6 research outputs found
Treatment of humeral diaphyseal fractures using Hackethals retrograde elastic nailing - a clinical and experimental verification of this method in contemporary traumatology
Hackethal's bundle nailing of diaphyseal humeral fractures was historically reliable and cheap method, used for stabilization of simple humeral shaft fractures. After arrival of solid nails, this technique was successively abandoned, initially in Germany, followed by countries of Central Europe. Several cliniques are at present still using this technique successfully. Goal of this work was to establish, whether the declared stability of this technique is comparable to those of more evolved methods, whether this technique does not cause higher amount of complications, and to describe how the stability of nails bundle depends on number and diameter of used implants. The cost efficiency of different modern osteosynthetic methods used for stabilization of humeral shaft fractures was also analyzed. For verification of determined hypotheses, two clinical and one experimental studies were developed. First clinical study was focused on success rate of osteosynthesis and it's complications. In studied population of 50 patients, 4 of them (8%) developed a non-union, which was in all cases caused by wrong indication or technical error during implantation. Superficial infection was observed once, no deep infection had developed. Nine patients (18%) have healed in rotational or axial malalingement that had no...Souhrn Hackethalova osteosyntéza zlomenin diafýzy humeru svazkem elastických hřebů byla ve své době spolehlivou a ekonomicky nenáročnou metodou ke stabilizaci jednoduchých zlomenin diafýzy humeru. Od nástupu solidních hřebů byla pro svou údajnou nestabilitu opouštěna nejprve v Německu, postupně i v našich zemích. Na několika pracovištích se ale úspěšně používá dodnes. Cílem této práce bylo zjistit, jestli stabilita uvedené metody je srovnatelná se stabilitou modernějších metod, jestli její použití není doprovázeno větším množstvím komplikací a jak závisí stabilita montáže na počtu a tloušťce použitých implantátů. Současně byla porovnána ekonomická náročnost jednotlivých metod moderní osteosyntézy diafýzy humeru. K ověření stanovených hypotéz byly vypracovány dvě klinické a jedna experimentální studie. První klinická studie byla zaměřena na úspěšnost osteosyntézy a její komplikace. V souboru 50 pacientů vznikl při hojení u čtyř pacientů (8 %) pakloub, příčinou byla vždy nesprávná indikace nebo chyba v technickém provedení operace. Jednou byla zaznamenána povrchní infekce, hluboká u žádného pacienta. Devět pacientů (18 %) se zhojilo s angulační nebo rotační úchylkou, ty neovlivnily funkčnost končetiny. Trvalé omezení hybnosti lokte nebylo v souboru zaznamenáno, ramene u pěti pacientů (10 %) lehké bez omezení...Department of Orthopaedics and Traumatology 3FM CU and UHKVOrtopedicko-traumatologická klinika 3. LF UK a FNKV3. lékařská fakultaThird Faculty of Medicin
NON-UNIONS AFTER FIXATION OF HUMERAL FRACTURES USING HACKETHAL'S BUNDLE NAILING TECHNIQUE
Treatment of humeral diaphyseal fractures using Hackethals retrograde elastic nailing - a clinical and experimental verification of this method in contemporary traumatology
Hackethal's bundle nailing of diaphyseal humeral fractures was historically reliable and cheap method, used for stabilization of simple humeral shaft fractures. After arrival of solid nails, this technique was successively abandoned, initially in Germany, followed by countries of Central Europe. Several cliniques are at present still using this technique successfully. Goal of this work was to establish, whether the declared stability of this technique is comparable to those of more evolved methods, whether this technique does not cause higher amount of complications, and to describe how the stability of nails bundle depends on number and diameter of used implants. The cost efficiency of different modern osteosynthetic methods used for stabilization of humeral shaft fractures was also analyzed. For verification of determined hypotheses, two clinical and one experimental studies were developed. First clinical study was focused on success rate of osteosynthesis and it's complications. In studied population of 50 patients, 4 of them (8%) developed a non-union, which was in all cases caused by wrong indication or technical error during implantation. Superficial infection was observed once, no deep infection had developed. Nine patients (18%) have healed in rotational or axial malalingement that had no..
Treatment of humeral diaphyseal fractures using Hackethals retrograde elastic nailing - a clinical and experimental verification of this method in contemporary traumatology
Hackethal's bundle nailing of diaphyseal humeral fractures was historically reliable and cheap method, used for stabilization of simple humeral shaft fractures. After arrival of solid nails, this technique was successively abandoned, initially in Germany, followed by countries of Central Europe. Several cliniques are at present still using this technique successfully. Goal of this work was to establish, whether the declared stability of this technique is comparable to those of more evolved methods, whether this technique does not cause higher amount of complications, and to describe how the stability of nails bundle depends on number and diameter of used implants. The cost efficiency of different modern osteosynthetic methods used for stabilization of humeral shaft fractures was also analyzed. For verification of determined hypotheses, two clinical and one experimental studies were developed. First clinical study was focused on success rate of osteosynthesis and it's complications. In studied population of 50 patients, 4 of them (8%) developed a non-union, which was in all cases caused by wrong indication or technical error during implantation. Superficial infection was observed once, no deep infection had developed. Nine patients (18%) have healed in rotational or axial malalingement that had no..
Computed modeling of humeral mid-shaft fracture treated by bundle nailing
Elastic
bundle nailing is a method for simple humeral mid-shaft fracture
osteosynthesis. The aim of our subsequent numerical simulations was to
find out torsional and bending stiffness of an elastic bundle nailed
humerus. Parametrical 3D numerical model was developed. The diameter of
nails was the varying parameter of 1.8, 2.5, 3 and 4 mm. From our
results can be seen that the bending stiffness in bundle nailing
technique does not depend on nail diameter. On the contrary the
torsional stiffness does highly depend on nail diameter. The dependency
of the maximal stress on a nail diameter during bending and torsion of
the humerus is non-linear. It can be seen that the higher diameter is
used the higher stress occurs. Achieved results allow us for the
recommendation of optimal nail diameter for this method, which lies
between 2 and 3 mm