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Use in Arthrodesis

  • Kyle M. SchweserEmail author
  • Brett D. Crist
Chapter
  • 58 Downloads

Abstract

Arthrodesis is typically reserved as a salvage procedure, can be performed utilizing multiple fixation constructs, and leads to successful fusion when biomechanical principles are followed. General principles for bony union such as joint preparation, compression, bony apposition, mechanical alignment, stable fixation, and appropriate strain at the arthrodesis site are observed with intramedullary nailing just like any other fixation construct. However, the use of intramedullary nails for arthrodesis is unique in its ability to limit soft tissue dissection and provide support to the fusion through its load-sharing properties. It is typically limited to knee and hindfoot fusions because the regional anatomy easily accommodates medullary fixation. Obtaining primary bony fusion is the goal of any arthrodesis; however, nails are particularly well suited for fusion through both primary and secondary healing, thus expanding the indications and abilities of a surgeon to achieve fusion. Intramedullary nailing offers its own unique challenges, particularly in obtaining and maintaining joint compression, which is likely contributory to nonunions when they occur, but can be mitigated by maximizing the biomechanical principles observed.

Keywords

Intramedullary nails Arthrodesis Fusion Biomechanics Case examples 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Orthopaedic Trauma Service, Department of Orthopaedic SurgeryUniversity of MissouriColumbiaUSA

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