Advanced Reaming System for Intramedullary Nailing – Experimental Cadaveric Analysis
Reaming is a critical step during intramedullary nailing, enhancing implant fit and promoting healing. However, conventional reaming systems can elevate intramedullary pressure and temperature, potentially leading to such complications as fat embolism and/or thermal damage. Recently, the Advanced Reaming System was introduced to address these issues, incorporating a Flexible Monobloc Reamer with both front- and side-cutting features and streamlined distal end for high performance and efficiency (Fig 1).
Fig 1: Flexible Monobloc Reamer with elastic shaft and deeply fluted reamer head incorporating both front- and side-cutting features to reduce intramedullary pressure, increase flow of bone chips and marrow, and facilitate high performance and efficiency.
Building on this innovation, an experimental study was performed to evaluate the performance of the novel reaming system versus the conventional Synream one, with focus on intramedullary pressure, temperature, thrust force, and integral effort/energy during sequential reaming stages. For this purpose, eight pairs of porcine cadaveric humeri – assigned to two study groups and instrumented with pressure sensors and thermocouples – underwent standardized reaming procedures in a testing machine setup.
The results demonstrate significantly lower intramedullary pressure, temperature, thrust force and integral effort/energy indicated for the Advanced Reaming System versus the conventional reaming system, P ≤ 0.018 (Fig 2). These findings highlight the potential of the novel reaming system to reduce surgical effort and enhance performance and efficiency during intramedullary reaming.
Fig 2: Thrust force during five sequential reaming stages of both tested reaming systems presented in terms of mean value and standard error.
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