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Re: Fixion nails
послал Erden Kilic 12 Март 2006, 18:35
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You are right. Diameter of unreamed locking nails is less than diameter of the isthmus. But these nails have a high incidence of delayed union, non-union and secondary procedures for union.
I meant that fixion's deflated diameter which is at least 2-3 mm less than the diameter of the bone, helps its insertion. In classic Kьnstcher or reamed locking nails, nail is inserted by force through the medullary canal and with some resistance. With fixion nails you can easily insert without reaming; actually it is the
same in unreamed nails.
I emphasized to use minimal incision through the fracture site in femoral fractures to help reduction and insertion of nail when surgeon does not have fluoroscopy. In fact the inventory you need to achieve operation is reasonably reduced, three nails, one you need, one longer and one shorter to be used in case, and the small insertion set.
Fractures proximal and distal to isthmus can be
managed by these nails, as it increases the contact area. Fractures very close to joints can be fixed with locking types of fixion nails.
I believe that important issues about these nails are: reduced operation time by easy insertion, optional reaming and no distal locking, reduced inventory, no floroscopy so no radiation to patient and to us.
I also want to add that biomechanics of these nails allow axial compression like Kьntscher nails. It resolves the stability problems of Kьnstcher nails and expands its indications. But indications of these fixion nails stand still between Kьntscher and locking nails.
Best regards.
Erden KILIC, MD
Konya Military Hospital
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