Practice of Intramedullary Locked Nails New Developments in Techniques and Applications

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Practice of Intramedullary Locked Nails

New Developments in Techniques and Applications

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Chief Editors K.-S. Leung ´ G. Taglang R. Schnettler

Co-Editors V. Alt ´ H.J.T.M. Haarman H. Seidel

Ed. Secretary I. Kempf

Practice of

Intramedullary Locked Nails

New Developments in Techniques and Applications

Recommended by

ªAssociation Internationale pour l'Ostosynth se Dynamiqueº (AIOD)

With 294 Figures and 20 Tables

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Chief Editors

Professor Dr. Kwok-Sui Leung The Chinese University of Hong Kong Department of Orthopaedics

and Traumatology Prince of Wales Hospital Shatin, Hong Kong SAR Republic of China Dr. Gilbert Taglang

Centre de Traumatologie et d'Orthopdie 10 Avenue A. Baumann

67400 Illkirch-Graffenstaden France

Prof. Dr. Dr. Reinhard Schnettler Universitåtsklinikum Gieûen

Klinik und Poliklinik fçr Unfallchirurgie Rudolf-Buchheim-Str. 7

35385 Gieûen Germany

ISBN-10 3-540-25349-1 ISBN-13 978-3-540-25349-5

Springer-Verlag Berlin Heidelberg New York

Library of Congress Control Number: 2005927734

This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of il- lustrations, recitation, broadcasting, reproduction on mi- crofilm or in any other way, and storage in data banks.

Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. Vio- lations are liable for prosecution under the German Copy- right Law.

Co-Editors Dr. Volker Alt

Universitåtsklinikum Gieûen

Klinik und Poliklinik fçr Unfallchirurgie Rudolf-Buchheim-Str. 7

35385 Gieûen Germany

Professor Dr. H.J.T. M. Haarman Academisch Ziekenhuis

Department of Surgery

De Boelelaan 1117, P.O. Box 7057 1007 MB Amsterdam, The Netherlands Dr. Hartmut Seidel

Rewentlowstr. 48

22605 Hamburg, Germany Ed. Secretary

Professor Dr. Ivan Kempf AIODRue du Parc, 16

67205 Oberhausbergen, France

Springer is a part of Springer Science+Business Media springer.com

° Springer Berlin ´ Heidelberg 2006 Printed in Germany

The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are ex- empt from the relevant protective laws and regulations and therefore free for general use.

Editor: Gabriele Schræder Desk editor: Irmela Bohn Production: Elke Beul-Gæhringer

Cover design: Estudio Calamar, F. Steinen-Broo, Pau/Girona, Spain

Typesetting: K + V Fotosatz GmbH, Beerfelden, Germany Printed on acid-free paper

24/3151/beu-gæh 5 4 3 2 1 0

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During the preparation and publishing of the first two volumes of our textbook, entitled Practice of Intramedullary Locked Nails, the editorial team took into account the most recent and then current technical evolutions in the treatment of long bone fractures. Progress, technical advances, and new concepts in bone biology and fracture healing were, as a result, included in some chap- ters. That is why Volume 2 was entitled Advanced Techniques and Special Applications at the time of its publication. Nevertheless, it was felt that this second volume was only a first step in presenting the new techniques and scientific information as- sociated with the biological, biomechanical, in- strumentation and technical improvements asso-

ciated with intramedullary nailing that were then just beginning to be introduced.

The goal of this third volume is to chronicle and present in more details this perpetual evolution. Numerous renowned authors with diverse specialisations kindly helped us to finalise this volume. Our special gratitude goes to all authors, as well as to the staff of the Association Interna- tionale pour l'Ostosynth se Dynamique (AIOD) and of the publishing house, Springer-Verlag, with particular recognition of Mrs. Margot Hamm from the AIOD, and Mrs. Gabriele Schroeder from Springer-Verlag.

Prof. Ivan Kempf

Preface

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Section 1 Introduction

Chapter 1.1

Introduction . . . . 3 K.-S. Leung, G. Taglang, R. Schnettler

Section 2 Advances in Biology and Fracture Healing in Locked Nails

Chapter 2.1

Cellular Aspects of Bone Defect Healing After Implantation of Calcium Phosphate-Based Bone Substitutes . . . . 7 R. Schnettler, V. Alt, J.-P. Stahl,

S. Wenisch Chapter 2.2

Osteoinduction: Basic Principles

and Developments . . . . 23 R. Capanna, P. De Biase

Chapter 2.3

Intramedullary Reaming of Long Bones . . . . . 43 J.P. Frælke

Chapter 2.4

Differentiation Capacity and Characterisation of Cells Growing Out of Human Reaming

Debris . . . . 57 K. Trinkaus, S. Wenisch, C. Siemers,

R. Schnettler

Section 3 Materials Used

for Intramedullary Devices

Chapter 3.1

Implant Alloys and Interfacial Engineering . . . 67 P. Procter, G. von Oldenburg,

H. von Wieding, A. Speitling

Section 4 New Designs

of Intramedullary Nails

Chapter 4.1

A New Titanium Nail for the Femur:

Concept and Design . . . . 85 T. Mçckley, V. Bçhren

Chapter 4.2

Advances in Tibial Nailing . . . . 99 J.R. Hsu, K. F. Dickson

Chapter 4.3

The Development of Retrograde Nailing

for Distal Femur Fractures . . . 109 D. Seligson

Chapter 4.4

Retrograde Nailing of the Femur:

Contemporary Indications and Technique . . . . 117 R.A. Probe, T.R. Lewis

Chapter 4.5

Antegrade Femoral Nailing

Without the Aid of a Fracture Table . . . 127 R.A. Probe

Chapter 4.6

The Operative Technique for the Latest

Generation Gamma Nail (the Gamma3) . . . 133 G. Taglang

Chapter 4.7

Evolution of Implants for Trochanteric Fracture Fixation: The Engineer's Point of View . . . 139 H. Mçller-Daniels

Chapter 4.8

A New Concept in the Treatment of Fibular

Fractures with Intramedullary Implants . . . 145 W. Roth, M. Weber

Contents

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Chapter 4.9

Hydraulically Expandable Nailing in the Treatment of Long Bone Fractures

and Pseudarthroses . . . . 155 D. Seligson, P.J. Buecker, J.S. Ogden

Chapter 4.10.1

Proximal Humeral Fractures . . . . 159 H. Seidel

Chapter 4.10.2 Intramedullary Nailing

of Proximal Humeral Fractures . . . . 169 A. Elsen

Chapter 4.10.3 Intramedullary Nailing

of Humeral Shaft Fractures . . . . 179 J. Franke

Chapter 4.11

A Fully Implantable, Programmable Distraction Nail (Fitbone) ± New Perspectives for Corrective and Reconstructive Limb Surgery . . . . 189 R. Baumgart, P. Thaller,

S. Hinterwimmer, M. Krammer, T. Hierl, W. Mutschler

Chapter 4.12

A Novel Internal Callus Distraction System . . . 199 U. Horas

Chapter 4.13

Callus Distraction with the Albizzia Nail . . . . 211 M. Hofmeister, C. Hierholzer,

V. Bçhren

Section 5 Intramedullary Fixation of Long Bone Fractures in Infancy and Adolescence

Chapter 5.1

Intramedullary Stabilization of the Long Bones in Children with Osteogenesis Imperfecta . . . 219 V. Topouchian, G. Finidori, C. Glorion

Chapter 5.2

Intramedullary Fixation of Long Bone Fractures in Infancy and Adolescence . . . . 231 C. Karger, P. Gicquel, J.-M. Clavert

Section 6 New Technologies:

Navigation and Targeting Devices

Chapter 6.1

Basic Principles of Fluoro-Navigation . . . . 243 A. Sarvestani

Chapter 6.2

New Technology: Image-Guided Navigation

in Orthopaedic Trauma Surgeries . . . . 249 K.-S. Leung

Chapter 6.3

Review of Existing, Mounted Targeting Devices for Distal Locking of Intramedullary Nails . . . 265 L. Cardador

Chapter 6.4

Distal Locking with Mechanical Jig

(Author's Own Technique) . . . . 271 G. Anastopoulos

Section 7 Coating of Implants and Infection Prophylaxis

Chapter 7.1

Rationale for Antibiotic Prophylaxis

in Open Fractures . . . . 277 J. Gaudias

Chapter 7.2

Active Coating of Implants used

in Orthopedic Surgery . . . . 283 M.-J. Raschke, T. Fuchs, R. Stange,

M. Lucke, F. Kandziora,

B. Wildemann, G. Schmidmaier Chapter 7.3

Plasma Polymer ± High-Porosity Silver Composite Coating for Infection Prophylaxis

in Intramedullary Nailing . . . . 297 V. Alt, M. Wagener, D. Salz, T. Bechert, P. Steinrçcke, R. Schnettler

Subject Index . . . . 305

VIII Contents

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Volker Alt

Universitåtsklinikum Giessen

Klinik und Poliklinik fçr Unfallchirurgie Rudolf-Buchheim-Straûe 7

35385 Giessen, Germany George Anastopoulos

Department of Orthopedic Surgery and Traumatology

Athens General Hospital 154 Messogion Ave.

11527 Athens, Greece Rainer Baumgart

Klinikum der LMU Mçnchen Chirurgische Klinik und Poliklinik Innenstadt

Nussbaumstraûe 20 80336 Mçnchen, Germany Thorsten Bechert

Bio-Gate Bioinnovative Materials GmbH Neumeyer Straûe 48

90411 Nçrnberg, Germany Pietro De Biase

Second Orthopaedic Division Centre of Oncological and Reconstructive Surgery Azienda Ospedaliera Careggi Centro Traumatologico Ortopedico Largo Palagi 1

50139 Florence, Italy Peter J. Buecker

Department of Orthopedic Surgery University of Louisville

Louisville, KY 40292, USA Volker Bçhren

BG ± Unfallklinik Murnau Unfallchirurgie

Prof.-Kçntscher-Straûe 8 82418 Murnau, Germany

Rodolfo Capanna

Second Orthopaedic Division Centre of Oncological and Reconstructive Surgery Azienda Ospedaliera Careggi Centro Traumatologico Ortopedico Largo Palagi 1

50139 Florence, Italy Lucio Cardador

Hospital do Litoral Alentejano Servico de Ortopedia

7450-239 Santiago Do Cacm, Portugal Jean-Michel Clavert

Pediatric Orthopedics Unit Department of Pediatric Surgery Hautepierre University Hospital Strasbourg, France

Kyle F. Dickson

Department of Orthopedic Surgery Trauma and Adult Reconstruction William Beaumont Army Medical Center El Paso, Texas, USA

Achim Elsen

Klinikum Hannover Nordstadt Klinik fçr Unfall-, Hand- und Wiederherstellungschirurgie Haltenhoffstraûe 41

30167 Hannover, Germany Georges Finidori

Service d'Orthopdie et Traumatologie Pdiatriques

Groupe Hospitalier Necker ± Enfants Malades 149, rue de S vres

75015 Paris, France

List of Contributors

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Jærg Franke

Klinikum Hannover Nordstadt Klinik fçr Unfall-, Hand- und Wiederherstellungschirurgie Haltenhoffstraûe 41

30167 Hannover, Germany Jan Paul Frælke

Trauma Surgery

University Medical Centre Nijmegen P.O. Box 9101

6500 HB Nijmegen, The Netherlands Thomas Fuchs

Klinik und Poliklinik fçr Unfall-, Hand- und Wiederherstellungschirurgie

Westfålische Wilhelms-Universitåt Mçnster Waldeyerstraûe 1

48149 Mçnster, Germany Jeannot Gaudias

67400 Illkirch-Graffenstaden, France Philippe Gicquel

Pediatric Orthopedics Unit Department of Pediatric Surgery Hautepierre University Hospital Strasbourg, France

Christophe Glorion

75015 Paris, France Christian Hierholzer

Prof.-Kçntscher-Straûe 8 82418 Murnau, Germany T. Hierl

Nussbaumstraûe 20 80336 Mçnchen, Germany

Stefan Hinterwimmer Klinikum der LMU Mçnchen Chirurgische Klinik und Poliklinik Innenstadt

Nussbaumstraûe 20 80336 Mçnchen, Germany Martin Hofmeister

Prof.-Kçntscher-Straûe 8 82418 Murnau, Germany Uwe Horas

Chirurgische Klinik II ± Unfallchirurgie Kliniken des Main-Taunus-Kreises Lindenstraûe 10

65719 Hofheim, Germany Joseph R. Hsu

Department of Orthopedic Surgery Trauma and Adult Reconstruction William Beaumont Army Medical Center El Paso, TX 79920-5001, USA

Frank Kandziora

Zentrum fçr Muskolo Skeletale Chirurgie der Charit Berlin (CMSC)

Klinik fçr Orthopådie Champus Charit Mitte Schumannstraûe 20/21 10117 Berlin, Germany Claude Karger

Pediatric Orthopedics Unit Department of Pediatric Surgery Hautepierre University Hospital Avenue Moli re

67000 Strasbourg, France Michael Krammer

Nussbaumstraûe 20 80336 Mçnchen, Germany Kwok-Sui Leung

Department of Orthopaedics and Traumatology Prince of Wales Hospital

The Chinese University of Hong Kong Shatin

Hong Kong SAR, Republic of China

X List of Contributors

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T. R. Lewis

Department of Orthopedic Surgery

Scott and White Memorial Hospital and Clinic Scott, Sherwood and Brindley Foundation The Texas A&M University System Health Science Center College of Medicine Temple, TX 76508, USA

Martin Lucke

Klinik fçr Unfall-

und Wiederherstellungschirurgie Champus Virchow-Klinikum Augustenburger Platz 1 13353 Berlin, Germany Thomas Mçckley

Friedrich-Schiller-Universitåt Jena Unfall-, Hand- und

Wiederherstellungschirurgie Erlanger Allee 101

07737 Jena, Germany Holger Mçller-Daniels

Stryker Trauma GmbH Prof.-Kçntscher-Straûe 1±5

24232 Schænkirchen/Kiel, Germany Wolf Mutschler

Nussbaumstraûe 20 80336 Mçnchen, Germany Justin S. Ogden

Department of Orthopedic Surgery University of Louisville

Louisville, KY 40292, USA Robert A. Probe

Department of Orthopedic Surgery

Scott and White Memorial Hospital and Clinic Scott, Sherwood and Brindley Foundation The Texas A&M University System Health Science Center College of Medicine Temple, TX 76508, USA

Philip Procter Applied Technology

and Science Technology Group Stryker Trauma SA

Chemin du Pont-du-Centenaire, 110 1228 Plan-les-Ouates

Geneva, Switzerland

Michael-J. Raschke

48149 Mçnster, Germany Wolfgang Roth

St. Elisabeth-Klinik

Chirurgische und Unfallchirurgische Klinik Kapuzinerstraûe 4

66740 Saarlouis, Germany Dirk Salz

Fraunhofer Institut fçr Fertigungstechnik und Angewandte Materialforschung Wiener Straûe 12

28359 Bremen, Germany Amir Sarvestani

Stryker Navigation Bætzinger Straûe 41 79111 Freiburg, Germany Gerhard Schmidmaier

Klinik fçr Unfall- und Wiederherstellungschirurgie Champus Virchow-Klinikum Augustenburger Platz 1 13353 Berlin Germany Reinhard Schnettler

35385 Giessen, Germany Hartmut Seidel

Reventlowstraûe 48 22605 Hamburg, Germany David Seligson

Department of Orthopedic Surgery School of Medicine

University of Louisville Louisville, KY 40292, USA Cornelia Siemers

Labor fçr Experimentelle Unfallchirurgie Kerkrader Straûe 9

35392 Giessen, Germany

List of Contributors XI

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Andreas Speitling Applied Technology

Geneva, Switzerland Jens-Peter Stahl

35385 Giessen, Germany Richard Stange

48149 Mçnster, Germany Peter Steinrçcke

Bio-Gate Bioinnovative Materials GmbH Neumeyer Straûe 48

90411 Nçrnberg, Germany Gilbert Taglang

67400 Illkirch-Graffenstaden, France Peter Thaller

Nussbaumstraûe 20 80336 Mçnchen, Germany Vicken Topouchian

75015 Paris, France Katja Trinkaus

Labor fçr Experimentelle Unfallchirurgie Kerkrader Straûe 9

35392 Giessen, Germany

Geert Von Oldenburg Applied Technology

Geneva, Switzerland Holger Von Wieding Applied Technology

Geneva, Switzerland Michael Wagener

Bio-Gate Bioinnovative Materials GmbH Wiener Straûe 12

28359 Bremen, Germany Michael Weber

St. Elisabeth-Klinik

Chirurgische und Unfallchirurgische Klinik Kapuzinerstraûe 4

66740 Saarlouis, Germany Sabine Wenisch

35385 Giessen, Germany Britt Wildemann

Klinik fçr Unfall-

und Wiederherstellungschirurgie Champus Virchow-Klinikum Augustenburger Platz 1 13353 Berlin Germany

XII List of Contributors