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Produtos >Trauma - Fixadores internos >Haste de Tibia 1) Validation of the accuracy of distal targeting and clinical results in the Orthofix tibial nailing system. Gandaifis N., Babis G. C., Papadopoulos E. C., Karachalios T., Tsarouchas J.; 1st Orthopaedic Department, University of Athens, KAT General Hospital and Trauma Center, Kifissia, Athens, Greece. Aims: We present our 5 year experience with the Orthofix tibial nailing system, evaluating also the distal locking targeting system. Methods: 97 fresh tibial fractures in the same number of patients with a mean age of 38,5 years (17-85) were treated. 3 were lost from the follow-up. 20 of the fractures were grade I open fractures, 4 grade II and 1 grade IIIA. Reduction was achieved under manual traction and manipulation. Conventional power reaming was performed in 67 cases (69%) and minimal hand reaming in the rest. The external targeting device failed in 10 distal locking screws, in 6 of which the second attempt was successful; an image intensifier was used in the remaining 4. Results: Fracture healing, confirmed clinically and radiographically, was observed at a mean of 17 weeks (12-28 weeks). No tibial non-union occurred, however six fractures showed delayed union. All patients eventually gained a full range of motion knee and ankle joint and only 12 of them (12%) complained of mild anterior knee pain. All patients returned to their previous activity, except for one disabled from a CNS injury. The radiographic evaluation showed preservation of the tibial axis in all patients and additionally that no mechanical failure of either the nail or the screws occurred. Conclusions: We conclude that the Orthofix nailing system is a clinically effective system. Distal locking can be performed with ease without significant exposure to radiation, provided that the operative technique is accurately followed. 2) Unreamed interlocking intramedullary nailing in patients with closed tibia shaft fracture as a final treatment. Pantazis E, Gouvas G, Manaloglou K, Vragalas V, Delaportas N, Karanassos TH. Orthopaedic Department of 424 General Military Training Hospital, Thessaloniki, Greece. Aims: To present the experience of our department in the treatment of the closed shaft tibial fractures using the unreamed nail of Orthofix. Material-Method: Between 1991-2001 we treated 180 closed fractures. There were 162 men and 18 women. The preferred method of stabilization is unreamed nailing. Results: The average follow-up was 38 months. 165 of the fractures that were treated with uiin, healed in the proper time (3-6 months). The rest of them did not have callus signs and we revised the nailing using reamed nails. No screws and nail failure was observed. Three deep venous thrombosis, healed with no further complications. 65% of our patients were able to return to their usual activities within 4 months and the rest between 4-8 months. 15 non-unions and 2 malunions occurred and were treated with correction and reamed interlocking nailing. P.W.B. allowed for fractures type A and B according AO classification from the beginning. F.W.B. allowed at mean 3 months. Conclusions: Immediate stabilization of the close fractures of the tibia using uiin (Orthofix device): advances the healing of the fractures, decreases hospitalization time, helps early return to social activities, is easier for the surgeon, easier to place the distal locking screws, requires less operative time and less radiation. We did not find this method inferior to reamed interlocking nailing. | |
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