Tibiotarsal index = Diaphysis diameter - Medullary canal
diameter / Diaphysis diameter X 100
The present technique is an innovative method for swift, easy, and accurate access to the medullary canal
Table 1--Flexion test results (Modulus of elasticity and rupture) of G1 (eight whole swine femurs, not osteotomized or drilled) and G2 (seven whole swine femurs, not osteotomized but with a 15mm diameter drilled medullary canal
A larger stem tended to be selected for osteoporotic bone (type C bone), which has a low cortical index and a wide medullary canal
. Moreover, stem stiffness increases with larger stems since the stem stiffness depends on stem thickness.
On the other hand, scanning electronic microscopy revealed a preserved bone ultrastructure with an increased number and size of bone lacunae in the tibia cortical bone and a significant increase in the medullary canal
when compared to healthy controls.
In this method, to understand the proximal femoral morphology with relevance for THA, the position of the femoral head and the geometrical variations in the medullary canal
should be evaluated in particular (Franklin et al., 2012; Husmann et al., 1997; Noble et al., 1988; Noble et al., 2003; Palierne et al., 2008; Tawada et al., 2015; Yang et al., 2014).
These differences may be explained by our secondary surgical procedure in which we elevated the soft tissue envelope and reestablished the medullary canal
in a comparable fashion to that used clinically in exchange nailing procedures.
The surgical method most commonly considered to achieve this is intramedullary (IM) nailing.12,13 However, the medullary canal
of the subtrochanteric area in the femur is broad and the proximal fragment is relatively short, which means that malreduction can occur easily.
Following biplanar X-ray control, the K-wire was inserted into the medullary canal
respecting a 7-degree valgus angle to the horizontal plane of the joint, and the cortex was opened using a 10-mm drill bit over the K-wire with a drill sleeve to protect from reaming debris.
The distal end of proximal bone fragment was grasped with bone holding forceps and pin was inserted proximally in medullary canal
. As the pin was driven proximally, an effort was made to direct it along the cranio-lateral surface of medullary cavity.
"A distinctive feature of this type of intervention is to create a "NEO" channel of the dura mater larger than 1/3 of the age norm medullary canal
and to fix interrupted sutures to avoid corrugation at its formation," the statement said.
Then all soft tissues were removed from the replant followed by the curettage of all contents of the medullary canal
and fastened to the parent bone by plates or Ilizarov apparatus.