Intramedullary pressure increase and increase in cortical temperature during reaming of the femoral medullary cavity: the effect of draining the medullary contents before reaming.

摘要: BACKGROUND Reaming is regarded as the most adverse aspect of intramedullary nailing procedure since it leads not only to impairment vessels but also an increase in pressure and cortical temperatures which may turn lead aseptic necroses pulmonary dysfunction. Intramedullary considered be detrimental these factors. METHODS The aim this study was investigate effect on temperature removing medullary fat before reaming. removed through a suction tube inserted proximally. measurements were made pairs human femora whereby one group contents medulla drained by measured mid diaphysis metaphysis. diaphysis. reamed water bath at 37 degrees C constant insertion force. RESULTS In comparison drained, for 9.0 mm reamer previously reduced follows: positive diaphyseal 88% (reamer insertion); metaphyseal 78% negative 84% withdrawal); 65% withdrawal). No significant difference determined (median suction, 39.7 C; median without 39.4 C). CONCLUSION removal inserting reaming instruments considerable statistically reduction. If are sucked out or unreamed nails, high risk embolization unaltered. Consequently new should developed facilitate commencing nails.