Steel Nails Research Articles

A Close Cut: A Technical Report of Endovascular Removal of a Penetrating Intravascular Foreign Body after a Lawn Mowing Injury

We present a case of endovascular retrieval of a penetrating foreign body that was originally lodged in the mediastinum and then migrated to the hepatic vein. The steel nail entered the thorax and traversed the left lung causing a pneumothorax. The patient underwent a thoracotomy, but the foreign body had migrated from its original mediastinal position. A postsurgical CT showed that the object was below the right hemidiaphragm. Diagnostic venogram demonstrated that the object was in the main hepatic vein. Using a double-snare technique, the object was safely and successfully removed from the hepatic vein via the right common femoral vein.

Flexible intramedullary nailing in paediatric femoral fractures. A report of 73 cases

BackgroundFlexible intramedullary nailing has emerged as an accepted procedure for paediatric femoral fractures. Present indications include all patients with femoral shaft fractures and open physis. Despite its excellent reported results, orthopaedic surgeons remain divided in opinion regarding its usefulness and the best material used for nails. We thus undertook a retrospective study of paediatric femoral fractures treated with titanium or stainless steel flexible nails at our institute with a minimum of 5 years follow up.Material and methodsWe included 73 femoral shaft fractures in 69 patients treated with retrograde flexible intramedullary nailing with a minimum follow up of 5 years. Final limb length discrepancy and any angular or rotational deformities were determined.ResultsMean age at final follow up was 15.5 years (10-21 years). Mean follow up was 7.16 years (5.0-8.6 years). Titanium and stainless steel nails were used in 43 and 30 cases respectively. There were 51 midshaft, 17 proximal, and 5 distal fractures.All fractures united at an average of 11 weeks but asymptomatic malalignment and LLD were seen in 19% and 58% fractures respectively. LLD ranged from -3 cm to 1.5 cm. Other complications included superficial infection(2), proximal migration of nail(3), irritation at nail insertion site(5) and penetration of femoral neck with nail tip(1). There were 59 excellent, 10 satisfactory and 4 poor results.ConclusionFlexible intramedullary nailing is reliable and safe for treating paediatric femoral shaft fractures. It is relatively free of serious complications despite asymptomatic malalignment and LLD in significant percentage of fractures.

Production of Helical Polymer Microfibers by Electrospinning

Curled polyvinylpyrrolidone (PVP) microfibers were prepared successfully with a modified electrospinning setup in which the commonly used collector, a piece of aluminum foil was replaced by a steel nail (a tip collector). PVP (45 wt %) ethanol solution was used.with the increase of voltage, the proportion of the curled fibers increased and the uniformity of the curled fibers improved, also the repeat distance (wavelength) of the curled structures became smaller. In addition, some curled fibers developed into helical structures under relatively high voltages. Further analyses suggest that the mechanism for the curled PVP fibers could be ascribed to electric driven bending instability and/or mechanical jet buckling when hitting the hard collector surface.

Trace Metals in Municipal Solid Waste Compost: Sources and Research Methodology

A concern regarding MSW compost quality is the trace metal content. A study was initiated to assess the impact of various metal contaminants on compost quality. One critical step in the study was to estimate metal transfer during composting, which was achieved by measuring the corrosion rate of different contaminants during the high rate composting stage for 3 weeks using alfalfa hay and straw as composting substrate. A corrosion quantification technique, weight loss/gain of metal specimens, was employed to estimate metal release into composting substrate. Among the 7 types of contaminants, stainless steel screws, brass screws, and light bulb aluminum alloy thread contacts showed little weight changes. This suggests minimum concerns for these materials in terms of metal release during composting. The highest metal release per unit area was from light bulb foot contacts, which was 3.66 × 10−3 g cm−2, while galvanized steel nails and zinc plated screw had a metal release rate in the range of 1.5 to 1.9 × 10−3 g cm−2. Scanning Electron Microscope (SEM) was employed to determine the chemistry of corrosion products and change of surface morphology by corrosion and X-ray diffraction/spectrum to determine the type of corrosion products formed on the surface of some selected samples. As there is little literature on this subject, methodology and data from this work can be served as a scientifically sound reference to academics, industry and legislators.

Biomechanical analysis of a synthetic femur spiral fracture model: Influence of different materials on the stiffness in flexible intramedullary nailing

Background Flexible intramedullary nail fixation of dislocated diaphyseal femur fractures has gained wide acceptance for children and adolescents with open physes. Studies with a special emphasis on complications reveal frequent problems regarding stability, usually in complex fracture types such as spiral fractures and in older children weighing > 40 kg. This biomechanical study analyses how much the material of the nails influences the stiffness in a synthetic bone model. Methods Twenty-four composite grafts (Sawbones®, 4th generation, medullar canal of 10 mm) with an identical spiral fracture were used in three configurations of eight grafts. Elastic stable intramedullary nailing was performed in a retrograde C-shaped manner with two nails of equal size (2 × 3.5 mm). Close contact of the fragments could be achieved. We compared Group A (steel nails) with Group B and C (two types of titanium nails). All specimens underwent 4-point bending, torsion and axial compression in the 0° and 9° positions, and the results were analysed. Findings Group A (steel nails) revealed a significantly higher stiffness in all directions than Group B. Apart from compression in the 9° position this steel nail fixation showed significant higher stiffness than titanium nails of Group C. Comparing Group B and C did not show an systematic difference. Interpretation In this biomechanical study with composite artificial bones the use of steel Nails demonstrated the highest stiffness in our model when compared to two different titanium nail configurations. Apart from in cases of known allergy or planned MRI-examinations our results and data from the literature question the use of titanium nails.

Shear Strength Properties of Embedded Wood Attacked by Brown Rot Fungi

There are a lot of traditional wooden houses, temples and shrines in Japan. These traditional wooden structures have already been standing for a long time. Many of these structural members and joints have suffered from biodeteriorations induced by fungi, termites and so on. It is difficult to know the residual strength of decayed structural members and joints. Therefore it is very important to evaluate the residual strength of structural members and joints for house in use for long term safety, and decide when repair and replacement of the members should be undertaken. The objective of this study is to evaluate the shear strength of nail joints attacked by fungi, which are often used in the wooden houses. In this study, we prepared the partial decayed specimens embedded by nails, and evaluated the shear strength. Those specimens were locally attacked by brown rot fungi (Fomitopsis palustris) for 7 weeks and evaluated the shear strength. In the case of steel nail joint, the shear strength of the decayed wood was higher than those of the sound wood. On the other hand, the shear strength of stainless steel nail joint was slightly decreased by the fungus attack.

A new approach to obtain flat nail embedding strength of double-sided nail plate joints

Embedding strength is recognized as a very important property in any dowel type timber joints since it affects bearing performance, load carrying capacity and failure mode of the joint. In this paper, using an inverse modelling technique effective flat nail embedding strengths of double-sided nail plate joints were predicted based on single-tooth 3-D finite element models. In those models, timber was treated as an orthotropic elasto-perfect plastic material, and steel nail as a rigid body. The predicted embedding strengths were compared with experimental ones and good correlation was obtained. Using the predicted embedding strength, the overall joint behaviour was simulated and validated against the corresponding experimental results. This paper presents a new approach to obtain embedding strength of double-sided nail plate joints.

Hydroxyapatite-lignin compound as an osseus-integrator between bone tissue and a metallic implant: mechanical evaluation

This study evaluated the compound hydroxyapatite-lignin as an osseous-integrator between bone tissue and a metal implant, using a traction test. The research was considered opportune, due to the necessity to discover a biomaterial, which guides and has chemical and mechanical properties similar to the bone, in order to replace the methyl methacrylate used in the stem joint fixation of prosthesis. 20 New Zealand rabbits were employed; in all of them the left tibia was treated with the compound and, the not treated right tibia was considered the control. A bone fail, 4mm in diameter, was performed in the proximal lateral tibial surface, up to the marrow channel. 1000mg of the compound were softened with ten drops of NaCl (0.9%) using part of the dough used to coat the thread of the intra-marrow Schanz steel nail for cortical bone, diameter 2.5mm. The other part was entered into the spinal channel of the treated group, with the help of a caliber 16-gauge catheter and a syringe. Afterwards, 7cm of the nail were introduced into the marrow channel. The affected anatomic parts were sutured. The same was executed with the control group, without the use of the compound. The assessments were performed 8, 30, 60, 90 and 120 days post surgery. In the traction test no statistical differences between treated and control group were observed, despite that in the first group, the result was double the resistance strength than that of the control. Based on the results it is concluded that the lignin-hydroxyapatite compound facilitates the osseous-integration of the intra-marrow nail.

Tibial Lengthening Over an Intramedullary Nail

Tibial Lengthening Over an Intramedullary Nail

SIGN Nailing of Humeral Fractures and Nonunions

Summary: This article outlines the Russian experience with the Surgical Implant Generation Network tibial nail in treating diaphyseal fractures of the humerus. This solid stainless steel nail has a unique targeting technique for the placement of distal interlocking screws. The surgical technique is reviewed and the results of treatment of 168 acute fractures and nonunions is presented.

Acute Abdomen Due to a Foreign Body in the Urinary Bladder in an Adolescent

A foreign body in the urinary bladder can cause an acute abdomen in an adolescent. A 14-year-old girl presented to the emergency department with severe suprapubic pain, dysuria, hematuria, and hypovolemic shock. An ultrasound examination revealed liquid in the abdomen. An X-ray study of the abdomen revealed an 8-cm-long metallic object located in the urinary bladder. The patient underwent an emergent laparotomy with the diagnosis of acute abdomen. At laparotomy, approximately 2000 cc of widely dispersed serohemorrhagic fluid was removed. Clearing of the abdomen exposed a nail; it had perforated the bladder and 5 cm of it was in the abdominal cavity. A vertical incision was made to the urinary bladder. A 10-penny caliber, 8.2-cm-long steel nail was gently removed and the perforation was closed primarily. The outcome was uneventful and the patient was discharged from the hospital on the seventh postoperative day. A foreign body can cause severe problems and should be kept in mind in the differential diagnosis of acute abdomen in an adolescent.

Femoral shaft fractures treated with stainless steel flexible nails in children aged between 5 and 12 years at the HUSVP: A two-year follow-up

The purpose of this study is to show our experience with stainless steel flexible nails in the treatment of femoral shaft fractures in children aged between 5 and 12 years and to observe if the type of material used for nails affects the results. A prospective, descriptive study of a series of cases was performed to evaluate patients treated at the Hospital Universitario San Vicente de Paúl (HUSVP) who had been followed up for at least 24 months. The study group was composed of 48 patients, with an average age of 8.6 years. According to the AO classification, the most common type of fracture was 32A3.2 (61%). The average follow-up period was 43 months. The alterations observed were six cases of clinical length discrepancy, two cases of overgrowing, four cases of shortening, and two malunions in valgus. These alterations had no repercussion in the children's function. The follow-up is the main strength of this study, as it demonstrated that, 2 years after surgery. The results with stainless steel nails are as good as those with titanium nails with a shorter follow-up as reported in the literature. Given the high costs of osteosynthesis material in our country, the results of this study provide a less expensive alternative. Level of evidence IV, case series.

Leachability, metal corrosion, and termite resistance of wood treated with copper-based preservative

Health-awareness and concern for the environment have resulted in voluntary removal of chromated copper arsenate (CCA) from wood preservatives in residential applications worldwide. Copper-based preservatives have been formulated as replacements, but these may not provide a permanent solution to all of the related problems, including copper contamination of aquatic environments and corrosion of fasteners. In this study, the copper retention (before and after the leaching process) of five softwood specimens vacuum-treated with alkaline copper quaternary (ACQ) and copper azole (CA) at three target retention levels was investigated by X-ray fluorescence studies. The metal corrosion and termite ( Coptotermes formosanus) resistance of treated specimens were studied under laboratory conditions. Except for treated Japanese larch wood, the copper retention levels of the other wood specimens were able to meet the target copper retention values (use classes 2–4) in Chinese National Standard 3000. The copper leaching rates were 6.92–19.54% for ACQ-treated wood and 9.38–22.46% for CA-treated wood. The metal corrosion rates of iron nails due to corrosion tests (CNS 6717) were influenced significantly by the 1.2% ACQ and 1.2% CA treatments; whereas the metal corrosion rates of zinc-galvanized steel nails were less than 2 and could meet the tested standard. Even though the ACQ and CA treatments caused higher copper leaching rates from the treated specimens, they also increased termite mortalities and reduced the mass loss significantly after termite-resistance tests (JIS K 1571).

Performance of Dowel-Welded Wood Furniture Linear Joints

Comparison of three types of furniture joints such as scarf joints, step butt joints and dovetail joints held together either by one or two welded dowels, glued dowels and steel nails showed that the dowels always gave better shear strength and greater stiffness than the steel nails. The results of welded dowels and glued dowel joints were found to be comparable. The application of the welded joint technique to joints where the number of dowels is limited by the narrow space in which they can be applied, such as in furniture, can give results comparable to those obtained by gluing the same dowels.

Novel Biologic Model for Percutaneous Renal Surgery Learning and Training in the Laboratory

To improve the learning and training of percutaneous renal access and intrarenal procedures with a biologic porcine kidney model. We set up a biologic bench model using a porcine kidney. The kidney was wrapped in a full-thickness skin flap with subcutaneous fascia and muscle and fixed to a wooden board with 2 long steel nails. The ureter was catheterized to inject radiologic contrast medium or normal saline. Percutaneous renal manipulations were then practiced on the model under radiographic or ultrasound guidance. Urologists with "partial" experience in advanced endourologic surgery were trained using this model. Of the 33 trainees practiced the percutaneous hands-on manipulations on this model, 20 (60.6%) attained success in performing the whole percutaneous procedure. One to three percutaneous access tracts were established successfully on each kidney practiced on. Of the 42 attendants, 36 (85.7%) rated this model for simulation as "very helpful" or "helpful." The porcine kidney model we developed is simple and easy to build with readily available materials. It provides realistic and reproducible practice for percutaneous renal surgery in the laboratory.

Complications of Titanium and Stainless Steel Elastic Nail Fixation of Pediatric Femoral Fractures

In vitro mechanical studies have demonstrated equal or superior fixation of pediatric femoral fractures with use of titanium elastic nails as compared with stainless steel elastic nails, and the biomechanical properties of titanium are often considered to be superior to those of stainless steel for intramedullary fracture fixation. We are not aware of any clinical studies in the literature that have directly compared stainless steel and titanium elastic nails for the fixation of pediatric femoral fractures. The purpose of the present study was to compare the complications associated with the use of similarly designed titanium and stainless steel elastic nails for the fixation of pediatric femoral fractures. A group of fifty-six children with femoral fractures that were treated with titanium elastic nails was compared with another group of forty-eight children with femoral fractures that were treated with stainless steel elastic nails. Both nail types were of similar design, and a similar retrograde insertion technique was used. The groups were compared with regard to complications as well as insertion and extraction time. Major complications were defined as malunion with sagittal angulation of >15 degrees and coronal angulation of >10 degrees, nail irritation requiring revision surgery, infection, delayed union, and rod breakage. Minor complications were defined as nail irritation or superficial infection not requiring surgery. The malunion rate was nearly four times higher in association with the titanium nails (23.2%; thirteen of fifty-six) as compared with the stainless steel nails (6.3%; three of forty-eight) (p = 0.017, chi-square test; odds ratio = 4.535 [95% confidence interval, 1.208 to 17.029]). The rate of major complications was 35.7% (twenty of fifty-six) for titanium nails and 16.7% (eight of forty-eight) for stainless steel nails. The rates of minor complications were similar for the two groups, as were the insertion times and extraction times. The supplier price of one titanium nail ranges from $259 to $328, depending on size, whereas the price of one stainless steel nail would be $78 in current United States dollars. Our results indicate that the less expensive stainless steel elastic nails are clinically superior to titanium nails for pediatric femoral fixation primarily because of a much lower rate of malunion.

Análise comparativa em modelo computadorizado bidimensional com simulação do emprego de hastes flexíveis de aço e titânio, na fratura do fêmur da criança, utilizando o método dos elementos finitos

OBJETIVO: Apresentar um modelo computadorizado bidimensional, simulando uma fratura do fêmur em criança tratada por hastes flexíveis de aço e titânio, utilizando o método dos elementos finitos, avaliando-se comparativamente o caminho e distribuição das tensões, tensões principais e deformações. MÉTODOS Foram utilizados dois modelos diferentes, gerados pelo aplicativo Ansys®, considerando a simulação de uma fratura transversal na região diafisária, com a espessura de 1mm, cuja estabilização foi feita mediante o emprego de hastes intramedulares de materiais diferentes (aço e titânio), à luz da teoria mecanostática proposta por Frost, em 1987. RESULTADOS: A introdução das hastes intramedulares no fêmur alterou o caminho das tensões, servindo como condutoras das forças compressivas. Na análise comparativa, o modelo com as hastes de titânio, à luz da teoria mecanostática proposta por Frost, apresentou desempenho mais homogêneo quando do estudo das deformações em relação ao modelo com hastes de aço inoxidável. CONCLUSÕES: O modelo proposto atingiu os objetivos de comparar as tensões e deformações entre as simulações das hastes de aço e titânio. Analisando o caminho e distribuição das tensões no modelo (Von Mises e tensões principais), observa-se comportamento biomecânico qualitativamente melhor no modelo com hastes de titânio; todavia, na análise quantitativa, restrita às regiões do foco de fratura, os valores são estatisticamente semelhantes. No estudo das deformações, observa-se comportamento biomecânico mais homogêneo no modelo com hastes de titânio, pois as deformações verificadas nas regiões do foco de fratura apresentam-se dentro das janelas fisiológicas propostas por Frost.

Propagation of thermal waves in multilayered cylinders using the thermal quadrupole method

In this work the surface temperature oscillation of multilayered cylindrical samples which are uniformly heated by a modulated light beam is calculated using the thermal quadrupole method. This temperature is compared with that calculated in cylinders with continuously varying in-depth thermal conductivity. Following this theoretical approach, photothermal techniques can be used for the quantitative thermophysical characterization of hardened steel wires, tubes and nails.

A computational evaluation of the effect of intramedullary nail material properties on the stabilization of simulated femoral shaft fractures

Titanium flexible intramedullary nails have become far more prevalent for stabilization of pediatric femur fractures in recent years. While steel may be expected to have superior fracture stability due to its higher elastic modulus; titanium alloy has experimentally demonstrated improved biomechanical stability, as measured by gap closure and nail slippage. The purpose of this study was to verify these observations computationally, and thus, explain why titanium alloy may be better suited for surgical fixation of fractured femurs. A finite element model of a femur with complete mid-diaphyseal fracture and having two 3.5 mm nails in a retrograde “C” pattern was created. Static analyses were run in which the nail material properties were titanium alloy or stainless steel, respectively. Gap closure for the stainless steel nails was 1.03 mm; while the titanium alloy nails had 0.69 mm of closure. Titanium alloy nails slipped slightly less at each loading increment than stainless steel nails. The titanium alloy nails distributed stress more evenly along the nail axis, resulting in lower peak magnitudes. These results agree with previously published clinical and biomechanical studies that reported increased gap closure and nail slippage with stainless steel nails. The increased deformation of the titanium alloy nail likely increases the contact area with the intramedullary canal wall, thus, increasing stability. Additionally, stainless steel nails had higher curve apex von Mises stresses, potentially inducing a stress-shielding effect which could hamper remodeling and consequently increase risk of re-fracture.

Stainless Steel Flexible Intramedullary Fixation of Unstable Femoral Shaft Fractures in Children

To assess the role of stainless steel flexible intramedullary fixation in unstable pediatric femur fractures, we compared a group of 41 stable (transverse or oblique) fractures with a group of 40 unstable (spiral and/or comminuted) fractures treated with stainless steel (Ender) nails placed through a single lateral insertion. The fractures were followed up until clinical and radiographic union was evident with an average follow-up period of 13 months. All fractures were healed at an average of 1.4 months. No infections or refractures occurred. Although minor radiographic angular deformities and shortening were present in both groups, no patient had a clinically detectable angular deformity. Two patients with stable fracture patterns had 10 to 20 degrees of asymmetry in foot progression angles, and 1 patient with an unstable fracture pattern (Winquist grade IV comminution) had a 3-cm limb length difference at final follow-up. Stainless steel flexible intramedullary fixation is effective for unstable pediatric femur fractures if cortical abutment is present.