The Clinical Application, Follow-up, Forearm Functional Assessment, And Related Anatomy Study Of Radial And Ulnar Interlocking Intramedullary Nails

Forearm intramedullary nails has many adavantages, including full-scale indication, strong and elastic fixation, early recovery and low-rale refracture. But it develops slower than nailing of the femur and tibia. A new designed forearm interlocking intramedullary nail was applied to clinical and was completely estimated after operation. The related study of anatomy was based on guidancing the operation.1.The Clinical Application, Follow-up and Forearm Functional Assessment of Radial and Ulnar Interlocking Intramedullary NailsObjective: A new designed forearm interlocking intramedullary nail is put into clinical application.The outcome will be evaluated especially for forearm function.Methods: The forearm interlocking intramedullary nails were used to treat with 28 cases of forearm fractures, nonunion and refractures after plate fixation.There were 24 cases of fractures, 3 cases of nonunion and 1 case of refracture after plate fixation. A new forearm function assessment index is formulated to evaluate all cases and was compared with other assessment indexes. The clinical application is also evaluated.Results: 25 fractures cases were followed up varying from 4 months to 20 months. 22 cases obtained solid union(88%), 2 cases got later union and 1 case got nonunion.3 cases of nonunion show solid porosis. Dorsal branches of superficial of radial nerve were injuried in 1 case, posterior interosseous nerve and ulnar nerve in other 2 cases, radiographic examination of 1 case revealed proximal radio-vlnar synostosis. No infection or nail breakage were found. The nails were removed in 8 :ases, no refracture occurred after 3 -7 months follow-up. The outome were assessed by the new reformed Broberg and Morrey index, the results were excellent in twenty-three; good in two; fair in one and poor in two. There is no stastistical difference compared with other indexes.(P<0.01)Conclusion: Forearm interlocking intramedullar} nail is a kind of strong and elastic fixation. It has small incision and a full range of motion is usually quickly regained after operation. Segmental fractures, seriously comminuted fractures, nonunion and refracture after plate fixation are the best indication.Closed nailing has many adavantages, including early union, low incidence of infection, less blood less, small scars and relatively short operating time with minimal surgical trauma. The cosmetic result alone should make it essential for the female patient. The new reformed Broberg and Morrey index is full-scale and integrated for assessment of forearm function. It is suitable for generalizing in clinical. 2. Obsevation of the Relation between Distal Radius Pin Insertion and Superficial Banch of Radial Nerve in AnatomicalObjective: To study the anatomy and clinical application of distal radial pin insertion and superficial branch of radial nerve.Methods: 10 sides of superficial branches of radial nerve in 5 adult specimens wereobserved.Results: The superficial branch of radial nerve divided into two major branches at a distance of 3.67 0.99cm to the Lister tuberosity and 1.39 0.35cm lateral to the line with external humeral epicondyle and Lister tuberosity.Tfce medial branch lies in the radial half of the Lister tuberosity and the radial styloid proccss,a mean distance of 1.42cm to theLister tuberosity.Conclusions: The Lister tuberosity as distal radius pin insertion has low probility to injury superficial branch of radial nerve.but incision must keep away from cephalic vein and the skin around the incision be protected when roaming.3.Relation of the Posterior Interosseous Nerve with Locking Screw Insertion Site in Locked Intramedullary Nail of Radius through three ApproachesObjective: To assess the relation of the posterior interosseous nerve(PIN) to the locking screw insertion site in locked intramedullary nail of radius from a standard anterior,posterolateral and posterior approach.Methods: 9 fresh anatomic specimen arms are divided into 3 groups.After a standard anterior(Henry incision),posterolateral(Tompson incision)and p...