[True/Flex intramedullary nailing for forearm shaft fractures. Long-term results]. 2012

J Trlica, and I Počepcov, and J Kočí, and M Frank, and T Holeček, and T Dědek
Chirurgická klinika Lékařské fakulty Univerzity Karlovy a Fakultní nemocnice Hradec Králové.

OBJECTIVE Presentation of technical experience and the clinical and functional results of intramedullary fixation of forearm shaft fractures. METHODS Between January 1994 and December 2009, a total of 96 patients with 144 radial and/or ulnar fractures (ulna, 33; radius,15; both, 48) were treated by nailing (True/Flex®). According to the AO classification there were 22-A, 22-B and 22-C type fractures in 39 (41%), 44 (46%) and 13 (13%).cases, respectively. Of these, 82 (85%) were closed (types: 0, 48; I, 33; II, 1) and 14 (15%) were open (types: I, 13; II, 1; III, 0) fractures. Seventy-eight patients (81%) were followed up and their functional outcomes were evaluated according to the criteria of Anderson et al. The average interval between the operation and final follow-up was 28 months (15 to 96 months) RESULTS The average time to surgery was 2.2 days (0 to 25 days). Early complications were recorded in 4% of the patients (1x bursitis olecrani; 1x end cup replacement; 1x bending of nails) and late complications in 15% (5x non-union; 2x delay union; 4x bursitis olecrani; 1x ruptured tendon). Bone healing was achieved in 95% of the cases and took on average 16 weeks (7 to 34 weeks). No infection, refracture or synostosis occurred. Primary loss of reduction was recorded in four cases due to distraction in one, bent nails in two and a wrong size of the implant in one; secondary loss of reduction was found in three cases, with two cases of radius shortening and one 10°malrotation. No primary malrotation was recorded, but secondary loss of alignment was seen in the distal part of the radius and the proximal part of the ulna. Functional results according to the Anderson criteria were excellent and good in 87% of the cases. CONCLUSIONS Intramedullary mailing provides good stability to mid- and distal-third shaft fractures of the ulna and mid- and proximalthird shaft fractures of the radius, particularly in AO type A and type B fractures. The technical aspects of the method are analysed in detail in this paper. CONCLUSIONS True/Flex® intramedullary nailing, because of its minimally invasive approach and close reduction, allows us to minimise the risk of wound and neurovascular complications, especially in proximal shaft fractures of the radius.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011885 Radius Fractures Fractures of the RADIUS. Galeazzi Fracture,Galeazzi Fracture Dislocation,Radial Fractures,Dislocation, Galeazzi Fracture,Fracture Dislocation, Galeazzi,Fracture, Galeazzi,Fracture, Radial,Fracture, Radius,Radial Fracture,Radius Fracture
D001858 Bone Nails Rods of bone, metal, or other material used for fixation of the fragments or ends of fractured bones. Bone Pins,Bone Nail,Bone Pin,Nail, Bone,Nails, Bone,Pin, Bone,Pins, Bone
D005594 Fracture Fixation, Intramedullary The use of nails that are inserted into bone cavities in order to keep fractured bones together. Intramedullary Nailing,Nailing, Intramedullary,Osteosynthesis, Fracture, Intramedullary,Fixation, Intramedullary Fracture,Fixations, Intramedullary Fracture,Fracture Fixations, Intramedullary,Intramedullary Fracture Fixation,Intramedullary Fracture Fixations,Intramedullary Nailings,Nailings, Intramedullary
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D014458 Ulna Fractures Fractures of the larger bone of the forearm. Fracture, Ulna,Fractures, Ulna,Ulna Fracture
D017102 Fracture Healing The physiological restoration of bone tissue and function after a fracture. It includes BONY CALLUS formation and normal replacement of bone tissue. Fracture Healings,Healing, Fracture,Healings, Fracture

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