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Re: Fixion nails
Nuno Craveiro Lopes 12 Март 2006, 14:30
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Alex,
We use Fixion nail since 2000 and reviewed our results two years ago on the treatment of 60cases of tibial, femoral and umeral close and open
fractures, pseudarthrosis and pathologic fractures and found:
8% complication rate, including: bending (5%) fissuration (3%). Both because of bad technique
Best indications are:
- Fractures within 10 cm of the extremities, transverse, oblique, segmental or with butterfly fragment but with cortical contact. Must have
not longitudinal fissures or comminution.
Advantages are:
-Can be used unreamed or reamed
-Fast surgical procedure (15 min)
-Less blood loss and radiological exposure
-Same price as an interlocking nail
Best regards,
Nuno Craveiro Lopes
Head of Orthopedic and Trauma Department
Garcia de Orta Hospital
Almada, Portugal
Web Page: http://clientes.netvisao.pt/nfrancac/
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Re: Fixion nails
Nuno Craveiro Lopes 12 Март 2006, 14:58
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Alex,
Some more comments:
-As interlocking nail we use Grosse-Kempf nails. Fixion nail has here an
equivalent price to a Grosse nail plus 4 interlocking screws.
- We found Fixion nail superior to interlocking nail on the indication I
mentioned on the previous mail, because it permits axial compression with
a good stability on bending and rotational forces at the fracture site and
consolidation is fast.
We continue using it on those cases.
Best regards
Nuno Craveiro Lopes
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Re: Fixion nails
Alexander Chelnokov 12 Март 2006, 15:13
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THX for the detailed comment!
NL> - Fractures within 10 cm of the extremities,
What do you mean?
NL> Must have not longitudinal fissures or comminution.
Is there any strong reason to have few systems of nailing instead of one which can cover all indications witout these exclusions?
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Re: Fixion nails
Отправитель: Nuno Craveiro Lopes 13 Март 2006, 00:51
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> NL> - Fractures within 10 cm of the extremities,
> AC>What do you mean?
Diaphyseal fractures within 10 cm of the extermities
> AC> Is there any strong reason to have few systems of nailing instead of
> one which can cover all indications without these exclusions?
Our policy is to use the best implant for a particular type of fracture/lesion with a good cost/benefit balance, including direct and
indirect costs (patient benefit).
We found fixion superior to interlocking on those fractures where compression forces induced by weight bearing on the fracture site improve the general result, including precocious weight bearing, functional recovering and faster consolidation. By the other side operating time is
much less: we can almost do two fixion nails on the same time we do an interlocking one, which is important because we have limited operating
periods.
By the other side, we fount fixion a great implant to treat pseudarthrosis (reamed) and pathologic fractures (not reamed).
Of course it does not substitute interlocking at all!
Other inconvenience of Fixion: Patients cannot be cremated with it, with risk of explosion and destruction of crematory!
Best regards,
Nuno Craveiro Lopes
Head of Orthopedic and Trauma Department
Garcia de Orta Hospital
Almada, Portugal
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Re: Fixion nails
Отправитель: Alexander Chelnokov 13 Март 2006, 00:57
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NL> Diaphyseal fractures within 10 cm of the extermities
I am still uncertain - within what 10 cm and of what extremities? Do you mean lower extremities? And shaft fractures not closer than 10 cm from bone ends? Or zone of shattering not longer than 10 cm? Or something else?
NL> We found fixion superior to interlocking on those fractures where
NL> compression forces induced by weight bearing on the fracture site improve
Really comparative studies are necessary to compare this to dynamically locked nails.
NL> By the other side operating time is much less: we can almost do
Yes, this is substantial.
NL> By the other side, we fount fixion a great implant to treat
NL> pseudarthrosis (reamed) and pathologic fractures (not reamed).
Pseudarthroses are successfully treated by interlocking nails. Again comparison is necessary.
NL> Of course it does not substitute interlocking at all!
Yes, thx for the clearance about indications.
NL> Other inconvenience of Fixion: Patients cannot be cremated with it, with
NL> risk of explosion and destruction of crematory!
You've made my day.
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Re: Fixion nails
Отправитель: Anthony N Brown 15 Март 2006, 20:37
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Dear Alex and List members,
I do not have experience with the fixion nail but it sounds like it is well descibed as an extension of a Kuntscher nail and therefore limited to fractures with some inherent stability and diaphyseal in location.
The gold standard for care of the unstable long bone fx is the locked intramedullary nail. The main drawbacks being cost and the need for reliable fluoroscopic control.
As you are aware, but I think a lot of the list members might not be, the SIGN nail is a low/no cost, us-fda approved, interlocking nail for the femur, tibia and humerus. Most importantly it was designed specifically for use by surgeons without access to fluoroscopic control. It is used by hundreds of surgeons in more than 40 countries.
In addition to bringing the gold standard of care of long bone fxs to those who could not previously afford it, the nail comes with the cumulative expertise of a community of surgeons from throughout the world as well as an ever growing database of cases.
We would like to invite interested/curious surgeons from anywhere to contact us thru the website http://www.sign-post.org/ or at our booth and seminar at AAOS. We are looking for surgeons who will help us toward our goal of creating equality of fracture care throughout the world.
Thanks,
Anthony N Brown
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