Pathophysiological advantages of rinsing-suction-reaming (RSR) in a pig model for intramedullary nailing

Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society
Marc SchultAlexander Joist

Abstract

Although reamed intramedullary nailing has been one of the greatest advances in modern fracture care, the concomitant increase in medullary cavity pressure leads to intravasation of bone marrow content into the blood stream, an effect that can evoke serious systemic reactions. A newly developed rinsing-suction-reamer (RSR) was able to substantially reduce the pressure and bone marrow intravasation content during experimental femoral nailing. We investigated the pathophysiological effects using the RSR, testing the hypothesis that by reducing marrow fat embolization, RSR would also reduce the activation of coagulation compared with the universal AO-Reamer (AOR) and comparable to external fixation. Twenty-two pigs were treated with either simulated external fixation or reamed femoral nailing using AOR or RSR. During surgery, the intramedullary pressure was measured and intravasation of medullary material was quantified. After surgery, the pigs were kept anaesthetised and monitored for 6 h. At defined intervals, serological, hematological, and hemodynamic parameters were evaluated. The RSR was significantly superior when compared to AOR with regard to the generation of intramedullary pressure and fat embolization; however, with ex...Continue Reading

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Citations

Jan 19, 2011·International Orthopaedics·George CoxPeter V Giannoudis
Oct 5, 2011·Injury·Nikolaos K KanakarisPeter V Giannoudis
May 9, 2008·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Paul N SmithRachel W Li
Jul 26, 2008·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Ryan M PorterChristopher H Evans
Oct 9, 2008·Clinical Orthopaedics and Related Research·Mohan V BelthurJohn E Herzenberg
Jan 27, 2009·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Michael OberstJoerg Haberstroh
Jul 27, 2010·Journal of Orthopaedic Trauma·Mudussar A AhmadPeter V Giannoudis
May 24, 2014·The Journal of Trauma and Acute Care Surgery·Frank HildebrandHans-Christoph Pape
Jun 5, 2020·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Takahiro NiikuraRyosuke Kuroda
May 18, 2021·Case Reports in Orthopedics·Dillon C O'NeillChristopher A Makarewich

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