Biomechanical comparision of femoral intramedullary nails for interfragmentary rotational stability.

OBJECTIVES: This study aims to investigate which intramedullary nail is biomechanically better for establishing interfragmentary rotational stability. MATERIALS AND METHODS: Thirty composite femurs were utilized in this study. We analyzed interfragmentary rotational arc displacements between 10 Nm external-6 Nm internal torques and 6 Nm external-6 Nm internal torques which imitate rotation torques while walking on a flat surface and descending stairs by administering 10 interlocking nails, 10 compression nails, and 10 Mehmet anti-rotation nails with tube compression. RESULTS: Maximum interfragmentary rotation arc displacement between 10 Nm external rotation and 6 Nm internal rotation torques was mean 1.64 mm in the Mehmet nail compressed by 7 Nm torque wrench. This value was lower by 309% (6.72 mm) from interlocking nail (p=0.000), 201% (5.42 mm) from compression nail compressed by 2.5 Nm torque wrench (p=0.000), and 26% (1.92 mm) from compression nail compressed by 7 Nm torque wrench (p>0.05). CONCLUSION: In axially stable transvers and short oblique femur fractures, Mehmet nail is superior to other intramedullary nails with limited movement between locking screw and hole, more interfragmentary compression without locking screw deformation, and no proximal nail migration.

Traumatic distal ulnar artery thrombosis.

This paper is about a posttraumatic distal ulnar artery thrombosis case that has occurred after a single blunt trauma. The ulnar artery thrombosis because of chronic trauma is a frequent condition (hypothenar hammer syndrome) but an ulnar artery thrombosis because of a single direct blunt trauma is rare. Our patient who has been affected by a single blunt trauma to his hand and developed ulnar artery thrombosis has been treated by resection of the thrombosed ulnar artery segment. This report shows that a single blunt trauma can cause distal ulnar artery thrombosis in the hand and it can be treated merely by thrombosed segment resection in suitable cases.

Isolated tuberculous tenosynovitis of the anterior tibial and extensor digitorum longus tendons.

Musculoskeletal system is involved in 1-5% of extrapulmonary cases of tuberculosis. Tuberculous tenosynovitis is a rare form of musculoskeletal tuberculosis. Tuberculosis of the tendon sheath in the hand has been seen in a few cases. Involvement of the tendons of the leg is less common. Diagnosis is not easy as there are no specific clinical symptoms or signs. A 33-year-old male presented with painful swelling in the distal right lower limb that caused restriction of movement. Imaging studies showed inflammation and infection of the extensor digitorium longus and tibialis anterior tendons. Histopathological studies showed a necrotizing granulomatous inflammation in the synovial tissue. A diagnosis of tuberculosis was made and medical treatment was initiated that proved successful. Patient remained infection-free at 26-month follow-up examination.