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Removal of Elastic Stable Intramedullary Nail

July 10, 2020/in Volume 6 | Issue 2 | July-December 2020

Vol 6 | Issue 2 | July-December 2020 | page: 19-21 | Vivek M. Sodhai, Sandeep A. Patwardhan, Parag K. Sancheti, Ashok K. Shyam Authors: Vivek M. Sodhai [1], Sandeep A. Patwardhan [1], Parag K. Sancheti [1], Ashok K. Shyam [1, 2] [1] Department of Paediatric Orthopaedics, Sancheti Institute for Orthopaedics & Rehabilitation, Shivaji Nagar, […]

Novel Adaptation of Suture Bridge Technique for Greater Tuberosity Redisplacement Post ORIF With PHILOS- A Technical Note

July 10, 2020/in Volume 6 | Issue 2 | July-December 2020

Vol 6 | Issue 2 | July-December 2020 | page: 15-18 | Khayas Omer Kunheen, MC Tomichan, Rajeev PB, Adarsh Krishna K Bhat Authors: Khayas Omer Kunheen [1], MC Tomichan [1], Rajeev PB [2], Adarsh Krishna K Bhat [1] [1] Department of Orthopaedics, Government Medical College Kottayam, Kerala, India. [2] Caritas hospital and Institute Of […]

Removal of Elastic Stable Intramedullary Nail

July 10, 2020/in Volume 6 | Issue 2 | July-December 2020

Novel Adaptation of Suture Bridge Technique for Greater Tuberosity Redisplacement Post ORIF With PHILOS- A Technical Note

July 10, 2020/in Volume 6 | Issue 2 | July-December 2020

Full Sized Blog Element (Big Preview Pic)

Removal of Elastic Stable Intramedullary Nail

July 10, 2020/in Volume 6 | Issue 2 | July-December 2020

Vol 6 | Issue 2 | July-December 2020 | page: 19-21 | Vivek M. Sodhai, Sandeep A. Patwardhan, Parag K. Sancheti, Ashok K. Shyam

Authors: Vivek M. Sodhai [1], Sandeep A. Patwardhan [1], Parag K. Sancheti [1], Ashok K. Shyam [1, 2]

[1] Department of Paediatric Orthopaedics, Sancheti Institute for Orthopaedics & Rehabilitation, Shivaji Nagar, Pune, Maharashtra, India.
[2] Department of Research, Indian Orthopaedic Research Group, Thane (W), Maharashtra. India.

Address of Correspondence
Dr. Vivek M. Sodhai,
Clinical fellow, Department of Paediatric Orthopaedics, Sancheti Institute for Orthopaedics & Rehabilitation, Shivaji Nagar, Pune, Maharashtra, India.
E-mail: vivek.sodhai89@gmail.com

Abstract

Introduction: Removal of the elastic stable intramedullary nail (ESIN) after the union is routinely performed in the pediatric population. However, ESIN removal can be lengthy and difficult due to the strong bonding between nail and bone.
Technique: We preferred keeping the nail tip tangentially flush (<5mm) to the bone to avoid skin irritation. In our technique, after incision and subcutaneous dissection, the nail tip is identified and exposed using a 6-mm osteotome, and a trough is created around it sufficient enough to pass the hollow mill over it. In cases with buried nail tip, a rectangular cortical window may be required. The nail tip is then gently bent at 90° using the hollow mill as the lever taking care not to cause an iatrogenic fracture. The nail tip is held at the bent from sideways with a plier and the nail is removed by rotatory backward motion or reverse impaction using a mallet in cases of strong bonding between nail and bone. Using this technique, ESIN removal was successful in all 28 cases using the previous incision. Of these cases, 10 were forearm (36%), 8 were tibia (28%), 7 were femur (25%) and 3 were humerus (11%). 6 cases (21%) were considered difficult due to increased thickness of the nails, deeper location of the nail tip, and increased bone growth around the tip of nails.
Conclusion: Our technique is simple, innovative, and can be easily reproduced by all Orthopaedic Surgeons. The use of this technique is recommended for all ESIN removals.
Keywords: Diaphyseal fractures; Elastic stable intramedullary nail; Hardware removal; Paediatric long bone.

References

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How to Cite this article: Sodhai VM, Patwardhan SA, Sancheti PK, Shyam AK | Removal of Elastic Stable Intramedullary Nail | Trauma International | July-December 2020; 6(2): 19-21.

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Novel Adaptation of Suture Bridge Technique for Greater Tuberosity Redisplacement Post ORIF With PHILOS- A Technical Note

July 10, 2020/in Volume 6 | Issue 2 | July-December 2020

Vol 6 | Issue 2 | July-December 2020 | page: 15-18 | Khayas Omer Kunheen, MC Tomichan, Rajeev PB, Adarsh Krishna K Bhat

Authors: Khayas Omer Kunheen [1], MC Tomichan [1], Rajeev PB [2], Adarsh Krishna K Bhat [1]

[1] Department of Orthopaedics, Government Medical College Kottayam, Kerala, India.
[2] Caritas hospital and Institute Of Health Sciences, Thellakom, Kottayam, Kerala, India.

Address of Correspondence
Dr. Khayas Omer Kunheen,
Chelat House, P.O Olavanna,Calicut 673019, Kerala, India.
E-mail: khayasomer@gmail.com

Abstract

Isolated Greater tuberosity (GT) fractures still pose a therapeutic challenge due to the wide variety of treatment options and lack of proper comparative studies on outcome. Plating still remains a valid option but has several unfavorable effects. One among them is redisplacement of tuberosity postoperatively especially in cases with comminution which may easily be missed in regular plain radiographs. Conventional techniques of fixation may remain insufficient in such scenarios. We hereby propose an adaptation of a described technique, in a 45-year-old male presenting with redisplacement of GT post plate fixation. Open double-row suture bridge construct was used to fix the displaced fragment maintaining the plate insitu and the patient had an excellent functional and radiological outcome on follow-up.
Keywords: Greater tuberosity fracture; Comminution; Double-row fixation; Suture anchor; Suture Bridge technique; PHILOS; Redisplacement.

References

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How to Cite this article: Kunheen KO, MC Tomichan , Rajeev PB, Bhat AKK | Novel Adaptation of Suture Bridge Technique for Greater Tuberosity Redisplacement Post ORIF With PHILOSA Technical Note | Trauma International | July-December 2020; 6(2): 15-18.

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Removal of Elastic Stable Intramedullary Nail

Novel Adaptation of Suture Bridge Technique for Greater Tuberosity Redisplacement Post ORIF With PHILOS- A Technical Note

Removal of Elastic Stable Intramedullary Nail

Novel Adaptation of Suture Bridge Technique for Greater Tuberosity Redisplacement Post ORIF With PHILOS- A Technical Note

Full Sized Blog Element (Big Preview Pic)

Removal of Elastic Stable Intramedullary Nail

Authors: Vivek M. Sodhai [1], Sandeep A. Patwardhan [1], Parag K. Sancheti [1], Ashok K. Shyam [1, 2]

Abstract

References

(Abstract)(Full Text HTML) (Download PDF)

Novel Adaptation of Suture Bridge Technique for Greater Tuberosity Redisplacement Post ORIF With PHILOS- A Technical Note

Authors: Khayas Omer Kunheen [1], MC Tomichan [1], Rajeev PB [2], Adarsh Krishna K Bhat [1]

Abstract

References

(Abstract)(Full Text HTML) (Download PDF)

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