*Corresponding Author:

Dharmshaktu GS
Department of Orthopaedics, Government Medical College, Haldwani, Uttarakhand, India
E-mail: drganeshortho@gmail.com

Citation: Dharmshaktu GS, Khan I. An alternative instrument for making entry point for elastic intramedullary nail. Ann Med Health Sci Res 2016;6:198.

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Abstract

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Dear Sir,

We read with great interest the article titled, “An alternative instrument for making entry point for elastic intramedullary nail” under section Methods and Devices.[1] This letter might be a corollary to the article in conception and practice. The versatility of the described method goes beyond the femoral fractures and can be applied very effectively for forearm fractures in pediatric age. We have been using the similar method for making entry point for elastic nailing in pediatric forearm fractures and found the method equally useful. The slender forearm bone with particular reference to radius which has curved trajectory for introduction of nails through dorsal entry point is easily made accessible with curved shape of the suction trocar. The ulnar entry is also made easy when we approach for a curved olecranon physeal‑sparing technique. The intramedullary nailing has been shown to work as very good internal splint and resist rotational forces to considerable magnitude.[2,3]

Availability of different sizes of suction drain trocars proves helpful in selecting the right one for particular thickness of the forearm bones. Besides it, sharp pointed end makes entry a smooth and less traumatic experience for the patient and surgeon alike. The method, we found, works equally well for introducing intramedullary nails other than elastic nails such as square nails for forearm bones. We agree with the authors to have these readily available instruments in our armamentarium for potential and relevant use.

References

1. Sharma P, Meena S, Gangary S, Chowdhury B. An alternative instrument for making entry point for elastic intramedullary nail. Ann Med Health Sci Res 2015;5:134-5.
2. Johnson CW, Carmichael KD, Morris RP, Gilmer B. Biomechanical study of flexible intramedullary nails. J Pediatr Orthop 2009;29:44-8.
3. Ono M, Bechtold JE, Merkow RL, Sherman RE, Gustilo RB. Rotational stability of diaphyseal fractures of the radius and ulna fixed with Rush pins and/or fracture bracing. Clin Orthop Relat Res 1989;240:236-43.