Radius Ulna Nailing with Lambrinudi Wire / "L" Wire 30 mins скачать в хорошем качестве

Radius Ulna Nailing with Lambrinudi Wire / "L" Wire 30 mins

Lambrinudi Wire fixation of Radius Ulna is a very well known method of Intramedullary Nailing of Radius and Ulna over last 70 years in India. Dr C. Lambrinudi published the paper about this technique in 1940. In India many from Bombay ( Then Bombay, Now Mumbai) were using regularly till the time Square Nail of Dr A K Talwalkar became more popular. Prof Dr V M Iyer from Solapur has been using this regularly since 60s and his large number of students have learnt the technique and using them regularly. Till the advent of C Arm IITV, it was done by mini open method by retrograde technique but with the availability of C arm IITV for the last 35 years closed nailing with L wires are being done as treatment of choice for fracture of the both bones of fore arm both in adults as well as in older children. With TENS becoming more popular in the last 20 years, we have advantageously used the principles of TENS like having a small bent at the tip for easy negotiation, giving a proper bend to get recoil effect of the nail to reduce the fracture as well as stretch the inter osseous membrane, etc are incorporated to get better results with the L Wires. Square nail used as a square peg in a round hole is a too thick implant and that straightens the curvature of radius a bit leading to restriction in the extreme rotational movements like terminal pronation and supination. If you use thinner square nails, it defeats the purpose of Square peg in a round hole. About TENS, definitely it has better flexibility and elastic memory after it is bent and inserted in the bones, but unfortunately there will be bone ingrowth on the surface of titanium material causing incarceration of the nail in the bone making it too difficult to extract if the patient does not come in time for removal of implants hence the author prefers Lambrinudi wires prepared from 316 steel for these fore arm fractures. With The availability of fore arm distractor and extrapolating the tips of closed femoral nailing learnt practically almost all the cases in the last 20 years are treated by closed nailing or at the most by intrafocal manipulation using a K wire. The author prefers plating only if nailing is contra indicated like single bone fracture( if nailing is done it takes longer time to unite), or blocked medullary canal due to previous malunion or very narrow medullary canals. The video shows the technique, use of fore arm distractor and few cases