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Implant that has been used for fixation of a broken wrist. Closed reduction internal fixation (CRIF) is reduction without any open surgery, followed by internal fixation. It appears to be an acceptable alternative in unstable distressed lateral condylar fractures of the humerus in children, but if fracture displacement after closed reduction exceeds 2 mm, open reduction and internal fixation ...
An intramedullary rod, also known as an intramedullary nail (IM nail) or inter-locking nail or Küntscher nail (without proximal or distal fixation), is a metal rod forced into the medullary cavity of a bone. IM nails have long been used to treat fractures of long bones of the body.
Orthopedic surgery attempts to recreate the normal anatomy of the fractured bone by reduction of the displacement. [citation needed] This sense of the term "reduction" does not imply any sort of removal or quantitative decrease but rather implies a restoration: re ("back [to initial position]") + ducere ("lead"/"bring"), i.e., "bringing back to ...
Bone malrotation refers to the situation that results when a bone heals out of rotational alignment from another bone, or part of bone. It often occurs as the result of a surgical complication after a fracture where intramedullary nailing (IMN) occurs, [1] especially in the femur and tibial bones, but can also occur genetically at birth.
For femoral shaft fractures, reduction and intramedullary nailing is currently recommended. [14] The bone is re-aligned, then a metal rod is placed into the femoral bone marrow, and secured with nails at either end. This method offers less exposure, a 98–99% union rate, lower infection rates (1–2%) and less muscular scarring. [14] [15] [17]
[1] Intramedullary nailing is a common technique, but external fixation may have equivalent outcomes and be preferred under certain patient conditions that may preclude intramedullary nailing, such as the presence of a total knee arthroplasty. [6] [7]
Surgical options may include open reduction and internal fixation, closed reduction and percutaneous pinning, and intramedullary nailing. [2] Joint replacement may be another option. [2] Proximal and shaft fractures generally have a good outcome while outcomes with distal fractures can be less good. [2] They represent about 4% of fractures. [2]
Unreamed intramedullary nailing is advantageous because it has a lower incidence of superficial infection and malunion compared to external fixation. [24] However, unreamed intramedullary nailing can result in high rates of hardware failure if a person's weight bearing after surgery is not closely controlled. [24]