Attractive nail漂亮指甲模仿秀

要想画出漂亮的指甲，改善手指不美观的小缺憾，自然要美上加美来个超in、极靓的指甲彩绘，但是，专业指甲沙龙里令人咋舌的价格给渴望变美的心情浇了一盆冷水……哈！哈！Bueaty老师拿出妙招绝活不只要修出完美的手指,还要有超炫的指甲彩绘!     

Proximal tibial fractures--should we nail them?

Intramedullary nails (IMNs) are the treatment of choice for diaphyseal tibial fractures. Its use has been expanded both distally and proximally to cover metaphyseal fractures at both ends of the tibia. Several authors have stated that IMN use in proximal tibial fractures (extra-articular) can become problematic, leading to a significantly increased rate of malunion. Different strategies for solving this problem have been reported in recent years, but no strategy is fault-free. We review the causes of and solutions for increased malunion following use of IMNs for proximal tibial fractures.     

Humeral shaft fractures Intramedullary nail versus plate fixation

AelectronicsearchwasperformedtoidentifystudiespublishedfromMay1998toOctober2003comparingintramedullarynailingtoplatefixationforfracturesofthehumeralshaft.Fromalistof17articlesidentifiedfromthesearchstrategy,fourcomparedintramedullarynailingtoplatefixation.Twowererandomizedclinicaltrials,onewasacohortstudy,andonewasacaseserieswithahistoricalcontrol.Allareincludedinthisappraisal.Weexcludedstudiesevaluatingthesetreatmentsindelayedornonunions.StudiesforthiscaseStudy1McCormackRG,BrienD,Buckley…     

Tongue piercing. The new "rusty nail"?

BACKGROUND: Cephalic tetanus is a rare form of the tetanus caused primarily by wounds or other infectious processes involving the head and neck. This condition frequently progresses to the generalized form of tetanus with the attendant risks and complications. METHODS: A case report of a young female who developed an unusual form of tetanus after a tongue piercing is presented here. We discuss this disorder as it applies to the contemporary caregiver with a focus on its presentation and recognition. RESULTS: A delay in diagnosis of 13 days from presentation occurred. The patient had a slow, uneventful but incomplete recovery course. She never developed significant airway compromise, nor did she demonstrate any evidence of hemodynamic instability but continued to have right facial weakness up to 6 months after discharge. CONCLUSIONS: A few factors were identified that contributed to the significant delay in diagnosis. The unusual nature of the disease and a lowered index of suspicion on the part of the initial caregivers were probably the major causes. Fortunately, no major adverse sequelae resulted from the delay. However, if this case heralds the onset of a rise in the incidence of tetanus, early recognition and diagnosis would seem essential to avoid much of the morbidity and mortality associated with the disease.     

Unstable subtrochanteric fractures—gamma nail versus dynamic condylar screw

We reviewed the operative treatment of subtrochanteric fractures. Before 1999, 15 fractures were treated with a dynamic condylar screw (DCS) and after 1999, 11 fractures were treated with a gamma nail (GN). The mean age of all patients was 70 (31–92) years, and the mean follow up was 16 (9–30) months for the DCS group and 14 (6–26) months for the GN group. All fractures united. There were no infections or implant cut out. In the DCS group, there was one malunion in varus and one late fracture of the implant. In the GN group, there was one malunion in internal rotation and three intraoperative fractures. Functional evaluation showed no significant differences in pain, range of movement, or walking ability, but recovery was significantly earlier in the GN group.

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Résumé Nous avons revus le traitement opératoire des fractures sous-trochantériennes. Avant 1999,15 fractures ont été traitées avec une vis dynamic condylar (DCS), et après 1999,11 fractures ont été traitées avec un clou gamma (GN). L'âge moyen de tous les malades était 70 ans (31–92) et le suivi moyen était de 16 mois (9–30) pour le groupe DCS et de 14 mois (6–26) pour le groupe GN. Toutes les fractures ont consolidé. Il n'y avait aucune infection ni démontage des implants. Dans le groupe DCS il y avait un cal vicieux en varus et une fracture tardive de l'implant. Dans le groupe GN il y avait un cal vicieux en rotation interne et trois fractures opératoires. L'évaluation fonctionnelle n'a pas montré de différences notables dans douleur, l'amplitude des mouvements ou les capacités de marche, mais la récupération était beaucoup plus précoce dans le groupe GN.

     

Mismatch of long Gamma intramedullary nail with bow of the femur: Does radius of curvature of the nail increase risk of distal femoral complications?

IntroductionAnterior cortical penetration of the distal nail tip is a recognized complication of intra-medullary nailing of the femur particularly in the geriatric population. This has been attributed to a mismatch between the femoral bow and the radius of curvature (ROC) of the femoral nail. We wanted to see if there was a reduction of this risk comparing cephalomedullary nails with ROC of 200 cm and 150 cm.Methods52 patients were split into 2 groups similar with respect to age, sex and comorbidities. Group A with 25 patients used a nail with a ROC of 200 cm and Group B with 27 patients used a 150 cm ROC nail. Lateral radiographs of the distal femur were evaluated to note the position of the nail tip in relation to the femoral canal. The diameter of the femur at the tip of the nail was divided into 3 equal zones. The anterior one-third was designated as Zone1, the middle one-third as Zone 2 and the posterior one-third as Zone 3.Results80% of the cases with a 200 cm ROC nail had the tip of the nail in the anterior one-third of the canal (zone 1). Fracture of the anterior femoral cortex distally by the nail tip was seen in 2 patients.Only 18.5% of cases with a 150 cm ROC nail had the tip of the nail in anterior one-third of the canal (zone 1). There were no incidences of complications such as fractures and anterior cortical perforation.ConclusionsA cephalomedullary nail with a ROC of 150 cm had its distal tip more towards the center of the femoral canal when compared to a nail with ROC of 200 cm. No case of anterior femoral penetration was seen when using a nail with an ROC of 150 cm.     

Kuntscher’s nail removal techniques: an illustrative walk-through its journey

The use of Kuntscher nail for femur fracture dates back to World War 2. Since then, the technique of intramedullary nailing has evolved and the use of Kuntscher nail has become almost obsolete. The orthopaedic surgeons across the globe are facing a new challenge of removal of these Kuntscher nails due to different indications. Different but scattered English literature has been published describing the experiences and techniques of surgeon with K nail removal. Up till now, no systematic analysis has been performed evaluating the available literature. We have planned a systematic review to evaluate and explore the various indications and techniques of K nail removal.

     

Interlocking nail for femoral shaft fractures: is dynamization always necessary?

A series of 179 closed femoral fractures treated by static interlocking nailing (Grosse-Kempf nail) was reviewed to evaluate the effect of dynamization on the time to bony union. In 75 patients, dynamization was performed whereas in 104 the implant was left static. Union occurred in 178 patients. We observed one infection. Time to union was significantly shorter in the static group (103 days) compared to the dynamized group (126 days).

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Résumé Une série de 179 fractures fémorales fermées traitées par enclouage verrouillé centro-médullaire statique (clou de Grosse-Kempf) a été examinée pour évaluer leffet de la dynamisation sur le temps de consolidation osseuse. Chez 75 malades la dynamisation a été exécuté, alors que pour 104 limplant était laissé statique. La consolidation sest effectuée chez 178 malades. Nous avons observé une infection. Le temps de consolidation était significativement plus court dans le groupe statique (103 jours) comparé au groupe dynamisé (126 jours).

     

Does an antibiotic nail made in a lubricated tube release antibiotic?

Introduction

The treatment of long-bone osteomyelitis has long been a difficult problem. Recently, antibiotic-impregnated intramedullary rods for the treatment of infected long-bone fractures have been gaining popularity but they are quite difficult to fabricate. Recently, a new technique that utilizes mineral oil to coat the inside of a chest tube mold prior to introduction of cement has been proven to ease fabrication. We hypothesized that the use of mineral oil would alter the elution characteristics of tobramycin from the intramedullary device.

Methods

Two groups of antibiotic nails were fabricated under sterile conditions. The control group utilized a chest tube mold. The study group utilized a chest tube that was coated with mineral oil prior to cement injection. Each intramedullary nail was placed in pooled human serum and incubated under physiologic conditions. The level of tobramycin in each sample was measured at timepoints 0, 1, 6, and 24 h.

Results

There was no significant difference when comparing control with the experimental group at any timepoint. Antibiotic nails eluted tobramycin at a rapid rate in the first 6 h of exposure to serum, regardless of their preparation with oil or without oil. The rate of elution fell precipitously between 6 and 24 h.

Conclusion

We believe that although this study, as with any study, cannot perfectly recreate in vivo conditions, we have clearly shown that mineral oil has no significant effect on elution of tobramycin from antibiotic nails.

     

Treatment of ipsilateral hip and femoral shaft fractures with reconstructive intramedullary interlocking nail

Objective: To evaluate the results of reconstructive intramedullary interlocking nail in the treatment of ipsllateral hip and femoral shaft fractures. Methods: From August 1997 to November 2001, 13 patients were treated with the reconstructive intramedullary interlocking nail. Nine patients were associated with ipsllateral femoral neck fractures, three with ipsilateral intertrochanteric fractures, and one with subtrochanteric fracture. Results: The follow-up time was from 6 to 38 months with an average of 14 months. All the femoral shaft and hip fractures healed up well. There was no nonunion of the femoral neck, and only one varns malunion. No patient had avascular necrosis of the femoral head. The average healing time for femoral neck fracture was 4.6 months and for shaft fracture 5.8 months. The joint movement and other functions were fairly resumed. Conclusions: The reconstructive intramedullary interlocking nail, with less trauma, refiable fixation, and high rate of fracture healing, is an ideal method of choice in the treatment of ipsilateral hip and femoral shaft fractures.     

Is nail dynamization beneficial after twelve weeks – An analysis of 37 cases

Purpose

Although nail dynamization in femoral and tibial fractures is an effective method of promoting healing, its role beyond twelve weeks is still not clear. It is usually done two to three months following interlocking nailing. This study was done to evaluate the efficacy of late dynamization (after 12 weeks) and factors affecting union.