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Sample records for acetabular internal fracture

  1. FUNCTIONAL OUTCOME OF SURGICAL MANAGEMENT OF ACETABULAR FRACTURES BY INTERNAL FIXATION

    Directory of Open Access Journals (Sweden)

    Sagar

    2015-06-01

    Full Text Available BACKGROUND: The treatment of acetabular fractures has seen major advances in the field of orthopaedic traumatology. Conservative treatment of acetabular fractures leads to poor results. Newer diagnostic tools like the Computed Tomography (CT scan help in analyzing the three dimensional disturbance in the normal anatomy and plan the surgical management accordingly. In recent years operative treatment has become the treat ment of choice in the management of acetabular fractures as precise anatomical reduction with adequate internal fixation can be attained. OBJECTIVES : To evaluate the functional outcome of operatively managed acetabular fractures , and assess the efficacy of operative fixation of acetabular fractures , and also study the complications of operative fixation of acetabular fractures. MATERIALS AND METHODS: Fifty five patients (49 male & six female admitted to Sanjay Gandhi Institute of Trauma and Orthopaedics wi th acetabular fractures underwent open reduction and internal fixation. All patients were evaluated with Matta et al score with a minimum of follow up of six months. RESULTS: There were 24 (43.6% patients with bicolumnar fractures , 15(27.3% had posterior column fractures , 10(18.1% had posterior wall fractures , five (9.1% had transverse fractures , and one (1.8% patient had an anterior column fracture. Full weight bearing was attained in thirty five (63.6% patients in 16 weeks and in twenty (36.4% pati ents after 16 weeks. Forty five (81.8% patients were free of complications. According to Matta et al score 27(49.1% had excellent , 15(27.3% had good , nine (16.4% had fair , and four (7.3% had poor results. CONCLUSION: Open reduction and internal fixati on of acetabular fractures is a reliable technique , minimizes healing time and provides congruent joint reduction. Operative treatment of acetabular fractures results in predictable union and good clinical results with a low rate of complications.

  2. Operative strategy of acetabular fractures

    Institute of Scientific and Technical Information of China (English)

    WANG Yan; TANG Pei-fu; HUANG Peng

    2006-01-01

    Anatomic structure of acetabular fractures are complex and operative exposure and fixation are extremely difficult.For those obviously displaced acetabular fractures, close reduction is doomed to cause deformative healing. Open reduction with internal fixation (ORIF) not only results in anatomic reduction, but also brings complications. No matter which method will be adopted, traumatic arthritis or avascular necrosis of femoral head might occur. In order to treat acetabular fractures more effectively, orthopedic surgeons should be required to fully master the acetabular anatomy, biomechanics, classification and the necessary knowledge for complication prevention.

  3. An Unusual Combination of Acetabular and Pelvic Fracture: Is This a New Subtype of Acetabular Fracture?

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    Reza Tavakoli Darestani

    2013-01-01

    Full Text Available Introduction: Acetabular fractures are a common problem among young males. An acetabular fracture with disruption of the joint surface, if untreated, will rapidly lead to post-traumatic osteoarthritis. Proper reduction and internal fixation depend on accurate classification and the quality of imaging.Case Presentation: We present an unusual form of acetabular fracture, which is not included in the conventional classification (Judet and Letournel ; this occurred in a middle-aged male who was operatively treated without any complications. In this case due to posterior extension of the fracture into the SI joint and concomitant anterior column fracture in the area above the acetabular dome, no portion of the acetabular anterior surface remained connected to the innominate bone.Conclusions: We recognized this type of fracture and treated it similarly to both column fractures. We recommend that the classification of acetabular fractures be modified to include this type of fracture.

  4. Open reduction and internal fixation aided by intraoperative 3-dimensional imaging improved the articular reduction in 72 displaced acetabular fractures

    DEFF Research Database (Denmark)

    Eckardt, Henrik; Lind, Dennis; Toendevold, Erik

    2015-01-01

    Background and purpose - During acetabular fracture surgery, the acetabular roof is difficult to visualize with 2-dimensional fluoroscopic views. We assessed whether intraoperative 3-dimensional (3D) imaging can aid the surgeon to achieve better articular reduction and improve implant fixation....... Patients and methods - We operated on 72 acetabular fractures using intraoperative 3D imaging and compared the operative results, duration of surgery, and complications with those for 42 consecutive acetabular fracture operations conducted using conventional fluoroscopic imaging. Postoperative reduction...... was evaluated on reconstructed coronal and sagittal images of the acetabulum. Results - The fracture severity and patient characteristics were similar in the 2 groups. In the 3D group, 46 of 72 patients (0.6) had a perfect result after open reduction and internal fixation, and in the control group, 17 of 42 (0...

  5. Surgical treatment for complicated acetabular fractures

    Institute of Scientific and Technical Information of China (English)

    Ning An; Yang Yanmin

    2004-01-01

    Objective: To sum up the surgical approaches and clinical outcome of complicated acetabular fractures. Methods: 17 patients with complicated acetabular fractures (including 4 cases of transverse with posterior wall fractures, 7 cases of posterior column and wall fractures, 4 cases of anterior and posterior columns fractures, 1 cases of T-type fracture and 1 cases of anterior column with posterior hemitransverse fractures) underwent open reduction and internal fixation with screws and plates by Kocher-Langenbeck (8 cases), ilio-inguinal (2 cases), extended iliofemoral (4 cases) or ilio-inguinal combined with K-L approaches (3 cases). Results: 12 patients with anatomical reduction, 4 patients with satisfactory reduction and 1 patient with non-satisfactory reduction. 15 out of 17 cases were followed up for 6 months to 5 years, and the excellent and good rate was 70.5%. Conclusion: Surgical treatment for complicated acetabular fractures can get a satisfactory reduction and a good clinical outcome.

  6. Management of acetabular fractures: challenging work

    Institute of Scientific and Technical Information of China (English)

    CHEN Zheng-rong; YANG Yi

    2006-01-01

    @@ Acetabular fractures are complex and special intraarticular fractures. For most orthopaedic surgeons management of acetabular fractures is hard and challenging because the fractures are the results of high-energy trauma, and usually accompany with severe associated injuries. In addition, these fractures are uncommon except in a few trauma centers. The number of cases a surgeon can encounter is scarce.

  7. Primary total hip arthroplasty for acetabular fracture

    Institute of Scientific and Technical Information of China (English)

    WANG Zi-ming; SUN Hong-zhen; WANG Ai-min; DU Quan-yin; WU Siyu; ZHAO Yu-feng; TANG Ying

    2006-01-01

    Objective: To explore the operative indications and operative methods of primary total hip arthroplasty for acetabular fracture and to observe the clinical curative effect.Methods: We retrospectively summarized and analyzed the traumatic conditions, fracture types, complications,operative time, operative techniques, and short-term curative effect of 11 patients( 10 males and 1 female, with a mean age of 42. 4 years ) with acetabular fracture who underwent primary total hip arthroplasty.Results: The patients were followed up for 6-45 months ( mean = 28 months). Their average Harris score of postoperative hip joint was 78.Conclusion: Under strict mastery of indications,patients with acetabular fracture may undergo primary total hip arthroplasty, but stable acetabular components should be made.

  8. Surgical treatment for complex acetabular fractures

    Institute of Scientific and Technical Information of China (English)

    LIU Qiang; WU Dou; LI Ping; HAN Shu-feng

    2006-01-01

    Objective: To explore the effect of surgical treatment on complex acetabular fractures.Methods: The data of 46 patients (38 males and 8 females, aged 16-75 years, mean = 38. 5 years ) with complex acetabular fractures, who were admitted to our hospital from January 1998 to December 2005, were analyzed retrospectively in this study. According to Letournel rules, posterior wall and posterior column fractures were found in 11 patients, transverse and posterior wall fractures in 13, T-type fracture in 4, both columns fracture in 10, and anterior column and posterior transverse fracture in 8. The choice of surgical approach was based on the individual fractures, which included ilioinguinal approach in 5 patients, Kocher-Langenbech approach in 7, combined approach in 26, and extended iliofemoral approach in 8.Results: All the patients were followed up for 3.5 years averagely. The clinical outcomes were analyzed with Harris hip score and radiography. In 36 patients (78.3%), the surgical procedure was successful (Harris hip score > 80 points). The rate of excellent and good was about 86 %.Conclusions: The keys to increase the effectiveness of surgical treatment on acetabular fractures are correct preoperative classification of factures and choices of appropriate surgical approach and time.

  9. Acetabular fractures in children and adolescents

    NARCIS (Netherlands)

    Heeg, M; de Ridder, VA; Tornetta, P; de Lange, S; Klasen, HJ

    2000-01-01

    A retrospective study of 29 acetabular fractures in children 2 to 16 years of age with an average followup of 14 years is presented. Nineteen patients had an additional dislocation of the femoral head and 14 patients had an associated neurologic injury. Surgical treatment was performed in 16 patient

  10. A reduction clamp for an aiming component in associated acetabular fractures

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    Zhang-Fu Wang

    2015-01-01

    Full Text Available Background: The treatment of acetabular fractures is complex and requires specialized equipment. However, all currently available instruments have some disadvantages. A new reduction clamp that can firmly enable reduction and not hinder subsequent fixation procedures for some special fracture types is needed. Materials and Methods: In this study, we introduce a new acetabular clamp and its preliminary clinical application in three T-shaped acetabular fractures. Results: This new clamp can successfully pull the posterior column back to the anterior column and firmly maintain the reduction. This clamp′s aiming plate can facilitate the insertion of long lag screws. The clamp is also easy to assemble and use. Conclusion: This reduction clamp is a useful instrument that can facilitate open reduction and internal fixation of acetabular fractures.

  11. Central acetabular fracture with dislocation treated by minimally invasive plate osteosynthesis.

    Science.gov (United States)

    2015-06-01

    Central acetabular fractures with dislocation are usually the result of high-energy trauma, resulting in joint incongruity, and are frequently associated with other injuries. Open reduction and internal fixation has been the standard treatment for acetabular fractures, but it is associated with extensive surgical trauma, and complications such as haematoma formation, iatrogenic nerve injury, and heterotopic ossification. We present the case of a 63-year-old female who sustained a central acetabular fracture of the hip with dislocation as a result of an automobile collision. Closed reduction of the dislocation was performed, and the fracture was managed by minimally invasive plate osteosynthesis using a specially prepared plate. At 01 year postoperatively, radiographs showed the fracture to have been well-healed with good congruity of the joint. However, heterotopic ossification of the joint was noted. The technique allowed reduction of the fracture with minimal surgical trauma.

  12. Acetabular fractures following rugby tackles: a case series

    LENUS (Irish Health Repository)

    Good, Daniel W

    2011-10-05

    Abstract Introduction Rugby is the third most popular team contact sport in the world and is increasing in popularity. In 1995, rugby in Europe turned professional, and with this has come an increased rate of injury. Case presentation In a six-month period from July to December, two open reduction and internal fixations of acetabular fractures were performed in young Caucasian men (16 and 24 years old) who sustained their injuries after rugby tackles. Both of these cases are described as well as the biomechanical factors contributing to the fracture and the recovery. Acetabular fractures of the hip during sport are rare occurrences. Conclusion Our recent experience of two cases over a six-month period creates concern that these high-energy injuries may become more frequent as rugby continues to adopt advanced training regimens. Protective equipment is unlikely to reduce the forces imparted across the hip joint; however, limiting \\'the tackle\\' to only two players may well reduce the likelihood of this life-altering injury.

  13. 骨盆并髋臼骨折内固定材料的生物相容性%Materials biocompatibility in the internal fixation of pelvic fracture combined with acetabular fracture

    Institute of Scientific and Technical Information of China (English)

    高明杰; 陶杰; 周孜辉; 杜琳

    2015-01-01

    背景:骨盆骨折合并髋臼骨折多由高能量暴力伤所致,常伴严重并发症,往往需要外科内固定治疗。目的:探讨骨盆骨折合并髋臼骨折内固定治疗以及材料的生物相容性。方法:以“骨盆骨折,髋臼骨折,内固定,材料;pelvis fracture,acetabulum fracture,internal fixators, materials”为关键词,应用计算机检索2005至2014年万方数据库、清华知网数据库和PubMed数据库,选取有关骨盆骨折合并髋臼骨折内固定治疗以及材料生物相容性研究的文献,同一领域文献选择权威杂志或发表时间为近期的文章,依据纳入排除标准选取29篇文献进行归纳分析。结果与结论:对于骨盆骨折合并髋臼骨折临床多采用重建钢板或拉力螺钉内固定,常用于内固定的重建钢板材料是钛板,弹性模量接近骨的弹性模量,生物相容性好,可在置入前预先弯曲塑形,使之与骨折部位骨面相匹配。可吸收螺钉具有良好的组织相容性,无毒副反应,避免金属螺钉的电解与腐蚀,在内固定早期保持一定的强度,随着时间的推移骨折逐渐愈合,材料强度也缓慢降低,材料最终降解为水和二氧化碳,治疗效果满意。以三维重建技术定制钢板固定和微创内固定是目前骨折治疗的重大进展,临床应用前景广阔。%BACKGROUND:Pelvic fractures combined with acetabular fractures are mostly caused by high-energy violence, often accompanied by severe complications and high mortality, and surgical fixation is preferred in most cases. OBJECTIVE:To investigate the internal fixation of pelvic fracture combined with acetabular fracture and to analyze the material biocompatibility. METHODS:A computer-based search of Wanfang, CNKI and PubMed databases was performed for articles related to the internal fixation of pelvic fracture combined with acetabular fracture and material biocompatibility published

  14. Early total hip arthroplasty for severe displaced acetabular fractures

    Institute of Scientific and Technical Information of China (English)

    YANG Shu-hua; ZHANG Yu-kun; XU Wei-hua; LI Jin; LIU Guo-hui; YANG Cao; LIU Yong; TIAN Hong-tao

    2006-01-01

    Objective : To investigate the effect of early total hip arthroplasty for severe displaced acetabular fractures.Methods: Total hip arthroplasty was performed on 17 cases of severe fracture of the acetabulum from 1997 to 2003. The mean follow-up was 2.1 years (1-6 years) and the average period from fracture to operation was 8 days (5-21 day). The average age of the patients was 53 years (26-69 years).Results: At the final follow-up the Harris hip score averaged 82(69-100) points and 15 cases have got a good outcome. There was one case of heterotopic bone formation. There were no radiographic evidences of late loosening of the prosthesis. One patient had severe central displacement of the cup.Conclusions: In patients with severe displaced acetabular fractures, particularly in elderly patients, early total hip arthroplasty is probably an alternative efficient way to achieve a painless and stable hip.

  15. Functional outcome of the surgical management of acute acetabular fractures

    Institute of Scientific and Technical Information of China (English)

    Naseem Munshi; Asad Abbas; Mohamed Amirali Gulamhussein; Ghulam Mehboob; Rija Aitzaz Qureshi

    2015-01-01

    Objective:To assess the functional outcome of early surgical management of displaced acetabular fractures and the complications associated with the procedure. Methods: This is a case series study and data was collected using specialized performance. The study included 75 patients and the sampling technique was a non-probability purposive type. Patients presenting with close displaced acetabular fractures of more than 2 mm within 10 days of injury were included. However, elderly patients presenting after 10 days of injury, with evidence of local infection, severe osteoporotic bone and co-morbid such as chronic obstructive pulmonary disease were not included in the study. New acetabular scoring system was used for assessing outcome of patients. Results:A total of 75 patients were operated on. Union was achieved in anatomical position in 66 (88%) patients and in malposition in 9 (12%) patients. Excellent results were obtained in 18 (24%) patients, good results in 41 (54.6%), fair results in 12 (16%), and poor results in 4 (5.4%) patients. Postoperative complications included infection [5 (6.7%)], heterotropic ossification [3 (4%)], sciatic nerve injury [10 (13.3%)], avascular necrosis [3 (4%)] patients. Conclusions: Patients with displaced acetabular fractures should be referred to specialised centres. Early surgical intervention and experienced management is a prime factor in achieving good results.

  16. Nonunion of acetabular fractures: evaluation with interactive multiplanar CT

    International Nuclear Information System (INIS)

    Nonunions involving fractures of the acetabulum are reportedly rare, with few citings and little discussion in the literature. It is possible that acetabular nonunions go undetected because imaging of the acetabulum is difficult by conventional radiography. We report two cases of fracture nonunion involving the weight-bearing surface of the acetabulum diagnosed with the aid of computed tomography (CT) and a newly developed interactive 2D/3D orthotool that uniquely processes and reformats routine CT data. The interactive 2D/3D orthotool is a sophisticated computer program that allows dynamic viewing of standard multiplanar reconstructions in the axial, coronal, and sagittal planes as well as multiple oblique projections. The 2D/3D orthotool provides on screen correlation of two-dimensional multiplanar images with three-dimensional reconstructions of the pelvis. The authors found this capability ideally suited for studying fractures with off-axis orientation such as those through the acetabular dome, greatly facilitating the diagnosis of nonunion

  17. Multiplanar and 3D CT of acetabular fractures

    Energy Technology Data Exchange (ETDEWEB)

    Haveri, M.; Suramo, I.; Laehde, S. [Oulu Univ., Dept. of Diagnostic Radiology (Finland); Junila, J. [Oulu Univ., Dept. of Orthopaedic Surgery (Finland)

    1998-05-01

    Purpose: To establish a standard protocol for the multiplanar (MPR) and 3D shaded surface display (SSD) reconstruction of CT data on acetabular fractures, and to assess the usefulness of these reformats. Material and Methods: Acetabular fractures in 15 patients were imaged by means of plain radiographs, transaxial CT, MPR reformats, and SSD reformats. Results: The classification of the acetabular fracture was revised in 7/15 cases when the transaxial CT images were read after the plain radiographs. Although the MPR and SSD reformats did not alter the classification, they did add to the degree of confidence in the diagnosis in 9/15 cases. In 2 patients, the MPR and SSD reformats indicated operative instead of conservative treatment. In the MPR reformats, the following views were considered essential in all cases: (a) along the anterior column; (b) along the posterior column; and (c) along both columns and the inferior ramus. In the SSD reformats, the following views were considered essential in all cases: (d) the latero-caudal en face view into the acetabulum; and 180 opposite to this, (e) the medio-cranial view (facing the quadrilateral plate). In 10/15 cases, these views were all that was needed for classification. It was, however, essential to remove the femur from the images before reconstructing the SSD views. Conclusion: Complex acetabular fractures with displacement should be evaluated by means of transaxial CT and additional MPR and SSD reformats. The use of appropriate standard MPR and SSD views shortens the time required to produce the reformats and thereby maximizes the benefit gained. (orig.).

  18. SeIectlng the incision In the surgical treatment of acetabular fractures

    OpenAIRE

    Asik, Mehmet; Basturk, Sırrı; Akpinar, Sercan; Taser, Omer; Akalin, Yilmaz

    2004-01-01

    In acetabular fractures which may have totally differing three dimensional appearances selecting the incision directly influences the quality, directly influences the quality of the surgical reduction and, therefore, the postoperative clinical outcome of the patierit. Becauseof this, it is a subject that has to be meticulously done. According to the fracture types, we used 6 distinct incisions on the 35 acetabular fractures which were operated in our clinic between 1988 and 1992. We presente...

  19. Simultaneous Periprosthetic Acetabular Fracture and Contralateral B-Type Compression Injury of the Pelvic Ring: A Case Report of a Rare Injury Combination

    Directory of Open Access Journals (Sweden)

    Sven Märdian

    2013-01-01

    Full Text Available The periprosthetic fracture of the acetabulum is a rare injury, and its management is only sporadically reported in the literature. A few case reports are available which mainly focus on periprosthetic acetabular fractures in the elderly population. In our case, a 32-year-old patient suffered from a periprosthetic acetabular fracture in combination with a pelvic ring injury following a high velocity accident. The fracture morphology allowed a salvage of the prosthesis with an open reduction and internal fixation with a good radiographic and functional outcome one year after trauma.

  20. Percutaneous Fixation of Anterior Column Acetabular Fracture in a Renal Transplant Recipient

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    Halil Ceylan

    2013-01-01

    Full Text Available Renal transplantation, performed per million population, ranges from 30 to 60 in developed countries. The transplanted kidney is generally placed in iliac fossa; therefore the treatment procedure of the pelvic trauma in these patients should be selected carefully. The gold standard technique for the treatment of displaced acetabulum fractures is open reduction and internal fixation. Our patient had received a living-related-donor renal transplant due to chronic renal failure. In the second year of transplantation, she had been injured in a motor-vehicle accident, and radiographs showed a right acetabular anterior column fracture and left pubic rami fractures. The patient was treated with percutaneous fixation techniques and at one year of postoperative period there was no evidence of degenerative signs and the clinical outcome was good. Beside having the advantage of avoiding dissection through the iliac fossa by the standard ilioinguinal approach, percutaneous techniques, with shorter surgical time, decreasing soft tissue disruption, and the potential for early discharge from hospital might be ideal for a renal transplant recipient carrying a higher risk of infection. Percutaneous fixation of selected acetabular fractures in a renal transplant recipient would presumably have the potential to decrease the morbidity associated with traditional open surgical procedures.

  1. Surgical Outcome of Acetabular Fracture Using Trochanteric Flip Osteotomy

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    Espandar R

    2012-01-01

    Full Text Available Background: One of the difficulties in acetabulum surgery is appropriate exposure of the site of surgery. Trochanteric flip osteotomy is one of the surgical methods for superoposterior and posterior acetabulum exposure. However, due to possible complications some surgeons prefer to avoid this procedure. This study was undertaken to determine the outcome of surgical treatment of acetabular fracture using trochanteric flip osteotomy. Methods : In this prospective cohort study, 14 patients with acetabular fracture who had been admitted in Imam Khomeini Hospital in Tehran, Iran, during 2003-2006 underwent trochanteric flip osteotomy. The patients were followed for at least one year post-surgically. Demographics, radiologic findings, intensity of pain using visual analogue scale (VAS, Harris hip score (HHS, force of hip abductors and complications were noted. Data analysis was performed using SPSS ver. 13.Results : The mean HHS was 82.5 (55-95. Heterotopic ossification was observed in three patients. There were no cases of postoperative infection or nonunion. Only two patients showed displacement of osteotomized fragments. Reduction was anatomic in 10 patients. In one patient, the force of hip abductors was three-fifth. The mean hip pain was 3.4 based on VAS. There were no cases of femoral head osteonecrosis. With respect to HHS, the final hip status was excellent and good in four and six patients, respectively. Three patients had fair and only one patient had poor condition.Conclusion: It seems that trochanteric flip osteotomy has much fewer complications in comparison to other methods justifying its use in such cases.

  2. Simultaneous bilateral shoulder and bilateral central acetabular fracture dislocation: What to do?

    Institute of Scientific and Technical Information of China (English)

    Hardik Sheth; Abhijeet Ashok Salunke; Ramesh Panchal; Jimmy Chokshi; G.I.Nambi; Saranjeet Singh; Amit Patel

    2016-01-01

    Musculoskeletal injuries following seizures have a high morbidity and mortality.These injuries are often missed and the diagnosis is delayed due to a lack of clinical suspicion and appropriate investigations.We report a case of 72 years old male with simultaneous bilateral central acetabular fracture dislocation and bilateral posterior shoulder fracture dislocation secondary to an epileptic seizure.Present study highlights the significance of clinical suspicion and clinico-radiological evaluation for diagnosis of a rare injury following episode of seizures.Simultaneous fracture dislocation of all four limbs treated with a holistic approach can lead to a good functional recovery.Surgical management with open reduction and internal fixation is preferred and replacement arthroplasty should be reserved for cases with implant failure and elderly patients.

  3. Modified ilioinguinal approach in combined surgical exposures for displaced acetabular fractures involving two columns.

    Science.gov (United States)

    Wang, Peng; Zhu, Xiaodong; Xu, Peng; Zhang, Yan; Wang, Lubo; Liu, Xiangyan; Mu, Weidong

    2016-01-01

    The purpose of this study is to assess the advantages of modified ilioinguinal approach in combined surgical exposures for displaced acetabular fractures involving two columns management. 73 patients with displaced acetabular fractures involving two columns underwent open reduction and internal fixation through combined surgical approaches between 2006 and 2014 in our hospital. The modified ilioinguinal approach combined with Kocher-Langenbeck approach group (group A) included 46 patients. The standard ilioinguinal approach combined with Kocher-Langenbeck approach group (group B) included 27 patients. Outcome was assessed in operative time, blood loss, function outcomes and complications. In group A, the average operative time was 123.2 min, and the average blood loss was 586.2 ml. Anatomic reduction was achieved in 39 patients (84.8 %). The functional recovery was good in 37 patients (80.4 %). Complications related to the approach were observed in 10 patients (21.7 %). In group B, the average operative time was 161.5 min, and the average blood loss was 830 ml. Anatomic reduction was achieved in 24 patients (88.9 %). The functional recovery was good in 22 patients (81.5 %). Complications related to the approach were observed in 9 patients (33.3 %). This study demonstrates that both combined approaches permits good postoperative function results for treatment of acetabular fractures involving two columns. However, the modified ilioinguinal approach combined with Kocher-Langenbeck approach provides less operative time, blood loss and complications. PMID:27652175

  4. Acetabular stress fractures in military endurance athletes and recruits: incidence and MRI and scintigraphic findings

    Energy Technology Data Exchange (ETDEWEB)

    Williams, T.R. [Portsmouth Naval Medical Center, Radiology Department, Charette Health Care Center, Portsmouth, VA (United States); Puckett, M.L.; Shin, A.Y.; Gorman, J.D. [Naval Medical Center San Diego, Radiology Department, San Diego, CA (United States); Denison, G. [US Naval Hospital Guam (United States)

    2002-05-01

    Objective: To evaluate the incidence and the MRI and scintigraphic appearance of acetabular stress (fatigue) fractures in military endurance athletes and recruits. Design and patients: One hundred and seventy-eight active duty military endurance trainees with a history of activity-related hip pain were evaluated by both MRI and bone scan over a 2-year period. Patients in the study ranged in age from 17 to 45 years. They had hip pain related to activity and had plain radiographs of the hip and pelvis that were interpreted as normal or equivocal. The study was originally designed to evaluate the MRI and scintigraphic appearance of femoral neck stress fractures. Patients had scintigraphy and a limited MRI examination (coronal imaging only) within 48 h of the bone scan. Twelve patients demonstrated imaging findings compatible with acetabular stress fractures. Results: Stress fractures are common in endurance athletes and in military populations; however, stress fracture of the acetabulum is uncommon. Twelve of 178 patients (6.7%) in our study had imaging findings consistent with acetabular stress fractures. Two patterns were identified. Seven of the 12 (58%) patients had acetabular roof stress fractures. In this group, two cases of bilateral acetabular roof stress fractures were identified, one with a synchronous tensile sided femoral neck stress fracture. The remaining five of 12 (42%) patients had anterior column stress fractures, rarely occurring in isolation, and almost always occurring with inferior pubic ramus stress fracture (4 of 5, or 80%). One case of bilateral anterior column stress fractures was identified without additional sites of injury. Conclusions: Stress fractures are commonplace in military populations, especially endurance trainees. Acetabular stress fractures are rare and therefore unrecognized, but do occur and may be a cause for activity-related hip pain in a small percentage of military endurance athletes and recruits. (orig.)

  5. Magnetic resonance imaging of para-acetabular insufficiency fractures in patients with malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Theodorou, S.J. [Department of Radiology, School of Medicine, University of California, San Diego Medical Center, San Diego, CA (United States)]|[Department of Radiology, Veterans Administration Medical Center, San Diego, CA (United States)]|[Department of Clinical Radiology, University of Manchester, Manchester (United Kingdom); Theodorou, D.J. [Department of Radiology, School of Medicine, University of California, San Diego Medical Center, San Diego, CA (United States)]|[Department of Radiology, Veterans Administration Medical Center, San Diego, CA (United States)]. E-mail: daphne_theodorou@hotmail.com; Schweitzer, M.E. [Department of Radiology, New York University Hospital for Joint Diseases, NY (United States); Kakitsubata, Y. [Department of Radiology, School of Medicine, University of California, San Diego Medical Center, San Diego, CA (United States)]|[Department of Radiology, Veterans Administration Medical Center, San Diego, CA (United States); Resnick, D. [Department of Radiology, School of Medicine, University of California, San Diego Medical Center, San Diego, CA (United States)]|[Department of Radiology, Veterans Administration Medical Center, San Diego, CA (United States)

    2006-02-15

    AIM: To describe the characteristic magnetic resonance imaging (MRI) findings of para-acetabular insufficiency fractures in patients with malignancy, and compare the MRI appearance of these fractures with that of metastatic bone disease. MATERIALS AND METHODS: MRI examinations were reviewed in 16 patients with a known malignant tumour and severe hip pain that raised the possibility of local recurrence or metastatic disease. Six patients had received pelvic irradiation, and three patients were receiving steroid medication. RESULTS: The total number of fractures detected was 21: a solitary fracture was present in 11 patients and five patients had bilateral para-acetabular fractures. Two patients had associated sacral insufficiency fractures, and one of them had stress fractures involving both acetabular columns. Conventional radiography allowed the diagnosis of 14 (67%) fractures; six (28%) radiographic examinations were negative; and one (5%) examination was equivocal for fracture. Available scintigraphic and computed tomography (CT) studies revealed typical findings of fracture. Using MRI, insufficiency fractures appeared as linear regions of low signal intensity on T1- and T2-weighted images. Marked marrow oedema was evident in all cases. Fractures characteristically were parallel to the superior acetabulum in a curvilinear fashion in 18 (86%) instances, and were oblique in three (14%) instances. The fractures demonstrated considerable enhancement after intravenous gadolinium administration. No associated soft tissue masses were documented. CONCLUSION: Para-acetabular insufficiency fractures are a cause of hip pain, which may mimic skeletal metastasis in the patient with malignancy and pelvic irradiation. Recognition of the characteristic MRI findings of these fractures can preclude misdiagnosis and unnecessary bone biopsy.

  6. Bone impaction grafting and a cemented cup after acetabular fracture at 3-18 years.

    NARCIS (Netherlands)

    Schreurs, B.W.; Zengerink, M.; Welten, M.L.M.; Kampen, A. van; Slooff, T.J.J.H.

    2005-01-01

    The outcome of total hip arthroplasty after acetabular fracture is compromised. We studied if the bone impaction grafting technique could provide long-term prosthesis survival in deformed and irregular acetabula. We studied 20 hips in 20 patients (mean age, 53.3 years; range, 35-75 years) that were

  7. Minimum ten-year follow-up of acetabular fracture fixation from the Irish tertiary referral centre.

    LENUS (Irish Health Repository)

    Magill, Paul

    2012-04-01

    Successful outcome from acetabular fracture fixation is multi-factorial. Long-term results are not frequently reported. Pooling such data from high output centres will help progress acetabular fixation. This paper presents the first ten-year data from the Irish tertiary referral centre.

  8. The place of computerized axial tomography in the evaluation of acetabular fractures

    OpenAIRE

    Asik, Mehmet; Akman, Senol; Taser, Omer; Aritamur, Ayhan

    2004-01-01

    Besides the importance of standard AP and Judet s 45° iliac and obturator pelvic views, CAT has proved to be very useful in the evaluation of the fractures of the acetabulum. Of 96 patients with acetabular fractures, who applied to the Orthopaedics and Traumatology Department, Istanbul Medical Faculty, Istanbul University between 1987 and 1991 in addition to conventional radiography, CAT investigation was done in 32 patients for whom it was considered necessary. The results of both convention...

  9. Long-term outcome of operative management of delayed acetabular fractures

    Institute of Scientific and Technical Information of China (English)

    ZHU Shi-wen; SUN Xu; YANG Ming-hui; LI Yu-neng; ZHAO Chun-peng; WU Hong-hua; CAO Qi-yong

    2013-01-01

    Background Surgical treatment of acetabular fracture has long been a challenging area in the field of orthopedic trauma.The aim of this research was to investigate the operative methods for delayed acetabular fractures and to assess the operation results.Methods The operative approaches,procedures,results,and complications of the delayed acetabular fractures between 1995 and 2005 were retrospectively evaluated at Beijing Jishuitan Hospital.Quality of life was assessed for each patient with the Merle d'Aubingne and Postel fracture function rating scale and the radiological result was assessed using the Matta radiological score.Results Sixty-eight cases (70 hips) were followed up with a minimal duration of five years (average of 5.8 years).Excellent functional results were observed in 10 hip joints,good results in 40,fair results in 11,and poor results in nine.The risks of poor prognosis include impact fracture or osteochondral fracture of femoral head,a time beyond 42 days from injury to operative management,and dislocation of femoral head during the injury.Some of the problems,which were observed included postoperative infection in two hips,iatrogenic sciatic nerve injury in eight hips,traumatic arthritis in 15 hips,heterotopic ossification in 17 hips,and necrosis of the femoral head in six hips.Conclusion A careful selection of operative indications for delayed acetabular fractures in combination with a proper ooerative aPProach and appropriate reduction and fixation could guarantee relatively good results.

  10. Massive heterotopic ossification associated with late deficits in posterior wall of acetabulum after failed acetabular fracture operation

    OpenAIRE

    Zhang, Yuntong; Xie, Yang; Xu, Shuogui; Zhang, Chuncai

    2013-01-01

    Background Heterotopic ossification is a common postoperative complication of acetabular fracture. However, functionally significant heterotopic ossification with associated late bone defects in the posterior wall of the acetabulum is rare and challenging to treat. When heterotopic ossification is a late complication of failed acetabular fracture operation, it is disabling and may only be treated by THA. THA is highly susceptible to premature failure in young and active patients and may requi...

  11. Surgical treatment of acetabular fractures: clinical and radiological results and its complications

    International Nuclear Information System (INIS)

    The objective of this work is to analyse a serie of consecutive cases of surigically treated acetabular fractures, evaluating middle-term clinical and radiological results. A retrospective analysis of clinical histories, surgical forms and X-rays was performed for 42 patients who underwent surgery in two centers (Instituto Nacional de Ortopedia y Traumatologia [INOT] and Banco de Protesis), from July 2001 through August 2007

  12. 髋臼双柱骨折四种固定方式的生物力学比较及临床意义%Biomechanical study of four kinds of internal fixation techniques in the treatment of acetabular both-column fractures

    Institute of Scientific and Technical Information of China (English)

    朱李梅; 李明; 徐爱君; 张经纬; 何贤峰; 王虎

    2015-01-01

    目的 比较髋臼双柱骨折4种内固定方法在不同载荷下的生物力学特点.方法 利用CT图像,建立左侧髋臼双柱骨折三维有限元模型.比较四边区十字钢板、后路双重建钢板、髋臼三柱空心螺钉、新型解剖钢板固定,模拟上半身重量约60 kg坐位、向左转身、向右转身时的受力,施加600N的垂直载荷,向左旋转及向右旋转方向分别施加8 N/M的扭矩,时长1 s,Von Mises应力公式分析内固定的受力.结果 (1)垂直载荷及向左旋转工况下,应力峰值为:解剖板>十字板>后路双板>三柱钉,向右旋转工况为:十字板>解剖板>后路双板>三柱钉.(2)坐位向右转身,四边区十字板位于髂窝臼顶区域的位移最大,耻骨结节处的螺钉应力最大.(3)坐位向左转身,臼顶区域的后路双板内侧钢板近端应力及位移最大,臼顶内上方区域的髋臼后柱螺钉应力最大,髂后上嵴区域的横向双柱钉位移最大.位移峰值为:十字板>解剖板>后路双板>三柱钉.结论 三柱钉固定最稳定,解剖板应力分布较均匀,稳定性与后路双重建钢板相似.钢板固定时,应避免与拧人螺钉反方向的转身动作,减少内植物变形、松动滑脱、断裂、复位丢失等并发症.%Objective To compare the biomechanical properties of four kinds of internal fixation techniques for acetabular both columns fractures.Methods A three-dimensional finite element model of left acetabular both-column fracture was established according to pelvic computed tomography (CT) images and photo software.Four kinds of internal fixation techniques,including quadrilateral double plates,posterior double reconstruction plates,acetabular three-column canulated screws,new anatomical plate were performed separately by the three-dimensional finite element model.These four models were put into Abaqus finite element program,axial load 600 N on vertical compression,and 8 N/M (1 S) torque were loaded on left

  13. Inguinal Abnormalities in Male Patients with Acetabular Fractures Treated Using an Ilioinguinal Exposure

    Directory of Open Access Journals (Sweden)

    Reza Firoozabadi

    2015-09-01

    Full Text Available Purpose: Surgeons performing an ilioinguinal exposure for acetabular fracture surgery need to be aware of aberrant findings such as inguinal hernias and spermatic cord lesions. The purpose of this study is to report these occurrences in a clinical series of adult males undergoing acetabular fracture fixation and a series of adult male cadavers. The secondary aim is to characterize these abnormalities to aid surgeons in detecting these abnormalities preoperatively and coordinating a surgical plan with a general surgeon.Methods: Clinical study- Retrospective review of treated acetabular fractures through an ilioinguinal approach. Incidence of inguinal canal and spermatic cord abnormalities requiring general surgery consultation were identified. Corresponding CT scans were reviewed and radiographic characteristics of the spermatic cord abnormalities and/or hernias were noted.Cadaveric study- 18 male cadavers dissected bilaterally using an ilioinguinal exposure. The inguinal canal and the contents of the spermatic cord were identified and characterized.Results: Clinical Study- 5.7% (5/87 of patients had spermatic cord lesion and/or inguinal hernia requiring general surgical intervention. Preoperative pelvic CT scan review identified abnormalities noted intraoperatively in four of the five patients. Cord lipomas visualized as enlargements of the spermatic cord with homogeneous density. Hernias visualized as enlarged spermatic cords with heterogeneous density. Cadaver Study- 31% (11/36 of cadavers studied had spermatic cord and/or inguinal canal abnormalities. Average cord diameter in those with abnormalities was 24.9 mm (15-28 compared to 16 mm (11-22 in normal cords, which was statistically significant.Conclusion: The clinical and cadaveric findings emphasize the importance of understanding inguinal abnormalities and the value of detecting them preoperatively. The preoperative pelvic CT scans were highly sensitive in detecting inguinal abnormalities.

  14. A Feasibility Study into the Use of Three-Dimensional Printer Modelling in Acetabular Fracture Surgery

    Directory of Open Access Journals (Sweden)

    A. W. Yu

    2015-01-01

    Full Text Available There are a number of challenges associated with the operative treatment of acetabular fractures. The approach used is often extensive, while operative time and perioperative blood loss can also be significant. With the proliferation of 3D printer technology, we present a fast and economical way to aid the operative planning of complex fractures. We used augmented stereoscopic 3D CT reconstructions to allow for an appreciation of the normal 3D anatomy of the pelvis on the fractured side and to use the models for subsequent intraoperative contouring of pelvic reconstruction plates. This leads to a reduction in the associated soft tissue trauma, reduced intraoperative time and blood loss, minimal handling of the plate, and reduced fluoroscopic screening times. We feel that the use of this technology to customize implants, plates, and the operative procedure to a patient’s unique anatomy can only lead to improved outcomes.

  15. Research on Transverse Acetabular Fracture Fixation Using Different Plate Attachment Methods

    Directory of Open Access Journals (Sweden)

    Gediminas Gaidulis

    2015-03-01

    Full Text Available The article deals with the problem of transverse acetabular fracture fixation using different plate attachment methods. A 3D model of pelvis and hip joint structure was created and the design of three different fixation plates using SolidWorks was made. The plates were fixed at distances of 10, 20 and 30 mm from the acetabulum. The model was meshed into finite elements, a static external load of 2500 N was added and the analysis of stress distribution in plates and fracture displacement was performed. The obtained results showed that fracture displacement was quite similar in all fixation methods. However, the maximal stress in the nearest from the acetabulum plate was higher than yield strength. Thus, this placement is not eligible. The plate fixed at a distance of 30 mm from the acetabulum appeared the most suitable because of the smallest and symmetrical stress distribution in the plate.

  16. The Association of Femoral Neck Stress Fractures with Femoral Acetabular Impingement

    Science.gov (United States)

    Safran, Marc R.; Goldin, Michael; Anderson, Christian; Fredericson, Michael; Stevens, Kathryn J.

    2013-01-01

    Objectives: To determine if there is an increased incidence of femoral acetabular impingement (FAI) in patients presenting with stress fractures of the femoral neck. Methods: After IRB approval, the imaging studies of 25 athletes (22 females, 3 males, mean age 26, range 19 - 39 years) with femoral neck stress injuries were assessed for the presence of features suggesting FAI, including acetabular retroversion, coxa profunda, abnormal femoral head-neck junction, fibrocystic change, os acetabulae, labral tear and chondral injury. All subjects had to have an adequate AP Pelvis radiograph, a lateral radiograph of the affected hip, and an MRI of the affected hip. The alpha angle, anterior offset ratio, and center to edge (CE) angle were measured on radiographs. The grade of stress injury was determined on MR images. All images and measurements were made by a musculoskeletal fellowship trained radiologist, a fellowship trained orthopaedic surgeon, an orthopaedic sports medicine fellow and a physical medicine and rehabilitation resident. Charts were reviewed to determine treatment of the stress fracture, outcome and final follow up, as well as to determine if the patient had any further treatment for their hip. Results: Of the 25 hips (18 right, 7 left) with femoral neck stress reactions, 9 were grade 2 (bone marrow edema), 5 were grade 3 (high T2 and low T1 marrow signal), and 11 were grade 4 (stress fracture). Twenty patients (80%) had coxa profunda - where the floor of the cotyloid fossa touches or extends beyond the ilioischial line (incidence in general population is 15.2% of males, and 19.4% of females). Coxa profunda, defined by the floor of the cotyloid fossa touching or extending beyond the ilioischial line and a center edge angle of more than 35o, was present in 28% of subjects. Acetabular retroversion as assessed by the crossover sign was present in 42% (normal incidence is 5% of population). Center edge angle was greater than 35o in 20% and greater than 40 o

  17. Delayed cementless total hip arthroplasty for neglected dislocation of hip combined with complex acetabular fracture and deficient bone stock

    Directory of Open Access Journals (Sweden)

    Gavaskar Ashok S

    2012-12-01

    Full Text Available 【Abstract】Total hip arthroplasty (THA for an un-treated acetabular fracture is technically challenging and the long-term result is not so favorable. A 45-year-old fe-male patient with untreated column and comminuted poste-rior wall fracture of the acetabulum was treated in our insti-tution by reconstruction of the posterior wall using iliac strut autograft and plate stabilization of the posterior col-umn with cancellous grafting and cementless THA in a single stage. At 3 years’ follow-up, the patient was independently mobile without limb length discrepancy. Radiological evalu-ation showed well integrated components and bone grafts. No evidence of aseptic loosening or osteolysis was found. This report aims to emphasize that bony acetabular recon-struction allows the use of primary hip components, which improves prosthesis longevity and preserves bone stock for a future revision. Key words: Acetabulum; Fractures, bone; Hip dislocation; Arthroplasty, replacement, hip

  18. 复杂性髋臼骨析合并C型骨盆骨折的手术治疗探讨%Complexity of the acetabular fracture merger C pelvic fractures the surgical treatment of the discussion

    Institute of Scientific and Technical Information of China (English)

    田素魁; 邓庭明; 王振强; 蒋华富; 张玉兴; 陈劲松

    2011-01-01

    Objective To study the complexity of the acetabular fracture merger C pelvic fractures the surgical treatment of the method. Methods Through Mar 2002 to Nov 2007 acetabular merger between fracture patients pelvic fractures are classified according to summarize, pelvic fractures Tile classification and the acetabular Judet-Letourol classification, improved 13 cases were complexity acetabular merger fracture C pelvic fractures, all through the positive before the operation after haing electie line, buried in joint incision open reduction steel plate, screw intemal fixation, average follow-up treatment 2.4 (0.5~4 years). Results 13 patients except 1 patient wound postponed to 20 days after the healing (fat lique-faction), the others are primary healing wound patient in 2 cases, the acetabular poor fracture restoration, follow-up of 0.5~4 years, have 1 patient traumatic hip osteoarthritis pain are more frequent, lame, and another in 2 cases only pain symptoms, without a limp, and analgesia symptoms after treatment, 5 patients feeling of the ache, can bear, not influence the work and life, 5 patients feel and no obvious difference between before the injury. Conclusion Positive preoperative preparation, do as early as possible fractures internal fixation (orif is for complex fracture acetabular merger C pelvic fractures the effective treatment means, in surgical approach and operation in the specific strategies should follow the principle of individual.%目的 探讨复杂性髋臼骨折合并C型骨盆骨折的手术治疗方法.方法 通过对2002年3月~2007年11月间髋臼骨折合并骨盆骨折的病人进行分类总结,按照骨盆骨折Tile分类法和髋臼改良Judet-Letourol分类法,共有13例复杂性髋臼骨折合并C型骨盆骨折,都通过积极手术前处埋后,择期行联合切口进行切开复位钢板、螺钉内固定,平均随访治疗2.4年(0.5~4年).结果 13例病人中除1例病人部分伤口延期至术后20天愈合外(脂

  19. Delayed cementless total hip arthroplasty for neglected dislocation of hip combined with complex acetabular fracture and deficient bone stock

    Institute of Scientific and Technical Information of China (English)

    Ashok S Gavaskar; Naveen Chowdary Tummala

    2012-01-01

    Total hip arthroplasty (THA) for an untreated acetabular fracture is technically challenging and the long-term result is not so favorable.A 45-year-old female patient with untreated column and comminuted posterior wall fracture of the acetabulum was treated in our institution by reconstruction of the posterior wall using iliac strut autograft and plate stabilization of the posterior column with cancellous grafting and cementless THA in a single stage.At 3 years' follow-up,the patient was independently mobile without limb length discrepancy.Radiological evaluation showed well integrated components and bone grafts.No evidence of aseptic loosening or osteolysis was found.This report aims to emphasize that bony acetabular reconstruction allows the use of primary hip components,which improves prosthesis longevity and preserves bone stock for a future revision.

  20. A very rare case with neglected hip dislocation coexisted with posterior acetabular lip fracture

    Directory of Open Access Journals (Sweden)

    Samet Karabulut

    2011-06-01

    Full Text Available Neglected hip dislocation is a rare situation among children. The coexistence of acetabulum fracture is less common. The result of treatment depends on the time of diagnosis. Early treatment is mandatory in such cases. Seven years old female brought to our outpatient clinic with the complaints of right hip pain and walking difficulty. Her parents said that she had fallen from a horse one month ago. X-ray and CT showed a posterior dislocation of her right hip and a fracture on her right posterior acetabular lip. We performed an open reduction via posterior approach. Because the hip was unstable we fixed the femoral head to the acetabulum by a Kirshner wire. Pelvipedal cast was applied after the operation for 6 weeks. After 6 months avascular necrosis (AVN developed on her right femoral head, the range of motion (ROM of the hip was restricted and she had minimal pain on her right hip. J Clin Exp Invest 2011;2(2:228-31

  1. Should money follow the patient: Financial implication for being the National Centre for the Treatment and Management of Pelvic and Acetabular Fractures in Ireland.

    LENUS (Irish Health Repository)

    Kelly, M E

    2013-03-13

    BACKGROUND: Pelvic and acetabular fractures are complex injuries requiring specialist treatment. Our institution is the National Centre for Treatment and Management of these injuries. AIM: To audit all referrals to our institution over a 6-month period and calculate the cost incurred by being the national referral centre. METHODS: Retrospective review of database, and subsequent allocation of Casemix points to assess total cost of treatment for each patient referred to our institution. RESULTS: 103 patients referred with pelvic or acetabular fracture for operative management. The furthest referral distance was 181miles. Over-all, the length of stay was 15.4 days. The average inclusive cost for a referral to our unit for operative management was €16,302. CONCLUSION: Pelvic and acetabular fractures are complex injuries that require specialist referral unit management. However for these units to remain sustainable money needs to "follow the patient".

  2. Reprodutibilidade da classificação de Tile para fraturas do acetábulo Reproducibility of Tile's classification of acetabular fractures

    Directory of Open Access Journals (Sweden)

    Marcos Almeida Matos

    2006-01-01

    Full Text Available Classificar corretamente as fraturas acetabulares é crucial para bom planejamento pré-operatório e para redução cirúrgica eficiente. Entretanto, para cumprir seus objetivos, qualquer sistema de classificação deve ser simples e reprodutível. O objetivo deste artigo é avaliar a reprodutibilidade interobservador da classificação de Tile para fraturas do acetábulo. Foram utilizadas 30 imagens radiográficas de 10 fraturas acetabulares nas incidências de Judet, analisadas por 10 observadores, sendo cinco especialistas em cirurgia de quadril e cinco residentes do terceiro ano de ortopedia. A concordância global obtida foi de 72,44% com Kappa (K = 0,52 (0,48 entre residentes e 0,57 entre especialistas. Conclui-se que a classificação de Tile para fraturas acetabulares apresenta moderada concordância interobservador, não havendo diferença estatisticamente significante entre residentes e especialistas.Properly classifying acetabular fractures is crucial for a good preoperative planning and for an efficient surgical reduction. However, in order to accomplish its objectives, any classification system must be simple and reproducible. The objective of this article is to assess inter-observer reproducibility of Tile’s classification concerning acetabular fractures. Thirty X-ray images of 10 acetabular fractures at Judet planes were used and assessed by 10 observers, being five hip surgery experts and five 3rd-grade orthopaedic residents. The global consistency achieved was 72.44% to Kappa (K = 0.52 (0.48 among resident doctors and 0.57 among experts. It was concluded that the Tile’s classification of acetabular fractures reveals a moderate inter-observer consistency, with no statistically significant difference between resident doctors and experts.

  3. Femoral shaft and intertrochanteric fracture with ipsilateral acetabular fracture surgery%股骨干及股骨转子间骨折合并同侧髋臼骨折的手术治疗

    Institute of Scientific and Technical Information of China (English)

    赵阳; 薛朝辉; 杨凯

    2013-01-01

    目的:探讨股骨干及股骨转子间骨折合并同侧髋臼骨折的治疗方法及临床疗效。方法股骨干及股骨转子间骨折合并同侧髋臼骨折10例,均为男性;年龄23~56岁,平均34.5岁。髋臼骨折按Letournel分型,后壁伴后柱骨折6例,单纯后壁骨折2例,髋关节中心性骨折脱位2例。均行重建钢板内固定。股骨骨折行加长髓内钉固定6例;股骨干行钢板内固定,股骨转子间骨折行动力髋螺钉固定4例。结果6例均获随访,随访时间12个月~3年,平均17.2个月。骨折均临床愈合,髋关节功能根据D’Aubigne疗效评定标准:优7例,良2例,可1例。10例中漏诊2例,漏诊率20%。结论股骨干及股骨转子间骨折合并同侧髋臼骨折受伤暴力大、机制复杂漏诊率较高,应早期明确诊断,合理内固定临床疗效尚好。%Objective: Explore the femoral shaft and intertrochanteric fracture with ipsilateral acetabular fracture treatment and the clinical efficacy .Methods: Femoral shaft and intertrochanteric fracture with ipsilateral acetabular fracture 10 cases, men; age 23- 56 years old, average 34.5 years old. Letournel acetabular fractures according to type, the posterior wal with 6 cases of posterior column fracture, 2 cases of posterior wal fractures alone are line Femoral shaft,Central fracture dislocation of the hip in 2 cases; with interlocking intramedul ary nailing Example,6; femur plate fixation line, intertrochanteric fracture of femur with dynamic hip screw fixation Example 4. Results: 10 patients were fol owed up for 12 months to 36 months, an average of 17.2 months. Clinical healing of fractures, hip function according to D’Aubigne efficacy criteria: excellent 7 cases, good in 2 cases, Example 1. Example 10 in two cases of missed diagnosis, missed diagnosis rate of 20%. Conclusion: Femoral shaft and intertrochanteric fracture with ipsilateral acetabular fracture were injured in the violence

  4. MRI assessment of the posterior acetabular wall fracture in traumatic dislocation of the hip in children

    Energy Technology Data Exchange (ETDEWEB)

    Rubel, Ivan F.; Kloen, Peter; Helfet, David L. [Department of Orthopaedic Surgery, Weill Medical College of Cornell University, New York, NY (United States); Potter, Hollis G. [MRI Department, Diagnostic Radiology, Hospital for Special Surgery, New York (United States)

    2002-06-01

    Traumatic hip dislocations associated with posterior wall fractures of the acetabulum in the pediatric population are in general a consequence of high-energy trauma. After expeditious reduction, instability mandates for further diagnosis and intervention. Plain radiographs or computerized tomography (CT) scans can misjudge the involvement of the posterior wall of the acetabulum due to the partially calcified nature of the pediatric bone. We present two cases of pediatric traumatic hip dislocation associated with posterior wall fractures of the acetabulum. In both cases, obvious postreduction instability was noted without conclusive findings of etiology on plain X-rays or CT scans. Magnetic resonance imaging (MRI) disclosed an extensive posterior wall traumatic involvement in both cases and helped to decide in favor of open reduction of the hip and internal fixation of the posterior wall fragment. (orig.)

  5. Classification and treatment of acetabular fractures%髋臼骨折的分类与治疗策略

    Institute of Scientific and Technical Information of China (English)

    曾令源

    2012-01-01

    Fracture of acetabulum is mostly caused by high energy trauma, which exists as a whole or a part of palvic fracture. Acetabulum is characterized by complex anatomical relationships irregular bone structures, which leads to the difficulties in surgery. The surgical approach is found to be closely related to the classification of cetabular fractures. And several factors are proved to influence the clinical efficacy. In this review, we present the progress on the classification and treatment of acetabular fractures.%髋臼为不规则骨,为丰厚软组织包裹,多为挤压或传导受力导致骨折,髋臼骨折与髋关节活动大有很大关联.髋臼的解剖关系复杂、骨性结构不规则,因而手术难度大.髋臼骨折的分类与手术入路的选择密切相关,此外,还有一些因素也会影响疗效.本文主要讨论髋臼骨折的分类及相应治疗的一些内容.

  6. One stage treatment of acetabular fractures combined with ipsilateral femoral head or neck fractures with total hip arthroplasty%Ⅰ期全髋置换术治疗合并股骨头或股骨颈骨折的髋臼骨折

    Institute of Scientific and Technical Information of China (English)

    唐孝明; 张耀明; 袁加斌; 庞健; 王跃

    2008-01-01

    目的 探讨全髋关节置换术(total hip arthroplasty,THA)治疗合并股骨头或股骨颈骨折的髋臼骨折方法、手术特点和疗效.方法 对7例合并股骨头或股骨颈骨折的髋臼骨折行Ⅰ期THA.髋臼骨折按AO分型:A型1例,B型3例,C型3例.股骨头骨折1例,股骨颈骨折6例.伤后7~21 d接受THA,5例行髋臼复位内固定后采用生物型髋臼,2例金属加强环配合骨水泥固定髋臼,股骨侧均采用生物型固定.结果 6例得到随访,平均随访时间3年9个月(2年3个月~6年5个月),出现脱位1例,经手法复位后未再脱位,1例出现异位骨化.所有随访患者髋关节功能均有明显改善,Harris评分术前平均48分,术后提高到91分.随访期内未发现假体松动.结论 THA是治疗合并同侧股骨头或股骨颈骨折髋臼骨折的有效方法,能显著改善关节功能,避免多次手术.%Objective To discuss method,operative characters and curative effect of total hip arthroplasty(THA)in treatment of acetabular fractures combined with ipsilateral femoral head or neck fractures.Methods One stage THA was done in seven patients with acetabular fractures combined with ipsilateral femoral head fracture(one patient)or femoral neck fractures(six patients)7-21 days after fractures.There were five males and two females,at age range of 41-65 years(average 50 years).According to AO classification,there were one patient with type A fracture,three with type B and three with type C.Of all,five patients received biological acetabular replacement after reduction and internal fixation of acetabular fracture and two received PMMA acetabular replacement with metal enforcement ring.All patients received biological femoral stem.Results Of all,six patients were followed up for from 2 years and 3 months to 6 years and 5 months(mean 3 years and 9 months),which showed heterotopic ossitlcation in one patient and dislocation in one who recovered after manipulative reduction.The Harris score was

  7. Modified Kocher-Langenbeck approach in combined surgical exposures for acetabular fractures management

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    Narender Kumar Magu

    2016-01-01

    Conclusion: We believe that modified K-L approach may be a good alternative for the standard K-L approach in the management of elementary fractures and associated fractures of the acetabulum when combined with an anterior surgical approach. It makes the procedure less invasive, shortens the operative time, minimizes blood loss and overcomes the exhaustion and fatigue of the surgical team.

  8. Osteocondroma acetabular Acetabular osteochondroma

    Directory of Open Access Journals (Sweden)

    Reynaldo Jesus Garcia

    2005-01-01

    Full Text Available Apresentamos o relato de um caso de osteocondroma solitário acetabular, tumor ósseo comum em diversas regiões do esqueleto porém raro nesta localização. O tratamento realizado foi a ressecção do tumor por uma via posterior ao quadril e o paciente evoluiu com resolução do quadro clínico.This is a case report of a patient with a intra-articular hip osteochondroma, an extremely rare location for this kind of lesion. The patient was treated with resection of the lesion and presented a very good evolution with total recovery of the hip movements.

  9. A Novel Fixation System for Acetabular Quadrilateral Plate Fracture: A Comparative Biomechanical Study

    Directory of Open Access Journals (Sweden)

    Guo-Chun Zha

    2015-01-01

    Full Text Available This study aims to assess the biomechanical properties of a novel fixation system (named AFRIF and to compare it with other five different fixation techniques for quadrilateral plate fractures. This in vitro biomechanical experiment has shown that the multidirectional titanium fixation (MTF and pelvic brim long screws fixation (PBSF provided the strongest fixation for quadrilateral plate fracture; the better biomechanical performance of the AFRIF compared with the T-shaped plate fixation (TPF, L-shaped plate fixation (LPF, and H-shaped plate fixation (HPF; AFRIF gives reasonable stability of treatment for quadrilateral plate fracture and may offer a better solution for comminuted quadrilateral plate fractures or free floating medial wall fracture and be reliable in preventing protrusion of femoral head.

  10. 改良 Stoppa 入路治疗骨盆髋臼骨折%Modified Stoppa approach in the treatment of pelvic and acetabular fractures

    Institute of Scientific and Technical Information of China (English)

    王树金; 孔丹辉; 吴树华; 王遥伟; 陈志军; 束伟平

    2015-01-01

    Objective To evaluate the modified Stoppa approach in the treatment of pelvic and acetabular fractures. Method Applica-tion of modified Stoppa approach for the treatment of pelvic and acetabular fractures in 13 cases. 8 cases of pelvic fracture according to Tile classification:type B2 2 cases,type C1 - 1 1 case,type C1 - 2 2 cases,type C1 - 3 1 case,type C2 in 3 cases,2 cases with pubic symphysis, bilateral pubic rami fractures in 3 cases,1 case of sacral iliac joint dislocation,sacral fracture in 1 case;type Letournel 8 cases of acetabular fractures:anterior column fracture in 2 cases,anterior column + Half transverse fracture in 2 cases,1 case of transverse fracture,double column fractures in 3 cases,2 cases with dislocation of hip joint. Results 16 cases were followed up,time 8 ~ 24 months,average 12 months,all fractures were healed,the healing time ranged from 3 to 5. 5 months,average 3. 9 months. 1 case of double column fracture hip flexion slightly restricted,1 case of dislocation of sacroiliac joint mild claudication,no screws loosening,fracture,without loss of reduction;1 case of incision infection,healed after dressing change. Results After operation,according to the Matta method,10 cases were excellent and 3 cases were good,The excellent and good rate was 81. 25%. Conclusion The modified Stoppa approach in the treatment of pelvic and ac-etabular fractures with a good clinical application value,which can be fully exposed iliac wing,anterior column,anterior and superior ramus of pubis,especially in the anterior column of the acetabulum or anterior displaced fracture,transverse fracture,T fracture,double column fractures or associated with the transverse fracture of the anterior column fractures,pelvic fracture and femoral head center dislocation anteri-or wall fractures or with pubic symphysis injury,superior medial sided body displaced acetabular fractures,it is an excellent choice in surgi-cal treatment of pelvic and acetabular fractures

  11. One stage total hip arthroplasty for acetabular fractures%Ⅰ期全髋关节置换治疗髋臼骨折

    Institute of Scientific and Technical Information of China (English)

    王子明; 孙红振; 王爱民; 杜全印; 吴思宇; 赵玉峰; 唐颖

    2008-01-01

    目的 探讨髋臼骨折后Ⅰ期全髋关节置换(total hip arthroplasty,THA)的手术适应证和手术方法,观察其临床疗效.方法 对11例髋臼骨折患者行Ⅰ期THA.其中前柱骨折3例,后壁骨折1例,后柱骨折2例,后柱合并后壁骨折2例,横形骨折1例,横形合并后壁骨折1例,两柱骨折1例.伤后8~37 d(平均24 d)接受THA.对新鲜髋臼骨折患者,先用重建钢板或螺钉固定骨折以恢复髋臼肇的形态,将切下的股骨头制成颗粒状或块状植于髋臼内后安置臼杯.陈旧性髋臼骨折有节段性髋臼骨缺损者,将切下的股骨头制成大块状进行髋臼内结构性植骨后再安置臼杯.结果 术后3个月完全负重,无人工关节脱位.随访时间6~45个月,平均28个月.Harris评分平均78分.髋关节屈伸平均活动度为95°.X线片示1例出现髋臼松动及骨溶解征象.结论 髋臼骨折移位明显,关节软骨面损伤严重,错过了手术复位时机,可以Ⅰ期行THA.如能创造稳定的髋臼杯结构,近期临床效果满意.%Objective To explore operative indications,methods and effect of one stage total hip arthroplasty(THA)in treatment of acetabular fractures.Methods One stage total hip arthroplasty (THA)was carried out in 11 patients with acetabular fractures including 10 males and one female(at mean age of 42.4 years)8-37 days(mean24 days)after injury.There were anterior column fractures in three patients,posterior wall fracture in one,posterior column fracture in two,posterior column fracture combined with posterior wall fracture in two,transverse fracture in one,transverse fracture combined with posterior wall fracture in one and two-column fracture in one.Fresh acetabular fractures were first fixed with reconstruction plate or screws to restore shape of acestbular wall;then,granule or bulk of resected femoral head were implanted into acetabulum posterior to placement of acetabular cup prosthesis.While for old acetabular fractures,the resected

  12. Bilateral central acetabular fracture dislocation in a young patient due to seizure activity:a case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Umesh Kumar Meena; Devi Sahai Meena; Prateek Behera; Om Singh Meel

    2014-01-01

    Various musculoskeletal injuries are well known complications of epilepsy either because of direct trauma or because of unbalanced forceful muscle contraction. We report a case of non-traumatic bilateral central acetabular fracture dislocation due to seizure activity induced by neurocysticercosis of the brain, which was managed conservatively and obtained reasonable good outcome. This case highlights the importance of proper evaluation in young non-osteoporotic patients who have experienced an epileptic attack without any previous history. It is also imperative to mention that these patients should be thoroughly examined neurologically to find out the exact etiology and should be treated accordingly to prevent future seizure activity.

  13. Fenestration operation for treatment of acetabular parastyle fracture combined with articular facet compression and collapse of acetabular top involving weight-bearing dome%开窗法复位植骨内固定治疗髋臼前柱骨折合并臼顶区关节面压缩塌陷的临床研究

    Institute of Scientific and Technical Information of China (English)

    陈国富; 朱忠; 梁军波; 林列; 陈海啸

    2011-01-01

    Objective:To analyze the fenestration operation for treatment of acetabular parastyle fracture combined with articular facet compression and collapse of aeetabular top involving weight-bearing dome. Methods: From July 2005 to February 2007,52 cases of acetabular parastyle fracture combined with articular facet compression and collapse of acetabular top involving weight-bearing dome were treated by two methods. Among them, 24 cases were treated by fenestration operation for articular facet reduction,bone grafing,anatomical reconstruction of the acetabular papastyle with internal fixation,incuded 17 males and 7 females with an average age of(35.2±6.4) years old ;the other 28 cases were treated only anatomical reconstruction of the acetabular papastyle with internal fixation,included 19 males and 9 females with an average age of(36.4±4.8) years old.All the patients were evaluated with modified d'Aubigne-Postel clinical evaluation standard. Results:All patients gained bone healing. There were only 1 patient occurenced femoral nerve injury and recovered 2 months later. There were no other complications. All patients were followed up from 12 to 51 months (averaged in 31.5 months). According to modified d'Aubigne-Postel clinical evaluation standard, there were statistic difference between the two groups of patients in pain, walking, range of motion and total score. In fenestration operation group, the results were excellent in 13 patients, good in 9, fair in 1, poor in 1 ;in parastyle reduction group, the results were excellent in 9 patients, good in 11, fair in 6, poor in 2 (u=0.613, P<0.05 ). Conclusion: Fenestration operation for treatment of acetabular parastyle fracture combined with articular facet compression and collapse of acetabular top involving weight-bearing dome is a feasible methed for the recovery of hip joint function.%目的:探讨开窗法复位植骨内固定和单纯行前柱复位内固定治疗髋臼前柱骨折合并臼顶区关节面压

  14. Design of ABC damage variable and positioning system for acetabular fractures and 1122 cases of multi-center statistic analysis%髋臼骨折ABC损伤变数定位系统的设计与1122例多中心研究分析

    Institute of Scientific and Technical Information of China (English)

    张春才; 苏佳灿; 曹烈虎; 徐永清; 阮墨; 陈庄洪; 黄继峰; 蔡贤华; 沈惠良; 刘利民; 王继芳; 许硕贵; 王岩; 唐佩福; 梁雨田; 王家让; 王愉思; 王振昊; 刘文德; 李文锐; 李文虎; 王序全; 禹宝庆; 周东生; 张鹏; 王仁; 王刚; 陈育岳; 丛永健; 纪方; 付青格; 刘欣伟; 章云童; 牛云飞; 王攀峰

    2011-01-01

    Objective:To design ABC damage variable and positioning system for acetabular fracture and explore the feasibility and clinical practical value of the system through the multi-center analysis of 1122 acetabular fractures. Methods: According to acetabular three-column conception, and pelvic ring lesions damage direction caused by acetabular fracture domino effect and injury degree of proximal femur joint,it defined class A as any column acetabular fracture; class B as any two-column acetabular fracture; class C as front,dome and posterior mixture acetabular fracture. Lower case English letters a,m,p represented front, dome, posterior fracture, respectively. Acetabular damage variables: 1 was simple displaced fractures; 2 was comminuted fractures; 3 was compression fractures. Pelvic ring lesions damage variables:α was sacroiliac joints or sacroiliac fracture horizontal separation deflection; β was sacroiliac joints or sacroiliac fracture vertical separation deflection; γwas pubic symphysis separation/superior and inferior ramus of pubis fracture deflection; αβγδ was compound floating damage. Proximal humerus joint damage variables: Ⅰ was femoral head fracture; Ⅱ was femoral neck fracture; Ⅲ was intertrochanteric fractures of femur; Ⅳ was Ⅰ to Ⅲ compound fracture. The ABC damage variable positioning system for acetabular fracture was made up by the above-mentioned variables. The statistics from March 1997 to February 2010 showed 1122 cases acetabular fractures with 18 cases of double side acetabular fracture and 1140 cases of acetabular fractures. The pelvics anterior-posterior view,ilium and obturator oblique view, and 2/3D-CT materials were analyzed and researched. Results: Each damage variables distribution situation in 1140 cases of acetabular fracture involved A in 237 cases (20.8%), B in 605 cases (53.1% ), C in 298 cases (26.1%);front column fracture in 808 cases (70.9%), dome fracture in 507 cases (44.5%), posterior fracture in

  15. 三维记忆内固定与髋臼重建钛板系统修复髋臼后壁骨折伴关节后脱位的比较%Three-dimensional memory fixationversusreconstruction titanium plate to repair posterior wall acetabular fracture with posterior dislocation

    Institute of Scientific and Technical Information of China (English)

    梁云扬

    2015-01-01

    通过对髋臼三维记忆内固定系统在髋臼后壁骨折伴髋臼关节后脱位中临床应用效果的分析,了解其治疗髋臼后壁骨折伴髋臼关节后脱位的可行性与特点。研究发现,其在固定时间及术后功能恢复等方面较之重建钛板内固定都具有明显的应用优势。%BACKGROUND:Posterior wal fractures of the acetabulum with posterior dislocation of the acetabular joint mostly require the operation of open reduction and internal fixation. Different materials can be chosen for internal fixation operation. OBJECTIVE: To explore the effect of acetabular three-dimensional memory fixation system on acetabular posterior wal fractures accompanying the acetabulum joint dislocation. METHODS: A retrospective analysis was performed on clinical data of 92 cases of acetabular posterior wal fracture and dislocation at the Heze Municipal Hospital of Shandong Province from February 2010 to February 2014. Al patients received the operation of open reduction and internal fixation. They were divided into three-dimensional memory fixation group (45 cases) and reconstruction titanium plate group (47 cases) according to different fixators. Al patients were folowed up for 12 months after fixation. RESULTS AND CONCLUSION:The operation time and intraoperative blood loss were significantly longer or higher in the reconstruction titanium plate group than in the three-dimensional memory fixation group (P < 0.05). Harris score was significantly greater in the three-dimensional memory fixation group than in the reconstruction titanium plate group during final folow-up (P < 0.05). Thromboembolic complications or deep infection were not detected after fixation in both groups. These findings confirm that three-dimensional memory fixation system obtained good effects in the treatment of the posterior wal fractures of the acetabulum with posterior dislocation.

  16. Acetabular fractures--Risk factors for a negative outcome of the surgical management%髋臼骨折--手术治疗效果欠佳的不利因素

    Institute of Scientific and Technical Information of China (English)

    Beate P. Hanson; David L. Helfet; Suthorn Bavonratanavech; Ian Harris; 陈国奋; 顾立强

    2004-01-01

    现有文献中没有确定性的治疗髋臼移位骨折的最佳方法.一般情况下倾向于开放复位内固定.但是,由于缺少不同特定内固定物间的比较,因此难以做出推荐.报道一致认为,导致结果差和一般的潜在不利因素包括老龄、术后复位不良、严重的骨折、股骨头损伤,以及延迟处理.%The optimal method of managing displaced acetabular fractures is not established in the literature.It may be that open reduction and internal fixation in general is universally preferred;however,specific types of hardware have not been compared and therefore recommendations cannot be made. Potential risk factors consistently reported to be associated with poor to fair outcomes include older age, poor post operative reduction, more severe fracture characteristics, femoral head injury, and a delay in treatment.

  17. C形臂X线透视导航下微创经皮拉力螺钉治疗髋臼前柱骨折%Treatment of anterior acetabular column fracture with minimally invasive percutaneous lag screws by C-arm X-ray fluoroscopy-based navigation

    Institute of Scientific and Technical Information of China (English)

    司庆华; 唐佩福; 丁珮; 胡磊; 樊喻波; 张立海; 彭晔; 袁新成; 董天祥; 娄昕

    2013-01-01

      目的探讨C型臂X线机透视导航下使用微创经皮拉力螺钉内固定治疗髋臼前柱骨折的方法及疗效.方法对2009年3月-2011年9月,在我院创伤骨科住院的8例无移位或轻度移位的髋臼前柱骨折患者,应用C形臂X线透视导航,用微创经皮拉力螺钉治疗髋臼前柱骨折.按Nakatani分型:Ⅰ型4例,Ⅱ型3例,Ⅲ型1例.受伤致手术时间为2~7 d.结果8例患者,男5例,女3例,年龄19~69岁,共置入10枚髋臼前柱经皮螺钉,其中2例为双侧髋臼前柱骨折,其余6例为单侧髋臼前柱骨折,各置入1枚螺钉.术后8例全部获得随访,随访时间10~26个月.8例全部骨性愈合,1例遗留轻度移位,无血管神经损伤等并发症.结论 C型臂X线机透视导航下使用微创经皮拉力螺钉内固定治疗髋臼前柱骨折可提高螺钉的精确度,有利于功能康复.%Objective To study the treatment of anterior acetabular column fractures with minimally invasive percutaneous lag screws by C-arm X-ray fluoroscopy-based navigation. Methods Eight patients with no or mild shift of anterior acetabular column fractures were treated with minimally invasive percutaneous lag screw by C-arm X-ray fluoroscopy- based navigation in our department from March 2009 to September 2011. The fractures were classified as typeⅠin 4 patients, typeⅡin 3 patients, and typeⅢin 1 patient according to Nakatani classification. The time from fracture to operation was 2~7 days. Results Of the 8 patients with 10 screws inserted, 5 were males and 3 were females aged 19~69 years, 2 were diagnosed with bilateral anterior acetabular column fracture and 6 with unilateral anterior acetabular column fracture with 1 screw inserted, respectively. The patients were followed up for 10~26 months, during which their fractures were healed with no complications such as vascular and nerve injury except for mild shift in 1 patient. Conclusion Internal fixation of anterior acetabular column fractures with

  18. Bicondylar tibial fractures: Internal or external fixation?

    Directory of Open Access Journals (Sweden)

    Gunasekaran Kumar

    2011-01-01

    Full Text Available Bicondylar fractures of the tibia, representing the Schatzker V and VI fractures represent a challenging problem. Any treatment protocol should aim at restoring articular congruity and the metaphyseo-diaphsyeal dissociation (MDD-both of these are equally important to long-term outcome. Both internal and external fixations have their proponents, and each method of treatment is associated with its unique features and complications. We review the initial and definitive management of these injuries, and the advantages and disadvantages of each method of definitive fixation. We suggest the use of a protocol for definitive management, using either internal or external fixation as deemed appropriate. This protocol is based on the fracture configuration, local soft tissue status and patient condition. In a nutshell, if the fracture pattern and soft tissue status are amenable plate fixation (single or double is performed, otherwise limited open reduction and articular surface reconstruction with screws and circular frame is performed.

  19. The application of 3D printing technique in the research of acetabular fractures%3D打印应用于髋臼骨折数字化设计的实验研究

    Institute of Scientific and Technical Information of China (English)

    吴章林; 林海滨; 张国栋; 陆俭军; 陈宣煌; 黄华军; 黄文华

    2014-01-01

    Objective To evaluate the digital design of acetabular fractures and the feasibility of the implementation, then using the 3D printing technique to verify the results. Methods Fifty-two patients with acetabular fractures were enrolled in this study. Data of lamellar CT scanning were imported into Mimics14.0 software for 3D anatomical modeling and virtual fracture reduction. Then the default embedded steel plate location was optimized , the screw path evaluated,and the screw length measured. 3D printing technique was used to print the bone. Plates were bended based on the printing bones. Internal fixation implants were simulated based on all the printed bones and bended plates. Finally, the real operation was compared with virtual preoperative design in terms of the fixation position of plates, the direction and the length of screws. Results In the study, 61 plates and 424 screws were planted. The position of plates and the direction of screws were in high accordance with the digital design. The length of screws are compared with Paired-samples t Test and P=0.325. Conclusion Firstly, the combination of the digital design and 3D printing technique have a good application in the bending of the plates and surgery simulation before operation. The real operation is quite consistent with the simulated results. Secondly, plate bending before the real operation has a certain value in the guidance of fracture reduction.%目的:探讨髋臼骨折数字化设计及实施的可行性方案并以3D打印技术进行验证。方法采集52例临床髋臼骨折薄层CT扫描数据,在Mimics14.0中进行三维建模和虚拟骨折复位并在复位模型上优化预设植入钢板位置和虚拟钉道模拟、测量钉道长度,三维切割预设植入钢板部位骨块并3D打印,据此进行钢板折弯。将所有骨折块进行3D打印为实体模型结合折弯钢板进行内固定植入模拟。将钢板现实位置、螺钉方向和长度同数字化

  20. 前后联合入路治疗复杂髋臼骨折的疗效观察%Before or after Consociation Go into the Road Cure the Curative Effect Observation of Complicated Bone Fracture of Acetabular

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

      目的探讨前后联合入路治疗复杂髋臼骨折的临床疗效。方法回顾性分析2006年1月至2012年1月期间我院采用经髂腹股沟入路联合K-L入路手术治疗32例复杂髋臼骨折患者的临床资料。结果全部32例患者均顺利完成手术,无1例术中死亡,手术时间为(2.9±0.7)h,术中失血量为(820±190)mL,全部患者均获得1~3年随访,出现异位骨化者3例,髋臼复位满意率为93.8%,髋关节功能总优良率为90.6%。结论前后联合入路治疗复杂髋臼骨折疗效显著,具有暴露充分、复位方便、固定可靠、功能恢复好等优点,值得临床推广应用。% Objective Inquire into associately going into the clinical curative effect that the road cures complicated bone fracture of Acetabular before or after. Methods Look back sex to analyze January, 2006~January, 2012 period I hospital adoption through Ka stomach the ditch go into road consociation K-L go into the road surgical operation cure the bone fracture sufferer's clinical data of 32 complicated Acetabular. Results All 32 sufferers complete surgical operation smoothly and have no to die in a Shu, surgical operation time BE(2.9±0.7) h, lose the amount of blood as ml(820±190) in the Shu, all sufferers acquire for 1~3 years with visit, appear difference the bone turn 3, the Acetabular resets a satisfaction to lead to 93.8%, Acetabular joint the function Be always good to lead to 90.6%.Conclusion Before or after consociation go into the road cure complicated Acetabular bone fracture curative effect to show Zhao and have expose well and reset convenience, fix credibility, the function resume a good etc. advantage, worth clinical expansion application.

  1. 髋臼骨折术后残留移位与髋关节功能的相关性分析%CORRELATION ANALYSIS BETWEEN RESIDUAL DISPLACEMENT AND HIP FUNCTION AFTER RECONSTRUCTION OF ACETABULAR FRACTURES

    Institute of Scientific and Technical Information of China (English)

    马坤龙; 方跃; 栾富钧; 屠重棋; 杨天府

    2012-01-01

    目的 通过术后CT评价髋臼骨折复位质量,探讨累及负重区和非负重区的残留移位(台阶移位和间隙移位)与术后髋关节功能的相关性. 方法 回顾分析2004年6月-2009年6月48例髋臼骨折患者术后CT检查和临床随访结果.患者均行切开复位内固定.术后均获随访,随访时间24~72个月,平均36个月;骨折均愈合.根据关节面残留移位是否累及负重顶,将患者分为负重区组(30例)和非负重区组(18例).髋关节功能按Merle d'Aubigné-Postel标准评定;术后关节面复位质量采用CT评价,于CT片上测量残留移位的两个指标(台阶移位和间隙移位)最大值.所得数据均采用Spearman秩相关检验分析. 结果 负重区组残留移位值与髋关节功能成强负相关性(rs=-0.722,P=0.001);非负重区组残留移位值与髋关节功能无相关性(rs=0.481,P=0.059).临床随访结果与相关性分析一致.负重区组台阶移位值与髋关节功能成极强负相关(rs=-0.825,P=0.002),而间隙移位值与髋关节功能无相关性(rs=0.577,P=0.134). 结论 髋臼骨折患者术后髋关节功能不仅与关节面残留移位大小相关,还与残留移位部位相关.与非负重区相比,累及负重区的残留移位是影响术后髋关节功能的关键因素;在负重区台阶移位值越大,髋关节功能越差.%Objective To investigate the relationships between residual displacement of weight-bearing and non weight-bearing zones (gap displacement and step displacement) and hip function by analyzing the CT images after reconstruction of acetabular fractures. Methods The CT measures and clinical outcome were retrospectively analyzed from 48 patients with displaced acetabular fracture between June 2004 and June 2009. All patients were treated by open reduction and internal fixation, and were followed up 24 to 72 months (mean, 36 months); all fractures healed after operation. The residual displacement involved the weight-bearing zone in

  2. Osteopathic diagnosis of an acetabular injury.

    Science.gov (United States)

    Morthland, Tim; Cote, Nicholas S; Humphrey, Jon; Fulk, Doug

    2010-05-01

    Physical findings demarking pathologic somatovisceral reflex activity and fascial strain patterns may lead the osteopathic physician to diagnoses that are masked within the initial presentation of a patient. The authors present a case report that demonstrates the use of osteopathic principles in the diagnosis of a chronic acetabular fracture and acetabular labral tear in a 19-year-old man. The injuries resulted from a posterior hip dislocation sustained during a basketball game more than 1 year before presentation. Osteopathic manipulative treatment and diagnostic techniques also relieved the patient's persistent thoracic pain, nausea, and vomiting. Subsequent orthopedic repair had the potential to avert or delay degenerative hip disease in the patient. PMID:20538751

  3. Loosening After Acetabular Revision

    DEFF Research Database (Denmark)

    Beckmann, Nicholas A.; Weiss, Stefan; Klotz, Matthias C.M.;

    2014-01-01

    The best method of revision acetabular arthroplasty remains unclear. Consequently, we reviewed the literature on the treatment of revision acetabular arthroplasty using revision rings (1541 cases; mean follow-up (FU) 5.7 years) and Trabecular Metal, or TM, implants (1959 cases; mean FU 3.7 years)...

  4. Clinical applications for multiplanar- and three-dimensional-reconstructions by helical-CT for the diagnosis of acetabular fractures; Klinischer Einsatz multiplanarer und 3D-Rekonstruktionen der Spiral-CT in der Diagnostik der Azetabulumfrakturen

    Energy Technology Data Exchange (ETDEWEB)

    Stroszczynski, C. [Strahlenklinik und Poliklinik im Virchow-Klinikum, Medizinische Fakultaet der Humboldt-Universitaet, Berlin (Germany); Schedel, H. [Strahlenklinik und Poliklinik im Virchow-Klinikum, Medizinische Fakultaet der Humboldt-Universitaet, Berlin (Germany); Stoeckle, U. [Unfallchirurgische Klinik und Poliklinik im Virchow-Klinikum, Medizinische Fakultaet der Humboldt-Universitaet, Berlin (Germany); Wellmann, A. [Strahlenklinik und Poliklinik im Virchow-Klinikum, Medizinische Fakultaet der Humboldt-Universitaet, Berlin (Germany); Beier, J. [Deutsches Herzzentrum Berlin, Virchow-Klinikum, Abt. Innere Medizin und Kardiologie (Germany); Wicht, L. [Strahlenklinik und Poliklinik im Virchow-Klinikum, Medizinische Fakultaet der Humboldt-Universitaet, Berlin (Germany); Hoffmann, R. [Unfallchirurgische Klinik und Poliklinik im Virchow-Klinikum, Medizinische Fakultaet der Humboldt-Universitaet, Berlin (Germany); Felix, R. [Strahlenklinik und Poliklinik im Virchow-Klinikum, Medizinische Fakultaet der Humboldt-Universitaet, Berlin (Germany)

    1996-03-01

    This review describes recent visualizations of computed tomography for the diagnosis of acetabular fractures. The techniques of conventional and helical-CT for the imaging of the acetabulum are compared. Furthermore, the different methods of multiplaner and three-dimensional reconstructions e.g. shaded surface display, maximum intensity projection, and volume rendering are presented. Figures of multiplanar and three-dimensional imaging for fractures of the pelvis is discussed. (orig.) [Deutsch] Es wird eine Uebersicht moderner computertomographischer Darstellungsmethoden der Azetabulumfrakturen vorgestellt. Auf die einzelnen Charaktersitika der konventionellen und Spiral-CT-Technik wird eingegangen, weiterhin werden die multiplanaren und verschiedenen 3dimensionalen Rekonstruktionsverfahren Shaded-Surface-Display (SSD), Maximum-Intensitaetsprojektion (MIP) und Volume-Rendering (VR) beschrieben und jeweils anhand von Abbildungen erlaeutert. Darueber hinaus wird das diagnostische Potential der einzelnen Methoden diskutiert. (orig.)

  5. Classification to guide internal fixation for tibial fracture

    Institute of Scientific and Technical Information of China (English)

    ZHANG Wen-xi; ZHENG Zhi-liang; JI Yue-ping; QIAO Zhi-jun

    2008-01-01

    Objective: To explore a classification method which can provide the clinical guidance for internal fixation of tibial fracture. Methods: The different fractures were fixed according to their mechanical classification. Totally, 71 cases of tibial plateau fracture, tibial proximal fracture, tibial distal fracture and Pilon fracture were analyzed to test this selective principle. Results: All 71 patients were followed up for 6-32 months. The displacement was seldomly observed in cases treated acccording to the classification principle, while some cases against the principle had postoperative displacement. The difference was statistically significant (P<0.05). It was proved that there was remarkable correlation between tibial fracture classification, internal fixator and fixation methods. Conclusion: Types IIIa3, IIIbl and IIIb2 fractures without eccentric moment should be fixed with double plates or anglestable materials combined with locking structure, otherwise displacement may occur.

  6. Establishment of classified pelvic and acetabular fractures and their significance%骨盆髋臼骨折三维数字化分型系统的建立及其意义

    Institute of Scientific and Technical Information of China (English)

    王会祥; 汪方; 王秋根; 林艳萍; 陈豪; 陶星光

    2013-01-01

    目的 建立骨盆、髋臼骨折三维数字化分型系统,评价其对骨科临床及教学的指导意义.方法 将一名健康男性志愿者CT扫描所得数据转换成DICOM格式并导入Mimics10.01软件中进行处理,分别重建骨盆、髋臼模型,同时模拟出国际内固定研究学会(A0)分型中各型骨盆、髋臼骨折,对各骨折块予以不同颜色渲染,并将完成制作的骨折三维模型以标准三维图形(STL)文件格式保存.利用视觉化图像工具库(VTK)及跨平台C+ +图形用户界面应用程序开发框架(Qt)等软件开发工具,完成骨盆、髋臼骨折三维数字化分型软件开发.10名骨科医生及20名医学生分别将三维数字化骨盆、髋臼骨折AO分型图谱和传统的二维分型图谱与患者影像学资料进行对比,并给予初步评价.结果 骨盆、髋臼骨折三维数字化分型软件可实现对骨折三维模型的旋转及放缩等操作,从任意角度观察骨折模型.9名骨科医生及18名医学生评价提示,三维数字化骨折分型系统与传统的二维平面分型系统相比,利于对骨盆、髋臼骨折AO分型的理解和判断.结论 骨盆、髋臼骨折三维数字化分型系统具有逼真、直观、立体、动态等特点,对于骨科临床及医学教学具有积极意义.%Objective To establish three-dimensional (3D) digital classification models of pelvic and acetabular fractures and evaluate its significance in orthopaedic clinical and teaching work. Methods Pelvic of a healthy male volunteer was scanned with CT, and the resulting data in DICOM format was imported to Mimics10. 01 software to reconstruct the model of the pelvis and acetabulum respectively. Based on the standards of AO/ASIF classification of pelvic and acetabular fractures, various types of fractures were simulated. The fracture fragments were displayed with different colors. The completed fracture models were saved in STL format. By use of VTK and Qt softwares, the software

  7. Measurements of the posterior acetabular surface and design of a new anatomical locking plate for acetabular fractures%髋臼后表面解剖形态测量及新型解剖锁定钢板的设计

    Institute of Scientific and Technical Information of China (English)

    张里程; 张立海; 许猛; 尹鹏; 赵喆; 吕厚辰; 尹鹏滨; 唐佩福

    2014-01-01

    directions of screws preset completely avoided the acetabulum.Conclusion The new type of anatomical locking plate we designed provides a new choice for the treatment of acetabular fractures,because it perfectly fits the anatomic shape of the posterior acetabular wall and presets reasonable directions of the locking screws to ensure better stability and safety of the fixation.%目的 基于髋臼后表面的三维重建解剖形态数据库,自行设计符合髋臼后表面形态且具有成角稳定作用的新型解剖锁定钢板. 方法 共纳入171例全骨盆,男100例,女71例;年龄18 ~ 60岁,平均45.9岁;将所有骨盆.dicom格式的影像学资料导入Mimics 10.0版软件进行三维重建及编辑,并保存为.stl格式文件,再导入Imageware V12.1软件,设立髋臼表面标准点、标准平面后进行图像分割和测量,得到髋臼后表面的点云数据库,并通过该点云数据库拟合形成髋臼后表而曲面,以设计锁定钢板形态和角度锁定螺钉系统最后,将设计好的钢板和螺钉数据输入数码铣床获得实体钢板. 结果 男、女髋臼直径平均分别为(57.6±2.9) mm、(52.6 ±2.6)mm,髋臼后壁宽度平均分别为(40.7±2.9)mm、(38.4±2.4) mm,以上项目男女之间比较差异均有统计学意义(P<0.05);但采用1/10髋臼直径(d)作为度量单位标准化后,男、女髋臼后壁宽度平均分别为(7.10±0.52)个d/10单位、(7.16±0.47)个d/10单位,差异无统计学意义(P>0.05).设计的新型髋臼解剖锁定钢板与云数据库所拟合的髋臼后表面曲面吻合好,钢板偏离骨表面的平均距离为(3.2±1.0)mm.而且随机抽取髋臼样本三维图像与设计的钢板图像完全吻合.预设的螺钉打入方向可完全避让髋臼. 结论 设计的髋臼新型解剖锁定钢板解剖形态匹配性好,锁定螺钉成角稳定性强,可完全避开髋臼方向,安全性高,为复杂髋臼骨折的治疗提供了新的选择.

  8. Complications of internal fixation of maxillofacial fractures with microplates

    NARCIS (Netherlands)

    Schortinghuis, J; Bos, RRM; Vissink, A

    1999-01-01

    Purpose: The aim of this retrospective study was to evaluate the complications of open reduction and internal fixation of maxillofacial fractures with microplates. Patients and Methods: In 44 patients with maxillofacial trauma, fractures of the maxillofacial skeleton were treated by open reduction a

  9. Virtual operation planning in orthopedic surgery for acetabular fractures based on real CT data%基于真实CT数据骨科虚拟手术计划在髋臼骨折手术中的运用

    Institute of Scientific and Technical Information of China (English)

    汪光晔; 张春才; 许硕贵; 薜双桃; 林清高

    2011-01-01

    BACKGROUND: Virtual operation planning can help surgeons to improve the accuracy of orthopedic operations. OBJECTIVE:To test the feasibility and clinical value of preoperative virtual surgical planning in pelvis and acetabular fractures using Mimics software based on an interactive virtual reality-style environment.METHODS: Thirteen patients with pelvis and acetabular fractures were scanned with spiral CT preoperatively. The real data from CT in DICOM format were transformed into Mimics software. With segmentation process, each fracture segment became a separate object. Bone fragments could be moved and rotated in all three planes and reduction was performed Then we performed all the steps of the surgical procedure.RESULTS AND CONCLUSION: The median time needed to segment the osseous parts of an entire pelvis and to extract a surface model was 45 minutes (ranging 30 to 70 minutes), and the median time for fracture reduction was 28 minutes (ranging 16 to 45 minutes). The planned approach was followed in 12 of the 13 cases, the planned fixation was followed completely in 12 cases and partially in 1 cases. The screw count was identical to the planned operation in 10 cases, the screw length was Identical in 8 cases, and fixation plate count was Identical in 11 cases. Postoperative congruence of the acetabular joint surface as determined according to Matta in the follow-up CT was anatomic in 6 cases (46%) and satisfactory In 7 cases (54%). There was no case with inadvertent penetration of the hip joint Virtual operation planning in orthopedic surgery is helpful for enacting accurate operation program and providing data reference for actual operation, which brings significant value and new opportunities in clinical practice.%背景:骨科虚拟手术计划有助于提高外科医生的手术精确性.目的:探索计算机术前模拟手术技术在骨盆、髋臼骨折的治疗中的应用方法及临床价值.方法:对13例骨盆及髋臼骨折患者进行螺旋CT影

  10. Pelvic Discontinuity Caused by Acetabular Overreaming during Primary Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Iori Takigami

    2011-01-01

    Full Text Available Intraoperative acetabular fracture is a rare complication of primary total hip arthroplasty (THA, typically occurring during impaction of the cementless acetabular component. Here we report an unusual case of pelvic discontinuity caused by overreaming of the acetabulum during primary THA. Restoration of posterior columnar continuity was achieved with an autologous fibular graft and a reconstruction plate. Wall defects and cavitary defects were reconstructed with metal mesh and femoral head allograft, followed by placement and fixation of a Kerboull-type acetabular reinforcement device. Previous reports of acetabular fracture during THA have indicated that it has a relatively good prognosis without extensive treatment. However, to our knowledge, there has been no report of pelvic discontinuity necessitating acetabular reconstruction surgery as an intraoperative complication of primary THA.

  11. 髋臼横行骨折采用前后柱拉力螺钉结合重建钢板固定疗效分析%Analysis of the Effect of the Acetabular Transverse Fracture Using the Lag Screw of the Acetabulum and the Reconstruction Plate With the Reconstruction Plate

    Institute of Scientific and Technical Information of China (English)

    张立峰; 冯卫; 包道日娜; 冬梅; 佟雁翔

    2015-01-01

    Objective To investigate the clinical effect of the application of the acetabular transverse fracture in the treatment of the acetabular fracture and the reconstruction of the plate fixation with the lag screw of the acetabulum. Methods 50 cases of patients with transverse acetabular fracture were selected,and subject to acetabular posterior column lag screw combined with reconstruction plate fixation treatment,Bleeding volume,operation time, the acetabulum repositioning and hip joint function recovery after surgical of patients were observed. Results The average operation time was 3.5 hours, the average amount of bleeding was 950ml, according to Matta reduction, 25 cases of anatomic reduction, satisfactory reduction in 21 cases, 4 cases of unsatisfactory reduction, and the excellent and good rate of hip joint function was 86.0%. Conclusion The clinical effect of the acetabular transverse fracture patients with the acetabular anterior and posterior column lag screw combined with the reconstruction plate fixation is worthy of promotion.%目的:探讨对髋臼横行骨折患者应用髋臼前后柱拉力螺钉结合重建钢板固定治疗的临床疗效。方法选取髋臼横行骨折患者50例,对其进行髋臼前后柱拉力螺钉结合重建钢板固定手术治疗,观察患者手术时出血量、手术时间等,手术治疗后患者髋臼复位情况以及髋关节功能恢复情况。结果平均手术时间为3.5小时,平均出血量为950 ml,根据 matta 复位,25例解剖复位,21例满意复位,4例复位不满意,髋关节功能优良率为86.0%。结论对髋臼横行骨折患者采取髋臼前后柱拉力螺钉结合重建钢板固定手术治疗临床疗效突出。

  12. 髋臼骨折病态肥胖对内固定术后并发症的影响%Acetabular fractures Impact of morbid obesity on complications afier fixation

    Institute of Scientific and Technical Information of China (English)

    Andrea C Skelly

    2011-01-01

    SummaryThree retrospective cohort studies of patients with acetabular fractures examined the impact of morbid obesity on patient complications after operative fracture fixation.The morbidly obese patient appears to have an elevated risk of more perioperative blood loss and of wound infection. While a higher rate of nerve palsy and pulmonary embolism was reported among morbidly obese patients compared with those in other weight categories in all studies, statistical significance was not achieved.One study reported increased risk of deep vein thrombosis (DVT) for obese patients compared with normal-weight patients.3项回顾性队列研究试图阐明髋臼骨折内固定术后,患者合并病态肥胖对术后并发症的影响。研究显示病态肥胖的患者术中失血量和伤口感染率更高。虽然与其他体质量的患者相比,病态肥胖的患者出现神经麻痹和肺栓塞的几率更高,但差异无统计学意义。1项研究报道,与正常体质量患者相比,肥胖患者深静脉血栓形成(DVT)的发生率更高。

  13. Biomechanical Study of Acetabular Tridimensional Memoryalloy Fixation System

    Science.gov (United States)

    Liu, Xin-Wei; Xu, Shuo-Gui; Zhang, Yun-Tong; Zhang, Chun-Cai

    2011-07-01

    We developed the acetabular tridimensional memoryalloy fixation system (ATMFS), which is made of NiTi shape memory alloy, according to the specific mechanical properties of biological memory material, NiTi shape memory alloy and measured distribution of contact area and pressure between the acetabulum and the femoral head of cadaveric pelvis. Seven formalin-preserved cadaveric pelves were used for this investigation. Pressure-sensitive film was used to measure contact area and pressure within the anterior, superior, and posterior regions of the acetabulum. The pelves were loaded under the following four conditions: (1) intact; (2) following a creation posterior wall fracture defect; (3) following reduction and standard internal fixation with reconstruction plate; and (4) following reduction and internal fixation with a new shape memory alloy device named ATMFS. A posterior wall fracture was created along an arc of 40° to 90° about the acetabulur rim. Creation of a posterior wall defect resulted in increased load in the superior acetabulum (1485 N) as compared to the intact condition (748 N, P = 0.009). Following reduction and internal fixation, the load distributed to the superior acetabulum (1545 N) was not statistically different from the defect condition. Following the fixation with ATMFS, the load seen at the superior region of the actabulum (964 N) was familiar with fixation with reconstruction plate and was not different from intact state ( P = 0.45). These data indicate that the use of ATMFS as a fracture internal fixation device resulted a partial restoration of joint loading parameters toward the intact state. ATMFS fixation may result in a clinical benefit.

  14. Internal plate fixation versus plaster in displaced complete articular distal radius fractures, a randomised controlled trial

    NARCIS (Netherlands)

    M.A.M. Mulders (Marjolein A. M.); M.M.J. Walenkamp (Monique); J.C. Goslings (Carel); N.W.L. Schep (Niels)

    2016-01-01

    textabstractBackground: Of all distal radius fractures, 25 % are complete articular fractures (AO/OTA type C fractures). Two thirds of those fractures are displaced and require reduction. According to several International Guidelines, adequately reduced intra-articular distal radius fractures are be

  15. Open reduction and internal fixation of radial head fractures.

    Science.gov (United States)

    King, G J; Evans, D C; Kellam, J F

    1991-01-01

    Open reduction and internal fixation of displaced fractures of the radial head were reviewed in 14 elbows. Follow-up averaged 32 months. The average elbow score for Mason type II fractures was 96.8 points, corresponding to 100% good or excellent results. Average flexion was 142.5 degrees, and the mean fixed flexion deformity was 3.9 degrees. There was no loss in grip strength. An almost normal elbow was the expected result. Good or excellent results were achieved in only 33% of Mason type III fractures treated with open reduction and internal fixation. The average elbow score was 72.9 points, and this was statistically significantly different than the Mason type II fractures (p less than 0.05). An associated elbow dislocation did not affect the results significantly, but was associated with a slightly increased fixed flexion deformity. Fractures may be more comminuted than suggested by plain radiographs, and intraoperative decision making is required in deciding between reconstruction or excision of the radial head. Excellent results were obtained provided an anatomical reduction with stable fixation and early range of motion were achieved. If a stable anatomic reduction cannot be obtained, then alternative treatment methods should be considered. PMID:2023039

  16. 经髂腹股沟和Kocher-Langenbeck联合入路治疗复杂移位髋臼骨折%Treatment of complex acetabular fractures with combined ilio-inguinal and Kocher-Langenbeck approach

    Institute of Scientific and Technical Information of China (English)

    连鸿凯; 李兴华; 王爱国; 白玉

    2011-01-01

    Objective To investigate the clinical effect and treatment experience of complicated acetabular fractures treated with open reduction with combined ilio-inguinal and Kocher-Langenbeck (K-L) approaches.Methods Sixty-six patients with complicated acetabular fractures were treated surgically with combined ilio-inguinal and K-L approaches from February 2004 to December 2009.Among them,45 cases were followed up for 8-45 months,with the average 26 months.Results Operation time was 1.4-5.7 h,with the average of 2.8 h.Intraoperative blood loss was 530-2300 ml,with the average of 1250 ml.According to Matta's score system,the excellent and good rate was 86.7%.According to modified Merle d' Aubigne and Postel score system,the excellent and good rate of function of hip was 86.7%.According to Brooker heterotopic ossification standard assessment system:Ⅰ degrees in 6,Ⅱ degrees in 3.According to Letournel and Judet clinical classification system,postoperative traumatic arthritis were 6 patients.Among them,3 patients with Ⅲ- Ⅴ period with symptoms of serious hip pain and joint activities obstacles were treated with total hip replacement secondly.Six cases of sciatic nerve injury and 9 cases of lateral femoral cutaneous nerve damage were recovered gradually after six months to a year.All incisions healed primarily.All got bony union,the healing time was 8 to 16 weeks,with the average of 10.4 weeks.None was complicated with femoral head necrosis.Conclusion For the patients with complicated acetabular fractures,open reduction with combined ilio-inguinal and K-L approaches can get clinical advantages of revealed fully,fracture restoration convenient,fixed tightly,fewer complications and satisfactory result.%目的 探讨采用经髂腹股沟和Kocher-Langenbeck(K-L)联合入路行切开复位内固定治疗复杂移位髋臼骨折的疗效.方法2004年2月至2009年12月,采用经髂腹股沟和K-L联合入路治疗66例复杂移位髋臼骨折,对其中获得随访的45

  17. Internal Fixation of Open Ankle Fracture. Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Yaniel Truffin Rodríguez

    2014-10-01

    Full Text Available Open ankle fracture is sporadically seen in the orthopedic practice. Its clinical course is subject to multiple factors, showing a propensity to cause ankle osteoarthritis over the years. Two cases treated at the Dr. Gustavo Aldereguía Lima University General Hospital in Cienfuegos are presented. The patients underwent emergency surgical treatment consisting of surgical cleaning of the open wound, reduction of the dislocation and internal fixation of the fracture. These cases are presented due to the infrequency of this type of ankle injury and its importance for the medical staff, especially orthopedic doctors.

  18. RESORBABLE HIGH-STRENGTH ROD FOR FRACTURE INTERNAL FIXATION

    Institute of Scientific and Technical Information of China (English)

    杨团民; 刘淼; 杨爱玲; 石宗利; 邱希江; 李毅; 同志超; 韩月

    2004-01-01

    Objective To find an ideal biomaterial for internal fixation. Methods Forty rabbits with fracture of the femur diaphysis (superiorcondyle) were treated by intramedullary nailing of femur with composites rod of resorbable DL-polylactic acid (PDLLA)-calcium metaphosphate (CMP), while steinmann's pin as control. The fracture healing, the material degradation and its mechanical properties were studied by X-ray films, macroscopic, microscopic and electron microscopic observations. Results No significant inflammatory reaction was found, and all the osteotomies were healed, while material was resorbed. Conclusion The PDLLA-CMP has excellent biocompatibility and mechanical properties, and it can be a promising implant material in orthopaedics surgery.

  19. Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution

    OpenAIRE

    Leonidou, Andreas; Chettiar, Krissen; Graham, Simon; Akhbari, Pouya; Antonis, Konstantinos; Tsiridis, Eleftherios; Leonidou, Omiros

    2014-01-01

    Lateral humeral condyle fractures account for 17 % of the distal humeral condyle fractures. Displaced and/or rotated fractures require appropriate reduction and stabilisation. There are, however, a number of controversies in the surgical management of these patients. The aim of the present study was to review the results of patients with a displaced lateral humeral condyle fracture treated with open reduction and internal fixation (ORIF). We retrospectively reviewed children treated with ORIF...

  20. Minimally invasive plate internal fixation for calcaneal fractures

    Institute of Scientific and Technical Information of China (English)

    SHAN Shu-lan; XU Jun-ling; YAO Shu-zhang; YU Guo-sheng; LIU Yu-qin

    2010-01-01

    Objective: To assess the clinical efficacy of minimally invasive plate internal fixation for the treatment of calcaneal fractures.Methods: Manual reduction, rectification of deformity,and cold compress with traditional Chinese medicine were used preoperatively to relieve swelling and pain. A small incision was made to expose the articular facet and to perform anatomic reduction and plate fixation. Self-made traditional Chinese pharmaceutics were applied postoperatively on the surface of the wound to accelerate bony union.Results: All the 40 patients were followed up for at least 1 year postoperatively. According to the Maryland scoring system, the excellent and good rate was 87.5%.Conclusion: Minimally invasive plate internal fixation has the advantages of relatively mild injury, reliable fixation,good recovery, and rare complications in the treatment of intraarticular fractures.

  1. Bilateral traumatic proximal humerus fractures managed by open reduction and internal fixation with locked plates

    Directory of Open Access Journals (Sweden)

    Jaiswal Atin

    2013-12-01

    Full Text Available 【Abstract】Fractures of the proximal humerus are uncommon in young patients. Although bilateral fracture of proximal humerus itself is rare, association with epilepsy and electrocution is frequent. Only one case of traumatic bilateral proximal humerus fracture has been reported in the literature. We report a rare case of bilateral traumatic dis- placed proximal humerus fractures in a 40 years old male patient, which was treated by means of open reduction and internal fixation with proximal humerus locked pates on both sides and obtained a good functional outcome. Key words: Humeral fractures; Shoulder fractures; Fracture fixation, internal

  2. Reconstruction of internal orbital fractures with Vitallium mesh.

    Science.gov (United States)

    Sargent, L A; Fulks, K D

    1991-07-01

    Trauma to the face frequently results in internal orbital fractures that may produce large orbital defects involving multiple walls. Accurate anatomic reconstruction of the bony orbit is essential to maintain normal appearance and function of the eye following such injuries. Autogenous bone grafts do not always produce predictable long-term support of the globe. Displacement and varying amounts of bone-graft resorption can lead to enophthalmos. This study examines the use of Vitallium mesh in the acute reconstruction of internal orbital defects. Fifty-four patients with 66 orbits underwent reconstruction of internal orbital defects with Vitallium mesh. Associated fractures were anatomically reduced and rigidly fixed. Forty-six patients and 57 orbits had adequate follow-up for analysis of results. The average follow-up was 9 months, with 85 percent of the patients followed 6 months or longer. There were no postoperative orbital infections, and none of the Vitallium mesh required removal. Large internal orbital defects can be reconstructed using Vitallium mesh with good results and little risk of infection. Vitallium mesh appears to be well tolerated in spite of free communication with the sinuses. Stable reconstruction of the internal orbit can be achieved and predictable eye position maintained without donor-site morbidity.

  3. 3D visualization of the Letournel-Judet clssification of acetabular fractures based on a desktop virtual reality%基于桌面虚拟现实技术实现髋臼骨折Letournel-Judet分类的三维浏览

    Institute of Scientific and Technical Information of China (English)

    苏秀云; 刘蜀彬; 裴国献

    2011-01-01

    目的 介绍使用HTML和虚拟现实建模语言(VRML)建立通过Web远程访问的髋臼骨折Letournel-Judet分类三维数字化浏览. 方法 首先,根据髋臼骨折Letounel-Judet分型,将重建的1例女性志愿者髋部骨骼模型通过Mimics软件的仿真模块切割模拟每一种骨折类型,将每一种骨折类型的骨折块以虚拟现实建模语言的格式.wrl导出.其次,编辑html网页,为每个骨折块建一个主菜单,每个主菜单设立调整透明度(透明、恢复、隐藏和显示)的子菜单.最后,编辑VRML文件,基于JavaScript语言建立 HTML与 VRML的通迅,实现各种骨折类型骨折块不同透明度的任意组合显示.结果 建立了髋臼骨折Letournel-Judet三维数字化分类系统(它分为5个部分),可以方便的通过远程网络访问.结论 该方法可以方便地应用于临床,提供对髋臼骨折的诊断与分析功能,使临床医生在极短的时间内可以对各类骨折的发生状况做出正确诊断.%Objective To establish a 3D atlas of Letournel-Judet classifications of acetabular fractures which provides remote access on the web through hypertext markup language (HTML) and virtual reality modeling language (VRML) for efficient remote diagnosis. Methods Firstly,different Letournel-Judet classifications of acetabular fracture were simulated based on 3D reconstruction models of healthy volunteers via Mimics software.The files of VRML format were exported after geometry modeling.Secondly,The.wrl files were edited by adding nodes of Sensor,Route,and Script to the files to make the static scene respond to users' interaction.Finally,the homepage of 3D atlas was established with the Dreamweaver software.Results The 3D atlas of Letournel-Judet classifications of acetabular fractures was established which can be accessed online.These virtual worlds can be browsed via the Internet and hyperlinked with the World Wide Web. Conclusion The 3D atlas of Letournel-Judet classifications of

  4. Comparison of acetabular reamings during hip resurfacing versus uncemented total hip arthroplasty.

    LENUS (Irish Health Repository)

    Brennan, S A

    2009-04-01

    PURPOSE: To compare the quantity of bone removed from the acetabulum during resurfacing hip arthroplasty versus uncemented total hip arthroplasty (THA). METHODS: 62 consecutive patients with osteoarthritis of the hip were prospectively studied. 24 men and 7 women aged 40 to 86 (mean, 59) years underwent Birmingham hip resurfacing. 13 men and 18 women aged 34 to 88 (mean, 61) years underwent uncemented THA using the trident acetabular cup. Obese elderly women at risk of femoral neck fracture and patients with large subchondral pseudocysts or a history of avascular necrosis of the femoral head were assigned to uncemented THA. Acetabular reamings were collected; marginal osteophytes were not included. The reamings were dehydrated, defatted, and weighed. RESULTS: The mean weight of acetabular reamings was not significantly different between patients undergoing hip resurfacing and uncemented THA (p=0.57). CONCLUSION: In hip resurfacing, the use of an appropriately small femoral component avoids oversizing the acetabular component and removal of excessive bone stock.

  5. Open reduction and internal fixation of proximal humerus fractures.

    Science.gov (United States)

    Drosdowech, Darren S; Faber, Kenneth J; Athwal, George S

    2008-10-01

    Open reduction of proximal humeral fractures has the advantage of providing direct control over each fracture fragment and permitting anatomic reduction and fixation with advanced devices. Modern fixed-angle locking plates designed specifically for proximal humerus fractures have allowed the expansion of surgical indications permitting surgeons to address more complicated fractures. Advanced preoperative imaging and fluoroscopy allow a better understanding of fracture patterns and permit the surgeon to use this knowledge intraoperatively. Research is required to further validate fracture classification systems, to develop surgical guidelines for decision making, and to compare the outcomes of the various treatments options for proximal humerus fractures.

  6. Displaced tibial shaft fractures treated with ASIF compression internal fixation

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Larsen, T K; Petersen, O C

    1990-01-01

    Fifty-one tibial shaft fractures treated by ASIF compression osteosynthesis were seen at follow-up at a median time of 46 weeks after injury. Twenty-four were open fractures and the patients received prophylactic antibiotics. The median stay in hospital was 15 days for open fractures and 6 days...... for closed fractures. There were complications in 26 cases, with deep infection in 9 cases. At present we cannot advocate the use of ASIF compression osteosynthesis for displaced tibial fractures....

  7. Options for acetabular fixation surfaces.

    Science.gov (United States)

    Klika, Alison K; Murray, Trevor G; Darwiche, Hussein; Barsoum, Wael K

    2007-01-01

    Aseptic loosening is the most common cause for revision total hip arthroplasty (THA). Due to poor long-term results with cemented acetabular components, cementless implants that rely on biologic fixation became popular in the United States for both primary and revision procedures in the early 1980s. Cementless acetabular components used in THA have been reported to have superior radiographic performance compared with cemented fixation, although the optimal method of acetabular fixation remains controversial. Cementless acetabular components require initial implant stability to allow for bone ingrowth and remodeling into the acetabular shell, providing long-term durability of the prosthesis. Many improved implant materials are available to facilitate bone growth and remodeling, including the 3 most common surface treatments; fibermesh, sintered beads, and plasma spray coatings. Recently added to these are porous metal surfaces, which have increased porosity and optimal pore sizes when compared with titanium fibermesh. The most studied of these materials is the titanium fibermesh fixation surface, which has demonstrated a mechanical failure rate of 1% at 10 to 15 years. This technology utilizes the diffusion bonding process to attach fiber metal pads to a titanium substrate using heat and pressure. The sintered bead fixation surface offers a porous coating of various sizes of spherical beads, achieved by the sintering process, and has been shown to provide long-term fixation. While there are less long-term published data regarding the titanium plasma spray surface, its early results have provided evidence of its durability, even in the face of significant osteolysis. The most recently added alternative fixation surface is porous tantalum metal, which offers potentially greater bone ingrowth and bone graft incorporation due to its high porosity (80%) and low modulus of elasticity (3 MPa). Porous tantalum implants have shown early favorable clinical results and have

  8. Options for acetabular fixation surfaces.

    Science.gov (United States)

    Klika, Alison K; Murray, Trevor G; Darwiche, Hussein; Barsoum, Wael K

    2007-01-01

    Aseptic loosening is the most common cause for revision total hip arthroplasty (THA). Due to poor long-term results with cemented acetabular components, cementless implants that rely on biologic fixation became popular in the United States for both primary and revision procedures in the early 1980s. Cementless acetabular components used in THA have been reported to have superior radiographic performance compared with cemented fixation, although the optimal method of acetabular fixation remains controversial. Cementless acetabular components require initial implant stability to allow for bone ingrowth and remodeling into the acetabular shell, providing long-term durability of the prosthesis. Many improved implant materials are available to facilitate bone growth and remodeling, including the 3 most common surface treatments; fibermesh, sintered beads, and plasma spray coatings. Recently added to these are porous metal surfaces, which have increased porosity and optimal pore sizes when compared with titanium fibermesh. The most studied of these materials is the titanium fibermesh fixation surface, which has demonstrated a mechanical failure rate of 1% at 10 to 15 years. This technology utilizes the diffusion bonding process to attach fiber metal pads to a titanium substrate using heat and pressure. The sintered bead fixation surface offers a porous coating of various sizes of spherical beads, achieved by the sintering process, and has been shown to provide long-term fixation. While there are less long-term published data regarding the titanium plasma spray surface, its early results have provided evidence of its durability, even in the face of significant osteolysis. The most recently added alternative fixation surface is porous tantalum metal, which offers potentially greater bone ingrowth and bone graft incorporation due to its high porosity (80%) and low modulus of elasticity (3 MPa). Porous tantalum implants have shown early favorable clinical results and have

  9. Treatment of severe bone deficiency in acetabular revision surgery using a reinforcement device and bone grafting

    Institute of Scientific and Technical Information of China (English)

    ZHAI Ji-liang; LIN Jin; JIN Jin; QIAN Wen-wei; WENG Xi-sheng

    2011-01-01

    Background Severe acetabular bone deficiency is a major challenge in acetabular revision surgery. Most cases require reconstruction of the acetabulum with bone grafting and a reinforcement device. The purpose of this study was to evaluate the results of this procedure for severe acetabular bone deficiency in acetabular revision surgery.Methods This study involved 12 patients (2 males and 10 females) with severe acetabular bone defects who underwent implantation of a reinforcement device (ring or cage) and bone grafting between February 2003 and October 2008. Using the Paprosky classification, 2 cases were Paprosky ⅡC, 6 were ⅢA, and 4 were ⅢB. The mean age at the time of surgery was 63.0 years (range, 46-78 years). During revision surgery, a reinforcement ring was implanted in 6patients, and a cage in 6 patients. The clinical and radiographic results were evaluated retrospectively. The mean duration of follow-up was 37 months (range, 9-71 months).Results The average Harris Hip Score improved from 35.2 preoperatively to 82.9 at the time of the final follow-up visit.The results were excellent in 8 hips (66.7%), good in 2 (16.7%), and fair in 2 (16.7%). Osteolysis was found in 1 case, but did not worsen. Three patients had yellow wound effusion, with healing after administration of dressing changes,debridement, and antibiotics. Dislocation occurred in a 62-year-old woman. Closed reduction was performed, and dislocation did not recur. There was no evidence of intraoperative acetabular fracture, nerve injury, ectopic ossification,aseptic loosening, or infection.Conclusion Reconstruction with a reinforcement device and bone grafting is an effective approach to the treatment of acetabular bone deficiency in acetabular revision surgery, given proper indications and technique.

  10. Common site of subchondral insufficiency fractures of the femoral head based on three-dimensional magnetic resonance imaging

    International Nuclear Information System (INIS)

    The objective of this study was to investigate the common sites of subchondral insufficiency fractures of the femoral head (SIF) based on three-dimensional (3-D) reconstruction of MR images. In 33 hips of 31 consecutive patients diagnosed with SIF, 3-D reconstruction of the bone, fracture, and acetabular edge was performed using MR images. These 3-D images were used to measure the fractured areas and clarify the positional relationship between the fracture and degree of acetabular coverage. The fractured area in the anterior portion was significantly larger than in the posterior area. In 11 cases, the fractures contacted the acetabular edge and were distributed on the lateral portion. The indices of acetabular coverage (center-edge angle and acetabular head index) in these cases were less than the normal range. In the remaining 22 cases, the fractures were apart from the acetabular edge and distributed on the mediolateral centerline of the femoral head. The majority of these cases had normal acetabular coverage. The common site of SIF is the anterior portion. In addition, two types of SIF are proposed: (1) Lateral type: the contact stress between the acetabular edge and lateral portion of the femoral head causes SIF based on the insufficient acetabular coverage, and (2) Central type: the contact stress between the acetabular surface and the mediolateral center of the femoral head causes SIF independent from the insufficiency of acetabular coverage. These findings may be useful for considering the treatment and prevention of SIF. (orig.)

  11. Common site of subchondral insufficiency fractures of the femoral head based on three-dimensional magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Iwasaki, Kenyu; Yamamoto, Takuaki; Motomura, Goro; Karasuyama, Kazuyuki; Sonoda, Kazuhiko; Kubo, Yusuke; Iwamoto, Yukihide [Kyushu University, Department of Orthopaedic Surgery Graduate School of Medical Sciences, Higashi-ku, Fukuoka (Japan)

    2016-01-15

    The objective of this study was to investigate the common sites of subchondral insufficiency fractures of the femoral head (SIF) based on three-dimensional (3-D) reconstruction of MR images. In 33 hips of 31 consecutive patients diagnosed with SIF, 3-D reconstruction of the bone, fracture, and acetabular edge was performed using MR images. These 3-D images were used to measure the fractured areas and clarify the positional relationship between the fracture and degree of acetabular coverage. The fractured area in the anterior portion was significantly larger than in the posterior area. In 11 cases, the fractures contacted the acetabular edge and were distributed on the lateral portion. The indices of acetabular coverage (center-edge angle and acetabular head index) in these cases were less than the normal range. In the remaining 22 cases, the fractures were apart from the acetabular edge and distributed on the mediolateral centerline of the femoral head. The majority of these cases had normal acetabular coverage. The common site of SIF is the anterior portion. In addition, two types of SIF are proposed: (1) Lateral type: the contact stress between the acetabular edge and lateral portion of the femoral head causes SIF based on the insufficient acetabular coverage, and (2) Central type: the contact stress between the acetabular surface and the mediolateral center of the femoral head causes SIF independent from the insufficiency of acetabular coverage. These findings may be useful for considering the treatment and prevention of SIF. (orig.)

  12. Treatment of Edentulous Mandibular Fractures with Rigid Internal Fixation: Case Series and Literature Review

    OpenAIRE

    Franciosi, Edgardo; Mazzaro, Eduardo; Larranaga, Juan; Rios, Alfredo; Picco, Pedro; Figari, Marcelo

    2014-01-01

    The aim of the study is to analyze the effectiveness of rigid internal fixation (RIF) for treating edentulous mandibular fractures. Because of the low incidence of fractures in edentulous mandible, there is no consensus of the optimal treatment for it. This study included all edentulous patients with mandibular fracture diagnosis, who were treated with internal fixation at the Hospital Italiano de Buenos Aires from November 1991 to July 2011. Data such as age, gender, etiology and location of...

  13. Treatment of proximal humeral fractures with open reduction and internal fixation with Kirschner wires

    OpenAIRE

    Esenyel, Cem Zeki; Yesiltepe, Ridvan; Bulbul, Murat; Bagriacik, Adnan; Kara, Ayhan Nedim

    2004-01-01

    Objectives: We evaluated the results of patients who were treated with open reduction and internal fixation for displaced proximal humeral fractures. Methods: Sixteen patients (mean age 49.31 years, range 22 to 78 years) with displaced proximal humeral fractures were treated by open reduction and internal fixation with Kirschner wires. According to the Neer classification, three patients had type II, 11 patients had type III, and two patients had type IV fractures. The mean duration betwee...

  14. Persistent knee complaints after retrograde unreamed nailing of femoral shaft fractures

    NARCIS (Netherlands)

    El Moumni, Mostafa; Schraven, Pim; ten Duis, Henk Jan; Wendt, Klaus

    2010-01-01

    Retrograde nailing is an attractive method for stabilisation of femoral shaft fractures in cases of polytrauma, ipsilateral pelvic, acetabular, tibial and femoral neck fractures, bilateral femoral fractures, obese and pregnant patients. However, retrograde nailing may result in complaints about the

  15. Evaluating the effect of internal aperture variability on transport in kilometer scale discrete fracture networks

    Science.gov (United States)

    Makedonska, Nataliia; Hyman, Jeffrey D.; Karra, Satish; Painter, Scott L.; Gable, Carl W.; Viswanathan, Hari S.

    2016-08-01

    The apertures of natural fractures in fractured rock are highly heterogeneous. However, in-fracture aperture variability is often neglected in flow and transport modeling and individual fractures are assumed to have uniform aperture distribution. The relative importance of in-fracture variability in flow and transport modeling within kilometer-scale field-scale fracture networks has been under a matter of debate for a long time because the flow in each single fracture is controlled not only by in-fracture variability but also by boundary conditions. Computational limitations have previously prohibited researchers from investigating the relative importance of in-fracture variability in flow and transport modeling within large-scale fracture networks. We address this question by incorporating internal heterogeneity of individual fractures into flow simulations within kilometer scale three-dimensional fracture networks, where fracture intensity, P32 (ratio between total fracture area and domain volume) is between 0.027 and 0.031 [1/m]. A recently developed discrete fracture network (DFN) simulation capability, dfnWorks, is used to generate DFNs that include in-fracture aperture variability represented by a stationary log-normal stochastic field with various correlation lengths and variances. The Lagrangian transport parameters, non-reacting travel time and cumulative retention, are calculated along particles streamlines. It is observed that due to local flow channeling early particle travel times are more sensitive to in-fracture variability than the tails of travel time distributions, where no significant effect of the in-fracture transmissivity variations and spatial correlation length is observed.

  16. Fractures of the radial head treated by internal fixation: late results in 26 cases.

    Science.gov (United States)

    Esser, R D; Davis, S; Taavao, T

    1995-01-01

    Twenty-six patients, ranging in age from 14 to 57 years (average 29 years), were evaluated an average of 7 years and 4 months (range 1-14 years) after open reduction and internal fixation of a displaced radial head fracture. Using Mason's classification, there were 11 type II fractures, 9 type III fractures, and 6 type IV fractures with associated dislocation of the elbow. Seven patients had ipsilateral extremity injuries that included fractures of the coronoid process, capitellum, humerus, and distal radius. Using the Broberg and Morrey elbow score, good or excellent results were achieved in all Mason type II and type III fractures. Four of the six Mason type IV fractures were rated good or excellent. Fair results were obtained in two patients who had an associated dislocation of the elbow and multiple ipsilateral extremity injuries. In these two patients, secondary excision of the radial head relieved pain and yielded some improvement in flexion and forearm rotation. PMID:7562154

  17. A proposal for an international brittle fracture acceptance criterion for nuclear material transport cask applications

    Energy Technology Data Exchange (ETDEWEB)

    Sorenson, K.B.; Salzbrenner, R.J.; Nickell, R.E.

    1989-01-01

    This paper presents a fundamental basis for a brittle fracture acceptance criterion, examine several existing criteria and propose examples for consideration as international brittle fracture acceptance criteria. The proposed criteria are intended to stimulate discussion in order to advance the development of a consensus approach. 8 refs., 1 fig., 1 tab.

  18. Bilateral traumatic proximal humerus fractures managed by open reduction and internal fixation with locked plates

    Institute of Scientific and Technical Information of China (English)

    Atin Jaiswal; Naiman Deepak Kachchhap; Rupak Chaterjee; Yashwant Singh Tanwar; Masood Habib; Satya Prakash Singh

    2013-01-01

    Fractures of the proximal humerus are uncommon in young patients.Although bilateral fracture of proximal humerus itself is rare,association with epilepsy and electrocution is frequent.Only one case of traumatic bilateral proximal humerus fracture has been reported in the literature.We report a rare case of bilateral traumatic displaced proximal humerus fractures in a 40 years old male patient,which was treated by means of open reduction and internal fixation with proximal humerus locked pates on both sides and obtained a good functional outcome.

  19. Bilateral traumatic proximal humerus fractures managed by open reduction and internal fixation with locked plates.

    Science.gov (United States)

    Jaiswal, Atin; Kachchhap, Naiman Deepak; Chaterjee, Rupak; Tanwar, Yashwant Singh; Habib, Masood; Singh, Satya Prakash

    2013-01-01

    Fractures of the proximal humerus are uncommon in young patients. Although bilateral fracture of proximal humerus itself is rare, association with epilepsy and electrocution is frequent. Only one case of traumatic bilateral proximal humerus fracture has been reported in the literature. We report a rare case of bilateral traumatic displaced proximal humerus fractures in a 40 years old male patient, which was treated by means of open reduction and internal fixation with proximal humerus locked pates on both sides and obtained a good functional outcome.

  20. OUTCOME ANALYSIS OF PROXIMAL HUMERUS FRACTURES TREATED BY MINIMAL INTERNAL FIXATION

    Directory of Open Access Journals (Sweden)

    Venkatesh Kumar

    2014-05-01

    Full Text Available The aim of the study was to evaluate the functional outcome in patients treated with proximal humeral fracture who were treated with minimally internal fixations like K-wires, osteosutures etc.

  1. Biomechanical evaluation of maxillary Lefort Ι fracture with bioabsorbable osteosynthesis internal fixation.

    Science.gov (United States)

    Wu, Wei; Zhou, Jiang; Xu, Chong-Tao; Zhang, Jie; Jin, Yan-Jiao; Sun, Geng-Lin

    2014-12-01

    The aim of this study was to apply biomechanical analysis model to evaluate the effects of bioabsorbable internal fixation devices on maxillary Lefort Ι fracture. CT scan technology and the finite element software (ansys) were used to establish three-dimensional finite element models of five resorbable internal fixation devices in maxillary Lefort Ι fractures. We used the model to calculate the stress of the upper jaw and internal fixation. We further analyzed the stability of fixation under four occlusions. The fixation using two bioabsorbable plates was not stable. The zygomaticomaxillary pillars fixation is more stable than other fixations. The stability of fracture fixation was influenced with the molar occlusion. The current study developed a functional three-dimensional finite element model of bioabsorbable internal fixation and compared the stability of five fixation methods for maxillary Lefort Ι fractures. The results would facilitate the application of bioabsorbable materials in dental clinic.

  2. Outcome of open reduction and internal fixation of intraarticular calcaneal fracture fixed with locking calcaneal plate

    OpenAIRE

    Jain Saurabh; Jain Anil Kumar; Kumar Ish

    2013-01-01

    【Abstract】Objective: Debate continues regarding the management of calcaneal fractures, between open re- duction and internal fixation and closed treatment. Hence we aim at evaluating the radiological and functional out- comes of open reduction and internal fixation in displaced joint depression type of calcaneal fractures fixed with lock- ing calcaneal plate. Methods: In this series, 28 patients (26 unilateral and 2 bilateral) with joint depression type of calcaneal fr...

  3. Pelvic or acetabular fractures Mortality for pediatric versus adult patients%骨盆或髋臼骨折儿童与成人患者死亡率的比较

    Institute of Scientific and Technical Information of China (English)

    Mohit Bhandari; 王簕; 杨云峰

    2013-01-01

    Three registry studies of pediatric versus adult patients with pelvic fractures report on the mortality rates of these patient populations.While pelvic fractures occur in the context of severe traumatic injury,rates of mortality directly attributable to the pelvic fracture are low for both pediatric and adult patients,particularly for pediatric patiens.

  4. Acute nursing care of the older adult with fragility hip fracture: An international perspective (Part 2)

    LENUS (Irish Health Repository)

    Maher, Ann Butler

    2012-10-23

    The second part of this paper provides those who care for orthopaedic patients with evidence-supported international perspectives about acute nursing care of the older adult with fragility hip fracture. Developed by an international group of nurse experts and guided by a range of information from research and clinical practice, it focuses on nurse sensitive quality indicators during the acute hospitalisation for fragility hip fracture. Optimal care for the patient who has experienced such a fracture is the focus. This includes (in the first, earlier, part):\\r\

  5. Treatment of stable and unstable intertrochanteric fractures with selfdynamisable internal fixator (concept of double dynamisation

    Directory of Open Access Journals (Sweden)

    Kostić Igor M.

    2015-01-01

    Full Text Available Bacground/Aim. Intertrochanteric fractures of the femur are the third most common fractures among all bone fractures. Today in everyday orthopedic practice a number of different methods of treatment of trochanteric fractures of the femur are applied. Despite the improvement in the development of new implants, the percentage of serious complications of the treatment of these fractures remains very high, varying from 10% to 20%. One of the most serious complications of internal fixation of intertrochanteric fractures is nonunion of fractures due to the lack of additional axial dynamisation of implants. The aim of this study was to determine the efficacy of double dynamisation in stable and unstable intertrochanteric fractures treatment using the self dynamisable internal fixator. Methods. During the period from 2000 to 2009 we analyzed the use of selfdynamisable internal fixator (SIF implant in the treatment of 247 patients with stable and unstable intertrochanteric fractures. Fracture types were classified according to the AO Fracture Classification/Orthopaedic Trauma Association Scheme. Salvati and Wilson scoring systems were used for functional assessment considering pain, walking ability and hip movements of operated patients. Results. Of the total number of treated patients, 134 were males and 113 females, aged 19 to 90 (average 49.6 years. More than a half of the patients were older than 50 years. Monitoring of the patients after the operation was carried out clinically and radiographically for a period of three to six months in all the patients, whereas a 2-year follow-up was conducted in 176 (71.2% patients. The average duration of surgery was 47 min, the average blood loss 145 mL, and the average fluoroscopy time was 16 sec (8-97 sec. The average time for union was 3.7 months (3-6.5 months. Double dynamisation (dynamisation along the neck and shaft of the femur was observed in 85 (34.4% patients, and was on average 4.3 mm (1.5-8 mm. All

  6. Proceedings of the International Symposium on Dynamics of Fluids in Fractured Rocks: Concepts and Recent Advances

    Energy Technology Data Exchange (ETDEWEB)

    Faybishenko, B. (ed.)

    1999-02-01

    This publication contains extended abstracts of papers presented at the International Symposium ''Dynamics of Fluids in Fractured Rocks: Concepts and Recent Advances'' held at Ernest Orlando Lawrence Berkeley National Laboratory on February 10-12, 1999. This Symposium is organized in Honor of the 80th Birthday of Paul A. Witherspoon, who initiated some of the early investigations on flow and transport in fractured rocks at the University of California, Berkeley, and at Lawrence Berkeley National Laboratory. He is a key figure in the development of basic concepts, modeling, and field measurements of fluid flow and contaminant transport in fractured rock systems. The technical problems of assessing fluid flow, radionuclide transport, site characterization, modeling, and performance assessment in fractured rocks remain the most challenging aspects of subsurface flow and transport investigations. An understanding of these important aspects of hydrogeology is needed to assess disposal of nu clear wastes, development of geothermal resources, production of oil and gas resources, and remediation of contaminated sites. These Proceedings of more than 100 papers from 12 countries discuss recent scientific and practical developments and the status of our understanding of fluid flow and radionuclide transport in fractured rocks. The main topics of the papers are: Theoretical studies of fluid flow in fractured rocks; Multi-phase flow and reactive chemical transport in fractured rocks; Fracture/matrix interactions; Hydrogeological and transport testing; Fracture flow models; Vadose zone studies; Isotopic studies of flow in fractured systems; Fractures in geothermal systems; Remediation and colloid transport in fractured systems; and Nuclear waste disposal in fractured rocks.

  7. 联合入路治疗复杂髋臼骨折的预后及影响因素分析%Prognosis of complex acetabular fractures treated by combined approaches

    Institute of Scientific and Technical Information of China (English)

    王光林; 张晖; 吴刚; 杨天府; 池雷霆; 方跃; 王京生

    2009-01-01

    目的 回顾性研究采用前后联合入路治疗复杂髋臼骨折患者的预后及影响因素. 方法自2000年1月至2006年8月采用前后联合入路治疗且获得2年以上随访的复杂髋臼骨折患者共28例(28髋),对患者术后进行复位质量和远期影像学评价.根据改良的Merle d'Aubigné和Postel评分标准及SF-36简便型健康调查问卷(MOS SF-36)对患者的髋关节临床功能和生命质量进行评估.分析本组患者与一般人群的生命质量有无差异,预后因素与功能结果的相关性. 结果所有患者平均随访31个月(14~82个月),影像学评估显示术后初始影像显示解剖复位17例(60.7%),良好复位9例(32.2%),差复位2例(7.1%).远期影像学结果:优16例,良7例,可3例,差2例,优良率82.1%(23/28).发生异位骨化18例(64.3%),股骨头缺血坏死2例(7.1%).改良Merle d'Aubigné和Postel平均得分15.5分(10~18分).优4例,良18例,可4例,差2例,优良率78.6%(22/28).对于复杂髋臼骨折患者,生命质量在一般健埭状况、生命力、情感角色和心理健康等4个维度与一般人群差异无统计学意义(P>0.05),在躯体功能、躯体角色、机体疼痛和社会功能等4个维度较一般人群下降(P0.05); however, the domains of physical function, physical role, body pain and social function had significantly lower scores(P<0.05) . Conclusions Indications for the combined approaches are limited to complex fracture patterns involved both columns, such as both column fractures, transverse and posterior wall fractures and T-type fractures, for which anatomical (or good) reduction or rigid internal fixation cannot be achieved by a single approach. The quality of reduction is a crucial and controllable prognostic factor.

  8. Locking internal fixator with minimally invasive plate osteosynthesis for the proximal and distal tibial fractures

    Directory of Open Access Journals (Sweden)

    TONG Da-ke

    2012-02-01

    Full Text Available 【Abstract】Objective: To investigate the efficacy of the locking internal fixator (LIF, which includes the locking compression plate (LCP and the less invasive stable system (LISS, in the proximal and distal tibial fractures. Methods: We did a retrospective study on a total of 98 patients with either proximal or distal tibial fractures from January 2003 to January 2007, who had received the opera- tion with LIF by the minimally invasive plate osteosynthesis (MIPO technique. The data consisted of 43 proximal tibial fractures (type AO41C3 and 55 distal tibial fractures (type AO43C3. Results: No complications were observed in all patients after operation. The mean healing time was 8.4 months (range 5-14 months. Only two cases of delayed union occurred at postoperative 10 months. No infections were reported after the definitive surgery even in the cases of open fractures. All patients reached a full range of motion at postoperative 6 to 9 months and regained the normal functions of knee and ankle joints. Conclusion: Using LIF in MIPO technique is a reliable approach towards the proximal and distal tibial fractures that are not suitable for intramedullary nailing. Key words: Internal fixator; Tibial fractures; Fracture fixation, intramedullary; Bone plates

  9. The outcome of surgically treated traumatic unstable pelvic fractures by open reduction and internal fixation

    Directory of Open Access Journals (Sweden)

    Keykhosro Mardanpour

    2013-07-01

    Full Text Available BACKGROUND: This study was performed to evaluate functional and radiological results of pelvic ring fractures treatment by open reduction and internal fixation. METHOD: Thirty eight patients with unstable pelvic fractures, treated from 2002 to 2008 were retrospectively reviewed. The mean patients’ age was 37 years (range 20 to 67. Twenty six patients were men (4patients with type B and 22 patients with type C fracture and 12 women (7 patients with type B and 5 patients with type C fracture. The commonest cause was a road traffic accident (N=37, about 97%. Internal fixation was done by plaque with ilioinguinal and kocher-langenbeek approaches for anterior, posterior pelvic wall and acetabulum fracture respectively. Quality of reduction was graded according to Majeed score system. RESULTS: There were 11 type-C and 27 type-B pelvic fractures according to Tile’s classification. Thirty six patients sustained additional injuries. the commonest additional injury was lower extremity fracture. The mean follow-up was 45.6 months (range 16 to 84 months.The functional outcome was excellent in 66%, good in 15%, fair in 11% and poor in 7% of the patients with type B pelvic fractures and functional outcome was excellent in 46%, good in 27%, fair in 27% and poor in 0% of the patients with type C pelvic fractures. There were four postoperative infections. No sexual functional problem was reported. Neurologic problem like Lateral cutaneous nerve of thigh injury recovered completely in 2 patients and partially in 2 patients. There was no significant relation between functional outcome and the site of fracture (P greater than 0.005. CONCLUSION: Unstable pelvic ring fracture injuries should be managed surgically by rigid stabilization. It must be carried out as soon as the general condition of the patient permits, and even up to two weeks

  10. Clinical observation of particulate cancellous bone impaction grafting in combination with total hip arthroplasty for acetabular reconstruction

    Institute of Scientific and Technical Information of China (English)

    LIU Xian-zhe; YANG Shu-hua; XU Wei-hua; LIU Guo-hui; YANG Cao; LI Jin; YE Zhe-wei; LIU Yong; ZHANG Yu-kun

    2008-01-01

    Objective: To investigate the effect of particulate cancellous bone impaction grafting in combination with total hip arthroplasty (THA) for acetabular reconstruction in patients with posttraumatic arthritis and bone loss afteracetabular fractures.Methods: Totally 15 consecutive cases with unilateral acetabular fracture were treated with bone impaction grafting in combination with THA in our department.There were 10 males and 5 females with mean age of 48.2 years (ranging from 36 to 73 years).Eight cases had the fracture at left hips,7 at right hips.The average age at injury was 28 years (ranging from 18 to 68 years).The mean follow-up period was 4.3 years (ranging from 2 to 7 years).Results: Compared with mean 42 points (ranging from 10 to 62) of the preoperative Harris score,the survival cases at the final follow-up had mean 84 points (ranging from 58 to 98).One patient had mild pain in the hip.No revision of the acetabular or femoral component was undertaken during the follow-up.Normal rotational centre of most hips was recovered except 2 cases in which it was 0.8 mm higher than that in opposite side.All of them had a stable radiographic appearance.Progressive radiolucent fines were observed in I,III zones in 2 cases.One patient had a nonprogressive radiolucent fine in zone III.The cup prosthesis was obviously displaced (6 mm) in one patient,but had not been revised.Conclusion: Particulate cancellous bone impaction grafting in combination with THA as a biological solution is an attractive procedure for acetabular reconstruction in patients with posttraumatic arthritis and bone loss after acetabular fracture,which can not only restore acetabular bone stock but also repair normal hip anatomy and its function.

  11. [Implant materials for the internal fixation of midfacial fractures].

    Science.gov (United States)

    Stuck, B A; Heller, T

    2011-11-01

    The material used for osteosynthesis plays a crucial role in the management of facial fractures. Plates need to be flexible enough to be bent and should not be palpable through the skin, while ensuring stable fixation und adequate biocompatibility. Although stainless steel was initially the material of choice, titanium has become the standard material due to its superior biocompatibility. While the explantation of titanium plates and screws appears unnecessary in general, it should be considered in cases of dislocation, cosmetic concerns, pain and infection. Due to their limited initial stability and a potential increase in local complications, resorbable materials based on polymeric lactose are used with caution in midfacial fractures in adults. Our own retrospective study comparing the postoperative complications after fixation of lateral midfacial fractures with titanium and resorbable systems demonstrated a low complication rate for both systems (7-8%) and no statistically significant difference between the two. The appropriate material for fixation should be selected based on the localization and severity of the fracture, the experience of the surgeon as well as on the age and overall condition of the patient.

  12. Osteoarthritis of the hip and acetabular dysplasia.

    OpenAIRE

    Croft, P.; Cooper, C.; Wickham, C; Coggon, D

    1991-01-01

    The relation between acetabular dysplasia and osteoarthritis of the hip was examined in a series of 1516 pelvic radiographs taken for non-skeletal indications. Osteoarthritis was assessed by measuring joint space, and dysplasia by the centre-edge angle and acetabular depth. In contrast with previous studies of patients with symptomatic osteoarthritis of the hip, no evidence that dysplasia predisposes to osteoarthritis was found. Possible reasons for the discrepancy are discussed. It was concl...

  13. Open Reduction and Internal Fixation of a Fracture-dislocation of the Ankle

    Directory of Open Access Journals (Sweden)

    Yaniel Truffin Rodriguez

    2015-12-01

    Full Text Available Open reduction and internal fixation of the fracture-dislocation of the ankle with plates, screws and Kirschner wires is a well-defined treatment method. This paper presents the management of a fracture-dislocation of the right ankle in a 33-year-old female patient stabilized by using a one-third tubular plate, screws, Kirschner wires with tension-band wires. Results were satisfactory.

  14. The results of internal fixation of proximal humeral fractures with the PHILOS locking plate

    OpenAIRE

    Korkmaz, Mehmet Fatih; Aksu, Neslihan; Gogus, Abdullah; Debre, Mursel; Kara, Ayhan Nedim; Isiklar, Zekeriya Ugur

    2004-01-01

    Objectives: Proximal and diaphyseal humeral fractures are common especially in the elderly, presenting as a challenging problem due to their high complication rates following surgical treatment. In this prospective study, we evaluated the results of patients treated with the PHILOS (Proximal Humeral Internal Locking System) locking plate, a new technique recently developed by the AO/ASIF. Methods: Forty-one patients who were treated with the PHILOS plate for proximal humeral fractures were...

  15. Numerical Simulation of Rock Fracturing under Uniaxial Compression Using Virtual Internal Bond Model

    Institute of Scientific and Technical Information of China (English)

    KE Chang-ren; JIANG Jun-ling; GE Xiu-run

    2009-01-01

    A multi-scale virtual internal bond (VIB) model for the isotropic materials has been recently proposed to describe the material deformation and fracturing. During the simulation process of material fracturing using VIB, the fracture criterion is directly built into the constitutive formulation of the material using the cohesive force law. Enlightened by the similarity of the damage constitutive model of rock under uniaxial compression and the cohesive force law of VIB, a VIB density function of rock under uniaxial compression is suggested. The elastic modulus tensor is formulated on the basis of the density function. Thus the complete deformation process of rock under the uniaxial compression is simulated.

  16. Experimental fracture studies on carbon steel elbows with and without internal pressure

    International Nuclear Information System (INIS)

    Pipe bends or elbows are commonly used components for nuclear power plant piping system. In service, these piping components are subjected to internal pressure in addition to bending loads and the internal pressure is known to have a significant effect on the load carrying capacity of these components. Hence, a systematic study was carried out to investigate and quantify the effect of internal pressure on the fracture behaviour of elbows used in nuclear power plant piping system. Fracture studies were conducted on five 219 mm diameter carbon steel elbows with and without internal pressure under in-plane opening moment. The investigations have shown that the presence of a circumferential notch at the intrados has a more detrimental effect on the fracture behaviour of the elbow, when compared with the presence of an axial notch at the intrados. It is also found that internal pressure plays a significant role in reducing the ovalization. -- Highlights: • Fracture studies were conducted on elbows with and without internal pressure. • Effect of internal pressure on load carrying capacity of the elbows was studied. • Various data acquired during the study include load, LLD, CMOD, ovality of the elbow. • Circumferential notch at intrados significantly affects elbow load carrying capacity

  17. Wave generation by fracture initiation and propagation in geomaterials with internal rotations

    Science.gov (United States)

    Esin, Maxim; Pasternak, Elena; Dyskin, Arcady; Xu, Yuan

    2016-04-01

    Crack or fracture initiation and propagation in geomaterials are sources of waves and is important in both stability and fracture (e.g. hydraulic fracture) monitoring. Many geomaterials consist of particles or other constituents capable of rotating with respect to each other, either due to the absence of the binder phase (fragmented materials) or due to extensive damage of the cement between the constituents inflicted by previous loading. In investigating the wave generated in fracturing it is important to distinguish between the cases when the fracture is instantaneously initiated to its full length or propagates from a smaller initial crack. We show by direct physical experiments and discrete element modelling of 2D arrangements of unbonded disks that under compressive load fractures are initiated instantaneously as a result of the material instability and localisation. Such fractures generate waves as a single impulse impact. When the fractures propagate, they produce a sequence of impulses associated with the propagation steps. This manifests itself as acoustic (microseismic) emission whose temporal pattern contains the information of the fracture geometry, such as fractal dimension of the fracture. The description of this process requires formulating criteria of crack growth capable of taking into account the internal rotations. We developed an analytical solution based on the Cosserat continuum where each point of body has three translational and three rotational degrees of freedom. When the Cosserat characteristic lengths are comparable with the grain sizes, the simplified equations of small-scale Cosserat continuum can be used. We established that the order of singularity of the main asymptotic term for moment stress is higher than the order of singularity for conventional stress. Therefore, the mutual rotation of particles and related bending and/or twisting of the bonds between the particles represent an unconventional mechanism of crack propagation.

  18. Free iliac crest grafts with periosteum for treatment of old acetabular defects

    Institute of Scientific and Technical Information of China (English)

    ZHAO De-wei; SUN Qiang; WANG Ben-jie; CUI Da-ping

    2006-01-01

    Objective: To inquire into the therapeutic effectiveness of free iliac crest grafts with periosteum on old acetabular defects.Methods: From February 1996 to June 2005, 9 patients were treated with free iliac crest grafts with periosteum to reconstruct old acetabular defects. There were 7 males and 2 females and the average age was 41.3 years. The acetabular defects were caused by traffic accidents in 6 cases and fall injury in 3 cases. The time from injury to treatment was 4-13 months and averaged 8 months. Intraoperatively we firstly removed the acetabular fracture fragments of the posterior wall. The femoral head was then reducted. Bone graft was harvested from the iliac crest with periosteum, which was sculpted with a rongeur to conform to the defect. The concave (iliac fossa) side of the graft was placed toward the femoral head. The graft was securedly fixed by two to three leg screws.Results: Postoperative syndrome was not found in any of the cases. Harris' score system showed that the score raised from 32. 3 points preoperatively to 81 points postoperatively. The hip function was evaluated as excellent in 3 cases, good in 4 cases and fair in 2 cases.Conclusions: Although this procedure could not exactly reproduce the anatomy of the hip joint, it enables to restore the posterior stability, provide bone-stock for the hip joints and prevent dislocation of the femoral head.

  19. Outcome after open reduction and internal fixation of intraarticular fractures of the calcaneum without the use of bone grafts

    OpenAIRE

    Pendse Aniruddha; Daveshwar R; Bhatt Jay; Shivkumar

    2006-01-01

    Background: Intraarticular fractures of calcaneum are commenest type of calcaneal fractures. Lots of controversies exist about the ideal management for them. The focus is now shifting on operative management by open reduction and internal fixation for these fractures with or without the use of bone grafts. Method: Thirty intraarticular fractures classified by Essex Lopresti radiological classification, were treated by open reduction and fixation. The patients were followed over a mean peri...

  20. The effect of welding residual stresses on brittle fracture in an internal surface cracked pipe

    International Nuclear Information System (INIS)

    The change in brittle fracture properties due to the presence of welding residual stresses (RS) is studied in a pipe. Welding RS are simulated by using a 3-D finite element (FE) model and experimentally verified. An internal circumferential thumbnail crack is introduced at the weld line. The modified Beremin model is used as local approach method to predict toughness distributions in the presence of welding RS. The model is calibrated using experimental fracture tests at −150 °C consisting of low and high constraint specimens. The results indicate that, in the welded pipe, the fracture toughness will decrease dramatically in comparison with the as-received pipe. For the same fracture probability of 90%, fracture toughness will decrease from 65 to 40 MPa √m. This is due to the influence of tensile welding RS on the crack tip stress state, which result in a decrease in the opening mode stresses at the near crack tip up to 40%. - Highlights: • A Two-pass pipe welding process is simulated and obtained residual stresses (RS) are experimentally verified. • An internal semi-elliptical circumferential cracked pipe is considered and Modified Beremin model is used. • Two sets of specimens with high and low crack-tip constraint are used for model calibration. • Welding RS will cause to change crack-tip stress field and fracture probability, dramatically. • RS cause 40% increase in maximum opening stress and 38% decrease in fracture toughness, for a fracture probability of 90%

  1. FALSIRE phase 2: CSNI project for fracture analyses of large- scale international reference experiments

    International Nuclear Information System (INIS)

    A summary of Phase II of the Project for Fracture Analysis of Large-Scale International Reference Experiments (FALSIRE) is presented. FALSIRE I was initiated by the CSNI/FAG in 1988 to assess various fracture methodologies through interpretive analyses of six large-scale fracture experiments. Following the successful completion of FALSIRE I in 1992, several participating organizations indicated a desire to proceed with further evaluation of fracture analysis methods in a Phase II program. FALSIRE II included seven reference cleavage fracture experiments that focused primarily on behavior of relatively shallow cracks in the transition temperature region. Included were experiments for which cracks showed either unstable extension or two stages of extension (e.g., stable crack extension followed by unstable extension) under transient thermal and mechanical loadings. Also, crack initiation was investigated in connection with clad surfaces and with biaxial loading conditions. A comparative assessment and discussion of the analysis results are presented in the report. Generally, structural responses of the test specimens were predicted with tolerable scatter bands; these represent a marked improvement over the results achieved in the initial phase (FALSIRE I). The analyses revealed that the loss-of-constraint effects observed in specific cases require a second (or dual) fracture parameter to be introduced into the fracture model to characterize crack-tip conditions. Additional toughness data obtained from a range of specimen geometries and constraint conditions are required to validate these dual-parameter cleavage fracture methodologies. Finally, proposals for future work in the context of cooperative international analytical projects similar to FALSIRE are provided

  2. OPEN REDUCTION AND CANNULATED SCREW INTERNAL FIXATION OF TALUS FRACTURE-DISLOCATION THROUGH MEDIAL-ANTERIOR APPROACH

    Institute of Scientific and Technical Information of China (English)

    董宇启; 董英海; 周健; 曹聪

    2004-01-01

    Objective To evaluate the role of open reduction through anterior-medial malleolar approach with cannulated screw internal fixation in the treatment of displaced talus fractures. Methods 16 cases of Hawkin type Ⅱ - Ⅲ displaced talus fractures were treated by open reduction through single anterior medial malleofar approach with cannulated screw internal fixation. Results All the 16 cases of displaced talus fractures achieved bony heal in which 5 cases suffered talus aseptic necrosis. The whole excellence-good ratio reached 62.5%.Conclusion Open reduction through anterior-medial malleolar approach with cannulated screw internal fixation is a less trauma, easy manipulation, effective method of treatment for displaced talus fractures.

  3. Outcome of open reduction and internal fixation of volar barton fracture treated with buttress plate

    International Nuclear Information System (INIS)

    Objective: To assess the outcome of volar Barton fracture treated with T-plate and locking plate. Methodology: From December 2011 to August 2014, prospective case series study was conducted at the Department of Orthopaedic Surgery, Dow University of Health Sciences/Civil Hospital, Karachi and included 45 patient of volar Barton fracture treated with buttress plate and locking plate. Colles fracture, dorsal barton and comminuted intraarticular fractures were excluded from the study. Results: Out of 45 patients, 33(73%) were male and 12(27%) female, Age ranged from 20 to 50 years. 17(38%) had fall and 28(62%) road traffic accident. 7(16%) patients were treated with locking plates and 38(84%) with T- buttress plate. Functional outcome was assessed on the basis of modified clinical staging system of Green and O'Brien, which showed excellent result in 20(44%) patient, good in 16(36%), fair in 7(16%), and poor in 2(4%) patients. Volar Barton fracture was associated with concomitant injuries, especially in trauma patients, 4(27%) had mid shaft femur fracture, 2(13%) scaphoid fracture, 4(27%) metacarpals and 5(33%) ulnar styloid fractures. With 9 months follow up, union was observed in all patients within 8 to 12 weeks. Conclusion: volar Barton fractures are unstable injuries; chances of displacement after closed reduction are high. So we recommend open reduction and internal fixation with T- buttress plate or locking plate to get the excellent functional outcome. (author)

  4. The influence of internal stresses on the fracture toughness of {alpha}/{beta} titanium alloys

    Energy Technology Data Exchange (ETDEWEB)

    Helbert, A.L.; Feaugas, X.; Clavel, M.

    1999-11-01

    The influence of internal stresses on fracture toughness was investigated in {alpha}/{beta} titanium alloys. It was shown that the direct linkage of K{sub IC} to various microstructural parameters was not so conclusive, since the different parameters act simultaneously on fracture toughness. On the contrary, the metallurgical parameters change the plastic strain incompatibilities inside the material. Thus X, which is a macroscopic measurement of these incompatibilities, is the relevant parameter to account for the different metallurgical influences on toughness. The influence on X of the {alpha}-phase percentage, aspect ratio, and the secondary {alpha}-phase percentage was determined, and it was established that low internal stresses could provide high fracture toughness. The present work also showed the ability of a modified Gurson-Tvergaard (GT) model to calculate the experimental K{sub IC} value.

  5. Promising Effect Of Intraarticular Ropivacaine In Femoral Neck Fractures Treated With Internal Fixation (Best Poster Award)

    DEFF Research Database (Denmark)

    Bech, Rune Dueholm

    2008-01-01

    , Southern Denmark University.   INTRODUCTION Reducing pain is an essential factor for early mobilisation after internal fixation of femoral neck fractures. Systemic opioids have side effects that might obstruct mobilisation and induce deliria and nausea. We hypothesized that intraarticular local anaesthetic...... Promising Effect Of Intraarticular Ropivacaine In Femoral Neck Fractures Treated With Internal Fixation Rune Bech*, Jens Lauritsen*+,Tine Dimon*, Ole Ovesen*, Claus Emmeluth, Søren Overgaard*. *:Dept. Ortopaedic Surgery, Odense University Hospital, +:Institute of Public Health-dept. biostatistics...... results in pain relief without side effects and reduction in systemic opioid usage. We found no other studies describing this method in the literature. We present a pilot study on use of intraarticular local anesthesia in femoral neck fracture S72.0 patients.   MATERIAL AND METHODS All 22 patients...

  6. When Should Open Reduction and Internal Fixation Ankle Fractures Begin Weight Bearing? A Systematic Review.

    Science.gov (United States)

    Smith, Toby O; Davies, Leigh

    2008-02-01

    The objective of this paper was to review the literature to assess when open reduction and internal fixation ankle fractures should commence weight bearing for the best outcome. An electronic search was undertaken of the databases AMED, Cinahl, Embase, Medline (via Ovid), Pedro and Pubmed, from their inception to November 2005. References lists were scrutinised and a hand search was also performed. We included all English language, human subject, controlled clinical trials, comparing the effects of early against later weight bearing following open reduction and internal fixation of ankle fractures. Two reviewers independently assessed the methodological quality of the literature using the PEDro (Physiotherapy Evidence Database) scoring system. Five papers comprising of 366 ankle fractures were reviewed. Overall, there was no significant difference between commencing early, compared to later weight bearing in subjects following open reduction and internal fixation, when evaluated against function, pain, range of movement, radiological assessment, complications, and return to work. The evidence reviewed was generally poor, with numerous methodological design limitations. The literature suggested that were was little difference between encouraging early or delayed weight bearing after open reduction and internal fixation of ankle fractures. Neither early nor later weight bearing significantly improves or jeopardises outcomes. However, due to the plethora of methodological limitations and limited evidence, it is not possible to reference this conclusion with conviction. Further large, well-designed randomized controlled trials are required to evaluate this area. PMID:26815494

  7. Stabilization of unstable pelvic fractures with a novel internal-external fixator

    Institute of Scientific and Technical Information of China (English)

    JIANG Zan-li; Gary Chen

    2011-01-01

    An internal-external fixator for stabilization in three cases with unstable pelvic fractures were reported.Compared with external fixation,the internal-external fixator,which is placed in the subcutaneous layer,decreased the risk of pin-track infection,pin site pain,and bowel obstruction; meanwhile,it had the advantage of external fixation:it was easy to apply,controlled damage,and resulted in minimal injury.

  8. Locking internal fixator with minimally invasive plate osteosynthesis for the proximal and distal tibial fractures

    Institute of Scientific and Technical Information of China (English)

    TONG Da-ke; JI Fang; CAI Xiao-bing

    2011-01-01

    Objective: To investigate the efficacy of the locking internal fixator (LIF), which includes the locking compression plate (LCP) and the less invasive stable system (LISS), in the proximal and distal tibial fractures. Methods: We did a retrospective study on a total of 98 patients with either proximal or distal tibial fractures from January 2003 to January 2007, who had received the operation with LIF by the minimally invasive plate osteosynthesis (MIPO) technique. The data consisted of 43 proximal tibial fractures (type AO41C3) and 55 distal tibial fractures (type AO43C3). Results: No complications were observed in all patients after operation. The mean healing time was 8.4 months (range 5-14 months). Only two cases of delayed union occurred at postoperative 10 months. No infections were reported after the definitive surgery even in the cases of open fractures. All patients reached a full range of motion at postoperative 6 to 9 months and regained the normal functions of knee and ankle joints. Conclusion: Using LIF in MIPO technique is a reliable approach towards the proximal and distal tibial fractures that are not suitable for intramedullary nailing.

  9. Dyaphiseal open fractures of the forearm follows internal or external fixation

    International Nuclear Information System (INIS)

    The treatment of dyaphiseal open fractures of the forearm follows internal or external fixation. However, the effectivity of both approaches remains controversial. The aim of this descriptive, Wais study, to assess the osteosynthesis by limited approach (internal fixation) as treatment of this type of fractures. Between 1996 and 1999, 22 patients with open dyaphiseal forearm fractures caused by gunshot and treated with this technique were analyzed. The men age was 26.8 years. There were 13 patients with type lllA and 9 patients with type lllB fractures. The mean of comminution was 6.34 mm. Additionally; the mean of quirurgical rinses was 3.7. The complications were: superficial infections, insufficient osteosynthesis and pseudoarthrosis. According to a functional scale the outcomes were, excellent good acceptable and bad. Within parenthesis are the numbers of patients. On the other hand, there were nineteen successful bone consolidations. The observed relative success of the limited approach, with 17 excellent-good cases and 79 bone consolidating, can be explained by the avoiding of unnecessary manipulation of the fractures area which promotes consolidation and reduces infection risk. Moreover the acceptable functional recovery, the absence of complications due to the technique and the restrained use of bone grafts make this technique highly performable

  10. Internal fixation with headless compression screws and back buttress plate for treatment of old Hoffa fracture

    Institute of Scientific and Technical Information of China (English)

    Min Li; Tu Chongqi; Wang Guanglin; Fang Yue; Duan Hong; Liu Lei; Zhang Hui

    2014-01-01

    Objective:To analyze the early clinical and radiographic outcomes of Hoffa fractures treated by a standard protocol of open reduction and internal fixation using headless compression screws combined with back buttress plate in a consecutive series of 8 Chinese patients.Methods:Open reduction and internal fixation was performed on all patients.The fractures were anatomically reduced and held temporarily by K-wire.If the ends of fractures were atrophic,autologous bone graft from the ipsilateral iliac crest was packed between the ends.Then the fracture fragments were fixed with AO 6.5 mm headless compression cannulated screws.At least two screws were used to provide rotational stability.One pre-contoured reconstruction plate was placed on the nonarticular surface posteromedially or posterolaterally as back buttress plate.Results:All the patients were followed up for at least 12 months (range 12-25 months).All fractures achieved anatomical reduction and healed clinically and radiographically.At recent follow-up,the mean flexion degree was 120.6° (range 110°-135°) and the mean extension degree was 2.5° (range 0°-5°).The average visual analogue scale score was 1.6 points (range 0-3).Six patients were assessed as excellent and 2 as good according to the hospital for special surgery knee score system.There were no superficial or deep infections,or hardware breakages.No patient had giving way or locking of the knee,though some had intermittent pain and swelling after strenuous exercise.Injury mechanism had significant influence on the functional outcome (P=0.046).Conclusion:Headless compression screws combined with back buttress plate and/or autologous bone grafting to treat old Hoffa fracture is one of effective measures.It would be conducive to not only fracture healing but also early exercise and functional recovery.

  11. Clinical effect of distal radius fracture treated with open reduction and internal plate fixation

    Institute of Scientific and Technical Information of China (English)

    ZHANG Pei-xun; XUE Feng; DANG Yu; WANG Tian-bing; CHEN Jian-hai; XU Hai-lin; FU Zhong-guo; ZHANG Dian-ying; JIANG Bao-guo

    2012-01-01

    Background For some specific comminuted unstable intra-articular fracture,the plaster cast can not maintain the alignment of the articular surface effectively.The aim of this study was to evaluate the clinical effects of distal radius fracture treated with open reduction and internal plate fixation retrospectively.Methods From January 2002 to March 2010,539 cases of distal radius fracture were treated with open reduction and internal fixation,including 184 males and 355 females aging 21-72 years (mean 57 years).Fractures were caused by falling to the ground in 459 cases,by traffic accident in 62 cases and by athletic injuries in 18 cases.Of 539 cases,there were 523 cases of closed fracture and 16 cases of open fracture.According to Arbeitsgemeinschaft fur Osteosynthesefragen (AO) standards of classification,there were 14 cases of A2 type,22 of A3 type,18 of B1 type,24 of B2 type,62 of B3 type,91 of C1 type,162 of C2 type and 146 of C3 type.The time from injury to operation was 1-16 days (mean 5 days).All patitents received open reduction and internal plate screw fixation.Forty-seven patients with bone defect were given 6-15 g autologous ilium and 75 cases were given 5 ml calcium sulphate artificial aggregate after reduction.Results All incisions healed by first intention after operation.Patients were followed up for 15 to 32 months postoperatively (mean 22 months).The fractures healed within 10-18 weeks after operation (mean 12 weeks).During the last follow-up,the mean palmar tilt was (7.0±0.9)° and the mean ulnar variance was (21.0±4.2)°,showing significant difference when compared with preoperation ((-5.0±1.2)° and (8.0±3.8)°).The radial heights were not abbreviated.According to Gartland and Werley assessment system,the results were excellent in 314 cases,good in 163 cases,fair in 46 cases,and poor in 16 cases 12 weeks after operation,the excellent and good rate was 88.5%.Conclusions The clinical effect of distal radius fracture treated with open

  12. FUNCTIONAL OUTCOME OF PATELLAR FRACTURES TREATED BY INTERNAL FIXATION: A RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Sudheendra

    2014-07-01

    Full Text Available BACKGROUND AND OBJECTIVES: Follow-up studies of displaced patellar fractures treated but various accepted contemporary internal fixation techniques have generally shown favorable results. However, reports of modest outcomes are not rare. The aims of this retrospective study were to review a series of patients with closed patellar fractures who a\\were treated by internal fixation, and to determine the final functional outcome. METHODS: In this study of retrospective design, the hospital records and radiographs of the 43 identified patients with 43 closed patellar fractures, treated by internal fixation between November 2000 and June 2005 were reviewed. These patients were called for a final follow-up evaluation, and the latest functional outcome assessed as per the modified Hospital for Special Surgery knee scores. Results were analyzed and statistical significance determined by Chi-square test. RESULTS: Younger patients showed significantly better outcomes. Modified tension band wiring was the most commonly associated with symptomatic hardware requiring removal. Different fixation techniques fared favorably against each other. The final functional outcome assessed using the modified Hospital for Special Surgery scores was encouraging with excellent or good results in 74%. Interpretations and conclusions: Operatively treated closed patellar fracture with accepted fixation techniques eventually result in a satisfactory return of knee function. Complications, particularly symptomatic hardware requiring removal, are not uncommon.

  13. Treatment of displaced radial head fractures by internal fixation with absorbable pins

    Institute of Scientific and Technical Information of China (English)

    HOU Zhen-hai; ZHOU Ji-hong; SHI Jian-guo; SHI Yi-bin; XIA Jun-jie; YAO Jun

    2006-01-01

    Objective: To study the effect of internal fixation with absorbable pins on treatment of displaced radial head fractures.Methods: From May 1999 to May 2004, 16 patients with displaced radial head fractures (Mason types Ⅱ and Ⅲ) were treated with internal fixation by absorbable pins.The duration of follow-up averaged 22.6 months (12-58 months). The outcome was assessed on the basis of elbow motion, radiographic findings and the functional rating score delineated by Broberg and Morrey.Results: All fractures healed within 10 months without avascular necrosis of radial head. The mean elbow flexion loss was 15°(0°-35°), and pronation and supination decreased by 10° (0°-30°) on average compared with those of the contralateral elbow. Five patients had an excellent result, 6 a good result, and 3 a fair result according to the criteria of Borberg and Morrey.Conclusions: Internal fixation with absorbable pins is an effective method in treating displaced radial head fractures. It can maintain the biomechanical stability of forearm, improve the elbow function and avoid second operation.

  14. Marginal-internal adaptation and fracture resistance of CAD/CAM crown restorations.

    Science.gov (United States)

    Yildiz, Coşkun; Vanlioğlu, Burçin Akoglu; Evren, Buket; Uludamar, Altay; Ozkan, Yasemin Kulak

    2013-01-01

    This study evaluated the marginal adaptation and fracture resistance of CAD/CAM-fabricated zirconia crowns luted using different luting agents. Twenty crown restorations were produced using IPS ZirCAD zirconium oxide blocks (IZC), and another 20 using Lava zirconium oxide blocks (L). Ten teeth were used as control. Luting agents used were an etch-and-rinse adhesive (Variolink II) and a self-etch adhesive (Multilink Automix). Internal and marginal adaptation was evaluated using silicone replica technique. Fracture resistance was evaluated using a compression test. Marginal discrepancy was 89.26 μm for L crowns and 88.84 μm for IZC crowns, and difference was statistically insignificant. However, L crowns showed significantly larger axial and occlusal gaps than IZC crowns (pCAD/CAM-fabricated crowns showed acceptable in vitro marginal discrepancies and fracture strengths. PMID:23370869

  15. Use of the trochanteric flip osteotomy to facilitate internal fixation of a femoral head fracture.

    Science.gov (United States)

    Gillespie, James A; Marsh, Andrew G; Patil, Sanjeev R

    2016-01-01

    We report the case of a 42-year-old male who suffered a fracture-dislocation of the femoral head. After a closed reduction of the hip, this proceeded to an open reduction with internal fixation of the fractured femoral head, in addition to labral repair and micro-fracture of an articular cartilage defect. After considering the risks to the femoral head blood supply, the trochanteric flip osteotomy was used. This provided ample and safe exposure. At 14 months follow-up, the patient-reported outcome measures are favourable: modified Harris Hip Score (81/100), the non-arthritic hip score (92.5/100) and SF-12 (41/48). PMID:27470013

  16. CT evaluation of acetabular dysplasta in adults.

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To evaluate methods of measurement by CT and their clinical significance for acetabular dysplasia(AD) in adults. Methods: CT imaging was examined and measured in 33 adult patients with AD, compared with the normal control group of 210 adults. Results: This study showed the results of AD patients

  17. Outcome of total hip arthroplasty as a salvage procedure for failed infected internal fixation of hip fractures

    OpenAIRE

    Shubhranshu S Mohanty; Agashe, Mandar V.; Sheth, Binoti A; Kumar K. Dash

    2013-01-01

    Background: Failed infected internal fixation produces significant pain and functional disability. In infected internal fixation of hip fractures with partial or complete head destruction, total hip arthroplasty (THA) can be technically challenging; however, it restores hip biomechanics. The present study is to evaluate the results and assess the complications of THA following failed infected internal fixation of these fractures. Materials and Methods: A retrospective review of prospectiv...

  18. Clinical results of using the proximal humeral internal locking system plate for internal fixation of displaced proximal humeral fractures.

    Science.gov (United States)

    Norouzi, Masoud; Naderi, Mohammad Nasir; Komasi, Mehdi Hemmati; Sharifzadeh, Seyyed Reza; Shahrezaei, Mostafa; Eajazi, Alireza

    2012-05-01

    Proximal humerus fractures are accounting for 4-5% of all fractures with increasing incidence. Proximal Humeral Internal Locking System (PHILOS) plate is a new plate which permits early mobility and lowers the risk of complications. The aim of this study was to evaluate the functional outcome and the complication rate after using this plate. Between 2006-2008, 37 patients with displaced 2-, 3-, and 4-part fractures of the proximal humerus underwent surgery using PHILOS plate. The mean range of follow-up was 12 months. Twenty patients were aged 60 years and younger, and 17 were aged older than 60 years. The average American Shoulder and Elbow Surgeons (ASES) score at the final follow-up was 77.62. According to Michener and colleagues classification, 5.4% of patients had an excellent outcome, 72.9% were minimally functionally limited, 16.2% were moderately functionally limited, and 5.4% were maximally functionally limited. The average ASES score between patients 60 years and older and those 60 years and younger was not different significantly. One patient developed avascular necrosis of the humeral head, 2 patients developed an infection, and no patients developed a nonunion. Fixation with PHILOS plate can be considered a good method with high union rates for this kind of fracture, especially in the older population with osteoporotic bone.

  19. CSNI Project for Fracture Analyses of Large-Scale International Reference Experiments (Project FALSIRE)

    Energy Technology Data Exchange (ETDEWEB)

    Bass, B.R.; Pugh, C.E.; Keeney-Walker, J. [Oak Ridge National Lab., TN (United States); Schulz, H.; Sievers, J. [Gesellschaft fuer Anlagen- und Reaktorsicherheit (GRS) mbH, Koeln (Gemany)

    1993-06-01

    This report summarizes the recently completed Phase I of the Project for Fracture Analysis of Large-Scale International Reference Experiments (Project FALSIRE). Project FALSIRE was created by the Fracture Assessment Group (FAG) of Principal Working Group No. 3 (PWG/3) of the Organization for Economic Cooperation and Development (OECD)/Nuclear Energy Agency`s (NEA`s) Committee on the Safety of Nuclear Installations (CSNI). Motivation for the project was derived from recognition by the CSNI-PWG/3 that inconsistencies were being revealed in predictive capabilities of a variety of fracture assessment methods, especially in ductile fracture applications. As a consequence, the CSNI/FAG was formed to evaluate fracture prediction capabilities currently used in safety assessments of nuclear components. Members are from laboratories and research organizations in Western Europe, Japan, and the United States of America (USA). On behalf of the CSNI/FAG, the US Nuclear Regulatory Commission`s (NRC`s) Heavy-Section Steel Technology (HSST) Program at the Oak Ridge National Laboratory (ORNL) and the Gesellschaft fuer Anlagen--und Reaktorsicherheit (GRS), Koeln, Federal Republic of Germany (FRG) had responsibility for organization arrangements related to Project FALSIRE. The group is chaired by H. Schulz from GRS, Koeln, FRG.

  20. A new coal-permeability model: Internal swelling stress and fracture-matrix interaction

    Energy Technology Data Exchange (ETDEWEB)

    Liu, H.H.; Rutqvist, J.

    2009-10-01

    We have developed a new coal-permeability model for uniaxial strain and constant confining stress conditions. The model is unique in that it explicitly considers fracture-matrix interaction during coal deformation processes and is based on a newly proposed internal-swelling stress concept. This concept is used to account for the impact of matrix swelling (or shrinkage) on fracture-aperture changes resulting from partial separation of matrix blocks by fractures that do not completely cut through the whole matrix. The proposed permeability model is evaluated with data from three Valencia Canyon coalbed wells in the San Juan Basin, where increased permeability has been observed during CH{sub 4} gas production, as well as with published data from laboratory tests. Model results are generally in good agreement with observed permeability changes. The importance of fracture-matrix interaction in determining coal permeability, demonstrated in this work using relatively simple stress conditions, underscores the need for a dual-continuum (fracture and matrix) mechanical approach to rigorously capture coal-deformation processes under complex stress conditions, as well as the coupled flow and transport processes in coal seams.

  1. A RETROSPECTIVE STUDY OF PROXIMAL HUMERUS INTERNAL LOCKING SYSTEM PLATING FOR DISPLACED PROXIMAL HUMERUS FRACTURES

    Directory of Open Access Journals (Sweden)

    Kumarswami Ramulu

    2016-05-01

    Full Text Available AIM The aim of the present study was to evaluate the functional outcome, benefits and complications of open reduction and internal fixation of displaced proximal humerus fractures with proximal humerus locking plate. METHODS We studied the functional outcome of 40 patients aged between 15 to 65 years from September 2013 to February 2015, who had displaced proximal humerus fracture and underwent PHILOS plate fixation for the same. Fractures were classified according to NEER’s and AO classification. Patients were followed up for a minimum period of 1 year. Functional outcomes and shoulder range of movement were assessed based on the Constant and Murley scoring system. RESULTS Patients were followed up for 12 months. All fractures healed satisfactorily; 12 weeks (27.5% was the most common union time (radiological finding in the study population followed by 8 weeks (22.5% and 10 weeks (20%. Avascular necrosis was noted in 1 patient, mild infection in 2 patients and stiffness in 2 patients. The mean Constant score at 6 weeks was 40.39, at 12 weeks was 59.24, at 6 months was 73.88 and at one year was 75.62. Constant score continues to improve till 1 year. CONCLUSION Proximal humerus locking plate gives a reliable, stable fixation for fractures of proximal humerus with a good radiological union and good functional outcome.

  2. Outcome after open reduction and internal fixation of intraarticular fractures of the calcaneum without the use of bone grafts

    Directory of Open Access Journals (Sweden)

    Pendse Aniruddha

    2006-01-01

    Full Text Available Background: Intraarticular fractures of calcaneum are commenest type of calcaneal fractures. Lots of controversies exist about the ideal management for them. The focus is now shifting on operative management by open reduction and internal fixation for these fractures with or without the use of bone grafts. Method: Thirty intraarticular fractures classified by Essex Lopresti radiological classification, were treated by open reduction and fixation. The patients were followed over a mean period of 30 months (25-40 months. Results: All the fractures united at a mean duration of 14 weeks. 86% patients had excellent functional outcome with one patient having fair and one having poor functional outcome. Conclusion: Open reduction and internal fixation with plate is a good method for treatment of intraarticular fractures of calcaneum to achieve anatomical restoration of articular surface under vision, stable fixation, early mobilization and an option for primary subtalar arthrodesis if deemed necessary.

  3. INTERNAL FIXATION OF INTRA ARTICULAR CALCANEUM FRACTURES USING LOCKING COMPRESSION PLATE

    Directory of Open Access Journals (Sweden)

    Neelakrishnan

    2014-10-01

    Full Text Available INTRODUCTION: Calcaneum is the most frequently fractured tarsal bone. Historically intra articular calcaneum fractures treated non-operatively which led to increased morbidity due to in congruency of articular surface resulting in subtalar arthritis. With advent of CT scan, better implants and improved methods of fixation. Operative treatment has now become a standard method. AIM OF THE STUDY: To study the functional and radiological outcome of intra articular calcaneum fractures treated by open reduction and internal fixation using locking compression plate. MATERIALS AND METHODS: Fifteen patients with intra articular calcaneum fractures treated by open reduction and internal fixation using locking compression plate from May 2012 to September 2014 at Rajah Muthiah Medical College Hospital with follow up of 6months. The fractures were classified on the basis of computer tomography (CT findings as Sanders type I to IV. The aim of our treatment is to achieve anatomical reconstruction of all articular surfaces, restore Bohler’s and Gissane angles, to carry out primary stable fixation and begin early mobilization. The patients were evaluated by Modified Maryland Foot Score, with excellent defined as90 - 100 points, good as 75 – 89 points, fair as 50 – 74 points and poor as <50 points. RESULTS: Fourteen patients were male and only one female. Twelve patients sustained fractures due to fall from height, three patients due to RTA. The mean pre-operative Bohler’s angle was 13 degree and mean post-operative angle was 26.2degree. The mean pre-operative Gissane angle was 147.6 degree and the mean post-operative angle was 121 degree. Excellent modified Maryland Foot score were achieved in 9 patients, good in 3, fair in 1patient.Only 2 had poor outcome. CONCLUSION: Surgical treatment of intra-articular calcaneum fractures using locking compression plate by lateral approach has good functional outcome. CT scan is required for understanding the

  4. Picturing internal fractures of historical statues using ground penetrating radar method

    OpenAIRE

    S. Kadioglu; Y. K. Kadioglu

    2010-01-01

    The aim of the study is to formulate an approach to the monitoring of internal micro discontiniuties in a hybrid 2-D/3-D image of ground penetrating radar (GPR) data gathered on historical monument groups, and to indicate methodologically rearranging amplitude-color scale and its opacity functions to activate micro fractures in monument groups including three colossal women, three men, and 24 lion statues in Mustafa Kemal ATATÜRK's mausoleum (ANITKABIR) in Ankara, Turkey. Ad...

  5. Internal fixation and muscle pedicle bone grafting in femoral neck fractures

    Directory of Open Access Journals (Sweden)

    Gupta A

    2008-01-01

    Full Text Available Background: The treatment of displaced intracapsular femoral neck fracture is still an unsolved problem. Non-union and avascular necrosis are the two main complications of this fracture, especially if patient presents late. Muscle pedicle bone grafting has been advocated to provide additional blood supply. We present analysis of our 32 cases of displaced femoral neck fracture treated by internal fixation and quadratus femoris based muscle pedicle bone grafting. Materials and Methods: Open reduction and internal fixation with muscle pedicle grafting was done in 32 patients. The age of patients varied from 14-62 years (average age 45 years with male to female ratio of 13:3. Twenty-nine fractures were more than three weeks old. All the cases were treated by Meyers′ procedure. The fracture was internally fixed after open reduction and then a muscle pedicle graft was applied. It was supplemented by cancellous bone graft in seven cases. Fixation was done by parallel cancellous lag screws ( n = 19, crossed Garden′s screws ( n = 7, parallel Asnis screws ( n = 5 and Moore′s pin ( n = 1.Quadratus femoris muscle pedicle graft was used in 32 cases. In the initial 12 cases the graft was fixed with circumferential proline sutures, but later, to provide a secure fixation, the graft was fixed with a cancellous screw ( n = 20. Postoperative full weight bearing was deferred to an average of 10 weeks. Results: Union was achieved in 26/29 (89.65% cases which could be followed for an average period of 3.4 years, (2-8.5 years with good functional results and had the ability to squat and sit cross-legged. Results were based on hip rating system given by Salvatti and Wilson. The results were excellent in 15 cases, good in four cases, fair in four cases and poor in six cases. Complications were avascular necrosis ( n = 2, transient foot drop ( n = 2, coxa-vara ( n = 1 and temporary loss of scrotal sensation ( n = 1. Conclusion: Muscle pedicle bone grafting with

  6. Fibular Strut Graft Augmentation for Open Reduction and Internal Fixation of Proximal Humerus Fractures

    Science.gov (United States)

    Saltzman, Bryan M.; Erickson, Brandon J.; Harris, Joshua D.; Gupta, Anil K.; Mighell, Mark; Romeo, Anthony A.

    2016-01-01

    Background: Proximal humerus fractures are common problems plaguing the elderly population. Purpose: The purposes of this study were to determine the outcomes of fibular strut allografts in treatment of proximal humerus fractures with open reduction internal fixation (ORIF) and to present the authors’ preferred surgical technique. The hypothesis was that the use of fibular strut allografts in treating proximal humerus fractures with ORIF will provide low reoperation rates with acceptable outcomes. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was registered with PROSPERO and performed with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines using 3 publicly available free databases. Therapeutic clinical outcome investigations reporting arthroscopic elbow outcomes with levels of evidence 1 through 4 were eligible for inclusion. All study, subject, and surgical technique demographics were analyzed and compared between continents and countries. Statistics were calculated using Student t tests, 1-way analysis of variance, chi-square tests, and 2-proportion Z tests. Results: Four studies met the inclusion criteria. While there is great heterogeneity existing in the literature surrounding use of a fibular strut allograft as an adjunct to ORIF of proximal humerus fractures, current evidence shows a humeral head screw penetration rate of 3.7% with acceptable functional outcome scores, with a reoperation rate of 4.4% at a weighted mean 80.78 weeks (1.55 years) of postoperative follow-up. Conclusion: There is great heterogeneity that exists in the literature surrounding the use of a fibular strut allograft as an adjunct to ORIF of proximal humerus fractures. Current evidence shows a screw penetration rate of 3.7% with acceptable functional outcome scores, demonstrating fibular strut allograft is a viable option for treating proximal humerus fractures. PMID:27504463

  7. Computed tomography analysis of acetabular anteversion and abduction

    Energy Technology Data Exchange (ETDEWEB)

    Stem, Eric S. [Mayo Clinic, Department of Orthopedic Surgery, Jacksonville, FL (United States); South Carolina Sports Medicine and Orthopaedic Center, North Charleston, SC (United States); O' Connor, Mary I. [Mayo Clinic, Department of Orthopedic Surgery, Jacksonville, FL (United States); Kransdorf, Mark J. [Mayo Clinic, Department of Radiology, Jacksonville, FL (United States); Crook, Julia [Mayo Clinic, Biostatistic Unit, Jacksonville, FL (United States)

    2006-06-15

    The purpose of this study is to define the normal range of acetabular abduction and anteversion in relation to pelvic anatomy as depicted on conventional CT scan. We retrospectively reviewed 100 pelvic CT scans performed on patients presenting for evaluation of non-orthopaedic pathology. The study group consisted of 58 women and 42 men, aged between 18 and 88 years. Standard imaging protocol included an anteroposterior (AP) topogram with contiguous 5-mm thick axial images from the superior margin of the iliac crest to the lesser trochanter of the femur. The acetabular abduction was measured from the AP topogram by obtaining the angle between a line drawn from the acetabular teardrop to the lateral acetabular margin and a horizontal line between the ischial tuberosities. Acetabular anteversion was measured on axial images at the level of the mid-femoral head. We found the mean acetabular abduction to be 39 degrees (standard deviation 4 degrees, range 27 to 51 degrees) and the mean acetabular anteversion to be 23 degrees (standard deviation 5 degrees, range 12 to 39 degrees). Data suggests that acetabular anteversion may average 2.7 degrees lower in males than females and increase slightly with age, while abduction may tend to decrease with age. Ninety percent of patients had acetabular abduction between 31 and 46 degrees; the 90% central range for acetabular anteversion was estimated to be from 14 to 31 degrees. CT scanning is useful in accurately defining the normal range of acetabular abduction and antiversion. Knowledge of this normal anatomy will allow accurate assessment of acetabular component position as delineated on conventional CT scanning. (orig.)

  8. Closed reduction and internal fixation versus total hip arthroplasty for displaced femoral neck fracture

    Institute of Scientific and Technical Information of China (English)

    Cao Liehu; Wang Bin; Li Ming; Song Shaojun; Weng Weizong; Li Haihang; Su Jiacan

    2014-01-01

    Objective:To compare the clinical effects between closed reduction and internal fixation (CRIF) and total hip arthroplasty (THA) for displaced femoral neck fracture.Methods:In this prospective randomized study,285 patients aged above 65 years with hip fractures (Garden Ⅲ or Ⅳ) were included from January 2001 to December 2005.The cases were randomly allocated to either the CRIF group or THA group.Patients with pathological fractures (bone tumors or metabolic bone disease),preoperative avascular necrosis of the femoral head,osteoarthritis,rheumatoid arthritis,hemiplegia,long-term bed rest and complications affecting hip functions were excluded.Results:During the 5-year follow-up,CRIF group had significantly higher rates of complication in hip joint,general complication and reoperation than THA group (38.3% vs.12.7%,P<0.01; 45.3% vs.21.7%,P<0.01; 33.6% vs.10.2%,P<0.05 respectively).There was no difference in mortality between the two groups.Postoperative function of the hip joint in THA group recovered favorably with higher Harris scores.Conclusion:For displaced fractures of the femoral neck in elderly patients,THA can achieve a lower rate of complication and reoperation,as well as better postoperative recovery of hip joint function compared with CRIF.

  9. Treatment of Humeral Shaft Fractures: Minimally Invasive Plate Osteosynthesis Versus Open Reduction and Internal Fixation

    Science.gov (United States)

    Esmailiejah, Ali Akbar; Abbasian, Mohammad Reza; Safdari, Farshad; Ashoori, Keyqobad

    2015-01-01

    Background: The optimal technique for operative fixation of humeral shaft fractures remains controversial and warrants research. Objectives: The purpose of the current study was to compare the functional and clinical outcomes of conventional open reduction and internal fixation (ORIF) with minimally invasive plate osteosynthesis (MIPO) in patients with fractures in two-third distal humeral shaft. Patients and Methods: In the current prospective case-control study, 65 patients with humeral shaft fractures were treated using ORIF (33 patients) or MIPO (32 patients). Time of surgery, time of union, incidence of varus deformity and complications were compared between the two groups. Also, the university of California-Los Angeles (UCLA) shoulder rating scale and Mayo Elbow performance score (MEPS) were used to compare the functional outcomes between the two groups. Results: The median of union time was shorter in the MIPO group (4 months versus 5 months). The time of surgery and functional outcomes based on the UCLA and MEPS scores were the same. The incidence of varus deformity was more than 5° and was higher and the incidence of nonunion, infection and iatrogenic radial nerve injury were lower in the MIPO group; however, the differences were not significant. Conclusions: Due to the shorter union time, to some extent less complication rate and comparable functional and clinical results, the authors recommend to use the MIPO technique in treating the mid-distal humeral shaft fracture. PMID:26543844

  10. Outcome of open reduction and internal fixation of intraarticular calcaneal fracture fixed with locking calcaneal plate

    Directory of Open Access Journals (Sweden)

    Jain Saurabh

    2013-12-01

    Full Text Available 【Abstract】Objective: Debate continues regarding the management of calcaneal fractures, between open re- duction and internal fixation and closed treatment. Hence we aim at evaluating the radiological and functional out- comes of open reduction and internal fixation in displaced joint depression type of calcaneal fractures fixed with lock- ing calcaneal plate. Methods: In this series, 28 patients (26 unilateral and 2 bilateral with joint depression type of calcaneal fractures as per Essex-Lopresti classification system were operated on with locking calcaneal plate within 3 weeks of injury. Patients were evaluated in terms of associated injuries and X-rays of anteroposterior, lateral and axial views of the calcaneum. CT scan was done to assess the amount of com- minution and articular depression. Patients were followed up clinically and radiologically at least for 1 year. Radiologi- cal assessment was done by Bohler’s angle and Gissane’s angle along with measurement of calcaneal height and width. Functional outcome was assessed using the American Or- thopaedics Foot and Ankle Society (AOFAS scale. Results: At average follow-up of 14.5 months, average AOFAS score was 86.3 (range 66 to 97, with 86% having excellent to good results and 2 (7.7% and 1 (3.7% having fair and poor results respectively. All patients had stable ankle joint with all having dorsiflexion and plantar flexion more than 30°. Average subtalar range of motion was 17°. The mean Bohler’s angle, mean Gissane’s angle, calcaneal height and width were 25.47°, 121.3°, 4.32 cm and 3.81cm respectively at final follow-up. Three patients had flap ne- crosis at incision site and one had superficial and deep infection. Subtalar arthritis was seen in 5 patients, whereas sural nerve hypoaesthesia in 1 patient. None of the patients had compartment syndrome, heel pad problems, peroneal tendinitis, reflex sympathetic dystropy or implant failure. Conclusion: Open reduction and

  11. Computerized tomography in evaluation of decreased acetabular and femoral anteversion

    International Nuclear Information System (INIS)

    Computerized tomography has received a new importance. It has been shown that decreased anteversion of femur and acetabulum, when both have decreased angles, are causing pain and osteoarthritis of the hip joint. Operative treatment should be performed before osteoarthritis develops. Exact measurements therefore are necessary. The investigation should be performed in prone position to have the pelvis lying in a defined and normal position. Femoral torsion is measured between the transverse axis of the knee and the femoral neck. The transverse axis for measurement of the femoral anteversion is defined by a rectangular line to the sagittal plane. For evaluation of the femoral anteversion in total the angle of the condyles has to be added to the femoral neck angle when the knee is found in internal rotation. Acetabular anteversion should be measured at the level where the femoral head is still in full contact and congruence with the anterior margin of the acetabulum. (orig.)

  12. Osteonecrosis and femoro-acetabular impingement: sequelae of developmental dysplasia of the hip

    OpenAIRE

    Cheung, Jason Pui Yin; Chow, Wang; To, Michael

    2012-01-01

    A 2-year-old girl with developmental dysplasia of the right hip underwent open reduction and capsulorrhaphy via the anterior approach with hip spica casting in an internally rotated position. During her 26 years of follow-up, she was found to have osteonecrosis and subsequently cam-type femoro-acetabular impingement at 28 years of age. She was treated with surgical dislocation of the hip and osteochondroplasty to recreate the normal contour of the head and neck offset.

  13. Open reduction and internal fixation of displaced clavicle fractures in adolescents

    Directory of Open Access Journals (Sweden)

    Harish S. Hosalkar

    2011-12-01

    Full Text Available The literature available on patient oriented outcomes of operative management for clavicle fractures in adolescents is fairly limited. The purpose of this study was to analyze the potential of open reduction and internal fixation for displaced mid-shaft clavicle fractures in adolescent patients. We reviewed our series of surgical cases performed in 19 adolescents (mean age: 14.6 years with displaced unilateral clavicle fractures. Baseline data acquisition included demographic and radiographic variables. A Synthes® LCP clavicular plate was utilized for fixation in all cases. Follow-up data included functional outcome assessment using the Quick Disability of Arm, Shoulder, and Hand Questionnaire (DASH, the simple shoulder test (SST and additional binary questions. At a mean follow-up of 16 months, quick DASH scores were 4.0 (range: 0-35.5 and mean number of positive yes responses on the SST for all operative patients was 11 (range: 9-12. All cases proved complete radiological union at the 3-month follow-up. All patients returned to full athletics at a mean time of 14 weeks (range: 12-17 weeks. Two patients had minimal hypertrophic scars while no patient was noted with keloid formation or neurovascular deficit. One patient complained of implant prominence and occasional symptoms of discomfort at the 15 month follow-up and opted for implant removal. This was successfully performed with uneventful full recovery. All patients were fully satisfied with their choice for surgical intervention. Anatomical reduction with internal fixation and early mobilization of adolescent displaced clavicle fractures remains a viable treatment option with predictable results and no major complications in reliable hands.

  14. Use of gentamicin-loaded collagen sponge in internal fixation of open fractures

    Institute of Scientific and Technical Information of China (English)

    Chaudhary Susheel; Sen Ramesh; Saini Uttam Chand; Soni Ashwani; Gahlot Nitesh; Singh Daljit

    2011-01-01

    management of open bone injuries. These sponges can be used easily with any form of internal fixation and there is no need of second surgery for the removal of these antibiotic carriers since they are bioabsorbable. Local antibiotic-impregnated collagen sponges along with systemic antibiotics for 3 to 5 days offer promising results in open fracture management.

  15. Combined fixation, intern and external, in proximal complex fractures of the tibia

    International Nuclear Information System (INIS)

    Between August of 1997 and December of 2001, they were treated in the orthopedics department and traumatology of the Hospital Clinica San Rafael, 16 patients with proximal complex fractures of the tibia, using internal fixation with plate in the lateral column and an unilateral external fixer, for the medial column. It carries out a clinical and radiological pursuit with average of 27 months (minimum 4.5, maximum 40 months). In 15 patients (93,7%) it was obtained a primary consolidation and 1 case (6,2%) it presented retard in the consolidation being necessary the placement of bony implants. in 2 cases (12,5%) there was superficial infection, one in the itinerary of the nails and another in area of superficial necrosis in soft fabrics in a closed fracture. single 1 case (6,2) it presented deep infection, which, it improve with bony curettage and antibiotics. In the final radiographic evaluation, 2 cases (12,5%) they presented depression of the lateral plate; according to the functional scale of Rasmussen excellent results were obtained (27 to 30 points) in 11 cases (68,7%) and good (20 to 26 points) in 5 cases (31,2%). The radiographic results and functional global they suggest that the combination of a technique less invasive in this area criticizes, it represents a good alternative for the treatment of the proximal complex fractures of the tibia

  16. Unusual Bilateral Rim Fracture in Femoroacetabular Impingement

    Directory of Open Access Journals (Sweden)

    Claudio Rafols

    2015-01-01

    Full Text Available This is a report of one case of bilateral acetabular rim fracture in association with femoroacetabular impingement (FAI, which was treated with a hip arthroscopic procedure, performing a partial resection, a labral reinsertion, and a subsequential internal fixation with cannulated screws. Up to date, there are in the literature only two reports of rim fracture and “os acetabuli” in association with FAI. In the case we present, the pincer and cam resection were performed without complications; the technique used was published previously. With this technique the head of the screw lays hidden by the reattached labrum. We removed partially the fractured rim fragment and the internal fixation of the remaining portion was achieved with a screw. In the event of a complete resection of the fragment, it would have ended with a LCE angle of 18° and a high probability of hip instability. We believe that this bilateral case helps establish the efficacy and reproducibility of the technique described by Larson.

  17. Treatment of stress fracture of the olecranon in throwing athletes with internal fixation through a small incision

    Directory of Open Access Journals (Sweden)

    Fujioka Hiroyuki

    2012-12-01

    Full Text Available Abstract The present study is a report of retrospective case series of stress fracture of the olecranon. Six patients presented posterior elbow pain in throwing in baseball and softball, but fracture was not diagnosed in radiographs. We detected stress fracture of the olecranon using computed tomographic (CT scan and treated the patient with internal fixation with a headless cannulated double threaded screw through a small skin incision. All patients returned to competitive level without elbow complaints after the operation. When throwing athletes present with unusual posterior elbow pain and no significant findings on radiographs, a CT scan examination should be performed. We recommend surgical treatment of internal fixation with a screw through a small skin incision, as a good option for stress fracture of the olecranon in order to allow early return to sports activity in competitive athletes.

  18. PREFACE: International Symposium on Dynamic Deformation and Fracture of Advanced Materials (D2FAM 2013)

    Science.gov (United States)

    Silberschmidt, Vadim V.

    2013-07-01

    Intensification of manufacturing processes and expansion of usability envelopes of modern components and structures in many cases result in dynamic loading regimes that cannot be resented adequately employing quasi-static formulations of respective problems of solid mechanics. Specific features of dynamic deformation, damage and fracture processes are linked to various factors, most important among them being: a transient character of load application; complex scenarios of propagation, attenuation and reflection of stress waves in real materials, components and structures; strain-rate sensitivity of materials properties; various thermo-mechanical regimes. All these factors make both experimental characterisation and theoretical (analytical and numerical) analysis of dynamic deformation and fracture rather challenging; for instance, besides dealing with a spatial realisation of these processes, their evolution with time should be also accounted for. To meet these challenges, an International Symposium on Dynamic Deformation and Fracture of Advanced Materials D2FAM 2013 was held on 9-11 September 2013 in Loughborough, UK. Its aim was to bring together specialists in mechanics of materials, applied mathematics, physics, continuum mechanics, materials science as well as various areas of engineering to discuss advances in experimental and theoretical analysis, and numerical simulations of dynamic mechanical phenomena. Some 50 papers presented at the Symposium by researchers from 12 countries covered various topics including: high-strain-rate loading and deformation; dynamic fracture; impact and blast loading; high-speed penetration; impact fatigue; damping properties of advanced materials; thermomechanics of dynamic loading; stress waves in micro-structured materials; simulation of failure mechanisms and damage accumulation; processes in materials under dynamic loading; a response of components and structures to harsh environment. The materials discussed at D2FAM 2013

  19. The influence of acetabular inclination angle on the penetration of polyethylene and migration of the acetabular component: a prospective, radiostereometric study on cemented acetabular components.

    Science.gov (United States)

    Kadar, T; Furnes, O; Aamodt, A; Indrekvam, K; Havelin, L I; Haugan, K; Espehaug, B; Hallan, G

    2012-03-01

    In this prospective study we studied the effect of the inclination angle of the acetabular component on polyethylene wear and component migration in cemented acetabular sockets using radiostereometric analysis. A total of 120 patients received either a cemented Reflection All-Poly ultra-high-molecular-weight polyethylene or a cemented Reflection All-Poly highly cross-linked polyethylene acetabular component, combined with either cobalt-chrome or Oxinium femoral heads. Femoral head penetration and migration of the acetabular component were assessed with repeated radiostereometric analysis for two years. The inclination angle was measured on a standard post-operative anteroposterior pelvic radiograph. Linear regression analysis was used to determine the relationship between the inclination angle and femoral head penetration and migration of the acetabular component. We found no relationship between the inclination angle and penetration of the femoral head at two years' follow-up (p = 0.9). Similarly, our data failed to reveal any statistically significant correlation between inclination angle and migration of these cemented acetabular components (p = 0.07 to p = 0.9).

  20. Treatment of Gustilo grade Ⅲ leg fractures by external fixation associated with limited internal fixation

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chun-qiang; ZHENG Hong-yu; WANG Bing; HUANG He; HE Fei; ZHAO Xue-ling

    2010-01-01

    Objective: To explore the clinical ef-fects of external fixation associated with limited internal fixa-tion on treatment of Gustilo grade Ⅲ leg fractures.Methods: From July 2006 to December 2008, 40 cases of Gustilo grade Ⅲ leg fiactures were emergently treated in our unit with external fixation frames.Soft tissue injuries were grouped according to the Gustilo classification as ⅢA in 17 cases, ⅢB in 13 cases, and ⅢC in 10 cases.All the patients were debrided within 8 hours, and then fracture reposition was preformed to reestablish the leg alignment.Limited internal fixation with plates and screws were per-formed on all the Gustilo Ilia cases and 10 Gustilo ⅢB cases at the first operation.But all the Gustilo ⅢC cases and 3 Gustilo ⅢB cases who had severe soft tissue injuries and bone loss only received Vacuum-sealing drainage (VSD).Broad-spectrum antibiotics were regularly used and VSD must be especially maintained easy and smooth for one week or more after operation.Limited internal fixation and transplanted free skin flaps or adjacent musculocutaneous flaps were not used to close wounds until the conditions of the wounds had been improved.Results: The first operations were completed within 90-210 minutes (170 minutes on average).The blood trans-fusions were from 400 ml to 1500 ml (those used for anti-shock preoperatively not included).All the 40 patients in this study were followed up for 6-28 months, 20.5 months on average.The lower limb function was evaluated accord-ing to the comprehensive evaluation standards of leg func-tion one year after operation and the results of 28 cases were excellent, 9 were good and 3 were poor.Conclusion: External fixation associated with limited internal fixation to treat Gustilo grade Ⅲ leg fractures can get satisfactory early clinical therapeutic effects.

  1. Failure of dual radius hydroxyapatite-coated acetabular cups

    Directory of Open Access Journals (Sweden)

    Zatti Giovanni

    2008-08-01

    Full Text Available Abstract Introduction Many kind of hydroxyapatite-coated cups were used, with favorable results in short term studies; it was supposed that its use could improve osteointegration of the cup, enhancing thus stability and survivorship. The purpose of this study is to analyze the long term behavior of the hemispheric HA coated, Dual Radius Osteonics cup and to discuss the way of failure through the exam of the revised components and of both periacetabular and osteolysis tissue. Materials and Methods Between 1994 and 1997, at the Department of Orthopedic Sciences of the Insubria University, using the posterolateral approach, were implanted 276 Dual Radius Osteonics® in 256 patients, with mean age of 63 years. Results At a mean follow-up of 10 years (range 8–12 years, 183 cups in 165 patients, were available for clinical and radiographical evaluation. 22 Cups among the 183 were revised (11%. The cause of revision was aseptic loosening in 17 cases, septic loosening in one case, periprosthetic fracture in another case, osteolysis and polyethylene wear in two cases and, finally, recurrent dislocations in the last one. In the remaining patients, mean HHS increased from a preoperative value of 50,15 to a postoperative value of 92,69. The mean polyethylene wear was 1,25 mm (min. 0,08, max. 3,9 mm, with a mean annual wear of 0,17 mm. The mean acetabular migration on the two axis was 1,6 mm and 1,8 mm. Peri-acetabular osteolysis were recorded in 89% of the implants (163 cases. The cumulative survivorship (revision as endpoint at the time was 88,9%. Conclusion Our study confirms the bad behavior of this type of cup probably related to the design, to the method of HA fixation. The observations carried out on the revised cup confirm these hypotheses but did not clarify if the third body wear could be a further problem. Another interesting aspect is the high incidence of osteolysis, which are often asymptomatic becoming a problem for the surgeon as the

  2. Outcome of open reduction and internal fixation of intraarticular calcaneal fracture fixed with locking calcaneal plate

    Institute of Scientific and Technical Information of China (English)

    Saurabh Jain; Anil Kumar Jain; Ish Kumar

    2013-01-01

    Objective:Debate continues regarding the management of calcaneal fractures,between open reduction and internal fixation and closed treatment.Hence we aim at evaluating the radiological and functional outcomes of open reduction and internal fixation in displaced joint depression type of calcaneal fractures fixed with locking calcaneal plate.Methods:In this series,28 patients (26 unilateral and 2 bilateral) with joint depression type of calcaneal fractures as per Essex-Lopresti classification system were operated on with locking calcaneal plate within 3 weeks of injury.Patients were evaluated in terms of associated injuries and X-rays of anteroposterior,lateral and axial views of the calcaneum.CT scan was done to assess the amount ofcomminution and articular depression.Patients were followed up clinically and radiologically at least for 1 year.Radiological assessment was done by Bohler's angle and Gissane's angle along with measurement ofcalcaneal height and width.Functional outcome was assessed using the American Orthopaedics Foot and Ankle Society (AOFAS) scale.Results:At average follow-up of 14.5 months,average AOFAS score was 86.3 (range 66 to 97),with 86% having excellent to good results and 2 (7.7%) and 1 (3.7%) having fair and poor results respectively.All patients had stable ankle joint with all having dorsiflexion and plantar flexion more than 30°.Average subtalar range of motion was 17°.The mean Bohler's angle,mean Gissane's angle,calcaneal height and width were 25.47°,121.3°,4.32 cm and 3.81cm respectively at final follow-up.Three patients had flap necrosis at incision site and one had superficial and deep infection.Subtalar arthritis was seen in 5 patients,whereas sural nerve hypoaesthesia in 1 patient.None of the patients had compartment syndrome,heel pad problems,peroneal tendinitis,reflex sympathetic dystropy or implant failure.Conclusion:Open reduction and internal fixation with locking calcaneal plate gives sound functional outcome

  3. Outcome of proximal humerus fractures treated by PHILOS plate internal fixation. Experience of a district general hospital.

    Science.gov (United States)

    Shahid, Rizwan; Mushtaq, Abid; Northover, Julian; Maqsood, Mohammad

    2008-10-01

    Proximal humerus fractures have been a challenge to achieve stable fixation. PHILOS (Proximal Humerus internal locking system) is part of the latest generation of locking compression plates for proximal humeral fracture fixation. We aim to assess the clinical and functional outcome of proximal humeral fractures (2-part, 3-part and 4-part) treated with the PHILOS plate. We prospectively reviewed 50 patients who had a proximal humeral fracture treated with the PHILOS plate from September 2002 to September 2006 in our institution. Clinical outcome was measured using the patient-based Oxford shoulder and DASH scoring systems. Five patients died and four were lost to follow-up. Eleven patients had 2-part, eleven 3-part and eighteen 4-part fractures. Mean follow-up time was 21.7 months (range: 6-44 months). Radiological union was achieved within 8 weeks in 40/41 fractures; complications were noted in four cases. Better results were achieved in younger than in older patients, and in male than in female patients. The number of fracture fragments did not appear to affect the results, but associated dislocation of the humeral head was a pejorative factor. Our study has shown that the PHILOS plate is a reliable implant. A direct correlation was observed between Oxford shoulder and DASH scores.

  4. Bioabsorbable fish scale for the internal fixation of fracture: a preliminary study.

    Science.gov (United States)

    Chou, Cheng-Hung; Chen, Yong-Guei; Lin, Chien-Chen; Lin, Shang-Ming; Yang, Kai-Chiang; Chang, Shih-Hsin

    2014-09-01

    Fish scales, which consist of type I collagen and hydroxyapatite (HA), were used to fabricate a bioabsorbable bone pin in this study. Fresh fish scales were decellularized and characterized to provide higher biocompatibility. The mechanical properties of fish scales were tested, and the microstructure of an acellular fish scale was examined. The growth curve of a myoblastic cell line (C2C12), which was cultured on the acellular fish scales, implied biocompatibility in vitro, and the morphology of the cells cultured on the scales was observed using scanning electron microscopy (SEM). A bone pin made of decellularized fish scales was used for the internal fixation of femur fractures in New Zealand rabbits. Periodic X-ray evaluations were obtained, and histologic examinations were performed postoperatively. The present results show good cell growth on decellularized fish scales, implying great biocompatibility in vitro. Using SEM, the cell morphology revealed great adhesion on a native, layered collagen structure. The Young's modulus was 332 ± 50.4 MPa and the tensile strength was 34.4 ± 6.9 MPa for the decellularized fish scales. Animal studies revealed that a fish-scale-derived bone pin improved the healing of bone fractures and degraded with time. After an 8-week implantation, the bone pin integrated with the adjacent tissue, and new extracellular matrix was synthesized around the implant. Our results proved that fish-scale-derived bone pins are a promising implant material for bone healing and clinical applications. PMID:25211643

  5. Retrospective comparison of percutaneous fixation and volar internal fixation of distal radius fractures.

    Science.gov (United States)

    Lozano-Calderón, Santiago A; Doornberg, Job N; Ring, David

    2008-06-01

    A change in the practice of a single surgeon provided an opportunity for retrospective comparison of comparable cohorts treated with percutaneous fixation (17 patients) or a volar plate and screws (23 patients) an average of 30 months after surgery. The final evaluation was performed according to the Gartland and Werley and Mayo rating systems and the DASH questionnaire. There were no significant differences on the average scores for the percutaneous and volar plating groups, respectively: Gartland and Werley, 4 vs 5; Mayo, 82 vs 83; and DASH score 13 for both cohorts. Motion, grip, and radiographical parameters were likewise comparable. Volar internal plate and screw fixation can achieve results comparable to percutaneous fixation techniques in the treatment of fractures of the distal radius.

  6. Evidence based postoperative treatment of distal radius fractures following internal locking plate fixation.

    Science.gov (United States)

    Klein, S M; Prantl, L; Koller, M; Vykoukal, J; Dolderer, J H; Graf, S; Nerlich, M; Loibl, M; Geis, S

    2015-01-01

    Originally, the treatment method of choice for distal radial fractures (DRF) has been a non-operative approach with six to eight weeks of plaster casting. The introduction of volar locking plate systems at the beginning of the 21 st century has pushed trends towards open reduction and internal fixation (ORIF). While the introduction of fixed angle locking plates together with the increasing knowledge on wrist function and related variable outcomes has led to consensus that operative fixation in instable DRF is the treatment method of choice, there is no agreement on a postoperative care of these injuries. The authors will discuss the available evidence for current concepts of postoperative treatment of DRFs following fixed angle fixation under socioeconomical, biomechanical and burden of disease aspects. Further, relevant randomized controlled trials are evaluated with regard to applied postoperative treatment regimes and related risks for complications.

  7. Rigid internal fixation with titanium versus bioresorbable miniplates in the repair of mandibular fractures in rabbits.

    Science.gov (United States)

    Hochuli-Vieira, E; Cabrini Gabrielli, M A; Pereira-Filho, V A; Gabrielli, M F R; Padilha, J G

    2005-03-01

    The purpose of this study was to compare by qualitative histology the efficacy of rigid internal fixation with titanium system and the Lacto Sorb system in mandibular fractures in rabbits. Thirty male adult rabbits Oryctolagus cuniculus were used. Unilateral mandibular osteotomies were performed between the canine and first premolar. The animals were divided into two groups: for Group I-rigid internal fixation was performed with titanium system 1.5 mm (Synthes, Oberdorf, Switzerland), with two screws of 6 mm (bicortical) on each side of the osteotomy. For Group II-rigid internal fixation was performed with PLLA/PGA system 1.5 mm (Lacto Sorb, WLorenz, Jacksonville, FL, USA). The histological analysis evaluated the presence of inflammatory reaction, degree of bone healing and degree of resorption of the Lacto Sorb screws. The results of both fixation systems were similar, only with a small difference after 15 and 30 days. In Group I a faster bony healing was noted. But after 60 days, bony healing was similar in both groups. It is concluded that both PLLA/PGA and titanium plates and screws provide sufficient strength to permit mandibular bone healing. The resorption process of PLLA/PGA osteosynthesis material did not cause acute or chronic inflammatory reaction or foreign body reaction during the studied period.

  8. Is there evidence for accelerated polyethylene wear in uncemented compared to cemented acetabular components? A systematic review of the literature

    NARCIS (Netherlands)

    van der Veen, Hugo; van Jonbergen, H.P.W.; Poolman, R.W.; Bulstra, S.K.; van Raay, J.J.A.M.

    2013-01-01

    Joint arthroplasty registries show an increased rate of aseptic loosening in uncemented acetabular components as compared to cemented acetabular components. Since loosening is associated with particulate wear debris, we postulated that uncemented acetabular components demonstrate a higher polyethyle

  9. CT of pelvic fractures

    International Nuclear Information System (INIS)

    Although magnetic resonance imaging has become the dominant modality for cross-sectional musculo-skeletal imaging, the widespread availability, speed, and versatility of computed tomography (CT) continue to make it a mainstay of emergency room (ER) diagnostic imaging. Pelvic ring and acetabular fractures occur as the result of significant trauma secondary to either a motor vehicle accident or a high-velocity fall. These injuries are correlated with significant morbidity and mortality, both from the complications of pelvic ring fractures and from commonly associated injuries. The most commonly used classification of pelvic and acetabular fractures has been based on conventional radiographs that are, in the majority of cases, sufficient to determine the type of injury. However, because of the complexity of pelvic and acetabular fractures, precise pathological anatomy is not easily demonstrated by routine radiographs and in many cases details of fractures are not visible. Moreover, the insufficient co-operation of the patient or the difficulty of maintaining special positions can be overcome by using computed tomography. Spiral computed tomography provides information regarding the extent of the fractures and is complementary to radiography for ascertaining the spatial arrangement of fracture fragments. Spiral computed tomography is an effective tool for understanding complex fracture patterns, particularly when combined with multi-planar reconstruction two-dimensional (MPR 2D) reformatted images or three-dimensional images (3D) images. Including these techniques of reconstruction in routine pelvic imaging protocols can change management in a significant number of cases. Subtle fractures, particularly those oriented in the axial plane, are better seen on MPR images or 3D volume-rendered images. Complex injuries can be better demonstrated with 3D volume-rendered images, and complicated spatial information about the relative positions of fracture fragments can be easily

  10. CT of pelvic fractures

    Energy Technology Data Exchange (ETDEWEB)

    Falchi, Marco E-mail: marcofalchi@yahoo.it; Rollandi, Gian Andrea

    2004-04-01

    Although magnetic resonance imaging has become the dominant modality for cross-sectional musculo-skeletal imaging, the widespread availability, speed, and versatility of computed tomography (CT) continue to make it a mainstay of emergency room (ER) diagnostic imaging. Pelvic ring and acetabular fractures occur as the result of significant trauma secondary to either a motor vehicle accident or a high-velocity fall. These injuries are correlated with significant morbidity and mortality, both from the complications of pelvic ring fractures and from commonly associated injuries. The most commonly used classification of pelvic and acetabular fractures has been based on conventional radiographs that are, in the majority of cases, sufficient to determine the type of injury. However, because of the complexity of pelvic and acetabular fractures, precise pathological anatomy is not easily demonstrated by routine radiographs and in many cases details of fractures are not visible. Moreover, the insufficient co-operation of the patient or the difficulty of maintaining special positions can be overcome by using computed tomography. Spiral computed tomography provides information regarding the extent of the fractures and is complementary to radiography for ascertaining the spatial arrangement of fracture fragments. Spiral computed tomography is an effective tool for understanding complex fracture patterns, particularly when combined with multi-planar reconstruction two-dimensional (MPR 2D) reformatted images or three-dimensional images (3D) images. Including these techniques of reconstruction in routine pelvic imaging protocols can change management in a significant number of cases. Subtle fractures, particularly those oriented in the axial plane, are better seen on MPR images or 3D volume-rendered images. Complex injuries can be better demonstrated with 3D volume-rendered images, and complicated spatial information about the relative positions of fracture fragments can be easily

  11. Osteochondritis dissecans after rotational acetabular osteotomy for dysplastic hip

    Energy Technology Data Exchange (ETDEWEB)

    Nozawa, Masahiko; Maezawa, Katsuhiko; Yuasa, Takahito; Morimoto, Kouichi; Asakura, Taro; Kurosawa, Hisashi [Juntendo University School of Medicine, Department of Orthopaedic Surgery, Tokyo (Japan)

    2005-12-01

    We encountered a rare case of osteochondritis dissecans of the femoral head after rotational acetabular osteotomy that recovered with conservative treatment 4 years after the detection of characteristic radiological findings. (orig.)

  12. Radiographic prevalence of CAM-type femoroacetabular impingement after open reduction and internal fixation of femoral neck fractures

    NARCIS (Netherlands)

    Mathew, G.; Kowalczuk, M.; Hetaimish, B.; Bedi, A.; Philippon, M.J.; Bhandari, M.; Simunovic, N.; Crouch, S.; Ayeni, O.R.; Kampen, A. van

    2014-01-01

    PURPOSE: The purpose of this study was to estimate the radiographic prevalence of CAM-type femoroacetabular impingement (FAI) in elderly patients (>/= 50 years) who have undergone internal fixation for femoral neck fracture. METHODS: A total of 187 frog-leg lateral radiographs of elderly patients

  13. Trabecular metal acetabular revision system (cup-cage construct to address the massive acetabular defects in revision arthroplasty

    Directory of Open Access Journals (Sweden)

    Rajesh Malhotra

    2012-01-01

    Full Text Available The increasing number of total hip replacements in the younger clique has added to the demand for revision procedures. Revision situations are often encountered with infection, loss of bone stock and bone defects. There are various methods of reconstruction of acetabular defects. The management options of type 3B Paprosky acetabular defects are limited with allograft and conventional cages. Trabecular metal technology has evolved to address these bone defects. Trabecular metal acetabular revision system (TMARS cup-cage construct is a new technique to address massive acetabular defects. We describe a case of failed hip reconstruction done for a Giant cell tumour of proximal femur managed by a two stage procedure, initial debridement and second stage reconstruction of acetabulum with TMARS cup-cage construct and femur with allograft prosthesis composite.

  14. Initial Results of an Acetabular Center Axis Registration Technique in Navigated Hip Arthroplasty with Deformed Acetabular Rims

    OpenAIRE

    Wada, Hiroshi; Mishima, Hajime; Yoshizawa, Tomohiro; Sugaya, Hisashi; Nishino, Tomofumi; Yamazaki, Masashi

    2016-01-01

    Background In cementless total hip arthroplasty, imageless computer-assisted navigation is usually used to register the anterior pelvic plane (APP). The accuracy of this method is influenced by the subcutaneous tissues overlying the registration landmarks. On the other hand, the acetabular center axis (ACA) is determined from the acetabular rim. Precise registration of the ACA is possible because of direct palpation using a pointer. Imageless navigation using the ACA usually targets patients ...

  15. Closed reduction external fixator fixation versus open reduction internal fixation in the patients with Bennett fracture dislocation

    Institute of Scientific and Technical Information of China (English)

    Li Zhongzhe; Guo Yang; Tian Wen; Tian Guanglei

    2014-01-01

    Background The Bennett fracture is either a common or a challenging problem to hand surgeons.It is still debated whether closed or open reduction gives optimal results.This study aimed to describe and assess a closed reduction and mini-external fixator fixation technique for the treatment of Bennett's fracture dislocation and to compare this technique versus open reduction and internal fixation.Methods From October 2002 to December 2012,56 patients with Bennett's fracture dislocation were treated by closed reduction and mini-external fixator fixation and 32 patients were treated by open reduction and internal fixation in Jishuitan Hospital.Patients with an articular step-off of more than 1 mm were excluded.All patients were assessed at a mean followup of 7 years (range 2-10 years) and the two groups were compared with pain levels,active range of trapeziometacarpal motion,grip strength and pinch strength,arthritic changes,and adduction deformity.Results Based on primary closed reduction maintained,the rate of anatomic reduction is 63.6%.Radiographic fracture union was achieved in all patients at a mean time of 5 weeks.At the final follow-up,there was no difference between the two groups in mean union time and pain levels (P=-0.2).There was also no difference between the two groups regarding the active range of trapeziometacarpal motion (P=0.3),grip stength (P=0.6),pinch strength (P=0.2),arthritic change and loss of reduction (P=0.2).There was a significant correlation between adduction deformity and the development of arthritis (P=0.02).Conclusion Closed reduction mini-external fixator fixation should be first tried to apply in the treatment of Bennett's fracture dislocation,and open reduction internal fixation should only be performed for irreducible fractures.

  16. Three-fin acetabular prosthesis for superior acetabular bone defects: a three-dimensional finite element analysis

    Institute of Scientific and Technical Information of China (English)

    LIU Yu-zeng; HAI Yong; ZHAO Hui

    2012-01-01

    Background Given that three-dimensional finite element models have been successfully used to analyze biomechanics in orthopedics-related research,this study aimed to establish a finite element model of the pelvic bone and three-fin acetabular component and evaluate biomechanical changes in this model after implantation of a three-fin acetabular prosthesis in a superior segmental bone defect of the acetabulum.Methods In this study,three-dimensional finite element models of the pelvic bone and three-fin acetabular component were first established.The prosthesis model was characterized by three different conformational fins to facilitate and optimize the prosthetic design.The spongy and cortical bones were evaluated using a different modulus of elasticity in this established model.Results The maximum and minimum von Mises stresses on the fins of the acetabular component were 15.2 and 0.74,respectively.The maximum and minimum micromotion between the three-fin acetabular component and the acetabulum bone interface were 27 and 13 μm,respectively.A high primary stability and implied better clinical outcome were revealed.Conclusion Finite element analysis may be an optimal strategy for biomechanics-related research of prosthetic design for segmental acetabular bone defects.

  17. Management of intra-articular fracture of the fingers via mini external fixator combined with limited internal fixation

    Institute of Scientific and Technical Information of China (English)

    LI Wen-jun; TIAN Wen; TIAN Guang-lei; CHEN Shan-lin; ZHANG Chang-qing; XUE Yun-hao; LI Zhong-zhe; ZHU Yin

    2009-01-01

    Background Intra-articular fractures of the fingers are common problems to emergency physicians and hand surgeons.Inappropriate management of these injuries may result in chronic pain,stiffness,deformity,or post traumatic arthritis.Ideal treatment necessitates the restoration of a stable and congruent joint that will allow early mobilization.The purpose of this study was to investigate the results of intra-articular fracture of the fingers by mini external fixator combined with limited internal fixation.Methods From May 2005 to May 2007,a total of 26 patients with intra-articular fracture of the fingers were treated by mini external fixator combined with limited internal fixation.Of the 26 cases,11 involved in metacarpophalangeal joint,and 15 interphalangeal joint in proximal interphalangeal.Kirschner wire,mini wire and absorbable suture were used for limited internal fixation.All patients were followed up and patients were accomplished with total active motion(TAM)of fingers.Results All patients were reviewed by an independent observer.The mean follow up was 13 months(range 9 to 24 months).Subjective,objective and radiographic results were evaluated.X-ray films revealed fracture union and the average radiographic union time was 7 weeks with a range of 5-12 weeks and the phalange shortening or rotation in 2 cases,joint incongruity(less than 1 mm)and joint space narrowing in 3 cases respectively.Phalangeal shortening or rotation was observed in 2 cases and joint incongruity or joint space narrowing was observed in 3 cases.An artificial implant was performed on one case for traumatic arthritis 1.5 years after surgery.Based on TAM the overall good-excellent rate of joint motion function was 80.8%.Conclusion Mini external fixator combined with limited internal fixation is a reliable and effective method for treatment of intra-articular fracture of the fingers.

  18. Internal fixation for coronal shear fracture of the capitellum with polylactide resorbable fixation

    OpenAIRE

    Kraan, Gerald A; Krijnen, Matthijs R; Eerenberg, Jan Peter

    2013-01-01

    A 24-year-old woman with pain in the right elbow after a fall demonstrated a coronal shear fracture on radiographic studies. Perioperative a coronal shear fracture was seen and treated successfully with a polylactide Rigid fix resorbable pin. The operative correction resulted in normal function at 6 months follow-up. We state that a capitellum shear fracture can be fixated with a single resorbable pin, leading to successful fusion.

  19. Rate of Improvement following Volar Plate Open Reduction and Internal Fixation of Distal Radius Fractures

    Directory of Open Access Journals (Sweden)

    Chris Dillingham

    2011-01-01

    Full Text Available Purpose. To determine recovery timeline of unstable distal radius fractures treated by open reduction and internal fixation with a locking volar plate. Methods. Data was collected prospectively on a consecutive series of twenty-seven patients during routine post-operative visits at 2 and 6 weeks, and 3, 6, 12 and 24 months. Range of motion measures and grip strength for both wrists were recorded. Results. Greatest gains were made within the first 3 months after surgery. Supination and pronation returned more quickly than flexion or extension, with supination and pronation both at 92% of the uninjured wrist at 3 months. Only flexion improved significantly between 3 and 6 months. All wrist motions showed some improvement until 1 year. Grip strength returned to 94% of the uninjured wrist by 12 months. Conclusions. Range of motion improvement will be greatest between 2 weeks and 3 months, with improvement continuing until 12 months. Grip strength should return to near normal by one year. Function and pain will improve, but not return to normal by the end of 12 months. Clinical Relevance. These results provide the surgeon with information that can be shared with patients on the anticipated timeline for normal recovery of function and strength.

  20. Effect of rehabilitation exercise in combined with nutrition intervention on the postoperative rehabilitation after internal fixation of lower humerus fracture

    Institute of Scientific and Technical Information of China (English)

    Ming-Chao Zhang

    2016-01-01

    Objective:To explore the effect of rehabilitation exercise in combined with nutrition exercise on the elbow joint function after internal fixation of lower humerus fracture.Methods: A total of 80 patients with lower humerus fracture who were admitted in our hospital from July, 2014 to July, 2015 were included in the study and randomized into the intervention group and the control group. All the patients were preformed with internal fixation and given anti-infection, pain relieving, and anticoagulation treatments after operation. On this basis, the patients in the intervention group were given rehabilitation exercise in combined with nutrition exercise. The serum protein level 1 and 10 d after operation, and the elbow joint function recovery 12 months after operation in the two groups were compared.Results: The comparison of serum Hb, ALB, PA, and Ca 1d after operation between the two groups was not statistically significant. The serum Hb, ALB, and PA levels 10 d after operation were significantly elevated when compared with 1 d after operation. The serum Hb and PA levels 10 d after operation in the intervention group were significantly higher than those in the control group. With the extending of rehabilitation time, the various ROM of elbow joint was significantly increased when compared with before treatment. The total active motion of elbow joint flexion and extension, and forearm pronation and supination 3 and 6 months after follow-up visit in the intervention group was significantly superior to that in the control group.Conclusions:After internal fixation of lower humerus fracture, systemic rehabilitation and nutrition intervention should be taken as early as possible. Rehabilitation can effectively prevent the tissue adhesion around the joint, and promote the fracture healing and the recovery of joint function. Nutrition intervention can significantly improve the nutrition status, and is beneficial to the fracture healing.

  1. Development of a brittle fracture acceptance criterion for the International Atomic Energy Agency (IAEA)

    Energy Technology Data Exchange (ETDEWEB)

    Sorenson, K.B.; Salzbrenner, R. (Sandia National Labs., Albuquerque NM (United States)); Nickell, R.E.

    1993-01-01

    An effort has been undertaken to develop a brittle fracture acceptance criterion for structural components of nuclear material transportation casks. The need for such a criterion was twofold. First, new generation cask designs have proposed the use of ferritic steels and other materials to replace the austenitic stainless steel commonly used for structural components in transport casks. Unlike austenitic stainless steel which fails in a high-energy absorbing, ductile tearing mode, it is possible for these candidate materials to fail via brittle fracture when subjected to certain combinations of elevated loading rates and low temperatures. Second, there is no established brittle fracture criterion accepted by the regulatory community that covers a broad range of structural materials. Although the existing IAEA Safety Series no.37 addressed brittle fracture, its the guidance was dated and pertained only to ferritic steels. Consultant's Services Meetings held under the auspices of the IAEA have resulted in a recommended brittle fracture criterion. The brittle fracture criterion is based on linear elastic fracture mechanics, and is the result of a consensus of experts from six participating IAEA-member countries. The brittle fracture criterion allows three approaches to determine the fracture toughness of the structural material. The three approaches present the opportunity to balance material testing requirements and the conservatism of the material's fracture toughness which must be used to demonstrate resistance to brittle fracture. This work has resulted in a revised Appendix IX to Safety Series no.37 which will be released as an IAEA Technical Document within the coming year. (author).

  2. Development of a brittle fracture acceptance criterion for the International Atomic Energy Agency (IAEA)

    Energy Technology Data Exchange (ETDEWEB)

    Sorenson, Ken B.; Salzbrenner, Richard [Sandia National Labs., Albuquerque, NM (United States); Nickell, Robert E. [Applied Science and Technology, Inc., Poway, CA (United States)

    1992-01-01

    An effort has been undertaken to develop a brittle fracture acceptance criterion for structural components of nuclear material transportation casks. The need for such a criterion was twofold. First, new generation cask designs have proposed the use of ferritic steels and other materials to replace the austenitic stainless steel commonly used for structural components in transport casks. Unlike austenitic stainless steel which fails in a high-energy absorbing, ductile tearing mode, it is possible for these candidate materials to fail via brittle fracture when subjected to certain combinations of elevated loading rates and low temperatures. Second, there is no established brittle fracture criterion accepted by the regulatory community that covers a broad range of structural materials. Although the existing IAEA Safety Series {number sign}37 addressed brittle fracture, its the guidance was dated and pertained only to ferritic steels. Consultant's Services Meetings held under the auspices of the IAEA have resulted in a recommended brittle fracture criterion. The brittle fracture criterion is based on linear elastic fracture mechanics, and is the result of a consensus of experts from six participating IAEA-member countries. The brittle fracture criterion allows three approaches to determine the fracture toughness of the structural material. The three approaches present the opportunity to balance material testing requirements and the conservatism of the material's fracture toughness which must be used to demonstrate resistance to brittle fracture. This work has resulted in a revised Appendix IX to Safety Series {number sign}37 which will be released as an IAEA Technical Document within the coming year.

  3. Accuracy of the modified Hardinge approach in acetabular positioning

    Science.gov (United States)

    Goyal, Prateek; Lau, Adrian; McCalden, Richard; Teeter, Matthew G.; Howard, James L.; Lanting, Brent A.

    2016-01-01

    Background The surgical approach chosen for total hip arthroplasty (THA) may affect the positioning of the acetabular component. The purpose of this study was to examine the accuracy in orienting the acetabular component using the modified Hardinge approach. Methods We used our institutional arthroplasty database to identify patients with primary, press-fit, hemispherical acetabular components of a metal-on-polyethylene THA performed between 2003 and 2011. Patients with radiographs obtained 1–3 years after the index procedure were included for measurement of anteversion and inclination angles. Acceptable values of anteversion and abduction angles were defined as 15° ± 10° and 40° ± 10°, respectively. Results We identified 1241 patients from the database, and the modified Hardinge approach was used in 1010 of the patients included in our analysis. The acetabular component was anteverted in the acceptable zone in 54.1% of patients. The abduction angle was within the defined range in 79.2% of patients. Combined anteversion and abduction angles within the defined zone were present in 43.6% of patients. Conclusion Consistent with studies examining accuracy from other approaches, our study reveals that the modified Hardinge approach was only moderately accurate in positioning the acetabular component in the acceptable zone. PMID:27240130

  4. A computer study of biodegradable plates for internal fixation of mandibular angle fractures

    NARCIS (Netherlands)

    Tams, J; Van Loon, JP; Otten, B; Bos, RRM

    2001-01-01

    Purpose: This computer-based study was performed to determine the suitability of small biodegradable plate systems for mandibular angle fractures. Materials and Methods: In a 3-dimensional computer model of the mandible, fracture mobility and plate strain were calculated for bite forces applied on 1

  5. Monteggia fracture dislocation equivalents - analysis of eighteen cases treated by open reduction and internal fixation

    Directory of Open Access Journals (Sweden)

    Singh Ajay Pal

    2012-02-01

    Full Text Available 【Abstract】 Objective: Monteggia fracture dislocation equivalent, though already described by Bado, is still an unclassified entity. We aimed to retrospectively analyze 18 cases of Monteggia variants and discuss the injury mechanisms, management, and outcome along with a review of the literature. Methods: A retrospective record of Monteggia fracture dislocation (2003-2008 was reviewed from medical record department of our institute. Classic Monteggia fracture dislocation, children below 12 years or adults over 50 years, as well as open grade II & III cases were excluded from this study. Monteggia variant inclusion criteria included fracture of the proximal ulna together with a fracture of the radial head or neck and skeletal maturity. Totally 26 patients were identified with Monteggia variants and 18 were available for follow-up, including 11 males and 7 females with the mean age of 35 years. The ulna fracture was treated by compression plating along with tension band wiring. Radial head/neck was reconstructed in 12 patients while excised in 6 patients. Results: Follow-up ranged from 1-4 years, mean 2.6 years. Patients were assessed clinicoradiologically. Mayo Elbow Performance Score was employed to assess the outcomes. At final follow-up, the results were excellent in 10 patients, good in 4, fair in 2 and poor in 2. Mean range of motion of the elbow was 20°, 116°, 50° and 55° for extension, flexion, pronation and supination, respectively. Two patients had complications in the form of heterotopic ossification and stiffness of the elbow. One nonunion ulna, primarily treated by tension band wiring, was managed by refixation with locking reconstruction plate and bone grafting. Bone grafting was only required in this patient for nonunion. Another patient had implants removed on his request. The results in our series closely correlated with extent of intraarticular damage, coronoid fracture and comminuted fractures. Conclusions: Monteggia

  6. IPSILATERAL TRAUMATIC POSTERIOR DISLOCATION OF THE HIP ACCOMPANIED BY PRETROCHANTERC FRACTURE

    OpenAIRE

    Taser, Omer; Cakmak, Mehmet; Cubuk, Mustafa Kemal; Domanic, Unsal; Karamehmetoglu, M.

    2004-01-01

    Attempts have been made to present a case with ipsilateral traumatic posterior dislocation of the hip and fracture of the trachanteric region without any acetabular fracture. In this unique case with no second in the literature, treatment of choice has been discussed and late results obtained from this case reported.

  7. MR imaging findings of acetabular dysplasia in adults

    Energy Technology Data Exchange (ETDEWEB)

    James, Steven; Connell, David [The Royal National Orthopaedic Hospital, Radiology Department, London, Middlesex (United Kingdom); Miocevic, Miranda; Malara, Frank; Pike, Jonathan [Victoria House Hospital, Radiology Department, Melbourne (Australia); Young, David [Melbourne Orthopaedic Group, Orthopaedic Surgery, Melbourne (Australia)

    2006-06-15

    To evaluate the diagnostic accuracy of MR imaging in the identification of labral and articular cartilage lesions in patients with acetabular dysplasia. Pre-operative MR imaging was performed on 27 hips in 25 consecutive patients (16 males, 9 females, age range 19-52 years, mean age 31.2 years) with radiographic evidence of acetabular dysplasia (centre-edge angle of Wiberg <20 degrees). The average duration of symptoms was 16.2 months. Two musculoskeletal radiologists assessed MR images in consensus for the presence of abnormality involving the acetabular labrum and adjacent acetabular articular cartilage. A high resolution, non-arthrographic technique was used to assess the labrum and labral chondral transitional zone. Surgical correlation was obtained in all cases by a single surgeon experienced in hip arthroscopy and ten patients with normal hip MRI were included to provide a control group. The acetabular labra in the dysplastic hips demonstrated abnormal signal intensity, and had an elongated appearance when compared with the control group (mean length 10.9 mm vs 6.4 mm). Morphological appearances in the labra included surface irregularity, fissures and cleft formation. MR imaging correctly identified the severity of chondral abnormality in 24 of 27 hips (89%) when compared with arthroscopic findings. MR imaging demonstrates an elongated labrum, focal intra-substance signal change and irregularity and fissuring of the margins in patients with acetabular dysplasia. Abnormality is also identified at the labral chondral transitional zone, where fissuring, focal clefts, chondral deficiency and subchondral cyst formation may be apparent. A high-resolution, non-arthrographic technique can provide an accurate preoperative assessment and evaluate the presence of premature osteoarthritis. (orig.)

  8. Distal tibial pilon fractures (AO/OTA type B, and C treated with the external skeletal and minimal internal fixation method

    Directory of Open Access Journals (Sweden)

    Milenković Saša

    2013-01-01

    Full Text Available Background/Aim. Distal tibial pilon fractures include extra-articular fractures of the tibial metaphysis and the more severe intra-articular tibial pilon fractures. There is no universal method for treating distal tibial pilon fractures. These fractures are treated by means of open reduction, internal fixation (ORIF and external skeletal fixation. The high rate of soft-tissue complications associated with primary ORIF of pilon fractures led to the use of external skeletal fixation, with limited internal fixation as an alternative technique for definitive management. The aim of this study was to estimate efficacy of distal tibial pilon fratures treatment using the external skeletal and minimal internal fixation method. Methods. We presented a series of 31 operated patients with tibial pilon fractures. The patients were operated on using the method of external skeletal fixation with a minimal internal fixation. According to the AO/OTA classification, 17 patients had type B fracture and 14 patients type C fractures. The rigid external skeletal fixation was transformed into a dynamic external skeletal fixation 6 weeks post-surgery. Results. This retrospective study involved 31 patients with tibial pilon fractures, average age 41.81 (from 21 to 60 years. The average follow-up was 21.86 (from 12 to 48 months. The percentage of union was 90.32%, nonunion 3.22% and malunion 6.45%. The mean to fracture union was 14 (range 12-20 weeks. There were 4 (12.19% infections around the pins of the external skeletal fixator and one (3.22% deep infections. The ankle joint arthrosis as a late complication appeared in 4 (12.90% patients. All arthroses appeared in patients who had type C fractures. The final functional results based on the AOFAS score were excellent in 51.61%, good in 32.25%, average in 12.90% and bad in 3.22% of the patients. Conclusion. External skeletal fixation and minimal internal fixation of distal tibial pilon fractures is a good method for

  9. Arthroscopic Technique for Acetabular Labral Reconstruction Using Iliotibial Band Autograft.

    Science.gov (United States)

    Chahla, Jorge; Soares, Eduardo; Bhatia, Sanjeev; Mitchell, Justin J; Philippon, Marc J

    2016-06-01

    The dynamic function of the acetabular labrum makes it an important structure for both hip stability and motion. Because of this, injuries to the labrum can cause significant dysfunction, leading to altered hip kinematics. Labral repair is the gold standard for symptomatic labral tears to keep as much labral tissue as possible; however, in cases where the labrum has been injured to such a degree that it is either deficient or repair is not possible, arthroscopic labral reconstruction is preferred. This article describes our preferred approach for reconstruction of the acetabular labrum using iliotibial band autograft.

  10. Peri-acetabular bone mineral density in total hip replacement

    OpenAIRE

    Gauthier, L.(University of Illinois at Chicago (UIC), Chicago, USA); Dinh, L.; Beaulé, P. E.

    2013-01-01

    Objectives To quantify and compare peri-acetabular bone mineral density (BMD) between a monoblock acetabular component using a metal-on-metal (MoM) bearing and a modular titanium shell with a polyethylene (PE) insert. The secondary outcome was to measure patient-reported clinical function. Methods A total of 50 patients (25 per group) were randomised to MoM or metal-on-polyethlene (MoP). There were 27 women (11 MoM) and 23 men (14 MoM) with a mean age of 61.6 years (47.7 to 73.2). Measurement...

  11. Acetabular Dysplasia and Surgical Approaches Other Than Direct Anterior Increases Risk for Malpositioning of the Acetabular Component in Total Hip Arthroplasty

    DEFF Research Database (Denmark)

    Gromov, Kirill; Greene, Meridith E; Huddleston, James I;

    2016-01-01

    BACKGROUND: Persistent acetabular dysplasia (AD) after periacetabular osteotomy has been hypothesized to increase the risk for malpositioning of the acetabular component. In this study, we investigate whether AD is an independent risk factor for cup malpositioning during primary total hip...... arthroplasty (THA). METHODS: Patient demographics, surgical approach, presence of AD assessed using the lateral center-edge angle, and acetabular cup positioning determined using Martell Hip Analysis Suite were investigated in 836 primary THA patients enrolled in a prospective multicenter study. RESULTS: We...

  12. Technique of Open Reduction and Internal Fixation of Comminuted Proximal Humerus Fractures With Allograft Femoral Head Metaphyseal Reconstruction.

    Science.gov (United States)

    Parada, Stephen A; Makani, Amun; Stadecker, Monica J; Warner, Jon J P

    2015-10-01

    Proximal humerus fractures are common injuries that can require operative treatment. Different operative techniques are available, but the hallmark of fixation for 3- and 4-part fractures is a locking-plate-and-screw construct. Despite advances in this technology, obtaining anatomical reduction and fracture union can be difficult, and complications (eg, need for revision) are not uncommon. These issues can be addressed by augmenting the fixation with an endosteally placed fibular allograft. Although biomechanical and clinical results have been good, the technique can lead to difficulties in future revision to arthroplasty, a common consequence of failed open reduction and internal fixation. The technique described, an alternative to placing a long endosteal bone graft, uses a trapezoidal, individually sized pedestal of allograft femoral head to facilitate the reduction and healing of the humeral head and tuberosity fragments in a displaced 3- or 4-part fracture of the proximal humerus. It can be easily incorporated with any plate-and-screw construct and does not necessitate placing more than 1 cm of bone into the humeral intramedullary canal, limiting the negative effects on any future revision to arthroplasty.

  13. Arthroscopically Assisted Open Reduction-Internal Fixation of Ankle Fractures: Significance of the Arthroscopic Ankle Drive-through Sign.

    Science.gov (United States)

    Schairer, William W; Nwachukwu, Benedict U; Dare, David M; Drakos, Mark C

    2016-04-01

    Standalone open reduction-internal fixation (ORIF) of unstable ankle fractures is the current standard of care. Intraoperative stress radiographs are useful for assessing the extent of ligamentous disruption, but arthroscopic visualization has been shown to be more accurate. Concomitant arthroscopy at the time of ankle fracture ORIF is useful for accurately diagnosing and managing syndesmotic and deltoid ligament injuries. The arthroscopic ankle drive-through sign is characterized by the ability to pass a 2.9-mm shaver (Smith & Nephew, Andover, MA) easily through the medial ankle gutter during arthroscopy, which is not usually possible with both an intact deltoid ligament and syndesmosis. This arthroscopic maneuver indicates instability after ankle reduction and fixation and is predictive of the need for further stabilization. Furthermore, when this sign remains positive after fracture fixation, it may guide the surgeon to further evaluate the adequacy of fixation for the possible need for further fixation of the syndesmosis or deltoid. We present the case of an ankle fracture managed with arthroscopy-assisted ORIF and describe the clinical utility of the arthroscopic ankle drive-through sign. PMID:27462542

  14. Biomechanical Comparison of Two Kinds of Internal Fixation in a Type C Zone Ⅱ Pelvic Fracture Model

    Institute of Scientific and Technical Information of China (English)

    Tao Wu; Wei Chen; Qi Zhang; Zhan-Le Zheng; Hong-Zhi Lyu; Yun-Wei Cui; Xiao-Dong Cheng

    2015-01-01

    Background:Unstable pelvic fractures are complex and serious injuries.Selection of a fixation method for these fractures remains a challenging problem for orthopedic surgeons.This study aimed to compare the stability of Tile C pelvic fractures fixed with two iliosacral (IS) screws and minimally invasive adjustable plate (MIAP) combined with one IS screw.Methods:This study was a biomechanical experiment.Six embalmed specimens of the adult pelvis were used.The soft tissue was removed from the specimens,and the spines from the fourth lumbar vertebra to the proximal one-third of both femurs were retained.The pubic symphysis,bilateral sacroiliac joints and ligaments,bilateral hip joints,bilateral sacrotuberous ligaments,and bilateral sacrospinous ligaments were intact.Tile C pelvic fractures were made on the specimens.The symphysis pubis was fixed with a plate,and the fracture on the posterior pelvic ring was fixed with two kinds of internal fixation in turn.The specimens were placed in a biomechanical machine at a standing neutral posture.A cyclic vertical load of up to 500 N was applied,and displacement was recorded.Shifts in the fracture gap were measured by a grating displacement sensor.Statistical analysis used:Paired-samples t-test.Results:Under the vertical load of 100,200,300,400,and 500 N,the average displacement of the specimens fixed with MIAP combined with one IS screw was 0.46,0.735,1.377,1.823,and 2.215 mm,respectively,which was significantly lower than that of specimens fixed with two IS screws under corresponding load (P < 0.05).Under the vertical load of 500 N,the shift in the fracture gap of specimens fixed with MIAP combined with one IS screw was 0.261 ± 0.095 mm,and that of specimens fixed with two IS screws was 0.809 ± 0.170 mm.The difference was significant (P < 0.05).Conclusion:The stability of Tile C pelvic fractures fixed with MIAP combined with one IS screw was better than that fixed with two IS screws.

  15. Second international conference on fundamentals of fracture. Program and abstract book. Summaries

    International Nuclear Information System (INIS)

    The approximately 95 papers and abstracts are grouped under the following headings: atomic theory, continuum theory, experimental studies, environmental effects, fatigue, ceramics, high-temperature phenomena, and interfacial fracture

  16. Second international conference on fundamentals of fracture. Program and abstract book. Summaries

    Energy Technology Data Exchange (ETDEWEB)

    1985-01-01

    The approximately 95 papers and abstracts are grouped under the following headings: atomic theory, continuum theory, experimental studies, environmental effects, fatigue, ceramics, high-temperature phenomena, and interfacial fracture. (DLC)

  17. INTERNAL FIXATION OF INTRA ARTICULAR CALCANEUM FRACTURES USING LOCKING COMPRESSION PLATE

    OpenAIRE

    Neelakrishnan; Balamurugavel; Barathiselvan; Viswanathan

    2014-01-01

    INTRODUCTION: Calcaneum is the most frequently fractured tarsal bone. Historically intra articular calcaneum fractures treated non-operatively which led to increased morbidity due to in congruency of articular surface resulting in subtalar arthritis. With advent of CT scan, better implants and improved methods of fixation. Operative treatment has now become a standard method. AIM OF THE STUDY: To study the functional and radiological outcome of intra articular calcaneum fr...

  18. Percutaneous acetabuloplasty for metastatic acetabular lesions

    Directory of Open Access Journals (Sweden)

    Logroscino Giandomenico

    2008-05-01

    Full Text Available Abstract Background Osteolytic metastases around the acetabulum are frequent in tumour patients, and may cause intense and drug-resistant pain of the hip. These lesions also cause structural weakening of the pelvis, limping, and poor quality of life. Percutaneous acetabuloplasty is a mini-invasive procedure for the management of metastatic lesions due to carcinoma of the acetabulum performed in patients who cannot tolerate major surgery, or in patients towards whom radiotherapy had already proved ineffective. Methods We report a retrospective study in 25 such patients (30 acetabuli who were evaluated before and after percutaneous acetabuloplasty, with regard to pain, mobility of the hip joint, use of analgesics, by means of evaluation forms: Visual Analog Scale, Harris Hip Score, Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC, Eastern Cooperative Oncology Group (ECOG. The results obtained were analysed using the χ2 Test and Fisher's exact test. Significance was sent at P Results Marked clinical improvement was observed in all patients during the first six post-operative months, with gradual a worsening thereafter from deterioration of their general condition. Complete pain relief was achieved in 15 of our 25 (59% of patients, and pain reduction was achieved in the remaining 10 (41% patients. The mean duration of pain relief was 7.3 months. Pain recurred in three patients (12% between 2 weeks to 3 months. No major complications occurred. There was transient local pain in most cases, and 2 cases of venous injection of cement without clinical consequences. Conclusion Percutaneous acetabuloplasty is effective in improving the quality of life of patients with osteolytic bone tumours, even though the improvement is observed during the first 6 months only. It can be an effective aid to chemo- and radiotherapy in the management of acetabular metastases.

  19. Supra-acetabular fixation and sacroiliac screws for treating unstable pelvic ring injuries: preliminary results from 20 patients☆

    Science.gov (United States)

    Guimarães, Rodrigo Pereira; de Góes Ribeiro, Arthur; Ulson, Oliver; de Ávila, Ricardo Bertozzi; Ono, Nelson Keiske; Polesello, Giancarlo Cavalli

    2016-01-01

    Objective To analyze the treatment results from 20 patients who underwent an alternative osteosynthesis method as definitive treatment for pelvic ring fractures. Methods A retrospective analysis was conducted on a series of 20 patients with pelvic ring fractures (Tile type C) and a high risk of postoperative infection, who were treated at Santa Casa de Misericórdia de São Paulo between August 2004 and December 2012. The patients underwent percutaneous supra-acetabular external fixation in association with cannulated 7.0 mm iliosacral screws. Results The patients’ mean age was 40 years (range 22–77 years) and the mean length of follow-up was 18.5 months (range 3–69 months). At the end of the treatment, ten patients (50%) were classified as having good results, nine patients (45%) had fair results and one patient (5%) did not have any improvement. Six patients presented complications, and paresthesia of the lateral femoral cutaneous nerve was the most frequent of these (two patients). Conclusion Supra-acetabular external fixation in association with iliosacral percutaneous osteosynthesis is a good definitive treatment method for patients with a high risk of postoperative infection. PMID:27069879

  20. CSNI Project for Fracture Analyses of Large-Scale International Reference Experiments (FALSIRE II)

    Energy Technology Data Exchange (ETDEWEB)

    Bass, B.R.; Pugh, C.E.; Keeney, J. [Oak Ridge National Lab., TN (United States); Schulz, H.; Sievers, J. [Gesellschaft fuer Anlagen- und Reaktorsicherheit (GRS) mbH, Koeln (Gemany)

    1996-11-01

    A summary of Phase II of the Project for FALSIRE is presented. FALSIRE was created by the Fracture Assessment Group (FAG) of the OECD/NEA`s Committee on the Safety of Nuclear Installations (CNSI) Principal Working Group No. 3. FALSIRE I in 1988 assessed fracture methods through interpretive analyses of 6 large-scale fracture experiments in reactor pressure vessel (RPV) steels under pressurized- thermal-shock (PTS) loading. In FALSIRE II, experiments examined cleavage fracture in RPV steels for a wide range of materials, crack geometries, and constraint and loading conditions. The cracks were relatively shallow, in the transition temperature region. Included were cracks showing either unstable extension or two stages of extensions under transient thermal and mechanical loads. Crack initiation was also investigated in connection with clad surfaces and with biaxial load. Within FALSIRE II, comparative assessments were performed for 7 reference fracture experiments based on 45 analyses received from 22 organizations representing 12 countries. Temperature distributions in thermal shock loaded samples were approximated with high accuracy and small scatter bands. Structural response was predicted reasonably well; discrepancies could usually be traced to the assumed material models and approximated material properties. Almost all participants elected to use the finite element method.

  1. Open Reduction Internal Fixation of a Bimalleolar Ankle Fracture With Syndesmotic Injury.

    Science.gov (United States)

    Ostrum, Robert F; Avery, Matthew C

    2016-08-01

    Rotational ankle fractures are incredibly common, resulting in a wide spectrum of bony and ligamentous injury patterns. After open reduction of an ankle fracture, the treating surgeon must always evaluate syndesmotic stability. If the syndesmosis is determined to be unstable, a reduction of the distal tibiofibular joint should be performed. Failure to adequately identify and treat injuries to the syndesmosis may result in continued ankle instability and poor patient outcomes. Lateral fluoroscopic images are necessary to assess a closed reduction of the syndesmosis before stabilization, although the accuracy of this tool has been questioned in several studies. Significant controversy surrounds many aspects of this injury and its treatment, including methods of diagnosis, ideal reduction clamp positioning, diameter and number of syndesmotic screws, and number of tibial cortices to be engaged. In the accompanying video, we describe our approach for the treatment of a bimalleolar ankle fracture with syndesmotic injury, using a posterior fibular plate and single tricortical syndesmotic screw. PMID:27441940

  2. Technical tips for (dry) arthroscopic reduction and internal fixation of distal radius fractures.

    Science.gov (United States)

    Del Piñal, Francisco

    2011-10-01

    Contrary to general belief, arthroscopic assisted reduction in distal radius fractures can be done in an expeditious manner and with minimal consumption of operating room resources. This article presents the steps for a pleasant arthroscopic experience in detail. The technique proposed combines the benefits of rigid fixation with volar locking plates (for the extra-articular component) and arthroscopic control of the reduction (for the articular component). It is important that the operation be carried out using the dry arthroscopic technique. However, arthroscopy is just an addition to conventional methods. Thorough knowledge of and facility with classic techniques of distal radius fracture treatment is essential for a good result. PMID:21971058

  3. MRI morphometric hip comparison analysis of anterior acetabular labral tears

    Energy Technology Data Exchange (ETDEWEB)

    Aly, Abdel Rahman [University of Saskatchewan, Department of Physical Medicine and Rehabilitation, Saskatoon, SK (Canada); Saskatoon City Hospital, Saskatoon, SK (Canada); Rajasekaran, Sathish [HealthPointe, Pain, Spine and Sport Medicine, Alberta (Canada); Obaid, Haron [Royal University Hospital, University of Saskatchewan, Department of Medical Imaging, Saskatoon, SK (Canada)

    2013-09-15

    Anterior (3 o'clock) acetabular labral tears (AALTs) have been reported to be associated with iliopsoas impingement (IPI). However, no study has examined the association between anatomical bony variables of the hip joint and AALTs. The purpose of this study was to evaluate the association between AALTs, femoroacetabular impingement (FAI) and other bony variables of the hip. Seventy-six out of 274 hip MRI records met the inclusion criteria. Two independent blinded investigators evaluated the location of acetabular labral tears (ALTs), edema at the musculotendinous junction of the iliopsoas insertion, femoral neck anteversion angle, femoral neck shaft angle, acetabular anteversion angle, alpha angle, lateral central edge angle (LCEA), acetabular index, and acetabular depth. Comparison analyses between groups were performed. Twenty-two patients had no ALTs (controls), 19 patients had AALTs, and 35 patients had ALTs not isolated at the 3 o'clock position (25 with cam-bony deformities [FAI-cam] and 10 with pincer-bony deformities [FAI-pincer]). The alpha angle mean was significantly higher (p < 0.001) in the FAI-cam group (62.7 , 95 % confidence interval [CI]: 56.2-69.2 ) compared with the AALTs group (46.9 , 95 % CI: 40.1-53.7 ). The LCEA mean was significantly higher (p < 0.001) in FAI-pincer group (41.9 , 95 % CI: 39.3 -44.5 ) compared to AALTs group (29.4 , 95 % CI: 24.2 -34.6 ). There was no statistically significant difference in any of the bony variables between the controls and the AALTs group. Our study demonstrated that AALTs are pathologically distinct and not associated with FAI or other bony abnormalities. This supports the previous studies, which proposed that AALTs are associated with IPI. (orig.)

  4. MRI morphometric hip comparison analysis of anterior acetabular labral tears

    International Nuclear Information System (INIS)

    Anterior (3 o'clock) acetabular labral tears (AALTs) have been reported to be associated with iliopsoas impingement (IPI). However, no study has examined the association between anatomical bony variables of the hip joint and AALTs. The purpose of this study was to evaluate the association between AALTs, femoroacetabular impingement (FAI) and other bony variables of the hip. Seventy-six out of 274 hip MRI records met the inclusion criteria. Two independent blinded investigators evaluated the location of acetabular labral tears (ALTs), edema at the musculotendinous junction of the iliopsoas insertion, femoral neck anteversion angle, femoral neck shaft angle, acetabular anteversion angle, alpha angle, lateral central edge angle (LCEA), acetabular index, and acetabular depth. Comparison analyses between groups were performed. Twenty-two patients had no ALTs (controls), 19 patients had AALTs, and 35 patients had ALTs not isolated at the 3 o'clock position (25 with cam-bony deformities [FAI-cam] and 10 with pincer-bony deformities [FAI-pincer]). The alpha angle mean was significantly higher (p < 0.001) in the FAI-cam group (62.7 , 95 % confidence interval [CI]: 56.2-69.2 ) compared with the AALTs group (46.9 , 95 % CI: 40.1-53.7 ). The LCEA mean was significantly higher (p < 0.001) in FAI-pincer group (41.9 , 95 % CI: 39.3 -44.5 ) compared to AALTs group (29.4 , 95 % CI: 24.2 -34.6 ). There was no statistically significant difference in any of the bony variables between the controls and the AALTs group. Our study demonstrated that AALTs are pathologically distinct and not associated with FAI or other bony abnormalities. This supports the previous studies, which proposed that AALTs are associated with IPI. (orig.)

  5. Lower reoperation rate for cemented hemiarthroplasty than for uncemented hemiarthroplasty and internal fixation following femoral neck fracture

    DEFF Research Database (Denmark)

    Viberg, Bjarke; Overgaard, Søren; Lauritsen, Jens;

    2013-01-01

    treated with either internal fixation (IF), cemented HA, or uncemented HA (with or without hydroxyapatite coating), after 12-19 years of follow-up. Methods 4 hospitals with clearly defined guidelines for the treatment of 75+ year-old patients with a displaced femoral neck fracture were included. Cohort 1...... an uncemented hydroxyapatite-coated Furlong HA. Data were retrieved from patient files, from the region-based patient administrative system, and from the National Registry of Patients at the end of 2010. We performed survival analysis with adjustment for comorbidity, age, and sex. Results Cemented HA had...

  6. Comparison of Percutaneous Cementoplasty with and Without Interventional Internal Fixation for Impending Malignant Pathological Fracture of the Proximal Femur

    International Nuclear Information System (INIS)

    PurposeTo compare the efficacy of percutaneous cementoplasty (PCP) with and without interventional internal fixation (IIF) on malignant impending pathological fracture of proximal femur.MethodsA total of 40 patients with malignant impending pathological fracture of proximal femur were selected for PCP and IIF (n = 19, group A) or PCP alone (n = 21, group B) in this non-randomized prospective study. Bone puncture needles were inserted into the proximal femur, followed by sequential installation of the modified trocar inner needles through the puncture needle sheath. Then, 15–45 ml cement was injected into the femur lesion.ResultsThe overall excellent and good pain relief rate during follow-ups were significantly higher in group A than that in group B (89 vs. 57 %, P = 0.034). The average change of VAS, ODI, KPS, and EFES in group A were significantly higher than those in group B at 1-, 3-, 6-month, 1-year (P < 0.05). Meanwhile, The stability of the treated femur was significantly higher in group A than that in group B (P < 0.05).ConclusionPCP and IIF were not only a safe and effective procedure, but resulted in greater pain relief, bone consolidation, and also reduced the risk of fracture than the currently recommended approach of PCP done on malignant proximal femoral tumor

  7. Antimicrobial prophylaxis in open reduction and internal fixation of compound mandibular fractures: a collaborative regional audit of outcome.

    Science.gov (United States)

    Singh, Rabindra P; Carter, Lachlan M; Whitfield, Paul H

    2013-07-01

    We conducted a regional 2-stage prospective audit involving 5 different maxillofacial units in the Yorkshire region of the UK to evaluate the effectiveness of perioperative antimicrobial prophylaxis in the treatment of mandibular fractures. In the first stage (145 patients) we surveyed current practice concerning antimicrobial prophylaxis and found out the current infection rate after open reduction and internal fixation (ORIF) of mandibular fractures. In the second stage (157 patients) we implemented a common antimicrobial protocol in all units and recorded the infection rates using the new regimen. In the first stage a wide range of antimicrobial prophylaxis was used in different units. The agreed perioperative antimicrobial protocol in the second stage was to begin amoxicillin or clarithromycin and metronidazole intravenously on admission and include 2 postoperative doses. The infection rates were 10.3% and 8.9%, respectively, and the difference between the two groups was not significant (χ(2)=0.051, df=1, p=0.83). The infection rate in the Yorkshire region was similar to results from other centres. We recommend short perioperative antimicrobial prophylaxis with a maximum of 2 postoperative doses after ORIF of mandibular fractures.

  8. Comparison of Percutaneous Cementoplasty with and Without Interventional Internal Fixation for Impending Malignant Pathological Fracture of the Proximal Femur

    Energy Technology Data Exchange (ETDEWEB)

    Tian, Qing-Hua, E-mail: ddqinghua-tian@163.com; He, Cheng-Jian, E-mail: tianhechengjian@163.com; Wu, Chun-Gen, E-mail: 649514608@qq.com; Li, Yong-Dong, E-mail: tianliyongdong@163.com; Gu, Yi-Feng, E-mail: tianyifenggu@163.com; Wang, Tao, E-mail: tianandwangtao@163.com; Xiao, Quan-Ping, E-mail: tianxiaoquanping@163.com; Li, Ming-Hua, E-mail: tianminghuali@163.com [Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Department of Diagnostic and Interventional Radiology (China)

    2016-01-15

    PurposeTo compare the efficacy of percutaneous cementoplasty (PCP) with and without interventional internal fixation (IIF) on malignant impending pathological fracture of proximal femur.MethodsA total of 40 patients with malignant impending pathological fracture of proximal femur were selected for PCP and IIF (n = 19, group A) or PCP alone (n = 21, group B) in this non-randomized prospective study. Bone puncture needles were inserted into the proximal femur, followed by sequential installation of the modified trocar inner needles through the puncture needle sheath. Then, 15–45 ml cement was injected into the femur lesion.ResultsThe overall excellent and good pain relief rate during follow-ups were significantly higher in group A than that in group B (89 vs. 57 %, P = 0.034). The average change of VAS, ODI, KPS, and EFES in group A were significantly higher than those in group B at 1-, 3-, 6-month, 1-year (P < 0.05). Meanwhile, The stability of the treated femur was significantly higher in group A than that in group B (P < 0.05).ConclusionPCP and IIF were not only a safe and effective procedure, but resulted in greater pain relief, bone consolidation, and also reduced the risk of fracture than the currently recommended approach of PCP done on malignant proximal femoral tumor.

  9. Functional outcome of open reduction and internal fixation of clavicle fracture

    Directory of Open Access Journals (Sweden)

    Manju G. Pillai

    2016-08-01

    Results: In 27 patients fracture were united at end of 12 weeks, in 2 patients fracture were united at end of 24 weeks and 1 patient went for non-union. One patient had superficial infection. None had deep infection. One patient had plate loosening at 4week but fracture was united at the end of 24 weeks. 2 patients had persistent pain which is controlled with occasional analgesic but not effecting ordinary work. One patient had gross restriction of shoulder movement. Functional outcome assessed according to near shoulder scoring system. 24 patients had excellent result, 4 patients had satisfactory result, 1 patient had unsatisfactory result and 1patients had failure. Conclusions: The study showed rigid fixation with plate and screw for fresh middle third clavicle fracture especially displaced and comminuted give immediate pain relief and prevent the development of shoulder stiffness and non-union and give good functional outcome. [Int J Res Med Sci 2016; 4(8.000: 3205-3210

  10. Internal derangement of the knee after ipsilateral femoral shaft fracture: MR imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Blacksin, M.F.; Zurlo, J.V. [Department of Radiology, University of Medicine and Dentistry of New Jersey, Newark, NJ (United States); Levy, A.S. [Department of Orthopedic Surgery, University of Medicine and Dentistry of New Jersey, University Hospital, Newark, NJ 07103-2426 (United States)

    1998-08-01

    Objective. This study uses magnetic resonance (MR) imaging to delineate the types and frequencies of injuries seen in the knee after ipsilateral femoral shaft fracture. We also compare the results of the orthopedic knee examination with the MR findings. Design and patients. MR imaging of the ipsilateral knee was performed on 34 patients with closed femoral shaft fractures. Indications for knee MR imaging included knee pain at the time of fracture, soft tissue swelling or an effusion of the knee, or a positive knee examination under anesthesia. The patients had a mean age of 27 years and all were stabilized with intramedullary nails. Imaging was performed a mean time of 2.5 days after surgery. All patients had knee examinations done under anesthesia, and the MR results were compiled and compared with the clinical examinations. Results. Ninety-seven percent of patients demonstrated knee effusions. Twenty-seven percent of patients demonstrated meniscal tears, with the posterior horn of the medial meniscus most frequently torn. The medial collateral ligament was the most frequent site of ligamentous injury (38%) followed by the posterior cruciate ligament (21%). Fifty percent of patients had injuries of the extensor mechanism. Bone bruises were noted in 32% of patients. Articular cartilage injuries were confined to the patella in four cases. One occult tibial plateau fracture and one meniscocapsular separation were seen. Conclusions. There is a common incidence of both ligamentous and meniscal injury to the knee after ipsilateral femoral shaft fracture. MR imaging can be useful in assessing the extent of injury, and may reveal findings unsuspected after clinical examination of the knee. (orig.) With 4 figs., 2 tabs., 13 refs.

  11. Internal derangement of the knee after ipsilateral femoral shaft fracture: MR imaging findings

    International Nuclear Information System (INIS)

    Objective. This study uses magnetic resonance (MR) imaging to delineate the types and frequencies of injuries seen in the knee after ipsilateral femoral shaft fracture. We also compare the results of the orthopedic knee examination with the MR findings. Design and patients. MR imaging of the ipsilateral knee was performed on 34 patients with closed femoral shaft fractures. Indications for knee MR imaging included knee pain at the time of fracture, soft tissue swelling or an effusion of the knee, or a positive knee examination under anesthesia. The patients had a mean age of 27 years and all were stabilized with intramedullary nails. Imaging was performed a mean time of 2.5 days after surgery. All patients had knee examinations done under anesthesia, and the MR results were compiled and compared with the clinical examinations. Results. Ninety-seven percent of patients demonstrated knee effusions. Twenty-seven percent of patients demonstrated meniscal tears, with the posterior horn of the medial meniscus most frequently torn. The medial collateral ligament was the most frequent site of ligamentous injury (38%) followed by the posterior cruciate ligament (21%). Fifty percent of patients had injuries of the extensor mechanism. Bone bruises were noted in 32% of patients. Articular cartilage injuries were confined to the patella in four cases. One occult tibial plateau fracture and one meniscocapsular separation were seen. Conclusions. There is a common incidence of both ligamentous and meniscal injury to the knee after ipsilateral femoral shaft fracture. MR imaging can be useful in assessing the extent of injury, and may reveal findings unsuspected after clinical examination of the knee. (orig.)

  12. Aumento acetabular pela técnica de Stahelli modificada Acetabular increase with modified Stahelli technique

    Directory of Open Access Journals (Sweden)

    Sílvio Pereira Coelho

    2000-09-01

    Full Text Available Os autores apresentam neste trabalho um estudo retrospectivo realizado em 18 pacientes submetidos a tratamento cirúrgico de insuficiência acetabular pela osteotomia da pelve seguindo a técnica descrita por Lynn T. Staheli. Enfatizam a modificação da técnica deste autor, com a introdução do enxerto ósseo, retirado da tábua externa do ilíaco, numa fenda aprofundada até cerca da cortical interna do ilíaco. Os pacientes foram acompanhados através de consultas ambulatoriais previamente a cirurgia e pós-operatoriamente com seguimento que variou de 2 meses a 4 anos no serviço de ortopedia infantil do Hospital Independência - Complexo Hospitalar ULBRA/Porto Alegre-RS. O objetivo do trabalho foi avaliar o quadril acometido pré e pós-operatoriamente, demonstrando a evolução e vantagens da variação da técnica de Staheli desenvolvida neste serviço. Observou-se que a cirurgia, se realizada sob técnica adequada e em mãos experientes, torna-se uma fonte válida de tratamento para aquelas patologias que levam a uma insuficiente cobertura da cabeça femoral.The authors present in this paper a retrospective study of eighteen patients treated surgically for insufficiency of the acetabular coverage with the shelf procedure according to Lynn T. Staheli. This study was done at the Service of Pediatric Orthopedics of Hospital Independência - Complexo Hospitalar ULBRA/Porto Alegre-RS. They call attention to the modification of the surgical technique in that the bone graft taken from outer cortex of the iliac bone, is deepened in the slot in the superior rim of the acetabulum. The follow-up ranged from two months to four years. The aim of this paper was to evaluate the affected hip pre and postoperatively showing the results and the advantages of the modified shelf technique. They observed that if the surgery is performed according to the correct technique and by an experienced surgeon, it is a very good alternative to the treatment of those

  13. Relationship between Wiberg's lateral center edge angle, Lequesne's acetabular index, and medial acetabular bone stock

    Energy Technology Data Exchange (ETDEWEB)

    Werner, Clement M.L. [Balgrist University Hospital Zurich, Department of Orthopaedics, Zurich (Switzerland); University of Maryland Medical Systems, R. Adams Cowley Shock Trauma Center, Baltimore, MD (United States); Copeland, Carol E.; Stromberg, Jeff; Turen, Clifford H. [University of Maryland Medical Systems, R. Adams Cowley Shock Trauma Center, Baltimore, MD (United States); Ruckstuhl, Thomas; Bouaicha, Samy [Balgrist University Hospital Zurich, Department of Orthopaedics, Zurich (Switzerland)

    2011-11-15

    Knowledge of acetabular anatomy is crucial for cup positioning in total hip replacement. Medial wall thickness of the acetabulum is known to correlate with the degree of developmental dysplasia of the hip (DDH). No data exist about the relationship of routinely used radiographic parameters such as Wiberg's lateral center edge angle (LCE-angle) or Lequesne's acetabular index (AI) with thickness of the medial acetabular wall in the general population. The aim of our study was to clarify the relationship between LCE, AI, and thickness of the medial acetabular wall. Measurements on plain radiographs (LCE and AI) and axial CT scans (quadrilateral plate acetabular distance QPAD) of 1,201 individuals (2,402 hips) were obtained using a PACS imaging program and statistical analyses were performed. The mean thickness of the medial acetabulum bone stock (QPAD) was 1.08 mm (95% CI: 1.05-1.10) with a range of 0.1 to 8.8 mm. For pathological values of either the LCE (<20 ) or the AI (>12 ) the medial acetabular wall showed to be thicker than in radiological normal hips. The overall correlation between coxometric indices and medial acetabular was weak for LCE (r =-0.21. 95% CI [-0.25, -0.17]) and moderate for AI (r = 0.37, [0.33, 0.41]). We did not find a linear relationship between Wiberg's lateral center edge angle, Lequesne's acetabular index and medial acetabular bone stock in radiological normal hips but medial acetabular wall thickness increases with dysplastic indices. (orig.)

  14. An in vivo evaluation of PLLA/PLLA-gHA nano-composite for internal fixation of mandibular bone fractures.

    Science.gov (United States)

    Peng, Weihai; Zheng, Wei; Shi, Kai; Wang, Wangshu; Shao, Ying; Zhang, Duo

    2015-12-01

    Internal fixation of bone fractures using biodegradable poly(L-lactic-acid) (PLLA)-based materials has attracted the attention of many researchers. In the present study, 36 male beagle dogs were randomly assigned to two groups: PLLA/PLLA-gHA (PLLA-grafted hydroxyapatite) group and PLLA group. PLLA/PLLA-gHA and PLLA plates were embedded in the muscular bags of the erector spinae and also implanted to fix mandibular bone fractures in respective groups. At 1, 2, 3, 6, 9, and 12 months postoperatively, the PLLA/PLLA-gHA and PLLA plates were evaluated by adsorption and degradation tests, and the mandibles were examined through radiographic analysis, biomechanical testing, and histological analysis. The PLLA/PLLA-gHA plates were non-transparent and showed a creamy white color, and the PLLA plates were transparent and faint yellow in color. At all time points following surgery, adsorption and degradation of the PLLA/PLLA-gHA plates were significantly less than those of the PLLA plates, and the lateral and longitudinal bending strengths of the surgically treated mandibles of the beagle dogs in the PLLA/PLLA-gHA group were significantly greater than those of the PLLA group and reached almost the value of intact mandibles at 12 months postoperatively. Additionally, relatively rapid bone healing was observed in the PLLA/PLLA-gHA group with the formation of new lamellar bone tissues at 12 months after the surgery. The PLLA/PLLA-gHA nano-composite can be employed as a biodegradable material for internal fixation of mandibular bone fractures. PMID:26551378

  15. Histological evidence of successful internal fixation for traumatic chondral fracture of the femoral groove

    Directory of Open Access Journals (Sweden)

    Kazuhisa Hatayama

    2014-07-01

    Full Text Available Isolated chondral fractures without cancellous bone have limited healing potential. We reattached a chondral fragment without cancellous bone using bone pegs for chondral fracture of the femoral groove in a 13-year-old boy. Five months after the surgery, we performed a biopsy to evaluate the histological findings for the healed osteochondral junction. Biopsy results showed that osteoblasts had proliferated in the subchondral layer, and some osteoblasts had invaded the calcified cartilage, suggesting active new bone formation. A tidemark was observed between the radial cartilage layer and the calcified cartilage, and it was evident that the osteochondral junction had been completely restored. Four years and 3 months after the surgery, magnetic resonance imaging revealed that the cartilage on the femoral groove was maintained and the patient can play basketball asymptomatically. This report shows that surgeons can attempt the reattachment of chondral fragments without cancellous bone in adolescent patients.

  16. Treatment of acetabular dysplasia by triple pelvic osteotomy and its short-term results

    OpenAIRE

    Dogan, Ahmet; Zorer, Gazi; Ozer, Utku Erdem

    2004-01-01

    Objectives: We evaluated the effect of triple pelvic osteotomy on acetabular coverage and its clinical implications by clinical and radiographic parameters in patients with acetabular dysplasia. Methods: Triple pelvic osteotomy was performed in 21 hips of 19 patients (13 females, 6 males; mean age during operation 16.3 years; range 8 to 32 years). Acetabular dysplasia was bilateral in two, and unilateral in 17 patients. Etiology was developmental dysplasia of the hip in 12 patients, Legg-C...

  17. Effect of different restorative procedures on the fracture resistance of teeth submitted to internal bleaching

    Directory of Open Access Journals (Sweden)

    Andiara Ribeiro Roberto

    2012-02-01

    Full Text Available The aim of this study was to evaluate the influence of different restorative procedures on the fracture resistance of endodontically treated teeth submitted to intracoronal bleaching. Fifty upper central incisors were distributed into 5 groups: GI - healthy teeth; GII - endodontically treated teeth sealed with Coltosol; GIII - endodontically treated teeth bleached and sealed with Coltosol; GIV - endodontically treated teeth bleached and restored with composite resin; and GV - endodontically treated teeth bleached and restored with a fiberglass post and composite resin. In the bleached specimens, a cervical seal was made prior to bleaching with 38% hydrogen peroxide. The gel was applied on the buccal surface and in the pulp chamber, and was then light-activated for 45 s. This procedure was repeated three times per session for four sessions, and each group was submitted to the restorative procedures described above. The specimens were submitted to fracture resistance testing in a universal testing machine. There were statistically significant differences among the groups (p 0.05. The restorative procedures using composite resin were found to successfully restore the fracture resistance of endodontically treated and bleached teeth.

  18. Difference in the acetabular cup orientation in standing and supine radiographs.

    Science.gov (United States)

    Khan, Munir; Beckingsale, Tom; Marsh, Martin; Holland, Jim

    2016-09-01

    Acetabular orientation changes with that of the pelvis during lying and standing. This study was designed to measure these changes. We assessed 17 BHR replacements using EBRA software. The mean acetabular anteversion was more (p = 0.02) on erect than supine radiographs. Linear regression analysis showed that anteversion and inclination increased in some while decreased in others, and Bland and Altman analysis showed wide limits of agreement. The changes in acetabular orientation are thus subject to significant variations between the patients. We suggest studying the factors affecting acetabular orientation in standing to help reduce joint reaction forces and improve outcomes. PMID:27408490

  19. Validation of a new radiographic measurement of acetabular version: the transverse axis distance (TAD)

    International Nuclear Information System (INIS)

    This study has three aims: (1) validate a new radiographic measure of acetabular version, the transverse axis distance (TAD) by showing equivalent TAD accuracy in predicting CT equatorial acetabular version when compared to a previously validated, but more cumbersome, radiographic measure, the p/a ratio; (2) establish predictive equations of CT acetabular version from TAD; (3) calculate a sensitive and specific cut point for predicting excessive CT acetabular anteversion using TAD. A 14-month retrospective review was performed of patients who had undergone a dedicated MSK CT pelvis study and who also had a technically adequate AP pelvis radiograph. Two trained observers measured the radiographic p/a ratio, TAD, and CT acetabular equatorial version for 110 hips on a PACS workstation. Mixed model analysis was used to find prediction equations, and ROC analysis was used to evaluate the diagnostic accuracy of p/a ratio and TAD. CT equatorial acetabular version can accurately be predicted from either p/a ratio (p < 0.001) or TAD (p < 0.001). The diagnostic accuracies of p/a ratio and TAD are comparable (p =0.46). Patients whose TAD is higher than 17 mm may have excessive acetabular anteversion. For that cutpoint, the sensitivity of TAD is 0.73, with specificity of 0.82. TAD is an accurate radiographic predictor of CT acetabular anteversion and provides an easy-to-use and intuitive point-of-care assessment of acetabular version in patients with hip pain. (orig.)

  20. Validation of a new radiographic measurement of acetabular version: the transverse axis distance (TAD)

    Energy Technology Data Exchange (ETDEWEB)

    Nitschke, Ashley [University of Colorado School of Medicine, University of Colorado Denver, Division of Musculoskeletal Radiology, Department of Radiology, Aurora, CO (United States); Lambert, Jeffery R. [University of Colorado, Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO (United States); Glueck, Deborah H. [University of Colorado, Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO (United States); University of Colorado School of Medicine, University of Colorado Denver, Department of Radiology, Aurora, CO (United States); Jesse, Mary Kristen; Strickland, Colin [University of Colorado School of Medicine, University of Colorado Denver, Division of Musculoskeletal Radiology, Department of Radiology and Orthopaedics, Aurora, CO (United States); Mei-Dan, Omer [University of Colorado School of Medicine, University of Colorado Denver, Division of Sports Medicine and Hip Preservation, Department of Orthopaedics, Aurora, CO (United States); Petersen, Brian [University of Colorado School of Medicine, University of Colorado Denver, Division of Musculoskeletal Radiology, Department of Radiology and Orthopaedics, Aurora, CO (United States); Inland Imaging, Division of Musculoskeletal Radiology, Spokane, WA (United States)

    2015-11-15

    This study has three aims: (1) validate a new radiographic measure of acetabular version, the transverse axis distance (TAD) by showing equivalent TAD accuracy in predicting CT equatorial acetabular version when compared to a previously validated, but more cumbersome, radiographic measure, the p/a ratio; (2) establish predictive equations of CT acetabular version from TAD; (3) calculate a sensitive and specific cut point for predicting excessive CT acetabular anteversion using TAD. A 14-month retrospective review was performed of patients who had undergone a dedicated MSK CT pelvis study and who also had a technically adequate AP pelvis radiograph. Two trained observers measured the radiographic p/a ratio, TAD, and CT acetabular equatorial version for 110 hips on a PACS workstation. Mixed model analysis was used to find prediction equations, and ROC analysis was used to evaluate the diagnostic accuracy of p/a ratio and TAD. CT equatorial acetabular version can accurately be predicted from either p/a ratio (p < 0.001) or TAD (p < 0.001). The diagnostic accuracies of p/a ratio and TAD are comparable (p =0.46). Patients whose TAD is higher than 17 mm may have excessive acetabular anteversion. For that cutpoint, the sensitivity of TAD is 0.73, with specificity of 0.82. TAD is an accurate radiographic predictor of CT acetabular anteversion and provides an easy-to-use and intuitive point-of-care assessment of acetabular version in patients with hip pain. (orig.)

  1. FUNCTIONAL OUTCOME OF SUPRACONDYLAR FRACTURES OF FEMUR MANAGED BY OPEN REDUCTION AND INTERNAL FIXATION WITH LOCKING COMPRESSION PLATE

    Directory of Open Access Journals (Sweden)

    Madhusudhana

    2015-10-01

    Full Text Available INTRODUCTION : Incidence of distal femur fractures is approximately 37 per 1 , 00,000 person - years.¹Distal femoral fractures has two different injury mechanisms, high energy trauma and low energy trauma. In high - energy trauma, the problem of restoring the function in a destroyed knee joint persists. Complex knee ligament injuries frequently occur additionally to extensive cartilage injuries. In elderly patients, extreme osteoporosis represents a particular problem for anchoring the implant. 2 Supracondylar and inter condylar fractures often are unstable and comminuted and tend to occur in the elderly or those with multiple injuries. Treatment options are many with varied results. The final outcome would depend upon the type of fracture, stabilization of fixation and and perhaps patient general condition. 3 The options for operative treatment are traditional plating techniques that require compression of the implant to the femoral shaft (blade plate, Dynamic Condylar Screw, non - locking condylar buttress plate, antegrade nailing fixation, retrograde nailing, sub muscular locked internal fixation and external fixation. 4 However, as the complexity of fractures needing treatment has changed from simple extra - articular supra - condylar types to inter - condylar and metaphyseal comminuted types, these implants may not be ideal. Double plating, and more recently, locked plating techniques have been advocated 5 . However with double plating there is often extensive soft tissue stripping on both sides of the femur, resulting in reduced blood supply and potential non - union and failure of the implants 6 . The LCP is a single beam construct where the strength of its fixation is equal to the sum of all screw - bone interfaces rather than a single screw’s axial stiffness or pullout resistance as seen in unlocked plates 7,8 . Its unique biomechanical function is based on splinting rather than compression resulting in flexible stabilization

  2. PATHOLOGICAL AND MORPHOLOGICAL RESEARCH OF EXPERIMENTAL ACETABULAR DYSPLASIA

    Institute of Scientific and Technical Information of China (English)

    张自明; 马瑞雪; 吉士俊; 牛之彬

    2004-01-01

    Objective To investigate the pathological mechanism of hip dysplasia. Methods The left knee joints of eighteen rabbits were fixed in extending position with plaster cylinder for four weeks, but their hip joints were flexed. The right side served as control. Roentgenogram was made in all animals. The changes of the xray films and the pathological findings between left and right hips were compared. Results Appearance of hip dysplasia was obvious at four weeks after plaster fixation. There were pathological changes, including shallow acetabulum and flat femoral head, increased acetabular index and decreased acetabular head index on the x-ray films.Conclusion The hip dysplasia is the result of prolonged extending position of the knee joint. Abnormal knee posture seems to be one of the important factors of hip dysplasia. This kind of deformation may be worsened with time.

  3. Acetabular prosthesis: Proff of migration with ruler and pencil?

    International Nuclear Information System (INIS)

    Conventional X-ray films were made with varying degrees of tilt of a pelvic phantom containing an acetabular prosthesis. The position of the prosthesis was then reconstructed graphically. The measurement errors were calculated and an estimate was made for the tilt. There is a linear correlation between the measurement error and the tilt of the prosthesis. Therefore a tilt dependent maximum error can be calculated. This error is very small for small degrees of tilt, so that acetabular migration can in this instance be evaluated with greater confidence than with other graphical methods. The error also correlates with the determination of the selected region of the acetabulum, but not with the position of the central focus spot or image magnification. (orig.)

  4. Transosseous Acetabular Labral Repair as an Alternative to Anchors

    OpenAIRE

    Pérez-Carro, Luis; Cabello, Andres Gonzalez; Rakha, Mohamed Ibrahim; Patnaik, Sarthak; Centeno, Elias; Miranda, Victor; Fernández, Ana Alfonso

    2015-01-01

    Labral tears are the most common pathology in patients undergoing hip arthroscopy and the most common cause of mechanical hip symptoms. Labral repair techniques have been described in the literature using suture anchors placed as close as possible to the acetabular rim without penetrating the articular surface. Optimal surgical technique for labral repair is very important, and an inappropriate entry point and guide angulation may lead to intra-articular penetration of the anchor, chondral da...

  5. Infiltration of soft tissue by myeloma after internal fixation of pathologic femoral fracture

    International Nuclear Information System (INIS)

    a 75-year-old man with multiple myeloma presented with a pathologic fracture of distal right femoral diaphysis, which was fixed with Ender nails. Two and a half months later, the patients was readmitted with rapidly progressive swelling of right thigh. Ultrasound computed tomography and magnetic resonance imaging revealed infiltration of anterior right thigh muscles, extending upward to the iliopsoas muscle and retroperitoneal space, above ipsilateral renal vein. Ultrasound-guided biopsy of the soft tissue of the thigh revealed diffuse myelomatous infiltration by plasma blasts. (Author) 9 refs

  6. Imaging diagnosis of acetabular dysplastic coxarthrosis in adult

    International Nuclear Information System (INIS)

    Objective: To investigate the imaging diagnosis of acetabular dysplastic coxarthrosis. Method: The imaging of the acetabular dysplasia was analyzed in 51 patients (87 hips). All but four patients were women. The age ranged from 22 to 78 years, and the mean age was 42.6 years. Pelvis radiographs were studied in all cases, and CT scan was performed in 18 cases and MRI in 10 cases. Results: The fundamental signs on the plain film included shallow acetabulum, increased obliquity and insufficient coverage of the femoral head by the acetabulum. The CE angles were determined in all the cases, ranging from -10 degree to 30 degree, mean 12.9 degree. The sharp angles ranged from 35 degree to 67 degree, mean 45.3 degree. The secondary osteoarthritis were revealed in 75 hips (84.2%). 54 hips (62.1%) had cyst-like lesions in weight-bear area of the acetabulum or femoral head. 19 hips had subluxation of femoral head. CT and MRI displayed small cyst-like lesions and forward shift of the femoral head, which could not be shown on plain film, respectively in 13 and 10 hips. Conclusion: The cyst-like lesion of subarticular region is a common sign in acetabular dysplastic coxarthrosis. CT or MRI can show the early osteolytic lesion and forward subluxations

  7. Retroperitoneal hematoma with bone resorption around the acetabular component after total hip arthroplasty: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Uchida Kenzo

    2012-09-01

    Full Text Available Abstract Introduction Vascular complications related to cup-fixating screws penetrating the medial acetabular wall during total hip arthroplasty are not uncommon but rarely are associated with serious adverse events in the late post-operative period. Case presentation We present the case of a 77-year-old Japanese woman who developed progressive extensive bone resorption and large hematoma in the acetabulum 13 years after total hip arthroplasty. On admission to our hospital, she was on oral warfarin (1.5mg/day for atrial fibrillation. About 5 months after the initiation of anticoagulant therapy, she suffered a major fall followed by massive subcutaneous and pelvic girdle bleeding, predominantly on the medial side of the right thigh, but a fracture or damage of total hip arthroplasty was not evident on an emergency orthopedic evaluation. One year after the accident, a routine follow-up examination showed an asymptomatic osteolytic lesion in the acetabulum on the right pelvis, and 2 years later our patient noticed progressive pain in her right hip during walking. A large osteolytic lesion was noted in the right acetabulum on a plain radiograph. On high-resolution computed tomography and magnetic resonance imaging, a huge granulomatous lesion in the acetabulum was suggestive of chronic hematoma in intrapelvic and extrapelvic gluteal regions. A closer computed tomography examination showed that one of the screws used for fixation of the acetabular component in the total hip arthroplasty had penetrated the acetabular bone and had reached the pelvic cavity. Surgery was performed in a single session by means of two approaches: anterior midline transperitoneal address to resect the low-density mass lesion followed by posterolateral acetabular implant re-settlement. Conclusions Though rare, total hip arthroplasty-related late vascular complications could be serious and potentially affect the limb and quality of life.

  8. [Influence of the pelvic trauma registry of the DGU on treatment of pelvic ring fractures].

    Science.gov (United States)

    Holstein, J H; Stuby, F M; Herath, S C; Culemann, U; Aghayev, E; Pohlemann, T

    2016-06-01

    Fractures of the pelvic ring are comparatively rare with an incidence of 2-8 % of all fractures depending on the study in question. The severity of pelvic ring fractures can be very different ranging from simple and mostly "harmless" type A fractures up to life-threatening complex type C fractures. Although it was previously postulated that high-energy trauma was necessary to induce a pelvic ring fracture, over the past decades it became more and more evident, not least from data in the pelvic trauma registry of the German Society for Trauma Surgery (DGU), that low-energy minor trauma can also cause pelvic ring fractures of osteoporotic bone and in a rapidly increasing population of geriatric patients insufficiency fractures of the pelvic ring are nowadays observed with no preceding trauma.Even in large trauma centers the number of patients with pelvic ring fractures is mostly insufficient to perform valid and sufficiently powerful monocentric studies on epidemiological, diagnostic or therapeutic issues. For this reason, in 1991 the first and still the only registry worldwide for the documentation and evaluation of pelvic ring fractures was introduced by the Working Group Pelvis (AG Becken) of the DGU. Originally, the main objectives of the documentation were epidemiological and diagnostic issues; however, in the course of time it developed into an increasingly expanding dataset with comprehensive parameters on injury patterns, operative and conservative therapy regimens and short-term and long-term outcome of patients. Originally starting with 10 institutions, in the meantime more than 30 hospitals in Germany and other European countries participate in the documentation of data. In the third phase of the registry alone, which was started in 2004, data from approximately 15,000 patients with pelvic ring and acetabular fractures were documented. In addition to the scientific impact of the pelvic trauma registry, which is reflected in the numerous national and

  9. Elastic-plastic fracture mechanics analyses of cracked steam generator tubes under internal pressure

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyeong Keun; Ahn, Min Yong; Moon, Seong In; Chang, Yoon Suk; Kim, Young Jin [Sungkyunkwan Univ., Suwon (Korea, Republic of); Hwang, Seong Sik; Kim, Joung Soo [KAERI, Taejon (Korea, Republic of)

    2005-07-01

    The structural and leakage integrity of steam generator tube should be maintained during operation even though a crack is existed on it. During the past three decades, several limit load solutions have been proposed to resolve the integrity issue. However, for exact load carrying capacity estimation of specific components under different conditions, these solutions have to be modified by using lots of experimental data. The purpose of this paper is to introduce a new burst pressure estimation scheme based on fracture mechanics analyses for steam generator tube with an axial or circumferential through-wall crack. To do this, closed-form engineering equations were derived to get relevant parameters from three dimensional elastic-plastic finite element analyses combined with reference stress method. Also, a series of structural integrity analyses were carried out using the calculated J-integral from engineering equations and fracture toughness data. Thereby, in comparison with the experimental data as well as corresponding estimation results from limit load solutions, it was proven that the proposed estimation scheme can be used as an efficient tool for integrity evaluation of cracked steam generator tubes.

  10. The biomechanical evaluation of polyester as a tension band for the internal fixation of patellar fractures.

    LENUS (Irish Health Repository)

    McGreal, G

    2012-02-03

    We use a braided polyester suture in place of cerclage wire in tension band fixations. The objective of this study was to test the biomechanical properties of this technique. Sixteen cadaveric patellae were fractured and repaired by modified tension band fixation. Eight were fixed using eighteen gauge stainless steel wire as a tension band and eight using braided polyester. All specimens were subjected to tensile testing. Polyester was 75.0% as strong as wire. For dynamic testing, the patellae of seven cadaveric knees were fractured and then fixed with polyester tension bands. These were mounted in a device capable of extending the knees from 90 degrees to neutral against an applied force. None of the fixations failed. Three of the specimens fixed using 18 gauge stainless steel wire were compared with three fixed using polyester over 2000 cycles of knee flexion and extension. Polyester performed as well as wire. We conclude that polyester is an acceptable alternative to wire in tension band fixation.

  11. The computed tomographic evaluation of patellofemoral joint in patellar fractures treated with open reduction and internal fixation

    Energy Technology Data Exchange (ETDEWEB)

    Benli, I.T.; Akalin, S.; Mumcu, E.F.; Citak, M.; Kilic, M.; Pasaoglu, E. (Ankara Social Security Hospital (Turkey))

    1992-08-01

    In this study, we examined 97 patella fractures in which open reduction and internal fixation had been performed at the 1st Orthopaedics and Trauma Clinic of Social Security Ankara Hospital between January 1983 and December 1988. After 24 to 96 months, on an average of 48.4 months follow-up period, the cases were evaluated clinically for knee function complaints and by CT and roentgenography for patellofemoral articulation. In 11 of the patients (11.5%) there was patellar displacement, 2 of the patients had patellar tilt (2.1%) and in 14 patients (14.5%) there was malalignment in which 1 patient (1.1%) had both patellar tilt and displacement. This data was obtained by measuring femoral trochlear angle (FTA) and patellar tilt angle (PTA) by CT at various degrees of knee flexion. Thirty three patients (34%) had slight and 19 patients (19.6%) had severe degenerative changes in the patellofemoral articulation. It is found that there is close relation between the variability of the pain complaints of the patients and the type of the fracture and the time of management and the postoperative rehabilitation. (author).

  12. The computed tomographic evaluation of patellofemoral joint in patellar fractures treated with open reduction and internal fixation

    International Nuclear Information System (INIS)

    In this study, we examined 97 patella fractures in which open reduction and internal fixation had been performed at the 1st Orthopaedics and Trauma Clinic of Social Security Ankara Hospital between January 1983 and December 1988. After 24 to 96 months, on an average of 48.4 months follow-up period, the cases were evaluated clinically for knee function complaints and by CT and roentgenography for patellofemoral articulation. In 11 of the patients (11.5%) there was patellar displacement, 2 of the patients had patellar tilt (2.1%) and in 14 patients (14.5%) there was malalignment in which 1 patient (1.1%) had both patellar tilt and displacement. This data was obtained by measuring femoral trochlear angle (FTA) and patellar tilt angle (PTA) by CT at various degrees of knee flexion. Thirty three patients (34%) had slight and 19 patients (19.6%) had severe degenerative changes in the patellofemoral articulation. It is found that there is close relation between the variability of the pain complaints of the patients and the type of the fracture and the time of management and the postoperative rehabilitation. (author)

  13. A CLINICAL STUDY OF MANAGEMENT OF FRACTURE BOTH BONES FOREARM WITH INTERNAL FIXATION BY TWO DIFFERENT METHODS

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    Venkateswara Rao

    2015-09-01

    Full Text Available BACKGROUND AND OBJECTIVES: 60 cases of fracture both bone forearm in adults were operated and fixed using two different instruments in Siddhartha Medical College/Government General Hospital, Vijayawada between May 2013 to April 2015. METHODS: Most of the cases were young adult male with age ranging between 20 - 75yrs. The functional outcome of two different modalities of surgical management of diaphyseal fracture of both bone forearm in adults are interpreted. 30 patients were operated with DCP, and 30 patients were operated with intramedullary nailing. RESULTS : By Anderson Scoring System out of 30 cases of DCP 66.67% were excellent, 33.33% were satisfactory. Out of 30 cases of Intramedullary nailing with Talwalker square nails 50% were excellent, 23.33% were satisfactory, 16.67% were unsatisfactory, 10% had failure results. CONCLUSION : Open reduction and internal fixation can be considered as the treatment of choice if there were no contraindications for this because it is important to maintain length, opposition, axial alignment and rotational alignment if a good range of movement of forearm is to be restored. This is achieved in the present study.

  14. Displaced Intra-Articular Fractures of the Distal Radius: Open Reduction With Internal Fixation Versus Bridging External Fixation

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    Fakoor

    2015-08-01

    Full Text Available Background Distal radius fracture is common in all ages. Mobility and wrist function is important. The choice of treatment should aim for optimal function with minimal complications. Objectives In this study we compared two surgical approaches, open reduction and internal fixation (ORIF and closed reduction with external fixation (CR + EF, for treatment of intra-articular distal radius fractures. Patients and Methods Ninety-four patients with distal radius fracture (type 3, 4 and 5 Fernandez classification were treated with two surgical methods (ORIF and CR + EF; 55 were treated with CR + EF and 39 were treated with ORIF by different surgeons. All patients were assessed at the end of the first, third and sixth week; and then after the third, sixth and 12th month. At the end of the follow-up, all patients completed the Michigan hand outcome questionnaire (MHOQ. We compared radiological parameters of distal radius, range of motion (ROM of the wrist, duration of rehabilitation, complication and patient satisfaction of the methods. Results In our study, radiological findings for the ORIF group were radial inclination (RI: 19.35, radial length (RL: 10.35, radial tilt (RT: 8.92, and ulnar variance (UV: 1.64, while for the CR + EF group these were RI: 15.13, RL: 8, RT: 4.78, and UV: 0.27. The ROM for ORIF were flexion/extension (F/E: 137, Radial/Ulnar deviation (R/U: 52, and Supination/Pronation (S/P: 141, while for the CR + EF group these were F/E: 117, R/U: 40 and S/P: 116. Michigan hand outcome score for ORIF was 75% and for Ext. fix was 60%. The rate of complication with the ORIF method was 58% and in Ext. fix this was 69%. The patients in CR + EF had more than the ORIF course of physiotherapy and rehabilitation. Conclusions In comparison of ORIF and CR + EF, all results including functional score, clinical and radiologic criteria were in favor of the ORIF method while there were less complications with this method. We believe that ORIF is a better

  15. Biomechanical Study Using the Finite Element Method of Internal Fixation in Pauwels Type III Vertical Femoral Neck Fractures

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    Noda

    2015-08-01

    Full Text Available Background Several factors are known to influence osseous union of femoral neck fractures. Numerous clinical studies have reported different results, hence with different recommendations regarding treatment of Pauwels III fractures: femoral neck fractures with a more vertically oriented fracture line. The current study aimed to analyze biomechanically whether this fracture poses a higher risk of nonunion. Objectives To analyze the influence of one designated factor, authors believe that a computerized fracture model, using a finite element Finite Element Method (FEM, may be essential to negate the influence of other factors. The current study aimed to investigate a single factor, i.e. orientation of the fracture line toward a horizontal line, represented by Pauwels classification. It was hypothesized that a model with a vertically oriented fracture line maintaining parity of all other related factors has a higher stress at the fracture site, which would delay fracture healing. This result can be applicable to other types of pinning. Patients and Methods The finite element models were constructed from computed tomography data of the femur. Three fracture models, treated with pinning, were constructed based on Pauwels classification: Type I, 30° between the fracture line and a horizontal line; Type II, 50°; and Type III, 70°. All other factors were matched between the models. The Von Mises stress and principal stress distribution were examined along with the fracture line in each model. Results The peak Von Mises stresses at the medial femoral neck of the fracture site were 35, 50 and 130 MPa in Pauwels type I, II, and III fractures, respectively. Additionally, the peak Von Mises stresses along with the fracture site at the lateral femoral neck were 140, 16, and 8 MPa in Pauwels type I, II, and III fractures, respectively. The principal stress on the medial femoral neck in Pauwels type III fracture was identified as a traction stress, whereas

  16. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3370 Section 888.3370 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... (hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip joint (hemi-hip) acetabular metal cemented prosthesis is a device intended to be implanted to replace a portion of the hip...

  17. A novel method of removal of a broken drill bit in the femoral medullary canal during internal fixation of a type C distal femoral fracture: a case report

    Directory of Open Access Journals (Sweden)

    Mounasamy Varatharaj

    2012-11-01

    Full Text Available 【Abstract】 Breakage of surgical instruments and implants during operative procedures is not uncommon in any surgical discipline. The need for removal and the out-come of leaving the broken instruments and implants in the surgical area have not been described in detail. Few studies have suggested removal if they are lying loosely in the tis-sues or joint, close to neurovascular structures. Challenges and the amount of time spent in the retrieval of broken in-struments and implants are well known among surgeons, so most choose to leave them in situ. We reported a novel method of retrieval of a broken drill bit in the femoral medul-lary canal during internal fixation of a type C distal femoral fracture. Key words: Fracture fixation, internal; Femoral fractures; Surgical instruments

  18. [Rehabilitation following hip fractures].

    Science.gov (United States)

    Maurer, F; Mutter, B; Weise, K; Belzl, H

    1997-04-01

    In the rehabilitation of patients with acetabular fractures, we try to achieve anatomical reconstruction of the joint as well as unlimited mobility. This is important for the patient's reintegration at work and in social life. These aims can only be reached with joint effort of the patient him/herself and all the different specialists concerned with the treatment. Functional physiotherapy should start as early as possible after trauma. Prophylaxis of joint stiffness, thrombosis, pneumonia and soft-tissue ulcers due to immobilization are not only important in the beginning. The restoration of circulation and resorption in the affected tissues, in addition to creation of global sensorimotor motion patterns, are the main aspects of this therapy. Definite long-term success should be ensured by concomitant ergotherapy and well-timed measures for the patient to regain his/her occupational abilities. PMID:9273497

  19. Effects of low-dose microwave on healing of fractures with titanium alloy internal fixation: an experimental study in a rabbit model.

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    Dongmei Ye

    Full Text Available BACKGROUND: Microwave is a method for improving fracture repair. However, one of the contraindications for microwave treatment listed in the literature is surgically implanted metal plates in the treatment field. The reason is that the reflection of electromagnetic waves and the eddy current stimulated by microwave would increase the temperature of magnetic implants and cause heat damage in tissues. Comparing with traditional medical stainless steel, titanium alloy is a kind of medical implants with low magnetic permeability and electric conductivity. But the effects of microwave treatment on fracture with titanium alloy internal fixation in vivo were not reported. The aim of this article was to evaluate the security and effects of microwave on healing of a fracture with titanium alloy internal fixation. METHODS: Titanium alloy internal fixation systems were implanted in New Zealand rabbits with a 3.0 mm bone defect in the middle of femur. We applied a 30-day microwave treatment (2,450MHz, 25W, 10 min per day to the fracture 3 days after operation. Temperature changes of muscle tissues around implants were measured during the irradiation. Normalized radiographic density of the fracture gap was measured on the 10th day and 30th day of the microwave treatment. All of the animals were killed after 10 and 30 days microwave treatment with histologic and histomorphometric examinations performed on the harvested tissues. FINDINGS: The temperatures did not increase significantly in animals with titanium alloy implants. The security of microwave treatment was also supported by histology of muscles, nerve and bone around the implants. Radiographic assessment, histologic and histomorphometric examinations revealed significant improvement in the healing bone. CONCLUSION: Our results suggest that, in the healing of fracture with titanium alloy internal fixation, a low dose of microwave treatment may be a promising method.

  20. Comparison of acetabular version angle measurements between prone and reformatted supine computed tomography images

    Energy Technology Data Exchange (ETDEWEB)

    Chong, Le Roy [Changi General Hospital, Department of Radiology, Singapore (Singapore); Too, Chow Wei [Singapore General Hospital, Department of Diagnostic Radiology, Singapore (Singapore)

    2014-03-15

    To compare acetabular version angle measurements of CT scans in the prone and reformatted supine positions. CT acetabular version angle measurements have previously been done in the prone position to correct for pelvic tilt. With the advent of multidetector CT, recent studies have evaluated acetabular version angles measured in the supine position. To our knowledge, a comparison between these two approaches has not been performed. Case series in which consecutive CT urography studies of 49 adult patients performed in both prone and supine positions were retrospectively reviewed, and acetabular version angles of both hips measured. Retrospective review of 49 consecutive CT urography studies performed in both prone and supine positions was done, and acetabular version angles of both hips were measured. Two radiologists measured the acetabular version angles independently. Multiplanar reformation of the supine CT images was performed to compensate for pelvic tilt and rotation prior to angle measurements. There was excellent interobserver agreement between the two readers (ICC = 0.90). Acetabular version angle measurements from the prone CT images were larger compared to reformatted supine images (24.0 and 21.3 , respectively, p < 0.0001), with greater angles found in women. There was strong correlation between supine and prone acetabular version angle measurements with a Pearson correlation coefficient of 0.743. Acetabular version angles measured from prone and reformatted supine CT images show strong correlation but are significantly different with larger angles obtained from the former and in women; clinical implications of these findings may require further study in other to determine the best method of version angle measurement. CT acetabular version angle measurement is also reliable with excellent interobserver correlation. (orig.)

  1. 髓内钉置入内固定治疗肱骨骨折☆%Intramedullary nail internal fixation for the treatment of humeral fracture

    Institute of Scientific and Technical Information of China (English)

    王一民; 徐开明; 黄醒中; 黄爱军; 李中檀; 马树强

    2013-01-01

    BACKGROUND: At present, for the treatment of humeral fracture, there has not yet been formed uniform treatment mode which is fixed and accepted by most scholars, and there are disagreements on the indications and surgical timing of humeral fracture treated with intramedul ary nail internal fixation. OBJECTIVE: To analyze the pathological anatomy, healing process and injury typing of humeral fracture and to investigate the indications and surgical timing of humeral fracture treated with intramedul ary nail internal fixation. METHODS: The purpose of the treatment of complex humeral fractures was to restore the necessary functional or anatomical bits, achieve stable fixation and placement, thus get the early-stage functional exercise. The articles concerning the treatment of humeral fractures with intramedul ary nail internal fixation were summarized to find out the cases with the similar treatment objects and the same curative effect evaluation criteria for the comparative study, in order to provide basis for the clinical treatment of humeral fractures. RESULTS AND CONCLUSION: For the treatment of humeral fractures, it is important to critical y assess the type of fracture and bone quality and to select the suitable intramedul ary nail during the treatment of humeral fractures. Understanding the type of intramedul ary nail and the manner of internal fixation, recognizing the value of different types of intramedul ary nail placement for the treatment of humeral fractures as wel as taking the effective measures to prevent the related complications during the treatment of humeral fractures with intramedul ary nail internal fixation can help to obtain the satisfactory results during the treatment of humeral fractures.%  背景:肱骨骨折的治疗到目前仍未形成一个固定的、被大多数学者接受的统一的治疗模式,髓内钉置入内固定治疗肱骨骨折的适应证、手术时机等一直存在分歧。目的:分析肱骨骨折的病理

  2. CLINICAL AND FUNCTIONAL OUTCOME OF DISTAL RADIUS FRACTURES MANAGED BY LIGAMENTOTAXIS AND/OR PERCUTANEOUS PINNING VERSUS OPEN REDUCTION & INTERNAL FIXATION BY BUTTRESS PLATES

    Directory of Open Access Journals (Sweden)

    Biju

    2015-05-01

    Full Text Available INTRODUCTI ON: We studied the clinical and functional outcome of distal radius fractures managed by ligamentotaxis and/or percutaneous pinning versus open reduction & internal fixation by buttress plates. METHODS : This prospective study was conducted during Aug 2012 to October 2014. All skeletally matured patients were having both Intra articular and extra articular Closed Distal Radius fractures were studied. Treatment was done either external fixator supplemented with k wires or internal fixation with plate and screws. The radiographic evaluation included radial length, palmar tilt, any evidence of jointincongruity and radio ulnar joint instability and arthritis. The assessments that were made includes Subjective assessment – pain, numbness, weakness of hand, stiffness, OBJECTIVE : R ange of motion measured by hand held goniometer, Measurement of grip strength done by commercially available hand dynamometer. Unaffected hand served as control. RESULTS : Male patients (85.46% outnumbered female patients (14.54% in incidence. The incidence of distal ra dius fractures was common between the ages of 20 to 40 years. Left sided fractures were more common (52.73%. Type III was most common type of fracture (Frykman’s Classification, accounting for 29% of all fractures.25 cases were treated by external fixati on and 30 cases were treated by open reduction and buttress plating. The results were evaluated by using STEWART ET AL anatomical and functional scoring system. The average range of movement at the knee joint was Dorsiflexion 70*, Palmar Flexion 65*, Ulnar Deviation 25*, Radial Deviation 15*, Supination 70*, Pronation 65*. Most common early complication was pin tract infection. Based on the stewar et al scoring, 4(7.27% had excellent, 43(78.18% had good, 7(12.72% had fair, 1(1.81% had poor results. CONC LUSION : We observed that both fixations were equally same, there is no superiority with over the other. The incidence of complications in

  3. External fixation combined with limited internal fixation for Pilon fractures%外固定支架结合有限内固定治疗Pilon骨折

    Institute of Scientific and Technical Information of China (English)

    周淮; 徐晓军

    2011-01-01

    Objective To investigate the clinical effect of Pilon fractures treated with external fixation and limited internal fixation.Methods 24 cases of Pilon fractures of tibia were treated with external fixation combined limited internal fixation.Results 24 cases were followed up for 10 ~ 20 months.No bone nonumon or skin necrosis complication was found.According to Mazur ankle joint scoring system, the results were excellent in 14, good in 7 , and fair in 3.Conclusions External fixation combined with limited internal fixation can immohilize the sections of fracture and achieve excellent ankle joint function,so it is an effective surgical treatment of Pilon fractures.%目的 探讨外固定支架结合有限内固定治疗Pilon骨折的疗效.方法 采用外固定支架结合有限内固定治疗24例Pilon骨折.结果 24例均获得随访,时间10~20个月.无骨不连、皮肤坏死发生.踝关节功能Mazur评分:优14例,良7例,可3例.结论 外固定支架结合有限内固定可以获得术后骨折稳定,取得良好踝关节功能,是治疗Pilon骨折有效的手术方案.

  4. Efficient radiologic diagnosis of pelvic and acetabular trauma; Rationelle bildgebende Diagnostik von Becken- und Azetabulumverletzungen

    Energy Technology Data Exchange (ETDEWEB)

    Kreitner, K.F.; Mildenberger, P.; Thelen, M. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Rommens, P.M. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Unfallchirurgie

    2000-01-01

    In spite of the widespread availability of CT scanners, conventional X-ray radiographs remain the basic imaging modality in patients with pelvic and/or acetabular trauma. However, the extent of their use will depend on local utilities (e.g., availability of CT scanners) and on the patient's clinical condition. Regarding the inaccuracy of conventional radiography in the diagnosis of injuries of the dorsal pelvic ring and of the acetabulum, computed tomography represents the most important imaging modality in the clinically stable patient. CT provides an exact staging of the extent of trauma and allows for differentiation of pelvic instabilities. CT clearly demonstrates the severity of acetabular trauma and is superior in the detection of local complicating factors, i.e., impressions fractures and (sub-)luxations of the femoral head as well as free intraarticular fragments. CT findings provide the basis for definite treatment regimens of the injured patient. By extension of the examination, all relevant organs and systems (craniospinal, cardiovascular, gastrointestinal, respiratory, genitourinary) can be imaged during one session. The speed of spiral CT scanners and their diagnostic accuracy will play a major role in the management of, especially, polytraumatized patients. The indication for angiography with the option of therapeutic embolization exists if a pelvic bleeding persists even after reposition and operative fixation of the injury. (orig.) [German] Bei der Klaerung einer Verletzung des Beckens oder des Azetabulums stellen konventionelle Uebersichtsaufnahmen weiterhin die Basis der bildgebenden Diagnostik dar. Art und Umfang werden bestimmt von lokalen Gegebenheiten (z.B. Verfuegbarkeit von CT-Geraeten) sowie vom klinischen Zustand des Patienten. Aufgrund der diagnostischen Ungenauigkeit der konventionellen Roentgendiagnostik gerade im Bereich des stabilitaetsbedeutsamen dorsalen Beckenringes und des Azetabulums schliesst sich beim klinisch stabilen

  5. Fracture of Ceramic Liner and Head in a Total Hip Arthroplasty with a Sandwich Type Cup

    Directory of Open Access Journals (Sweden)

    Diego Reátegui

    2013-01-01

    Full Text Available Due to its advantages, ceramic-on-ceramic bearings have been widely used in young patients for almost 30 years. Long-term survivorship, low wear, and low biological reactivity to particles are some of its characteristics. Even though this material has had a lot of improvements, the risk of fracture is one of the concerns. There have been reports of fracture of ceramic in the acetabular liner and head but no fractures of both in the same patient. We report a case of a fracture in a sandwich type acetabular liner and the ceramic head in a patient involving ankylosing spondylitis. It occurred three years after the operation and with no history of direct trauma. We decided to change the bearing surfaces to metal polyethylene without removing the metal back. The patient is satisfied by the clinical results after a 5-year followup.

  6. Utilization of virtual reality technology in acetabular surgery%虚拟现实技术在髋臼手术中的应用

    Institute of Scientific and Technical Information of China (English)

    王玫; 张月东; 张兰华

    2011-01-01

    BACKGROUND: At present, abroad has carried out some research and practice on the medical virtual reality technology,especially in a virtual medical simulation training and other aspects of surgery, but it does not fully meet the needs of clinical orthopedic surgery. The acetabular fractures are difficult to treat because of its com plexity. Clinicians select appropriate treatment options and surgical approaches according to imaging studies, which are difficult to accurately determine the spatial three-dimensional relationship.OBJECTIVE: To review the application of virtual reality technology in acetabular surgery.METHODS: CNKI, PubMed, Wanfang and VIP databases were searched for papers addressing application of virtual reality in acetabular surgery using key words of "finite element model, acetabular fracture, and virtual surgery" both in English and Chinese.The repetitive studies or papers with blur parameter were removed.RESULTS AND CONCLUSION: Totally 115 documents were initial searched by computer, and 32 papers were included in this review. Acetabular virtual surgery system can analyze the complex of acetabulum and simulate the actual situation, thus, provides a 3-dimensional virtual procedure for clinical operations. A virtual platform can provide guidance for making preoperative plan,which has good prospect in medical surgery teaching and simulation training.%背景:目前国外已经对医学虚拟现实,尤其是在虚拟医学手术仿真训练等方面都进行了一定的研究和实践,但并不能完全适应骨科手术的临床需要.而髋臼骨折因其复杂性治疗困难,临床医师选择适当治疗方案和手术入路的主要依据来源于影像学检查,常难以准确判断空间立体关系.目的:综合分析虚拟现实技术在髋臼手术中的应用情况.方法:作者于2010-10通过互联网计算机检索了中国期刊全文数据库(CNKI)、PubMed数据库、万方数据库及维普数据库1980-01/2010-10以中文或英文

  7. The use of cementless acetabular component in revision surgery without pelvic discontinuity.

    Science.gov (United States)

    Cherubino, Paolo; D'Angelo, Fabio; Surace, Michele Francesco; Murena, Luigi; Vulcano, Ettore

    2010-10-01

    Reconstruction of the failed acetabular component in total hip arthroplasty (THA) can be challenging. Although there are multiple reconstructive options available, a cementless acetabular component inserted with screws has been shown to have good intermediate-term results and is the reconstructive method of choice for the majority of acetabular revisions This reconstruction is feasible provided at least 50% of the implant contacts host bone. When such contact is not possible, and there is adequate medial and peripheral bone, techniques using alternative uncemented implants can be used for acetabular reconstruction. An uncemented cup can be placed at a "high hip center." Alternatively, the acetabular cavity can be progressively reamed to accommodate extra-large cups. Oblong cups, which take advantage of the oval-shaped cavity resulting from many failed acetabular components, can also be used. The success of these cementless techniques depends on the degree and location of bone loss. The correct indication to revision and the choice of the correct implant is the keystone for the success of this type of surgery and follows an accurate preoperative planning in order to understand the specific pathologic scenario. The aim of this paper is to review some technical options for the revision of the acetabular component also taking into account our personal experiences and series. PMID:21082580

  8. Massive acetabular bone loss: Limits of trabecular metal cages

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    Villanueva-Martínez Manuel

    2011-01-01

    Full Text Available Massive acetabular bone loss (more than 50% of the acetabular area can result in insufficient native bone for stable fixation and long-term bone ingrowth of conventional porous cups. The development of trabecular metal cages with osteoconductive properties may allow a more biological and versatile approach that will help restore bone loss, thus reducing the frequency of implant failure in the short-to-medium term. We report a case of massive bone loss affecting the dome of the acetabulum and the ilium, which was treated with a trabecular metal cage and particulate allograft. Although the trabecular metal components had no intrinsic stability, they did enhance osseointegration and incorporation of a non-impacted particulate graft, thus preventing failure of the reconstruction. The minimum 50% contact area between the native bone and the cup required for osseointegration with the use of porous cups may not hold for new trabecular metal cups, thus reducing the need for antiprotrusio cages. The osteoconductive properties of trabecular metal enhanced allograft incorportation and iliac bone rebuilding without the need to fill the defect with multiple wedges nor protect the reconstruction with an antiprotrusio cage.

  9. Para-acetabular peritendinitis calcarea; its radiographic manifestations

    International Nuclear Information System (INIS)

    Peritendinitis calcarea and os acetabuli have long been confused during interpretations of hip-joint radiographs. Such confusion is reflected in the medical literature. The present study differentiated these two entities according to their interval radiographic progression and regression. There were 137 instances of para-acetabular calcifications among 110 subjects (59 men and 51 women), whose mean age was 46.8 years at the time of their initial detection. Twenty-six of the subjects had lumbago, which was probably unrelated. Other abnormalities including narrowed intervertebral spaces, scoliosis, and spondylolysis were observed in 21 of the subjects. These could have been responsible for any symptoms they had had, but none of the subjects complained of local hip-joint pain when the radiographs in question were made. Ninety-three of these instances of calcification were reviewed by means of serial radiographs. Interval changes in the sizes and shapes of the calcifications occurred among 90 of them, indicative of the latent type of peritendinitis calcarea. No interval changes were noted in the remaining three cases, indicating they were secondary ossification centers; namely, os acetabuli. This study showed that in asymptomatic adults, most para-acetabular calcifications were really not os acetabuli, but actually peritendinitis calcarea. (author)

  10. Incidence and Future Projections of Periprosthetic Femoral Fracture Following Primary Total Hip Arthroplasty: An Analysis of International Registry Data.

    Science.gov (United States)

    Pivec, Robert; Issa, Kimona; Kapadia, Bhaveen H; Cherian, Jeffery J; Maheshwari, Aditya V; Bonutti, Peter M; Mont, Michael A

    2015-01-01

    As the number of total hip arthroplasties (THA) increases, the number of fractures will increase as well. The purpose of this study was to determine the incidence and prevalence of intra- and post-operative periprosthetic fractures following THA based on national joint registry data and to create a projection model that estimates the future fracture burden. Registry data from multiple joint registries were analyzed. Data on the incidence and prevalence of intra- and post-operative periprosthetic fractures were extracted. The prevalences between individual countries were analyzed to determine the mean prevalence. Three quantitative models were then generated to predict the fracture burden in the United States based on future population trends between 2015 and 2060. The mean incidence of post-operative periprosthetic fractures requiring revision was 0.8% while the incidence of intraoperative fractures was 0.8%. When all revision arthroplasties were assessed, the mean proportion of hips revised due to periprosthetic fracture was 6.6%. Projection models demonstrated that the number of periprosthetic fractures is expected to rise by a mean 4.6% every decade over the next 30 years. Periprosthetic fractures represent a small but important proportion of the revision THA burden worldwide. The incidence of both intra- and post-operative fractures is low, but the number is likely to steadily increase along with the number of surgeries performed. The number of fractures may rise even further as the incidence may potentially be higher in elderly, osteoporotic patients who are likely to represent a greater proportion of the arthroplasty population, particularly. PMID:26852635

  11. Fixation of femoral capital physeal fractures with 7.0 mm cannulated screws in five bulls

    International Nuclear Information System (INIS)

    Salter-Harris type I fractures of the femoral capital physis were repaired in five Holstein bulls with three 7.0 mm cannulated screws placed in lag fashion. Radiographically at months 7 to 10, the fractures were healed and there was periarticular bone production on the femoral necks and the dorsal acetabular rims. Four bulls had normal gaits, and one bull had muscle atrophy and barely detectable lameness

  12. Radiographic anatomy of the proximal femur: correlation with the occurrence of fractures

    OpenAIRE

    Pires, Robinson Esteves Santos; Prata, Eric Fontes; Gibram, Athos Vilela; Santos, Leandro Emilio Nascimento; Lourenço, Paulo Roberto Barbosa de Toledo; Belloti, João Carlos

    2012-01-01

    Objective To evaluate the correlation between radiographic parameters of the proximal femur anatomy and fractures. Methods Three hundred and five digital x-rays of the pelvis were analyzed in the anteroposterior view. Of these x-rays, twenty-seven showed femoral neck or transtrochanteric fractures. The anatomical parameters analyzed were: femoral neck width (FNW), femoral neck length (FNL), femoral axis length (FAL), cervicodiaphyseal angle (CDA), acetabular tear-drop distance (ATD) and great...

  13. A CLINICAL STUDY ON FUNCTIONAL OUTCOME AFTER COMBINED ARTHROSCOPIC AND FLUOROSCOPIC ASSISTED REDUCTION AND INTERNAL FIXATION OF CLOSED TIBIAL PLATEAU FRACTURES IN ADULTS

    Directory of Open Access Journals (Sweden)

    Bhavani Prasad

    2015-06-01

    Full Text Available BACKGROUND AND INTRODUCTION: Management of tibial plateau fractures had witnessed tremendous improvement in surgical techniques over the past decades. Conservative treatment of these fractures results in consistently poor results. The present literature supports that absolute anatomi cal reduction and stable fixation of peri articular fractures followed by early post - operative rehabilitation is crucial for good results. And if this is achieved by minimal damage to soft tissue the results are much better. In this study it is achieved by arthroscopy and fluoroscopy. MATERIALS AND METHODS: We have conducted a prospective study between September 2009 to august 2013 including 9 patients with tibial plateau fractures treated with combined arthroscopic and fluoroscopic reduction and internal f ixation with or without bone grafting. And then the radiographic and functional evaluation done. RESULTS: According to Hohl’s clinical and radiographic scoring systems 4 patients were assessed excellent, 3 good, 2 fair. According to Rasmussen’s clinical sc oring system 4 patients excellent, 3 good and 2 fair results. CONCLUSION: The use of arthroscopy and fluoroscopy in the management of tibial plateau fractures results in good outcome. It also helped to simultaneously treat the meniscal injuries. But its use is mainly limited to Shatzkar type1, 2, 3, 4

  14. Distal radius fracture arthroscopic intraarticular displacement measurement after open reduction and internal fixation from a volar approach

    International Nuclear Information System (INIS)

    The purpose of this study was to assess articular surface reduction arthroscopically after volar locked-plate fixation of distal radius fractures (DRFs) via fluoroscopy-guided open reduction/internal fixation. We also aimed to develop preoperative radiographic criteria to help assist in determining which DRFs may need arthroscopic evaluation. A total of 31 consecutive patients with DRF were prospectively enrolled. Posteroanterior (PA) and lateral radiographs as well as axial, coronal, and sagittal CT scans were obtained just after attempted reduction of the DRF. The widest articular displacement at the radiocarpal joint surface of the distal radius (preopD) was then measured using a digital radiography imaging system. The DRF was reduced under fluoroscopy, and a volar locked plate was applied. The degree of residual articular displacement was then measured arthroscopically, and the maximum displacement (postopD) was measured with a calibrated probe. Of the 31 patients, 7 had an arthroscopically assessed maximum postopD of ≥2 mm after internal fixation. The correlation coefficients between each preopD and postopD of all radiographs and CTs were statistically significant. The cutoff values were 0.5 mm for PA radiographs, 2.10 mm for lateral radiographs, 2.15 mm for axial CT scans, 3.15 mm for coronal CT scans, and 1.20 mm for sagittal CT scans. All cutoff values for PA and lateral radiographs and for axial, coronal, and sagittal CT scans were unsuitable as screening criteria for arthroscopic reduction of DRF because of their low sensitivities and specificities. The cutoff value of the new preopD (the sum of the preopDs determined by lateral radiography and coronal CT scan) was 5.80 mm, and its sensitivity and specificity were 100% and 83.3%, respectively. Because a new preopD cutoff value of 5.80 mm is a good indicator for residual articular displacement after internal fixation of >2 mm, it is also a good indicator for the need for arthroscopic evaluation after

  15. Analysis of Internal Fixation for Tri-ankle Fracture in 36 Cases%内固定治疗三踝骨折36例分析

    Institute of Scientific and Technical Information of China (English)

    张小东; 钟桂午; 王晓红; 杜小龙; 王贻幸

    2011-01-01

    Objective: To evaluate the efficacy and prognosis of internal fixation treatment for the tri-malleolar fracture with posterolateral approach combined with medial approach. Methods:36 cases of trimalleo-lar fracture were treated with internal fixation by posterolateral approach combined with medial approach. Results:All the patients were followed up for 6 -21 months, the average time is 12. 5 months; the fracture healed in 12 - 16 weeks postoperative. According to Baird - Jackson criteria,there were excellent in 20 cases, good in 12 cases and fair in 4 case. Excellent and good rate clinical result was 88. 9%. Conclusions:The internal fixation treatment of trimalleolar fracture with posterolateral approach combined with medial approach is easy to perform and the fixation is reliable, which is suitable for the surgical treatment of the trimalleolar fracture.%目的:探讨后外侧入路联合内侧入路内固定治疗三踝骨折的疗效及预后.方法:对36例三踝骨折采用后外侧入路联合内侧入路切开复位内固定.结果:术后均得到10~32个月,平均12.5个月的随访.骨折愈合时间12~16周.疗效评定依据Baird-jackson踝关节评分标准:本组优20例,良12例,可4例,优良率88.9%.结论:采用后外侧入路联合内侧入路进行内固定治疗三踝骨折,其操作简便,固定可靠,适用于三踝骨折的手术治疗.

  16. Local anaesthetic wound infiltration after internal fixation of femoral neck fractures: a randomized, double-blind clinical trial in 33 patients

    DEFF Research Database (Denmark)

    Bech, Rune D; Lauritsen, Jens; Ovesen, Ole;

    2011-01-01

    Pain control may assist early mobilisation after internal fixation of femoral neck fractures. Systemic opioids have significant side effects in elderly patients. We present an evaluation of the effect of local anaesthetic infiltration in such cases , the objective being to decrease the need...... for postoperative opioids and to improve pain control for patients after surgery. 33 patients undergoing internal fixation with 2 parallel hook pins were randomized into 2 groups in a double blind study (ClinicalTrials.gov: NCT00529425). 33 patients received intraoperative infiltration followed by 6 postoperative...... in the study group on the second postoperative day, there were no significant differences in the occurrence of side effects between the groups. On day 2 the placebo group had less pain than the study group. Local anaesthetic infiltration after fixation of femoral neck fractures does not reduce opioid...

  17. Galeazzi fracture.

    Science.gov (United States)

    Atesok, Kivanc I; Jupiter, Jesse B; Weiss, Arnold-Peter C

    2011-10-01

    Galeazzi fracture is a fracture of the radial diaphysis with disruption at the distal radioulnar joint (DRUJ). Typically, the mechanism of injury is forceful axial loading and torsion of the forearm. Diagnosis is established on radiographic evaluation. Underdiagnosis is common because disruption of the ligamentous restraints of the DRUJ may be overlooked. Nonsurgical management with anatomic reduction and immobilization in a long-arm cast has been successful in children. In adults, nonsurgical treatment typically fails because of deforming forces acting on the distal radius and DRUJ. Open reduction and internal fixation is the preferred surgical option. Anatomic reduction and rigid fixation should be followed by intraoperative assessment of the DRUJ. Further intraoperative interventions are based on the reducibility and postreduction stability of the DRUJ. Misdiagnosis or inadequate management of Galeazzi fracture may result in disabling complications, such as DRUJ instability, malunion, limited forearm range of motion, chronic wrist pain, and osteoarthritis.

  18. A novel classification to guide total hip arthroplasty for adult acetabular dysplasia

    OpenAIRE

    Zhu, Chen; CHENG, MENG-QI; Cheng, Tao; MA, RUI-XIANG; Kong, Rong; GUO, YONG-YUAN; Qin, Hui; SHI, SI FENG; Zhang, Xian-long

    2013-01-01

    In the field of hip arthroplasties, the secondary fixation of the implants depends directly on the quality of the primary stability. A good acetabular fit and metaphyseal filling between the prostheses and implants improve the initial stabilization, and optimize the transmission of forces to the bone. A precise knowledge of the three-dimensional acetabular or femoral shape is essential to the selection of adapted implants. A total of 63 patients diagnosed with developmental dysplasia were ana...

  19. Numerical modelling of the pelvis and acetabular construct following hip arthroplasty

    OpenAIRE

    Phillips, Andrew T. M.

    2005-01-01

    The study presents finite element models of the acetabular construct and the pelvis. Particular attention is given to investigating the behaviour of the acetabular construct following revision hip arthroplasty, carried out using the Slooff-Ling impaction grafting technique. Mechanical tests are carried out on bone graft, and constitutive models are developed to describe its non-linear elasto-plastic behaviour, for inclusion in finite element analyses. Impaction of bone graft was found to have...

  20. Radiologic analysis of femoral acetabular impingement: from radiography to MRI

    Energy Technology Data Exchange (ETDEWEB)

    Dwek, Jerry R. [University of California at San Diego, Department of Radiology, Rady Children' s Hospital and Health Center, San Diego, CA (United States); San Diego Imaging, San Diego, CA (United States); Monazzam, Shafagh [Rady Children' s Hospital and Health Center, Department of Orthopedics, San Diego, CA (United States); Chung, Christine B. [University of California at San Diego, Department of Radiology, San Diego, CA (United States)

    2013-03-15

    Femoral acetabular impingement is a set of morphologic abnormalities that are considered to be a major cause of degenerative disease in the hip joint. Early changes are already present in adolescence when it is the pediatric radiologist who must assess current damage with the aim of averting progression to more severe and debilitating osteoarthritis. A multimodality approach is used for diagnosis, that includes conventional radiography and CT to assess the osseous structures. MR arthrography is the primary advanced imaging modality for assessment of morphologic changes as well as injuries of the labrum and articular cartilage. Details of radiologic imaging are offered to guide the radiologist and provide an avenue for the accurate description of the osseous and articular alterations and injury. (orig.)

  1. The concentric all-polyethylene Exeter acetabular component in primary total hip replacement.

    Science.gov (United States)

    Veitch, S W; Whitehouse, S L; Howell, J R; Hubble, M J W; Gie, G A; Timperley, A J

    2010-10-01

    We report the outcome of the flangeless, cemented all-polyethylene Exeter acetabular component at a mean of 14.6 years (10 to 17) after operation. Of the 263 hips in 243 patients, 122 prostheses are still in situ; 112 patients (119 hips) have died, 18 hips have been revised, and three patients (four hips) were lost to follow-up. Radiographs at the final review were available for 110 of the 122 surviving hips. There were acetabular radiolucent lines in 54 hips (49%). Two acetabular components had migrated but neither patient required revision. The Kaplan-Meier survivorship at 15 years with 61 hips at risk with revision for any cause as the endpoint was 89.9% (95% confidence interval (CI) 84.6 to 95.2) and for aseptic loosening of the acetabular component or lysis 91.7% (95% CI 86.6 to 96.8). In 210 hips with a diagnosis of primary osteoarthritis, survivorship with revision for any cause as the endpoint was 93.2% (95% CI 88.1 to 98.3), and for aseptic loosening of the acetabular component 95.0% (95% CI 90.3 to 99.7). The cemented all-polyethylene Exeter acetabular component has an excellent long-term survivorship.

  2. Patient-specific acetabular shape modelling: comparison among sphere, ellipsoid and conchoid parameterisations.

    Science.gov (United States)

    Cerveri, Pietro; Manzotti, Alfonso; Baroni, Guido

    2014-04-01

    The shape of the human acetabular cup was commonly represented as a hemisphere, but different geometries and patient-specific shapes have been recently proposed in the literature. Our aim was to test the limits of the sphericity assumption by comparing three different parameterisations, namely the sphere, the ellipsoid and the rotational conchoid. Models of hip surfaces, reconstructed from CT scans taken from Caucasian race cadavers and patients, were automatically processed to extract the acetabular surface. Two separate analyses were carried out on the overall acetabular shape, including both the acetabular fossa and the lunate surface (case A) and acetabular cup represented by the lunate surface only (case B). Nonlinear gradient-based and evolutionary computation approaches were implemented for the fitting process. Minor differences from the three idealised geometries were detected (median values of the fitting errors different from both the ellipsoid (p difference was detected between the ellipsoid and the conchoid for case A. Significance of the difference between ellipsoid and sphere (p difference was detected between the ellipsoid and the conchoid. In conclusion, we synthesise that the morphology of the overall acetabular cup can be parameterised both with an ellipsoid shape and with a conchoid shape as well with superior quality than the simple sphere. Differently, if one considers just the lunate surface, better fitting results are expected when using the ellipsoid. PMID:22789071

  3. Three-dimensional computed tomography analysis of non-osteoarthritic adult acetabular dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Hiroshi; Matsuno, Takeo; Hirayama, Teruhisa; Tanino, Hiromasa; Yamanaka, Yasuhiro [Asahikawa Medical College, Department of Orthopaedic Surgery, Asahikawa (Japan); Minami, Akio [Hokkaido University School of Medicine, Department of Orthopaedic Surgery, Sapporo (Japan)

    2009-02-15

    Little data exists on the original morphology of acetabular dysplasia obtained from patients without radiographic advanced osteoarthritic changes. The aim of this study was to investigate the distribution and degree of acetabular dysplasia in a large number of patients showing no advanced degenerative changes using three-dimensional computed tomography (3DCT). Eighty-four dysplastic hips in 55 consecutive patients were studied. All 84 hips were in pre- or early osteoarthritis without radiographic evidence of joint space narrowing, formation of osteophytes or cysts, or deformity of femoral heads. The mean age at the time of CT scan was 35 years (range 15-64 years). 3D images were reconstructed and analyzed using recent computer imaging software (INTAGE Realia and Volume Player). Deficiency types and degrees of acetabular dysplasia were precisely evaluated using these computer software. The average Harris hip score at CT scans was 82 points. Twenty-two hips (26%) were classified as anterior deficiency, 17 hips (20%) as posterior deficiency, and 45 hips (54%) as lateral deficiency. No significant difference was found in the Harris hip score among these groups. The analysis of various measurements indicated wide variations. There was a significant correlation between the Harris hip score and the acetabular coverage (p < 0.001). Our results indicated wide variety of deficiency type and degree of acetabular dysplasia. Hips with greater acetabular coverage tended to have a higher Harris hip score. (orig.)

  4. Failure analysis of retrieved PE-UHMW acetabular liners.

    Science.gov (United States)

    Laska, Anna; Archodoulaki, Vasiliki-Maria; Duscher, Bernadette

    2016-08-01

    Ultra-high molecular weight polyethylene (PE-UHMW) acetabular liners have a limited lifespan in a patient's body. There are many factors affecting the performance of the implant and furthermore the properties of the polymeric material are changing after implantation. In this work material changes according to structure and morphology and their implication on mechanical properties are in focus. The physical and mechanical properties of ten crosslinked (xL) PE-UHMW and nine conventional (conv) gamma-sterilized PE-UHMW hip components, used as sliding surface in total hip joint replacement, with different in-vivo times are compared. The evaluation of the retrieved acetabular liners is performed in view of crosslinking and conventional gamma-sterilization but also in terms of the influence of gender concerning alteration in properties. The oxidative degradation in the PE-UHMW is investigated by means of Fourier Transformed Infrared Spectroscopy (FTIR). The characterization of the morphology is carried out via differential scanning calorimetry (DSC). A depth profile of the micro-hardness and elastic modulus is taken over the cross-section of the components in order to find the influence of chemical constitution and morphology on the micro-mechanical properties. It could be shown that crosslinking and oxidative degradation influence the degree of crystallinity of the polymer. Oxidation occurs for both types of the material due to in-vivo time. Higher degree of crystallinity can be correlated to higher hardness and indentation modulus. No unequivocal superiority of crosslinked over conventional liners can be observed. The influence of sex concerning alteration of the evaluated properties matters but need to be further investigated.

  5. 髌骨骨折关节镜下闭合复位内固定术后的康复训练%Rehabilitation exercises after closed reduction internal fixation of fracture of patella under arthroscope

    Institute of Scientific and Technical Information of China (English)

    朴成哲; 李培; 阿良; 王敏

    2003-01-01

    @@ INTRODUCTION Closed reduction internal fixation under arthroscope is performed from August, 2000 to April, 2001 and advanced domestic and foreign rehabilitation programs are combined to treat fracture of patella comprehensively, satisfying effects are achieved.

  6. Chinese traditional medicine rehabilitative treatment of femoral neck fracture after screw thread needle internal fixation%螺纹针内固定术后中药康复治疗股骨颈骨折

    Institute of Scientific and Technical Information of China (English)

    高广升; 李凤辉

    2001-01-01

    @@ Background:Femoral neck fracture is one of common and severe injury in old people. We utilize transcutaneous Screw thread needle internal fixation treat it, cooperated with Chinese medicine treatment, and gained good effects.

  7. 股骨颈骨折内固定手术的研究历程与展望%History and prospect of internal fixation operation of femoral neck fracture

    Institute of Scientific and Technical Information of China (English)

    梅炯

    2015-01-01

    Femoral neck fracture is one of the major damages to health and life in the elderly population. But man has had his own understanding of that damage for only 600 years. The following research efforts had their milepost signiifcance in the development of the internal ifxation operation on femoral neck fracture. In 1858, a German surgeon, Von Langenbeck, did the ifrst internal ifxation of femoral neck fracture. But the patient unfortunately died of septicemia. In 1875, Franz König succeeded in the same operation with metal screws on disinfection. In 1883, Nicholass Senn, an American Surgeon, suggested that all femoral neck fractures should be treated with operation based on his animal experiments, but his proposal was not widely accepted. In 1931, Smith-Petersen etc. from the USA ifrst published the results of open reduction and internal ifxation of femoral neck fracture with the use of triifn nail. In 1938, an American doctor, Henderson, publisized his results of the treatment of femoral neck fracture with cannulated screws in Mayo Clinic. In 1941, American Academy of Orthopaedic Surgeons ( AAOS ) advocated the technique of triifn nail, which was pointed out to be unsuitable for the displaced femoral neck fracture by British Medical Research Council in 1976. Asnis cannulated screws appeared in 1980, which is still in use today. Fairly good effects have been achieved in the treatment of femoral neck fracture with internal ifxation, but in some patients it still results in the necrosis of the femoral head. Thus, people are still making different choices between arthroplasty or internal ifxation for the femoral neck fracture, depending largely on the surgeon’s judgment on the degree of the impairment on blood supply to femoral head after the fracture and the influence of the impairment on its healing. The individualized choice of operation method, the maximal retainability of the femoral head blood supply, and the retaining of the residual blood supply from the

  8. Combined circular external fixation and open reduction internal fixation with pro-syndesmotic screws for repair of a diabetic ankle fracture

    Directory of Open Access Journals (Sweden)

    Zacharia Facaros

    2010-10-01

    Full Text Available The surgical management of ankle fractures among the diabetic population is associated with higher complication rates compared to the general population. Efforts toward development of better methods in prevention and treatment are continuously evolving for these injuries. The presence of peripheral neuropathy and the possible development of Charcot neuroarthropathy in this high risk patient population have stimulated much surgical interest to create more stable osseous constructs when open reduction of an ankle fracture/dislocation is required. The utilization of multiple syndesmotic screws (pro-syndesmotic screws to further stabilize the ankle mortise has been reported by many foot and ankle surgeons. In addition, transarticular Steinmann pins have been described as an adjunct to traditional open reduction with internal fixation (ORIF of the ankle to better stabilize the talus, thus minimizing risk of further displacement, malunion, and Charcot neuroarthropathy. The authors present a unique technique of ORIF with pro-syndesmotic screws and the application of a multi-plane circular external fixator for management of a neglected diabetic ankle fracture that prevented further deformity while allowing a weight-bearing status. This technique may be utilized for the management of complex diabetic ankle fractures that are prone to future complications and possible limb loss.

  9. Generation mechanism and treatment progress of common complications of the acetabulum fracture%髋臼骨折常见并发症的产生机制及治疗进展

    Institute of Scientific and Technical Information of China (English)

    张长杰

    2014-01-01

    With the development of the transportation, high-energy injuries caused by traffic accidents are on the rise, acetabular fractures have been increasing recently. We take surgical therapy or conservative therapy considering a variety of factors and the patient’s conditions. Due to the particularity of acetabular anatomy and the complexity of its physiological functions, there are many complications caused by the acetabular fractures and its treatment no matter what method we take, such as nerve injury, heterotopic ossiifcation, thromboembolism, traumatic arthritis et al. All these will seriously affect the patient’s daily activities. This paper aims to give a general review on the generation mechanism and treatment progress of common complications of the acetabulum fracture.

  10. Warwick Hip Trauma Study: a randomised clinical trial comparing interventions to improve outcomes in internally fixed intracapsular fractures of the proximal femur. Protocol for The WHiT Study

    OpenAIRE

    Griffin Xavier; Parsons Nick; Achten Juul; Costa Matthew L

    2010-01-01

    Abstract Background Controversy exists regarding the optimal treatment for patients with displaced intracapsular fractures of the proximal femur. The recognised treatment alternatives are arthroplasty and internal fixation. The principal criticism of internal fixation is the high rate of non-union; up to 30% of patients will have a failure of the fixation leading to revision surgery. We believe that improved fracture healing may lead to a decreased rate of failure of fixation. We therefore pr...

  11. Monteggia fracture dislocation equivalents——analysis of eighteen cases treated by open reduction and internal fixation

    Institute of Scientific and Technical Information of China (English)

    Ajay Pal Singh; Ish Kumar Dhammi; Anil Kumar Jain; Rajeev Raman; Prashant Modi

    2011-01-01

    Objective: Monteggia fracture dislocation equivalent, though already described by Bado, is still an unclassified entity. We aimed to retrospectively analyze 18 cases of Monteggia variants and discuss the injury mechanisms, management, and outcome along with a re view of the literature. Methods: A retrospective record of Monteggia fracture dislocation (2003-2008) was reviewed from medical record department of our institute. Classic Monteggia fracture dislocation, children below 12 years or adults over 50 years, as well as open grade Ⅱ & Ⅲ cases were excluded from this study. Monteggia variant inclusion criteria included fracture of the proximal ulna together with a fracture of the radial head or neck and skeletal maturity. Totally 26 patients were identified with Monteggia variants and 18 were available for follow-up, including 11 males and 7 females with the mean age of 35 years. The ulna fracture was treated by compression plating along with tension band wiring. Radial head/neck was reconstructed in 12 patients while excised in 6 patients. Results: Follow-up ranged from 1 -4 years, mean 2.6 years. Patients were assessed clinicoradiologically. Mayo Elbow Performance Score was employed to assess the outcomes. At final follow-up, the results were excellent in 10 patients, good in 4, fair in 2 and poor in 2. Mean range of motion of the elbow was 20°, 116°, 50° and 55° for extension, flexion, pronation and supination, respectively. Two patients had complications in the form of heterotopic ossification and stiffness of the elbow. One nonunion ulna, primarily treated by tension band wiring, was managed by refixation with locking reconstruction plate and bone grafting. Bone grafting was only required in this patient for nonunion. Another patient had implants removed on his request. The results in our series closely correlated with extent of intraarticular damage, coronoid fracture and comminuted fractures. Conclusions: Monteggia fracture dislocation equivalents

  12. Quantitative Computerized Assessment of the Degree of Acetabular Bone Deficiency: Total radial Acetabular Bone Loss (TrABL

    Directory of Open Access Journals (Sweden)

    Frederik Gelaude

    2011-01-01

    Full Text Available A novel quantitative, computerized, and, therefore, highly objective method is presented to assess the degree of total radical acetabular bone loss. The method, which is abbreviated to “TrABL”, makes use of advanced 3D CT-based image processing and effective 3D anatomical reconstruction methodology. The output data consist of a ratio and a graph, which can both be used for direct comparison between specimens. A first dataset of twelve highly deficient hemipelves, mainly Paprosky types IIIB, is used as illustration. Although generalization of the findings will require further investigation on a larger population, it can be assumed that the presented method has the potential to facilitate the preoperative use of existing classifications and related decision schemes for treatment selection in complex revision cases.

  13. Combining of small fragment screws and large fragment plates for open reduction and internal fixation of periprosthetic humeral fractures.

    Science.gov (United States)

    Seybold, Dominik; Citak, Mustafa; Königshausen, Matthias; Gessmann, Jan; Schildhauer, Thomas A

    2011-10-01

    Operative treatment of periprosthetic humeral fractures in elderly patients with osteoporotic bone requires a stable fixations technique. The combination of 3.5 cortical screws with washers in a 4.5 Arbeitsgemeinschaft für Osteosynthesefragen, Limited-contact dynamic compression plate or Locking plate, allows a stable periprosthetic fixation with the small 3.5 screws and 4.5 screws above and below the prosthesis, respectively. This combination is a cost-effective technique to treat periprosthetic humeral fractures.

  14. First TRUE Stage - Transport of solutes in an interpreted single fracture. Proceedings from the 4th international seminar

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-08-01

    . The outcome of the 4th International Aespoe seminar focused on the TRUE-1 experiments can be summarised in the following main points: There is a general consensus that the observed retardation observed in the TRUE-1 experiments requires diffusion into geological material to be an active process. This supported by the -3/2 slope noted in log-log BTCs. Whether this is due to diffusion (and subsequent sorption) in the altered matrix rock, or in possible fault gouge cannot be differentiated with available data; Some researchers claim that the observed enhanced retardation may be explained by diffusion into stagnant water pools, pure surface sorption, or may be due to an underestimation in the flow-wetted surface area. The latter effect may be attributed to a more complex flow path (multi-layered structure) or three-dimensional effects; A clear differentiation between the principal active process can only assessed by resin injection and subsequent excavation and analysis; It was identified that experiments of TRUE type are important for improving the understanding of retention processes. However, this type of experiment will not be part of a site characterisation programme; It was recommended to broaden the data base from the TRUE-1 site before characterising pore space with resin techniques. This includes tracer dilution tests using sinks in other features than Feature A. The seminar was divided into four sessions: 1. Detailed characterisation of transport-related properties (Three contributions separately indexed). 2. Alternative evaluation of TRUE-1 results (Five contributions separately indexed). 3. Related studies (Three contributions separately indexed). 4. Understanding of retention processes in a single fracture (Two contributions separately indexed)

  15. Smallness kerf pedicle screw internal fixation cure thoracolumbar fracture%小切口椎弓根钉棒内固定治疗胸腰椎骨折

    Institute of Scientific and Technical Information of China (English)

    胡红耘

    2009-01-01

    Objective Smallness kerr rout of retreat pedicle screw posting restoration fixing cure thoracolum-bar fracture. Methods Versus 12 example thoracolumbar fracture adopt smallness keff micro-wound rout of retreat pedicle screw posting restoration fixing technology. Results 12 example fracture patient follow-up survey 8 loaf months to 2 year, average long dozen month, fracture restoration satisfaction, pedicle screw position all right, without height lost, without looseness,lapse sever natl. Conclusion Thoracolumbar fracture met pedicle screw push off resto-ration internal fixation, reestablish physiologic protrusion, operation kerf smallness, esthetic appearance, hemorrhage fewness wound reaction smallness, in favor of skill post-recovery.%目的 探讨椎弓根钉棒置入复位固定治疗胸腰椎骨折的手术入路方法.方法 对12例胸腰椎骨折的病例采用小切口微创后路椎弓根钉棒置入复位固定技术.结果 12例骨折患者随访8个月至2年,平均13个月,骨折复位满意,椎弓根钉棒位置良好,无高度丢失、无松动、失效、断钉.结论 胸腰椎骨折可选择后路小切口术式行椎弓根钉棒撑开复位内固定,重建生理前突,手术切口小、美观、出血少、创伤反应小,有利于术后恢复.

  16. The early influence of hip traction or internal rotating on blood circulation of femoral head with neck fracture: study by superselective digital subtraction arteriography

    International Nuclear Information System (INIS)

    Objective: To investigate the early influence of hip traction or internal rotating on the femur head blood circulation with femur neck fracture. Methods: Using digital subtraction angiography (DSA), nine patients underwent selective arteriography of the medial and lateral femoral circumflex artery from 2 to 23 days after the femoral neck fracture in a neutral position. Seven of them were done in the presence of 3 kg hip traction, and six were in 5 kg hip traction (4 cases after 3 kg traction). Angiography was also performed in a intorted position without traction in 5 patients. In 3 cases, retinacular artery angiography was done simultaneously using the micro catheter. The femoral circumflex arteriography of the normal leg was done in 8 patients, and three of them were simultaneously done in a postion of internal rotating of straight leg. Results: Comparison with the arteriographic findings in absence of traction, all retinacular arteries but inferior arteries were depicted few branches and less femoral head perfusion in all 9 patients, especially in that of medial femoral circumflex arteriography, as hip joint was tractating in neutral position with the same speed and volume of injecting contrast medium and, the veins were demonstrated poorly or delayed. Those changes became notable as traction weight increased from 3 kg to 5 kg in all four cases. While hip joint was internally rotating with the sick leg straightened in 5 patients, all retinacular arteries especially their branches and femoral head perfusion were hardly shown, which were also seen in normal leg in 2 cases, and those changes were more marked than that of in traction. Conclusion: Traction and internally rotating of hip joint decrease blood perfusion of major areas of the femoral head while blood flow of major retinacular arteries are reduced or even failed to be displayed with the vein drainage being impeded. Traction may be one of the important causes of avascular osteonecrosis of the femoral head

  17. Utilization of the less-invasive stabilization system internal fixator for open fractures of the proximal tibia: A multi-center evaluation

    Directory of Open Access Journals (Sweden)

    Stannard James

    2008-01-01

    Full Text Available Background: Locked plating has become popular and has clear biomechanical advantages when compared with conventional plating. When combined with minimally invasive surgical techniques, locked plating may cause substantially less iatrogenic tissue damage when compared with conventional plating. These characteristics may make locked plating an attractive option for treating open fractures of the tibial plateau and proximal tibia for which coverage over the plate can be obtained. The purpose of this study was to evaluate the use of the Less-Invasive Stabilization System (LISS for high-energy open fractures involving either the tibial plateau or proximal tibia. Materials and Methods: This study is a retrospective evaluation of a consecutive multicenter series of 52 consecutive patients operated by seven surgeons, who used LISS plating in open proximal tibia or tibial plateau fractures seen at one of four Level I Trauma Centers. All patients were treated using a locked plating system that was implanted using minimally invasive submuscular surgical techniques. The primary outcome measure was the incidence of deep and superficial infection. Results: Fifty-two patients with open fractures have been evaluated, with a mean follow-up of 16.8 (12-36 months. Three patients (5.8% developed deep infections. Two patients (6.3% with tibial plateau and one (4.3% of patients with a tibial shaft fracture developed deep infections. Fifteen patients required flap coverage of their open wounds. The incidence of deep infection as per Gustilo and Anderson classification was Type I and II - 0 (0%; Type IIIA - 2 (7.7%; Type IIIB - 1 (7.1%; and Type IIIC - 0 (0%. Conclusions: Biomechanically, the LISS functions as an "internal-external fixator" rather than a plate. Traditional plate osteosynthesis has yielded rates of infection between 18% and 35%. Our data indicate that locked plating using minimally invasive techniques yield deep infections rates that are no worse than

  18. 锁定接骨板治疗肱骨近端骨折%Internal Fixation of Proximal Humeral Fractures with Locking Plate

    Institute of Scientific and Technical Information of China (English)

    王振堂; 申海波; 吴艳刚; 董军政; 刘艳梅; 焦顺成

    2011-01-01

    Objective: To evaluate the clinical results of proximal humeral fractures treated by locking plate. Methods: From March 200S to March 2010,43 cases of proximal humeral fractures were treated with open reduction and internal fixation with Locking plate. According to Neer classification, 20 cases were two-part fractures, 19 cases three-part fractures and 4 cases four-part fractures. The clinical results were evaluated by using Neer'S evaluation system and X-ray films. Results: 43 cases were followed up for average 14.2 months(9~21 months). All fractures got complete healing, the mean time for bony union was 10.4 (8~1 2)weeks. According to Neer'S evaluation system: 19 patients were graded as excellent, 19 as good, 5 as fair. The excellent and good rate was 88.4%. Conclusions: Inter fixation of proximal humeral fractures with locking plate has the advantages of less invasive, easy operation, stable fixation, which permit early functional rehabilitation and lead to satisfactory clinical results.%目的:探讨锁定钢板治疗肱骨近端骨折的临床疗效.方法:2005年3月~2010年3月应用锁定钢板(包括肱骨近端锁定钢板或肱骨近端锁定内固定系统)治疗肱骨近端骨折43例,按Neer分型2部分骨折20例,3部分骨折19例,4部分骨折4例.随访评定包括X线片、Neer肩关节功能评分标准.结果:43例患者获得平均14.2个月(9~21个月)临床随访,骨折全部愈合,愈合平均时间10.4周(8~12周).根据Neer肩关节功能评分标准:优19例,良19例,可5例,优良率88.4%.结论:锁定钢板治疗肱骨近端骨折具有手术创伤小、操作方便、固定可靠的优点,允许早期功能锻炼,疗效满意.

  19. Increasing thickness and fibrosis of the cartilage in acetabular dysplasia: a rabbit model research

    Institute of Scientific and Technical Information of China (English)

    LI Tian-you; MA Rui-xue

    2010-01-01

    Background The order and mechanism of pathological changes in acetabular dysplasia are still unclear. This study investigated cartilage changes in rabbit acetabular dysplasia models at different ages.Methods Twenty-seven 1-month-old New Zealand rabbits underwent cast immobilization of the left hind limb in knee extension. Serial acetabular dysplasia models were established by assessment of the acetabular index and Sharp's angle on radiographs. The thickness of the acetabular cartilage was measured under a microscope, and fibrosis was observed. Ultrastructural changes were investigated with scanning electron microscopy and transmission electron microscopy. The messenger RNA expression of collagen Ⅰ and Ⅱ, β1 integrin, and caspase-9 were measured by real-time fluorescence quantitative polymerase chain reaction.Results In an immature group of rabbits, the acetabular index of the treated hip increased with animal growth. The cartilage on the brim of the left acetabulum was significantly thicker than that on the right side. The collagen fibrils on the surface of the cartilage became gross, and the chondrocytes in the enlargement layer underwent necrosis. In a mature group of rabbits, the left Sharp's angle increased in the rabbits with 6-week casting. The cartilage on the brim of the left acetabulum underwent fibrosis. The chondrocytes were weakly stained, and the number of lysosomes was much larger than normal. The messenger RNA expression of collagen Ⅰ and Ⅱ, β1 integrin, and caspase-9 in the cartilage differed significantly at different ages.Conclusions Increasing thickness followed by fibrosis may be the order of pathological cartilage changes in acetabular dysplasia, with changes in ultrastructure and collagen expression contributing to the process.

  20. A porous tantalum uncemented acetabular cup in acetabular revision arthroplasty%生物学固定骨小梁金属杯在髋臼翻修中的应用

    Institute of Scientific and Technical Information of China (English)

    徐卫东; 陈刚; 张东华

    2009-01-01

    前后X射线平片显示无假体移位下沉等不稳迹象,骨小梁金属杯周围骨质向内长入.本组患者无置换后并发症发生,截至最后1次随访有14例行走时无疼痛,2例轻度疼痛伴轻度跛行.未出现症状性深静脉血栓或神经损伤.无需要再度翻修病例.结论:初次固定人工髋臼杯失败的病例,若无骨缺损,翻修时使用骨小梁金属杯可以获得良好的早期效果.%BACKGROUND: Biological fixation refers to the treatment of coarse or porous prosthetic surface. It is favorable to "bone ingrowth" prosthesis to achieve long-term stability. Porous tantalum is the latest scientific product that appears suitable to prosthetic surface owing to its porous feature and has been attracting a great deal attention.OBJECTIVE: To investigate the therapeutic efficacy of a porous tantalum uncemented acetabular cup in acetabular revision arthroplasty.DESIGN, TIME AND SETTING: A retrospective case analysis was performed at the Department of Orthopedics, Changhai Hospital, Second Military Medical University of Chinese PLA between April and November 2006.PARTICIPANTS/MATERIALS: Sixteen patients (16 hips), 7 males and 9 females, aged 54-81 years old, who received treatment at the Department of Orthopedics, Changhai Hospital, Second Military Medical University of Chinese PLA were included in this study. Of these patients, 2 suffered from femoral neck fracture, 6 from aseptic femoral head necrosis, and 8 from osteoarthritis. Trabecular metal cup (Zimmer, Warsaw, Indiana) provided a titanium alloy bottom layer and porous tantalum-coated surface, which was realized by technical combination of bone trabecular tantalum and titanium alloy. The prosthesis contained an ultrahigh modulus polyethylene lining.METHODS: All patients underwent acetabular revision with modular porous tantalum uncemented acetabular cup. Prior to replacement, acetabular defects and femoral prosthesis were evaluated. A posterolateral approach of hip joint was made. Following

  1. AF系统与USS系统治疗胸腰段爆裂性骨折的临床疗效比较%Efficacy Comparison between AF Internal System and USS Internal System in Thoracolumgbar Burst Fracture

    Institute of Scientific and Technical Information of China (English)

    张贤锋; 徐应林

    2013-01-01

    目的:比较AF系统与USS系统治疗胸腰段爆裂性骨折的临床疗效.方法:2008年12月~2011年7月,分别采用AF系统与USS系统治疗胸腰段爆裂性骨折32例和33例,观察两组患者术后神经功能恢复、骨折复位、内固定及植骨融合等情况,比较两者的临床疗效.结果:经平均16个月的随访,AF和USS两种系统治疗胸腰段爆裂性骨折均有可靠的复位和固定作用,术后神经功能Frankel分级情况组间比较差异无统计学意义(P>0.05);但AF系统术后断钉3例,且随访期间椎体高度丢失.结论:采用USS系统复位内固定治疗胸腰段爆裂性骨折,其近期疗效优于AF系统.%Objective:To compare the clinical efficacy of AF internal system and USS internal system in thoracolumbar burst fracture.Methods:65 patients were randomly divided into 2 groups,Group 1 was treated with AF internal system,while Group 2 was treated with USS internal system.During the follow-up time the neurological function and fracture reduction fixation were observed.Results:After mean 16 months follow-up time,all cases treated with AF internal system or USS internal system got reliable reduction and fixation,and there was no significant difference in Frankel grading of the neurological function between the two groups (P > 0.05).The height of vertebral body was lost in AF internal system group during the follow-up time,and among which,3 cases internal fixation were broken.Conclusions:USS internal system can get better clinical efficiency than AF internal system in thoracolumbar fracture burst.

  2. Combining of small fragment screws and large fragment plates for open reduction and internal fixation of periprosthetic humeral fractures

    Directory of Open Access Journals (Sweden)

    Dominik Seybold

    2011-01-01

    Full Text Available Operative treatment of periprosthetic humeral fractures in elderly patients with osteoporotic bone requires a stable fixations technique. The combination of 3.5 cortical screws with washers in a 4.5 Arbeitsgemeinschaft fόr Osteosynthesefragen, Limited-contact dynamic compression plate or Locking plate, allows a stable periprosthetic fixation with the small 3.5 screws and 4.5 screws above and below the prosthesis, respectively. This combination is a cost-effective technique to treat periprosthetic humeral fractures.

  3. Low bone mineral density is not related to failure in femoral neck fracture patients treated with internal fixation

    DEFF Research Database (Denmark)

    Viberg, Bjarke; Ryg, Jesper; Overgaard, Søren;

    2014-01-01

    new hip fracture). A stratified Cox regression model on fracture displacement was applied and adjusted for age, sex, quality of reduction, implant positioning, comorbidity, and walking disability. Results - 49 patients had a T-score below -2.5 (standard deviation from the young normal reference mean......, implant positioning, and quality of reduction. From a questionnaire completed during admission, 2 variables for comorbidity and walking disability were chosen. Primary outcome was low hip BMD (amount of mineral matter per square centimeter of hip bone) compared to hip failure (resection, arthroplasty, or...

  4. 应用钩钢板内固定技术治疗mallet骨折%Treatment of Mallet fractures with internal fixation using hook plate technique

    Institute of Scientific and Technical Information of China (English)

    李忠哲; 易传军; 胡琪; 田光磊

    2009-01-01

    目的 介绍应用钩钢板内固定技术治疗mallet骨折的手术方法 及疗效.方法 2006年8月-2008年2月,应用钩钢板内固定技术治疗25例mallet骨折患者,其中Ⅰ B型18例,ⅡB型7例.采用2.0 mm Medicon微型直钢板制备1孔钩钢板,切开复位内固定骨折,术后行限制性远指间关节早期功能锻炼.结果 所有患者术后获2~18个月(平均10个月)随访,骨折均顺利愈合,愈合时间平均5周.术后疼痛程度和关节屈伸活动度评价:优14例,良9例,可2例,差0例;优良率为92%.术后未发生严重并发症.结论 应用钩钢板切开复位内固定技术治疗mllet骨折,复位牢固可靠,内固定物不固定骨折块和关节,允许早期关节活动,有效降低术后关节疼痛和关节活动受限,是治疗撕脱骨折块大于末节指骨基底关节面1/3 mallet骨折的有效方法 .%Objective To introduce the surgical techniques and clinical outcomes of trestment of Mallet fractures using hook plate internal fixation. Methods From August 2006 to February 2008, 25 cases of Mallet fractures were treated with hook plate internal fixation. There were 18 cases of Ⅰ B type fractures and 7 cases of Ⅱ B type fractures. Open reduction and internal fixation was performed using a one-hole hook plate fabricated from a 2.0 mm Medicon straight plate. Early postoperative protected motion of the distal interphalangeal (DIP) joint was allowed. Results All the cases were followed up for 2 to 18 months, with an average of 10 months. All the fractures healed successfully, with an average bone union time of 5 weeks. Functional evaluation included degree of pain and DIP joint flexion and extension. The results were rated as excellent in 14 cases, good in 9 cases, fair in 2 cases and poor in 0 case. The overall good-excellent rate was 92%. There were no postoperative complications. Conclusion Treatment of Mallet fractures with hook plate internal fixation technique can achieve more tellable fixation

  5. 胫腓骨骨折内固定术后护理措施探讨%Nursing Experience after the Tibia and Fibulac Fracture Internal Fixation

    Institute of Scientific and Technical Information of China (English)

    张志静

    2016-01-01

    Objective To introduce the nursing experience after the tibia and fibulac fracture internal fixation of adults. Methods 120 cases of adults with tibia and fibulac fractures treated in our hospital from June 2012 to January 2015 were selected and were treated with steel plate or intramedullary nail internal fixation, and the patients obtained systematic nurs-ing guidance after operation. Results All patients were followed up after operation and limb functional recovery was good in 120 cases after operation. Conclusion The accurate and appropriate nursing for adults after tibia and fibulac fracture inter-nal fixation can improve the excellent and good rate of their limb functions.%目的:探讨成年人胫腓骨骨折内固定术后护理措施。方法整群选择该院2012年6月—2015年1月共120例成年人胫腓骨骨折的患者,这些患者均实施钢板或髓内钉内固定术,并在术后都得到系统的护理指导。结果所有的患者在术后都得到了随访,120例患者术后肢体功能恢复良好。结论对成年人胫腓骨骨折内固定术后的患者进行正确、恰当的护理,可以提高肢体功能优良率。

  6. Radiographic and clinical analysis of cementless acetabular fixation in total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hui; PEI Fu-xing; YANG Jing; SHEN Bin; SHI Rui

    2005-01-01

    Objective: To investigate the factors affecting the fixation, loosening and therapeutic effect of cementless acetabular prosthesis through following up the patients with total hip arthroplasty clinically and radiographically.Methods: From February 1998 to May 1999, 139 patients (148 hips) underwent total hip arthroplasty with cementless acetabular prosthesis in our department. In this study, the clinical therapeutic effect and the anteroposterior radiographs of the pelvis and anteroposterior and lateral radiographs of the hips of 109 patients (116 hips) made before operation, at 1 week, 3, 6, and 12 months after operation and annually thereafter were analyzed retrospectively. The clinical therapeutic effects were evaluated with Harris hip score. Radiographs were used to observe the position of prostheses and the bone changes around the implant, and to measure the wearing speed and direction of the acetabular cup. All evaluations were made by an independent examiner who did not participate in the operation. The patients were followed up for 5-6 years.Results: The mean Harris score was 44 points (range, 10-70 points) before operation, but it increased to 92.4 points (range, 80-100 points) at the latest review after operation, which was significantly higher than that before operation (P<0.05). No acetabular component was revised because of infection or aseptic loosening. And no acetabular component migrated. There was no revision of fixed acetabular component because of pelvic osteolysis secondary to polyethylene wear. The mean linear wear rate was 0.15 mm per year. All the acetabular prostheses were classified as stable on the radiographs.Conclusions: In terms of fixation, total hip arthroplasty with cementless acetabular components was successful. Although there is no aseptic loosening and a low incidence of osteolysis at the latest follow-up evaluation, polyethylene wear cannot be avoided and can lead to expansile osteolysis near the cups. This kind of osteolysis

  7. Pelvic Incidence: A Predictive Factor for Three-Dimensional Acetabular Orientation—A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Christophe Boulay

    2014-01-01

    Full Text Available Acetabular cup orientation (inclination and anteversion is a fundamental topic in orthopaedics and depends on pelvis tilt (positional parameter emphasising the notion of a safe range of pelvis tilt. The hypothesis was that pelvic incidence (morphologic parameter could yield a more accurate and reliable assessment than pelvis tilt. The aim was to find out a predictive equation of acetabular 3D orientation parameters which were determined by pelvic incidence to include in the model. The second aim was to consider the asymmetry between the right and left acetabulae. Twelve pelvic anatomic specimens were measured with an electromagnetic Fastrak system (Polhemus Society providing 3D position of anatomical landmarks to allow measurement of acetabular and pelvic parameters. Acetabulum and pelvis data were correlated by a Spearman matrix. A robust linear regression analysis provided prediction of acetabulum axes. The orientation of each acetabulum could be predicted by the incidence. The incidence is correlated with the morphology of acetabula. The asymmetry of the acetabular roof was correlated with pelvic incidence. This study allowed analysis of relationships of acetabular orientation and pelvic incidence. Pelvic incidence (morphologic parameter could determine the safe range of pelvis tilt (positional parameter for an individual and not a group.

  8. Acetabular rim and surface segmentation for hip surgery planning and dysplasia evaluation

    Science.gov (United States)

    Tan, Sovira; Yao, Jianhua; Yao, Lawrence; Summers, Ronald M.; Ward, Michael M.

    2008-03-01

    Knowledge of the acetabular rim and surface can be invaluable for hip surgery planning and dysplasia evaluation. The acetabular rim can also be used as a landmark for registration purposes. At the present time acetabular features are mostly extracted manually at great cost of time and human labor. Using a recent level set algorithm that can evolve on the surface of a 3D object represented by a triangular mesh we automatically extracted rims and surfaces of acetabulae. The level set is guided by curvature features on the mesh. It can segment portions of a surface that are bounded by a line of extremal curvature (ridgeline or crestline). The rim of the acetabulum is such an extremal curvature line. Our material consists of eight hemi-pelvis surfaces. The algorithm is initiated by putting a small circle (level set seed) at the center of the acetabular surface. Because this surface distinctively has the form of a cup we were able to use the Shape Index feature to automatically extract an approximate center. The circle then expands and deforms so as to take the shape of the acetabular rim. The results were visually inspected. Only minor errors were detected. The algorithm also proved to be robust. Seed placement was satisfactory for the eight hemi-pelvis surfaces without changing any parameters. For the level set evolution we were able to use a single set of parameters for seven out of eight surfaces.

  9. Stress fractures in athletes.

    Science.gov (United States)

    Hulkko, A; Orava, S

    1987-06-01

    During the 14-year period of 1971-1985, 368 stress fractures in 324 athletes were treated. The series contained 268 fractures in males and 100 fractures in females; 32 fractures occurred in children (less than 16 years), 117 in adolescents (16-19 years), and 219 in adults. Forty-six fractures were incurred by athletes at an international level, 274 by athletes at a national or district level and 48 by recreational athletes. Of the total cases, 72% occurred to runners and a further 12% to athletes in other sports after running exercises. The distribution of the stress fractures by site was: tibia 182, metatarsal bones 73, fibula 44, big toe sesamoid bones 15, femoral shaft 14, femoral neck 9, tarsal navicular 9, pelvis 7, olecranon 5 and other bones 10. Of the total fractures, 342 were treated conservatively and 26 fractures required surgical treatment. The operative indication was dislocation in 5 cases and delayed union/nonunion in 21 cases. The sites most often affected by delayed union were: anterior midtibia, sesamoid bones of the big toe, base of the fifth metatarsal, olecranon, and tarsal navicular. The athletes at an international level experienced the greatest risk of multiple separate fractures, protracted healing, or fractures requiring surgery. PMID:3623785

  10. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

    Science.gov (United States)

    2010-04-01

    ... uncemented acetabular component, prosthesis. 888.3330 Section 888.3330 Food and Drugs FOOD AND DRUG..., prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis is a two-part device intended to be implanted to replace a hip joint. The...

  11. 21 CFR 888.3320 - Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented acetabular component, prosthesis. 888.3320 Section 888.3320 Food and Drugs FOOD AND DRUG..., prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis is a two-part device intended to be implanted to replace a hip joint. The...

  12. Cemented total hip arthroplasty with impacted morcellized bone-grafts to restore acetabular bone defects in congenital hip dysplasia.

    NARCIS (Netherlands)

    Bolder, S.B.T.; Melenhorst, J.; Gardeniers, J.W.M.; Slooff, T.J.J.H.; Veth, R.P.H.; Schreurs, B.W.

    2001-01-01

    We evaluated the results of 27 acetabular reconstructions in 21 patients with secondary osteoarthritis resulting from congenital dysplasia of the hip in which the acetabular bone defects were restored with impacted morcellized bone-grafts in combination with a cemented cup. At an average follow-up o

  13. Percutaneous Reduction and Fixation with Kirschner Wires versus Open Reduction Internal Fixation for the Management of Calcaneal Fractures: A Meta-Analysis.

    Science.gov (United States)

    Wu, Jianbin; Zhou, Feiya; Yang, Lei; Tan, Jun

    2016-01-01

    The aim of our meta-analysis was to compare outcomes for two surgical treatments of calcaneal fractures, percutaneous reduction and fixation with Kirschner wires (PRFK) and open reduction internal fixation (ORIF), with the intent of evaluating the quality of evidence to inform practice. Search of MEDLINE, Cochrane and CNKI databases to identify randomized controlled trials (RCTs) comparing PRKF and ORIF on the following outcomes: post-operative function, complications and quality of the reduction. Odd ratios (OR) and weighted mean differences were pooled using either a fixed-effects or random-effects model, depending on the heterogeneity of the trials included in the analysis. Eighteen RCTs provided the data from 1407 patients. PRFK was associated with a lower risk of surgical wound complications, and ORIF with better post-operative function, angle of Gissane, calcaneal height, and calcaneal width. There were no statistically significant differences between the techniques with regards to post-operative Böhler's angle. PRFK does not provide a substantive advantage over ORIF for the treatment of calcaneal fractures in adults. PRFK may, however, yield comparable functional outcomes to ORIF for closed Sanders type II calcaneal fractures but with less complication related to surgical wound healing. PMID:27457262

  14. Comparison of Isocentric C-Arm 3-Dimensional Navigation and Conventional Fluoroscopy for Percutaneous Retrograde Screwing for Anterior Column Fracture of Acetabulum: An Observational Study.

    Science.gov (United States)

    He, Jiliang; Tan, Guoqing; Zhou, Dongsheng; Sun, Liang; Li, Qinghu; Yang, Yongliang; Liu, Ping

    2016-01-01

    Percutaneous screw insertion for minimally displaced or reducible acetabular fracture using x-ray fluoroscopy and computer-assisted navigation system has been advocated by some authors. The purpose of this study was to compare intraoperative conditions and clinical results between isocentric C-arm 3-dimensional (Iso-C 3D) fluoroscopy and conventional fluoroscopy for percutaneous retrograde screwing of acetabular anterior column fracture.A prospective cohort study was conducted. A total of 22 patients were assigned to 2 different groups: 10 patients in the Iso-C 3D navigation group and 12 patients in the conventional group. The operative time, fluoroscopic time, time of screw insertion, blood loss, and accuracy were analyzed between the 2 groups.There were significant differences in operative time, screw insertion time, fluoroscopy time, and mean blood loss between the 2 groups. Totally 2 of 12 (16.7%) screws were misplaced in the conventional fluoroscopy group, and all 10 screws were in safe zones in the navigation group. Percutaneous screw fixation using the Iso-C 3D computer-assisted navigation system significantly reduced the intraoperative fluoroscopy time and blood loss in percutaneous screwing for acetabular anterior column fracture.The Iso-C 3D computer-assisted navigation system provided a reliable and effective method for percutaneous screw insertion in acetabular anterior column fractures compared to conventional fluoroscopy.

  15. The International Classification of Functioning as an explanatory model of health after distal radius fracture: A cohort study

    Directory of Open Access Journals (Sweden)

    MacDermid Joy C

    2005-11-01

    Full Text Available Abstract Background Distal radius fractures are common injuries that have an increasing impact on health across the lifespan. The purpose of this study was to identify health impacts in body structure/function, activity, and participation at baseline and follow-up, to determine whether they support the ICF model of health. Methods This is a prospective cohort study of 790 individuals who were assessed at 1 week, 3 months, and 1 year post injury. The Patient Rated Wrist Evaluation (PRWE, The Wrist Outcome Measure (WOM, and the Medical Outcome Survey Short-Form (SF-36 were used to measure impairment, activity, participation, and health. Multiple regression was used to develop explanatory models of health outcome. Results Regression analysis showed that the PRWE explained between 13% (one week and 33% (three months of the SF-36 Physical Component Summary Scores with pain, activities and participation subscales showing dominant effects at different stages of recovery. PRWE scores were less related to Mental Component Summary Scores, 10% (three months and 8% (one year. Wrist impairment scores were less powerful predictors of health status than the PRWE. Conclusion The ICF is an informative model for examining distal radius fracture. Difficulty in the domains of activity and participation were able to explain a significant portion of physical health. Post-fracture rehabilitation and outcome assessments should extend beyond physical impairment to insure comprehensive treatment to individuals with distal radius fracture.

  16. Internal fixation for intra-articular distal radius fracture (AO type C3) using condylar stabilizing technique

    International Nuclear Information System (INIS)

    Authors' fixation procedure involving their unique technique for the fracture in the title is precisely presented. In the technique, subchondral support of fragments of ventral palmar lunate bone and anatomical reintegration are thought to be important. The fixation for the AO type C3 fracture is conducted with Acu-Loc Distal Radius Plate System (Kobayashi Medical Co.) by condylar stabilizing technique for 20 patients (M 9/F 11, 60.8 years old in average). Fractures involve the comminuted Colles and Smith types of 18 and 2 cases, respectively (C3-1/7 case, C3-2/12, C3-3/1). Before and 2 weeks after surgery, multi-slice CT is performed to construct images of multiplanar inclination to calculate the radial inclination (RI) and ulnar variance (UV) from frontal images, and the palmar tilt (PT), and gap/step-off of articular surface from sagittal images with Synapse (FUJI FILM Medical Co., Ltd). Average angles or distances at the injury/after operation are respectively; RI, 16.7/22.6 degrees; PT (Colles type), -14.6/5.8 degrees; or UV; 4.3/1.0 mm; gap, 2.3/1.2 mm; step-off, 1.3/0.5 mm; which are all statistically significant improvement. Thus the procedure is thought useful for reintegrating fixation of highly depressed intra-articular fracture surface. (K.I.)

  17. External Fixation versus two-stage Open Reduction Internal Fixation of distal intra-articular Tibia fractures; a Systematic Review

    DEFF Research Database (Denmark)

    Ladeby Erichsen, Julie; Jensen, Carsten; Damborg, Frank Lindhøj;

    Background: Distal Intra-Articular Tibia Fractures (DIATF) is challenging to treat and severe loss of physical function affecting working abilities has been reported. Aim: To investigate differences in physical function and complications following DIATF surgery with two-stage Open Reduction...

  18. Results of Chiari pelvic osteotomy for acetabular dysplasia in adults

    International Nuclear Information System (INIS)

    In an attempt to determine indications of Chiari pelvic osteotomy in acetabular dysplasia, postoperative outcome of hip joint (64 joints) was examined on the basis of findings of bone scintigraphy. The subjects were 61 patients with osteoarthrosis of hip joint who underwent preoperative bone scintigraphy. The follow-up period ranged from 2 years to 9 years and 7 months with a mean of 4 years and 9 months. According to X-ray findings, 37 osteoarthrosis joints were staged as early and 27 as progressive. Preoperative bone scintigraphic findings fell into three: (I) normal or slight hot type (33 joints), (II) hot type at the weighting part (16 joints), and (III) double hot type in the weighting part and inside part (15 joints). None of the patients had severe surgical complications such as deep-seated infection, neuroparalysis and pseudojoint. According to the clinical staging for hip joint function, 7 (47%) of 64 joints were judged as poor after osteotomy, belonging to type III. Deterioration of osteoarthrosis was seen in 11 joints (41%) on X-ray films. Of these, 9 had type III. In conclusion, Chiari pelvic osteotomy should not be indicated when type III is shown on bone scintigrams. (N.K.)

  19. Ultrasound versus Magnetic Resonance Arthrography in Acetabular Labral Tear Diagnostics: A Prospective Comparison in 20 Dysplastic Hips

    Energy Technology Data Exchange (ETDEWEB)

    Troelsen, A.; Jacobsen, S.; Bolvig, L.; Gelineck, J.; Roemer, L.; Soeballe, K. [Orthopedic Research Unit and Dept. of Radiology, Univ. Hospital of Aarhus, A arhus (Denmark)

    2007-11-15

    Background: Acetabular labral tears are highly associated with hip dysplasia. Magnetic resonance arthrography (MR arthrography) is the expensive and time-consuming contemporary gold-standard method in the radiological assessment of acetabular labral tears. Purpose: To assess the diagnostic ability of noninvasive ultrasound (US) examination compared to MR arthrography in diagnosing acetabular labral tears in dysplastic hip joints. Material and Methods: The study compared US examination and MR arthrography diagnosis of labral tears in 20 consecutively referred dysplastic hip joints. Results: The ability to diagnose acetabular labral tears upon US examination was calculated: sensitivity 44%, specificity 75%, positive predictive value 88%, and negative predictive value 25%. Conclusion: The ability of US examination in diagnosing acetabular labral tears is not yet good enough. The technique is still to be developed, and more experience, especially with the interpretation of US examinations, is needed.

  20. Percutaneous screw fixation of a vertebral pedicle fracture under CT-guidance: A new technique

    International Nuclear Information System (INIS)

    We report on a new minimally invasive technique for the vertebral pedicle fracture after placement of a prosthetic disc. This intervention is an adaptation of CT-guided sacroiliac and acetabular fracture screw fixation. This type of procedure enables the perfect placement and measurement of the screw, as well as an extremely small incision under local anesthesia. CT guided Transpedicular fixation could be a useful strategy in the treatment of future cases involving poorly healing pedicle fractures causing persistent symptoms. This intervention confirms the range of capacities of CT scan-controlled interventions in terms of precision, safety, speed, minimal invasiveness, rapid return to everyday activity and consequently, economical management.

  1. Oxidation and other property changes of retrieved sequentially annealed UHMWPE acetabular and tibial bearings.

    Science.gov (United States)

    Reinitz, Steven D; Currier, Barbara H; Van Citters, Douglas W; Levine, Rayna A; Collier, John P

    2015-04-01

    This investigation analyzed retrieved sequentially crosslinked and annealed (SXL) ultra-high molecular weight polyethylene bearings to determine whether the material is chemically stable in vivo. A series of retrieved tibial and acetabular components were analyzed for changes in ketone oxidation, crosslink density, and free radical concentration. Oxidation was observed to increase with in vivo duration, and the rate of oxidation in tibial inserts was significantly greater than in acetabular liners. SXL acetabular bearings oxidized at a rate comparable to gamma-sterilized liners, while SXL tibial inserts oxidized at a significantly faster rate than their gamma-sterilized counterparts. A significant decrease in crosslink density with increased mean ketone oxidation index was observed, suggesting that in vivo oxidation may be causing material degradation. Furthermore, a subsurface whitened damage region was also found in a subset of the bearings, indicating the possibility of a clinically relevant decrease in mechanical properties of these components.

  2. Effect of limited internal fixation + external fixation combined with Taohong Siwu decoction on imaging and biochemical indexes assessment in patients of tibial plateau fracture

    Institute of Scientific and Technical Information of China (English)

    Yong-Gang Zhu; Da-Wei Zhang; Guang-Yue Zhao; Wei Qi; Qiang Sun; Ji-Wei Zou

    2016-01-01

    Objective:To study the effect of limited internal fixation + external fixation combined with Taohong Siwu decoction on imaging healing and biochemical indicators in patients with tibial plateau fracture.Methods:A total of 34 patients with Schatzker type V and VI tibial plateau fracture who were treated in our hospital from March 2010 to October 2014 were selected as the research subjects and randomly divided into combined treatment group and surgical treatment group, anteroposterior and lateral film examination of the knee joint was performed before and after surgery in order to make clear the imaging healing, serum was collected to determine bone alkaline phosphatase (BALP), serum C-terminal telopeptide of collagen type 1 (β-CTX), thromboxane B2 (TXB-2) and 6-ketone prostaglandin F1α (6-Keto-PGF1α) content.Results:One month after surgery, anteroposterior and lateral film of the knee joint of both groups showed internal fixation and external fixation in-place, and the healing of fracture end of combined treatment group was better than that of the surgical treatment group. Serumβ-CTX and TXB2 content as well as TXB2/6-Keto-PGF1α ratio of combined treatment group 14 days after surgery were significantly lower than those on the very day after surgery while BALP and 6-Keto-PGF1α content were significantly higher than those on the very day after surgery (P0.05). Serum BALP and 6-Keto-PGF1α content of combined treatment group 14 days after surgery were higher than those of surgical treatment group whileβ-CTX and TXB2 content as well as TXB2/6-Keto-PGF1α ratio were lower than those of surgical treatment group (P<0.05).Conclusions:Limited internal fixation + external fixation combined with Taohong Siwu decoction can promote the healing of tibial plateau fracture, and adjusting the osteoblast/osteoclast activity and TXA2/PGF1α balance is the functioning molecular target of Taohong Siwu decoction.

  3. Heterotopic Ossification around the Knee after Internal Fixation of a Complex Tibial Plateau Fracture Combined with the Use of Demineralized Bone Matrix (DBM: A Case Report

    Directory of Open Access Journals (Sweden)

    1.\tSjoerd P.F.T. Nota

    2014-10-01

    Full Text Available Demineralized bone matrix has been successfully commercialized as an alternative bone graft material that not only can function as filler but also as an osteoinductive graft. Numerous studies have confirmed its beneficial use in clinical practice. Heterotopic ossification after internal fixation combined with the use of demineralized bone matrix has not been widely reported. In this paper we describe a 39 year old male who sustained a complex articular fracture that developed clinically significant heterotopic ossification after internal fixation with added demineralized bone matrix. Although we cannot be sure that there is a cause-and-effect relation between demineralized bone matrix and the excessive heterotopic ossification seen in our patient, it seems that some caution in using demineralised bone matrix in similar cases is warranted. Also, given the known inter- and intraproduct variability, the risks and benefits of these products should be carefully weighed.

  4. Quantifying the contribution of pincer deformity to femoro-acetabular impingement using 3D computerised tomography

    Energy Technology Data Exchange (ETDEWEB)

    Dandachli, Wael; Najefi, Ali; Iranpour, Farhad; Lenihan, Jonathan; Hart, Alister; Cobb, Justin [Imperial College London, Charing Cross Hospital, Department of Orthopaedic Surgery, London (United Kingdom)

    2012-10-15

    To provide a simple, reliable method for the three-dimensional quantification of pincer-type hip deformity. Computerised tomography scans of 16 normal female hips and 15 female hips with clinical femoro-acetabular impingement (FAI) and radiographic signs of pincer secondary to acetabular protrusio were analysed. After orientating the pelvis in the anterior pelvic plane, the acetabular centre was determined, and the ratios of its coordinates to the corresponding pelvic dimensions were calculated. Acetabular coverage of the femoral head and centre-edge angles were also measured for the two groups. In hips with a pincer, the hip was medialised by 37 % (p = 0.03), more proximal by 5 % (p = 0.05) and more posterior by 9 % (p = 0.03) compared with the normal hips. Coverage of the femoral head in protrusio hips was significantly greater than normal (average 71 % vs 82 %, p = 0.0001). Both the lateral centre-edge angle and the combined anterior-posterior centre-edge angle were greater in protrusio hips than in the normal ones (48 vs 37 , p < 0.001; and 216 vs 176 , p < 0.0001 respectively). Displacement in acetabular protrusio occurs in all planes. This CT-based method allows for the accurate and standardised quantification of the extent of displacement, as well as 3D measurement of femoral head coverage. In the adult female population, a combined centre-edge angle of over 190 suggests an acetabulum that is too deep and a potential cause of symptoms of femoro-acetabular impingement. Conversely, an acetabulum that has a combined centre-edge angle of less than 190 may be considered to be of normal depth, and therefore not contributing a pincer to FAI should it occur. (orig.)

  5. Quantifying the contribution of pincer deformity to femoro-acetabular impingement using 3D computerised tomography

    International Nuclear Information System (INIS)

    To provide a simple, reliable method for the three-dimensional quantification of pincer-type hip deformity. Computerised tomography scans of 16 normal female hips and 15 female hips with clinical femoro-acetabular impingement (FAI) and radiographic signs of pincer secondary to acetabular protrusio were analysed. After orientating the pelvis in the anterior pelvic plane, the acetabular centre was determined, and the ratios of its coordinates to the corresponding pelvic dimensions were calculated. Acetabular coverage of the femoral head and centre-edge angles were also measured for the two groups. In hips with a pincer, the hip was medialised by 37 % (p = 0.03), more proximal by 5 % (p = 0.05) and more posterior by 9 % (p = 0.03) compared with the normal hips. Coverage of the femoral head in protrusio hips was significantly greater than normal (average 71 % vs 82 %, p = 0.0001). Both the lateral centre-edge angle and the combined anterior-posterior centre-edge angle were greater in protrusio hips than in the normal ones (48 vs 37 , p < 0.001; and 216 vs 176 , p < 0.0001 respectively). Displacement in acetabular protrusio occurs in all planes. This CT-based method allows for the accurate and standardised quantification of the extent of displacement, as well as 3D measurement of femoral head coverage. In the adult female population, a combined centre-edge angle of over 190 suggests an acetabulum that is too deep and a potential cause of symptoms of femoro-acetabular impingement. Conversely, an acetabulum that has a combined centre-edge angle of less than 190 may be considered to be of normal depth, and therefore not contributing a pincer to FAI should it occur. (orig.)

  6. Application of porous tantalum in acetabular revision after total hip arthroplasty%多孔金属钽髋臼在全髋关节置换术后髋臼翻修中的应用

    Institute of Scientific and Technical Information of China (English)

    李亮; 赵阳; 王志强

    2013-01-01

    To review the application effects of the porous tantalum acetabular cup in acetabular revision for acetabular failure after total hip arthroplasty ( THA ). The related literatures about the characteristics of porous tantalum and its application in acetabular revision in recent 10 years were retrieved from China National Knowledge Internet ( CNKI ) and PubMed databases, and a review was made. The porous tantalum acetabular cup had unique high porosity, low elasticity, high friction coefficient and good function to promote bone ingrowth inwardly. Good clinical results could be obtained using the porous tantalum acetabular cup in acetabular revision for patients with initial fixation failure using the artificial acetabular cup. In acetabular revision, the porous tantalum acetabular cup can provide superior mechanical stability, with good early and medium-term results.

  7. Flap reconstruction for soft-tissue defects with exposed hardware following deep infection after internal fixation of ankle fractures.

    Science.gov (United States)

    Ovaska, Mikko T; Madanat, Rami; Tukiainen, Erkki; Pulliainen, Lea; Sintonen, Harri; Mäkinen, Tatu J

    2014-12-01

    The aim of the present study was to determine the outcome for patients treated with flap reconstruction following deep ankle fracture infection with exposed hardware. Out of 3041 consecutive ankle fracture operations in 3030 patients from 2006 to 2011, we identified 56 patients requiring flap reconstruction following deep infection. Thirty-two of these patients could be examined at a follow-up visit. Olerud-Molander Ankle (OMA) score, 15D score, Numeric Rating Scale (NRS), and clinical examination were used to assess the outcome. A total of 58 flap reconstructions were performed in 56 patients with a mean age of 57 years (range 25–93 years) and mean follow-up time of 52 months. The most commonly used reconstruction was a distally based peroneus brevis muscle flap with a split-thickness skin graft. A microvascular free flap was required in only one patient. 22 (39%) patients required subsequent surgical interventions because of a flap-related complication. With flap reconstruction, hardware could eventually be salvaged in 53% of patients with a non-consolidated fracture. The mean OMA score was fair or poor in 53% of the patients, and only 56% had recovered their pre-injury level of function. Half of the patients had shoe wear limitations. The 15D score showed a significantly poorer health-related quality of life compared to an age-standardised sample of the general population. The mean pain NRS was 2.1 (range 0–6), and the mean satisfaction NRS was 6.6 (range 0–10). Our study showed that successful treatment of a soft-tissue defect with exposed hardware following ankle fracture infections can be achieved with local flaps. Despite eventual reconstructive success, complications are common. Patients perceive a poorer health-related quality of life, have shoe wear limitations, and only half of them achieve their pre-injury level of function. PMID:25458066

  8. Transstyloid, transscaphoid, transcapitate fracture: a variant of scaphocapitate fractures.

    LENUS (Irish Health Repository)

    Burke, Neil G

    2014-01-01

    Transstyloid, transscaphoid, transcapitate fractures are uncommon. We report the case of a 28-year-old man who sustained this fracture following direct trauma. The patient was successfully treated by open reduction internal fixation of the scaphoid and proximal capitate fragment, with a good clinical outcome at 1-year follow-up. This pattern is a new variant of scaphocapitate fracture as involves a fracture of the radial styloid as well.

  9. Acetabular anteversion is associated with gluteal tendinopathy at MRI

    Energy Technology Data Exchange (ETDEWEB)

    Moulton, Kyle M. [University of Saskatchewan, Department of Medical Imaging, Saskatoon, SK (Canada); Royal University Hospital, Department of Medical Imaging, Saskatoon, SK (Canada); Aly, Abdel-Rahman [University of Saskatchewan, Department of Physical Medicine and Rehabilitation, Saskatoon, SK (Canada); Rajasekaran, Sathish [Health Pointe - Pain, Spine and Sport Medicine, Edmonton, AB (Canada); Shepel, Michael; Obaid, Haron [University of Saskatchewan, Department of Medical Imaging, Saskatoon, SK (Canada)

    2015-01-15

    Gluteal tendinopathy and greater trochanteric pain syndrome (GTPS) remain incompletely understood despite their pervasiveness in clinical practice. To date, no study has analyzed the morphometric characteristics of the hip on magnetic resonance imaging (MRI) that may predispose to gluteal tendinopathy. This study aimed to evaluate whether acetabular anteversion (AA), femoral neck anteversion (FNA), and femoral neck-shaft angle (FNSA) are associated with MRI features of gluteal tendinopathy. A total of 203 MRI examinations of the hip met our inclusion and exclusion criteria. A single blinded investigator measured AA, FNA, and FNSA according to validated MRI techniques. Two blinded subspecialty-trained musculoskeletal radiologists then independently evaluated the presence of gluteal tendinosis, trochanteric bursitis, and subgluteal bursitis. Statistical analysis was performed using a one-way analysis of variance (ANOVA; post-hoc Tukey's range test). At MRI, 57 patients had gluteal tendinosis with or without bursitis, 26 had isolated trochanteric bursitis, and 11 had isolated subgluteal bursitis. AA was significantly (p = 0.01) increased in patients with MRI evidence of gluteal tendinosis with or without bursitis [mean: 18.4 , 95 % confidence interval (CI): 17.2 -19.6 ] compared with normal controls (mean: 15.7 , 95 % CI: 14.7 -16.8 ). Similarly, AA was significantly (p = 0.04) increased in patients with isolated trochanteric bursitis (mean: 18.8 , 95 % CI: 16.2 -21.6 ). No association was found between FNA or FNSA and the presence of gluteal tendinopathy. Interobserver agreement for the presence and categorization of gluteal tendinopathy was very good (kappa = 0.859, 95 % CI: 0.815-0.903). Our MRI study suggests that there is an association between increased AA and gluteal tendinopathy, which supports a growing body of evidence implicating abnormal biomechanics in the development of this condition. (orig.)

  10. Biological internal fixation of the fracture and performance analysis of the internal fixation materials%骨折的生物学内固定及内固定材料性能分析

    Institute of Scientific and Technical Information of China (English)

    成翔宇; 纪斌; 庞金辉

    2012-01-01

    BACKGROUND: In recent years, the focus of internal fixation for the fracture has developed from rigidity, stability and anatomic reduction to biological fixation which can preserve soft tissue blood supply, relatively stable and had anatomical axis arrangement.OBJECTIVE: To summarize the clinical characteristics of various materials for fracture fixation, and to analyze the biocompatibility after fixation device implantation.METHODS: A computer-based online retrieval of CNKI database and VIP database from January 1990 to November 2011 was conducted for articles addressing fracture internal fixation materials, by screening the key words of "fracture, internal fixation, plates, screws" in title and "loose, breakage, compatibility" in abstract. Documents related with fracture fixation treatment were involved, and those published in recent years or in authorized journals were preferred in the same field. After preliminary retrieval, 178 literatures were screened out and 24 of them were involved in the retrospective analysis according to inclusion criteria. RESULTS AND CONCLUSION: With the advanced progress on raw materials industry and biomedicine, internal fixation devices are rapidly developing. The vast majority of current orthopedic internal fixation plates and screws used in medical institutions show very good biocompatibility and stiffness. However, fixation materials in different parts and different types of fracture alter, thus resulting in different bending resistance, axial, lateral and anti-rotational stability, as well as complications and compatibility after fixation. Biological fixation for the fracture can greatly reduce the injury at soft tissue and rate of bone graft, thereby shortening fracture healing time and significantly reducing the incidence of fracture non-union, second fracture and infection.%背景:近年来,骨折内固定已经从强调坚强内固定、绝对稳定和解剖复位,转向强调保留软组织血运、相对稳定和解剖

  11. Clinical analysis of the removal of internal fixation device after the internal fixation of limb fracture healing%四肢骨折内固定术愈合后内固定装置取出临床分析

    Institute of Scientific and Technical Information of China (English)

    戈光群

    2015-01-01

    Objective: To investigate the specific performance and reason of the removal difficult of internal fixation device after the internal fixation of limb fracture healing,in order to put forward specific strategies.Methods:We retrospective analyzed 20 cases of limb fixation healing after internal fixation device removal difficult patients as the observation group,and other 209 cases who were removed relatively easy were selected as the control group.Results:The device does not match was 25% ,the callus growth around the embedded screw was 25%,screw groove damage was 55%,bone cement embedding implants was 5%;the age of the control group was higher than that of the observation group,the total complication cases of the observation group was higher than that of the control group(P<0.05).Conclusion:The internal fixation device is difficult to take out after internal fixation of limb fracture healing,which is related to the fracture injury,bone cement embedding quality,physician removal preparations and other causes.%目的:探讨四肢骨折内固定术愈合后内固定装置取出困难具体表现与原因,提出针对性的解决策略。方法:20例四肢内固定术愈合后内固定装置取出困难患者作为观察组,将209例取出相对容易者作为对照组。结果:器械不匹配25.00%,周围骨痂生长包埋螺钉25.00%,螺钉凹槽损坏55.00%,骨水泥包埋内固定物5.00%;对照组年龄高于观察组,观察组并发症合计例次率高于对照组(P<0.05)。结论:四肢骨折内固定术愈合后内固定装置取出困难,与骨折伤情、骨水泥包埋质量、医师取出术准备工作等原因有关。

  12. Determinación del desgaste del componente acetabular en prótesis totales de cadera. // Wear determination of acetabular component in total hip prosthesis.

    Directory of Open Access Journals (Sweden)

    G. García del Pino

    2002-01-01

    Full Text Available En este trabajo se realiza un estudio a través del Método de los Elementos Finitos “MEF” sobre el desgaste del componenteacetabular durante el ciclo de marcha y considerando algunos casos extremos de cargas como subir y bajar escaleras,levantarse de una silla, etc. Utilizando el MEF fueron modelados independientemente los componentes acetabular yfemoral de la prótesis total de cadera y puestos en contacto posteriormente. Fueron estudiadas varias posiciones delacetábulo así como diferentes casos de carga simulando pacientes con diferente peso corporal y actividades físicas. Paraevaluar los resultados se crearon rutinas en lenguaje C que organizaron los mismos para un tratamiento estadísticoposterior.Palabras claves: biomecánica, ortopedia, elementos finitos, modelación, desgaste, prótesis de cadera.___________________________________________________________________________Abstract.A wear study of acetabular component during the marching cycle, considering some extreme loads cases as: ascend anddescend stairways, get up from a seat, etc , by means of Finite Elements Method ( FEM , is carried out. The acetabular andfemoral component of the total hip prosthesis were independently modeled and placed in contact lastly. Several acetabulpositions were studied as well as different load cases, simulating patients with different body weight and different physicalactivities. To evaluate the results routines in C language were created in order to organized the same ones for a laterstatistical treatment.Key words. biomechanics, ortophedy, finite elements, modelation, wear, hip bone prosthesis.

  13. 3.0 T conventional hip MR and hip MR arthrography for the acetabular labral tears confirmed by arthroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Tian, Chun-Yan [Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191 (China); Wang, Jian-Quan [Department of Sports Medicine, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191,PR China (China); Zheng, Zhuo-Zhao, E-mail: zzhuozhao@aliyun.com [Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191 (China); Ren, A.-Hong [Department of Radiology, Beijing Daxing Hospital, 26 West Huangcun Road, Daxing District, Beijing 102600 (China)

    2014-10-15

    Highlights: • MR is the preferred imaging modality for diagnosing acetabular labral tears. • The diagnostic performance of MR arthrography are superior than conventional hip MR. • The hip MR arthrography is recommended for diagnosing acetabular labral lesions. - Abstract: Objective: To evaluate the value of hip MR for diagnosing acetabular labrum tears, and to further compare the diagnostic performances of conventional MR with MR arthrography in acetabular labrum tears. Methods: 90 patients undergoing both hip MR examination and subsequent hip arthroscopy were retrospectively evaluated. Of these patients, 34 accepted both conventional MR and MR arthrography; while the other 56 only underwent conventional MR examination. All hip MR images were independently reviewed by two radiologists, and further compared with the results of hip arthroscopy. Results: 59 of 90 patients were confirmed with acetabular labral tears by hip arthroscopy and 31 without tears. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of conventional MR for evaluating the acetabular labral tears were 61.0%, 77.4%, 83.7% and 51.1% (radiologist A), and 66.1%, 74.2%, 82.9% and 53.4% (radiologist B), respectively, with good consistency between the two observers (K = 0.645). The sensitivity, specificity, PPV and NPV of MR arthrography for assessing the acetabular labral tears were 90.5%, 84.6%, 90.5% and 84.6% (radiologist A), and 95.2%, 84.6%, 90.9% and 91.7% (radiologist B), respectively, with excellent good consistency between the two observers (K = 0.810). The sensitivity and NPV of MR arthrography for diagnosing the acetabular labral tears were significantly higher than those of conventional MR (both P < 0.05). Conclusion: Hip MR arthrography is a reliable evaluation modality for diagnosing the acetabular labral tears, and its diagnostic performance is superior to that of conventional MR at 3.0 T.

  14. Open reduction and internal fixation for displaced supracondylar fractures of the humerus in children with crossed K-wires via lateral approach

    Institute of Scientific and Technical Information of China (English)

    Shahid Hussain; Manzoor Ahmad; Tufail Muzaffar

    2014-01-01

    Objective:To assess the therapeutic results of open reduction and internal fixation with crossed K-wires via lateral approach for displaced supracondylar fractures of the humerus in children.Methods:We prospectively followed 52 children who presented with Gartland type 3 displaced supracondylar fractures of the humerus and were managed by open reduction and internal fixation with crossed K-wires via lateral approach.There were 37 male and 15 female patients; average age was 7.39 years.The most common mechanism of trauma was fall while playing (n=23),followed by fall from height (n=20),road traffic accidents (n=5) and fall from standing height (n=2).In 2 cases,mode of injury was not available.The mean follow-up was 12 months and patients were assessed according to Flynn's criteria.Results:Lateral approach provided an excellent view of the lateral column between two nervous planes and enabled an anatomical reduction in all cases.Immobilizing the elbow at 90 degrees or more of flexion was not needed after cross K-wire fixation.Majority of patients regained full range of motion within 6 weeks of pin removal.Two patients had postoperative ulnar nerve injuries that resolved after pin removal.The common late complication of cubitus varus was not seen in any patient.Delayed presentation to the emergency department,repeated manipulations by bone setters and massage with edible oil were responsible for stiffness in 5 patients.Superficial pin tract infection was noted in 5 patients that resolved with dressings and antibiotics.No deep infection occurred.A detailed clinical examination and radiographic analysis was done at final follow-up.They included measurement of carrying angle and range of movements of both operated and normal sides,and radiographs of both upper limbs for comparison.According to Flynn's criteria,90.4% patients showed satisfactory results.Conclusion:Lateral approach for open reduction and internal fixation of the widely-displaced supracondylar fracture of

  15. The 10-year international development trends of intertrochanteric fracture of femur%股骨转子间骨折10年国际发展趋势

    Institute of Scientific and Technical Information of China (English)

    贺建军; 葛建忠

    2012-01-01

    背景:随着社会逐渐老龄化和骨质疏松人数的增加,股骨转子间骨折发生率呈逐渐上升趋势.目的:检索股骨转子间骨折的研究文献资料,利用SCI数据库文献检索和深度分析功能对其发病及其治疗趋势进行多层次探讨分析.设计:文献计量学研究.资料提取:以"股骨转子间骨折(intertrochanteric fracture of femur or intertrochanteric fracture or femoral intertrochanteric fracture);髓内钉(intramedullary nail or nail);动力髋螺钉(dynamic hip screws);股骨头置换(femoral head replacement or femoral head arthroplasty or femur head prosthesis replacement)"为关键词,检索SCI数据库2001-01/2010-12的相关文献,以文字和图表的形式进行统计和结果分析,描述其特征.入选标准:纳入标准:股骨转子间骨折相关的文献:①研究原著.②会议文章.③快报.④会议摘要.⑤综述.⑥编辑素材.⑦勘误.排除标准:校对、随笔、短讯及未发表的文章.主要数据判定指标:分析文献出版时间、国家地区分布、研究机构、文献类型、来源期刊、文献被引情况以及学科类别.结果:检索到SCI数据库2001/2010收录的584篇股骨转子间骨折相关文献,研究原著以500篇位居首位,其中有5篇可以确定为经典文献.文献数量在2001/2010呈总体上升趋势,Injury -International Journal of the Care of the Injured杂志发表文献量最多,59篇,占全部文献的10.10%.结论:以文献计量学方法研究来源于SCI数据库关于股骨转子间骨折的文献,可提供该领域的现状和趋势,可为研究者进一步确定研究热点提供有价值的量化数据参考.%BACKGROUND: With the gradual aging of the society and the number of osteoporosis increasing, the rate of intertrochantericfracture of femur is also on the rise.OBJECTIVE: To multivariately analyze the literature on the intertrochanteric fracture of femur through Science Citation Index(SCI) database and its analysis tool

  16. High-precision measurements of cementless acetabular components using model-based RSA: an experimental study

    DEFF Research Database (Denmark)

    Baad-Hansen, Thomas; Kold, Søren; Kaptein, Bart L;

    2007-01-01

    BACKGROUND: In RSA, tantalum markers attached to metal-backed acetabular cups are often difficult to detect on stereo radiographs due to the high density of the metal shell. This results in occlusion of the prosthesis markers and may lead to inconclusive migration results. Within the last few yea...

  17. What is the role of clinical tests and ultrasound in acetabular labral tear diagnostics?

    DEFF Research Database (Denmark)

    Troelsen, Anders; Mechlenburg, Inger; Gelineck, John;

    2009-01-01

    BACKGROUND AND PURPOSE: An acetabular labral tear is a diagnostic challenge. Various clinical tests have been described, but little is known about their diagnostic sensitivity and specificity. We investigated the diagnostic validity of clinical tests and ultrasound as compared with MR arthrograph...

  18. An unusual mode of failure of a tripolar constrained acetabular liner: a case report.

    LENUS (Irish Health Repository)

    Banks, Louisa N

    2012-02-01

    Dislocation after primary total hip arthroplasty (THA) is the most commonly encountered complication and is unpleasant for both the patient and the surgeon. Constrained acetabular components can be used to treat or prevent instability after primary total hip arthroplasty. We present the case of a 42-year-old female with a BMI of 41. At 18 months post-primary THA the patient underwent further revision hip surgery after numerous (more than 20) dislocations. She had a tripolar Trident acetabular cup (Stryker-Howmedica-Osteonics, Rutherford, New Jersey) inserted. Shortly afterwards the unusual mode of failure of the constrained acetabular liner was noted from radiographs in that the inner liner had dissociated from the outer. The reinforcing ring remained intact and in place. We believe that the patient\\'s weight, combined with poor abductor musculature caused excessive demand on the device leading to failure at this interface when the patient flexed forward. Constrained acetabular components are useful implants to treat instability but have been shown to have up to 42% long-term failure rates with problems such as dissociated inserts, dissociated constraining rings and dissociated femoral rings being sited. Sometimes they may be the only option left in difficult cases such as illustrated here, but still unfortunately have the capacity to fail in unusual ways.

  19. Relationship between developmental dislocation of the hip in infant and acetabular dysplasia at skeletal maturity.

    Science.gov (United States)

    Okano, Kunihiko; Yamaguchi, Kazumasa; Ninomiya, Yoshikazu; Matsubayashi, Shohei; Aoyagi, Kiyoshi; Osaki, Makoto; Enomoto, Hiroshi; Takahashi, Katsuro

    2015-01-01

    Previous reports demonstrated 8-60% patients treated for developmental dislocation of hip (DDH) in infancy have residual acetabular dysplasia (AD) at skeletal maturity. AD patients reportedly exhibit abnormal morphology of the pelvis, high rates of comorbid spinal congenital anomalies and high bone mineral density. These physical findings suggest that AD patients have genetic background. We examined the percentage of AD patients with hip pain at skeletal maturity having a history of DDH in infancy and the correlation between the severity of AD at skeletal maturity and history of DDH treatment to investigate the relationship between AD and DDH.A total of 245 patients were radiographically examined for any history of DDH treatment in infancy. The study included 226 women and 19 men with a mean age at examination of 40.7 years (range 17-59 years).Eighty-eight patients (36%) had a history of DDH treatment (DDH group) and the remaining 157 patients (64%) had no history of DDH treatment (non-DDH group). The average age was lower and acetabular angle was larger in the DDH group. There was a significant increasing trend of the percentage of DDH patients associated with the severity of AD classified with CE, acetabular angle, and acetabular roof angle.Our data suggest that there are several AD patients without a history of DDH in Japan, and AD in patients without a history of DDH has different characteristics from AD in patients with a history of DDH. PMID:25569642

  20. SACRAL FRACTURES

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective. To delineate the clinical spectrum and treatment choice of sacral fractures.Methods. In this series, 39 sacral fractures were retrospectively reviewed and classified utilizing Denis′ classification. There were 21 Zone Ⅰ fractures, 6 Zone Ⅱ fractures and 12 Zone Ⅲ fractures. Neurological deficits were present in seven patients. Thirty seven patients were treated conservatively and two underwent surgical management.Results.Thirty eight patients were followed up for three months to 19 years. Thirty three have recovered, four improved, and one remained disabled.Conclusion.The treatment of sacral fractures requires assessment of pelvic stability and existing nerve injury. The patients with pelvic ring instability and neurological deficits should be treated with fracture reduction and stability reconstruction. When the patients with pelvic fracture are complicated with neurological deficits, sacral fracture should be first suspected. Once the diagnosis of sacral fracture is made, fracture reduction should be indicated. Conservative treatment usually permits satisfactory results.

  1. A novel method of removal of a broken drill bit in the femoral medullary canal during internal fixation of a type C distal femoral fracture: a case report

    Institute of Scientific and Technical Information of China (English)

    Varatharaj Mounasamy; Pingal Desai; Satya Mallu; Senthil Sambandam

    2012-01-01

    Breakage of surgical instruments and implants during operative procedures is not uncommon in any surgical discipline.The need for removal and the outcome of leaving the broken instruments and implants in the surgical area have not been described in detail.Few studies have suggested removal if they are lying loosely in the tissues or joint,close to neurovascular structures.Challenges and the amount of time spent in the retrieval of broken instruments and implants are well known among surgeons,so most choose to leave them in situ.We reported a novel method of retrieval of a broken drill bit in the femoral medullary canal during internal fixation of a type C distal femoral fracture.

  2. Progressive Fracture of Composite Structures

    Science.gov (United States)

    Chamis, Christos C.; Minnetyan, Levon

    2008-01-01

    A new approach is described for evaluating fracture in composite structures. This approach is independent of classical fracture mechanics parameters like fracture toughness. It relies on computational simulation and is programmed in a stand-alone integrated computer code. It is multiscale, multifunctional because it includes composite mechanics for the composite behavior and finite element analysis for predicting the structural response. It contains seven modules; layered composite mechanics (micro, macro, laminate), finite element, updating scheme, local fracture, global fracture, stress based failure modes, and fracture progression. The computer code is called CODSTRAN (Composite Durability Structural ANalysis). It is used in the present paper to evaluate the global fracture of four composite shell problems and one composite built-up structure. Results show that the composite shells and the built-up composite structure global fracture are enhanced when internal pressure is combined with shear loads.

  3. Cranial acetabular retroversion is common in developmental dysplasia of the hip as assessed by the weight bearing position

    DEFF Research Database (Denmark)

    Troelsen, Anders; Mikkelsen, Lone Rømer; Jacobsen, Steffen;

    2010-01-01

    The appearance of acetabular version differs between the supine and weight bearing positions in developmental dysplasia of the hip. Weight bearing radiographic evaluation has been recommended to ensure the best coherence between symptoms, functional appearance, and hip deformities. Previous preva...

  4. Tantalum acetabular augments in one-stage exchange of infected total hip arthroplasty: a case-control study.

    Science.gov (United States)

    Klatte, Till Orla; Kendoff, Daniel; Sabihi, Reza; Kamath, Atul F; Rueger, Johannes M; Gehrke, Thorsten

    2014-07-01

    During the one-stage exchange procedure for periprosthetic joint infection (PJI) after total hip arthroplasty (THA), acetabular defects challenge reconstructive options. Porous tantalum augments are an established tool for addressing acetabular destruction in aseptic cases, but their utility in septic exchange is unknown. This retrospective case-control study presents the initial results of tantalum augmentation during one-stage exchange for PJI. Primary endpoints were rates of re-infection and short-term complications associated with this technique. Study patients had no higher risk of re-infection with equivalent durability at early follow-up with a re-infection rate in both groups of 4%. In conclusion, tantalum augments are a viable option for addressing acetabular defects in one-stage exchange for septic THA. Further study is necessary to assess long-term durability when compared to traditional techniques for acetabular reconstruction. PMID:24559522

  5. 髌骨骨折内固定板的生物力学性能%Biomechanical properties of internal fixation plate for patellar fracture

    Institute of Scientific and Technical Information of China (English)

    管志海; 王勤业; 王以进; 罗亚平; 常小波; 冯夏莺

    2014-01-01

    背景:目前治疗髌骨骨折的各种手术方法均有优缺点,不能更好地满足患者的需求。  目的:评价髌骨内固定板固定髌骨骨折的生物力学性能,为临床应用提供基础理论依据。  方法:根据国人髌骨数据,采用钛合金制成蜘蛛形内固定板。采集6具新鲜尸体膝关节标本,随机分为两组,制成粉碎性骨折模型,分别采用髌骨内固定板和NiTi聚髌器固定,行生物力学实验,比较两种内固定物的生物力学性能。  结果与结论:两种不同内固定方法均能满足1 kN股四头肌收缩力,髌骨内固定板固定后髌骨的分离位移、肌力和关节力以及髌骨关节接触面力学特征均优于常用聚髌器内固定,统计两者力学指标差异有显著性意义(P OBJECTIVE:To evaluate biomechanical properties of internal fixation plate to treat patel ar fracture and to provide theoretical evidence for clinical application. METHODS:According to the statistics of patel a in the Chinese population, a titanium al oy spider internal fixation plate was designed and manufactured for the treatment of patel ar fractures. Knee joint specimens in six fresh cadavers were randomly divided into two groups and the comminuted fracture model of patel a were established. The models were fixed with internal fixation plate of patel a and NiTi patel ar concentrator. Biomechanical tests were carried out to compare the biomechanical properties. RESULTS AND CONCLUSION:Both the two fixation methods could meet the 1-kN quadriceps femoris contraction. The internal fixation plate of patel a was superior to NiTi patel ar concentrator in the patel ar isolation shift, muscle strength and joint strength, as wel as mechanical properties of patel a-point surface. There were significant differences between the two groups (P<0.05). The internal fixation plate of patel a is designed in accordance with the anatomical and biomechanical properties of the

  6. Open reduction and internal fixation of extracapsular mandibular condyle fractures: a long-term clinical and radiological follow-up of 25 patients

    OpenAIRE

    Spinzia, Alessia; Patrone, Renato; Belli, Evaristo; Dell'Aversana Orabona, Giovanni; Ungari, Claudio; Filiaci, Fabio; Agrillo, Alessandro; De Riu, Giacomo; Meloni, Silvio Mario; Liberatore, Gianmauro; Piombino, Pasquale

    2014-01-01

    Background: During the last 2 decades, many studies on the treatment of mandibular condyle fracture have been published. The incidence of mandibular condyle fractures is variable, ranging from 17.5% to 52% of all mandibular fractures. This retrospective study evaluated the long-term clinical and radiological outcomes after surgical treatment of 25 patients with a total of 26 extracapsular condyle fractures. Methods: We used 2 types of surgical approaches, the retromandibular retroparotid o...

  7. Mini-plate internal fixation for the treatment of metacarpal and phalangeal fractures:Biomechanical evaluation%微型钢板内固定掌指骨骨折的生物力学评价

    Institute of Scientific and Technical Information of China (English)

    石海林; 罗轶

    2013-01-01

    BACKGROUND:Metacarpal and phalangeal fractures is one of the common fracture, and usual y treated with internal fixation in clinic. OBJECTIVE:To evaluate the biomechanical performance as wel as the corresponding clinical effect of different internal fixation implants for the treatment of metacarpal and phalangeal fractures. METHODS:The changes of biomechanical performance, such as the axial compressive strain, the axial displacement and bending strain of mini-plate internal fixation, screw internal fixation, Kirschner wire internal fixation and wire internal fixation in the treatment of metacarpal and phalangeal fractures were measured to determine the ideal internal fixator for the treatment of metacarpal and phalangeal fractures, and to identify the clinical effect. RESUTLS AND CONCLUSION:Biomechanical test showed that under the same physiological loads, the mini-plate internal fixation showed the lowest axial compressive strain, axial displacement and bending strain, fol owed by Kirschner wire internal fixation, while the wire internal fixation showed the highest axial compressive strain, axial displacement and bending strain. The test results indicate that mini-plate internal fixation is the preferred internal fixation implant for the treatment of metacarpal and phalangeal fractures. The clinical results suggest that the excel ent and good rate of mini-plate internal fixation for the treatment of metacarpal and phalangeal fractures can reach 87%, and the mini-plate internal fixation can achieve the good fixation effect without complications of loosening of implants, fracture and loss of reduction.%  背景:掌指骨骨折是常见的骨折之一,临床多应用内固定物置入治疗。  目的:评价不同内固定物置入固定掌指骨骨折的生物力学性能以及相应的临床应用效果。  方法:通过测定掌指骨骨折微型钢板内固定、螺钉内固定、克氏针内固定以及钢丝内固定的轴向压缩应变

  8. Assessment of the influence of Laser phototherapy on the bone repair process of complete fractures in tibiae of rabbits stabilized with semi-rigid internal fixation treated with or without MTA graft: a histological study

    Science.gov (United States)

    Soares, Luiz G. P.; Silva, Aline C. P.; Silva, Anna Paula L. T.; Neves, Bruno Luiz R. C.; Santos, Nicole R. S.; dos Santos, Jean N.; Pinheiro, Antonio L. B.

    2016-03-01

    Beside biomaterials, Laser phototherapy has shown positive effects as auxiliary therapy in bone repair process, especially when involving large bone losses. The aim of this histological study was to evaluate, by light microscopy, the influence of laser phototherapy on the repair of complete tibial fractures in rabbits treated or not with semi-rigid internal fixation and Mineral Trioxide Aggregate - MTA graft. Twelve Rabbits were randomly divided into four groups with three animals each. After general anesthesia, complete fractures were created in one tibia with a carborundum disk. All animals (groups I-IV) had the fracture stabilized with semi-rigid fixation (wire osteosynthesis - WO). Group I was routinely fixed with WO; groups II and IV fracture was filled by blood clot and MTA implant. In Groups III and IV fracture was filled by blood clot and further irradiated with laser (λ780 nm, 70 mW, CW, Φ = 0.04 cm2, 20.4 J/cm2, per session, t = 300s, 142.8 J/cm2 per treatment). The phototherapy protocol was applied immediately after the surgery and repeated each 48 hours during 15 days. Animal death occurred on the 30th postoperative day. After removal of the specimens, the samples were routinely processed, stained with HE and evaluated by light microscopy. Histologically, the group treated with MTA graft and irradiated with laser showed the fracture filled by a more organized and mature trabecular bone, when compared with all other groups. From the results of the present study, it may be concluded that the association of Laser phototherapy + MTA graft in fractures treated with WO improved bone repair when compared with fractures treated only with WO.

  9. Internal fixation of femoral neck fractures in the elderly%老年股骨颈骨折的内固定治疗

    Institute of Scientific and Technical Information of China (English)

    危杰; 吴晓亮; 王满宜

    2009-01-01

    目的 探讨内固定治疗老年股骨颈骨折的疗效. 方法回顾研究2000年1月至2007年12月采用内固定治疗且获得随访的139例老年股骨颈骨折患者资料,其中男52例,女87例;年龄65~93岁,平均71.6岁;受伤至入院时间为1 h~30 d,平均56.7 h.骨折按Garden分型:Ⅰ型17例,Ⅱ型43例,Ⅲ型62例,Ⅳ型17例.移位骨折79例,非移位骨折60例.内固定材料:空心钉131例,动力髋螺钉5例,动力髋螺钉加空心钉3例.对患者住院时间、骨折愈合率、术后并发症、股骨头缺血坏死率、内固定失效率及患者功能恢复情况进行总结分析. 结果 139例患者住院时间为5~59 d,平均15.4 d.术后获7~77个月(平均35个月)随访.骨折愈合126例,占90.6%(126/139);愈合时间2~12个月,平均6.2个月.其中22例患者术后出现并发症.骨折不愈合内固定失效13例,占9.4%(13/139);股骨头缺血性坏死9例,占6.5%(9/139).正常行走者81例,占58.3%(81/139),需要助行器械者50例,占36.0%(50/139),不能行走者8例,占5.7%(8/139).结论 老年股骨颈骨折内固定治疗骨折愈合率高,股骨头缺血坏死率较低,内固定治疗老年股骨颈骨折具有积极意义.术前病情评估和合并症的积极治疗非常重要,条件允许时应尽早手术.%Objective To evaluate the outcome of the old patients who were treated for femoral neck fractures in our hospital during 2000-2007. Methods A retrospective study was conducted to evaluate outcomes of the 139 old patients who had received internal fixation for femoral neck fractures in our department during 2000-2007. The mechanism of injury, duration between injury and hospitalization, severity of fracture, anamnesis, time of hospital stay, anaesthesia, operation, postoperative complications, fracture healing, in-cidence of avascular necrosis of femoral head, failure of fixation, and functional restoration of the patients were documented. Results Fracture healing was found in 126 cases (90

  10. “钢筋混凝土”在髋臼重建中的应用★%Application of “reinforced concrete” in acetabular reconstruction

    Institute of Scientific and Technical Information of China (English)

    王子富; 尚希福

    2013-01-01

    -up. RESULTS AND CONCLUSION: Al the patients were fol owed-up for 1-3 years and average in 24 months without losing. The Harris score at 3 months after operation was higher than that before operation, and the hip activity at 2 years after operation was higher than that before operation, and the difference was significant (P <0.05). Two patients stil had leg length discrepancy, one patient with dislocation after squatting, and recovered after conservative treatment. The last fol ow-up showed there were no early infection, dislocation and pelvic discomfort. Radiographic results showed that there was no aseptic loosening and displacement of the acetabular cap and there was no fracture on titanium mesh. Screw fixed titanium mesh combined with a cemented cup is satisfactory process in the treatment of hip revision in over 65 years old patients, and the long-term effects are needed to be further fol owed-up and observed.

  11. Determinación del desgaste del componente acetabular en prótesis totales de cadera. // Wear determination of acetabular component in total hip prosthesis.

    OpenAIRE

    G. García del Pino; Gonçalves, E; R. Gonzáles Lima; R. Dantas Queiroz; J. L. Valín Rivera

    2002-01-01

    En este trabajo se realiza un estudio a través del Método de los Elementos Finitos “MEF” sobre el desgaste del componenteacetabular durante el ciclo de marcha y considerando algunos casos extremos de cargas como subir y bajar escaleras,levantarse de una silla, etc. Utilizando el MEF fueron modelados independientemente los componentes acetabular yfemoral de la prótesis total de cadera y puestos en contacto posteriormente. Fueron estudiadas varias posiciones delacetábulo así como diferentes cas...

  12. Warwick Hip Trauma Study: a randomised clinical trial comparing interventions to improve outcomes in internally fixed intracapsular fractures of the proximal femur. Protocol for The WHiT Study

    Directory of Open Access Journals (Sweden)

    Griffin Xavier

    2010-08-01

    Full Text Available Abstract Background Controversy exists regarding the optimal treatment for patients with displaced intracapsular fractures of the proximal femur. The recognised treatment alternatives are arthroplasty and internal fixation. The principal criticism of internal fixation is the high rate of non-union; up to 30% of patients will have a failure of the fixation leading to revision surgery. We believe that improved fracture healing may lead to a decreased rate of failure of fixation. We therefore propose to investigate strategies to both accelerate fracture healing and improve fixation that may significantly improve outcomes after internal fixation of intracapsular femoral fractures. We aim to test the clinical effectiveness of the osteoinductive agent platelet rich plasma and conduct a pilot study of a novel fixed-angle fixation system. Design We have planned a three arm, single centre, standard-of-care controlled, double blinded, pragmatic, randomised clinical trial. The trial will include a standard two-way comparison between platelet-rich plasma and standard-of-care fixation versus standard-of-care fixation alone. In addition there will be a subsidiary pilot arm testing a fixed-angle screw and plate fixation system. Trial Registration Current Controlled Trials ISRCTN49197425

  13. Corrosion on the acetabular liner taper from retrieved modular metal-on-metal total hip replacements.

    Science.gov (United States)

    Gascoyne, Trevor C; Dyrkacz, Richard M; Turgeon, Thomas R; Burnell, Colin D; Wyss, Urs P; Brandt, Jan-M

    2014-10-01

    Eight retrieved metal-on-metal total hip replacements displayed corrosion damage along the cobalt-chromium alloy liner taper junction with the Ti alloy acetabular shell. Scanning electron microscopy indicated the primary mechanism of corrosion to be grain boundary and associated crevice corrosion, which was likely accelerated through mechanical micromotion and galvanic corrosion resulting from dissimilar alloys. Coordinate measurements revealed up to 4.3mm(3) of the cobalt-chromium alloy taper surface was removed due to corrosion, which is comparable to previous reports of corrosion damage on head-neck tapers. The acetabular liner-shell taper appears to be an additional source of metal corrosion products in modular total hip replacements. Patients with these prostheses should be closely monitored for signs of adverse reaction towards corrosion by-products.

  14. An Automated Size Recognition Technique for Acetabular Implant in Total Hip Replacement

    CERN Document Server

    Shapi'i, Azrulhizam; Hasan, Mohammad Khatim; Kassim, Abdul Yazid Mohd; 10.5121/ijcsit.2011.3218

    2011-01-01

    Preoperative templating in Total Hip Replacement (THR) is a method to estimate the optimal size and position of the implant. Today, observational (manual) size recognition techniques are still used to find a suitable implant for the patient. Therefore, a digital and automated technique should be developed so that the implant size recognition process can be effectively implemented. For this purpose, we have introduced the new technique for acetabular implant size recognition in THR preoperative planning based on the diameter of acetabulum size. This technique enables the surgeon to recognise a digital acetabular implant size automatically. Ten randomly selected X-rays of unidentified patients were used to test the accuracy and utility of an automated implant size recognition technique. Based on the testing result, the new technique yielded very close results to those obtained by the observational method in nine studies (90%).

  15. Femoro-acetabular impingement and hip pain with conventionally normal x-rays.

    LENUS (Irish Health Repository)

    Baker, J F

    2010-06-01

    There has in recent years been a fundamental change in the understanding of hip pain in the young adult and hip pain without plain radiographic findings of arthritis. Pain in these groups has long represented a diagnostic and therapeutic challenge. With new appreciation of hip biomechanics, pathological processes and the arrival of modern imaging modalities we now have a greater understanding of non-arthritic hip pathology. One of the commonest yet least well recognized \\'new\\' diagnoses around the hip is femoro-acetabular impingement (FAI). FAI is a developmental condition of the hip joint that is associated with abnormal anatomical configuration and thus joint mechanics on either the femoral or acetabular sides or both. It is hypothesized to have a variety of precipitants and may ultimately lead to labral and chondral injury and what has previously been referred to as \\'primary\\' or \\'idiopathic\\' hip osteoarthritis.

  16. The effect of femoro-acetabular impingement on the kinematics and kinetics of the hip joint

    OpenAIRE

    Alshameeri, Zeiad; Khanduja, Vikas

    2014-01-01

    Gait analysis is an objective tool that has been used to assess and monitor treatment for many musculoskeletal conditions. Recently, it has been used to assess the impact of femoro-acetabular impingement (FAI) on the hip and lower limb movements. There have been a fairly limited number of studies published so far reporting unexpected and inconsistent results, which calls for more research to be conducted in this arena. In the light of the limited data available, it has been challenging to rec...

  17. Rapid Hip Osteoarthritis Development in a Patient with Anterior Acetabular Cyst with Sagittal Alignment Change

    Directory of Open Access Journals (Sweden)

    Yasuhiro Homma

    2014-01-01

    Full Text Available Rapidly destructive coxarthrosis (RDC is rare and develops unusual clinical course. Recent studies suggest multiple possible mechanisms of the development of RDC. However the exact mechanism of RDC is still not clear. The difficulty of the study on RDC is attributed to its rareness and the fact that the data before the onset of RDC is normally unavailable. In this report, we presented the patient having the radiographic data before the onset who had rapid osteoarthritis (OA development after contralateral THA, which meets the current criteria of RDC. We thought that the increased posterior tilt of the pelvis after THA reinforced the stress concentration at pre-existed anterior acetabular cyst, thereby the destruction of the cyst was occurred. As a result the rapid OA was developed. We think that there is the case of rapid osteoarthritis developing due to alternating load concentration by posterior pelvic tilt on preexisting anterior acetabular cyst such as our patient among the cases diagnosed as RDC without any identifiable etiology. The recognition of sagittal alignment changes and anterior acetabular cyst may play important role in prediction and prevention of the rapid hip osteoarthritis development similar to RDC.

  18. 全髋关节置换术治疗成人髋臼发育不良继发骨性关节炎疗效分析%Analysis Curative Effect of Total Hip Arthroplasty in Treatment of Adult Acetabular Dysplasia With Bad Osteoarthritis Secondary

    Institute of Scientific and Technical Information of China (English)

    时梦猇

    2015-01-01

    Objective To observe curative effect of total hip arthroplasty in treatment of adult acetabular dysplasia with bad osteoarthritis secondary. Methods Retrospective analyzed the clinical data of total hip arthroplasty of adult acetabular dysplasia with bad osteoarthritis secondary. Results The symptoms of pain disappeared, and the body was short and the case was correct. The acetabular angle was located at 35 to 40 angle, and the CE angle of the prosthesis was more than 20 angle. No prosthesis loosening, fracture of acetabulum, handle, neurovascular injury and so on. The excellent and good rate of postoperative Harris hip score was 94.6%. Conclusion The effect of total hip arthroplasty on adult acetabular dysplasia with bad osteoarthritis secondary os obvious.%目的 观察全髋关节置换术治疗成人髋臼发育不良继发骨性关节炎疗效.方法 回顾性分析在我院接受全髋关节置换术治疗的成人髋臼发育不良继发骨性关节炎患者临床资料.结果 疼痛症状基本消失,肢体短缩情况矫正良好.髋臼角位于35°~40°,假体CE角>20°,无假体臼、柄松动、骨折、神经血管损伤等发生.患者术后Harris髋关节功能评分优良率94.6%.结论 全髋关节置换术治疗成人髋臼发育不良继发骨性关节炎疗效明显.

  19. Root fractures

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Christensen, Søren Steno Ahrensburg; Tsilingaridis, Georgios

    2012-01-01

    The purpose of this study was to analyze tooth loss after root fractures and to assess the influence of the type of healing and the location of the root fracture. Furthermore, the actual cause of tooth loss was analyzed.......The purpose of this study was to analyze tooth loss after root fractures and to assess the influence of the type of healing and the location of the root fracture. Furthermore, the actual cause of tooth loss was analyzed....

  20. Magnetic resonance imaging and magnetic resonance arthography of the acetabular labrum: Comparison with surgical findings; Magnetresonanztomographie und Magnetresonanzarthrographie des Labrum acetabulare: Vergleich mit operativen Ergebnissen

    Energy Technology Data Exchange (ETDEWEB)

    Czerny, C. [Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria). Abt. fuer Osteologie; Kramer, J. [Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria). Abt. fuer Osteologie; Institut fuer bildgebende Diagnostik am Schillerpark, Linz (Austria); Neuhold, A. [Krankenhaus Rudolfinerhaus, Vienna (Austria). Inst. fuer bildgebende Diagnostik; Urban, M. [Krankenhaus Sozialmedizinisches Zentrum Ost, Vienna (Austria). Abt. fuer Radiodiagnostik; Tschauner, C. [Orthopaedisches Landeskrankenhaus Stolzalpe (Austria); Hofmann, S. [Krankenhaus Sozialmedizinisches Zentrum Ost, Vienna (Austria). Abt. fuer Radiodiagnostik; Orthopaedisches Landeskrankenhaus Stolzalpe (Austria)

    2001-08-01

    Aim of the study: To evaluate the accuracy of magnetic resonance imaging (MRI) and magnetic resonance (MR) arthrography in detecting acetabular labral lesions in correlation to surgical findings. Patients and methods: Forty patients (40 hips) with chronic hip pain and a strong clinical suspicion of labral lesions were examined with MRI in the coronal and axial plane by obtaining T{sub 1} weighted and proton density-weighted spin echo sequences. Additionally, MR arthrography of the high joint in the coronal oblique and sagittal oblique plane was performed by obtaining T{sub 1}-weighted three-dimensional gradient echo sequences after the intraarticular injection of gadopentate dimeglumine. The labra were prospectively evaluated on the basis of morphology, signal intensity, the presence or absence of a tear, and their attachment to the acetabulum. All patients underwent surgery, and the MRI findings and MR arthrography findings were compared with the surgical results. Results: Surgically, 34 labral lesions, and 6 normal labra were detected. MRI correctly depicted labral lesions in 24 patients and two normal labra, and MR arthrography correctly depicted labral lesions in 30 patients and 5 normal labra compared with the surgical results. The sensitivity of MRI was 80%, the accuracy of MRI was 65%, the sensitivity of MR arthrography was 95%, and the accuracy of MR arthgrography was 88%. Conclusions: MR arthrography enables considerably more accurate detection of acetabular labral lesions than MRI. MR arthrography should be the method of choice for the diagnosis of the presence or absence of acetabular labral lesions in patients with chronic hip pain and a strong clinical suspicion of labral lesions. (orig.) [German] Ziel: Die Bestimmung der Wertigkeit der konventionellen Magnetresonanztomographie (MRT) und der Magnetresonanzarthrographie (MR-Arthrographie) in der Abklaerung von Laesionen des Labrum acetabulare im Vergleich mit Operationsbefunden (Goldstandard). Methode

  1. Magnetic resonance imaging evaluation of acetabular orientation in normal Chinese children.

    Science.gov (United States)

    Li, YiQiang; Liu, YuanZhong; Zhou, QingHe; Chen, WeiDong; Li, JingChun; Yu, LingJia; Xu, HongWen; Xie, DengHui

    2016-09-01

    There are no data regarding the acetabular orientation on magnetic resonance imaging (MRI); this study investigates the changes of acetabular orientation with age in normal Chinese children.We retrospectively analyzed the medical records of children who underwent hip MRI examination at our hospital from January 2009 to December 2015. A total of 180 patients with normal MRI reading of the hip joints were included and were divided into 14 groups according to age: from 6 months of age and then for each year from 1 to 16 years. The bony and cartilage acetabular anteversion angle (AAA), acetabular inclination angle (AIA), and acetabular index (AI) were measured. Total bony and cartilage femoral head coverage angles were measured on axial section total femoral head coverage angle (a-TCA) and coronal section total femoral head coverage angle (c-TCA).The mean bony AAA and AIA were 12.2 ± 2.5° and 50.9 ± 2.5°, respectively; both of them stayed constant from the age of 6 months to 16 years. Similar results were found in cartilage AAA (12.1 ± 2.5°) and AIA (41.2 ± 3.0°). There was no difference between bony and cartilage AAA, but bony AIA was significantly larger than cartilage AIA. Bony AI was 24.1 ± 2.4° at the age of 6 months, decreasing to 12.5 ± 2.3° by 12 to 13 years of age; cartilage AI (5.9 ± 1.7°) maintained a steady value with age. The mean bony a-TCA and c-TCA at 6 months were 117.0 ± 5.8° and 127.5 ± 5.1°, increasing to 144.5 ± 4.6° and 140.7 ± 2.5° at the age of 16 years. However, the cartilage a-TCA (145.2 ± 7.2°) and c-TCA (154.1 ± 5.7°) did not change significantly with age.Both bony and cartilage AAA and AIA remain constant up to the age of 16 years in normal Chinese pediatric population. Although the cartilage coverage of femoral head by the acetabulum remains unchanged with age, the bony coverage of femoral head increases. PMID:27631258

  2. Bipolar hip arthroplasty as salvage treatment for loosening of the acetabular cup with significant bone defects

    Directory of Open Access Journals (Sweden)

    Ghanem, Mohamed

    2016-04-01

    Full Text Available Introduction: Revision arthroplasty of the hip is becoming increasingly important in recent years. Early primary arthroplasty and longer life expectancy of the patients increases the number of revision surgery. Revision surgery of hip arthroplasty is major surgery for the patients, especially the elderly, with significant risks concerning the general condition of the patient. The aim of this work is to evaluate the outcome of bipolar hip arthroplasty as a salvage procedure for treatment of loosening of the acetabular cup with significant acetabular bone defects after total hip replacement (THR in multi-morbid patients.Patients and methods: During the period from January 1 2007 to December 31 2011 19 revision hip surgeries were performed in , in which the loosened acetabular cup was replaced by a bipolar head. The examined patient group consisted exclusively of female patients with an average of 75 years. The predominant diagnosis was “aseptic loosening” (84.2%. All patients in our study were multi-morbid. We decided to resort to bipolar hip arthroplasty due to the compromised general condition of patients and the major acetabular bone defects, which were confirmed intraoperatively. The postoperative follow-up ranged from 0.5 to 67 months (average 19.1 months. Results: Evaluation of the modified Harris Hip Score showed an overall improvement of the function of the hip joint after surgery of approximately 45%.Surgery was less time consuming and thus adequate for patients with significantly poor general health condition. We noticed different complications in a significant amount of patients (68.4%. The most common complication encountered was the proximal migration of the bipolar head.The rate of revision following the use of bipolar hip arthroplasty in revision surgery of the hip in our patients was high (21%. Despite the high number of complications reported in our study, we have noticed significant improvement of hip joint function as well

  3. Fracture Union in Closed Interlocking Nail in Humeral Shaft Fractures

    Directory of Open Access Journals (Sweden)

    Ramji Lal Sahu

    2015-01-01

    Conclusions: The results of the present study indicates that in the presence of proper indications, reamed antegrade intramedullary interlocked nailing appears to be a method of choice for internal fixation of osteoporotic and pathologic fractures.

  4. Ankle Injury Management (AIM): design of a pragmatic multi-centre equivalence randomised controlled trial comparing Close Contact Casting (CCC) to Open surgical Reduction and Internal Fixation (ORIF) in the treatment of unstable ankle fractures in patients over 60 years

    OpenAIRE

    Willett, K; Keene, DJ; Morgan, L.; Gray, B.; Handley, R; Chesser, T; Pallister, I; Tutton, E; Knox, C; Lall, R; A. Briggs; Lamb, SE

    2014-01-01

    BACKGROUND: Ankle fractures account for 9% of all fractures with a quarter of these occurring in adults over 60 years. The short term disability and long-term consequences of this injury can be considerable. Current opinion favours open reduction and internal fixation (ORIF) over non-operative treatment (fracture manipulation and the application of a standard moulded cast) for older people. Both techniques are associated with complications but the limited published research indicates higher c...

  5. Acetabular bone density and metal ions after metal-on-metal versus metal-on-polyethylene total hip arthroplasty; short-term results

    NARCIS (Netherlands)

    Zijlstra, Wierd P.; van der Veen, Hugo C.; van den Akker-Scheek, Inge; Zee, Mark J. M.; Bulstra, Sjoerd K.; van Raay, Jos J. A. M.

    2014-01-01

    Information on periprosthetic acetabular bone density is lacking for metal-on-metal total hip arthroplasties. These bearings use cobalt-chromium instead of titanium acetabular components, which could lead to stress shielding and hence periprosthetic bone loss. Cobalt and chromium ions have detriment

  6. Microarchitecture and Peripheral BMD are Impaired in Postmenopausal White Women With Fracture Independently of Total Hip T-Score: An International Multicenter Study.

    Science.gov (United States)

    Boutroy, Stephanie; Khosla, Sundeep; Sornay-Rendu, Elisabeth; Zanchetta, Maria Belen; McMahon, Donald J; Zhang, Chiyuan A; Chapurlat, Roland D; Zanchetta, Jose; Stein, Emily M; Bogado, Cesar; Majumdar, Sharmila; Burghardt, Andrew J; Shane, Elizabeth

    2016-06-01

    Because single-center studies have reported conflicting associations between microarchitecture and fracture prevalence, we included high-resolution peripheral quantitative computed tomography (HR-pQCT) data from five centers worldwide into a large multicenter analysis of postmenopausal women with and without fracture. Volumetric BMD (vBMD) and microarchitecture were assessed at the distal radius and tibia in 1379 white postmenopausal women (age 67 ± 8 years); 470 (34%) had at least one fracture including 349 with a major fragility fracture. Age, height, weight, and total hip T-score differed across centers and were employed as covariates in analyses. Women with fracture had higher BMI, were older, and had lower total hip T-score, but lumbar spine T-score was similar between groups. At the radius, total and trabecular vBMD and cortical thickness were significantly lower in fractured women in three out of five centers, and trabecular number in two centers. Similar results were found at the tibia. When data from five centers were combined, however, women with fracture had significantly lower total, trabecular, and cortical vBMD (2% to 7%), lower trabecular number (4% to 5%), and thinner cortices (5% to 6%) than women without fracture after adjustment for covariates. Results were similar at the radius and tibia. Similar results were observed with analysis restricted to major fragility fracture, vertebral and hip fractures, and peripheral fracture (at the radius). When focusing on osteopenic women, each SD decrease of total and trabecular vBMD was associated with a significantly increased risk of major fragility fracture (OR = 1.55 to 1.88, p data were pooled across centers and the sample size increased, we observed significant and consistent deficits in vBMD and microarchitecture independent of total hip T-score in all postmenopausal white women with fracture and in the subgroup of osteopenic women, compared to women who never had a fracture. © 2016 American

  7. 分体式髌骨爪内固定治疗髌骨骨折效果探讨%Effect Analysis of the Treatment of Patellar Fracture by Internal Fixation with Split Type of Patella

    Institute of Scientific and Technical Information of China (English)

    孙勇

    2015-01-01

    Objective To explore patel a claws separate the ef ect of internal fixation treatment of patel a fracture.Methods From January 2013~June 2015 for the treatment of 50 cases of patel ar fracture patients,the implementation of internal fixation for treatment of patel a claw of separate patients with retrospective analysis of clinical therapeutic ef ect.Results 50 cases of patel ar fracture patients with patel ar claw internal fixation for treatment of separate treatment of fine rate was 98%.Conclusion Internal fixation treatment of patel a fracture of patel a claw separate,not only the simple operation,good rigidity,and shorter operation time,do not need special auxiliary equipment,reduce the occur ence of complications.%目的:探析分体式髌骨爪内固定治疗髌骨骨折的效果。方法选取我院2013年1月~2015年6月治疗的50例髌骨骨折患者,实施分体式髌骨爪内固定进行治疗,回顾分析患者的临床治疗效果。结果50例髌骨骨折患者使用分体式髌骨爪内固定进行治疗,治疗优良率是98%。结论分体式髌骨爪内固定治疗髌骨骨折,不仅操作简单,固定性好,而且手术时间较短,不需要特殊器械的辅助,减少并发症的发生。

  8. Management of subtrochanteric femur fractures with internal fixation and recombinant human bone morphogenetic protein-7 in a patient with osteopetrosis: a case report

    Directory of Open Access Journals (Sweden)

    Golden Robert D

    2010-05-01

    Full Text Available Abstract Introduction Osteopetrosis is a group of conditions characterized by defects in the osteoclastic function of the bone resulting in defective bone resorption. Clinically, the condition is characterized by a dense, sclerotic, deformed bone which, despite an increased density observable by radiography, often results in an increased propensity to fracture and delayed union. Case Presentation We report the case of a 27-year-old Asian man presenting with bilateral subtrochanteric femur fractures. He had a displaced right subtrochanteric femur fracture after a low-energy fall, which was treated surgically. The second fracture that our patient endured was diagnosed as a stress fracture ten weeks later when he complained of pain in the contralateral left thigh. By that time, the right-sided fracture exhibited no radiographic evidence of healing, and when the left-sided stress fracture was being treated surgically, bone grafting with recombinant human bone morphogenetic protein-7 was also performed on the right side. Conclusion While there are no data supporting the use of bone morphogenic proteins in the management of delayed healing in patients with osteopetrosis, no other reliable osteoinductive grafting options are available to treat this condition. Both fractures in our patient healed, but based on the serial radiographic assessment it is uncertain to what degree the recombinant human bone morphogenetic protein-7 may have contributed to the successful outcome. It may have also contributed to the formation of heterotopic bone around the fracture site. Further investigation of the effectiveness and indications of bone morphogenic protein use for the management of delayed fracture healing in patients with osteopetrosis is warranted.

  9. Clinical observation of posterior internal fixation with vertebral pedicle screw and rod system on thoracolumbar spine fractures%椎弓根钉棒系统在胸腰椎骨折的疗效分析

    Institute of Scientific and Technical Information of China (English)

    黎华茂; 李敬中; 向峥; 林晓岗

    2012-01-01

    Objective To observe the clinical efficacy of posterior internal fixation of vertebral pedicle screw and rod system for thoracolumbar spine fractures. Methods Totally 59 patients with thoracic or lumbar vertebral fractures were treated with internal fixation of vertebral pedicle screw and rod system. The Frankel scale combined with X ray and CT images was used for the judgment of efficacy. Results Radiographic parameters were significantly improved after the experiment, the Frankel degree of cases with nerve injury symptoms was improved 2-4 degrees after surgery. Conclusions Internal fixation of vertebral pedicle screw and rod system is efficient for thoraco lumbar spine fractures.%目的 观察椎弓根钉棒系统内固定治疗胸腰椎骨折的临床疗效.方法 应用椎弓根钉棒系统内固定治疗胸腰椎骨折59例,采用Frankel分级结合X线片、CT影像表现判断疗效.结果 术后各项影像学指标均有明显改善,患者术后神经功能Frankel分级大多数都有2~4级提高.结论 椎弓根钉棒系统内固定是治疗胸腰椎骨折的一种有效方法,值得临床推广应用.

  10. Hip fracture - discharge

    Science.gov (United States)

    Inter-trochanteric fracture repair - discharge; Subtrochanteric fracture repair - discharge; Femoral neck fracture repair - discharge; Trochanteric fracture repair - discharge; Hip pinning surgery - discharge

  11. Proximal femoral fractures

    DEFF Research Database (Denmark)

    Palm, Henrik; Teixidor, Jordi

    2015-01-01

    searched the homepages of the national heath authorities and national orthopedic societies in West Europe and found 11 national or regional (in case of no national) guidelines including any type of proximal femoral fracture surgery. RESULTS: Pathway consensus is outspread (internal fixation for un...

  12. Open reduction and internal fixation versus casting for highly comminuted and intra-articular fractures of the distal radius (ORCHID: protocol for a randomized clinical multi-center trial

    Directory of Open Access Journals (Sweden)

    Seiler Christoph

    2011-03-01

    Full Text Available Abstract Background Fractures of the distal radius represent the most common fracture in elderly patients, and often indicate the onset of symptomatic osteoporosis. A variety of treatment options is available, including closed reduction and plaster casting, K-wire-stabilization, external fixation and open reduction and internal fixation (ORIF with volar locked plating. The latter is widely promoted by clinicians and hardware manufacturers. Closed reduction and cast stabilization for six weeks is a simple, convenient, and ubiquitously available intervention. In contrast, ORIF requires hospitalization, but allows for functional rehabilitation. Given the lack of randomized controlled trials, it remains unclear whether ORIF leads to better functional outcomes one year after injury than closed reduction and casting. Methods/Design ORCHID (Open reduction and internal fixation versus casting for highly comminuted intra-articular fractures of the distal radius is a pragmatic, randomized, multi-center, clinical trial with two parallel treatment arms. It is planned to include 504 patients in 15 participating centers throughout Germany over a three-year period. Patients are allocated by a central web-based randomization tool. The primary objective is to determine differences in the Short Form 36 (SF-36 Physical Component Score (PCS between volar locked plating and closed reduction and casting of intraarticular, comminuted distal radius fractures in patients > 65 years of age one year after the fracture. Secondary outcomes include differences in other SF-36 dimensions, the EuroQol-5D questionnaire, the Disability of the Arm, Shoulder, and Hand (DASH instrument. Also, the range of motion in the affected wrist, activities of daily living, complications (including secondary ORIF and revision surgery, as well as serious adverse events will be assessed. Data obtained during the trial will be used for later health-economic evaluations. The trial architecture

  13. Late fiber metal shedding of the first and second-generation Harris Galante acetabular component. A report of 5 cases.

    Science.gov (United States)

    Mayman, David J; González Della Valle, Alejandro; Lambert, Edward; Anderson, John; Wright, Timothy; Nestor, Bryan; Sculco, Thomas P; Salvati, Eduardo A

    2007-06-01

    Five patients presented with fiber metal mesh shedding of a Harris Galante II acetabular cup detected between 11 and 15 years after implantation. All patients presented with hip pain and 4 demonstrated gross acetabular loosening and fiber metal separation on preoperative radiographs. The remaining patient underwent revision surgery because of a liner dislodgment and had a radiographically well fixed shell. Loosening and fiber metal separation were detected intraoperatively. Scanning electron microscopy of the retrieved shells demonstrated isolated diffusion bonding marks in the areas where the mesh separated from the substrate and no evidence of corrosion. Progressive osteolysis in the iliac bone was evident in 4 of our cases. Progressive iliac osteolysis may lead to loss of bone support in well-fixed cups and excessive stresses transferred to the interface between the fiber metal mesh and the titanium substrate leading to the separation of the 2 layers. Fiber metal separation may contribute to long-term loosening in the Harris Galante acetabular component.

  14. Femoral anteversion is correlated with acetabular version and coverage in Asian women with anterior and global deficient subgroups of hip dysplasia: a CT study

    Energy Technology Data Exchange (ETDEWEB)

    Akiyama, Mio; Nakashima, Yasuharu; Fujii, Masanori; Sato, Taishi; Yamamoto, Takuaki; Mawatari, Taro; Motomura, Goro; Matsuda, Shuichi; Iwamoto, Yukihide [Kyushu University, Department of Orthopaedic Surgery, Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka (Japan)

    2012-11-15

    Morphological correlation between the acetabulum and femur at the hip joint is still controversial. We tested the hypothesis that femoral anteversion correlates with acetabular version and coverage in patients with developmental dysplasia of the hip (DDH). Using pelvic computed tomography (CT) images of 79 hips in 49 Asian women with DDH and 49 normal hips, we measured femoral anteversion, the axial and vertical acetabular version and the acetabular sector angle (ASA) to demarcate femoral head coverage. Depending on the location of the acetabular bone defect, dysplastic hips were divided into three subgroups: the anterior, global and posterior deficiency groups. We performed a comparative analysis between dysplastic and normal hips using the Wilcoxon rank sum test, and a relative analysis between femoral anteversion and acetabular measurements in dysplastic hips using Pearson's correlation coefficient. The amount of femoral anteversion in dysplastic hips was greater and more variable than in normal hips (p < 0.0001, p = 0.0277 respectively). Femoral anteversion in dysplastic hips correlated significantly with acetabular anteversion in the groups with anterior and global deficiency subgroups (p < 0.05, r = 0.2990, p < 0.05, r = 0.451 respectively), but not with the posterior deficiency subgroup. Femoral anteversion also correlated with vertical acetabular version. When acetabular coverage was examined, significant correlations were noted between femoral anteversion and anterior and superior coverage, but not with posterior coverage. These correlations were not observed in normal hips. Our results showed significantly greater and more variable femoral anteversion in DDH, and a significant correlation between femoral anteversion and acetabular version and coverage in DDH with anterior and global acetabular bone deficiency. (orig.)

  15. Femoral anteversion is correlated with acetabular version and coverage in Asian women with anterior and global deficient subgroups of hip dysplasia: a CT study

    International Nuclear Information System (INIS)

    Morphological correlation between the acetabulum and femur at the hip joint is still controversial. We tested the hypothesis that femoral anteversion correlates with acetabular version and coverage in patients with developmental dysplasia of the hip (DDH). Using pelvic computed tomography (CT) images of 79 hips in 49 Asian women with DDH and 49 normal hips, we measured femoral anteversion, the axial and vertical acetabular version and the acetabular sector angle (ASA) to demarcate femoral head coverage. Depending on the location of the acetabular bone defect, dysplastic hips were divided into three subgroups: the anterior, global and posterior deficiency groups. We performed a comparative analysis between dysplastic and normal hips using the Wilcoxon rank sum test, and a relative analysis between femoral anteversion and acetabular measurements in dysplastic hips using Pearson's correlation coefficient. The amount of femoral anteversion in dysplastic hips was greater and more variable than in normal hips (p < 0.0001, p = 0.0277 respectively). Femoral anteversion in dysplastic hips correlated significantly with acetabular anteversion in the groups with anterior and global deficiency subgroups (p < 0.05, r = 0.2990, p < 0.05, r = 0.451 respectively), but not with the posterior deficiency subgroup. Femoral anteversion also correlated with vertical acetabular version. When acetabular coverage was examined, significant correlations were noted between femoral anteversion and anterior and superior coverage, but not with posterior coverage. These correlations were not observed in normal hips. Our results showed significantly greater and more variable femoral anteversion in DDH, and a significant correlation between femoral anteversion and acetabular version and coverage in DDH with anterior and global acetabular bone deficiency. (orig.)

  16. Proximal Humeral Internal Locking System for Humeral Proximal Fractures of Elderly Patients%应用肱骨近端内锁定系统治疗高龄肱骨近端骨折

    Institute of Scientific and Technical Information of China (English)

    王宇; 刘欣伟; 季欣然; 朱德刚; 禹宝庆

    2011-01-01

    目的:探讨应用肱骨近端内锁定系统(PHILOS)治疗高龄肱骨近端骨折的方法及疗效.方法:2007年10月至2010年02月问,我院使用PHILOS内固定钢板治疗高龄肱骨近端骨折45例,男19例,女26例,年龄54~75岁,平均66岁.根据Neer分型.一部分骨折4例,二部分骨折6例,三部分骨折17例,四部分骨折18例.手术采用三角肌钝性劈开入路,保护附着于大骨折块和大、小结节上的软组织,骨折复位后均行PHILOS固定.患肩功能按Neer肩关节评分系统进行评价.结果:本组随访时间10~24个月,平均16个月.骨折均愈合,平均愈合时间3个月,患侧肩关节评分优28例,良12例,可3例,差2例,优良率为88.9%.结论:PHILOS钢板可牢固固定高龄患者骨折,使骨折愈合与功能恢复相同步,适于粉碎性骨折和肱骨近端骨质疏松骨折的治疗.%Objective: To investigate the clinical effect of open reduction and internal fixation with proximal humeral internal locking system (PHILOS) for the treatment of proximal humeral fractures of elderly patients. Methods: Forty-five cases of proximal humeral fractures of elderly treated with PHILOS from Oct. 2007 to Feb. 2010 were studied retrospectively, in which nineteen males and twenty-six females with age of 54 to 75 years old (mean 66 years). According to Neer classification, four cases with one-part fractures,six cases with two-part fractures, seventeen cases with three-part fractures and eighteen cases with four-part fractures. Reduction and fixation was done via modified approach, without peeling the soft tissues of the greater and lesser tuberosity. All the cases accepted the treatment of PHILOS plate internal fixation. Assessment was done using the Neer scoring system. Results: The follow up period was 10 to 24 months (mean 16 months) and it showed that all fractures were healed with average union period of 3 months. According to the Neer scoring system, there were 28 excellent cases, 12 good cases,3 fair

  17. The proximal humeral internal locking system (PHILOS) plate for the proximal humerus fractures in the elderly patients%肱骨近端锁定内固定系统治疗老年肱骨近端骨折

    Institute of Scientific and Technical Information of China (English)

    吕巍; 储波

    2013-01-01

    Objective To evaluate the treatment outcome of the proximal humeral internal locking system (PHILOS) plate for the proxi-mal humerus fractures in the 30 elders .Methods January 2010 to January 2012 ,there were elderly proximal humeral fractures in 30 cases ,an average of 70 .5 years (65 to 82 years) ,6 males and 24 females .According to the Neer classification fractures two -part fracture in five ca-ses ,three-part fracture in 20 cases ,four -part fractures in five cases .Surgery are used PHILOS internal fixation ,pectoralis major deltoid space approach ,and reserves the soft tissue on the fracture fragments and nodules ,and five cases of four parts fractures are the filling of the artificial bone particles .All patients were followed up for up for 3 to 18 months ,with an average of 14 .6 months .Results All patients with fractures were healing ,no incision infection .Good rate of Neer shoulder score :excellent in 15 cases ,good in 7 cases ,satisfaction of six ca-ses ,excellent rate of 73 .3% (22/30) .Conclusion PHILOS can play firmly fixed proximal humeral fractures ,the treatment of the elderly proximal humerus fractures ,osteoporosis ,comminuted to obtain satisfactory clinical efficacy .%目的:评价肱骨近端锁定内固定系统(PHILOS)治疗老年肱骨近端骨折的方法及临床疗效。方法2010年1月~2012年1月收治老年肱骨近端骨折30例,平均70.5岁(65~82岁),男性6例,女性24例。根据N eer分型二部分骨折5例,三部分骨折20例,四部分骨折5例。手术均采用 PHILOS内固定治疗,三角肌胸大肌间隙入路,保留附着于骨折碎片及大小结节上的软组织,5例四部分均予人工颗粒骨充填。所有病人均获得随访,随访时间3~18个月,平均14.6个月。结果所有患者骨折均获得愈合,无切口感染。按 N eer肩关节功能评分的优良率:优15例,良7例,满意6例,优良率73.3%(22/30)。结论 PHILOS可起到牢固固

  18. 空心螺钉内固定术治疗Jones骨折32例分析%The analyses of 32 Jones fracture by using hollow screw internal fixation

    Institute of Scientific and Technical Information of China (English)

    唐兵; 秦定扬

    2010-01-01

    目的 观察空心螺钉内固定术治疗Jones骨折的临床疗效.方法 回顾性分析采用切开复位空心螺钉内固定术治疗Jones骨折32例患者的临床资料.结果 32例患者均治愈出院,平均随访18个月,根据Maryland足部评分系统评分:优25例,良6例,差1例,优良率96.9%.结论 空心螺钉内固定术治疗Jones骨折,操作简单,术后不用外固定,功能恢复快,并发症少,疗效满意.%Objective To analyze the therapy method and the therapeutic effect of Jones fracture by using hollow screw internal fixation.Methods All the Jones fractures were treated by open reduction hollow screw internal fixation and the plaster external fixation were not used after operation.Results The 32 cases with Jones fractures got excellent 25 cases,good 6cases and poor 1 case which used by Maryland foot score system to appraisal.All the cases were followed up for 6 months to 30 months and the average follow-up time is 18 months.Conclusion The treatment of hollow screw internal fixation was a satisfactory method to cure Jones fracture,which had get advantages of simple operation,small wound,short operation time,not external fixation,quick recovery and few complications.

  19. Examination and treatment of a professional ballet dancer with a suspected acetabular labral tear: A case report.

    Science.gov (United States)

    Khoo-Summers, Lynnette; Bloom, Nancy J

    2015-08-01

    Dancers are at risk for developing groin pain that is due to acetabular labral tears. Although surgical management of labral tears has been reported extensively, conservative management has been poorly described. This case report describes the examination, diagnosis, and treatment of groin pain in a professional ballet dancer with a suspected acetabular labral tear. Treatment focused on decreasing anterior hip joint stresses and improving the precision of hip motion through correction of alignment and movement impairments noted during functional activities and dance. Successful outcomes included a reduction in pain and return to professional ballet dancing. PMID:25725589

  20. Acetabular morphometry and prevalence of hip dysplasia in the South Asian population

    Directory of Open Access Journals (Sweden)

    Masood Umer

    2009-07-01

    Full Text Available We carried out a cross-sectional study to measure the association of the seven acetabular parameters with pelvic morphometry and prevalence of hip dysplasia in our population. Convenience sampling was carried out and 250 consecutive patients who came to AKUH for intravenous pyelogram and had no complaints in the region of the hip joint were enrolled in the study. Post-micturition standardized plain antero-posterior pelvic radiographs of 250 asymptomatic adults (500 hip joints was studied. There were 136 males (54.4% and 114 females (45.6%. Mean age of our study population was 38 years (15-78 years. The average center edge angle was 35.5±6.6° standard deviation (SD, acetabular angle was 37.76±4.37°, depth to width ratio was 0.31±4.6°, roof obliquity was 10.6±6.2°, extrusion index was 0.1±5.8, lateral subluxation 8.9±2.7 mm, and peak to edge distance 17±3.98 mm. There was significant influence (p lower than  0.05 of age in all angles except depth to width ratio. A total of seven hip joints (1.4% were dysplastic with CE angle lower than 25° while four of the seven hips were severely dysplastic with CE angle  lower than 20°. In the dysplastic group there was significant correlation (p lower than 0.05 of CE angle with acetabular angle, depth to width ratio, extrusion index and peak to edge distance. Prevalence of hip dysplasia was found to be very low in our population. These results are consistent with the findings of studies carried out in other Asian countries.

  1. 微型钛板植入体可坚强内固定修复下颌骨骨折%Mini-titanium plate implant can enhance internal fixation for mandibular fracture

    Institute of Scientific and Technical Information of China (English)

    姚红磊; 纳应坤; 陈涌; 刘华

    2012-01-01

    背景:下颌骨折越来越多的采用口内切开小型钛板张力带内固定治疗,那么微小型钛板在颌骨骨折中起怎样的作用?目的:评价下颌骨骨折骨缺损重建微型钛板坚固内固定的重要性.方法:以 "钛板,下颌骨,骨折,坚固内固定"为关键词.采用计算机检索1995-01/2011-10 PubMed数据库,维普数据库有关坚固内固定技术在下颌骨骨折中的临床应用的文章.排除重复研究,以20篇为重点进行探讨.结果与结论:采用钛板在下颌角上缘张力带内固定辅以颌间固定治疗下颌角骨折,临床操作简单,易掌握,缩短颌间固定的时间,固定稳固性有了可靠的保证,创伤较小,患者能早期张口训练,避免关节强直.有利于内固定后骨折愈合及恢复正常咬合关系.%BACKGROUND: Intraoral incision and mini-plate fixation as tension band have been used to treat for mandibular fracture. The effect of mini-plate has not been fully investigated. OBJECTIVE: To assess the importance of mini-plate fixation during bone defect reconstruction following mandibular fracture. METHODS: With “titanium plate, mandible, fracture, and rigid internal fixation” as key words, a computer-based online search of PubMed and VIP database was performed for articles published between January 1995 and October 2011 related to clinical application of rigid internal fixation in mandibular fracture. Repetitive articles were excluded, and 20 were included and further discussed. RESULTS AND CONCLUSION: Titanium plate has been used as tension band in the superior margin of the mandibular angle, assisted with intermaxillary fixation to treat mandibular angle fracture. This method is simple, convenient, and can shorten duration for intermaxillary fixation, ensuring stability of the fixation. In addition, the incision is minimal, allowing early mouth open training and preventing ankylosis. This method benefits fracture healing and recovery of normal occluding relation

  2. Experimental and analytical validation of a modular acetabular prosthesis in total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Aram Luke

    2007-05-01

    Full Text Available Abstract A finite element model has been developed to predict in vivo micro motion between a modular acetabular cup and liner after cement less total hip arthroplasty. The purpose of this study is to experimentally validate the model. Six LVDT sensors were used to monitor the micromotion of the liner when subjected to loading conditions ranging from 250 N to 5000 N. Deformations at points of interest for both the experiment and FEM were compared. Results of the FEM with different coefficient of friction between the liner and the cup were investigated to correlate with the experimental results.

  3. Migration measurement of acetabular components in cementless total hip arthroplasty; Messung der Pfannenwanderung bei zementfreien Hueftimplantaten

    Energy Technology Data Exchange (ETDEWEB)

    Eckardt, A.; Karbowski, A.; Schwitalle, M.; Vogel, J.; Boden, F.; Seeleitner, C. [Mainz Univ. (Germany). Orthopaedische Klinik und Poliklinik; Schunk, K. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Mayrhofer, P. [Innsbruck Univ. (Austria). Inst. fuer Mathematik und Geometrie

    1998-08-01

    Migration measurements of acetabular components using a special computer aided method (EBRA = abbrevation for the German term ``Ein-Bild-Roentgenanalyse``) were performed to evaluate early results of the implants and predict aseptic loosening. Methods: Standard ap-radiographs of the pelvis were marked, specific points were digitised. Simulating the spatial situation the programme computes lengitudinal and vertical migration of the cup. 74 acetabular components in 71 patients could be studied by migration measurements. Results: 14 patients showed migration of more than 1 mm, which is the confidence limit of this method. Each of these patients showed diverse reasons for the migration, i.e. osteoporosis of the acetabular bone stock or problems concerning the surgical technique which means malposition of the cup or insufficient reaming of the bone. There were some patients with severe congenital dysplasia of the hip and in some cases the inclination angle of the cup was too great. Conclusion: The technique applied for measuring migration of acetabular components can be useful for evaluating early instability of the implant and can be helpful in detecting problems concerning the surgical technique. (orig.) [Deutsch] Mittels der Ein-Bild-Roentgenanalyse wurden Pfannenwanderungen nach Implantation von zementfreien, sphaerischen Hueftgelenkspfannen erfasst, um Praediktoren fuer die langfristige Prognose der Implantate zu evaluieren. Methoden: Nach Markierung von Referenzpunkten in den Beckenuebersichtsaufnahmen wurden diese digitalisiert, vom Programm verrechnet und die Wanderung des Implantats im Verlauf angegeben. Bei 71 Patienten wurden von 74 Pfannen ueber einen Mindestnachuntersuchungszeitraum von 12 Monaten Migrationsmessungen durchgefuehrt. Das Konfidenzintervall der Methode liegt bei <1 mm. Bei jedem dieser Patienten fanden sich Hinweise entweder auf ein schlechtes Knochenlager, auf operationsbedingte Probleme, wenn keine ausreichende Primaerstabilitaet der Pfanne

  4. Outcomes of total hip arthroplasty, as a salvage procedure, following failed internal fixation of intracapsular fractures of the femoral neck:a systematic review and meta-analysis

    OpenAIRE

    Mahmoud, Samer; Pearse, Eyiyemi; Smith, Toby; Hing, Caroline

    2016-01-01

    The management of intracapsular femoral neck fractures in independently mobile patients remains controversial. Successful fixation obviates the limitations of arthroplasty for this group of patients, however with fixation failure rates as high as 30%, the outcome of revision surgery to salvage total hip replacement (THR) must be considered. We carried out this review to determine the outcome of salvage THR and how this compares to primary THR for fracture. We performed a PRISMA compliant syst...

  5. 应用改良AF脊柱内固定系统经皮微创内固定治疗胸腰椎压缩骨折%The Application of Improved AF Spinal Internal Fixation System With Percutaneous Minimally Invasive Internal Fixation for the Treatment of Thoracic and Lumbar Vertebral Compression Fracture

    Institute of Scientific and Technical Information of China (English)

    李晓龙; 王志军

    2015-01-01

    Objective To explore the efficacy of the AF spinal internal fixation system with percutaneous minimally invasive internal fixation for the treatment of thoracic and lumbar vertebral compression fracture. Methods Collected in our hospital 48 cases of thoracolumbar compression fractures, application of improved percutaneous minimally invasive internal fixation of AF spinal internal fixation system in the treatment of thoracolumbar compression fractures, postoperative review X-ray for curative effect analysis. Results 48 cases of compression injury vertebral height of vertebral body than preoperative obviously restoration, 90%of the average recovery to normal height of vertebral body Conclusion Application of improved percutaneous minimally invasive internal ifxation of AF spinal internal fixation system in the treatment of thoracolumbar compression fractures curative effect is distinct.%目的:探讨应用AF脊柱内固定系统经皮微创内固定治疗胸腰椎压缩骨折的疗效。方法收集本院48例胸腰椎压缩骨折,应用改良AF脊柱内固定系统经皮微创内固定治疗胸腰椎压缩骨折,术后复查X片进行疗效分析。结果48例压缩的伤椎椎体高度比术前明显得到恢复,平均恢复至正常椎体高度的90%。结论应用改良AF脊柱内固定系统经皮微创内固定治疗胸腰椎压缩骨折疗效显著。

  6. Iliotibial band avulsion fracture: a case report with differential diagnosis.

    Science.gov (United States)

    Fay, Kristin; Mannem, Rajeev; Baynes, Keith; Sarin, Dhruv; DuBois, Melissa

    2016-02-01

    Avulsion injuries of the knee are common sequelae of significant trauma given the number of ligamentous and tendinous insertions around the joint. Commonly discussed avulsion fractures of the lateral knee include the Segond fracture of the lateral tibial plateau and the arcuate complex avulsion fracture of the fibular styloid process. A less common avulsion fracture is the iliotibial (IT) band avulsion fracture involving the anterolateral corner of the tibia (Gerdy's tubercle). It is crucial to identify IT band avulsion fractures because of the frequent associated internal derangements of the knee. This case report describes the imaging of an acute IT band avulsion fracture and compares these findings with other lateral knee avulsion fractures.

  7. Computerized tomography in evaluation of decreased acetabular and femoral anteversion; Besonderheiten bei der Bestimmung der Hueftpfannenanteversion und Schenkelhalsantetorsion durch Computertomographie

    Energy Technology Data Exchange (ETDEWEB)

    Toennis, D.; Skamel, H.J. [Institut fuer Strahlendiagnostik, Klinikum Dortmund GmbH (Germany)

    2003-09-01

    Computerized tomography has received a new importance. It has been shown that decreased anteversion of femur and acetabulum, when both have decreased angles, are causing pain and osteoarthritis of the hip joint. Operative treatment should be performed before osteoarthritis develops. Exact measurements therefore are necessary. The investigation should be performed in prone position to have the pelvis lying in a defined and normal position. Femoral torsion is measured between the transverse axis of the knee and the femoral neck. The transverse axis for measurement of the femoral anteversion is defined by a rectangular line to the sagittal plane. For evaluation of the femoral anteversion in total the angle of the condyles has to be added to the femoral neck angle when the knee is found in internal rotation. Acetabular anteversion should be measured at the level where the femoral head is still in full contact and congruence with the anterior margin of the acetabulum. (orig.) [German] Fuer die Computertomographie hat sich eine neue Aufgabe ergeben. Es hat sich gezeigt, dass verringerte Pfannenanteversion und Schenkelhalsantetorsion haeufige Ursachen von Hueftschmerz und -arthrose sind, v. a. wenn beide gegen 0 gehen. Da operative Massnahmen vor Eintreten der Arthrose ergriffen werden sollten, sind genaue Messwerte erforderlich. Die Untersuchung sollte in Bauchlage durchgefuehrt werden, um eine einheitliche und weitgehend normale Beckenkippung zu gewaehrleisten. Die Schenkelhalstorsion wird zwischen der Kniegelenk- und der Schenkelhalsachse gemessen. Zur Festlegung der Sagittalebene legt man am besten eine Mittellinie zwischen die Beckenschaufeln. Die Messung der Pfannenanteversion sollte in der Schnitthoehe erfolgen, wo die Bewegungseinschraenkung der Innenrotation auftritt. (orig.)

  8. The efficacy of a "double-D-shaped" wire marker for radiographic measurement of acetabular cup orientation and wear.

    Science.gov (United States)

    Derbyshire, Brian; Raut, Videshnandan V

    2013-01-01

    Historically, wire markers were attached to cemented all-plastic acetabular cups to demarcate the periphery and to measure socket wear. The wire shape was either a semi-circle passing over the pole of the cup, or a circle around the cup equator. More recently, "double-D" shaped markers were introduced with a part-circular aspect passing over the pole and a semi-circular aspect parallel to the equatorial plane. This configuration enabled cup retroversion to be distinguished from anteversion. In this study, the accuracy of radiographic measurement of cup orientation and wear was assessed for cups with "double-D" and circular markers. Each cup was attached to a measurement jig which could vary the anteversion/retroversion and internal/external rotation of the cup. A metal femoral head was fixed within the socket and radiographic images were created for all combinations of cup orientation settings. The images were measured using software with automatic edge detection, and cup orientation and zero-wear accuracies were determined for each setting. The median error for cup version measurements was similar for both types of wire marker (0.2° double-D marker, -0.24° circular marker), but measurements of the circular marker were more repeatable. The median inclination errors were 2.05° (double-D marker) and 0.23° (circular marker). The median overall "zero wear" errors were 0.19 mm (double-D marker) and 0.03 mm (circular marker). Measurements of the circular wire marker were much more repeatable.

  9. Fracture Mechanics

    CERN Document Server

    Zehnder, Alan T

    2012-01-01

    Fracture mechanics is a vast and growing field. This book develops the basic elements needed for both fracture research and engineering practice. The emphasis is on continuum mechanics models for energy flows and crack-tip stress- and deformation fields in elastic and elastic-plastic materials. In addition to a brief discussion of computational fracture methods, the text includes practical sections on fracture criteria, fracture toughness testing, and methods for measuring stress intensity factors and energy release rates. Class-tested at Cornell, this book is designed for students, researchers and practitioners interested in understanding and contributing to a diverse and vital field of knowledge. Alan Zehnder joined the faculty at Cornell University in 1988. Since then he has served in a number of leadership roles including Chair of the Department of Theoretical and Applied Mechanics, and Director of the Sibley School of Mechanical and Aerospace Engineering.  He teaches applied mechanics and his research t...

  10. 胫骨粉碎性骨折的微创内固定支架固定疗效分析%Tibial comminuted fracture of minimally invasive internal ifxation bracket curative effect analysis

    Institute of Scientific and Technical Information of China (English)

    智建勋

    2015-01-01

    ABSTRACT:Objective To observe the tibia comminuted fracture of minimally invasive internal fixation bracket of technology in the treatment of comminuted fracture curative effect, to explore the surgical technique and advantages. Methods From 2009 to 2013 treated 114 cases of tibial comminuted fracture patients were randomly divided into fixed stent technology of minimally invasive internal fixation treatment group (observation group) and traditional open reduction and internal fixation group (control group), each group of 57 cases, compared two groups of clinical curative effect. Results Follow-up for 3~12 months, an average of eight months, minimally invasive internal fixation bracket (observation group) technology treatment, fracture had 1 case to heal, the others all healing. the rate of good clinical curative effect was 96.3%. traditional open reduction and internal fixation treatment (control group), the healing of 51 patients, 6 cases were treated. 2 cases of patients with postoperative incision surrounding skin necrosis, osteomyelitis in 1 case , Clinical curative effect was 62.7%, the rate of good curative effect of two groups of patients and the difference between the average healing time was statistically significant (P <0.05). Conclusion Tibial comminuted fracture bracket technology of minimally invasive internal fixation treatment of fracture is a kind of safety, less injury, high fracture healing rate, fewer complications, and the minimally invasive treatment of fixed and reliable.%目的:观察胫骨粉碎性骨折的微创内固定支架固定技术治疗粉碎性骨折的临床疗效,探讨该手术的技巧、优点。方法将2009至2013年间收治的114例胫骨粉碎性骨折患者随机分为微创内固定支架固定技术治疗组(观察组)和传统切开复位内固定组(对照组),每组各57例,比较两组临床疗效。结果均获3~12个月随访,平均8个月,微创内固定支架固定技术

  11. Early efficacy analysis on Herbert screw internal fixation for carpal scaphoid fracture%Herbert螺钉治疗腕舟状骨骨折的早期临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    施纯南; 庄志伟; 王志杰; 吴金凤; 张金山; 李懿

    2014-01-01

    目的:分析 Herbert螺钉治疗腕舟状骨骨折的早期临床疗效.方法:2010年1月~2013年6月我院通过手术方法使用 Herbert螺钉内固定治疗23例腕舟状骨骨折,通过随访评价骨折愈合情况和腕关节功能.结果:随访6~18个月(平均12.6个月),所有骨折均达到骨性愈合,腕关节功能通过 Mayo法评分:其中优15例,良7例,差1例,优良率达86.9%.结论:腕舟状骨骨折采用方法通过 Herbert进行内固定治疗,骨折愈合率高,腕关节功能恢复良好,疗效确切.%Objective:To analyze the early clinical ef ect of carpal scaphoid fracture treated by Herbert screw fixation.Methods:From 2010.01-2013.06,23 carpal scaphoid fracture patients were operated by Herbert screw internal fixation in our Hospital.To observe the union of fracture and the function of wrist was evaluated according to Mayo score system.Conclusion:Carpal scaphoid fracture treated by Herbert screw fixation can elevate the rate of union of fracture and improved the wrist function,the clinical ef ect is gratification.

  12. Evaluation of Medial Acetabular Wall Bone Stock in Patients with Developmental Dysplasia of the Hip Using a Helical Computed Tomography Multiplanar Reconstruction Technique

    Energy Technology Data Exchange (ETDEWEB)

    Rui Yu Liu; Kun Zheng Wang; Chun Sheng Wang; Xiao Qian Dang; Zhi Qin Tong (Second Hospital Affiliated to the Medical College of Xi' an Jiaotong Univ., Xi' an Shaanxi (China))

    2009-08-15

    Background: The technique of medialization has been used to reconstruct acetabula at the level of true acetabula in total hip arthroplasty (THA) in patients with developmental dysplasia of the hip (DDH). Appreciation of the bone stock in the medial acetabular wall is significant for making an optimal acetabular reconstruction plan and avoiding complications. Purpose: To evaluate the bone stock of the medial acetabular wall and its relation to the degree of subluxation in patients with DDH using computed tomography (CT). Material and Methods: Helical CT scans of 27 hips were obtained from 21 patients with osteoarthritis secondary to DDH who were scheduled for total hip arthroplasty. Eleven hips belonged to Crowe class I, while 16 hips belonged to Crowe class II/III. The raw CT data were reprocessed in various planes by scrolling multiplanar reformation (MPR). Acetabular opening, depth, and medial bone stock, as indicated by the minimum thickness of the medial acetabular wall, were measured in the transverse reformed MPR plane. Results: The minimum thicknesses of the medial acetabular wall in Crowe-I and Crowe-II/III hips were 3.8+-2.1 mm and 7.1+-3.1 mm, respectively, with statistically significant differences between the groups (P<0.05). Furthermore, the bone stock in the medial acetabular wall correlated with the degree of subluxation (R=0.69) and the acetabular depth (R= ;- ;0.71). Conclusion: There was significantly more bone stock in the medial acetabular wall in patients with higher-degree subluxation than there was in the less-severe class. This difference should be taken into consideration when reconstructing acetabula in THA in patients with DDH using the technique of medialization

  13. Acetabular labral tears: contrast-enhanced MR imaging under continuous leg traction

    Energy Technology Data Exchange (ETDEWEB)

    Nishii, T. [Div. of Functional Diagnostic Imaging, Biomedical Research Center, Osaka Univ. Medical School, Suita (Japan); Nakanishi, K. [Dept. of Radiology, Osaka Univ. Medical School, Suita (Japan); Sugano, N. [Dept. of Orthopaedic Surgery, Osaka Univ. Medical School, Suita (Japan); Naito, H. [Div. of Functional Diagnostic Imaging, Biomedical Research Center, Osaka Univ. Medical School, Suita (Japan); Tamura, S. [Div. of Functional Diagnostic Imaging, Biomedical Research Center, Osaka Univ. Medical School, Suita (Japan); Ochi, T. [Dept. of Orthopaedic Surgery, Osaka Univ. Medical School, Suita (Japan)

    1996-05-01

    The objective of this study was to evaluate the effects of continuous leg traction on contrast-enhanced MR imaging of the hip joint and to determine whether MR imaging under these conditions is useful for demonstrating acetabular labral tears. Nineteen hips underwent MR imaging with a T1-weighted spin-echo sequence, followed by MR imaging under continuous leg traction after intravenous injection of gadolinium-DTPA. Joint fluid enhancement and labral contour detection were evaluated. Eleven hips had labral tears shown by conventional arthrography, arthroscopy and macroscopic surgical findings. Assessment of labral tears by MR imaging was correlated with the diagnosis based on these standard techniques. Joint fluid enhancement was obtained in all hips at 30 min after injection. Superior and inferior labral surfaces were completely delineated in 1 hip on the unenhanced MR images, and in 7 and 13 hips, respectively, on the enhanced images under traction. The enhanced images under traction depicted 9 of the 11 labral tears. Comparison between the unenhanced image and the enhanced image under traction avoided mistaking undercutting of the labrum for a tear in 4 hips. Contrast-enhanced MR imaging under traction was valuable for detecting labral tears non-invasively and without radiation. Follow-up examinations using this method in patients with acetabular dysplasia can help to clarify the natural course of labral disorders and enable better treatment planning. (orig./MG)

  14. Analysis and prevention of the failure reason of internal fixation in peritrochanteric fractures%股骨转子间骨折内固定失败原因与预防

    Institute of Scientific and Technical Information of China (English)

    林奋强; 蔡东岭

    2013-01-01

    Objective To summarize and analyze the failure reason of internal fixation operation in peritrochanteric fractures and propose appropriate prevention measures.Methods The clinical data of 229 patients with peritrochanteric fractures were retrospectively analyzed,the failure reason of internal fixation was analyzed by the univariate and multivariate Logistic regression analysis.Results The univariate analysis showed that the patients' age,gender composition,types of internal fixation had no significantly correlated with the failure of internal fixation (P > 0.05) ; the Garden reset index,bone quality,fracture type and load time had significantly correlated with the failure of internal fixation (P < 0.05).The multivariate Logistic analysis showed that load time was the independent risk factors for fixation failure (OR =13.515).Conclusion The weight-bearing time points should be selected according to the bone quality,fracture type,and degree of intraoperative reset,thereby reducing the risk of surgery failure.%目的 总结分析股骨转子间骨折行手术内固定后失败发生的原因,并提出相应预防措施.方法 回顾性分析229例股骨转子间骨折患者的临床资料,采用单因素和多因素Logistic回归分析内固定失败的原因.结果 单因素分析结果显示,患者年龄、性别构成、内固定种类与内固定失败无相关性(P>0.05);Garden复位指数、骨骼质量、骨折类型、负重时间与内固定失败有相关性(P<0.05).多因素分析结果显示,负重时间为骨折内固定失败的独立危险因素(OR=13.515).结论 负重时间点的选择应根据骨骼质量、骨折类型以及术中复位程度制定,从而降低手术失败的风险.

  15. Precision of radiostereometric analysis (RSA) of acetabular cup stability and polyethylene wear improved by adding tantalum beads to the liner

    DEFF Research Database (Denmark)

    Nebergall, Audrey K; Rader, Kevin; Palm, Henrik;

    2015-01-01

    Background and purpose - In traditional radiostereometric analysis (RSA), 1 segment defines both the acetabular shell and the polyethylene liner. However, inserting beads into the polyethylene liner permits employment of the shell and liner as 2 separate segments, enabling distinct analysis of th...

  16. Reliability of ultrasonographic measurements in suspected patients of developmental dysplasia of the hip and correlation with the acetabular index

    Directory of Open Access Journals (Sweden)

    Cem Copuroglu

    2011-01-01

    Full Text Available Background: Ultrasonography is accepted as a useful imaging modality in the early detection of developmental dysplasia of the hip (DDH. Early detection and early treatment of DDH prevents hip dislocation and related physical, social, economic, and psychological problems. The purpose of this study was to evaluate the reliability of ultrasonographic and roentgenographic measurements measured by seven different observers. Materials and Methods: The alpha angles of 66 hips in 33 patients were measured using the Graf method by seven different observers. Acetabular index degrees on plane roentgenograms were measured in order to assess the correlation between the ultrasonographic alpha angle and the radiographic acetabular index, which both show the bony acetabular depth, retrospectively. Results: The interclass correlation coefficient, measuring the interobserver reliability, was high and statistically significant for the ultrasonographic measurements. There was a negative correlation between the alpha angle and the acetabular index. Conclusions: Ultrasonography, when applied properly, is a reliable technique between different observers, in the diagnosis and follow up of DDH. When assessed concomitantly with the roentgenographic measurements, the results are reliable and statistically meaningful.

  17. 胫腓骨骨折切开复位内固定与单臂外固定架治疗骨折疗效对比分析%The comparative analysis of the treatment of fractures tibia and fibula fractures with open reduction and internal fixation with a single-arm external fixator

    Institute of Scientific and Technical Information of China (English)

    尹怀林

    2013-01-01

      目的研究分析胫腓骨骨折切开复位内固定与单臂外固定架治疗骨折的疗效.方法以82例胫腓骨骨折患者为研究对象,随机分为两组,内固定组给予切开复位内固定治疗,外固定组给予单臂外固定架治疗,对比观察两组治疗效果.结果外固定组患者成骨性愈合率较高,功能完全正常率高,患者术后并发症少,与对照组比较,P <0.05,差异有统计学意义.结论对胫腓骨骨折患者给予单臂外固定架治疗具有较好的效果.%Objective To study analysis of the tibia and fibula fracture ORIF arm external fixator fractures. Methods 82 cases of tibia and fibula fracture patients for the study were randomly divided into two groups,internal fixation group were treated with open reduction and internal fixation of the external fixation group was given a single arm external fixator,comparing the effect of treatment were observed. Results Patients with external fixation group into a higher rate of bone healing,the function is completely normal rate, fewer postoperative complications,compared with the control group(P < 0.05),the difference was statistically significant. Conclusion The tibia and fibula fracture patients given arm external fixator with good results.

  18. 双钢板内固定急诊手术治疗复杂肱骨远端骨折%Dual plating internal fixation for the emergency surgery of complex distal humeral fractures

    Institute of Scientific and Technical Information of China (English)

    薛锦标; 陈丹华; 汤春平; 葛许峰; 潘刚; 姚长海

    2008-01-01

    目的 探讨复杂肱骨远端骨折(肱骨髁间加髁上骨折)应用经尺骨鹰嘴截骨入路,行双钢板内固定急诊手术的疗效.方法 急诊手术治疗复杂肱骨远端骨折47例患者,取鹰嘴旁肘后轻度弧形正中切口,经尺骨鹰嘴截骨入路,行切开复位双钢板内同定急诊手术,术后早期功能锻炼.结果 全部患者随访5~50个月,平均18个月,骨折在3~6个月全部愈合.采用Cassebaum评分系统评定肘关节功能,优36例,良4例,可5例,差2例,优良率85.1%.结论 复杂肱骨远端骨折,应用经尺骨鹰嘴截骨入路,双钢板坚强内固定急诊手术,可以早期进行肘关节功能锻炼,最大限度恢复肘关节功能,在临床可取得满意疗效.%Objective To investigate the efficacy of dual plating internal fixation with olecranon osteotomy approach for the emergency surgery of complex distal humeral fractures (intereondylar and supracondylar fracture).Methods Forty-seven cases of complex distal humeral fractures were treated with emergency surgery from May 2002 to May 2007.The dual plating internal fLxation was implemented with olecranon osteotomy approach in a posteubital slight arc shaped median incision.Early postoperative rehabilitation was necessary.Results The follow-up period differed from 5 to 50 months,averaged 18 months.All fractures healed in 3-6 months after surgery.The Cassebaum scoring system was used for the assessment of cubital joint function,36 cases were excellent,4 cases were good,5 cases were common,and 2 cases were bad.The excellent and good rate was 85.1%.Conclusions For complex distal humeral fractures,dual plating internal fixation emergency surgery with olecranon osteotomy approach ensures the early postoperative rehabilitation of the cubital joint and the maximum possible functional recovery.It shows the efficacy is satisfactory.

  19. 微创内固定系统治疗膝关节周围骨折临床疗效分析%Clinical Efficacy Analysis of Minimally Invasive Internal Fixation System Treating Fracture Around Knees

    Institute of Scientific and Technical Information of China (English)

    崔志民; 张国峰; 周天宝; 冷雪; 陈韶丽

    2013-01-01

      目的:研究微创内固定系统治疗膝关节周围骨折的治疗效果,为治疗膝关节周围骨折提供临床参考。方法:60例膝关节周围骨折患者分为采用微创内固定系统治疗的微创组和常规治疗的传统组,观察两组的治疗效果及恢复状况。结果:微创组在平均手术所需时间、手术中的出血量、骨折愈合时间、肢体缩短长度、关节功能外形及患者痛感等各项指标上均较优于传统组。结论:微创内固定系统治疗膝关节周围骨折治疗效果及关节功能恢复较好,值得在临床实践中推广应用。%Objective:To study the therapeutic effects of minimally invasive internal fixation system treating fractures around knees, and provide clini-cal reference for the treatment of fractures around knees. Methods:60 cases of patients with fractures around knees were divided into minimally inva-sive group treated with minimally invasive internal fixation system and traditional group with conventional therapy, to observe the efficacy and recov-ery of two groups. Results:The average required operation time, amount of bleeding, fracture healing time, limbs shortening length, joint function shape, pain perception of patients and other indicators of minimally invasive group were all better than the those of traditional group. Conclusion:The therapeutic effects of minimally invasive internal fixation system treating fractures around the knees, and its recovery of joint function are better, being worthy of popularization and application in clinical practice.

  20. Multiscale Multifunctional Progressive Fracture of Composite Structures

    Science.gov (United States)

    Chamis, C. C.; Minnetyan, L.

    2012-01-01

    A new approach is described for evaluating fracture in composite structures. This approach is independent of classical fracture mechanics parameters like fracture toughness. It relies on computational simulation and is programmed in a stand-alone integrated computer code. It is multiscale, multifunctional because it includes composite mechanics for the composite behavior and finite element analysis for predicting the structural response. It contains seven modules; layered composite mechanics (micro, macro, laminate), finite element, updating scheme, local fracture, global fracture, stress based failure modes, and fracture progression. The computer code is called CODSTRAN (Composite Durability Structural ANalysis). It is used in the present paper to evaluate the global fracture of four composite shell problems and one composite built-up structure. Results show that the composite shells. Global fracture is enhanced when internal pressure is combined with shear loads. The old reference denotes that nothing has been added to this comprehensive report since then.

  1. 内、外固定与保守方法治疗不稳定型骨盆骨折:骨痂生长及骨折愈合率比较%Internal fixation, external fixation and conservative treatment for unstable pelvic fractures:callus growth and fracture healing rate

    Institute of Scientific and Technical Information of China (English)

    刘国雄; 肖柳斌; 李鹏飞; 马翰斐; 连银川; 汪清华; 吴元成

    2015-01-01

    背景:对于骨盆骨折的治疗临床上有很多方法,其中以保守治疗、内固定治疗和外固定治疗3种方法为主。传统的保守治疗常因骨折的不良复位而造成相关并发症。固定治疗对于一般不稳定型骨折有着良好的修复效果,但对于骨盆骨折报道甚少。  目的:观察内固定治疗对不稳定型骨盆骨折的修复效果,并与外固定及保守治疗进行对比。  方法:将深圳市龙华新区人民医院2008年1月至2014年6月收治的126例不稳定型骨盆骨折患者,根据修复方式分为保守治疗组、外固定组和内固定组,每组42例。治疗后行X射线片检查,以Lindahl影像学标准为依据,对骨折复位的质量进行评估。治疗后定期随访,依据Majeed标准对患者肢体功能恢复情况进行评价。末次随访时评估患者修复效果、骨折愈合优良率及骨痂生长优良率。  结果与结论:末次随访时,内固定组患者的治疗总有效率为81%,保守治疗组为69%,外固定组为71%,内固定组明显优于其余两组,差异有显著性意义(P OBJECTIVE:To observe the effects of internal fixation on unstable pelvic fractures, and compare with conservative treatment and external fixation. METHODS:126 cases of unstable pelvic fractures from Longhua District People’s Hospital of Shenzhen City from January 2008 to June 2014 were divided into three groups:conservative treatment group, external fixation group and internal fixation group (n=42). After treatment, patients received X-ray examination. Lindahl imaging criteria were used as evidence. The quality of fracture reduction was evaluated. Patients were regularly fol owed up after treatment. The recovery of limb function was evaluated according to Majeed standard. Repair effects, the excel ent and good rates of fracture healing and cal us growth were evaluated in the last fol ow-up. RESULTS AND CONCLUSION:During the last fol ow

  2. Internal bioabsorbable fixation for the treatment of the tibiofibula fractures in children%可吸收内固定在儿童胫腓骨骨折中的应用

    Institute of Scientific and Technical Information of China (English)

    戴进; 王晓东; 张福勇

    2013-01-01

    Objective To explore the availability and feasibility of the bioabsorbable fixation to treat tibiofibula fractures in children.Methods Twenty patients with tibiofibula fractures underwent internal absorbable fixation in this institute from January 2011 to January 2012.The distal tibiofibula fractures were fixed with bioabsorbable screws,while the midpiece fractures of tibiofibula were fixed with bioabsorbable screws combined with elastic intramedullary nail.Distal tibial epiphyseal fractures were fixed using bioabsorbable spiral and pin.Fracture healing and functional recovery were followed up after surgery.Results Follow-up period was 6 to 12 months.All fractures were healed.One patient's tibia comminuted fracture was fixed with absorbable elastic intramedullary nail,and postoperative X-radiogram suggested bony callus formed slower than average during follow-up.However,continuous weight-bearing exercises accelerated bony callus formation and a mass of bony callus was found on the X-radiogram 6 months after surgery.Conclusions The bioabsorbable internal fixation is safe and effective for the treatment of tibiofibula fractures in children.%目的 探讨可吸收植入物在儿童胫腓骨骨折中的应用及临床疗效.方法 2011年1月至2012年1月20例儿童胫腓骨骨折行切开复位,远端斜形及螺旋形骨折应用可吸收内固定螺钉固定,中端斜形及螺旋形骨折行弹性髓内钉结合可吸收螺钉固定,远端骨骺骨折行可吸收骨棒或螺钉固定.术后定期复查X线片,对骨折愈合及临床功能恢复行回顾性分析总结.结果 随访6个月~1年,骨折全部愈合.1例胫骨中端粉碎骨折行弹性髓内钉结合可吸收螺钉固定,术后2个月复查骨痂生长缓慢,更换短腿支具后下地负重锻炼,6个月后复查骨痂生长丰富.结论 可吸收螺钉及棒应用于儿童胫腓骨骨折临床疗效明确,避免二次手术,减少儿童创伤及痛苦,可作为儿童胫骨中远端斜形及螺

  3. The Use of Calcaneal Anatomic Plate in Arthroscopically-assisted Open Reduction and Internal Fixation of Intra-articular Calcaneal Fractures

    Institute of Scientific and Technical Information of China (English)

    WANG Hong; ZHANG Qingsong; DUAN Deyu; YAN Lijun

    2006-01-01

    To discuss and evaluate the method and effect of using calcaneal anatomic plate in treatment of intra-articular fractures of the calcaneus with assistant of arthroscope, 86 intra-articular fractures of the calcaneus in 78 patients were reduced by open reduction, and rigid fixation was made with calcaneal anatomic plate under assistant of arthroscope. The average follow-up duration was 18 months (range 12-30 months). The effect of treatment was evaluated according to AOFAS and X-ray before and after operation. The results showed that 86 patients have obtained satisfactory reduction according to X-ray, and there was significant difference before and after operation (P<0.01), the total excellent and fine rate was 91.86 %. Treating intra-articular fractures of the calcaneus with calcaneal anatomic plate under arthroscope may provide more chance to achieve anatomical reconstruction, which can lead to satisfied recovery of function and few complication.

  4. Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

    OpenAIRE

    Kang-Young Choi; Jung-Dug Yang; Ho-Yun Chung; Byung-Chae Cho

    2012-01-01

    The incidence of condylar fractures is high, but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of ...

  5. Hoffa fracture associated with ipsilateral femoral shaft fracture: clinical feature and treatment

    Institute of Scientific and Technical Information of China (English)

    GONG Yu-bao; LI Qing-song; YANG Chen; LI Shu-qiang; LIU Jian-guo; QI Xin

    2011-01-01

    Hoffa fracture associated with ipsilateral femoral shaft fracture is very rare.Three cases of this rare type of injury were retrospectively reviewed.The sites of femoral shaft fractures and Hoffa fractures were documented.All femoral shaft fractures were managed with internal fixation.The rate of misdiagnosis for the Hoffa fractures was documented.Functions of the affected knees were evaluated according to the modified Hospital for Special Surgery (HSS) scores at two years follow-up.Femoral fractures were either transverse or composite in all three cases.Ipsilateral Hoffa fractures occurred at medial condyle in two cases,and lateral condyle in one case.Only one Hoffa fracture was identified preoperatively.All the femoral shaft fractures healed uneventfully.In the patient whose Hoffa fracture was correctly diagnosed,the modified HSS score was 94.In another patient,whose Hoffa fracture was treated by a second operation,the modified HSS score was 93.And in the third case,who refused additional operation for the Hoffa fracture,the modified HSS score was only 70.Conclusively femoral shaft fracture can be associated with ipsilateral Hoffa fracture,especially in motorcycle accident.This type of injury is very rare and misdiagnosis is common.

  6. International

    International Nuclear Information System (INIS)

    This rubric reports on 10 short notes about international economical facts about nuclear power: Electricite de France (EdF) and its assistance and management contracts with Eastern Europe countries (Poland, Hungary, Bulgaria); Transnuclear Inc. company (a 100% Cogema daughter company) acquired the US Vectra Technologies company; the construction of the Khumo nuclear power plant in Northern Korea plays in favour of the reconciliation between Northern and Southern Korea; the delivery of two VVER 1000 Russian reactors to China; the enforcement of the cooperation agreement between Euratom and Argentina; Japan requested for the financing of a Russian fast breeder reactor; Russia has planned to sell a floating barge-type nuclear power plant to Indonesia; the control of the Swedish reactor vessels of Sydkraft AB company committed to Tractebel (Belgium); the renewal of the nuclear cooperation agreement between Swiss and USA; the call for bids from the Turkish TEAS electric power company for the building of the Akkuyu nuclear power plant answered by three candidates: Atomic Energy of Canada Limited (AECL), Westinghouse (US) and the French-German NPI company. (J.S.)

  7. Clinical effect of internal fixation of screw intramedullary nail in the treatment of midshaft tibia fracture: report of 13 cases.%旋入式髓内针内固定治疗胫骨中段骨折13例

    Institute of Scientific and Technical Information of China (English)

    郭岁利

    2012-01-01

    目的 观察开放复位旋入式髓内针内固定治疗胫骨中段骨折的疗效.方法 选择2009年5月至2011年5月胫骨中段骨折患者13例,采用开放复位旋入式髓内针内固定对其进行治疗,并随访6~9个月,观察临床疗效.结果 13例均达骨性愈合,膝踝关节活动范围正常;优11例,良2例,优良率100%.无髓内针断裂、松动、变形等并发症.结论 采用开放复位旋入式髓内针内固定治疗胫骨中段骨折是一种简便易行的手术方法.%Objective To observe the clinical effect of open reduction and internal fixation of screw intramedullary nail in the treatment of midshaft tibia fracture. Methods Thirteen cases of midshaft tibia fracture were treated with open reduction and internal fixation of intramedullary nail surgery. The patients were followed up for 6 to 9 months after surgery. Results All of the 13 cases reached osseous healing. The range of knee joint motion and the range of ankle joint motion were all normal. The rate of excellent and good was 100% ( excellent in 11 cases and good in 2 cases ). Conclusion Open reduction and internal fixation of intramedullary nail is a simple and feasible operation for the treatment of midshaft tibia fracture.

  8. Limited internal fixation combined external fixation in the treatment of distal radius comminuted fractures%有限内固定加外固定支架治疗桡骨远端粉碎性骨折

    Institute of Scientific and Technical Information of China (English)

    向乾彬; 范海泉; 黄海讯; 俞阳; 江洋; 刘江川; 陈铭

    2012-01-01

    目的 探讨有限内固定加外固定支架治疗桡骨远端粉碎性骨折的临床疗效.方法 采用有限内固定加外固定支架治疗桡骨远端粉碎性骨折45例.结果 42例患者获得随访,时间3~36个月.按Lidstrom评分系统行影像学评价:优30例,良7例,中5例,优良率为88.09%;依据Dienst标准评价腕关节功能:优30例,良8 例,中4 例,优良率为90.47%.无严重并发症发生.结论 有限内固定结合外固定支架治疗桡骨远端粉碎性骨折,复位满意,操作简单,固定牢固,疗效满意.%Objective To study the effect of limited internal fixation and external fixation for the treatment of comminuted fracture of distal radius. Methods Limited internal fixation combined with external fixation were used in the treatment of 45 cases of comminuted fracture of distal radius. Results 42 cases were followed up for 3 ~ 36 months. With Lidstrom scoring system image evaluation, excellent 30 cases,7 good,5 fair,and the excellent and good rate was 88. 09% ; According to Dienst functional evaluation standard, the wrist joint function evaluation was excellent in 30 cases, good in 8, and fair in 4 cases, and the excellent and good rate was 90. 47%. No serious complications were found. Conclusions Limited internal fixation combined external fixation for distal radius comminuted fractures provide good reduction and satisfactory effect.

  9. A randomized controlled trial of nonoperative treatment versus open reduction and internal fixation for stable, displaced, partial articular fractures of the radial head: The RAMBO trial

    NARCIS (Netherlands)

    W. Bruinsma (Wendy); I.F. Kodde (Izaäk Frederik); R.-J. De Muinck Keizer (Robert-Jan); P. Kloen (Peter); A. Lindenhovius (Anneluuk); J.P.A.M. Vroemen (Jos); R. Haverlag (Robert); M.P.J. van den Bekerom (Michel); H.W. Bolhuis (Hugo); P. Bullens (Pieter); S.A.G. Meylaerts (Sven); P. van der Zwaal (Peer); E.P. Steller; G.S. Hageman (Gregory); D. Ring (David); D. den Hartog (Dennis); E.R. Hammacher (Eric); G. King (Graham); G. Athwal (George); K. Faber (Ken); D. Drosdowech (Darren); R. Grewal (Ruby); J.C. Goslings (Carel); N.W.L. Schep (Niels); D. Eygendaal (Denise)

    2014-01-01

    textabstractBackground: The choice between operative or nonoperative treatment is questioned for partial articular fractures of the radial head that have at least 2 millimeters of articular step-off on at least one radiograph (defined as displaced), but less than 2 millimeter of gap between the frag

  10. Functional outcome and incidence of avascular necrosis after two years in four part proximal humeral fractures treated by proximal humerus internal locking system

    Directory of Open Access Journals (Sweden)

    Akshdeep Singh Bawa

    2016-11-01

    Conclusions: The importance of early mobilization of the shoulder joint cannot be underestimated in the final outcome of these fractures. We observed better functional outcome in the patients who started early physiotherapy and continued it at home. [Int J Res Med Sci 2016; 4(11.000: 4979-4984

  11. The Long-Term Outcome of Open Reduction and Internal Fixation of Stable Displaced Isolated Partial Articular Fractures of the Radial Head

    NARCIS (Netherlands)

    A.L.C. Lindenhovius; Q. Fesch; D. Ring; P. Kloen

    2009-01-01

    Background: Excellent long-term results have been reported for nonoperative treatment of stable isolated displaced partial articular (Mason 2) fractures of the radial head, suggesting that the role of operative treatment can be questioned. This investigation reports the long-term outcome of operativ

  12. 超声振动单向拉伸20号钢内部应力及断口形貌分析%Analysis of Internal Stress and Fracture Morphology for 20 Steel Under Ultrasonic Vibration Uniaxial Tensile

    Institute of Scientific and Technical Information of China (English)

    程雪利; 赵明利; 秦军; 刘传绍

    2013-01-01

    对20号钢进行了超声振动单向拉伸试验,对其内部应力进行了有限元分析,得出了工件在直径最小处两端的应力最大,中间次之,这和断口断裂的位置是一致的.研究了工件中心点处塑性应变及应力随时间变化的曲线,证明了在超声振动单向拉伸下工件内部受到的是一个交变的应力载荷.通过对超声与常态拉伸断口的比较,发现了所有断口都是杯锥型断口,而超声拉伸的断口杯状边缘更明显,断口内部更平整,断口更明亮;还发现了随着频率的降低,断口变得粗糙且不均匀,功率越大,典型疲劳条纹也越明显.%In this paper,the ultrasonic vibration uniaxial tensile test of the #20 steel was conducted and the internal stress was analyzed by finite element method.It is concluded that the stress of workpiece on both ends of the minimum diameter place is the biggest and that of the middle is bigger,which is consistent with the position of the fracture.Since the plastic strain and stress curve are changed with time,it is proved that the intemal workpiece is subject to an altemative stress load under ultrasonic vibration uniaxial tensile.Based on the comparison between the tensile fracture of the ultrasonic and that of the common condition,it is found that all the fracture is a cup of cone fracture type and the fracture has more apparent cup edges,more smooth and bright at ultrasound stretch.Furthermore,it is found that the fracture becomes coarse and uneven with the decrease of frequency.Therefore,the greater the power is,the more obvious the typical fatigue stripe is.

  13. Efficacy of treatment of senile proximal humeral fracture by locking plate internal fixation%老年性肱骨近端骨折锁定钢板内固定疗效探讨

    Institute of Scientific and Technical Information of China (English)

    赵军舰; 程小宾; 翟晓刚; 孙丽娜; 关鹏飞; 郑强; 白洁

    2014-01-01

    目的:探讨锁定钢板内固定治疗老年性肱骨近端骨折的临床疗效。方法回顾性分析2007-08至2012-12某院收治的老年性肱骨近端骨折55例资料。 Neer分型:二部分骨折11例,三部分骨折25例,四部分骨折19例,采用有限切开复位锁定钢板内固定治疗,对四部分骨折19例内侧均进行了取自体髂骨植骨。注重锁定钢板固定术后的早期功能锻炼;分析锁定钢板较传统钢板固定治疗老年肱骨近端骨折的优势。结果所有病例均随访6~18个月,平均9个月。骨折愈合时间11~15周,平均13周。根据Neer肩关节功能评分:优17例,良31例,可7例,优良率87.3%。并发伤口脂肪液化伴轻度感染2例,螺丝钉穿出关节面1例,肱骨头轻度内翻1例,肱骨头坏死2例。结论锁定钢板内固定治疗老年性肱骨近端骨折,相比传统内固定方法,损伤小、固定可靠,可以早期进行肩关节功能锻炼,促进功能康复,尤其适合合并骨质疏松的老年骨折患者的治疗。%Objective To study the clinical effects of locking plate internal fixation for treating the senile proximal humeral fracture.Methods The clinical data of 55 patients with senile proximal humeral fracture in this hospital from August 2007 to Decem-ber 2012 were analyzed retrospectively.According to Neer classification system, there were 11 cases of two-part fractures, 25 cases of three-part fractures and 19 cases of four-part fractures.We used limited open reduction with locking plate internal fixation for treat-ment.Self iliac bone graft was used for the 19 cases of four-part fractures.We paid attention to early postoperative functional exercise and analyzed its advantages compared with traditional methods.Results All patients were followed up for 6-18 months ( average 9 months) , the healing time was 11 to 15 weeks ( average 13 weeks) , 17 cases were evaluated as excellent, 31 cases as good and 7 ca

  14. Acetabular deepening in the treatment of severe canine hip dysplasia Aprofundamento do acetábulo no tratamento de displasia coxofemoral grave em cães

    OpenAIRE

    Paulo Iamaguti; Luciana S. Iamaguti; Raquel Sartor

    2009-01-01

    A technique to restore acetabular anatomy by deepening the acetabular cavity and reconstructing the femoral head ligament and the joint capsule was tested on nine large breed dogs with severe hip dysplasia and acute subdislocation or dislocation. The technique consisted of two phases. First, all dogs were submitted to bilateral pectinotomy. In a second surgical intervention on the same dogs the acetabulum was approached and deepened, and the femoral head ligament and the joint capsule were re...

  15. Polyethylene sterilized without irradiation in a polished uncemented acetabular component-a clinical and radiographic analysis.

    Science.gov (United States)

    Crockarell, John R

    2008-09-01

    Clinical and radiographic analysis of the Reflection uncemented acetabular component was performed. Features of this component include a polished inner shell and ethylene oxide sterilization. Clinical information was available for 158 hips (mean, 4.6 years follow-up). A total of 19 hips have undergone or were recommended revision, 8 for aseptic loosening or wear (5%). Wear analysis was performed for 38 hips with more than 5 years of follow-up (mean, 6.7 years). Osteolysis was present in 20 of these patients. Penetration rate averaged 0.15 mm/y. Patients with uncemented femoral fixation (vs cemented) had a significantly higher penetration rate. Increased volumetric wear was seen with uncemented femoral fixation, thin liners, and ceramic heads. This component demonstrated relatively high penetration and osteolysis rates. Continued surveillance is recommended, particularly for active patients with thin liners. PMID:18534518

  16. Precooling an acetabular liner makes its insertion into a metal shell easier.

    Science.gov (United States)

    Kyle, Richard F; Bourgeault, Craig A; Lew, William D; Bechtold, Joan E

    2006-02-01

    Temporary shrinkage of an acetabular polyethylene liner due to precooling could reduce the force required to snap the liner into its metal shell. This study documented cooling and heating rates of liners with a particular locking mechanism design, determined forces required to seat liners in their shells as a function of temperature, and quantified the force surgeons can exert with their thumbs when seating a liner. It took up to 8 minutes to cool 58- and 70-mm liners in an ice-water bath from room temperature to near 0 degrees C, and up to 24 minutes to subsequently warm these liners to near body temperature. Forces required to seat liners were greater at room and body temperatures than at 0 degrees C. Liners precooled to 0 degrees C required insertion forces that could be generated manually by surgeons. PMID:16520215

  17. Tranexamic acid reduces the blood loss and blood transfusion requirements following peri-acetabular osteotomy.

    Science.gov (United States)

    Wassilew, G I; Perka, C; Janz, V; Krämer, M; Renner, L

    2015-12-01

    We have investigated the effect of using tranexamic acid (TXA) during peri-acetabular osteotomy (PAO) on peri-operative blood loss and blood transfusion requirements. In addition we analysed whether the use of TXA was associated with an increased risk of venous thromboembolism (VTE) following this procedure. A consecutive series of 96 PAOs, performed by a single surgeon, were reviewed. A total of 48 patients received TXA and 48 did not. The TXA group received a continuous infusion of TXA at a rate of 10 mg/kg/h. The primary outcome measure was the requirement for blood transfusion. Secondary outcomes included total blood loss, the decrease in the level of haemoglobin in the blood, the length of hospital stay, and the complications of this treatment. The mean rate of transfusion was significantly lower in the TXA group (62.5% vs 12.5%, p transfusion after PAO significantly, without adverse effects such as an increased rate of VTE.

  18. 髋臼发育不良髋关节置换前髋臼侧的三维测量%Three-dimensional measurement of acetabular side before arthroplasty for acetabular dysplasia

    Institute of Scientific and Technical Information of China (English)

    许杰; 马若凡; 李登; 蔡志清; 李亮平

    2013-01-01

    BACKGROUND:The anatomical strucure of acetabulum is smal and shal ow in adult acetabular dysplasia patients. The large amount of cal us and scar tissues in the acetabulum make it difficult to identify and instal the acetabular cup during arthroplasty. The comprehensive understanding of the acetabulum before arthroplasty is the premise for selecting the appropriate acetabular prosthesis and making the acetabular reconstruction program. OBJECTIVE:To evaluate the application value of three-dimensional reconstruction technique in choosing the size of acetabular cup before total hip arthroplasty for acetabular dysplasia. METHODS:Spiral CT was carried out in the 11 acetabular dysplasia patients who waiting for total hip arthroplasty. The acetabulum was multi-planar reconstructed, and the size of the acetabular cup was determined through digitized acetabular cup template implantation, and then the mathching degree assessment was performed to compare with the actual size. RESULTS AND CONCLUSION:Spiral CT could clearly show the acetabular morphology, and the 71.4%of the acetabular size chosen in the three-dimensional preoperative plan was the same as actual one, the intraclass correlation coefficient was 0.888. The agreement was much higher than that of two-dimensional preoperative plan based on X-ray plain film. For the patients with acetabular dysplasia, the acetabulum became saml er and shal ower, and there were various extents of bone defects in the superior-lateral acetabulum. Three-dimensional multi-planar reconstruction can effectively evaluate the acetabular morphology, and three-dimensional preoperative plan can provide useful information for the choice of implant.%背景:成人髋臼发育不良髋臼小而浅,臼内有大量骨痂和瘢痕组织等都为人工髋关节置换术中真臼的辨认、臼杯的准确安装带来极大困难,关节置换前对髋臼的全面认识是选择合适的髋臼假体和制定个性化髋臼重建方案的前提。目

  19. 经皮克氏针内固定结合术后康复训练治疗Bennett骨折对关节功能恢复的观察%Internal fixation with Kirschner pins in combination of postoperative trainig recovering joint function following Bennett fracture

    Institute of Scientific and Technical Information of China (English)

    查天文; 聂梅

    2002-01-01

    Background:Bennett fracture belongs to intraarticular injury.Conventionally,external fixation with splint or plaster failures to maintain postrepair position,leading to fracture and translocation.On the other hand,longer term outer fixation will result in joint stiffness.Internal fixation with Kirschner pins in combination of postoperative training was characterized by stable fixation,less injury,allow early functional exercise and is beneficial to recovery of joint function.

  20. Acetabular shell deformation as a function of shell stiffness and bone strength.

    Science.gov (United States)

    Dold, Philipp; Pandorf, Thomas; Flohr, Markus; Preuss, Roman; Bone, Martin C; Joyce, Tom J; Holland, James; Deehan, David

    2016-04-01

    Press-fit acetabular shells used for hip replacement rely upon an interference fit with the bone to provide initial stability. This process may result in deformation of the shell. This study aimed to model shell deformation as a process of shell stiffness and bone strength. A cohort of 32 shells with two different wall thicknesses (3 and 4 mm) and 10 different shell sizes (44- to 62-mm outer diameter) were implanted into eight cadavers. Shell deformation was then measured in the cadavers using a previously validated ATOS Triple Scan III optical system. The shell-bone interface was then considered as a spring system according to Hooke's law and from this the force exerted on the shell by the bone was calculated using a combined stiffness consisting of the measured shell stiffness and a calculated bone stiffness. The median radial stiffness for the 3-mm wall thickness was 4192 N/mm (range, 2920-6257 N/mm), while for the 4-mm wall thickness the median was 9633 N/mm (range, 6875-14,341 N/mm). The median deformation was 48 µm (range, 3-187 µm), while the median force was 256 N (range, 26-916 N). No statistically significant correlation was found between shell stiffness and deformation. Deformation was also found to be not fully symmetric (centres 180° apart), with a median angle discrepancy of 11.5° between the two maximum positive points of deformation. Further work is still required to understand how the bone influences acetabular shell deformation.

  1. Outcome of periacetabular osteotomy for the management of acetabular dysplasia: experience in an academic centre.

    LENUS (Irish Health Repository)

    Burke, Neil G

    2011-02-01

    Periacetabular osteotomy (PAO) is a very effective reconstructive procedure for treatment of acetabular dysplasia. An orthopaedic paediatric surgeon and a reconstructive hip arthroplasty surgeon performed this procedure together in the early phase of their learning curve and then performed it individually. The early clinical and radiographic results of 85 consecutive PAOs performed in this academic orthopaedic unit were reviewed. The mean Merle-d\\'Aubigné score increased from 12.4 preoperatively to 16 at follow-up. Pre-operatively 73 hips were anteverted and 12 were neutral or retroverted. The mean angle of Wiberg improved from 5 degrees to 21 degrees (p < 0.0001) in anteverted hips, and from 9 degrees to 30 degrees in neutral or retroverted hips. The mean angle of Lequesne and de Sèze improved from 6 degrees to 35 degrees (p < 0.0001) in anteverted hips, and in neutral or retroverted hips from 9 degrees to 30 degrees (p < 0.0001). The acetabular index improved from 26 degrees to 8 degrees (p < 0.0001) in anteverted hips, and from 21 degrees to 7 degrees (p < 0.0001) in neutral or retroverted hips. Over the 7 year period the blood loss and operative time improved from 2000 ml to 900 ml and 4 hours to 2 hours respectively. Four hips (four patients) required conversion to total hip replacement. The radiographic correction and improved clinical scores are similar to those in previous studies. This study shows a survival rate of 94% at 58 months following periacetabular osteotomy. The learning curve and the early results of this procedure performed in our academic unit are encouraging.

  2. Supra-Acetabular Brown Tumor due to Primary Hyperparathyroidism Associated with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Rosaria M. Ruggeri

    2010-01-01

    Full Text Available A 63-year-old woman presented to the Orthopedic Unit of our hospital complaining of right hip pain of 6 months'duration associated with a worsening limp. Her past medical history included chronic renal insufficiency. Physical examination revealed deep pain in the iliac region and severe restriction of the right hip's articular function in the maximum degrees of range of motion. X-rays and CT scan detected an osteolytic and expansive lesion of the right supra-acetabular region with structural reabsorption of the right iliac wing. 99mTc-MDP whole-body bone scan showed an abnormal uptake in the right iliac region. Bone biopsy revealed an osteolytic lesion with multinucleated giant cells, indicating a brown tumor. Serum intact PTH was elevated (1020 pg/ml; normal values, 12 62 pg/ml, but her serum calcium was normal (total = 9.4 mg/dl, nv 8.5–10.5; ionized = 5.0 mg/dl, nv 4.2–5.4 due to the coexistence of chronic renal failure. 99mTc-MIBI scintigraphy revealed a single focus of sestamibi accumulation in the left retrosternal location, which turned out to be an intrathoracic parathyroid adenoma at surgical exploration. After surgical removal of the parathyroid adenoma, PTH levels decreased to 212 pg/ml. Three months after parathyroidectomy, the imaging studies showed complete recovery of the osteolytic lesion, thus avoiding any orthopedic surgery. This case is noteworthy because (1 primary hyperparathyroidism was not suspected due to the normocalcemia, likely attributable to the coexistence of chronic renal failure; and (2 it was associated with a brown tumor of unusual location (right supra-acetabular region.

  3. Recent trends in fracture and damage mechanics

    CERN Document Server

    Zybell, Lutz

    2016-01-01

    This book covers a wide range of topics in fracture and damage mechanics. It presents historical perspectives as well as recent innovative developments, presented by peer reviewed contributions from internationally acknowledged authors.  The volume deals with the modeling of fracture and damage in smart materials, current industrial applications of fracture mechanics, and it explores advances in fracture testing methods. In addition, readers will discover trends in the field of local approach to fracture and approaches using analytical mechanics. Scholars in the fields of materials science, engineering and computational science will value this volume which is dedicated to Meinhard Kuna on the occasion of his 65th birthday in 2015. This book incorporates the proceedings of an international symposium that was organized to honor Meinhard Kuna’s contributions to the field of theoretical and applied fracture and damage mechanics.

  4. The industrial application of fracture mechanics concepts discussed at the background of international standards and guidelines; Die industrielle Anwendung bruchmechanischer Konzepte vor dem Hintergrund internationaler Bewertungsvorschriften und Regelwerke

    Energy Technology Data Exchange (ETDEWEB)

    Zerbst, U. [GKSS-Forschungszentrum Geesthacht GmbH (Germany). Inst. fuer Werkstofforschung; Langenberg, P. [Ingenieurbuero fuer Werkstofftechnik, Aachen (Germany)

    2000-07-01

    Many features from the background for an intensified application of fracture mechanics concepts in many industries world-wide. These include requirements for a permanent increase of the level of performance of technical components and structures by the introduction of new materials, joining technologies and design principles, the problem of ageing components and life extension, an increased emphasis on non-destructive in-service inspection combined with improved NDT techniques, and also a number of failure events caused by fatigue and fracture The aim of the present paper is to give a brief state-of-the-art review on how fracture mechanics is applied in different industrial branches today. This is based on standards and guidelines in the aerospace industry, in the nuclear and fossil power generation, in the chemical and petrochemical and the pipeline industry, in civil engineering, offshore technique and other fields. Based on the review an outlook is given on a future development that would be reasonable and desirable from the point of view of a basically unified philosophy of fracture mechanics application. (orig.) [German] Die Erhoehung der Leistungsparameter vieler Maschinen und Anlagen verbunden mit dem Einsatz neuer Werkstoffe, Fuegeverfahren und Konstruktionsprinzipien, der Betrieb vieler Strukturen ueber ihre projektierte Lebensdauer hinaus, technische Verbesserungen und ein durchgaengigerer Einsatz zerstoerungsfreier Defektpruefverfahren, aber auch immer wieder einmal auftretende Schadensfaelle bilden den Hintergrund fuer die zunehmende Nutzung bruchmechanischer Bewertungsvorschriften in der industriellen Praxis. Die vorliegende Studie zieht eine momentane Bilanz dieser Entwicklung am Beispiel von Fachbereichsstandards der Luft- und Raumfahrtindustrie, der konventionellen und Kernkrafttechnik, der Chemie und Petrochemie, der Pipelineindustrie, des Stahlbaus, der Offshore-Technik und anderer Bereiche. Ausgehend von dieser Bestandsaufnahme wird ein Ausblick

  5. DESIGNING DRUG TRIALS FOR SARCOPENIA IN OLDER ADULTS WITH HIP FRACTURE - A TASK FORCE FROM THE INTERNATIONAL CONFERENCE ONFRAILTY AND SARCOPENIA RESEARCH (ICFSR).

    Science.gov (United States)

    Vellas, B; Fielding, R; Miller, R; Rolland, Y; Bhasin, S; Magaziner, J; Bischoff-Ferrari, H

    2014-01-01

    In May 2012, a Sarcopenia Consensus Summit was convened by the Foundation of the National Institutes of Health (FNIH), National Institute of Aging (NIA), and the U.S. Food and Drug Administration (FDA); and co-sponsored by five pharmaceutical companies. At this summit, sarcopenia experts from around the world worked to develop agreement on a working definition of sarcopenia, building on the work of previous efforts to generate a consensus. With the ultimate goal of improving function and independence in individuals with sarcopenia, the Task Force focused its attention on people at greatly increased risk of muscle atrophy as a consequence of hip fracture. The rationale for looking at this population is that since hip fracture is a recognized condition, there is a clear regulatory path forward for developing interventions. Moreover, patients with hip fracture may provide an appropriate population to advance understanding of sarcopenia, for example helping to define diagnostic criteria, develop biomarkers, understand the mechanisms that underlie the age-related loss of muscle mass and strength, and identify endpoints for clinical trials that are reliable, objective, and clinically meaningful. Task Force members agreed that progress in treating sarcopenia will require strengthening of partnerships between academia, industry, and government agencies, and across continents to reach consensus on diagnostic criteria, optimization of clinical trials design, and identification of improved treatment and preventive strategies. In this report, the main results of the Task Force discussion are presented. PMID:26380231

  6. Close reduction and percutaneous internal fixation with hollow screw in treatment of posterior malleolus fractures%闭合复位经皮空心螺钉内固定治疗后踝骨折

    Institute of Scientific and Technical Information of China (English)

    冯青; 许效坤; 苏海涛

    2011-01-01

    目的探讨闭合复位经皮空心螺钉内固定选择性治疗后踝骨折的手术方法、适应证及临床效果.方法回顾性分析2004年7月至2010年4月期间采用闭合复位经皮空心拉力螺钉内固定治疗42例成人后踝骨折的临床资料,其中旋后-外旋型28例,旋前-外旋型6例,旋前-外展型8例.采用X线片评估骨折愈合率,采用美国足踝骨科协会(AOFAS)推荐的足踝评分系统评估踝关节功能.结果平均随访22个月(6~75个月),骨折愈合时间为6~12周.按AOFAS足踝评分系统评分,平均为96分(78~100分),优41例,可1例,优良率为97.6%.结论闭合复位经皮空心螺钉内固定是一种可用于治疗后踝骨折的微创术式,具有骨折愈合快,骨折愈合率高,踝关节功能好的优点.%Objective To investigate the indication and efficacy of close reduction and percutaneous internal fixation with hollow screws in the treatment of posterior malleolus fractures. Methods The clinical data of 42 cases of posterior malleolus fracture treated by this method from July,2004 to April ,2010 were retrospectively analyzed,including 28 cases of supination-eversion fractures,6 cases of pronation-eversion fractures and 8 cases of pronation-abduction fractures. The fracture healing rate was assessed by X-ray film and the function of the ankle joint was evaluated by foot and ankle scoring system recommended by American Orthopedic Foot & Ankle Society ( AOFAS). Results The followup averaged for 22 months (6 ~75 months). The fracture healing time ranged form 6 to 12 weeks. According to the results of foot and ankle function scores, the average score was 96 points (78 ~ 100 points), including 41 cases of excellence and 1 case of fairness, the rate of excellent and good amounting to 97.6%. Conclusion With the advantage of quick recovery, high healing rate and better healing effect, close reduction and percutaneous internal fixation with hollow screws is feasible in the treatment of

  7. Fracture Blisters

    Directory of Open Access Journals (Sweden)

    Uebbing, Claire M

    2011-02-01

    Full Text Available Fracture blisters are a relatively uncommon complication of fractures in locations of the body, such as the ankle, wrist elbow and foot, where skin adheres tightly to bone with little subcutaneous fat cushioning. The blister that results resembles that of a second degree burn.These blisters significantly alter treatment, making it difficult to splint or cast and often overlying ideal surgical incision sites. Review of the literature reveals no consensus on management; however, most authors agree on early treatment prior to blister formation or delay until blister resolution before attempting surgical correction or stabilization. [West J Emerg Med. 2011;12(1;131-133.

  8. 拉力螺钉辅加抗滑钢板内固定治疗Hoffa骨折%Internal fixation with lag screws plus an auxiliary anti-sliding plate for the treatment of Hoffa fractures

    Institute of Scientific and Technical Information of China (English)

    徐培; 孙杰; 袁天祥; 马宝通

    2012-01-01

    Objective To investigate the clinical efficacy of internal fixation with lag screws plus an auxiliary sliding plate for the treatment of Hoffa fractures.Methods A retrospective analysis was made for 12 patients (14 condyles) with Hoffa fracture who had been treated in our hospital from December 2007 through November 2011.They were 8 males (10 condyles) and 4 females (4 condyles),with an average age of 36.2 years (range,from 20 to 61 years).By the Hoffa classification,6 cases were medial condylar fractures,4 lateral condylar fractures and 2 bicondylar fractures.By the AO/OTA classification,10 cases were type 33B32 and 2 type 33B33.By Letenneur's classification,7 condyles were type Ⅰ,one condyle was type Ⅱ and 6 condyles were type Ⅲ.There were 2 open fractures and 10 closed ones.Femoral shaft fracture was complicated in one case,proximal tibia fracture in 3 cases,ankle fracture in one,injury to the knee extensor mechanism in 2,cruciate ligament injury in 4,medial collateral ligament injury in one,and meniscus injury in 3.The time from injury to surgery averaged 3.2 days (from 2 hours to 7 days).All fractures were reduced under direct vision and fixated with cancellous lag screws plus an additional anti-sliding plate.Results All the patients were followed for 6 to 54 months (average,20.3 months).Union was achieved in all patients after an average time of 16.6 weeks (from 11 to 23 weeks).No implant failure or fracture displacement occurred.Incision infection and incision disunion occurred in one case each,but both were cured after intensive care.According to Letenneur's functional assessment,11 cases were excellent or good and one case was fair,giving a good to excellent rate of 91.7%.Conclusions Open reduction and internal fixation with lag screws and an additional anti-sliding plate may result in excellent results for Hoffa fractures.The key to a successful surgery is an appropriate approach,anatomic reduction and rigid fixation.%目的 探讨拉力螺钉辅

  9. Effect of proximal humeral internal locking system in treating complex proximal humeral fractures in elderly patients%应用PHILOS接骨板治疗复杂老年肱骨近端骨折

    Institute of Scientific and Technical Information of China (English)

    苑娜; 郑继会; 胡思斌; 孙宏辉; 赵爱军

    2011-01-01

    目的 探讨肱骨近端内固定锁定系统(PHILOS)接骨板治疗复杂老年肱骨近端骨折的疗效.方法 回顾性分析我院2005年6月~2008年12月应用PHILOS接骨板手术治疗复杂老年肱骨近端骨折27例临床资料,其中男性15例,女性12例;平均年龄74岁(59~83岁).按Neer分型:三部分骨折19例,四部分骨折8例,均有原发性骨质疏松.复位后PHILOS接骨板固定.结果 术后随访8~36个月,平均13个月.骨折全部愈合,2例出现肱骨头坏死.按照Neer肩关节功能评分标准:优6例,良14例,可4例,差3例;优良率74%.结论 应用PHILOS接骨板治疗复杂老年肱骨近端骨折固定可靠,可以早期功能锻炼,术后功能恢复满意,对复杂老年肱骨近端骨折是一种有效的治疗方法.%Objective To summarize the treatment effect of proximal humeral internal locking system( PHILOS ) for complex proximal humeral fractures in old patients. Methods A retrospective study was done on 27 cases of complex proximal humeral fracture treated with PHILOS plate from Jun. 2005 to Dec. 2008, including 15 males and 12 females aged 59-83 years ( average 74 years). According to the Neer classification, 19 cases were three-part fractures, 8 cases were four-part fractures, and all cases were observed primary osteoporosis. A deltoid-pectoral approach was used in all patients and fixed the fracture with PHILOS plate after reduction, the tubercle fragments were sutured with non-absorbable ethibond. Results The follow-up time ranged from 8 to 36 months,with mean of 13 months. All fractures got bone union and humeral head necrosis was observed in 2 cases. By Neer shoulder scoring system, 6 cases were excellent,14 cases were good,4 cases were fair and 3 cases were poor. Conclusion Applying PHILOS plate in treatment of the complex proximal humeral fractures in old patients provides a stable fixation and earlier rehabilitation. It is an effective method for complex proximal humeral fractures in old patients.

  10. Comparison of biomechanical properties of different internal fixation methods for the treatment of posterior ankle fractures%后踝关节骨折不同内固定方式的生物力学性能对比

    Institute of Scientific and Technical Information of China (English)

    万全会

    2015-01-01

    BACKGROUND:Different fixtures can be used for the internal fixation treatment of patients with posterior ankle fractures in clinic, however, different internal fixation methods wil produce different biomechanical effect. OBJECTIVE:To compare and analyze the biomechanical properties of mini steel plate internal fixation and tension screw internal fixation in the treatment of posterior ankle fracture. METHODS:The clinical data of 95 patients with posterior ankle fractures were retrospectively analyzed. Al patients were treated with internal fixation. Mini steel plate group (n=48 cases) and tension screw group (n=47 cases) were divided according to the internal fixation methods. RESULTS AND CONCLUSION:The fixation effect of these two groups was simulated and analyzed using three-dimensional finite element model. The results showed that when the posterior ankle joint fracture block spreaded to the distal tibial articular surface of more than 25%, the mean pressure of internal fixation failure of tension screw group was significantly less than that of the mini steel plate group (P  目的:比较分析后踝关节骨折行微型钢板内固定以及拉力螺钉内固定治疗的生物力学性能。  方法:回顾性分析95例后踝关节骨折患者的临床资料,均接受内固定治疗,按照内固定方法分为微型钢板组48例和拉力螺钉组47例。  结果与结论:对两组的固定效果进行三维有限元模型模拟和分析,经分析发现,在后踝关节骨折块波及到胫骨远端关节面25%以上的情况下,在内固定失效平均压力方面,拉力螺钉组显著小于微型钢板组(P<0.05);而当后踝关节骨折块波及到胫骨远端关节面25%以下的情况下,在内固定失效平均压力方面,拉力螺钉组显著大于微型钢板组(P <0.05)。拉力螺钉组的踝关节内固定优良率显著高于微型钢板组(P <0.05)。两组治疗过程中均未出现任何内固定材料相关不

  11. External fixation combined with limited internal flxation and bone grafting for Pilon fracture%有限内固定结合外固定架治疗胫骨远端 Pilon骨折临床观察

    Institute of Scientific and Technical Information of China (English)

    刘建; 刘俊宾; 王文珠; 郑卫东

    2014-01-01

    目的:观察有限内固定结合外固定架治疗胫骨Pilon骨折的临床效果。方法采用三维单侧多功能外固定支架结合有限切开内固定治疗Ruedi和Allgower分型中Ⅱ、Ⅲ型有移位骨折57例。结果根据Pi-lon骨折复位的Burwell-Charnley放射学标准及踝关节主观评分结果示,优45例,良10例,差2例。术后并发症:4例感染,3例皮肤坏死,2例发生骨筋膜综合征,5例踝关节功能障碍但未见骨不连或畸形愈合。结论根据Pilon骨折的类型和软组织损伤程度选择合适的手术方式和手术时机,合理使用外固定支架结合有限内固定维持骨折复位和下肢力线,干骺端缺损区充分植骨,整复关节面,适当功能锻炼,晚负重,术后可达到良好的临床效果。%Objective To investigate the clinical efficacy of external fixation combined with limited internal fixation and bone graft for the treatment of Pilon fractures .Methods Fifty-seven patients of Ruedi and AllgowerⅡ ,Ⅲ type of displaced fracture from March 2008 to October 2013 had treated with external fixation combined with limited internal flxation and bone grafting .Results According to Mazur function assessment system ,the curative effect was excellent in 45 patients ,good in 10 patients and poor in 2 patients .The complications included wound in-fection in 4 cases ,skin necrosis in 3 cases ,fascia syndrome in 2 cases and functional disturbance of ankle in 5 cases . Conclusion Accurate assess local soft tissue conditions for Pilon fractures is essential .According to Pilon fracture type and degree of soft tissue injury ,appropriate surgical method and surgical opportunity can be selected .External fixation combined with limited internal fixation and bone grafting maintains fracture reduction and mechanical axis of lower limb .Metaphyseal bone defect area can be filled with autogenous bone or artificial bone to prompt restora-tion of articular surface .Appropriate

  12. Implementing a Greener Hydraulic Fracturing in Scotland

    OpenAIRE

    Cano, Michele; Matthew, Anietie; Quinn, Brian

    2015-01-01

    International audience Abstract - The drive to implement unconventional gas drilling by means of hydraulic fracturing in United Kingdom (UK) has been a major issue of concern due to the potential environmental and health impacts. This paper is aimed at examining the following: what triggers the need for the unconventional gas; the process of unconventional gas through hydraulic fracturing method; the potential risks of hydraulic fracturing to the environment and to human health; key succes...

  13. Geostatistical Evaluation of Fracture Frequency and Crushing

    OpenAIRE

    Séguret, Serge Antoine; Guajardo Moreno, Cristian; Freire Rivera, Ramon

    2014-01-01

    International audience This work details how to estimate the Fracture Frequency (FF), ratio of a number of fractures divided by a sample length. The difficulty is that often, a part of the sample cannot be analyzed by the geologist because it is crushed, a characteristics of the rock strength that must also be considered for the Rock Mass Rating. After analyzing the usual practices, the paper describes the (geo)statistical link between fracturing and crushing and the resulting method to ob...

  14. Fractures of distal radius: an overview.

    Science.gov (United States)

    Meena, Sanjay; Sharma, Pankaj; Sambharia, Abhishek Kumar; Dawar, Ashok

    2014-01-01

    Fractures of distal radius account for up to 20% of all fractures treated in emergency department. Initial assessment includes a history of mechanism of injury, associated injury and appropriate radiological evaluation. Treatment options include conservative management, internal fixation with pins, bridging and non-bridging external fixation, dorsal or volar plating with/without arthroscopy assistance. However, many questions regarding these fractures remain unanswered and good prospective randomized trials are needed. PMID:25657938

  15. Contemporary Management of Infected Mandibular Fractures

    OpenAIRE

    Alpert, Brian; Kushner, George M.; Tiwana, Paul S.

    2008-01-01

    The treatment of infected mandibular fractures has advanced rather dramatically over the past 50 years. Immobilization with maxillomandibular fixation and/or splints, removal of diseased teeth in the fracture line, external fixation, use of antibiotics, debridement, and rigid internal fixation has played a role in management. Perhaps the most important advance was the realization that infected fractures also result from moving fragments and nonvital bone, not just bacteria. Controlling moveme...

  16. 胸腰椎骨折内固定方法应用的比较分析%The Comparison of Application about Internal Fixation Method Applied to Thoracolumbar Fracture

    Institute of Scientific and Technical Information of China (English)

    王兴水

    2013-01-01

    Objective:To compare and analysis the application effect of internal fixation method applied to thoracolumbar fracture.Method:The 82 patients were surgical treatment respectively with internal fixation of posterior(internal fixation of decompression from the posterior called Harrington and internal fixation from the posterior through the pedicle of vertebral arch called AF system)and internal fixation from the front path called Kaneda,then compare the the improvement about cobb’s angle of injured spinal cord and the height of front and rear edge、the changes of Frankel classification and the adverse reaction case after treatment.Result:The effect of AF was better than Harrington and Kaneda on cobb’s angle and the height of front and rear edge;The adverse reaction case of Harrington and AF was less than Kaneda.Conclusion:Medical clinical should choose the right way of internal fixation when treatment with thoracolumbar fracture,internal fixation of decompression from the posterior can be considered first in the feasible premise.%  目的:比较分析胸腰椎骨折内固定方法的应用效果。方法:对82例患者分别采用后路内固定(后路减压式内固定方式Harrington和后路经椎弓根内固定AF系统)及前路内固定Kaneda方式进行手术治疗,比较治疗后伤椎Cobb’s角和前、后缘高度改善情况,以及Frankel分级变化情况、并发症发生情况。结果:Cobb’s角和前、后缘高度改善情况及Frankel分级上,AF较之Harrington与Kaneda效果更佳;另外,Harrington与AF较之Kaneda,并发症发生率相对更少。结论:治疗胸腰椎骨折时,应根据患者的具体情况选择合适的内固定方式,后路方式可行的前提下可优先考虑采用。

  17. Fracture source

    Directory of Open Access Journals (Sweden)

    2003-07-01

    Full Text Available The fracture properties of many different types of fibers are covered in a timely new book that will prove to be a tremendous source of information and references for researchers in the wide and diverse field of fibers and composites, says Bill Clegg.

  18. 平行双钢板内固定治疗成人肱骨远端复杂骨折疗效观察%Internal fixation for complex distal humeral fractures in adults with parallel-plating

    Institute of Scientific and Technical Information of China (English)

    李明

    2011-01-01

    Objective To study the efficacy of complex distal humeral fractures in adults with the parallel-plate technique. Methods 16 patients with complex distal humeral fractures were treated by open reduction and internal fixation using parallel plating. The function of elbow was assessed according to Mayo elbow performance score (MEPS) and plain X-ray films. Results 16 patients had been followed up for 3~18 months (mean, 9.5 months). The mean fracture healing time was 6~16 weeks (mean, 10.5 weeks), with no nonunion, delayed union, displacement, avascular necrosis of implant failure. The range of motion of the elbow joint averaged 113.2°and the mean MEPS was 83.9. The overall excellent to good rate was 87.5%. Conclusion The parallel-plate technique can obtain stable internal fixation, early postoperative rehabilitation and satisfactory clinical effect in the treatment of complex distal humeral fractures in adults.%目的 观察平板双钢板内固定治疗成人肱骨远端复杂骨折的临床效果.方法 采用平板双钢板内固定方法治疗16例成人肱骨远端复杂骨折患者,按照Mayo肘关节功能评分(MEPS)标准及X线平片结果评估疗效.结果 本组16例患者骨折均一期愈合,时间为6~16周,平均10.5周,无一例内固定松动及骨折移位发生.术后均随访3~18个月,平均10个月,患侧肘关节MEPS评分为46~100分(平均83.9分),疗效评定:优8例(50%),良6例(37.5%),可2例(12.5%),差0例,优良率为87.5%.结论 平板双钢板内固定治疗成人肱骨远端复杂骨折,固定强度和抗疲劳作用强,利于肘关节早期功能锻炼,效果满意.

  19. 跟骨内固定法治疗粉碎性跟骨骨折的临床效果分析%Analysis of clinical effect of internal calcaneal fixation treatment for comminuted calcaneal fractures

    Institute of Scientific and Technical Information of China (English)

    陈星

    2011-01-01

    目的:探讨跟骨内固定治疗粉碎性跟骨骨折的疗效.方法:选取我院2005年12月~2008年12月行切开复位可塑形钛质钢板固定加植骨术治疗粉碎性跟骨骨折患者41例52足,所有跟骨骨折患者均采用L型大切口跟骨钢板固定,保护腓肠神经,钢板外侧固定,术后评价骨折复位效果.结果:采用Marglang足部评分标准,优24足,良16足,中7足,差5足,优良率为76.9%.切口一期愈合47足,切口延迟愈合3足,钢板外露伴浅感染2足.结论:跟骨内固定法治疗粉碎性跟骨骨折疗效较好.%Objective: To investigate the effect of internal calcaneal fixation treatment for comminuted calcaneal fractures.Methods: 41 cases with 52 calcaneal fractures of patients with comminuted calcaneal fratures in the treatment of open reduction with plastic titanic steel plate fired and bone graft operation were selected.All were fixed with L-shaped calcaneal steel plates for large incision, with the sural nerve protected and the lateral side of the plate fixed.Postoperative effects of fracture reduction were evaluated.Results: The Marglang foot scoring standards were used to evaluate the postoperative effect, with 24 feet excellent, 16 feet good, 7 feet fair and 5 feet poor.The excellent and good rate was 76.9%.47 feet were primary wound healing, 3 patients had delayed wound healing and 2 feet appeared steel plate exposion with superficial infection.Conclusion: The effect of internal calcaneal fixation treatment for comminuted calcaneal fractures is preferably.

  20. Roles of radiograph, magnetic resonance imaging, threedimensional computed tomography in early diagnosis of femoro-acetabular impingement in 17 cases

    Institute of Scientific and Technical Information of China (English)

    GU Gui-shan; ZHU Dong; WANG Gang; WANG Cheng-xue

    2009-01-01

    Objective: To evaluate the roles of radiograph, magnetic resonance imaging (MRI), three-dimensional computed tomography (3-D CT) in early diagnosis of femoro-acetabular impingement (FAI) in 17 cases. Methods: Plain radiographs of the pelvis, 3-D CT, and MRI of the hip were made on 17 patients with groin pain, which was worse with prolonged sitting (i.e. hip flexion). There was no history of trauma or childhood hip disorders in the patients who did not complain of any other joint problems or neurologic symptoms. All patients had positive anterior or posterior impingement test. Plain radiographs included an antero-posterior (AP) view of the hip and a cross table lateral view with slight internal rotation of the hip. CT scan was performed with the Lightspeed 16 row spiral (General Electric Company, USA) at 1.25 mm slice reconstruction. MRI scan was performed on the Siemens Avanto (Siemens Company, Germany)1.5T supraconducfion magnetic resonance meter. The CT and MRI scans were taken from 1 cm above the acetabulum to the lesser trochanter in 5 series. Results: The plain radiographs of the pelvis showed that among the 17 patients, 12 (70.59%) had "Cam" change of the femoral head, 6 (35.29%) had positive "cross-over" sign, and 17 (100%) had positive "Pincer" change of the acetabulum. The 16 row spiral CT noncontrast enhanced scan and 3-D reconstruction could discover minus femoral offset and ossification and osteophyte of the acetabulum labrum in all the 17 cases (100%). The MRI noncontrast enhanced scan could discover more fluid in the hip joint in 15 cases (88.33%), subchondral ossification in 3 cases (17.6%), and labium tears in 3 cases (17.6%). Conclusions: Plain radiographs can provide the initial mainstay for the diagnosis of FAI, 3-D CT can tell us the femoral offset, while MRI can show labrum tears in the very early stage of FAI. Basically, X-ray examination is enough for the early diagnosis of FAI, but 3-D CT and MRI may be useful for the treatment.

  1. Early history of scapular fractures.

    Science.gov (United States)

    Bartoníček, Jan; Kozánek, Michal; Jupiter, Jesse B

    2016-01-01

    The first to use the term Scapula was Vesalius (1514-1564) and thus it has remained ever since. Probably the oldest injured scapula, from 250 million years ago, was described by Chinese authors of a skeletal examination of a fossilised remains of a dinosaur Yangchuanosaurus hepingensis. In humans, the oldest known scapular fractures date back to the prehistoric and early historic times. In ancient times, a fracture of acromion was described in the treatises of Hippocrates. Early modern history of the treatment of scapular fractures is closely interlinked with the history of the French surgery. The first to point out the existence of these fractures were Petit, Du Verney and Desault in the 18th century. The first study devoted solely to scapular fractures was published by Traugott Karl August Vogt in 1799. Thomas Callaway published in 1849 an extensive dissertation on injuries to the shoulder girdle, in which he discussed a number of cases known at that time. The first radiograph of a scapular fracture was published by Petty in 1907. Mayo Robson (1884), Lambotte (1913) and Lane (1914) were pioneers in the surgical treatment of these fractures, followed in 1923 by the French surgeons Lenormat, Dujarrier and Basset. The first internal fixation of the glenoid fossa, including a radiograph, was published by Fischer in 1939. PMID:26133287

  2. Early history of scapular fractures.

    Science.gov (United States)

    Bartoníček, Jan; Kozánek, Michal; Jupiter, Jesse B

    2016-01-01

    The first to use the term Scapula was Vesalius (1514-1564) and thus it has remained ever since. Probably the oldest injured scapula, from 250 million years ago, was described by Chinese authors of a skeletal examination of a fossilised remains of a dinosaur Yangchuanosaurus hepingensis. In humans, the oldest known scapular fractures date back to the prehistoric and early historic times. In ancient times, a fracture of acromion was described in the treatises of Hippocrates. Early modern history of the treatment of scapular fractures is closely interlinked with the history of the French surgery. The first to point out the existence of these fractures were Petit, Du Verney and Desault in the 18th century. The first study devoted solely to scapular fractures was published by Traugott Karl August Vogt in 1799. Thomas Callaway published in 1849 an extensive dissertation on injuries to the shoulder girdle, in which he discussed a number of cases known at that time. The first radiograph of a scapular fracture was published by Petty in 1907. Mayo Robson (1884), Lambotte (1913) and Lane (1914) were pioneers in the surgical treatment of these fractures, followed in 1923 by the French surgeons Lenormat, Dujarrier and Basset. The first internal fixation of the glenoid fossa, including a radiograph, was published by Fischer in 1939.

  3. The treatment of distal radius fractures of by LCP internal fixation implanted under pronator quadratus%经旋前方肌下置入LCP内固定治疗桡骨远端骨折

    Institute of Scientific and Technical Information of China (English)

    刘红军; 明立功; 明立德; 明立山; 明朝戈

    2014-01-01

    Objective To evaluate the clinical effect and method of LCP internal fixation for the treatment of fractures of the distal radius under the pronator quadratus. Methods From April 2008 to January 2001, by the volar approach with reservation of pronator, the unstable distal radius fractures were treated by LCP internal fixation inserted under the pronator quadratus in 17 cases, according to AO classification: type B1 2 cases, type B2 7 cases, type B3 2 cases, type C1 in 4 cases, 2 cases of C2 type. All the cases were taken by volar approach, pronator quadratus were reserved, or only to cut off partly and LCP internal fixation were inserted under pronator to treat distal radius fractures. Results The patients were followed up for 9~44 months, with the average of 13 months. All fracture healed, the average healing time was 7 weeks. No infection, nonunion, carpal tunnel syndrome and other complications occurred. According to the improved Mcbride wrist joint function evaluation standard: excellent in 15 cases, good in 1 case, moderate in 1 case, the excellent and good rate was 94.1%. Conclusion The LCP internal fixation inserted under the pronator quadratus for treatment of distal fractures is completely feasible, in line with the point of view of modern minimally invasive operation. Pronator can cover the plate, reduces interference of wrist tendon, reduce tissue injury, to maximize the retention of forearm rotation function, is advantageous to the recovery of wrist function.%目的:探讨经旋前方肌下置入LCP内固定治疗桡骨远端骨折的方法及临床效果。方法2008年4月-2011年1月,采用掌侧入路保留旋前方肌的方法,于旋前方肌下置入LCP内固定治疗桡骨远端不稳定骨折17例,按AO分类标准:B1型2例,B2型7例,B3型2例,C1型4例,C2型2例。所有病例均采取掌侧入路,术中不切断旋前方肌,或仅切断部分旋前方肌行旋前方肌下置入LCP内固定治疗桡骨远端骨折。结

  4. Internal fixation of the unstable pelvic fracture based on the anatomic features of the pelvis%骨盆的形态特点与不稳定型骨折内固定治疗评价

    Institute of Scientific and Technical Information of China (English)

    翁阳华; 吴显奎; 彭扬国; 欧耀芬

    2011-01-01

    目的 探讨根据骨盆的形态特点选择不同的内固定手术治疗不稳定型骨盆骨折的临床应用价值。方法65例不稳定型骨盆骨折,31例Tile B型骨折经前入路,将耻骨联合或耻骨支复位用重建钢板固定,其中8例合并髂骨骨折经髂窝入路将之复位用重建钢板固定;34例Tile C型骨折的前环损伤均采用与Tile B型骨盆骨折相同的方法处理,后环损伤的固定方法:17例骶骨骨折或骶髂关节脱位之中,复位后在透视引导下从后方经皮骶髂螺钉固定11例,经髂骨的螺栓固定4例,经后路在双侧髂骨后嵴之间用张力带钢板固定2例;9例骶髂关节骨折-脱位之中,经皮骶髂螺钉固定6例,钢板固定3例;8例合并髋臼骨折行重建钢板内固定。结果通过对术后骨盆X线测量骨折分离移位的最大距离,根据Matta评分标准:小于4 mm为优,占86.1%(56例);4~10mm为良,占7.7%(5例);10~20 mm为可,占6.2%(4例);大于20 mm为差(0例)。本组骨盆X线测量结果总优良率为93.8%。结论不稳定型骨盆骨折应在血流动力学稳定时尽早根据骨折的类型及骨盆的解剖形态特点选择合理的内固定手术方案。%Objective To explore clinical efficiency of different surgical internal fixations on treating the unstable pelvic fracture according to the anatomic features of the pelvis. Methods 65 cases suffering from the unstable pelvic fractures, were included in this study. Anterior approach, with the replacement and plate fixation of symphysis pubis or ramus of pubis, was performed for 31 cases of Tile B type fracture. 8 cases combined with ilium fracture among them were replaced and fixed through iliac fossa approach. As well, anterior approach also was used for fixing damaged anterior girdle of 34 cases of Tile C type fracture. However, the damaged posterior girdles were treated with the replacement and the posterior sacroiliac screw fixation

  5. Study of the three-dimensional orientation of the labrum: its relations with the osseous acetabular rim

    Science.gov (United States)

    Bonneau, Noémie; Bouhallier, July; Baylac, Michel; Tardieu, Christine; Gagey, Olivier

    2012-01-01

    Understanding the three-dimensional orientation of the coxo-femoral joint remains a challenge as an accurate three-dimensional orientation ensure an efficient bipedal gait and posture. The quantification of the orientation of the acetabulum can be performed using the three-dimensional axis perpendicular to the plane that passes along the edge of the acetabular rim. However, the acetabular rim is not regular as an important indentation in the anterior rim was observed. An innovative cadaver study of the labrum was developed to shed light on the proper quantification of the three-dimensional orientation of the acetabulum. Dissections on 17 non-embalmed corpses were performed. Our results suggest that the acetabular rim is better represented by an anterior plane and a posterior plane rather than a single plane along the entire rim as it is currently assumed. The development of the socket from the Y-shaped cartilage was suggested to explain the different orientations in these anterior and posterior planes. The labrum forms a plane that takes an orientation in between the anterior and posterior parts of the acetabular rim, filling up inequalities of the bony rim. The vectors VL, VA2 and VP, representing the three-dimensional orientation of the labrum, the anterior rim and the posterior rim, are situated in a unique plane that appears biomechanically dependent. The three-dimensional orientation of the acetabulum is a fundamental parameter to understand the hip joint mechanism. Important applications for hip surgery and rehabilitation, as well as for physical anthropology, were discussed. PMID:22360458

  6. Analysis of acetabular version in the native hip: comparison between 2D axial CT and 3D CT measurements

    Energy Technology Data Exchange (ETDEWEB)

    Dandachli, Wael [Department of Orthopaedic Surgery, Imperial College London Hospitals, London (United Kingdom); Ul Islam, Saif; Tippett, Richard; Hall-Craggs, Margaret A.; Witt, Johan D. [University College London Hospitals, London (United Kingdom)

    2011-07-15

    To compare two-dimensional (2D) axial with three-dimensional (3D) computerized tomography (CT) measurements of acetabular version in native hips. CT scans of 34 hips in 17 consecutive patients being investigated for femoroacetabular impingement were analyzed. Acetabular version was measured using 2D CT at two different axial levels, one cranial (slice 2) and the other at the equator (slice 3). The measurements were repeated after correction for pelvic tilt. The results were compared to the measurements of anatomical version obtained using a 3D CT method that automatically corrects for pelvic tilt. The mean acetabular version using the 3D CT method was 15.7 (SD 6.9 ). The mean version using slice 2 was 9.3 (SD 6.5 ) before correction for pelvic tilt and 15.7 (SD 8.0 ) after the correction. The mean version using slice 3 was 16.4 (SD 4.2 ) before tilt correction and 19.0 (SD 5.0 ) after the correction. In relation to the 3D method, the intraclass correlation coefficient (ICC) was 0.58 for the uncorrected and 0.93 for the corrected slice 2 method. For the uncorrected and corrected slice 3 methods, the ICC was 0.64 and 0.89, respectively. The 2D axial methods produced variable results. The results that correlated best with the 3D method were those of the cranial slice (slice 2) after correction for pelvic tilt. Interpretation of 2D axial CT measurements of acetabular version should be done with caution. The level at which the measurement is done and the presence of pelvic tilt appear to be significant factors. (orig.)

  7. Infiltration of soft tissue by myeloma after internal fixation of pathologic femoral fracture; Infiltracion de partes blandas por mieloma, tras la fijacion interna de una fractura patologica femoral

    Energy Technology Data Exchange (ETDEWEB)

    Martinez, J.; Escape, I.; Bastart, F.; Solduga, C. [Hospital de Barcelona. Barcelona (Spain)

    2002-07-01

    a 75-year-old man with multiple myeloma presented with a pathologic fracture of distal right femoral diaphysis, which was fixed with Ender nails. Two and a half months later, the patients was readmitted with rapidly progressive swelling of right thigh. Ultrasound computed tomography and magnetic resonance imaging revealed infiltration of anterior right thigh muscles, extending upward to the iliopsoas muscle and retroperitoneal space, above ipsilateral renal vein. Ultrasound-guided biopsy of the soft tissue of the thigh revealed diffuse myelomatous infiltration by plasma blasts. (Author) 9 refs.

  8. Absence or interruption of the supra-acetabular line: a subtle plain film indicator of hip pathology

    Energy Technology Data Exchange (ETDEWEB)

    Major, N.M. [Department of Radiology, University of California San Francisco, Box 0628, San Francisco, CA 94143 (United States); Helms, C.A. [Department of Radiology, University of California San Francisco, Box 0628, San Francisco, CA 94143 (United States)

    1996-08-01

    Objective. To show that absence or interruption of the supraacetabular line is a subtle plain film indicator of pathology in the acetabulum. Design. Nineteen hips from 17 patients with known disease processes involving the acetabulum as demonstrated by subsequent magnetic resonance imaging, bone scan or plain film follow-up were evaluated with antero-posterior (AP) plain films of the pelvis. Three additional cases were diagnosed prospectively using interruption of the supra-acetabular line as the criterion for inclusion. Fifty AP plain films of the pelvis in patients without hip pain were examined prospectively to determine normal imaging criteria. Results and conclusions. The normal supra-acetabular line measures 2-3 mm in thickness superiorly and is a thin sclerotic line in the medial aspect. In all 22 hips (with pathology) in this series, the line was interrupted or absent. Loss or interruption of the supra-acetabular line may thus be a subtle pain film indicator of a disease process involving the acetabulum. This plain film sign has not previously been reported. (orig.). With 8 figs., 1 tab.

  9. The Ankle Injury Management (AIM) trial: a pragmatic, multicentre, equivalence randomised controlled trial and economic evaluation comparing close contact casting with open surgical reduction and internal fixation in the treatment of unstable ankle fractures in patients aged over 60 years.

    Science.gov (United States)

    Keene, David J; Mistry, Dipesh; Nam, Julian; Tutton, Elizabeth; Handley, Robert; Morgan, Lesley; Roberts, Emma; Gray, Bridget; Briggs, Andrew; Lall, Ranjit; Chesser, Tim Js; Pallister, Ian; Lamb, Sarah E; Willett, Keith

    2016-01-01

    BACKGROUND Close contact casting (CCC) may offer an alternative to open reduction and internal fixation (ORIF) surgery for unstable ankle fractures in older adults. OBJECTIVES We aimed to (1) determine if CCC for unstable ankle fractures in adults aged over 60 years resulted in equivalent clinical outcome compared with ORIF, (2) estimate cost-effectiveness to the NHS and society and (3) explore participant experiences. DESIGN A pragmatic, multicentre, equivalence randomised controlled trial incorporating health economic evaluation and qualitative study. SETTING Trauma and orthopaedic departments of 24 NHS hospitals. PARTICIPANTS Adults aged over 60 years with unstable ankle fracture. Those with serious limb or concomitant disease or substantial cognitive impairment were excluded. INTERVENTIONS CCC was conducted under anaesthetic in theatre by surgeons who attended training. ORIF was as per local practice. Participants were randomised in 1 : 1 allocation via remote telephone randomisation. Sequence generation was by random block size, with stratification by centre and fracture pattern. MAIN OUTCOME MEASURES Follow-up was conducted at 6 weeks and, by blinded outcome assessors, at 6 months after randomisation. The primary outcome was the Olerud-Molander Ankle Score (OMAS), a patient-reported assessment of ankle function, at 6 months. Secondary outcomes were quality of life (as measured by the European Quality of Life 5-Dimensions, Short Form questionnaire-12 items), pain, ankle range of motion and mobility (as measured by the timed up and go test), patient satisfaction and radiological measures. In accordance with equivalence trial US Food and Drug Administration guidance, primary analysis was per protocol. RESULTS We recruited 620 participants, 95 from the pilot and 525 from the multicentre phase, between June 2010 and November 2013. The majority of participants, 579 out of 620 (93%), received the allocated treatment; 52 out of 275 (19%) who received CCC later

  10. Failure cause and treatment countermeasure of internal fixation on femoral intertrochanteric fracture%股骨粗隆间骨折内固定失效原因分析及对策

    Institute of Scientific and Technical Information of China (English)

    任周奎; 吕应文; 余定华; 于金华

    2011-01-01

    目的 探讨股骨粗隆间骨折内固定失效原因及治疗对策.方法 回顾总结我院2003~2009年行手术治疗的123例股骨粗隆间骨折病例,按Evans分型,分析各型骨折内固定失效原因,内固定方式与内固定失效类型及发生率情况.结果 123例均得到随访,有23例骨折内固定失效,其中稳定型骨折内固定失效5例,不稳定型骨折内固定失效18例;发生率为18.69%.失效类型:髋内翻、股骨颈短缩、内固定物断裂导致骨折畸形.不稳定型骨折内固定失效发生率远高于稳定性骨折,而钉板系统内固定失效发生率远高于髓内系统.钉板系统中近端解剖钢板内固定失效发生率高于动力髋螺钉(DHS).结论 对各类型骨折特点认识不够从而导致内固定方式选择不当;骨质疏松症患者术后过早负重;术者操作不当.%Objective To discuss the failure cause and treatment countermeasure of internal fixation on femoral intertrochanteric fracture. Methods Clinical data of 123 patients with femoral intertrochanteric fracture ad mitted into our hospital from 2003 to 2009 were retrospectiverly collected , analyzing the failure causes of operation , methods of inlernal fixation ,failure types of internal fixalion and failure incidence of inlernal fixalion , Results All the patients were followed up for 1.5 to 36(mean,24. 3) months. Totally 23 patients didn't achieve good internal fixation , with the failure rate of 18. 69% . The types of failure included coxa vara deformity , short femoral neck ,fixity breakage. The failure incidence of inlernal fixation in unstable fracture pafienls was higher than that of stable fracture palienls , and the failure incidence of inlernal fixation in screw -plate system was higher lhan that of intramedul lary system. While for the screw-plate system,the failure incidence at internal fixation in the distal anatomical plate was higher than that of dynamic hip screw . Conclusion The internal fixalion

  11. 颈丛臂丛阻滞麻醉用于锁骨骨折内固定的临床观察%Clinical Observation of Brachial Plexus and Cervical Plexus Block Anesthesia for Internal Fixation of Clavicle Fracture

    Institute of Scientific and Technical Information of China (English)

    郝永婷; 龚丽娜

    2011-01-01

    Objective: To observe the effect of brachial plexus and cervical plexus block anesthesia for the internal fixation of clavicle fractures. Method: We selected 96 cases of internal fixation of clavicle fractures which were admitted in our hospital from January 2008 to January 2010. The patients were divided into three groups that called A, B, C. Group A took brachial plexus block anesthesia; Group B took cervical plexus block anesthesia; Group C took cervical plexus and cervical plexus block anesthesia. Then compared the effect of three groups and selected the best group of anesthesia. Result: There was no significant difference ( P>0.05 ) between group A and group B. However, Group C were different fromgroup A and group B ( P <0.05 ), which showed that group C was better than group A or B. That showed cervical plexus and cervical plexus block anesthesia had a better effect on the patient than the others. Conclusion: The combined of cervical plexus and brachial plexus block anesthesia is superior to simple cervical or plexus block anesthesia,it is worth to promote the cervical plexus and brachial plexus block anesthesia in the internal fixation of clavicie fracture.%目的:观察颈丛臂丛阻滞麻醉用于锁骨骨折内固定的麻醉效果.方法:选取我院2008年1月到2010年1月锁骨骨折手术患者96例,随机分成A、B、C三组,每组32例,A组采用臂丛阻滞麻醉;B组采用颈丛阻滞麻醉;C组采用先进行臂丛阻滞麻醉,15min后进行颈丛阻滞麻醉的联合麻醉方法,比较三组麻醉效果.结果:A组与B组比较,两者无显著性差异(P>0.05),C的麻醉效果明显优于A组与B组,C组与A和B组均存在显著性差异(P<0.05).结论:颈丛臂丛联合阻滞麻醉优于单纯的臂丛和颈丛阻滞麻醉,值得在锁骨骨折内固定手术中的推广应用.

  12. Effect of Posterior Surgery Internal Fixation in Treatment of Spinal Fractures%后路手术内固定治疗脊柱骨折的效果探析

    Institute of Scientific and Technical Information of China (English)

    邢龙

    2015-01-01

    目的:探析脊柱骨折采用后路手术内固定治疗的效果。方法研究对象取本院2014年4月~2015年4月脊柱骨折42例,依据不同治疗方式将其分两组。对照组21例,接受传统手术;研究组21例,治疗方式为后路手术内固定,观察比较两组效果。结果组间对比,研究组伤椎前缘高度、伤椎后缘高度及Cobb角改善程度较大(P<0.05),治疗有效率高(P<0.05),差异有统计学意义。结论脊柱骨折后路手术内固定治疗效果佳。%Objective Posterior surgery internal fixation effect in treatment of spinal fractures is to be studied.Methods Chose 42 patients with spinal fracture who were treated in hospital from April 2014 to April 2015 and separated them into two groups according to different treatment methods,21 patients in control group were given conventional surgery treatment,while 21 patients in study group were given posterior surgery internal fixation treatment and then observed and compared patients’ treatment effects between two groups. Results Patients’ height of fronting injured vertebral as wel as height of posterior injured vertebral and Cobb angle improvement in study group were much better than counterparts in control group(P< 0.05),and in addition,treatment efficacy in study group was much higher,there was a differential between two groups.ConclusionPosterior surgery internal fixation is of efficacy in treatment of spinal fractures. patients with diabetes,strengthening the management of the diet to improve the treatment effect.

  13. 切开复位双重建钛板内固定治疗青壮年肱骨远端粉碎性骨折%Double plates internal fixation for comminuted distal humeral fracture in young adults

    Institute of Scientific and Technical Information of China (English)

    韩芳; 魏世隽; 蔡贤华

    2011-01-01

    Objective To evaluate the clinical efficacy of double plates internal fixation for comminuted distal humeral fracture in young adults. Methods From June 2003 to June 2009,41 patients( 18 females and 23males)with distal humeral fracture underwent open reduction and internal fixation with double plates in our hospital. Thirty - seven patients were followed up for 14 to 35 mon( average 25 mon).Clinical outcomes were evaluated according to the Cassebaum criteria. Results Bone union was achieved in all the 37 patients. The efficacy was excellent in 14 patients, good in 9 patients, fair in 3 patients, poor in 1 patient. The overall satisfactory rate was 87.2%. Conclusion Early internal fixations with double narrow plates in combination with rehabilitation program is the key for the successful treatment of humeral shaft fractures.%目的 探讨青壮年肱骨远端粉碎性骨折的手术治疗方法及疗效.方法 回顾性总结2003年6月至2009年6月期间采用手术切开复位双侧重建钛板90度成角内固定治疗肱骨远端双柱骨折41例,其中37例患者获得术后随访(15~35个月),平均随访25个月,应用Cassebaum方法评定术后疗效.结果 以上病例骨折均获得愈合,其中优14例,良19例,可3例,差1例,优良率达87.2%.结论 早期行切开复位双侧重建钛板90度成角固定配合术后无痛状态下早期活动是成功治疗青壮年肱骨远端粉碎性骨折的关键点.

  14. Clinical observation of posterior internal fixation with vertebral pedicle screw and rod system on thoracolumbar spine fracture%采用后路椎弓根钉棒系统治疗胸腰椎骨折疗效观察

    Institute of Scientific and Technical Information of China (English)

    王洽君

    2013-01-01

    目的 观察后路椎弓根钉棒系统治疗胸腰椎骨折的临床疗效.方法 回顾性分析32例采用后路椎弓根钉棒系统治疗胸腰椎骨折患者的临床资料,术后最长获得2年随访,分析椎体高度、椎体序列和Cobb角的改变.结果 32例患者获得6~ 48个月随访,平均15.8个月.术后椎体前、后缘高度分别为(96.85±14.33)%、(97.44±12.38)%,明显大于术前的(46.67±11.25)%、(76.76±12.62)%(均P<0.05);术后Cobb角为(7.45±2.12)°,显著小于术前的(20.56±7.51).(P<0.05).术后患者Frankel分级均有改善.结论 应用椎弓根钉棒系统治疗胸腰椎骨折能取得良好的临床疗效.%Objective To observe the clinical effect of posterior internal fixation with vertebral pedicle screw and rod system on thoracolumbar spine fracture.Methods The clinical data of 32 patients diagnosed as thoracolumbar spine fracture in our hospital who treated with posterior internal fixation with vertebral pedicle screw and rod system were retrospectively analyzed.The Frankel scale combined with X-ray and CT images were used for the judgment of efficacy.Results The vertebral Height and Cobb angles were improved significantly after the operations (P <0.05).And the Frankel degree of cases with nerve symptoms was also improved.Conclusion Posterior internal fixation with vertebral pedicle screw and rod system is effective in treating patients with thoracolumbar spine fracture.

  15. A comparative study of "plasmacup" and "porous-coated" acetabular components: survival after 10 to 12 years of follow-up

    Directory of Open Access Journals (Sweden)

    José Ricardo Negreiros Vicente

    2010-01-01

    Full Text Available OBJECTIVES: Our primary aim was to compare the long-term survivorship rates and the rates of successful osseointegration between two different types of uncemented acetabular components. INTRODUCTION: Two types of alloys have primarily been used for the manufacture of the uncemented acetabular components: titanium-based and cobalt-based alloys. A titanium-based alloy appears to be more effective with regard to interface stress transfer to the host bone because of its lower elastic modulus relative to a cobalt-based alloy. This supposed mechanical advantage of a titanium-based alloy component motivated this comparative study. METHODS: Two uncemented acetabular components, a porous-coated acetabulum and a Plasmacup®, were compared with a focus on long-term prosthesis survivorship and the development of acetabular osseointegration. Five radiographic signs of osseointegration were evaluated at the last follow-up appointment: (1 absence of radiolucent lines, (2 presence of a superolateral buttress, (3 medial stress-shielding, (4 radial trabeculae, and (5 an inferomedial buttress. We considered the presence of any three of these radiographic signs, in the absence of acetabular dislocation or symptoms, to be indicative of successful acetabular osseointegration. RESULTS: Among 70 patients implanted with the porous-coated acetabulum, 80% achieved osseointegration over a mean follow-up time of 11.9 years versus 75.3% of the 73 patients who received a Plasmacup insert over a mean of 10.7 years. Prosthesis survivorship rates were not different between the two groups. Revision surgery due to mild or severe acetabular osteolysis, polyethylene wear, and aseptic loosening occurred in eight patients (11.4% with a PCA versus nine (12.3% with a Plasmacup. CONCLUSIONS: We conclude that, during the first ten years after surgery, there is no significant difference between these two types of uncemented cups with regard to either prosthesis survivorship or successful

  16. Open reduction and internal fixation for treatment of severely impacted valgus proximal humeral fractures%切开复位内固定治疗严重嵌插外展型肱骨近端骨折

    Institute of Scientific and Technical Information of China (English)

    曹毅; 刘璠; 王洪; 周振宇; 陶然; 王友华

    2009-01-01

    目的 评价切开复位内固定治疗严重嵌插外展型肱骨近端骨折的临床效果.方法 004年4月-2008年2月,手术治疗严重嵌插外展型肱骨近端骨折23例,采用改良的Thompson切口切开复位,用肱骨近端锁定钢板固定,其中20例行一期自体骨移植,8例术中发现有明显的肩袖撕裂而行修补术.术后进行系统的肩关节功能锻炼.结果 23例获得1年以上的随访,平均随访时间为17个月(12~33个月).所有骨折均于术后2个月内愈合,最近一次X线片检查未出现内固定失效和肱骨头坏死.采用肩关节Neer评分系统评分:优9例,良10例,可3例,差1例;优良率为82.6%.患者主观满意率为91.3%.5例出现供骨区髂部疼痛.结论 采用切开复位LPHP内固定治疗严重嵌插外展型肱骨近端骨折有利于早期功能锻炼,疗效满意.%Objective To assess the clinical results of open reduction and internal fixation(ORIF) for treatment of severely impacted valgus proximal humeral fractures. Methods From April 2004 to February 2008,twenty-three patients with a severely impacted valgus fractures of the proximal part of the humerus were treated with ORIF.The modified Thompson approach was employed to facilitate open reduction of the fractures and fixation with LPHP.Autologous bone graft was filled in the metaphyseal defect created behind the humeral head following its reduction in 20 cases.The rotator cuff tear was identified in 8 cases and was repaired with nonabsorbable sutures during the surgery.Systematic rehabilitation of the shoulder joint was performed postoperatively. Results All patients were followed up for at least one year,with an averaged of 17 months (ranged from 12 to 33 months).All fractures united within two years postoperatively.No patient had signs of internal fixation failure and avascular necrosis on the latest radiographys.The clinical outcomes were rated using Neer score system.Nine cases were graded as excellent,10 cases as good,3

  17. Absorbable internal fixation materials in the repair of patellar transverse fractures%可吸收内固定材料修复髌骨横断性骨折

    Institute of Scientific and Technical Information of China (English)

    王峰; 贾金领

    2016-01-01

    BACKGROUND: In recent years, al kinds of absorbable internal fixation materials have been used in the clinical treatment of patel ar transverse fractures. OBJECTIVE: To investigate the repairing effect of absorbable internal fixation materials on patel ar transverse fractures. METHODS: Total y 102 cases of fresh patel ar transverse fractures were included 62 males and 40 females cases, with a mean age of (41.85±11.15) years, and according to treatment methods, they were divided into two groups: observation group (n=52) using absorbable screws for reconstruction and control group (n=50) using Kirschner wire repair. At 12 months after repair, Lysholm knee function score were measured and evaluated, and the occurrence of adverse events was recorded. RESULTS AND CONCLUSION: The knee function score and excel ent rate of the observation group were significantly higher than those of the control group (both P < 0.05). In the observation group, there were four cases of fracture displacement, but no skin irritation and other adverse events occurred; in the control group, there were two cases of nonunion and five cases of skin irritation or internal fixation loosening and slippage. Therefore, there was a higher incidence of adverse events in the control group compared with the observation group (P < 0.05). These experimental results show that the use of absorbable screws in the repair of patel ar transverse fracture can promote the functional recovery of the knee joint, with good biocompatibility.%背景:近几年来,各种可吸收内固定材料开始被积极应用于各种髌骨横断性骨折的临床治疗中。目的:探讨可吸收内固定材料修复髌骨横断性骨折的效果。方法:纳入102例新鲜髌骨横断性骨折患者,其中男62例,女40例,年龄(41.85±11.15)岁,按治疗方法分为2组,观察组(n=52)采用可吸收螺钉修复,对照组(n=50)采用改良张力带钢丝内固定修复。修复后12个月,进行 Lysholm

  18. External Fixation Combined with Limited Internal Fixation for the Treatment of Tile C Type Pelvic Fracture%外固定联合有限内固定治疗Tile C型骨盆骨折

    Institute of Scientific and Technical Information of China (English)

    李琳

    2014-01-01

    Objective To explore the clinical effects of the external fixation combined with limited internal fixation in the treatment of Tile C type pelvic fracture. Methods 27 patients of Tile C type pelvic fracture were administrated with external fixation combined with limited internal fixation. 25 of the 27 patients were followed up. There were 17 patients of Tile C1pelvic fracture;8 patients of Tile C2 pelvic fracture. Results 25 patient were followed up for 6 months to 2 year( average,1. 5 years). According to Tornetta standard evaluation score after reduction of fracture,the results were excellent in 12 cases,good in 9 cases,fair in 3 cases and bad in 1 cases. The total excellent and good rate was 84%. According to Majeed score system af-ter the postoperative functional recovery,the results were excellent in 11 cases,good in 11 cases,fair in 2 cases and bad in 1 cases,the total excellent and good rate was 88%. Conclusion External fixation combined with limited internal fixation can not only restore pelvic ring continuity and overall stability of structure but also have mang advantages,such as practical,effective operation,small trauma,less bleeding,convenient adjustment and disassemble. The methods is worthy of wide application.%目的:探究外固定联合有限内固定治疗Tile C型骨盆骨折的临床疗效。方法对27例Tile C型骨盆骨折采用外固定支架联合有限内固定进行治疗,本组27例,25例获得随访,根据Tile分型,C1型17例,C2型8例。结果本组随访时间为6个月~2年,平均1.5年。骨盆骨折复位后根据Tornetta评分标准评价,优12例,良9例,可3例,差1例,总体优良率为84%;术后功能恢复情况采用MaJeed评分系统评价,优11例,良11例,中2例,差1例,总体优良率为88%。结论对于Tile C型骨盆骨折,采用外固定联合有限内固定双重固定不仅可以恢复骨盆环解剖序列的连续性和整体结构的稳定性,而且该方法具有实

  19. Femoral fractures : indications an[d] biomechanics of external fixation

    NARCIS (Netherlands)

    A.H. Broekhuizen (Tom); B. van Linge

    1988-01-01

    textabstractInternal fixation can be carried out in various ways. For femoral shaft fractures, an (interlocking) nail is becoming increasingly popular, instead of open realignment of the fracture. External fixation, which has become a generally accepted method of treating fractures of the lower leg,

  20. Fiber-matrix interface studies on bioabsorbable composite materials for internal fixation of bone fractures. I. Raw material evaluation and measurement of fiber-matrix interfacial adhesion.

    Science.gov (United States)

    Slivka, M A; Chu, C C; Adisaputro, I A

    1997-09-15

    The objective of this study was to characterize and evaluate the performance of various fiber-matrix composite systems by studying the mechanical, thermal, and physical properties of the fiber and matrix components, and by studying the fiber-matrix interface adhesion strength using both microbond and fragmentation methods. The composites studies were poly(L-lactic acid) (PLLA) matrix reinforced with continuous fibers of either nonabsorbable AS4 carbon (C), absorbable calcium phosphate (CaP), poly(glycolic acid) (PGA), or chitin. Carbon and CaP single fibers had high Young's moduli and failed in a brittle manner. PGA and chitin single fibers had relatively lower Young's moduli and relatively higher ductility. Upon in vitro hydrolysis, CaP fibers retained 17% of their tensile strength and 39% of their Young's modulus after 12 h, PCA fibers retained 10% of their tensile strength and 52% of their Young's modulus after 16 days, and chitin fibers retained 87% of their tensile strength and 130% of their Young's modulus after 25 days. PLLA films had much lower strength and Young's moduli, but much higher ductility relative to the single fibers. Using the microbond method, the initial fiber-matrix interfacial shear strength (IFSS) of C/PLLA and CaP/PLLA microcomposites was 33.9 and 12.6 MPa, respectively. Upon in vitro hydrolysis, C/PLLA retained 49% of IFSS after 15 days and CaP/PLLA retained 46% of IFSS after 6 h. Using a fiber fragmentation method, the initial IFSS of C/PLLA, CaP/PLLA, and chitin/ PLLA was 22.2, 15.6, and 28.3 MPa, respectively. The performance of carbon fibers and C/PLLA composites was superior to the other fibers and fiber/PLLA systems, but the carbon fiber was nonabsorbable. CaP had the most suitable modulus of the absorbable fibers for fixing cortical bone fracture, but its rapid deterioration of mechanical properties and loss of IFSS limits its use. PGA and chitin fibers had suitable mechanical properties and their retention for fixing cancellous

  1. Type IIA Monteggia Fracture Dislocation with Ipsilateral Distal Radius Fracture in Adult – A Rare Association

    Science.gov (United States)

    James, Boblee

    2016-01-01

    Monteggia fracture constitutes about 5-10% of the forearm fractures. Monteggia fracture by definition is proximal ulnar fracture with disruption of proximal radioulnar joint. Bado classified Monteggia fracture dislocation into four types and Jupiter subclassified type II Bado’s fractures into four types. The associated injury in the form of distal radial fractures and distal humerus fractures are rare though many cases of distal radial physeal injuries have been reported in paediatric population. Hereby we report a rare association of type IIA Monteggia fracture dislocation with ipsilateral distal radius fracture in an adult patient. This case report also highlights on proper examination and full length radiographs of forearm to avoid missing injury at wrist in cases of elbow injuries. Management of such complex injuries included open reduction and internal fixation of olecronon fracture, distal radius fracture and radial head resection. Functional outcome at six months was good at wrist whereas at elbow, stiffness was a major concern with elbow range of movement from 40°-110°. PMID:27656518

  2. Type IIA Monteggia Fracture Dislocation with Ipsilateral Distal Radius Fracture in Adult - A Rare Association.

    Science.gov (United States)

    Kembhavi, Raghavendra S; James, Boblee

    2016-08-01

    Monteggia fracture constitutes about 5-10% of the forearm fractures. Monteggia fracture by definition is proximal ulnar fracture with disruption of proximal radioulnar joint. Bado classified Monteggia fracture dislocation into four types and Jupiter subclassified type II Bado's fractures into four types. The associated injury in the form of distal radial fractures and distal humerus fractures are rare though many cases of distal radial physeal injuries have been reported in paediatric population. Hereby we report a rare association of type IIA Monteggia fracture dislocation with ipsilateral distal radius fracture in an adult patient. This case report also highlights on proper examination and full length radiographs of forearm to avoid missing injury at wrist in cases of elbow injuries. Management of such complex injuries included open reduction and internal fixation of olecronon fracture, distal radius fracture and radial head resection. Functional outcome at six months was good at wrist whereas at elbow, stiffness was a major concern with elbow range of movement from 40°-110°. PMID:27656518

  3. 肱骨近端锁定加压钢板系统治疗肱骨近端骨折%Proximal humeral internal locking system for the treatment of proximal humeral fractures

    Institute of Scientific and Technical Information of China (English)

    周斌; 王桂华; 陈建军; 徐国浩

    2014-01-01

    Objective To evaluate the clinical effect of proximal humeral internal locking system (PHILOS)plate for the treatment of proximal humeral fractures.Methods 37 patients with fractures of the proximal humerus were oper-ated by using PHILOS plate and clinical effect was evaluated.Results All cases were followed up for 10~14 (12 ± 1.8)months and all fractures were healed.There were 1 patient in humerus head necrosis,3 in malunion,3 shoul-der joint stiffness,and 2 shoulder pain in the final follow-up.The average American Shoulder and Elbow Surgeons (ASES)score at the final follow-up was 68~85 (77.6 ±3.5).According to Michener and colleagues classification, 27 patients had an excellent outcome,2 were minimally functionally limited,6 were moderately functionally limited, and 2 were maximally functionally limited,the excellent and good rate of shoulder joint function were 78.3%.Con-clusions Fixation with PHILOS plate for proximal humeral fractures has definite therapeutic effect,especially in the older population with osteoporotic bone.%目的:探讨肱骨近端锁定加压钢板系统(PHILOS)治疗肱骨近端骨折的临床效果。方法对37例肱骨近端骨折患者行切开复位PHILOS治疗,评价临床效果。结果患者均获随访,时间10~14(12±1.8)个月,骨折均临床愈合。末次随访1例出现肱骨头坏死,3例骨折畸形愈合,3例患肩僵直,其中2例患肩疼痛。AS-ES 功能评分为68~85(77.6±3.5)分;依据MCC标准评价临床疗效:优27例,良2例,可6例,差2例,优良率为78.3%。结论 PHILOS治疗肱骨近端骨折疗效确切,尤其适宜老年骨质疏松患者。

  4. Amputated Lower Limb Fixation to the Fracture Table.

    Science.gov (United States)

    Gamulin, Axel; Farshad, Mazda

    2015-11-01

    Fractures of the proximal and diaphyseal femur are frequently internally fixed using a fracture table with fracture reduction obtained by traction and adequate rotation exerted on the slightly abducted extremity. Although rare, these fractures may occur on an amputated limb. If so, standard use of a fracture table is not possible. To address this situation, the authors describe a simple novel technique allowing rigid fixation of the amputated limb to the traction device of the fracture table that provides accurate control of reduction in all planes. PMID:26558660

  5. Fracture and crack growth in orthotropic laminates. Part 2: Experimental determination of internal damage growth in unidirectional boron/aluminum composite laminates

    Science.gov (United States)

    Goree, J. G.

    1982-01-01

    The fracture behavior of unidirectional boron/aluminum composite laminates is investigated in order to verify the results of mathematical models. These models predict the stresses and displacements of fibers and the amount of damage growth in a center-notched lamina as a function of the applied remote stress and the matrix and fiber material properties. The damage may take the form of longitudinal yielding and splitting in the matrix as well as stable transverse damage consisting of broken fibers and matrix yielding ahead of the notch. A brittle lacquer coating is used to detect the yielding in the matrix while X-ray techniques are used to detemine the number of broken fibers in the laminate. The notched strengths and the amounts of damage found in the experimental specimens agree well with those predicted by the mathematical model.

  6. A new measurement for posterior tilt predicts reoperation in undisplaced femoral neck fractures: 113 consecutive patients treated by internal fixation and followed for 1 year

    DEFF Research Database (Denmark)

    Palm, Henrik; Gosvig, Kasper; Krasheninnikoff, Michael;

    2009-01-01

    BACKGROUND AND PURPOSE: Preoperative posterior tilt in undisplaced (Garden I-II) femoral neck fractures is thought to influence rates of reoperation. However, an exact method for its measurement has not yet been presented. We designed a new measurement for posterior tilt on preoperative lateral......, and rate of reoperation within the first year. In a subgroup of 50 randomly selected patients, reliability tests for measurement of posterior tilt were performed. RESULTS: Intra- and interclass coefficients for the new measurement were > or = 0.94. 23% (26/113) of patients were reoperated and increased...... score, time from admission to operation, surgeon's expertise, postoperative reduction, and implant positioning, a preoperative posterior tilt of > or = 20 degrees was the only significant predictor of reoperation (p measurement for posterior tilt appears to be reliable...

  7. Open reduction and fixation of proximal humeral fractures and fracture-dislocations.

    Science.gov (United States)

    Moda, S K; Chadha, N S; Sangwan, S S; Khurana, D K; Dahiya, A S; Siwach, R C

    1990-11-01

    Open reduction and internal fixation was employed in the treatment of 25 severely displaced fractures and fracture-dislocations of the proximal humerus. Our aims were accurate reduction and stable fixation to allow early mobilisation and to achieve full functional recovery. In 15 fractures an AO T-plate was used and in 10 a bent semitubular plate was employed as a blade plate. Excellent or satisfactory results were obtained in all six patients with two-part fractures involving the surgical neck; in four of the five patients with three-part fractures involving the surgical neck and tuberosities; in nine of the 11 patients with fracture-dislocation; and in two of the three patients with split fractures of the humeral head. Overall results were good or satisfactory in 21 of the 25 cases. Unsatisfactory results were associated with rotator cuff damage.

  8. Fixation of displaced proximal humeral fractures with proximal humeral internal locking plate in the elderly%肱骨近端锁定型钉板治疗老年人移位的肱骨近端骨折

    Institute of Scientific and Technical Information of China (English)

    纪泉; 文良元; 薛庆云; 赵立连; 黄公怡

    2011-01-01

    Objective To investigate the treatment effect of the proximal humeral internal locking system (PHIL()S) on the elderly patients with displaced proximal humeral fractures.Methods From Feb 2004 to Mar 2007, 36 patients (mean age: 72.2 years) with proximal humeral fractures were treated with PHILOS plate fixation which included 14 cases with 2-part, 17 cases with three-part and 5 cases with four-part fractures according to Neer classification. Operation time,intraoperative blood loss, blood transfusion, perioperative complications and function evaluation of the operated shoulder joint were calculated with 14.5 months follow-up at average.Results The average operation time and blood loss were (61.5± 11.6) min and ( 165.2±91.2) ml, respectively. 1 case with accidents of blood vessel and 1 case with pneumonia were found without neurovascular injuries. All fractures were radiographically healed in an average of 3-5 months. No necrosis of humeral head appeared and 30 (83.3%) cases were excellent or good according to Neer scoring system. Two part fracture and early operation ( within 3 days after operation) might improve the postoperative function of shoulder joint, but the patient's age, gender and ASA score were not statistically with Neer score.Conclusions PHILOS plate fixation is a suitable procedure for displaced proximal humeral fractures via stable fixation and early rehabilitation, especially for elderly patients combined with osteoporosis.%目的 探讨肱骨近端锁定型钉(PHILOS)板治疗老年人移位的肱骨近端骨折的疗效。方法 回顾性分析2004年2月至2007年3月用PHILOS板治疗的36例肱骨近端骨折患者,Neer分型二部分骨折14例,三部分骨折17例,四部分骨折5例。统计手术时间、输血量和手术并发症,评价肩关节功能。 结果 患者平均年龄72.2岁,平均随访14.5个月。术中平均输血165.2 ml,术后X线显示骨折复位满意,无神经、血管损

  9. New anterolateral LCP for internal fixation of pilon fractures%新型胫骨远端前外侧锁定加压钢板用于Pilon骨折内固定

    Institute of Scientific and Technical Information of China (English)

    史德海; 卢华定; 李东会; 蔡道章

    2010-01-01

    Objective To introduce experience of using the new AO anterolateral distal tibia locking com-pression plate (LCP) for treatment of Pilon fractures. Methods Between February and August of 2009,8 closed Pi-lon fractures were treated by open reduction and internal fixation. The distal fibula was fixed with a one-third tubular plate or an recontruction plate via a straight incision posterior to the fibular crest. The distal tibia was approched by a straight incision over the ankle joint, and the fracture was stabilized using an anterolateral distal tibia LCP. Regular follow up was made to observe and evaluate the preliminary clinical outcomes. Results Seven of the 8 patients were availabe for follow up for 3 ~ 6 months (average 4.5 months). All incisions obtained primary healing, though one ex-perienced mild superficial inflammation,and none developed deep infections. Based on the Burwell and Charnley radi-ographic criteria,anatomical reduction was obtained in 5 cases,good in 1 ,and fair in 1. Among the 5 cases exceeding 5 months postsurgery,4 were evaluated as excellent and 1 us good according to Tometta' s clinically based criteria for Pilon fractures. Conclusion With good surgical timing,internal fixation with anterolateral LCP for Pilon fractures is reliable and warrants less complications.%目的 介绍新型AO胫骨远端前外侧锁定加压钢板(IEP)治疗胫骨远端骨折(Pilon骨折)的初步经验.方法 手术治疗8例闭合性Pilon骨折,腓骨作外踝后方纵切口,复位后用1/3管形或重建钢板固定;胫骨远端骨折采用踝关节前方中点纵向直切口,复位后采用胫骨远端前外侧LCP内固定,术后进行定期临床随访.观察初步疗效.结果 术后7例患者获得随访3~6个月(平均4.5个月).虽有1例切口出现短暂的表浅轻微炎症,最终所有切口均一期愈合,无深部感染发生.按照Burwell-Charnley骨折复位放射学评价标准,解剖复位5例,1例复位好,1例可;采用Tometta治

  10. Acetabular retroversion as a rare cause of chronic hip pain: recognition of the ''figure-eight'' sign

    Energy Technology Data Exchange (ETDEWEB)

    Banks, Kevin P. [Brooke Army Medical Center, Department of Radiology, Fort Sam Houston, TX (United States); Grayson, David E. [Wilford Hall Medical Center, Department of Radiology, Lackland Air Force Base, TX (United States)

    2007-06-15

    While well-recognized in the orthopedic literature as a cause of chronic hip pain, acetabular retroversion has not been specifically described in the radiologic literature. Acetabular retroversion represents a particular form of hip dysplasia characterized by abnormal posterolateral orientation of the acetabulum. This pathophysiology predisposes the individual to subsequent anterior impingement of the femoral neck upon the anterior acetabular margin and fibrous labrum. Without treatment, cases may progress to damage of the anterior labrum and cartilage, with eventual early onset of osteoarthritic disease. This impinging condition has been described as occurring in isolation or as part of a complex dysplasia. We describe two cases of acetabular retroversion diagnosed by conventional radiographic evaluation of the pelvis, one in isolation and one occurring in the setting of a larger congenital syndrome. These cases illustrate the utility of the ''figure-eight'' sign in identifying abnormalities of acetabular version and thus assisting clinicians in properly identifying these individuals so that appropriate therapy may be instituted. (orig.)

  11. 钢板内固定与外固定架治疗跟骨骨折效果比较%PLATE INTERNAL FIXATION VERSUS EXTERNAL FIXATOR IN THE TREATMENT OF CALCANEAL FRACTURES

    Institute of Scientific and Technical Information of China (English)

    李玉椿; 杨斌; 王振宇

    2012-01-01

    目的 分析比较切开复位钢板内固定和闭合复位外固定架治疗跟骨骨折的效果.方法 钢板内固定组43侧,采用切开复位钢板内固定治疗;外固定架组19侧,采用闭合复位外固定治疗,术后测量Bohler角,按Marry Land评分系统进行效果评定.结果 钢板内固定组优34侧,良6侧,可3侧,优良率93%;外固定架组优14侧,良5侧,优良率100%.两种治疗方法疗效比较差异无显著性(P>0.05).钢板内固定组术后2例出现切口拐角处感染不愈合,1例深部感染.结论 两种方法治疗跟骨关节内骨折均取得满意的疗效,但外固定架治疗跟骨骨折简单易行,降低了手术切口不愈合及神经肌腱损伤的风险,是一种可靠的治疗办法.%Objective To compare the effectiveness between open reduction plus plate internal fixation and closed reduction plus external fixator in the treatment of calcaneal fractures. Methods Forty-three patients with calcaneal fractures were treated with open reduction and internal plate fixation, and 19 received closed reduction plus external fixation. Postoperatively, the Bohler Angle was measured, and the efficacy was assessed according to Marry Land scoring system. Results In plate fixation group: 34 were excellent, six were good, and three were improved, the excellent and good rate being 93%. In external fixation group, 14 were excellent and five were good, the excellent and good rate being 100%. The difference between the two groups was no significant in regard to the two methods of therapy (P>0. 05). In plate fixation group, postoperative infection occurred in two cases and did not heal, one with deep-part infection. Conclusion Both therapies can obtain satisfactory for intra-articular fracture of calcis, but external fixation is simple and easy to perform, being a reliable therapy, which decreases the risk of wound disunion, and injury of nerve and tendon.

  12. Distal humerus fractures: a review of current therapy concepts

    OpenAIRE

    Amir, Steinitz; Jannis, Sailer; Daniel, Rikli

    2016-01-01

    Fractures of the distal humerus in the adult comprise approximately one third of all humeral fractures. Successful management of distal humerus fractures depends on correct reduction of the fracture, reconstruction of the articular surface if needed, stability and rigidity of the fixation, and appropriate rehabilitation. In this review, we evaluated the available literature and highlighted current therapy concepts. We assessed the evolution of internal fixation and elbow arthroplasty focusing...

  13. Different fixation methods for transverse acetabular fracture:a finite element analysis%有限元分析髋臼横行骨折不同植入物的内固定方式

    Institute of Scientific and Technical Information of China (English)

    周坚锋; 李建涛; 张浩; 李辰; 尹鹏; 李志锐; 陈宇翔; 唐佩福; 张立海

    2016-01-01

    BACKGROUND:Transverse acetabular fracture often involves the damage of anterior and posterior columns of acetabulum. The most popular fixation of the anterior and posterior columns needs the combined anterior and posterior approach. Big trauma is not conducive to patient’s recovery after surgery. Limited incision or percutaneous minimaly invasive lag screw placement can reduce soft tissue injuries, but the strength of the fixation lacks of biomechanical verification. OBJECTIVE: To compare different types of fixations for transverse acetabular fracture, explore the appropriate fixation options that can achieve effective fixation and reduce tissue injury by combing with repair approach and the condition of soft tissue. METHODS: The fourth generation of synthetic semi-pelvic sawbones was set as a template to establish a model of acetabular transverse fracture using finite element analysis. Five different fixation options were used to fix the transverse acetabular fracture. The magnitudes of anterior and posterior displacement of transverse fracture were compared to assess the stability of different options under a simulated condition of incomplete weight bearing stand. RESULTS AND CONCLUSION:The motion at anterior column was minimal when fixed by anterior column locking plate + posterior column screw and the minimum displacement at posterior column was the fixation of anterior column screw + posterior column locking plate. Both of the motions of these two fixations were less than the reconstruction plate fixation respectively. The worst fixation was the anterior column and posterior column lag screw fixation with the largest displacement. The anterior column locking plate + posterior column screw, accomplished by single approach, could not only reduce surgical trauma, but also has a stronger stability. Moreover, this fixation option is effective method to place posterior column lag screw under direct vision and reduce the difficulty of screw implantation.%背景:

  14. The effect of femoro-acetabular impingement on the kinematics and kinetics of the hip joint.

    Science.gov (United States)

    Alshameeri, Zeiad; Khanduja, Vikas

    2014-08-01

    Gait analysis is an objective tool that has been used to assess and monitor treatment for many musculoskeletal conditions. Recently, it has been used to assess the impact of femoro-acetabular impingement (FAI) on the hip and lower limb movements. There have been a fairly limited number of studies published so far reporting unexpected and inconsistent results, which calls for more research to be conducted in this arena. In the light of the limited data available, it has been challenging to reconcile the contradictions in some of these results, and therefore no coherent conclusions could be drawn. In this short article, we attempt to explain some of the abnormal kinematic and kinetic patterns associated with FAI by highlighting similarities between the gait seen in early osteoarthritis (OA) and that of FAI. We also propose an approach for future research in this field and emphasise the importance of quantifying early OA in FAI based on magnetic resonance imaging (MRI) scans and the amount of chondral damage seen during open or arthroscopic surgery. PMID:24687267

  15. Therapeutic efficacy of percutaneous compression plate internal fixation in treatment for elderly patients with interchanteric fractures%经皮加压钢板治疗老年股骨转子间骨折疗效观察

    Institute of Scientific and Technical Information of China (English)

    张传志; 刘莉; 匡志平; 曹洪辉; 肖楸钶; 王加俊; 卢卫忠

    2013-01-01

    Objective To explore the therapeutic efficacy of percutaneous compression plate internal fixation in the treatment for elder-ly patients with interchanteric fractures. Methods All 17 patients with interchanteric fractures from March 2012 to January 2013 were trea-ted with percutaneous compression plate internal fixation(Fracture classification:type A1. 2 with 3cases,A1. 3 with 4cases,A2. 1 with 6 ca-ses,A2. 2 with 3 cases,A2. 3 with 1 case). After operation,the patients did functional exercises at the early stage. Then the efficacy were e-valuated and analyzed. Results Operation time was 30~80 min,with average time 50 min, blood loss was (40~100) mL,with average volume 60 mL,time of X-ray exposure was 12~22 s,with average time 20 s. All 17 patients were followed up for 3~18 months. Postoperative function were evaluated according to Harris Hip Score,15 cases were excellent,and 2 cases were good,the excellent and good rate was 100%. Conclusion Percutaneous compression plate internal fixation is suitable for the elderly patients of interchanteric fractures,with shorter oper-ation time,less blood loss,reliable fixation and less complications.%目的探讨经皮加压钢板治疗老年股骨转子间骨折的方法和疗效。方法2012年3月至2013年1月17例股骨粗隆间骨折患者,骨折分型:A1.2型3例,A1.3型4例,A2.1型6例,A2.2型3例,A2.3型1例,均利用经皮加压钢板内固定,术后早期进行功能锻炼,观察疗效和分析结果。结果手术时间30~80 min,平均50 min,术中出血量40~100 mL,平均60 mL,放射投照时间为12~22 s,平均20 s。17例患者均获得随访,时间为3~18个月,参照 Harris 髋关节功能评分标准评价术后功能,优15例(88%),良2例(12%),优良率达100%。结论经皮加压钢板治疗股骨转子间骨折手术创伤小,手术时间短,术中出血量少,固定牢靠,并发症少,尤其适用于老年患者。

  16. 平行双钢板双柱固定技术治疗成人肱骨远端粉碎骨折%Parallel-double-plate internal fixation technique in the treatment of distal humeral comminuted fracture in adults

    Institute of Scientific and Technical Information of China (English)

    陈广辉; 王洪伟; 阮美树

    2013-01-01

    目的 评价平行双钢板双柱固定技术重建成人肱骨远端粉碎性骨折的手术效果.方法 2006年10月至2009年10月,采用切开复位平行双钢板双柱固定技术治疗成人肱骨远端粉碎性骨折20例,受伤至手术时间平均2d,手术采用肘后正中切口,术后3d开始保护性功能锻炼.所有患者按照Mayo肘关节功能评分(MEPS)评价,影像学检查评价内固定及骨折愈合情况.结果 20例患者均获随访,时间(18.4±2)个月.X线证实骨折均一期愈合,无伤口感染及神经损伤并发症,无短缩和旋转畸形,无内固定失败.术后1年随访MEPS中位分数86分,优良率85.3%.结论 平行双钢板双柱内固定治疗肱骨远端复杂骨折可实现骨折早期稳定固定,有助于患肢早期功能锻炼及关节功能的恢复.%Objective To assess the effects of parallel-double-plate internal fixation on distal humeral comminuted fracture in adults.Methods Twenty consecutive adults with distal humeral comminuted fracture who received open reduction and internal fixation with parallel-double-plating at day 2 following bone facture between October 2006 and October 2009 were enrolled.Posterior elbow median incision was adopted for surgery.The functional exercise program commenced at day 3 postoperatively.The function of elbow was assessed by Mayo elbow performance score (MEPS),and the internal fixation and fracture healing by plain X-ray films.Results The 20 patients were followed up for 12 to 36 months [mean (18.4±2.0) months].Neither infection of incisions,nor nerve injury,or deformity of shortening,rotation,or implantation failure were found.The median MEPS was 86 points and the overall excellence rate was 85.3% in the first year of follow-up.Conclusion The parallel-double-plate technique may facilitate early-stage solid fixation of distal humeral comminuted fracture and promote postoperative functional exercise of the affected extremity and joint rehabilitation.

  17. Approach for computing 1D fracture density: application to fracture corridor characterization

    Science.gov (United States)

    Viseur, Sophie; Chatelée, Sebastien; Akriche, Clement; Lamarche, Juliette

    2016-04-01

    Fracture density is an important parameter for characterizing fractured reservoirs. Many stochastic simulation algorithms that generate fracture networks indeed rely on the determination of a fracture density on volumes (P30) to populate the reservoir zones with individual fracture surfaces. However, only 1D fracture density (P10) are available from subsurface data and it is then important to be able to accurately estimate this entity. In this paper, a novel approach is proposed to estimate fracture density from scan-line or well data. This method relies on regression, hypothesis testing and clustering techniques. The objective of the proposed approach is to highlight zones where fracture density are statistically very different or similar. This technique has been applied on both synthetic and real case studies. These studies concern fracture corridors, which are particular tectonic features that are generally difficult to characterize from subsurface data. These tectonic features are still not well known and studies must be conducted to better understand their internal spatial organization and variability. The presented synthetic cases aim at showing the ability of the approach to extract known features. The real case study illustrates how this approach allows the internal spatial organization of fracture corridors to be characterized.

  18. Open Calcaneus Fractures and Associated Injuries.

    Science.gov (United States)

    Worsham, Jacob R; Elliott, Mark R; Harris, Anthony M

    2016-01-01

    Open calcaneus fractures are usually the result of high-energy mechanisms and are associated with other orthopedic and whole body system injures. Understanding the difference between open versus closed fractures is essential for the provider, and they must be vigilant for the associated injuries that present with this condition. We performed a retrospective medical record review of 62 patients (64 calcaneus fractures) with open calcaneus fractures from January 2003 to January 2013 presenting at a level 1 trauma center. Sex, age, laterality, mechanism of injury, wound appearance, initial management, and associated injures were recorded. The most common mechanisms were motor vehicle accidents (35 [56.4%]) and falls from >6 ft (15 [24.1%]). Four (6.4%) patients had a posterior tibial artery transection. Eight (12.9%) patients had a femoral shaft fracture, 14 (22.5%) an ipsilateral ankle fracture, 16 (25.8%) a metatarsal fracture, and 11 (17.7%) had associated midfoot fractures. Of the midfoot fractures, 12 (19.3%) patients had a talus fracture and 5 (8.0%) a cuboid fracture. Spinal fractures were present in 9 (14.5%) of the patients, with lumbar fractures occurring in 6 (9.6%) patients. Fifteen (24.1%) patients had associated upper extremity fractures. Thirteen (20.9%) patients had an associated pulmonary injury, including 8 pneumothoraces. Ten (16.1%) patients had a closed head injury and 6 (9.6%) had an abdominal injury. Fifteen (23.4%) patients were treated with percutaneous wire fixation and 7 (10.9%) with open reduction internal fixation. A total of 44 (68.7%) fractures were treated without internal fixation. Overall, 5 (8.0%) patients with an open calcaneus fracture eventually underwent a below-the-knee amputation. Open calcaneus fractures are severe, high-energy injuries with the potential for considerable morbidity to the patient, given the high rate of concomitant orthopedic and whole body system injuries. Type III open injuries have an increased risk of

  19. Open Calcaneus Fractures and Associated Injuries.

    Science.gov (United States)

    Worsham, Jacob R; Elliott, Mark R; Harris, Anthony M

    2016-01-01

    Open calcaneus fractures are usually the result of high-energy mechanisms and are associated with other orthopedic and whole body system injures. Understanding the difference between open versus closed fractures is essential for the provider, and they must be vigilant for the associated injuries that present with this condition. We performed a retrospective medical record review of 62 patients (64 calcaneus fractures) with open calcaneus fractures from January 2003 to January 2013 presenting at a level 1 trauma center. Sex, age, laterality, mechanism of injury, wound appearance, initial management, and associated injures were recorded. The most common mechanisms were motor vehicle accidents (35 [56.4%]) and falls from >6 ft (15 [24.1%]). Four (6.4%) patients had a posterior tibial artery transection. Eight (12.9%) patients had a femoral shaft fracture, 14 (22.5%) an ipsilateral ankle fracture, 16 (25.8%) a metatarsal fracture, and 11 (17.7%) had associated midfoot fractures. Of the midfoot fractures, 12 (19.3%) patients had a talus fracture and 5 (8.0%) a cuboid fracture. Spinal fractures were present in 9 (14.5%) of the patients, with lumbar fractures occurring in 6 (9.6%) patients. Fifteen (24.1%) patients had associated upper extremity fractures. Thirteen (20.9%) patients had an associated pulmonary injury, including 8 pneumothoraces. Ten (16.1%) patients had a closed head injury and 6 (9.6%) had an abdominal injury. Fifteen (23.4%) patients were treated with percutaneous wire fixation and 7 (10.9%) with open reduction internal fixation. A total of 44 (68.7%) fractures were treated without internal fixation. Overall, 5 (8.0%) patients with an open calcaneus fracture eventually underwent a below-the-knee amputation. Open calcaneus fractures are severe, high-energy injuries with the potential for considerable morbidity to the patient, given the high rate of concomitant orthopedic and whole body system injuries. Type III open injuries have an increased risk of

  20. 小针刀结合手法对髌骨骨折内固定术后膝关节创伤性关节炎的治疗效果观察%Curative Effect Observation on Needle Knife Combined With Manipulation on Patella Fracture After Internal Fixation of Knee Joint Traumatic Arthritis

    Institute of Scientific and Technical Information of China (English)

    乔正华

    2015-01-01

    ObjectiveTo observe the summary with needle knife combined with surgery for patelar fracture by internal fixation after traumatic arthritis of knee joint treatment effect.Methods Study from 32 cases of patelar fracture by internal fixation after knee joint traumatic arthritis patients with smal needle knife combined with surgical treatment.Results32 cases of patelar fracture internal fixation after the treatment of traumatic arthritis of the knee joint was 93.8%.Conclusion Patelar fracture after internal fixation of knee joint traumatic arthritis patients with needle knife combined with operation therapy significantly.%目的:观察总结小针刀结合手法对髌骨骨折内固定术后膝关节创伤性关节炎的治疗效果。方法研究收治的32例髌骨骨折内固定术后膝关节创伤性关节炎患者用小针刀联合手法治疗效果。结果32例髌骨骨折内固定术后膝关节创伤性关节炎治疗后优良率为93.8%。结论髌骨骨折内固定术后膝关节创伤性关节炎患者实施小针刀结合手法治疗疗效显著。

  1. 后内侧入路切开复位内固定治疗后 Pilon 骨折的疗效分析%Clinical outcome of open reduction and internal fixation through posteromedial approach for posterior Pilon fracture

    Institute of Scientific and Technical Information of China (English)

    黄晓楠; 郝磊; 沈明杰; 范猛

    2015-01-01

    Objective To evaluate the clinical outcome of open reduction and internal fixation through pos -teromedial approach for the treatment of posterior Pilon fracture .Methods Data of 139 patients with posterior mal-leolar fractures from Apr .2008 to Apr.2013 in our hospital were retrospectively analyzed .Among them,29 patients whose X ray and CT scan showed posterior Pilon fracture were involved in this study .There were 19 males and 10 females with the mean age of 46.3 years(ranged from 21 to 74 years).The mechanism of injury included falling in 12 patients,strain in 10 patients,and motor vehicle accidents in 7 patients.All patients were accompanied with lat-eral malleolus fracture and articular cartilage collapse .All patients had foot and ankle swelling ,deformity and re-stricted movement .Open reduction and internal fixation through posteromedial approach was applied .The period from injury to surgery was 1 to 11 days,with an average of 5.3 days.The condition of wound and fracture healing was regularly recorded after operation .Function was evaluated according to the AOFAS Ankle Hindfoot Scale .Re-sults All 29 patients were followed up for 15 to 47 months(mean,24.6 months).The incisions in all patients re-ceived primary healing .Postoperative X ray showed anatomical reduction in 26 patients with no articular collapse and normal ankle mortise and 1 mm of collapse and 1mm widening of the medial ankle mortise in 3 patients.The rate of anatomical reduction was 89.7%(26/29).All patients achieved fracture union and the healing time ranged from 12 to 21 weeks(mean,15.2 weeks).The AOFAS Ankle Hindfoot Scale were 81 to 100 points(mean,89.5 points).There were excellent outcomes in 21 patients and good in 8 patients,and the excellent and good rate was 100%.Conclusion Treatment of posterior Pilon fracture through posteromedial approach can achieve a good sur -gical field and easy anatomical reduction with satisfactory clinical outcome .Therefore,the posteromedial approach

  2. Three dimensional finite element analysis of acetabulum loaded by static stress and its biomechanical significance

    Institute of Scientific and Technical Information of China (English)

    SU Jia-can; ZHANG Ben; YU Bao-qing; ZHANG Chun-cai; CHEN Xue-qiang; WANG Bao-hua; DING Zu-quan

    2005-01-01

    Objective:To explore the mechanical behavior of acetabulum loaded by static stress and provide the mechanical basis for clinical analysis and judgement on acetabular mechanical distribution and effect of static stress. Methods:By means of computer simulation, acetabular three dimensional model was input into three dimensional finite element analysis software ANSYS7.0. The acetabular mechanical behavior was calculated and the main stress value, stress distribution and acetabular unit displacement in the direction of main stress were analyzed when anterior wall of acetabulum and acetabular crest were loaded by 1 000 N static stress. Results :When acetabular anterior wall loaded by X direction and Z direction composition force, the stress passed along 4 directions: (1)from acetabular anterior wall to pubic symphysis a long superior branch of pubis firstly, (2)from acetabular anterior wall to cacroiliac joint along pelvic ring,(3)in the acetabulum, (4)from the suffered point to ischium. When acetabular crest loaded by X direction and Y direction composition force, the stress transmitted to 4 directions: (1)from acetabular crest to ilium firstly, (2)from suffered point to cacroiliac joint along pelvic ring, (3) in the acetabulum , (4)along the pubic branch ,but no stress transmitted to the ischium branch. Conclusion:Analyzing the stress distribution of acetabulum and units displacement when static stress loaded can provide internal fixation point for acetabular fracture treatment and help understand the stress distribution of acetabulum.

  3. 内外侧切口入路植入物内固定治疗肱骨中下段骨折%Internal fixation via medial and lateral approaches for the middle and inferior humeral fracture

    Institute of Scientific and Technical Information of China (English)

    王伟; 艾尔肯•玉麦尔; 张青春; 艾合买提江•玉素甫

    2014-01-01

    BACKGROUND:The open reduction and internal fixation in treatment of middle and inferior humeral fractures often choose anterolateral approach. As the rapid development of microsurgical technique in recent years, some domestic hospitals try to adopt the medial approach, but the operation safety and efficacy are rarely reported. OBJECTIVE:To evaluate the clinical efficacy of two different approaches of open reduction and internal fixation for treating the middle and inferior humeral fractures. METHODS:A total of 68 patients with the middle and inferior humeral fractures were selected from Orthopedic Center of Xinjiang Medical University from January 2010 to January 2012, and were retrospectively analyzed. According to the approach of incision, the involved patients were divided into anterolateral approach group (n=33) and medial approach group (n=35). The blood loss in two groups was analyzed using Gross equation. The postoperative complications and functional recovery were compared. RESULTS AND CONCLUSION:During the fol ow-up at 12-18 months, X-ray results showed that the fractures achieved bone healing, fracture healing time was 16.9±3.9 weeks in anterolateral approach group and 15.5±2.2 weeks in the medial approach group. Shoulder Neer system score was 86±5 points in anterolateral approach group and 84±4 points in the medial approach group;elbow Mayo system score was 78±7 points in anterolateral approach group and 81±8 points in the medial approach group. Three cases in anterolateral approach group and one case in medial approach group presented postoperative radial nerve numbness and wrist dorsiflexion weakness, which were self-healed after 3 months. There was no nonunion, chronic osteomyelitis for other complications. The fracture healing time, the incidence of complications and the functional recovery between the two groups showed no significant difference (P>0.05). The medial approach is a feasible and safe surgical approach of internal fixation for

  4. MR-arthrography of the acetabular labrum - radiologic-pathologic correlation in 20 cadaveric hip joints; MR-Arthrographie des Labrum acetabulare - Radiologisch-anatomische Korrelation an 20 Leichenhueften

    Energy Technology Data Exchange (ETDEWEB)

    Brossmann, J.; Steffens, J.C.; Heller, M. [Kiel Univ. (Germany). Klinik fuer Diagnostische Radiologie; Ploetz, G.M.J.; Hassenpflug, J. [Kiel Univ. (Germany). Klinik fuer Orthopadie

    1999-08-01

    Purpose: To investigate frequency of acetabular labral lesions in elderly hip joints, and to determine sensitivity and specificity of MR arthrography (MRa) for the detection of these abnormalities. Materials and Methods: Twenty cadaveric hip joints were examined by MRa. For MRa, 15 ml of a solution of iodinated contrast solution (Solutrast 300) and Gd-DTPA (100:1) were injected under fluoroscopic guidance. MR imaging was performed on a 1.5 TM scanner (Vision, Siemens; FOV 16 cm, matrix 256x256, fat-suppressed 3D-FLASH). Multiplanar image reconstructions were done perpendicular to the acetabulum in the oblique-coronal, oblique-axial, and radial planes. The labral specimens were examined macroscopically. Results: In 12/20 hips (60%), a labral lesion was found on pathologic examination. In 7 specimens, the labrum was partially or completely detached in the weight-bearing superior region. One flap-like variant of the labrum was seen; in 4 hip joints, the labrum was degenerated (one cystic degeneration). Pathologic findings were confirmed by MRa in 8/12 specimens (sensitivity 67%). All degenerated labra were correctly diagnosed on MRa. Three small labral detachments and the flap-like variant were misinterpreted as being normal. There were no false positive findings (specificity 100%). The accuracy was 80%. Labral lesions were seen in 6/8 and in 6/12 of hips with and without osteoarthritis, respectively. Conclusion: MRa is well suited to delineate the acetabular labrum and to diagnose labral abnormalities. Detection of small labral detachments and anatomic variants is difficult and requires some experience. Labral lesions are correlated to osteoarthritis of the hip, but may be frequently seen in the elderly without underlying osteoarthritis. (orig.) [German] Ziel: Feststellung der Haeufigkeit von Laesionen des Labrum acetabulare bei aelteren Hueftgelenkspraeparaten und Untersuchung der Sensitivitaet und Spezifitaet der MR-Arthrographie (MRa) fuer die Darstellung dieser

  5. Trapezoid fracture caused by assault

    Directory of Open Access Journals (Sweden)

    Malshikare V

    2007-01-01

    Full Text Available In this report we describe an open fracture of trapezoid and break in anterior cortex of capitate due to assault in a young adult male. Direct impact force of a sharp object to the first web space caused the above fractures. Open reduction and internal fixation of the trapezoid was carried out using Kirschner wires. Cut extensor tendons, extensor retaniculum, capsule, adductor pollicis muscle, first dorsal interosseous muscle, soft tissue and overlying skin were sutured primarily. Three months after the operation the patient has made a complete recovery. There is no similar case reported in the literature.

  6. Comparative study of open reduction and internal fixation versus external fixation combined with limited internal fixation in the treatment of Pilon fractures%切开复位内固定与有限内固定结合外固定治疗胫骨Pilon骨折的对比研究

    Institute of Scientific and Technical Information of China (English)

    张小兵

    2012-01-01

    目的 比较切开复位内固定与有限内固定结合外固定治疗胫骨Pilon骨折的疗效.方法 将76例经X线或CT证实的胫骨Pilon骨折患者随机分为研究组(n = 38,接受有限内固定结合外固定架治疗)和对照组(n = 38,接受切开复位内固定术),比较两组骨折愈合时间、患者术后踝关节功能恢复情况及并发症发生情况.结果 研究组平均骨折愈合时间[(5.9±0.6)个月]较对照组[(5.2±0.4)个月]稍长,但差异无统计学意义(P > 0.05);两组患者术后踝关节功能均得到恢复,但研究组疗效优良率(84.21%)显著高于对照组(68.42%)(P < 0.05);研究组并发症发生率为15.79%(6/38),显著低于对照组的28.95%(11/38)(P < 0.05),其中软组织感染发生率较对照组高(P < 0.05),骨髓炎及骨折畸形愈合发生率较对照组低(P < 0.05),关节融合发生率差异无统计学意义(P > 0.05).结论 有限内固定结合外固定治疗胫骨Pilon骨折操作简单、安全,并发症少,可获得较好的踝关节功能和预后,值得临床推广应用.%Objective To compare the efficacy of open reduction and internal fixation versus external fixation combined with limited internal fixation in the treatment of Pilon fractures. Methods 76 patients with Pilon fractures confirmed by X-ray or CT were divided into study group (n = 38, received external fixation combined with limited internal fixation) and control group (n = 38, received open reduction and internal fixation) at random, the fracture healing time, postoperative ankle joint function recovery and complications of the two groups were compared. Results The mean fracture healing time of study group was (5.9 ±0.6) months, slightly longer than control group of (5.2±0.4) months, but no statistical difference was observed (P > 0.05). The ankle joint function of both groups was well recovered, but the good rate of study group (84.21%) was significantly higher than control group (68.42%) (P 0

  7. Distal tibia fractures: management and complications of 101 cases

    OpenAIRE

    Joveniaux, Pierre; Ohl, Xavier; Harisboure, Alain; Berrichi, Aboubekr; Labatut, Ludovic; Simon, Patrick; Mainard, Didier; Vix, Nicolas; Dehoux, Emile

    2009-01-01

    Distal tibia fractures are complex injuries with a high complication rate. In this retrospective and multicentre study we attempted to detail complications and outcomes of this type of injury in order to determine predictive factors of poor results. Between 2002 and 2004, 104 patients were admitted for 105 distal tibia fractures. One hundred patients (101 fractures) were reviewed with an average follow-up of 19 months (range, 12–46). Internal fixation, external fixation, limited internal fixa...

  8. 锚钉内固定治疗后交叉韧带胫骨止点撕脱性骨折%Open reduction and internal fixation with anchor screw for tibial avulsion fracture of the posterior cruciate ligament

    Institute of Scientific and Technical Information of China (English)

    李建赤; 黄必留; 梁江声; 谭加群; 徐自强; 吴春辉

    2013-01-01

    Objective To investigate the clinical efficacy of the treatment for tibial avulsion fracture of the posterior cruciate ligament ( PCL) with open reduction and anchor screw internal fixation. Methods 32 patients of tibial avulsion fracture of the posterior cruciate ligament were treated with open reduction and anchor screw internal fixation through inverted L-shaped posterior-medial approach. All the patients were given postoperative plaster immobilization of knee at 30° flexion for about four weeks. The patients were allowed to appropriate functional exercise of knee flexion and extension after removal of the plaster. Results 30 patients were followed up for seven to 30 months with an average of (13 ±5.2) months. The bony union was achieved in all the patients after operation in two to four months, (3 ±0. 6) months in average. According to Lysholm knee score system, six months after surgery, 26 cases were excellent, three cases were good and one case was fair . The excellent rate was 96. 7%. Conclusions Inverted L-shaped posterior-medial approach and anchor screw internal fixation is a safe, effective method for tibial avulsion fracture of PCL. Reliable internal fixation may be effective in the early reconstruction of the knee stability and restoring knee function.%目的 探讨锚钉内固定治疗后交叉韧带(PCL)胫骨止点撕脱性骨折的临床疗效.方法 对32例膝关节PCL胫骨止点撕脱骨折患者,采用膝关节后内侧倒"L"形入路切开复位,以锚钉内固定治疗,术后给予石膏托固定膝关节屈曲30°约4周,拆除石膏外固定后适当行膝关节伸屈功能锻炼.结果 30例获得随访,时间7~30个月,平均(13 ± 5.2)个月.术后2~4个月均获骨性愈合,平均为(3 ± 0.6)个月.手术6个月后依据Lysholm 等膝关节评分系统评估膝关节功能,评定优26 例,良3例,可1例,优良率96.7%.结论 膝后内侧"L"形入路应用锚钉内固定治疗PCL胫骨止点撕脱骨折是安全有效、内固

  9. Anterior subcutaneous fixation with screw-rod internal fixator for the treatment of unstable anterior pelvic ring fractures%经皮钉-棒内支架治疗不稳定骨盆前环骨折

    Institute of Scientific and Technical Information of China (English)

    王朝晖; 何波涌; 曾敏川; 郭建辉; 唐艳平; 赵快平; 刘建伟

    2016-01-01

    目的探讨经皮钉-棒内支架治疗不稳定骨盆前环骨折临床应用。方法回顾性分析经皮钉-棒内支架治疗的12例不稳定骨盆前环骨折患者的临床资料,男性8例,女性4例;年龄23~63岁,平均43.8岁。骨盆骨折按照Tile分类:B34例,C14例,C23例,C31例。后环损伤采用经皮骶髂螺钉固定2例,髂腰固定1例,钢板固定6例,其中M张力带钢板固定4例。结果前环固定平均出血70mL(50~90mL),平均手术时间65min(50~85min)。单侧股外侧皮神经损伤5例,均恢复正常;随访4~15个月,无切口感染、内固定失效等,骨折均获骨性愈合,疗效满意。结论经皮钉-棒内支架是治疗不稳定骨盆前环骨折微创舒适、简便、安全的方法,疗效好,但术中应警惕股外侧皮神经损伤。%Objective To study percutaneous internal fixation with screw-rod system for the treatment of unstable anterior pelvic ring fractures .Methods The clinical data of 12 cases of unstable anterior pelvic ring frac-tures treated with anterior subcutaneous fixation with screw-rod system was retrospectively analyzed . According to the Tile’s classification,4 cases were B3,4 cases were C1,3 cases were C2,and 1 case was C3.In all these poste-rior ring fractures,2 cases were treated with percutaneous iliosacral screw fixation ,1 case with ilio-lumbar fixation,and 6 cases with plate fixation (including M-shaped tension plate fixation in 4 cases).Results The average blood loss and operation time of anterior pelvic ring fixation were 70 mL ( ranged from 50 to 90 mL) and 65 min( ranged from 50 to 85min)respectively.Unilateral lateral femoral cutaneous nerves were inpaired in 5 cases and the symptoms resolved after 2 weeks.All cases were followed up for 4 to 15 months,indicating bone healing and satisfactory clinical results , without wound infection or fixation failure .Conclusion The percutaneous internal fixation with screw-rod system

  10. Fracture of a titanium sleeve-encased third-generation ceramic liner in a modern THA.

    Science.gov (United States)

    Chotai, Pranit N; Su, Edwin P

    2011-10-01

    Due to their excellent tribology, ceramics are increasingly used for total hip arthroplasty (THA) in young patients. Fracture rates for contemporary ceramics range from 0% to 0.004%. Recently, ceramic liners are encased in a titanium sleeve to further decrease the chances of fracture. We encountered 1 case of a metal-encased acetabular liner fracture in a ceramic-on-ceramic articulation in a series of 764 hips. Our literature review revealed no reports of metal-encased ceramic liner fracture. A 60-year-old woman presented 27 months after a bilateral ceramic-on-ceramic THA. She reported mechanical grinding and clicking from the left hip on extension. There was no history of trauma or fall. Examination revealed a nonantalgic gait and audible-palpable crepitations on the left hip. Range of motion of the left hip was intact with no subluxation. Radiographs revealed fractured ceramic insert and an excessively anteverted socket on the left side. Intraoperative findings revealed gross impingement in the form of indentation of the metal femoral neck against the elevated metal rim encasing the liner. Revision THA was performed using an uncemented polyethylene liner while retaining the well-fixed cup and stem. The Harris Hip Score at 4.5-year follow-up was 100, with no evidence of osteolysis or polyethylene wear.

  11. The acetabular fossa hot spot on 18F-FDG PET/CT: epidemiology, natural history, and proposed etiology

    International Nuclear Information System (INIS)

    To describe a benign focus of increased activity in the acetabular fossa (the acetabular fossa hot spot, AFHS) on 18F-FDG PET/CT that can mimic a neoplasm. 18F-FDG PET/CT images from four patient populations were examined. Group 1 (n = 13) was collected from a search of radiology reports and used to define the AFHS and for hypothesis generation. Group 2 (n = 1,150) was used for prevalence of AFHS. Group 3 (n = 1,213) had PET/CT and MRI pelvis within a week of each other and was used to correlate metabolic and anatomic findings. Group 4 (n = 100) was used to generate the control group. Data were collected on demographics, common comorbidities, underlying cancer diagnosis and status, and hip symptoms. Prevalence of AFHS was 0.36 % (95 % CI 0.10-0.91 %). None progressed to malignancy or was associated with cancer status. The majority (71 %) were on the left, and 6 % were bilateral. Mean SUVmax of the AFHS was 4.8 (range, 2.7-7.8). Male patients were more likely to have the AFHS (OR = 8.69, 95 % CI 1.88-40.13). There was no difference with respect to other collected data, including hip symptoms. Average minimum duration of AFHS was 346 days (range, 50-1,010 days). Readers did not detect corresponding hip abnormalities on MRIs. AFHS is a benign finding that may be caused by subclinical ligamentum teres injury, focal synovitis, or degeneration of acetabular fossa fat. Despite uncertainty regarding its etiology, recognition of AFHS as a benign finding can prevent morbidity associated with unnecessary biopsy or initiation of therapy. (orig.)

  12. The acetabular fossa hot spot on {sup 18}F-FDG PET/CT: epidemiology, natural history, and proposed etiology

    Energy Technology Data Exchange (ETDEWEB)

    Kubicki, Shelby L. [Trinity University, San Antonio, TX (United States); Richardson, Michael L. [University of Washington, Department of Radiology, Seattle, WA (United States); Martin, Thomas [X-Ray Associates of New Mexico, Department of Radiology, Albuquerque, NM (United States); Rohren, Eric [The University of Texas M.D. Anderson Cancer Center, Department of Diagnostic Radiology, Division of Nuclear Medicine,