Osteosynthesis and Trauma Care 2002; 10(Suppl 1): S28-S31
DOI: 10.1055/s-2002-33813
© Georg Thieme Verlag Stuttgart · New York

Composition of Reaming Products in Relation to Reaming Drill Diameter

A. T. Kouzelis1 , H. Kourea2 , P. Megas1 , E. Lambiris1
  • 1Department of Orthopaedics, Patras University Hospital, Patras, Greece
  • 2Department of Pathology, General Hospital “Agios Andreas”, Patras, Greece
Further Information

Publication History

Publication Date:
11 September 2002 (online)

Abstract

The change of substance of reaming products in the different grades of reaming were examined. Intramedullary bone reamings were obtained from the tibia or femur of thirty-nine patients during intramedullary nailing procedures. Histological examination in paraffin sections showed that the main substance of reaming products were viable, non-viable bone trabeculae and bone marrow elements. Statistical analysis of these histological findings depending on the different grades of reaming revealed that reamer diameter correlates with the percentage of viable and non-viable bone mass. Preoperative planning in intramedullary nailing procedures can provide a good source of bone graft material only with a careful estimation of the medullary canal diameter.

References

  • 1 Anglen J O, Blue J M. A comparison of reamed and unreamed nailing of the tibia.  J Trauma. 1995;  39 351-355
  • 2 Baumgart F, Kohler G, Ochsner P E. The physics of heat generation during reaming of the medullary cavity.  Injury. 1998;  29 11-25
  • 3 Bone L B, Cassman S, Stegemann P. Prospective study of the union rate of open tibial fractures treated with locked, unreamed intramedullary nails.  J Orthop Trauma. 1994;  8 45-49
  • 4 Court-Brown C M, Christie J, McQueen M M. Closed intramedullary tibial nailing. Its use in closed and type I open fractures.  J Bone Joint Surg. 1990;  72 605-611
  • 5 Danckwardt-Lilliestrom G. Reaming of the medullary cavity and its effect on diaphyseal bone: a fluorochromic, microangiographic and histologic study on the rabbit tibia and dog femur.  Acta Orthop Scand Suppl. 1969;  128 1-153
  • 6 Ekeland A, Thoresen B O, Alho A, Stromsoe K, Folleras G, Haukebo A. Interlocking intramedullary nailing in the treatment of tibial fractures.  Clin Orthop. 1988;  231 205-215
  • 7 Froelke J PM, Klein Nulend J, Elzinga M J. Bone cell growth in reaming debris.  Calcif Tissue Int (Suppl 1). 2000;  66 99
  • 8 Grundes O, Utvag S E, Reikeras O. Effects of graded reaming on fracture healing: blood flow and healing studied in rat femurs.  Acta Orthop Scand. 1994;  65 32-36
  • 9 Gustilo R B, Nelson G A, Hamel A, Moe J H. The effect of intramedullary nailing on the blood supply of the diaphysis of long bones in mature dogs.  J Bone Joint Surg [Am]. 1964;  46 1362-1363
  • 10 Hupel T M, Aksenov S A, Schemitsch E H. The effect of limited and standard reaming on cortical bone blood flow and early strength of union following segmental fracture.  J Orthop Trauma. 1998;  12 400-406
  • 11 Hupel T M, Weinberg J A, Aksenov S A, Schemitsch E H. Effect of Unreamed, Limited Reamed, and Standard Reamed Intramedullary Nailing on Cortical Bone Porosity and New Bone Formation.  J Orthop Trauma. 2001;  15 18-27
  • 12 Kessler S B, Hallfeldt K KJ, Perren S M, Schweiberer L. The effect of reaming and intramedullary nailing on fracture healing.  Clin Orthop. 1986;  212 18-25
  • 13 Klein M PM, Rahn B A, Frigg R. Reaming versus non reaming in medullary nailing: Interference with cortical circulation of the canine tibia.  Arch Orthop Trauma Surg. 1990;  109 314-316
  • 14 Klemm K W, Boerner M. Interlocking nailing of complex fractures of the femur and tibia.  J Bone Joint Surg [Am]. 1980;  62 1264-1273
  • 15 Küntscher G. Intramedullary surgical technique and its place in orthopaedic surgery. My present concept.  J Bone Joint Surg [Am]. 1964;  47 809-818
  • 16 Olerud S, Karlstrom G. The spectrum of intramedullary nailing of the tibia.  Clin Orthop. 1986;  212 101-112
  • 17 Pfister U, Rahn B A, Perren S M, Weller S. Vaskularität und Knochenumbau nach Marknagelung langer Röhrenknochen.  Akt Traumat. 1979;  9 191-195
  • 18 Puno R M, Teynor J T, Nagano J, Gustilo R B. Critical analysis of results of treatment of 201 tibial shaft fractures.  Clin Orthop. 1986;  212 113-121
  • 19 Rand J A, An K N, Chao E YS, Kelly P J. A comparison of the effect of open intramedullary nailing and compression-plate fixation on fracture site blood flow and fracture union.  J Bone Joint Surg [Am]. 1968;  50 784-800
  • 20 Rhinelander F W. The normal microcirculation of diaphyseal cortex and its response to fracture.  J Bone Joint Surg [Am]. 1968;  50 784-800
  • 21 Saunders R, Jersinovich I, Anglen J. The treatment of open tibial shaft fractures using an interlocked intramedullary nail without reaming.  J OrthopTrauma. 1994;  8 504-510
  • 22 Schemitsch E H, Kowalski M J, Swiontkowski M F, Senft D. Cortical bone blood flow in reamed and unreamed locked intramedullary nailing: a fractured tibia model in sheep.  J Orthop Trauma. 1994;  8 373-382
  • 23 Smith S R, Bronk J T, Kelly P J. Effect of fracture fixation on cortical bone blood flow.  J Orthop Res. 1990;  8 471-478
  • 24 Tydings G D, Martino L G, Kircher M, Alfred R H, Lozman J. Viability of intramedullary canal bone reamings for continued calcification.  Am J Surg. 1987;  15 306-309

A. T. KouzelisM.D. 

Gerasimou Markora 30

26442 Patras

Greece

Phone: +30/61 0 99 95 56

Phone: +30/61 99 71 63

Email: E-mail: kuzean@europe.com & kuzean@internet.gr

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