and half nail and splinter hemorrhages were found to be significantly higher (p<0.05. Conclusion: The frequency of nail diseases in hemodialysis patients is higher than in the healthy control group. In our study, absence of lunula is the most frequently observed finding in hemodialysis patients. Although the second most common nail change was vertical streaking, it was not different from the control group statistically. We recommend that, when hemodialysis patients are examined, nail examination (as a part of physical examination should be performed. (Turk J Dermatol 2012; 6: 35-8

  6. Femoral neck fracture following groin irradiation

    International Nuclear Information System (INIS)

    Purpose: The incidence and risk factors are evaluated for femoral neck fracture following groin irradiation for gynecologic malignancies. Methods and Materials: The radiation therapy records of 1313 patients with advanced and recurrent cancer of the vagina, vulva, cervix, and endometrium, treated at the Mallinckrodt Institute of Radiology from 1954 to 1992, were reviewed. Median follow-up was 12.7 years. From this group, 207 patients were identified who received irradiation to the pelvis and groins with anterposterior-posterior anterior (AP-PA), 18 MV photons. Data were reviewed regarding irradiation dose to the femoral neck and other presumed risk factors including age, primary site, stage, groin node status, menopausal status, estrogen use, cigarette use, alcohol consumption, and osteoporosis. Results: The per-patient incidence of femoral neck fracture was 4.8% (10 out of 207). Four patients developed bilateral fractures. However, the cumulative actuarial incidence of fracture was 11% at 5 years and 15% at 10 years. Cox multivariate analysis of age, weight, and irradiation dose showed that only irradiation dose may be important to developing fracture. Step-wise logistic regression of presumed prognostic factors revealed that only cigarette use and x-ray evidence of osteoporosis prior to irradiation treatment were predictive of fracture. Conclusion: Femoral head fracture is a common complication of groin irradiation for gynecologic malignancies. Fracture in our database appears to be related to irradiation dose, cigarette use, and x-ray evidence of osteoporosis. Special attention should be given in treatment planning (i.e., shielding of femoral head/neck and use of appropriate electron beam energies for a portion of treatment) to reduce the incidence of this complication

  7. MANAGEMENT OF DISEASES OF LONG BONES WITH KUNTSCHER NAILS

    OpenAIRE

    Ravikant; Vibha; Singh,, G.; Srivastava

    2015-01-01

    BACKGROUND: AIMS: SETTINGS AND DESIGN : The aim of this study was, to devise economical, easy, simple, quick method of fixation of diseased long bones, so that pathological fracture could be prevented and to provide rigid fixation, in those cases which have already developed pathological fractu re, and to achieve arthrodesis. Ten, cases of long bone diseases were managed with the help of K nails, in the Department of Orthopaedics, in CIMS, between, December 2002 ...

  8. Effects of organic solvents on the barrier properties of human nail.

    Science.gov (United States)

    Smith, Kelly A; Hao, Jinsong; Li, S Kevin

    2011-10-01

    The effects of organic solvent systems on nail hydration and permeability have not been well studied. The objectives of the present study were to investigate the effects of binary aqueous organic solvent systems of ethanol (EtOH), propylene glycol (PPG), and polyethylene glycol 400 (PEG) on the barrier properties of nail plates. (3) H-water, (14) C-urea, and (14) C-tetraethylammonium ions were the probes in the nail uptake and transport experiments to study the effect(s) of organic solvents on nail hydration and permeability. Gravimetric studies were also performed as a secondary method to study nail hydration and the reversibility of the nail after organic solvent treatments. Both ungual uptake and transport were directly related to the concentration of the organic solvent in the binary systems. Partitioning of the probes into and transport across the nail decreased with an increase in the organic solvent concentration. These changes corresponded to the changes in solution viscosity and the barrier properties of the nail. In general, the effects for PPG and PEG were more pronounced than those for EtOH. Practically, these results suggest that organic solvents in formulations can increase nail barrier resistivity. PMID:21607952

  9. Effects of Organic Solvents on the Barrier Properties of Human Nail

    OpenAIRE

    Smith, Kelly A; HAO, JINSONG; Li, S. Kevin

    2011-01-01

    The effects of organic solvent systems on nail hydration and permeability have not been well studied. The objectives of the present study were to investigate the effects of binary aqueous organic solvent systems of ethanol (EtOH), propylene glycol (PPG), and polyethylene glycol 400 (PEG) on the barrier properties of nail plates. 3H–water, 14C–urea, and 14C–tetraethylammonium ions were the probes in the nail uptake and transport experiments to study the effect(s) of organic solvents on nail hy...

  10. Effects of organic solvents on the barrier properties of human nail.

    Science.gov (United States)

    Smith, Kelly A; Hao, Jinsong; Li, S Kevin

    2011-10-01

    The effects of organic solvent systems on nail hydration and permeability have not been well studied. The objectives of the present study were to investigate the effects of binary aqueous organic solvent systems of ethanol (EtOH), propylene glycol (PPG), and polyethylene glycol 400 (PEG) on the barrier properties of nail plates. (3) H-water, (14) C-urea, and (14) C-tetraethylammonium ions were the probes in the nail uptake and transport experiments to study the effect(s) of organic solvents on nail hydration and permeability. Gravimetric studies were also performed as a secondary method to study nail hydration and the reversibility of the nail after organic solvent treatments. Both ungual uptake and transport were directly related to the concentration of the organic solvent in the binary systems. Partitioning of the probes into and transport across the nail decreased with an increase in the organic solvent concentration. These changes corresponded to the changes in solution viscosity and the barrier properties of the nail. In general, the effects for PPG and PEG were more pronounced than those for EtOH. Practically, these results suggest that organic solvents in formulations can increase nail barrier resistivity.

  11. Nail as a biomarker of selenium and methyl mercury in a rat model

    International Nuclear Information System (INIS)

    The purpose of this study was to examine the nail response to concurrent intake of methyl mercury (MeHg) and Se. Weanling male Long Evans rats were fed diets containing Se and MeHg. The Se concentration in the nail was well correlated (r2>0.90) with dietary Se in every MeHg supplementation group. Good correlation was observed between dietary MeHg and nail Hg concentration in every Se group. Exposure to high levels of MeHg resulted in a lower (p<0.03) measured nail Se concentration in the highest Se experimental group relative to control. (author)

  12. MECHANICAL FAILURE OF THE LONG GAMMA NAIL IN TWO PROXIMAL FEMUR FRACTURES

    OpenAIRE

    Najibi, Soheil; Mark, Lemos; Fehnel, David

    2010-01-01

    Mechanical failure of the long gamma nail was encountered in two elderly patients with proximal femur fractures over a 6-month period. One of the patients had a known history of lymphoma. The other patient had a history of rheumatoid arthritis but no history of cancer or other metabolic bone disease. Both nails failed at the junction of the compression screw and the nail. The angle of failure of the nail was the same in both cases. The index of suspicion for imminent mechanical failure of the...

  13. Lengthening over nails using the double plate system ONAS-DPS.

    Science.gov (United States)

    Antolič, Vane

    2016-01-01

    Stable insertion of large Schanz screws behind an intramedullary (IM) nail when lengthening over nails (LON) may be difficult due to the limited bone stock. Additionally, the highly probable contact between the screws and IM nail (which is difficult to avoid) increases the likelihood of infection spreading from the skin via Schanz screws directly to the IM nail. A new device for LON has been developed. Instead of inserting Schanz screws from the external fixator beside the IM nail (as in standard LON), a system of two overlaying plates was constructed. Schanz screws can be fixed to the plates without entering the bone. The plates are fixed to the bone using four angle stability screws. The holes in the plates offer stabile fixation for a chosen angle under which the screw is positioned through the cortical bone. Using the new system there is no need to place Schanz screws behind the IM nail. Instead, Schanz screws pass to the plate and not through the bone. The new system for elongation over IM nail is called "Over Nail Angle Stability-Double Plate System" (ONAS-DPS) [Antolič V (2013) Modular side device with an intramedullary nail for guiding a bone during its lengthening. World Intellectual Property Organization. International Publication number: WO 2013/176632 A1]. PMID:27163094

  14. Lengthening over nails using the double plate system ONAS-DPS

    Directory of Open Access Journals (Sweden)

    Antolič Vane

    2016-01-01

    Full Text Available Stable insertion of large Schanz screws behind an intramedullary (IM nail when lengthening over nails (LON may be difficult due to the limited bone stock. Additionally, the highly probable contact between the screws and IM nail (which is difficult to avoid increases the likelihood of infection spreading from the skin via Schanz screws directly to the IM nail. A new device for LON has been developed. Instead of inserting Schanz screws from the external fixator beside the IM nail (as in standard LON, a system of two overlaying plates was constructed. Schanz screws can be fixed to the plates without entering the bone. The plates are fixed to the bone using four angle stability screws. The holes in the plates offer stabile fixation for a chosen angle under which the screw is positioned through the cortical bone. Using the new system there is no need to place Schanz screws behind the IM nail. Instead, Schanz screws pass to the plate and not through the bone. The new system for elongation over IM nail is called “Over Nail Angle Stability-Double Plate System” (ONAS-DPS [Antolič V (2013 Modular side device with an intramedullary nail for guiding a bone during its lengthening. World Intellectual Property Organization. International Publication number: WO 2013/176632 A1].

  15. Contribution to the method for determining femoral neck axis

    Directory of Open Access Journals (Sweden)

    Anđelković Zoran

    2014-01-01

    Full Text Available Introduction. Femoral neck axis plotting is of great significance in measuring parameters that define femoral head-neck junction sphericity in the group of patients with the femoroacetabular impingement. Literature methods of femoral neck axis determination have weaknesses associated with the risk of obtaining inaccurate values of certain parameters. Objective. Method of plotting of the femoral neck axis by two parallel lines that belong to the medial quarter of the femoral neck is proposed. Method was tested on the anatomic specimens and the respective radiograms. Methods. A total of 31 anatomic specimens of the proximal femur and respective radiographs were used, on which three axes of the femoral neck were plotted; accordingly, alpha angle value was determined and tested with corresponding parametric tests, with the measurement error of less than 5% and the strength of the applied tests of 80%. Results. Alpha angle values obtained by plotting femoral neck axis using the literature and methods we have proposed were not significantly different in our series, and, in more than a half of the specimens, the two axes overlapped each other. Conclusion. The advantage of the proposed method does not depend on the position of the femoral head rotation center in relation to the femoral neck, which favors proposed method for measuring the angles of femoral head sphericity in patients with the femoral head translation. Disadvantage of the study is a small sample size for valid conclusions about the applicability of this method in clinical practice.

  16. Fracture Union in Closed Interlocking Nail in Humeral Shaft Fractures

    Institute of Scientific and Technical Information of China (English)

    Ramji Lal Sahu; Rajni Ranjan; Ajay Lal

    2015-01-01

    Background:Fracture shaft humerus is a major cause of morbidity in patients with upper extremity injuries.The aim of this study was to evaluate the outcome of interlocking nail in humeral shaft fractures.Methods:This study was conducted in the Department of Orthopedic Surgery in SMS and R Sharda University from January 2010 to November 2013.Seventy-eight patients were recruited from emergency and out-patient department having a close fracture of humerus shaft.All patients were operated under general anesthesia and closed reamed interlocking nailing was done.All patients were followed for 9 months.Results:Out of 78 patients,69 patients underwent union in 90-150 days with a mean of 110.68 days.Complications found in four patients who had nonunion,and five patients had delayed union,which was treated with bone grafting.All the patients were assessed clinically and radiologically for fracture healing,joint movements and implant failure.The results were excellent in 88.46% and good in 6.41% patients.Complete subjective,functional,and clinical recovery had occurred in almost 100% of the patients.Conclusions:The results of the present study indicates that in the presence of proper indications,reamed antegrade intramedullary interlocked nailing appears to be a method of choice for internal fixation of osteoporotic and pathologic fractures.

  17. Distal Locking Screws for Intramedullary Nailing of Tibial Fractures.

    Science.gov (United States)

    Agathangelidis, Filon; Petsatodis, Georgios; Kirkos, John; Papadopoulos, Pericles; Karataglis, Dimitrios; Christodoulou, Anastasios

    2016-01-01

    Recently introduced tibial intramedullary nails allow a number of distal screws to be used to reduce the incidence of malalignment and loss of fixation of distal metaphyseal fractures. However, the number of screws and the type of screw configuration to be used remains obscure. This biomechanical study was performed to address this question. Thirty-six Expert tibial nails (Synthes, Oberdorf, Switzerland) were introduced in composite bone models. The models were divided into 4 groups with different distal locking configurations ranging from 2 to 4 screws. A 7-mm gap osteotomy was performed 72 mm from the tibial plafond to simulate a 42-C3 unstable distal tibial fracture. Each group was divided in 3 subgroups and underwent nondestructive biomechanical testing in axial compression, coronal bending, and axial torsion. The passive construct stiffness was measured and statistically analyzed with one-way analysis of variance. Although some differences were noted between the stiffness of each group, these were not statistically significant in compression (P=.105), bending (P=.801), external rotation (P=.246), and internal rotation (P=.370). This in vitro study showed that, when using the Expert tibial nail for unstable distal tibial fractures, the classic configuration of 2 parallel distal screws could provide the necessary stability under partial weight-bearing conditions. PMID:26840700

  18. Intramedullary nailing of clavicular midshaft fractures in adults using titanium elastic nail

    Directory of Open Access Journals (Sweden)

    CHEN Qing-yv

    2012-02-01

    Full Text Available 【Abstract】 Objective: Studies showed elastic stable intramedullary nailing (ESIN of displaced midclavicular fractures has excellent outcomes, as well as high complication rates and specific problems. The aim was to discuss ESIN of midshaft clavicular fractures. Methods: Totally 60 eligible patients (aged 18-63 years were randomized to either ESIN group or non-operative group between January 2007 and May 2008. Clavicular shortening was measured after trauma and osseous consolidation. Radiographic union and complications were assessed. Function analysis including Constant shoulder scores and disabilities of the arm, shoulder and hand (DASH scores were performed after a 15-month follow-up. Results: ESIN led to a signifcantly shorter time to union, especially for simple fractures. In ESIN group, all patients got fracture union, of which 5 cases had medial skin irritation and 1 patient needed revision surgery because of implant failure. In the nonoperative group, there were 3 nonunion cases and 2 symptomatic malunions developed requiring corrective osteotomy. At 15 months after intramedullary stabilization, patients in the ESIN group were more satisfied with the appearance of the shoulder and overall outcome, and they benefited a lot from the great improvement of post-traumatic clavicular shortening. Furthermore, DASH scores were lower and Constant scores were significantly higher in contrast to the non-operative group. Conclusion: ESIN is a safe minimally invasive surgical technique with lower complication rate, faster return to daily activities, excellent cosmetic and better functional results, restoration of clavicular length for treating mid-shaft clavicular fractures, resulting in high overall satisfaction, which can be regard as an alternative to plate fixation or nonoperative treatment of mid-shaft clavicular fractures. Key words: Clavicle; Fracture fixation intramedu- llary; Outcome assessment

  19. PP-waves and softly broken N=1 SYM

    OpenAIRE

    Bigazzi, F.; Cotrone, A. L.

    2004-01-01

    We review the Penrose limit of the Type IIB dual of softly broken N=1 SYM in four dimensions obtained as a deformation of the Maldacena-Nunez background. We extract the string spectrum on the resulting pp-wave background and discuss some properties of the conjectured dual gauge theory hadrons, the so called ``Annulons''.

  20. Quantum restoration of broken symmetry in onedimensional loop space

    Indian Academy of Sciences (India)

    Pinaki Patra; Tanmay Mandal; Jyoti Prasad Saha

    2014-06-01

    For one-dimensional loop space, a nonlinear nonlocal transformation of fields is given to make the action of the self-interacting quantum field to the free one. A specific type of classically broken symmetry is restored in quantum theory. One-dimensional sine-Gordon system and sech interactions are treated as the explicit examples.