Fixator-assisted nailing of tibial fractures: New surgical technique and presentation of first 30 cases

Background

Intramedullary nailing is considered a “gold standard” for treatment of tibial shaft fractures. However, some types of fractures are typically considered as “difficult for nailing”. This group includes the periarticular fractures, fractures of both bones at the same level, comminuted and segmental fractures of the tibia. Fixator-assisted nailing (FAN) is an effective method treatment of these types of fractures. The main requirements for the ideal reduction device are an ease of its installation and an ability of multiplanar fracture reduction. Fixator-assisted nailing (FAN) with the use of two perpendicular to each other monolateral tubular frames perfectly meets these requirements. In this study we present this new surgical technique and the analysis of first 30 cases.

Theoretical and clinical bases of the method of osteosynthesis by screws in oblique and spiral fractures of the tibia

The results of experiments with axial loading of human tibia preparations used for simulation of oblique (spiral) fractures and different methods of osteosynthesis by screws revealed that higher strength was ensured by the method of bone connection with the screws directed perpendicular to the segment axis (4.1 times more than in case of screws directed perpendicular to the plane of fracture). Explanation of the obtained facts necessitated development of more precise biomechanical model of deformation. Practical recommendations have been formulated.     

Tympanic membrane prosthesis using soft magnetoelastomer]

This paper presents a new method for tympanum prosthesis application. The prosthesis is fixed by the interaction of magnetic pondermotive forces between two soft petals of a magnetoelastomer. This type of prosthesis was applied to 30 patients with dry perforative otitis media, aged 51-75 years. The intervention was performed in the outpatient department. Prostheses are recommended to be replaced every 3 months. These patients showed good tolerance of the treatment, which significantly improved their hearing level. The method of prosthesis fixation was reliable and atraumatic.