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Fat extravasation due to unreamed and experimentally reamed intramedullary nailing of the sheep femur
Authors:Florian Hö  gel,Lukas Kamer,Berton Rahn,Christof A. Mü  ller
Affiliation:a Department of Biomechanics, BG Trauma Center Murnau, Prof. Kuentscher Str. 8, 82418 Murnau, Germany
b AO Development Institute, Davos, Switzerland
c AO Research Institute, Davos, Switzerland
d AO Foundation, Davos, Switzerland
e Departement Orthopädie und Traumatologie, Universitätsklinikum Freiburg i. Brsg, Freiburg, Germany
f Abt. f. Unfall-, Hand- und orthopädische Chirurgie, Kralsruhe, Germany
Abstract:

Aim

To compare systemic fat extravasation in unreamed and experimentally reamed nailing.

Methods

An osteotomy was created in the proximal third of the femoral shaft in 16 sheep, and intramedullary pressure increase and fat extravasation were monitored for the two nailing techniques.

Results

The highest intramedullary pressures, median 2700 mmHg, and highest percentages of fat extravasation, peaking at almost 90% of fat, were found for the unreamed nailing technique. The values for the reamed group were significantly lower.

Conclusions

The extravasation of intramedullary fat can be attributed to the great increase in intramedullary pressure that occurs during unreamed nailing. Correctly performed intramedullary reaming with the new reaming system produces lower pressures and much less systemic fat extravasation, reducing the risk for fat embolism.
Keywords:Fracture   Fat embolism   Intramedullary nailing   GURD-Test
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