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Monitoring and Controlling Intramedullary Pressure Increase in Long Bone Instrumentation: A Study on Sheep

Smith, Paul; Leditschke, Isabel; McMahon, Damien; Sample, Roxanne; Perriman, Diana; Prins, Anne; Bruessel, Thomas; Li, Rachel

Description

Intramedullary reamed nailing causes elevation in intramedullary pressure and extravazation of intramedullary contents into the venous blood system. This study investigated the effect of an intramedullary suction system, recently developed in our laboratory, on the pressure and fat extravazation in isolated bovine bone and a sheep model. During reaming, the pressure with and without suction was recorded at each step of the procedure. Hemodynamic parameters of mean arterial blood pressure,...[Show more]

dc.contributor.authorSmith, Paul
dc.contributor.authorLeditschke, Isabel
dc.contributor.authorMcMahon, Damien
dc.contributor.authorSample, Roxanne
dc.contributor.authorPerriman, Diana
dc.contributor.authorPrins, Anne
dc.contributor.authorBruessel, Thomas
dc.contributor.authorLi, Rachel
dc.date.accessioned2015-12-08T22:25:02Z
dc.identifier.issn0736-0266
dc.identifier.urihttp://hdl.handle.net/1885/33243
dc.description.abstractIntramedullary reamed nailing causes elevation in intramedullary pressure and extravazation of intramedullary contents into the venous blood system. This study investigated the effect of an intramedullary suction system, recently developed in our laboratory, on the pressure and fat extravazation in isolated bovine bone and a sheep model. During reaming, the pressure with and without suction was recorded at each step of the procedure. Hemodynamic parameters of mean arterial blood pressure, pulmonary artery pressure, pulmonary arterial CO2 (PaCO2), heart rate, and oxygen saturation were monitored. Blood and lung tissue samples were collected for the examination of medullary fat intravazation. The increases of intramedullary pressure were dramatically reduced in the suction group (p < 0.05) in both in vitro and in vivo experiments. PaCO2 was significantly lower in the suction group than nonsuction group (32 vs. 40 mmHg, respectively, p = 0.02), while oxygen saturation was higher in the suction group (99 vs. 91 mmHg, respectively, p = 0.009). Histological data revealed a significant higher count of fat emboli in sheep lung tissue in the nonsuction group. Total lipids in lung specimens was lower in the suction group (7.6 mg/g tissue) than in the nonsuction group (13.6 mg/g, p = 0.04). The suction system appears to control the surge in intramedullary pressure and therefore prevent fat embolism.
dc.publisherElsevier
dc.sourceJournal of Orthopaedic Research
dc.subjectKeywords: fat; lipid; animal experiment; animal model; animal tissue; arterial carbon dioxide tension; article; blood pressure monitoring; blood sampling; controlled study; cow; extravasation; fat embolism; heart rate; hemodynamic parameters; histopathology; in vit Fat embolism; Intramedullary pressure (IMP); Intramedullary reaming; Intramedullary suction system (ISS); Technique
dc.titleMonitoring and Controlling Intramedullary Pressure Increase in Long Bone Instrumentation: A Study on Sheep
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume26
dc.date.issued2008
local.identifier.absfor110314 - Orthopaedics
local.identifier.ariespublicationu4241283xPUB100
local.type.statusPublished Version
local.contributor.affiliationSmith, Paul, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationLeditschke, Isabel, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationMcMahon, Damien, The Canberra Hospital
local.contributor.affiliationSample, Roxanne, Canberra Hospital
local.contributor.affiliationPerriman, Diana, Canberra Hospital
local.contributor.affiliationPrins, Anne, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationBruessel, Thomas, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationLi, Rachel, College of Medicine, Biology and Environment, ANU
local.description.embargo2037-12-31
local.bibliographicCitation.issue10
local.bibliographicCitation.startpage1327
local.bibliographicCitation.lastpage1333
local.identifier.doi10.1002/jor.20564
dc.date.updated2015-12-08T09:01:39Z
local.identifier.scopusID2-s2.0-53549098558
local.identifier.thomsonID000259465300005
CollectionsANU Research Publications

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