Abstract

PRETORIUS, Henry S; BURGER, Marilize C  and  FERREIRA, Nando. Evaluating the design modifications of an intramedullary forearm nail system: a cadaver study. SA orthop. j. [online]. 2022, vol.21, n.1, pp.12-15. ISSN 2309-8309.  http://dx.doi.org/10.17159/2309-8309/2022/V21N1A1.

BACKGROUND: Current orthopaedic practice requires a forearm nail that is length and rotationally stable and which can restore functional anatomy. A forearm nailing system was designed based on clinical need. This nailing system features unique designs and locking holes that offer a larger approach and escape angle for ease of interlocking. The aim of the present study was to test the prototype and evaluate the design changes in cadaver bonesMETHODS: A cross-sectional cadaveric study, including ten cadavers with normal forearm anatomy (n = 20 forearms) was conducted. Both forearms of the cadavers were used to evaluate the locking times and exposure time during i) insertion; ii) locking; and iii) removal of the nails, resulting in the evaluation of a total of 40 procedures. All nails were assessed for insertions of interlocking screwsRESULTS: The nail was successfully inserted into 38 bones. Inserted nails were available for locking (n = 38), and all locking attempts at both driving ends (n = 38, 100%), as well as the non-driving ends (n = 76, 100%), were successful. Freehand locking at the non-driving end of the nail (38 cases, 76 locking holes) took a median of 44.5 seconds (interquartile range [IQR] 33.0-59.0), while the number of exposures ranged from 2 to 12 with a median of 5.5 exposures (IQR 4.0-8.0). The freehand locking procedure's exposure time was 0.09 minutes (IQR 0.07-0.23CONCLUSION: The proposed forearm intramedullary nail design modifications allowed for successful implantation, interlocking and removal of nails in both radius and ulna cadaver bones, with acceptable radiation exposureLevel of evidence: Level 5

Keywords : radius and ulna intramedullary nail; locked forearm nail; forearm fractures.

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