INTRAMEDULLARY PRESSURE AND BONE-MARROW FAT INTRAVASATION IN UNREAMEDFEMORAL NAILING

Objective: To investigate whether intramedullary pressure and bone mar row fat embolization are different in unreamed compared with conventio nal reamed femoral nailing, The null hypothesis is that there is no di fference between the two techniques, Design: A prospective consecutive nonrandomized clinical trial. Methods: Intramedullary pressure was me asured in the distal femoral fracture fragment at the supracondylar re gion, Bone marrow fat intravasation was measured bg means of the modif ied Gurd-test, Monitoring was carried out in 31 unreamed and eight rea med intramedullary femoral nailing procedures, Results: Intramedullary pressure increased in the unreamed group to 82 +/- 11 mm Hg during th e insertion of 9-mm and 10-mm nails and in the reamed group to 396 +/- 85 nun Hg during reaming of the medullary cavity, Insertion of nails after reaming Bed to an increase in intramedullary pressure of 79 +/- 13 mm Hg, A positive correlation between fat intravasation and intrame dullary pressure was found in each group (r(s) = 0.73), resulting in l ess liberation of hone marrow fat in the unreamed group than in the se amed. group, Conclusions: Intramedullary pressure increased significan tly in the reamed more than in the unreamed group, Bone marrow fat int ravasation depended on the rise in intramedullary pressure, and occurr ed less frequently in unreamed than in reamed intramedullary femoral f racture stabilization.