OBJECTIVE To determine the effect of reamed versus nonreamed intramedullary (IM) nailing of lower extremity long bone fractures on the rates of nonunion, implant failure, malunion, compartment syndrome, pulmonary embolus, and infection. DESIGN Quantitative systematic review of prospective, randomized controlled trials. DATA IDENTIFICATION MEDLINE and SCISEARCH computer searches provided lis...

Reamed locked intramedullary nailing remains the standard treatment for displaced tibial shaft fractures. Supra-patellar tibial nailing in the semiextended position has been suggested as a safe and effective surgical technique that allows mitigating certain challenges of the standard subpatellar approach. Suprapatellar nailing seems to facilitate achieving and maintaining fracture reduction, pa...

BACKGROUND Intramedullary nailing is commonly used for treating fractures of the tibial shaft. These fractures are one of the most common long bone fractures in adults. OBJECTIVES To assess the effects (benefits and harms) of different methods and types of intramedullary nailing for treating tibial shaft fractures in adults. SEARCH METHODS We searched the Cochrane Bone, Joint and Muscle Tra...

BACKGROUND Approximately 2 million patients in the United States annually undergo total joint arthroplasty with reaming and placement of intramedullary nails, resulting in extravasation of bone marrow and fat into the circulatory system and potentially causing fat embolism syndrome. Acute and chronic changes in mental status documented after these procedures may be related to embolic events. Th...

OBJECTIVE To compare the results and complications of the various modalities for treating closed fractures of the tibial shaft described in the prospective literature. DATA SOURCES A MEDLINE search of the English language literature from 1966 to 1999 was conducted using the MeSH heading "tibial fractures." Studies pertaining to the management of closed tibial shaft fractures were reviewed, an...

A review of the literature in 2002, analyzing 13 articles with 895 tibial shaft fractures treated by cast immobilization, fixation with plate and screws, and reamed or unreamed intramedullary nailing, concludes that the combined incidence of delayed union and nonunion was lower with operative, surgical treatment especially with plate osteosynthesis, than with closed treatment. This incidence wa...

Introduction: Intramedullary nailing (IMN) of high tibia fracture has some mechanical and biological advantages over the other form of fixation. However, valgus, apex anterior malalignment and anterior displacement of proximal fragment commonly occur after isolated IMN fixation of proximal high tibia fracture. The purpose of this study is to determine the effectiveness of using 3.5-mm locking c...

The need for reaming and the number of locking screws to be used in intramedullary (IM) tibial nailing of acute fractures as well as routine bone grafting of tibial aseptic nonunions have not been clearly defined. We describe the results of reamed interlocked IM nails in 233 patients with 247 tibial fractures (190 closed, 27 open and 30 nonunions). Ninety-six percent of the fractures were unite...

INTRODUCTION Heterotopic ossification is a rare complication of musculoskeletal injuries, characterized by bone growth in soft tissues. Percutaneous antegrade intramedullary nailing represents the 'gold standard' for the treatment of femur shaft fractures. Minor bone growth is frequently seen around the proximal end of reamed femoral nails (so-called 'callus caps'), which are asymptomatic and l...

AO Principles are described today as follows: * appropriate reduction * appropriate stabilization * preservation of vascularity * painless early mobilization These requirements can all be met by intramedullary osteosynthesis for suitable indications. The modern generation of nails is highly user-friendly and application of the systems is very safe. Outcome predictions favor reamed locked nailin...