Kuntscher nail plural kuntscher nails a metal rod forced into the medullary cavity of a bone to treat a fracture. This is the first described nail which has some disadvantages such as rotational instability and causing bone necrosis 1. The length of the distal fragment should be measured over the thigh, up to the proximal pole of the patella to avoid penetration of tlie nail into the knee joint. Pdf use of a cementloaded kuntscher nail in firststage. Biarticular total femur spacer for massive femoral bone loss. We looked at the galvanic reactions between the two and.
A case of jamming of a kuntscher nail is presented and a technique of its removal without the use of special instruments is described. Rotating the bent end of nail as a lever arm to its sideways loosens the nail. Since then, the technique of intramedullary nailing has evolved and the use of kuntscher nail has become almost obsolete. Both a bone fixation device and a method for retrofitting this device in a conventional hollow, intramedullary nail are disclosed herein.
Heat treatment shall be hardened and tempered to 400 to 450 hv. Accuracy of distal long femur nail locking with different. Possible use of nail and cement to fix torque fractures are discussed. Removal of a kuntscher nail is usually a simple procedure. However the kuntscher rod is a load sharing device of relatively low stiffness, compared with the intact femur, as shown in recent biomechanical studies allen,1968, laurence,1969, martens 1973. Both the kuntscher nail and cerclage wire are made of stainless steel but with different percentages of constituent elements. In 1940 in germany, he introduced new nailing methods and followed the. A longstem cemented prosthesis as part of a temporary. Pdf principles of fixation with interlocking nailing semantic. Patients who refused consent were treated with plate and screws or the unlocked kuntscher intramedullary nail knail. Use of a cementloaded kuntscher nail in firststage revision hip arthroplasty for massive femoral bone loss secondary to infection. The use of the kuntscher nail has been the most important advancement in. However, this can sometimes be very difficult if there is no eye in the proximal end of the nail, either due to sawing off the end of the rod during its insertion or due to breakdown of the eye when attempting removal. Before surgery, all patients underwent staging studies, including plain radiographs and mri of the limb, contrast enhanced computerized tomography cect scans of the chest and wholebody isotope bone scan.
Presentation of a humeral shaft fracture treated by locked. Controversies in the intramedullary nailing of proximal and. Different but scattered english literature has been published. Along with this, the offered range of kuntscher cloverleaf nails is suitably checked on different parameters to ensure that defect free products are delivered at clients premises. The same fractures were fixed consecutively with kuntscher nail, double compression plates and kuntscher nail and cement, and were similarly tested in torque. An innovative technique to cut and extract loose bent kuntscher nail article pdf available in indian journal of medical sciences 5810. However, the management of massive bone defects constitutes a surgical challenge, requiring the use of different nails, expensive long stems, or cementcoated tumor prostheses for preparing the spacer. At the time of this case report, the patient is free from pain in the leg with only. Transverse openings are provided in the body near the distal tip and in the head for receiving locking screws.
Orthopedics the lateral percutaneous suprapatellar approach in a semiextended position is an excellent approach for intramedullary nailing of tibia fractures. Peter broad consultant orthopaedic surgeon, bournemouth and east dorset group anthony j. Gerhard kuntscher is credited with the first use of this device in 1939. Im nails have long been used to treat fractures of long bones of the body. Four patients are presented who had closed femoral shaft fractures and developed either extensive callus or osteomyelitis following open kuntscher nailing and cerclage wiring of a butterfly fragment. A 2stage revision total hip replacement thr is the standard treatment for a chronically infected thr with severe metadiaphyseal bone loss. Scope prescribes dimensional and other requirements for kuntscher nail set used in orthopaedic.
Microsofts free reader application, or a booksized computer this is used solely as a. In the past, these kind of disadvantages has limited the use of unlocked nails. Sep 29, 2010 patients who refused consent were treated with plate and screws or the unlocked kuntscher intramedullary nail knail. The distal nail matrix forms the ventral underside nail surface an atlas of diseases of the nail 2. The history of intramedullary nailing presentation grafix, inc. The turning point for the new nailing method dates back to gerhard kuntscher. Best orthopaedic offering best ortho round kuntscher cloverleaf nails at rs 300piece in delhi, delhi. All content on this website, including dictionary, thesaurus, literature, geography, and other reference data is for informational purposes only.
The body is of tantalum, an alloy thereof containing more than 50% tantalum, niobium, or an alloy thereof containing more than 50% niobium and is provided with a female thread 1 at. The aim of this article is to report a complication that was common with kuntscher unlocked intramedullary nail to remind surgeons of its existence even in this era of improved implant design and to consider it as an etiology in knee pathology. Though others had tried before him, it was kuntscher of. Kuntscher first reported use of the vshaped nail in 1940 and proposed the nail would act as an internal splint that created an elastic union with the inner medullary cavity. The rod who flied from germany inside the legs of america article pdf available in emergency medicine 0203 december 20 with 1,082 reads how we measure reads.
Yeow, ms institute of orthopaedics and traumatology, general hospital, jalan pahang, 50586 kuala lumpur introduction complex andor segmental fractures of the femur pose a problem for the surgeon when he attempts to internally fix them. Jun 17, 2019 the use of kuntscher nail for femur fracture dates back to world war 2. Interlocking nails for treatment of femoral fractures. In order to promote public education and public safety, equal justice for all, a better informed citizenry, the rule of law, world trade and world peace, this legal document is hereby made available on a noncommercial basis, as it is the right of all humans to know and speak the laws that govern them. Despite following all these recommendations except that our patient was, in fact. Intramedullary nails can be broadly categorized into two types. The modern technique of intramedullary nailing was largely developed and perfected by the dedicated work of the german surgeons gerhard kuntscher and his student, richard maatz. Kuntscher nail is an unlocked type, and is the only one of its kind now available 4, 5. A technical note for extracting an incarcerated femoral kuntscher. Kuntscher nails kuntscher cloverleaf nails manufacturer india. The orthopaedic surgeons across the globe are facing a new challenge of removal of these kuntscher nails due to different indications. Reamer, flexible for kuntscher nail medullary canal. Bone cement spacers loaded with antibiotic are the gold standard in septic revision. Comparative study of interlocking nailing and kuntscher.
Newlife surgical works is the manufacturer and exporter of kuntscher nails, kuntscher cloverleaf nails, tibia kuntscher cloverleaf nail, kuntscher cloverleaf nail tibia, kuntscher cloverleaf nail femur, interlocking nails, tibia nails, femur nails, interlocking set, external fixator set, surgical nails, orthopaedic nails, interlocking nail, interlocking nails supplier. We describe a novel technique for preparing a biarticular. Migratednail, tibial, fracture, implant, removal 1department of surgery, bayero university. The results were compared with an equal number of cases of femur shaft fractures treated with k nail and adjunctive plating, retrospective or concurrent. A kuntscher nail is strongest when the open section faces anterior and is loaded in tension because of a local buckling effect when the open section is loaded in compression. Standard knails of sizes 12 and were converted to interlocking nails by drilling one hole at the proximal end the hole was placed obliquely at to the long axis of the nail and started at 2 cm below the end of the. Different techniques for reduction of these fractures are available and can be applied with either fixation device. None of the patients had distant metastasis at the time of operation. Open interlocked nailing without a targeting device or xray. Us4446857a medullary nail and process for the production. Use of a cementloaded kuntscher nail in firststage revision. The proximal matrix forms the superficial dorsal part of the nail plate. The nail is rigid and has a cloverleaf shape in crosssection. This study included 25 patients in each group, 1860 years of age having diaphyseal fractures of the femur treated with intramedullary interlocking nailing.
Kuntscher first performed the process using the nail in november 1939 at the university department of surgery in kiel. Pdf an innovative technique to cut and extract loose. Current indications for open kuntscher nailing of femoral. Biarticular total femur spacer for massive femoral bone. Kuntscher himself never gave up his idea of closed nailing an went ahead to develop his new nail called the detensor nail in 1968 to give rotational stability to the fracture by creating a proximal and distal hole in his nail for transfixing pins. Adopted 20 december 1973 i 0 february 1974, isi i indian standards institution manak bhavan, 9 bahadur shah zafar marg new delhi 11. Pdf download for a technique for extracting a buried kuntscher nail. We offer high quality kuntscher cloverleaf nails at best prices. Intramedullary nailing of long bone fractures has to be regarded as the most significant achievement in. Home december 2005 volume 59 issue 6 removal of broken kuntschers nail. In order to understand the biomechanics of the device, pilster 1980 measured the anteriorposterior and slot deflections at one point ten cm from. Scope specifies dimensional and other requirements for striker type extractor kuntscher nail used in orthopaedic surgery. Proximal humeral reconstruction using nail cement spacer. Best ortho round kuntscher cloverleaf nails, rs 300 piece.
At the end of the war, kuntscher himself was taken to the uni ted states to work. Pdf on apr 1, 2009, ayman m a tadros and others published segmentally fractured. The use of kuntscher nail for femur fracture dates back to world war 2. The fixation of experimental femoral shaft torque fractures. But spontaneous distal migration of the knail across the knee joint and protrusion over the tibia till the tibial tuberosity is a complication that has very rarely been reported in the literature previously. Abstract interlocking intramedullary nails is now the standard in the treatment of femoral shaft fractures however costs precludes its common use in developing countries, making open kuntscher nailing a common procedure. Open interlocked nailing without a targeting device or x. The rod who flied from germany inside the legs of america. Gpc medical indias largest manufacturer and supplier of kuntscher nails. Kuntscher after initial cadaveric studies in 1939, began inserting his intramedullary devices in 1940 on injured servicemen german and pows and actually presented and published his findings amongst his german peers during the war years. A comparison of size of kuntscher nails with the length and the width of femurs and humeri in dogs a comparison of size of kuntscher nails with the length and the width of femurs and humeri in dogs charles, knecht.
History is a strange thing when considered retrospectively with 2020 vision. Proximal femur nail with locking and stabilisation screws for treatment of femur fractures of left thigh. Fig, 2 driver, slotted, kuntscher nail, orthdpaedic all dlmenslons in mlllimetres. Case report removal of distally migrated cannulated. Radiation free insertion of distal interlocking screw by nail over.
The history, physical findings, results of investigations and past medical history of the presenting patient were. The bone fixation device of the invention generally comprises at least one blade member having a top portion registrable with a blade slot provided in the body of the nail, and a bottom surface including a rail slot, as well as at least one wedge member. The study concluded that the kuntscher nail and the unlocked ao nail. An intramedullary rod, also known as an intramedullary nail im nail or interlocking nail or kuntscher nail without proximal or distal fixation, is a metal rod forced into the medullary cavity of a bone. Knee arthropathy due to distally migrated kuntscher nail. Mar 31, 2017 bone cement spacers loaded with antibiotic are the gold standard in septic revision. An intramedullary nail for use in fractures of the left or right femur includes a body having a head, an intermediate portion and a distal tip. These have included a ball or olivetipped guidewire, 18,32 an enders nail, 31 1. The t2 tibial nailing system is intended to provide temporary stabilization of various types of fractures, malunion and nonunion of the tibia. Register for a free account existing user log in existing user log in. One opening in the head has its axis within the femoral neck and another opening has its axis generally transverse thereto. Surgical treatment of humeral shaft fractures commonly includes intramedullary nailing imn, which offers good clinical outcomes.
Closed locked nailing has now become a gold standard method of internal fixation for the management of tibial. Pdf segmentally fractured femoral kuntscher nail extraction using. A technique for extracting a buried kuntscher nail from the femur. The use of schanz screw is a safe, cheap and effective means of free hand removal of distally migrated cannulated interlocking nails. Acknowledgement my thanks are due to rolls royce limited, crewe, for technical facilities for this. Since professor kuntscher and his team were working within germany during world war ii, their work remained largely unknown to the rest of the. Overall outcomes appear to be nearly equivalent, with minor differences in complications. Use of a cementloaded kuntscher nail in firststage. Kuntscher nails kuntscher cloverleaf nails, kuntscher nails. Kiel who, at the beginning of the second world war, perfected intramedullary nailing for fractures of the shaft of the femur. All patients of k nail group needed blood transfusion, while only 17 patients of. Registered users can save articles, searches, and manage email alerts.
However, this can sometimes be very difficult if there is no eye in the proximal end of the nail, either due to sawing off the end of the rod during its insertion or due to breakdown of the eye when. Conclusion we believe that open kuntscher nailing is still indicated in hospitals where a traction table or. Interlocking nails for treatment of femoral fractures c. Galvanic reactions between cerclage wires and kuntscher. Different but scattered english literature has been.
Kuntscher nails kuntscher cloverleaf nails manufacturer. There is provided a medullary nail having a hollow body provided with a plurality of longitudinal concave zones 3 in the outer surface and contiguous zones of annular form 2 and having a cutter 4 at one end. Material shall be according to designation 30cr of is. The evolution of kuntscher nailing gerhard kuntscher was born in. The german military initially disapproved kuntschers im nailing technique but introduced it in 1942. Biomechanics of the kuntscher intramedullary rod sciencedirect. Injury, 9,57 printed in great britain 5 the jammed kuntscher nail. L percy senior orthopaedic registrar, westminster hospital, london summary a case of jamming of a kuntscher nail is presented and the technique of longitudinal splitting of the. Cureus spontaneous distal migration and protrusion of a.
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