The intramedullary device (IMD) for proximal femur comprises of a nail with an expanded proximal end as well as a tunnel for a large-diameter smooth shank lag screw. It’s the orthopedic implant of choice for fixation of the four-part fracture of the proximal femur. The IMD offers the benefits of an intramedullary nail combined with an SHS that enables impaction of the peritrochanteric fracture. The intramedullary position declines the lever-arm on the device and generates its own lateral buttress that prevents extreme lateral migration of the proximal fragment. The strength of the device enables immediate weight bearing. Use of a long intramedullary nail avoids fracture of the femoral shaft. The insertion of IMD is technically demanding as the fracture must be reached before reaming and insertion of a nail to avoid comminution of the fracture site and adjacent cortex. Learning curve is steep and ortho implant should be utilized on stable fractures before undertaking, reconstruction of unstable 4-part fracture: open reduction prior to nailing is suggested unless a nearly perfect closed reduction is attained.
Intramedullary fixation (IM) is particularly recommended for treatment of diaphyseal fractures of previously weakened osteoporotic bone. Intramedullary nail is centrally located and distributes load evenly. Interlocking at both the ends is important. Helical implants as locking devices are more useful than standard locking screws that often cut out or break.
Nails for distal femoral and proximal humerus fractures are inserted by a minimally invasive technique that conserves the blood supply of the periosteum as well as soft tissue while simultaneously offering strong fixation. Ordinary screw in these 2 porotic locations doesn’t provide ideal fixation. Use of helical blade as a locking device rises the load-bearing surface, as it has an increased, 75% greater surface area than conventional locking screw. This rise in load-bearing surface lessens osseous stress at bone-metal interface. In porotic distal femur fracture, retrograde intramedullary nail doesn’t offer the same stability as does a 95⁰ device and should be kept for fracture around total knee replacement, or any severe comminution into the diaphysis, and for one with serious skin compromise around the knee.
Polarus nail is appropriate for complicated osteoporotic proximal humeral fractures. Multidirectional screw holes at its proximal end aid fixation of multiple bone fragments whereas its distal locking screws make the construct very stable.
Siora Surgicals Pvt. Ltd. also manufactures different type of orthopaedic products like intramedullary implants such as delta tibial nail, end cap for tibia nail, delta femoral nail, delta slim femur cannulated nail, end cap for femoral nail, unnamed (solid) delta tibial nail etc.