Expandable intramedullary nails in lower limb trauma: a systematic review of clinical and radiological outcomes

Development of an additively-manufactured functionally-graded expandable implant via the application of the adaptive response surface method: feasibility study on intramedullary humerus nail

The paper introduces the concept of the rational design of a deployable humeral intramedullary nail plug based on a honeycomb structure used for the surgical treatment of humeral shaft fractures. The concept serves for to restore the axial alignment of bone fragments and to maintain stability via bone-nail friction and locking screws. The design nail plug was gained by optimisation process the Latin Hypercube Sampling Design algorithm and Multi-Objective Genetic Algorithm. It was shown that we can use statistical shape function combined by 3 D printing for designing of a new rationally designed implants.

Preliminary Results with the Shape Memory Nail: A Self-contained Distal Locking Mechanism for Diaphyseal Femur Fractures

Distal interlocking of intramedullary nails can be challenging if not done regularly and can be associated with a prolonged operating time and excessive radiation exposure. Multiple techniques have been developed to overcome these problems but all still rely on conventional distal locking methods. Between December 2011 and March 2013, 18 patients with diaphyseal femur fractures were treated with the shape memory nail (Orthofix, Verona, Italy). These nails use self-contained nitinol memory metal ‘wings’ at the distal aspect of the nail to provide rotational and longitudinal stability. We observed fracture union in all 18 cases with no non-unions, rotational malalignments or peri-prosthetic infections. Median theatre time was 35 (18–71) minutes and median total radiation time was 50 (20–209) seconds. The shape memory nail (Orthofix, Verona, Italy) is an attractive alternative to conventional interlocking femoral nails. It provides sufficient stability to allow fracture union while decreasing theater time and limiting radiation exposure.

Comparison of free-hand fluoroscopic guidance and electromagnetic navigation in distal locking of tibia intramedullary nails

BACKGROUND

It is challenges for surgeon to position the distal locking screw of a tibia intramedullary nail. The traditional free-hand (FH) technique is related to the proficiency of surgeons and has a long learning curve. Furthermore, the radiation dose and the accuracy of screw placement should be taken into account. The new technology, the electromagnetic navigation system (ET), which is a radiation-free way to locate the position of the drill bit. The purpose of our study is to evaluate the results of the ET for distal locking screw of a tibia intramedullary nail and to compare the effects with the FH technique.

METHODS

Eighty-nine cases of tibia diaphyseal fracture who needed to treat by intramedullary nails were analyzed retrospectively, and were divided into 2 groups. Patients in navigation group (n = 54) were treated with intramedullary nail using the ET for distal locking, while other 35 patients using FH technique. Intraoperative fluoroscopy exposure times, screw insertion times, and healing times were recorded. The parameter was used for comparison in 2 groups.

RESULTS

The mean time of distal locking in the ET technique was significant less than that in the FH group (5.89 ± 2.02 minutes vs 12.26 ± 4.40 minutes) and the exposure time was reduced in ET group significantly (2.13 ± 0.73 seconds vs 19.09 ± 10.41 seconds). The healing time was proved to be coincident in FH group and ET group (15.34 ± 2.98w vs 16.06 ± 3.74w). The one-time success rate of distal locking nail operation was 100% in the navigation group, which was significantly higher than that in FH group (P < .05).

CONCLUSION

Compared with the FH technique, the ET for distal locking of tibia intramedullary nail has the advantages of high efficiency and short locking time without radiation.

Environmental impacts caused by cemeteries and crematoria, new funeral technologies, and preferences of the Northeastern and Southern Brazilian population as for the funeral process

Cemeteries and crematoria are the main funeral ways used in the world nowadays. It is a little-studied segment in the present days, mainly as for the possible environmental impacts in the environment, such as those derived from dental amalgam, prostheses, and dioxins, among other. This article aimed to identify the environmental impacts caused by cemeteries and crematoria and to point out new trends in funeral processes such as freeze-drying and alkaline hydrolysis. The study is justified due to the large part of the Brazilian population that do not know the environmental impacts caused by cemeteries and crematoria, as well as to bring information about the new processes. For that, a research was carried out with 400 people. The main results show that among all the funeral processes, the new freeze-drying process was opted by 33% of the sample. We also identified that the main reasons for choosing the funeral process were less environmental impact (28%), no after-death expenses (grave payment) (16.1%), and the possibility of putting away or throwing away the remains wherever you want (14.9%). Finally, new funeral processes were well accepted by the Brazilian population-those who were interviewed-due to their benefits.