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Sample records for bone fixation devices

  1. Regional alterations in long bone 85Sr clearance produced by internal fixation devices. Part II. Histomorphometry

    International Nuclear Information System (INIS)

    The effects of each of the surgical stages involved in compression plating on the development of cortical thinning and porosity were assessed in the intact midshaft, stress-shielded femoral segments of adult mongrel dogs 6 months postoperatively. The data were evaluated in terms of a postsurgical tetracycline-based measure of remodeling and terminal 85Sr clearance (SrC) values for the plated segments of bone. Drilling had no effect on any parameter. Screw application was associated with minimal cortical thinning (p less than 0.05), while plate fixation clearly promoted thinning (p less than 0.01) and porosity (p less than 0.05). The percentage of labeled osteons, a measure of remodeling activity, increased only after plate fixation (p less than 0.05), and the labeling patterns suggested that most osteons had formed during the first 4 postsurgical months. That none of these changes were correlated with the 6-month SrC values suggests that the development of plate-induced osteopenia involves disparate histomorphometric time constants, rather than lack of any association

  2. In vitro and in vivo evaluation of a polylactic acid-bioactive glass composite for bone fixation devices.

    Science.gov (United States)

    Vergnol, Gwenaelle; Ginsac, Nathalie; Rivory, Pascaline; Meille, Sylvain; Chenal, Jean-Marc; Balvay, Sandra; Chevalier, Jérôme; Hartmann, Daniel J

    2016-01-01

    Poly(lactic acid) is nowadays among the most used bioabsorbable materials for medical devices. To promote bone growth on the material surface and increase the degradation rate of the polymer, research is currently focused on organic-inorganic composites by adding a bioactive mineral to the polymer matrix. The purpose of this study was to investigate the ability of a poly(L,DL-lactide)-Bioglass® (P(L,DL)LA-Bioglass(®) 45S5) composite to be used as a bone fixation device. In vitro cell viability testing of P(l,dl)LA based composites containing different amounts of Bioglass(®) 45S5 particles was investigated. According to the degradation rate of the P(L,DL)LA matrix and the cytocompatibility experiments, the composite with 30 wt % of Bioglass® particles seemed to be the best candidate for further investigation. To study its behavior after immersion in simulated physiological conditions, the degradation of the composite was analyzed by measuring its weight loss and mechanical properties and by proceeding with X-ray tomography. We demonstrated that the presence of the bioactive glass significantly accelerated the in vitro degradation of the polymer. A preliminary in vivo investigation on rabbits shows that the addition of 30 wt % of Bioglass(®) in the P(L,DL)LA matrix seems to trigger bone osseointegration especially during the first month of implantation. This composite has thus strong potential interest for health applications. PMID:25677798

  3. In vitro and in vivo evaluation of a polylactic acid-bioactive glass composite for bone fixation devices.

    Science.gov (United States)

    Vergnol, Gwenaelle; Ginsac, Nathalie; Rivory, Pascaline; Meille, Sylvain; Chenal, Jean-Marc; Balvay, Sandra; Chevalier, Jérôme; Hartmann, Daniel J

    2016-01-01

    Poly(lactic acid) is nowadays among the most used bioabsorbable materials for medical devices. To promote bone growth on the material surface and increase the degradation rate of the polymer, research is currently focused on organic-inorganic composites by adding a bioactive mineral to the polymer matrix. The purpose of this study was to investigate the ability of a poly(L,DL-lactide)-Bioglass® (P(L,DL)LA-Bioglass(®) 45S5) composite to be used as a bone fixation device. In vitro cell viability testing of P(l,dl)LA based composites containing different amounts of Bioglass(®) 45S5 particles was investigated. According to the degradation rate of the P(L,DL)LA matrix and the cytocompatibility experiments, the composite with 30 wt % of Bioglass® particles seemed to be the best candidate for further investigation. To study its behavior after immersion in simulated physiological conditions, the degradation of the composite was analyzed by measuring its weight loss and mechanical properties and by proceeding with X-ray tomography. We demonstrated that the presence of the bioactive glass significantly accelerated the in vitro degradation of the polymer. A preliminary in vivo investigation on rabbits shows that the addition of 30 wt % of Bioglass(®) in the P(L,DL)LA matrix seems to trigger bone osseointegration especially during the first month of implantation. This composite has thus strong potential interest for health applications.

  4. Regional alterations in long bone produced by internal fixation devices. Part I. 85Sr clearance

    International Nuclear Information System (INIS)

    We examined the effect of rigid plate application on the radiostrontium clearance of the intact canine femur at 6 months. We examined each of the component surgical steps. We calculated the clearance both for the whole bone and for each of the five transverse sections of the whole bone. Screw application, but not drilling, increased the clearance in the segment about the screw holes. Plate application produced an increase in the segment beneath the plate as well as around the screws and in the whole bone. These changes are accomplished not only by an absolute increase in clearance to the middle three segments, but by a relative diminution in clearance by the most proximal and distal segments. The histomorphometric changes in long bones following rigid plating may be accompanied by regional increases in bone blood flow

  5. The role of bone SPECT/CT in the evaluation of lumbar spinal fusion with metallic fixation devices

    DEFF Research Database (Denmark)

    Damgaard, Morten; Nimb, Lars; Madsen, Jan L

    2010-01-01

    PURPOSE: It is difficult to evaluate the stability of the lumbar spondylodesis with metallic fixation devices by conventional imaging methods such as radiography or magnetic resonance imaging. It is unknown whether single photon emission computed tomography/computed tomography (SPECT/CT) may be u...

  6. The role of bone SPECT/CT in the evaluation of lumbar spinal fusion with metallic fixation devices

    DEFF Research Database (Denmark)

    Damgaard, Morten; Nimb, Lars; Madsen, Jan L

    2010-01-01

    PURPOSE: It is difficult to evaluate the stability of the lumbar spondylodesis with metallic fixation devices by conventional imaging methods such as radiography or magnetic resonance imaging. It is unknown whether single photon emission computed tomography/computed tomography (SPECT/CT) may...... stabilizing lumbar surgery with metallic implants. The SPECT/CT findings were compared with observations from subsequent surgical reexploration. RESULTS: In 6 of 9 patients, the SPECT/CT fully or partially detected the vertebral level of loose pedicle screws. Of 9 cases, 2 were considered inconclusive...

  7. Acid-resistant calcium silicate-based composite implants with high-strength as load-bearing bone graft substitutes and fracture fixation devices.

    Science.gov (United States)

    Wei, Chung-Kai; Ding, Shinn-Jyh

    2016-09-01

    To achieve the excellent mechanical properties of biodegradable materials used for cortical bone graft substitutes and fracture fixation devices remains a challenge. To this end, the biomimetic calcium silicate/gelatin/chitosan oligosaccharide composite implants were developed, with an aim of achieving high strength, controlled degradation, and superior osteogenic activity. The work focused on the effect of gelatin on mechanical properties of the composites under four different kinds of mechanical stresses including compression, tensile, bending, and impact. The evaluation of in vitro degradability and fatigue at two simulated body fluid (SBF) of pH 7.4 and 5.0 was also performed, in which the pH 5.0 condition simulated clinical conditions caused by bacterial induced local metabolic acidosis or tissue inflammation. In addition, human mesenchymal stem cells (hMSCs) were sued to examine osteogenic activity. Experimental results showed that the appropriate amount of gelatin positively contributed to failure enhancement in compressive and impact modes. The 10wt% gelatin-containing composite exhibits the maximum value of the compressive strength (166.1MPa), which is within the reported compressive strength for cortical bone. The stability of the bone implants was apparently affected by the in vitro fatigue, but not by the initial pH environments (7.4 or 5.0). The gelatin not only greatly enhanced the degradation of the composite when soaked in the dynamic SBF solution, but effectively promoted attachment, proliferation, differentiation, and formation of mineralization of hMSCs. The 10wt%-gelatin composite with high initial strength may be a potential implant candidate for cortical bone repair and fracture fixation applications. PMID:27254281

  8. Periprosthetic fracture fixation in osteoporotic bone.

    Science.gov (United States)

    Lenz, Mark; Lehmann, Wolfgang; Wähnert, Dirk

    2016-06-01

    Fixation techniques of periprosthetic fractures are far from ideal although the number of this entity is rising. The presence of an intramedullary implant generates its own fracture characteristics since stiffness is altered along the bone shaft and certain implant combinations affect load resistance of the bone. Influencing factors are cement fixation of the implant, intramedullary locking and extramedullary or intramedullary localization of the implant and the cortical thickness of the surrounding bone. Cerclage wires are ideally suited to fix radially displaced fragments around an intramedullary implant but they are susceptible to axial and torsional load. Screws should be added if these forces have to be neutralized. Stability of the screw fixation itself can be enhanced by embracement configuration around the intramedullary implant. Poor bone stock quality, often being present in metaphyseal areas limits screw fixation. Cement augmentation is an attractive option in this field to enhance screw purchase. PMID:27338227

  9. Design and Optimization of Resorbable Silk Internal Fixation Devices

    Science.gov (United States)

    Haas, Dylan S.

    Limitations of current material options for internal fracture fixation devices have resulted in a large gap between user needs and hardware function. Metal systems offer robust mechanical strength and ease of implantation but require secondary surgery for removal and/or result in long-term complications (infection, palpability, sensitivity, etc.). Current resorbable devices eliminate the need for second surgery and long-term complications but are still associated with negative host response as well as limited functionality and more difficult implantation. There is a definitive need for orthopedic hardware that is mechanically capable of immediate fracture stabilization and fracture fixation during healing, can safely biodegrade while allowing complete bone remodeling, can be resterilized for reuse, and is easily implantable (self-tapping). Previous work investigated the use of silk protein to produce resorbable orthopedic hardware for non- load bearing fracture fixation. In this study, silk orthopedic hardware was further investigated and optimized in order to better understand the ability of silk as a fracture fixation system and more closely meet the unfulfilled market needs. Solvent-based and aqueous-based silk processing formulations were cross-linked with methanol to induce beta sheet structure, dried, autoclaved and then machined to the desired device/geometry. Silk hardware was evaluated for dry, hydrated and fatigued (cyclic) mechanical properties, in vitro degradation, resterilization, functionalization with osteoinductive molecules and implantation technique for fracture fixation. Mechanical strength showed minor improvements from previous results, but remains comparable to current resorbable fixation systems with the advantages of self-tapping ability for ease of implantation, full degradation in 10 months, ability to be resterilized and reused, and ability to release molecules for osteoinudction. In vivo assessment confirmed biocompatibility, showed

  10. The influence on the contact condition and initial fixation stability of the main design parameters of a self-expansion type anterior cruciate ligament fixation device

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Dae [Jeonju University, Jeonju (Korea, Republic of); Oh, Chae Youn; Kim, Cheol Sang [Chonbuk National University, Jeonju (Korea, Republic of)

    2008-12-15

    This paper proposes a self-expansion type anterior cruciate ligament fixation device. The proposed fixation device provides graft fixation force by maintaining contact with the bone tunnel. Since the device maintains contact with the bone tunnel by the force that expands by the self-driven elastic force of the device, the main design parameters that determine the performance of this device are the ring thickness and expansion angle. This paper develops the three-dimensional finite element models of the fixation device and bone. By simulation with the developed finite element model, this paper studies the influence of the main design parameters of the device on the maximum stress around the ring when grasping the fixation device. Through the analysis of the stress on the bone tunnel wall when the fixation device comes in contact with the bone tunnel, this paper shows the influence of the main design parameters of the fixation device on the contact condition. In addition, through the analysis of the migration that occur upon application of the pull-out force, this paper studies the influence of the main design parameters on the initial fixation stability of the fixation device

  11. 骨外固定器在胫腓骨骨折中的应用及护理体会%The Application of External Bone Fixation Device in Tibia and Fibulac Fractures & Nursing Experience

    Institute of Scientific and Technical Information of China (English)

    唐红波; 陈克; 刘莉莉

    2012-01-01

    Objective:discuss the nursing experience when external bone fixation device is applied in tibia and fibulae fractures. Methods:select 58 people who suffered from tibia and fibulae fractures and were treated by external bone fixation device to summarize and analyse methods of treatment for fracture and humanistic nursing measures.Results:it took 7.8 months on average for 58 suffers of tibia and fibulae fractures to unite fractures. Among which, bone union was accomplished by 57 cases, while one wasn't healed.Conclusion:in terms of the treatment for tibia and fibulae fractures, external bone fixation device has been widely applied. Positive and effective measures shall be taken to facilitate the bone healing process and functional recovery of limbs so as to avoid the occurrence of complications.%目的:探讨在胫腓骨骨折中应用骨外固定器的护理体会.方法:选取58例使用骨外固定器治疗的胫腓骨骨折患者,对骨折治疗方法及人性化护理措施进行归纳和分析.结果:58例胫腓骨骨折患者的骨折平均愈合时间为7.8个月,其中,骨性愈合57例,未愈合1例.结论:在胫腓骨骨折的治疗中,骨外固定器已广泛应用,应当采取积极有效的护理措施,以促进骨折的愈合及肢体的功能恢复,防止并发症的发生.

  12. Fixation of a human rib by an intramedullary telescoping splint anchored by bone cement.

    Science.gov (United States)

    Liovic, Petar; Šutalo, Ilija D; Marasco, Silvana F

    2016-09-01

    A novel concept for rib fixation is presented that involves the use of a bioresorbable polymer intramedullary telescoping splint. Bone cement is used to anchor each end of the splint inside the medullary canal on each side of the fracture site. In this manner, rib fixation is achieved without fixation device protrusion from the rib, making the splint completely intramedullary. Finite element analysis is used to demonstrate that such a splint/cement composite can preserve rib fixation subjected to cough-intensity force loadings. Computational fluid dynamics and porcine rib experiments were used to study the anchor formation process required to complete the fixation. PMID:26733094

  13. Machining of a bioactive nanocomposite orthopedic fixation device.

    Science.gov (United States)

    Sparnell, Amie; Aniket; El-Ghannam, Ahmed

    2012-08-01

    Bioactive ceramics bond to bone and enhance bone formation. However, they have poor mechanical properties which restrict their machinability as well as their application as load bearing implants. The goal of this study was to machine bioactive fixation screws using a silica-calcium phosphate nanocomposite (SCPC50). The effect of compact pressure, holding time, and thermal treatment on the microstructure, machinability, and mechanical properties of SCPC50 cylinders were investigated. Samples prepared by powder metallurgy technique at compact pressure range of 100-300 MPa and treated at 900°C/1 h scored a poor machinability rating of (1/5) due to the significant formation of amorphous silicate phase at the grain boundaries. On the other hand, lowering of compact pressure and sintering temperature to 30 MPa/3 h and 700°C/2 h, respectively, minimized the formation of the amorphous phase and raised the machinability rating to (5/5). The modulus of elasticity and ultimate strength of machinable SCPC50 were 10.8 ± 2.0 GPa and 72.8 ± 22.8 MPa, respectively, which are comparable to the corresponding values for adult human cortical bone. qRT-PCR analyses showed that bone cells attached to SCPC50 significantly upregulated osteocalcin mRNA expression as compared to the cells on Ti-6Al-4V. Moreover, cells attached to SCPC50 produced mineralized bone-like tissue within 8 days. On the other hand, cells attached to Ti-6Al-4V failed to produce bone mineral under the same experimental conditions. Results of the study suggest that machinable SCPC50 has the potential to serve as an attractive new material for orthopedic fixation devices.

  14. Use of polymethylmethacrylate to enhance screw fixation in bone.

    Science.gov (United States)

    Cameron, H U; Jacob, R; Macnab, I; Pilliar, R M

    1975-07-01

    Pull-out testing of screws inserted into cement and bone under various conditions showed that the cement-screw complex was significantly stronger when the screw was placed in soft cement and the cement was allowed to polymerize without further manipulation. When screw fixation in osteoporotic bone was reinforced with cement, the bone was the weakest component in the system. Fixation under these conditions should be enhanced by increasing the area of contact between the cement and bone. By cooling the cement to prolong its working time, it could be injected with a syringe in such a way that maximum endosteal and periosteal contact was provided. PMID:1150708

  15. Novel anterior cruciate ligament graft fixation device reduces slippage

    Directory of Open Access Journals (Sweden)

    Lopez MJ

    2013-05-01

    Full Text Available Mandi J Lopez,1 Allen Borne,2 W Todd Monroe,3 Prakash Bommala,1 Laura Kelly,1 Nan Zhang11Laboratory for Equine and Comparative Orthopedic Research, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, 2Louisiana State University, New Orleans Health Sciences Center, School of Medicine, New Orleans, 3Department of Biological and Agricultural Engineering, Agricultural Center, Louisiana State University, Baton Rouge, LA, USAAbstract: Clinically significant laxity occurs in 10%–30% of knees after anterior cruciate ligament reconstruction. Graft slippage and tension loss at the hamstring graft tibial fixation site during and after reconstruction surgery contribute to postoperative joint laxity and are detrimental to long-term knee stability and graft properties. Limiting graft slippage will reduce associated complications. We sought to compare the in vitro mechanical properties and in vivo joint stabilization, postoperative limb use, and graft incorporation of the novel GraftGrab™ (GG device designed to reduce hamstring graft tibial fixation slippage with the commercially available bioabsorbable Bio-Post™ and spiked washer (BP. Mechanical testing was performed on canine tibia-hamstring graft constructs to quantify initial fixation properties. In vivo joint stabilization, postoperative limb use and graft incorporation of hamstring graft reconstructions were determined in a canine model. Outcomes included tibial translation and ground reaction forces preoperatively and 4 and 8 weeks postoperatively, three-dimensional graft and bone tunnel dimensions at the latter two time points, and graft-bone microstructure, as well as mechanical properties 8 weeks after implantation. Immediately after fixation, all grafts slipped from the BP constructs versus about 30% of GG constructs. In vivo limb use remained low, and tibial translation increased with time in the BP cohort. These results together

  16. Fixation of tibial plateau fractures with synthetic bone graft versus natural bone graft: a comparison study.

    LENUS (Irish Health Repository)

    Ong, J C Y

    2012-06-01

    The goal of this study was to determine differences in fracture stability and functional outcome between synthetic bone graft and natural bone graft with internal fixation of tibia plateau metaphyseal defects.

  17. Bone graft materials in fixation of orthopaedic implants in sheep.

    Science.gov (United States)

    Babiker, Hassan

    2013-07-01

    Bone graft is widely used within orthopaedic surgery especially in revision joint arthroplasty and spine fusion. The early implant fixation in the revision situation of loose joint prostheses is important for the long-term survival. Bone autograft has been considered as gold standard in many orthopaedic procedures, whereas allograft is the gold standard by replacement of extensive bone loss. However, the use of autograft is associated with donor site morbidity, especially chronic pain. In addition, the limited supply is a significant clinical challenge. Limitations in the use of allograft include the risk of bacterial contamination and disease transmission as well as non-union and poor bone quality. Other bone graft and substitutes have been considered as alternative in order to improve implant fixation. Hydroxyapatite and collagen type I composite (HA/Collagen) have the potential in mimicking skeletal bones. The osteoconductive properties of the composite might be improved by adding bone marrow aspirate (BMA), which can be harvested during surgery. Other alternatives to bone graft are demineralised bone matrix (DBM) and human cancellous bone (CB). DBM is prepared by acid extraction of human bone and includes bone collagen, morphogenetic proteins and growth factors. The combination of DBM with CB and with allograft might improve the healing potential of these grafts around non-cemented orthopaedic implants and thereby the implant fixation. Study I investigates the effect of HA/Collagen composite alone and in combination with BMA on the early fixation of porous coated titanium implants. In addition, the study compares also the effect of autograft with the gold standard allograft. By using a sheep model, the implants were inserted in the trabecular bone of femoral condyles. The test biomaterials were placed in a well defined peri-implant gap. After the observation period, the bone-implant specimens were harvested and evaluated mechanically by a destructive push

  18. The Weak Link in Anterior Cruciate Ligament Reconstruction: What is the Evidence for Graft Fixation Devices?

    Science.gov (United States)

    Campbell, Kirk A; Looze, Christopher; Bosco, Joseph A; Strauss, Eric J

    2016-03-01

    Anterior cruciate ligament (ACL) rupture is a common injury that mostly affects young adults. The mechanisms of injury and surgical treatment have been extensively studied in both the laboratory and clinical arenas; however, great controversy still exists in regards to the best surgical technique, graft choice, and graft fixation device. In the area graft fixation, multiple breakthroughs have occurred in terms of fixation devices. These devices generally fall within the broad categories of interference screw, cross-pins, or cortical-based devices. Furthermore, some of these devices are available in either metal or bioabsorbable materials, which adds to the already great variety of options. Although biomechanically these devices have been shown to be able to withstand the typical forces experienced by the ACL graft during the early phases of rehabilitation before the graft has fully incorporated into the bone, little is known about the clinical outcomes. It is well recognized that graft fixation is the weakest link in the early postoperative period after ACL reconstruction. This review of the outcomes of ACL fixation devices explores some of the evidence available for the different devices. PMID:26977545

  19. Bone graft materials in fixation of orthopaedic implants in sheep

    DEFF Research Database (Denmark)

    Babiker, Hassan

    2013-01-01

    Bone graft is widely used within orthopaedic surgery especially in revision joint arthroplasty and spine fusion. The early implant fixation in the revision situation of loose joint prostheses is important for the long-term survival. Bone autograft has been considered as gold standard in many...... orthopaedic procedures, whereas allograft is the gold standard by replacement of extensive bone loss. However, the use of autograft is associated with donor site morbidity, especially chronic pain. In addition, the limited supply is a significant clinical challenge. Limitations in the use of allograft include...... skeletal bones. The osteoconductive properties of the composite might be improved by adding bone marrow aspirate (BMA), which can be harvested during surgery. Other alternatives to bone graft are demineralised bone matrix (DBM) and human cancellous bone (CB). DBM is prepared by acid extraction of human...

  20. Joint prosthesis and method of bone fixation

    OpenAIRE

    Oosterom, R; Pijl, A J; Bersee, H.E.N.; Van der Helm, F.C.; Herder, J. L.

    2006-01-01

    The invention relates to a joint prosthesis (10), for example, a knee joint or shoulder joint prosthesis comprising a first, socket-holding prosthesis part (11) for attachment to a first bone (12) and a second, ball-holding prosthesis part (13) for attachment to a second bone (14) that intermates with the first prosthesis part, wherein the first bone and the second bone are situated at either side of a joint, and wherein the ball (2) of the second prosthesis part is rotatably received in the ...

  1. Strength analysis of clavicle fracture fixation devices and fixation techniques using finite element analysis with musculoskeletal force input.

    Science.gov (United States)

    Marie, Cronskär

    2015-08-01

    In the cases, when clavicle fractures are treated with a fixation plate, opinions are divided about the best position of the plate, type of plate and type of screw units. Results from biomechanical studies of clavicle fixation devices are contradictory, probably partly because of simplified and varying load cases used in different studies. The anatomy of the shoulder region is complex, which makes it difficult and expensive to perform realistic experimental tests; hence, reliable simulation is an important complement to experimental tests. In this study, a method for finite element simulations of stresses in the clavicle plate and bone is used, in which muscle and ligament force data are imported from a multibody musculoskeletal model. The stress distribution in two different commercial plates, superior and anterior plating position and fixation including using a lag screw in the fracture gap or not, was compared. Looking at the clavicle fixation from a mechanical point of view, the results indicate that it is a major benefit to use a lag screw to fixate the fracture. The anterior plating position resulted in lower stresses in the plate, and the anatomically shaped plate is more stress resistant and stable than a regular reconstruction plate.

  2. Joint prosthesis and method of bone fixation

    NARCIS (Netherlands)

    Oosterom, R.; Van der Pijl, A.J; Bersee, H.E.N.; Van der Helm, F.C.; Herder, J.L

    2006-01-01

    The invention relates to a joint prosthesis (10), for example, a knee joint or shoulder joint prosthesis comprising a first, socket-holding prosthesis part (11) for attachment to a first bone (12) and a second, ball-holding prosthesis part (13) for attachment to a second bone (14) that intermates wi

  3. Transpedicular vertebral body augmentation reinforced with pedicle screw fixation in fresh traumatic A2 and A3 lumbar fractures: comparison between two devices and two bone cements.

    Science.gov (United States)

    Korovessis, Panagiotis; Vardakastanis, Konstantinos; Repantis, Thomas; Vitsas, Vasilios

    2014-07-01

    This retrospective study compares efficacy and safety of balloon kyphoplasty (BK) with calcium phosphate (Group A) versus KIVA implant with PMMA (Group B) reinforced with three vertebrae pedicle screw constructs for A2 and A3 single fresh non-osteoporotic lumbar (L1-L4) fractures in 38 consecutive age- and diagnosis-matched patient populations. Extracanal leakage of both low-viscosity PMMA and calcium phosphate (CP) as well as the following roentgenographic parameters: segmental kyphosis (SKA), anterior (AVBHr) and posterior (PVBHr) vertebral body height ratio, spinal canal encroachment (SCE) clearance, and functional outcome measures: VAS and SF-36, were recorded and compared between the two groups. All patients in both groups were followed for a minimum 26 (Group A) and 25 (Group B) months. Extracanal CP and PMMA leakage was observed in four (18 %) and three (15 %) vertebrae/patients of group A and B, respectively. Hybrid fixation improved AVBHr, SKA, SCE, but PVBHr only in group B. VAS and SF-36 improved postoperatively in the patients of both groups. Short-segment construct with the novel KIVA implant restored better than BK-fractured lumbar vertebral body, but this had no impact in functional outcome. Since there was no leakage difference between PMMA and calcium phosphate and no short-term adverse related to PMMA use were observed, we advice the use of PMMA in fresh traumatic lumbar fractures. PMID:23982115

  4. Bioreactor activated graft material for early implant fixation in bone

    DEFF Research Database (Denmark)

    Snoek Henriksen, Susan; Ding, Ming; Overgaard, Søren

    2011-01-01

    Introduction The combined incubation of a composite scaffold with bone marrow stromal cells in a perfusion bioreactor could make up a novel hybrid graft material with optimal properties for early fixation of implant to bone. The aim of this study was to create a bioreactor activated graft (BAG......) material, which could induce early implant fixation similar to that of allograft. Two porous scaffold materials incubated with cells in a perfusion bioreactor were tested in this study. Methods and Materials Two groups of 8 skeletally mature female sheep were anaesthetized before aspiration of bone marrow...... from the iliac crest. For both groups, mononuclear cells were isolated, and injected into a perfusion bioreactor (Millenium Biologix AG, Switzerland). Scaffold granules (Ø~900-1500 µm, ~88% porosity) in group 1, consisted of hydroxyapatite (HA, 70%) with β-tricalcium-phosphate (β-TCP, 30%) (Danish...

  5. Histomorphometric evaluation of bone healing in rabbit fibular osteotomy model without fixation

    Directory of Open Access Journals (Sweden)

    Paixão Fabio B

    2008-01-01

    Full Text Available Abstract Background Animal models of fracture consolidation are fundamental for the understanding of the biological process of bone repair in humans, but histological studies are rare and provide only qualitative results. The objective of this article is to present the histomorphometric study of the bone healing process using an experimental model of osteotomy in rabbit fibula without interference of synthesis material. Methods Fifteen rabbits were submitted to fibular osteotomy without any fixation device. Groups of five animals were submitted to pharmacological euthanasia during a period of one (group A, two (group B and four weeks (group C after osteotomy. Histomorphometric evaluation was performed in the histological sections. Results During week one there was intense cellularity (67/field, a large amount of woven bone (75.7% and a small amount of lamellar bone (7.65%. At two weeks there was a decrease in woven bone (41.59% and an increase in lamellar bone (15.16%. At four weeks there was a decrease of cellularity (19.17/field and lamellar bone (55.56% exceeded the quantity of woven bone (31.68%. Conclusion Histomorphometric (quantitative evaluation of the present study was shown to be compatible with bone healing achieved in qualitative experimental models that have been commended in the literature.

  6. Autologous bone graft versus demineralized bone matrix in internal fixation of ununited long bones

    Directory of Open Access Journals (Sweden)

    Rubenbauer Bianka

    2009-12-01

    Full Text Available Abstract Background Non-unions are severe complications in orthopaedic trauma care and occur in 10% of all fractures. The golden standard for the treatment of ununited fractures includes open reduction and internal fixation (ORIF as well as augmentation with autologous-bone-grafting. However, there is morbidity associated with the bone-graft donor site and some patients offer limited quantity or quality of autologous-bone graft material. Since allogene bone-grafts are introduced on the market, this comparative study aims to evaluate healing characteristics of ununited bones treated with ORIF combined with either iliac-crest-autologous-bone-grafting (ICABG or demineralized-bone-matrix (DBM. Methods and results From 2000 to 2006 out of sixty-two consecutive patients with non-unions presenting at our Level I Trauma Center, twenty patients had ununited diaphyseal fractures of long bones and were treated by ORIF combined either by ICABG- (n = 10 or DBM-augmentation (n = 10. At the time of index-operation, patients of the DBM-group had a higher level of comorbidity (ASA-value: p = 0.014. Mean duration of follow-up was 56.6 months (ICABG-group and 41.2 months (DBM-group. All patients were clinically and radiographically assessed and adverse effects related to bone grafting were documented. The results showed that two non-unions augmented with ICABG failed osseous healing (20% whereas all non-unions grafted by DBM showed successful consolidation during the first year after the index operation (p = 0.146. No early complications were documented in both groups but two patients of the ICABG-group suffered long-term problems at the donor site (20% (p = 0.146. Pain intensity were comparable in both groups (p = 0.326. However, patients treated with DBM were more satisfied with the surgical procedure (p = 0.031. Conclusion With the use of DBM, the costs for augmentation of the non-union-site are more expensive compared to ICABG (calculated difference: 160

  7. Press-fit Femoral Fixation in ACL Reconstruction using Bone-Patellar Tendon-Bone Graft

    Directory of Open Access Journals (Sweden)

    Kaseb Mohammad Hasan

    2009-05-01

    Full Text Available Bone-patellar tendon auto graft is probably the most widely used graft for ACL reconstruction. Several methods for graft fixation have been described. To avoid intra-articular hardware we adopt biological fixation with a femoral trapezoidal press-fit fixation. A prospective study was performed on 30 consecutive active people who underwent ACL reconstruction with this technique by two surgeons between september2004 and march2007 (mean follow-up 15.2 months. Results were evaluated by an independent examiner using radiography, subjective and objective evaluation. Assessment using the IKDC knee scoring revealed 92% of the patients with a normal or nearly normal knee joint. Lysholm's score was 63.6(40- 86 preoperatively and 91.88(73-100 at the latest follow up (P < 0.005. No patient complained of instability at latest follow up. The quadriceps muscle showed mild atrophy at 3 and 6 months and at final follow-up. Five Patients complained of anterior knee pain and had a positive kneeling test. We found no graft displacement on follow up radiographs. All cases showed radiological evidence of graft osteointegration at last follow up. Our results show that press-fit fixation of trapezoidal bone graft in femoral tunnel is a simple, reliable, and cost-effective alternative for ACL recon-struction using bone-patellar tendon-bone graft.

  8. Treatment of tibial defect and bone nonunion with limb shortening with external fixator and reconstituted bone xenograft

    Institute of Scientific and Technical Information of China (English)

    王志刚; 刘建; 胡蕴玉; 孟国林; 金格勒; 袁志; 王海强; 戴先文

    2003-01-01

    Objective: To explore the effect of external fixator and reconstituted bone xenograft (RBX) in the treatment of tibial bone defect, tibial bone nonunion and congenital pseudarthrosis of the tibia with limb shortening. Methods: Twenty patients ( 13 males and 7 females) with tibial bone defect, tibial bone nonunion or congenital pseudarthrosis of the tibia with limb shortening were treated with external fixation. Two kinds of external fixators were used: a half ring sulcated external fixator used in 13 patients and a combined external fixator in 7 patients. Foot-drop was corrected at the same time with external fixation in 4 patients. The shortened length of the tibia was in the range of 2-9 cm, with an average of 4.8 cm. For bone grafting, RBX was used in 12 patients, autogenous ilium was used in 3 patients and autogenous fibula was implanted as a bone plug into the medullary canal in 1 case, and no bone graft was used in 4 patients. Results: All the 20 patients were followed-up for 8 months to 7 years, averaging 51 months. Satisfactory function of the affected extremities was obtained. All the shortened extremities were lengthened to the expected length. For all the lengthening area and the fracture sites, bone union was obtained at the last. The average healing time of 12 patients treated with RBX was 4.8 months. Conclusions: Both the half ring sulcated external fixator and the combined external fixator have the advantages of small trauma, simple operation, elastic fixation without stress shielding and non-limitation from local soft tissue conditions, and there is satisfactory functional recovery of affected extremities in the treatment of tibial bone defects, tibial bone nonunion and congenital pseudarthrosis of the tibia combined with limb shortening. RBX has good biocompatibility and does not cause immunological rejections. It can also be safely used in treatment of bone nonunion and has reliable effect to promote bone healing.

  9. Fragment reconstruction and bone plate fixation versus bridging plate fixation for treating highly comminuted femoral fractures in dogs: 35 cases (1987-1997)

    International Nuclear Information System (INIS)

    To compare fragment reconstruction and bone plate fixation versus bridging plate fixation for treating highly comminuted (> 4 fragments) femoral fractures in dogs. Retrospective study. 35 dogs with highly comminuted fractures of the femur. Medical records of all dogs included in this study were reviewed. Dogs had been treated with fragment reconstruction and bone plate application (n = 20) or major fragment alignment and bridging plate fixation (15). Postoperative and follow-up radiographs were evaluated. Operating and hospitalization times, bone alignment, bone healing, and complications were considered. There were no differences in hospitalization times, limb alignment, and complications between dogs with fractures treated with fragment reconstruction and dogs with fractures treated with bridging plate fixation. Dogs with fractures treated with bridging plate fixation had shorter operative times and faster times to radiographic evidence of bone healing. Bridging plate fixation is quicker to perform and results in faster healing than fragment reconstruction and bone plate fixation when used to treat comminuted femoral fractures

  10. Biomechanical testing of implant free wedge shaped bone block fixation for bone patellar tendon bone anterior cruciate ligament reconstruction in a bovine model

    Directory of Open Access Journals (Sweden)

    Willis-Owen Charles A

    2010-09-01

    Full Text Available Abstract Background The use of an interference fit wedged bone plug to provide fixation in the tibial tunnel when using bone-patellar tendon-bone autograft for anterior cruciate ligament reconstruction offers many theoretic advantages including the potential to offer a more economical and biological alternative to screw fixation. This technique has not been subjected to biomechanical testing. We hypothesised that a wedged bone plug fixation technique provides equivalent tensile load to failure as titanium interference screw fixation. Methods In a controlled laboratory setting, anterior cruciate ligament reconstruction was performed in 36 bovine knees using bone-patella-bone autograft. In 20 knees tibial fixation relied upon a standard cuboid bone block and interference screw. In eight knees a wedge shaped bone block with an 11 mm by 10 mm base without a screw was used. In a further eight knees a similar wedge with a 13 mm by 10 mm base was used. Each specimen used a standard 10 mm tibial tunnel. The reconstructions were tested biomechanically in a physiological environment using an Instron machine to compare ultimate failure loads and modes of failure. Results Statistical analysis revealed no significant difference between wedge fixation and screw fixation (p = 0.16, or between individual groups (interference screw versus 11 mm versus 13 mm wedge fixation (P = 0.35. Conclusions Tibial tunnel fixation using an impacted wedge shaped bone block in anterior cruciate ligament reconstruction has comparable ultimate tensile strength to titanium interference screw fixation.

  11. Influence of different methods of internal bone fixation on characteristics of bone callus in experimental animals

    Directory of Open Access Journals (Sweden)

    Gajdobranski Đorđe

    2014-01-01

    Full Text Available Introduction. Correct choice of osteosynthesis method is a very important factor in providing the optimal conditions for appropriate healing of the fracture. There are still disagreements about the method of stabilization of some long bone fractures. Critically observed, no method of fracture fixation is ideal. Each osteosynthesis method has both advantages and weaknesses. Objective. The objective of this study was to compare the results of the experimental application of three different internal fixation methods: plate fixation, intramedullary nail fixation and self-dynamisable internal fixator (SIF. Methods. A series of 30 animals were used (Lepus cuniculus as experimental animals, divided into three groups of ten animals each. Femoral diaphysis of each animal was osteotomized and fixed with one of three implants. Ten weeks later all animals were sacrificed and each specimen underwent histological and biomechanical testing. Results. Histology showed that the healing process with SIF was more complete and bone callus was more mature in comparison to other two methods. During biomechanical investigation (computerized bending stress test, it was documented with high statistical significance that using SIF led to stronger healing ten weeks after the operation. Conclusion. According to the results obtained in this study, it can be concluded that SIF is a suitable method for fracture treatment.

  12. Assessment of activated porous granules on implant fixation and early bone formation in sheep

    Directory of Open Access Journals (Sweden)

    Ming Ding

    2016-04-01

    Conclusion: In conclusion, despite nice bone formation and implant fixation in all groups, bioreactor activated graft material did not convincingly induce early implant fixation similar to allograft, and neither bioreactor nor by adding BMA credited additional benefit for bone formation in this model.

  13. Suboccipital neuropathy after bone conduction device placement

    NARCIS (Netherlands)

    Faber, H.T.; Ru, J.A. de

    2013-01-01

    OBJECTIVE: To describe the clinical characteristics of a 70-year-old female with occipital neuropathy following bone conduction device surgery. DESCRIPTION: A 65-year-old woman underwent bone conduction device placement surgery on the left temporal bone. Postoperatively she progressively developed c

  14. Outcome of rail fixator system in reconstructing bone gap

    Directory of Open Access Journals (Sweden)

    Amit Lakhani

    2014-01-01

    Conclusion: All patients well tolerated rail fixator with good functional results and gap reconstruction. Easy application of rail fixator and comfortable distraction procedure suggest rail fixator a good alternative for gap reconstruction of limbs.

  15. Negative pressure wound therapy and external fixation device: a simple way to seal the dressing.

    Science.gov (United States)

    Bulla, Antonio; Farace, Francesco; Uzel, André-Pierre; Casoli, Vincent

    2014-07-01

    Negative pressure therapy is widely applied to treat lower limb trauma. However, sealing a negative pressure dressing in the presence of an external fixation device may be difficult and time consuming. Therefore, screws, pins, wires, etc, may preclude the vacuum, preventing the plastic drape to perfectly adhere to the foam. To maintain the vacuum, we tried to prevent air leaking around the screws putting bone wax at the junction between the pins and the plastic drape. This solution, in our hands, avoids air leakage and helps maintain vacuum in a fast and inexpensive way. PMID:24296597

  16. Combination of bone cement filling and plate internal fixation with limb salvage is used for metastatic malignant bone tumors☆

    Institute of Scientific and Technical Information of China (English)

    Yang Jun; Yu Bin; Guo Xin-hui; Yang Peng; Zhang Kai-rui; Zhang Sheng; Cai Wei-bin; Ku Jian-bin; Tian Ling-yan

    2013-01-01

    BACKGROUND:Currently, limb salvage therapy has become the standard treatment of malignant bone tumors way, but improper treatments wil result in tumor recurrence, secondary infection, internal fixation or prosthesis loosening. OBJECTIVE:Based on the traditional surgical principle for metastatic bone tumors of the limbs, this study designed a user-friendly, individualized, simplistic pal iative treatment regimen from the actual conditions of patients to observe the reasonability, clinical efficacy and prognosis of bone cement fil ing combined with internal fixation in the treatment of metastatic malignant bone tumors. METHODS:Thirty-one patients with metastatic malignant bone tumors who required salvage treatment were screened from the Department of Orthopedics, the 421 Hospital of Chinese PLA, and their clinical data were retrospectively analyzed. Al the 31 patients were divided into two groups:tumor removal+internal fixation group (non-chemoradiotherapy group, n=11) treated with bone cement fil ing plus plate internal fixation (pal iative treatment);tumor removal+internal fixation+chemoradiotherapy group (chemoradiotherapy group, n=20), treated with radiotherapy before internal fixation plus plate internal fixation with limb salvage. The fol ow-up period was 4-38 months, averagely 18 months. RESULTS AND CONCLUSION:The fol ow-up results showed that in the non-chemoradiotherapy group, al the 11 patients survived, who could live independently and have good motor functions;in the chemoradiotherapy group, 17 of the 20 patients survived and the rest three patients died of tumor metastasis, their poor conditions and complications at 9 and 13 months after internal fixation. In patients undergoing tumor removal+plate internal fixation with limb salvage, the integrated scores for nerve and motor functions were increased by more than level 1. These findings confirm that a simple pal iative therapy of bone cement fil ing and internal fixation without chemoradiotherapy is

  17. Periosteal augmentation of allograft bone and its effect on implant fixation - an experimental study on 12 dogs()

    DEFF Research Database (Denmark)

    Barckman, Jeppe; Baas, Jorgen; Sørensen, Mette;

    2013-01-01

    Periosteum provides essential cellular and biological components necessary for fracture healing and bone repair. We hypothesized that augmenting allograft bone by adding fragmented autologous periosteum would improve fixation of grafted implants.......Periosteum provides essential cellular and biological components necessary for fracture healing and bone repair. We hypothesized that augmenting allograft bone by adding fragmented autologous periosteum would improve fixation of grafted implants....

  18. Fixation strength analysis of cup to bone material using finite element simulation

    Science.gov (United States)

    Anwar, Iwan Budiwan; Saputra, Eko; Ismail, Rifky; Jamari, J.; van der Heide, Emile

    2016-04-01

    Fixation of acetabular cup to bone material is an important initial stability for artificial hip joint. In general, the fixation in cement less-type acetabular cup uses press-fit and screw methods. These methods can be applied alone or together. Based on literature survey, the additional screw inside of cup is effective; however, it has little effect in whole fixation. Therefore, an acetabular cup with good fixation, easy manufacture and easy installation is required. This paper is aiming at evaluating and proposing a new cup fixation design. To prove the strength of the present cup fixation design, the finite element simulation of three dimensional cup with new fixation design was performed. The present cup design was examined with twist axial and radial rotation. Results showed that the proposed cup design was better than the general version.

  19. A Technique of Superficial Medial Collateral Ligament Reconstruction Using an Adjustable-Loop Suspensory Fixation Device

    OpenAIRE

    Deo, Shaneel; Getgood, Alan

    2015-01-01

    This report describes superficial medial collateral ligament reconstruction of the knee using a novel method of graft fixation with the ACL Tightrope RT (Arthrex, Naples, FL). After tibial fixation with either a standard interference screw or staple, femoral fixation of the semitendinosus tendon is performed with the adjustable-loop suspensory fixation device, which allows for both initial graft tensioning and re-tensioning after cyclical knee range of motion. This provides the ability for th...

  20. The influence of tibial component fixation techniques on resorption of supporting bone stock after total knee replacement

    NARCIS (Netherlands)

    Chong, D.Y.; Hansen, U.N.; Venne, R. van der; Verdonschot, N.J.J.; Amis, A.A.

    2011-01-01

    Periprosthetic bone resorption after tibial prosthesis implantation remains a concern for long-term fixation performance. The fixation techniques may inherently aggravate the "stress-shielding" effect of the implant, leading to weakened bone foundation. In this study, two cemented tibial fixation ca

  1. Novel intramedullary-fixation technique for long bone fragility fractures using bioresorbable materials.

    Directory of Open Access Journals (Sweden)

    Takanobu Nishizuka

    Full Text Available Almost all of the currently available fracture fixation devices for metaphyseal fragility fractures are made of hard metals, which carry a high risk of implant-related complications such as implant cutout in severely osteoporotic patients. We developed a novel fracture fixation technique (intramedullary-fixation with biodegradable materials; IM-BM for severely weakened long bones using three different non-metallic biomaterials, a poly(l-lactide (PLLA woven tube, a nonwoven polyhydroxyalkanoates (PHA fiber mat, and an injectable calcium phosphate cement (CPC. The purpose of this work was to evaluate the feasibility of IM-BM with mechanical testing as well as with an animal experiment. To perform mechanical testing, we fixed two longitudinal acrylic pipes with four different methods, and used them for a three-point bending test (N = 5. The three-point bending test revealed that the average fracture energy for the IM-BM group (PLLA + CPC + PHA was 3 times greater than that of PLLA + CPC group, and 60 to 200 times greater than that of CPC + PHA group and CPC group. Using an osteoporotic rabbit distal femur incomplete fracture model, sixteen rabbits were randomly allocated into four experimental groups (IM-BM group, PLLA + CPC group, CPC group, Kirschner wire (K-wire group. No rabbit in the IM-BM group suffered fracture displacement even under full weight bearing. In contrast, two rabbits in the PLLA + CPC group, three rabbits in the CPC group, and three rabbits in the K-wire group suffered fracture displacement within the first postoperative week. The present work demonstrated that IM-BM was strong enough to reinforce and stabilize incomplete fractures with both mechanical testing and an animal experiment even in the distal thigh, where bone is exposed to the highest bending and torsional stresses in the body. IM-BM can be one treatment option for those with severe osteoporosis.

  2. Study of Bone-screw Surface Fixation in Lumbar Dynamic Stabilization

    Directory of Open Access Journals (Sweden)

    Yun-Gang Luo

    2015-01-01

    Full Text Available Background: We aimed to use the animal model of dynamic fixation to examine the interaction of the pedicle screw surface with surrounding bone, and determine whether pedicle screws achieve good mechanical stability in the vertebrae. Methods: Twenty-four goats aged 2-3 years had Cosmic ® pedicle screws implanted into both sides of the L2-L5 pedicles. Twelve goats in the bilateral dynamic fixation group had fixation rods implanted in L2-L3 and L4-L5. Twelve goats in the unilateral dynamic fixation group had fixation rods randomly fixed on one side of the lumbar spine. The side that was not implanted with fixation rods was used as a static control group. Results: In the static control group, new bone was formed around the pedicle screw and on the screw surface. In the unilateral and bilateral dynamic fixation groups, large amounts of connective tissue formed between and around the screw threads, with no new bone formation on the screw surface; the pedicle screws were loose after the fixed rods were removed. The bone mineral density and morphological parameters of the region of interest (ROI in the unilateral and bilateral dynamic fixation group were not significantly different (P > 0.05, but were lower in the fixed groups than the static control group (P 0.05; however the maximum pull force of the fixation groups was significantly less than the static control group (P < 0.01. Conclusions: Fibrous connective tissue formed at the bone-screw interface under unilateral and bilateral pedicle dynamic fixation, and the pedicle screws lost mechanical stability in the vertebrae.

  3. Refined methodology for implantation of a head fixation device and chronic recording chambers in non-human primates.

    Science.gov (United States)

    Lanz, F; Lanz, X; Scherly, A; Moret, V; Gaillard, A; Gruner, P; Hoogewoud, H M; Belhaj-Saif, A; Loquet, G; Rouiller, E M

    2013-10-15

    The present study was aimed at developing a new strategy to design and anchor custom-fitted implants, consisting of a head fixation device and a chronic recording chamber, on the skull of adult macaque monkeys. This was done without the use of dental resin or orthopedic cement, as these modes of fixation exert a detrimental effect on the bone. The implants were made of titanium or tekapeek and anchored to the skull with titanium screws. Two adult macaque monkeys were initially implanted with the head fixation device several months previous to electrophysiological investigation, to allow optimal osseous-integration, including growth of the bone above the implant's footplate. In a second step, the chronic recording chamber was implanted above the brain region of interest. The present study proposes two original approaches for both implants. First, based on a CT scan of the monkey, a plastic replicate of the skull was obtained in the form of a 3D print, used to accurately shape and position the two implants. This would ensure a perfect match with the skull surface. Second, the part of the implants in contact with the bone was coated with hydroxyapatite, presenting chemical similarity to natural bone, thus promoting excellent osseous-integration. The longevity of the implants used here was 4 years for the head fixation device and 1.5 years for the chronic chamber. There were no adverse events and daily care was easy. This is clear evidence that the present implanting strategy was successful and provokes less discomfort to the animals.

  4. DESIGN AND BIOMECHANICAL EVALUATION OF A RODENT SPINAL FIXATION DEVICE

    Science.gov (United States)

    Shahrokni, Maryam; Zhu, Qingan; Liu, Jie; Tetzlaff, Wolfram; Oxland, Thomas R.

    2016-01-01

    Structured Abstract Study Design An in vitro and in vivo study in rats. Objectives To design a novel rat spinal fixation device and investigate its biomechanical effectiveness in stabilizing the spine up to eight weeks post injury. Methods A fixation device made of polyetheretherketone was designed to stabilize the spine via bilateral clamping pieces. The device effectiveness was assessed in a Sprague-Dawley rat model after it was applied to a spine with a fracture-dislocation injury produced at C5–C6. Animals were euthanized either immediately (n=6) or eight weeks (n=9) post-injury and the C3-T1 segment of the cervical spine was removed for biomechanical evaluation. Segments of intact spinal columns (C3-T1) (n=6) served as uninjured controls. In these tests, anterior-posterior shear forces were applied to the C3 vertebra to produce flexion and extension bending moments at the injury site (peak 12.8Nmm). The resultant two-dimensional motions at the injury site (i.e. C5–C6) were measured using digital imaging and reported as ranges of motion (ROM) or neutral zones (NZ). Results Flexion/extension ROMs (average ± S.D.) were 18.1 ± 3.3°, 19.9 ± 7.5°, and 1.5 ± 0.7°, respectively for the intact, injured/fixed, and injured/8-week groups, with the differences being highly significant for the injured/8-week group (p=0.0002). Flexion/extension NZs were 3.4 ± 2.8°, 5.0 ± 2.4°, and 0.7 ± 0.5°, respectively for the intact, injured/fixed, and injured/8-week groups, with the differences being significant for the injured/8-week group (p =0.04). Conclusion The device acutely stabilizes the spine and promotes fusion at the site of injury. PMID:22289899

  5. Investigation of metallic and carbon fibre PEEK fracture fixation devices for three-part proximal humeral fractures.

    Science.gov (United States)

    Feerick, Emer M; Kennedy, Jim; Mullett, Hannan; FitzPatrick, David; McGarry, Patrick

    2013-06-01

    A computational investigation of proximal humeral fracture fixation has been conducted. Four devices were selected for the study; a locking plate, intramedullary nail (IM Nail), K-wires and a Bilboquet device. A 3D model of a humerus was created using a process of thresholding based on the grayscale values of a CT scan of an intact humerus. An idealised three part fracture was created in addition to removing a standard volume from the humeral head as a representation of bone voids that occur as a result of the injury. All finite element simulations conducted represent 90° arm abduction. Simulations were conducted to investigate the effect of filling this bone void with calcium phosphate cement for each device. The effect of constructing devices from carbon fibre polyetheretherketone (CFPEEK) was investigated. Simulations of cement reinforced devices predict greater stability for each device. The average unreinforced fracture line opening (FLO) is reduced by 48.5% for metallic devices with a lesser effect on composite devices with FLO reduced by 23.6%. Relative sliding (shear displacement) is also reduced between fracture fragments by an average of 58.34%. CFPEEK device simulations predict reduced stresses at the device-bone interface.

  6. Study of Bone-screw Surface Fixation in Lumbar Dynamic Stabilization

    Institute of Scientific and Technical Information of China (English)

    Yun-Gang Luo; Tao Yu; Guo-Min Liu; Nan Yang

    2015-01-01

    Background:We aimed to use the animal model of dynamic fixation to examine the interaction of the pedicle screw surface with surrounding bone,and determine whether pedicle screws achieve good mechanical stability in the vertebrae.Methods:Twenty-four goats aged 2-3 years had Cosmic(R) pedicle screws implanted into both sides of the L2-L5 pedicles.Twelve goats in the bilateral dynamic fixation group had fixation rods implanted in L2-L3 and L4-L5.Twelve goats in the unilateral dynamic fixation group had fixation rods randomly fixed on one side of the lumbar spine.The side that was not implanted with fixation rods was used as a static control group.Results:In the static control group,new bone was formed around the pedicle screw and on the screw surface.In the unilateral and bilateral dynamic fixation groups,large amounts of connective tissue formed between and around the screw threads,with no new bone formation on the screw surface; the pedicle screws were loose after the fixed rods were removed.The bone mineral density and morphological parameters of the region of interest (ROI) in the unilateral and bilateral dynamic fixation group were not significantly different (P > 0.05),but were lower in the fixed groups than the static control group (P < 0.05).This showed the description bone of the ROI in the static control group was greater than in the fixation groups.Under loading conditions,the pedicle screw maximum pull force was not significantly different between the bilateral and unilateral dynamic fixation groups (P > 0.05); however the maximum pull force of the fixation groups was significantly less than the static control group (P < 0.01).Conclusions:Fibrous connective tissue formed at the bone-screw interface under unilateral and bilateral pedicle dynamic fixation,and the pedicle screws lost mechanical stability in the vertebrae.

  7. Design and fabrication of biomimetic multiphased scaffolds for ligament-to-bone fixation.

    Science.gov (United States)

    He, Jiankang; Zhang, Wenyou; Liu, Yaxiong; Li, Xiang; Li, Dichen; Jin, Zhongmin

    2015-05-01

    Conventional ligament grafts with single material composition cannot effectively integrate with the host bones due to mismatched properties and eventually affect their long-term function in vivo. Here we presented a multi-material strategy to design and fabricate composite scaffolds including ligament, interface and bone multiphased regions. The interface region consists of triphasic layers with varying material composition and porous structure to mimic native ligament-to-bone interface while the bone region contains polycaprolactone (PCL) anchor and microchanneled ceramic scaffolds to potentially provide combined mechanical and biological implant-bone fixation. Finite element analysis (FEA) demonstrated that the multiphased scaffolds with interference value smaller than 0.5 mm could avoid the fracture of ceramic scaffold during the implantation process, which was validated by in-vitro implanting the multiphased scaffolds into porcine joint bones. Pull-out experiment showed that the initial fixation between the multiphased scaffolds with 0.47 mm interference and the host bones could withstand the maximum force of 360.31±97.51 N, which can be improved by reinforcing the ceramic scaffolds with biopolymers. It is envisioned that the multiphased scaffold could potentially induce the regeneration of a new bone as well as interfacial tissue with the gradual degradation of the scaffold and subsequently realize long-term biological fixation of the implant with the host bone. PMID:25746239

  8. An application of principal component analysis to the clavicle and clavicle fixation devices

    Directory of Open Access Journals (Sweden)

    Fitzpatrick David

    2010-03-01

    Full Text Available Abstract Background Principal component analysis (PCA enables the building of statistical shape models of bones and joints. This has been used in conjunction with computer assisted surgery in the past. However, PCA of the clavicle has not been performed. Using PCA, we present a novel method that examines the major modes of size and three-dimensional shape variation in male and female clavicles and suggests a method of grouping the clavicle into size and shape categories. Materials and methods Twenty-one high-resolution computerized tomography scans of the clavicle were reconstructed and analyzed using a specifically developed statistical software package. After performing statistical shape analysis, PCA was applied to study the factors that account for anatomical variation. Results The first principal component representing size accounted for 70.5 percent of anatomical variation. The addition of a further three principal components accounted for almost 87 percent. Using statistical shape analysis, clavicles in males have a greater lateral depth and are longer, wider and thicker than in females. However, the sternal angle in females is larger than in males. PCA confirmed these differences between genders but also noted that men exhibit greater variance and classified clavicles into five morphological groups. Discussion And Conclusions This unique approach is the first that standardizes a clavicular orientation. It provides information that is useful to both, the biomedical engineer and clinician. Other applications include implant design with regard to modifying current or designing future clavicle fixation devices. Our findings support the need for further development of clavicle fixation devices and the questioning of whether gender-specific devices are necessary.

  9. A Technique of Superficial Medial Collateral Ligament Reconstruction Using an Adjustable-Loop Suspensory Fixation Device.

    Science.gov (United States)

    Deo, Shaneel; Getgood, Alan

    2015-06-01

    This report describes superficial medial collateral ligament reconstruction of the knee using a novel method of graft fixation with the ACL Tightrope RT (Arthrex, Naples, FL). After tibial fixation with either a standard interference screw or staple, femoral fixation of the semitendinosus tendon is performed with the adjustable-loop suspensory fixation device, which allows for both initial graft tensioning and re-tensioning after cyclical knee range of motion. This provides the ability for the graft to accommodate for resultant soft-tissue creep and stress relaxation, thereby allowing for optimal soft-tissue tension and reduction in laxity at the end of the procedure.

  10. A Technique of Superficial Medial Collateral Ligament Reconstruction Using an Adjustable-Loop Suspensory Fixation Device.

    Science.gov (United States)

    Deo, Shaneel; Getgood, Alan

    2015-06-01

    This report describes superficial medial collateral ligament reconstruction of the knee using a novel method of graft fixation with the ACL Tightrope RT (Arthrex, Naples, FL). After tibial fixation with either a standard interference screw or staple, femoral fixation of the semitendinosus tendon is performed with the adjustable-loop suspensory fixation device, which allows for both initial graft tensioning and re-tensioning after cyclical knee range of motion. This provides the ability for the graft to accommodate for resultant soft-tissue creep and stress relaxation, thereby allowing for optimal soft-tissue tension and reduction in laxity at the end of the procedure. PMID:26258041

  11. Coupled external fixator and skin flap transposition for treatment of exposed and nonunion bone

    Directory of Open Access Journals (Sweden)

    ZHAO Yong-gang

    2011-02-01

    Full Text Available 【Abstract】Objective: To discuss the effect of coupled external fixator and skin flap transposition on exposed and nonunion bones. Methods: The data of 12 cases of infected nonunion and exposed bone following open fracture treated in our hospital during the period of March 1998 to June 2008 were analysed. There were 10 male patients, 2 female patients, whose age were between 19-52 years and averaged 28 years. There were 10 tibial fractures and 2 femoral fractures. The course of diseases lasted for 12-39 months with the mean period of 19 months. All the cases were treated by the coupled external fixator and skin flap transposition. Results: Primary healing were achieved in 10 cases and delayed healing in 2 cases in whom the tibia was exposed due to soft tissue defect and hence local flap transposition was performed. All the 12 cases had bony union within 6-12 months after operation with the average time of 8 months. They were followed up for 1-3 years and all fractures healed up with good function and no infection recurrence. Conclusion: The coupled external fixator and skin flap transposition therapy have shown optimal effects on treating infected, exposed and nonunion bones. Key words: External fixators; Fracture fixation; Infection; Surgical flap

  12. Is there enough evidence to regularly apply bone screws for intermaxillary fixation in mandibular fractures?

    NARCIS (Netherlands)

    A. Bins; M.A.E. Oomens; P. Boffano; T. Forouzanfar

    2015-01-01

    Purpose Intermaxillary fixation (IMF) is traditionally achieved with arch bars; however, this method has several well-known disadvantages and other techniques, such as bone screws, are available. This study evaluated current evidence regarding these IMF screws (IMFSs) for mandibular trauma and to as

  13. Bone compaction enhances fixation of weight-bearing hydroxyapatite-coated implants

    DEFF Research Database (Denmark)

    Kold, Søren; Rahbek, Ole; Vestermark, Marianne;

    2006-01-01

    The effect of bone compaction vs conventional drilling on the fixation of hydroxyapatite-coated implants was examined in a weight-bearing canine model. In each dog, one knee joint had the implant cavity prepared with drilling, the other with compaction. Eight dogs were euthanized after 2 weeks...

  14. New method of fixation of in-bone implanted prosthesis

    Directory of Open Access Journals (Sweden)

    Mark Pitkin, PhD

    2013-08-01

    Full Text Available This article presents results on the effectiveness of a new version of the titanium porous composite skin and bone integrated pylon (SBIP. The SBIP is designed for direct skeletal attachment of limb prostheses and was evaluated in a preclinical study with three rabbits. In accordance with the study protocol, a new version of the pylon (SBIP-3 was implanted into the hind leg residuum of three rabbits. The SBIP-3 has side fins that are designed to improve the bond between the bone and pylon. The fins are positioned inside two slots precut in the bone walls; their length can be adjusted to match the thickness of the bone walls. After 13 (animal 1 or 26 (animals 2 and 3 wk, the animals were sacrificed and samples collected for histopathological analysis. The space between the fins and the bone into which they were fit was filled with fibrovascular tissue and woven bone. No substantial inflammation was found. We suggest that if further studies substantiate the present results, the proposed method can become an alternative to the established technique of implanting prostheses into the medullary canal of the hosting bone.

  15. Augmentation of femoral neck fracture fixation with an injectable calcium-phosphate bone mineral cement.

    Science.gov (United States)

    Stankewich, C J; Swiontkowski, M F; Tencer, A F; Yetkinler, D N; Poser, R D

    1996-09-01

    The first goal of this study was to determine if augmentation with an injectable, in situ setting, calcium-phosphate cement that is capable of being remodeled and was designed to mimic bone mineral significantly improved the strength and stiffness of fixation in a cadaveric femoral neck fracture model. The second goal was to determine if greater increases in fixation strength were achieved as the bone density of the specimen decreased. Sixteen pairs of fresh cadaveric human femora with a mean age of 70.9 years (SD = 17.2 years) were utilized. The bone density of the femoral neck was measured with dual-energy x-ray absorptiometry. The femoral head was impacted vertically with the femoral shaft fixed in 12 degrees of adduction using a materials testing machine to create a fully displaced fracture. Following fracture, 30% inferior comminution was created in each specimen. One randomly chosen femur from each pair underwent anatomic reduction and fixation with three cannulated cancellous bone screws, 7 mm in diameter, in an inverted triangle configuration. The contralateral femur underwent the same fixation augmented with calcium-phosphate cement. Specimens were preconditioned followed by 1.000 cycles to one body weight (611.6 N) at 0.5 Hz to simulate single-limb stance loading. The stiffness in the first cycle was observed to be significantly greater in cement-augmented specimens compared with unaugmented controls (p bone mineral cement failed at a mean of 4,573 N (SD = 1,243 N); this was significantly greater (p bone density (p = 0.25, R2 = 0.09), was weakly correlated to the volume of cement injected (p = 0.07, R2 = 0.22), and was inversely related to the fixation failure load of the control specimen (p = 0.001, R2 = 0.54). There was a mean relative improvement in fixation strength of 169.6% (SD = 77.5). These findings suggest that calcium-phosphate cement provides initial beneficial augmentation to fixation of femoral neck fractures. PMID:8893773

  16. Serial strain gauge measurement of bone healing in hoffmann® external fixation.

    Science.gov (United States)

    Nishimura, N

    1984-04-01

    In order to better assess callus strength for postoperative management of Hoffmann external fixation patients, the author attempted to estimate the amount of strain when bending or compressing the fracture site with a strain gauge glued to the middle of a connecting rod. Calculations in a computer architectural model of a plane beam structure show that the amount of strain on a connecting rod would decrease hyperbolically when the mechanical properties of the callus increased. Strength testing in a cadaveric crural bone confirms the importance of callus volume. The serial strain gauge measurement technique was applied to a series of 23 cases treated with Hoffmann external fixation, 20 of which achieved bone healing. On the basis of the bone healing curve obtained with the strain gauge measurements, the healing process is classified into five types. PMID:24822815

  17. Silver Nanoparticles in Alveolar Bone Surgery Devices

    Directory of Open Access Journals (Sweden)

    Stefano Sivolella

    2012-01-01

    Full Text Available Silver (Ag ions have well-known antimicrobial properties and have been applied as nanostrategies in many medical and surgical fields, including dentistry. The use of silver nanoparticles (Ag NPs may be an option for reducing bacterial adhesion to dental implant surfaces and preventing biofilm formation, containing the risk of peri-implant infections. Modifying the structure or surface of bone grafts and membranes with Ag NPs may also prevent the risk of contamination and infection that are common when alveolar bone augmentation techniques are used. On the other hand, Ag NPs have revealed some toxic effects on cells in vitro and in vivo in animal studies. In this setting, the aim of the present paper is to summarize the principle behind Ag NP-based devices and their clinical applications in alveolar bone and dental implant surgery.

  18. External fixation of femoral defects in athymic rats: Applications for human stem cell implantation and bone regeneration

    Directory of Open Access Journals (Sweden)

    Terasa Foo

    2013-01-01

    Full Text Available An appropriate animal model is critical for the research of stem/progenitor cell therapy and tissue engineering for bone regeneration in vivo. This study reports the design of an external fixator and its application to critical-sized femoral defects in athymic rats. The external fixator consists of clamps and screws that are readily available from hardware stores as well as Kirschner wires. A total of 35 rats underwent application of the external fixator with creation of a 6-mm bone defect in one femur of each animal. This model had been used in several separate studies, including implantation of collagen gel, umbilical cord blood mesenchymal stem cells, endothelial progenitor cells, or bone morphogenetic protein-2. One rat developed fracture at the proximal pin site and two rats developed deep tissue infection. Pin loosening was found in nine rats, but it only led to the failure of external fixation in two animals. In 8 to 10 weeks, various degrees of bone growth in the femoral defects were observed in different study groups, from full repair of the bone defect with bone morphogenetic protein-2 implantation to fibrous nonunion with collagen gel implantation. The external fixator used in these studies provided sufficient mechanical stability to the bone defects and had a comparable complication rate in athymic rats as in immunocompetent rats. The external fixator does not interfere with the natural environment of a bone defect. This model is particularly valuable for investigation of osteogenesis of human stem/progenitor cells in vivo.

  19. Attention attraction in an ophthalmic diagnostic device using sound-modulated fixation targets.

    Science.gov (United States)

    Gramatikov, Boris I; Rangarajan, Shreya; Irsch, Kristina; Guyton, David L

    2016-08-01

    This study relates to eye fixation systems with combined optical and audio systems. Many devices for eye diagnostics and some devices for eye therapeutics require the patient to fixate on a small target for a certain period of time, during which the eyes do not move and data from substructures of one or both eyes are acquired and analyzed. With young pediatric patients, a monotonously blinking target is not sufficient to retain attention steadily. We developed a method for modulating the intensity of a point fixation target using sounds appropriate to the child's age and preference. The method was realized as a subsystem of a Pediatric Vision Screener which employs retinal birefringence scanning for detection of central fixation. Twenty-one children, age 2-18, were studied. Modulation of the fixation target using sounds ensured the eye fixated on the target, and with appropriate choice of sounds, performed significantly better than a monotonously blinking target accompanied by a plain beep. The method was particularly effective with children of ages up to 10, after which its benefit disappeared. Typical applications of target modulation would be as supplemental subsystems in pediatric ophthalmic diagnostic devices, such as scanning laser ophthalmoscopes, optical coherence tomography units, retinal birefringence scanners, fundus cameras, and perimeters. PMID:27245750

  20. Evaluation of K-wire fixation for nasal bone fractures using CT images

    International Nuclear Information System (INIS)

    A nasal bone fracture is the most common facial fracture. Successful treatment requires accurate diagnosis and careful surgical management. Fractures usually are diagnosed on the basis of macroscopic inspection and X-rays. In some cases, CT can be useful in diagnosis of nasal bone fractures because CT images have few shadows and consequently are of high contrast. The authors therefore utilized CT in the classification of 83 cases of nasal bone fractures. CT also was used in 36 cases for postoperative evaluation. During the five-year period from 1989 to 1994, the authors diagnosed 83 cases of nasal bone fractures. CT findings were used to evaluate the types of fractures, which were classified as lateral (unilateral and bilateral), frontal, and lateral-frontal mixed. Included were 22 cases of unilateral fracture, 26 cases of bilateral fracture, 25 cases of frontal fracture, and 8 cases of frontal-lateral fracture. The authors performed closed reduction utilizing K-wire fixation under general anesthesia. Reduction resulted in an angle of θ formed between the nasal bone and maxillary bone, and with its apex at the fracture point. Of the 36 cases postoperatively evaluated by CT, 11 showed excellent results, 12 good results, and 13 fair results. Eleven of the 13 fair reduction cases had a free bone at the fracture point. Five of the 6 cases of fair reduction lateral-frontal mixed fractures had a free bone at the fracture point. Based on CT findings, the authors concluded that reduction and fixation utilizing K-wire was insufficient in cases with free bone fragments. It therefore is important that the existence and position of any free bone fragment should be given careful consideration before undertaking surgery. (author)

  1. Simulated bone remodeling around two types of osseointegrated implants for direct fixation of upper-leg prostheses

    NARCIS (Netherlands)

    Tomaszewski, P.K.; Verdonschot, N.; Bulstra, S.K.; Rietman, J.S.; Verkerke, G.J.

    2012-01-01

    Direct attachment of an upper leg prosthesis to the skeletal system by a percutaneous implant is an alternative solution to the traditional socket fixation. In this study, we investigated long-term periprosthetic bone changes around two types of fixation implants using two different initial conditio

  2. [Serial strain gauge measurement of bone healing in Hoffmann external fixation].

    Science.gov (United States)

    Nishimura, N

    1984-01-01

    Since 1978, the author has applied Hoffmann external fixation to the treatment of open fractures and infected pseudoarthrosis of long bones in the lower limbs, but has some difficulties in determining when weight bearing should be started after operation, how much weight bearing should be and when the pin should be removed. As new method to mechanically analyze the callus strength, I tried to estimate the amount of strain at intervals of 2 to 3 weeks, beginning from the second week after operation, by bending or compressing the fracture site through the strain gauge glued to the middle of the external fixator's connecting rod. From a strength test by means of a model of fracture using a vinyl chloride pipe and also from a study of computer calculation using the model of plane beam structure for architectural design, it was found that the amount of the strain on the connecting rod decreased hyperbolically when the mechanical properties of the callus increased, and that it became constant when the mechanical properties of the callus reached 50% of the intact bone. The strength test using an cadaveric skin bone demonstrated that the callus volume was one of the most important and affecting factor. Twenty-three cases were treated by Hoffmann external fixation, and the bone healing was achieved in 20 of them. On the basis of the bone healing curve obtained by the serial strain gauge measurement in those cases, the bone healing process could be classified into 5 types: normal healing, slow healing, non-union, arrest in evolution and breakage of callus; and were employed as indexes in the post-operative rehabilitation program. PMID:6747402

  3. Internal fixation and bone grafting for intraarticular nonunion of tibial plateau: a report of four cases

    Institute of Scientific and Technical Information of China (English)

    Ramesh K Sen; Ashwani Soni; Uttam Chand Saini; Daljit Singh

    2011-01-01

    Intraarticular nonunion of tibial plateau is rare.In the literature,only 9 patients were found to be treated for intraarticular tibial plateau nonunion and they got varying results.Internal fixation along with bone grafting was done as a standard treatment in all cases.We treated 4 different profile cases of intraarticular tibial plateau nonunion in our institution by 4 different methods.We treated these cases with plaster of paris cast,internal fixation along with bone graft,arthrodesis with K-nail and total knee replacement.Case 1 was treated with plaster of paris (POP)cast as the patient refused surgery.The fracture was united and the patient was fully satisfied with full range of motion despite valgus malalignment.Case 2 was managed with open reduction internal fixation along with bone grafting.The patient had a good union and got full range of motion at the knee joint.Case 3 was treated with total knee arthroplasty due to her old age and got satisfactory result.Case 4 was an infected nonunion.Arthrodesis was done and the patient could walk with full weight bearing independently.We conclude that internal fixation along with bone grafting may not be suitable in all cases of intraarticular nonunion of tibial plateau.Causes of nonunion,present condition and range of motion of the knee joint,as well as the age of patient should be all considered and the treatment should be individualised according to each patient's situation.

  4. Biomechanical Comparison Between Bashti Bone Plug Technique and Biodegradable Screw for Fixation of Grafts in Ligament surgery

    OpenAIRE

    Kaveh Bashti; Mohammad Naghi Tahmasebi; Hasan Kaseb; Farzam Farahmand; Mohammad Akbar; Amir Mobini

    2015-01-01

      Background: Ligament reconstruction is a common procedure in orthopedic surgery. Although several popular techniques are currently in use, new methods are proposed for secure fixation of the tendon graft into the bone tunnel. Purposes: We sought to introduce our new technique of Bashti bone plug for fixation of soft tissue graft in anterior cruciate ligament (ACL) reconstruction and to compare its biomechanical features with conventional absorbable interference screw technique in a bovine ...

  5. Coupled external fixator and skin flap transposition for treatment of exposed and nonunion bone

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yong-gang; DING Jing; WANG Neng

    2011-01-01

    Objective: To discuss the effect of coupled external fixator and skin flap transposition on exposed and nonunion bones.Methods: The data of 12 cases of infected nonunion and exposed bone following open fracture treated in our hospital during the period of March 1998 to June 2008 were analysed. There were 10 male patients, 2 female patients,whose age were between 19-52 years and averaged 28 years.There were 10 tibial fractures and 2 femoral fractures. The course of diseases lasted for 12-39 months with the mean period of 19 months. All the cases were treated by the coupled external fixator and skin flap transposition.Results: Primary healing were achieved in 10 cases and delayed healing in 2 cases in whom the tibia was exposed due to soft tissue defect and hence local flap transposition was performed. All the 12 cases had bony union within 6-12 months afer operation with the average time of 8 months. They were followed up for 1-3 years and all fractures healed up with good function and no infection recurrence.Conclusion: The coupled external fixator and skin flap transposition therapy have shown optimal effects on treating infected, exposed and nonunion bones.

  6. Augmentation of screw fixation with injectable calcium sulfate bone cement in ovariectomized rats.

    Science.gov (United States)

    Yu, Xiao-Wei; Xie, Xin-Hui; Yu, Zhi-Feng; Tang, Ting-Ting

    2009-04-01

    The objective of this study was to determine the effect of augmenting screw fixation with an injectable calcium sulfate cement (CSC) in the osteoporotic bone of ovariectomized rats. The influence of the calcium sulfate (CS) on bone remodeling and screw anchorage in osteoporotic cancellous bone was systematically investigated using histomorphometric and biomechanical analyses. The femoral condyles of 55 Sprague-Dawley ovariectomized rats were implanted with screw augmented with CS, while the contralateral limb received a nonaugmented screw. At time intervals of 2, 4, 8, 12, and 16 weeks, 11 rats were euthanized. Six pair-matched samples were used for histological analysis, while five pair-matched samples were preserved for biomechanical testing. Histomorphometric data showed that CS augmented screws activated cancellous bone formation, evidenced by a statistically higher (p < 0.05) percentage of osteoid surface at 2, 4, and 8 weeks and a higher rate of bone mineral apposition at 12 weeks compared with nonaugmented screws. The amount of the bone-screw contact at 2, 8, and 12 weeks and of bone ingrowth on the threads at 4 and 8 weeks was greater in the CS group than in the nonaugmented group (p < 0.05), although these parameters increased concomitantly with time for both groups. The CS was resorbed completely at 8 weeks without stimulating fibrous encapsulation on the screw surface. Also, the cement significantly increased the screw pull-out force and the energy to failure at 2, 4, 8, and 12 weeks after implantation, when compared with the control group (p < 0.05). These results imply that augmentation of screw fixation with CS may have the potential to decrease the risk of implant failure in osteoporotic bone.

  7. 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

  8. A Novel Technique Using Customized Headgear for Fixation of Rigid External Distraction Device in an Infant With Crouzon Syndrome.

    Science.gov (United States)

    Hariri, Firdaus; Rahman, Zainal Ariff Abdul; Mahdah, Saridah; Mathaneswaran, Vickneswaran; Ganesan, Dharmendra

    2015-11-01

    Rigid external distraction device is often indicated for superior midfacial advancement in pediatric syndromic craniosynostosis patients. Even though the technique is proven reliable to treat the functional issues related to the craniofacial deformity, major complications associated with its fixation, such as intracranial pin perforation and migration have been reported. We report a novel technique of using a customized headgear to prevent intracranial pin perforation over a very thin temporal bone region in an 8-month-old infant with Crouzon syndrome who underwent monobloc Le Fort III distraction osteogenesis using a combination of bilateral internal and a rigid external distraction device. The customized headgear provides a protective platform at the temporal region thus preventing intracranial pin perforation and allows stable fixation during the early phase of consolidation period to prevent central component relapse. The headgear can be used short term when rigid external distractor is indicated in infant patient but requires close monitoring because of risks of skin necrosis and temporal region indentation. PMID:26594993

  9. 3D perfusion bioreactor-activated porous granules on implant fixation and early bone formation in sheep

    DEFF Research Database (Denmark)

    Ding, Ming; Snoek Henriksen, Susan; Martinetti, Roberta;

    2016-01-01

    to induce early implant fixation were tested in a bilateral implant defect model in sheep, with allograft as the control group. Defects were bilaterally created in the distal femurs of the animals, and titanium implants were inserted. The concentric gaps around the implants were randomly filled with either...... allograft, granules, granules with bone marrow aspirate or bioreactor-activated graft material. Following an observation time of 6 weeks, early implant fixation and bone formation were assessed by micro-CT scanning, mechanical testing, and histomorphometry. Bone formations were seen in all groups, while...

  10. 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。

  11. Efficacy of a small cell-binding peptide coated hydroxyapatite substitute on bone formation and implant fixation in sheep

    DEFF Research Database (Denmark)

    Ding, Ming; Andreasen, Christina Møller; Dencker, Mads L.;

    2015-01-01

    Cylindrical critical size defects were created at the distal femoral condyles bilaterally of eight female adult sheep. Titanium implants with 2-mm concentric gaps were inserted and the gaps were filled with one of the four materials: allograft; a synthetic 15-amino acid cell-binding peptide coated...... hydroxyapatite (ABM/P-15); hydroxyapatite + βtricalciumphosphate+ Poly-Lactic-Acid (HA/βTCP-PDLLA); or ABM/P-15+HA/βTCP-PDLLA. After nine weeks, bone-implant blocks were harvested and sectioned for micro-CT scanning, push-out test, and histomorphometry. Significant bone formation and implant fixation could...... formation in concentric gap, and its enhancements on bone formation and implant fixation were at least as good as allograft. It is suggested that ABM/P-15 might be a good alternative biomaterial for bone implant fixation in this well-validated critical-size defect gap model in sheep. Nevertheless, future...

  12. Numerical analysis of an osseointegrated prosthesis fixation with reduced bone failure risk and periprosthetic bone loss

    NARCIS (Netherlands)

    Tomaszewski, P. M.; van Diest, M.; Bulstra, S. K.; Verdonschot, N.; Verkerke, G. J.

    2012-01-01

    Currently available implants for direct attachment of prosthesis to the skeletal system after transfemoral amputation (OPRA system. Integrum AB, Sweden and ISP Endo/Exo prosthesis, ESKA Implants AG, Germany) show many advantages over the conventional socket fixation. However, restraining biomechanic

  13. Numerical analysis of an osseointegrated prosthesis fixation with reduced bone failure risk and periprosthetic bone loss.

    NARCIS (Netherlands)

    Tomaszewski, P.K.; Diest, M. van; Bulstra, S.K.; Verdonschot, N.J.; Verkerke, G.J.

    2012-01-01

    Currently available implants for direct attachment of prosthesis to the skeletal system after transfemoral amputation (OPRA system, Integrum AB, Sweden and ISP Endo/Exo prosthesis, ESKA Implants AG, Germany) show many advantages over the conventional socket fixation. However, restraining biomechanic

  14. Titanium alloys as fixation device material for cranioplasty and its safety in electroconvulsive therapy.

    Science.gov (United States)

    Kaido, Takanobu; Noda, Takamasa; Otsuki, Taisuke; Kaneko, Yuu; Takahashi, Akio; Nakai, Tetsuji; Nabatame, Maki; Tani, Mariko

    2011-03-01

    Here, we report the case of a patient successfully treated by a series of electroconvulsive therapy (ECT) who had implanted skull fixation devices made of titanium alloy. The patient was a 57-year-old man with bipolar I disorder. He was hospitalized for the treatment of manic symptoms of bipolar I disorder with pharmacotherapy and ECT. He sustained a fall and hit his head hard on the ground. Acute subdural hematoma developed, and emergent surgery to remove the hematoma was carried out. Cranioplasty was performed using fixation devices made of titanium alloy (Ti 6Al-4V). In order to control his manic symptoms, a series of ECT was readministered from 1 week after surgery. No adverse effects occurred. Devices must be investigated and chosen very carefully for permanent implantation, especially in patients during a course of ECT.

  15. A novel technique of lumbar hernia repair using bone anchor fixation.

    Science.gov (United States)

    Carbonell, A M; Kercher, K W; Sigmon, L; Matthews, B D; Sing, R F; Kneisl, J S; Heniford, B T

    2005-03-01

    Lumbar hernias are difficult to repair due to their proximity to bone and inadequate surrounding tissue to buttress the repair. We analyzed the outcome of patients undergoing a novel retromuscular lumbar hernia repair technique. The repair was performed in ten patients using a polypropylene or polytetrafluoroethylene mesh placed in an extraperitoneal, retromuscular position with at least 5 cm overlap of the hernia defect. The mesh was fixed with circumferential, transfascial, permanent sutures and inferiorly fixed to the iliac crest by suture bone anchors. Five hernias were recurrent, and five were incarcerated; seven were incisional hernias, and three were posttraumatic. Back and abdominal pain was the most common presenting symptom. Mean hernia size was 227 cm(2) (60-504) with a mesh size of 620 cm(2) (224-936). Mean operative time was 181 min (120-269), with a mean blood loss of 128 ml (50-200). Mean length of stay was 5.2 days (2-10), and morphine equivalent requirement was 200 mg (47-460). There were no postoperative complications or deaths. After a mean follow-up of 40 months (3-99) there have been no recurrences. Our sublay repair of lumbar hernias with permanent suture fixation is safe and to date has resulted in no recurrences. Suture bone anchors ensure secure fixation of the mesh to the iliac crest and may eliminate a common area of recurrence.

  16. Biomechanical Comparison Between Bashti Bone Plug Technique and Biodegradable Screw for Fixation of Grafts in Ligament surgery

    Directory of Open Access Journals (Sweden)

    Kaveh Bashti

    2015-01-01

    Full Text Available   Background: Ligament reconstruction is a common procedure in orthopedic surgery. Although several popular techniques are currently in use, new methods are proposed for secure fixation of the tendon graft into the bone tunnel. Purposes: We sought to introduce our new technique of Bashti bone plug for fixation of soft tissue graft in anterior cruciate ligament (ACL reconstruction and to compare its biomechanical features with conventional absorbable interference screw technique in a bovine model. Methods: Twenty pairs of bovine knees were harvested after death. Soft tissue was removed and the Achilles tendon was harvested to be used as an ACL graft. It was secured into the bone tunnel on the tibial side via two different methods: Bashti Bone Plug technique and conventional screw method. Biomechanical strength was measured using 200 N and 300 N cyclic loading on the graft. Pull out strength was also tested until the graft fails. Results: No graft failure was observed after 200 N and 300 N cyclic loading in either fixation methods. When testing for pull out failure, 21 tendons (53% were torn and 19 tendons (48% slipped out. No fixation failure occurred, which did not reveal a significant difference between the bone plug or interference screw group (P=0.11. The mean pull out force until failure of the graft was 496±66 N in the screw group and 503±67 N in the bone plug group (P=0.76. Conclusions: Our suggested fixation technique of Bashti bone plug is a native, cheap, and feasible method that provides comparable biomechanical strength with interference screw when soft tissue fixation was attempted in bovine model.

  17. 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...

  18. The use of postoperative irradiation for the prevention of heterotopic bone after total hip replacement with biologic fixation (porous coated) prosthesis: An animal model

    International Nuclear Information System (INIS)

    Radiation has been shown to be effective in the prevention of heterotopic bone. The exact etiology of heterotopic bone is unknown. Total hip prosthetic devices that do not depend upon bone cement for fixation have become increasingly popular. The mechanism by which the bone forms around the prosthesis is similar to the process by which fractures heal which has been shown to be sensitive to irradiation. Using a rabbit model we have undertaken a study to investigate the effect of irradiation on the bony ingrowth on porous coated implants. Forty-five rabbits had porous coated implants surgically placed in the tibiae bilaterally. Each rabbit had one tibia randomly irradiated with 1,000 cGy in 5 fractions starting on the first post-operative day. Animals were sacrificed weekly starting 2 weeks post-operatively and the tibae were sent for pullout studies. The amount of force necessary to pullout the treated tibae was statistically less than the amount of force necessary to remove the untreated tibae at 2 weeks. From 3 weeks on there was no difference in the force necessary to remove the prosthesis from the untreated or treated tibae. Histologically, the untreated tibae showed bone formation while the treated tibae did not. Because of these results, it is suggested that the treatment of patients at risk for development of heterotopic bone be modified to only include the area between the femur and pelvis avoiding treatment of the prosthetic device

  19. A STUDY ON FUNCTIONAL OUTCOME OF ILIZAROV FIXATION IN THE MANAGEMENT OF INFECTED NONUNION OF LONG BONES

    Directory of Open Access Journals (Sweden)

    Vellanki

    2016-01-01

    Full Text Available Healing of non-union infected fracture bones like tibia is a challenging one. Ilizarov external ring fixation is the appropriate method. The aim of our study is to evaluate the efficacy of Ilizarov external ring fixator in infected nonunion of bones and functional results in 20 patients and to conduct the study of complications. The age group included in our study were between 30 to 40 years of the 20 cases 17 were males and 3 were females. Of the 20 cases in our study, 14 cases had excellent results, 4 cases had good outcome, 1 patient had fair outcome, 1 cases had poor outcome. The study shows that Ilizarov ring external fixator system is ideal for limb salvage in infected nonunion of long bones.

  20. External fixation and bone grafting for collapsed and comminuted distal radius fracture

    Institute of Scientific and Technical Information of China (English)

    ZHANG Shuang-xi; GU Fang-rui; PENG Yong-li; ZHU Guang-ming; FU Jiang; LU Jun-yue; WANG Jiang-tao; LIU Zhang-min

    2005-01-01

    Objective: To study the therapeutic effect of collapsed and comminuted distal radius fracture. Methods: Twenty-six patients with collapsed and comminuted distal radius fracture were hospitalized from July 1998 to June 2003. All fractures were treated by the methods of open reduction, sustained bone grafting and passing joint external fixator to restore the anatomic shape of distal radius. Results: All 26 cases were followed up, and the results showed that the fractures have been united radiographically. The joint surfaces were intact and there was no length discrepancy occurred in patient's radius. The average volar tilt was 6° to 15° and the average ulnar tilt was 18° to 25°. According to the Dieust criterion, 19 cases were rated as excellent and 7 as good. Conclusions: The method that applying passing joint external fixator and bone grafting for the treatment of collapsed and comminuted distal radius fracture could maintain the stability of fracture and restore the length of radius and the intact of joint surface.

  1. Mechanical testing of a device for subcutaneous internal anterior pelvic ring fixation versus external pelvic ring fixation

    OpenAIRE

    Osterhoff, Georg; Tiziani, Simon; Ferguson, Stephen J.; Spreiter, Gregor; Scheyerer, Max J.; Spinas, Gian-Leza; Wanner, Guido A; Simmen, Hans-Peter; Werner, Clément M. L.

    2014-01-01

    BACKGROUND Although useful in the emergency treatment of pelvic ring injuries, external fixation is associated with pin tract infections, the patient's limited mobility and a restricted surgical accessibility to the lower abdomen. In this study, the mechanical stability of a subcutaneous internal anterior fixation (SIAF) system is investigated. METHODS A standard external fixation and a SIAF system were tested on pairs of Polyoxymethylene testing cylinders using a universal testing machine...

  2. Mechanical testing of a device for subcutaneous internal anterior pelvic ring fixation versus external pelvic ring fixation

    OpenAIRE

    Osterhoff, Georg; Tiziani, Simon; Ferguson, Stephen J.; Spreiter, Gregor; Scheyerer, Max J.; Spinas, Gian-Leza; Wanner, Guido A; Simmen, Hans-Peter; Werner, Clément ML

    2014-01-01

    Background Although useful in the emergency treatment of pelvic ring injuries, external fixation is associated with pin tract infections, the patient’s limited mobility and a restricted surgical accessibility to the lower abdomen. In this study, the mechanical stability of a subcutaneous internal anterior fixation (SIAF) system is investigated. Methods A standard external fixation and a SIAF system were tested on pairs of Polyoxymethylene testing cylinders using a universal testing machine. E...

  3. Stress corrosion cracking of an aluminum alloy used in external fixation devices.

    Science.gov (United States)

    Cartner, Jacob L; Haggard, Warren O; Ong, Joo L; Bumgardner, Joel D

    2008-08-01

    Treatment for compound and/or comminuted fractures is frequently accomplished via external fixation. To achieve stability, the compositions of external fixators generally include aluminum alloy components due to their high strength-to-weight ratios. These alloys are particularly susceptible to corrosion in chloride environments. There have been several clinical cases of fixator failure in which corrosion was cited as a potential mechanism. The aim of this study was to evaluate the effects of physiological environments on the corrosion susceptibility of aluminum 7075-T6, since it is used in orthopedic external fixation devices. Electrochemical corrosion curves and alternate immersion stress corrosion cracking tests indicated aluminum 7075-T6 is susceptible to corrosive attack when placed in physiological environments. Pit initiated stress corrosion cracking was the primary form of alloy corrosion, and subsequent fracture, in this study. Anodization of the alloy provided a protective layer, but also caused a decrease in passivity ranges. These data suggest that once the anodization layer is disrupted, accelerated corrosion processes occur. PMID:18257055

  4. MR imaging and cervical fixation devices: evaluation of ferromagnetism, heating, and artifacts at 1.5 Tesla.

    Science.gov (United States)

    Shellock, F G

    1996-01-01

    The purpose of this study was to assess ferromagnetism, heating, and artifacts for cervical fixation devices exposed to a 1.5 T MR system. Cervical fixation devices (three halos, one tong and two halo vests) were evaluated for compatibility with MR procedures. Ferromagnetism was determined using a previously described technique. Heating was evaluated by measuring temperatures at various positions on the cervical fixation devices while applied to a volunteer subject before and during the use of various pulse sequences, including an magnetization transfer contrast (MTC) sequence. Artifacts associated with routine clinical MR imaging of the cervical spine were qualitatively evaluated with the cervical fixation devices applied to a volunteer subject. None of the devices displayed attraction to the magnetic field. The temperature changes were +/-1.5 degrees C in each instance. The MTC pulse sequence produced a sensation of "heating" the skull pins that may have been caused by vibration of the cervical fixation device. The MR images of the cervical spine were obtained without apparent artifacts using each routine, clinical pulse sequence. The lack of ferromagnetism, negligible heating, and capability of obtaining diagnostically acceptable studies of the cervical spine indicate that MR imaging performed at 1.5 T or less may be conducted safely in patients with each of the cervical fixation devices tested using conventional pulse sequences. PMID:9071001

  5. The effects of bone marrow aspirate, bone graft, and collagen composites on fixation of titanium implants

    DEFF Research Database (Denmark)

    Babiker, Hassan; Ding, Ming; Sandri, Monica;

    2012-01-01

    contamination, and non union as well as the potential risk of disease transmission. Hydroxyapatite and collagen composites (HA/Collagen) have the potential in mimicking and replacing skeletal bones. This study attempted to determine the effects of newly developed HA/Collagen-composites with and without bone....../Collagen-BMA; autograft or allograft. Allograft was served as the control group. The observation period was 5 weeks. The sheep were euthanized and both femurs were harvested. A push-out mechanical test and histological analysis were performed. Results: No significant differences were seen in the mechanical properties...

  6. Bone cement enhanced pedicle screw fixation combined with vertebroplasty for elderly patients with malignant spinal tumors

    Institute of Scientific and Technical Information of China (English)

    TAN Jiang-wei; SHEN Bing-hua; DU Wei; LIU Jiang-qing; LU Shi-qiao

    2013-01-01

    Background Older patients with malignant spinal tumors are difficult to treat because they have many co-morbidities including osteoporosis.The purpose of this research is to discuss the technique and clinical outcome of bone cement enhanced pedicle screw fixation combined with vertebroplasty (the Sandwich Procedure) for elderly patients with severe osteoporosis and malignant spinal tumors.Methods This study includes 28 consecutive elderly patients with malignant thoracic or lumbar spinal tumors.There were nine patients with myelomas,and 19 patients with metastatic bone tumors.The Sandwich Procedure began with curettage of the tumor and a vertebroplasty with bone cement (polymethyl methacrylate,PMMA),followed by PMMA enhanced pedicle screw fixation.Patients were evaluated with the visual analogue scale (VAS),oswestry disability index (ODI),American Spinal Cord Injury Association (ASIA) neurological function classification,and the radiographic degree of kyphosis (Cobb angle).Data were analyzed using paired t-test to compare the pre-and post-operative values.The complications,local recurrences,and the survival status were also recorded.Results There was no operative mortality,and the mean operative time was 210 minutes (range 150-250 minutes).The average blood loss was 1550 ml (range 650-3300 ml).The average amount of cement for vertebroplasty was 3.6 ml (range 3-5 ml).The VAS,ODI,and ASIA scores were significantly improved after surgery (P <0.05).However,we found no differences between the pre and post-operative Cobb angles.The shortest survival time was 3 months,and we found no evidence of local recurrence in this group of patients.Conclusion The Sandwich Procedure is a safe operation and provides symptomatic relief in these difficult patients,permitting further treatment with chemotherapy or radiotherapy.

  7. Efficacy of a small cell-binding peptide coated hydroxyapatite substitute on bone formation and implant fixation in sheep.

    Science.gov (United States)

    Ding, Ming; Andreasen, Christina M; Dencker, Mads L; Jensen, Anders E; Theilgaard, Naseem; Overgaard, Søren

    2015-04-01

    Cylindrical critical size defects were created at the distal femoral condyles bilaterally of eight female adult sheep. Titanium implants with 2-mm concentric gaps were inserted and the gaps were filled with one of the four materials: allograft; a synthetic 15-amino acid cell-binding peptide coated hydroxyapatite (ABM/P-15); hydroxyapatite + βtricalciumphosphate+ Poly-Lactic-Acid (HA/βTCP-PDLLA); or ABM/P-15+HA/βTCP-PDLLA. After nine weeks, bone-implant blocks were harvested and sectioned for micro-CT scanning, push-out test, and histomorphometry. Significant bone formation and implant fixation could be observed in all four groups. Interestingly, the microarchitecture of the ABM/P-15 group was significantly different from the control group. Tissue volume fraction and thickness were significantly greater in the ABM/P-15 group than in the allograft group. Bone formation and bone ingrowth to porous titanium implant were not significantly different among the four groups. The ABM/P-15 group had similar shear mechanical properties on implant fixation as the allograft group. Adding HA/βTCP-PDLLA to ABM/P-15 did not significantly change these parameters. This study revealed that ABM/P-15 had significantly bone formation in concentric gap, and its enhancements on bone formation and implant fixation were at least as good as allograft. It is suggested that ABM/P-15 might be a good alternative biomaterial for bone implant fixation in this well-validated critical-size defect gap model in sheep. Nevertheless, future clinical researches should focus on prospective, randomized, controlled trials in order to fully elucidate whether ABM/P-15 could be a feasible candidate for bone substitute material in orthopedic practices.

  8. 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.

  9. A modified cementing technique using BoneSource to augment fixation of the acetabulum in a sheep model.

    NARCIS (Netherlands)

    Timperley, A.J.; Nusem, I.; Wilson, K.; Whitehouse, S.L.; Buma, P.; Crawford, R.W.

    2010-01-01

    BACKGROUND AND PURPOSE: Our aim was to assess in an animal model whether the use of HA paste at the cement-bone interface in the acetabulum improves fixation. We examined, in sheep, the effect of interposing a layer of hydroxyapatite cement around the periphery of a polyethylene socket prior to fixi

  10. Thoracolumbar spinal fractures : radiological results of transpedicular fixation combined with transpedicular cancellous bone graft and posterior fusion in 183 patients

    NARCIS (Netherlands)

    Leferink, VJM; Zimmerman, KW; Veldhuis, EFM; ten Vergert, EM; ten Duis, HJ

    2001-01-01

    In internal posterior fixation of thoracolumbar fractures combined with transpedicular cancellous bone graft and posterior fusion of the intervertebral facet joints at the level of the destroyed end plate it is still uncertain as to whether significant vertebral body collapse and loss of correction

  11. Arthroscopic suture fixation in patients with a tibial intercondylar eminence fracture using a simple device to penetrate the anterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Masato Aratake

    2014-04-01

    Full Text Available Displaced tibial intercondylar eminence fractures require early reduction and stable fixation to prevent nonunion, knee instability, and a lack of extension. Many types of surgical procedure are recommended including arthrotomy or an arthroscopic technique to stabilize the fracture segment using Kirschner wire, screws, staples, and suture fixation. However, contemporary arthroscopic techniques and devices can facilitate intra-articular surgery and have been applied to the treatment of this fracture. In our current report, we describe a simple suture fixation method under arthroscopy for the treatment of tibial intercondylar eminence fractures. We treated eight knees of eight patients. One patient had a Type II fracture and seven patients had a Type III fracture according to Meyer's classification. Following the arthroscopic inspection of concomitant injuries, debridement of hematoma, and reduction of the fragment, two nonabsorbable sutures (Ethibond No. 2, Johnson & Johnson, Somerville, NJ, USA were advanced through the suture passer device, which is used to penetrate the anterior cruciate ligament (ACL near to the insertion site of the displaced fragment. Two surgical sutures were pulled out by the suture retriever from the anterior proximal tibia hole and were fixed to the tibia cortex bone with a double-spike plate. At follow-up, radiographic examinations showed that bone union was achieved in all cases. All but one patient could resume normal activities with no restrictions and no ligamentous instability. All knees had a negative Lachman's test and showed a gain of stable ligament function by KT2000 arthrometer evaluation. One patient had an insignificant extension limitation and experienced slight pain after walking but these symptoms were minimal. In conclusion current arthroscopic surgery techniques for tibial intercondylar fractures can be easily performed and reproducibly achieve secure fixation and early mobilization of the knee.

  12. HYBRID EXTERNAL FIXATOR FOR THE TREATMENT OF UNICAMERAL BONE CYSTS WITH PATHOLOGICAL FRACTURE IN THE PROXIMAL HUMERUS

    Institute of Scientific and Technical Information of China (English)

    郭征; 王臻; 赵黎

    2004-01-01

    Objective: Unicameral bone cyst is a nonneoplastic bone lesion characterized by its tenacity and risk of recurrence. Pathological fracture is common and is often the presenting symptom. The objective of the present study was to evaluate the results of hybrid external fixator for the treatment of a unicameral bone cyst with a pathological fracture. Methods: Hybrid external fixator for the treatment of a unicameral bone cyst was performed in twelve patients. These patients presented with a pathological fracture and were managed immediately with hybrid external fixator, of whom four had been managed conservatively at other clinics before they were referred to our department. The cyst was located in the proximal humerus in all patients. The mean age of the patients at the time of surgery was 8.7 years, and the mean duration of follow-up was 32.6 months. Radiographic evaluation was performed according to the criteria of Capanna et al., and the cyst was classified as completely healed, healed with residual radiolucency (osteolysis), recurred, or having no response. Results: The healing period ranged from three to eight months. Eight cysts healed completely, and three healed with residual radiolucent areas visible on radiographs. There was recurrence of one cyst that had healed with residual radiolucency. All of the cysts in the present study responded to treatment. A modulation of hybrid external fixator was necessary in three patients, as the bars had become too short after bone growth or the pins had been loose. No major complications were observed.Conclusion: Hybrid external fixator provides early stability, which allows early mobilization and thus obviates the need for a plaster cast. This method of treatment also allows for an early return to normal activity.

  13. Three-dimensional stabilization provided by the external spinal fixator compared to two internal fixation devices: a biomechanical in vitro flexibility study.

    Science.gov (United States)

    Lund, Teija; Nydegger, Thomas; Rathonyi, Gabor; Nolte, Lutz-Peter; Schlenzka, Dietrich; Oxland, Thomas R

    2003-10-01

    We performed an in vitro study to investigate the stabilization (i.e. motion reduction) provided by the external spinal fixator (ESF), and to compare the three configurations of the ESF with two internal fixation techniques. Six human cadaveric lumbar spine specimens (L3-S1) were subjected to multidirectional flexibility testing in six configurations: (1) intact, (2) ESF in neutral, (3) ESF in distraction, (4) ESF in compression, (5) translaminar facet screw fixation, and (6) internal transpedicular fixation. Both the ESF and the internal fixation systems stabilized the specimens from L4 to S1. In each testing configuration, pure bending moments of flexion-extension, bilateral axial rotation, and bilateral lateral bending were applied to the uppermost vertebra stepwise to a maximum of 10 Nm. The rigid body motion between the vertebrae was measured using an optoelectronic camera system, and custom software was used to calculate the intervertebral rotations. For each applied motion in all testing configurations, the total range of motion (ROM) of L4-S1 is reported. All three ESF configurations stabilized the spine significantly when compared to the intact specimen. The ESF in compression provided significantly more stabilization in flexion-extension than the two other ESF configurations, but no other significant differences were found between the three ESF modes. In flexion-extension the ESF stabilized the spine significantly when compared with the two internal fixation devices. Only in bilateral lateral bending was the ESF inferior to internal transpedicular fixation in providing stabilization. The results of the present study suggest that the ESF provides a high degree of stabilization for preoperative assessment of selected low back pain patients. Whether other non-mechanical factors affect the pain relief experienced by the patients remains unknown.

  14. Early Fixation of Cobalt-Chromium Based Alloy Surgical Implants to Bone Using a Tissue-engineering Approach

    Directory of Open Access Journals (Sweden)

    Yasuaki Tohma

    2012-05-01

    Full Text Available To establish the methods of demonstrating early fixation of metal implants to bone, one side of a Cobalt-Chromium (CoCr based alloy implant surface was seeded with rabbit marrow mesenchymal cells and the other side was left unseeded. The mesenchymal cells were further cultured in the presence of ascorbic acid, β-glycerophosphate and dexamethasone, resulting in the appearance of osteoblasts and bone matrix on the implant surface. Thus, we succeeded in generating tissue-engineered bone on one side of the CoCr implant. The CoCr implants were then implanted in rabbit bone defects. Three weeks after the implantation, evaluations of mechanical test, undecalcified histological section and electron microscope analysis were performed. Histological and electron microscope images of the tissue engineered surface exhibited abundant new bone formation. However, newly formed bone tissue was difficult to detect on the side without cell seeding. In the mechanical test, the mean values of pull-out forces were 77.15 N and 44.94 N for the tissue-engineered and non-cell-seeded surfaces, respectively. These findings indicate early bone fixation of the tissue-engineered CoCr surface just three weeks after implantation.

  15. Biomechanics of bone-fracture fixation by stiffness-graded plates in comparison with stainless-steel plates

    Directory of Open Access Journals (Sweden)

    Ghista Dhanjoo N

    2005-07-01

    Full Text Available Abstract Background In the internal fixation of fractured bone by means of bone-plates fastened to the bone on its tensile surface, an on-going concern has been the excessive stress-shielding of the bone by the excessively-stiff stainless-steel plate. The compressive stress-shielding at the fracture-interface immediately after fracture-fixation delays callus formation and bone healing. Likewise, the tensile stress-shielding of the layer of the bone underneath the plate can cause osteoporosis and decrease in tensile strength of this layer. Method In order to address this problem, we propose to use stiffness-graded plates. Accordingly, we have computed (by finite-element analysis the stress distribution in the fractured bone fixed by composite plates, whose stiffness is graded both longitudinally and transversely. Results It can be seen that the stiffness-graded composite-plates cause less stress-shielding (as an example: at 50% of the healing stage, stress at the fracture interface is compressive in nature i.e. 0.002 GPa for stainless steel plate whereas stiffness graded plates provides tensile stress of 0.002 GPa. This means that stiffness graded plate is allowing the 50% healed bone to participate in loadings. Stiffness-graded plates are more flexible, and hence permit more bending of the fractured bone. This results in higher compressive stresses induced at the fractured faces accelerate bone-healing. On the other hand, away from the fracture interface the reduced stiffness and elastic modulus of the plate causes the neutral axis of the composite structure to be lowered into the bone resulting in the higher tensile stress in the bone-layer underneath the plate, wherein is conducive to the bone preserving its tensile strength. Conclusion Stiffness graded plates (with in-built variable stiffness are deemed to offer less stress-shielding to the bone, providing higher compressive stress at the fractured interface (to induce accelerated healing as

  16. Effect of zoledronate acid treatment on osseointegration and fixation of implants in autologous iliac bone grafts in ovariectomized rabbits.

    Science.gov (United States)

    Qi, Mengchun; Hu, Jing; Li, Jianping; Li, Jinyuan; Dong, Wei; Feng, Xiaojie; Yu, Jing

    2012-01-01

    One main problem associated with alveolar bone augmentation in implant dentistry is resorption of grafted bone, which may be further compromised by systemic skeletal disorders such as osteoporosis. Zoledronate acid (ZOL) is the most potent bisphosphonate to treat osteoporosis and therefore it is hypothesized to be able to invert the negative effect of osteoporosis on osseointegration and fixation of dental implants in autologous bone grafts. In this study, 56 rabbits received bilateral ovariectomy (OVX) (40 rabbits) or sham operation (16 rabbits). Three months later, 8 animals from each group were sacrificed for bone mineral density (BMD) examination. Then the remaining animals underwent bilateral autologous iliac bone grafting with simultaneous implantation of titanium implants in tibiae and were divided into 5 groups (n=8): Sham, OVX, Loc-ZOL (local treatment), Sys-ZOL (systemic treatment) and Loc+Sys-ZOL (local plus systemic) group. At 3 months after implantation, all animals were sacrificed and specimens were harvested for examinations. Both BMD and histological examinations of femurs showed osteoporotic changes after ovariectomy, while systemic treatment with ZOL restored mineralized bone. Micro-CT examination demonstrated that OVX group showed significant decrease of mineralized bone and implant-bone contact when compared with sham control, whereas both systemic and local treatments of ZOL significantly increased mineralized bone and implant-bone contact in ovariectomized animals. However, the best effects were observed in Loc+Sys-ZOL group (combined use of ZOL) and most of bone indices were similar to (IBCR, p>0.05) or higher than (BV/TV, Conn.D and Tb.N) (peffects were also confirmed by histomorphometric analysis of bone indices on implant-bone contact and mineralized bone. In addition, biomechanical testing further supported the beneficial effect of ZOL treatment and maximal removal torque of titanium implants was observed in Loc+Sys-ZOL group. In

  17. The treatment of femoral bone loss by axial external fixation and susbequent locking plate application: a case report.

    Science.gov (United States)

    Boero, Emanuele; Mogollo, Maria del Amparo Paredes

    2015-12-01

    A 20-year-old man was admitted to our hospital having sustianed bilateral high-energy femoral fractures. The right femoral fracture was an open grade 3B with OTA grade 3 bone loss. The patient had also a brain contusion with a subdural haematoma and a closed fracture of the left clavicle. Initial management included temporarily stabilisation of the femoral fractures wth external fixators and prompt transfer to the intensive care unit. Three weeks later the external fixator of the right femur was converted to an hybrid system, and the fixator of the left side was removed and a reamed intramedullary locking nail was applied. Two months after the accident the patient underwent bone transport (11 cm long) of the right femur with an monolateral external fixation. When the final length was achieved there were knee stiffness (ROM 0° to 30°) and non-union of the docking site. Therefore, the patient underwent a Judet's procedure to treat the knee stiffness and stabilisation of the non united femur with a locking plate (LISS). After the operation the patient started progressive weight bearing. A year after trauma and following union of the femur, the patient underwent soft tissue reconstruction of the anterior side of the thigh with a free vascularised flap. At final follow upo the patient had a good functional recovery with return to his previous occupation. PMID:26738458

  18. Locking plate fixation combined with iliac crest bone autologous graft for proximal humerus comminuted fracture

    Institute of Scientific and Technical Information of China (English)

    Zhu Lian; Liu Yueju; Yang Zongyou; Li Han; Wang Juan; Zhao Changping; Chen Xiao

    2014-01-01

    Background Although the use of an intramedullary fibular allograft together with locking plate fixation can provide additional medial support and prevent varus malalignment in displaced proximal humeral fractures with promising results,the fibular autograft donor site often sustains significant trauma and cannot restore the articular surface of comminuted fractures.The aim of this study was to evaluate the clinical and radiographic outcomes of a locking plate and crest bone autologous graft for treating proximal humerus comminuted fractures.Methods We assessed the functional outcomes and complication rates in 40 patients with proximal humerus comminuted fractures.Eighteen patients were treated with a locking plate and an autologous crest bone graft (experimental group),and 22 were treated with only the locking plate and no bone graft (control group).Postoperative assessments included radiographic imaging,range of motion analysis,pain level based on the visual analogue scale (VAS),and the SF-36 (Short Form (36) Health Survey),as well as whether patients could retum to their previous occupation.Results All fractures healed both clinically and radiologically in the experimental group.There was no more than 2 mm collapse of the humeral head,and no osteonecrosis or screw penetration of the articular surface.In contrast,two patients had a nonunion in the control group,and they eventually accepted total shoulder replacements.The average time from surgery to radiographic union was significantly shorter in the experimental group ((4.66±1.63) months) compared with the control group ((5.98±1.57) months) (P <0.05).For the experimental versus controls groups,the mean shoulder active flexion (148.00±18.59 vs.121.73±17.20) degrees,extension (49.00±2.22 vs.42.06±2.06) degrees,internal rotation (45.00±5.61 vs.35.00±3.55)degrees,external rotation (64.00±9.17 vs.52.14±5.73)degrees,and abduction (138.00±28.78 vs.105.95±15.66) degrees were all significantly higher (all P

  19. Experimental and Numerical Analyses of the Pull-out Response of a Steel Post/Bovine Bone Cementless Fixation

    Institute of Scientific and Technical Information of China (English)

    Khaled Gammoudi; Mohamed Kharrat; Maher Dammak

    2012-01-01

    Effect of initial interference fit on pull-out strength in cementless fixation between bovine tibia and smooth stainless steel post was investigated in this study.Compressive behavior of bovine spongious bone was studied using mechanical testing in order to evaluate the elastic-plastic properties in different regions of the proximal tibia.Friction tests were carried out in the aim to evaluate the friction behavior of the contact between bovine spongious bone and stainless steel.A cylindrical stainless steel post inserted in a pre-drilled bovine tibia with an initial interference fit was taken as an in vitro model to assess the contribution of post fixation to the initial stability of the Total Knee Arthroplasty (TKA) tibial component.Pull-out experiments were carried out for different initial interference fits.Finite Element Models (FEM) using local elastic-plastic properties of the bovine bone were developed for the analysis of the experimental ultimate pull-out force results.At the post/bone interface,Coulomb friction was considered in the FEM calculations with pressure-dependent friction coefficient.It was found that the FEM results of the ultimate force are in good agreement with the experimental results.The analysis of the FEM interfacial stresses indicates that the micro-slip initiation depends on the local bone properties.

  20. Characterization of short-fibre reinforced thermoplastics for fracture fixation devices.

    Science.gov (United States)

    Brown, S A; Hastings, R S; Mason, J J; Moet, A

    1990-10-01

    This study focuses on determining the effects of clinically relevant procedures on the flexural and fracture toughness properties of three short-fibre thermoplastic composites for potential application as fracture fixation devices. The procedures included sterilization, heat contouring and saline soaking. The three materials tested were polysulphone, polybutylene terephthalate and polyetheretherketone, all reinforced with 30% short carbon fibres. The polysulphone composite showed significant degradation in mechanical properties due to saline soaking. The polybutylene terephthalate exhibited significant degradation of mechanical properties following both contouring and saline soaking. The polyetheretherketone composite, however, exhibited no degradation in mechanical properties. The results demonstrated that flexion and fracture toughness testing were effective for determining the response of the composites to different applied conditions and demonstrated the stability of polyetheretherketone subjected to these treatments. Scanning electron microscopy demonstrated the most effective fibre-matrix bonding to be in the polyetheretherketone.

  1. Should in the treatment of osteochondritis dissecans biodegradable or metallic fixation devices be used? A comparative study in goat knees

    NARCIS (Netherlands)

    Wouters, Diederick B.; Bos, Rudolf R. M.; van Horn, Jim R.; van Luyn, Marja J. A.

    2008-01-01

    Most of the metallic devices have to be removed, treating osteochondritis dissecans lesions. This animal study describes the biological and mechanical behavior of screws and pins, made of commercially available PGA/PLA and PLA96 and metallic screws and pins, used for fragment fixation. A sham operat

  2. Bioabsorbable bone fixation plates for X-ray imaging diagnosis by a radiopaque layer of barium sulfate and poly(lactic-co-glycolic acid).

    Science.gov (United States)

    Choi, Sung Yoon; Hur, Woojune; Kim, Byeung Kyu; Shasteen, Catherine; Kim, Myung Hun; Choi, La Mee; Lee, Seung Ho; Park, Chun Gwon; Park, Min; Min, Hye Sook; Kim, Sukwha; Choi, Tae Hyun; Choy, Young Bin

    2015-04-01

    Bone fixation systems made of biodegradable polymers are radiolucent, making post-operative diagnosis with X-ray imaging a challenge. In this study, to allow X-ray visibility, we separately prepared a radiopaque layer and attached it to a bioabsorbable bone plate approved for clinical use (Inion, Finland). We employed barium sulfate as a radiopaque material due to the high X-ray attenuation coefficient of barium (2.196 cm(2) /g). The radiopaque layer was composed of a fine powder of barium sulfate bound to a biodegradable material, poly(lactic-co-glycolic acid) (PLGA), to allow layer degradation similar to the original Inion bone plate. In this study, we varied the mass ratio of barium sulfate and PLGA in the layer between 3:1 w/w and 10:1 w/w to modulate the degree and longevity of X-ray visibility. All radiopaque plates herein were visible via X-ray, both in vitro and in vivo, for up to 40 days. For all layer types, the radio-opacity decreased with time due to the swelling and degradation of PLGA, and the change in the layer shape was more apparent for layers with a higher PLGA content. The radiopaque plates released, at most, 0.5 mg of barium sulfate every 2 days in a simulated in vitro environment, which did not appear to affect the cytotoxicity. The radiopaque plates also exhibited good biocompatibility, similar to that of the Inion plate. Therefore, we concluded that the barium sulfate-based, biodegradable plate prepared in this work has the potential to be used as a fixation device with both X-ray visibility and biocompatibility.

  3. Treatment of Thoracolumbar Vertebrate Fracture by Transpedicular Morselized Bone Grafting in Vertebrae for Spinal Fusion and Pedicle Screw Fixation

    Institute of Scientific and Technical Information of China (English)

    Jinguo WANG; Hua WU; Xiaolin DING; Yutian LIU

    2008-01-01

    To enhance the fusion of graft bone in thoracolumbar vertebrae and minimize the postoperative loss of correction, short-segment pedicle screw fixation was reinforced with posterior moselizee bone grafting in vertebrae for spinal fusion in patients with thoracrolumbar vertebrate fractures. Seventy patients with thoracrolumbar vertebrate fractures were treated by short-segment pedicle screw fixation and were randomly divided into two groups. Fractures in group A (n=20) were reinforced with posterior morselized bone grafting in vertebrae for spinal fusion, while patients group B (n=50) did not receive the morselized bone grafting for bone fusion. The two groups were compared in terms of kyphotic deformity, anterior vertebral height, instrument failure and neurological functions after the treatment. Frankel grading system was used for the evaluation of neurological evaluation and Denis scoring scale was employed for pain assessment. The results showed that the kyphosis correction was achieved in both group A and group B (group A: 6.4 degree; group B: 5.4 degree)/At the end of follow-up, kyphosis correction was maintained in group A but lost in group B (P=0.0001). Postoperatively, greater anterior height was achieved in group A than in group B (P<0.01). During follow-up study, anterior vertebral height was maintained only in Group A (P<0.001). Both group A and group B showed good Denis pain scores (P1 and P2) but group A outdid group B in terms of control of severe and constant pain (P4 and P5). By Frankel criteria, the changes in neurological functions in group A was better than those of group B (P<0.001). It is concluded that reinforcement of short-segment pedicle fixation with morselized bone grafting for the treatment of patients with thoracolumbar vertebrae fracture could achieve and maintain kyphosis correction, and it may also increase and maintain anterior vertebral height. Morselized bone grafting in vertebrae offers immediate spinal stability in patients with

  4. Poly(L-lactide) bone plates and screws for internal fixation of mandibular swing osteotomies

    NARCIS (Netherlands)

    Tams, J; Rozema, FR; Bos, RRM; Roodenburg, JLN; Nikkels, PGJ; Vermey, A

    1996-01-01

    This study evaluated bone healing after mandibular swing osteotomies fixed with biodegradable poly(L-lactide) (PLLA) bone plates in four patients. A step osteotomy treated with two PLLA bone plates (n=3), and a straight osteotomy treated with one PLLA bone plate (n=1) were performed. Bone healing wa

  5. Treatment of Midshaft Clavicle Fractures: Application of Local Autograft With Concurrent Plate Fixation.

    Science.gov (United States)

    Slette, Erik L; Mikula, Jacob D; Turnbull, Travis Lee; Hackett, Thomas R

    2016-06-01

    Currently, open reduction-internal fixation using contoured plates or intramedullary nails is considered the standard operative treatment for midshaft clavicle fractures because of the immediate rigid stability provided by the fixation device. In addition, autologous iliac crest bone graft has proved to augment osteosynthesis during internal fixation of nonunion fractures through the release of osteogenic factors. The purpose of this article is to describe a surgical technique developed to reduce donor-site morbidity and improve functional and objective outcomes after open reduction-internal fixation with autologous bone graft placement through local autograft harvesting and concurrent plate fixation. PMID:27656378

  6. 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.

  7. 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

  8. Coracoid bone graft osteolysis after Latarjet procedure: A comparison study between two screws standard technique vs mini-plate fixation

    Directory of Open Access Journals (Sweden)

    Giovanni Di Giacomo

    2013-01-01

    Full Text Available Aims: One of the reason for Latarjet procedure failure may be coracoid graft osteolysis. In this study, we aimed to understand if a better compression between the coracoid process and the glenoid, using a mini-plate fixation during the Latarjet procedure, could reduce the amount of coracoid graft osteolysis. Materials and Methods: A computed tomography scan analysis of 26 prospectively followed-up patients was conducted after modified Latarjet procedure using mini-plate fixation technique to determine both the location and the amount of coracoid graft osteolysis in them. We then compared our current results with results from that of our previous study without using mini-plate fixation to determine if there is any statistical significant difference in terms of corcacoid bone graft osteolysis between the two surgical techniques. Results: The most relevant osteolysis was represented by the superficial part of the proximal coracoid, whereas the deep part of the proximal coracoid graft is least involved in osteolysis and has best bone healing. The current study showed a significant difference only for the deep part of the distal coracoid with our previous study (P < 0.01. Discussion: To our knowledge, there are no studies in literature that show the causes of coracoid bone graft osteolysis after Latarjet procedure. Conclusion: Our study suggests that there is a significant difference only for the deep part of the distal coracoid in terms of osteolysis. At clinical examination, this difference did not correspond with any clinical findings. Level of Evidence: Level 4. Clinical Relevance: Prospective case series, Treatment study.

  9. Osteogenic protein 1 device increases bone formation and bone graft resorption around cementless implants

    DEFF Research Database (Denmark)

    Jensen, Thomas B; Overgaard, Søren; Lind, Martin;

    2002-01-01

    In each femoral condyle of 8 Labrador dogs, a non weight-bearing hydroxyapatite-coated implant was inserted surrounded by a 3 mm gap. Each gap was filled with bone allograft or ProOsteon with or without OP-1 delivered in a bovine collagen type I carrier (OP-1 device). 300 microg OP-1 was used in ...

  10. 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.

  11. Demineralized bone matrix and human cancellous bone enhance fixation of porous-coated titanium implants in sheep

    DEFF Research Database (Denmark)

    Babiker, Hassan; Ding, Ming; Overgaard, Søren

    2013-01-01

    of DBM alone, DBM with CB, or allograft on the fixation of porous-coated titanium implants. DBM100 and CB produced from human tissue were included. Both materials are commercially available. DBM granules are placed in pure DBM and do not contain any other carrier. Titanium alloy implants, 10 mm long × 10...

  12. Finite element analysis of osteosynthesis screw fixation in the bone stock: an appropriate method for automatic screw modelling.

    Science.gov (United States)

    Wieding, Jan; Souffrant, Robert; Fritsche, Andreas; Mittelmeier, Wolfram; Bader, Rainer

    2012-01-01

    The use of finite element analysis (FEA) has grown to a more and more important method in the field of biomedical engineering and biomechanics. Although increased computational performance allows new ways to generate more complex biomechanical models, in the area of orthopaedic surgery, solid modelling of screws and drill holes represent a limitation of their use for individual cases and an increase of computational costs. To cope with these requirements, different methods for numerical screw modelling have therefore been investigated to improve its application diversity. Exemplarily, fixation was performed for stabilization of a large segmental femoral bone defect by an osteosynthesis plate. Three different numerical modelling techniques for implant fixation were used in this study, i.e. without screw modelling, screws as solid elements as well as screws as structural elements. The latter one offers the possibility to implement automatically generated screws with variable geometry on arbitrary FE models. Structural screws were parametrically generated by a Python script for the automatic generation in the FE-software Abaqus/CAE on both a tetrahedral and a hexahedral meshed femur. Accuracy of the FE models was confirmed by experimental testing using a composite femur with a segmental defect and an identical osteosynthesis plate for primary stabilisation with titanium screws. Both deflection of the femoral head and the gap alteration were measured with an optical measuring system with an accuracy of approximately 3 µm. For both screw modelling techniques a sufficient correlation of approximately 95% between numerical and experimental analysis was found. Furthermore, using structural elements for screw modelling the computational time could be reduced by 85% using hexahedral elements instead of tetrahedral elements for femur meshing. The automatically generated screw modelling offers a realistic simulation of the osteosynthesis fixation with screws in the adjacent

  13. Finite element analysis of osteosynthesis screw fixation in the bone stock: an appropriate method for automatic screw modelling.

    Directory of Open Access Journals (Sweden)

    Jan Wieding

    Full Text Available The use of finite element analysis (FEA has grown to a more and more important method in the field of biomedical engineering and biomechanics. Although increased computational performance allows new ways to generate more complex biomechanical models, in the area of orthopaedic surgery, solid modelling of screws and drill holes represent a limitation of their use for individual cases and an increase of computational costs. To cope with these requirements, different methods for numerical screw modelling have therefore been investigated to improve its application diversity. Exemplarily, fixation was performed for stabilization of a large segmental femoral bone defect by an osteosynthesis plate. Three different numerical modelling techniques for implant fixation were used in this study, i.e. without screw modelling, screws as solid elements as well as screws as structural elements. The latter one offers the possibility to implement automatically generated screws with variable geometry on arbitrary FE models. Structural screws were parametrically generated by a Python script for the automatic generation in the FE-software Abaqus/CAE on both a tetrahedral and a hexahedral meshed femur. Accuracy of the FE models was confirmed by experimental testing using a composite femur with a segmental defect and an identical osteosynthesis plate for primary stabilisation with titanium screws. Both deflection of the femoral head and the gap alteration were measured with an optical measuring system with an accuracy of approximately 3 µm. For both screw modelling techniques a sufficient correlation of approximately 95% between numerical and experimental analysis was found. Furthermore, using structural elements for screw modelling the computational time could be reduced by 85% using hexahedral elements instead of tetrahedral elements for femur meshing. The automatically generated screw modelling offers a realistic simulation of the osteosynthesis fixation with

  14. CT Guided Bone Biopsy Using a Battery Powered Intraosseous Device

    Energy Technology Data Exchange (ETDEWEB)

    Schnapauff, Dirk, E-mail: dirk.schnapauff@charite.de; Marnitz, Tim, E-mail: tim.marnitz@charite.de; Freyhardt, Patrick, E-mail: Patrick.freyhardt@charite.de; Collettini, Federico, E-mail: Federico.collettini@charite.de [Charite Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Department of Radiology (Germany); Hartwig, Kerstin, E-mail: kerstin.hartwig@charite.de [Charite Universitaetsmedizin Berlin, Campus Charite Mitte, Department of Haematology and Oncology (Germany); Joehrens, Korinna, E-mail: korinna.joehrens@charite.de [Charite Universitaetsmedizin Berlin, Campus Charite Mitte, Department of Pathology (Germany); Hamm, Bernd, E-mail: bernd.hamm@charite.de; Kroencke, Thomas, E-mail: thomas.kroencke@charite.de; Gebauer, Bernhard, E-mail: Bernhard.gebauer@charite.de [Charite Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Department of Radiology (Germany)

    2013-10-15

    Purpose: To evaluate the feasibility of a battery powered intraosseous device to perform CT-fluoroscopy guided bone biopsy. Methods: Retrospective analysis of 12 patients in whom bone specimen were acquired from different locations under CT-fluoroscopy guidance using the OnControl bone marrow biopsy system (OBM, Vidacare, Shavano Park, TX, USA). Data of the 12 were compared to a historic cohort in whom the specimen were acquired using the classic Jamshidi Needle, as reference needle using manual force for biopsy. Results: Technical success was reached in 11 of 12 cases, indicated by central localisation of the needle within the target lesion. All specimen sampled were sufficient for histopathological workup. Compared to the historical cohort the time needed for biopsy decreased significantly from 13 {+-} 6 to 6 {+-} 4 min (P = 0.0001). Due to the shortened intervention time the radiation dose (CTDI) during CT-fluoroscopy was lowered significantly from 169 {+-} 87 to 111 {+-} 54 mGy Multiplication-Sign cm (P = 0.0001). Interventional radiologists were confident with the performance of the needle especially when using in sclerotic or osteoblastic lesions. Conclusion: The OBM is an attractive support for CT-fluoroscopy guided bone biopsy which is safe tool and compared to the classical approach using the Jamshidi needle leading to significantly reduced intervention time and radiation exposure.

  15. Acceleration and holographic studies on different types of dynamization of external fixators of the bones

    Science.gov (United States)

    Podbielska, Halina; Kasprzak, Henryk T.; Voloshin, Arkady S.; Pennig, Dietmar; von Bally, Gert

    1992-08-01

    The unilateral axially dynamic fixator (Orthofix) was mounted on a sheep tibial shaft. Three fixation modes: static, dynamic controlled, and dynamic free were examined by means of double exposure holographic interferometry. Simultaneously, the acceleration was measured by an accelerometer and displayed on the monitor together with loading characteristics. The first exposure was made before the acting force was applied to the tibia plateau. The second one after the moment when the acceleration wave started to propagate through the specimen. We stated that in the case of dynamization less torsion occurs at the fracture site. So far, we have not been able to determine any correlation between results of holographic and accelerometric measurements.

  16. A Comparative Finite-Element Analysis of Bone Failure and Load Transfer of Osseointegrated Prostheses Fixations

    NARCIS (Netherlands)

    Tomaszewski, P. K.; Verdonschot, N.; Bulstra, S. K.; Verkerke, G. J.

    2010-01-01

    An alternative solution to conventional stump-socket prosthetic limb attachment is offered by direct skeletal fixation. This study aimed to assess two percutaneous trans-femoral implants, the OPRA system (Integrum AB, Goteborg, Sweden), and the ISP Endo/Exo prosthesis (ESKA Implants AG, Lubeck, Germ

  17. A comparative finite-element analysis of bone failure and load transfer of osseointegrated prostheses fixations.

    NARCIS (Netherlands)

    Tomaszewski, P.K.; Verdonschot, N.J.J.; Bulstra, S.K.; Verkerke, G.J.

    2010-01-01

    An alternative solution to conventional stump-socket prosthetic limb attachment is offered by direct skeletal fixation. This study aimed to assess two percutaneous trans-femoral implants, the OPRA system (Integrum AB, Goteborg, Sweden), and the ISP Endo/Exo prosthesis (ESKA Implants AG, Lubeck, Germ

  18. BOHLER'S ANGLE: CORRELATION WITH OUTCOME IN DISPLACED INTRA-ARTICULAR CALCANEAL FRACTURES TREATED WITH LOCKING COMPRESSION PLATE FIXATION WITH AND WITHOUT BONE GRAFTING

    OpenAIRE

    Deepak P; Eknath D; Vijayanand; Satish

    2014-01-01

    BOHLER'S ANGLE: correlation with outcome in displaced intra-articular calcaneal fractures Treated with locking compression Plate Fixation with and without bone grafting. AIMS: The aim is an accurate reduction of the fracture with reconstruction of Bohler’s angle, length and axis and sub talar joint surface. To determine whether autologous bone graft supplementation is beneficial in achieving and maintaining restoration of Calcaneal height and anatomic reduction. SETTINGS AND ...

  19. Biomechanical and finite element analyses of bone cement-Injectable cannulated pedicle screw fixation in osteoporotic bone.

    Science.gov (United States)

    Liu, Yaoyao; Xu, Jianzhong; Sun, Dong; Luo, Fei; Zhang, Zehua; Dai, Fei

    2016-07-01

    The objectives of this study were to investigate the safety and biomechanical stability of a polymethylmethacrylate (PMMA)-augmented bone cement-injectable cannulated pedicle screw (CICPS) in cancellous bone model, and to analyze the stress distribution at the screw-cement-bone interface. The OMEGA cannulated pedicle screw (OPS) and conventional pedicle screw (CPS) were used as control groups. Safety of the CICPS was evaluated by the static bending and bending fatigue tests. Biomechanical stability was analyzed by the maximum axial pullout strength and maximum torque tests. Stress distribution at the screw-cement-bone interface was analyzed by the finite element (FE) method. The CICPS and CPS produced statistically similar values for bending stiffness, bending structural stiffness, and bending yield moment. The maximum pullout force was 53.47 ± 8.65 N in CPS group, compared to 130.82 ± 7.32 N and 175.45 ± 43.01 N in the PMMA-augmented OPS and CICPS groups, respectively (p screw-cement-bone interface in the CICPS group. In conclusion, PMMA-augmentation with CICPS may be a potentially useful method to increase the stability of pedicle screws in patients with osteoporosis. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 960-967, 2016. PMID:25976272

  20. Hollow-Bone-Graft Dynamic Hip Screw Can Fix and Promote Bone Union after Femoral Neck Fracture: an Experimental Research

    OpenAIRE

    SHEN, Jia-zuo; YAO, Jian-fei; LIN, Da-sheng; Lian, Ke-jian; Ding, Zhen-qi; Lin, Bin; GUO, Zhi-min; Zhang, Ming-Hua; Li, Qiang; LI, Lin; Qi, Peng

    2012-01-01

    Background: Delayed bone union, nonunion or osteonecrosis often occur after femoral neck fractures in young adults. Secondary bone healing requires strong internal fixation, intramedullary pressure reduction and early functional exercise. Objective: To compare bone healing of femoral neck fractures treated with hollow-bone-graft dynamic hip screws (Hb-DHS) and standard dynamic hip screws (DHS) in an animal model. Design: Testing of specifically designed fixation devices in a pig animal model....

  1. Hollow-Bone-Graft Dynamic Hip Screw Can Fix and Promote Bone Union after Femoral Neck Fracture: an Experimental Research

    OpenAIRE

    Jia-zuo SHEN, Jian-fei YAO, Da-sheng LIN, Ke-jian LIAN, Zhen-qi DING, Bin LIN, Zhi-min GUO, Ming-hua ZHANG, Qiang LI, Lin LI, Peng QI

    2012-01-01

    Background: Delayed bone union, nonunion or osteonecrosis often occur after femoral neck fractures in young adults. Secondary bone healing requires strong internal fixation, intramedullary pressure reduction and early functional exercise.Objective: To compare bone healing of femoral neck fractures treated with hollow-bone-graft dynamic hip screws (Hb-DHS) and standard dynamic hip screws (DHS) in an animal model.Design: Testing of specifically designed fixation devices in a pig animal model.In...

  2. Fixation of metatarsal fracture with bone plate in a dromedary heifer

    Directory of Open Access Journals (Sweden)

    S. Hashmi

    2013-03-01

    Full Text Available An oblique fracture of the distal third of the right metatarsus in a three-year-old dromedary heifer weighing about 300 kilograms was immobilized with a 4.5 mm broad-webbed 12-hole dynamic compression bone plate and two interfragmental compression screws. The animal showed slight lameness after 16 weeks of surgery that disappeared after removal of the plate. The result was quite encouraging and the fracture healed in 16 weeks without major complications. It is concluded that the fracture of this bone can be successfully handled with bone plating at least in young, light weight animals.

  3. Histomorphometric evaluation of bone healing in rabbit fibular osteotomy model without fixation

    OpenAIRE

    Paixão Fabio B; Araújo Francisco P; Matos Marcos A

    2008-01-01

    Abstract Background Animal models of fracture consolidation are fundamental for the understanding of the biological process of bone repair in humans, but histological studies are rare and provide only qualitative results. The objective of this article is to present the histomorphometric study of the bone healing process using an experimental model of osteotomy in rabbit fibula without interference of synthesis material. Methods Fifteen rabbits were submitted to fibular osteotomy without any f...

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

    Directory of Open Access Journals (Sweden)

    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.

  5. In vivo study of extracellular matrix coating enhancing fixation of the pedicle screw-bone's interface

    Institute of Scientific and Technical Information of China (English)

    LIU Guo-min; ZHANG Xing-yi; XU Chuan-jie; ZHU Xiao-min; WANG Jun; LIU Yi

    2011-01-01

    Background Based on in vivo research on the effect of the coating of the extracellular matrix composition of pedicle screws on the conduction and induction of bone formation in young sheep,the aim of this study was to investigate the application of coated pedicle screws in sheep with scoliosis whose spines are under constant development.Methods Four groups of pedicle screws were randomly implanted into bilateral L2-L5 pedicles of 2.5- to 3-month-old sheep.A static experiment was performed on one side and a loading test was performed on the other side by implanting connecting rods at the L2-L3 and L4-L5 segments.The changes in the force on the coated screws and the combination of the surface of the coated screws with the surrounding bone in the growth process of young sheep's spines with aging were observed.After 3 months,the lumbar vertebrae with the screws were removed and examined by micro-CT,histological,and biomechanical analyses.Results Under nonloading conditions,there is bone formation around the surfaces of coated screws.The bone forming on the surface of collagen/chondroitin sulfate/hydroxyapatite coating of pedicle screws is the most,the one of the collagen / chondrcitin sulfate coating and hydroxyapatite coating is followed,and no significant difference between the two groups.In terms of the trabecular bone morphology parameters of the region of interest around the surface of the pedicle screws,such as bone mineral content,bone mineral density,tissue mineral content,tissue bone mineral density,bone volume fraction,and connection density,those associated with collagen/chondroitin sulfate/hydroxyapatite coatings are largest and those unassociated with coatings are smallest.Under nonloading conditions,the pullout strength of the collagen/chondroitin sulfate/hydroxyapatite-coated screws was largest,and that of the uncoated screws was minimal (P <0.01).Under loading conditions,the maximum pullout strength of each group of pedicle screws was less than that

  6. Guided bone augmentation using ceramic space-maintaining devices: the impact of chemistry

    Science.gov (United States)

    Anderud, Jonas; Abrahamsson, Peter; Jimbo, Ryo; Isaksson, Sten; Adolfsson, Erik; Malmström, Johan; Naito, Yoshihito; Wennerberg, Ann

    2015-01-01

    The purpose of the study was to evaluate histologically, whether vertical bone augmentation can be achieved using a hollow ceramic space maintaining device in a rabbit calvaria model. Furthermore, the chemistry of microporous hydroxyapatite and zirconia were tested to determine which of these two ceramics are most suitable for guided bone generation. 24 hollow domes in two different ceramic materials were placed subperiosteal on rabbit skull bone. The rabbits were sacrificed after 12 weeks and the histology results were analyzed regarding bone-to-material contact and volume of newly formed bone. The results suggest that the effect of the microporous structure of hydroxyapatite seems to facilitate for the bone cells to adhere to the material and that zirconia enhance a slightly larger volume of newly formed bone. In conclusion, the results of the current study demonstrated that ceramic space maintaining devices permits new bone formation and osteoconduction within the dome. PMID:25792855

  7. Bone allograft and implant fixation tested under influence of bio-burden reduction, periosteal augmentation and topical antibiotics. Animal experimental studies.

    Science.gov (United States)

    Barckman, Jeppe

    2014-01-01

    Loosening of an artificial joint prosthesis is a painful and debilitating condition that can be treated only by re-operation. Re-operations accounted for approximately 15% of all hip replacement operations performed in Denmark between the year 1995 and 2010. The process of loosening is often accompanied by destructive inflammation and osteolysis, which leads to insufficient bone stock that often requires extensive bone grafting. Impacted morselized bone graft is a well-established method for improving the amount and quality of bone stock that ensures sufficient stability and anchorage of the revision implants. Among bone graft options, the autologous bone graft is considered the gold standard. It is naturally biocompatible, but its use in revision surgery is curtailed by its limited volume and by considerable donor site morbidity. Allograft bone is readily available and is the most commonly used graft material. However, it has been shown that the incorporation of allograft bone into the host bone is not always complete, and substantial fibrous tissue formation has been described. A reason for this may be that allograft bone is a foreign tissue, which, contrary to autogenic bone, may induce an immunogenic response that leads to increased fibrous tissue formation. Furthermore, the fresh-frozen allograft has minimal osteoinductive and no osteogenic capacity. The studies in this thesis have investigated ways of improving the incorporation of allograft bone by adding osteoinductive cells from the periosteum and reducing the immunogenic load of the allograft bone by rinsing. Furthermore, the impact of antibiotic protection of the bone graft has been evaluated. The same experimental implant model was used in all three studies. This model enables evaluation of early implant fixation and osseointegration of an uncemented implant surrounded by impacted morselized bone graft. Unloaded gap implants were inserted into the metaphysis of the proximal tibia (Study I) and distal

  8. Cost effectiveness of total hip arthroplasty in osteoarthritis: comparison of devices with differing bearing surfaces and modes of fixation.

    Science.gov (United States)

    Pulikottil-Jacob, R; Connock, M; Kandala, N-B; Mistry, H; Grove, A; Freeman, K; Costa, M; Sutcliffe, P; Clarke, A

    2015-04-01

    Many different designs of total hip arthroplasty (THA) with varying performance and cost are available. The identification of those which are the most cost-effective could allow significant cost-savings. We used an established Markov model to examine the cost effectiveness of five frequently used categories of THA which differed according to bearing surface and mode of fixation, using data from the National Joint Registry for England and Wales. Kaplan-Meier analyses of rates of revision for men and women were modelled with parametric distributions. Costs of devices were provided by the NHS Supply Chain and associated costs were taken from existing studies. Lifetime costs, lifetime quality-adjusted-life-years (QALYs) and the probability of a device being cost effective at a willingness to pay £20 000/QALY were included in the models. The differences in QALYs between different categories of implant were extremely small (< 0.0039 QALYs for men or women over the patient's lifetime) and differences in cost were also marginal (£2500 to £3000 in the same time period). As a result, the probability of any particular device being the most cost effective was very sensitive to small, plausible changes in quality of life estimates and cost. Our results suggest that available evidence does not support recommending a particular device on cost effectiveness grounds alone. We would recommend that the choice of prosthesis should be determined by the rate of revision, local costs and the preferences of the surgeon and patient. PMID:25820881

  9. Do Bone Graft and Cracking of the Sclerotic Cavity Improve Fixation of Titanium and Hydroxyapatite-coated Revision Implants in an Animal Model?

    DEFF Research Database (Denmark)

    Elmengaard, Brian; Baas, Joergen; Jakobsen, Thomas;

    2016-01-01

    (crack, noncrack) using paired contralateral implants while implant surface (Ti6Al4V, HA) was qualitatively compared between the two (unpaired) series. All groups received bone allograft tightly packed around the implant. This revision model includes a cylindrical implant pistoning 500 μm in a 0.75-mm...... gap, with polyethylene particles, for 8 weeks. This engenders a bone and tissue response representative of the metaphyseal cancellous region of an aseptically loosened component. At 8 weeks, the original implants were revised and followed for an additional 4 weeks. Mechanical fixation was assessed...

  10. 骨外固定治疗复杂骨不连与骨缺损的临床效果%External Fixation for the Treatment of Complex Bone Nonunion and Bone Defect of Clinical effect

    Institute of Scientific and Technical Information of China (English)

    徐占辉

    2015-01-01

    目的:探讨骨外固定治疗复杂骨不连及骨缺损临床效果。方法对56例患者采用骨外固定技术治疗复复杂骨不连与骨缺损的效果进行分析。结果56例骨不连与骨缺损患者均实现骨性愈合。17例感染性骨不连患者的伤口得到有效控制。非感染性骨不连患者一般需要4个月左右的时间愈合,感染性骨不连患者一般需要6个月左右的时间愈合,患者重建肢体长度后肢体长度均衡。结论采用骨外固定技术治疗骨不连患者可获得令人满意的疗效。%Objective To study the bone external fixation in treatment of complex bone nonunion and bone defect of clinical effects.Methods colecting effect were treated byexternal fixation for treatment of bone nonunion in 56 cases were analyzed.Results 56 cases of nonunion patients achieved bone healing.Not even the patient's wound infection has been effectively controled in 17 cases of infected bone.The healing of non infectious nonunion Bone patients generaly need 5 months time,healing of infected nonunion Bone patients generaly need about 6 months time,reconstruction in limb length after limb length equalization.Conclusion The use of external fixation for treatment of nonunion has obtained the satisfactory effect.

  11. Development of a biointegrated mandibular reconstruction device consisting of bone compatible titanium fiber mesh scaffold.

    Science.gov (United States)

    Hirota, Makoto; Shima, Takaki; Sato, Itaru; Ozawa, Tomomichi; Iwai, Toshinori; Ametani, Akihiro; Sato, Mitsunobu; Noishiki, Yasuharu; Ogawa, Takahiro; Hayakawa, Tohru; Tohnai, Iwai

    2016-01-01

    Coating biomaterials with a thin hydroxyapatite (HA) was proven effective in enhancing bone compatibility. Segmental bone defects are considered as the most difficult defect to repair in bone regeneration therapy. We developed submicron-thin HA-coated titanium fiber mesh scaffolds to reconstruct immediately loaded segmental mandibular defects and evaluated their bone compatibility in vitro and in vivo. Human osteoblasts attachment, proliferation, and osteocalcin expression in non- and HA-coated scaffolds were evaluated. A 10-mm long segmental bone defect in a rabbit mandibular bone was reconstructed with non- or HA-coated scaffolds, which were removed at 9 and 21 weeks, to evaluate the mechanical strength of the bone-scaffold connection and the bone formation around the scaffold. Expression of osteocalcin was greater in HA-coated scaffolds. In vivo bone formation in HA-coated scaffolds was greater than that in non-coated scaffolds at 21 weeks. Newly formed bone in HA-coated scaffolds mostly restored bone continuity. Scanning electron microscopy identified strong integration of the bone and HA-coated scaffolds. The mechanical strength of the bone-scaffold connection was 3-fold greater in HA-coated scaffolds than that in non-coated scaffolds. These results suggest that a thin HA-coated titanium fiber mesh scaffold is a bone-compatible mandibular reconstruction device in immediately loaded segmental defects.

  12. An application of principal component analysis to the clavicle and clavicle fixation devices.

    LENUS (Irish Health Repository)

    Daruwalla, Zubin J

    2010-01-01

    Principal component analysis (PCA) enables the building of statistical shape models of bones and joints. This has been used in conjunction with computer assisted surgery in the past. However, PCA of the clavicle has not been performed. Using PCA, we present a novel method that examines the major modes of size and three-dimensional shape variation in male and female clavicles and suggests a method of grouping the clavicle into size and shape categories.

  13. Fixation of osteochondral fragments in the human knee using Meniscus Arrows

    NARCIS (Netherlands)

    Wouters, D.B.; Burgerhof, J.G.; de Hosson, J.T.; Bos, R.R.

    2011-01-01

    The aim of this study is to compare the hold in bone of Meniscus Arrows and Smart Nails, followed by the report of the results of the clinical application of Meniscus Arrows as fixation devices. First, pull-out tests were performed to analyse the holdfast of both nails in bone. Statistical analysis

  14. Fixation of osteochondral fragments in the human knee using Meniscus Arrows (R)

    NARCIS (Netherlands)

    Wouters, Diederick B.; Burgerhof, Johannes G. M.; de Hosson, Jeff. T. M.; Bos, Rudolf R. M.

    2011-01-01

    The aim of this study is to compare the hold in bone of Meniscus Arrows(A (R)) and Smart Nails(A (R)), followed by the report of the results of the clinical application of Meniscus Arrows(A (R)) as fixation devices. First, pull-out tests were performed to analyse the holdfast of both nails in bone.

  15. Wireless and acoustic hearing with bone-anchored hearing devices

    Science.gov (United States)

    Bosman, Arjan J.; Mylanus, Emmanuel A.M.; Hol, Myrthe K.S.; Snik, Ad F.M.

    2016-01-01

    Abstract Objective: The efficacy of wireless connectivity in bone-anchored hearing was studied by comparing the wireless and acoustic performance of the Ponto Plus sound processor from Oticon Medical relative to the acoustic performance of its predecessor, the Ponto Pro. Study sample: Nineteen subjects with more than two years' experience with a bone-anchored hearing device were included. Thirteen subjects were fitted unilaterally and six bilaterally. Design: Subjects served as their own control. First, subjects were tested with the Ponto Pro processor. After a four-week acclimatization period performance the Ponto Plus processor was measured. In the laboratory wireless and acoustic input levels were made equal. In daily life equal settings of wireless and acoustic input were used when watching TV, however when using the telephone the acoustic input was reduced by 9 dB relative to the wireless input. Results: Speech scores for microphone with Ponto Pro and for both input modes of the Ponto Plus processor were essentially equal when equal input levels of wireless and microphone inputs were used. Only the TV-condition showed a statistically significant (p <5%) lower speech reception threshold for wireless relative to microphone input. In real life, evaluation of speech quality, speech intelligibility in quiet and noise, and annoyance by ambient noise, when using landline phone, mobile telephone, and watching TV showed a clear preference (p <1%) for the Ponto Plus system with streamer over the microphone input. Due to the small number of respondents with landline phone (N = 7) the result for noise annoyance was only significant at the 5% level. Conclusion: Equal input levels for acoustic and wireless inputs results in equal speech scores, showing a (near) equivalence for acoustic and wireless sound transmission with Ponto Pro and Ponto Plus. The default 9-dB difference between microphone and wireless input when using the telephone results in a substantial

  16. Adhesive B-doped DLC films on biomedical alloys used for bone fixation

    Indian Academy of Sciences (India)

    A A Ahmad; A M Alsaad

    2007-08-01

    The long-term failure of the total hip and knee prostheses is attributed to the production of wear particles at the articulating interface between the metals, ceramics and polymers used for surgical implants and bone-fixtures. Therefore, finding an adhesive and inert coating material that has low frictional coefficient should dramatically reduce the production of wear particles and hence, prolong the life time of the surgical implants. The novel properties of the non-toxic diamond-like carbon (DLC) coatings have proven to be excellent candidates for biomedical applications. However, they have poor adhesion strength to the alloys and biomaterials. The addition of a thin interfacial layer such as Si, Ti, TiN, Mo and Cu/Cr and/or adding additives such as Si, F, N, O, W, V, Co, Mo, Ti or their combinations to the DLC films has been found to increase the adhesion strength substantially. In our study, grade 316L stainless steel and grade 5 titanium alloy (Ti–6Al–4V) were used as biomaterial substrates. They were coated with DLC films containing boron additives at various levels using various Si interfacial layer thicknesses. The best film adhesion was achieved at 8% and 20% on DLC coated Ti–6Al–4V and grade 316L substrates, respectively. It has been demonstrated that doping the DLC with boron increases their adhesion strength to both substrates even without silicon interfacial layer and increases it substantially with optimum silicon layer thickness. The adhesion strength is also correlated with the hydrogen contents in the B-DLC films. It is found to reach its maximum value of 700 kg/cm2 and 390 kg/cm2 at 2/7 and 3/6 for CH4/Ar partial pressures (in mTorr ratio) for Ti–6Al–4V and 316L substrates, respectively.

  17. Comparison of the effects of bilateral posterior dynamic and rigid fixation devices on the loads in the lumbar spine: a finite element analysis

    OpenAIRE

    Rohlmann, Antonius; Burra, Nagananda K.; Zander, Thomas; Bergmann, Georg

    2007-01-01

    A bilateral dynamic stabilization device is assumed to alter favorable the movement and load transmission of a spinal segment without the intention of fusion of that segment. Little is known about the effect of a posterior dynamic fixation device on the mechanical behavior of the lumbar spine. Muscle forces were disregarded in the few biomechanical studies published. The aim of this study was to determine how the spinal loads are affected by a bilateral posterior dynamic implant compared to a...

  18. The effect of Hydroxyapatite/collagen I composites, bone marrow aspirate and bone graft on fixation of bone implants in sheep

    DEFF Research Database (Denmark)

    Babiker, Hassan

    of bone implants.   Materials and Methods: Titanium alloy implants were inserted into bilateral femoral condyles of 8 skeletally mature sheep, four in each sheep. The implant has a circumferential gap of 2 mm. The gap was filled with: HA/coll; HA/coll-BMA; autograft or allograft. Allograft was served...

  19. BOHLER'S ANGLE: CORRELATION WITH OUTCOME IN DISPLACED INTRA-ARTICULAR CALCANEAL FRACTURES TREATED WITH LOCKING COMPRESSION PLATE FIXATION WITH AND WITHOUT BONE GRAFTING

    Directory of Open Access Journals (Sweden)

    Deepak P

    2014-09-01

    Full Text Available BOHLER'S ANGLE: correlation with outcome in displaced intra-articular calcaneal fractures Treated with locking compression Plate Fixation with and without bone grafting. AIMS: The aim is an accurate reduction of the fracture with reconstruction of Bohler’s angle, length and axis and sub talar joint surface. To determine whether autologous bone graft supplementation is beneficial in achieving and maintaining restoration of Calcaneal height and anatomic reduction. SETTINGS AND DESIGN: Level 1 trauma center, Prospective, randomized. METHODS AND MATERIAL: Consecutive 46 patients who had fracture calcaneum were treated by open reduction and internal fixation by locking plate with and without bone graft during the period from November 2009 to April 2012. STATISTICAL ANALYSIS USED: AOFAS-Ankle-Hind foot Scale, t Test. RESULTS: Fewer complications and statistically significant better results related to treatment with locking plates with bone grafting confirmed in comparison to without bone grafting ones were noted for intra-articular calcaneal fractures. In Group A the mean time for union was 10.39wks. The results were good and excellent in 86.95%, 8.69 % had fair result and 4.34% had poor results. In Group B the mean time for union was 11.95 wks. The overall results were good and excellent in 73.91%, 13.04 % had fair result and 13.04 % had poor results. CONCLUSIONS: The operative treatment of intra-articular calcaneal fractures could restore Böhler's angle better and the patient could return to full weight bearing earlier. We confirmed that autologous bone graft supplementation is beneficial in achieving and maintaining restoration of calcaneal height and anatomic reduction.

  20. Role of mechanical factors in the evaluation of pedicle screw type spinal fixation devices

    OpenAIRE

    Goel V; Ebraheim N; Biyani A; Rengachary S; Faizan A

    2005-01-01

    Prior to implantation, spinal implants are subjected to rigorous testing to ensure safety and efficacy. A full battery of tests for the devices may include many steps ranging from biocompatibility tests to in vivo animal studies. This paper describes some of the essential tests from a mechanical engineering perspective (e.g., motion, load sharing, bench type tests, and finite element model analyses). These protocols reflect the research experience of the past decade or so.

  1. Rehabilitation instruction after intervertebral bone graft internal fixation of lumbar spondylolisthesis%腰椎滑脱椎体间植骨固定术后的康复指导

    Institute of Scientific and Technical Information of China (English)

    张晋亭

    2003-01-01

    @@ BACKGROUND:Internal fixation of lumbral spondylolisthesis has resolved the problem caused by vertebral translocation and postoperative rehabilitation instruction can prevent moving of bone.Directed to different stages,suitable posture and rehabilitation function exercises can effectively prevent loose intervertebral grafted bone and adhesion of nerve root.

  2. Guided bone augmentation using ceramic space-maintaining devices: the impact of chemistry

    Directory of Open Access Journals (Sweden)

    Anderud J

    2015-03-01

    Full Text Available Jonas Anderud,1,2 Peter Abrahamsson,2 Ryo Jimbo,1 Sten Isaksson,2 Erik Adolfsson,3 Johan Malmström,2 Yoshihito Naito,4 Ann Wennerberg1 1Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden; 2Maxillofacial Unit Halmstad, Region Halland, Halmstad, Sweden; 3Swedish Ceramic Institute, IVF, Mölndal, Sweden; 4Department of Oral and Maxillofacial Prosthodontics and Oral Implantology, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan Abstract: The purpose of the study was to evaluate histologically, whether vertical bone augmentation can be achieved using a hollow ceramic space maintaining device in a rabbit calvaria model. Furthermore, the chemistry of microporous hydroxyapatite and zirconia were tested to determine which of these two ceramics are most suitable for guided bone generation. 24 hollow domes in two different ceramic materials were placed subperiosteal on rabbit skull bone. The rabbits were sacrificed after 12 weeks and the histology results were analyzed regarding bone-to-material contact and volume of newly formed bone. The results suggest that the effect of the microporous structure of hydroxyapatite seems to facilitate for the bone cells to adhere to the material and that zirconia enhance a slightly larger volume of newly formed bone. In conclusion, the results of the current study demonstrated that ceramic space maintaining devices permits new bone formation and osteoconduction within the dome. Keywords: hydroxyapatite, zirconia, guided bone regeneration, GBR, histology, membrane

  3. Clinical results of reversed V-shaped high tibial corticotomy with minimally invasive surgery without internal fixation devices.

    Science.gov (United States)

    Madadi, Firooz; Eajazi, Alireza; Madadi, Firoozeh; Daftari Besheli, Laleh; Rokni, Reza; Abbasian, Mohammad Reza; Bigdeli, Mohammad Reza

    2010-06-01

    High tibial osteotomy is a method of treating knee osteoarthritis due to genu varum in advanced stages. High tibial osteotomy-associated problems continue to be reported. The purpose of this study was to investigate the clinical results of a new, innovative method of high tibial osteotomy with 3- to 13-year follow-up. Between 1996 and 2006, our new surgical method was performed on 293 patients with medial compartment osteoarthritis and genu varum. All patients were examined preoperatively, 6 months postoperatively, and at final follow-up. The Hospital for Special Surgery Knee Scoring System (HSS) was used at final follow-up, and limb alignment and patient satisfaction were reassessed. Immediate postoperative complications included varus recurrence, knee instability, and peroneal nerve palsy, and no signs of tibial nonunion or infection were observed. At final follow-up, 3 cases of genu recurvatum, 2 cases of peroneal nerve palsy, and 25 cases of loss of correction were observed. Average postoperative HSS score was 85 (range, 47-97), and 97.8% of the patients were satisfied. This new method is a good alternative for the correction of genu varum because it requires a small incision, is soft tissue friendly, is a corticotomy instead of an osteotomy, requires no internal or external fixation devices, has a shorter duration and an acceptable complication and recurrence rate, and results in satisfactory HSS scores and higher patient satisfaction rates. PMID:20806771

  4. 可吸收固定系统在开颅骨瓣复位固定手术中的初步应用%PRELIMINARY APPLICATION OF ABSORBABLE FIXATION SYSTEM ON CRANIAL BONE FLAP REPOSITION AND FIXATION AFTER CRANIOTOMY

    Institute of Scientific and Technical Information of China (English)

    邓跃飞; 郑眉光; 吴锦铨

    2012-01-01

    目的 观察可吸收固定系统对开颅游离骨瓣复位的固定效果及不良反应.方法 2010年7月-2011年12月,对67例开颅游离骨瓣成型切除颅内病变后患者,采用可吸收固定系统进行骨瓣复位固定.其中男38例,女29例;年龄5个月~73岁,中位年龄32岁.病程3个月~6年,中位病程25个月.幕上病变41例,幕下病变26例;其中位于额颞部13例,额顶部12例,颞顶部8例,颞枕部5例,顶枕部4例,后颅窝25例.诊断为胶质瘤15例,脑血管性疾病(动脉瘤、动静脉畸形及海绵状血管瘤)8例,脑膜瘤和蛛网膜囊肿各7例,听神经瘤和原发三叉神经痛各5例,胆脂瘤和脑脓肿各3例,垂体瘤、颅咽管瘤、转移瘤及放射性脑病各2例,髓母细胞瘤、室管膜瘤、生殖细胞瘤、非典型畸胎瘤/横纹肌样瘤、面肌痉挛及硬膜下血肿各1例.颅内病变范围3cm×2cm~7cm×5cm.观察术后局部切口及全身情况变化.结果 术后有2例幕上和3例幕下病变患者少许皮下积液,均经穿刺抽吸2周后消失;术后切口均Ⅰ期愈合,无红肿、发热等表现;术后2周内复查CT或MRI示骨瓣复位良好,内、外颅骨面均平整,无任何影像伪影.67例均获随访,随访时间3~20个月,平均10.3个月.切口无不适,头颅外观正常,无局部凹陷、积液等.CT或MRI复查未见骨瓣移位凹陷及伪影.结论 应用可吸收固定系统进行骨瓣复位固定简便、安全、可靠,且能消除术后CT或MRI复查时金属固定材料导致的伪影,近期疗效较好.%Objective To investigate the effectiveness and adverse effect of the absorbable fixation system on cranial bone flap reposition and fixation after craniotomy. Methods Between July 2010 and December 2011, 67 cases underwent cranial bone flap reposition and fixation with absorbable fixation system after craniotomy and resection of intracranial lesions. There were 38 males and 29 females with a median age of 32 years (range, 5 months to 73

  5. Observation of Clinical Nursing Self-locking Gastric Tube Fixation Device%自锁式胃管固定器的临床护理观察

    Institute of Scientific and Technical Information of China (English)

    樊玲; 吴李莉

    2012-01-01

    Objective: To observe the effect and adverse reaction of nursing self-locking gastric tube fixation device. Methods: Patients were randomly divided into test group (whose Gastric Tube were fixed by self-locking gastric tube fixation device) and control group (whose gastric tube were fixed by routine rubberized fabric. The course of treatment was 1 ~2 weeks. Results: The effect and adverse reaction of test group was better than that of control group. Conclusions: Self-locking gastric tube fixation device has good effect and safety.%目的 观察自锁式胃管固定器对胃管固定的有效性和不良反应.方法 将患者随机分为试验组(自锁式胃管固定器固定胃管)和对照组(常规胶布固定胃管),观察时间为1~2周.结果 试验组固定胃管的有效性和不良反应方面均优于对照组的.结论 自锁式胃管固定器固定胃管有效且安全.

  6. Therapeutic efficacy of pedicle screw-rod internal fixation after one-stage posterior transforaminal lesion debridement and non-structural bone grafting for tuberculosis of lumbar vertebra

    Directory of Open Access Journals (Sweden)

    Jia-ming LIU

    2015-11-01

    Full Text Available Objective To evaluate the efficacy and safety of pedicle screw-rod internal fixation after one-stage posterior transforaminal lesion debridement and non-structural bone grafting in the treatment of tuberculosis of mono-segmental lumbar vertebra. Methods From January 2010 to April 2013, 21 patients (9 males and 12 females with an average age of 49.1 years with mono-segmental tuberculosis of lumbar vertebra underwent surgery in our hospital were included. Eight patients had neurological deficit. The focus of tuberculosis was located on one side of the vertebral body, and all the patients had obvious signs of bone destruction on CT and MRI. All the patients were given anti-tuberculosis chemotherapy for 2-3 weeks before surgery. The local bone chips and autologous iliac cancellous bone were used as the intervertebral bone graft. Postoperative plain radiographs and CT were obtained to evaluate the fusion rate and degree of lumbar lordosis. The visual analogue scale score (VAS, erythrocyte sedimentation rate (ESR, and C-reactive protein (CRP before and after operation, and at final follow-up date were recorded. Results All the patients were followed up for 25.3±4.2 months. The mean operation time was 157±39 minutes, and the average blood loss was 470±143ml. The fusion rate of the interbody bone graft was 95.2%, with an average fusion period of 6.1±2.5 months. The neurological function was improved by 100%, and no severe complication or neurological injury occured. The preoperative and postoperative lordosis angles of the lumbar spine were 21.4°±5.7° and 33.6°±3.1°, respectively, and it was 31.3°±2.7° at the final follow up. The preoperative and postoperative VAS scores were 7.8±2.6 and 2.4±1.7 respectively, and it was 0.9±0.7 at the final follow up. The ESR and CRP were significantly decreased 3 months after surgery, and they became normal at 6 months. Conclusion Pedicle screw-rod internal fixation after one-stage posterior

  7. CT pre-operative planning of a new semi-implantable bone conduction hearing device

    Energy Technology Data Exchange (ETDEWEB)

    Law, Eric K.C.; Bhatia, Kunwar S.S. [Prince of Wales Hospital, The Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Hong Kong, SAR (China); Tsang, Willis S.S.; Tong, Michael C.F. [Prince of Wales Hospital, The Chinese University of Hong Kong, Department of Otorhinolaryngology, Head and Neck Surgery, Hong Kong, SAR (China); Shi, Lin [The Chinese University of Hong Kong, Department of Medicine and Therapeutics, Hong Kong, SAR (China); The Chinese University of Hong Kong, Chow Yuk Ho Technology Center for Innovative Medicine, Hong Kong, SAR (China)

    2016-06-15

    Accommodating a novel semi-implantable bone conduction hearing device within the temporal bone presents challenges for surgical planning. This study describes the utility of CT in pre-operative assessment of such an implant. Retrospective review of pre-operative CT, clinical and surgical records of 16 adults considered for device implantation. Radiological suitability was assessed on CT using 3D simulation software. Antero-posterior (AP) dimensions of the mastoid bone and minimum skull thickness were measured. CT planning results were correlated with operative records. Eight and five candidates were suitable for device placement in the transmastoid and retrosigmoid positions, respectively, and three were radiologically unsuitable. The mean AP diameter of the mastoid cavity was 14.6 mm for the transmastoid group and 4.6 mm for the retrosigmoid group (p < 0.05). Contracted mastoid and/or prior surgery were predisposing factors for unsuitability. Four transmastoid and five retrosigmoid positions required sigmoid sinus/dural depression and/or use of lifts due to insufficient bone capacity. A high proportion of patients being considered have contracted or operated mastoids, which reduces the feasibility of the transmastoid approach. This finding combined with the complex temporal bone geometry illustrates the importance of careful CT evaluation using 3D software for precise device simulation. (orig.)

  8. 人工骨或自体骨移植联合椎弓根钉内固定修复脊柱结核%Artificial bone or autologous bone grafting combined with pedicle screw fixation for repair of spinal tuberculosis

    Institute of Scientific and Technical Information of China (English)

    姜棚菲; 翟文斌

    2015-01-01

    BACKGROUND:With the development of fixation materials and technology, scholars began to use artificial bone materials combined with pedicle screw fixation in the repair of spinal tuberculosis. OBJECTIVE: To summarize the characteristics of artificial bone materials combined with pedicle screw fixation in the repair of spinal tuberculosis. METHODS:The literatures about artificial bone graft materials in repair of spinal tuberculosis were retrieved from CNKI and PubMed database during 1985 to 2014 by computer. The keywords were “spinal tuberculosis, bone transplantation, internal fixation” in Chinese and English, respectively. RESULTS AND CONCLUSION:In the repair of spinal tuberculosis using artificial bone materials combined with pedicle screw fixation, autologous bone is the gold standard for bone grafting, presenting with no immune rejection. To avoid the occurrence of limited bone mass, pain and other complications, however, artificial bone materials have been extensively studied. Currently used artificial materials mainly include titanium and its aloys, hydroxyapatite composites and medical calcium sulfate, which al have good biocompatibility. But there are stil certain limitations and shortcomings.%背景:随着内固定材料和内固定技术的发展,越来越多的国内外学者开始应用人工骨材料联合椎弓根钉内固定修复脊柱结核。目的:综述人工骨修复材料联合椎弓根内固定修复脊柱结核的特点。方法:应用计算机检索CNKI和PubMed数据库1985至2014年有关人工骨移植材料修复脊椎结核方面的文献,中文关键词为“脊椎结核、骨移植、内固定”,英文关键词为“Spinal tuberculosis,Bone graft,Fixation”。结果与结论:在骨修复材料联合椎弓根内固定修复脊柱结核中,自体骨是骨移植的金标准,无免疫排斥反应,但为了避免自体骨取骨量有限、取骨后疼痛等并发症的发生,人工骨材料得到了广泛

  9. Uterine doughnut by intrauterine device-induced photon attenuation on three-phase bone scintigraphy: artifact

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Myung Hee; Jeong, Hwan Jeong; Lim, Seok Tae [Chonbuk National University Medical School, Jeonju (Korea, Republic of)

    2007-02-15

    A 44-year-old female underwent three-phase bone scintigraphy for an evaluation of right hip joint pain. The blood-flow and blood-pool images show a pelvic blush with a photopenic center (doughnut) prior to bladder filling. On the three hour delayed image, the pelvic uptake disappeared. The scintigraphic findings indicated the possibility of an early pregnancy. However, plain radiography demonstrated an intrauterine device. A uterine doughnut developed as a result of photon attenuation of intrauterine device.

  10. Review: Bone conduction devices and contralateral routing of sound systems in single-sided deafness

    NARCIS (Netherlands)

    Peters, Jeroen P M; Smit, Adriana L; Stegeman, Inge; Grolman, Wilko

    2015-01-01

    OBJECTIVES/HYPOTHESIS: Systematically review the literature on the clinical outcome of bone conduction devices (BCD) and contralateral routing of sound systems (CROSS) for patients with single-sided deafness (SSD). DATA SOURCES: PubMed, Embase, Cochrane Library, and CINAHL databases were searched up

  11. Fixation of non-cemented total hip arthroplasty femoral components in a simulated proximal bone defect model.

    Science.gov (United States)

    Sangiorgio, Sophia N; Ebramzadeh, Edward; Knutsen, Ashleen R; Borkowski, Sean L; Kalma, Jeremy J; Bengs, Benjamin C

    2013-10-01

    An accelerated sequential proximal femoral bone loss model was used to measure the initial stability of three noncemented femoral stem designs: fully porous-coated, proximally porous-coated, and dual-tapered, diaphyseal press-fit (N=18). Only dual-tapered, diaphyseal press-fit stems remained stable with as much as 105 mm of bone loss, with average cyclic micromotion remaining below 25 μm in ML and below 10 μm in AP planes. In contrast, with proximally coated and fully coated stem designs with circular or oval cross-sections, 60mm of bone loss, resulting in lower than 10 cm of diaphyseal bone contact length, led to gross instability, increasing average cyclic micromotions to greater than 100 μm prior to failure. Therefore, the results provide support for using a dual-tapered stem in revision cases with proximal bone loss. PMID:23523487

  12. Efficacy and safety of biodegradable osteofixation devices in oral and maxillofacial surgery : a systematic review

    NARCIS (Netherlands)

    Buijs, G. J.; Stegenga, B.; Bos, R. R. M.

    2006-01-01

    The use of osteofixation devices should be evidence-based if uncomplicated bone healing is to be achieved. Numerous studies describe and claim the advantages of biodegradable over titanium devices as a bone fixation method. Here, we systematically review the available literature to determine the cli

  13. Osteogenic protein-1 increases the fixation of implants grafted with morcellised bone allograft and ProOsteon bone substitute: an experimental study in dogs

    DEFF Research Database (Denmark)

    Baad-Hansen, Thomas Einer; Overgaard, S; Lind, M;

    2007-01-01

    weeks osteogenic protein-1 increased bone formation and the energy absorption of implants grafted with allograft and ProOsteon. A composite of allograft, ProOsteon and osteogenic protein-1 was comparable, but not superior to, allograft used on its own. ProOsteon alone cannot be recommended as a......Impacted bone allograft is often used in revision joint replacement. Hydroxyapatite granules have been suggested as a substitute or to enhance morcellised bone allograft. We hypothesised that adding osteogenic protein-1 to a composite of bone allograft and non-resorbable hydroxyapatite granules...... surrounded by a concentric 3 mm gap. These gaps were randomly allocated to four different procedures in each dog: 1) bone allograft used on its own; 2) ProOsteon used on its own; 3) allograft and ProOsteon used together; or 4) allograft and ProOsteon with the addition of osteogenic protein-1. After three...

  14. A Mechatronic Loading Device to Stimulate Bone Growth via a Human Knee

    Directory of Open Access Journals (Sweden)

    Sai Krishna Prabhala

    2016-09-01

    Full Text Available This paper presents the design of an innovative device that applies dynamic mechanical load to human knee joints. Dynamic loading is employed by applying cyclic and periodic force on a target area. The repeated force loading was considered to be an effective modality for repair and rehabilitation of long bones that are subject to ailments like fractures, osteoporosis, osteoarthritis, etc. The proposed device design builds on the knowledge gained in previous animal and mechanical studies. It employs a modified slider-crank linkage mechanism actuated by a brushless Direct Current (DC motor and provides uniform and cyclic force. The functionality of the device was simulated in a software environment and the structural integrity was analyzed using a finite element method for the prototype construction. The device is controlled by a microcontroller that is programmed to provide the desired loading force at a predetermined frequency and for a specific duration. The device was successfully tested in various experiments for its usability and full functionality. The results reveal that the device works according to the requirements of force magnitude and operational frequency. This device is considered ready to be used for a clinical study to examine whether controlled knee-loading could be an effective regimen for treating the stated bone-related ailments.

  15. Analysis and an overview of fixators in medicine and the methods of processing materials for producing fixators

    OpenAIRE

    Dalibor Milojko Đenadić; Miodrag T. Manić; Dejan I. Tanikić; Saša S. Ranđelović; Petar S. Đekić

    2013-01-01

    The fixator is a medical device that provides support to fractured biological structures. Metal biomaterials are mainly used for replacing broken or damaged hard tissues such as bones because of their high strenght, toughness and corrosion resistance. Materials such as stainless steel, titanium and aluminium alloys (Ti-6Al-4V), cobalt and chromium alloys, composite materials and other biocompatible materials are used in orthopedy for the stabilization of connective tissue injuries or as a sub...

  16. Latarjet Fixation

    Science.gov (United States)

    Alvi, Hasham M.; Monroe, Emily J.; Muriuki, Muturi; Verma, Rajat N.; Marra, Guido; Saltzman, Matthew D.

    2016-01-01

    Background: Attritional bone loss in patients with recurrent anterior instability has successfully been treated with a bone block procedure such as the Latarjet. It has not been previously demonstrated whether cortical or cancellous screws are superior when used for this procedure. Purpose: To assess the strength of stainless steel cortical screws versus stainless steel cannulated cancellous screws in the Latarjet procedure. Study Design: Controlled laboratory study. Methods: Ten fresh-frozen matched-pair shoulder specimens were randomized into 2 separate fixation groups: (1) 3.5-mm stainless steel cortical screws and (2) 4.0-mm stainless steel partially threaded cannulated cancellous screws. Shoulder specimens were dissected free of all soft tissue and a 25% glenoid defect was created. The coracoid process was osteomized, placed at the site of the glenoid defect, and fixed in place with 2 parallel screws. Results: All 10 specimens failed by screw cutout. Nine of 10 specimens failed by progressive displacement with an increased number of cycles. One specimen in the 4.0-mm screw group failed by catastrophic failure on initiation of the testing protocol. The 3.5-mm screws had a mean of 274 cycles (SD, ±171 cycles; range, 10-443 cycles) to failure. The 4.0-mm screws had a mean of 135 cycles (SD, ±141 cycles; range, 0-284 cycles) to failure. There was no statistically significant difference between the 2 types of screws for cycles required to cause failure (P = .144). Conclusion: There was no statistically significant difference in energy or cycles to failure when comparing the stainless steel cortical screws versus partially threaded cannulated cancellous screws. Clinical Relevance: Latarjet may be performed using cortical or cancellous screws without a clear advantage of either option. PMID:27158630

  17. The effects of hydroxyapatite coating and bone allograft on fixation of loaded experimental primary and revision implants

    DEFF Research Database (Denmark)

    Søballe, Kjeld; Mouzin, Olivier R G; Kidder, Louis A;

    2003-01-01

    for the presence of particulate polyethylene. During this procedure, a sclerotic endosteal bone rim forms, and a dense fibrous membrane is engendered, having macrophages with ingested polyethylene and high levels of inflammatory cytokines. At the time of revision after 8 weeks, the cavity is revised with either...

  18. Posterior transodontoid fixation: A new fixation (Kotil technique

    Directory of Open Access Journals (Sweden)

    Kadir Kotil

    2011-01-01

    Full Text Available Anterior odontoid screw fixation or posterior C1-2 fusion techniques are routinely used in the treatment of Type II odontoid fractures, but these techniques may be inadequate in some types of odontoid fractures. In this new technique (Kotil technique, through a posterior bilateral approach, transarticular screw fixation was performed at the non-dominant vertebral artery (VA side and posterior transodontoid fixation technique was performed at the dominant VA side. C1-2 complex fusion was aimed with unilateral transarticular fixation and odontoid fixation with posterior transodontoid screw fixation. Cervical spinal computed tomography (CT of a 40-year-old male patient involved in a motor vehicle accident revealed an anteriorly dislocated Type II oblique dens fracture, not reducible by closed traction. Before the operation, the patient was found to have a dominant right VA with Doppler ultrasound. He was operated through a posterior approach. At first, transarticular screw fixation was performed at the non-dominant (left side, and then fixation of the odontoid fracture was achieved by directing the contralateral screw (supplemental screw medially and toward the apex. Cancellous autograft was scattered for fusion without the need for structural bone graft or wiring. Postoperative cervical spinal CT of the patient revealed that stabilization was maintained with transarticular screw fixation and reduction and fixation of the odontoid process was achieved completely by posterior transodontoid screw fixation. The patient is at the sixth month of follow-up and complete fusion has developed. With this new surgical technique, C1-2 fusion is maintained with transarticular screw fixation and odontoid process is fixed by concomitant contralateral posterior transodontoid screw (supplemental screw fixation; thus, this technique both stabilizes the C1-2 complex and fixes the odontoid process and the corpus in atypical odontoid fractures, appearing as an

  19. 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...

  20. A laboratory investigation to assess the influence of cement augmentation of screw and plate fixation in a simulation of distal femoral fracture of osteoporotic and non-osteoporotic bone.

    Science.gov (United States)

    Wähnert, D; Lange, J H; Schulze, M; Gehweiler, D; Kösters, C; Raschke, M J

    2013-10-01

    The augmentation of fixation with bone cement is increasingly being used in the treatment of severe osteoporotic fractures. We investigated the influence of bone quality on the mechanics of augmentation of plate fixation in a distal femoral fracture model (AO 33 A3 type). Eight osteoporotic and eight non-osteoporotic femoral models were randomly assigned to either an augmented or a non-augmented group. Fixation was performed using a locking compression plate. In the augmented group additionally 1 ml of bone cement was injected into the screw hole before insertion of the screw. Biomechanical testing was performed in axial sinusoidal loading. Augmentation significantly reduced the cut-out distance in the osteoporotic models by about 67% (non-augmented mean 0.30 mm (sd 0.08) vs augmented 0.13 mm (sd 0.06); p = 0.017). There was no statistical reduction in this distance following augmentation in the non-osteoporotic models (non-augmented mean 0.15 mm (sd 0.02) vs augmented 0.15 mm (sd 0.07); p = 0.915). In the osteoporotic models, augmentation significantly increased stability (p = 0.017). PMID:24078541

  1. Bone cement and bone grafting in nail path to strengthen dynamic hip screw fixation for senile osteoporotic intertrochanteric fracture%骨水泥、钉道植骨强化动力髋螺钉固定修复老年骨质疏松性股骨转子间骨折

    Institute of Scientific and Technical Information of China (English)

    林周胜; 孙鸿涛; 夏雄智; 江成; 黎飞猛

    2015-01-01

    背景:对于老年骨质疏松性髋部骨折的动力髋螺钉固定,如能避免使用过程中造成的骨量丢失,或是采用其他手段增加固定螺钉把持力,将改善动力髋螺钉固定的治疗效果。目的:对比研究3种固定方式修复老年骨质疏松性股骨转子间骨折的效果。方法:回顾性分析近5年来采用常规动力髋螺钉内固定、骨水泥强化后动力髋螺钉固定及主钉道压配植骨配合动力髋螺钉固定3种固定方式治疗老年骨质疏松性股骨转子间骨折患者的资料,分别设为对照组、骨水泥组和植骨组。结果与结论:经固定后2年随访,植骨组、骨水泥组和对照组Harris髋关节功能评分优良率分别为95%,80%,70%。植骨组骨折临床愈合时间明显缩短(P <0.05),出现螺钉固定失败情况与骨水泥组相当。对照组较其他2组相对更多出现退钉等内固定失败情况。结果表明,与其他常规动力髋螺钉内固定、骨水泥强化后动力髋螺钉固定方式相比较,主钉道压配植骨配合动力髋螺钉内固定的疗效及安全性更好。%BACKGROUND:In dynamic hip screw fixation for treating aged osteoporotic intertrochanteric fracture, avoiding the loss of bone mass, or by other means that can increase the fixed screw pulout strength, wil improve the therapeutic effect of dynamic hip screw fixation. OBJECTIVE: To compare the effects of three kinds of repair methods on aged osteoporotic intertrochanteric fracture. METHODS:Data of aged osteoporosis intertrochanteric fracture patients, who received conventional dynamic hip screw fixation, bone cement augmentation with dynamic hip screw fixation and bone grafting with dynamic hip screw fixation, were retrospectively analyzed. They were divided into control group, bone cement group and bone grafting group. RESULTS AND CONCLUSION:After two years of folow-up, the excelent and good rates of Harris hip function were 95%, 80% and 70% in

  2. [Ultrasound bone densitometry in children and adolescents; Italian refence curves with multi-site device (Omnisense)].

    Science.gov (United States)

    Pedrotti, L; Mora, R; Bertani, B; Tuvo, G; Galli, G B; Pazzano, S; Quattrini, F; Crivellari, I

    2007-01-01

    The values of bone density represent one of the best parameters for the prediction of the risk of fracture in the adult. Since the peak of bone mass depends over that on genetic factors also on modifiable environmental factors, the evaluation of the state of bone health in paediatric populations has assumed great importance; the ultrasound techniques seem to represent a potential alternative to DXA and QTC. Using Omnisense device (Omnisense, Sunlight Ultrasound Technologies) we have evaluated the bone strength in a champion of 652 children and teen-agers aged 6-18 (328 females, 324 males). The measurements have been made at the distal third of the radius and midshaft tibia. The purpose has been to record the values of SOS in a healthy paediatric population, building a normal database and to find a correlation between the SOS values and anthropometric data, dietary factors and physical activity. The comparison with an analogous study conducted by other Authors prompted us to conclude that in the paediatric population the construction of proper curves of reference, with which to compare the data of the patients, is essential to avoid errors in the evaluation of bone density, in agreement with how much already underlined in literature. Besides a correct interpretation of the data obtained with ultrasounds systems asks for a change of the thresholds values established by the OMS for the diagnosis of osteopenia/osteoporosis with the DXA. As already happened for the adult population in children also it will be therefore necessary to compare a great number of pathological subjects with the normal database, establishing so the new values of Z-Score and giving a clinical meaning to the effected measurements.

  3. The influence of sacral morphology on the existence of secure S1 and S2 transverse bone corridors for iliosacroiliac screw fixation.

    Science.gov (United States)

    Mendel, T; Noser, H; Kuervers, J; Goehre, F; Hofmann, G O; Radetzki, F

    2013-12-01

    Sacroiliac (SI) screw fixation for unstable pelvic fractures stands out as the only minimally invasive method among all other ORIF procedures. A strictly transverse screw trajectory is needed for central or bilateral fracture patterns up to a complete iliosacroiliac fixation. However, secure screw insertion is aggravated by a narrow sacroiliac bone stock. This study investigates the influence of a highly variable sacral morphology to the existence of S1 and S2 transverse corridors. The analysis contained in this study is based on 125 CT datasets of intact human pelvises. First, sacral dysplasia was identified using the "lateral sacral triangle" method in a lateral 3-D semi-transparent pelvic view. Second, 3-D corridors for a 7.3mm screw in the upper two sacral levels were visualised using a proprietary IT workflow of custom-made programme scripts based on the Amira(®)-software. Shape-describing measurement variables were calculated as output variables. The results show a significant linear correlation between ratioT and the screw-limiting S1 isthmus height (Pearson coefficient of 0.84). A boundary ratio of 1.5 represented a positive predictive value of 96% for the existence of a transverse S1-corridor for at least one 7.3mm screw. In 100 out of 125 pelvises (80%), a sufficient S1 corridor existed, whereas in 124 specimens (99%), an S2 corridor was found. Statistics revealed significantly larger S1 and S2 corridors in males compared to females (pS1 and 1 screw in S2. The expanse of the S1 corridor is highly influenced by the dimensions of the dysplastic elevated upper sacrum, whereas the S2 corridor is not affected. Hence, in dysplastic pelvises, sacroiliac screw insertion should be recommended into the 2nd sacral segment. Our IT workflow for the automatic computation of 3-D corridors may assist in surgical pre-operative planning. Furthermore, the workflow could be implemented in computer-assisted surgery applications involving pelvic trauma.

  4. Relationship of shape and structure of internal fixation implant to biomechanics following bone injury%骨损伤内固定植入物形状和结构与生物力学的关系

    Institute of Scientific and Technical Information of China (English)

    杨君建

    2012-01-01

    背景 实践证明内固定材料良好的生物力学性能对受损骨的治疗效果影响较大,而通过改善内固定材料的形状和结构可以实现较好的力学效果.目的 以骨科置入内固定材料的生物力学特征为视角,分析与阐述骨科植入物的形状和结构与内固定效果的关系.方法 应用计算机检索PubMed、维普和万方数据库中1990-01/2011-12 关于骨损伤治疗及其内固定材料学方面的文章,在标题和摘要中以"骨,固定,形状,材料"或"bone,fixed,shape,material"为检索词进行检索,排除重复研究、普通综述或Meta 分析类文章.初检得到156 篇文献,根据纳入标准选择26 篇文章进行综述.结果与结论 骨科植入物材料的生物力学性能对骨的固定、骨血供以及成骨细胞的成长和再生起着重要的制约因素,而材料形状和结构的改变会对其生物力学性能产生较大的影响进而影响治疗效果.如何运用新工艺对骨科植入物材料的形状或结构进行改善,通过对其进行巧妙的物理改性以达到理想的内固定治疗效果应成为研究者关注的问题.%BACKGROUND: Good biomechanical property of internal fixation material has great effects on therapeutic outcomes of damaged bone. Good mechanics outcomes can be obtained by improving the shape and structure of internal fixation material. OBJECTIVE: From the view angle of biomechanical feature of orthopedic implant internal fixation material, to analyze the correlation of shape and structure of orthopedic implant and internal fixation outcomes.METHODS: We retrieved PubMed, Vip and Wanfang Database for articles concerning bone injury treatment and internal fixation material published from January 1990 to December 2011. The key words were “bone, fixation, shape, material”, which were searched in titles and abstracts. The articles addressing repetitive studies, common reviews or Meta analysis were excluded. A total of 156 articles were

  5. Anterior plate internal fixation and autologous iliac bone graft fusion in the repair of thoracic spinal tuberculosis:bone healing%前路钢板置入内固定与自体髂骨植骨融合修复胸椎结核的骨愈合

    Institute of Scientific and Technical Information of China (English)

    黄江; 李小峰; 杨渊

    2014-01-01

    focus and achieve a good internal fixation, but this treatment needs to cut the rid. The surgeon discovered in years of clinical practice that distraction of intercostal space without cutting off the ribs could completely remove the focus and achieve fixation and fusion. OBJECTIVE:To explore the feasibility, advantages and disadvantages of anterior plate fixation and autologous bone graft fusion in the repair of thoracic spinal tuberculosis. METHODA total of 30 cases of thoracic spinal tuberculosis were enrol ed. On the base of traditional thoracic spinal anterior surgical approach, the rib was reserved. Anterior distraction device was used to open the ribs for clearance and to move the focus of thoracic spinal tuberculosis. Autologous ilium was obtained and subjected to fusion and anterior plate fixation. Visual Analog Scale, Oswestry Disability Index, Frankel grade and Bridwel bone healing rating were used before and after treatment. RESULTS AND CONCLUSION:A total of 30 patients were fol owed up for 3-60 months. The bone healing (class A) was seen, but no fistula formation was visible. Nerve compression symptoms were improved, without aggravating cases. Postoperatively, the average Cobb angle correction was 10.32°. After 6 months, imaging revealed bone fusion of affected vertebral body. After 18 months, the vertebral height was not lost obviously, no recurrence of vertebral tuberculosis. These results indicated that anterior intercostal space without cutting ribs exposed clearly, showing a large space, where can meet the requirement of first-stage debridement fixation and fusion in the repair of thoracic tuberculosis. The pathological changes were visibly clear;the focus was thoroughly removed, and the ribs were reserved. The outcomes are identical to rib resection. Simultaneously, autogenous iliac trilateral cortex has good supporting effects. Loose cancellous bone mesh has good osteogenesis and is helpful to bone healing.

  6. 石膏固定和空心螺钉内固定修复腕部舟状骨新鲜骨折:功能恢复比较%Plaster fixationversus cannulated screw internal fixation for the wrist scaphoid bone fresh fracture:comparison of functional recovery

    Institute of Scientific and Technical Information of China (English)

    卡依沙尔•买买提明; 赵岩

    2015-01-01

      结果与结论:随访3-6个月对比分析石膏组和空心螺钉组患者腕关节功能Cooney评分,空心螺钉组优9例,良1例,可1例,差0例;石膏组优1例,良5例,可3例,差2例,空心螺钉组患者治疗后优良率为91%,石膏组患者治疗后优良率为55%,空心螺钉组显著高于石膏组(t=4.817,P OBJECTIVE:To compare and analyze functional recovery of the wrist scaphoid bone fresh fracture after plaster fixation and internal fixation. METHODS: Twenty-two patients with wrist scaphoid bone fresh fracture were recruited from the First Affiliated Hospital of Xinjiang Medical University from March 2012 to March 2014, and the injury time was 2 hours to 12 days. Preoperative X-ray films revealed that, the involved patients had no wrist scaphoid bone colapses, lunate bone dislocation, ischemic necrosis of bone and osseous changes. Al the cases showed shift, unstable fractures. According to the patient’s wiling and the surgical method, the involved patients were divided into two groups, receiving plaster fixation and cannulated screw internal fixation respectively. Each group contained 11 cases. Wrist joint function was evaluated using Cooney score system. There was no significant difference in the age distribution and gender between the two groups (P > 0.05). RESULTS AND CONCLUSION: At 3-6 months of folow-up, wrist joint function of patients in the two groups was compared and analyzed with Cooney scores. According to the Cooney scores, nine cases in internal fixation group were excelent, 1 good, 1 fair and none poor; one case in plaster fixation group was excelent, 5 good, 3 fair, and 2 poor. The excelent and good rate in the internal fixation group was significantly higher than that in the plaster fixation group (91%, 55%,t=4.817,P < 0.05). Although plaster fixation has certain effects on wrist scaphoid bone fresh fracture, open reduction and canulated screw fixation has obvious effect and promotes the

  7. 骨水泥强化椎弓根螺钉固定L1压缩性骨折:与单纯椎弓根螺钉固定的比较%Pedicle screw fixation with bone cementversus pedicle screw fixation alone for L1 compression fractures

    Institute of Scientific and Technical Information of China (English)

    亚力坤•亚森

    2015-01-01

    背景:椎体成形术与椎弓根螺钉内固定都是胸腰椎骨折的有效修复方案,但胸腰椎压缩性骨折内固定取出后脊柱角度丢失是较为常见的并发症,经皮椎体成形术可能是预防脊柱角度丢失的较好选择。  目的:观察骨水泥强化椎弓根螺钉置入内固定修复L1压缩性骨折的临床疗效及并发症,并与单纯椎弓根螺钉内固定比较。  方法:纳入L1压缩性骨折患者76例,根据内固定修复方案分为两组,经皮椎体成形组40例行骨水泥联合椎弓根螺钉置入内固定治疗,单纯椎弓根内固定组36例仅行椎弓根螺钉置入内固定治疗。比较两组的修复效果,置入后即刻、置入后3,6个月以伤椎为中心进行MRI检查测量Cobb角、伤椎椎体前缘高度,同时记录目测类比评分;另外了解有无内固定松动断裂。  结果与结论:两组患者随访6个月内均获骨性愈合,无螺钉松动、折断。两组置入后6个月损伤节段后凸Cobb角、伤椎椎体前缘高度均较置入前明显改善(P0.05)。表明应用骨水泥强化椎弓根螺钉内固定及椎弓根钉内固定修复L1压缩性均可获得满意复位,重建椎体高度。但抗压稳定性结果表明应用骨水泥强化椎弓根螺钉内固定的固定效果更好一些,未见短期断钉、矫正丢失等并发症,椎体骨水泥灌注可提高椎弓根螺钉置入后的稳定性。%BACKGROUND:Vertebroplasty and edicle screw fixation are effective repair methods for thoracolumbar fractures. Spine angle loss is a more common complication after removal of implant for thoracolumbar compression fractures. Percutaneous vertebroplasty may be a better choice for preventing spine angle loss. OBJECTIVE:To investigate the clinical curative effect and complication of pedicle screw fixation with bone cement for repair of L1 compression fractures, and to compare with pedicle screw fixation alone. METHODS: A total

  8. Correção de falhas ósseas diafisárias: trasnporte ósseo fixado com placa Corretive procedure in diaphyseal bone gaps: bone trasnpot fixated with plate

    Directory of Open Access Journals (Sweden)

    Celso Hermínio Ferraz Picado

    2007-01-01

    Full Text Available O objetivo deste estudo é descrever um novo sistema de transporte ósseo que dispensa o uso de fios transfixantes. O sistema, constituído por uma placa, um carro móvel e por um dispositivo tracionador, foi instalado na tíbia direita de 17 ovelhas para preencher um defeito ósseo de 1 cm. O transporte ósseo foi iniciado 7 dias após a cirurgia numa taxa de 0,8 mm/dia, dividido em 0,2 mm a cada 6 horas. Radiografias em ântero-posterior e perfil foram realizadas imediatamente após a cirurgia e semanalmente até o término do transporte. Em todos os 12 animais que completaram o estudo, o defeito ósseo foi preenchido com formação do regenerado e consolidação do foco alvo. O estudo demonstra que o sistema aqui apresentado realiza o transporte ósseo de maneira efetiva, eliminando o uso de fios ou pinos transfixantes.The objective of this study is to describe a new bone transport system not requiring the use of transfixating wires. The system, which is constituted by a plate, a movable conveyor and a hauling device, was set up on the right tibia of 17 sheep intending to fill a 1-cm bone gap. Bone transport started 7 days after surgery on a rate of 0.8 mm/day, divided into 0.2 mm at each 6 hours. X-ray images of anteroposterior and lateral planes were taken immediately after surgery and on a weekly basis until transport was finished. In all 12 animals completing the study, the bone gap was filled with regenerated formation and target focus consolidation. The study shows that the system presented here effectively performs bone transport, eliminating the use of transfixating wires or pins.

  9. Studies on Poly(propylene fumarate-co-caprolactone diol Thermoset Composites towards the Development of Biodegradable Bone Fixation Devices

    Directory of Open Access Journals (Sweden)

    M. Jayabalan

    2009-01-01

    Full Text Available The effect of reinforcement in the cross-linked poly(propylene fumarate-co-caprolactone diol thermoset composites based on Kevlar fibres and hydroxyapatite was studied. Cross-linked poly(propylene fumarate-co-caprolactone diol was also studied without any reinforcement for comparison. The reinforcing fibre acts as a barrier for the curing reaction leading to longer setting time and lesser cross-link density. The fibre and HA reinforced composites have almost the same compressive strength. Nonreinforced material undergoes greater degree of swelling. Among the reinforced materials, the hydroxyapatite reinforced composite has a much higher swelling percentage than the fibre reinforced one. The studies on in vitro degradation of the cured materials reveal hydrolytic degradation in Ringer's solution and PBS medium during aging. All the three materials are found to swell initially in Ringer's solution and PBS medium during aging and then undergo gradual degradation. Compression properties of these cross-linked composites increase with aging; HA reinforced composite has the highest compressive strength and compressive modulus, whereas the aged fibre-reinforced composite has the least compressive strength and modulus.

  10. 不同固定方式对腱-骨愈合界面影响的形态学研究%Effect of different fixations on tendon-bone healing interface:a morphological study

    Institute of Scientific and Technical Information of China (English)

    刘建锋; 李艳菊

    2013-01-01

    背景:关节镜下重建交叉韧带已得到广泛应用,关于腱骨愈合状态的研究多集中在患肢功能恢复以及愈合程度及稳定性观察方面。  目的:了解韧带重建过程中各种固定方式对肌腱-骨界面愈合的影响。  方法:2009年7月至2009年9月以长白二号体重100千克左右的八头成年猪的双膝关节作为实验对象进行动物实验,采用四种固定方式对腱-骨进行固定,包括纽扣接骨板悬吊固定、肌腱包裹自体松质骨方式、界面挤压螺钉固定、横穿可吸收钉固定,对手术后6周、12周时界面愈合的情况进行病理切片观察。  结果:纽扣接骨板固定模式腱骨界面愈合均匀,理论抗拉力大,相反固定物对腱骨界面干扰明显的界面愈合不理想,骨纤维细胞排列不整齐,理论拉力降低,尤其表现在界面挤压螺钉方面;对于有自体松质骨植入的在腱骨愈合过程中活性骨质坏死,无促进腱骨愈合的作用。  结论:在腱骨愈合过程中界面固定方式对早期愈合有不同程度的影响,悬吊固定方式腱-骨愈合界面形态学表现理想。%Background:The reconstruction of cruciate ligament under arthroscope has been widely applied. Nowadays, the study on tendon-bone healing is mostly focused on function recovery of patients and stability of healing. Objective:The purpose of the study is to explore the influence of different fixed styles to tendon-bone healing in the process of ligament reconstruction. Methods:From July 2009 to September 2009, eight adult Landrace II pigs weighing 100 kg was used as experiment animal and divided into four groups (n=2). Four tendon-bone fixed methods were applied in both knee in each group respectively, including button-plate suspension fixation, autologous bone tendon wrapped mode, interface extrusion screw, and adsorb-able screw. The healing of interface was observed at 6 and 12 weeks

  11. Engineering and commercialization of human-device interfaces, from bone to brain.

    Science.gov (United States)

    Knothe Tate, Melissa L; Detamore, Michael; Capadona, Jeffrey R; Woolley, Andrew; Knothe, Ulf

    2016-07-01

    Cutting edge developments in engineering of tissues, implants and devices allow for guidance and control of specific physiological structure-function relationships. Yet the engineering of functionally appropriate human-device interfaces represents an intractable challenge in the field. This leading opinion review outlines a set of current approaches as well as hurdles to design of interfaces that modulate transfer of information, i.a. forces, electrical potentials, chemical gradients and haptotactic paths, between endogenous and engineered body parts or tissues. The compendium is designed to bridge across currently separated disciplines by highlighting specific commonalities between seemingly disparate systems, e.g. musculoskeletal and nervous systems. We focus on specific examples from our own laboratories, demonstrating that the seemingly disparate musculoskeletal and nervous systems share common paradigms which can be harnessed to inspire innovative interface design solutions. Functional barrier interfaces that control molecular and biophysical traffic between tissue compartments of joints are addressed in an example of the knee. Furthermore, we describe the engineering of gradients for interfaces between endogenous and engineered tissues as well as between electrodes that physically and electrochemically couple the nervous and musculoskeletal systems. Finally, to promote translation of newly developed technologies into products, protocols, and treatments that benefit the patients who need them most, regulatory and technical challenges and opportunities are addressed on hand from an example of an implant cum delivery device that can be used to heal soft and hard tissues, from brain to bone. PMID:27108404

  12. Bone transportion by composite external fixator on refractory chronic osteomyelitis of femur%组合式外固定架骨搬运术治疗难治性股骨慢性骨髓炎疗效评价

    Institute of Scientific and Technical Information of China (English)

    海国栋; 张春雷

    2014-01-01

    Objective To evaluate the clinical effect of bone transport by composite external fixator on chronic osteomyelitis of femur. Methods Thirteen patients with bone defect of femur after chronic osteomyelitis were treated by bone transport with composite external fixator. The mean length of the bone defect was 8. 7 cm. Results All patients were followed up for 21-32 months. The bone lengthening area grew well,the length of callus distraction was 6. 8~14. 5 cm,and the mean radiographic con-solidation index was 19. 7 d/cm. According to the Paley’s criteria,the healing effect of 10 cases was excellent,and that of the rest 3 cases was good. The functional recovery of 9 cases was excellent,and that of the rest 4 cases was good. Conclusion Bone trans-port by composite external fixator is a reliable method in the reconstruction of bone defect caused by chronic osteomyelitis.%目的:评价应用组合式外固定架骨搬运术治疗股骨慢性骨髓炎的临床疗效。方法应用组合式外固定架骨搬运技术治疗13例股骨慢性骨髓炎清除后骨缺损,平均骨缺损长度8.7 cm。结果随访21~32个月,骨缺损接触并全部愈合,骨延长区骨生长满意,切口一期愈合,窦道和骨外露消失。骨延长6.8~14.5 cm,平均外固定指数19.7 d/cm。依据Paley 的评定标准进行骨愈合评定,优为11例,良为2例;功能评定优为9例,良为4例。结论组合式外固定架骨搬运术是治疗难治性股骨慢性骨髓炎可靠方法。

  13. 三种固定器械固定胫骨骨折的应力松弛实验%Stress relaxation study of tibial fractures treated by three types of fixation devices

    Institute of Scientific and Technical Information of China (English)

    吴志峰; 李艳玲; 刘光耀; 马洪顺

    2012-01-01

    背景:骨力学是生物力学的分支,研究内外固定器固定骨折后的生物力学特性是评价固定效果的重要方法之一.目的:比较3种内外固定器械固定胫骨骨折后骨的应力松弛特性.方法:模拟胫骨骨折分别以髓内钉,钢板,外固定支架进行固定.在电子万能试验机上对3组标本进行轴向压缩应力松弛实验.结果与结论:从各组内、外固定标本轴向压缩应力松弛曲线可以看出,外固定支架组7 200 s应力松弛量大于钢板和髓内钉组,但差异无显著性意义(P > 0.05).初步表明股骨颈骨折钢板固定、髓内钉固定、外固定支架固定后对骨的应力松弛特性影响基本一致.%BACKGROUND: Bone mechanics is a branch of biomechanics. Biomechanical property research of fractures after internal andexternal fixation is an important method to estimate the fixed-effects.OBJECTIVE: To compare the stress relaxation properties of tibial fractures fixed by three different internal and external fixationdevices.METHODS: The simulated tibial fractures were fixed by the intramedullary nails, plate, and external fixation respectively. Axialcompression stress relaxation experiment was performed in the specimens of the three groups using electronic universal testingmachine.RESULTS AND CONCLUSION: Axial compression stress relaxation curves of the specimens fixed with internal and externalfixation in each group showed that the stress relaxation at 7 200 s in the external fixation group was higher than those of the platefixation group and the intramedullary nail fixation group, but the differences were not significant (P > 0.05). The results preliminaryshowed that the effects of plate fixation, intramedullary nail fixation, and external fixation on stress relaxation property of bone infemoral neck fractures were similar.

  14. Femoral Reconstruction Using External Fixation

    Directory of Open Access Journals (Sweden)

    Yevgeniy Palatnik

    2011-01-01

    Full Text Available Background. The use of an external fixator for the purpose of distraction osteogenesis has been applied to a wide range of orthopedic problems caused by such diverse etiologies as congenital disease, metabolic conditions, infections, traumatic injuries, and congenital short stature. The purpose of this study was to analyze our experience of utilizing this method in patients undergoing a variety of orthopedic procedures of the femur. Methods. We retrospectively reviewed our experience of using external fixation for femoral reconstruction. Three subgroups were defined based on the primary reconstruction goal lengthening, deformity correction, and repair of nonunion/bone defect. Factors such as leg length discrepancy (LLD, limb alignment, and external fixation time and complications were evaluated for the entire group and the 3 subgroups. Results. There was substantial improvement in the overall LLD, femoral length discrepancy, and limb alignment as measured by mechanical axis deviation (MAD and lateral distal femoral angle (LDFA for the entire group as well as the subgroups. Conclusions. The Ilizarov external fixator allows for decreased surgical exposure and preservation of blood supply to bone, avoidance of bone grafting and internal fixation, and simultaneous lengthening and deformity correction, making it a very useful technique for femoral reconstruction.

  15. Better performance with bone-anchored hearing aid than acoustic devices in patients with severe air-bone gap

    NARCIS (Netherlands)

    Wolf, M.J. de; Hendrix, S.; Cremers, C.W.R.J.; Snik, A.F.M.

    2011-01-01

    OBJECTIVES/HYPOTHESIS: A study performed in the 1990s with analogue linear hearing aids showed that in patients with mixed hearing loss and an air-bone gap that exceeded 25 to 30 dB, speech perception was better with a bone-anchored hearing aid (Baha) than with a conventional behind-the-ear (BTE) de

  16. Bone

    Science.gov (United States)

    Helmberger, Thomas K.; Hoffmann, Ralf-Thorsten

    The typical clinical signs in bone tumours are pain, destruction and destabilization, immobilization, neurologic deficits, and finally functional impairment. Primary malignant bone tumours are a rare entity, accounting for about 0.2% of all malignancies. Also benign primary bone tumours are in total rare and mostly asymptomatic. The most common symptomatic benign bone tumour is osteoid osteoma with an incidence of 1:2000.

  17. Clinical and Analytical Evaluation of a Single-Vial Stool Collection Device with Formalin-Free Fixative for Improved Processing and Comprehensive Detection of Gastrointestinal Parasites.

    Science.gov (United States)

    Couturier, Brianne A; Jensen, Ryan; Arias, Nora; Heffron, Michael; Gubler, Elyse; Case, Kristin; Gowans, Jason; Couturier, Marc Roger

    2015-08-01

    Microscopic examination of feces is a standard laboratory method for diagnosing gastrointestinal parasite infections. In North America, the ovum and parasite (O&P) examination is typically performed using stool that is chemically fixed in polyvinyl alcohol (PVA) and formalin, after which the stool is concentrated by filtration to enhance sensitivity. Mini Parasep solvent-free (SF) tubes allow collection and concentration within a single collection vial. The goal of the study was to determine whether consolidated processing and concentration with the Parasep tubes using an alcohol-based fixative (Alcorfix) provide O&P examinations equivalent to or better than those done by processing of PVA-formalin-fixed stool using a SpinCon concentration device. Parasep tubes revealed filtration performance equivalent to that of the SpinCon concentration device using PVA-formalin-fixed stool containing protozoa. Specimens cocollected in Parasep tubes containing PVA-formalin and Alcorfix revealed comparable morphology and staining for various protozoa. Alcorfix effectively fixed live Cryptosporidium and microsporidia such that morphology and staining were conserved for modified acid-fast and modified trichrome stains. A work flow analysis revealed significant time savings for batches of 10 or 30 O&P specimens in tubes with Alcorfix compared to the amount of time that it took to analyze the same number of specimens in tubes with PVA-formalin. The direct hands-on time savings with Mini Parasep tubes were 17 min and 41 s and 32 min and 1 s for batches of 10 and 30 specimens, respectively. Parasep tubes containing Alcorfix provide significant work flow advantages to laboratories that process medium to high volumes of O&P specimens by streamlining processing and converting to a single tube. These improvements in work flow, reduction of the amount of formalin used in the laboratory, and equivalent microscopy results are attractive advancements in O&P testing for North American

  18. Effect of plaster external fixation on the histomorphological changes for bone-tendon junction healing%石膏外固定修复兔髌骨-腱连接点断裂的组织形态学变化

    Institute of Scientific and Technical Information of China (English)

    王靖; 张朝跃; 谭财福

    2012-01-01

    BACKGROUND: Plaster external fixation has a positive effect on bone-tendon junction healing, but there is no in-depth study on the repair mechanism.OBJECTIVE: To investigate the effect of plaster external fixation on the histomorphological changes for bone-tendon junction healing.METHODS: The bone-tendon junction healing models were established by cutting off the junction between the patellar tip and the patellar tendon as well as the distal part of the patella. The models were divided into experimental group and model group. The models in the experimental group were performed with plaster external fixation and those in the model group were without fixation. Each group got the sample at 2, 4 and 8 weeks after operation.RESULTS AND CONCLUSION: Hematoxylin-eosin staining, Safranin'O staining, macrophages immunohistochemistry staining and integral absorbance showed that the tissue edema and adhesion at the bone-tendon junction in the experimental group were better than those in the model group, cartilage cells and bone tissue formation and differentiation in the experimental group were significantly better those those in the model group, and degree of the inflammation in the experimental group was light and disappeared quickly. External fixation can accelerate the process of bone-tendon repair and promote the healing.%背景 石膏外固定对髌骨-腱连接点断裂的治疗作用肯定,但相关修复机制一直未有深入研究.目的 观察石膏外固定对髌骨-腱连接点断裂修复的组织形态学改变.方法 切断髌尖与髌腱连接处并切除远端部分髌骨建立兔髌骨-腱连接点损伤模型,实验组在造模的基础上给予石膏外固定,模型组不予固定,分别在造模后2,4,8 周取材.结果与结论 苏木精-伊红染色、Safranin'O 染色和巨噬细胞免疫组化染色及其积分吸光度检测均显示实验组造模后骨-腱结合部组织修复快,软骨细胞及骨组织的形成、分化明显优于模型组,

  19. 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

  20. 不同固定、脱钙方式对骨组织常规制片的影响%The Influence of Different Way of Fixation and Decalcification on the Conventional Slide of Bone Tissue

    Institute of Scientific and Technical Information of China (English)

    万俊峰; 王影; 侯俊

    2012-01-01

    目的 通过对骨标本不同固定和脱钙方式的比较,探索适合于骨标本的固定和脱钙方式.方法 分别采取先固定后脱钙、同时固定加脱钙和先脱钙后固定这三种方式对50例长骨肿瘤标本进行对比分析.结果 先固定后脱钙组常规HE染色效果优于同步固定脱钙组,但两组比较差异无统计学意义(P>0.05),该两组常规染色效果均明显优于先脱钙后固定组(P 0. 05) . The routine HE staining results of the DAF and DWF group were better than that of the DBF group with significantly difference(P <0. 01) . Conclusion; For the routine HE slide of bone tissue, the way of fixation is very important. Decalcification should be conducted before fixation or performed simultaneously with fixation. The DBF methodis not recommended.

  1. 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.

  2. Bone

    International Nuclear Information System (INIS)

    Bone scanning provides information on the extent of primary bone tumors, on possible metastatic disease, on the presence of osteomyelitis prior to observation of roentgenographic changes so that earlier therapy is possible, on the presence of collagen diseases, on the presence of fractures not disclosed by x-ray films, and on the evaluation of aseptic necrosis. However, the total effect and contribution of bone scanning to the diagnosis, treatment, and ultimate prognosis of pediatric skeletal diseases is, as yet, unknown. (auth)

  3. 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

  4. 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

  5. Comparative study of external fixation device and interlocking intramedullary nail in treatment of tibiofibular fractures%外固定支架和带锁髓内钉治疗胫腓骨骨折的对比研究

    Institute of Scientific and Technical Information of China (English)

    金粉勤; 薛锋; 徐雪荣

    2013-01-01

    Objective To compare curative effect of tibiofibular fractures treated by external fixation device and interlocking intramedullary nail.Methods A total of 121 patients with tibiofibular fractures were included in the study and were divided into external fixator group (56 patients) and interlocking intramedullary nail group (65 patients),according to diverse surgical approaches.The two groups were compared in indices of postoperative good-excellent rate,intraoperative blood loss,operation time,subsided time of postoperative swelling,hospital stay,fracture healing time,time of fixation removal and incidence of postoperative complications.Results The postoperative excellence rate in external fixator group and interlocking intramedullary nail group was 88% and 89%,respectively (P > 0.05).Compared with interlocking intramedullary nail group,the intraoperative blood loss was reduced more in external fixator group,with more evidently shortened operation time,subsided time of postoperative swelling and hospital stay (P < 0.01).Fracture healing time and time of fixation removal,however,were significantly shorter in the interlocking intramedullary nail group than those in the external fixator group (P < 0.01).Incidence of postoperative complications was 11% in the external fixator group and 28% in the interlocking intramedullary nail group (P <0.05).Conclusions External fixation device and interlocking intramedullary nail are both effective in treatment of tibial and fibular fractures.External fixation device with less damage to tissue is relatively more helpful to postoperative recovery.On the contrary,the interlocking intramedullary nail is relatively more conducive to fracture healing.%目的 比较外固定支架和带锁髓内钉内固定治疗胫腓骨骨折的疗效. 方法 选择121例胫腓骨骨折患者,根据手术方式不同分为外固定支架组(56例)和带锁髓内钉组(65例).比较两组患者术后优良率、术中出血量、手术

  6. Biomechanical comparison of interspinous distraction device and facet screw fixation system on the motion of lumbar spine: a finite element analysis

    Institute of Scientific and Technical Information of China (English)

    Wang Hongwei; Wang Xiaohong; Chen Wenchuan; Zhao Fuqiang; Xiang Liangbi; Zhou Yue; Cheng Chengkung

    2014-01-01

    Background A large amount of biomechanical and clinical evidence from previous studies suggest the efficiency of the two different posterior lumber non-fusion methods,interspinous distraction device (ISDD) and facet screw fixation system (FSS),but the biomechanical comparison of ISDD and FSS has not been thoroughly clarified.Methods In the current study,finite element methods were used to investigate the biomechanical comparison of ISDD and FSS.The range of motion (ROM),intradiscal pressure (IDP) and the protective effects gained by maintaining disc heights were evaluated.Results The ROM was similar between the two non-fusion methods under static standing,flexion and lateral bending.The FSS appeared to be more effective in resisting extension.At the implanted level L3/4,FSS displayed better results for maintaining and increasing posterior disc heights.At the L4/5 level in extension and lateral bending,FSS was better than ISDD,with comparable results observed in other motions.Comparing the posterior and lateral disc heights,FSS appeared to be more effective than ISDD.FSS also had a minor effect on the inferior adjacent segment than ISDD.FSS was more effective in reducing IDP than ISDD in extension.Conclusion Through the finite element analysis study,it can be seen that FSS demonstrates more beneficial biomechanical outcomes than does ISDD,such as being more effective in resisting extension,maintaining and increasing lumbar disc heights and reducing the inferior adjacent IDP in extension.

  7. Hollow-Bone-Graft Dynamic Hip Screw Can Fix and Promote Bone Union after Femoral Neck Fracture: an Experimental Research

    Directory of Open Access Journals (Sweden)

    Jia-zuo SHEN, Jian-fei YAO, Da-sheng LIN, Ke-jian LIAN, Zhen-qi DING, Bin LIN, Zhi-min GUO, Ming-hua ZHANG, Qiang LI, Lin LI, Peng QI

    2012-01-01

    Full Text Available Background: Delayed bone union, nonunion or osteonecrosis often occur after femoral neck fractures in young adults. Secondary bone healing requires strong internal fixation, intramedullary pressure reduction and early functional exercise.Objective: To compare bone healing of femoral neck fractures treated with hollow-bone-graft dynamic hip screws (Hb-DHS and standard dynamic hip screws (DHS in an animal model.Design: Testing of specifically designed fixation devices in a pig animal model.Interventions/Methods: We designed Hb-DHS and DHS devices appropriate to the femoral neck and head of experimental animals and used them in eight pigs (4-month-old, male or female, 30-40 kg/each. Under anesthesia, we induced medium neck type, Garden III type femoral neck fractures in each pig with fracture gaps of 0.5 mm and then fixed each left femur with Hb-DHS and each right femur with DHS. We assessed the animals radiographically and by postmortem visual appraisal of evidence of bone healing 8 and 16 weeks postoperatively.Results: There were significant differences in radiographic and general findings between the Hb-DHS and DHS groups at weeks 8 and 16 postoperatively. We found statistically significant differences between the Hb-DHS and DHS groups in bone healing scores, trabecular bone volume percentage and bone mineral density as assessed on plain radiographs and computed tomography images (P < 0.05. There were also significant differences between the Hb-DHS and DHS groups in postmortem visually assessed indicators of bone healing at both 8 and 16 weeks postoperatively.Conclusions: The Hb-DHS device promotes femoral neck bone union, stimulates trabecular bone formation, increases BMD and has advantages over DHS for internal fixation of femoral neck fractures. This animal experiment will contribute to developing optimal treatment for femoral neck fractures in young adults.

  8. Biomechanical evaluation of fixation degree of fragments by periosteal osteosynthesis

    Directory of Open Access Journals (Sweden)

    Barabash Yu.A.

    2010-09-01

    Full Text Available Expansion of indications for surgery and plate osteosynthesis of long bones points to increased number of complications caused by instability of fragments, that can be associated in their turn with constructive features or iatrogenic factors. Insufficient rigidity of fragment fixation is due to incorrect technical treatment and wrong choice of fixator. Biomechanical parameters of periosteal fixation rigidity have been experimentally proved, depending on fixator lever

  9. 骨水泥强化椎弓根螺钉固定对骨质疏松患者有利无弊?★%Pedicle screw fixation augmented with bone cement benefits osteoporosis patients?

    Institute of Scientific and Technical Information of China (English)

    岳文峰; 夏虹; 王建华

    2013-01-01

    BACKGROUND:During the pedicle screw fixation for lumbar disease patients accompanied with osteoporosis, addition of bone cement in osteoporotic vertebral body can significantly increase the stability of internal fixation, but the effect on adjacent segments is not clear. OBJECTIVE:To observe the effect on adjacent segments of osteoporosis patients after pedicle screw fixation augmented with bone cement in early and medium-term fol ow-up period. METHODS:We reviewed the medical information of 87 patients suffering from lumbar disease accompanied with osteoporosis who underwent operation of pedicle screw fixation and posterior lumbar spinal decompression, and the patients were divided into three groups:conventional pedicle screw group, conventional pedicle screw+bone cement group, novel perfusional pedicle screw+bone cement group. The samples were fol owed-up for 6-18 months, averaged 9 months. The Oswestry disability index, intervertebral distance of the upper adjacent segments, deformation index of the upper adjacent vertebral body, concave angle of the fixed lumbar vertebrae superior end-plate and the upper adjacent vertebral body inferior end-plate, and Cobb angle were measured before operation, at 3 days postoperation and during final fol ow-up. RESULTS AND CONCLUSION:The Oswestry disability index of the final fol ow-up in the three groups were decreased when compared with that before operation (P0.05). This showed that in posterior spinal fixation operation, there was no significant difference in the early and medium-term subjective effect between addition of bone cement or not and different adding ways, and addition of bone cement or not and different adding ways could remarkably improve the life quality of the patients. The change of Cobb angle of fixed lumbar vertebrae between the final fol ow-up and 3 days after operation in conventional pedicle screw+bone cement group and novel perfusional pedicle screw+bone cement group was both less than that in the

  10. Internal fixation: a historical review.

    Science.gov (United States)

    Greenhagen, Robert M; Johnson, Adam R; Joseph, Alison

    2011-08-01

    Internal fixation has become a pillar of surgical specialties, yet the evolution of these devices has been relatively short. The first known description of medical management of a fracture was found in the Edwin Smith Papyrus of Ancient Egypt (circa 2600 bc). The first description of internal fixation in the medical literature was in the 18th century. The advancement of techniques and technology over the last 150 years has helped to preserve both life and function. The pace of advancement continues to accelerate as surgeons continue to seek new technology for osseous fixation. The authors present a thorough review of the history of internal fixation and the transformation into a multibillion dollar industry. PMID:21944395

  11. Biomechanics of cortical bone allografts among different fixation modes%异体皮质骨板不同固定方式的生物力学比较

    Institute of Scientific and Technical Information of China (English)

    张仁明; 廖瑛; 李宝兴; 余黎明

    2008-01-01

    BACKGROUND:The materials for internal fixation of bone allografts have been used in the clinic.However,they are only used in the regions bearing little stress because of low strength.The focus of current studies is how to enhance the fixation strength of the materials to expand application range.OBJECTIVE:To compare the strength difference of cortical bone allografts among different fixation modes and to investigate the possible mechanisms of action.DESIGN,TIME AND SETTING:An in vitro biomechanical experiment was performed at the Laboratory of Biomechanics,Nanhua University between October 2005 and March 2006.MATERIALS:Twenty-seven pieces of cadaveric femurs were included in this study.A total of 45 cortical bone allografts with a size of 110 mm×10 mm×3 mm and 90 bone screws were also used.METHODS:Twenty-seven femurs were made into simulated fracture models and randomized to 3 groups,with 9 models per group:A,B,and C.In the group A,the models were fixed with two cortical bone all6grafts; the models from the groups B and C were fixed with two bone allografts plus 5 bone screws and one bone allograft plus 5 bone screws accordingly.MAIN OUTCOME MEASURES:Biomechanical tests were performed in the above-mentioned 3 groups to measure compressive,bending and torsional stiffness as well as the maximum loads.RESULTS:Different fixation models displayed different mechanical characteristics.The group A exhibited similar compressive stiffness compared to the group B,but the level was significantly higher compared to the group C (P < 0.05).The other two stiffness parameters including bending and torsion were significantly greater in the group A than in the groups B and C (P < 0.05).The maximum loads of compression,bending,and torsion were significantly greater in the group A compared to the group B (P < 0.05) and group C (P < 0.01).CONCLUSION:The strength of bone allograft is highly related to fixation mode. The two bone allografts showed greater strength and stiffness

  12. 双维控制牙槽骨牵张器的成骨效应%A bidirectional alveolar bone distraction device for osteogenesis of alveolar bone

    Institute of Scientific and Technical Information of China (English)

    黄代营; 聂二民; 孙明; 黎炽彬

    2011-01-01

    背景:牵张成骨增高牙槽嵴在基础研究及临床已有很多成功报道,双维控制垂直牙槽骨牵张器可有效防止单向直线牵张器行牙槽骨牵张发生轴向移位.目的:研制双维控制的牙槽骨牵张器,并通过动物实验观察其成骨效应.方法:选择杂种犬4只,拔除一侧下颌前磨牙形成萎缩牙槽骨模型.1个月后行骨切开放置双维牵张器,7 d后垂直牵张 (1 mm/d,共5 d).完成垂直牵张后,利用双维牵张器颊向控制功能将移动骨块颊向牵出(大约2.4 mm),固定2个月后行大体观察及组织学检查.结果与结论:4只犬中2只黏膜伤口愈合良好,2只黏膜出现裂开,行二次缝合后愈合,牵张器固位良好,未出现松动、脱落.牵张骨块向垂直向及颊向的位移量满足实验目的要求,牙槽骨垂直向高度平均增加(5.0±0.2) mm,颊向宽度平均增加(2.4±0.3) mm.大体观察及组织学检查均证实牵张成骨的骨块新骨形成良好.说明双维控制垂直牙槽骨牵张器能较好的控制移动骨块垂直或颊向的移动方向,并且新骨形成良好.%BACKGROUND: Alveolar bone augmentation using a unidirectional dist raction device may lead to axial displacement. Abidirectional distraction device can control the vertical and buccal-lingual directions. But studies regarding this have been rarelyreported.OBJECTIVE: To develop a bidirectional alveolar bone distraction device and to investigate its effects on osteogenic effectsthrough an animal experiment.METHODS: Four adult mongrel dogs were established into models of alveolar bone atrophy by extraction of unilateral mandiblepremolars. After 1 month, alveolar bone was cut open and a bilateral distraction device was placed. Seven days later, thedistraction was started at a rate of 1 mm/day for 5 days. At last, buccal-lingual direction distraction (approximately 2.4 mm) wastaken for once, followed by a consolidation period of 2 months. Subsequently, gross observation and

  13. Experience of Clinical the Load of Streptomycin Powder Bone Morselized Bone Fusion and Internal Fixation for the Treatment of Spinal Tuberculosis%负载链霉素粉骨颗粒植骨融合内固定术治疗脊柱结核的治疗体会

    Institute of Scientific and Technical Information of China (English)

    王永松; 王冶; 陈志龙; 王群芳

    2015-01-01

    目的:探讨负载链霉素粉骨颗粒植入融合及内固定术治疗脊柱结核的临床疗效和应用价值。方法对16例脊柱结核使用一期病灶清除,带链霉素粉骨颗粒植入融合和钉棒系统内固定治疗。结果术后腰痛缓解93.2%。术后1年X线片植骨融合率达96.2%。结论治疗腰椎结核采用一期病灶清除,负载链霉素粉骨颗粒植入融合,钉棒系统内固定具有良好的效果。%Objective To evaluate the load streptomycin powder particles are bone fusion and internal fixation in the treatment of spinal tuberculosis curative ef ect and application value. Methods 16 cases of spinal tuberculosis using a phase lesions cleared, with streptomycin powder particles are bone fusion and good nail internal fixation treatment system. Results 93.2% postoperative back pain relief. A year after X line piece of bone graft fusion rate was 96.2%. Conclusion Treatment of lumbar spinal tuberculosis using a phase lesions cleared, load streptomycin powder particles are bone fusion and internal fixation of screw rod system has a good ef ect.

  14. 骨水泥和纳米骨浆强化椎弓根螺钉植入固定骨质疏松椎体的生物力学特点%Bone cement and nano bone putty strengthen pedicle screw implantation in the fixation of osteoporotic vertebral body:biomechanical characteristics

    Institute of Scientific and Technical Information of China (English)

    卢小兵; 孟祥翔

    2015-01-01

    BACKGROUND:Nano bone putty and bone cement injection are two common methods to strengthen the fixation of pedicle screws, but there are relatively few reports on the comparison of their strengthening effects. OBJECTIVE:To compare the biomechanical characteristics of bone cement and nano bone putty strengthening pedicle screw implantation in the fixation of osteoporotic vertebral body. METHODS: Totaly 24 human cadaveric pedicles were obtained, which were al in line with osteoporosis standards, and randomly divided into 3 groups: control group (only implanted pedicle screws), bone cement group (first injected bone cement in the nail channel, and then implanted pedicle screws) and nano bone putty group (first injected nano bone putty in the nail channel, and then implanted pedicle screws). After 2 hours of implantation, the maximum axial pulout strength and the maximum rotation torque of specimens in each group were determined. RESULTS AND CONCLUSION:The maximum axial pulout strength and maximum rotation torque of the bone cement and the nano bone putty groups were greater than those of the control group (P < 0.05), and the maximum axial pulout strength and the maximum rotation torque of the bone cement group were greater than those of the nano bone putty group (P < 0.05). These results demonstrate that the maximum axial pulout strength and the maximum rotation torque of pedicle screw implantation in the fixation of osteoporotic vertebral body can be effectively improved by injection of bone cement and nano bone putty, and the strengthening effect of bone cement is more obvious. %背景:纳米骨浆和骨水泥注入是强化椎弓根螺钉固定的两种常用方法,但目前关于两种加强方法的强化效果比较的报道相对较少。目的:对比骨水泥或纳米骨浆强化椎弓根螺钉植入固定骨质疏松椎体的生物力学特点。方法:取24个人尸体椎弓根,均符合骨质疏松标准,随机均分为3组,对照组仅植

  15. Resorbable dome device and guided bone regeneration: an alternative bony defect treatment around implants. A case series.

    Science.gov (United States)

    Parma-Benfenati, Stefano; Roncati, Marisa; Galletti, Primo; Tinti, Carlo

    2014-01-01

    This case series presents the use of a resorbable "dome device" made of a slow, long-lasting resorbable suturing material to support the barrier creating and maintaining a secluded space to promote bone regeneration. Acellular dermal matrix or cross-linked resorbable collagen membrane, as barriers, combined with mineralized freeze-dried bone allograft, with simultaneous implant placement, were utilized in reconstructing non-space-making defects. Eight implants in six healthy patients were treated with a combination of these resorbable regenerative materials. Only one of seven was treated with a nonsubmerged approach. All sites remained completely covered and no implant exposure occurred during healing. At the 9- to 24-month reentry surgeries, the clinical bone density was equivalent to that of the native bone and the mean number of final exposed threads was 0.5. The mean buccal bone thickness achieved was 3.12 mm, with a mean total coverage of exposed threads in approximately 87.5% of the cases.

  16. Analysis and an overview of fixators in medicine and the methods of processing materials for producing fixators

    Directory of Open Access Journals (Sweden)

    Dalibor Milojko Đenadić

    2013-06-01

    Full Text Available The fixator is a medical device that provides support to fractured biological structures. Metal biomaterials are mainly used for replacing broken or damaged hard tissues such as bones because of their high strenght, toughness and corrosion resistance. Materials such as stainless steel, titanium and aluminium alloys (Ti-6Al-4V, cobalt and chromium alloys, composite materials and other biocompatible materials are used in orthopedy for the stabilization of connective tissue injuries or as a substitute for the bone tissues. Fixators are classified according to the place of installation to external and internal fixators. Widely used medical fixators are pins, rods plates, screws, pipes, wires, nails and external fixators. Conventional and non-conventional methods of processing are used in the production process for all types of fixators. Introduction Fixators are medical devices manufactured to support damaged biological structures. In the field of orthopedic surgery that deals with skeletal disorders such as bone, spine, joints, muscles and tendons injuries and diseases, various metals, titanium and cobalt alloys etc. are used to stabilize the supporting tissue injuries or as a substitute for bone tissues. Metallic implants are frequently used in orthopedic surgery as joint prosthesis (hip, knee and elbow fracture fixation devices (plates, screws, external fixators and devices for the fixation of the spine. In principle, fixators are devided into external and internal ones, depending on the place of installation (outside or inside the body. The most common types of medical fixators are pins, rods and plates. This paper presents some of the most common materials used for the production of fixators, their processing and possibilties of use in medicine for various purposes. Types of fixators and materials used for their production Nowadays, biocompatible materials are usually used for the production of fixators and implants. These materials show good

  17. Complications of rigid internal fixation.

    Science.gov (United States)

    Campbell, Chris A; Lin, Kant Y

    2009-03-01

    Over the past 20 years, there have been many advances in the development of bone fixation systems used in the practice of craniomaxillofacial surgery. As surgical practices have evolved, the complications of each technologic advance have changed accordingly. Interfragmentary instability of interosseous wiring has been replaced by the risk of exposure, infection, and palpability of plate and screw fixation systems. The improved rigidity of plate fixation requires anatomic alignment of fracture fragments. Failure to obtain proper alignment has led to the phenomenon known as "open internal fixation" of fracture fragments without proper reduction. The size of the plates has decreased to minimize palpability and exposure. However limitations in their application have been encountered due to the physiologic forces of the muscles of mastication and bone healing. In the pediatric population, the long-standing presence of plates in the cranial vault resulted in reports of transcranial migration and growth restriction. These findings led to the development of resorbable plating systems, which are associated with self-limited plate palpability and soft tissue inflammatory reactions. Any rigid system including these produces growth restriction in varying amounts. In this discussion, we review the reported complication rates of miniplating and microplating systems as well as absorptive plating systems in elective and traumatic craniofacial surgery.

  18. Biological fixation in anterior cruciate ligament surgery

    Directory of Open Access Journals (Sweden)

    Chih-Hwa Chen

    2014-04-01

    Full Text Available Successful anterior cruciate ligament (ACL reconstruction with tendon graft requires extensive tendon-to-bone healing in the bone tunnels and progressive graft ligamentization for biological, structural, and functional recovery of the ACL. Improvement in graft-to-bone healing is crucial for facilitating early, aggressive rehabilitation after surgery to ensure an early return to pre-injury activity levels. The use of various biomaterials for enhancing the healing of tendon grafts in bone tunnels has been developed. With the biological enhancement of tendon-to-bone healing, biological fixation of the tendon graft in the tunnel can be achieved in ACL reconstruction.

  19. Review of 31 cases of anterior thoracolumbar fixation with the anterior thoracolumbar locking plate system.

    Science.gov (United States)

    Wilson, J A; Bowen, S; Branch, C L; Meredith, J W

    1999-07-15

    Anterior fixation devices for the thoracolumbar spine have gained wide acceptance as viable alternatives to long-segment posterior fixation in cases of thoracolumbar spine trauma. This review was undertaken to evaluate the safety and efficacy of the Synthes anterior thoracolumbar locking plate (ATLP) system. Over a 3-year period, 31 patients with unstable traumatic fractures of the thoracolumbar spine underwent corpectomy, placement of a structural bone graft, and anterior fixation in which the Synthes ATLP system was used. Long-term follow-up data were obtained in 29 patients. Two patients were lost to follow up, one at 4 months and the other at 1 year. In the remaining patients, the average length of follow up was 20 months. In all patients radiographic evidence of solid bone fusion was demonstrated on follow-up plain x-ray films, and there were no signs or symptoms of pseudarthrosis. No patient suffered neurological deterioration as a result of surgery, and there was relatively little morbidity associated with this plating system. To date, none of the patients in this study has developed any delayed complications related to the fixation device. In one patient, who had sustained a severe flexion injury, loosening of the anterior fixation device occurred, and the patient developed progressive kyphosis, which required a posterior stabilization procedure. These results appear slightly better than those obtained in published studies in which other anterior plating systems were used, indicating that this system is safe and effective in the treatment of unstable fractures of the thoracolumbar spine. PMID:16918232

  20. 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.

  1. Study on rehabilitative exercise for patients with long bone comminuted fractures of lower limbs after operation of external fixation combined with auto-graft bone implantation%下肢长骨粉碎性骨折进行髓腔内自体骨支撑并外固定后的康复治疗

    Institute of Scientific and Technical Information of China (English)

    石蛟; 刘殿梅; 曹国恒; 司志军

    2012-01-01

    Objective To study the effect of early rehabilitative exercise for patients with long bone comminuted fractures of lower limbs after operation of external fixation combined with auto - graft bone implantation. Methods Twelve patients with long bone comminuted fractures of lower limbs were allocated into this study. After operation by using external fixation combined with auto - graft bone implantation, early rehabilitative exercise had been applied to reinforce the strength of muscles in lower limbs and range of movement ( ROM ) in knees of these patients. After treatment for 12 months, the strength of muscles in lower limbs and ROM in knees were assessed for evaluating the effect of treatment. Results After rehabilitative therapy for 12 months, all patients obtained their normal muscle strength of lower limbs and ROM in knees. Conclusion Early rehabilitative therapy is an efficient method to improve activities of daily living for patients with long bone comminuted fractures of lower limbs after operation of external fixation combined with auto - graft bone implantation.%目的 探讨下肢长骨粉碎性骨折患者进行髓腔内自体骨支撑并外固定支架固定术后早期患肢进行康复训练的疗效.方法 对12例下肢长骨粉碎性骨折采用髓腔内自体骨支撑并外固定支架固定,术后1~3天采用镇痛、早期运动疗法及主、被动关节功能练习等综合康复锻炼.结果 12例经有效康复治疗关节的活动度达到生理要求,肌肉萎缩程度明显减轻.结论 下肢长骨粉碎性骨折进行髓腔内自体骨支撑并外固定支架固定术后早期康复治疗是保证肢体早期功能恢复的有效方法.

  2. Metallic Fixation of Mandibular Segmental Defects: Graft Immobilization and Orofacial Functional Maintenance

    Science.gov (United States)

    Shayesteh Moghaddam, Narges; Jahadakbar, Ahmadreza; Amerinatanzi, Amirhesam; Elahinia, Mohammad; Miller, Michael

    2016-01-01

    Background: The aim of this study is to investigate the behavior of the healthy mandible under maximum molar bite force to demonstrate the problems associated with the current standard of care procedures for mandibular segmental defect reconstruction (ie, use of Ti–6Al–4V hardware and either a single- or double-barrel fibular graft). With current Ti–6Al–4V mandibular reconstruction hardware, there is a significant stiffness mismatch among the hardware, graft, and the remaining host anatomy. How the distribution of mechanical forces through the mandible is altered after a segmental bone loss and reconstruction is incompletely understood. Methods: We studied a healthy adult mandible for stress, strain, and reaction force distribution during normal mastication. Stress distribution of this model was then used to study problems encountered after mandibular segmental defect reconstructive surgery. We model the use of both single- and double-barrel fibular grafts to repair the loss of the left M1–3 containing segment of the mandible. These simulations were done using 2 sets of plates with different thicknesses. Results: We found that the stiffness mismatching between the fixation hardware and the graft and host bone causes stress shielding of that bone and stress concentrations in the fixation hardware and screws. These effects are expected, especially during the bone healing period. However, long term, this abnormal stress–strain distribution may lead to either the hardware’s failure due to stress concentration or graft failure due to bone resorption as a result of stress shielding. We found that the stress–strain distribution is more normal with a double-barrel fibular graft. Additionally, we found that thinner fixation plates can reduce stress shielding. Conclusion: The proposed model can be used to evaluate the performance and optimization of the fixation device.

  3. Optimizing Stability in Femoral Neck Fracture Fixation.

    Science.gov (United States)

    Ye, Ye; Hao, Jiandong; Mauffrey, Cyril; Hammerberg, E Mark; Stahel, Philip F; Hak, David J

    2015-10-01

    Optimizing stability of femoral neck fracture fixation is important in obtaining a successful outcome. The mechanical problems and strategies for achieving optimal stability differ depending on patients' age and degree of osteoporosis. Femoral neck fractures in younger adults usually result from high-energy trauma and have a vertical fracture pattern. Strategies for optimizing fixation stability in this group include placing additional screws at right angles to the fracture plane and medial buttress plate augmentation. In elderly patients, screw position relative to the intact cortical femoral neck bone is of critical importance. Additional strategies for optimizing fixation stability in this group include the concept of length stable fixation, use of adjunctive calcium phosphate cement, and use of novel fixed angle fixation implants. PMID:26488776

  4. Evaluations of guided bone regeneration in canine radius segmental defects using autologous periosteum combined with fascia lata under stable external fixation

    OpenAIRE

    Yu, Zhe; Geng, Jie; Gao, Haoran; Zhao, Xinwen; Chen, Jingyuan

    2014-01-01

    Background Although bone defect is one of the most common orthopaedic diseases, treatment remains a challenge and an issue of debate. Guided bone regeneration (GBR) is primarily accompanied by barrier membranes; however, optional membranes show some inherent flaws in clinical application. The purpose of this study was to observe the healing velocity and quality of repairing canine radius segmental defect using transferred autologous periosteum combined with fascia lata, which can provide bett...

  5. Biomechanical analysis of fracture fixation with external fixator in vivo

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To investigate the different ways of measuring the main axial strain during treatment with an external fixator and to find the suitable compression loaded by the external fixator at an early stage.Methods: Eighteen healthy big-ear rabbits were randomly divided into two groups according to different measuring methods: Group A and Group B. In Group A,a strain gauge was affixed to the external tibial cortex with 502 glue, and in Group B, a bone cement-coated strain gauge was installed on the internal tibial cortex. Groups A and B were divided into two subgroups A1, A2 and B1,B2, respectively, according to the pressure of half of and the same as the body weight. A Z-shaped left mid-shaft tibial osteotomy was performed and fixed by an external fixator. Results: The scaler curves of Group A changed dramatically during the early stage. The trendlines of the internal and external cortex went consistently after reaching the stable stage while the latter strain value was higher than the former. The time for Group B reaching the stable stage was short, but its absolute strain value was less than that of Group A. Before they were pressed to the stable stage, the declined speed of Subgroup A1 was more slowly than that of Subgroup A2 while the results of Subgroups B1 and B2 were same. Group A had an ascending trend after it declined while Group B didn't have. After they reached the stable stage, both Subgroups A1 and A2 had a declining trend while Subgroup A2 was more quickly than Subgroup Al, Subgroup B1 was kept at a definite level while Subgroup B2 fluctuated.Conclusions: The axial strain under external fixator can be measured by bone cement coated-strain gauge in vivo. The data may suggest that half of the body weight load was suitable for external fixator.

  6. Titanium-Based Biomaterials for Preventing Stress Shielding between Implant Devices and Bone

    Directory of Open Access Journals (Sweden)

    M. Niinomi

    2011-01-01

    Full Text Available β-type titanium alloys with low Young's modulus are required to inhibit bone atrophy and enhance bone remodeling for implants used to substitute failed hard tissue. At the same time, these titanium alloys are required to have high static and dynamic strength. On the other hand, metallic biomaterials with variable Young's modulus are required to satisfy the needs of both patients and surgeons, namely, low and high Young's moduli, respectively. In this paper, we have discussed effective methods to improve the static and dynamic strength while maintaining low Young's modulus for β-type titanium alloys used in biomedical applications. Then, the advantage of low Young's modulus of β-type titanium alloys in biomedical applications has been discussed from the perspective of inhibiting bone atrophy and enhancing bone remodeling. Further, we have discussed the development of β-type titanium alloys with a self-adjusting Young's modulus for use in removable implants.

  7. Dual fibular grafting - A new technique of fixation of the femoral neck fractures

    Directory of Open Access Journals (Sweden)

    Yadav S

    2005-01-01

    Full Text Available Background: To achieve osteosynthesis of femoral neck fractures is a challenge to the treating surgeon. Plethora of devices and methods has been described. Method: A new technique of achieving union of femoral neck fractures by dual-fibular fixation has been reported in 150 patients. The age of the patients ranged from 6-75 years. Results: Nearly two-third of these were Garden type II and III with an average follow-up of 120 months. In this series 67% had good to excellent long term results. Conclusion: Two fibular struts provide autologous bone, filling the whole of the osteopenic femoral neck and prevent the rotational forces. Since the total fixation is biologically active, the technique has proved advantageous even when stable / desirable reduction is not possible and adequate fixation is not achieved, because of posterior communition at the fracture site or due to osteoporosis. Being autologous bone, the twin-fibular graft is advantageous even when there is ′subsequent loss of reduction′ of the fracture. It is, therefore, suggested that this simple, inexpensive and biological technique has many advantages over the existing methods of fixation of these fractures.

  8. Titanium-Based Biomaterials for Preventing Stress Shielding between Implant Devices and Bone

    OpenAIRE

    Niinomi, M.; Nakai, M

    2011-01-01

    β-type titanium alloys with low Young's modulus are required to inhibit bone atrophy and enhance bone remodeling for implants used to substitute failed hard tissue. At the same time, these titanium alloys are required to have high static and dynamic strength. On the other hand, metallic biomaterials with variable Young's modulus are required to satisfy the needs of both patients and surgeons, namely, low and high Young's moduli, respectively. In this paper, we have discussed effective methods...

  9. The clinical effects of osteoporosis of lumbar degenerative disease by injectable calcium sulfate bone cement to strengthen pedicle screw internal fixation%骨质疏松腰椎退行性疾病的手术治疗分析

    Institute of Scientific and Technical Information of China (English)

    孔祥瑞; 刘德政; 刘海峰; 杨计策; 赵志超

    2015-01-01

    ObjectiveTo explore the clinical effects of osteoporosis of lumbar degenerative disease by injectable calcium sulfate bone cement to strengthen pedicle screw internal fixation. Methods 82 cases of patients with lumbar degenerative dis-ease of osteoporosis word randomly divided into experiment group(41 cases) and control group(41 cases). The control group were treated by transpedicle screws fixation, the experiment group were treated by injectable calcium sulfate bone cement to strengthen pedicle screw internal fixation. The time of operation, mean bleeding volum, the scores of VAS, ODI, JOA were com-pared for the two groups. ResultsThe time of operation, mean bleeding volum for the experiment group were better than the control group; There was no significant difference on the scores of VAS, ODI, JOA; The scores of VAS, ODI for the experiment group were lower than the control group postoperation for 1 week, 2 months, 12 months; The scores of JOA for the experiment group were higher than the control group postoperation for 1 week, 2 months, 12 months. ConclusionIt can improve the scores of VAS, ODI, JOA for the patients with osteoporosis of lumbar degenerative disease by injectable calcium sulfate bone cement to strengthen pedicle screw internal fixation. It is worthy of clinical promotion.%目的:探讨可注射硫酸钙骨水泥强化椎弓根钉内固定治疗骨质疏松腰椎退行性疾病的临床疗效。方法:按照随机数字表法将我院收治的82例骨质疏松腰椎退行性疾病患者均分为实验组和对照组,对照组给予单纯椎弓根内固定治疗,实验组给予可注射硫酸钙骨水泥强化椎弓根钉内固定治疗。比较两组患者手术时间、术中出血量以及治疗前后疼痛视觉模拟评分(VAS)、Oswestry 功能障碍指数(ODI)、JOA 腰椎病疗效评分变化情况。结果:实验组患者手术时间和术中出血量显著高于对照组;两组患者术前 VAS 评分、ODI 评分、JOA

  10. Distal Humeral Fixation of an Intramedullary Nail Periprosthetic Fracture

    Directory of Open Access Journals (Sweden)

    Hiren M. Divecha

    2013-01-01

    Full Text Available Distal humeral periprosthetic fractures below intramedullary nail devices are complex and challenging to treat, in particular due to the osteopenic/porotic nature of bone found in these patients. Fixation is often difficult to satisfactorily achieve around the intramedullary device, whilst minimising soft tissue disruption. Descriptions of such cases in the current literature are very rare. We present the case of a midshaft humeral fracture treated with a locking compression plate that developed a nonunion, in a 60-year old female. This went on to successful union after exchange for an intramedullary humeral nail. Unfortunately, the patient developed a distal 1/5th humeral periprosthetic fracture, which was then successfully addressed with a single-contoured, extra-articular, distal humeral locking compression plate (Synthes with unicortical locking screws and cerclage cables proximally around the distal nail tip region. An excellent postoperative range of motion was achieved.

  11. Design, characterisation and in vivo testing of a new, adjustable stiffness, external fixator for the rat femur

    Directory of Open Access Journals (Sweden)

    V Glatt

    2012-04-01

    Full Text Available Very little is known about the influence of the mechanical environment on the healing of large segmental defects. This partly reflects the lack of standardised, well characterised technologies to enable such studies. Here we report the design, construction and characterisation of a novel external fixator for use in conjunction with rat femoral defects. This device not only imposes a predetermined axial stiffness on the lesion, but also enables the stiffness to be changed during the healing process. The main frame of the fixator consists of polyethylethylketone with titanium alloy mounting pins. The stiffness of the fixator is determined by interchangeable connection elements of different thicknesses. Fixators were shown to stabilise 5 mm femoral defects in rats in vivo for at least 8 weeks during unrestricted cage activity. No distortion or infections, including pin infections, were noted. The healing process was simulated in vitro by inserting into a 5 mm femoral defect, materials whose Young’s moduli approximated those of the different tissues present in regenerating bone. These studies confirmed that, although the external fixator is the major determinant of axial stiffness during the early phase of healing, the regenerate within the lesion subsequently dominates this property. There is much clinical interest in altering the mechanics of the defect to enhance bone healing. Our data suggest that, if alteration of the mechanical environment is to be used to modulate the healing of large segmental defects, this needs to be performed before the tissue properties become dominant.

  12. Results of screw fixation combined with cortical drilling for treatment of dorsal cortical stress fractures of the third metacarpal bone in 56 Thoroughbred racehorses

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate screw fixation with cortical drilling as a surgical treatment for dorsal cortical stress fractures of MCIII in the Thoroughbred racehorse. Details of age, sex, limb affected, fracture assessment, and post operative recommendations were obtained from medical records and radiographs. Fracture healing was assessed radiographically at the time of screw removal. Performance evaluation was determined from race records obtained from The Jockey Club Information System, Lexington, Kentucky. Fifty-six Thoroughbred racehorses were treated surgically for stress fracture of MCIII with screw fixation and cortical drilling. Stress fractures occurred primarily in the left front limb of the male 3-year-olds, in the dorsolateral cortex of the middle third of MCIII. Ninety-seven percent of the fractures travelled in a dorsodistal to palmaroproximal direction. Median period to screw removal was 2.0 months. Evaluation at time of screw removal revealed 98% of single stress fractures of the left front limb were healed radiographically. Median period to resume training was 2.75 months (single stress fractures); median period to race was 7.62 months. There was no statistically significant difference in earnings/start before and after surgical intervention. Of the 63 fractures treated, two recurred. There were no catastrophic failures, and no incisional infections

  13. One-stage posterior debridement, bone grafting and internal fixation for thoracolumbar spinal tuberculosis%一期后路病灶清除植骨融合内固定治疗胸腰椎结核

    Institute of Scientific and Technical Information of China (English)

    任之强; 丁金勇; 晋大祥; 庄洪; 万梓成

    2014-01-01

    Objective To evaluate the clinical efficacy of one-stage posterior debridement, bone grafting and internal fixation for thoracolumbar spinal tuberculosis.Methods From January 2010 to June 2012,28 patients with thoracolumbar spinal tuberculosis undergoing one-stage posterior debridement, bone grafting and internal fixation procedure were reviewed retrospectively .All cases were followed up.The kyphosis Cobb’s angle, erythrocyte sedimentation rate (ESR), C-reaction protein (CRP), bone fusion and American Spinal Injury Association (ASIA) grade before and after surgery were reviewed and compared.Results The median peri-od of follow-up was 1.2 years.There was no significant loss of kyphosis Cobb’s angle after operation.The average kyphosis Cobb’s angle was corrected 4.12 °, the average correction rate was 24.5%.The ESR and CRP levels returned to normal at final follow-up. The majority of bony fusion was achieved within 7.8 months.Most of the original symptoms disappeared.According to ASIA grade, the neurological function was improved after operation.Conclusion Treatments with one-stage posterior debridement, bone grafting and internal fixation for thoracolumbar spinal tuberculosis can effectively achieve debridement, spinal cord decompression, correc-tion of spinal kyphosis, reconstruction of spinal stability.%目的:探讨一期后路病灶清除植骨融合内固定治疗胸腰椎结核的临床疗效。方法回顾性分析2010年1月~2012年6月本院采用一期后路病灶清除植骨融合内固定治疗的28例胸腰椎结核患者的临床资料,对比研究患者手术前后患椎后凸Cobb角、红细胞沉降率( erythrocyte sedimentation rate, ESR)、C 反应蛋白( C-reaction protein, CRP)、植骨融合及美国脊髓损伤协会( American Spinal Injury Association, ASIA)分级变化情况。结果28例获得随访,平均随访1.2年,术后Cobb角无明显丢失,后凸畸形平均纠正4.12°,平均矫正率24

  14. Pitfalls during biomechanical testing - Evaluation of different fixation methods for measuring tendons endurance properties.

    Science.gov (United States)

    Hangody, Gy; Pánics, G; Szebényi, G; Kiss, R; Hangody, L; Pap, K

    2016-03-01

    The goal of the study was to find a proper technique to fix tendon grafts into an INSTRON loading machine. From 8 human cadavers, 40 grafts were collected. We removed the bone-patella tendon-bone grafts, the semitendinosus and gracilis tendons, the quadriceps tendon-bone grafts, the Achilles tendons, and the peroneus longus tendons from each lower extremity. We tested the tendon grafts with five different types of fixation devices: surgical thread (Premicron 3), general mounting clamp, wire mesh, cement fixation, and a modified clamp for an INSTRON loading machine. The mean failure load in case of surgical thread fixation was (381N ± 26N). The results with the general clamp were (527N ± 45N). The wire meshes were more promising (750N ± 21N), but did not reach the outcomes we desired. Easy slippages of the ends of the tendons from the cement encasements were observed (253N ± 18N). We then began to use Shi's clamp that could produce 977N ± 416N peak force. We combined Shi's clamp with freezing of the graft and the rupture of the tendon itself demonstrated an average force of 2198 N ± 773N. We determined that our modified frozen clamp fixed the specimens against high tensile forces.

  15. Novel Osteogenic Ti-6Al-4V Device For Restoration Of Dental Function In Patients With Large Bone Deficiencies: Design, Development And Implementation

    Science.gov (United States)

    Cohen, D. J.; Cheng, A.; Kahn, A.; Aviram, M.; Whitehead, A. J.; Hyzy, S. L.; Clohessy, R. M.; Boyan, B. D.; Schwartz, Z.

    2016-01-01

    Custom devices supporting bone regeneration and implant placement are needed for edentulous patients with large mandibular deficiencies where endosteal implantation is not possible. We developed a novel subperiosteal titanium-aluminum-vanadium bone onlay device produced by additive manufacturing (AM) and post-fabrication osteogenic micro-/nano-scale surface texture modification. Human osteoblasts produced osteogenic and angiogenic factors when grown on laser-sintered nano-/micro-textured surfaces compared to smooth surfaces. Surface-processed constructs caused higher bone-to-implant contact, vertical bone growth into disk pores (microCT and histomorphometry), and mechanical pull-out force at 5 and 10 w on rat calvaria compared to non surface-modified constructs, even when pre-treating the bone to stimulate osteogenesis. Surface-modified wrap-implants placed around rabbit tibias osseointegrated by 6 w. Finally, patient-specific constructs designed to support dental implants produced via AM and surface-processing were implanted on edentulous mandibular bone. 3 and 8 month post-operative images showed new bone formation and osseointegration of the device and indicated stability of the dental implants. PMID:26854193

  16. 前路一期病灶清除植骨U型钛板内固定治疗腰骶段结核%Anterior primary debridement,bone grafting and internal fixation for lumbosacral spinal tuberculosis

    Institute of Scientific and Technical Information of China (English)

    罗鹏; 方忠; 李光辉; 熊伟; 李锋; 李红刚

    2011-01-01

    Aim To evaluate the clinical outcomes of primary anterior radical debridement, bone autograft , and internal fixation in treating tuherculosis of the lumbosacral segments. Methods From January 2005 to September 2009,21 patients with tuberculosis of the lumbosacral segments were treated with anterior radical debridement. autologous iliac bone graft , and internal fixation with titanium plate ,including 12 males and 9 females. All patients experienced toxic symptoms of the tuherculosis and 19 cases experienced various degrees of pain in the lumbosacral area,8 cases unilateral lower limb muscle.feel drops , and 2 cases saddle area anaesthesia. All cases received four antitubercular drugs for 2 to 4 weeks. Operation was performed when the toxic symptom of the tuberculosis was under control and ESR was decreased. Results All cases were followed up for 11 - 38 months( average 20 months ). No postoperative erectile dysfunction and retrograde ejaculation occurred in the 12 male patients. The radical pain in the lower extremities and the saddle area anaesthesia disappeared. Two patients had mild pain in the lumbosacral area, and the pain was eliminated after symptomatic treatment. All patients achieved bony fusion 6 months after operation. The curativerate was 90. 4 percent. Conclusion The surgical treatment of tuberculosis of the lumbosacral segments with primary anterior focus debridement.bone autograft, and titanium plate fixation can reconstruct spinal stability and achieve satisfying bony fusion.%目的 总结经腰骶椎前路一期病灶清除植骨U型钛板内固定治疗腰骶段结核的临床疗效.方法 2005年1月~2009年9月,采用经腰骶椎前路一期病灶清除植骨U型钛板内固定治疗腰骶段结核21例,其中男12例,女9例.19例有不同程度腰骶部持续疼痛,11例伴下肢放射痛,8例单侧下肢肌力、感觉减退,2例伴鞍区麻木.术前使用四联抗结核2~4周,待结核中毒症状改善或血沉呈

  17. 骨水泥强化治疗骨质疏松症伴脊柱侧弯疗效分析%Effects of pedicle screw fixation with bone cement tract augmentation on scoliolosis accompanying osteoporosis

    Institute of Scientific and Technical Information of China (English)

    丁金勇; 洪少勇; 晋大祥; 梁德; 江晓兵

    2012-01-01

    目的 探讨对伴骨质疏松症的退行性脊柱侧弯病人行后路减压、骨水泥强化钉道椎弓根内固定融合治疗的临床疗效.方法 2006-10-2009-07收治伴骨质疏松症的退变性脊柱侧弯患者18例,女11例,男7例,平均年龄64.5岁,均冠状面畸形,Cobb's角>15°或合并椎体旋转半脱位以及合并椎体骨质疏松性病理性骨折.手术采取部分椎板切除,松解神经根以充分减压,骨水泥强化钉道的椎弓根长节段钉棒系统进行矫形,记录手术前后Cobb's角、前凸角,手术前后进行ODI评分.结果 所有病例切口均Ⅰ期愈合,无感染或深静脉血栓等近期并发症;进行24~54个月随访(平均36个月),未出现断钉、断棒,及椎弓根钉拔出、松动、融合节段假关节形成或感染等远期并发症.患者术后冠状面Cobb's角均低于术前(P<0.05),腰椎矢状面前凸角均高于术前(P<0.05),ODI综合评分均低于术前(P<0.05).结论 在充分减压消除症状的基础上,用骨水泥强化钉道进行侧弯的矫形,可以获得脊柱平衡并能够避免矫形的丢失.%Objective To evaluate the clinical effect of the treatment that part or full laminecto-my and correction with posterior long segment pedicle screw/rod internal fixation system by augmentation and restoration with bone cement in the screw tract and posterolateral or intervertebral spinal fusion, about degenerative scoliolosis accompanying with osteoporosis. Methods Eighteen patients, 11 females and 7 males (average age of 643 years),with degenerative scoliosis accompanying by osteoporosis were selected from our hospital, between October 2006 and July 2009. The patients were treated with part or full laminectomy and posterior long segment pedicle screw/rod internal fixation system by augmentation and restoration with bone cement in the screw tract and posterolateral or intervertebral spinal fusion. Result All cases were followed up for 36 months (range 24-54 months). No

  18. Suture anchor fixation strength with or without augmentation in osteopenic and severely osteoporotic bones in rotator cuff repair: a biomechanical study on polyurethane foam model

    OpenAIRE

    Er, Mehmet Serhan; Altinel, Levent; Eroglu, Mehmet; Verim, Ozgur; Demir, Teyfik; Atmaca, Halil

    2014-01-01

    Background The purpose of the present study was to compare the results of various types of anchor applications with or without augmentation in both osteopenic and severely osteoporotic bone models. Methods Two different types of suture anchors were tested in severely osteoporotic (SOP) and osteopenic polyurethane (PU) foam blocks using an established protocol. An Instron machine applied static loading parallel to the axis of insertion until failure, and the mean anchor failure strengths were ...

  19. Surgical treatment of the osteoporotic spine with bone cement-injectable cannulated pedicle screw fixation: technical description and preliminary application in 43 patients

    Directory of Open Access Journals (Sweden)

    Fei Dai

    2015-02-01

    Full Text Available OBJECTIVES: To describe a new approach for the application of polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws. METHODS: Between June 2010 and February 2013, 43 patients with degenerative spinal disease and osteoporosis (T-score <-2.5 underwent lumbar fusion using cement-injectable cannulated pedicle screws. Clinical outcomes were evaluated using a Visual Analog Scale and the Oswestry Disability Index. Patients were given radiographic follow-up examinations after 3, 6, and 12 months and once per year thereafter. RESULTS: All patients were followed for a mean of 15.7±5.6 months (range, 6 to 35 months. The Visual Analog Scale and Oswestry Disability Index scores showed a significant reduction in back pain (p = 0.018 and an improvement in lower extremity function (p = 0.025 in patients who underwent lumbar fusion using the novel screw. Intraoperative cement leakage occurred in four patients, but no neurological complications were observed. Radiological observation indicated no loosening or pulling out of the novel screw, and bone fusion was excellent. CONCLUSIONS: The described polymethylmethacrylate augmentation technique using bone cement-injectable cannulated pedicle screws can reduce pain and improve spinal dysfunction in osteoporotic patients undergoing osteoporotic spine surgery.

  20. Posterior treatment of delayed traumatic atlantoaxial joint dislocation with apofix internal fixation

    International Nuclear Information System (INIS)

    Objective: To assess the effect of posterior fixation and fusion with Apofix device for the treatment of delayed traumatic atlantoaxial joint dislocation. Methods: Eighteen patients with delayed traumatic atlantoaxial joint dislocation were included. Posterior fixation and fusion with Apofix device were performed. First step was one or two week skull traction. After the atlantoaxial joint dislocation had been reduced, the posterior fixation and fusion with Apofix was performed. Using local anaesthesia, atlantoaxial interval and posterior structure of atlas and dentata were exposed by midline operative approach. Apofix interlaminar clamps were placed at posterior arch of atlas and odontoid vertebral laminae, autologous iliac bone graft was placed for fusion. Then the device to proper position was pressurized and items locked. Results: All of the patients were followed up, the mean follow-up period was 38 months (13 ∼ 84 months). Fifteen patients obtained complete reduction, the others were partial reduction. Seventeen patients had successful fusion after 3 or 4 months, only 1 patient who had partial reduction had internal fixation loose and nonfusion, leading to recurrence of atlantoaxial joint dislocation. An occipitocervical fusion surgery was performed on this patient. As to neurological assessment, 16 patients had neurological deficit before operation, while 6 of them recovered completely after operation, another 10 patients' neurological status improved significantly. JOA score was improved from 9.5 pre-operative to 15.8 post-operative. Conclusion: Apofix internal fixation and fusion seems to be feasible in treatment of delayed traumatic atlantoaxial joint dislocation. Successful reduction before operation and proper treatment after operation is also important. (authors)

  1. The Hopper: A Wearable Robotic Device Testbed for Micro-Gravity Bone-Loading Proof-of-Concept

    Science.gov (United States)

    Beck, C. E.; Rovekamp, R. N.; Neuhaus, P. D.

    2015-01-01

    Wearable robotic systems are showing increased potential for addressing crew countermeasures needs. Wearable robots offer a compactness, programmability, and eccentric loading capability not present in more conventional exercise equipment. Correspondingly, advancements in the man to machine interface has progressed, allowing for higher loads to be applied directly to the person in new and novel ways. Recently, the X1 exoskeleton, a lower extremity wearable robot originally designed for mobility assistance and rehabilitation, underwent human subject testing to assess its potential as a knee dynamometer. This was of interest to NASA physiologists because currently strength is not assessed in flight due to hardware limitations, and thus there is a poor understanding of the time course of in-flight changes to muscle strength. The study concluded that the X1 compared well with the Biodex, the "gold standard" in terrestrial dynamometry, with coefficients of variation less than 6.0%. In a following study, the X1 powered ankle was evaluated for its efficacy in exercising calf muscles. Current on-orbit countermeasures equipment does not adequately protect the calf from atrophy. The results of this study were also positive (targeted muscle activity demonstrated via comparing pre- and post-exercise magnetic resonance imaging T2 measurements), again showing the efficacy of wearable robotic devices for addressing the countermeasure needs of our astronauts. Based on these successes and lessons learned, the Grasshopper was co-developed between IHMC (Florida Institute for Human and Machine Cognition) and NASA. The Grasshopper, or the Hopper for short, is a wearable robotic device designed to address muscle and bone density loss for astronauts spending extended periods of time in micro-gravity. The Grasshopper connects to the user's torso like a hiking backpack, over the shoulders and around the waist. At the feet are footplates that strap to the user. There are two actuators, one

  2. Transosseous osteosynthesis with annular external fixator for the treatment of long bone defect after tibial traumatic%环形外固定架骨搬运治疗胫骨创伤后大段骨缺损

    Institute of Scientific and Technical Information of China (English)

    龙超; 刘炳胜; 王玮; 沈作佳

    2013-01-01

    Objective:To investigate the efficacy of the application of transosseous osteosynthesis with annular external fixator for the treatment of traumatic large bone defects of the tibia. Methods: From 2002 to 2011,17 cases of traumatic tibial long bone defect were treated by transosseous osteosynthesis with annular external fixator including 11 males and 6 females with an average age of (31.00±2.35) years old ranging from 22 to 45 years. The length of defect was from 5 to 13.1 cm with an average of (7.50+1.01) cm. The fixed time, bone healing time and the extend length of the affected limb were observed, and the degree of recovery of limb function after surgery were assessed ccording to the Paley's limb function evaluation. Results:All patients were followed up from 12 to 48 months with an average of (30.00±2.35) months,the bone defects of 17 patients achieved bone healing. The average bone healing time was (10.10±0.59) months (8 to 15 months) ;the average time of fixed time was (14.10±0.65 ) months (12 to 16 months) ;the average extend length of the affected limb was (7.50±1.01) cm. The results of Paley's functional evaluation was excellent in 9 cases,good in 6,fair in 2. Conclusion:Transosseous osteosynthesis with annular external fixator is an effective method for treatment of large bone defects of the tibia. It is successful reconstruction of limb length, simple operation, less soft tissue injury, and is clinical worthy of promotion.%目的:探讨应用环形外固定架辅助骨搬运术治疗创伤后胫骨大段骨缺损的疗效.方法:自2002年至2011年采用骨搬运术对17例创伤性胫骨长段骨缺损进行治疗,男11例,女6例;年龄22 ~45岁,平均(31.00±2.35)岁.骨缺损范围5~13.1 cm,平均(7.50±1.01) cm.观察外固定时间、骨性愈合时间、术后患肢延长长度.术后患肢功能恢复程度参照Paley评价标准进行功能评价.结果:全部病例获随访,时间12~48个月,平均(30.00±2.35)个月.17例

  3. 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

  4. Estudo biomecânico da fixação transcortical ou transesponjosa do enxerto de tendão patelar com pinos bioabsorvíveis na reconstrução do LCA em ovinos Biomechanical study of transcortical or transtrabecular bone fixation of patellar tendon graft with bioabsorbable pins in ACL reconstruction in sheep

    Directory of Open Access Journals (Sweden)

    Mauro Batista Albano

    2012-02-01

    Full Text Available OBJETIVO: Determinar a resistência inicial de fixação do sistema RigidFix® e comparar com o método tradicional de fixação que utiliza parafusos de interferência metálicos. Avaliar a resistência da fixação com o sistema RigidFix® ao se modificar o posicionamento rotacional do bloco ósseo no interior do túnel femoral. MÉTODOS: 40 espécimes de joelhos (soldras de ovinos, foram submetidos à reconstrução do ligamento cruzado anterior (LCAutilizando enxerto osso-tendão-osso. Em 20 espécimes utilizou-se o método RigidFix®, este grupo foi subdividido em dois, 10 joelhos foram utilizados para fixação através da esponjosa e 10 para fixação cruzando a tábua óssea cortical. Nos 20 espécimes restantes fixou-se o enxerto com parafusos de interferência metálico de 9mm. RESULTADOS: A comparação do método RigidFix® com o método de fixação com parafuso de interferência metálico não mostrou diferenças estatisticamente significativas ao se considerar carga máxima e rigidez, também não houve diferenças estatisticamente significativas ao se modificar o posicionamento rotacional do bloco ósseo no interior do túnel femoral. Para estas avaliações considerou-se o p OBJECTIVE: to determine the initial resistance of fixation using the Rigid Fix® system, and compare it with traditional fixation methods using metal interference screws; and to evaluate the resistance of the fixation with the rigid fix system when the rotational position of the bone block is altered in the interior of the femoral tunnel. METHODS: forty ovine knee specimens (stifle joints were submitted to anterior cruciate ligament reconstruction (ACL using a bone-tendon-bone graft. In twenty specimens, the RigidFix® method was used; this group was subdivided into two groups: ten knees used for fixation with trabecular bone screw, and ten for fixation passing through the layer of cortical bone. In the twenty remaining specimens, the graft was fixed with 9

  5. A novel technique for impaction bone grafting in acetabular reconstruction of revision total hip arthroplasty using an ex vivo compaction device

    International Nuclear Information System (INIS)

    Impaction bone grafting allows restoration of the acetabular bone stock in revision hip arthroplasty. The success of this technique depends largely on achieving adequate initial stability of the component. To obtain well-compacted, well-graded allograft aggregates, we developed an ex vivo compaction device to apply it in revision total hip arthroplasty on the acetabular side, and characterized mechanical properties and putative osteoconductivity of allograft aggregates. Morselized allograft bone chips were compacted ex vivo using the creep technique and subsequent impaction technique to form the bone aggregates. Impaction allograft reconstruction of the acetabulum using an ex vivo compaction device was performed on eight hips. The mechanical properties and three-dimensional micro-CT-based structural characteristics of the bone aggregates were investigated. In clinical practice, this technique offered good reproducibility in reconstructing the cavity and the segmental defects of the acetabulum, with no migration and no loosening of the component. In vitro analysis showed that the aggregates generated from 25 g fresh-frozen bone chips gained compression stiffness of 13.5-15.4 MPa under uniaxial consolidation strain. The recoil of the aggregates after compaction was 2.6-3.9%. The compression stiffness and the recoil did not differ significantly from those measured using a variety of proportions of large- and small-sized bone chips. Micro-CT-based structural analysis revealed average pore sizes of 268-299 μm and average throat diameter of pores in the bone aggregates of more than 100 μm. These sizes are desirable for osteoconduction, although large interconnected pores of more than 500 μm were detectable in association with the proportion of large-sized bone chips. Cement penetration into the aggregates was related to the proportion of large-sized bone chips. This study introduces the value of an ex vivo compaction device in bone graft compaction in clinical

  6. 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.

  7. When Planning Screw Fracture Fixation Why the 5.5 mm Screw is the Goldilocks Screw. An Observational Computer Tomographic Study of Fifth Metatarsal Bone Anatomy in a Sample of Patients.

    Science.gov (United States)

    Iselin, Lukas D; Ramawat, Sunil; Hanratty, Brian; Klammer, Georg; Stavrou, Peter

    2015-05-01

    We wanted to verify our clinical experience that the 5.5 mm screw was ideal in the majority of fifth metatarsal fracture fixation. The size of a screw is important for the successful surgical treatment of these fractures in order to obtain the maximal stability while reducing the risk for iatrogenic fracture.A sample of patients undergoing computer tomographic imaging of the foot for investigation other than fifth metatarsal pathology were recruited. The parameters of the fifth metatarsal bone anatomy were measured.These parameters of the 5.5 mm screw were correlated with this data. The upper parameter (the diameter of the threads) was 5.5 and the lower parameter (the diameter of the shank) was 4.0 mm.Twenty seven patients were recruited.The proximal third internal diameter ranged from 3.6 to 7.0 mm with a mean of 5.0 mm. 93% of the metatarsals could easily accommodate the 5.5 mm screw. Two of the metatarsals had an internal diameter of < 4 mm (7%).It is our belief that the 5.5 mm screw may be used safely in the majority of patients with fifth metatarsal fractures.

  8. THE FUNCTIONAL OUTCOME OF MANAGEMENT OF SCHATZKER TYPE II AND III TIBIAL PLATEAU FRACTURES TREATED WITH INDIRECT ELEVATION, PERCUTANEOUS FIXATION AND BONE GRAFTING

    Directory of Open Access Journals (Sweden)

    Sheshagiri

    2016-02-01

    Full Text Available INTRODUCTION Damage to the joint is more extensive in tibia plateau fractures than the roentgenograms Indicate. It may be associated with soft tissue trauma, ligament injuries (4-33% medial Collateral ligament being the most common, meniscal injuries (20%, lateral collateral Ligament injury (3%, peroneal nerve injuries (3%. Posttraumatic arthritis is associated with residual instability or axial malalignment rather than joint depression. So we use minimally invasive approach to the depressed tibial plateau fractures (Schatzker type II & III. MATERIALS AND METHODS 32 patients were studied. They were followed up for maximum of 3yrs and a minimum of 1.5yrs with an average of 2.2yrs. Inclusion criteria included those patients with an age group between 20yrs and 60yrs, joint depression more than 3mm. Patients with open fracture, severe osteoporotic bones and with radiographic evidence of osteoarthritis are excluded from the study. CT was done in all patients. Mean age group was 28.8yrs and 19(76% were males; the mean articular depression was 11.32 mm measured in CT. Pre-op evaluation includes x-rays of the knee, stress x-rays if needed, and CT was done with 2mm limited cuts. Cancellous Bone graft was taken from opposite tibia through a 3-4cm long incision made below the tibial tuberosity over the medial aspect of the tibia. Cortical window was made in the affected limb, just enough to introduce the punch, and its position was confirmed under c-arm and depressed fragment was elevated with punch and reduction was held with k wires in subarticular plane and later two cannulated cancellous screws was introduced and the defect packed with bone grafts, Post-operatively all patients were immobilized with plaster of Paris (POP for 3 weeks and then mobilized. RESULTS The mean duration of the follow up was 2.2yrs. Results were excellent in 21 patients (84%, good 3(12% and fair in 1 patients (4% according to anatomic and functional criteria by Hohl and Luck

  9. Application of the active shape model in a commercial medical device for bone densitometry

    DEFF Research Database (Denmark)

    Thodberg, Hans Henrik; Rosholm, Anders

    2003-01-01

    a sufficient list of initial guesses for the ASM. The performance of ASM and the experience with the integration of ASM in a commercial medical device is reported. The ASM achieves 99.5% reconstruction success and is able to validate its own reconstruction in 97% of the cases. The system (Pronosco X...

  10. Bone status in rheumatoid arthritis assessed at peripheral sites by three different quantitative ultrasound devices

    DEFF Research Database (Denmark)

    Madsen, O R; Suetta, C; Egsmose, C;

    2004-01-01

    sites in 27 women with RA (mean disease duration 15 years) and in 36 healthy women matched for age, height and weight. Speed of sound (SOS, m/s), broadband ultrasound attenuation (BUA, dB/MHz) and stiffness of the calcaneus were assessed by a Lunar Achilles device. Amplitude-dependent SOS (Ad-SOS, m...

  11. Hybrid approach of ventricular assist device and autologous bone marrow stem cells implantation in end-stage ischemic heart failure enhances myocardial reperfusion

    Directory of Open Access Journals (Sweden)

    Khayat Andre

    2011-01-01

    Full Text Available Abstract We challenge the hypothesis of enhanced myocardial reperfusion after implanting a left ventricular assist device together with bone marrow mononuclear stem cells in patients with end-stage ischemic cardiomyopathy. Irreversible myocardial loss observed in ischemic cardiomyopathy leads to progressive cardiac remodelling and dysfunction through a complex neurohormonal cascade. New generation assist devices promote myocardial recovery only in patients with dilated or peripartum cardiomyopathy. In the setting of diffuse myocardial ischemia not amenable to revascularization, native myocardial recovery has not been observed after implantation of an assist device as destination therapy. The hybrid approach of implanting autologous bone marrow stem cells during assist device implantation may eventually improve native cardiac function, which may be associated with a better prognosis eventually ameliorating the need for subsequent heart transplantation. The aforementioned hypothesis has to be tested with well-designed prospective multicentre studies.

  12. Three Dimensional Finite Element Analysis of Stress Distribution and Displacement of the Maxilla Following Surgically Assisted Rapid Maxillary Expansion with Tooth- and Bone-Borne Devices

    Directory of Open Access Journals (Sweden)

    Mohsen Dalband

    2015-10-01

    Full Text Available Objectives: The aim of this study was to investigate the displacement and stress distri- bution during surgically assisted rapid maxillary expansion under different surgical conditions with tooth- and bone-borne devices.Materials and Methods: Three-dimensional (3D finite element model of a maxilla was constructed and an expansion force of 100 N was applied to the left and right molars and premolars with tooth-borne devices and the left and right of mid-palatal sutures at the first molar level with bone-borne devices. Five CAD models were simulated as fol- lows and surgical procedures were used:  G1: control group (without surgery; G2: Le Fort I osteotomy; G3: Le Fort I osteotomy and para-median osteotomy; G4: Le Fort I osteotomy and pterygomaxillary separation; and G5: Le Fort I osteotomy, para-median osteotomy, and pterygomaxillary separation.Results: Maxillary displacement showed a gradual increase from group 1 to group 5 in all three planes of space, indicating that Le Fort I osteotomy combined with para-me- dian osteotomy and pterygomaxillary separation produced the greatest displacement of the maxilla with both bone- and tooth-borne devices. Surgical relief and bone-borne devices resulted in significantly reduced stress on anchored teeth.Conclusion: Combination of Le Fort I and para-median osteotomy with pterygomaxil-lary separation seems to be an effective procedure for increasing maxillary expansion, and excessive stress side effects are lowered around the anchored teeth with the use of bone-borne devices.

  13. Bone and muscle structure and quality preserved by active versus passive muscle exercise on a new stepper device in 21 days tail-suspended rats.

    Science.gov (United States)

    Sun, L W; Blottner, D; Luan, H Q; Salanova, M; Wang, C; Niu, H J; Felsenberg, D; Fan, Y B

    2013-06-01

    Human performance in microgravity is characterized by reversed skeletal muscle actions in terms of active vs. passive mode contractions of agonist/antagonist groups that may challenge principal biodynamics (biomechanical forces translated from muscle to bone) of the skeletal muscle-bone unit. We investigated active vs. passive muscle motions of the unloaded hindlimb skeletal muscle-bone unit in the 21 days tail-suspended (TS) rat using a newly designed stepper exercise device. The regimen included both active mode motions (TSA) and passive mode motions (TSP). A TS-only group and a normal cage group (CON) served as positive or negative controls. The muscle and bone decrements observed in TS-only group were not seen in the other groups except TSP. Active mode motions supported femur and tibia bone quality (5% BMD, 10% microtrabecular BV/TV, Tb.Th., Tb.N. parameters), whole soleus muscle/myofiber size and type II distribution, 20% increased sarcolemma NOS1 immunosignals vs. CON, with 25% more hybrid fiber formation (remodeling sign) for all TS groups. We propose a new custom-made stepper device to be used in the TS rat model that allows for detailed investigations of the unique biodynamic properties of the muscle-bone unit during resistive-load exercise countermeasure trials on the ground or in microgravity.

  14. Tibial inlay press-fit fixation versus interference screw in posterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Max Ettinger

    2013-11-01

    Full Text Available Reconstruction of the posterior cruciate ligament (PCL by a tibial press-fit fixation of the patellar tendon with an accessory bone plug is a promising approach because no foreign materials are required. Until today, there is no data about the biomechanical properties of such press-fit fixations. The aim of this study was to compare the biomechanical qualities of a bone plug tibial inlay technique with the commonly applied interference screw of patellar tendon PCL grafts. Twenty patellar tendons including a bone block were harvested from ten human cadavers. The grafts were implanted into twenty legs of adult German country pigs. In group P, the grafts were attached in a press-fit technique with accessory bone plug. In group S, the grafts were fixed with an interference screw. Each group consisted of 10 specimens. The constructs were biomechanically analyzed in cyclic loading between 60 and 250 N for 500 cycles recording elongation. Finally, ultimate failure load and failure mode were analyzed. Ultimate failure load was 598.6±36.3 N in group P and 653.7±39.8 N in group S (not significant, P>0.05. Elongation during cyclic loading between the 1st and the 20th cycle was 3.4±0.9 mm for group P and 3.1±1 mm for group S. Between the 20th and the 500th cycle, elongation was 4.2±2.3 mm in group P and 2.5±0.9 mm in group S (not significant, P>0.05. This is the first study investigating the biomechanical properties of tibial press-fit fixation of the patellar tendon with accessory bone plug in posterior cruciate ligament reconstruction. The implant-free tibial inlay technique shows equal biomechanical characteristics compared to an interference screw fixation. Further in vivo studies are desirable to compare the biological behavior and clinical relevance of this fixation device.

  15. Applied Researches on Polylactide Internal Fixation Devices%骨科聚乳酸内固定物应用研究

    Institute of Scientific and Technical Information of China (English)

    段宏; 宋跃明

    2001-01-01

    目前,骨科可吸收内固定物的基础和临床研 究日益增多 。本文综述了聚乳酸材料的一般理化特性、生物降解吸收性能、机械性能、对骨折愈合影响 及临床应用研究,并指出存在的问题和今后研究重点。%Nowadays, more and more basic and clinicalrese arches on polylactide internal fixators were carried out in China. In this paper are reviewed the researches of polylactide acid(PLA), including its physical an d chemical characters, biodegradation, absorption and mechanical properties, effects on fracture healing, and clinical application. Some pro blems that have not been solved are high-lighted and discussed. Also dealt with are some researches of PLA in future.

  16. 腰椎内固定中两种椎弓根钉加强技术与骨水泥的应用%Two strengthening pedicle screw techniques and bone cement in lumbar internal fixation

    Institute of Scientific and Technical Information of China (English)

    江泽华; 朱如森; 袁建军; 邵高升; 张学利

    2013-01-01

    BACKGROUND:Screw loosening and shedding may occur after osteoporosis associated with lumbar degenerative disease treated with pedicle screw fixation. Application of pedicle screw enhanced with cured materials can improve the therapeutic effect. OBJECTIVE:To compare the clinical effect of pedicle screws enhanced with poly(methyl methacrylate) and injectable calcium sulfate cement in the lumbar internal fixation of osteoporosis. METHODS:Sixty-one patients diagnosed with osteoporosis combined with lumbar spondylolisthesis, lumbar spinal instability, and severe lumbar spinal stenosis were col ected. Al patients were divided into two groups according to the treatment method:poly(methyl methacrylate) bone cement enhanced pedicle screw group and calcium sulfate bone cement enhanced pedicle screw group. RESULTS AND CONCLUSION:There were no significant differences in the operation time, blood loss, preoperative and postoperative visual analog scale score, Japanese Orthopedic Association scores and the Japanese Orthopedic Association score improvement rate between two groups (P>0.05). The results showed that two patients had bone cement leakage in poly(methyl methacrylate) group which had no neurological symptoms caused by new symptoms during fol ow-up period. The bone mineral density was not improved gradual y in poly(methyl methacrylate) group with fol ow-up time prolonging;however, in calcium sulfate group, the bone mineral density was increased significantly after treatment, and the change of bone mineral density was linearly related with Japanese Orthopaedic Association score improvement rate in calcium sulfate group. No screw loosening, pul ing out or neurological dysfunction occurred in both groups. The results indicate that like poly(methyl methacrylate), balcium sulfate bone cement can increase the stability of pedicle screws.%背景:骨质疏松伴腰椎退行性病变行椎弓根钉固定骨质疏松的椎体后可能会出现螺钉的松动、脱落,使用

  17. Management of adult diaphyseal both-bone forearm fractures.

    Science.gov (United States)

    Schulte, Leah M; Meals, Clifton G; Neviaser, Robert J

    2014-07-01

    Simultaneous diaphyseal fractures of the radius and ulna, often referred to as both-bone forearm fractures, are frequently encountered by orthopaedic surgeons. Adults with this injury are typically treated with open reduction and internal fixation because of the propensity for malunion of the radius and ulna and the resulting loss of forearm rotation. Large case series support the use of plate and screw fixation for simple fractures. More complex fractures are managed according to strain theory, with the intention of controlling rather than eliminating motion at the fracture site. This can be achieved with flexible plate and screw constructs or intramedullary nails. In general, results of surgical fixation have been good, with only modest losses of forearm strength and rotation. Notable complications include nonunion, malunion, and refracture after device removal. PMID:24966250

  18. Fixation of distal radius fractures in adults: a review.

    Science.gov (United States)

    Obert, L; Rey, P-B; Uhring, J; Gasse, N; Rochet, S; Lepage, D; Serre, A; Garbuio, P

    2013-04-01

    In patients for whom function is a priority, anatomic reduction and stable fixation are prerequisites for good outcomes. Several therapeutic options exist, including orthopedic treatment and internal fixation with pins (intra- and extrafocal), external fixation which may or may not bridge the wrist, and different internal fixation techniques with dorsal or palmar plates using or not, locking screws. Arthroscopy may be necessary in case of articular fracture. In the presence of significant metaphyseal bone defects, filling of the comminution with phosphocalcic cements provides better graft stability. The level of evidence is too low to allow recommending one type of fixation for one type of fracture; and different fixation options to achieve stable reduction exist, each with its own specific complications. With the new generations of palmar plate, secondary displacement is becoming a thing of the past. PMID:23518070

  19. Locking plate fixation for proximal humerus fractures.

    LENUS (Irish Health Repository)

    Burke, Neil G

    2012-02-01

    Locking plates are increasingly used to surgically treat proximal humerus fractures. Knowledge of the bone quality of the proximal humerus is important. Studies have shown the medial and dorsal aspects of the proximal humeral head to have the highest bone strength, and this should be exploited by fixation techniques, particularly in elderly patients with osteoporosis. The goals of surgery for proximal humeral fractures should involve minimal soft tissue dissection and achieve anatomic reduction of the head complex with sufficient stability to allow for early shoulder mobilization. This article reviews various treatment options, in particular locking plate fixation. Locking plate fixation is associated with a high complication rate, such as avascular necrosis (7.9%), screw cutout (11.6%), and revision surgery (13.7%). These complications are frequently due to the varus deformation of the humeral head. Strategic screw placement in the humeral head would minimize the possibility of loss of fracture reduction and potential hardware complications. Locking plate fixation is a good surgical option for the management of proximal humerus fractures. Complications can be avoided by using better bone stock and by careful screw placement in the humeral head.

  20. Mechanics research of bone cement augmentation on pedicle screw in revision of internal lumbar fixation%椎弓根螺钉骨水泥强化技术在腰椎内固定翻修手术中的力学研究

    Institute of Scientific and Technical Information of China (English)

    陈路; 廖琦; 龚玉琴

    2014-01-01

    目的:评价骨水泥强化技术在钉道扩大时对椎弓根螺钉固定强度的影响,为腰椎内固定翻修选择可靠的补救技术提供依据。方法选用成人尸体腰椎标本40个,观察组进行骨水泥强化,对照组普通方法置钉,进行生物力学检测。结果两种固定方法的最大轴向拔出力及最大旋出扭矩具有显著性差异(P<0.001),并提示弱相关。结论(1)在腰椎内固定翻修手术中,对椎弓根螺钉进行骨水泥强化可以有效提高椎弓根螺钉的固定强度。(2)钉道本身的骨质量对进行强化后的椎弓根螺钉固定强度影响有限。%Objective To evaluate the effect of bone cement augmentation technique on fixation strength of pedicle screw dur-ing trajectory expansion,to provide the basis of reliable remedial technique selection for revision of internal lumbar fixation.Methods A total of 40 lumbar vertebrae and 80 pedicles were obtained to stimulate the trajectory of pedicle needing revision after internal lumbar fixation surgery. 40 lumbar vertebrae were randomly divided into Group A and Group B ,with 20 simple fixed sides and 20 augmented fixed sides in each group. In Group A,pedicles on both sides of all the specimens were determined for the maximum axial pullout of strength;while in Group B,pedicles on both sides of all the specimens were detected for the maximum rotary torque,and differences between the two sides were compared. Results (1) There was significant difference between the two fixations,indicating a weak correlation. Conclusion (1)It was confirmed that in revision of internal lumbar fixation,bone cement augmentation on pedicle screw can effectively improve the strength of pedicle screw. (2)Maximum axial pullout of strength and maximum rotary torque in reinforced group were weakly correlated with those in the control group ,suggesting the bone quality of the trajectory had limited influence on the strength of reinforced pedicle screw

  1. Analysis the Clinical Curtive Effect of Thoracic Lumbar Spine Fractures of Posterior Pedicle Screw Fixation Combined Bone Graft Surgery%脊柱胸腰段骨折行后路椎弓根螺钉内固定联合植骨手术的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    慕志广

    2016-01-01

    Objective To evaluate the clinical curative effect for joint posterior pedicle screw internal fixation bone graft surgery in treatment of thoracic lumbar spine fractures.Methods Selected 72 cases of thoracic lumbar spine fracture patients in our hospital, which were randomly divided into two groups, each group had 36 cases, control group with posterior pedicle screw internal fixation treatment, the observation group patients give posterior pedicle screw internal fixation with bone graft surgery therapy.ResultsAfter surgery, VAS score, Cobb Angle observation group were better than the control group (P<0.05), two groups of data difference was statistically signiifcant (P<0.05).Conclusion Posterior pedicle screw internal fixation with bone graft surgery therapy thoracic lumbar spine fracture effect is remarkable was statistically significant (P<0.05). Conclusion Posterior pedicle screw internal fixation with bone graft surgery therapy thoracic lumbar spine fracture effect is remarkable.%目的:探讨后路椎弓根螺钉内固定联合植骨手术治疗脊柱胸腰段骨折的临床疗效。方法将我院收治的72例脊柱胸腰段骨折患者随机分为两组,各36例。对照组单用后路椎弓根螺钉内固定治疗,观察组给予后路椎弓根螺钉内固定联合植骨手术治疗。结果手术后,观察组VAS评分、Cobb角均优于对照组(P<0.05),差异有统计学意义(P<0.05)。结论后路椎弓根螺钉内固定联合植骨手术治疗脊柱胸腰段骨折效果显著。

  2. 外固定架联合带蒂皮瓣用于胫骨骨折术后感染并骨外露治疗的疗效分析%COMBINED WITH EXTERNAL FIXATION FOR TIBIAL FRACTURES WITH PEDICLE FLAPS AND POSTOPERATIVE INFECTION OF THE THERAPEUTIC EFFECT OF BONE EXPOSURE

    Institute of Scientific and Technical Information of China (English)

    蒋晖

    2011-01-01

    [Objective] To analyze and summarize the joint use of pedicle flaps treated with external fixation of tibial fractures after infection and the clinical effect of bone exposure. [Methods] 13 cases with tibial fractures leg after infection, bone and plate exposure were collected from 2008 and 2009 in our hospital, external fixation was used for reconstruction of bone stability Kirschner, and we also used the ipsilateral leg, the .lateral vascular pedicle flap. [Results] All patients transferred flaps survived well and were at the range of 6 to 36 months, with an average of 24 months. All fractures were healed limb function recovered well, and no obvious infection occurred. [Conclusion] The external fixator combined pedicled flap is effective in treatment of infected tibial fractures and bone exposed.%[目的]分析并总结利用外固定架联合带蒂皮瓣治疗胫骨骨折术后感染并骨外露的临床效果.[方法]总结我院2008-2009年收治的小腿胫骨骨折术后感染、骨及钢板外露者13例,治疗用外固定支架联合克氏针重建骨稳定性,采用同侧小腿内、外侧血管蒂皮瓣.[结果]治疗患者所有转移皮瓣全部成活良好,经6~36个月随访,平均24个月,所有骨折患者均愈合良好,下肢功能恢复良好,未见明显感染.[结论]外固定架联合带蒂皮瓣是治疗胫骨骨折术后感染并骨外露切实有效的临床手段.

  3. Photographic fixative poisoning

    Science.gov (United States)

    Photographic developer poisoning; Hydroquinone poisoning; Quinone poisoning; Sulfite poisoning ... Quinones Sodium thiosulfate Sodium sulfite/bisulfite Boric acid Photographic fixative can also break down (decompose) to form ...

  4. Femoral Aperture Fixation Improves Anterior Cruciate Ligament Graft Function When Added to Cortical Suspensory Fixation

    Science.gov (United States)

    Porter, Mark D.; Shadbolt, Bruce

    2016-01-01

    Background: Recommendations for bone tunnel placement during anterior cruciate ligament (ACL) reconstruction have become more precise. However, these recommendations differ neither with the choice of graft nor with the method of fixation used. The influence of the method of femoral fixation used on the biomechanical function of a soft tissue ACL graft remains unknown. Hypothesis: Our null hypothesis was that adding femoral aperture fixation to femoral cortical fixation, using the same bone tunnels, will not alter the control of anterior translation (AT) and internal rotation (IR) during ACL reconstruction using a hamstring graft. Study Design: Controlled laboratory study. Methods: A total of 22 patients with an acute isolated ACL rupture underwent reconstruction using a single-bundle autologous hamstring graft. Computer navigation was used intraoperatively to plot the AT and IR during the pivot-shift test before reconstruction, after ACL reconstruction using cortical suspensory fixation, and after the addition of femoral aperture fixation. Statistical analysis (analysis of variance) was used to compare the AT and IR during the pivot shift at each stage in the procedure. Results: Before ACL reconstruction, the mean (±SD) AT was 14.2 ± 7.3 mm and mean IR was 17.2° ± 5.5°. After reconstruction using femoral cortical suspension, these figures were significantly reduced to 6.2 ± 3.5 mm and 12.5° ± 3.20°, respectively (P < .001). The addition of the aperture fixation was associated with a further significant reduction to 4.6 ± 3.2 mm and 10.4° ± 2.7°, respectively (P < .001). Conclusion: The addition of femoral aperture fixation to suspensory fixation results in a significant reduction in both the AT and IR that occurs during the pivot-shift assessment immediately after ACL reconstruction using autologous hamstring graft. Clinical Relevance: The most precise positioning of bone tunnels during soft tissue ACL reconstruction needs to take into consideration

  5. Femoral Aperture Fixation Improves Anterior Cruciate Ligament Graft Function When Added to Cortical Suspensory Fixation

    Science.gov (United States)

    Porter, Mark D.; Shadbolt, Bruce

    2016-01-01

    Background: Recommendations for bone tunnel placement during anterior cruciate ligament (ACL) reconstruction have become more precise. However, these recommendations differ neither with the choice of graft nor with the method of fixation used. The influence of the method of femoral fixation used on the biomechanical function of a soft tissue ACL graft remains unknown. Hypothesis: Our null hypothesis was that adding femoral aperture fixation to femoral cortical fixation, using the same bone tunnels, will not alter the control of anterior translation (AT) and internal rotation (IR) during ACL reconstruction using a hamstring graft. Study Design: Controlled laboratory study. Methods: A total of 22 patients with an acute isolated ACL rupture underwent reconstruction using a single-bundle autologous hamstring graft. Computer navigation was used intraoperatively to plot the AT and IR during the pivot-shift test before reconstruction, after ACL reconstruction using cortical suspensory fixation, and after the addition of femoral aperture fixation. Statistical analysis (analysis of variance) was used to compare the AT and IR during the pivot shift at each stage in the procedure. Results: Before ACL reconstruction, the mean (±SD) AT was 14.2 ± 7.3 mm and mean IR was 17.2° ± 5.5°. After reconstruction using femoral cortical suspension, these figures were significantly reduced to 6.2 ± 3.5 mm and 12.5° ± 3.20°, respectively (P < .001). The addition of the aperture fixation was associated with a further significant reduction to 4.6 ± 3.2 mm and 10.4° ± 2.7°, respectively (P < .001). Conclusion: The addition of femoral aperture fixation to suspensory fixation results in a significant reduction in both the AT and IR that occurs during the pivot-shift assessment immediately after ACL reconstruction using autologous hamstring graft. Clinical Relevance: The most precise positioning of bone tunnels during soft tissue ACL reconstruction needs to take into consideration

  6. External fixation for phalangeal and metacarpal fractures

    NARCIS (Netherlands)

    Drenth, DJ; Klasen, HJ

    1998-01-01

    From 1987 to 1993 we treated 33 patients with 29 phalangeal and seven metacarpal fractures by external fixation using a mini-Hoffmann device. There were 27 open and 25 comminuted fractures, In 12 patients one or more tendons was involved, The mean follow-up was 4.4 years, Complications occurred in t

  7. Guide to radiation fixatives

    International Nuclear Information System (INIS)

    This report identifies and then characterizes a variety of substances available in the market place for potential effectiveness as a fixative on radiologically contaminated surfaces. The substances include both generic chemicals and proprietary products. In selecting a fixative for a particular application, several attributes of the fixative may be relevant to the choice. These attributes include: toxicity, durability, and cleanliness and removability. In addition to the attributes of the fixative, one should also take into account certain characteristics of the site to be treated. These characteristics relate to climate, nature of the surface, use to which the treated surface will be put, subsequent cleanup operations, and type of neighboring surfaces. Finally, costs and potential environmental effects may influence the decision. A variety of fixatives are evaluated with respect to these various attributes and summarized in a reference table

  8. 后路椎间盘摘除联合两种不同植骨融合椎弓根内固定治疗退变性腰椎间盘突出症疗效分析%The Effectiveness of Posterior Discectomy in Combination of Two Different Types of Bone Fusion Transpedicular Internal Fixation in Treating Degenerative Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    易军飞; 黄卫国; 白瑞飞; 陈通; 刘友军

    2013-01-01

    Objective:To investigate effectiveness of two kinds of surgical treatments,posterior discectomy autologous intervertebral bone graft and intertransverse-bone graft on transpedicular internal fixation,on the degenerative disc herniation.Method:Among 76 patients(122 lumbar segment)with degenerative disc disease went through posterior discectomy under autogenous bone graft fusion pedicle screw fixation.Of which,45 patients were treated with autologous intervertebral bone graft and the rest were treated with autogenous intertransverse-bone graft.The initial clinical results were measured regularly.Result:The follow-up period was 6 to 76 months. Oswestry Disability Index(ODI)was applied to assess the treatment efficacy.In the intervertebral bone graft group,there were 31 excellent cases and 10 good cases,with good-excellent ratio at 91.1%. In the intertransverse-bone graft group,there were 25 excellent cases and 4 good cases,with good-excellent ratio at 93.5%.Bone fusion rate was 100%for the intervertebral bone graft group and 96.8%for intertransverse-bone graft group. Conclusion:The effectiveness of two kinds of surgical treatments,posterior discectomy autologous intervertebral bone graft and intertransverse-bone graft on transpedicular internal fixation,on the degenerative disc herniation is satisfactory. After carefully explored and clarified the dominant pathogenic mechanism of LDH low back pain,we selectively use different fusions.Intertransverse bone fusion has low operation costs and leads to fewer complications.%目的:总结后路椎间盘摘除自体椎间植骨和横突间植骨融合椎弓根内固定两种手术方法治疗退变性椎间盘突出症的疗效。方法:对76例(122个腰椎节段)退变性椎间盘突出症患者行后路椎间盘摘除自体骨移植融合椎弓根内固定术,其中45例采用自体骨椎间植骨,31例采用自体骨横突间植骨,同时随访观察初期的临床疗效。结果:76例获随访,时间6

  9. The effect of latency on bone lengthening force and bone mineralization: an investigation using strain gauge mounted on internal distractor device

    OpenAIRE

    Wang Jue; Wu Zhongying; Liu Yaxiong; Li Dichen; Singare Sekou

    2006-01-01

    Abstract Background The purpose of this study was to investigate the effect of latency on the development of bone lengthening force and bone mineralization during mandible distraction osteogenesis. Methods Distraction tensions were investigated at different latency period in 36 rabbits using internal unilateral distractor. Strain gauges were prepared and attached to the distractor to directly assess the level of distraction tension during mandible lengthening. The tensile force environment of...

  10. The effect of latency on bone lengthening force and bone mineralization: an investigation using strain gauge mounted on internal distractor device

    Directory of Open Access Journals (Sweden)

    Wang Jue

    2006-03-01

    Full Text Available Abstract Background The purpose of this study was to investigate the effect of latency on the development of bone lengthening force and bone mineralization during mandible distraction osteogenesis. Methods Distraction tensions were investigated at different latency period in 36 rabbits using internal unilateral distractor. Strain gauges were prepared and attached to the distractor to directly assess the level of distraction tension during mandible lengthening. The tensile force environment of the mandible of rabbit during distraction was evaluated through in vivo experiments using two gauges. The animals were divided into 3 groups each containing 12 rabbits. Latency periods of 0, 4 and 7 days respectively were observed prior to beginning distraction. The distraction protocol consisted of a lengthening rate of 1 mm once daily for 8 days, followed by a consolidation phase of 2 weeks after which the animals were killed. Biopsies specimens were taken from the distracted area at the end of the distraction period. A non-distracted area of the mandible bone served as control. The specimens were analyzed by scanning electron microscopy to assess the ultrastructural pattern, and the bone mineralization. Results The resting tension acting on the distraction gap increases through distraction. The 7-day latency groups exhibit higher tension then those of 0-day and 4-days latency groups. Quantitative energy dispersive spectral analysis confirmed that immediate distractions were associated with lower calcium and phosphate atomic weight ratio. Conclusion the latency periods could affect the bone lengthening tension and the bone mineralization process.

  11. A new adhesive technique for internal fixation in midfacial surgery

    Directory of Open Access Journals (Sweden)

    Riediger Dieter

    2008-05-01

    Full Text Available Abstract Background The current surgical therapy of midfacial fractures involves internal fixation in which bone fragments are fixed in their anatomical positions with osteosynthesis plates and corresponding screws until bone healing is complete. This often causes new fractures to fragile bones while drilling pilot holes or trying to insert screws. The adhesive fixation of osteosynthesis plates using PMMA bone cement could offer a viable alternative for fixing the plates without screws. In order to achieve the adhesive bonding of bone cement to cortical bone in the viscerocranium, an amphiphilic bone bonding agent was created, analogous to the dentin bonding agents currently on the market. Methods The adhesive bonding strengths were measured using tension tests. For this, metal plates with 2.0 mm diameter screw holes were cemented with PMMA bone cement to cortical bovine bone samples from the femur diaphysis. The bone was conditioned with an amphiphilic bone bonding agent prior to cementing. The samples were stored for 1 to 42 days at 37 degrees C, either moist or completely submerged in an isotonic NaCl-solution, and then subjected to the tension tests. Results Without the bone bonding agent, the bonding strength was close to zero (0.2 MPa. Primary stability with bone bonding agent is considered to be at ca. 8 MPa. Moist storage over 42 days resulted in decreased adhesion forces of ca. 6 MPa. Wet storage resulted in relatively constant bonding strengths of ca. 8 MPa. Conclusion A new amphiphilic bone bonding agent was developed, which builds an optimizied interlayer between the hydrophilic bone surface and the hydrophobic PMMA bone cement and thus leads to adhesive bonding between them. Our in vitro investigations demonstrated the adhesive bonding of PMMA bone cement to cortical bone, which was also stable against hydrolysis. The newly developed adhesive fixing technique could be applied clinically when the fixation of osteosynthesis plates

  12. Carbon based prosthetic devices

    Energy Technology Data Exchange (ETDEWEB)

    Devlin, D.J.; Carroll, D.W.; Barbero, R.S.; Archuleta, T. [Los Alamos National Lab., NM (US); Klawitter, J.J.; Ogilvie, W.; Strzepa, P. [Ascension Orthopedics (US); Cook, S.D. [Tulane Univ., New Orleans, LA (US). School of Medicine

    1998-12-31

    This is the final report of a one-year, Laboratory Directed Research and Development (LDRD) project at the Los Alamos National Laboratory (LANL). The project objective was to evaluate the use of carbon/carbon-fiber-reinforced composites for use in endoprosthetic devices. The application of these materials for the metacarpophalangeal (MP) joints of the hand was investigated. Issues concerning mechanical properties, bone fixation, biocompatibility, and wear are discussed. A system consisting of fiber reinforced materials with a pyrolytic carbon matrix and diamond-like, carbon-coated wear surfaces was developed. Processes were developed for the chemical vapor infiltration (CVI) of pyrolytic carbon into porous fiber preforms with the ability to tailor the outer porosity of the device to provide a surface for bone in-growth. A method for coating diamond-like carbon (DLC) on the articulating surface by plasma-assisted chemical vapor deposition (CVD) was developed. Preliminary results on mechanical properties of the composite system are discussed and initial biocompatibility studies were performed.

  13. GSS pedicle screw fixation combined with two-stage bone cement perfusion for thoracolumbar fractures%GSS椎弓根螺钉内固定并二期伤椎骨水泥灌注治疗胸腰椎骨折

    Institute of Scientific and Technical Information of China (English)

    宋洁富; 李利军; 常峰; 荆志振

    2012-01-01

    Objective To explore the efficacy and safety of surgical treatment of thoracolumbar fractures by GSS pedicle screw fixation combined with two-stage bone cement perfusion. Methods From March 2005 to October 2010, 31 patients with thoracolumbar bursting fractures were treated with posterior GSS pedicle screw fixation. The patients were reviewed by X-ray and CT scan 3-18 months postoperatively. Once "eggshell phenomenon" appeared, bone cement was used in the injured vertebral body before removing the fixators. Injured vertebral height and Cobb' s angle were measured preoperatively, postoperatively and at the final follow-up. Results No leakage of bone cement happened in all the patients. The internal fixators were removed 12-18 months postoperatively. Then the patients were followed up for 1-3 years. Fractured vertebral height and Cobb' s angle were significantly improved after surgery. Conclusion GSS combined with two-stage bone cement perfusion for thoracolumbar fractures can achieve a good therapeutic effect. It can be taken as an attempt at the treatment of thoracolumbar fractures.%目的 探讨GSS椎弓根螺钉内固定结合二期伤椎骨水泥灌注治疗胸腰椎骨折的有效性和安全性.方法 2005年3月~2010年10月共31例胸腰椎爆裂性骨折患者行后路GSS椎弓根螺钉内固定治疗,术后3~18个月根据X线及CT复查情况,出现"蛋壳现象"的患者在取出内固定前行伤椎骨水泥灌注,记录术前、术后及末次随访时的伤椎高度及X线片测量的Cobb角角度.结果 本组患者均未出现骨水泥渗漏,术后12~18个月取出内固定后再随访1~3年.术后伤椎椎体高度及Cobb角与术前相比有明显改善.结论 GSS椎弓根螺钉内固定结合二期伤椎骨水泥灌注治疗胸腰椎骨折可达到良好的治疗效果,可作为治疗胸腰椎骨折的新的尝试.

  14. 病灶清除植骨内固定加灌注冲洗局部化疗治疗胸腰椎结核24例临床分析%Debridement Bone Graft and Internal Fixation with Irrigation and Local Chemotherapy in the Treatment of Thoracic and Lumbar Tuberculosis:Clinical Analysis of 24 Cases

    Institute of Scientific and Technical Information of China (English)

    王剑龙; 孙建锋

    2013-01-01

    Objectives To summary the curative effect of lesion clearance , bone transplantation internal fixation ,local chemotherapy and persistent local drainage on spinal tuberculosis. Methods 24 cases of spinal tuberculosis with abscess, all given systemic chemotherapy, were accepted lesion clearance, posterior (anterior) internal fixation ,auto-iliac bone graft, placing perfusion tube for local drainage and putting into a epidural catheter for local chemotherapy. Results 24 cases of spinal tuberculosis with abscess ,followed up for 6 months to 30 months, of which 23 cases had satisfactory effects,had no relapse ,had stable internal fixation without fixation relaxation and fracture, and got solid fusion within 6 months .Only one case occurred wound dehiscence one month after the surgery , and healed after debridement and wound dressing . Conclusion The curative effect of lesion clearance , bone transplantation internal fixation ,local chemotherapy and persistent local drainage had obvious effect in treatment of spinal tuberculosis. Lesion clearance bone transplantation internal fixation could effectively correct the spine deformity, stabilize the spine,promote spinal bone transplantation crasis, shorten in-bed time, walk as soon as possible,reduce complications. local chemotherapy and persistent local drainage could clear the focus away thoroughly,reduce the chance of relapse.%  目的总结病灶清除植骨内固定术加置管灌注冲洗局部化疗治疗脊柱结核的疗效。方法24例脊柱结核并脓肿患者,全部患者在全身化疗的同时,采用病灶清除(前路),后路(或前路)内固定,取髂骨植骨,病灶部位放置灌注冲洗管进行灌注冲洗和持续局部化疗,并同时置一硬膜外导管于体外,局部注射抗结核药物。结果24例脊柱结核并脓肿患者经过6~30个月随访,其中1例术后1个月出现伤口裂开,清创换药20天后痊愈。余23例疗效满意,无结核复发。所

  15. A novel intramedullary callus distraction system for the treatment of femoral bone defects.

    Science.gov (United States)

    Horas, Konstantin; Schnettler, Reinhard; Maier, Gerrit; Horas, Uwe

    2016-08-01

    An intramedullary device has some advantages over external fixation in callus distraction for bone defect reconstruction. There are difficulties controlling motorized intramedullary devices and monitoring the distraction rate which may lead to poor results. The aim of this study was to design a fully implantable and non-motorized simple distraction nail for the treatment of bone defects. The fully implantable device comprises a tube-in-tube system and a wire pulling mechanism for callus distraction. For the treatment of femoral bone defects, a traction wire, attached to the device at one end, is fixed to the tibial tubercle at its other end. Flexion of the knee joint over a predetermined angle generates a traction force on the wire triggering bone segment transport. This callus distraction system was implanted into the femur of four human cadavers (total 8 femora), and bone segment transport was conducted over 60-mm defects with radiographic monitoring. All bone segments were transported reliably to the docking site. From these preliminary results, we conclude that this callus distraction system offers an alternative to the current intramedullary systems for the treatment of bone defects. PMID:27221258

  16. [Bone diseases].

    Science.gov (United States)

    Uebelhart, Brigitte; Rizzoli, René

    2016-01-13

    Calcium intake shows a small impact on bone mineral density and fracture risk. Denosumab is a more potent inhibitor of bone resorption than zoledronate. Abaloparatide, PTHrP analog, increases bone mineral density and decreases fracture incidence. Teriparatide could be delivered via a transdermic device. Romosozumab and odanacatib improve calculated bone strength. Sequential or combined treatments with denosumab and teriparatide could be of interest, but not denosumab followed by teriparatide. Fibrous dysplasia, Paget disease and hypophosphatasia are updated, as well as atypical femoral fracture and osteonecrosis of the jaw. PMID:26946704

  17. 脊柱结核内植物置入后基于C-反应蛋白及红细胞沉降率多样性与植骨融合时间的相关分析%C-reactive protein and erythrocyte sedimentation rate associate with bone graft union in patients with spinal tuberculosis following internal fixation

    Institute of Scientific and Technical Information of China (English)

    蓝常贡; 唐毓金; 陆敏安; 韦玮; 谢克恭; 潘生才; 卢贤哲

    2012-01-01

    背景:脊柱结核行结核病灶清除、植骨、加或不加钢板内固定后患者C-反应蛋白及红细胞沉降率变化与植骨块骨性融合时间有一定的联系.目的:分析脊柱结核内置物置入后C-反应蛋白及红细胞沉降率动态多样性和植骨融合时间的相关性.方法:60例脊柱结核患者均行结核病灶清除、自体髂骨植骨、加或不加钢板内固定治疗,其中内固定38例,无内固定22例.根据术后C-反应蛋白水平及红细胞沉降率分别分为轻度升高、中度升高、高度升高组和极度升高组.分析术后C-反应蛋白、红细胞沉降率和植骨块骨性融合时间差异性和相关性.结果与结论:①C-反应蛋白:轻度升高18例,中度升高21例,高度升高13例,极度升高8例.4组骨性愈合时间差异有非常显著性意义(P=0.003).Spearman相关分析显示相关系数为r=0.420,P=0.001,说明术后C-反应蛋白水平多样性与骨性融合时间长短呈正相关.②红细胞沉降率:轻度升高16例,中度升高20例,高度升高13例,极度升高11例.4组骨性愈合时间差异有非常显著性意义(P=0.003).Spearman相关分析显示相关系数为r=0.414,P=0.001,说明术后红细胞沉降率多样性与骨性融合时间长短呈正相关.③内固定组植骨融合时间快于无内固定组,说明即时坚强内固定有利于促进骨性愈合.%BACKGROUND: Tuberculosis clearance, bone graft, internal fixation with or without plate for patients with spinal tuberculosis always lead to C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) changes, which are associated with bone graft union time to certain degree.OBJECTIVE: To analyze the correlation between CRP, ESR and bone graft union time in patients with spinal tuberculosis.METHODS: A total of 60 patients with spinal tuberculosis underwent tuberculose focus clearance, autologous iliac bone grafting, and internal fixation without or with plate, including 38 undergoing fixation

  18. Bone cement-augmented pedicle screw fixation for lumbar spondylolisthesis combined with osteoporosis:1-year follow-up%骨水泥强化椎弓根螺钉置入固定骨质疏松性腰椎滑脱:1年随访

    Institute of Scientific and Technical Information of China (English)

    丁权; 陈勇

    2015-01-01

    BACKGROUND:For patients with lumbar spondylolisthesis combined with osteoporosis, appropriate fixation system for effective reset and good fixation stability is currently a hot issue of clinical concern. Pedicle screw screw-rod system after bone cement perfusion can achieve the effective fixation between pedicle screw system and the vertebral bone. OBJECTIVE:To observe the therapeutic effect of bone cement-augmented pedicle screw on patients with lumbar spondylolisthesis combined with osteoporosis. METHODS:17 cases of lumbar spondylolisthesis combined with osteoporosis were identified by bone density test. They received the posterior open reduction and internal fixation, and implanted with 68 bone cement-augmented pedicle screws. Their repair effects were observed by short-term fol ow-up. Patients were evaluated using low back pain Visual Analog Scale and lower limb Oswestry Disability Index before treatment, 1 week, 3 months and 1 year after treatment. Vertebral height, intervertebral height, screw loosening and bone cement leakage were observed using imaging. RESULTS AND CONCLUSION:Compared with pre-treatment, low back pain Visual Analog Scale score and lower limb Oswestry Disability Index were significantly improved at 1 week, 3 months and 1 year after treatment (P0.05), which indicated that clinical repair effect could be effectively maintained. At 3 months of fol ow-up, one screw loosening occurred in two patients. During fixation, mild bone cement leakage appeared in seven vertebral bodies with screw fixation, no symptoms or subsequent complications were observed. There were no significant differences in vertebral height and intervertebral height before and after treatment and during fol ow-up (P>0.05). These results suggest that bone cement-augmented pedicle screw for patients with lumbar spondylolisthesis combined with osteoporosis can effectively reset vertebral slippage, effectively provide good anti-pul-out force for a long term, and the effect was

  19. Removal of lumbar disc with cage bone graft fusion and internal fixation for the treatment of lumbar disc herniation%腰椎间盘摘除加cage植骨融合内固定治疗腰椎间盘突出症

    Institute of Scientific and Technical Information of China (English)

    张亚; 冯虎; 李健华; 刁天月; 蒋学军; 杨挺

    2016-01-01

    目的:探讨腰椎间盘摘除加cage植骨融合内固定治疗腰椎间盘突出症的临床疗效。方法对32例腰椎间盘突出症患者行腰椎间盘摘除加cage植骨融合内固定术,采用Oswestry功能障碍指数( ODI)和疼痛视觉模拟评分( VAS)对手术疗效进行评估。结果患者均获得随访,时间12~36(18±6.5)个月。患者术后疼痛均明显缓解,功能改善,术后ODI与VAS评分均较术前明显降低,差异有统计学意义( P<0.05)。术后融合节段均骨性愈合。随访期间内cage位置正常,内固定物无断裂及滑脱。结论腰椎间盘摘除加cage植骨融合内固定术能增加脊柱的稳定性及脊柱融合率,缓解患者症状及改善功能,临床疗效满意。%Objective To investigate the clinical effect of removal of lumbar disc with cage bone graft fusion and in-ternal fixation for the treatment of lumbar disc herniation. Methods 32 patients with lumbar disc herniation who un-derwent removal of lumbar disc with cage bone graft fusion and internal fixation systems. Oswestry disability index ( ODI) and visual analogue scale ( VAS) were used to evaluate the surgical effect. Results All patients were fol-lowed up for 12 ~36 ( 18 ± 6. 5 ) months. The postoperative pain was significantly relieved and function was im-proved, postoperative ODI and VAS decreased significantly comparing with that of the preoperation (P<0. 05). All fusion segments achieved solid fusion, all these implants were in good places without displacement or internal fixation failure. Conclusions Removal of lumbar disc with cage bone graft fusion and internal fixation for the treatment of lumbar disc herniation can increase the stability of the spine and the rate of fusion, significantly relieve symptoms and improve patients′function, which can obtain a satisfactory clinical effect.

  20. Ilizarov Method: A Limb Salvage Device in a Child.

    Science.gov (United States)

    Faruque, M G; Mollah, M U; Siddiquee, T H; Bari, S

    2016-07-01

    Ilizarov method is the best weapon for the treatment of the limb length discrepancy, especially in traumatic or congenital shortening of long bones. Post burn bony defect can be corrected by osteosynthesis. Here we treated a 7 years old boy, suffering from 33% electric burn affecting face, trunk, left upper limb & both lower limbs with loss of soft tissue of medial side of right leg along with dead and exposed of some segment (about 14cm) of Left tibia . Initially the patient was managed by plastic surgeons in the form of surgical toileting, wound debridement and wound coverage by split thickness skin graft. After about 6 weeks, we applied Ilizarov fixator on the affected limb and maintained it for 7 days to increase vascularity. As there was minimum bone in the proximal part, we did corticotomy at the distal end. After 7 days further, we started distal to proximal bone transport at a rate of 1mm per day. Staged excision of about 2.5 to 3cm dead bone was done, after transporting the same length of bone each time. In 5 such sittings, a total of 14cm bone was excised. Thus the burned portion was replaced by new bone; bony union was achieved after applying compression. Now the patient is able to walk individually, without any difficulty. So, we found that, Ilizarov method is a good option for the management of post burn bone loss. To our knowledge, such an application of the Ilizarov external fixation device in post burn bone loss has yet to be reported. PMID:27612909

  1. 同种异体骨切割设备夹持装置的设计%Design of Gripping Device of Allogeneic Bone Cutting Equipment

    Institute of Scientific and Technical Information of China (English)

    方新果; 萨拉; 赵改平; 王晨曦; 柏磊磊

    2014-01-01

    Based on bionic principle and the mechanics analysis of bone implant materials,a mechanics model for hand clamping structure with six degrees of freedom is established and a gripping device for bone cutting is designed. It is suitable for the processing of bone materials of irregular shapes and can meet requirements for va-rious specific clinic products. In addition,the operation safety and the efficiency of bone material utilization are both improved.%根据对骨植入材料的力学分析,从仿生学原理入手,建立六自由度的手夹持结构的力学模型,设计了骨切割设备夹持手机械结构。它能适应不规则形状骨材料的加工,满足临床对不同规格产品的需求,可提高操作的安全性、骨料的利用率。

  2. Midterm results of biologic fixation or mosaicplasty and drilling in osteochondritis dissecans

    Directory of Open Access Journals (Sweden)

    Tuluhan Yunus Emre

    2011-01-01

    Conclusion: Biologic fixation or mosaicplasty and drilling as a technique to treatment of the lesion in OCD by osteochondral autograft transfer has resulted in good and excellent clinical outcomes in our patients and it is considered that providing blood flow to subchondral bone by circumferencial drilling leads to an increase in the robustness of biological internal fixation and shortens the duration of recovery.

  3. 伤椎椎弓根植骨加短节段椎弓根螺钉置入内固定治疗老年人胸腰椎骨折%Transpedicular bone graft combined with short-segment pedicle screw internal fixation for senile thoracolumbar fracture

    Institute of Scientific and Technical Information of China (English)

    王宏伟; 王宇; 王军辉; 穆尚强; 姜波; 潘锋

    2011-01-01

    BACKGROUND: Traditional pedicle screw internal fixation combined with posterolateral lumbar fusion in the treatment of senilethoracolumbar burst fracture are easily to occur reset angle, high loss, delayed nerve damage and internal fixation loosening.OBJECTIVE: To investigate the method and effect of transpedicular bone graft combined with pedicle screw internal fixation onthe treatment of senile thoracolumbar fracture.METHODS: Totally 32 patients who were more than 60 years old with thoracolumbar burst fracture were treated by posteriorpedicle fixation combined with grafting through the injured pedicle. Height of fractured vertebrae, Cobb angle, occupying of spinalcanal, neuropathic function, lumbar and back pain were measured and analyzed preoperatively, postoperatively and during thefollow up period.RESULTS AND CONCLUSION: All the patients were followed-up over 6 months. The internal fixation was not break or loose, theheight of fractured vertebrae, the Cobb angle, the occupying of spinal canal, the neuropathic function, lumbar and back painimproved obviously, and the height of fractured vertebrae, the Cobb angle and the occupying of spinal canal were not obviouslylose. It is indicated that application of transpedicular bone graft combined with posterior pedicle screw internal fixation is aneffective method in treatment of senile thoracolumbar burst fracture, it can restore the height and strength of the vertebral body,and immediately increase vertebral bone content and the stability of the spine, and reduce the possibility of breaking nail, breakingrod, the loss of height and other complications, which are caused by stress.%背景:传统椎弓根内固定系统加后外侧植骨融合治疗老年胸腰椎爆裂性骨折易发生复位角度、高度丢失,迟发性神经损伤,内固定松动.目的:观察经骨折椎椎弓根植骨联合椎弓根内固定治疗老年胸腰椎爆裂性骨折的方法和效果.方法:采用经骨折椎椎弓根植骨结合短

  4. 空心拉力螺钉加镍钛聚髌器置入内固定重建骨折髌骨的生物力学条件%Biomechanical requirement for the reconstruction of patellar fracture treated with cancellous bone screw and nickel-titanium-patellar concentrator internal fixation

    Institute of Scientific and Technical Information of China (English)

    高振巢; 刘德昌; 蔡国平

    2013-01-01

    BACKGROUND: There are various internal fixation methods for the clinical treatment of patel ar fractures, but each method has advantages and disadvantages, respectively. The selection of proper internal fixation method wil directly affect the healing time and recovery of knee joint function. OBJECTIVE: To investigate the biomechanical reconstruction effect on patel ar fracture treated with cancel ous bone screw and nickel-titanium-patel ar concentrator internal fixation. METHODS: A retrospective analysis was performed on 27 cases of acute patel ar fracture patients from January 2011 to January 2012 in the Department of Orthopedics, Jinshan Hospital, Fudan University, including 13 cases of transverse fracture, 11 cases of comminuted fracture and three cases of upper or lower pole fracture. Al the 27 patients received cancel ous bone screw and nickel-titanium-patel ar concentrator internal fixation without plaster external fixation, and then the quadriceps active contraction training was performed from the 2nd day after internal fixation, and bed knee flexion and extension exercises were performed at 1 week after internal fixation. The knee joint function was evaluated with Böstman score system. RESULTS AND CONCLUSION: Al the 27 patients were fol owed-up for 4-14 months. Incisions obtained stage Ⅰ healing, and there was no fracture fixation or shedding, wound infection, skin necrosis or other complications. The average healing time was 8.5 weeks without delayed healing. According to clinical grading scale of Böstman score system, the mean score was 27.9, included 27 cases of excel ent (81%), four cases of good (15%), one case of poor (4%), and the excel ent and good rate was 96%. The results suggest that cancel ous bone screw combined with nickel-titanium-patel ar concentrator internal fixation can maintain the advantages of traditional internal fixation method, and can avoid the disadvantages of the traditional internal fixation method.%  背景:目前

  5. Immediate ipsilateral fibular transfer in a large tibial defect using a ring fixator : A case report

    OpenAIRE

    Kim, H S; Jahng, J. S.; Han, D. Y.; Park, H. W.; Chun, C. H.

    1998-01-01

    Massive segmental bony defects in open tibial fractures are generally treated with conventional bone grafting, a free vascularised fibular graft or the ring fixator technique. A vascularised fibular graft may be superior to a conventional bone graft, but it is technically difficult and occasionally impossible. In such circumstances, fibular transfer in conjunction with a ring fixator is an alternative method. This procedure can be accomplished by transferring the osteotomised part of the fibu...

  6. Clinical application of augmented pedicle screw fixation with bone cement in lumber spondylolisthesis accompanied with osteoporosis%骨水泥强化椎弓根螺钉在腰椎滑脱伴骨质疏松椎体中的临床应用

    Institute of Scientific and Technical Information of China (English)

    李鹏; 毛克亚; 王岩; 肖嵩华; 张永刚; 张西峰; 张雪松; 程自申; 毛克政

    2011-01-01

    目的 探讨骨水泥强化椎弓根螺钉在腰椎滑脱伴骨质疏松患者的手术方法和疗效.方法 2008年7月至2010年11月年期间收治腰椎滑脱伴骨质疏松患者12例,平均68岁.骨质疏松按Jikei分级Ⅱ级4例,Ⅲ级8例.所有患者行经椎弓根螺钉内固定,术中采用骨水泥强化提高螺钉稳定性,植入椎弓根螺钉共26枚,观察椎弓根螺钉术中及术后的稳定性.结果 患者未发生手术并发症,腰腿痛症状改善明显,术后VAS评分较术前比较改善明显.12例患者均获得随访,随访时间8-16个月,平均14个月.12例均获得骨性融合,X线片显示内固定无松动、断裂或脱落,螺钉周围未见透亮线出现.结论 经椎弓根骨水泥强化椎弓根螺钉,固化椎体的同时增加了椎弓根螺钉界面把持力,能够满足腰椎滑脱伴骨质疏松患者脊椎后路固定手术对力学稳定的要求.%Objective To explore the surgical method and efficacy of augmented pedicle screw fixation with bone cement for the treatment of lumber spondyiolisthesis accompanied with osteoporosis. Methods Twelve lumber spondyiolisthesis patients accompanied with osteoporosis were collected and treated from July 2008 to November 2010, with an average age of 68 years old. According to Jikei scale for osteoporosis, 4 patients were in stage II and 8 patients were in stage III. All patients were treated with internal fixations of pedicle screws and the stabilities of screws were augmented by bone cement augment during operations. Twenty-six pedicle screws were instrumented in this study. The stabilities of pedicle screws during and after the operation were observed. Results There were no operative complications. The symptoms of waist and leg pain were clearly alleviated. The VAS scores after operations were clearly ameliorated compared to those before the operation. All 12 patients were followed up for 8-16 months, with a mean of 14 months. All 12 patients achieved bone unions. The X

  7. Ingenious Protection Method of External Fixation after Operation%外固定架术后的巧妙保护法

    Institute of Scientific and Technical Information of China (English)

    谢婷; 张楠; 李娅; 王宁; 白宁娟

    2014-01-01

    External fixation (ESF) is a method of treating fractures, it refers to far in fractures of the proximal bone segment percutaneous needle high-intensity discharge, and then exposed in vitro stability of the system and the outer skin of the needle terminal linking the purpose of fixing fractures. Mechanical devices for external fixation technique called external fixator (ET), or an external fixator. External fixator is now very common surgery to correct the deformity after a treatment, external fixation primarily as fixed fracture, deformity and reduce the department's shift. Then apply for external fixator frame nonunion fractures with very serious skin and soft tissue injury cases, external fixator can show its unique role to save the limb provides an important means of treatment. Postoperative use of external fixation, there are certain complications, including: skin necrosis, infection, traumatic arthritis and other external fixator group of skin necrosis and traumatic arthritis was significantly lower than the control group, the dif erence was statistically significant .%骨外固定(ESF)是治疗骨折的一种方法,它是指在骨折的远、近心骨段经皮穿放高强度钢针,再用体外稳定系统与裸露于皮外的针端连接起来,达到固定骨折的目的。用于骨外固定技术的机械装置称为外固定器(ET),或外固定架。外固定架现在是矫正畸形手术后很常见了一种治疗方法,外固定架主要起到固定骨折处,减少该处的畸形和移位。外固定架架适用于是对骨不连、十分严重的骨折伴皮肤软组织损伤的病例,骨外固定器更能显示出其独特的作用,为挽救肢体提供了重要的治疗手段。术后使用外固定架,有一定的并发症,其中包括院皮肤坏死、感染、创伤性关节炎等。

  8. PERCUTANEOUS BIPLANAR EXTERNAL FIXATOR METHOD FOR TREATMENT OF CALCONEAL FRACTURES

    OpenAIRE

    Jagadeesh Kumar; Parthasaradhy M.; Subramanian,; Thiyageswaran; Abinandharajha; Adhiyamaan; Shivakumar

    2015-01-01

    Calcaneal fracture, the most common tarsal bone fracture, occurs predominantly in manual labors and subsequently has got considerable socioeconomic implications. Treatment modality which can offer early weight bearing and early return to work is therefore needed for those patient s. We have used a biplanar percutaneous external fixator for treating calcaneal fractures per operative visualization of the fractures. We have treated 20 ca...

  9. Multipurpose external fixator for intraarticular fracture of distal radius.

    Science.gov (United States)

    Siripakarn, Yongyuth; Siripakarn, Zongyuti

    2010-12-01

    Fracture of distal radius is one of a complicated injury which can be difficult in reduction and maintaining its alignment and may result in malunion and shortening following a variety of fixation. Since Anderson's and O'neil described the use of sustain traction by extraskeletal device anchored to the radius and the first metacarpal of the hand. Vidal et al [1979] demonstrated that the ligamentotaxis could be used to reduce the fracture around the wrist, ankle, hip and knee. The external fixation frame can maintain radial length and inclination by the pullout force from the radial styloid. External fixation is useful for management of complex intraarticular fracture of distal radius. There are few types of commercially available fixator. It is important to use one that allow versatility and follow biomechanic principles of ligamentotaxis, which can be used to reduce the severe comminution and the most difficult fracture by distraction and stabilization effectively. The ideal characteristic of the external fixation are: Telescoping connecting frame fixed externally compose of two joints which can be easily adjust in any direction, two pins clamp connected to the external connecting rod. Our TU Multipurpose external fixator can be designed as a multiplana, can be used as a bridge or non bridge fixation, and can be adjusted to any direction which require for the treatment of distal radius fracture. It is differed to other commercially available devices. PMID:21294433

  10. A cell shrinkage artefact in growth plate chondrocytes with common fixative solutions: importance of fixative osmolarity for maintaining morphology

    Directory of Open Access Journals (Sweden)

    MY Loqman

    2010-05-01

    Full Text Available The remarkable increase in chondrocyte volume is a major determinant in the longitudinal growth of mammalian bones. To permit a detailed morphological study of hypertrophic chondrocytes using standard histological techniques, the preservation of normal chondrocyte morphology is essential. We noticed that during fixation of growth plates with conventional fixative solutions, there was a marked morphological (shrinkage artifact, and we postulated that this arose from the hyper-osmotic nature of these solutions. To test this, we fixed proximal tibia growth plates of 7-day-old rat bones in either (a paraformaldehyde (PFA; 4%, (b glutaraldehyde (GA; 2% with PFA (2% with ruthenium hexamine trichloride (RHT; 0.7%, (c GA (2% with RHT (0.7%, or (d GA (1.3% with RHT (0.5% and osmolarity adjusted to a ‘physiological’ level of ~280mOsm. Using conventional histological methods, confocal microscopy, and image analysis on fluorescently-labelled fixed and living chondrocytes, we then quantified the extent of cell shrinkage and volume change. Our data showed that the high osmolarity of conventional fixatives caused a shrinkage artefact to chondrocytes. This was particularly evident when whole bones were fixed, but could be markedly reduced if bones were sagittally bisected prior to fixation. The shrinkage artefact could be avoided by adjusting the osmolarity of the fixatives to the osmotic pressure of normal extracellular fluids (~280mOsm. These results emphasize the importance of fixative osmolarity, in order to accurately preserve the normal volume/morphology of cells within tissues.

  11. A feasibility investigation for modeling and optimization of temperature in bone drilling using fuzzy logic and Taguchi optimization methodology.

    Science.gov (United States)

    Pandey, Rupesh Kumar; Panda, Sudhansu Sekhar

    2014-11-01

    Drilling of bone is a common procedure in orthopedic surgery to produce hole for screw insertion to fixate the fracture devices and implants. The increase in temperature during such a procedure increases the chances of thermal invasion of bone which can cause thermal osteonecrosis resulting in the increase of healing time or reduction in the stability and strength of the fixation. Therefore, drilling of bone with minimum temperature is a major challenge for orthopedic fracture treatment. This investigation discusses the use of fuzzy logic and Taguchi methodology for predicting and minimizing the temperature produced during bone drilling. The drilling experiments have been conducted on bovine bone using Taguchi's L25 experimental design. A fuzzy model is developed for predicting the temperature during orthopedic drilling as a function of the drilling process parameters (point angle, helix angle, feed rate and cutting speed). Optimum bone drilling process parameters for minimizing the temperature are determined using Taguchi method. The effect of individual cutting parameters on the temperature produced is evaluated using analysis of variance. The fuzzy model using triangular and trapezoidal membership predicts the temperature within a maximum error of ±7%. Taguchi analysis of the obtained results determined the optimal drilling conditions for minimizing the temperature as A3B5C1.The developed system will simplify the tedious task of modeling and determination of the optimal process parameters to minimize the bone drilling temperature. It will reduce the risk of thermal osteonecrosis and can be very effective for the online condition monitoring of the process.

  12. Computer navigated percutaneous screw fixation for traumatic pubic symphysis diastasis of unstable pelvic ring injuries

    Institute of Scientific and Technical Information of China (English)

    MU Wei-dong; WANG Hong; ZHOU Dong-sheng; YU Ling-zhi; JIA Tang-hong; LI Lian-xin

    2009-01-01

    Displaced and unstable pelvic ring injuries have been treated mainly by open reduction and internal fixation. The goal of treatment relies on restoration of pelvic anatomy with stable internal fixation, allowing early mobilization of the patient.1,2 The symphysis pubis dislocation (>25 mm) is consistent indication for anterior internal fixation.3 In most situations, the fixation of the displaced symphysis pubis requires extensive exposure, which may lead to complications including blood loss, neural or vascular injury, postoperative infections, wound healing problems and heterotopic bone formation.

  13. 植骨及内固定治疗半椎体和重度先天性脊柱侧后凸畸形:三维矫形的有效及安全性%Bone graft and internal fixation for the treatment of hemivertebrae and severe congenital kyphoscoliosis:Effectiveness and safety of three-dimensional correction

    Institute of Scientific and Technical Information of China (English)

    王晓平; 秦柳花; 郑蕊; 张敬; 陆明; 马华松; 周建伟; 袁伟; 牛晶; 崔凯; 陈阳; 黄子瑞

    2013-01-01

    BACKGROUND:Clinical treatment of hemivertebrae-induced congenital scoliosis is a complex medical problem. OBJECTIVE:To find the optimal treatment for hemivertebrae accompanied by congenital scoliosis. METHODS:Total y 142 hemivertebrae patients who had received surgical treatment in the Department of Orthopedics, the 306 Hospital of Chinese PLA, China from 2010 to 2012 were enrol ed. The main surgical treatment was hemivertebrae resection and bone fusion with internal fixation, apical osteotomy for severe scoliosis and spinal shortening with internal fixation, one-stage posterior thoracolumbar osteotomy with internal fixation, spinal decompression with internal fixation. RESULTS AND CONCLUSION:After treatment, the average correction rate was 70.9%for scoliosis and 71.7%for kyphosis. The fol ow-up period was 14-35 months, with an average of 23.4 months. By the end of the final fol ow-up, the loss rate for Cobb’s angle was 7.3%for scoliosis and 7.7%for kyphosis. Fol ow-up X-ray films showed bone fusion and internal fixation without loosening, fracture, and decompensation. Implementation of one-stage posterior thoracolumbar osteotomy with internal fixation can effectively correct hemivertebrae-induced kyphoscoliosis to obtain a satisfactory spinal sagittal and coronal balance.%背景:由半椎体形成的先天性脊柱侧弯在临床治疗上一直较为复杂。  目的:寻找治疗半椎体以及半椎体合并极重度先天性脊柱侧弯的最佳方法。  方法:选择2010至2012年间在解放军306医院骨科进行手术治疗的半椎体畸形患者共142例,手术治疗的方法主要为单纯半椎体切除植骨融合内固定,重度脊柱侧弯顶椎截骨脊柱短缩矫形内固定,一期后路胸腰椎截骨矫形,椎管减压矫形内固定手术。  结果与结论:治疗后侧凸平均矫正率为70.9%,后凸平均矫正率为71.7%,随访14-35个月,平均23.4个月。末次随访时侧凸Cobb角丢失率为7.3%

  14. Unilateral external fixator in the treatment of lower third humeral shaft fractures

    Institute of Scientific and Technical Information of China (English)

    LI Zhen-zhou; HOU Shu-xun; WU Ke-jian; ZHANG Wei-jia; LI Wen-feng; SHANG Wei-lin; WU Wen-wen

    2005-01-01

    Objective: To retrospectively analyze the effect of unilateral external fixators in the treatment of lower third humeral shaft fractures.Methods: From October 1997 to October 2003, 33 patients aged 15 -70 years (average 31 years) with lower third humeral shaft fractures were treated with unilateral external fixators. There were 9 spiral fractures (type A1), 1 oblique fracture (type A2), 3 transverses fractures (type A3) and 20 comminuted fractures (11 type B1, 9 type B2) according to AO classification. Fifteen cases were treated with open reduction and limited internal fixation and fixation with external fixators, 10 cases treated with open reduction and fixation with external fixators, and 8 cases treated with closed reduction and fixation with external fixators. Nerve exploration was undertaken in 9 cases with preoperative radial nerve injury. External fixators were removed after bone healing. The average follow-up was 18 months with a range from 8 to 24 months. Results: The time of bone healing ranged 11-22 weeks (average 14 weeks). The latest follow-up showed the functions of 9 cases of preoperative radial nerve injury and of 2 cases postoperative radial nerve injury and the function of elbow were recovered to normal. There were only 7 cases of superficial infection at pin hole, which was subsided by using oral antibiotics and pin-hole care with mild disinfectants.Conclusions: Fixation with unilateral external fixators combined with open reduction and limited internal fixation has a good effect in the treatment of lower third humeral shaft fractures.

  15. 后路固定椎间碎骨植骨与髂骨块植骨融合术治疗退行性腰椎不稳的临床研究%Clinical study of posterior internal fixation and iliac crest or granular bone grafting lumbar interbody fusion for the treatment of the degenerative lumbar instability

    Institute of Scientific and Technical Information of China (English)

    林斌; 林秋燕; 邵泽豹

    2012-01-01

    [Objective] To compare the clinical outcome of posterior pedicle screw fixation and iliac crest or granular bone grafting lumbar interbody fusion for the treatment of degenerative lumbar instability. [ Methods] There were 75 patients with degenerative lumbar disease. They were 41 males and 34 females, aged from 27 to 68 years with an average of 55. 6 years. Clinical manifestation; there were 72 cases with lower back pain and 47 cases with intermittent claudication. All of 75 cases had leg pain, including 37 cases of unilateral kg pain, 23 cases of bilateral leg pain and 15 cases of alternative leg pair.. Fifty - seven cases were positive with straight leg raising test, 66 cases had sensory disturbance, 58 cases had movement disorders, and 45 cases had abnormal achilles tendon reflex and knee jerk reflex, and 45 cases had injuries of cauda equina. There were 32 cases with degeneration of L4、5 , 26 cases with degeneration of L5S1 , 6 cases with degeneration of L3、4, and 11 cases with degeneration more than 2 segments. They were divided into two groups randomly: iliac bone group and granular bone group. The iliac bone group were treated with decompression, internal fixation for degenerative lumbar instability with pedicle screw and interbody fusion with iliac crest grafting. The granular bone group were treated with decompression, internal fixation and with granular bone grafting fusion. All of the cases had X -ray in routine and oblique view, CT and MRI preoperatively. The Japanese Orthopedic Association (JOA) score, Oswestry Disability Index (ODI) were evaluated before and 3, 6, 12 months after surgery. And fusion situation was evaluated by reviewing the roentgenographic film. [ Results] ( I ) Significant difference of JOA score and 0D1 were founded in each group before and after surgery. But it was no significant different between two groups. (2) The loss of intervertebral height was significant different between two group before and after surgery. The loss of

  16. Umbilical cord Wharton's jelly repeated culture system: a new device and method for obtaining abundant mesenchymal stem cells for bone tissue engineering.

    Directory of Open Access Journals (Sweden)

    Zhengqi Chang

    Full Text Available To date, various types of cells for seeding regenerative scaffolds have been used for bone tissue engineering. Among seed cells, the mesenchymal stem cells derived from human umbilical cord Wharton's jelly (hUCMSCs represent a promising candidate and hold potential for bone tissue engineering due to the the lack of ethical controversies, accessibility, sourced by non-invasive procedures for donors, a reduced risk of contamination, osteogenic differentiation capacities, and higher immunomodulatory capacity. However, the current culture methods are somewhat complicated and inefficient and often fail to make the best use of the umbilical cord (UC tissues. Moreover, these culture processes cannot be performed on a large scale and under strict quality control. As a result, only a small quantity of cells can be harvested using the current culture methods. To solve these problems, we designed and evaluated an UC Wharton's jelly repeated culture device. Using this device, hUCMSCs were obtained from the repeated cultures and their quantities and biological characteristics were compared. We found that using our culture device, which retained all tissue blocks on the bottom of the dish, the total number of obtained cells increased 15-20 times, and the time required for the primary passage was reduced. Moreover, cells harvested from the repeated cultures exhibited no significant difference in their immunophenotype, potential for multilineage differentiation, or proliferative, osteoinductive capacities, and final osteogenesis. The application of the repeated culture frame (RCF not only made full use of the Wharton's jelly but also simplified and specified the culture process, and thus, the culture efficiency was significantly improved. In summary, abundant hUCMSCs of dependable quality can be acquired using the RCF.

  17. CARBON DIOXIDE FIXATION.

    Energy Technology Data Exchange (ETDEWEB)

    FUJITA,E.

    2000-01-12

    Solar carbon dioxide fixation offers the possibility of a renewable source of chemicals and fuels in the future. Its realization rests on future advances in the efficiency of solar energy collection and development of suitable catalysts for CO{sub 2} conversion. Recent achievements in the efficiency of solar energy conversion and in catalysis suggest that this approach holds a great deal of promise for contributing to future needs for fuels and chemicals.

  18. Improving Carbon Fixation Pathways

    OpenAIRE

    Ducat, Daniel C.; Silver, Pamela A

    2012-01-01

    A recent resurgence in basic and applied research on photosynthesis has been driven in part by recognition that fulfilling future food and energy requirements will necessitate improvements in crop carbon-fixation efficiencies. Photosynthesis in traditional terrestrial crops is being reexamined in light of molecular strategies employed by photosynthetic microbes to enhance the activity of the Calvin cycle. Synthetic biology is well-situated to provide original approaches for compartmentalizing...

  19. The value of calcaneal bone mass measurement using a dual X-ray laser calscan device in risk screening for osteoporosis

    Directory of Open Access Journals (Sweden)

    Gulseren Kayalar

    2009-01-01

    Full Text Available OBJECTIVE: To evaluate how bone mineral density in the calcaneus measured by a dual energy X-ray laser (DXL correlates with bone mineral density in the spine and hip in Turkish women over 40 years of age and to determine whether calcaneal dual energy X-ray laser variables are associated with clinical risk factors to the same extent as axial bone mineral density measurements obtained using dual energy x-ray absorbtiometry (DXA. MATERIALS AND METHODS: A total of 2,884 Turkish women, aged 40-90 years, living in Ankara were randomly selected. Calcaneal bone mineral density was evaluated using a dual energy X-ray laser Calscan device. Subjects exhibiting a calcaneal dual energy X-ray laser T- score <-2.5 received a referral for DXA of the spine and hip. Besides dual energy X-ray laser measurements, all subjects were questioned about their medical history and the most relevant risk factors for osteoporosis. RESULTS: Using a T-score threshold of -2.5, which is recommended by the World Health Organization (WHO, dual energy X-ray laser calcaneal measurements showed that 13% of the subjects had osteoporosis, while another 56% had osteopenia. The mean calcaneal dual energy X-ray laser T-score of postmenopausal subjects who were smokers with a positive history of fracture, hormone replacement therapy (HRT, covered dressing style, lower educational level, no regular exercise habits, and low tea consumption was significantly lower than that obtained for the other group (p<0.05. A significant correlation was observed between the calcaneal dual energy X-ray laser T-score and age (r=-0.465, p=0.001, body mass index (BMI (r=0.223, p=0.001, number of live births (r=-0.229, p=0.001, breast feeding time (r=-0.064, p=0.001, and age at menarche (r=-0.050, p=0.008. The correlations between calcaneal DXL and DXA T-scores (r=0.340, p=0.001 and calcaneal DXL and DXA Z-scores (r=0.360, p=0.001 at the spine, and calcaneal DXL and DXA T- scores (r=0.28, p=0.001 and calcaneal

  20. DEXA as a Predictor of Fixator Removal in Distraction Osteogenesis

    OpenAIRE

    Saran, Neil; Hamdy, Reggie C.

    2008-01-01

    Premature removal of the fixator after a lengthening procedure can result in gradual bending or acute fracture of the regenerate. We reviewed the records of 26 patients who underwent 28 limb lengthenings between 1997 and 2005 to assess the post lengthening regenerate fracture rate and bone healing index when using dual energy xray absorptiometry (DEXA) to aid in deciding on when to remove the fixator. Sixteen male and 10 female patients with an average age at lengthening of 12.3 years underwe...

  1. Subtrochanteric femur fracture treated by intramedullary fixation

    Institute of Scientific and Technical Information of China (English)

    Zu-Bin Zhou; Song Chen; You-Shui Gao; Yu-Qiang Sun; Chang-Qing Zhang; Yao Jiang

    2015-01-01

    Purpose: To discuss surgical technique, operative efficacy and clinical outcome of intramedullary fixation in the treatment of subtrochanteric femur fractures.Methods: From February 2011 to February 2013, 76 cases of subtrochanteric femur fractures were treated by intramedullary fixation in our hospital, including 53 males and 23 females, with the age range of 37 -72 years (mean 53.5 years).According to Seinsheimer classification, there were 2 cases of type Ⅰ, 7 type Ⅱ,15 type Ⅲ, 23 type Ⅳ and 29 type Ⅴ.Firstly, all patients underwent closed reduction with the guidance of C-arm fluoroscopy in a traction table.Two cases of type Ⅰ and 3 cases of type Ⅲ fractures had ideal closed reduction followed by internal fixation.The others needed additional limited open reduction.Radiographic examination was used to evaluate callus formation and fracture healing in postoperative 1, 3, 6 and 12 months follow-up.Functional recovery was evaluated by Harris Hip Scoring (HHS) system.Results: Patients were followed up for 6-12 months.All fractures were healed except one patient with delayed union.The average bone union time was 4.5 months.According to HHS system, 65 cases were considered as excellent in functional recovery, 8 good, 2 fair and 1 poor.The proportion of the patients with excellent and good recovery was 96.05%.Conclusion: Intramedullary fixation is feasible for the treatment of subtrochanteric femur fracture.The accuracy of intraoperative reduction and surgical skill are important for the clinical outcome and the patients' prognosis.

  2. Estudo experimental da influência da altura do enxerto ósseo intersomático na estabilidade da fixação monossegmentar anterior da coluna cervical Experimental study of the impact of intersomatic bone graft height on the stability of anterior monosegmental fixation of the cervical spine

    Directory of Open Access Journals (Sweden)

    Jorge Alfredo Léo

    2008-06-01

    Full Text Available OBJETIVO: Estudar experimentalmente a influência da altura do enxerto ósseo intersomático da coluna cervical na estabilidade mecânica da fixação cervical anterior. MÉTODOS: Foram realizados ensaios mecânicos utilizando a coluna cervical de suínos (C3-C4. Foram formados três grupos experimentais compostos por 20 segmentos da coluna cervical (C3-C4, de acordo com o grau de instabilidade produzido e a fixação do segmento vertebral. Grupo I: retirada do disco intervertebral e colocação de enxerto intersomático. Grupo II: retirada do disco intervertebral, colocação de enxerto intersomático e fixação anterior com placa. Grupo III: retirada do disco intervertebral, secção dos ligamentos posteriores e cápsulas articulares bilateralmente, colocação do enxerto intersomático e fixação anterior com placa. Cada grupo experimental foi dividido em dois subgrupos, de acordo com a altura do enxerto ósseo utilizado (3,0mm ou 6,0mm. Os segmentos vertebrais foram submetidos a ensaios mecânicos de flexão, flexão lateral e torção em máquina universal de ensaio. Os parâmetros analisados foram força máxima (N e o momento (Nm para produzir uma deflexão preestabelecida. RESULTADOS: Não foi observada em todos os grupos experimentais diferença estatística dos valores da força máxima (N e do momento (Nm, entre as diferentes alturas (3,0mm e 6,0mm do enxerto ósseo intersomático. Conclusões: A estabilidade mecânica imediata da artrodese cervical monossegmentar anterior não sofreu influência da altura do enxerto ósseo intersomático nos ensaios de flexão, flexão lateral e torção.OBJECTIVE: To perform an experimental study of the impact of intersomatic bone graft height of the cervical spine on the mechanical stability of anterior cervical fixation. METHODS: Mechanical assays were performed using swine cervical spine (C3-C4. Three experimental groups were formed with 20 cervical spine segments (C3-C4 according to the degree

  3. Single-stage posterior debridement combined with bone grafting and internal fixation in treatment of thoracic spinal tuberculosis through Wiltse approach%一期后路经Wiltse入路病灶清除植骨内固定术治疗胸椎椎体结核

    Institute of Scientific and Technical Information of China (English)

    郑燕平; 田永昊; 刘新宇; 王磊; 王竹青; 李康

    2012-01-01

    Objective To investigate the feasibility and clinical outcomes of single-stage posterior debridement combined with bone grafting and internal fixation in treatment of thoracic spinal tuberculosis within anterior column through Wiltse approach. Methods From May 2009 to February 2012, 12 patients with thoracic spinal tuberculosis were treated with single-stage posterior debridement and bone grafting and internal fixation in this study. There were 8 males and 4 females with an average age of 46. 1 years. The mean disease duration was 16 months. The involved vertebral body ranged from T4 to T12 , including single segment in 3 cases, 2 segments in 5 cases, and 3 segments in 4 cases. The kyphosis Cobb' s angle was 20° ± 15° before operation. According to Frankel classfication for spinal cord injury, 5 cases were classified as grade E, 4 case as grade D, and 3 cases as grade C. Preoperative visual analogue scale ( VAS ) score was 5. 9 ±1. 1. Results All incisions achieved primary healing. All patients were followed up for 15.4 months on average. According to Frankel classification, 10 cases were classified as grade E and 2 cases as grade D at the final follow-up and VAS score was 1. 9 ± 1. 1. No loosening, emersion and breakage of internal fixation or complications occurred 1 year after operation. Conclusion Single-stage posterior debridement and bone grafting and internal fixation through Wiltse approach is safe and effective in the treatment of thoracic spinal tuberculosis within anterior column.%目的 探讨一期后路经Wiltse入路病灶清除植骨内固定术治疗胸椎椎体结核的可行性及疗效.方法 2009年5月~2012年2月,收治胸椎结核患者12例,其中男8例,女4例;平均46.1岁;病程平均16个月.单节段受累3例,双节段5例,3个节段4例.术前后凸Cobb角20°±15°.脊髓损伤程度按Frankel分级:E级5例,D级4例,C级3例.疼痛视觉模拟量表(visual analogue scale,VAS)评分为 5.9±1.1.均接受一期后路经Wiltse

  4. Comparative study of bone repair in mandibular body osteotomy between metallic and absorbable 2.0 mm internal fixation systems. Histological and histometric analysis in dogs: a pilot study.

    Science.gov (United States)

    Sverzut, C E; Kato, R B; Rosa, A L; Trivellato, A E; Sverzut, A T; da Silveira, K M; de Oliveira, P T

    2012-11-01

    The objective of this study was to compare the bone repair along a mandibular body osteotomy stabilized with 2.0 mm absorbable and metallic systems. 12 male, adult mongrel dogs were divided into two groups (metallic and absorbable) and subjected to unilateral osteotomy between the mandibular third and fourth premolars, which was stabilized by applying two 4-hole plates. At 2 and 18 weeks, three dogs from each group were killed and the osteotomy sites were removed and divided equally into three parts: the upper part was labelled the tension third (TT), the lower part the compression third (CT), and the part between the TT and CT the intermediary third (IT). Regardless of the treatment system, union between the fragments was observed at 18 weeks and the CT showed more advanced stages of bone repair than the TT. Histometric analysis did not reveal any significant differences among the 3 parts or systems in the distance between bone fragments at 2 weeks. Although at 18 weeks the proportions of newly formed bone did not differ among TT, IT and CT, significantly enhanced bone formation was observed in all sections for the metallic group. The patterns of repair were distinct between treatments.

  5. Evaluation of Qualitative Changes in Simulated Periodontal Ligament and Alveolar Bone Using a Noncontact Electromagnetic Vibration Device with a Laser Displacement Sensor.

    Science.gov (United States)

    Kobayashi, Hiroshi; Hayashi, Makoto; Yamaoka, Masaru; Yasukawa, Takuya; Ibi, Haruna; Ogiso, Bunnai

    2016-01-01

    Evaluating periodontal tissue condition is an important diagnostic parameter in periodontal disease. Noncontact electromagnetic vibration device (NEVD) was previously developed to monitor this condition using mechanical parameters. However, this system requires accelerometer on the target tooth. This study assessed application of laser displacement sensor (LDS) to NEVD without accelerometer using experimental tooth models. Tooth models consisted of cylindrical rod, a tissue conditioner, and polyurethane or polyurethane foam to simulate tooth, periodontal ligament, and alveolar bone, respectively. Tissue conditioner was prepared by mixing various volumes of liquid with powder. Mechanical parameters (resonant frequency, elastic modulus, and coefficient of viscosity) were assessed using NEVD with the following methods: Group A, measurement with accelerometer; Group B, measurement with LDS in the presence of accelerometer; and Group C, measurement with LDS in the absence of accelerometer. Mechanical parameters significantly decreased with increasing liquid volume. Significant differences were also observed between the polyurethane and polyurethane foam models. Meanwhile, no statistically significant differences were observed between Groups A and B; however, most mechanical parameters in Group C were significantly larger and more distinguishable than those of Groups A and B. LDS could measure mechanical parameters more accurately and clearly distinguished the different periodontal ligament and alveolar bone conditions. PMID:27274995

  6. Evaluation of Qualitative Changes in Simulated Periodontal Ligament and Alveolar Bone Using a Noncontact Electromagnetic Vibration Device with a Laser Displacement Sensor

    Directory of Open Access Journals (Sweden)

    Hiroshi Kobayashi

    2016-01-01

    Full Text Available Evaluating periodontal tissue condition is an important diagnostic parameter in periodontal disease. Noncontact electromagnetic vibration device (NEVD was previously developed to monitor this condition using mechanical parameters. However, this system requires accelerometer on the target tooth. This study assessed application of laser displacement sensor (LDS to NEVD without accelerometer using experimental tooth models. Tooth models consisted of cylindrical rod, a tissue conditioner, and polyurethane or polyurethane foam to simulate tooth, periodontal ligament, and alveolar bone, respectively. Tissue conditioner was prepared by mixing various volumes of liquid with powder. Mechanical parameters (resonant frequency, elastic modulus, and coefficient of viscosity were assessed using NEVD with the following methods: Group A, measurement with accelerometer; Group B, measurement with LDS in the presence of accelerometer; and Group C, measurement with LDS in the absence of accelerometer. Mechanical parameters significantly decreased with increasing liquid volume. Significant differences were also observed between the polyurethane and polyurethane foam models. Meanwhile, no statistically significant differences were observed between Groups A and B; however, most mechanical parameters in Group C were significantly larger and more distinguishable than those of Groups A and B. LDS could measure mechanical parameters more accurately and clearly distinguished the different periodontal ligament and alveolar bone conditions.

  7. Evaluation of Qualitative Changes in Simulated Periodontal Ligament and Alveolar Bone Using a Noncontact Electromagnetic Vibration Device with a Laser Displacement Sensor

    Science.gov (United States)

    Kobayashi, Hiroshi; Hayashi, Makoto; Yamaoka, Masaru; Yasukawa, Takuya; Ibi, Haruna; Ogiso, Bunnai

    2016-01-01

    Evaluating periodontal tissue condition is an important diagnostic parameter in periodontal disease. Noncontact electromagnetic vibration device (NEVD) was previously developed to monitor this condition using mechanical parameters. However, this system requires accelerometer on the target tooth. This study assessed application of laser displacement sensor (LDS) to NEVD without accelerometer using experimental tooth models. Tooth models consisted of cylindrical rod, a tissue conditioner, and polyurethane or polyurethane foam to simulate tooth, periodontal ligament, and alveolar bone, respectively. Tissue conditioner was prepared by mixing various volumes of liquid with powder. Mechanical parameters (resonant frequency, elastic modulus, and coefficient of viscosity) were assessed using NEVD with the following methods: Group A, measurement with accelerometer; Group B, measurement with LDS in the presence of accelerometer; and Group C, measurement with LDS in the absence of accelerometer. Mechanical parameters significantly decreased with increasing liquid volume. Significant differences were also observed between the polyurethane and polyurethane foam models. Meanwhile, no statistically significant differences were observed between Groups A and B; however, most mechanical parameters in Group C were significantly larger and more distinguishable than those of Groups A and B. LDS could measure mechanical parameters more accurately and clearly distinguished the different periodontal ligament and alveolar bone conditions. PMID:27274995

  8. 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.

  9. Late vertebral body fracture after lumbar transpedicular fixation. Report of three cases.

    Science.gov (United States)

    Missori, Paolo; Ramieri, Alessandro; Costanzo, Giuseppe; Peschillo, Simone; Paolini, Sergio; Miscusi, Massimo; D'Andrea, Giancarlo; Delfini, Roberto

    2005-07-01

    Late-onset vertebral body (VB) fracture after lumbar transpedicular fixation has not been previously described in the literature. The authors present three cases in which VB fracture occurred several months after posterolateral fixation in patients with degenerative disease or traumatic injury. The authors suggest that postoperative osteopenia, modified load-sharing function, and intravertebral clefts were responsible for the fractures. Two women and one man were evaluated at a mean follow-up interval of 3 months. Two patients suffered recurrent lumbar pain. Radiography and magnetic resonance imaging revealed fracture of some of the instrumentation-treated VBs. These two patients underwent surgical superior or inferior extension of instrumentation. The third, an asymptomatic patient, received conservative management. The two patients who underwent reoperation made complete recoveries, and there was no evidence of further bone collapse in any case. The authors speculate that alterations in the VBs may occur following application of spinal instrumentation. In rare cases, the device can fracture and consequently lead to recurrent lumbar back pain. Recovery can be achieved by extending the instrumentation in the appropriate direction.

  10. BONE MECHANOTRANSDUCTION: A REVIEW

    OpenAIRE

    Reis, Joana; Capela e Silva, Fernando; Queiroga, Cristina; Lucena, Sónia; Potes, José

    2011-01-01

    This review focus on the bone physiology and mechanotransduction elements and mechanisms. Bone biology and architecture is deeply related to the mechanical environment. Orthopaedic implants cause profound changes in the biomechanics and electrophysiology of the skeleton. In the context of biomedical engineering, a deep reflexion on bone physiology and electromechanics is needed. Strategic development of new biomaterials and devices that respect and promote continuity with bone str...

  11. Salvage of infected total knee arthroplasty with Ilizarov external fixator

    Directory of Open Access Journals (Sweden)

    Venkata Gurava Reddy

    2011-01-01

    Full Text Available Background: Knee arthrodesis may be the only option of treatment in cases of chronic infected total knee arthroplasty (TKA with concomitant irreparable extensor mechanism disruption, extensive bone loss or severe systemic morbidities. Circular external fixation offers possible progressive adjustment to stimulate the bony fusion and to make corrections in alignment. We evaluated the results of knee arthrodesis with one or two stage circular external fixator for infected TKA. Materials and Methods: 16 cases of femoro-tibial fusion were retrospectively evaluated. Male-to-female ratio was 10:6. Mean age of the patients was 62.2 years. Cierney-Mader classification was used for anatomical and physiological evaluation while the bone stock deficiency was classified into mild, moderate and severe. Surgical technique involved either single or two stage arthrodesis using circular external fixator. Results: Union was achieved in 15 patients (93.75%. The mean duration for union (frame application time in these patients was 28.33 weeks (range 22 to 36 weeks. Analysis showed that in the group with frame application time of less than 28 weeks, the incidence of mild to moderate bone deficiency was 83.33%, while in the frame application time more than 28 weeks group the incidence was 20% (P-value 0.034. Similarly the incidence of Cierney-Mader 4B (Bl, Bs, Bls was found to be 33.33% in the group of frame application time of less than 28 weeks, while it was 90% in the group with frame application time more than 28 weeks (P-value 0.035. Conclusion: Circular external fixator is a safe and reliable method to achieve knee arthrodesis in cases of deep infection following TKA. Severe bone stock deficiency and Cierney- Mader type B host are likely risk factors for prolonged frame application time. We recommend a two-stage procedure especially when there is compromised host or severe bone loss.

  12. Clinical Observation on Anterior Cervical Decompression and Bone Graft Fusion with Locking Plate Internal Fixation in Treatment of Cervical Spinal Cord Injury without Fracture and Dislocation%颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤的临床探讨

    Institute of Scientific and Technical Information of China (English)

    孙海中

    2016-01-01

    Objective To discuss the effect of anterior cervical decompression and bone graft fusion with locking plate inter-nal fixation in treatment of cervical spinal cord injury without fracture and dislocation (SCIWORA). Methods 60 cases of patients with SCIWORA treated in our hospital from March 2011 to March 2014 were selected as the research object and randomly divided into two groups, the control group were given anterior cervical decompression and bone graft treatment, and the observation group were given anterior cervical decompression and bone graft fusion with locking plate internal fixa-tion treatment, both groups were scored by Japan department of orthopedics association (JOA)before and after operation, and the improvement rates of clinical symptoms after operation and the intervertebral fusion rates after half a year of the two groups were evaluated. Results Six months later after operation, the intervertebral fusion rate in the observation group was obviously higher than that in the control group (96.67%vs 80.0%), the difference was statistically significant (P<0.05), the JOA scores after three months of operation and six months of operation in the observation group were respectively (12.38± 1.69)points and (15.96±2.33)points, which were obviously higher than those in the control group, and the differences were statistically significant (P<0.05). Conclusion The curative effect of anterior cervical decompression and bone graft fusion with locking plate internal fixation in treatment of SCIWORA is definite.%目的 探讨颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤(SCIWORA)的效果. 方法 整群选取该院2011年3月—2014年3月收治的无骨折脱位型颈脊髓损伤(SCIWORA)患者60例作为研究对象,采用数字随机对照表将患者分为对照组和观察组,对照组行颈前路减压植骨融合术治疗,观察组在对照组基础上加锁钛板内固定治疗,手术前后均行日本骨科协

  13. Clinical Observation on Anterior Cervical Decompression and Bone Graft Fusion with Locking Plate Internal Fixation in Treatment of Cervical Spinal Cord Injury without Fracture and Dislocation%颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤的临床探讨

    Institute of Scientific and Technical Information of China (English)

    孙海中

    2016-01-01

    目的 探讨颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤(SCIWORA)的效果. 方法 整群选取该院2011年3月—2014年3月收治的无骨折脱位型颈脊髓损伤(SCIWORA)患者60例作为研究对象,采用数字随机对照表将患者分为对照组和观察组,对照组行颈前路减压植骨融合术治疗,观察组在对照组基础上加锁钛板内固定治疗,手术前后均行日本骨科协会(JOA)评分,评估两组术后临床症状好转率及半年后植骨融合率.结果 观察组术后半年后植骨融合率为96.67%显著高于对照组80.0%,差异具有统计学意义(P<0.05);观察组术后3、6个月JOA评分分别为(12.38±1.69)分、(15.96±2.33)分均显著高于对照组,差异具有统计学意义(P<0.05). 结论 颈前路减压植骨融合带锁钛板内固定治疗SCIWORA疗效确切.%Objective To discuss the effect of anterior cervical decompression and bone graft fusion with locking plate inter-nal fixation in treatment of cervical spinal cord injury without fracture and dislocation (SCIWORA). Methods 60 cases of patients with SCIWORA treated in our hospital from March 2011 to March 2014 were selected as the research object and randomly divided into two groups, the control group were given anterior cervical decompression and bone graft treatment, and the observation group were given anterior cervical decompression and bone graft fusion with locking plate internal fixa-tion treatment, both groups were scored by Japan department of orthopedics association (JOA)before and after operation, and the improvement rates of clinical symptoms after operation and the intervertebral fusion rates after half a year of the two groups were evaluated. Results Six months later after operation, the intervertebral fusion rate in the observation group was obviously higher than that in the control group (96.67%vs 80.0%), the difference was statistically significant (P<0.05), the JOA scores after three

  14. In vivo implant fixation of carbon fiber-reinforced PEEK hip prostheses in an ovine model.

    Science.gov (United States)

    Nakahara, Ichiro; Takao, Masaki; Bandoh, Shunichi; Bertollo, Nicky; Walsh, William R; Sugano, Nobuhiko

    2013-03-01

    Carbon fiber-reinforced polyetheretherketone (CFR/PEEK) is theoretically suitable as a material for use in hip prostheses, offering excellent biocompatibility, mechanical properties, and the absence of metal ions. To evaluate in vivo fixation methods of CFR/PEEK hip prostheses in bone, we examined radiographic and histological results for cementless or cemented CFR/PEEK hip prostheses in an ovine model with implantation up to 52 weeks. CFR/PEEK cups and stems with rough-textured surfaces plus hydroxyapatite (HA) coatings for cementless fixation and CFR/PEEK cups and stems without HA coating for cement fixation were manufactured based on ovine computed tomography (CT) data. Unilateral total hip arthroplasty was performed using cementless or cemented CFR/PEEK hip prostheses. Five cementless cups and stems and six cemented cups and stems were evaluated. On the femoral side, all cementless stems demonstrated bony ongrowth fixation and all cemented stems demonstrated stable fixation without any gaps at both the bone-cement and cement-stem interfaces. All cementless cases and four of the six cemented cases showed minimal stress shielding. On the acetabular side, two of the five cementless cups demonstrated bony ongrowth fixation. Our results suggest that both cementless and cemented CFR/PEEK stems work well for fixation. Cup fixation may be difficult for both cementless and cemented types in this ovine model, but bone ongrowth fixation on the cup was first seen in two cementless cases. Cementless fixation can be achieved using HA-coated CFR/PEEK implants, even under load-bearing conditions.

  15. 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.

  16. 后路一期病灶清除结合内固定治疗多节段脊柱结核%Surgical Treatment with Posterior Pedicle Screw Fixation,Focal Cleaning,Titanium Mesh and Bone Graft Fusion for Multi-segmental Spinal Tuberculosis

    Institute of Scientific and Technical Information of China (English)

    杨启远; 冯敬; 杨雯栋; 罗小丽; 李英博; 雷超; 冯志; 赖显金

    2016-01-01

    Objective To study the clinical effect of Surgical treatment with posterior pedicle screw fixation,focal clean-ing,titanium mesh and bone graft fusion for multi-segmental spinal tuberculosis. Methods The clinical data from 16 patients with multi-segmental spinal tuberculosis from January 2009 to December 2014 were retrospectively analyzed. There were 7 males and 9 females,ranging in age from 19 to 56 years with an average of 36. 5 years old. 2 vertebral bodies involved in 6 ca-ses,3 vertebral bodies in 7 cases,4 vertebral bodies in 2 eases,and 5 vertebral bodies in 1case. Among these cases,there were 9 cases of thoracic vertebra,5 cases of thoracolumbar vertebra,2 cases of lumbar vertebra. The kyphosis angel of diseased seg-ments was 28° to 53°,37. 6° in average. According to the Frankel classification before operation,there were Frankel A in 0 case,Frankel B in 1 cases,Frankel C in 2 cases,Frankel D in 6 cases,Frankel E in 7 cases. After intensive anti-tuberculosis medication(HRSZ)for 2 to 4 weeks before operation,all patients were treated with posterior pedicle screw fixation,focal clean-ing,titanium mesh and bone graft fusion. After operation,the anti-tuberculosis medication was continued for 12 ~ 18 months. Results The operation time ranged from 160 mins to 290 mins,215 mins in average. The blood loss ranged from 400 to 1 800 mL,780 mL in average. All the cases were followed up for 6 months to 2 years with the average of 1 year and 7 months. 1 cases was complicated with CSF leakage. No wound infection and sinus tract formation were noted. All the cases showed excellent bone graft fusion,all internal fixation had good position without looseness,displacement and breakage. The Mean kyphosis angle was 28. 2°(range,8°to 27°)after operation,with an average correction rate of 75% . Neurologic status of all patients with pre-opertative neurologic deficit was :1 with grade B recovered to grade C;2 with grade C,1 recovered to grade D and 1 recovered to grade E;6

  17. No effect of hydroxyapatite particles in phagocytosable sizes on implant fixation: an experimental study in dogs

    DEFF Research Database (Denmark)

    Rahbek, O; Kold, S; Bendix, K;

    2005-01-01

    The influence of wear debris on bone healing around orthopedic implants is debated. Hydroxyapatite (HA) particles and polyethylene (PE) particles have been shown to have a negative effect on osteoblast cultures in vitro. The present study investigated the in vivo effects of HA and PE particles on....... HA particles were also integrated in newly formed bone. We found no negative effect of the particulate material on mechanical fixation of the implants or on bone formation around the implants....

  18. 聚甲基丙烯酸甲酯和自体骨加强的椎弓根螺钉技术治疗退变性脊柱侧凸的临床疗效比较%Autogenous bone and polymethylmethacrylate augmentation of screw fixation for degenerative scoliosis

    Institute of Scientific and Technical Information of China (English)

    谢杨; 傅强; 陈自强; 石志才; 朱晓东; 孙晓飞; 李明

    2012-01-01

    Objective To compare the clinical effect of autogenous bone and polymethylmethacrylate (PMMA) augmentation of screw fixation in degenerative scoliosis with osteoporosis. Methods A retrospective analysis was conducted on 31 consecutive patients with degenerative scoliosis combined with osteoporosis who accepted pedicle screw fixation from December 2000 to December 2006. Fourteen of them underwent fixation with pedicle screw by augmentation with PMMA and the other 17 patients with autogenous bone. Peri-operative data were recorded. Preoperative, postoperative and final follow up corrective effects were compared. Results No significant difference was found in clinical data except for administration time of oral pain relief medicines and surgery cost between the two surgical strategies. Cement leakage was observed in 2 patients in PMMA augmentation group, but there was no evidence of nerve damage. Conclusion There is no difference in surgical effect between two surgery strategies on degenerative scoliosis combined with osteoporosis. Less oral pain medicines are taken in the polymethylmethacrylate-augmented pedicle screw fixation and fusion, but with much more cost and danger of cement leakage.%目的 比较应用聚甲基丙烯酸甲酯( PMMA)和自体骨加强的椎弓根螺钉技术治疗合并骨质疏松的退变性脊柱侧凸的临床疗效.方法 回顾性分析2000年12月至2006年12月手术治疗的31例伴骨质疏松的退变性脊柱侧凸患者,其中14例采用PMMA加强钉道,17例采用自体骨加强钉道.记录并发症等围手术期情况,比较手术前后及随访期间侧凸的矫正效果.结果 两种手术除口服止痛药使用时间和手术费用外,其他临床数据差异无统计学意义,PMMA加强组中2例出现骨水泥渗漏,但未出现神经损伤的症状.结论 两种手术对伴骨质疏松的退变性脊柱侧凸的临床疗效无明显差异,PMMA加强的椎弓根螺钉内固定融合术可减少口服止痛药的用量,

  19. Nonunited humerus shaft fractures treated by external fixator augmented by intramedullary rod

    Directory of Open Access Journals (Sweden)

    Mahmoud A El-Rosasy

    2012-01-01

    Full Text Available Background: Nonunion of humeral shaft fractures after previously failed surgical treatment presents a challenging therapeutic problem especially in the presence of osteoporosis, bone defect, and joint stiffness. It would be beneficial to combine the use of external fixation technique and intramedullary rod in the treatment of such cases. The present study evaluates the results of using external fixator augmented by intramedullary rod and autogenous iliac crest bone grafting (ICBG for the treatment of humerus shaft nonunion following previously failed surgical treatment. Materials and Methods: Eighteen patients with atrophic nonunion of the humeral shaft following previous implant surgery with no active infection were included in the present study. The procedure included exploration of the nonunion, insertion of intramedullary rod (IM rod, autogenous ICBG and application of external fixator for compression. Ilizarov fixator was used in eight cases and monolateral fixator in ten cases. The monolateral fixator was preferred for females and obese patients to avoid abutment against the breast or chest wall following the use of Ilizarov fixator. The fixator was removed after clinical and radiological healing of the nonunion, but the IM rod was left indefinitely. The evaluation of results included both bone results (union rate, angular deformity and limb shortening and functional outcome using the University of California, Los Angeles (UCLA rating scale. Results: The mean follow-up was 35 months (range 24 to 52 months. Bone union was obtained in all cases. The functional outcome was satisfactory in 15 cases (83% and unsatisfactory in 3 cases (17% due to joint stiffness. The time to bone healing averaged 4.2 months (range 3 to 7 months. The external fixator time averaged 4.5 months (range 3.2 to 8 months. Superficial pin tract infection occurred in 39% (28/72 of the pins. No cases of nerve palsy, refracture, or deep infection were encountered

  20. 21 CFR 888.3027 - Polymethylmethacrylate (PMMA) bone cement.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Polymethylmethacrylate (PMMA) bone cement. 888... Polymethylmethacrylate (PMMA) bone cement. (a) Identification. Polymethylmethacrylate (PMMA) bone cement is a device...: Polymethylmethacrylate (PMMA) Bone Cement.”...

  1. Eighth international congress on nitrogen fixation

    Energy Technology Data Exchange (ETDEWEB)

    1990-01-01

    This volume contains the proceedings of the Eighth International Congress on Nitrogen Fixation held May 20--26, 1990 in Knoxville, Tennessee. The volume contains abstracts of individual presentations. Sessions were entitled Recent Advances in the Chemistry of Nitrogen Fixation, Plant-microbe Interactions, Limiting Factors of Nitrogen Fixation, Nitrogen Fixation and the Environment, Bacterial Systems, Nitrogen Fixation in Agriculture and Industry, Plant Function, and Nitrogen Fixation and Evolution.

  2. Feasibility of low anterior cervical approach decompression and bone graft fusion for internal fixation in the treatment of patients with spine and spinal cord trauma in cervicothoracic junction%低位颈前入路减压植骨融合内固定治疗颈胸段脊柱脊髓损伤的可行性

    Institute of Scientific and Technical Information of China (English)

    刘明明; 程建; 华臻

    2015-01-01

    Objective:To explore the feasibility of low anterior cervical approach decompression and bone graft fusion for internal fixation in the treatment of patients with spine and spinal cord trauma in cervicothoracic junction.Methods:20 patients with spine and spinal cord trauma in cervicothoracic junction were selected.All patients were treated with low anterior cervical approach decompression and bone graft fusion for internal fixation.We discussed the efficacy and postoperative recovery of the patients. Results:All patients recovered well,and there was no case with loosening of the screws,loss of the titanium plate,the fracture of the titanium plate and other circumstances.Only 1 case with the position of titanium mesh not well fixed when detected by X tablets after operation.It has been adjusted after six months of surgery,after 1 year of operation,it recovered well,no titanium mesh moved. Conclusion:Patients with spine and spinal cord trauma in cervicothoracic junction with low anterior cervical approach decompression and bone graft fusion and internal fixation for the treatment can effectively promote the patients with cervicothoracic spine sequence returned to normal,and improve the patients' postoperative recovery.%目的:探讨低位颈前入路减压植骨融合内固定治疗颈胸段脊柱脊髓损伤的可行性。方法:收治颈胸段脊柱脊髓损伤患者20例,实施低位颈前入路减压植骨融合内固定治疗,对术后疗效及恢复情况进行探讨。结果:所有患者恢复良好,无一例患者出现螺钉松动、脱落、钛板断裂等情况,只有1例在术后经过X片检测后发现其钛网位置固定不佳,术后0.5年对其进行了调整,术后1年检测见其恢复良好,没有出现钛网移动情况。结论:颈胸段脊柱脊髓损伤患者采用低位颈前入路减压植骨融合内固定治疗,可以有效促进患者颈胸段脊柱序列恢复正常,改善患者的术后恢复情况。

  3. Investigation of the effects of treating spinal tuberculosis with the way of extraperitoneal debridement and posterior bone graft fixation%经腹膜外病灶清除植骨一期后路内固定术治疗脊柱结核的效果

    Institute of Scientific and Technical Information of China (English)

    何生; 谢造福; 邹尚浏; 黄少辉

    2012-01-01

    Objective To investigate the effects of treating spinal tuberculosis with the way of extraperitoneal debridement and posterior bone graft fixation. Methods 43 patients with spinal tuberculosis, who received the treatment of extraperitoneal debridement and posterior bone graft fixation, were selected to follow up for 6 ~23 months. The status of spinal cord injury and the angle of kyphosis before and after surgery were examined carefully. The cure rate was evaluated as well. Results ASIA classification of spinal cord function was evaluated, there were 21 cases for the E level and 10 cases for the D level before surgery. Except for one recovered to the D level, the rest of them recovered to the E level. There were significant differences statistically in the spinal cord function (P < 0.01) before and after surgery. After the last follow-up, the angulation of kyphosis and scoliosis was corrected in varying degrees. Physiologic curve restoration was well. Compared with preoperative, the Cobb angle changed significantly (P < 0.01). Evaluated by Mehtaet standards, 41 cases were cured and the cure rate was 95.34%. Conclusion The way of extraperitoneal debridement and posterior bone graft fixation is effective for treatment of spinal tuberculosis.%目的:探讨经腹膜外病灶清除植骨一期后路内固定术治疗脊柱结核的效果.方法:43例脊柱结核患者,采用腹膜外病灶清除植骨一期后路内固定术治疗,随访6 ~ 23个月,评价患者术前、术后末次脊髓损伤情况和脊柱后凸畸形角度,并评定治愈标准.结果:术前脊髓神经功能ASIA分级有21例为E级,10例为D级;末次随访ASIA分级脊髓神经功能除1例恢复为D级外,其余的均恢复为E级,术前和术后末期随访脊髓神经功能ASIA分级情况有在统计学上差异非常显著(P<0.01).术后末次随访,脊柱后凸、侧凸成角均有不同程度纠正,生理弧度恢复并保持满意,术后末次随访Cobb角度与术前比

  4. Treatment of anterior decompression, bone grafting and internal fixation combined with coblation neucleoplasty for patients with cervical spondylosis involved multilevel%前路减压植骨内固定联合髓核成形术治疗多节段受累颈椎病

    Institute of Scientific and Technical Information of China (English)

    张非; 李青; 张爱明; 梁道臣

    2013-01-01

    目的:探讨前路减压植骨内固定联合等离子髓核成形术治疗多节段受累颈椎病的临床效果。方法回顾性分析2012年3月至12月中山市人民医院采用前路减压植骨内固定结合等离子髓核成形术治疗的30例多节段受累颈椎病患者的临床资料,采用日本骨科学会(JOA)评分对术后临床症状改善情况进行评价。结果30例患者均获得有效随访,随访时间4~9个月(平均6.8个月)。患者术前不适症状均有不同程度改善,无神经功能加重及内固定松动、骨笼脱出等严重并发症发生。术后3个月JOA评分为(14±1)分,较术前的(10±2)分明显改善(t =8.143,P=0.000),JOA改善率为45%。结论前路减压植骨内固定结合等离子髓核成形术治疗多节段受累颈椎病近期效果稳定,并发症少。%Objective To explore clinical effect of anterior decompression, bone grafting and internal fixation combined with coblation neucleoplasty in the treatment of multilevel cervical spondylosis. Methods Clinical data of 30 patients with multilevel cervical spondylosis from March 2012 to December 2012 were retrospectively analyzed and all of them were treated by mono-segmented cervical anterior decompression, bone grafting and internal fixation combined with coblation neucleoplasty in Zhongshan People's Hospital. Clinical effects were evaluated by Japanese Orthopaedic Association (JOA) score. Results All patients obtained follow-up with the average time of 6.8 months (4-9 months). Discomfort symptoms were improved after the operation. No nerve function aggravation occurred, also, no serious complications such as internal fixation loosening or cage pull-out had happened. Compared to preoperative JOA score, JOA score at 3 months postoperatively was improved from (10 ± 2) to (14 ± 1) (t = 8.143,P = 0.000), JOA improvement rate was 45%. Conclusions Mono-segmented cervical anterior decompression, bone graft fusion

  5. 骨水泥强化椎弓根钉固定联合椎体成形术治疗重度骨质疏松性脊柱骨折%Pedicle screw fixation strengthened with bone cement combined with vertebroplasty for the treatment of severe osteoporotic fractures

    Institute of Scientific and Technical Information of China (English)

    胡明; 李大伟; 黄凤山; 刘玉川; 杨达宇; 马远征

    2011-01-01

    Objective To explore the peri-operative treatment and clinical efficacy of pedicle screw fixation strengthened with bone cement combined with vertebroplasty for the treatment of severe osteoporotic fractures. Methods The clinical data of 15 patients with severe vertebral osteoporotic compression fractures were retrospectively analyzed from August 2005 to April 2009. The average age of the patients was 63. 1 years old. They had no severe basal diseases. They were all treated with posterior pedicle screw fixation strengthened with bone cement combined with vertebroplasty. All patients were followed up for 10-38 months (21 months in average) after the operation. Results All patients could tolerate the surgery and the average operating time was 106. 7 ±5. 3 min. The average bleeding volume was 370 ± 6. 1 ml. The twist and back pain were significantly ameliorated after the surgery. The height of vertebral body recovered back to 90% after operation. The height loss was not obvious during the following up. Conclusion The efficacy of pedicle screw fixation strengthened with bone cement combined with vertebroplasty for the treatment of severe osteoporotic fractures is good at correcting fracture and maintaining the recovering effect of the vertebra. The key point of this therapy is the surgical indication and osteoporotic medicine treatment.%目的 探讨骨水泥强化椎弓根钉固定联合椎体成形术治疗严重骨质疏松性椎体压缩骨折的围术期处理和临床疗效.方法 回顾分析2005年8月~ 2009年4月收治的15例严重骨质疏松性椎体压缩骨折患者的临床资料,平均63.1岁,无重大基础病存在,经脊柱后入路椎弓根钉撑开复位,钉道采用骨水泥灌注加强并行经伤椎椎体成形术.术后随访10~ 38个月,平均21月.结果 均耐受手术,平均手术时间为106.7±5.3min;平均失血量为370±6.1ml,术后腰背痛明显改善,椎体高度恢复至90%左右,随访椎体高度

  6. Contralateral reversed distal femoral locking plate for fixation of subtrochanteric femoral fractures

    Institute of Scientific and Technical Information of China (English)

    Paritosh Gogna; Reetadyuti Mukhopadhyay; Amanpreet Singh; Ashish Devgan; Sahil Arora; Amit Batra; Sushil Kumar Yadav

    2015-01-01

    Purpose:Subtrochanteric fractures of the femur are being managed successfully with various intramedullary and extramedulary implants with reasonable success.However,these implants require precise placement under image intensifier guidance,which exposes the surgeon to substantial amount of radiation.It also restricts the management of these fractures at peripheral centers where facility of image intensifiers is not available.Keeping this in mind we designed this study to identify if contralateral reversed distal femoral locking plate can be used successfully without the use of image intensifier.Methods:Twenty-four consecutive patients (18 men and 6 women) with a mean age of 28 years (range 19-47 years) suffering subtrochanteric fractures of the femur underwent open reduction and internal fixation with reversed contralateral distal femoral locking plate.The outcome was assessed at the mean follow-up period of 3.2 years (range 2-4.6 years) using the Harris hip score.Results:Twenty-one fractures united with the primary procedure,with a mean time of consolidation being 11 weeks (range,9-16 weeks).One patient developed superficial suture line infection,which resolved with oral antibiotics.Another patient had a fall 3 weeks after surgery and broke the plate.Repeat surgery with reversed distal femoral locking compression plate was performed along with bone grafting and the fracture united.Two cases had nonunion,which went in for union after bone grafting.The mean Harris hip score at the time of final follow-up was 90.63 (range 82-97).Conclusion:The reversed contralateral distal femoral plate is a biomechanically sound implant,which when used for fixation of the subtrochanteric fractures with minimal soft tissue stripping shows results comparable to those achieved by using other extramedullary implants as well as intramedullary devices.The added advantage of this implant is its usability in the absence of an image intensifier.

  7. Bone tumor

    Science.gov (United States)

    Tumor - bone; Bone cancer; Primary bone tumor; Secondary bone tumor ... The cause of bone tumors is unknown. They often occur in areas of the bone that grow rapidly. Possible causes include: Genetic defects ...

  8. Traumatic lumbar hernia repair: a laparoscopic technique for mesh fixation with an iliac crest suture anchor.

    Science.gov (United States)

    Links, D J R; Berney, C R

    2011-12-01

    Traumatic lumbar hernia (TLH) is a rare presentation. Traditionally, these have been repaired via an open approach. Recurrence can be a problem due to the often limited tissue available for mesh fixation at the inferior aspect of the hernia defect. We report the successful use of bone suture anchors placed in the iliac crest during transperitoneal laparoscopy for mesh fixation to repair a recurrent TLH. This technique may be particularly useful after previous failed attempts at open TLH repair.

  9. CEPHALOMEDULLARYS FRACTURE FIXATION IN THE MANAGEMENT OF UNSTABLE HIP FRACTURES.

    Directory of Open Access Journals (Sweden)

    Fonseca-Caro John Fredy

    2015-12-01

    Full Text Available Introduction: unstable hip fractures in elderly people are a public health problem. The treatment is carried out with osteolysis and cephalomedullarys bone nails of which there are others designs. Objective: to determine in the clinical results whether there are differences between PF Targon bone nails and TFN spiral plate. Methods: prospective study was carried out in 69 patients who presented unstable intertrochanteric fracture. The patients were taken to surgery for osteosynthesis with cephalomedullarys bone nails. They were divided in two groups: [A] Two screws fixation in neck (PF Targon and [B] (TFN spiral plate. For both groups were performed by conventional surgical technique and evaluated the surgical time, the bleeding, the intraoperative complications, the functionality results, clinical and radiological consolidation. Results: the procedure was followed in an average of 23 months. No differences were observed in the return of functionality between the use of an implant or other. Complications with Cut Out were more frequent and PF Targon not in the right position without significant difference. Surgical time was lower with TFN, 62.4 ± 15.7 minutes, while with Targon-PF was 86.5 ± 31.7 minutes p<0.0002. Conclusion: no significant differences were observed in the clinical results between the use of PF Targon bone nails and TFN spiral plate. Rev. cienc.biomed. 2015;6(2:265-271 KEY WORDS Bone Nails, Fracture Fixation, Hip.

  10. Influence of internal fixation systems on radiation therapy for spinal tumor.

    Science.gov (United States)

    Li, Jingfeng; Yan, Lei; Wang, Jianping; Cai, Lin; Hu, Dongcai

    2015-07-08

    In this study, the influence of internal fixation systems on radiation therapy for spinal tumor was investigated in order to derive a theoretical basis for adjustment of radiation dose for patients with spinal tumor and internal fixation. Based on a common method of internal fixation after resection of spinal tumor, different models of spinal internal fixation were constructed using the lumbar vertebra of fresh domestic pigs and titanium alloy as the internal fixation system. Variations in radiation dose in the vertebral body and partial spinal cord in different types of internal fixation were studied under the same radiation condition (6 MV and 600 mGy) in different fixation models and compared with those irradiated based on the treatment planning system (TPS). Our results showed that spinal internal fixation materials have great impact on the radiation dose absorbed by spinal tumors. Under the same radiation condition, the influence of anterior internal fixation material or combined anterior and posterior approach on radiation dose at the anterior border of the vertebral body was the greatest. Regardless of the kinds of internal fixation method employed, radiation dose at the anterior border of the vertebral body was significantly different from that at other positions. Notably, the influence of posterior internal fixation material on the anterior wall of the vertebral canal was the greatest. X-ray attenuation and scattering should be taken into consideration for most patients with bone metastasis that receive fixation of metal implants. Further evaluation should then be conducted with modified TPS in order to minimize the potentially harmful effects of inappropriate radiation dose.

  11. Pedicle Screw Fixation Study in Immature Porcine Spines to Improve Pullout Resistance during Animal Testing

    OpenAIRE

    Le Cann, Sophie; Cachon, Thibaut; Viguier, Eric; MILADI, Lotfi; Odent, Thierry; Rossi, Jean-Marie; Chabrand, Patrick

    2015-01-01

    The porcine model is frequently used during development and validation of new spinal devices, because of its likeness to the human spine. These spinal devices are frequently composed of pedicle screws with a reputation for stable fixation but which can suffer pull-outs during preclinical implantation on young animals, leading to high morbidity. With a view to identifying the best choices to optimize pedicle screw fixation in the porcine model, this study evaluates ex vivo the impact of weight...

  12. 21 CFR 888.3000 - Bone cap.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Bone cap. 888.3000 Section 888.3000 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3000 Bone cap. (a) Identification. A bone cap is a...

  13. The Role of Minimally Invasive Plate Osteosynthesis in Rib Fixation: A Review.

    Science.gov (United States)

    Bemelman, Michael; van Baal, Mark; Yuan, Jian Zhang; Leenen, Luke

    2016-02-01

    More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950's, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft für osteosynthesefragen/Association for the Study of Internal Fixation. Since the introduction of plate fixation for fractures, several plates and screws have been developed, all with their own characteristics. To accomplice more fracture stability, it was thought the bigger the plate, the better. The counter side was a compromised blood supply of the bone, often resulting in bone necrosis and ultimately delayed or non-union. With the search and development of new materials and techniques for fracture fixation, less invasive procedures have become increasingly popular. This resulted in the minimally invasive plate osteosynthesis (MIPO) technique for fracture fixation. With the MIPO technique, procedures could be performed with smaller incisions and thus with less soft tissue damage and a better preserved blood supply. The last 5 years rib fixation has become increasingly popular, rising evidence has become available suggesting that surgical rib fixation improves outcome of patients with a flail chest or isolated rib fractures. Many surgical approaches for rib fixation have been described in the old literature, however, most of these techniques are obscure nowadays. Currently mostly large incisions with considerable surgical insult are used to stabilize rib fractures. We think that MIPO deserves a place in the surgical treatment of rib fractures. We present the aspects of diagnosis, preoperative planning and operative techniques in regard to MIPO rib fixation.

  14. Local delivery of zoledronate from a poly (D,L-lactide)-Coating increases fixation of press-fit implants.

    Science.gov (United States)

    Jakobsen, Thomas; Bechtold, Joan E; Søballe, Kjeld; Jensen, Thomas; Greiner, Stefan; Vestermark, Marianne T; Baas, Jørgen

    2016-01-01

    Early secure fixation of total joint replacements is crucial for long-term survival. Antiresorptive agents such as bisphosphonates have been shown to increase implant fixation. We investigated whether local delivery of zoledronate from poly-D, L-lactide (PDLLA)-coated implants could improve implant fixation and osseointegration. Experimental titanium implants were bilaterally inserted press-fit into the proximal tibiae of 10 dogs. On one side the implant was coated with PDLLA containing zoledronate. The contralateral implant was uncoated and used as control. Observation period was 12 weeks. Implant fixation was evaluated with histomorphometry and biomechanical push-out test. We found an approximately twofold increase in all biomechanical parameters when comparing data from the zoledronate group with their respective controls. Histomorphometry showed increased amount of preserved bone and increased bone formation around the zoledronate implants. This study indicates that local delivery of zoledronate from a PDDLA coating has the potential to increase implant fixation. PMID:26177742

  15. A comparative study of fixation techniques for type II fractures of the odontoid process.

    Science.gov (United States)

    Graziano, G; Jaggers, C; Lee, M; Lynch, W

    1993-12-01

    Primary screw fixation of a Type II odontoid fracture or non-union is an attractive alternative to posterior atlanto-axial arthrodesis in that normal cervical motion can be maintained. Eight cervical cadaver spines, ranging in age from 17-90 years, were used for study. Type II fractures of the dens were created using an osteotome. Simulated fractures were fixed using one or two 3.5-mm bone screws. After testing each screw fixation technique, the screws were removed and a posterior C1-C2 brooks sublaminar wiring was performed using four 18-gauge wires with wooden blocks to simulate bone graft. No significant differences were found between bending and torsional stiffnesses for the one-screw and two-screw specimens. No significant differences were found between one- and two-screw fixation when compared with primary C1-C2 wiring in torsion. One- or two-screw fixation was as stiff as primary C1-C2 wiring in bending. One or two screws offers similar stability for fixation for a dens fracture. One- and two-screw fixation is at least as stiff as primary C1-C2 wiring in torsion and one- or two-screw fixation is stiffer than primary C1-C2 wiring in bending. PMID:8303437

  16. Porous surface modified bioactive bone cement for enhanced bone bonding.

    Directory of Open Access Journals (Sweden)

    Qiang He

    defect. CONCLUSIONS: Our findings suggested a new bioactive bone cement for prosthetic fixation in total joint replacement.

  17. Nursing of nail fixation combined with bone cement replantation treatment of femoral shaft nonunion.%交锁髓内钉固定结合骨泥回植治疗股骨干骨折不愈合的护理

    Institute of Scientific and Technical Information of China (English)

    柯阳芳; 邓月兴; 李文英; 黄瑞生; 樊仕才

    2009-01-01

    目的:探讨交锁髓内钉固定结合扩髓之骨泥回植治疗股骨干骨折不愈合的围手术期护理特点.方法:交锁髓内钉固定并将扩髓时产生的骨泥回植于骨折端治疗股骨干骨折不愈合29例,其中男23例,女6例.年龄26~54岁,平均39.5岁.术后48 h拔引流管,使用抗生素预防感染3 d,所有患者均未行外固定,摄X线片根据骨折稳定情况进行关节功能锻炼.结果:29例平均骨性愈合时间为47周,膝关节功能较术前明显改善,无感染、肢体短缩、旋转或成角畸形,无内固定断裂等并发症.结论:交锁髓内钉固定结合扩髓之骨泥回植治疗股骨干骨折不愈合,术前心理辅导、术前准备、术中配合监护、术后康复训练等环节护理对手术成功至关重要.%Objective:Discussion the characteristics of perioperative nursing of locked reamed intramedullary nailing for replantation of the bone cement treatment of femoral shaft fracture nonunion. Methods:Care line locked intramedullary reaming and nailing of the bone cement when replantation in the treatment of femoral shaft fracture nonunion in 29 cases, male 23 cases, six cases of women; age 26-54 years old, average 39.5 years old.After surgery 48h the drainage tube out, the use of antibiotics to prevent infection in 3 d, not all patients with external fixation line, taken X-ray conducted in accordance with the stability of articular fracture functional exercise.Results:Average of 29 cases of bone healing time for 47 weeks, pre-operative knee function improved significantly compared with no infection, limb shortening, rotation or angulation deformity, no complications such as fracture fixation. Conclusion:Locked reamed intramedullary nailing for replantation of the bone cement treatment of femoral shaft fracture nonunion of perioperative nursing, with emphasis on pre-operative psychological, preoperative preparation, intraoperative with guardianship, such as postoperative rehabilitation

  18. Far-forward fracture stabilization: external fixation versus splinting.

    Science.gov (United States)

    Camuso, Matthew R

    2006-01-01

    With improvements in body armor, soldiers often survive previously fatal injuries but incur devastating extremity trauma. Orthopaedic and general surgeons in forward-deployed areas must be well-versed in the selection and application of both external fixation and splinting devices in order to best preserve life and limb of the wounded. The surgeon must consider tactical environment, injury severity, injury location, available resources, and his or her own level of experience. Advantages to using external fixation in the field include preventing future injury to the traumatized soft-tissue envelope, reducing the risk of infection, minimizing fracture hemorrhage, providing pain control, and facilitating medical evacuation. Splinting is reserved for closed, low-energy, stable fractures of either the upper or lower extremity and for unstable fractures that are not amenable to battlefield external fixation; because of the risks of compartment syndrome, casts are avoided. PMID:17003182

  19. 21 CFR 888.3050 - Spinal interlaminal fixation orthosis.

    Science.gov (United States)

    2010-04-01

    ... compression or distraction rod. The device is implanted, usually across three adjacent vertebrae, to straighten and immobilize the spine to allow bone grafts to unite and fuse the vertebrae together. The...

  20. Human postmortem device retrieval and analysis--orthopaedic, cardiovascular, and dental systems.

    Science.gov (United States)

    Lemons, J; Brott, B; Eberhardt, A

    2010-01-01

    On the basis of decades of analyzing implant devices, tissues, and clinical records from revision surgical explants (called device failure), studies now include postmortem donors and in situ conditions (called success). A key issue has been information exchange from an interdisciplinary team where basic physical and biological studies complement details of the clinical conditions for each device. Overall, the summary information has shown that most revisions were based on factors associated with the patient health, disease, and compliance, with few outcomes directly correlated with technology and device-specific factors. However, because of the large numbers of devices implanted annually (millions), any sampling that reveals adverse circumstances could result in a high level of importance and the need for additional studies of this type. Experience from prior retrieval and analysis demonstrates significant value where peer reviewed results from investigations have altered the discipline and have improved the quality and longevity of health care associated with implanted devices. This report summarizes completed and ongoing studies of cardiovascular, dental, and orthopaedic systems. Endovascular stents from autopsies showed damage including fretting and corrosion from overlapping and intersecting conditions, plus some corrosion and element transfers to tissues from individual stents. Studies are proposed to increase numbers to evaluate clinical significance. Dental implants from postmortem donors that functioned more than 10 years provided evaluations of cobalt alloy devices and calcium phosphate bone graft substitutes originally investigated in the 1970s. Tissue integration and stability correlated with data from prior laboratory in vitro and in vivo investigations. Studies of articulation and fixation from orthopaedic total joint arthroplasties showed some limitations related to surface changes of YTZ zirconia, specific damage due to implantation procedures, which

  1. Use of tightrope fixation in ankle syndesmotic injuries

    Institute of Scientific and Technical Information of China (English)

    Julian Maempel; Anthony Ward; Tim Chesser; Michael Kelly

    2014-01-01

    Objective:Conventional fixation of syndesmotic injuries with screws remains problematic.A novel fibrewire device (Tightrope(R)) has suggested advantages.However,small case series have reported high soft tissue complication rates.The purpose of our study was to quantify complication rates and further procedures in patients treated with Tightropes.A secondary objective was to determine incidence of complications and further procedures in those treated with syndesmotic screws over the same period.Methods:All patients undergoing syndesmotic fixation for ankle fracture between May 2008 and October 2009 were retrospectively reviewed.Incidence of complications,secondary procedures,maintenance of syndesmotic reduction and time spent on non-weight bearing were recorded.Family doctors were contacted for those treated with Tightropes to check for any complications managed elsewhere.Results:Thirty-five patients required syndesmotic fixation,in which 12 were treated with Tightropes.They were followed up in clinic for a mean of 12.4 weeks.Family doctors were contacted at mean 14.6 months after treatment to determine any complications suffered.There were no complications attributable to method of fixation.In this series,12 patients underwent 13 procedures and no patient had recurrent diastasis at discharge; 23 patients treated with screw fixation underwent 45 procedures (19 were screw removals).There was 1 case ofsyndesmotic diastasis.Screw removal resulted in 2 minor complications.Conclusion:Tightrope fixation provideds effective syndesmotic fixation that is maintained at discharge.We do not experience soft tissue complications reported elsewhere.

  2. Atlantoaxial fixation: Overview of all techniques

    Directory of Open Access Journals (Sweden)

    Mummaneni Praveen

    2005-01-01

    Full Text Available Over the past century, steady advances have been made in fixating an unstable atlantoaxial complex. Current options for fixation of the atlantoaxial complex include posterior clamps, posterior wiring techniques, C1-C2 transarticular screw fixation, posterior C1 lateral mass screw with C2 pars or pedicle screw fixation, and anterior transoral C1 lateral mass to C2 vertebral body fixation.

  3. Disckectomy, Partial Adjacent Centrum Resection, Bone Graft with Titanium Mesh and Titanium Plate Fixation for the Treatment of Single Segment Cervical Disc Degeneration with Adjacent Vertebral Posterior Osteophyte%椎间盘及部分椎体切除加钛网植骨钛板内固定术治疗单节段颈椎椎间盘突出伴椎体后缘骨赘

    Institute of Scientific and Technical Information of China (English)

    孙继飞; 何强; 刘振利; 陈庆胜

    2012-01-01

    目的 评价颈椎椎间盘及相邻椎体部分切除加钛网植骨钛板内固定术治疗单节段颈椎椎间盘退变突出伴相邻椎体后缘骨赘的疗效. 方法 应用颈椎椎间盘及相邻椎体部分切除加钛网植骨钛板内固定术治疗单节段颈椎椎间盘退变突出伴相邻椎体后缘骨赘22例.取颈椎前路手术切口,术中仅切除突出的椎间盘及相邻椎体的1/3~ 1/2,使脊髓得到彻底的减压.再用填满碎骨的钛网植于骨缺损处加用钛板螺丝钉内固定,固定范围仅限于相邻椎体.术前和术后通过神经功能JOA评分、颈部轴性症状、颈椎动态侧位片和颈椎MRI比较临床疗效. 结果 均获随访,平均15(6 ~24)个月,术后JOA评分优良率86.4%,颈部轴性症状减轻,脊髓功能明显得到恢复.颈椎活动度良好.X线检查见钛网植骨及钛板内固定良好,未见不稳现象.MRI示颈髓压迫解除. 结论 颈椎椎间盘及相邻椎体部分切除加钛网植骨钛板内固定术治疗单节段颈椎椎间盘突出伴相邻椎体骨赘效果显著,可最大限度地保留颈椎节段的活动度.%Objective To evaluate the clinical effects of disckectomy, partial adjacent centrum resection , bone graft with titanium mesh and titanium plate fixation for the treatment of single segment cervical disc degeneration with adjacent vertebral posterior osteophyte. Methods There were 22 cases received this kind of surgical procedure. By anterior cervical incision, the herniated disc and only 1/3 to 1/2 of the adjacent vertebral body were removed for the decompression of the spinal cord. Then the titanium mesh filled with the small bones was implanted in the bone defect followed by titanium screw fixation. The fixation was limited to the adjacent vertebral bodies. Preoperative and postoperative neurological functions of the JOA score, the cervical axial symptoms, the cervical dynamic radiographs and cervical spine MRI were used to compare the clinical

  4. Bone Biopsy

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Bone Biopsy Bone biopsy uses a needle and imaging guidance ... limitations of Bone Biopsy? What is a Bone Biopsy? A bone biopsy is an image-guided procedure ...

  5. Bone Diseases

    Science.gov (United States)

    ... avoid smoking and drinking too much alcohol. Bone diseases can make bones easy to break. Different kinds ... break Osteogenesis imperfecta makes your bones brittle Paget's disease of bone makes them weak Bones can also ...

  6. Lumbopelvic fixation: a surgical alternative for lumbar stability

    Directory of Open Access Journals (Sweden)

    Gabriel Virgilio Ortiz García

    2014-09-01

    Full Text Available OBJECTIVE: Lumbopelvic fixation is a valid surgical option to achieving great stability in cases where it is particularly demanded, such as in patients with poor quality bone, degenerative scoliosis, and revision surgeries with modern materials and techniques. It enables simple integration of the iliopelvic systems with the rest of the spinal structure, maintaining hemorrhagia at acceptable levels, as well as surgery time. METHODS: We analyzed a case series of 15 patients of our center, who required major construction and/or presented poor quality bone. RESULTS: A total of 15 patients was studied, of which 12 (80% were women and three (20%, men. Nine (60% of these were revision surgeries, maintaining a surgery time of 5 hours (±1 h, with average blood loss of 1380 ml (±178 ml. All the patients received six to eight transpedicular screws, including iliac screws, and in all cases, a bone graft was inserted. CONCLUSION: Lumbopelvic fixation in patients with characteristics associated with osteopenia and osteoporosis, and in major instrumentations, particularly revision surgeries, three-dimensional correction is achieved, constructing a strong, stable pelvic base that is very useful, in patients with fragile surgical anatomy, for changes of implant or extensive decompression, provided the arthrodesis technique is adequate and with the insertion of a sufficient bone graft, and obviously, taking care to maintain the sagittal balance.

  7. PRIMARY ANTERIOR FOCUS DEBRIDEMENT AND BONE AUTOGRAFT WITH INTERNAL FIXATION VIA TRANSPERITONEAL APPROACH FOR TUBERCULOSIS OF LUMBOSACRAL JUNCTION%前路经腹腔一期病灶清除植骨融合内固定术治疗腰骶段脊柱结核

    Institute of Scientific and Technical Information of China (English)

    肖联平; 江毅; 田永刚; 李晓东; 尹庆伟; 刘智; 韩立强; 福嘉欣

    2009-01-01

    Objective To evaluate the clinical outcomes of primary anterior focus debridement, bone autograft, and internal fixation via transperitoneal approach in treating tuberculosis of the lumbosacral junction. Methods From February 2002 to April 2007, 16 patients with tuberculosis of the lumbosacral junction underwent anterior radical debridement, autologous iliac bone graft (two pieces of fliac bone, 5 cm × 3 cm in size), and internal fixation via transperitoneal approach, including 4 males and 12 females aged 27-63 years old (average 38 years old). The course of the disease ranged from 6 to 18 months (average 10 months). All patients experienced various degrees of pain in the lumbosacral area and toxic symptoms of the tuberculosis. Nine cases were complicated with radicular pain in the lower extremities, and 3 cases had saddle area anaesthesia. Two cases were initially diagnosed as lumbar intervertebral disc protrusion and treated accordingly. The segments involved by the tuberculosis were L5-S1 level in all cases. The average erythrocyte sedimentation rate (ESR) was 61 mm/hour. Imaging examination confirmed the diagnosis of spinal tuberculosis. All cases received four antitubercular drugs and nutrition support for nerve before operation. Operation was performed when hepatorenal function was normal, and the toxic symptom of the tuberculosis was under control or ESR was decreased. Results Operation was performed safely in all cases without injuries of abdominal viscera, major blood vessel, cauda equina nerve and ureter. All wounds healed by first intention. No recurrence of tuberculosis and formation of sinuses occurred. All cases were followed up for 12-37 months (average 21 months). No such complications as tuberculous peritonitis and intestinal obstruction occurred. No postoperative erectile dysfunction and retrograde ejaculation occurred in the 4 male patients. ESR was recovered to normal 3-6 months after operation, and regular X-ray and CT exams showed no

  8. Treatment of Lumbar Degenerative Disease with Unilateral Decompression,Bone Graft Fusion and Unilateral Pedicle Screw Fixation%经单侧减压融合、单边椎弓根螺钉内固定治疗腰椎退变性疾病

    Institute of Scientific and Technical Information of China (English)

    宋晋刚; 崔易坤; 苗艳; 尹振宇; 羊刚毅; 黄海锋

    2016-01-01

    目的:探讨经单侧行病变节段椎管减压、椎间植骨融合、单边椎弓根螺钉内固定治疗腰椎退变性疾病的临床疗效。方法我院2010年1月~2013年12月对35例腰椎退变性疾病采用经单侧减压、椎间植骨融合、单边椎弓根螺钉固定手术治疗。根据 JOA 评分法评估术后腰椎功能改善情况,采用视觉模拟评分(visual analog scale,VAS)评估术后疼痛缓解情况,腰椎正侧位 X 线片及 CT 扫描了解植骨融合情况。结果随访12~18个月,平均15个月。术前 JOA 评分(8.2±2.1)分,显著低于术后3个月(20.8±3.8)分(q =22.123,P <0.05)和术后12个月(21.7±3.9)分(q =23.703,P <0.05);VAS 评分术前(7.9±2.1)分,显著高于术后3个月(2.4±0.4)分(q =26.107,P <0.05)和12个月(2.3±0.3)分(q =26.582,P <0.05);JOA 评分和 VAS 评分随访期间无显著变化(P >0.05)。1年后椎间植骨融合率100%,未发现椎弓根螺钉松动、断裂、拔钉等异常。结论经单侧减压、椎间植骨融合联合单边椎弓根螺钉内固定治疗腰椎退变性疾病疗效满意,可在合适病例中推广应用。%Objective To investigate the clinical effects of unilateral vertebral canal decompression,intervertebral bone graft fusion,and unilateral pedicle screw fixation in the treatment of lumbar degenerative disease. Methods From January 2010 to December 2013,a total of 35 cases of lumbar degenerative disease were treated with unilateral decompression,intervertebral bone graft fusion,and unilateral pedicle screw fixation.The postoperative spine functions were evaluated with the JOA scores,the postoperative pain relief was evaluated with the VAS scores,and bone graft fusion was reviewed with lumbar X-ray and CT scanning. Results The patients were followed up for 12 -18 months (mean,15 months).The preoperative JOA scores (8.2 ±2

  9. Fibrin sealant versus mechanical stapling for mesh fixation during endoscopic extraperitoneal inguinal hernioplasty: a randomized prospective trial

    OpenAIRE

    H. Lau

    2005-01-01

    OBJECTIVE: To compare the clinical outcome of simultaneous bilateral endoscopic totally extraperitoneal inguinal hernioplasty (TEP) using fibrin sealant (FS) and mechanical stapling for prosthetic mesh fixation. SUMMARY BACKGROUND DATA: Similar efficacy of FS and mechanical stapling for mesh fixation has been demonstrated in a swine model, but no clinical trial has been conducted to compare the outcomes of TEP using these 2 fixation devices. FS adheres the prosthetic mesh without causing inju...

  10. Fixador esquelético pino-resina acrílica e enxerto ósseo esponjoso no tratamento de complicações secundárias à imobilização inadequada de fratura do rádio e ulna em cães Acrylic-pin external fixator and cancellous bone graft in the treatment of complications caused by inadequate immobilization of radius and ulna fracture in dogs

    Directory of Open Access Journals (Sweden)

    Sheila Canevese Rahal

    2005-10-01

    Full Text Available O objetivo do estudo foi avaliar a eficácia do fixador esquelético pino-resina, configuração tipo II, coadjuvado pelo enxerto ósseo esponjoso autólogo, no tratamento das complicações secundárias à imobilização inadequada de fraturas do rádio e ulna em 10 cães, com peso entre 1,8 e 33,6 kg. Detectou-se não-união (n=4, osteomielite (n=1, má-união (n=1, falência ou quebra de implante (n=4, sendo 60% das lesões referente ao uso prévio de pino intramedular no rádio. A montagem do fixador foi realizada com transfixação de pinos lisos em sua maioria angulados, cujas extremidades excedentes foram dobradas e estabilizadas com resina acrílica. Em todos os casos, utilizou-se enxerto esponjoso autólogo fresco, após debridamento do foco de fratura. O tempo de permanência do aparelho variou entre 45 dias e 5 meses e a maior complicação foi o afrouxamento dos pinos transfixantes. A consolidação das fraturas ocorreu por formação de calo periosteal de mínimo a moderado, indicando boa rigidez da montagem.The aim of this study was to evaluate the acrylic-pin external fixator, type II-configuration, and cancellous bone autograft for treating complications of radius and ulna fractures in 10 dogs weighing between 1.8 and 33.6 kg. Nonunion (n=4, osteomyelitis (n=1, malunion (n=1, failure or breakage of implant (n=4 were detected, and 60 % of them were associated with previous intramedullary pin placement in the radius. The fixator frame was constructed using most of the smooth transfixation pins angled. The fixation rods were constructed by placing acrylic resin over the ends of the transfixation pins that were previously bent. In all cases fresh cancellous bone autograft was used after cleaning of the fracture site. The permanence time of the external fixator ranged from 45 days to 5 months, and the most important complication was pin loosening. Fracture healing was by minimal to moderate periosteal callus, suggesting good rigidity

  11. Ultrastructural evaluation of shrinkage artefacts induced by fixatives and embedding resins on osteocyte processes and pericellular space dimensions.

    Science.gov (United States)

    Shah, Furqan A; Johansson, Bengt R; Thomsen, Peter; Palmquist, Anders

    2015-04-01

    The integrity of the interface between the osteocyte (Ot) process and the canalicular wall was investigated in terms of change in the lateral dimensions of the Ot process in relation to the canalicular width, i.e., widening of the pericellular space. This has been interpreted as shrinkage of the Ot process relative to the canalicular wall during sample preparation stages of fixation, dehydration, and resin embedding. Sprague-Dawley rat tibial cross-sections were prepared for transmission electron microscopy (TEM). Four different fixative preparations: paraformaldehyde (PF), modified Karnovsky's (MK), glutaraldehyde (GRR) with ruthenium red (GRR), and zinc formalin (ZF); and two different embedding resins: LR Gold (LRG) and Epon812 (Epon) were evaluated. It was found that for LRG embedding, formalin-only fixatives (PF and ZF) induced lower shrinkage than GRR-containing fixatives (MK and GRR). In contrast, for Epon embedding, MK showed the highest shrinkage, while no differences were found between the remaining fixatives (PF, ZF, and GRR). All formalin-containing fixatives (MK, PF, and ZF) induced similar shrinkage in both embedding media. The most dramatic difference was for GRR fixation, which in combination with LRG embedding showed ∼ 62% more shrinkage than with Epon embedding, suggesting that the combination of GRR fixation and LRG embedding synergistically amplifies Ot shrinkage. These differences likely suggest a role of the resin in secondarily influencing the tissue structure following fixation. Further, the work confirms LRG as a poor embedding medium for bone specimens, as it causes large variations in shrinkage depending on fixation.

  12. 一期后路内固定前路病灶清除植骨治疗严重腰骶椎结核的临床研究%Clinical research of one-stage posterior internal fixation and anterior debridement of bone grafting in the treatment of severe lumbosacral tuberculosis

    Institute of Scientific and Technical Information of China (English)

    羊明智; 彭立军; 胡文凯

    2013-01-01

    Objective To investigate the clinical efficacy of one-stage posterior internal fixation with pedicle screw and anterior debridement of bone grafting through the extraperitoneal approach the medial edge of rectus abdominis in treating severe lumbosa-cral tuberculosis .Methods 17 cases with L4-S1 tuberculosis were treated by internal fixation with pedicle screw ,anterior debride-ment through the extraperitoneal approach the medial edge of rectus abdominis ,and application of allogenic bone from January 2008 to December 2011 .All patients performed X-ray ,CT and MRI examinations before surgery .L5-S1 were involved in 8 cases ,L4-5 were involved in 6 cases ,and L4-S1 were involved in 3 cases;unilateral psoas abscess was found in 6 cases ,while bilateral psoas ab-scess was found in 3 cases ;Among the 17 cases ,8 cases had intraspinal invasion ,and 5 cases were combined with neurological dys-functions ,however ,according to Frankel grade ,4 cases were grade D ,and 1 case was grade C .Regular anti-tuberculosis treatment was given for more than 2 weeks before surgery ,and regular supportive treatment and anti-tuberculosis treatment were given for 9-12 months after surgery .As for regular follow-up(3 ,6 ,9 ,and 12 months after surgery ,and every 6 months later on) ,patients had examinations including ESR and X-ray to evaluate the tuberculosis activity and the condition of bone graft fusion ;while accord-ing to Frankel grade of nerves function ,changes in nerve function before and after surgery were evaluated in patients ,and changes of lumbosacral angle were also comparatively studied before and after surgery .Results There were no great vessel injuries and no nerve injuries except one case who had intraoperative ureteral injury which was repaired in time .The 17 patients were all followed up for 10-36 months(18 months average) ,and all reached clinical healing without complications such as tuberculous peritonitis ,e-rectile dysfunction and retrograde ejaculation .During

  13. The clinical effect of treatment with external circular fixator in bone defect after tibial shaft fractures secondary infection%可调组合环小腿同步延长器治疗胫骨感染骨缺损的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    郑峰; 刘建宇

    2014-01-01

    analyze the clinical effectiveness,safety and significance of treatment with external circular fixator,through the relationship of inducible nitric oxide synthase (iNOS) and bone regeneration to further explore the mechanism of the molecular biology of bone lengthening at the same time.Methods Collected bone defect after tibial shaft fractures secondary infection who were treated with external circular fixator as study group (28 cases),all the cases fixed by external circular fixator,20 healthy volunteers as control group.Study group in different time point measured the levels of serum iNOS content,were compared with the control group.Results All patients were scheduled to reach the extremity lengthening and the bone defect were repaired and healed in study group.The bacterial culture results showed that 18 cases (64.29%,18/28) of resistant Staphylococcus aureus,5 cases (17.86%,5/28) of Hemolytic streptocaccus,2 cases (7.14%,2/28) ofP.aeruginosa,one case (3.57%,1/28) of drug-resistant Enterobacter cloacae,one case(3.57%,1/28) of Staphylococcus epidermidis,one case(3.57%,1/28) of Onion-like aeromonas,the proportion of the former two was significantly higher than other bacteria (P < 0.05).The levels of serum iNOS content 1 d after surgery in study group were increased,compared with control group,difference was no significant (P > 0.05).The levels of serum iNOS content 14 d after surgery,stoped extend,1 d stoped extend,3 d stoped extend in study group were significantly higher than those in control group [(118.8 ± 6.6) U/L vs.(86.4 ± 5.4) U/L,(136.2 ± 8.4) U/L vs.(88.2 ± 3.6) U/L,(132.6 ± 9.0) U/L vs.(87.6 ± 4.8) U/L,(103.8 ± 5.4) U/L vs.(86.4 ± 4.2) U/L] (P < 0.05),there was no significant difference between two groups in other times (P > 0.05).Conclusions External circular fixator for the repair and reconstruction effects in patients with bone defect can achieve the desired therapeutic goal,the higher expression of iNOS may be one of the

  14. Fixation performance of an ultrasonically fused, bioresorbable osteosynthesis implant: A biomechanical and biocompatibility study.

    Science.gov (United States)

    Augat, P; Robioneck, P B; Abdulazim, A; Wipf, F; Lips, K S; Alt, V; Schnettler, R; Heiss, C

    2016-01-01

    Bioresorbable implants may serve as an alternative option for the fixation of bone fractures. Because of their minor inherent mechanical properties and insufficient anchorage within bone bioresorbable implants have so far been limited to mechanically nondemanding fracture types. By briefly liquefying the surface of the biomaterial during insertion, bioresorbable implants can be ultrasonically fused with bone to improve their mechanical fixation. The objective of this study was to investigate the biomechanical fixation performance and in vivo biocompatibility of an ultrasonically fused bioresorbable polymeric pin (SonicPin). First, we biomechanically compared the fused pin with press fitted metallic and bioresorbable polymeric implants for quasi-static and fatigue strength under shear and tensile loading in a polyurethane foam model. Second, fused implants were inserted into cancellous bovine bone and tested biomechanically to verify the reproducibility of their fusion behavior. Finally, the fused pins were tested in a lapine model of femoral condyle osteotomies and were histologically examined by light and transmission electron microscopy. While comparable under static shear loads, fixation performance of ultrasonically fused pins was significantly (p = 0.001) stronger under tensile loading than press fit implants and showed no pull-out. Both bioresorbable implants withstood comparable fatigue shear strength, but less than the K-wire. In bovine bone the ultrasonic fusion process worked highly reproducible and provided consistent mechanical fixation. In vivo, the polymeric pin produced no notable foreign body reactions or resorption layers. Ultrasonic fusion of polymeric pins achieved adequate and consistent mechanical fixation with high reproducibility and exhibits good short-term resorption and biocompatibility. PMID:25678144

  15. MANAGEMENT OF DISEASES OF LONG BONES WITH KUNTSCHER NAILS

    OpenAIRE

    Ravikant; Vibha; Singh,, G.; Srivastava

    2015-01-01

    BACKGROUND: AIMS: SETTINGS AND DESIGN : The aim of this study was, to devise economical, easy, simple, quick method of fixation of diseased long bones, so that pathological fracture could be prevented and to provide rigid fixation, in those cases which have already developed pathological fractu re, and to achieve arthrodesis. Ten, cases of long bone diseases were managed with the help of K nails, in the Department of Orthopaedics, in CIMS, between, December 2002 ...

  16. 持续闭式引流(VSD)结合骨水泥抗生素链珠治疗腰椎骨折椎弓根钉棒系统内固定术后早期感染%Treatment of early postoperative infection of lumbar fracture internal fixation of pedicle screw rod system with vacuum sealing drainage(VSD)combined with antibiotic bone cement chain

    Institute of Scientific and Technical Information of China (English)

    朱余龙; 朱海涛; 丁德刚; 徐亮

    2014-01-01

    目的:探讨持续闭式引流(VSD)结合骨水泥抗生素链珠治疗腰椎骨折椎弓根钉棒系统内固定术后早期感染的临床疗效。方法2010年3月一2014年3月,使用持续闭式引流(VSD)结合骨水泥抗生素链珠治疗腰椎骨折椎弓根钉棒系统内固定术后早期感染11例,随访其临床效果。结果11例患者均得到随访,随访时间8—12月,平均10.5月。手术后感染治愈,无一例需取出原内固定物重新或者更换固定材料。结论持续闭式引流(VSD)结合骨水泥抗生素链珠治疗腰椎骨折椎弓根钉棒系统内固定术后早期感染操作简单、安全有效,可以作为治疗腰椎骨折椎弓根钉棒系统内固定术后早期感染手段之一。%Objective: To investigate the efficacy of the treatment of early postoperative infection of umbar fracture internal fixation of pedicle screw rod system with VSD combined with antibiotic bone cement chain. Methods: from 2010 March to 2014 March, the use of continuous closed drainage (VSD) combined with antibiotic bone cement bead chain, lumbar fracture internal fixation of pedicle screw rod system treatment of early postoperative infection in 11 cases, folow-up clinical results. Results: 11 patients were folowed up from 8-12 months, with an average of 8.5 months. Cured of infection after surgery, no case of need to remove or replace the original re-fixed within the implant material. Conclusion: The continuous closed drainage (VSD) combined with antibiotic bone cement beads chain to treat early infection is simple, safe and effective treatment of lumbar fracture internal fixation of pedicle screw rod system can be used as a means of early postoperative infection.

  17. Anterior transarticular screw fixation as a conventional operation for rigid stabilization

    Directory of Open Access Journals (Sweden)

    Manabu Sasaki

    2014-01-01

    Full Text Available Background: Anterior transarticular screw (ATS fixation is a useful surgical option for atlantoaxial (AA stabilization. This report presents a revised ATS method for AA fusion. Methods: A 79-year-old male presented with AA instability attributed both to an old odontoid fracture and severe degeneration of the lateral atlantoaxial joints (LAAJs. ATS fixation was performed through the conventional anterior cervical approach. The longest screw trajectories were planned preoperatively using multiplanar reconstruction computed tomography (CT scans, with entry points of the screws situated at the midpoint on the inferior border of the axial body. The surgical exposure was limited to opening at the entry points alone. Our retractor of choice was the Cusco speculum; it sufficiently secured space for utilizing the required instruments for screw placement while offering sufficient protection of soft tissues. Cannulated full-threaded bicortical screws stabilized the LAAJs. Screw insertion required a significant amount of coronal angulation up to the superior articular process of the atlas under open-mouth and lateral fluoroscopy image guidance. After ATS fixation, bone grafting was performed between the posterior laminae of the axis and the atlas through a conventional posterior approach. Results: Bony fusion between the atlas and the axis was confirmed radiographically. Arthrodesis of the LAAJs occurred despite no bone grafting. Conclusions: Rigid fixation of the LAAJs was obtained by our ATS technique, indicating that it is an alternative method for AA fixation when posterior rigid internal fixation is not applicable.

  18. Intraocular lens fixation with dacron.

    Science.gov (United States)

    Peyman, G A; Koziol, J E

    1978-10-01

    To overcome the problem of postoperative lens dislocation, we evaluated a new means of lens fixation. Our experimental studies in rabbits and primates demonstrated that Dacron polyethylene terephtalate induced a cellular reaction from either the anterior or posterior iris surface when placed in contact with the iris, thereby establishing a bond between the Dacron fibers and the iris. Dacron mesh can be attached to the distal portion of either the anterior or posterior loops of a Binkhorst iris clip (4-loop) lens. In the rabbit eye, lens fixation occurred within five days; in the primate eye, 30 days. When combined with silk, Dacron produced tissue ingrowth in the primate eye within 14 days. No unwanted reaction occurred in any animal with the Dacron and silk combination. Being biodegradable, the silk induced faster cellular ingrowth than the Dacron. However, Dacron, which is not biodegradable, provided a permanent means of fixation. PMID:155053

  19. Double calcaneal osteotomy with percutaneous Steinmann pin fixation as part of treatment for flexible flatfoot deformity: a review of consecutive cases highlighting our experience with pin fixation.

    Science.gov (United States)

    Boffeli, Troy J; Abben, Kyle W

    2015-01-01

    Surgical correction of flexible flatfoot deformity and posterior tibial tendon dysfunction has been extensively reported in published studies. When appropriate, calcaneal osteotomies for flatfoot correction have been a favorite of foot and ankle surgeons because of the corrective power achieved without the need to fuse any rearfoot joints. The medial displacement calcaneal osteotomy and Evans calcaneal osteotomy, together termed the double calcaneal osteotomy, have been reported several times by various investigators with a wide variety of fixation options. We undertook an institutional review board-approved retrospective review of 9 consecutive patients (11 feet), who had undergone double calcaneal osteotomy with 2 percutaneous Steinmann pin fixation for the correction of flexible flatfoot deformity, with or without posterior tibial tendon dysfunction. All patients had radiographic evidence of bone healing of the posterior calcaneal osteotomy and incorporation of the Evans osteotomy bone graft at 6 weeks and demonstrated clinical healing at 6 weeks. All patients had 2 percutaneous Steinmann pins placed through both osteotomies, and these were removed an average of 6 weeks postoperatively. No patient developed pin site complications. The only complication noted was sural neuritis, which was likely incision related. No patients had delayed union or nonunion, and we did not identify any graft shifting postoperatively. The present retrospective series highlights our experience with 2 percutaneous Steinmann pin fixation, demonstrating equal or better results than many previous published fixation methods for double calcaneal osteotomy. It is cost-effective and minimizes the potential risk of iatrogenic Achilles pathologic features associated with screw fixation.

  20. QWIX螺钉置入内固定修复髌骨骨折:骨折断端的持续动静态加压作用%QWIX screw fixation in repair of patellar fractures:continuous dynamic and static pressure in the broken ends of the bones

    Institute of Scientific and Technical Information of China (English)

    刘杰; 高仕长; 梁安霖

    2014-01-01

    remaining patients. In accordance with Bostman score, there were excellent in 27 cases, good in 3 cases, and poor in 0 case, with an excellent and good rate of 100%at 1 year fol owing surgery. Results data suggested that QWIX screws combined with Kirschner wire and wire fixation in repair of patel ar fracture have some advantages such as continuous dynamic and static pressure at the broken ends of the bones, early flexion and extension exercises, and reducing the fixation-related complications. It is an effective method to repair patel ar fracture.

  1. Sistemas osso-implante ex vivo utilizando haste intramedular polimérica para imobilização de fraturas femorais em bovinos jovens Ex vivo bone-implant systems using polymeric intramedullary nails for fixation of femoral fractures in young calves

    Directory of Open Access Journals (Sweden)

    Odael Spadeto Junior

    2011-02-01

    Full Text Available O desenvolvimento de novos aparatos usando materiais disponíveis e de baixo custo pode ser uma alternativa viável para o tratamento cirúrgico de fraturas em ossos longos de bovinos. O objetivo deste estudo foi avaliar a resistência mecânica de fêmures de bovinos jovens com fratura diafiseal, imobilizados com hastes intramedulares bloqueadas, compostas por diferentes polímeros. Para tanto, testes físicos de compressão e flexão, por meio de uma máquina universal de ensaios foram realizados em quatro grupos distintos de seis fêmures obtidos de bovinos jovens. Em um dos grupos, os ossos foram mantidos íntegros (grupo controle, enquanto que os outros os ossos, foram fraturados e imobilizados com uma haste intramedular bloqueada, composta por polipropileno, poliacetal ou poliamida (uma para cada grupo. Independente do polímero utilizado, nenhuma das hastes estudadas ofereceu aos fêmures fraturados resistência comparável ao osso íntegro, quando consideradas em conjunto as forças de flexão e compressão. A concordância desses achados com resultados in vivo previamente publicados, demonstra que a metodologia utilizada para testes ex vivo pode ser útil na seleção de materiais mais resistentes para confecção de novos modelos.The development of new devices using available and low cost materials may be an useful alternative for the treatment of long bone fractures in large animals. The aim of this study was to evaluate the mechanical strength of young bovine femur with diaphyseal fracture fixed with different polymeric intramedullary nails. Bending and compression tests using a universal machine were carried out in 4 distinct groups of 6 femurs from young calves. In one of the groups bones were intact while in the other three fractured bones were fixed using an intramedullary nail made of polypropylene, polyacetal or polyamide (one for each group. Considering bending and compression tests together, none of the used polymers offered

  2. 带缝匠肌骨瓣移植联合空心钉内固定治疗青少年股骨颈骨折的临床效果分析%Clinical effect analysis of sartorial-pedicled ilium bone transplantation combined with hollow screw fixation treating femoral neck fracture of youngsters

    Institute of Scientific and Technical Information of China (English)

    郑凌云; 邓秋平; 田华强; 方良韬

    2015-01-01

    目的:分析带缝匠肌骨瓣移植联合空心钉内固定对青少年股骨颈骨折的治疗效果。方法选取本院2012年7月~2014年6月收治的80例青少年股骨颈骨折患者,按随机数字表法分成研究组和对照组,各40例。研究组采用带缝匠肌骨瓣移植术联合空心钉内固定术进行治疗;对照组单纯采用空心螺钉内固定术进行治疗。比较两组手术时间、术中出血量、住院时间、股骨头缺血性坏死发生率、骨折愈合时间、临床疗效及治疗前、后生活质量。结果研究组手术时间长于对照组(P0.05);研究组股骨头缺血性坏死发生率低于对照组(P0.05);研究组治疗后生活质量得分高于对照组(P0.05). The life quality score of research group after treatment was higher than that of control group (P<0.05). Conclusion Sartorial-pedicled ilium bone transplantation combined with hollow screw fixation treating femoral neck fracture of youngsters has the advantages of rapid recovery and good efficacy.

  3. Posterior atlantoaxial transpedicle screw fixation for traumatic atlatoaxial instability

    Directory of Open Access Journals (Sweden)

    Zheng-lei WANG

    2015-10-01

    Full Text Available Objective To explore the clinical efficacy of posterior atlantoaxial pedicle screw fixation for traumatic atlantoaxial instability. Methods From September 2009 to March 2013, 17 patients with atlantoaxial instability received posterior atlantoaxial pedicle screw fixation. There were 12 males and 5 females, with a mean age of 42 years old (ranged from 19 to 63 years old. Transpedicle screw fixation was employed in 8 patients with atlantoaxial fracture and dislocation, in 2 with traumatic disruption of transverse atlantal ligament, and in 7 with odontoid fracture. The Japanese Orthopaedic Association (JOA score before operation was from 5 to 14, with a mean of 11.2. Preoperative CT, MRI and radiographs, as well as intraoperative screw placement and bone graft were administered in all the patients. Results In all the patients, complete reduction was achieved without injury to the vertebral artery, spinal cord or never root, and they started to be ambulatory on the first day after the operation. The patients were followed up for 6-36 months (mean 21 months, and clinical symptoms were seen to be improved significantly. Imaging reexamination 6 months after the surgery showed satisfactory healing of implanted bone and position of all the screws without loosening of the implant. The mean JOA scores was 15.5(11.0-17.0 twelve months after the operation. Conclusion Atlantoaxial pedicle screw fixation for traumatic atlantoaxial instability is safe and reliable with a favorable clinical result. DOI: 10.11855/j.issn.0577-7402.2015.09.14

  4. Ankle fusion stability: a biomechanical comparison of external versus internal fixation.

    Science.gov (United States)

    Hoover, Justin R; Santrock, Robert D; James, William C

    2011-04-11

    This biomechanical study compares bimalleolar external fixation to conventional crossed-screw construct in terms of stability and compression for ankle arthrodesis. The goals of the study were to determine which construct is more stable with bending and torsional forces, and to determine which construct achieves more compression.Fourth-generation bone composite tibia and talocalcaneal models were made to 50th percentile anatomic specifications. Fourteen ankle fusion constructs were created with bimalleolar external fixators and 14 with crossed-screw constructs. Ultimate bend, torque, and compression testing were completed on the external fixator and crossed-screw constructs using a multidirectional Materials Testing Machine (MTS Systems Corp, Eden Prairie, Minnesota). Ultimate bend testing revealed a statistically significant difference (P=.0022) with the mean peak load to failure for the external fixator constructs of 973.2 N compared to 612.5 N for the crossed-screw constructs. Ultimate torque testing revealed the mean peak torque to failure for the external fixator construct was 80.2 Nm and 28.1 Nm for the crossed-screw construct, also a statistically significant difference (P=.0001). The compression testing yielded no statistically significant difference (P=.9268) between the average failure force of the external fixator construct (81.6 kg) and the crossed-screw construct (81.2 kg).With increased stiffness in both bending and torsion and comparable compressive strengths, bimalleolar external fixation is an excellent option for tibiotalar ankle arthrodesis.

  5. Prevention of Thumb Web Space Contracture With Multiplanar External Fixation.

    Science.gov (United States)

    Harper, Carl M; Iorio, Matthew L

    2016-09-01

    Thumb web space contracture following hand trauma can be disabling with numerous reconstructive procedures existing to correct the resultant deformity. Following marked soft tissue injury to the hand we utilized the Stryker Hoffmann II Micro External Fixator System to link the first and second metacarpals by a multiplanar system using 1.6 or 2.0 mm self-drilling half-pins and 3 mm carbon fiber connecting rods. This facilitated placement of the thumb in maximal palmar abduction as well as allowed adjustment of thumb position throughout the postoperative period. This technique was performed on 5 patients. Two patients were treated with a first web space external fixator for table saw injuries to the radial aspect of the hand. An additional 2 patients were treated with a first web space external fixator following metacarpophalangeal joint capsular release in the setting of thermal burns. A fifth patient underwent second ray amputation, trapeziectomy and trapezoidectomy for squamous cell carcinoma with subsequent stabilization with the external fixator. The external fixator was left in place until soft tissues were healed (average 5.5 wk). The patients were allowed to mobilize their hand in as much as the external fixator allowed, and no device-associated complications were noted. Thumb web space was preserved with passive and supple thumb circumduction and web space abduction/adduction in all patients at an average follow-up of 5 months. The average Quick Dash Score was 35±5 and the average Modern Activity Subjective Survey of 2007 was 30±8.

  6. Correction of abnormal healing of distal radius fractures using bone flap graft and external fixation in young adults%骨瓣植骨联合外固定支架在青壮年桡骨远端骨折畸形愈合矫形中的应用

    Institute of Scientific and Technical Information of China (English)

    吴咏德; 蔡贤华; 梁杰; 周才胜; 李宁; 陈波; 邓桂; 伍伟飞; 姚紫洲

    2016-01-01

    Objective To evaluate the correction of abnormal healing of distal radius fractures using bone flap graft and external fixation in young adult patients.Methods A retrospective analysis of the clinical data was done for 17 young patients with abnormal healing of distal radius fracture who had been treated from July 2012 to September 2015 at our department.They were 13 males and 4 females,with an average age of 40.2 years (range,from 30 to 55 years).There were 8 Colles fractures,5 Smith fractures and 4 Barton fractures.Seven cases were the left side and 10 the right side.The abnormal healing of fracture was corrected by open osteotomy through the dorsoradial approach,graft with a pronator quadratus ulnar flap,partial or complete excision of the remaining ulnar head,and external fixation combined with Kirschner wiring.The pronation,supination,dorsal extension,palmar flexion,radial deviation,ulnar deviation,Visual Analogue Scale (VAS)and Cooney scores were compared between preoperation and the final follow-ups.Results The 17 patients were followed up for 12 to 37 months (average,21.4 months).No incision infection,skin margin necrosis,plate breakage,or screw loosening occurred.The postoperative X-rays revealed union of all the bone grafts at the distal radius after 8 to 20 weeks after operation (average,12 weeks).The symptoms of the wrist joint were significantly relieved.The final follow-ups showed significant improvements in pronation,supination,dorsal extension,palmar flexion,radial deviation,ulnar deviation,VAS and Cooney scores (P < 0.05).Conclusion Abnormal healing of distal radius fractures can be effectively corrected using bone flap graft and external fixation in young adult patients,because this simple but practical operation not only corrects the deformity but also improves function satisfactorily.%目的 探讨骨瓣植骨联合外固定支架在开放截骨植骨复位治疗青壮年桡骨远端骨折畸形愈合的疗效. 方法 回顾性分析2012年7

  7. Bone Cement Augmentation of Pedicle Screw Fixation Combined with Kyphoplasty for Osteoporotic Thoracolumbar Burst Fractures%骨水泥强化椎弓根螺钉固定结合椎体后凸成形术治疗骨质疏松性胸腰段爆裂骨折

    Institute of Scientific and Technical Information of China (English)

    于亮; 蒋伟宇; 赵刘军; 马维虎; 徐荣明

    2014-01-01

    [目的]评估骨水泥强化椎弓根螺钉固定结合椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性胸腰椎爆裂骨折的临床疗效。[方法]收集本院2011年1月至2012年12月采用骨水泥强化椎弓根螺钉固定结合PKP治疗的31例无神经损伤的骨质疏松性胸腰椎爆裂骨折患者,观测术前、术后1周及术后1年伤椎前后缘压缩率改变、后凸Cobb角、视觉模拟评分(visual analogue scale,VAS)及术后并发症,评估手术效果。[结果]术前椎体前、后缘压缩率分别为(49.5±6.1)%和(16.7±3.2)%,术后1年椎体前后缘压缩率分别为(9.1±1.3)%和(1.2±0.9)%,Cobb角由术前平均(25.7±4.5)°矫正至术后(3.3±2.1)°,平均矫正19.8°,VAS评分由术前平均(7.2±0.5)分降为术后(1.9±0.6)分,各项指标术后与术前比较差异均有统计学意义(P<0.05)。术后随访12~24个月,无1例发生手术并发症。[结论]骨水泥强化椎弓根螺钉固定结合PKP治疗骨质疏松性胸腰椎爆裂骨折,能有效恢复脊柱矢状序列,同时也能较好地维持伤椎的高度和强度,避免术后椎体塌陷,有助于早期康复,减少并发症。%Objective] To assess the efficacy of bone cement augmentation of pedicle screw fixation combined with kyphoplasty for osteoporotic thoracolumbar burst fractures. [Methods] Thirty-one cases of neurological y intact osteoporotic thoracolumbar burst fractures treated by bone cement augmentation of pedicle screw fixation combined with kyphoplasty between January 2011 and December 2012 were included in this study. Then analyze the front and back edges height of the injured vertebra, kyphosis Cobb ’s angle, visual analogue scale(VAS) and complications. [Results] Patients were fol owed up for 12 to 24 months(mean 18.2 months), there was no complication. Al patients recovered satisying, front and back edges of the compression ratio was (49.5±6.1)%and

  8. 强化螺钉治疗老年腰椎管狭窄近中期疗效%The short and midterm clinical effect of pedicle screw fixation with bone cement augmentation in the treatment of senile lumbar spinal stenosis

    Institute of Scientific and Technical Information of China (English)

    瞿岱彪; 黄圣升; 吴华; 刘礼金

    2015-01-01

    目的:评价骨水泥强化椎弓根螺钉内固定治疗伴老年腰椎管狭窄症的近中期临床疗效。方法2012年6月至2014年6月间应用骨水泥强化椎弓根螺钉治疗老年性腰椎管狭窄患者24例,所有患者术前均行骨密度测定诊断为骨质疏松症。采用VAS、JOA下腰痛评分及Oswestry功能障碍指数问卷表(ODI)评分标准评价临床疗效。结果24例患者随访6-24个月,平均(11.50±2.11)个月,不适症状均得到一定改善。 VAS评分术前(7.55±1.30)、术后3个月为(3.65±0.87)、术后6个月为(3.15±0.71)、末次为(2.83±2.04);JOA评分术前为(8.66±7.01)、术后3个月为(14.09±2.07)、术后6个月为(16.88±1.95)、末次随访为(17.33±1.74);ODI评分术前为(0.71±0.31)、术后3个月为(0.44±0.12)、术后6个月为(0.31±0.11)、末次随访为(0.29±0.07)。术后3个月、6个月、末次随访所有评价指标分别与术前对比,差异均有统计学意义(P<0.05)。随访时复查相关影像学资料示只有1例因外伤出现椎弓根螺钉松动,末次随访椎间融合率高达87%。结论对于老年性合并骨质疏松的腰椎管狭窄症患者,应用骨水泥强化椎弓根螺钉技术临床疗效确切,有术后椎间融合率高、发生内固定松动率低、二次手术风险低等优势。%Objective To observe the short and midterm clinical effect of pedicle screw fixation with bone cement augmenta-tion in the treatment of senile lumbar spinal stenosis. Methods From June 2012 to June 2014,24 patients with Lumbar Spinal Stenosis and osteoporosis were treated by posterior decompression,intervertebral fusion with pedicle screw fixation with bone ce-ment augmentation. Osteoporosis was diagnosed by dual-energy X-ray absorptiometry (DEXA) examination in all cases preopera-tively. The clinical results were investigated by measuring VAS and JOA and ODI scoring. Results 24 patients were followed up from 6 to 24 months (average 11.50

  9. 四肢长骨干骨折治疗的有限接触动力加压钢板和动力加压钢板临床比较%Clinical comparison of dynamic compression plate and limited contact dynamic compression plate fixation in the treatment of limbs long bone fracture

    Institute of Scientific and Technical Information of China (English)

    张星华

    2014-01-01

    目的 对比动力加压钢板(DCP)与有限接触动力加压钢板(LC-DCP)内固定治疗四肢长骨干骨折的临床疗效,为临床内固定的选择提供一定依据.方法 回顾性分析采用DCP和LC-DCP内固定治疗的172例四肢长骨干骨折患者的临床资料.其中LC-DCP组101例,DCP组71例,比较两组手术时间、术中出血量、住院时间、骨折愈合时间、骨折不愈合发生率、日常活动能力和关节功能评分及临床疗效.结果 LC-DCP组手术时间、骨折愈合时间、骨折不愈合发生率均优于DCP组[(62±13) min比(88±20) min、(60.0±20.5)d比(85.0±25.5)d、1.0%(1/101)比7.0%(5/71)],差异有统计学意义(P<0.05),而两组术中出血量与住院时间比较差异无统计学意义(P>0.05).LC-DCP组Barthel和Harris评分分别为(72.61±8.63)分和(69.28±7.63)分,均优于DCP组的(52.58±5.53)分和(55.07±6.26)分,差异有统计学意义(P<0.05).LC-DCP组优良率优于DCP组[99.0%(100/101)比90.1%(64/71)],差异有统计学意义(x2=15.71,P<0.01).结论 四肢长骨干骨折采用LC-DCP治疗,能提高临床疗效,减少手术并发症,提高患者的日常关节功能,值得临床推广使用.%Objective To compare the clinical effect of dynamic compression plate (DCP) and limited contact dynamic compression plate (LC-DCP) fixation in the treatment of limbs long bone fracture,provide certain basis for the choice of clinical internal fixation.Methods The clinical data of 172 patients with limbs long bone fracture treated with DCP and LC-DCP fixation were retrospectively analyzed.One hundred and one cases in LC-DCP group,and 71 cases in DCP group,the operation time,intraoperative blood loss,hospitalization time,fracture healing time,incidence of nonunion,daily activity ability and joint function score and clinical curative effect in two groups were compared.Results The operation time,fracture healing time,incidence of nonunion in LC-DCP group were better than those in DCP

  10. Clinical research of posterior limited decompression bone fusion internal fixation in treatment of lumbar degenerative instability%后路有限减压植骨融合内固定治疗腰椎退变性不稳的临床研究

    Institute of Scientific and Technical Information of China (English)

    吴发泳; 尹金铭; 林榕镔; 罗佛长

    2015-01-01

    目的:探讨后路有限减压植骨融合内固定治疗腰椎退变性不稳的临床效果。方法选取本院2010年10月~2014年2月诊治的腰椎退变性不稳患者106例,采用随机数字表法分为两组,各53例。对照组患者采用传统后路开放手术治疗,观察组患者采用后路有限减压植骨融合内固定治疗,比较两组的治疗效果。结果观察组患者的术中出血量、术后引流量明显少于对照组,切口长度明显小于对照组,下床活动时间、术后住院时间明显短于对照组(P<0.05)。治疗后,两组患者的Oswestry功能障碍指数(疼痛、行走、坐立、自理能力、提物、睡眠、总评分)、VAS评分均显著降低,疼痛程度均明显减轻,且观察组治疗后的Oswestry功能障碍指数(疼痛、行走、坐立、自理能力、提物、睡眠、总评分)、VAS评分明显低于对照组,疼痛程度明显轻于对照组(P<0.05);观察组的术后并发症发生率均明显低于对照组(P<0.05)。结论后路有限减压植骨融合内固定是治疗腰椎退变性不稳的有效方法,具有创伤小、疼痛轻、术后恢复快、并发症少、安全性高等优点。%Objective To investigate clinical effect of posterior limited decompression bone fusion internal fixation in treatment of lumbar degenerative instability. Methods 106 patients with lumbar degenerative instability diagnosed and treated in our hospital were selected from October 2010 to February 2014,and they were randomly divided into two groups,and there were 53 patients in each group.Control group was treated with traditional posterior open operation while observation group was treated with posterior limited decompression bone fusion internal fixation as observation group.Ttreatment effect was compared between two groups. Results Intraoperative bleeding volume and postoperative drainage volume in observation group was obviously less than that of control group respectively

  11. Computer assisted preoperative planning of bone fracture reduction: Simulation techniques and new trends.

    Science.gov (United States)

    Jiménez-Delgado, Juan J; Paulano-Godino, Félix; PulidoRam-Ramírez, Rubén; Jiménez-Pérez, J Roberto

    2016-05-01

    The development of support systems for surgery significantly increases the likelihood of obtaining satisfactory results. In the case of fracture reduction interventions these systems enable surgery planning, training, monitoring and assessment. They allow improvement of fracture stabilization, a minimizing of health risks and a reduction of surgery time. Planning a bone fracture reduction by means of a computer assisted simulation involves several semiautomatic or automatic steps. The simulation deals with the correct position of osseous fragments and fixation devices for a fracture reduction. Currently, to the best of our knowledge there is no computer assisted methods to plan an entire fracture reduction process. This paper presents an overall scheme of the computer based process for planning a bone fracture reduction, as described above, and details its main steps, the most common proposed techniques and their main shortcomings. In addition, challenges and new trends of this research field are depicted and analyzed.

  12. 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.

  13. First metatarsophalangeal joint arthrodesis: current fixation options.

    Science.gov (United States)

    Moon, Jared L; McGlamry, Michael C

    2011-04-01

    This article reviews the current literature on first metatarsophalangeal joint arthrodesis rates using various forms of fixation, as well as reviewing biomechanical studies comparing the strengths of the different fixation options that are available.

  14. Bone Grafts

    Science.gov (United States)

    ... repair and rebuild diseased bones in your hips, knees, spine, and sometimes other bones and joints. Grafts can also repair bone loss caused by some types of fractures or cancers. Once your body accepts the bone ...

  15. 颅脑外伤术后头部固定装置的研制%Research and Development of a Head Fixation Device for Post-Operative Patients with Cranio-Cerebral Trauma

    Institute of Scientific and Technical Information of China (English)

    王学建

    2015-01-01

    针对颅脑外伤术(尤其是枕部手术)后头部切口不易保护、包扎易松动、易致切口污染等问题,本文研制了一款神经外科头部固定装置,该装置主要由头部包扎部分及可拆卸保护装置等结构构成,具有包扎牢固、舒适、切口保护等功能,可解决头部外伤术后包扎的问题。临床实际应用证实其具有省时、方便、实用、舒适等效果,值得临床推广。%In view of the issues occurring after cranio-cerebral trauma surgeries, especially occipital surgeries, including difficulty in incision protection, loose dressing, and incision pollution, a kind of neurosurgery head ifxation device was researched and developed, which mainly consisted of the head bandage and removable protection structure. With the functions of steady and comfortable bandage as well as incision protection, the device was intended to solve the problem of incision protection after head trauma surgeries. Clinical application proved its time-saving, easy-to-use, practical and comfortable features, deserving wider clinical promotion.

  16. UK DRAFFT - A randomised controlled trial of percutaneous fixation with kirschner wires versus volar locking-plate fixation in the treatment of adult patients with a dorsally displaced fracture of the distal radius

    OpenAIRE

    Brown Jaclyn; Edlin Richard P; Rangan Amar; Parsons Nick R; Achten Juul; Costa Matthew L; Lamb Sarah E

    2011-01-01

    Abstract Background Fractures of the distal radius are extremely common injuries in adults. However, the optimal management remains controversial. In general, fractures of the distal radius are treated non-operatively if the bone fragments can be held in anatomical alignment by a plaster cast or orthotic. However, if this is not possible, then operative fixation is required. There are several operative options but the two most common in the UK, are Kirschner-wire fixation (K-wires) and volar ...

  17. Rapid method for fetal brain fixation.

    OpenAIRE

    Nicholls, J. M.

    1988-01-01

    A quicker alternative to the standard removal and fixation of brain tissue was sought. Whole fetal brains were fixed in situ using a mercuric based fixative. The subarachnoid space was perfused overnight with Heidenhain's Susa fixative. The following day the brains were removed from the cranium in the standard manner. After storage for three days in Susa's fixative the brain was sliced and processed, with excellent preservation of gross and microscopic architecture. The cost is only marginall...

  18. External fixation in contemporary fracture management

    OpenAIRE

    McCoy, G. F.; Orr, J. F.; Templeton, J.

    1987-01-01

    Important advances have been made within the last two decades in the field of fracture management. The development of the AO internal fixation system and the advances in cast bracing techniques are but two of the improvements worthy of mention. It is, however, in the field of external fixation of fractures that the greatest advances have been made. This paper traces the history of external fixation up to the present day and discusses, with examples, the application of external fixation in the...

  19. Minimally Invasive Pedicle Screw Fixation Combined with Vertebroplasty with Calcium Phosphate Bone Cement in the Treatment of Thoracolumbar Burst Fracture%微创椎弓根钉内固定联合磷酸钙骨水泥椎体成形术治疗胸腰椎爆裂性骨折

    Institute of Scientific and Technical Information of China (English)

    顾宇彤; 梁朝革; 张亮; 林红; 周健

    2015-01-01

    目的:评估微创椎弓根钉内固定(微小切口非空心椎弓根钉技术)联合磷酸钙骨水泥经皮穿刺椎体成形术(percutaneous vertebroplasty ,PVP)治疗胸腰椎爆裂性骨折的疗性和安全性。方法:采用微创椎弓根钉内固定联合磷酸钙骨水泥 PVP术治疗23例单节段胸腰椎新鲜爆裂性骨折且无神经症状的患者,伤椎位于 T11~L2,均属A3型骨折。记录手术时间、术中出血量、骨水泥注射量和住院天数。记录术前及术后即刻、1个月、2个月、3个月、6个月、1年、2年的腰背痛评分,计算并比较各时点的椎体高度压缩率、恢复率、椎体后凸角、椎体后凸矫正率。结果:磷酸钙骨水泥平均注射量为4.9(3.8~6.4)mL,平均手术时间92(75~120) min ,平均出血量52(40~75) mL ,平均住院5.6(4~7) d ,术后平均随访26(24~29)个月。VAS评分由术前的(8.8±1.2)分下降至术后即刻的(1.8±0.6)分及术后2年的(0.4±0.5)分,差异均有显著统计学意义(P<0.001)。高度压缩率由术前的(50.4±7.2)%显著下降至术后即刻的(6.2±1.5)%及术后2年的(6.9±1.4)%,差异均有显著统计学意义(P<0.001)。后凸角由术前的(22.6±1.8)°下降至术后即刻的(3.2±1.7)°及术后2年的(5.1±1.5)°,差异均有显著统计学意义( P<0.001)。随访过程中术后高度恢复率、后凸矫正率无明显减小;未出现螺钉松动、断钉或断棒。结论:微创椎弓根钉内固定联合磷酸钙骨水泥PV P术是治疗胸腰椎爆裂性骨折的安全、有效的方法。%Objective:To evaluate the efficacy and safety of minimally invasive pedicle screw fixation combined with percutaneous vertebroplasty(PVP) with calcium phosphate bone cement in the treatment of acute thoracolumbar burst fracture . Methods:Twenty‐three patients

  20. Understanding Nitrogen Fixation

    Energy Technology Data Exchange (ETDEWEB)

    Paul J. Chirik

    2012-05-25

    synthesis of ammonia, NH{sub 3}, from its elements, H{sub 2} and N{sub 2}, via the venerable Haber-Bosch process is one of the most significant technological achievements of the past century. Our research program seeks to discover new transition metal reagents and catalysts to disrupt the strong N {triple_bond} N bond in N{sub 2} and create new, fundamental chemical linkages for the construction of molecules with application as fuels, fertilizers and fine chemicals. With DOE support, our group has discovered a mild method for ammonia synthesis in solution as well as new methods for the construction of nitrogen-carbon bonds directly from N{sub 2}. Ideally these achievements will evolve into more efficient nitrogen fixation schemes that circumvent the high energy demands of industrial ammonia synthesis. Industrially, atmospheric nitrogen enters the synthetic cycle by the well-established Haber-Bosch process whereby N{sub 2} is hydrogenated to ammonia at high temperature and pressure. The commercialization of this reaction represents one of the greatest technological achievements of the 20th century as Haber-Bosch ammonia is responsible for supporting approximately 50% of the world's population and serves as the source of half of the nitrogen in the human body. The extreme reaction conditions required for an economical process have significant energy consequences, consuming 1% of the world's energy supply mostly in the form of pollution-intensive coal. Moreover, industrial H{sub 2} synthesis via the water gas shift reaction and the steam reforming of methane is fossil fuel intensive and produces CO{sub 2} as a byproduct. New synthetic methods that promote this thermodynamically favored transformation ({Delta}G{sup o} = -4.1 kcal/mol) under milder conditions or completely obviate it are therefore desirable. Most nitrogen-containing organic molecules are derived from ammonia (and hence rely on the Haber-Bosch and H{sub 2} synthesis processes) and direct synthesis from

  1. 踝关节融合术固定方式研究进展%RECENT PROGRESS OF FIXATION TECHNIQUES OF ANKLE ARTHRODESIS

    Institute of Scientific and Technical Information of China (English)

    左乔; 魏显招; 苏佳灿

    2012-01-01

    Objective To review the latest research progress of fixation techniques of ankle arthrodesis. Methods The literature concerning the research of fixation techniques of ankle arthrodesis in recent years was reviewed. Then the characteristics and new research progress of different internal and external fixation techniques were analysed and compared. Results There are plenty of different types of internal and external fixation devices, each with distinct characteristics. Now it is widely considered that internal fixation is the first choice for end-stage ankle arthropathy. However, under the circumstances that patients with serious bone defect, chronic active infection, or extensive soft tissue damage are not suitable for internal fixation, ankle arthrodesis with external fixation is still a safe and effective method. Conclusion For severe or end-stage ankle arthropathy, ankle arthrodesis is a mature therapeutic way with exact effect. Researches on these two aspects, expansion of indications of internal fixation and comparison and combination of internal and external fixation techniques, need to be deepened, which is of great significance for choosing a better fixation method and acquiring a better therapeutic effect.%目的 对踝关节融合术的固定技术和研究进展进行综述. 方法 广泛查阅近年来国内外关于踝关节融合术固定技术研究的文献,对临床常用各种内、外固定方式的特点及研究进展进行分析总结. 结果 内、外固定器材种类众多,各具特点.目前普遍认为内固定术是治疗晚期踝关节疾病的首选方式,但对于伴有严重骨缺损、慢性活动性感染、软组织广泛受损等不适用内固定装置的情况,外固定术安全、可靠. 结论 对于严重或晚期踝关节疾病,踝关节融合术是一项技术成熟、疗效确切的治疗手段.在内固定使用适应证的拓展研究和内、外固定技术对比与联合应用两个方面的研究有待进

  2. Bone within a bone

    Energy Technology Data Exchange (ETDEWEB)

    Williams, H.J.; Davies, A.M. E-mail: wendy.turner@roh.nhs.uk; Chapman, S

    2004-02-01

    The 'bone within a bone' appearance is a well-recognized radiological term with a variety of causes. It is important to recognize this appearance and also to be aware of the differential diagnosis. A number of common conditions infrequently cause this appearance. Other causes are rare and some remain primarily of historical interest, as they are no longer encountered in clinical practice. In this review we illustrate some of the conditions that can give the bone within a bone appearance and discuss the physiological and pathological aetiology of each where known.

  3. 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.

  4. Clinical effects of posterior decompression and fixation with trans-pedicle bone graft on 24 cases of fresh upper and middle thoracic spine burst fracture%后路减压经椎弓根植骨配合脊柱后路内固定术治疗中上段胸椎新鲜爆裂骨折24例疗效观察

    Institute of Scientific and Technical Information of China (English)

    宫岩虎; 金正; 张伟

    2014-01-01

    目的:观察后路减压经椎弓根植骨配合脊柱后路内固定术治疗中上段胸椎新鲜爆裂骨折的疗效。方法对2007年1月至2012年12月收治的24例中上段胸椎新鲜爆裂骨折患者的临床资料进行回顾性研究。其中,男20例,女4例;年龄18~54岁,平均32.4岁;骨折累及节段:T21例,T32例,T44例,T53例,T66例,T78例,T83例,T92例,T102例;均合并脊髓损伤,神经损伤按Frankel分级:A级6例,B级5例,C级7例,D级6例。均行脊柱后路减压内固定、经椎弓根植骨术。结果所有患者术后获6~48个月(平均13个月)随访。18例患者神经功能有1~2级的改善,6例A级患者无改善。所有患者植骨融合良好,均无钢板、螺钉松动或断裂发生。对24例患者的cobb角、椎体前、后缘高度、椎管狭窄率进行评价,术后即刻、术后1年与术前比较均有改善,差异有统计学意义(P<0.05),而术后即刻与术后1年比较差异无统计学意义(P>0.05)。结论应用后路减压经椎弓根植骨配合脊柱后路内固定术治疗中上段胸椎新鲜爆裂骨折,具有减压彻底、术后脊柱稳定性好和植骨融合率高等优点。%Objective To explore the clinical effects of posterior decompression and fixation with transvertebral pedicle bone graft in the treatment of fresh upper and middle thoracic spine burst fracture .Methods A retrospective study was made on 24 cases of fresh upper and middle thoracic spine burst fracture hospitalized for treatment from January 2007 to December 2012, including 20 male and 4 female patients, with an age range between 18 and 54, averaging 32.4 years.Bone fracture were involved in the following seg-ments:T2 ( 1 case ), T3 ( 2 cases), T4 ( 4 cases), T5 ( 3 cases), T6 ( 6 cases), T7 ( 8 cases), T8 (3 cases), T9 ( 2 cases), T10 (2 cases), with all the cases complicated with spinal cord injury .In accordance with the Frankel

  5. New method for fixation point of tibialis posterior tendon transfer

    OpenAIRE

    Yeganeh, Ali; Motaghi, Arash; Shahhoseini, Gholamreza; Farahini, Hosein

    2013-01-01

    Background The transfer of the tibialis posterior tendon to the dorsum of foot can restore the function of theparalyzed dorsiflexor muscles of the foot and ankle. In order to reduce the wound complication in the insertionsite of tendon to bone by a plantar knop we used a new method of fixation by an absorbable screw inserted dorsally. Methods we performed this operation on 15 patients in a 3 years period. All patients had drop foot deformitydue to irreversible lesions of the peroneal nerve. T...

  6. Miniplate fixation for the repair of segmental mandibular defects filled with autogenous bone in cats Uso de miniplacas na fixação de mandíbulas de gatos com defeitos segmentares preenchidos com osso autógeno

    Directory of Open Access Journals (Sweden)

    Adelina Maria da Silva

    2011-06-01

    Full Text Available PURPOSE: To evaluate the use of maxillofacial miniplate 1.5 in the repair of segmental mandibular defects filled with autogenous bone in cats. METHODS: Twelve adult cats were divided into two groups. A segmental defect of 4mm was created in one of the hemimandibles and filled with autogenous iliac crest bone graft. The operated hemimandible was fixed with a 1.5mm titanium miniplate. In group 1 (n=6, the defect was performed in the body of the mandible, behind the 1st molar. In group 2 (n=6, the defect was performed between the 4nd premolar and 1st molar, with extraction of the 1st molar. Oral alimentation was reinitiated 24 hours after surgery. Cats were euthanized at 20 weeks postoperative. RESULTS: Incorporation of the graft was suggested by the radiographs taken 20 weeks after surgery. Macroscopic examination confirmed alignment and bone union of operated hemimandibles. Histological examination showed formation of woven bone in rostral and caudal mandible/graft interfaces. The percentage of bone tissue at these areas was measured by the histometry. There was no statistically significant difference between the values of group 1(64.48 ± 4.51 and group 2 (71.69 ± 14.47 (Mann-Whitney's test p= 0.294. CONCLUSION: The use of miniplate 1.5 for the fixation of mandibular defects filled with autogenous bone in cats provided the main goals in the treatment of mandibular fractures: bone union, normal dental occlusion and immediate return to oral alimentation.OBJETIVO: Avaliar o uso de miniplacas na fixação de mandíbulas de gatos com defeitos segmentares preenchidos com osso autógeno. MÉTODOS: Foram utilizados 12 gatos adultos divididos em dois grupos de seis animais cada. Em uma das hemimandíbulas foi criado um defeito segmentar de 4mm, preenchido com enxerto autógeno do osso ilíaco. A hemimandíbula operada foi fixada com uma miniplaca 1.5 de titânio. No grupo 1, o defeito foi realizado caudalmente ao 1º molar e no grupo 2, entre o 4º pr

  7. Allogeneic bone grafting strengthens the internal fixation of proximal humeral fractures in high-risk groups%同种异体骨移植强化高危人群肱骨近端骨折内固定的疗效观察

    Institute of Scientific and Technical Information of China (English)

    苏志辉; 鲁厚根; 刘军; 邹立学; 胡伟

    2016-01-01

    BACKGROUND:Numerous studies have focused on the clinical efficacy of alogeneic bone graft and humeral head replacement for the treatment of proximal humeral fractures, but their comparative studies are rarely reported. OBJECTIVE:To investigate the effect of alogeneic bone grafting in the treatment of proximal humeral fractures in the high risk group. METHODS:Clinical data of 120 cases of proximal humeral fractures aged≥ 60 years were retrospectively analyzed. Sixty of the 120 cases underwent alogeneic bone grafting combined with locking plate fixation as experimental group, and the other 60 cases were subjected to semi-shoulder joint replacement as control group. Al patients were folowed up for 8-24 months. Fracture healing, colodiaphyseal angle, humeral head height and shoulder joint function were observed and measured. RESULTS AND CONCLUSION:During the postoperative 8-24 months, al the fractures were healed by first intention, and there were no rejection reactions, large/smal nodules, humeral head displacement, necrosis, and screw loosening. Loss of the humeral head height at the last folow-up and the active flexion angle of the shoulder at postoperative 12 weeks were significantly higher in the experimental group than the control group (P < 0.05). Scores on forearm, shoulder and hand dysfunction were significantly lower in the experimental group than the control group (P < 0.05). However, no significant difference was observed in the colodiaphyseal angle and SF-36 scores between the two groups. These finding indicate that alogeneic bone grafting can strength the internal fixation of proximal humeral fractures in the high-risk group, and improve patient’s upper limb function.%背景:大量研究对同种异体骨移植和人工肱骨头置换治疗肱骨近端骨折的临床效果进行了评价,但关于二者的对比性研究报道却非常有限。目的:分析同种异体骨移植强化高危人群肱骨近端骨折内固定的效

  8. 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

  9. DISTRACTION OF OSTEOGENESIS AND LENGTHENING OF CRANIOFACIAL BONE-PRELIMINARY REPORT OF AN EXPERIMENTAL RESEARCH

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective The method of bone lengthening by distraction of callus was used on dog mandible as a model to study the capability and changes of membranous bone during distraction osteogenesis. Methods 15 dogs aged 5~7 months were chosen as the subjects. The operation included a unilateral or bilateral periosteal preserving corti cotomy of mandibular bone, and an introral mini lengthening device were fixed to the buccal side of the mandible. After 7d, the mandible was lengthened lmm/d for 20d and then held in internal fixation for 7~ 140d (1 ~ 20 weeks). Results The dogs were killed at 3 times. Anthropometric measurements, X-ray examination and histological observa tion were conducted and conformed that the distracted bone had formed in the expanded zone successfully. Conclu sion The results suggested that we could use the DO technique in the area of craniofacial clinic. The strong ability of generating new bone in membranous skeleton by DO technique should be further demonstrated in the future.

  10. Cement embolism into the venous system after pedicle screw fixation: case report, literature review, and prevention tips

    Directory of Open Access Journals (Sweden)

    Ghassan Kerry

    2013-09-01

    Full Text Available The strength of pedicle screws attachment to the vertebrae is an important factor affecting their motion resistance and long term performance. Low bone quality, e.g. in osteopenic patients, keeps the screw bone interface at risk for subsidence and dislocation. In such cases, bone cement could be used to augment pedicle screw fixation. But its use is not free of risk. Therefore, clinicians, especially spine surgeons, radiologists, and internists should become increasingly aware of cement migration and embolism as possible complications. Here, we present an instructive case of cement embolism into the venous system after augmented screw fixation with fortunately asymptomatic clinical course. In addition we discuss pathophysiology and prevention methods as well as therapeutic management of this potentially life-threatening complication in a comprehensive review of the literature. However, only a few case reports of cement embolism into the venous system were published after augmented screw fixation.

  11. 一期前路病灶清除植骨重建钛板内固定术治疗腰骶段脊柱结核%Clinical efficacy of one-stage anterior debridement, bone graft and reconstruction titanium plate internal fixation in treating lumbosacral spinal tuberculosis

    Institute of Scientific and Technical Information of China (English)

    夏曦; 唐绍锋; 曹志武; 王辉; 姚女兆; 王文军

    2016-01-01

    Objective To evaluate clinical outcomes following one-stage anterior radical debridement, interbody fusion, and reconstruction titanium plate internal fixation for the treatment of lumbosacral spinal tuberculosis.Methods The clinical data of 30 patients(17 males and 13 females,aged range from 27 to 65 years, mean 37. 5 years) with tuberculosis of the lumbosacral segments(including L5 -S1 ) who were treated with anterior radical debridement, autologous iliac bone graft,and internal fixation with reconstruction titanium plate at Department of Spinal Surgery of the First Affiliated Hospital of University of South China from August 2011 to August 2014 were retrospectively reviewed. All patients routinely received antitubercular drugs for 2 to 3 weeks before operation. Operation was performed when the general condition improved. All patients were systematically and routinely treated with antituberculous drug for 12-18 months after operation. The preoperative, 3 months after operation, last follow up erythrocyte sedimentation rate ( ESR) , C reactive protein( CRP) , visual analog scale ( VAS) , as well as Oswestry disability index ( ODI) were analyzed.Results Thirty patients were followed up for 12-36 months,mean 18 months.At last follow-up, no lower limb radiation pain and tuberculosis recurrence were found in all cases. The VAS scores were significantly decreased from 7. 8 ± 1. 7 at preoperation to 1. 7 ± 0. 6 at 3 months after operation, and 1.5±0.5 at last follow-up(all P values0.05).Conclusions Based on systemic and routine antituberculosis treatment,the surgical treatment of lumbosacral spinal tuberculosis with one-stage anterior debridement, bone graft and reconstruction titanium plate internal fixation have a direct and safe access to lesions of lumbosacral tuberculosis, and eradicate tuberculosis kitchen, reconstruct spinal stability and achieve good clinical outcome.%目的:探讨一期前路结核病灶清除植骨重建钛板内固定治疗腰骶段脊

  12. Mechanical Comparison of Headless Screw Fixation and Locking Plate Fixation for Talar Neck Fractures.

    Science.gov (United States)

    Karakasli, Ahmet; Hapa, Onur; Erduran, Mehmet; Dincer, Cemal; Cecen, Berivan; Havitcioglu, Hasan

    2015-01-01

    For talar neck fractures, open reduction and internal fixation have been thought to facilitate revascularization and prevent osteonecrosis. Newer screw systems allow for placement of cannulated headless screws, which provide compression by virtue of a variable pitch thread. The present study compared the biomechanical fixation strength of cannulated headless variable-pitch screw fixation and locking plate fixation. A reproducible talar neck fracture was created in 14 fresh cadaver talar necks. Talar head fixation was then performed using 2 cannulated headless variable-pitch 4-mm/5-mm diameter (4/5) screws (Acutrak; Acumed, Hillsboro, OR) and locking plate fixation. Headless variable-pitch screw fixation had lower failure displacement than did locking plate fixation. No statistically significant differences were found in failure stiffness, yield stiffness (p = .655), yield load (p = .142), or ultimate load between the 2 fixation techniques. Cannulated headless variable-pitch screw fixation resulted in better failure displacement than locking plate fixation in a cadaveric talus model and could be considered a viable option for talus fracture fixation. Headless, fully threaded, variable-pitch screw fixation has inherent advantages compared with locking plate fixation, because it might cause less damage to the articular surface and can compress the fracture for improved reduction. Additionally, plate fixation can increase the risk of avascular necrosis owing to the wider incision and dissection of soft tissues.

  13. Relative motion at the bone-prosthesis interface

    NARCIS (Netherlands)

    Keja, M.; Wevers, H.W.; Siu, D.; Grootenboer, H.J.

    1994-01-01

    Bone ingrowth in porous surfaces of human joint implants is a desired condition for long-term fixation in patients who are physically active (such as in sport or work). It is generally recognized that little actual bone ingrowth occurs. The best clinical results report between 10 and 20% of the tota

  14. Experimental micromechanics of the cement-bone interface.

    NARCIS (Netherlands)

    Mann, K.A.; Miller, M.A.; Cleary, R.J.; Janssen, D.; Verdonschot, N.J.J.

    2008-01-01

    Despite the widespread use of cement as a means of fixation of implants to bone, surprisingly little is known about the micromechanical behavior in terms of the local interfacial motion. In this work, we utilized digital image correlation techniques to quantify the micromechanics of the cement-bone

  15. Treatment of neglected elbow dislocations with the help of hinged external fixator: Report of two cases

    Directory of Open Access Journals (Sweden)

    Özgür Karakoyun

    2014-06-01

    Full Text Available Elbow dislocations are cases that have to be treated in emergency conditions. Neglected elbow dislocations are seen very rarely and the treatment of such cases are more complicated than acute cases. We present two cases of neglected elbow dislocations treated with open reduction and hinged external fixators. Case 1: 23 year old female patient had a neglected posterior dislocation of left elbow with ipsilateral humeral shaft fracture caused by car accident. The patient was treated after 3 months of initial trauma. We have performed open reduction for the joint. After that we fixed the joint whit a hinged external fixator. The humeral shaft fracture was also fixed with the components of the external fixator. Case 2: 33 year male patient had a large bone and soft tissue defect around the left elbow accompanying with neglected medial elbow dislocation. He presented to our clinic with a delay of 2 months. The patient was treated with open reduction and hinged external fixator after reconstruction of bone defect of distal humerus. Conclusion: The treatment of neglected cases is quite challenging. Open reduction and external fixation has satisfactory results in treatment of late cases of elbow dislocation with the possibility of early rehabilitation. This method can be considered as an option for such cases. J Clin Exp Invest 2014; 5 (2: 443-446

  16. Pedicle screw fixation for thoracolumbar fracture with spinal cord injury:a comparison of the selective injury segment and the whole bone graft fusion%椎弓根置钉修复胸腰椎骨折合并脊髓损伤:选择性损伤节段及全部固定节段植骨融合的比较

    Institute of Scientific and Technical Information of China (English)

    史晓林; 张昊; 刘磊; 史晓东; 金晓宁; 刘清阁; 袁伟东

    2016-01-01

    BACKGROUND:Spinal canal decompression is needed in posterior pedicle screw fixation surgery for thoracolumbar burst fractures combine with spinal cord injury. The structure of posterior spine is often damaged. The posterolateral bone fusion in al fixed segment is stil the main surgery. In order to further reduce fusion segment and maintain motor unit, it is necessary to perform selective segmental bone graft fusion during fixation and decompression. OBJECTIVE: To discuss the advantages of selective posterolateral vertebral fusion for thoracolumbar fracture with spinal injury through comparing with posterolateral vertebral fusion. METHODS: Data of 83 thoracolumbar burst fracture cases, who received posterior lumbar decompression and short segment fixation with pedicle screws and bone graft through injured vertebra from January 2006 to July 2013, were analyzed retrospectively. According to fusion segments, above patients were divided into selective posterolateral vertebral fusion group (n=42) and the whole posterolateral vertebral fusion group (n=41). Perioperative index, internal fixation, vertebral height loss rate, Cobb angle, spinal nerve recovery and Oswestry Disability Index were compared between the two groups. RESULTS AND CONCLUSION:(1) Al cases were folowed up for 25-32 months. (2) There was no statistical significance in operation time, intraoperative blood loss and ambulation time between the two groups (P > 0.05). Postoperative drainage volume was less in the selective posterolateral vertebral fusion group than in the whole posterolateral vertebral fusion group (P 0.05). (4) There was no significant difference in fusion rate at 6 months after treatment between the two groups (P > 0.05). Fusion was achieved in both groups before removal of the fixator. (5) Spinal nerve recovery was found after treatment in both groups. No significant difference in Oswestry Disability Index was detected in final folow-up (P > 0.05). (6) Results verified that compared with

  17. PERCUTANEOUS BIPLANAR EXTERNAL FIXATOR METHOD FOR TREATMENT OF CALCONEAL FRACTURES

    Directory of Open Access Journals (Sweden)

    Jagadeesh Kumar

    2015-07-01

    Full Text Available Calcaneal fracture, the most common tarsal bone fracture, occurs predominantly in manual labors and subsequently has got considerable socioeconomic implications. Treatment modality which can offer early weight bearing and early return to work is therefore needed for those patient s. We have used a biplanar percutaneous external fixator for treating calcaneal fractures per operative visualization of the fractures. We have treated 20 calcaneal fractures in 18 patients, 12 intra articular and five extra articular, with our percutaneou s external fixator system with under image intensifier and achieving the fracture reduction. Functional outcome was measured using the American Orthopaedic Foot and ankle society Hind foot score. All fractures united with a mean of 55 days. Partial weight bearing was possible in a mean of 1.8 days and full bearing was possible in a mean of 11.6 days. All the patients were returned to their original work within six weeks. Minor infectious complications occurred in 17.6 percent of cases. The average AOFAS sco re at six months follow up was 83.8. We conclude that our percutaneous external fixator technique for fracture calcaneum is an effective alternative to the currently available – surgical and conservative treatment modalities especially in lower socio econo mic labor population who need to return to their job as early as possible. Level of Evidence – IV Case series

  18. Osteoporotic Hip Fractures: The Burden of Fixation Failure

    Directory of Open Access Journals (Sweden)

    J. M. Broderick

    2013-01-01

    Full Text Available Osteoporotic hip fractures are a major cause of morbidity and mortality in the elderly. Furthermore, reduced implant anchorage in osteoporotic bone predisposes towards fixation failure and with an ageing population, even low failure rates represent a significant challenge to healthcare systems. Fixation failure in fragility fractures of the hip ranges from 5% in peritrochanteric fractures through to 15% and 41% in undisplaced and displaced fractures of the femoral neck, respectively. Our findings, in general, support the view that failed internal fixation of these fragility fractures carries a poor prognosis: it leads to a twofold increase in the length of hospital stay and a doubling of healthcare costs. Patients are more likely to suffer a downgrade in their residential status upon discharge with a consequent increase in social dependency. Furthermore, the marked disability and reduction in quality of life evident before salvage procedures may persist at long-term followup. The risk, of course, for the elderly patient with a prolonged period of decreased functioning is that the disability becomes permanent. Despite this, however, no clear link between revision surgery and an increase in mortality has been demonstrated in the literature.

  19. Osteoporotic hip fractures: the burden of fixation failure.

    Science.gov (United States)

    Broderick, J M; Bruce-Brand, R; Stanley, E; Mulhall, K J

    2013-01-01

    Osteoporotic hip fractures are a major cause of morbidity and mortality in the elderly. Furthermore, reduced implant anchorage in osteoporotic bone predisposes towards fixation failure and with an ageing population, even low failure rates represent a significant challenge to healthcare systems. Fixation failure in fragility fractures of the hip ranges from 5% in peritrochanteric fractures through to 15% and 41% in undisplaced and displaced fractures of the femoral neck, respectively. Our findings, in general, support the view that failed internal fixation of these fragility fractures carries a poor prognosis: it leads to a twofold increase in the length of hospital stay and a doubling of healthcare costs. Patients are more likely to suffer a downgrade in their residential status upon discharge with a consequent increase in social dependency. Furthermore, the marked disability and reduction in quality of life evident before salvage procedures may persist at long-term followup. The risk, of course, for the elderly patient with a prolonged period of decreased functioning is that the disability becomes permanent. Despite this, however, no clear link between revision surgery and an increase in mortality has been demonstrated in the literature.

  20. REVERSE ENGINEERING OF THE MITKOVIC TYPE INTERNAL FIXATOR FOR LATERAL TIBIAL PLATEAU

    Directory of Open Access Journals (Sweden)

    Nikola Vitković

    2015-12-01

    Full Text Available In orthopaedic surgery it is very important to use proper fixation techniques in the treatment of various medical conditions, i.e. bone fractures or other traumas. If an internal fixation method, such as plating, is required, it is possible to use Dynamic Compression Plates (DCP or Locking Compression Plates (LCP and their variants. For DCP implants it is important to match the patient's bone shape with the most possible accuracy, so that the most frequent implant bending is applied in the surgery. For LCP implants it is not so important to match the patient’s bone shape, but additional locking screw holes are required. To improve the geometrical accuracy and anatomical correctness of the shape of DCP and to improve the LCP geometric definition, new geometrical modelling methods for the Mitkovic type internal fixator for Lateral Tibia Plateau are developed and presented in this research. The presented results are quite promising; it can be concluded that these methods can be applied to the creation of geometrical models of internal fixator customized for the given patient or optimized for a group of patients with required geometrical accuracy and morphological correctness.

  1. Cheek drooping in 2 patients with maxillary fractures after rigid fixation with bioabsorbable mesh.

    Science.gov (United States)

    Oh, Seung Hyun; Kim, Chung Hun; Choi, Hyun Gon; Hwang, Euna

    2014-03-01

    Bioabsorbable plate-screw systems are commonly used for the internal fixation of facial bone fractures. The anterior maxilla has a unique curved shape, and fractured bony fragments tend to be small and fragile; therefore, more effective rigid fixation can be achieved using a molded bioabsorbable mesh rather than a bioabsorbable plate. Herein, we describe 2 patients with cheek drooping after a rigid fixation of comminuted maxillary fracture using bioabsorbable meshes and screws.The postoperative courses were uneventful, but both showed soft tissue bulging in the cheek area of the operation site for 12 to 13 months after the operation. No other symptom or sign related to inflammation or foreign body reaction was noted.In comminuted maxillary fractures, bone fragments are more conveniently fixed with a 1-piece molded bioabsorbable mesh. However, it is believed that a single large mesh may interfere with adhesion between the maxillary surface and the overlying soft tissue. Therefore, we recommend using the least amount of mesh to fixate maxillary bone fragments.

  2. A retrospective report on three implant devices used to restore posterior partial edentulism: overall performance and changes in crestal bone levels.

    Science.gov (United States)

    Kermalli, Jaffer Y; Deporter, Douglas A; Atenafu, Eshetu G; Lam, Ernest W

    2014-01-01

    Three implant designs were used to treat posterior partial edentulism. A total of 799 implants (563 Osseotite, 65 Straumann SLA,171 Endopore SPS) were placed in 345 patients. SPS implants were used in sites with less bone, had shorter lengths, and functioned longer than the threaded implant designs. Comparing implant losses, SPS implants had a higher failure rate (9.3%) compared with Osseotite (4.0%) or SLA (0%) implants. SPS implant losses generally occurred as late failures, while Osseotite losses were early failures. However, among surviving implants, SPS implants had less crestal bone loss at all time intervals compared with both of the threaded implant designs. PMID:24600658

  3. 椎间打压植骨联合棘突椎板复合体回植内固定治疗退变性腰椎不稳症%LUMBAR INTERBODY FUSION IMPACTED BONE GRAFTS COMBINED WITH REGRAFTING IN SITU WITH SPINOUS PROCESS AND VERTEBRAL PLATE COMPLEX AND PEDICLE SCREW FIXATION FOR LUMBAR DEGENERATIVE INSTABILITY

    Institute of Scientific and Technical Information of China (English)

    张超远; 孟祥翔; 秦晓彬; 付玉娟; 付鹏军

    2012-01-01

    Objective To evaluate the effectiveness of lumbar interbody fusion impacted bone grafts combined with regrafting in situ with spinous process and vertebral plate complex and pedicle screw fixation for lumbar degenerative instability. Methods Between January 1998 and October 2010, 48 patients with lumbar degenerative instability were treated by posterior decompression, lumbar interbody fusion impacted bone grafts combined with regrafting in situ with spinous process and vertebral plate complex and pedicle screw fixation. There were 26 males and 22 females, aged 52-76 years (mean, 62.4 years). The disease duration was 7 months to 25 years (mean, 6.5 years). One segmental instability was located at L3,4 in 1 case, at L4,5 in 10 cases, and at L5, S1 in 11 cases; multi-segmental instability was located at L3,4, L4,5, and L5, S1 in 5 cases, at L2,3 and L3,4 in 2 cases, at L3,4 and L4,5 in 10 cases, and at L4,5 and L5, S1 in 9 cases. Of 48 patients, 32 complicated by lumbar disc herniation, 46 by lumbar spinal stenosis, and 16 by degenerative scoliosis. The clinical results were evaluated by the Japanese Orthopaedic Association (JOA) score, recovery rate, disc height, and lumbar lordosis angles. Results The incisions obtained healing by first intention after operation. No nerve injury, rod or screw breakage, and infection occurred during and after operation. All 48 patients were followed up 1 to 6 years. The fusion time was 12-18 weeks (mean, 16.2 weeks). Vertebra slipping or degenerative scoliosis was corrected, and spinal column series became normal. At preoperation, 6 months after operation, and last follow-up, the disc heights were (5.2 ± 2.3), (11.9 ± 2.0), and (11.6 + 2.1) mm, respectively; the JOA scores were 3.2 + 2.1, 12.8 ± 1.6, and 13.6 + 1.2, respectively; and the lumbar lordosis angles were (-20.5 ± 10.5), (30.5 ± 8.5), and (31.2 + 5.6)°, respectively. The JOA scores, disc heights, and lumbar lordosis angles were significantly improved at 6 months after

  4. Impact of bone graft harvesting techniques on bone formation and graft resorption

    DEFF Research Database (Denmark)

    Saulacic, Nikola; Bosshardt, Dieter D; Jensen, Simon S;

    2015-01-01

    formation and graft resorption in vivo. MATERIAL AND METHODS: Four harvesting techniques were used: (i) corticocancellous blocks particulated by a bone mill; (ii) bone scraper; (iii) piezosurgery; and (iv) bone slurry collected from a filter device upon drilling. The grafts were placed into bone defects...

  5. Use of a hybrid external skeletal fixator for repair of a periarticular tibial fracture in a Patagonian cavy.

    Science.gov (United States)

    Joyner, Priscilla H; Rochat, Mark C; Hoover, John P

    2004-04-15

    An 8-week-old female Patagonian cavy was examined because of acute right hind limb lameness; radiography revealed a moderately displaced, comminuted fracture of the proximal third of the tibia. The fracture was stabilized with a hybrid external skeletal fixator. Two Kirschner wires were placed in the main proximal fragment, parallel to the tibial plateau and at right angles to each other. These wires were connected to a partial circular external fixator ring. Three half pins were placed in the distal fragment, and a straight connecting rod positioned on the medial side of the limb was connected to these pins and the fixator ring. A second connecting rod was positioned on the craniomedial side of the limb and was connected to the fixator ring and a fourth half pin in the distal fragment. The fracture healed without complications, and the fixator was removed 3 weeks after surgery. Hybrid external skeletal fixators combine the benefits of circular and linear external skeletal fixation methods, enabling rigid fixation of periarticular long bone fractures without adversely affecting mobility of the adjacent joint. PMID:15112778

  6. Polymethylmethacrylate-augmented screw fixation for stabilization in metastatic spinal tumors. Technical note.

    Science.gov (United States)

    Jang, Jee Soo; Lee, Sang Ho; Rhee, Chang Hun; Lee, Seung Hoon

    2002-01-01

    Screw fixation augmented with polymethylmethacrylate (PMMA) or some other biocompatible bone cement has been used in patients with osteoporosis requiring spinal fusion. No clinical studies have been conducted on PMMA-augmented screw fixation for stabilization of the vertebral column in patients with metastatic spinal tumors. The purpose of this study was to determine whether screw fixation augmented with PMMA might be suitable in patients treated for multilevel metastatic spinal tumors. Ten patients with metastatic spinal tumors involving multiple vertebral levels underwent stabilization procedures in which PMMA was used to augment screw fixation after decompression of the spinal cord. Within 15 days, partial or complete relief from pain was obtained in all patients postoperatively. Two of four patients in whom neurological deficits caused them to be nonambulatory before surgery were able to ambulate postoperatively. Neither collapse of the injected vertebral bodies nor failure of the screw fixation was observed during the mean follow-up period of 6.7 months. Screw fixation augmented with PMMA may offer stronger stabilization and facilitate the instrumentation across short segments in the treatment of multilevel metastatic spinal tumors. PMID:11795702

  7. Ossiculoplasty with a cartilage-connecting hydroxyapatite prosthesis for tympanosclerotic stapes fixation.

    Science.gov (United States)

    Kawano, Hirokazu; Matsuda, Keiji; Nakanishi, Haruka; Toyama, Katsuhiro; Nagai, Noriaki; Tono, Tetsuya

    2010-06-01

    Many cases of tympanosclerotic stapes fixation are accompanied by fixation or erosion of malleus and/or incus. This status of the ossicular chain is one of the reasons that ossiculoplasty for tympanosclerotic stapes fixation is more difficult than that for otosclerosis. We conducted a retrospective review of seven patients who were operated on for tympanosclerotic stapes fixation between 2002 and 2006. All of the patients had abnormal conditions of the malleus and/or incus and underwent stapedectomy and total ossiculoplasty with hydroxyapatite prosthesis (Apaceram T-7 type), which has a planar-like head portion that contacts a piece of cartilage. Postoperative hearing results were assessed in all seven patients after at least 1 year. The postoperative air-bone gap (ABG) was closed within 10 dB in two of seven patients, and was less than 20 dB in six of seven patients. The mean postoperative ABG was closed within 10 dB at 1 and 2 kHz and less than 20 dB at low frequencies (0.25 and 0.5 Hz). There was almost no hearing improvement at high frequencies (4 and 8 kHz). There were no patients with postoperative sensorineural hearing loss. The present study shows that stapedectomy and total ossiculoplasty with cartilage-connecting hydroxyapatite prosthesis is effective and safe for stapes fixation accompanied by fixation or erosion of the malleus and/or incus. PMID:19902232

  8. Lumbar pedicle cortical bone trajectory screw

    Institute of Scientific and Technical Information of China (English)

    Song Tengfei; Wellington K Hsu; Ye Tianwen

    2014-01-01

    Objective The purpose of this study was to demonstrate the lumbar pedicle cortical bone trajectory (CBT) screw fixation technique,a new fixation technique for lumbar surgery.Data sources The data analyzed in this review are mainly from articles reported in PubMed published from 1994 to 2014.Study selection Original articles and critical reviews relevant to CBT technique and lumbar pedicle fixation were selected.Results CBT technique was firstly introduced as a new fixation method for lumbar pedicle surgery in 2009.The concepts,morphometric study,biomechanical characteristics and clinical applications of CBT technique were reviewed.The insertional point of CBT screw is located at the lateral point of the pars interarticularis,and its trajectory follows a caudocephalad path sagittally and a laterally directed path in the transverse plane.CBT technique can be used for posterior fixation during lumbar fusion procedures.This technique is a minimally invasive surgery,which affords better biomechanical stability,fixation strength and surgical safety.Therefore,CBT technique has the greatest benefit in lumbar pedicle surgery for patients with osteoporosis and obesity.Conclusion CBT technique is a better alternative option of lumbar pedicle fixation,especially for patients with osteoporosis and obesity.

  9. Monotest in the complement fixation test: the Chorus system

    Directory of Open Access Journals (Sweden)

    Laura Meli

    2009-06-01

    Full Text Available The complement fixation test (CFT is a method used for the detection of antibodies against pathogens of infectious diseases, it has been proved to be a useful diagnostic method in the detection of acute disease in many medical laboratories.The test performed manually is time consuming and needs very skilled personnel.This study evaluates the automated Chorus CFT system with 87 serum samples in comparison with manual method using Virion-Serion reagents, against a panel of antigens, such as Adenovirus, Influenza A and B virus, Respiratory Syncythial Virus, Parainfluenza Mix, Mycoplasma Pneumoniae, and Echinococcus. The Chorus system includes standardized reagents and a monotest device to perform the single assay. In comparison to the manual CFT method, the correlation is 91.6% (7/83.The results obtained show that the automated Chorus system can be applied for detecting complement fixation antibodies against different infectious disease agents.

  10. Bone compaction enhances implant fixation in a canine gap model

    DEFF Research Database (Denmark)

    Kold, Søren; Rahbek, Ole; Toft, Marianne;

    2005-01-01

    ) were bilaterally inserted into cavities initially expanded to 8 mm diameters in the proximal humeri. Each dog served as its own control; thus, one humerus had the implant cavity prepared with compaction, the other with drilling. Eight dogs were euthanized after 2 weeks, and 7 dogs after 4 weeks. Humeri...

  11. Bone compaction enhances fixation of weightbearing titanium implants

    DEFF Research Database (Denmark)

    Kold, Søren Vedding; Rahbek, Ole; Vestermark, Marianne Toft;

    2005-01-01

    . In each dog, one knee had the implant cavity prepared with drilling, and the other knee was prepared with compaction. Eight dogs were euthanized after 2 weeks, and eight dogs were euthanized after 4 weeks. Femoral condyles from an additional eight dogs represented Time 0. Compacted specimens had higher...

  12. Nanocomposites and bone regeneration

    Science.gov (United States)

    James, Roshan; Deng, Meng; Laurencin, Cato T.; Kumbar, Sangamesh G.

    2011-12-01

    This manuscript focuses on bone repair/regeneration using tissue engineering strategies, and highlights nanobiotechnology developments leading to novel nanocomposite systems. About 6.5 million fractures occur annually in USA, and about 550,000 of these individual cases required the application of a bone graft. Autogenous and allogenous bone have been most widely used for bone graft based therapies; however, there are significant problems such as donor shortage and risk of infection. Alternatives using synthetic and natural biomaterials have been developed, and some are commercially available for clinical applications requiring bone grafts. However, it remains a great challenge to design an ideal synthetic graft that very closely mimics the bone tissue structurally, and can modulate the desired function in osteoblast and progenitor cell populations. Nanobiomaterials, specifically nanocomposites composed of hydroxyapatite (HA) and/or collagen are extremely promising graft substitutes. The biocomposites can be fabricated to mimic the material composition of native bone tissue, and additionally, when using nano-HA (reduced grain size), one mimics the structural arrangement of native bone. A good understanding of bone biology and structure is critical to development of bone mimicking graft substitutes. HA and collagen exhibit excellent osteoconductive properties which can further modulate the regenerative/healing process following fracture injury. Combining with other polymeric biomaterials will reinforce the mechanical properties thus making the novel nano-HA based composites comparable to human bone. We report on recent studies using nanocomposites that have been fabricated as particles and nanofibers for regeneration of segmental bone defects. The research in nanocomposites, highlight a pivotal role in the future development of an ideal orthopaedic implant device, however further significant advancements are necessary to achieve clinical use.

  13. Determining the modulus of intact bovine vertebral cancellous bone tissue: Development and validation of a protocol

    Science.gov (United States)

    Engbretson, Andrew Craig

    Cancellous, or spongy, bone accounts for nearly 80% of the human skeleton's internal surface area, despite comprising only 20% of its mass. It is made up of a network of struts and plates that provide lightweight internal support to mammalian bones. In addition, it often serves as the main interface between the skeletal system and implanted devices such as artificial hips, knees, and fracture fixation devices. However, hip arthroplasties can succumb to loosening of the implant due to bone resorption, which is thought to be caused by a mismatch in both apparent and real stiffness between the device and the surrounding bone. Many studies have attempted to determine the Young's modulus of cancellous bone tissue, but the results are far from being in agreement. Reported values range from less than 1 to nearly 20 GPa. In addition, the small size of trabeculae has made dissection and testing a challenge. In this thesis, whole individual trabeculae from a bovine lumbar spine were tested in three-point bending to determine their Young's modulus using custom-made equipment to fit a miniature single-axis testing device. The device itself was validated by testing materials with moduli ranging from 1 to 200 GPa. The structure of the cancellous bone and the morphology of the individual struts were determined using micro x-ray computed tomography (muXCT). Individual struts were manually isolated from slices made using a low-speed saw under constant lubrication and measured under a stereomicroscope. Samples exhibiting no machined surfaces (and thus deemed to be whole, or "uncut" were compared to struts that had been cut by the saw during sectioning. Validation showed that the system was capable of determining the modulus of materials that were approximately five times stiffer than the expected cancellous modulus (copper, at 115 GPa) to within 10% of published values. This gave confidence in the results for bone. The modulus of the "uncut" specimens was found to be 15.28 2.26 GPa

  14. Bone Biochemistry on the International Space Station

    Science.gov (United States)

    Smith, Scott M.; Heer, Martina; Zwart, Sara R.

    2016-01-01

    Bone biochemical measures provide valuable insight into the nature and time course of microgravity effects on bone during space flight, where imaging technology cannot be employed. Increased bone resorption is a hallmark of space flight, while markers of bone formation are typically unchanged or decreased. Recent studies (after the deployment to ISS of the advanced resistive exercise device, ARED), have documented that astronauts with good nutritional intake (e.g., maintenance of body mass), good vitamin D status, and exercise maintained bone mineral density. These data are encouraging, but crewmembers exercising on the ARED do have alterations in bone biochemistry, specifically, bone resorption is still increased above preflight levels, but bone formation is also significantly increased. While this bone remodeling raises questions about the strength of the resulting bone, however documents beneficial effects of nutrition and exercise in counteracting bone loss of space flight.

  15. Metaphyseal bone loss in revision knee arthroplasty.

    Science.gov (United States)

    Ponzio, Danielle Y; Austin, Matthew S

    2015-12-01

    The etiology of bone loss encountered during revision total knee arthroplasty (TKA) is often multifactorial and can include stress shielding, osteolysis, osteonecrosis, infection, mechanical loss due to a grossly loose implant, and iatrogenic loss at the time of implant resection. Selection of the reconstructive technique(s) to manage bone deficiency is determined by the location and magnitude of bone loss, ligament integrity, surgeon experience, and patient factors including the potential for additional revision, functional demand, and comorbidities. Smaller, contained defects are reliably managed with bone graft, cement augmented with screw fixation, or modular augments. Large metaphyseal defects require more extensive reconstruction such as impaction bone grafting with or without mesh augmentation, prosthetic augmentation, use of bulk structural allografts, or use of metaphyseal cones or sleeves. While each technique has advantages and disadvantages, the most optimal method for reconstruction of large metaphyseal bone defects during revision TKA is not clearly established. PMID:26362647

  16. Epoxy putty external skeletal fixation in a tibiotarsal fracture of a wild choroy parakeet (Enicognathus leptorhynchus

    Directory of Open Access Journals (Sweden)

    J. I. Arias

    2015-06-01

    Full Text Available Tibiotarsal fractures are common in birds because in most birds this is the longest, most exposed bone in the leg. Transverse fractures are most common and rotational and shear forces must be stabilized in order to achieve good bone regeneration. A 230g male Slender-billed Parakeet or Choroy parakeet (Enicognathus leptorhynchus, with more than five years of age, was received with non-weight bearing lameness with 24 hours duration. X-rays were taken, and these revealed a closed, complete, non-comminuted transverse fracture of the distal diaphysis of the left tibiotarsal bone. Fixation was planned with 10-minute fast-setting epoxy putty. In order to assess the temperature of polymerization of the epoxy dough and the possibility of heat-bone necrosis, the temperature was recorded every 30 seconds for 12 minutes with three different amounts of the epoxy material in an ex vivo test. The temperature of the pieces reached a peak of 50-60ºC, where the highest peak corresponds to the highest amount of material. When approximately 6g of putty were used, the peak temperature reached only 51ºC. This peak changed to 58ºC when 4 times more epoxy was mixed and measured. If the temperature of the pins inserted in the bone exceeds 70ºC, bone necrosis could occur. In light of these results, the fracture was treated with 6 g of epoxy putty that was allowed to polymerize over a 1A 2/2 external skeletal fixation, with 1-mm pins bent at 90º and joined together with cerclage wire. At 6 weeks after surgery the bird had formed a good primary bone callus, and the external fixators were therefore removed. With this approach a satisfactory recovery of the patient was achieved with normal use of the affected limb.

  17. Modeling fixation locations using spatial point processes.

    Science.gov (United States)

    Barthelmé, Simon; Trukenbrod, Hans; Engbert, Ralf; Wichmann, Felix

    2013-10-01

    Whenever eye movements are measured, a central part of the analysis has to do with where subjects fixate and why they fixated where they fixated. To a first approximation, a set of fixations can be viewed as a set of points in space; this implies that fixations are spatial data and that the analysis of fixation locations can be beneficially thought of as a spatial statistics problem. We argue that thinking of fixation locations as arising from point processes is a very fruitful framework for eye-movement data, helping turn qualitative questions into quantitative ones. We provide a tutorial introduction to some of the main ideas of the field of spatial statistics, focusing especially on spatial Poisson processes. We show how point processes help relate image properties to fixation locations. In particular we show how point processes naturally express the idea that image features' predictability for fixations may vary from one image to another. We review other methods of analysis used in the literature, show how they relate to point process theory, and argue that thinking in terms of point processes substantially extends the range of analyses that can be performed and clarify their interpretation.

  18. Primary fixation of mini slings: a comparative biomechanical study in vivo

    Directory of Open Access Journals (Sweden)

    Paulo Palma

    2012-04-01

    Full Text Available INTRODUCTION AND OBJECTIVES: The mini sling concept for stress urinary incontinence is an anatomical approach that involves placing a midurethral low-tension tape anchored to the obturator internus muscles bilaterally. They overcome the blind passage of long needles and all the related complications. There are many different devices available and because these are outpatient procedures, primary fixation plays an important role in the outcome. The objective is to evaluate the primary fixation of the various devices of attachment of the commercially available mini-slings through biomechanical tests. MATERIALS AND METHODS: A total of 45 Wistar rats were divided in 3 groups of 15 rats each. They underwent 5 subcutaneous implantation of different mini slings and one polipropilene mesh (control, as follows: TVT-Secur® (Gynecare, USA, Type 1 polypropylene mesh (control; Ophira Mini Sling System® (Promedon, Argentina, Tissue Fixation System® (TFS PTY, Australia, Zipper Sling® and "T device" (Prosurg, USA. The abdominal wall was removed on bloc at different times after implant for biomechanical evaluation, which consisted in application of unidirectional force to the extremity of the fixation system or mesh, until it was completely removed from the tissue using a tension meter (Nexygen 3.0 Universal Testing Machine - LLOYD Instruments. The force was measured in Newtons (N. RESULTS: There was significant difference in the resistance to extraction among the different fixation systems. At 7 days the Ophira Mini Sling System® presented the best fixation and "T dispositive" the worst. CONCLUSION: Ophira mini sling System® presented the best primary fixation at 7º, 14º and 30º days. The impact of this feature in the clinical setting needs to be verified.

  19. Tissue fixation and the effect of molecular fixatives on downstream staining procedures

    OpenAIRE

    Howat, William J.; Wilson, Beverley A.

    2014-01-01

    It is impossible to underplay the importance of fixation in histopathology. Whether the scientist is interested in the extraction of information on lipids, proteins, RNA or DNA, fixation is critical to this extraction. This review aims to give a brief overview of the current “state of play” in fixation and focus on the effect fixation, and particularly the effect of the newer brand of “molecular fixatives” have on morphology, histochemistry, immunohistochemistry and RNA/DNA analysis. A method...

  20. Biomechanical properties of a structurally optimized carbon-fibre/epoxy intramedullary nail for femoral shaft fracture fixation.

    Science.gov (United States)

    Samiezadeh, Saeid; Fawaz, Zouheir; Bougherara, Habiba

    2016-03-01

    Intramedullary nails are the golden treatment option for diaphyseal fractures. However, their high stiffness can shield the surrounding bone from the natural physiologic load resulting in subsequent bone loss. Their stiff structure can also delay union by reducing compressive loads at the fracture site, thereby inhibiting secondary bone healing. Composite intramedullary nails have recently been introduced to address these drawbacks. The purpose of this study is to evaluate the mechanical properties of a previously developed composite IM nail made of carbon-fibre/epoxy whose structure was optimized based on fracture healing requirements using the selective stress shielding approach. Following manufacturing, the cross-section of the composite nail was examined under an optical microscope to find the porosity of the structure. Mechanical properties of the proposed composite intramedullary nail were determined using standard tension, compression, bending, and torsion tests. The failed specimens were then examined to obtain the modes of failure. The material showed high strength in tension (403.9±7.8MPa), compression (316.9±10.9MPa), bending (405.3±8.1MPa), and torsion (328.5±7.3MPa). Comparing the flexural modulus (41.1±0.9GPa) with the compressive modulus (10.0±0.2GPa) yielded that the material was significantly more flexible in compression than in bending. This customized flexibility along with the high torsional stiffness of the nail (70.7±2.0Nm(2)) has made it ideal as a fracture fixation device since this unique structure can stabilize the fracture while allowing for compression of fracture ends. Negligible moisture absorption (~0.5%) and low porosity of the laminate structure (flexible axially while being relatively rigid in bending and torsion and is strong enough in all types of physiologic loading, making it a potential candidate for use as an alternative to the conventional titanium-alloy intramedullary nails. PMID:26703226

  1. Bone Anchored Hearing Treatment Procedure

    Medline Plus

    Full Text Available ... implanted, the Baha device will allow sound to travel through bone and restore close-to-normal hearing ... through the abutment so the sound can then travel through the head to the functional cochlea, or ...

  2. Favorable outcome of a total hip arthroplasty with insufficient bone coverage of the roof reinforcement ring

    Directory of Open Access Journals (Sweden)

    Fernando M. Judas

    2015-01-01

    Conclusion: This result can be supported by the good fixation of the metal ring to the pelvis with screws, the adequate orientation of both components of the total hip arthroplasty, and the bone graft incorporation.

  3. Development of a bone tissue-engineered construct to enhance new bone formation in revision total hip replacement

    OpenAIRE

    García Gareta, E.

    2012-01-01

    The main issue associated with revision total hip replacements (rTHRs) is how to generate new bone and restore bone stock for fixation of the revision stem. Bone tissue engineering (BTE) seeks the generation of constructs ex vivo in order to replace damaged or lost bone. The aim of this thesis was to develop a bone tissue-engineered construct with a calcium-phosphate (CaP) coated porous metal scaffold seeded throughout its structure with mesenchymal stem cells (MSCs) in order to enhance new b...

  4. Self-deploying shape memory polymer scaffolds for grafting and stabilizing complex bone defects: A mouse femoral segmental defect study.

    Science.gov (United States)

    Baker, Richard M; Tseng, Ling-Fang; Iannolo, Maria T; Oest, Megan E; Henderson, James H

    2016-01-01

    Treatment of complex bone defects places a significant burden on the US health care system. Current strategies for treatment include grafting and stabilization using internal metal plates/screws, intramedullary rods, or external fixators. Here, we introduce the use of shape memory polymer (SMP) materials for grafting and adjunct stabilization of segmental defects. Self-deploying SMP grafts and SMP sleeves capable of expanding and contracting, respectively, under intraoperative conditions were developed and evaluated in a mouse segmental defect model in vivo. Integration between grafts/sleeves and native bone was assessed using x-ray radiography, microcomputed tomography, and torsional mechanical testing. We found that SMP grafts were able to integrate with the native bone after 12 weeks, maintain defect stability, and provide torsional mechanical properties comparable to an allograft alone treatment; however no gross de novo bone formation was observed. SMP sleeves did not inhibit bony bridging at the margins, and limbs treated with a sleeve/allograft combination had torsional mechanical properties comparable to limbs treated with an allograft alone. In vitro torsional and bending tests suggest sleeves may provide additional torsional stability to defects. Incorporation of shape memory into synthetic bone graft substitutes and adjunct stabilization devices is anticipated to enhance functionality of synthetic materials employed in both applications.

  5. Accessory device fixation for voice rehabilitation in laryngectomised patients

    OpenAIRE

    Hallers, Egbert Jan Olivier ten

    2006-01-01

    Summary In most patients with advanced or recurrent laryngeal or hypopharyngeal cancer, total laryngectomy is indicated. This means the loss of the three main laryngeal functions: phonation; respiration; and the prevention of aspiration during deglutition. Laryngectomy patients have various options to restore phonation such as an esophageal voice, an electrolaryngeal voice or a tracheo-esophageal voice with a shunt valve. In the latter case a silicone rubber shunt valve is placed in the trach...

  6. Accessory device fixation for voice rehabilitation in laryngectomised patients

    NARCIS (Netherlands)

    Hallers, Egbert Jan Olivier ten

    2006-01-01

    Summary In most patients with advanced or recurrent laryngeal or hypopharyngeal cancer, total laryngectomy is indicated. This means the loss of the three main laryngeal functions: phonation; respiration; and the prevention of aspiration during deglutition. Laryngectomy patients have various options

  7. 21 CFR 872.3930 - Bone grafting material.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3930 Bone grafting material. (a) Identification... “Class II Special Controls Guidance Document: Dental Bone Grafting Material Devices.” (See § 872.1(e) for...) Date premarket approval application (PMA) or notice of product development protocol (PDP) is...

  8. High-impact poly(L/D-lactide) for fracture fixation: in vitro degradation and animal pilot study.

    Science.gov (United States)

    Tams, J; Joziasse, C A; Bos, R R; Rozema, F R; Grijpma, D W; Pennings, A J

    1995-12-01

    The impact strength of amorphous lactide copolymers can be significantly improved by blending with biodegradable rubbers. Rubber toughening of amorphous poly(85L/15D -lactide) with the copolymer poly (50/50-trimethylenecarbonate-co-epsilon-caprolactone) results in a high-impact polymer (PDLLA/P(TMC-CL)). In vitro, the PDLLA/P(TMC-CL) blend retained its tensile and impact strength for a long period of time. Up to 45 weeks, the amount of water absorbed by the blend remained very low and no significant mass loss was observed. To test the suitability for fracture fixation, in a dog study mandibular fractures were fixated with PDLLA/P(TMC-CL) bone plates and screws. Bone healing was uneventful without premature failure of the implants. Although long-term degradation studies have to be carried out, PDLLA/P(TMC-CL) seems to be promising for application in fracture fixation.

  9. 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

  10. 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.

  11. Applying Cross-Pin System in Both Femoral and Tibial Fixation in Anterior Cruciate Ligament Reconstruction Using Hamstring Tendons.

    Science.gov (United States)

    Qi, Wei; Liu, Yujie; Xue, Jing; Li, Haifeng; Wang, Junliang; Qu, Feng

    2015-10-01

    Use of the RigidFix Cross Pin System (DePuy Mitek, Raynham, MA) is a popular technique for femoral fixation of grafts in anterior cruciate ligament reconstruction (ACLR). However, tibial fixation is still limited to the use of interference screws and post fixation, and few surgeons apply the femoral RigidFix system in tibial fixation. Meanwhile, tunnel enlargement is still a problem that affects the outcome of ACLR with hamstring grafts. We have used the femoral RigidFix system in femoral and tibial fixation. The rod top of the guide frame should be placed under the level of the subchondral bone at the proximal end of the tibial tunnel to ensure that the pins will not be inserted into the joint. The pins are inserted through the center of the lateral tibia. Using our technique, the fixation points of the femur and tibia are close to the anterior cruciate ligament insertions, and full contact of the graft with the tunnel wall can be accomplished. On the basis of our preliminary observations and investigation, we are optimistic about the prospect of performing ACLR using the RigidFix system in femoral and tibial fixation. PMID:26697293

  12. [Angle-fixed plate fixation or double-plate osteosynthesis in fractures of the proximal humerus: a biomechanical study].

    Science.gov (United States)

    Hessmann, Martin H; Korner, Jan; Hofmann, Alexander; Sternstein, Werner; Rommens, Pol M

    2008-06-01

    Internal fixation of fractures of the proximal humerus needs a high stability of fixation to avoid secondary loss of fixation. This is especially important in osteoporotic bone. In an experimental study, the biomechanical properties of the angle-fixed Philos plate (internal fixator) and a double-plate osteosynthesis using two one-third tubular plates were assessed. The fracture model was an unstable three-part fracture (AO type B2). Eight pairs of human cadaveric humeri were submitted to axial load and torque. In the first part of the study, it was assessed to which degree the original stiffness of the humeri could be restored after the osteotomy by the osteosynthesis procedure. Subsequently, subsidence during 200 cycles of axial loading and torque was analysed. During axial loading, the Philos plate was significantly stiffer and showed less irreversible deformation. Two double-plate fixations, but none of the Philos plate osteosynthesis, failed. During torsion, there were no significant differences between the two implants. From the biomechanical point of view, the angle-fixed Philos plate represents the implant of choice for the surgical fixation of highly unstable three-part fractures of the proximal humerus, as the internal fixator system is characterised by superior biomechanical properties.

  13. Review of fixation techniques for the four-part fractured proximal humerus in hemiarthroplasty

    Directory of Open Access Journals (Sweden)

    Lorenzetti Silvio

    2011-07-01

    Full Text Available Abstract Introduction The clinical outcome of hemiarthroplasty for proximal humeral fractures is not satisfactory. Secondary fragment dislocation may prevent bone integration; the primary stability by a fixation technique is therefore needed to accomplish tuberosity healing. Present technical comparison of surgical fixation techniques reveals the state-of-the-art approach and highlights promising techniques for enhanced stability. Method A classification of available fixation techniques for three- and four part fractures was done. The placement of sutures and cables was described on the basis of anatomical landmarks such as the rotator cuff tendon insertions, the bicipital groove and the surgical neck. Groups with similar properties were categorized. Results Materials used for fragment fixation include heavy braided sutures and/or metallic cables, which are passed through drilling holes in the bone fragments. The classification resulted in four distinct groups: A: both tuberosities and shaft are fixed together by one suture, B: single tuberosities are independently connected to the shaft and among each other, C: metallic cables are used in addition to the sutures and D: the fragments are connected by short stitches, close to the fragment borderlines. Conclusions A plurality of techniques for the reconstruction of a fractured proximal humerus is found. The categorisation into similar strategies provides a broad overview of present techniques and supports a further development of optimized techniques. Prospective studies are necessary to correlate the technique with the clinical outcome.

  14. 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.

  15. 中空加压螺钉及带旋髂深血管髂骨移位对青壮年股骨颈骨折髋关节功能恢复的影响%Effect of canulate compression bone screws and iliac bone flap with deep iliac circumflex vessel on functional restoration of hip joint after femoral neck fracture of young people

    Institute of Scientific and Technical Information of China (English)

    袁宏伟; 叶应荣

    2002-01-01

    Objective To retrospect therapeutic effects of iliac flap with deep iliac circumflex vessel with canulate compression bone screws internal fixation on femoral neck fracture of young people. Method 34 cases of femoral neck fracture had been treated with pedicle bone flap with deep iliac circumflex artery and canulate bone screws internal fixation. Result By follow-up for 1 to 1.5 years, 32 cases were healing by first intention, and patients obtained satisfactory joint function. Conclusion Femoral neck fracture can be treated by transplanting pedicle bone flap with deep iliac circumflex vessel and canulate bone screws internal fixation.

  16. Osseointegration: a review of the fundamentals for assuring cementless skeletal fixation

    Directory of Open Access Journals (Sweden)

    Isaacson BM

    2014-04-01

    Full Text Available Brad M Isaacson,1,2 Sujee Jeyapalina3,4 1Henry M Jackson Foundation for the Advancement of Military Medicine, 2The Center for Rehabilitation Sciences Research, Department of Physical Medicine and Rehabilitation, Uniformed Services University of Health Sciences, Bethesda, MD, USA; 3Department of Orthopedics, 4Orthopedic Research Laboratory, University of Utah, Salt Lake City, UT, USA Abstract: Direct skeletal fixation, termed osseointegration, has expanded in the last century and includes use in total joint replacements, the edentulous mandible and maxilla, and percutaneous osseointegrated prosthetics. Although it is well known that titanium and bone have the ability to form a durable bone–implant interface, new applications have emerged in the field of orthopedics, which requires a more thorough assessment of the literature. This review aims to introduce the basic biological principles for attaining osseointegration and discusses the major factors for assuring successful cementless fixation. Keywords: osseointegration, bone, skeletal attachment, total joint replacements, dental implants, percutaneous

  17. Fibular grafting with cannulated hip screw fixation in late femoral neck fracture in young adults

    Directory of Open Access Journals (Sweden)

    Goyal R

    2006-01-01

    Full Text Available Background: We reviewed the operative results of fibular bone graft with cannulated hip screw fixation in femoral neck fracture in young adults. Method: Sixteen young adults with femoral neck fracture were treated by fibular bone graft with cannulated hip screw fixation. All the fractures were more than 3 weeks old. Results: Results were assessed in 15 patients while one patient died due to complications not related to surgery. Union occurred in all 15 patients. One patient had intra-operative complication in the form of screw cut out with graft in the joint space. The average fallow up was 24.4 months. Out of 15 patients assessed clinico-radiologically 11 showed good results, 3 had fair while 1 had poor result. Conclusion: We conclude that this is a simple and cost effective procedure for late femoral fleck fracture in young adults with good results.

  18. Experimental assessment of a new direct fixation implant for artificial limbs.

    NARCIS (Netherlands)

    Tomaszewski, P.K.; Lasnier, B.; Hannink, G.J.; Verkerke, G.J.; Verdonschot, N.J.J.

    2013-01-01

    An alternative to prosthetic socket rehabilitation of patients with transfemoral amputation is realized by means of direct skeletal fixation devices. offering significant improvements in mobility and comfort. However, strain shielding due to high stiffness of these metal-based implants causes consid

  19. Experimental assessment of a new direct fixation implant for artificial limbs

    NARCIS (Netherlands)

    Tomaszewski, P. K.; Lasnier, B.; Hannink, G.; Verkerke, G. J.; Verdonschot, N.

    2013-01-01

    An alternative to prosthetic socket rehabilitation of patients with transfemoral amputation is realized by means of direct skeletal fixation devices, offering significant improvements in mobility and comfort. However, strain shielding due to high stiffness of these metal-based implants causes consid

  20. Effect of Additive on Sulfur-fixation Process of Sulfur-fixation Agent

    Institute of Scientific and Technical Information of China (English)

    XIE Jun-lin; QIU Jian-rong; ZHAO Gai-ju; LOU Jin-ping; HAN Chun-hua

    2003-01-01

    The crystallization behavior of desulfurization product is directly related to its high-temperatureresistant ability. Effects of the additive on the sulfur-fixation efficiency of the Ba-sulfur-fixation agent and also on the crystallization behavior of the sulfur-fixation product were studied when CaCO3 and BaCO3 were used as the desulfurization agent and MgO and SrCO3 used as the assistant sulfur-fixation agent. The result shows that increase of sulfur-fixation capability for the additive is not owe to their directly react to form sulfate or interact with CaCO3 and BaCO3 to form composite mineral heat-resistant in high temperature, but owe to their activation to sulfur-fixation reaction of the sulfur-fixation agent.

  1. Bone Densitometry (Bone Density Scan)

    Science.gov (United States)

    ... of DXA Bone Densitometry? What is a Bone Density Scan (DXA)? Bone density scanning, also called dual-energy x-ray absorptiometry ( ... is today's established standard for measuring bone mineral density (BMD). An x-ray (radiograph) is a noninvasive ...

  2. Eighth international congress on nitrogen fixation. Final program

    Energy Technology Data Exchange (ETDEWEB)

    1990-12-31

    This volume contains the proceedings of the Eighth International Congress on Nitrogen Fixation held May 20--26, 1990 in Knoxville, Tennessee. The volume contains abstracts of individual presentations. Sessions were entitled Recent Advances in the Chemistry of Nitrogen Fixation, Plant-microbe Interactions, Limiting Factors of Nitrogen Fixation, Nitrogen Fixation and the Environment, Bacterial Systems, Nitrogen Fixation in Agriculture and Industry, Plant Function, and Nitrogen Fixation and Evolution.

  3. Treatment of Spinal Tuberculosis by Debridement, Interbody Fusion and Internal Fixation via Posterior Approach Only.

    Science.gov (United States)

    Tang, Ming-xing; Zhang, Hong-qi; Wang, Yu-xiang; Guo, Chao-feng; Liu, Jin-yang

    2016-02-01

    Surgical treatment for spinal tuberculosis includes focal tuberculosis debridement, segmental stability reconstruction, neural decompression and kyphotic deformity correction. For the lesions mainly involved anterior and middle column of the spine, anterior operation of debridement and fusion with internal fixation has been becoming the most frequently used surgical technique for the spinal tuberculosis. However, high risk of structural damage might relate with anterior surgery, such as damage in lungs, heart, kidney, ureter and bowel, and the deformity correction is also limited. Due to the organs are in the front of spine, there are less complications in posterior approach. Spinal pedicle screw passes through the spinal three-column structure, which provides more powerful orthopedic forces compared with the vertebral body screw, and the kyphotic deformity correction effect is better in posterior approach. In this paper, we report a 68-year-old male patient with thoracic tuberculosis who underwent surgical treatment by debridement, interbody fusion and internal fixation via posterior approach only. The patient was placed in prone position under general anesthesia. Posterior midline incision was performed, and the posterior spinal construction was exposed. Then place pedicle screw, and fix one side rod temporarily. Make the side of more bone destruction and larger abscess as lesion debridement side. Resect the unilateral facet joint, and retain contralateral structure integrity. Protect the spinal cord, nerve root. Clear sequestrum, necrotic tissue, abscess of paravertebral and intervertebral space. Specially designed titanium mesh cages or bone blocks were implanted into interbody. Fix both side rods and compress both sides to make the mesh cages and bone blocks tight. Reconstruct posterior column structure with allogeneic bone and autologous bone. Using this technique, the procedures of debridement, spinal cord decompression, deformity correction, bone grafting

  4. Bone Metabolism on ISS Missions

    Science.gov (United States)

    Smith, S. M.; Heer, M. A.; Shackelford, L. C.; Zwart, S. R.

    2014-01-01

    Spaceflight-induced bone loss is associated with increased bone resorption (1, 2), and either unchanged or decreased rates of bone formation. Resistive exercise had been proposed as a countermeasure, and data from bed rest supported this concept (3). An interim resistive exercise device (iRED) was flown for early ISS crews. Unfortunately, the iRED provided no greater bone protection than on missions where only aerobic and muscular endurance exercises were available (4, 5). In 2008, the Advanced Resistive Exercise Device (ARED), a more robust device with much greater resistance capability, (6, 7) was launched to the ISS. Astronauts who had access to ARED, coupled with adequate energy intake and vitamin D status, returned from ISS missions with bone mineral densities virtually unchanged from preflight (7). Bone biochemical markers showed that while the resistive exercise and adequate energy consumption did not mitigate the increased bone resorption, bone formation was increased (7, 8). The typical drop in circulating parathyroid hormone did not occur in ARED crewmembers. In 2014, an updated look at the densitometry data was published. This study confirmed the initial findings with a much larger set of data. In 42 astronauts (33 male, 9 female), the bone mineral density response to flight was the same for men and women (9), and those with access to the ARED did not have the typical decrease in bone mineral density that was observed in early ISS crewmembers with access to the iRED (Figure 1) (7). Biochemical markers of bone formation and resorption responded similarly in men and women. These data are encouraging, and represent the first in-flight evidence in the history of human space flight that diet and exercise can maintain bone mineral density on long-duration missions. However, the maintenance of bone mineral density through bone remodeling, that is, increases in both resorption and formation, may yield a bone with strength characteristics different from those

  5. Evaluation of Qualitative Changes in Simulated Periodontal Ligament and Alveolar Bone Using a Noncontact Electromagnetic Vibration Device with a Laser Displacement Sensor

    OpenAIRE

    Hiroshi Kobayashi; Makoto Hayashi; Masaru Yamaoka; Takuya Yasukawa; Haruna Ibi; Bunnai Ogiso

    2016-01-01

    Evaluating periodontal tissue condition is an important diagnostic parameter in periodontal disease. Noncontact electromagnetic vibration device (NEVD) was previously developed to monitor this condition using mechanical parameters. However, this system requires accelerometer on the target tooth. This study assessed application of laser displacement sensor (LDS) to NEVD without accelerometer using experimental tooth models. Tooth models consisted of cylindrical rod, a tissue conditioner, and p...

  6. Early Weight-bearing Using Percutaneous External Fixator for Calcaneal Fracture

    OpenAIRE

    Sengodan, Vetrivel Chezian; Sengodan, Mugundhan Moongilpatti

    2012-01-01

    Calcaneal fracture, the most common tarsal bone fracture, occurs predominantly in manual labors and subsequently has got considerable socioeconomic implications. Treatment modality which can offer early weight bearing and early return to work is therefore needed for those patients. We have used a biplanar percutaneous external fixator for treating calcaneal fractures without operative and per operative visualization of the fractures. We have treated 17 calcaneal fractures in 16 patients, 12 i...

  7. 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...

  8. Appraisal of logicality and safety of intramedullary fixation of paediatric diaphyseal fractures by titanium elastic nails

    Directory of Open Access Journals (Sweden)

    Arun Vashisht

    2016-03-01

    Conclusions: The intramedullary fixation of paediatric bones with TENs appears quite logical in terms of fracture stability for early mobilisation, early return to school, lesser hospital stay, and lesser parental off-duty. The technique is safe, does not interfere with fracture healing and does not violate the physis as nails are not passed through the physis. [Int J Res Med Sci 2016; 4(3.000: 866-870

  9. Humeral repair in birds by guided tissue regeneration and external and internal associated fixation techniques

    International Nuclear Information System (INIS)

    Ten pigeons (Columba livia domestic form) with humeral diaphyseal fracture were treated with external and internal fixation techniques (Boston technique and intamedullary pin). Longitudinal space was intentionally left between fracture surfaces during osteosynthesis. This space was filled with bovine lyophilized collagen, set around an intramedullary pin, in five samples. Ossification process was checked by radiography every seven days. Results show the utility of this technique in pneumatic bird bones. In fact, shortening control and callus formation facility were observed

  10. Radionuclide fixation mechanisms in rocks

    International Nuclear Information System (INIS)

    In the safety evaluation of the radioactive waste disposal in geological environment, the mass balance equation for radionuclide migration is given. The sorption of radionuclides by geological formations is conventionally represented by the retardation of the radionuclides as compared with water movement. In order to quantify the sorption of radionuclides by rocks and sediments, the distribution ratio is used. In order to study quantitatively the long term behavior of waste radionuclides in geological environment, besides the distribution ratio concept in short term, slower radionuclide retention reaction involving mineral transformation should be considered. The development of microspectroscopic method for long term reaction path modeling, the behavior of iron during granite and water interaction, the reduction precipitation of radionuclides, radionuclide migration pathways, and the representative scheme of radionuclide migration and fixation in rocks are discussed. (K.I.)

  11. Experimental and Numerical Analysis of Screw Fixation in Anterior Cruciate Ligament Reconstruction

    Science.gov (United States)

    Chizari, Mahmoud; Wang, Bin; Snow, Martyn; Barrett, Mel

    2008-09-01

    This paper reports the results of an experimental and finite element analysis of tibial screw fixation in anterior cruciate ligament (ACL) reconstruction. The mechanical properties of the bone and tendon graft are obtained from experiments using porcine bone and bovine tendon. The results of the numerical study are compared with those from mechanical testing. Analysis shows that the model may be used to establish the optimum placement of the tunnel in anterior cruciate ligament reconstruction by predicting mechanical parameters such as stress, strain and displacement at regions in the tunnel wall.

  12. Sliding-screw plate fixation of proximal femoral fractures: Radiographic assessment

    International Nuclear Information System (INIS)

    The sliding compression screw-sideplate combination is currently the most widely employed device for internal fixation of stable and unstable intertrochanteric fractures of the femur. The normal and abnormal radiogrpahic appearances of this device in the immediate post-operative period are discussed. Potential long-term complications including mal- or non-union, intra-articular penetration, metal failure, rotation of the proximal fracture fragment, disengagement, trochanteric bursitis, leg length discrepancy, delayed cervical stress fracture, and ischemic necrosis are reviewed. (orig.)

  13. The effect of cement creep and cement fatigue damage on the micromechanics of the cement-bone interface.

    NARCIS (Netherlands)

    Waanders, D.; Janssen, D.; Mann, K.A.; Verdonschot, N.J.J.

    2010-01-01

    The cement-bone interface provides fixation for the cement mantle within the bone. The cement-bone interface is affected by fatigue loading in terms of fatigue damage or microcracks and creep, both mostly in the cement. This study investigates how fatigue damage and cement creep separately affect th

  14. 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.

  15. Adjunctive hyperbaric oxygen therapy in the treatment of atrophic tibial nonunion with Ilizarov external fixator: a radiographic and scintigraphic study in rabbits*

    OpenAIRE

    Kurklu, Mustafa; Yurttas, Yuksel; Kose, Ozkan; Demiralp, Bahtiyar; Yuksel, Halil Yalcin; Komurcu, Mahmut

    2012-01-01

    Objective: The aim of this experimental study was to determine the effects of adjunctive hyperbaric oxygen therapy (HBO) on atrophic tibial nonunion treatment using Ilizarov external fixator. Methods: Twenty New Zealand white rabbits were randomly divided into two equal groups. A circular external fixator was applied to the right tibia of all the rabbits. A 5-mm bone block was resected and a tibial pseudarthrosis was obtained after a 6-month waiting period. The experimental group rabbits ...

  16. Effects of Lateral Mass Screw Rod Fixation to the Stability of Cervical Spine after Laminectomy

    Science.gov (United States)

    Rosli, Ruwaida; Kashani, Jamal; Kadir, Mohammed Rafiq Abdul

    There are many cases of injury in the cervical spine due to degenerative disorder, trauma or instability. This condition may produce pressure on the spinal cord or on the nerve coming from the spine. The aim of this study was, to analyze the stabilization of the cervical spine after undergoing laminectomy via computational simulation. For that purpose, a three-dimensional finite element (FE) model for the multilevel cervical spine segment (C1-C7) was developed using computed tomography (CT) data. There are various decompression techniques that can be applied to overcome the injury. Usually, decompression procedures will create an unstable spine. Therefore, in these situations, the spine is often surgically restabilized by using fusion and instrumentation. In this study, a lateral mass screw-rod fixation was created to stabilize the cervical spine after laminectomy. Material properties of the titanium alloy were assigned on the implants. The requirements moments and boundary conditions were applied on simulated implanted bone. Result showed that the bone without implant has a higher flexion and extension angle in comparison to the bone with implant under applied 1Nm moment. The bone without implant has maximum stress distribution at the vertebrae and ligaments. However, the bone with implant has maximum stress distribution at the screws and rods. Overall, the lateral mass screw-rod fixation provides stability to the cervical spine after undergoing laminectomy.

  17. Dinitrogen fixation in aphotic oxygenated marine environments

    Directory of Open Access Journals (Sweden)

    Eyal eRahav

    2013-08-01

    Full Text Available We measured N2 fixation rates from oceanic zones that have traditionally been ignored as sources of biological N2 fixation; the aphotic, fully oxygenated, nitrate (NO3--rich, waters of the oligotrophic Levantine Basin (LB and the Gulf of Aqaba (GA. N2 fixation rates measured from pelagic aphotic waters to depths up to 720 m, during the mixed and stratified periods, ranged from 0.01 nmol N L-1 d-1 to 0.38 nmol N L-1 d-1. N2 fixation rates correlated significantly with bacterial productivity and heterotrophic diazotrophs were identified from aphotic as well as photic depths. Dissolved free amino acid amendments to whole water from the GA enhanced bacterial productivity by 2to 3.5 and N2 fixation rates by ~ 2 fold in samples collected from aphotic depths while in amendments to water from photic depths bacterial productivity increased 2 to 6 fold while N2 fixation rates increased by a factor of 2 to 4 illustrating that both BP an heterotrophic N2 fixation are carbon limited. Experimental manipulations of aphotic waters from the LB demonstrated a significant positive correlation between transparent exopolymeric particles (TEP concentration and N2 fixation rates. This suggests that sinking organic material and high carbon (C: nitrogen (N micro-environments (such as TEP-based aggregates or marine snow could support high heterotrophic N2 fixation rates in oxygenated surface waters and in the aphotic zones. Indeed, our calculations show that aphotic N2 fixation accounted for 37 to 75 % of the total daily integrated N2 fixation rates at both locations in the Mediterranean and Red Seas with rates equal or greater to those measured from the photic layers. Moreover, our results indicate that that while N2 fixation may be limited in the surface waters, aphotic, pelagic N2 fixation may contribute significantly to new N inputs in other oligotrophic basins, yet it is currently not included in regional or global N budgets.

  18. Low Bone Density

    Science.gov (United States)

    ... Density Exam/Testing › Low Bone Density Low Bone Density Low bone density is when your bone density ... people with normal bone density. Detecting Low Bone Density A bone density test will determine whether you ...

  19. Micromotion in knee arthroplasty. A roentgen stereophotogrammetric analysis of four different concepts of prosthetic fixation

    International Nuclear Information System (INIS)

    In a prospective study, micromotion between tibial components and bone was analysed using roentgen stereophotogrammetric analysis (RSA), the potential of which was assessed. The patient material consisted of 96 arthrotic knees subjected to arthroplasty with six types of prosthese representing four different fixation concepts with and without bone cement. Provided stable conditions of the objects studied, RSA proved to have an accuracy (=resolution) of 0.3 degrees for rotation and 0.2 mm for translation (3 S.D.). This resolution was 10 times better than conventional radiography and sufficient for the study of micromotion. Micromotion, both gradual over time (migration) and instant, in response to applied forces (inducible displacement), was found for all tibial components studied. For conventional cemented prostheses the mean migration was 1-1.5 mm for the different groups. Most of the migration occurred during the first 6 months. Inducible displacement of 0.2-1.0 mm was found in most cases. Metal support did not improve the prosthetic fixation. For the non-cemented cases both migration and inducible displacement was significantly larger than in cemented cases. All prostheses proved to be bonded to the bone in a semi-rigid way permitting micromotion. The newer fixation concept did not prove superior to conventional cementing of all-polyethylene prostheses. The micromotion occurred wihtin the soft tissue layer constituing the radiolucent zone, which in some cases was of tensile origin. Other radiographic of clinical variables did not correlate with the micromotion. (Author)

  20. Application of Ultrasonic Devices in Management of Periodontal Lesions - Bone Response in a Case of a Tooth with Poor Treatment Prognosis

    Directory of Open Access Journals (Sweden)

    Blagova Bistra Y.

    2016-04-01

    Full Text Available BACKGROUND: Surgical treatment of odontogenic jaw cysts may include one of the following four basic methods: enucleation, marsupialization, staged combination of marsupialization and enucleation, or enucleation with curettage. Enucleation/cystectomy, alone or combined with other procedures, is the preferred choice of treatment. OBJECTIVE: The aim of the case report was to present the outcome of an ultrasound-assistant periapical cystectomy in a frontal upper tooth with indications for extraction. RESULTS: Postoperative recovery was uneventful. The functional result was satisfactory. On the follow-up X-rays a reduction of the intraosseous defect by a new bone formation could be observed. CONCLUSION: We found ultrasonic surgery to be a promising approach for safe and effective odontogenic jaw cyst removal reducing the risk of its recurrence.

  1. Application of Ultrasonic Devices in Management of Periodontal Lesions - Bone Response in a Case of a Tooth with Poor Treatment Prognosis

    Directory of Open Access Journals (Sweden)

    Blagova Bistra Y.

    2015-12-01

    Full Text Available BACKGROUND: Surgical treatment of odontogenic jaw cysts may include one of the following four basic methods: enucleation, marsupialization, staged combination of marsupialization and enucleation, or enucleation with curettage. Enucleation/cystectomy, alone or combined with other procedures, is the preferred choice of treatment. OBJECTIVE: The aim of the case report was to present the outcome of an ultrasound-assistant periapical cystectomy in a frontal upper tooth with indications for extraction. RESULTS: Postoperative recovery was uneventful. The functional result was satisfactory. On the follow-up X-rays a reduction of the intraosseous defect by a new bone formation could be observed. CONCLUSION: We found ultrasonic surgery to be a promising approach for safe and effective odontogenic jaw cyst removal reducing the risk of its recurrence.

  2. Salient in space, salient in time: Fixation probability predicts fixation duration during natural scene viewing.

    Science.gov (United States)

    Einhäuser, Wolfgang; Nuthmann, Antje

    2016-09-01

    During natural scene viewing, humans typically attend and fixate selected locations for about 200-400 ms. Two variables characterize such "overt" attention: the probability of a location being fixated, and the fixation's duration. Both variables have been widely researched, but little is known about their relation. We use a two-step approach to investigate the relation between fixation probability and duration. In the first step, we use a large corpus of fixation data. We demonstrate that fixation probability (empirical salience) predicts fixation duration across different observers and tasks. Linear mixed-effects modeling shows that this relation is explained neither by joint dependencies on simple image features (luminance, contrast, edge density) nor by spatial biases (central bias). In the second step, we experimentally manipulate some of these features. We find that fixation probability from the corpus data still predicts fixation duration for this new set of experimental data. This holds even if stimuli are deprived of low-level images features, as long as higher level scene structure remains intact. Together, this shows a robust relation between fixation duration and probability, which does not depend on simple image features. Moreover, the study exemplifies the combination of empirical research on a large corpus of data with targeted experimental manipulations. PMID:27627736

  3. Immaturity of Visual Fixations in Dyslexic Children.

    Science.gov (United States)

    Tiadi, Aimé; Gérard, Christophe-Loïc; Peyre, Hugo; Bui-Quoc, Emmanuel; Bucci, Maria Pia

    2016-01-01

    To our knowledge, behavioral studies recording visual fixations abilities in dyslexic children are scarce. The object of this article is to explore further the visual fixation ability in dyslexics compared to chronological age-matched and reading age-matched non-dyslexic children. Fifty-five dyslexic children from 7 to 14 years old, 55 chronological age-matched non-dyslexic children and 55 reading age-matched non-dyslexic children participated to this study. Eye movements from both eyes were recorded horizontally and vertically by a video-oculography system (EyeBrain(®) T2). The fixation task consisted in fixating a white-filled circle appearing in the center of the screen for 30 s. Results showed that dyslexic children produced a significantly higher number of unwanted saccades than both groups of non-dyslexic children. Moreover, the number of unwanted saccades significantly decreased with age in both groups of non-dyslexic children, but not in dyslexics. Furthermore, dyslexics made more saccades during the last 15 s of fixation period with respect to both groups of non-dyslexic children. Such poor visual fixation capability in dyslexic children could be due to impaired attention abilities, as well as to an immaturity of the cortical areas controlling the fixation system.

  4. Immaturity of Visual Fixations in Dyslexic Children.

    Directory of Open Access Journals (Sweden)

    TIADI eBi Kuyami Guy Aimé

    2016-02-01

    Full Text Available To our knowledge, behavioral studies recording visual fixations abilities in dyslexic children are scarce. The object of this paper is to explore further the visual fixation ability in dyslexics compared to chronological age-matched and reading age-matched non-dyslexic children. Fifty-five dyslexic children from 7 to 14 years old, fifty-five chronological age-matched non-dyslexic children and fifty-five reading age-matched non-dyslexic children participated to this study. Eye movements from both eyes were recorded horizontally and vertically by a video-oculography system (EyeBrain® T2. The fixation task consisted in fixating a white-filled circle appearing in the centre of the screen for 30 seconds. Results showed that dyslexic children produced a significantly higher number of unwanted saccades than both groups of non-dyslexic children. Moreover, the number of unwanted saccades significantly decreased with age in both groups of non-dyslexic children, but not in dyslexics. Furthermore, dyslexics made more saccades during the last 15 sec of fixation period with respect to both groups of non-dyslexic children. Such poor visual fixation capability in dyslexic children could be due to impaired attention abilities, as well as to an immaturity of the cortical areas controlling the fixation system.

  5. In Vivo Gait Analysis During Bone Transport.

    Science.gov (United States)

    Mora-Macías, J; Reina-Romo, E; Morgaz, J; Domínguez, J

    2015-09-01

    The load bearing characteristics of the intervened limb over time in vivo are important to know in distraction osteogenesis and bone healing for the characterization of the bone maturation process. Gait analyses were performed for a group of sheep in which bone transport was carried out. The ground reaction force was measured by means of a force platform, and the gait parameters (i.e., the peak, the mean vertical ground reaction force and the impulse) were calculated during the stance phase for each limb. The results showed that these gait parameters decreased in the intervened limb and interestingly increased in the other limbs due to the implantation of the fixator. Additionally, during the process, the gait parameters exponentially approached the values for healthy animals. Corresponding radiographies showed an increasing level of ossification in the callus. This study shows, as a preliminary approach to be confirmed with more experiments, that gait analysis could be used as an alternative method to control distraction osteogenesis or bone healing. For example, these analyses could determine the appropriate time to remove the fixator. Furthermore, gait analysis has advantages over other methods because it provides quantitative data and does not require instrumented fixators. PMID:25650097

  6. In Vivo Gait Analysis During Bone Transport.

    Science.gov (United States)

    Mora-Macías, J; Reina-Romo, E; Morgaz, J; Domínguez, J

    2015-09-01

    The load bearing characteristics of the intervened limb over time in vivo are important to know in distraction osteogenesis and bone healing for the characterization of the bone maturation process. Gait analyses were performed for a group of sheep in which bone transport was carried out. The ground reaction force was measured by means of a force platform, and the gait parameters (i.e., the peak, the mean vertical ground reaction force and the impulse) were calculated during the stance phase for each limb. The results showed that these gait parameters decreased in the intervened limb and interestingly increased in the other limbs due to the implantation of the fixator. Additionally, during the process, the gait parameters exponentially approached the values for healthy animals. Corresponding radiographies showed an increasing level of ossification in the callus. This study shows, as a preliminary approach to be confirmed with more experiments, that gait analysis could be used as an alternative method to control distraction osteogenesis or bone healing. For example, these analyses could determine the appropriate time to remove the fixator. Furthermore, gait analysis has advantages over other methods because it provides quantitative data and does not require instrumented fixators.

  7. Design and clinical application of cervical hollow threaded fixator

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective Cervical hollow threaded fixator (CHTY) was designed and applied to stabilize tha cervical spine following anterior decompression due to cervical spondylosis or acute cervical disc herniation. Methods Medical use titanium alloy with no magnetism was made into a hollow threaded structure with holes on the wall of the fixator. Forly-two patients with cervical spondylosis and acute cervical disc herniation were stabilized using the CHTF technique after anterior decompression. X-ray films and CT scans were taken after the oberation to observe the stability ann fusion rate of the segments. Results Patients were allowed to walk one day after the operation and were followed up for 6 to 36 months. The operated segments were stable and solid fusion was observed 3-6 months after surgery. Conclusions Immediate stability of the operated segments can be obtained using the CHTF technique. Patients ware easy to manage after5 the operation and returned to their jobs in a short time.The CHTF technique is safe and simpa to perfoirme and eliminates the complications of an autograft.It may be an alternative to traditional cervical interbody fusion with bone graft.

  8. Stiffness of modified Type 1a linear external skeletal fixators.

    Science.gov (United States)

    Reaugh, H F; Rochat, M C; Bruce, C W; Galloway, D S; Payton, M E

    2007-01-01

    Modifications of a Type 1a external skeletal fixator (ESF) frame were evaluated by alternately placing transfixation pins on opposite sides of the connecting rod (Type 1a-MOD) or by placing additional connecting rods on either of the two inside (Type 1a-INSIDE) or two outside (Type 1a-OUTSIDE) transfixation pins. The objective of this study was to evaluate the stiffness of these modifications in terms of axial compression (AC), cranial-caudal bending (CCB), and medial-lateral bending (MLB). We hypothesized that these designs would allow significant increase in unilateral frame stiffness, over Type 1a, without proportional increase in frame complexity or technical difficulty of application. All of the ESF frames were constructed using large IMEX SKtrade mark clamps, 3.2 mm threaded fixation pins, 9.5 mm carbon fibre connecting rods and Delrin rods as bone models. Nine, eight pin frames of each design were constructed, and subjected to repetitive non-destructive loading forces (AC, CCB, MLB) using a materials testing machine. Frame construct stiffness for each force (AC, CCB, MLB) was derived from load-deformation curve analysis and displayed in N/mm. Data revealed the 1a-MOD and 1a-OUTSIDE constructs had significantly increased stiffness in CCB and AC as compared to the Type 1a constructs while all of the modified constructs were significantly stiffer in MLB than the Type 1a constructs. PMID:18038001

  9. SURVEY SUBAXIAL CERVICAL VERTEBRAE FOR TRANSPEDICULAR SCREW FIXATION

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Objective In this study, the pedicles of subaxial vertebrae from C3 to C7 were measured to provide some morphometric data for cervical transpedicular screw fixation. Methods 20 dried bone cervical spinal columns (C3-C7), pedicle dimensions (pedicle height, width, length), and transverse and sagittal angles of the pedicles were performed with vernier in linear and angular measurements. Results The obtained data revealed that the mean values were approximately ranging from 6.7 to 7.2 mm for pedicle height, 4.4 to 4.9 mm for pedicle width, 22.2 to 27.7 mm for pedicle axis length, 42.3° to 51.5° for transverse angle, and 5.2° to 14.1° for sagittal angle. Conclusion Linear measurements of pedicle dimensions and also axial angles from horizontal and vertical planes may provide some anatomic limitations for subaxial cervical transpedicular screw fixation, and also contribute to the safety of the surgical procedure.

  10. Decision of the 20 april 2005 fixing the modalities of the quality control of bone densitometers devices using ionizing radiations; Decision du 20 avril 2005 fixant les modalites du controle de qualite des dispositifs d'osteodensitometrie utilisant les rayonnements ionisants

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-06-15

    This text defines the modalities of the quality control of bone densitometers devices using ionizing radiations. It precises the internal and external quality control operations to implement, the periodicity of the control, the criteria of the performances acceptability and what to do in case of non conformity. (A.L.B.)

  11. [An experimental study of the effects of stress-relaxation plate on bone remodeling].

    Science.gov (United States)

    Dai, M; Dai, K; Qui, S

    1995-11-01

    An ideal bone plate would provide rigid fixation to ensure stabilization of bone fragments at the early stage after fracture, while at the late stage osteoporosis induced by stress shielding effect of the plate should be prevented. However, there is no report of such a plate that could meet with all these requirements. Twenty-eight adult New Zealand rabbits were used in this experiment. Ordinary stainless-steel plate (no washer plate) and similar plate padded with ultrahigh molecular polyethylene washers in its screw holes (washer plate) were fixed respectively on mid-shelf of each side of tibiae. The animals were killed at 2, 4, 8, 12, 16, 20 and 24 weeks after operation, and the fixed bone segments of both tibiae were removed for light microscopy, polarized light microscopy and fluoroscopy. The results showed that the tibiae fixed with plate fixation both appeared bone resorption, but there was more severe resorption in bone with no washer plate fixation than that with washer plate fixation. Cancelization of cortical bone was seen in the former but not in the latter at 12 weeks postopertively. This demonstrated that the washer might creep and damage with fixation time, resulting in gradual decrease in the rigidity of the plate-screw system and thus reducing bone resorption as caused by stress shielding. PMID:8731919

  12. 14CO2 fixation pattern of cyanobacteria

    International Nuclear Information System (INIS)

    The 14CO2 fixation pattern of three cyanobacteria in the light and dark were studied. Two different chromatographic methods widely used for separating labelled photosynthetic intermediates were compared. After ethanolic extraction, a rather uniform fixation pattern reflecting mainly the β-carboxylation pathway is obtained for all 3 species. Of the intermediates, glucosylglycerol is specific and high citrulline and low malate contents are fairly specific to cyanobacteria. The composition of the 14CO2 fixation pattern is hardly affected by changes in temperature or light intensity, but it is severely affected by changes in the water potential of the medium. (author)

  13. Apparatus for fixation of grinder shells upon a vibration-grinding casing

    Energy Technology Data Exchange (ETDEWEB)

    Pogosov, Yu.A.; Pugachev, V.S.

    1981-01-01

    A device is proposed for the fixation of grinder shells upon a vibration grinding table. This apparatus utilizes a table-mounting consisting of a shaft with a threaded head for a nut and lock-washer which is located in a mobile position below the locknut. Servicability is improved by utilizing radial-cantilevered protrusions in the mounting to facilitate end contact and fixation to the casing. The bushings and shaft are connected by pairs of threaded nuts while the bushings are spring-loaded relative to the table.

  14. Bone Cancer

    Science.gov (United States)

    ... cancer. Surgery is often the main treatment for bone cancer. Other treatments may include amputation, chemotherapy, and radiation therapy. Because bone cancer can come back after treatment, regular follow-up visits are important. NIH: National ...

  15. Diagnostic and therapeutic appropriateness in bone and joint infections: results of a national survey.

    Science.gov (United States)

    Esposito, Silvano; Russo, Enrico; De Simone, Giuseppe; Gioia, Renato; Petta, Ester; Leone, Sebastiano; Noviello, Silvana; Artioli, Stefania; Ascione, Tiziana; Bartoloni, Alessandro; Bassetti, Matteo; Bertelli, Davide; Boccia, Giovanni; Borrè, Silvio; Brugnaro, Pierluigi; Caramello, Pietro; Coen, Massimo; Crisalli, Maria Paola; De Caro, Francesco; Dodi, Ferdinando; Fantoni, Massimo; Foti, Giuseppe; Giacometti, Andrea; Leoncini, Francesco; Libanore, Marco; Migliore, Simona; Venditti, Mario

    2016-06-01

    The impact of infectious diseases (ID) specialist consultation in the management of many types of bacterial infections has been fully demonstrated but not for bone and joint infections (BJIs). Nineteen ID Italian centres collected of data from June 2009 to May 2012. Italian guidelines (2009) were used to determine the appropriateness of the diagnostic and therapeutic process of BJIs before and after consulting an ID specialist. Data on 311 patients were collected: 111 cases of prosthetic joint infection, 99 osteomyelitis, 64 spondylodiscitis and 37 fixation device infection. A significant increase of microbiological investigations, imaging techniques and blood inflammation markers were noted after consulting the ID specialist. Moreover, inappropriateness of treatment duration, dosage, and number of administrations significantly decreased after consultation. Infectious disease specialist intervention in the management of BJIs significantly increases the appropriateness both in performing instrumental and laboratory analysis, but especially in determining the correct therapy. PMID:25800800

  16. The Evaluation of Daily Life Activities after Application of an Osseointegrated Prosthesis Fixation in a Bilateral Transfemoral Amputee

    Science.gov (United States)

    Schalk, Stephanie A.F.; Jonkergouw, Niels; van der Meer, Fred; Swaan, Willem M.; Aschoff, Horst-H.; van der Wurff, Peter

    2015-01-01

    Abstract Individuals with a transfemoral amputation (TFA) may experience limitations in daily life due to reduced mobility and prosthesis-related problems. An osseointegrated prosthesis fixation (OPF) procedure in amputees might contribute to a solution for patients with short stumps or socket-related problems. To date, no study has specifically described the application of an OPF procedure in individuals with a TFA. This study evaluated the level of daily life activities of a 21-year old service member with a bilateral TFA and cerebral trauma. Due to a short stump length and coordination problems, an OPF procedure was deemed the most suitable option. The result of this procedure and the rehabilitation program showed an increased mobility and satisfaction as obtained by the assessment of life habits questionnaire (LIFE-H) and lower extremity functional scale. The participant was able to walk short distances and the Genium knee provided a stance position. Stair ambulation is impossible because of inadequate muscle capacity. In this specific case we conclude that the quality of life improved through the use of an OPF. However, OPF might not be the appropriate device for every individual with TFA, due to varying bone compositions, co-morbidities, and limited clinical experience and unknown long-term effects. PMID:26356693

  17. Only fixation for lumbar canal stenosis: Report of an experience with seven cases

    Directory of Open Access Journals (Sweden)

    Atul Goel

    2014-01-01

    Full Text Available Study Design and Objective: The author reports experience with treatment of degenerative lumbar canal stenosis that involved fixation-arthrodesis of the affected spinal segment using "double insurance" transarticular screws for each joint. No direct bone, ligament or disc resection is done for decompression of the spinal dural tube or root canal. Methods and Summary of Background Data: During the period March 2011-September 2011, seven patients having lumbar canal stenosis were treated with a modification of transarticular method of screw fixation that involved insertion of two or "double insurance" screws at each articular joint. The operation involved section of the spinous process at its base, opening up of the facet joint, denuding of articular cartilage, insertion of intra-articular bone graft and insertion of two transarticular screws at each facet joint. The fixation was done in four levels in two patients, at three levels in four patients and at two levels in one patient. Oswestry disability index and visual analog scale were used to clinically assess the patients before and after the surgery and at follow-up. Results: During the average period of follow-up of 26.9 months (range 24-30 months, there was varying degree of recovery of symptoms. The procedure resulted in firm stabilization and fixation of the spinal segment and provided a ground for arthrodesis. During the period of follow-up, one patient underwent re-exploration and decompressive laminectomy as she continued to have significant pain symptom. Conclusions: Vertical instability and telescoping, listhesis or overriding of the facets on physical activity seems to be the defining phenomenon in the pathogenesis of lumbar canal stenosis. The clinical outcome in our patients suggest that fixation of the spinal segment can be a rationale form of treatment. "Double insurance" transarticular method of treatment is a simple, safe, and effective method of spinal stabilization.

  18. Antimicrobial activity of UMFix tissue fixative

    OpenAIRE

    Cleary, T J; Morales, A. R.; Nadji, M.; Nassiri, M.; Vincek, V.

    2005-01-01

    Aims: The aim of this study was to determine the antimicrobial effects of UMFix, an alcohol based tissue fixative, on various microorganisms. The UMFix solution was compared with 10% neutral buffered formalin.

  19. 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.

  20. Triple fixation of Bacillus subtilis dormant spores.

    OpenAIRE

    Kozuka, S; Tochikubo, K

    1983-01-01

    A triple-fixation method with a sequential application of 5% glutaraldehyde, 1% osmium tetroxide, and 2% potassium permanganate gave superior preservation of the ultrastructure of Bacillus subtilis dormant spores with a thick spore coat.

  1. Methanotrophy Induces Nitrogen Fixation in Boreal Mosses

    Science.gov (United States)

    Tiirola, M. A.

    2014-12-01

    Many methanotrophic bacterial groups fix nitrogen in laboratory conditions. Furthermore, nitrogen (N) is a limiting nutrient in many environments where methane concentrations are highest. Despite these facts, methane-induced N fixation has previously been overlooked, possibly due to methodological problems. To study the possible link between methanotrophy and diazotrophy in terrestrial and aquatic habitats, we measured the co-occurrence of these two processes in boreal forest, peatland and stream mosses using a stable isotope labeling approach (15 N2 and 13 CH4 double labeling) and sequencing of the nifH gene marker. N fixation associated with forest mosses was dependent on the annual N deposition, whereas methane stimulate N fixation neither in high (>3 kg N ha -1 yr -1) nor low deposition areas, which was in accordance with the nifH gene sequencing showing that forest mosses (Pleurozium schreberi and Hylocomium splendens ) carried mainly cyanobacterial N fixers. On the other extreme, in stream mosses (Fontinalis sp.) methane was actively oxidized throughout the year, whereas N fixation showed seasonal fluctuation. The co-occurrence of the two processes in single cell level was proven by co-localizing both N and methane-carbon fixation with the secondary ion mass spectrometry (SIMS) approach. Methanotrophy and diazotrophy was also studied in peatlands of different primary successional stages in the land-uplift coast of Bothnian Bay, in the Siikajoki chronosequence, where N accumulation rates in peat profiles indicate significant N fixation. Based on experimental evidence it was counted that methane-induced N fixation explained over one-third of the new N input in the younger peatland successional stages, where the highest N fixation rates and highest methane oxidation activities co-occurred in the water-submerged Sphagnum moss vegetation. The linkage between methanotrophic carbon cycling and N fixation may therefore constitute an important mechanism in the rapid

  2. Enhancing the mechanical integrity of the implant-bone interface with BoneWelding technology: determination of quasi-static interfacial strength and fatigue resistance.

    Science.gov (United States)

    Ferguson, Stephen J; Weber, Urs; von Rechenberg, Brigitte; Mayer, Joerg

    2006-04-01

    The BoneWelding technology is an innovative bonding method, which offers new alternatives in the treatment of fractures and other degenerative disorders of the musculoskeletal system. The BoneWelding process employs ultrasonic energy to liquefy a polymeric interface between orthopaedic implants and the host bone. Polymer penetrates the pores of the surrounding bone and, following a rapid solidification, forms a strong and uniform bond between implant and bone. Biomechanical testing was performed to determine the quasi-static push-out strength and fatigue performance of 3.5-mm-diameter polymeric dowels bonded to a bone surrogate material (Sawbones solid and cellular polyurethane foam) using the BoneWelding process. Fatigue tests were conducted over 100,000 cycles of 20-100 N loading. Mechanical test results were compared with those obtained with a comparably-sized, commercial metallic fracture fixation screw. Tests in surrogate bone material of varying density demonstrated significantly superior mechanical performance of the bonded dowels in comparison to conventional bone screws (p Ultrasonically inserted implants migrated, on average, less than 20 microm over, and interfacial stiffness remained constant the full duration of fatigue testing. With further refinement, the BoneWelding technology may offer a quicker, simpler, and more effective method for achieving strong fixation and primary stability for fracture fixation or other orthopaedic and dental implant applications. PMID:16211571

  3. Pelvic fixation for neuromuscular scoliosis deformity correction

    OpenAIRE

    Dayer, Romain; Ouellet, Jean Albert; Saran, Neil

    2012-01-01

    Pelvic fixation is most frequently indicated in the pediatric population for the treatment of neuromuscular scoliosis with significant pelvic obliquity. Neuromuscular scoliosis surgery is associated with a high risk of complications, and this is further increased by extension of fusion to the sacrum. Numerous techniques have been described for pelvic fixation associated with a long spine fusion each with its own set of specific benefits and risks. This article reviews the contemporary surgica...

  4. IRAT research work on nitrogen fixation

    International Nuclear Information System (INIS)

    The Institut de Recherches Agronomiques Tropicales et des Cultures Vivrieres (IRAT), in co-operation with the IAEA, has carried out research on groundnut and soybean in Senegal at the Institut Senegalais de Recherche Agricole (ISRA) in Bambey. The use of 15N to study dinitrogen fixation as affected by various agronomic factors is discussed. A model to determine the limiting factors in dinitrogen fixation in a given system is presented. (author)

  5. Tips and Tricks in Mallet Fracture Fixation.

    Science.gov (United States)

    Chin, Yuin Cheng; Foo, Tun-Lin

    2016-10-01

    We describe three steps to aid fracture assessment and fixation in the extensor block pin technique for mallet fractures. The first step is the use of fluoroscopy in the initial assessment to determine indication for fixation. Next is the use of supplementary extension block pin to control larger dorsal fragments. The third technique described details the steps of open reduction of nascently malunited fractures. PMID:27595969

  6. Maxwellian Eye Fixation during Natural Scene Perception

    Science.gov (United States)

    Duchesne, Jean; Bouvier, Vincent; Guillemé, Julien; Coubard, Olivier A.

    2012-01-01

    When we explore a visual scene, our eyes make saccades to jump rapidly from one area to another and fixate regions of interest to extract useful information. While the role of fixation eye movements in vision has been widely studied, their random nature has been a hitherto neglected issue. Here we conducted two experiments to examine the Maxwellian nature of eye movements during fixation. In Experiment 1, eight participants were asked to perform free viewing of natural scenes displayed on a computer screen while their eye movements were recorded. For each participant, the probability density function (PDF) of eye movement amplitude during fixation obeyed the law established by Maxwell for describing molecule velocity in gas. Only the mean amplitude of eye movements varied with expertise, which was lower in experts than novice participants. In Experiment 2, two participants underwent fixed time, free viewing of natural scenes and of their scrambled version while their eye movements were recorded. Again, the PDF of eye movement amplitude during fixation obeyed Maxwell's law for each participant and for each scene condition (normal or scrambled). The results suggest that eye fixation during natural scene perception describes a random motion regardless of top-down or of bottom-up processes. PMID:23226987

  7. Fixational eye movements predict visual sensitivity.

    Science.gov (United States)

    Scholes, Chris; McGraw, Paul V; Nyström, Marcus; Roach, Neil W

    2015-10-22

    During steady fixation, observers make small fixational saccades at a rate of around 1-2 per second. Presentation of a visual stimulus triggers a biphasic modulation in fixational saccade rate-an initial inhibition followed by a period of elevated rate and a subsequent return to baseline. Here we show that, during passive viewing, this rate signature is highly sensitive to small changes in stimulus contrast. By training a linear support vector machine to classify trials in which a stimulus is either present or absent, we directly compared the contrast sensitivity of fixational eye movements with individuals' psychophysical judgements. Classification accuracy closely matched psychophysical performance, and predicted individuals' threshold estimates with less bias and overall error than those obtained using specific features of the signature. Performance of the classifier was robust to changes in the training set (novel subjects and/or contrasts) and good prediction accuracy was obtained with a practicable number of trials. Our results indicate a tight coupling between the sensitivity of visual perceptual judgements and fixational eye control mechanisms. This raises the possibility that fixational saccades could provide a novel and objective means of estimating visual contrast sensitivity without the need for observers to make any explicit judgement. PMID:26468244

  8. Variable Nitrogen Fixation in Wild Populus.

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    Sharon L Doty

    Full Text Available The microbiome of plants is diverse, and like that of animals, is important for overall health and nutrient acquisition. In legumes and actinorhizal plants, a portion of essential nitrogen (N is obtained through symbiosis with nodule-inhabiting, N2-fixing microorganisms. However, a variety of non-nodulating plant species can also thrive in natural, low-N settings. Some of these species may rely on endophytes, microorganisms that live within plants, to fix N2 gas into usable forms. Here we report the first direct evidence of N2 fixation in the early successional wild tree, Populus trichocarpa, a non-leguminous tree, from its native riparian habitat. In order to measure N2 fixation, surface-sterilized cuttings of wild poplar were assayed using both 15N2 incorporation and the commonly used acetylene reduction assay. The 15N label was incorporated at high levels in a subset of cuttings, suggesting a high level of N-fixation. Similarly, acetylene was reduced to ethylene in some samples. The microbiota of the cuttings was highly variable, both in numbers of cultured bacteria and in genetic diversity. Our results indicated that associative N2-fixation occurred within wild poplar and that a non-uniformity in the distribution of endophytic bacteria may explain the variability in N-fixation activity. These results point to the need for molecular studies to decipher the required microbial consortia and conditions for effective endophytic N2-fixation in trees.

  9. Maxwellian Eye Fixation during Natural Scene Perception

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    Jean Duchesne

    2012-01-01

    Full Text Available When we explore a visual scene, our eyes make saccades to jump rapidly from one area to another and fixate regions of interest to extract useful information. While the role of fixation eye movements in vision has been widely studied, their random nature has been a hitherto neglected issue. Here we conducted two experiments to examine the Maxwellian nature of eye movements during fixation. In Experiment 1, eight participants were asked to perform free viewing of natural scenes displayed on a computer screen while their eye movements were recorded. For each participant, the probability density function (PDF of eye movement amplitude during fixation obeyed the law established by Maxwell for describing molecule velocity in gas. Only the mean amplitude of eye movements varied with expertise, which was lower in experts than novice participants. In Experiment 2, two participants underwent fixed time, free viewing of natural scenes and of their scrambled version while their eye movements were recorded. Again, the PDF of eye movement amplitude during fixation obeyed Maxwell’s law for each participant and for each scene condition (normal or scrambled. The results suggest that eye fixation during natural scene perception describes a random motion regardless of top-down or of bottom-up processes.

  10. A STUDY OF FUNCTIONAL AND RADIOLOGICAL OUTCOME OF UNDISPLACED SCAPHOID FRACTURES TREATED WITH PERCUTANEOUS HEADLESS SCREW FIXATION

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    Tarigopula

    2016-04-01

    Full Text Available BACKGROUND Scaphoid is the most commonly fractured carpal bone, accounting for approximately 60% of all carpal fractures. This injury is commonly seen in active young adults after a fall on an outstretched hand. Management of scaphoid fractures is controversial. Displaced scaphoid fractures are associated with risk of non-union and osteonecrosis. Surgical fixation is recommended for displaced scaphoid fractures of proximal pole, fractures with delayed treatment or diagnosis and non-union. Open reduction and internal fixation of acute scaphoid fractures has been reported to give good results in several nonrandomised, retrospective studies. The incidence of complications after operative treatment of non-displaced fractures has decreased with the advent of safer, more reliable implants and percutaneous techniques. CONCLUSION Percutaneous headless screw fixation is a well-documented surgical procedure. Undisplaced scaphoid fractures fixed by percutaneous headless screw fixation yield better results than patients treated conservatively. Good range of motion is achieved after fixation. It relieves pain and functional disability experienced by patients. Patients achieve good range of motion. Trabecular continuity is achieved in most of the patients before 8 weeks. Most of the patients had resumed normal daily activities before 3 months. This study suggests that percutaneous headless screw fixation for undisplaced scaphoid fractures provides satisfactory clinical and radiographic outcomes after an intermediate duration follow-up. Even though the procedure is not free of complications, the overall functional and clinical outcome had shown good results.

  11. Fixação esquelética externa tipo Ia (unilateral-uniplanar para osteossíntese diafisária de úmero em pombos domésticos (Columba livia Type Ia (unilateral-uniplanar external Skeletal fixation for treatment of humeral diaphysis fracture in domestic pigeons (Columba livia

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    Alessandro Moraes Leotte

    2004-12-01

    Full Text Available Das várias patologias que podem acometer as aves, são mais freqüentes as fraturas de ossos longos das asas e dos membros pélvicos. Este experimento teve como objetivo observar, por meio de exames clínicos, histológicos e radiográficos, a resposta cicatricial óssea ao uso do fixador externo tipo Ia (unilateral-uniplanar na redução aberta de fratura diafisária, de úmero em pombos domésticos (Columba livia. Foram estudados 14 pombos com peso variando entre 290 e 420 gramas. A fratura foi realizada na diáfise do úmero direito e, logo após, estabilizada com aparelho de fixação externa tipo Ia, utilizando-se, como barra de fixação, o acrílico autopolimerizável. O tempo médio para o completo desaparecimento da linha de fratura foi de 28±6,44 dias e para formação de calo ósseo, 17±3,26 dias. As aves, mesmo com o aparelho de fixação, retornaram ao vôo aos 28±1,2 dias, exceto uma que não recuperou a capacidade de vôo. A técnica de fixação externa demonstrou ser eficaz para o tratamento de fraturas diafisárias de úmero em pombos domésticos.Among the various pathologies that can inflict birds, the long bones fractures of the wings, and pelvic members are more commom. Fourteeen domestic pigeons (Columba livia weighing 290 to 420g, were submitted to open reduction of humeral diaphysis fracture with external fixator type Ia (unilateral-uniplanar in order to evaluate the clinical, histological and radiographic evolution of the bone healing. The external fixator device was stabilized with methilmetacrylate acrylic. The average time necessary to the complete disappearance of the fracture line by radiographic evaluation was 28±6.44 days. The bone callus was identified at 17±3.26 postoperative days. The birds returned to flying in 28±1.2 days yet with the fixation device and only one did not recovere the flying abillity. The external fixation technique is an efficient method to treat diaphiseal humeral fracture in domestic

  12. Effect of insulating layer material on RF-induced heating for external fixation system in 1.5 T MRI system.

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    Liu, Yan; Kainz, Wolfgang; Qian, Songsong; Wu, Wen; Chen, Ji

    2014-09-01

    The radio frequency (RF)-induced heating is a major concern when patients with medical devices are placed inside a magnetic resonance imaging (MRI) system. In this article, numerical studies are applied to investigate the potentials of using insulated materials to reduce the RF heating for external fixation devices. It is found that by changing the dielectric constant of the insulation material, the RF-induced heating at the tips of devices can be altered. This study indicates a potential technique of developing external fixation device with low MRI RF heating.

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

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    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.

  14. Extraosseous radiotracer uptake on bone scan in beta-thalassemia: report of one case; Fixation extraosseuse du radiotraceur lors de la realisation d'une scintigraphie du squelette chez un patient atteint de beta-thalassemie: a propos d'un cas

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    Guezguez, M.; Nouira, M.; Sfar, R.; Chatti, K.; Ben Fradj, M.; Ben Ali, K.; Ajmi, S.; Essabbah, H. [CHU Sahloul, Service de Medecine Nucleaire, Sousse (Tunisia); Zrour, S. [EPS F. Bourguiba, Service de Rhumatologie, Monastir (Tunisia)

    2009-10-15

    Red blood cell transfusion, main therapeutic modality of beta-thalassemia, leads to iron overload which may perturb several metabolic ways. The aim of this paper is to illustrate the uptake abnormalities observed on bone scan of thalassaemic patients and to discuss mechanisms of extraosseous accumulation of the radiopharmaceutical in this pathology. We report a 16-year-old child suffering from beta-thalassemia major undergoing transfusion therapy. A bone scan was indicated to look for osseous infection. This study revealed a little skeletal uptake and abnormal liver, splenic and renal accumulation. A repeat bone scan, performed three weeks later showed a better skeletal uptake which enabled the discovery of focal abnormalities and made the diagnostic easier. The effect of iron overload on radiopharmaceuticals uptake in bone scan is known since 1975. Dissociation of {sup 99m}Tc from the carrier ligand due to the presence of iron excess seems the most plausible hypothesis. Free {sup 99m}Tc can be bound to other tissular substrates which can explain extraosseous uptake. The normally available pool for bone is reduced and then the skeletal uptake decreased. This report limits considerably the sensitivity of the bone scan. A well-led iron chelation and eventually the use of diuretic drug may guarantee a better quality of bone scan images. (authors)

  15. Assessment of external fixator reusability using load- and cycle-dependent tests.

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    Matsuura, Maiko; Lounici, Smain; Inoue, Nozomu; Walulik, Stephen; Chao, Edmund Y S

    2003-01-01

    No standard method has been established for investigating repeated use of an external fixator. The purpose of the current study was to establish a fatigue testing method for assessing fixator frame reuse. A unilateral DynaFix trade mark external fixator system was tested using high-load and low-cycle (900-150 N at 5 Hz) and low-load and high-cycle (450-100 N at 10 Hz) tests (assumed one use of 500,000 and 1 million cycles, respectively). These loading conditions were selected to simulate single clinical use and to satisfy Food and Drug Administration requirements. In the high-load low-cycle test, substantial failure of the serrated joint occurred before completion of the first simulated use. In the low-load high-cycle test, all fixators completed three simulated clinical uses without failure, although (1/4) of the serrated joint components had hairline cracks. The high-load low-cycle test identified the fixator components which should be examined and replaced if reuse of the fixator is to be considered. Wear and deformation of the set screw on the rotary joint and telescoping mechanisms were observed in the low-load high-cycle test but not in the high-load low-cycle test. Therefore, if the unilateral DynaFix trade mark fixators are being considered for reusability, the number of reuses should be limited as the whole structure of the device will experience fatigue damage as the loading cycle increases.

  16. Effect of Different Distal Fixation Augmentation Methods on the Pullout Strength of Fassier-Duval Telescoping Rods.

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    Mansour, Alfred; Barsi, James; Baldini, Todd; Georgopoulos, Gaia

    2016-01-01

    Antegrade telescoping rods have been introduced for use in pediatric patients with osteogenesis imperfecta (OI) to decrease the incidence of long-bone fractures and to correct and prevent deformities. Recent studies have documented failures of telescoping intramedullary rods due to inadequate distal fixation. The purpose of this study was to evaluate the pullout strength of distal fixation of the telescoping rod with and without synthetic calcium phosphate or polymethylmethacrylate (PMMA) augmentation. Four sets of 6 telescoping distal fixation rods were fixed according to standard insertion technique into an open-cell rigid-foam synthetic bone block simulating OI bone. The groups tested were as follows: control (no augmentation), 0.75 mL of PMMA-augmented, 0.75 mL of PMMA-rescued (stripped distal fixation, then resecured after PMMA augmentation), and 0.75 mL of bioabsorbable-calcium phosphate (CP)-augmented. All rods were tested to failure. The peak load was recorded. Average pullout strengths were as follows: control, 20±6.6 N; PMMA, 125±16.8 N; PMMA-rescued, 137±11.9 N; bioabsorbable-CP, 81±10.3 N. All augmented groups had significantly higher pullout strength compared with the control (P<.001). The PMMA and PMMA-rescued groups failed at the PMMA/bone interface, whereas the bioabsorbable-CP group failed at the cement/rod interface. All augmented constructs improved pullout strength by at least 400% compared with the control. Bioabsorbable cement may be less detrimental to the physis if pullout still occurs despite augmentation due to its mode of failure. This study provides biomechanical evidence to support the further in vivo investigation of either PMMA or bioabsorbable cement augmentation to improve pullout strength of distal telescoping rod fixation.

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

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    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

  18. INTRA MEDULLARY FIXATION OF SUB TROCHANTERIC FRACTURERS WITH LONG PROXIMAL FEMORAL NAIL & STAINLESS STEEL WIRE FIXATION: A STUDY

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    Sree Krishna

    2015-01-01

    Full Text Available INTRODUCTION: The objective of this study was to prospectively evaluate the clinical outcome of traumatic subtrochanteric fractures fixed with long proximal femoral nail (PFN & Stainless s te e l wire banding Fixation with particular emphasis on our experience of surgical techniques. Materials and Methods: We reviewed the results of 49 consecutive patients who had undergone intramedullary fixation specifically with a long PFN with S.S wire banding fixation for traumatic subtrochanteric fractures in our hospital during a 2 - year period from January 2013 to December 2014. The average age of the patients was 53 years. Clinical and radiographic analyses were performed when follow - up was made at 6 weeks, 12 weeks, 6 months, 1 year and 2 years. Results: All the 49 traumatic subtro chanteric fractures healed uneventfully except 1 case of delayed union. Walking and squatting ability was completely restored in every case at follow - up examination 6 months postoperatively. Among them, 32 fractures were successfully reduced with traction on a fracture table under fluoroscopy & cerclage wiring or bandage with S.S wire of various diameters (1.6, 1.8 etcthrough a small incision near the fragment to be fixed. The average operative time was 70 minutes (range, 45 to 120. Seventeen Seinsheimer type II fractures were left unlocked distally, and static distal interlocking with 1 bolt was carried out in the other 31 cases. No complications such as cutout or breakage of the implants were encountered. Conclusions: The objective of this study was to evaluate the clinical and radiological outcome of traumatic subtrochanteric fractures with trochanteric exten sion treated with long proximal femoral locking nail (PFNL & S.S wire. This study suggests that long PFN is a reliable implant for subtrochanteric fractures, leading to high rate of bone union and minimal soft tissue damage. Intramedullary fixation has bi ological and biomechanical advantages, but the operation

  19. 半月板移植的固定法对胫股关节屈曲中韧带及骨骼的力学特性影响%EFFECTS OF THE FIXATION METHODS OF MENISCUS ALLOGRAFT ON THE MECHANICAL CHARACTERISTIC OF LIGAMENTS AND BONE IN TIBIOFEMORAL JOINT

    Institute of Scientific and Technical Information of China (English)

    郭云飞; 黄荣瑛; 张高龙

    2013-01-01

    基于正常膝关节4个屈曲角度(0°/25°/60°/80°)下的MRI图像数据,构建了正常以及内侧半月板移植术中双隧道固定和三隧道固定的胫股关节有限元模型,对屈曲角系列下的4种模型分别施加10N·m的内外旋扭矩进行有限元仿真,得到各模型在两种载荷作用下的应力及位移分布,通过从仿真结果中提取各韧带表面的最大拉应力、韧带内的张力及韧带的最大变形量以及股骨、胫骨最大等效应力进行对比分析,获得了内侧半月板移植的双隧道/三隧道固定方法对胫股关节屈曲中韧带及骨骼力学特性的影响.结果表明:同类异体半月板移植的两种固定方法均在一定程度上改善了半月板切除引起的韧带力学行为的异常情况,尤其以采用三隧道固定后的改善更为明显.与双隧道固定相比,三隧道固定使各屈曲角度下韧带表面最大拉应力的变化更为小些,且对各韧带内张力的大小的改变也更微小;虽然三隧道固定使两种载荷作用下韧带的平均变形量的变化更大一些,但4个屈曲角度下的平均变化百分比不超过10%.同类异体半月板移植的两种固定方法均在一定程度上影响股骨和胫骨应力分布,但采用三隧道固定后的影响相对于双隧道固定的小.综合而言,三隧道固定比双隧道固定更利于移植膝韧带力学性能的恢复和胫骨/股骨接近正常的骨骼应力分布.该文的研究结果能为同类异体半月板移植手术的临床实施和术后分析提供参考数据.%Based on MRI images of the normal human knee at four flexion angles(0°25°60°/80°), the finite element models of the normal tibiofemoral joint and two medial meniscus transplantation models (2-tunnel fixation and 3-tunnel fixation) were built in this paper. The internal and external rotation torque of 10N·m were applied to models for the finite element simulation and the stress and displacement

  20. UK DRAFFT - A randomised controlled trial of percutaneous fixation with kirschner wires versus volar locking-plate fixation in the treatment of adult patients with a dorsally displaced fracture of the distal radius

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    Brown Jaclyn

    2011-09-01

    Full Text Available Abstract Background Fractures of the distal radius are extremely common injuries in adults. However, the optimal management remains controversial. In general, fractures of the distal radius are treated non-operatively if the bone fragments can be held in anatomical alignment by a plaster cast or orthotic. However, if this is not possible, then operative fixation is required. There are several operative options but the two most common in the UK, are Kirschner-wire fixation (K-wires and volar plate fixation using fixed-angle screws (locking-plates. The primary aim of this trial is to determine if there is a difference in the Patient-Reported Wrist Evaluation one year following K-wire fixation versus locking-plate fixation for adult patients with a dorsally-displaced fracture of the distal radius. Methods/design All adult patients with an acute, dorsally-dis