Biomedical Engineering Reference
In-Depth Information
13.20
A severe comminuted fracture in the distal forearm, which
produced a lot of bone fragments and a shortening of the radius. See
also Fig. 13.21.
Nails
Transfixing nails are still used in orthopaedic surgery, particularly to synthesize
percutaneaous small bone segments in the hand or foot. However, the most
important application nowadays is intramedullary nailing, which prescribes
that a large nail be introduced into the medullary canal of a long bone to
restore its axial geometry and support an early load bearing capability (Fig.
13.23 and Fig. 13.24).
Historically, the most successful intramedullary nail was the Kuentscher's
nail, which was a press-fit nail developed for fracture of the tibia and femur
and which enabled the walking ability of the patient to be restored in a
short time. This is because intramedullary nailing is a so-called 'dynamic
osteosynthesis' which does not require the rigid fixation of the bone fragments
but, quite the opposite, favours a compression-distraction mechanism at the
fracture site, a mechanism able to promote bone growth if applied in the
proper range (according to Wolff's law).
