To quantify the changes in nutrient artery
following reamed and unreamed nailing
of intact canine tibias.
In vivo animal study.
Eighteen dogs underwent nutrient artery
measurements over a fourteen-day period. The intervention groups consisted of controls (Group I), nailing
(Group II), and nailing
Main Outcome Measurements: Nutrient artery
was measured through implantable ultrasonic blood flow
probes placed around the nutrient artery
of the tibia
Results: Nutrient artery
averaged 1.94 milliliters per minute over the fourteen-day period in Group I (no reaming
performed). Nutrient artery
(Group II) decreased to 44 percent of baseline values immediately after the procedure. By postoperative day 1, flow
had decreased to 23 percent of baseline; over the fourteen-day period, nutrient artery
recovered toward baseline values. Immediately following nailing
(Group III), nutrient artery
measured zero milliliters per minute. Over the fourteen-day period, nutrient artery
in this group averaged 39 percent of the baseline level (range 19 to 58 percent). Whereas nutrient artery
recovered toward baseline values (99 percent of baseline) by fourteen days in Group II, nutrient artery
measured only 26 percent of the baseline level on postoperative day fourteen in Group III.
The preliminary data suggest that nailing
provides a double insult to the nutrient artery