Multi–functional intramedullary self-locking ulna nailing system: Proximal oblique locking without the need of fluoroscopic guidance, and it’s effects on olecranon joint surface
Multi–functional intramedullary self-locking ulna nailing system: Proximal oblique locking without the need of fluoroscopic guidance, and it’s effects on olecranon joint surface
Aim: Due to the necessity of using the small diameter nails in the ulna, negative outcomes such as failure in the self-locking, longterm exposure to radiation, and increased operation time are expected. Several clinical trials propose that an ideal nail system forunlar fixation challenge has not been developed yet.Material and Methods: This study involved the use of a new multifunctional intramedullary self-locking ulna nailing system and 36intact dry cadaveric ulna bones. The relationship between the oblique self-locking screw, which has made a crucial contributionto the nailing system, and the joint surface of olecranon was investigated because this screw does not necessitate the use offluoroscopic guidance and is easy to apply.Results: In our study, during anterior or medial or posterior oblique locking, no olecranon joint surface damage occurred on any bonewith a locking rate of 100%.Conclusion: The clinical trials demonstrated that the proximal oblique locking was achieved easily in a short period of time, indicatingthe device’s immense value for the patient and the surgeon.
___
- 1. Krzykawski R, Król R, Kamiński A. The results of locked intramedullary nailing for non-union of forearm bones. Ortop Traumatol Rehabil 2008;10:35-43.
- 2. Labbe JL, Peres O, Leclair O, et al. Isolated fracture of the unlar diaphysis, from plate osteosynthesis to intramedullary nailing. Rev Chir Orthop Reparatrice Appar Mot 1998;84:515-22. [Article in French].
- 3. Mseddi MB, Manicom O, Filippini P, et al. Intramedullary pinning of diaphyseal fractures of both forearm bones in adults: 46 cases. Rev Chir Orthop Reparatrice Appar Mot 2008;94:160-7. [Article in French]
- 4. Visna P, Kalvach J, Valcha M, et al. Treatment of diaphyseal forearm fractures with locking intramedullary nail. Rozhl Chir 2006;85:631-36. [Article in Czech]
- 5. Akpinar F, Aydinlioglu A, Tosun N, et al. Morphologic evaluation of the ulna. Acta Orthop Scand 2003;74: 415-19.
- 6. Wang AA, Mara M, Hutchinson DT. The proximal ulna: An anatomic study with relevance to olecranon osteotomy and fracture fixation. J Shoulder Elbow Surg 2003;12:293-6.
- 7. Boussouga M, Bousselmam N, Lazrek K, et al. Surgical management of isolated fractures of the ulnar shaft. Acta Orthop Belg 2002;68:343-7. [Article in French]
- 8. Holmenschlager F, Winckler S, Brug E. Intramedullary nailing in forearm shaft fractures – an 18 year retrospective study of a patient sample. Zentralbl Chir 1997;122:1002-9. [Article in German]
- 9. McFarlane AG, Macdonald LT. Parameters of the unlar medullary canal for locked intramedullary nailing. J Biomed Eng 1991;13:74-6.
- 10. Ring D, Jupiter JB, Simpson NS. Monteggiafractures in adults. J Bone Joint Surg Am 1998;80:1733-44.
- 11. Weckbach A, Blattert TR, Weisser Ch. Interlocking nailing of forearm fractures. Arch Orthop Trauma Surg 2006;126:309-15.
- 12. Boriani S, Lefevre C, Malingue E, et al. The Lefevre ulnar nail. Chir Organi Mov 1991;76:151-5.
- 13. De Pedro JA, Garcia-Navarrete F, Garcia De Lucas F, et al. Internal fixation of unlar fractures by locking nail. Clin Orthop Relat Res 1992;283:81-5.
- 14. Hong G, Luo CF, Zhang CQ, et al. Internal fixation of diaphyseal fractures of the forearm by interlocking intramedullary nail: short-term results in eighteen patients. J OrthopTrauma 2005;19:384-91.
- 15. Gehr J, Friedl W. Intramedullary locking compression nail for the treatment of an olecranon fracture. Oper OrthopTraumatol 2006;18:199-213.
- 16. Hofmann A, Hessmann MH, Rudig L, et al. Intramedullary osteosynthesis of the ulna in revision surgery. Unfallchirurg 2004;107:583-92. [Article in German]
- 17. Walz M, Kolbow B, Möllenhoff G. Fracture of the distal ulna accompanying fracture of thedistalradius. Minimally invasive treatment with elastic stable intramedullary nailing (ESIN). Unfallchirurg 2006;109:1058-63. [Article in German]
- 18. Chapman MW, Gordon JE, Zissimos AG. Compression plate fixation of acute fractures of the diaphysis of the radius and ulna. J Bone Joint Surg Am 1989;71:159- 69.
- 19. Hidaka S, Gustilo RB. Refracture of Bones of theForearm After Plate Removal. J Bone JointSurg 1984;66:1241-3.
- 20. Moerman J, Lenaert A, De Coninck D, et al. Intramedullary fixation of forearm fractures in adults. Acta Orthop Belg 1996;62:34-40.
- 21. Schone G. Behandlungvon Vorderarm frakturenmit Bolzung. Munch Med Wochenschr 1913;60:2327.
- 22. VonSaal F. Review of complications in intramedullary nailing. J Bone Joint Surg 1950;32:717.
- 23. Rush LV, Rush HL. Reconstruction operation for comminuted fracture of the upper third of the ulna. Am J Surg 1937;38:332.
- 24. Bohler L. Medullary Nailing of Kuntscher. (Trans. Tretter, H.) Baltimore: Williams &Wilkins, 1948;334-74.
- 25. Street DM. Intramedullary forearm nailing. Clin Orthop 1986;2:2-19.
- 26. Sage FP. Medullary fixation of fractures of theforearm. A study of the medullary canal of the radius and a report of fifty fractures of the radius treated with a prebent triangular nail. J Bone Joint Surg Am 1959;41:1489-516.
- 27. Jones DJ, Henley MB, Schemitsch EH,et al. A biomechanical comparison of two method of fixation of fractures of the forearm. J OrthopTrauma 1995;9:198-206.
- 28. Windisch G, Clement H, Grechenig W, et al. A morphometrical study of the medullary cavity of the ulna referred to intramedullary nailing. Surg Radiol Anat 2007;29:47-53.
- 29. Windisch G, Clement H, Grechenig W, et al. The anatomy of the proximal ulna. Shoulder Elbow Surg 2007;16:661-6.
- 30. Saka G, Saglam N, Kurtulmus T, et al. Interlocking intramedullary ulna nails in isolated ulna diaphyseal fractures: a retrospective study. Acta Orthop Traumatol Turc 2013;47:236-3.