Cephalomedullary nails (CMN) are commonly used for the treatment of intertrochanteric (IT) hip fractures. Total hip arthroplasty (THA) is commonly used as a salvage procedure for failed IT hip fractures that progress to post-traumatic arthritis.
What does Cephalomedullary mean?
Cephalomedullary nailing is the surgical stabilization of the fracture with an intramedullary device usually inserted through the piriformis fossa, the tip or lateral greater trochanter, or the medial greater trochanter.
How does Cephalomedullary nail work?
The nail features a small proximal section that is designed to minimize the amount of bone that must be removed for nail insertion. A lag screw is placed through the nail into the femoral head to secure the nail in place proximally and help control the different segments of the bone while healing occurs.
How long does it take for an intertrochanteric fracture to heal?
All the intertrochanteric fractures healed on average 70.5 days (range 31-213 days) after operation. The fractures resulting from vehicular trauma or fall from a height healed significantly more slowly (p = 0.02, univariant log-rank test).
What is CMN condition?
Congenital melanocytic nevi (CMN) are visible pigmented (melanocytic) proliferations in the skin that are present at birth. CMN are benign, tumor-like malformations resulting from faulty development of pigment cell (melanocyte) precursors in the embryo, and composed of an abnormal mixture of skin elements.
Is Cephalomedullary the same as intramedullary?
This new class of intramedullary nail, the so-called “cephalomedullary nail” includes the Long Gamma Nail (LGN), the Trochanteric Femoral Nail (TFN), and the Intertroch/Subtroch Nail (ITST).
What is a gamma nail in hip surgery?
This procedure stabilizes severe fractures of the femur with a metal rod and screws implanted into the center of the bone. This system provides great strength while the bone heals.
What is a intertrochanteric fracture?
Intertrochanteric fractures are defined as extracapsular fractures of the proximal femur that occur between the greater and lesser trochanter. The intertrochanteric aspect of the femur is located between the greater and lesser trochanters and is composed of dense trabecular bone.
What is a recon nail?
Reconstruction nails are a subset of cephalomedullary nails that are distinguished by two proximal interlocking screws that permit sliding lag-screw fixation into the femoral head, which enhance rotational stability in the proximal femur, and distal interlocking screws, which ensure rotational and axial stability.
What is a Hemi in orthopedics?
“Hemi-“means half and “-arthroplasty” means joint replacement. A hemiarthroplasty is a rare surgery that is only performed under unique circumstances. Replacing half of a hip joint is usually done after rare traumatic injury in which the femoral head is fractured.
Are there hip precautions with IM nailing?
Do not get the incision wet. to protect the leg while ambulating. Do not engage in prolonged periods of standing or walking over the first 7-10 days following surgery. Elevate the operative leg to chest level whenever possible to decrease swelling.
How do you handle an intertrochanteric fracture?
Intertrochanteric fractures are treated surgically with either a sliding compression hip screw and side plate or an intramedullary nail. The compression hip screw is fixed to the outer side of the bone with bone screws. A large secondary screw (lag screw) is placed through the plate into the femoral head and neck.
Can intertrochanteric fracture heal without surgery?
Depending on health and injury pattern this bone can take 3-4 months to heal without surgery. Physical therapy for hip and knee range of motion is started around 6 weeks once bone has healed enough to prevent displacement with motion.
What causes intertrochanteric fracture?
Causes. The most common causes of intertrochanteric fractures are falls or trauma. These problems are more likely to occur among older people, who are at a higher risk of falling. In some cases, people who have weak bones can get a fracture from simply walking or standing.
Does CMN go away in babies?
Most cases of CMN never require treatment, but there are some cases in which the moles may be removed. This is usually done to lower the risk of skin cancer or to improve appearance. You and your child’s doctor can learn how to monitor the moles and follow up with a dermatologist if there are any concerns.
Do CMN birthmarks fade?
In most children the CMN will lighten to some degree in the first few years of life. This is still being studied but it appears to be more prevelant in children with light or red hair and pale skin than in those with darker hair and skin colour.
