Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Dec 1978
Comparative Study[Combined Kuntscher nailing and screw fixation (author's transl)].
The authors describe a technique of Kuntscher intramedullary nailing combined with screws driven through the bone and the nail above and below the fracture site. This technique gives better stability of the fracture and allows extension of intramedullary nailing to severely comminuted fractures, fractures with loss of bone and to proximal or distal fractures. Risks of rotational instability or shortening are diminished. ⋯ Biomechanical experiments conducted to determine the best position of the screws for optimal locking of the nail are described. The results obtained in one hundred and sixteen cases are analysed. The technique was also used in the treatment of non-union and in the fixation of osteotomies.
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Rev Chir Orthop Reparatrice Appar Mot · Dec 1978
[Intramedullary nailing with reaming. A critical analysis of Kuntscher's principle (author's transl)].
The authors have reviewed two of Kuntscher's principles relating to intramedullary nailing: the moment of elasticity of the nail should be close to the moment of elasticity of the bone and the suppression of rotation movements at the fracture site is due to locking of the nail by virtue of its elasticity. They have conducted an experimental study which does not confirm these views. They considered that rotary stability is due to muscle tone, the line of the fracture and the anchorage of the ends of the nail at the upper and lower end of the bone.