[Experimental results of intra-osseous pressure in various surgical procedures of the long bones].

The generation of intramedullary pressure in medullary nailing and total hip and knee replacement is now well-known. This pressure increase is generally recognized as an important factor in local and systemic bone marrow embolization. In various clinical and experimental studies methods for reducing the intramedullary pressure build-up have been tested. In prosthetic joint replacement a distal venting hole, a large insertion hole and a modified technique for cement insertion have been shown to be valuable methods for pressure reduction. In intramedullary nailing, a distal venting hole, an unreamed nailing technique using solid nails and slow nailing did not alter the pressure increase effectively. Measures such as redimensioning the flexible drive, possibly in combination with special reamer heads, reduction of the insertion force or use of irrigation suction drainage during reaming of the medullary canal represent potential ways preventing this undesirable side effect in this popular internal fixation technique.