Advantages and disadvantages of intramedullary nail fixation of fractures

Since many people do not pay attention to protecting their personal safety in normal times, various accidents often occur, and accidents often lead to fractures. When a fracture occurs, the bone is usually fixed with an intramedullary nail to give the bone time to recover. However, although intramedullary nailing can alleviate the fracture situation, it will damage the endosteal blood supply and cause soft tissue infection.

advantage

① It can control the axial force line at the fracture site, and the locked intramedullary nail can prevent fracture rotation deformity and reduce the risk of implant breakage.

②The use of closed and minimally invasive techniques reduces the surgical infection rate.

③ Factors such as reducing damage to periosteum blood supply, retaining osteogenic growth factors in the hematoma, the autologous bone grafting effect of medullary expansion debris, and muscle contraction producing micromotion to provide mechanical stimulation promote fracture healing.

④ Central fixation, elastic fixation and stress dispersion avoid stress shielding and reduce the incidence of re-fracture.

⑤ Firm fixation allows for early functional training and weight-bearing.

⑥ Insertion, fixation and removal are performed through a small incision, minimally invasive.

shortcoming

① Marrow expansion destroys the endosteal blood supply and affects the formation of internal callus, which can easily lead to delayed fracture healing and nonunion.

②The incidence of infection after open fracture surgery depends on the injury and contamination of the soft tissue and the treatment method of the soft tissue.

③Medullary expansion causes bone marrow components to enter the blood, which may lead to fat embolism syndrome.

④ Pain in adjacent joints or iatrogenic fractures.

⑤The diameter of the bone marrow cavity limits the use of intramedullary nails, which are not as good as steel plates and external fixation in controlling rotation.

⑥ The scope of application is limited. Intramedullary nails cannot be used for metaphyseal fractures and open fractures.