![]() Fractures have been classified according to Laulan & Bismuth. There was no redo for insufficient result. The clinical results were analyzed with the Constant score: 55 excellent, 20 satisfactory and 8 poor result. A Velcro splint has been routinely used for a period of 5 weeks. The hospital stay was 2 days up to 2013, when all these fractures were then treated as outpatients. The average age was 67 years, ranging from 18 to 89 years. Of these 83 cases, the female/male ratio was 7 to 1. The preliminary series includes 83 cases. All cases presenting an extra-articular fracture (Colles or Smith) and/or an intra-articular fracture (except marginal fracture and comminuted fractures with 4 fragments or more) have been treated. It must be locked at its distal part, with at least two epiphyseal screws (Figure 6).īetween May 2008 and May 2015, the Nail-o-flex® nail was used to treat fractures of the lower end of the radius. It is also elastic since the 2/3 of the nail are fine as a pin (2mm) and automatically realigns the distal epiphysis and keeps the focus open. The nail is freestanding thanks to its “S” design and its 3 points of support. Locking is performed as for the femur or tibia. It is stopped by the aiming frame which stumbles on the radial styloid. It is inserted with curvature upside down to fit the metaphyseal angle, it is then turned over and entirely inserted. The entrance is perforated with a small square point. The nail is inserted at the level of the snuffbox, outside the tendinous areas. The radius fracture is reduced by manual traction. The nail-o-flex® nail application technique is directly derived from the long bones nailing of the lower limb. It comprises a distal portion which is perforated and a long, smooth proximal part that is thin and flexible to ensure elasticity. It is a specific nail for fractures of the distal radius. The Nail-o-flex® nail was introduced in 2005. “The present study supports the view that intramedullary nail fixation and flat fixation for the treatment of displaced extra-articular distal radius fractures have equivalent radiographic and functional outcomes. Most recent series seem to show the equivalence of radiological and functional results, between closed nailing and the anterior plates. The real goal was to go back to closed focus osteosynthesis as done for the lower limbs. Since de year 2000 it has been applied to the upper limbs. This method has revolutionized the treatments of long bones fractures. This lock was improved by Kempf & Grosse in 1978 to the point where it prevailed over the screw plate osteosynthesis which popular in the 1960-1980. The transverse locking of the nail has been described by Modny and Bambara in 1953. The later used his nails on the wounded of the Finnish front during the Second World War. Küntscher at the University of Kiel (Germany) in 1939. Danis of the University of Brussels (Belgium) in 1938 and by G. ![]() The nailing of long bones was described by R. ![]() Today, there are specifically designed wires for fractures of the radial diaphysis. ![]() Several types of flexible nails dedicated to distal fractures appeared in the early 2000s. The long wires were first used during the first World War while the flexible pins were described as early as the 1950s. The radius is a long, relatively straight bone, and frequently subject to fractures because of its protective role in the event of a fall or accident. But if the material is correctly adapted, it is reasonable to offer a stable and non-invasive osteosynthesis of those kinds of fractures. Overall, if the spongious bone underwent a deep crush. And, when the nail is placed, the material must fit to prevent any secondary collapse. In order to operate on those patients with very few skin damages, an appropriate reduction is necessary before the nailing procedure. Therefore, their mechanism should better be fully understood. The simplicity, the efficiency and the low cost of the surgical procedure are decisive factors in terms of public health. It is estimated that 150,000 people sustain a distal radius fracture every year in France. The fracture of the distal radius is frequent. ![]()
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