Peter R E, Selz T, Koestli A
Département de Chirurgie, Hôpital Cantonal Universitaire Genève, Switzerland.
Injury. 1993;24 Suppl 3:S48-55. doi: 10.1016/0020-1383(93)90007-s.
The generation of intramedullary pressure during reaming of the femur was compared for two different reamer systems: the AO/ASIF universal reamer and the Gray flexible reamer system (Howmedica), while reaming in 9 oncologic patients undergoing prophylactic nailing of metastatic femora as indicated by impending fractures (unbroken femora). An intracranial fibre optic catheter pressure-monitoring device inserted through the distal supracondylar cortex was used to perform measurements. Preliminary data are presented. Maximum pressures of up to 450 mmHg were recorded during reaming with the smaller 9.0 and 9.5 mm theta reamers. Rapid penetration of the reamer in both proximal and distal metaphyses caused much higher pressures than reaming the cortex of the diaphysis. Speed of penetration and volume of the reaming shaft were found to be important parameters. No significant differences between maximal pressures generated by the two types of reamers could be observed.
在9例因股骨即将骨折（股骨未断裂）而接受转移性股骨预防性钉扎的肿瘤患者中，使用两种不同的扩髓系统（AO/ASIF通用扩髓器和Gray柔性扩髓系统（豪美迪克公司））进行股骨扩髓时，比较了髓内压力的产生情况。通过远端髁上皮质插入颅内光纤导管压力监测装置进行测量。给出了初步数据。使用较小的9.0和9.5毫米θ扩髓器扩髓时，记录到的最大压力高达450毫米汞柱。扩髓器在近端和远端干骺端的快速穿透所产生的压力远高于扩髓骨干皮质时的压力。发现穿透速度和扩髓轴的体积是重要参数。未观察到两种扩髓器产生的最大压力之间存在显著差异。
