The importance of reaming the posterior femoral cortex before inserting lengthening nails and calculation of the amount of reaming

Journal of Orthopaedic Surgery and Research
Metin KüçükkayaMehmet Fatih Erol

Abstract

Lengthening nails have been used to correct limb length discrepancy caused by different etiologies, as well as for post-traumatic reasons. Two important lengthening nail-related complications are damage to the distraction mechanism and femoral fractures around the nail tip. As a result of the curved anatomy of the femur, straight nails impinge on the anterior cortex. Therefore, proper reshaping of the medullary canal to accommodate straight lengthening nails is crucial for the prevention of this problem. Reaming the dense posterior cortex is important when aiming to insert a lengthening nail without incurring anterior cortex nail tip impingement-related complications. Posterior femoral cortex over-reaming is a solution to this situation. Sixty patients received lengthening nails during 2008-2013, (ISKD, Fitbone, Precice). Posterior cortex rigid-reaming technique was used successfully in 45 retrograde femoral lengthening cases. The preoperatively planned posterior cortex amount was reamed until the impingement was overcome during the operation under fluoroscopic control for each case. Since the preoperative determination of posterior cortex reaming amount is time consuming and operator dependent, we evaluated the X-rays of the p...Continue Reading

References

Sep 6, 2014·Acta Orthopaedica·Joachim HornHarald Steen
Oct 20, 2014·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Metin KüçükkayaRamazan Soydan

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Citations

Oct 7, 2016·Current Reviews in Musculoskeletal Medicine·Amanda T Whitaker, Carley Vuillermin
May 10, 2017·Journal of Orthopaedic Trauma·Austin T Fragomen
Oct 19, 2017·Strategies in Trauma and Limb Reconstruction·Austin T Fragomen, Fiona R Fragomen
Aug 18, 2017·The Journal of Bone and Joint Surgery. American Volume·Reggie C HamdyS Robert Rozbruch

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Methods Mentioned

BETA
X-ray

Software Mentioned

Coral draw
CorelDRAW® Graphic Suite X6

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