WorldWideScience

Sample records for bone fixation devices

  1. The effects of laparoscopic mesh fixation device on bone, costo-chondral junction and tendon site.

    Science.gov (United States)

    Ekçi, Baki; Altinli, Ediz; Dervisoglu, Sergülen; Demir, Mustafa; Tasci, Ihsan

    2011-01-01

    Osteitis pubis is one of the important complications of inguinal hernia repair surgery occurring with the placement of sutures through the periosteum. The aim of this study is to evaluate scintigraphic and histopathological alterations associated with the use of mesh fixation device on pelvic bone, cartilage and tendons in an experimental animal model. Twenty New-Zealand young male rabbits were used. A mesh fixation device was inserted at each animal's costa-chondral junction, superior anterior iliac crest, and achiles tendon. One week prior to the surgery and 16 weeks after the operation, scintigraphic evaluation was performed. Histopathological evaluation was performed at the end of study. No nuclear activity or pathological change was found at bone site (p > 0.05). Foreign body reaction was evident at the tendon and costa-chondral site (p = 0.001). In conclusion; the mesh fixation device leads to foreign body reaction in costa-chondral junction and tendon. It does not cause any nuclear activity increase. PMID:21657163

  2. 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

  3. Self-dissolution assisted coating on magnesium metal for biodegradable bone fixation devices

    Science.gov (United States)

    Khakbaz, Hadis; Walter, Rhys; Gordon, Timothy; Bobby Kannan, M.

    2014-12-01

    An attempt was made to develop a self-dissolution assisted coating on a pure magnesium metal for potential bone fixation implants. Magnesium phosphate cement (MPC) was coated successfully on the magnesium metal in ammonium dihydrogen phosphate solution. The in vitro degradation behaviour of the MPC coated metal was evaluated using electrochemical techniques. The MPC coating increased the polarisation resistance (RP) of the metal by ˜150% after 2 h immersion in simulated body fluid (SBF) and reduced the corrosion current density (icorr) by ˜80%. The RP of the MPC coated metal remained relatively high even after 8 h immersion period. However, post-degradation analysis of the MPC coated metal revealed localized attack. Hence, the study suggests that MPC coating alone may not be beneficial, but this novel coating could provide additional protection if used as a precursor for other potential coatings such as biodegradable polymers or calcium phosphates.

  4. Self-dissolution assisted coating on magnesium metal for biodegradable bone fixation devices

    International Nuclear Information System (INIS)

    An attempt was made to develop a self-dissolution assisted coating on a pure magnesium metal for potential bone fixation implants. Magnesium phosphate cement (MPC) was coated successfully on the magnesium metal in ammonium dihydrogen phosphate solution. The in vitro degradation behaviour of the MPC coated metal was evaluated using electrochemical techniques. The MPC coating increased the polarisation resistance (RP) of the metal by ∼150% after 2 h immersion in simulated body fluid (SBF) and reduced the corrosion current density (icorr) by ∼80%. The RP of the MPC coated metal remained relatively high even after 8 h immersion period. However, post-degradation analysis of the MPC coated metal revealed localized attack. Hence, the study suggests that MPC coating alone may not be beneficial, but this novel coating could provide additional protection if used as a precursor for other potential coatings such as biodegradable polymers or calcium phosphates. (paper)

  5. 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

  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

    useful to detect a lack of fixation of the pedicle screws and hence to predict instability of the fused vertebral segments. MATERIALS AND METHODS: A retrospective analysis of 9 patients who were referred to bone scintigraphy, including combined SPECT/CT, due to persistent pain or discomfort after...

  7. 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...

  8. 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

  9. 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

  10. A new concept for implant fixation: bone-to-bone biologic fixation

    OpenAIRE

    D-Y Kim; J-R Kim; KY Jang; K-B Lee

    2015-01-01

    Many attempts have been made to reduce complications of bone implant, such as pedicle screw loosening. To address this problem, the authors suggest a new concept of bone-to-bone biologic fixation using recombinant human bone morphogenetic protein-2 (rhBMP-2)-loaded cannulated pedicle screws. Recombinant human bone morphogenetic protein-2 is an osteoinductive cytokine. Four types of titanium pedicle screws were tested (uncannulated, cannulated with no loading, beta-tricalcium phosphate (TCP)-l...

  11. A new concept for implant fixation: bone-to-bone biologic fixation.

    Science.gov (United States)

    Kim, D-Y; Kim, J-R; Jang, K Y; Lee, K-B

    2015-01-01

    Many attempts have been made to reduce complications of bone implant, such as pedicle screw loosening. To address this problem, the authors suggest a new concept of bone-to-bone biologic fixation using recombinant human bone morphogenetic protein-2 (rhBMP-2)-loaded cannulated pedicle screws. Recombinant human bone morphogenetic protein-2 is an osteoinductive cytokine. Four types of titanium pedicle screws were tested (uncannulated, cannulated with no loading, beta-tricalcium phosphate (TCP)-loaded, and TCP/BMP2 loaded) using 16 miniature pigs. Radiological evaluation was conducted to assess the fusion and loosening of pedicle screws. Twelve weeks after implantation, peak torsional extraction torque was measured, and the pedicle screw and bone interface was evaluated by micro-computed tomography (µCT) and histologic examination. The mean value of the radiological score was significantly greater in the TCP/BMP2 loaded group at 12 weeks post-operation compared to those in the other groups. CT images showed distinct bone formation surrounding TCP/BMP2 loaded cannulated pedicle screws compared to the other groups. Mean extraction torsional peak torque at 12 weeks postoperative was more than 10-fold higher in the TCP/BMP2 loaded pedicle screw group than in the other groups. Bone surface and bone volume, as quantitated through µCT, were higher in the TCP/BMP2 loaded group. Histologic examination revealed bone-to-bone fixation at the interface of pedicle screws and pre-existing bone. Bone-to-bone biologic fixation through the holes of TCP/BMP2 loaded pedicle screws significantly increased fixation strength and represents a novel method that can be applied to osteoporotic or tumour spine surgeries. PMID:25978116

  12. A new concept for implant fixation: bone-to-bone biologic fixation

    Directory of Open Access Journals (Sweden)

    D-Y Kim

    2015-05-01

    Full Text Available Many attempts have been made to reduce complications of bone implant, such as pedicle screw loosening. To address this problem, the authors suggest a new concept of bone-to-bone biologic fixation using recombinant human bone morphogenetic protein-2 (rhBMP-2-loaded cannulated pedicle screws. Recombinant human bone morphogenetic protein-2 is an osteoinductive cytokine. Four types of titanium pedicle screws were tested (uncannulated, cannulated with no loading, beta-tricalcium phosphate (TCP-loaded, and TCP/BMP2 loaded using 16 miniature pigs. Radiological evaluation was conducted to assess the fusion and loosening of pedicle screws. Twelve weeks after implantation, peak torsional extraction torque was measured, and the pedicle screw and bone interface was evaluated by micro-computed tomography (µCT and histologic examination. The mean value of the radiological score was significantly greater in the TCP/BMP2 loaded group at 12 weeks post-operation compared to those in the other groups. CT images showed distinct bone formation surrounding TCP/BMP2 loaded cannulated pedicle screws compared to the other groups. Mean extraction torsional peak torque at 12 weeks postoperative was more than 10-fold higher in the TCP/BMP2 loaded pedicle screw group than in the other groups. Bone surface and bone volume, as quantitated through µCT, were higher in the TCP/BMP2 loaded group. Histologic examination revealed bone-to-bone fixation at the interface of pedicle screws and pre-existing bone. Bone-to-bone biologic fixation through the holes of TCP/BMP2 loaded pedicle screws significantly increased fixation strength and represents a novel method that can be applied to osteoporotic or tumour spine surgeries.

  13. 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

  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

    DEFF Research Database (Denmark)

    Babiker, Hassan

    2013-01-01

    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...

  18. A biomechanical comparison between cortical bone trajectory fixation and pedicle screw fixation

    OpenAIRE

    Oshino, Hiroki; Sakakibara, Toshihiko; Inaba, Tadashi; Yoshikawa, Takamasa; Kato, Takaya; Kasai, Yuichi

    2015-01-01

    Purpose There have been several reports on the pullout strength of cortical bone trajectory (CBT) screws, but only one study has reviewed the stability of functional spine units using the CBT method. The purpose of this study was to compare vertebral stability after CBT fixation with that after pedicle screw (PS) fixation. Methods In this study, 20 lumbar spine (L5–6) specimens were assigned to two groups: the CBT model group that underwent CBT screw fixation (n = 10) and the PS model group t...

  19. Study on the Algorithm of Multifunctional Bone External Fixator

    Directory of Open Access Journals (Sweden)

    Chen Jianwen

    2015-01-01

    Full Text Available This paper discussed the problem that parameters of bone external fixator are difficult to calculate in the practical application. Positive solution is described in detail. We used MATLAB software to make simulation experiment. The innovation lies the development idea of using inverse position to verify the accuracy of positive solution. Forward displacement analysis was mainly developed using analytical method, which has many advantages, such as small dependence to the inverse solution and the higher precision. With further software development, we will have the algorithms; research model and interface program connected and form high precision smart compliance multifunctional bone external fixator products, which will greatly enhance the overall level of bone external fixation technology and clinical application treatment.

  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. Bone compaction enhances implant fixation in a canine gap model

    DEFF Research Database (Denmark)

    Kold, Søren; Rahbek, Ole; Toft, Marianne;

    2005-01-01

    A new bone preparation technique, compaction, has increased fixation of implants inserted with exact-fit or press-fit to bone. Furthermore, a demonstrated spring-back effect of compacted bone might be of potential value in reducing the initial gaps that often exist between clinical inserted...... implants and bone. However, it is unknown whether the compression and breakage of trabeculae during the compaction procedure results in impaired gap-healing of compacted bone. Therefore, we compared compaction with conventional drilling in a canine gap model. Grit-blasted titanium implants (diameter 6 mm...... that the beneficial effect of reduced gap size, as compacted bone springs back, is not eliminated by an impaired gap-healing of compacted bone....

  2. Inadvertent Screw Stripping During Ankle Fracture Fixation in Elderly Bone

    OpenAIRE

    Dinah, A. Feroz; Mears, Simon C.; Knight, Trevor A.; Soin, Sandeep P.; Campbell, John T.; Belkoff, Stephen M.

    2011-01-01

    Poor screw purchase because of osteoporosis presents difficulties in ankle fracture fixation. The aim of our study was to determine if cortical thickness, unicortical versus bicortical purchase, and bone mineral density are predictors of inadvertent screw stripping and overtightening. Ten paired cadaver ankles (average donor age, 81.7 years; range, 50-97 years) were used for the study. Computed tomography scanning with phantoms of known density was used to determine the bone density along the...

  3. 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

  4. 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. PMID:25850983

  5. A new 3-dimensional head fixation device for brain imaging

    International Nuclear Information System (INIS)

    We have developed a new head fixation device for studies of brain function. This device was designed to immobilize subject's heads during image scanning and to precisely reproduce the head position for two different imaging modalities such as MRI and PET. The device consists of a plastic frame, a pillow filled with beads of styrene foam, and a face mask of thermoplastic resin which was originally intended for application in radiotherapy. A bridge for biting was incorporated into the mask for stable fixation. The device enables immobilization of subject's heads with good reproducibility of position at the practical level. Our results indicate that this head fixation system is useful for fixation of head during activation studies using PET. (author)

  6. Bone resorption around pedicle screws after pedicle screw plate fixation

    International Nuclear Information System (INIS)

    To determine the frequency, level, distribution, onset, and pattern of progression of bone resorption that occurring around pedicle screws after pedicle screw plate fixation. Bone resorption around 902 pedicle screws was analyzed in post-operative, and follow-up radiographs obtained from 156 patients who underwent pedicle screw plate fixation. To determine the resorption degree, categorized arbitrarily as grade 1 (less than 1 mm), grade 2 (1mm or more, but less than 2 mm), or grade 3 (2mm or more), the width of radiolucent zones was measured. In 39 patients in whom resorption was graded 1, 2 or 3, the pattern of progression of 78 screws was evaluated. Resorption occurred around 78 (8.6%) screws in 39 (25%) patients, 26 of whom had more than on lesion. For 99% of screws, there was evidance of resorption within 12 weeks of pedicle screw plate fixation. During follow-up, 61.5% of screws (48/78) remained stable, while 38.5% (30 screws) showed progression to higher grades. The possibility of progression to a higher grade is less when the initial grade is lower. An understanding of the radiographic patterns of bone resorption is useful for monitoring a patient after pedicle screw plate fixation

  7. 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

  8. A Paradigm for the Development and Evaluation of Novel Implant Topologies for Bone Fixation: In Vivo Evaluation

    OpenAIRE

    Long, Jason P.; Hollister, Scott J; Goldstein, Steven A.

    2012-01-01

    While contemporary prosthetic devices restore some function to individuals who have lost a limb, there are efforts to develop bio-integrated prostheses to improve functionality. A critical step in advancing this technology will be to securely attach the device to remnant bone. To investigate mechanisms for establishing robust implant fixation in bone while undergoing loading, we previously used a topology optimization scheme to develop optimized orthopaedic implants and then fabricated select...

  9. Study on the Algorithm of Multifunctional Bone External Fixator

    OpenAIRE

    Chen Jianwen; Shi Xuewei; Wei Mengting; Sun Hao

    2015-01-01

    This paper discussed the problem that parameters of bone external fixator are difficult to calculate in the practical application. Positive solution is described in detail. We used MATLAB software to make simulation experiment. The innovation lies the development idea of using inverse position to verify the accuracy of positive solution. Forward displacement analysis was mainly developed using analytical method, which has many advantages, such as small dependence to the inverse solution and t...

  10. Demineralized bone matrix and human cancellous bone enhance fixation of titanium implants

    DEFF Research Database (Denmark)

    Babiker, Hassan; Ding, Ming; Overgaard, Søren

    produced from human tissue were included (IsoTis OrthoBiologics, Inc. USA). Both materials are commercially available. Titanium alloy implants (Biomet Inc.) of 10 mm in length and 10 mm in diameter were inserted bilaterally into the femoral condyles of 8 skeletally mature sheep. Thus four implants with a......Best Poster 5Demineralized bone matrix and human cancellous bone enhance fixation of titanium implants AuthorsBabiker , H.; Ding M.; Overgaard S.InstitutionOrthopaedic Research Laboratory, Department of Orthopaedic Surgery, Odense University Hospital, Clinical Institute, University of Southern......- and autograf as they have the capability of inducing new bone and improving implant fixation through enhancing bone ingrowth. The purpose of this study was to investigate the effect of DBM alone or with CB on the fixation of porous-coated titanium implants.Material and MethodsDBM100 (pure DBM) and CB...

  11. 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.

  12. 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

  13. Mathematical simulation of the biomechanical system bone-fixator

    Science.gov (United States)

    Krasnoschekov, Viktor V.; Maslov, Leonid B.

    2001-02-01

    Problems of static and dynamic simulation of the biomechanical system consisting of the human tibia bone and external fixator apparatus as the simplest frame construction are considered. The finite element method implemented as the program code MechanicsFE3D_ESO on the basis of 20 nodal isoparametric elements is utilized. Both general stressed-deformed state of the construction under transversal loading and basic frequencies and forms of free oscillations of the system were defined by the numerical analysis. The results obtained can be used as the theoretical fundament to developing of static and vibration resonance methods for physiological state diagnostics of the regenerating osseous tissue in fracture zone.

  14. 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.

  15. Bone compaction enhances fixation of weightbearing titanium implants

    DEFF Research Database (Denmark)

    Kold, Søren Vedding; Rahbek, Ole; Vestermark, Marianne Toft; Overgaard, Søren; Søballe, Kjeld

    2005-01-01

    weightbearing, the effects of compaction on weightbearing implants were examined. The hypothesis was that compaction would increase implant fixation compared with conventional drilling. Porous-coated titanium implants were inserted bilaterally into the weightbearing portion of the femoral condyles of dogs. 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...... bone-implant contact and periimplant bone density at 0 and 2 weeks, but not at 4 weeks. A biphasic response of compaction was found with a pushout test, as compaction increased ultimate shear strength and energy absorption at 0 and 4 weeks, but not at 2 weeks. This biphasic response indicates that...

  16. 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.

  17. 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

  18. 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.

  19. Unilateral Pedicle Screw Fixation with Bone Graft vs. Bilateral Pedicle Screw Fixation with Bone Graft or Cage: A Comparative Study.

    Science.gov (United States)

    Yang, Si-Dong; Chen, Qian; Ding, Wen-Yuan; Zhao, Jian-Qiang; Zhang, Ying-Ze; Shen, Yong; Yang, Da-Long

    2016-01-01

    BACKGROUND The aim of this study was to explore the clinical efficacy of unilateral pedicle screw fixation with bone graft (UPSFB) in treating single-segment lumbar degenerative diseases (LDD), as compared to bilateral pedicle screw fixation with bone graft (BPSFB) or with cage (BPSFC). MATERIAL AND METHODS Medical records were retrospectively collected between 01/2010 and 02/2015 in Longyao County Hospital. According to surgical methods used, all patients were divided into 3 groups: UPSFB group, BPSFB group, and BPSFC group. Clinical outcomes were evaluated by blood loss, blood transfusion, duration of operation, hospital stay, postoperative complications, interbody fusion rate, reoperation rate, medical expenses, patient satisfaction survey, and JOA score. RESULTS Ninety-five patients were included and underwent 2.5-year follow-up, with 7 patients lost to regular follow-up. As compared to the BPSFB group and BPSFC group, the UPSFB group had less blood loss and less blood transfusion, as well as shorter hospital stay (pfusion rate, reoperation rate, JOA score, and patient satisfaction (all p>0.05). CONCLUSIONS As compared to BPSFB and BPSFC, UPSFB has the same reliability and effectiveness in treating single-segment LDD with unilateral radicular symptoms in a single lower extremity, with the additional advantage being less expensive. PMID:26988532

  20. Unilateral Pedicle Screw Fixation with Bone Graft vs. Bilateral Pedicle Screw Fixation with Bone Graft or Cage: A Comparative Study

    Science.gov (United States)

    Yang, Si-Dong; Chen, Qian; Ding, Wen-Yuan; Zhao, Jian-Qiang; Zhang, Ying-Ze; Shen, Yong; Yang, Da-Long

    2016-01-01

    Background The aim of this study was to explore the clinical efficacy of unilateral pedicle screw fixation with bone graft (UPSFB) in treating single-segment lumbar degenerative diseases (LDD), as compared to bilateral pedicle screw fixation with bone graft (BPSFB) or with cage (BPSFC). Material/Methods Medical records were retrospectively collected between 01/2010 and 02/2015 in Longyao County Hospital. According to surgical methods used, all patients were divided into 3 groups: UPSFB group, BPSFB group, and BPSFC group. Clinical outcomes were evaluated by blood loss, blood transfusion, duration of operation, hospital stay, postoperative complications, interbody fusion rate, reoperation rate, medical expenses, patient satisfaction survey, and JOA score. Results Ninety-five patients were included and underwent 2.5-year follow-up, with 7 patients lost to regular follow-up. As compared to the BPSFB group and BPSFC group, the UPSFB group had less blood loss and less blood transfusion, as well as shorter hospital stay (p0.05). Conclusions As compared to BPSFB and BPSFC, UPSFB has the same reliability and effectiveness in treating single-segment LDD with unilateral radicular symptoms in a single lower extremity, with the additional advantage being less expensive. PMID:26988532

  1. 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.

  2. 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

    marrow aspirate (BMA) on enhancement of bone implant fixation. Method: Titanium alloy implants were inserted into bilateral femoral condyles of eight skeletally mature sheep, four implants per sheep. The implant had a circumferential gap of 2 mm. The gap was filled with: HA/Collagen; HA......Replacement of extensive local bone loss especially in revision joint arthroplasty and spine fusion is a significant clinical challenge. Allograft and autograft have been considered as gold standards for bone replacement. However, there are several disadvantages such as donor site pain, bacterial...... 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...

  3. Improving Distal Fixation with Total Shoulder Arthroplasty in Cases of Severe Humeral Bone Loss.

    Science.gov (United States)

    Jacobson, Amanda; Stroud, Nick; Roche, Christopher P

    2015-12-01

    The usage of and indications for total shoulder arthroplasty have grown in recent years. Certain aspects of these arthro - plasty procedures can be very complex, especially in revi - sion and fracture cases, often leading to proximal humerus bone loss. For cases with significant bone loss, there is a need for improved devices with additional options to treat a wider range of deformities while also mitigating existing complications and rates, such as poor distal fixation, inad - equate soft tissue reattachment options, and joint instability. To that end, a fatigue and torsional test was conducted on two different devices to assess the ability of each to survive an extreme fatigue and torsional load when assembled in worst-case configurations. Evaluation of the Equinoxe ® humeral reconstruction prosthesis demonstrated superior fixation in both the fatigue loading scenario and also the torsional loading scenario as compared to the 8 mm x 215 mm cemented humeral long stem, where each had only 80 mm of cemented fixation. The results of the fatigue test demonstrated that despite the humeral reconstruction pros - thesis being subjected to a 960 N force and 45 Nm bending moment (which was significantly more challenging than the 576 N force and 24.2 Nm bending moment subjected to the cemented humeral long stem), the humeral reconstruction prosthesis completed 1 M cycles without fracture or failure. Additionally, the Equinoxe ® humeral reconstruction pros - thesis was associated with a significantly greater torsional resistance in both the torque to initial slip (29.4 Nm versus 8.2 Nm; p = 0.0002) and also the maximum torque to failure (44.3 Nm versus 12.1 Nm; p fer the potential for the Equinoxe ® humeral reconstruction prosthesis to be an improved treatment option for patients with proximal humeral bone loss, though clinical follow-up is necessary to confirm these positive biomechanical results. PMID:26631195

  4. 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

  5. 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

  6. The effect of bone marrow aspirate, bone graft and collagen composites on fixation of bone implants

    DEFF Research Database (Denmark)

    Babiker, Hassan; Ding, Ming; Overgaard, Søren

    2007-01-01

     Introduction: Replacement of extensive local bone loss especially in revision joint arthroplasties is a significant clinical challenge. Autogenous and allogenic cancellous bone grafts have been the gold standard in reconstructive orthopaedic surgery, but it is well known that there is morbidity...... associated with harvesting of autogenous bone graft and limitations in the quantity of bone available. Disadvantages of allograft include the risk of bacterial or viral contamination and non union as well as the potential risk of disease transmission. Alternative options are attractive and continue to be...... sought. Hydroxyapatite and collagen composites have the potential in mimicking and replacing skeletal bones. Aim: This study attempted to determine the effect of hydroxyapatite/collagen composites in the fixation of bone implants. The composites used in this study is produced by Institute of Science and...

  7. 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

  8. Titanium-alloy enhances bone-pedicle screw fixation: mechanical and histomorphometrical results of titanium-alloy versus stainless steel

    OpenAIRE

    Christensen, F.B.; Dalstra, M.; Sejling, F.; Overgaard, S.; Bünger, C.

    2000-01-01

    Several types of pedicle screw systems have been utilized to augment lumbar spine fusion. The majority of these systems are made of stainless steel (Ss), but titanium-alloy (Ti-alloy) devices have recently been available on the market. Ti-alloy implants have several potential advantages over Ss ones. High bioactivity and more flexibility may improve bone ingrowth and mechanical fixation, and the material also offers superior magnetic resonance imaging (MRI) and computed tomography (CT) resolu...

  9. 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.

  10. 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

  11. 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

    We used our established experimental model of revision joint replacement to examine the roles of hydroxyapatite coating and bone graft in improving the fixation of revision implants. The revision protocol uses the Søballe micromotion device in a preliminary 8-week period of implant instability 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...

  12. 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...

  13. Deformation measurement of the bone fixed with external fixator using holographic interferometry

    Science.gov (United States)

    Kojima, Arata; Ogawa, Ryokei; Izuchi, N.; Yamamoto, Manabu; Nishimoto, T.; Matsumoto, Toshiro

    1991-08-01

    Mechanical properties of tibia fixed with an external fixative device (external fixator) were investigated under some simulated loading conditions. Deformation measurements were performed using double exposure holographic interferometry and real-time holographic interferometry. According to the results of the holographic interferometry, strains on the fixation pins and rods were also measured using strain gauges. The results showed that, with most types of external fixator, dislocations of both fractured ends were mainly caused by decrease in strength of the fixation pins. With increase in strength of fixation pins, angular deformation of the rod was more obvious. Increase in the strength of the rod was not always effective in decreasing dislocation of both fractured ends. Changes in bracing technique with marked change in rigidity of external fixator were useful to decrease dislocation of both fractured ends.

  14. 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.

  15. 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

  16. Radiostrontium clearance and bone formation in response to simulated internal screw fixation

    International Nuclear Information System (INIS)

    Changes in radiostrontium clearance (SrC) and bone formation (tetracycline labeling) were observed in the femurs of skeletally mature dogs following the various operative steps involved in bone screw fixation. Drilling, but not periosteal stripping, produced a small but statistically significant increase in SrC and endosteal bone formation in the distal third of the bone. Strontium clearance values equivalent to those produced by drilling alone were recorded after screw fixation at low or high torque (5 versus 20 inch pounds), as well as by the insertion of loosely fitting stainless steel implants. Bone formation (equals the percentage tetracycline-labeled trabecular bone surfaces) was increased by 30% when SrC values exceeded 3.5 ml/100 g bone/min, and the relationship was linear when SrC values ranged between 1.0 and 7.0 ml/100 g bone/min. The changes in SrC and bone formation one-week after bone screw application are primarily those associated with a response to local trauma caused by drilling

  17. 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

  18. 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

  19. 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

      The effect of Hydroxyapatite/collagen I composites, bone marrow aspirate and bone graft on fixation of bone implants IN SHEEP   Ph.D. Student, Hassan Babiker; Associate Professor, Ph.D. Ming Ding; Professor, dr.med., Soren Overgaard. Department of Orthopaedic Surgery, Odense University Hospital......, Odense, Denmark   Background: Hydroxyapatite and collagen composites (HA/coll) have the potential in mimicking and replacing skeletal bones. This study attempted to determine the effect of newly developed HA/coll-composites with and without bone marrow aspirate (BMA) in order to enhance the fixation 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 as...

  20. FIBULA AND ILIAC BONE GRAFTING WITH INTERNAL FIXATION FOR GAINT CELL TUMOUR OF PROXIMAL TIBIA

    OpenAIRE

    Nishant Gaonkar; Takale; Kolekar; Vaibhav Koli; Jimit Shah

    2015-01-01

    Middle aged old female with swelling in left knee suggestive of giant cell tumour was treated with excisional biopsy with curettage, phenol cauterisation , bone graft and proximal tibia locking plate fixation. Sample sent for histopathology was consistent with diagnosis of giant cell tumour. No recurrence has been seen after 1 year of follow up.

  1. FIBULA AND ILIAC BONE GRAFTING WITH INTERNAL FIXATION FOR GAINT CELL TUMOUR OF PROXIMAL TIBIA

    Directory of Open Access Journals (Sweden)

    Nishant Gaonkar

    2015-02-01

    Full Text Available Middle aged old female with swelling in left knee suggestive of giant cell tumour was treated with excisional biopsy with curettage, phenol cauterisation , bone graft and proximal tibia locking plate fixation. Sample sent for histopathology was consistent with diagnosis of giant cell tumour. No recurrence has been seen after 1 year of follow up.

  2. Management of periarticular fractures of long bones of the lower extremity by hybrid external fixation

    Directory of Open Access Journals (Sweden)

    Natarajan Mayil

    2006-01-01

    Full Text Available Background : Management of periarticular fractures is associated with many complications. Hybrid fixators allows for early partial weight bearing and range of motion exercises at adjoining joints. Furthermore, it promotes callous formation by continuous axial micro movements in the fixation frame. Methods : We have prospectively analyzed the results of hybrid external fixation in the management of periarticular fractures of long bones of the lower extremity in 20 patients accounting for 22 limbs. We treated 19 fractures (18 compound and 1 closed and three fracture nonunions with this method. The mean age of the patients was 36.5 years. In 12 patients hybrid fixation was the primary procedure while in 8 patients hybrid fixation was done following initial emergency AO Uniplanar external fixation. Fourteen patients required subsequent surgeries such as bone grafting and soft tissue cover. Results : The mean follow up of our patients was 13.2 months (5 - 25 months. We achieved excellent results in 10 fractures, good in 4 fractures, fair in 3 fractures and poor results in 3 fractures. Two patients were lost to follow up. Bony union was achieved in 18 of the fractures. A short-term acceptable result was achieved in 17 cases. Conclusion : Hybrid external fixation is a very effective and useful treatment modality in the management of fractures close to a joint providing excellent to good results. It combines the advantages of both Ilizarov and AO external fixators. It is minimally invasive, modular and yet efficient in promoting massive new proliferative callus formation at the fracture site.

  3. 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.

  4. BIOMECHANICAL STUDY OF TRANSCORTICAL OR TRANSTRABECULAR BONE FIXATION OF PATELLAR TENDON GRAFT WITH BIOABSORBABLE PINS IN ACL RECONSTRUCTION IN SHEEP

    Science.gov (United States)

    Albano, Mauro Batista; Borges, Paulo César; Namba, Mario Massatomo; da Silva, João Luiz Vieira; de Assis Pereira Filho, Francisco; Filho, Edmar Stieven; Matias, Jorge Eduardo Fouto

    2015-01-01

    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 Rigid Fix method was used; this group was subdivided into two groups: ten knees the pins transfixed only the spongious area of the bone block, and ten for fixation passing through the layer of cortical bone. In the twenty remaining specimens, the graft was fixed with 9mm metal interference screws. Results: comparison of the RIGIDFIX® method with the metal interference screw fixation method did not show any statistically significant differences in terms of maximum load and rigidity; also, there were no statistically significant differences when the rotational position of the bone block was altered inside the femoral tunnel. For these evaluations, a level of significance of p < 0.017 was considered. Conclusion: fixation of the bone-tendon-bone graft with 2 bioabsorbable pines, regardless of the rotational position inside the femoral tunnel, gave a comparable fixation in terms of initial resistance to the metal interference screw, in this experimental model. PMID:27027081

  5. The short-term fixation of radiopharmaceuticals in bone

    International Nuclear Information System (INIS)

    The relationship between local blood flow and bone clearance of 18 F, 32 P-P (orthophosphate), 32 P-PPi (pyrophosphate), 45 Ca, 85 Sr, 99mTc- and 113 Sn-EHDP was evaluated in the non-adult rat. During one single blood passage nearly 100% of 18 F was extracted in the femoral diaphysis, the extraction efficiency for the other radiopharmaceuticals was about 40%. Blood flow and bone clearance was higher and the extraction efficiency lower in the distal femoral epiphysis including the growth plate. The short-term bone uptake of 32 P-P was lowered considerably by the simultaneous application of inactive orthophosphate, whereas the bone uptake of 32 P-PP, was not suppressed. It is suggested that the rapid deposition of radiopharmaceuticals in bone is not caused by an ionic exchange process on crystal surfaces of already existing mineral but is due to an ionic exchange during the precipitation of calcium phosphate in the calcifying bone matrix. Only 18 F is exchanged with hydroxyl groups of already precipitated hydroxyapatite, whereas the calcium and phosphate ions in the precipitated hydroxyapatite are not further accessible to an exchange process. (orig.) 891 MG/orig. 892 MBE

  6. 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

  7. Non-vascularized bone graft with herbert-type screw fixation for proximal pole scaphoid nonunion

    International Nuclear Information System (INIS)

    Since proximal pole fractures of the scaphoid are frequently overlooked, the poor vascularity in the proximal pole fragment often leads to nonunion. Vascularized bone grafts have been recently tested in cases with scaphoid proximal pole nonunion, but the indication for this treatment has not been well established. Alternatively, we have been treating such patients with a non-vascularized iliac bone graft and Herbert-type screw fixation with considerable success. The purpose of this investigation is to evaluate these cases retrospectively and clarify the surgical efficacy of our procedure. Between 1996 and 2009, 11 consecutive patients with proximal pole scaphoid nonunion were treated with a non-vascularized corticocancellous iliac bone graft and Herbert-type screw fixation. They were all male aged from 12 to 26 years. In two patients, avascular changes were recognized in the proximal pole in preoperative radiographs or MRI. Follow-up ranged from 12 to 76 months. Bone union was radiographically confirmed in all patients, who returned to their former activities without any complications. The period from operation to union ranged from 12 to 24 weeks. The mean Mayo modified wrist score was 76.4 points preoperatively and 91.4 points postoperatively, and was improved in all cases. A non-vascularized iliac bone graft with Herbert-type screw fixation obtained satisfactory clinical and radiographic results in cases with scaphoid proximal pole nonunion, regardless of the vascularity in the proximal fragment. (author)

  8. 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

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

    DEFF Research Database (Denmark)

    Kold, Søren; Rahbek, Ole; Vestermark, Marianne; Overgaard, Søren; Søballe, Kjeld

    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 and...... implant fixation after 4 weeks. The results of this study suggest that compaction may be beneficial in optimizing the crucial initial implant stability, even when hydroxyapatite-coated implants with osteoconductive properties are inserted in vivo....

  10. Suspensory Anterior Tibial Fixation in the Anatomic Transtibial Posterior Cruciate Ligament Reconstruction

    OpenAIRE

    Elazab, Ashraf; Lee, Yong Seuk; Kang, Seo Goo

    2016-01-01

    The transtibial technique is the most relevant among many surgical techniques for posterior cruciate ligament reconstruction, and many types of fixation devices are used for tibial fixation according to the technique and the length of the graft. However, bone density in the fixation areas should be taken into consideration when choosing the fixation device to achieve rigid and stable fixation. However, density is not a substantial issue for anteromedial cortical fixation using a cortical susp...

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

    Science.gov (United States)

    Babiker, Hassan; Ding, Ming; Overgaard, Søren

    2016-03-01

    Allogenic bone graft has been considered the gold standard in connection with bone graft material in revision joint arthroplasty. However, the lack of osteogenic potential and the risk of disease transmission are clinical challenges. The use of osteoinductive materials, such as demineralized bone matrix (DBM), alone or in combination with allograft or commercially available human cancellous bone (CB), may replace allografts, as they have the capability of inducing new bone and improving implant fixation through enhancing bone ongrowth. The purpose of this study was to investigate the effect 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 mm diameter, were inserted bilaterally into the femoral condyles of eight skeletally mature sheep. Thus, four implants with a concentric gap of 2 mm were implanted in each sheep. The gap was filled with: (a) DBM; (b) DBM:CB at a ratio of 1:3; (c) DBM:allograft at a ratio of 1:3; or (d) allograft (gold standard), respectively. A standardized surgical procedure was used. At sacrifice 6 weeks after implantation, both distal femurs were harvested. The implant fixation was evaluated by mechanical push-out testing to test shear mechanical properties between implant and the host bone and by histomorphometry. Non-parametric tests were applied; p strengths among the DBM/CB, DBM/allograft and allograft groups were not statistically different. The strength of the DBM group was 0.01 MPa, which was statistical significantly lower than the other three groups (p < 0.05). Histomorphometry results showed that the bone ongrowth in the DBM group was statistically significantly lower than the other three groups, while the volume fraction of new bone showed no significant difference among

  12. 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)

  13. 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

  14. 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

  15. [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

  16. 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.

  17. 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 ...

  18. 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.

  19. 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.

  20. On the accuracy of dose prediction near metal fixation devices for spine SBRT.

    Science.gov (United States)

    Cheng, Zhangkai J; Bromley, Regina M; Oborn, Brad; Carolan, Martin; Booth, Jeremy T

    2016-01-01

    The metallic fixations used in surgical procedures to support the spine mechani-cally usually consist of high-density materials. Radiation therapy to palliate spinal cord compression can include prophylactic inclusion of potential tumor around the site of such fixation devices. Determination of the correct density and shape of the spine fixation device has a direct effect on the dose calculation of the radiation field. Even with the application of modern computed tomography (CT), under- or overestimation of dose, both immediately next to the device and in the surround-ing tissues, can occur due to inaccuracies in the dose prediction algorithm. In this study, two commercially available dose prediction algorithms (Eclipse AAA and ACUROS), EGSnrc Monte Carlo, and GAFchromic film measurements were com-pared for a clinical spine SBRT case to determine their accuracy. An open six-field plan and a clinical nine-field IMRT plan were applied to a phantom containing a metal spine fixation device. Dose difference and gamma analysis were performed in and around the tumor region adjacent to the fixation device. Dose calculation inconsistency was observed in the open field plan. However, in the IMRT plan, the dose perturbation effect was not observed beyond 5 mm. Our results suggest that the dose effect of the metal fixation device to the spinal cord and the tumor volume is not observable, and all dose calculation algorithms evaluated can provide clinically acceptable accuracy in the case of spinal SBRT, with the tolerance of 95% for gamma criteria of 3%/3 mm. PMID:27167252

  1. 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

  2. Application of external fixation devices for fractures of the femur in modern practice

    Directory of Open Access Journals (Sweden)

    Ямщиков О.Н.

    2014-12-01

    Full Text Available Diaphyseal fractures of the femur are rather common. In the treatment of fractures of the femur various methods of osteosynthesis can be used: intramedullary, of plate, transosseus. In our country external fixation using external fixation devices has traditionally been popular. Objective. The analysis of the frequency of use of transosseous osteosynthesis in the treatment of fractures of the femur and the identification of the most common indications for the use of the method in the present practice. Materials and Methods. The analysis of the structure of external fixation in fractures of the femur, on the experience of treatment of 126 patients with diaphyseal fractures of the femur. Results. The results of the study revealed that the structure of the osteosynthesis of fractures of the femur transosseous osteosynthesis with the use of external fixation devices is not considered to be common and is used as an alternative method of treatment. Conclusion. The treatment of fractures of the femur using transosseous osteosynthesis is currently used mostly for open, comminuted fractures and revision osteosynthesis, as well as a high risk of infectious complications in the zone of fracture, due to complexity of the method, the lowest strength of fixation and a relatively high percentage of non-specific complications.

  3. 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

    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...... 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...

  4. 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

  5. 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

  6. 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。

  7. 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.

  8. 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...

  9. 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

  10. 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.

  11. 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

  12. Bioabsorbable pins for bone fixation in the less invasive innominate osteotomy.

    Science.gov (United States)

    Dawson, Peter H; O'Briain, David E; Connolly, Paul J; McCormack, Damien

    2014-09-01

    For the less invasive innominate osteotomy for the treatment of developmental dysplasia of the hip, we aim to report radiological outcomes, complication rates and reoperation rates for patients whose bone grafts were secured using bioabsorbable pins. A retrospective study of all patients who underwent less invasive innominate osteotomy for persistent or delayed diagnosis developmental dysplasia of the hip over a period of 2 years from 2008 to 2010 was carried out. A total of 59 hips were identified as having had their bone graft secured with two bioabsorbable pins made from copolymers of L-lactic acid, D-lactic acid and trimethylene carbonate. The average angular correction of the acetabular index in the bioabsorbable group at late follow-up was 16.48° (P<0.0001). Seven percent of patients from the bioabsorbable pin group went on to require reoperation for persistent dysplasia. No patient required reoperation due to implant failure. There was no incidence of postoperative wound infection or other complication requiring medical or surgical intervention. These results demonstrate that the use of bioabsorbable pins to secure the bone graft is as effective and safe as metal fixation. PMID:24911940

  13. 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.

  14. Bone Anchor Fixation in Abdominal Wall Reconstruction: A Useful Adjunct in Suprapubic and Para-iliac Hernia Repair.

    Science.gov (United States)

    Blair, Laurel J; Cox, Tiffany C; Huntington, Ciara R; Ross, Samuel W; Kneisl, Jeffrey S; Augenstein, Vedra A; Heniford, B Todd

    2015-07-01

    Suprapubic hernias, parailiac or flank hernias, and lumbar hernias are difficult to repair and are associated with high-recurrence rates owing to difficulty in obtaining substantive overlap and especially mesh fixation due to bone being a margin of the hernia. Orthopedic suture anchors used for ligament reconstruction have been used to attach prosthetic material to bony surfaces and can be used in the repair of these hernias where suture fixation was impossible. A prospective, single institution study of ventral hernia repairs involving bone anchor mesh fixation was performed. Demographics, operative details, and outcomes data were collected. Twenty patients were identified, with a mean age 53 (range: 35-70 years) and mean body mass index 28.4 kg/m(2) (range 21-38). Ten lumbar, seven suprapubic, and three parailiac hernias were studied. The majority were recurrent hernias (n = 13), with one to seven previously failed repairs. The mean hernia defect size was very large (270 cm(2); range: 56-832 cm(2)) with average mesh size of 1090 cm(2) (range 224-3640 cm(2)). Both Mitek GII (Depuy, Raynham, MA) and JuggerKnot 2.9-mm (Biomet, Biomedical Instruments, Warsaw, IN) anchors were used, with an average of four anchors/case (range: 1-16). Mean operative time was 218 minutes (120-495). There were three minor complications, no operative mortality, and no recurrences during an average follow-up of 24 months. Pelvic bone anchors permit mesh fixation in high-recurrence areas not amenable to traditional suture fixation. The ability to safely and effectively use bone anchor fixation is an essential tool in complex open ventral hernia repair. PMID:26140889

  15. 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.

  16. Implantable Subcutaneous Venous Access Devices: Is Port Fixation Necessary? A Review of 534 Cases

    International Nuclear Information System (INIS)

    Conventional surgical technique of subcutaneous venous port placement describes dissection of the port pocket to the pectoralis fascia and suture fixation of the port to the fascia to prevent inversion of the device within the pocket. This investigation addresses the necessity of that step. Between October 8, 2004 and October 19, 2007, 558 subcutaneous chest ports were placed at our institution; 24 cases were excluded from this study. We performed a retrospective review of the remaining 534 ports, which were placed using standard surgical technique with the exception that none were sutured into the pocket. Mean duration of port use, total number of port days, indications for removal, and complications were recorded and compared with the literature. Mean duration of port use was 341 days (182,235 total port days, range 1-1279). One port inversion/flip occurred, which resulted in malfunction and necessitated port revision (0.2%). Other complications necessitating port removal included infection 26 (5%), thrombosis n = 2 (<1%), catheter fracture/pinch n = 1 (<1%), pain n = 2 (<1%), and skin erosion n = 3 (1%). There were two arrhythmias at the time of placement; neither required port removal. The overall complication rate was 7%. The 0.2% incidence of port inversion we report is concordant with that previously published, although many previous reports do not specify if suture fixation of the port was performed. Suture fixation of the port, in our experience, is not routinely necessary and may negatively impact port removal.

  17. Pedicle screw fixation combined with intervertebral bone grafting for the treatment of thoracolumbar fracture: a report of 24 cases

    Directory of Open Access Journals (Sweden)

    Chuan-lin DU

    2014-01-01

    Full Text Available Objective To explore the clinical effect of pedicle screw fixation combined with intervertebral bone grafting for the treatment of thoracolumbar fractures. Methods The clinical data of 24 cases of unstable and/or bursting thoracolumbar fractures treated with pedicle screw fixation and intervertebral bone grafting from July 2007 to July 2010 were analyzed retrospectively. The 24 patients (18 males and 6 females were aged from 24 to 61 years (mean 31.5 years, in whom 8 with fracture of T12, 9 of L1, 5 of L2, and 2 of L3 vertebral fracture. According to Denis classification, in 8 patients it was compression fracture, and in 16 patients it was burst fracture. According to American Spinal Injury Association (ASIA criteria, 2 patients were classified as grade C, 2 as grade D and 20 as grade E. All of the 24 patients received pedicle screw fixation combined with intervertebral bone grafting to reduce and fix the thoracolumbar fractures using pedicle screw-rod system, and 4 of them received posterior decompression. Results Twenty-two patients were followed-up from 12 to 24 months (mean 18 months. No obvious loss of vertebral height or posterior protuberance was found. There was no evidence of screw loosening or breakage, neither overdistraction of intervertebral space among 22 patients. The Cobb angle was corrected from 15-44 degrees (32.3±7.6 degrees, preoperatively to 0-9.6 degrees (6.6±2.4 degrees as observed at the time of last follow-up. Conclusion Pedicle screw fixation combined with intervertebral bone grafting could reconstruct the mechanical structure of anterior and middle spinal columns, obtain effective intervertebral height and bone union, and long-term spine stability. DOI: 10.11855/j.issn.0577-7402.2013.12.11

  18. 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

  19. 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

  20. 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

  1. 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.

  2. Employment of the adhesive buthyl-2-cyanoacrylate in the fixation of bone fragments in femural fractures in dogs. Radiologic study

    International Nuclear Information System (INIS)

    The butyl-2-cyanoacrylate adhesive was utilized in the fixation of bone fragments in femoral fractures in 30 clinically healthy dogs of both sexes. All animals were anesthetized with sodium pentobarbital and the left femur exposed and fractured at the middle third of the bone. A triangular bone fragment, approximately of 2.0 cm in length was taken off from the proximal fragment of the femur. The fracture was immediately reduced and immobilized using an intramedular Steinman pin. The bone fragment was then reintroduced in the same position and glued on with the adhesive butyl-2-cyanoacrylate, applied in droplets at a distance of 8 mm approximately. Healing was assessed through radiographs at 10 day intervals, when it was observed, in all animals, the bone fragment in place right after the surgical procedure. At the end of the experiment 6.67% of animals showed the bone fragment shifted from the focus of fracture. In 30% of the animals the fracture did not consolidate

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

    Directory of Open Access Journals (Sweden)

    1.\tSjoerd P.F.T. Nota

    2014-10-01

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

  4. 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

  5. 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

  6. 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

    Allogenic bone graft has been considered the gold standard in connection with bone graft material in revision joint arthroplasty. However, the lack of osteogenic potential and the risk of disease transmission are clinical challenges. The use of osteoinductive materials, such as demineralized bone...

  7. The factors affecting outcome after non-vascular bone grafting and internal fixation for nonunion of the scaphoid.

    Science.gov (United States)

    Ramamurthy, C; Cutler, L; Nuttall, D; Simison, A J M; Trail, I A; Stanley, J K

    2007-05-01

    This study identified variables which influence the outcome of surgical management on 126 ununited scaphoid fractures managed by internal fixation and non-vascular bone grafting. The site of fracture was defined by a new method: the ratio of the length of the proximal fragment to the sum of the lengths of both fragments, calculated using specific views in the plain radiographs. Bone healing occurred in 71% (89) of cases. Only the site of nonunion (p = 1 x 10(-6)) and the delay to surgery (p = 0.001) remained significant on multivariate analysis. The effect of surgical delay on the probability of union increased as the fracture site moved proximally. A prediction model was produced by stepwise logistic regression analysis, enabling the surgeon to predict the success of surgery where the site of the nonunion and delay to surgery is known. PMID:17540748

  8. Fixation filter, device for the rapid in situ preservation of particulate samples

    Science.gov (United States)

    Taylor, C. D.; Edgcomb, V. P.; Doherty, K. W.; Engstrom, I.; Shanahan, T.; Pachiadaki, M. G.; Molyneaux, S. J.; Honjo, S.

    2015-02-01

    Niskin bottle rosettes have for years been the workhorse technology for collection of water samples used in biological and chemical oceanography. Studies of marine microbiology and biogeochemical cycling that aim to analyze labile organic molecules including messenger RNA, must take into account factors associated with sampling methodology that obscure an accurate picture of in situ activities/processes. With Niskin sampling, the large and often variable times between sample collection and preservation on deck of a ship, and the sometimes significant physico-chemical changes (e.g., changes in pressure, light, temperature, redox state, etc.) that water samples and organisms are exposed to, are likely to introduce artifacts. These concerns are likely more significant when working with phototrophs, deep-sea microbes, and/or organisms inhabiting low-oxygen or anoxic environments. We report here the development of a new technology for the in situ collection and chemical preservation of particulate microbial samples for a variety of downstream analyses depending on preservative choice by the user. The Fixation Filter Unit, version 3 (FF3) permits filtration of water sample through 47 mm diameter filters of the user's choice and upon completion of filtration, chemically preserves the retained sample within 10's of seconds. The stand-alone devices can be adapted to hydrocasting or mooring-based platforms.

  9. A comparative study on the in vivo degradation of poly(L-lactide) based composite implants for bone fracture fixation

    Science.gov (United States)

    Wang, Zongliang; Wang, Yu; Ito, Yoshihiro; Zhang, Peibiao; Chen, Xuesi

    2016-02-01

    Composite of nano-hydroxyapatite (n-HAP) surface grafted with poly(L-lactide) (PLLA) (g-HAP) showed improved interface compatibility and mechanical property for bone fracture fixation. In this paper, in vivo degradation of n-HAP/PLLA and g-HAP/PLLA composite implants was investigated. The mechanical properties, molecular weight, thermal properties as well as crystallinity of the implants were measured. The bending strength of the n- and g-HAP/PLLA composites showed a marked reduction from an initial value of 102 and 114 MPa to 33 and 24 MPa at 36 weeks, respectively. While the bending strength of PLLA was maintained at 80 MPa at 36 weeks compared with initial value of 107 MPa. The impact strength increased over time especially for the composites. Significant differences in the molecular weight were seen among all the materials and g-HAP/PLLA appeared the fastest rate of decrease than others. Environmental scanning electron microscope (ESEM) results demonstrated that an apparently porous morphology full of pores and hollows were formed in the composites. The results indicated that the in vivo degradation of PLLA could be accelerated by the g-HAP nanoparticles. It implied that g-HAP/PLLA composites might be a candidate for human non-load bearing bone fracture fixation which needs high initial strength and fast degradation rate.

  10. One lesson from arthroplasty to osseointegration in search for better fixation of in-bone implanted prosthesis

    OpenAIRE

    Pitkin, Mark

    2008-01-01

    Direct transcutaneous prosthetic attachment (osseointegration) consists of implanting directly into the residuum bone a metal pylon whose external fraction connects the residuum to the external prosthesis. Since the introduction of osseointegration about 20 years ago, the obvious challenge associated with this technology has been the skin-pylon interface as a source of infections. In comparison, the bone-device interface was considered less problematic because of the knowledge and experience ...

  11. 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

  12. 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

  13. 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.

  14. 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 ...

  15. 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.

  16. 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 ...

  17. Changes in the computed tomography (pixel) value of mandibular ramus bone and fixation screws after sagittal split ramus osteotomy.

    Science.gov (United States)

    Ueki, K; Moroi, A; Iguchi, R; Kosaka, A; Ikawa, H; Yoshizawa, K

    2015-11-01

    The purpose of this retrospective study was to evaluate the changes in computed tomography (CT) values of ramus bone and screws after sagittal split ramus osteotomy (SSRO) setback surgery. The subjects were 64 patients (128 sides) who underwent bilateral SSRO setback surgery. They were divided into six groups according to the fixation plate type used and the use or not of self-setting α-tricalcium phosphate (Biopex): group 1: titanium plate and screws; group 2: titanium plate and screws with Biopex; group 3: poly-l-lactic acid (PLLA) plate and screws; group 4: PLLA plate and screws with Biopex; group 5: uncalcined and unsintered hydroxyapatite particles and poly-l-lactic acid (uHA/PLLA) plate and screws; group 6: PLLA/uHA plate and screws with Biopex. CT values (pixel values) of the lateral cortex, medial cortex, osteotomy site, and screws were measured preoperatively, immediately after surgery, and 1 year postoperatively using horizontal CT images at the mandibular foramen taken parallel to the Frankfort horizontal plane. There were significant differences in the time-course change of pixel values for the lateral cortex (Pmaterial may affect bone quality during the process of bone healing after SSRO. PMID:26139563

  18. Radiological Evaluation of the Initial Fixation between Cortical Bone Trajectory and Conventional Pedicle Screw Technique for Lumbar Degenerative Spondylolisthesis

    Science.gov (United States)

    Iwatsuki, Koichi; Ohnishi, Yu-Ichiro; Yoshimine, Toshiki

    2016-01-01

    Study Design Retrospective study. Purpose To compare initial fixation using the cortical bone trajectory (CBT) technique versus conventional pedicle screws (PS) in radiographs of postsurgical lumbar degenerative spondylolisthesis. Overview of Literature Few reports have documented the holding strength of CBT technique for spondylolisthesis cases. Methods From October 2009 to June 2014, 21 cases of degenerative spondylolisthesis were surgically treated in our institution. Ten were treated with conventional PS technique and 11 of with CBT technique. Mean lumbar lordosis and percent slippage were evaluated preoperatively, immediately after surgery, and 6 months and 1 year postoperatively using radiographs. We also investigated percent loss of slip reduction. Results There were statistically significant differences between preoperative percent slippage and postoperative slippage in both PS and CBT procedures over 1 year, and both techniques showed good slip reduction. On the other hand, lumbar lordosis did not change significantly in either the PS or CBT groups over 1 year. Conclusions CBT technique showed similarly good initial fixation compared with the PS procedure in the treatment of lumbar degenerative spondylolisthesis. PMID:27114765

  19. 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.

  20. 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

  1. Impact of Different Screw Designs on Durability of Fracture Fixation: In Vitro Study with Cyclic Loading of Scaphoid Bones

    Science.gov (United States)

    Gruszka, Dominik; Herr, Robert; Hely, Hans; Hofmann, Peer; Klitscher, Daniela; Hofmann, Alexander; Rommens, Pol Maria

    2016-01-01

    Purpose The use of new headless compression screws (HCSs) for scaphoid fixation is growing, but the nonunion rate has remained constant. The aim of this study was to compare the stability of fixation resulting from four modern HCSs using a simulated fracture model to determine the optimal screw design(s). Methods We tested 40 fresh-frozen cadaver scaphoids treated with the Acumed Acutrak 2 mini (AA), the KLS Martin HBS2 midi (MH), the Stryker TwinFix (ST) and the Synthes HCS 3.0 with a long thread (SH). The bones with simulated fractures and implanted screws were loaded uniaxially into flexion for 2000 cycles with a constant bending moment of 800 Nmm. The angulation of the fracture fragments was measured continuously. Data were assessed statistically using the univariate ANOVA test and linear regression analysis, and the significance level was set at p < 0.05. Results The median angulation of bone fragments φ allowed by each screw was 0.89° for AA, 1.12° for ST, 1.44° for SH and 2.36° for MH. With regards to linear regression, the most reliable curve was achieved by MH, with a coefficient of determination of R2 = 0.827. This was followed by AA (R2 = 0.354), SH (R2 = 0.247) and ST (R2 = 0.019). Data assessed using an adapted ANOVA model showed no statistically significant difference (p = 0.291) between the screws. Conclusions The continuous development of HCSs has resulted in very comparable implants, and thus, at this time, other factors, such as surgeons’ experience, ease of handling and price, should be taken into consideration. PMID:26741807

  2. Impact of Different Screw Designs on Durability of Fracture Fixation: In Vitro Study with Cyclic Loading of Scaphoid Bones.

    Directory of Open Access Journals (Sweden)

    Dominik Gruszka

    Full Text Available The use of new headless compression screws (HCSs for scaphoid fixation is growing, but the nonunion rate has remained constant. The aim of this study was to compare the stability of fixation resulting from four modern HCSs using a simulated fracture model to determine the optimal screw design(s.We tested 40 fresh-frozen cadaver scaphoids treated with the Acumed Acutrak 2 mini (AA, the KLS Martin HBS2 midi (MH, the Stryker TwinFix (ST and the Synthes HCS 3.0 with a long thread (SH. The bones with simulated fractures and implanted screws were loaded uniaxially into flexion for 2000 cycles with a constant bending moment of 800 Nmm. The angulation of the fracture fragments was measured continuously. Data were assessed statistically using the univariate ANOVA test and linear regression analysis, and the significance level was set at p < 0.05.The median angulation of bone fragments φ allowed by each screw was 0.89° for AA, 1.12° for ST, 1.44° for SH and 2.36° for MH. With regards to linear regression, the most reliable curve was achieved by MH, with a coefficient of determination of R2 = 0.827. This was followed by AA (R2 = 0.354, SH (R2 = 0.247 and ST (R2 = 0.019. Data assessed using an adapted ANOVA model showed no statistically significant difference (p = 0.291 between the screws.The continuous development of HCSs has resulted in very comparable implants, and thus, at this time, other factors, such as surgeons' experience, ease of handling and price, should be taken into consideration.

  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. 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....

  5. 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...

  6. Analysis of elements in the soft tissue covering titanium plates and screws for internal bone fixation by the PIXE method

    International Nuclear Information System (INIS)

    We made a comparative study of the elements in the periosteum on titanium plates and screws for internal bone fixation, normal periosteum, and oral mucosa by the PIXE method. We studied 11 patients, 4 men and 7 women, with mandibular fracture or facial deformity. The implanted time length of the materials in the body was 5 to 16 months. The analyzed samples were 11 periostea on the materials, 11 normal periostea and 4 oral mucosae. The results were as follows. Twenty- four essential and 11 contaminated elements were detected in the periostea on the materials as well as in the normal periostea and the oral mucosae. In the mean values of titanium and aluminum, there were significantly higher values in the periostea on the materials than in the normal periostea. The mean concentration values of the other elements did not differ significantly between that in the periostea on the materials and that in the normal periostea. The concentration of titanium in the periostea on the materials was not correlated with sex, age of the patients, or the implanted time length. However, there was a significantly higher titanium concentration value in tile periostea on the plates than on the screws. Our results could indicate that the existence of a titanium element in the periostea on the materials was caused by its dissolution from the materials. (author)

  7. 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.

  8. 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

  9. Comparative study of safety and efficacy of electrocautery blade with cold scalpel blade for skin opening during fixation of fracture of forearm bone with plate and screws

    Directory of Open Access Journals (Sweden)

    K T Madhukar

    2012-01-01

    Full Text Available Introduction: The art of performing surgeries have improved in recent years with the development of various electrosurgical devices assisting surgeons in performing safer surgeries with better outcomes. Skin incision has traditionally been made with a standard scalpel blade with good primary healing end results of the wound. The electrocautery has been used safely in performing deeper dissections. Use of electrocautery in skin incision has been discouraged in the past for the fear of cutaneous scarring, wound dehiscence, and infections particularly in orthopedic surgeries using internal implants. A review of the literature shows not many studies have been conducted to evaluate the safety and efficacy of electrocautery in skin incisions during orthopedic surgeries using internal implants. Aim: A prospective study was conducted in a tertiary care hospital with the aim to determine whether an electrocautery blade can be used safely for skin incisions. Materials and Methods: Sixty-two patients with single-bone fracture of the forearm undergoing open reduction and internal fixation received one-half of the incision with a standard scalpel blade and another half with electrocautery in pure cutting mode randomly. Analysis: Wounds were compared on operating day for any physical changes and on days 3, 5, and 12, and again on 3 rd and 6 weeks follow-up to know any difference in skin healing between the incised wounds of the two halves. Results: No evidence of any difference in healing of the two halves of skin incision was noted. There was also no increased risk of wound scarring, dehiscence, or infection with electrocautery incision when compared with standard scalpel incision. The time taken for skin incision with electrocautery was significantly less when compared with cold scalpel incision. Conclusion: We propose that electrocautery can be safely used for performing skin incision, with comparable results to that of a standard scalpel skin incision.

  10. 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.

  11. 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.

  12. Biomechanical analysis of lumbosacral fixation.

    Science.gov (United States)

    McCord, D H; Cunningham, B W; Shono, Y; Myers, J J; McAfee, P C

    1992-08-01

    Flexion testing was performed until failure on 66 lumbosacral bovine spinal segments comparing ten different lumbosacral instrumentation techniques. Maximum flexion moment at failure, flexural stiffness, and maximum angulation of the lumbosacral joint at failure were determined as well as strain measurements across the anterior aspect of the lumbosacral intervertebral disc using an extensometer. The maximum moment at failure was significantly greater for the only two devices that extended fixation into the ilium anterior to the projected image of the middle osteoligamentous column: ISOLA Galveston and ISOLA iliac screws (F = 12.2, P less than 0.001). The maximum stiffness at failure reinforced these findings (F = 23.7, P less than 0.001). A second subset of stability showed the advantages of S2 pedicle fixation by increasing the flexural lever arm (Cotrel-Dubousset butterfly plate, and Cotrel-Dubousset Chopin block, P less than 0.05). This exhaustive in vitro biomechanical study introduces the concept of a pivot point at the lumbosacral joint at the intersection of the middle osteoligamentous column (sagittal plane) and the lumbosacral intervertebral disc (transverse plane). A spinal surgeon can increase the stability of lumbosacral instrumentation by extending fixation through the anterior sacral cortex (Steffee plate group with pedicle screws that medially converge in a triangular fashion). A means of enhancing this fixation was to achieve more inferior purchase by extending the fixation down to the S2 pedicle (Cotrel-Dubousset Chopin and Cotrel-Dubousset butterfly groups). However, the best fixation was achieved by obtaining purchase between the iliac cortices down into the superior acetabular bone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1523506

  13. 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.

  14. 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.

  15. Percutaneous reduction and fixation of an intra-articular calcaneal fracture using an inflatable bone tamp: description of a novel and safe technique

    Directory of Open Access Journals (Sweden)

    Mauffrey Cyril

    2012-03-01

    Full Text Available Abstract Calcaneal fractures are common injuries involving the hind foot and often a source of significant long-term morbidity. Treatment options have changed throughout the ages from periods of preferred nonoperative management to closed reduction with a mallet, and more recently, open reduction and anatomic internal fixation. The current treatment of choice; however, is often debated, as open management of these fractures carries many risks to include wound breakdown and infection. A less invasive form of surgical management through small incisions, while maintaining the ability to obtain joint congruency, anatomic alignment, and restore calcaneal height and width would be ideal. We propose a novel form of fracture reduction using an inflatable bone tamp and percutaneous fracture fixation. Preoperative planning and experienced fluoroscopy is crucial to successful management using this method. Although we achieved successful radiographic outcome in this case, long-term functional outcome of this technique are yet to be published.

  16. 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

  17. 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.

  18. Preparation and Characterization of an Advanced Medical Device for Bone Regeneration

    OpenAIRE

    Dorati, Rossella; Colonna, Claudia; Genta, Ida; Bruni, Giovanna; Visai, Livia; Conti, Bice

    2013-01-01

    Tridimensional scaffolds can promote bone regeneration as a framework supporting the migration of cells from the surrounding tissue into the damaged tissue and as delivery systems for the controlled or prolonged release of cells, genes, and growth factors. The goal of the work was to obtain an advanced medical device for bone regeneration through coating a decellularized and deproteinized bone matrix of bovine origin with a biodegradable, biocompatible polymer, to improve the cell engraftment...

  19. Degradation and biological properties of Ca-P contained micro-arc oxidation self-sealing coating on pure magnesium for bone fixation

    OpenAIRE

    Wang, Weidan; Wan, Peng; Liu, Chen; Tan, Lili; Li, Weirong; Li, Lugee; Yang, Ke

    2014-01-01

    Poor corrosion resistance is one of the main disadvantages for biodegradable magnesium-based metals, especially applied for bone fixation, where there is a high demand of bio-mechanical strength and stability. Surface coating has been proved as an effective method to control the in vivo degradation. In this study a Ca-P self-sealing micro-arc oxidation (MAO) coating was studied to verify its efficacy and biological properties by in vitro and in vivo tests. It was found that the MAO coating co...

  20. 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

  1. 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

  2. A comparison of the rates of union after cancellous iliac crest bone graft and Kirschner-wire fixation in the treatment of stable and unstable scaphoid nonunion.

    Science.gov (United States)

    Park, H Y; Yoon, J O; Jeon, I H; Chung, H W; Kim, J S

    2013-06-01

    This study was performed to determine whether pure cancellous bone graft and Kirschner (K-) wire fixation were sufficient to achieve bony union and restore alignment in scaphoid nonunion. A total of 65 patients who underwent cancellous bone graft and K-wire fixation were included in this study. The series included 61 men and four women with a mean age of 34 years (15 to 72) and mean delay to surgery of 28.7 months (3 to 240). The patients were divided into an unstable group (A) and stable group (B) depending on the pre-operative radiographs. Unstable nonunion was defined as a lateral intrascaphoid angle > 45°, or a radiolunate angle > 10°. There were 34 cases in group A and 31 cases in group B. Bony union was achieved in 30 patients (88.2%) in group A, and in 26 (83.9%) in group B (p = 0.439). Comparison of the post-operative radiographs between the two groups showed no significant differences in lateral intrascaphoid angle (p = 0.657) and scaphoid length (p = 0.670) and height (p = 0.193). The radiolunate angle was significantly different (p = 0.020) but the mean value in both groups was scaphoid nonunion. PMID:23723277

  3. 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

  4. 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

  5. Load bearing capacity of bone anchored fiber-reinforced composite device.

    Science.gov (United States)

    Ballo, Ahmed Mansour; Lassila, Lippo V; Vallittu, Pekka K; Närhi, Timo O

    2007-10-01

    The purpose of this study was to evaluate the push-out load-bearing capacity of threaded fiber-reinforced composite (FRC) devices for use as bone-anchored devices. The purpose was also to evaluate the possibility to use bioactive glass (BAG) granules on the experimental FRC devices in terms the mechanical behavior. Three experimental FRC devices (n = 15) were fabricated for the study: (a) threaded device with smooth surface; (b) threaded device with BAG granules (S53P4, Vivoxid Ltd, Turku, Finland) and supplementary retention grooves, and (c) unthreaded device with BAG granules. Threaded titanium devices were used as controls. The FRC devices were prepared from a light-polymerized dimethacrylate resin reinforced with preimpregnated unidirectional and bidirectional E-glass fibers (EverStick, StickTech Ltd, Turku, Finland). Experimental and control devices were embedded into dental plaster to simulate bone before the mechanical push-out test was carried out. ANOVA and Weibull analysis were used for the statistical evaluation. Threaded FRC devices had significantly higher push-out strength than the threaded titanium device (p < .001). The push-out forces exceeding 2,500 N were measured for threaded FRC devices with supplementary grooves and BAG coating. No thread failures were observed in any FRC devices. The unthreaded FRC devices with BAG lost 70% of glass particles during the test, while no BAG particles were lost from threaded FRC devices. It can be concluded that threaded FRC devices can withstand high push-out forces in the dental plaster without a risk of thread failure under physiological load. PMID:17558473

  6. The new concept of the monitoring and appraisal of bone union inflexibility of fractures treated by Dynastab DK external fixator.

    Science.gov (United States)

    Lenz, Gerhard P; Stasiak, Andrzej; Deszczyński, Jarosław; Karpiński, Janusz; Stolarczyk, Artur; Ziółkowski, Marcin; Szczesny, Grzegorz

    2003-10-30

    Background. This work focuses on problems of heuristic techniques based on artificial intelligence. Mainly about artificial non-linear and multilayer neurons, which were used to estimate the bone union fractures treatment process using orthopaedic stabilizers Dynastab DK. Material and methods. The author utilizes computer software based on multilayer neuronal network systems, which allows to predict the curve of the bone union at early stages of therapy. The training of the neural net has been made on fifty six cases of bone fracture which has been cured by the Dynastab stabilizers DK. Using such trained net, seventeen fractures of long bones shafts were being examined on strength and prediction of the bone union as well. Results. Analyzing results, it should be underlined that mechanical properties of the bone union in the slot of fracture are changing in nonlinear way in function of time. Especially, major changes were observed during the forth month of the fracture treatment. There is strong correlation between measure number two and measure number six. Measure number two is more strict and in the matter of fact it refers to flexion, as well as the measure number six, to compression of the bone in the fracture slot. Conclusions. Consequently, deflection loads are especially hazardous for healing bone. The very strong correlation between real curves and predicted curves shows the correctness of the neuronal model. PMID:17679847

  7. 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

  8. 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.)

  9. 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...

  10. 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.

  11. External fixation for the treatment of open fractures of the proximal humerus caused by firearms

    Directory of Open Access Journals (Sweden)

    Mirić Dragan

    2004-01-01

    Full Text Available Nine patients with open fractures of the proximal humerus were treated using an external fixation device. All of them had grade III open fractures resulting from high-velocity missile and explosive injuries with massive foreign body contamination. Radial nerve injury was present in five and two multiply injuried patients with thoracic wall and abdominal viscera were present. There were no major arterial injuries. Chronic osteitis with fistula and sequestra developed in one. There were no nonunions and no refractures. Minor painless limitation of shoulder and elbow motion presented in all patient. Upper-third humeral open fractures due to firearms are a unique type of open fractures. They are usually highly comminuted therefore, stable fixation is difficult or impossible to achieve. On the other hand, the risk of infection is high following plate fixation. External fixation allows adequate management of the soft tissue wounds, provides stable bone fixation and allows early mobilization of the shoulder and elbow.

  12. 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

  13. 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...

  14. Bone healing and mineralization, implant corrosion, and trace metals after nickel-titanium shape memory metal intramedullary fixation.

    Science.gov (United States)

    Ryhänen, J; Kallioinen, M; Serlo, W; Perämäki, P; Junila, J; Sandvik, P; Niemelä, E; Tuukkanen, J

    1999-12-15

    Its shape memory effect, superelasticity, and good wear and damping properties make the NiTi shape memory alloy a material with fascinating potential for orthopedic surgery. It provides a possibility for making self-locking, self-expanding, and self-compressing implants. Problems, however, may arise because of its high nickel content. The purpose of this work was to determine the corrosion of NiTi in vivo and to evaluate the possible deleterious effects of NiTi on osteotomy healing, bone mineralization, and the remodeling response. Femoral osteotomies of 40 rats were fixed with either NiTi or stainless steel (StSt) intramedullary nails. The rats were killed at 2, 4, 8, 12, 26, and 60 weeks. Bone healing was examined with radiographs, peripheral quantitative computed tomography, (pQCT) and histologically. The corrosion of the retrieved implants was analyzed by electron microscopy (FESEM). Trace metals from several organs were determined by graphite furnace atomic absorption spectrometry (GF-AAS) or by inductively coupled plasma-atomic emission spectrometry (ICP-AES). There were more healed bone unions in the NiTi than in the StSt group at early (4 and 8 weeks) time points. Callus size was equal between the groups. The total and cortical bone mineral densities did not differ between the NiTi and StSt groups. Mineral density in both groups was lower in the osteotomy area than in the other areas along the nail. Density in the nail area was lower than in the proximal part of the operated femur or the contralateral femur. Bone contact to NiTi was close. A peri-implant lamellar bone sheet formed in the metaphyseal area after 8 weeks, indicating good tissue tolerance. The FESEM assessment showed surface corrosion changes to be more evident in the StSt implants. There were no statistically significant differences in nickel concentration between the NiTi and StSt groups in any of the organs. NiTi appears to be an appropriate material for further intramedullary use because it

  15. 21 CFR 872.4880 - Intraosseous fixation screw or wire.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Intraosseous fixation screw or wire. 872.4880... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4880 Intraosseous fixation screw or wire. (a) Identification. An intraosseous fixation screw or wire is a metal device intended to be...

  16. 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...

  17. 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

    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......Osteoporosis is a common disorder characterised mainly by low bone mineral density (BMD), and leading to an increased risk of fracture. We have developed a new device that estimates BMD from ordinary hand radiographs. A crucial element of this method is the reconstruction of the metacarpals. This...

  18. Measurement of cancellous bone strain during mechanical tests using a new extensometer device.

    Science.gov (United States)

    Boyd, S; Shrive, N; Wohl, G; Müller, R; Zernicke, R

    2001-07-01

    A device for measuring mid-substance strain in bone during uniaxial compression was developed with special attention to subsequent FE modelling. It is based on dual instrumented cantilever arms that measure the difference in tip-to-tip deflection. The so-called extensometer device was compared to two standard methods of measuring strain based on platen measurements. The extensometer device output was highly linear with tip deflection (r(2)>0.99), and contact of the devices with the specimen was optimized by using an axial distribution of three devices fixed in a free-floating jig. Deflection of the extensometer arms was accurate to 4.8 microm, and precision was between 2-5 microm. Tests included measuring rubber test specimens and cylindrical cancellous bone cores extracted from canine femoral condyles. A trend of decreasing apparent modulus with decreasing strain rate was evident with the extensometer technique. Correlation between the extensometer method and the other two methods was r(2)=0.55. The measure of mid-substance strain avoids non-linearities in the compression tests caused by early failure at the specimen ends, and the uniaxial testing conditions result in boundary conditions that are well suited for subsequent finite element analysis. PMID:11551817

  19. 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

  20. 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

  1. 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

  2. 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.

  3. Acetabular reconstruction with human and bovine freeze-dried bone grafts and a reinforcement device

    Directory of Open Access Journals (Sweden)

    Ricardo Rosito

    2008-01-01

    Full Text Available BACKGROUND: This is a cohort trial (1997-2005 of 49 patients submitted to an acetabular component revision of a total hip arthroplasty, using impacted human and bovine freeze-dried cancellous bone grafts (H&FDBG and a reinforcement device. OBJECTIVE: To compare clinical/radiographic graft incorporation capability between cancellous bone grafts. PATIENTS/METHODS: There were two groups: I (n=26 receiving human grafts and II (n=25 receiving bovine grafts. The average follow-up times were 55 and 49 months, respectively. Clinical analysis was based on the Merle d'Aubigné and Postel score, and the radiographic analysis involved an established score based on Conn's et al. criteria for radiographic bone incorporation. RESULTS: No clinical/radiographic differences were found between the groups and both showed an overall rate of 88.5% and 76% of graft incorporation (p=0.424. CONCLUSION: The results presented here are comparable to those in the literature with the use of deep-FG. Therefore, cancellous bone grafts can be safely and adequately used in acetabular component revision in total hip arthroplasty.

  4. Acetabular Reconstruction with Human and Bovine Freeze- Dried Bone Grafts and a Reinforcement Device

    Science.gov (United States)

    Rosito, Ricardo; Galia, Carlos Roberto; Macedo, Carlos Alberto Souza; Moreira, Luis Fernando; Quaresma, Lourdes Maria Araújo C.; Palma, Humberto Moreira

    2008-01-01

    BACKGROUND This is a cohort trial (1997–2005) of 49 patients submitted to an acetabular component revision of a total hip arthroplasty, using impacted human and bovine freeze-dried cancellous bone grafts (H&FDBG) and a reinforcement device. OBJECTIVE To compare clinical/radiographic graft incorporation capability between cancellous bone grafts. PATIENTS/METHODS There were two groups: I (n=26) receiving human grafts and II (n=25) receiving bovine grafts. The average follow-up times were 55 and 49 months, respectively. Clinical analysis was based on the Merle d’Aubigné and Postel score, and the radiographic analysis involved an established score based on Conn’s et al. criteria for radiographic bone incorporation. RESULTS No clinical/radiographic differences were found between the groups and both showed an overall rate of 88.5% and 76% of graft incorporation (p=0.424). CONCLUSION The results presented here are comparable to those in the literature with the use of deep-FG. Therefore, cancellous bone grafts can be safely and adequately used in acetabular component revision in total hip arthroplasty. PMID:18719763

  5. 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

  6. 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.

  7. 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。

  8. 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.

  9. Arthroscopic Treatment of Acute Tibial Avulsion Fracture of the Posterior Cruciate Ligament Using the TightRope Fixation Device

    OpenAIRE

    Gwinner, Clemens; Kopf, Sebastian; Hoburg, Arnd; Haas, Norbert P; Jung, Tobias M.

    2014-01-01

    Avulsion fracture of the posterior cruciate ligament from its tibial insertion is a rare condition. Early surgical treatment has been regarded as necessary, but the optimal surgical technique remains unclear. The purpose of this technical note is to present a novel all-inside arthroscopic reconstruction technique for bony tibial avulsion fractures of the posterior cruciate ligament using the TightRope device (Arthrex, Naples, FL).

  10. Fixação de fraturas ilíacas em cães com parafusos, fios de aço e cimento ósseo de polimetilmetacrilato Canine iliac fracture fixation with screws, orthopedic wire and polymethylmethacrylate bone cement

    Directory of Open Access Journals (Sweden)

    Claudio Roehsig

    2008-09-01

    years and weighted between 1.8 and 16.0kg. Two dogs had bilaterally fractures stabilized, totalizing 18 ilium osteosynthesis performed. The ilium was achieved via lateral approach. The fractures were reduced and on each bone segment was inserted two to three screws connected by a band tension. Over them a mixture of bone cement added with cefalozin was applied as a definitive fixation device. Suture of soft tissues was made as usual. Postoperative evaluations were periodically performed. After 3 months, 15 dogs showed proper use of the operated limb. Radiographic signs of complete bone healing were observed between 60 and 90 days. Stabilization failure occurred in two cases and one of them required another surgery. Both cases showed a good outcome. Based on these results it was possible to conclude that in dogs weighting up to 16.0kg, iliac fracture fixation with screws, orthopedic wires and bone cement is an efficient technique promoting early limb use and complete bone healing as a result of adequate bone stabilization.

  11. 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.

  12. Plastibell Device Circumcision versus Bone Cutter Technique in terms of Operative Outcomes and Parent’s Satisfaction

    Science.gov (United States)

    Mehmood, Tahir; Azam, Hammad; Tariq, Muhammad; Iqbal, Zafar; Mehmood, Hassan; Shah, Syed Asif Hussain

    2016-01-01

    Objective: To compare the rate of complications of Plastibell and bone cutter circumcision technique and recognition of top worries and satisfaction rate in the mind of parents before and after the procedure of Plastibell device (PD) circumcision in infants less than 6 months of age. Methods: It was a descriptive prospective study conducted at department of surgery Sheikh Zayed Hospital, Rahim Yar Khan. Two hundred parents of infants of less than six months of age were recruited for this study. Infants were divided into two equal groups. Group I included Plastibell circumcision technique and Group II included Bone Cutter Circumcision technique. Data was analyzed using SPSS Version 17. Independent sample t-test and chi-square test was used to compare quantitative and qualitative variables respectively. P-value <0.05 was taken as significant difference. Results: Total number of two hundred infants were included in this study. Most common worries of parents about Plastibell Device circumcision were; fear of fever (42.0%). Fear of pain and bleeding (66.0%). Plastibell Device method was associated with less operation time and bleeding as compared to bone cutter method (P-value <0.0001 and <0.0001 respectively). Incidence of complications other than bleeding and infection was 3.0% in bone cutter method and 1.0% in Plastibell device method. Pain score was significantly less in plastibell device group (p-value <0.0001). Post-operatively, 98% parents showed complete procedural satisfaction in Plastibell group versus 87% parents in bone cutter one month after surgery (P-value 0.003). About 4% parents in bone cutter method group showed cosmetic displeasure versus only 1% parents in plastibell device group. Conclusion: The study concluded that Plastibell Device circumcision is a safer technique for circumcision and is associated with highest level of parent’s satisfaction. PMID:27182237

  13. Strain-stress analysis of lower limb with applied fixator

    Directory of Open Access Journals (Sweden)

    Mrázek M.

    2010-07-01

    Full Text Available This paper compares physiological state of tibia before and after application of an external fixator. The fixator systems’ models but also model of tibia are loaded in the direction of body axis. The paper is focused on the examination of differences in stiffness before and after the application of fixation. Two types of axial external fixators are compared. Both fixators differ in their construction. The first fixator is two-frame and fixation rods are used for fixing the bone tissue (variant I. The second one is fixed into tibia with screws (variant II. We have found out that the two-frame external fixator has much bigger stiffness during limb fixation than the fixator with one body. Much higher deformations compared to physiological state of tibia occur in the variant II.

  14. 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

  15. 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.

  16. 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,

  17. 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

  18. 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

  19. 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.

  20. 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

  1. 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

  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. 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.

  4. Integration of Rabbit Adipose Derived Mesenchymal Stem Cells to Hydroxyapatite Burr Hole Button Device for Bone Interface Regeneration

    Science.gov (United States)

    Gayathri, Viswanathan; Harikrishnan, Varma; Mohanan, Parayanthala Valappil

    2016-01-01

    Adipose Derived Mesenchymal Stem Cells, multipotent stem cells isolated from adipose tissue, present close resemblance to the natural in vivo milieu and microenvironment of bone tissue and hence widely used for in bone tissue engineering applications. The present study evaluates the compatibility of tissue engineered hydroxyapatite burr hole button device (HAP-BHB) seeded with Rabbit Adipose Derived Mesenchymal Stem Cells (ADMSCs). Cytotoxicity, oxidative stress response, apoptotic behavior, attachment, and adherence of adipose MSC seeded on the device were evaluated by scanning electron and confocal microscopy. The results of the MTT (3-(4,5-dimethylthiazol)-2,5-diphenyl tetrazolium bromide) assay indicated that powdered device material was noncytotoxic up to 0.5 g/mL on cultured cells. It was also observed that oxidative stress related reactive oxygen species production and apoptosis on cell seeded device were similar to those of control (cells alone) except in 3-day period which showed increased reactive oxygen species generation. Further scanning electron and confocal microscopy indicated a uniform attachment of cells and viability up to 200 μm deep inside the device, respectively. Based on the results, it can be concluded that the in-house developed HAP-BHB device seeded with ADMSCs is nontoxic/safe compatible device for biomedical application and an attractive tissue engineered device for calvarial defect regeneration. PMID:26880922

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

    Rheumatoid arthritis (RA) is characterized by periarticular and generalized loss of bone mass. Quantitative ultrasound (QUS) has been introduced as a method for the assessment of bone status and fracture risk. In this cross-sectional study bone status was assessed by QUS at different peripheral...

  10. 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.

  11. 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

  12. 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

  13. Comparative outcomes of active and passive hearing devices by transcutaneous bone conduction.

    Science.gov (United States)

    Zernotti, Mario Emilio; Di Gregorio, Maria Fernanda; Galeazzi, Pablo; Tabernero, Paola

    2016-06-01

    Conclusion Bonebridge (BB) and Sophono (SP) devices improved hearing; with the BB implant showing a better performance at medium and high frequencies. Furthermore, the BB, as an active implant, showed higher functional gain and increased time of use, when compared to the SP, a passive system. Objectives This study aims to compare surgical and audiological outcomes of SP and BB devices in order to assess and further differentiate the indication criteria. Methods Fourteen patients with conductive and mixed hearing loss were evaluated pre- and post-operatively (BB or SP) (period 2013-2014). Age, gender, surgical history, cause and type of hearing loss, implant use per day, levels of bone and air conduction, and functional gain were recorded. Data was analysed by Wilcoxon singed-rank and Wilcoxon rank-sum tests. Results Fourteen patients (BB; n = 10 and SP; n = 4) with an average age = 25.42 years (CI95 = 12.41-38.43) were evaluated. The gender relation was equal (1:1), with pre-implantation osseous thresholds of 20.42 dB (CI95 = 11.15-29.69), and pre-implantation aerial thresholds of 70.83 dB (CI95 = 62.52-79.14). The SP wearing time was significantly lower than that of the BB (SP = 7-10 h/day, BB = 8-12 h/day; p = 0.0323). The functional gain did not differ significantly between the two devices (BB = 40.00 ± 13.19 dB, SP = 34.06 ± 15.63 dB; p = 0.3434), but a significant improvement from pre- to post-implantation was observed (p < 0.05). BB and SP decreased auditory thresholds at 1 and 2 kHz (< 0.01), respectively. The BB even significantly decreased thresholds at 0.5 kHz (p = 0.0140) and 4 kHz (p < 0.0001). No relevant surgical complications were found. PMID:26981711

  14. 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.

  15. 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.

  16. 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.

  17. 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...

  18. MANAGEMENT OF INFECTED NON UNION TIBIAL FRACTURES WITH ILIZAROV EXTERNAL FIXATION

    Directory of Open Access Journals (Sweden)

    Nageshwara Rao

    2015-10-01

    Full Text Available BACKGROUND & OBJECTIVES: Infected non - union of tibia per se is a challenge to treat. Subcutaneous bone causes susceptibility to compartment syndrome, non - responsive infection, non - union, fibrosis, sinuses, deformities, shortening and various other sets of problems which are assoc iated with it. Ilizarov External fixation provides correction of all the complications associated with non - union, bone gap, infection, shortening, and deformities. Objective of this study is to assess the efficacy and safety of Ilizarov fixator method of t reatment in infected non - union tibia and to study various complications associated with Ilizarov external fixation. MATERIALS AND METHODS: 23 patients admitted and treated in Government General Hospital under the Department of Orthopaedics during the perio d of May 2010 to December 2012 were included in the study. Results were evaluated according to ASAMI criteria . 1 RESULTS : 59% patients had excellent bony results, 27.3% had good bony results, 9.1% had fair bony results, 4.6% had poor bony results. 68.1% had excellent functional results, 9.1% had good functional results, 9.1% had fair functional results, 13.7% had poor functional results. CONCLUSION : Ilizarov external fixator system is the best device and best solution for infected non - union tibia management.

  19. 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.

  20. 21 CFR 888.3045 - Resorbable calcium salt bone void filler device.

    Science.gov (United States)

    2010-04-01

    ... SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3045 Resorbable calcium... are caused by trauma or surgery and are not intrinsic to the stability of the bony structure....

  1. 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

  2. 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.

  3. 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

  4. 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.

  5. 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

  6. 21 CFR 878.3250 - External facial fracture fixation appliance.

    Science.gov (United States)

    2010-04-01

    ... SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3250... maxillofacial bone fragments in their proper facial relationship. (b) Classification. Class I (general...

  7. 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...

  8. 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

  9. 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 ...

  10. Ureteral injury after posterior lumbar discectomy with interbody screw fixation

    OpenAIRE

    Pillai, Sunil Bhaskara; Hegde, Padmaraj; Venkatesh, Giridhar; Iyyan, Bhalaguru

    2013-01-01

    We report a case of iatrogenic ureteral injury secondary to L5 laminectomy and microdiscectomy with L5–S1 bone graft with posterior lumbar interbodyfusion using presacral cancellous screw fixation, managed by initial ureteral stent placement and subsequent Boari bladder flap repair. A 33-year-old woman underwent L5 laminectomy and microdiscectomy with L5–S1 bone graft with posterior lumbar interbody fusion using presacral cancellous screw fixation. On postoperative day 10, she developed lower...

  11. 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.

  12. 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)

  13. 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

  14. 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

  15. Complicaciones de los tornillos de bloqueo intermaxilar en el tratamiento de las fracturas mandibulares Complications of self-tapping bone screws for maxillomandibular fixation in the treatment of jaw fracture

    Directory of Open Access Journals (Sweden)

    J. Molina Montes

    2008-08-01

    Full Text Available Durante la última década se ha introducido el tornillo de bloqueo intermaxilar como método de fijación maxilomandibular en el tratamiento de las fracturas de mandíbula. El propósito del estudio es evaluar las complicaciones de la técnica y la yatrogenia dental que derivan de su aplicación durante un periodo de 4 años. Se han revisado un total de 62 pacientes y 272 tornillos y, aunque han aparecido complicaciones, su incidencia es baja.In the last decade, self-tapping bone screws have been used widely as a temporary maxillomandibular fixation method in the treatment of jaw fractures. The purpose of the present study was to evaluate the complications of the technique and potential dental iatrogenesis over a period of 4 years. We reviewed a total of 62 patients and 272 screws. Although complications appeared, the complication rate was low.

  16. 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

  17. 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

  18. Experimental and Numerical Modeling of Screws Used for Rigid Internal Fixation of Mandibular Fractures

    OpenAIRE

    Naresh Chaudhary; Lovald, Scott T.; Jon Wagner; Tariq Khraishi; Bret Baack

    2008-01-01

    Experimental and numerical methods are used to explore the stresses generated around bone screws used in rigid internal fixation of mandibular fractures. These results are intended to aid in decisions concerning both the design and the use of these bone screws. A finite element (FE) model of a human mandible is created with a fixated fracture in the parasymphyseal region. The mandibular model is anatomically loaded, and the forces exerted by the fixation plate onto the simplified screws are o...

  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. 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

  1. 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

  2. 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

  3. 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.

  4. 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

  5. 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.

  6. 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。

  7. Surgical management of proximal splint bone fractures in the horse

    International Nuclear Information System (INIS)

    Fractures of Metacarpal and Metatarsal II and IV (the splint bones) were treated in 283 horses over an 11 year period. In 21 cases the proximal portion of the fractured bone was stabilized with metallic implants. One or more cortical bone screws were used in 11 horses, and bone plates were applied in 11 horses. One horse received both treatments. Complications of screw fixation included bone failure, implant failure, radiographic lucency around the screws, and proliferative new bone at the ostectomy site. Only two of the horses treated with screw fixation returned to their intended use. Complications of plate fixation included partial fixation failure (backing out of screws), wound drainage, and proliferative bony response around the plate. Six of the 11 horses treated by plate fixation returned to their intended use. The authors recommend consideration of plate fixation techniques for repair of fractures in the proximal third of the splint bone

  8. 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.

  9. Stability Testing of a Wide Bone-Anchored Device after Surgery without Skin Thinning

    Directory of Open Access Journals (Sweden)

    Malou Hultcrantz

    2015-01-01

    Full Text Available Objective. To longitudinally follow the osseointegration using Resonance Frequency Analysis (RFA for different lengths of abutment on a new wide bone-anchored implant, introduced with the non-skin thinning surgical technique. Study Design. A single-center, prospective 1 year study following adults with bone-anchored hearing implants. Materials and Methods. Implantation was performed and followed for a minimum of 1 year. All patients were operated on according to the tissue preserving technique. A 4.5 mm wide fixture (Oticon Medical with varying abutments (9 to 12 mm was used and RFA was tested 1 week, 7 weeks, 6 months, and 12 months later. Implant Stability Quotient (ISQ, was measured from 1 to 100. Stability was compared to a group of patients (N=7 implanted with another brand (Cochlear BI400 of 4.5 mm fixtures. Results. All 10 adults concluded the study. None of the participants lost their implant during the test period indicating a good anchoring of abutments to the wide fixture tested. Stability testing was shown to vary depending on abutment length and time after surgery and with higher values for shorter abutments and increasing values over the first period of time. One patient changed the abutment from 12 to 9 mm and another from a 9 to a 12 during the year. No severe skin problems, numbness around the implant, or cosmetic problems arose. Conclusion. After 1 year of follow-up, combination of a wide fixture implant and the non-skin thinning surgical technique indicates a safe procedure with good stability and no abutment losses.

  10. 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

  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. Comparison of Routine Fixation of Tissues with Rapid Tissue Fixation

    OpenAIRE

    Tripathi, Meenakshi; Bansal, Rani; Gupta, Mamta; Bharat, Vinay

    2013-01-01

    Introduction: Conventional formalin-fixed, paraffin-embedded tissue provides superior cellular morphology and long-term storage. Problems with formalin fixation comprise delay of fixation and variations in the duration of fixation. Microwave assisted tissue fixation removes the use of noxious and potentially toxic formalin that decreases the turnaround time and creates a personnel friendly workflow.

  13. Hexapod External Fixation of Tibia Fractures in Children.

    Science.gov (United States)

    Iobst, Christopher A

    2016-06-01

    Most tibia fractures in children can be treated nonoperatively. For fractures that do require surgery, however, the most common methods of management include plating or flexible nail insertion. Some fracture patterns, such as periphyseal fractures, fractures with bone and/or soft tissue loss, or fractures with delayed presentation, are not easily amenable to these techniques. Hexapod external fixators are especially helpful in these difficult cases. The purpose of this review is to discuss the principles of performing hexapod circular external fixation applied to pediatric tibia fractures. Some of the additional capabilities of the hexapod external fixator will also be highlighted. PMID:27078228

  14. 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.

  15. Multiple Looping Technique for Tibial Fixation in Posterior Cruciate Ligament Reconstruction of the Knee

    OpenAIRE

    Noh, Jung Ho; Yoon, Kyoung Ho; Song, Sang Jun; Roh, Young Hak; Lee, Jae Woo

    2015-01-01

    The outcomes of posterior cruciate ligament reconstruction may be negatively affected by insufficient tibial tunnel fixation due to relatively lower bone density of the proximal tibia. We introduce a new technique of tibial fixation for posterior cruciate ligament reconstruction using free tendon Achilles allograft that is less affected by the bone density of the tibial metaphysis.

  16. Outcomes of Ilizarov ring fixation in recalcitrant infected tibial non-unions – a prospective study

    OpenAIRE

    Shah Harshad M; Manjunath KS; Ramesh Balasundaram; Madhusudhan Thayur R; Sundaresh Dabir C; Krishnappa N

    2008-01-01

    Abstract Background Infected non-union of long bones is a problem in the developing countries. Persistent infection, deformity, shortening, bone loss, joint stiffness and disability complicate the non-union. Secondary procedures are often required for correction of bone defects and deformity. Ilizarov method addresses all the above problems simultaneously and offers a panacea for infected non-unions. The stability of the fixation and provision for bone transport allows bridging of bone defect...

  17. 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...

  18. 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

  19. 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.

  20. 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

  1. 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.

  2. 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

  3. [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

  4. Desenvolvimento e desempenho de um fixador flexível na consolidação de fraturas diafisárias transversais provocadas iatrogênicamente na tíbia de carneiros Development and performance of a flexible fixator on bone healing of transverse diaphyseal fracture caused iatrogenically in the sheep tibiae

    Directory of Open Access Journals (Sweden)

    Giuliano Barbieri

    2011-06-01

    Full Text Available Foi realizado um estudo experimental sobre o desenvolvimento e desempenho de um fixador externo flexível no processo de consolidação de tíbias de carneiros submetidas à osteotomia transversa mediodiafisária. Foram empregados no estudo 20 carneiros da raça Santa Inês, com massa corporal média de 37kg, divididos em diferentes grupos conforme o período de observação pós-operatória, de 30, 45, 60 e 90 dias. Ao final, os animais sofreram a eutanásia e as tíbias foram removidas para estudo de volumetria transversal do calo ósseo por tomografia computadorizada e ensaio mecânico destrutivo. Os resultados mostraram que ocorreu a formação de calo ósseo volumoso, caracterizando assim a ocorrência de deslocamento de carga axial para o foco da osteotomia, promovida pelo fixador externo utilizado. No ensaio mecânico, observou-se que as comparações entre os grupos respectivos intactos e operados foram significantemente diferentes (PAn experimental study was carried out to verify the development and performance of a flexible external fixator on the bone healing process of the tibia of sheep submitted to a transverse diaphyseal osteotomy. It was used twenty Santa Inês sheep with average weigh of 37kg divided in groups, according to the period of postoperative observation of 30, 45, 60 and 90 days. At the end, the animals were sacrificed and the tibiae were removed for study of transverse callus volumetric by computed tomography and destructive mechanical testing. The results had shown that the formation of voluminous callus occurred, thus characterizing the occurrence of displacement of axial load to the focus of the osteotomy, promoted by the used external fixator used. The mechanical testing showed that the comparisons between the respective intact and operated groups were significantly different (P<0.05 except for the group with 90 days, which demonstrated equivalent stiffness when compared to normal bone. In none of the animals

  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. 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

  7. 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

  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. 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。

  10. 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

  11. Rigid internal fixation of zygoma fractures: A comparison of two-point and three-point fixation

    Directory of Open Access Journals (Sweden)

    Parashar Atul

    2007-01-01

    Full Text Available Background: Displaced fractures of the zygomatic bone can result in significant functional and aesthetic sequelae. Therefore the treatment must achieve adequate and stable reduction at fracture sites so as to restore the complex multidimensional relationship of the zygoma to the surrounding craniofacial skeleton. Many experimental biophysical studies have compared stability of zygoma after one, two and three-point fixation with mini plates. We conducted a prospective clinical study comparing functional and aesthetic results of two-point and three-point fixation with mini plates in patients with fractures of zygoma. Materials and Methods: Twenty-two patients with isolated zygomatic fractures over a period of one year were randomly assigned into two-point and three-point fixation groups. Results of fixation were analyzed after completion of three months. This included clinical, radiological and photographic evaluation. Results: The three-point fixation group maintained better stability at fracture sites resulting in decreased incidence of dystopia and enophthalmos. This group also had better malar projection and malar height as measured radiologically, when compared with the two-point fixation group. Conclusion: We recommend three-point rigid fixation of fractured zygoma after accurate reduction so as to maintain adequate stabilization against masticatory forces during fracture healing phase.

  12. Radionuclides fixation by hydroxyapatite

    International Nuclear Information System (INIS)

    Some characteristic results on strontium fixation by coprecipitation and sorption with hydroxyapatite are presented. Coprecipitation experiments performed at wide range of experimental conditions have confirmed that strontium incorporated into hydroxyapatite by isomorphous substitution of calcium. Adsorption on the surface of well crystallized hydroxyapatite follows Langmuir's adsorption isotherm with monolayer capacity of 1.5 10-4 mol/g. (author)

  13. 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.

  14. Fracture fixation with two locking screws versus three non-locking screws

    OpenAIRE

    Grawe, B.; Le Van, T.; Williamson, S.; Archdeacon, A.; Zardiackas, L

    2012-01-01

    Objectives We aimed to further evaluate the biomechanical characteristics of two locking screws versus three standard bicortical screws in synthetic models of normal and osteoporotic bone. Methods Synthetic tubular bone models representing normal bone density and osteoporotic bone density were used. Artificial fracture gaps of 1 cm were created in each specimen before fixation with one of two constructs: 1) two locking screws using a five-hole locking compression plate (LCP) plate; or 2) thre...

  15. Primary stability of inferior tilt fixation of the glenoid component in reverse total shoulder arthroplasty: A finite element study.

    Science.gov (United States)

    Chae, Soo-Won; Lee, Haea; Kim, Soo Min; Lee, Juneyoung; Han, Seung-Ho; Kim, Soung-Yon

    2016-06-01

    Glenoid component fixation with inferior tilt has been suggested as one of the surgical methods to decrease scapular notching and improve stability, but its clinically beneficial effect remains a concern. We evaluated the influence of inferior tilt fixation of the glenoid component on primary stability in reverse total shoulder arthroplasty by finite element analysis. Finite element models were constructed from cadaveric scapulae of females over the age of 60 years and glenoid components from reverse total shoulder arthroplasty. The relative micromotion at the bone-glenoid component interface, distribution of bone stress under the glenoid component and around the screws, contact area between the bone and screws, and cut surface area of the cancellous bone exposed after glenoid reaming were analyzed and compared between a neutral and 10° inferior tilt fixation of the glenoid component. The 10° inferior tilt fixation demonstrated greater relative micromotion and higher bone stress than the neutral tilt fixation. Eccentric reaming, which is done to produce the inferior tilt fixation of the glenoid component, increased glenoid cancellous bone exposure and decreased bone-screws contact area. Inferior tilt fixation of the glenoid component may adversely affect primary stability and longevity after reverse total shoulder arthroplasty. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1061-1068, 2016. PMID:26621211

  16. Bone mineral density measurement over the shoulder region

    DEFF Research Database (Denmark)

    Doetsch, A M; Faber, J; Lynnerup, N; Wätjen, I; Bliddal, H; Danneskiold-Samsøe, B

    2002-01-01

    The purpose of this study was to (1). establish a method for measuring bone mineral density (BMD) over the shoulder region; (2). compare the relationship between shoulder BMD levels with hip BMD and body mass index (BMI); and (3). discuss the relevance of the shoulder scan as an early indicator of...... osteoporosis compared with hip scans, the latter representing a weight-bearing part of the skeleton. We developed a scanning procedure, including a shoulder fixation device, and determined the most appropriate software in order to establish a reference material with the highest possible precision. Duplicate...

  17. 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%

  18. 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.

  19. 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...

  20. Significantly lower femoral neck growth in screw fixation of the asymptomatic contralateral hip in unilateral slipped capital femoral epiphysis.

    Science.gov (United States)

    Wölfle-Roos, Julia V; Urlaub, Stefanie; Reichel, Heiko; Taurman, Rita

    2016-05-01

    There is an ongoing debate on which fixation technique should be preferred for the prophylactic fixation of the asymptomatic contralateral hip in slipped capital femoral epiphysis (SCFE). In the case of Kirschner-wire (K-wire) fixation, there is a possibility of secondary loss of fixation because of longitudinal growth of the physis, whereas in screw fixation, physeal growth of the femoral neck might be impaired. The aim of this matched-pair study was to compare the longitudinal growth of the femoral neck in screw fixation versus K-wire fixation of the asymptomatic contralateral hip in SCFE. All 18 patients (female : male=3 : 15), who had undergone screw fixation of the asymptomatic contralateral hip between 9/2001 and 9/2011, were matched according to age, bone age, sex, and time to follow-up to another 18 patients with K-wire fixation. The length of the femoral neck of the contralateral hip was measured in parallel to either screw or K-wire from the apex of the femoral head to the opposite cortical bone. The ratio of the femoral neck length measured directly after surgery and on follow-up was defined as femoral neck growth. There was no significant difference between groups with respect to age, modified Oxford Bone age score, and time to follow-up. We found a significant difference in femoral neck growth between patients with screw fixation (5.5±4.3%) compared with K-wire fixation (8.9±5.7%, P=0.048 matched Wilcoxon test). The difference in femoral neck growth of patients with K-wire or screw fixation of the contralateral asymptomatic hip in SCFE was small, but statistically significant. Thus, despite high rates of secondary loss of fixation, K-wire fixation should still be considered, especially in very young patients. PMID:26919622

  1. 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...

  2. The stiffness characteristics of hybrid Ilizarov fixators.

    Science.gov (United States)

    Baran, Onder; Havitcioglu, Hasan; Tatari, Hasan; Cecen, Berivan

    2008-10-20

    The use of hybrid Ilizarov models around femoral area is gaining clinical popularity lately. Hybrid systems show different mechanical properties. The purpose of this report is to examine the stiffness characteristics of the C-arch and half-pins on the hybrid Ilizarov fixators. Eight models that included standard Ilizarov and hybrid models were applied to six femoral sawbones. The distal part of fixation was composed of a two-ring frame applied identically to all bones. The difference of the configuration was at the proximal part, where half-pins with or without C-arches were either added to the proximal two-ring frame or replaced the proximal one- or two-ring frame. Osteotomy was performed in the femoral diaphysis and the bone was distracted 2cm. The stability of the system was tested with the axial compression testing machine. Displacements between the adjacent fracture sides were measured with the video extensometer in three dimensions. We found that proximal half-pin applications alone had less stiffness, but half-pins with C-arch had more stiffness than the model including only half-pins. Additional half-pins onto one- or two-ring frames had more longitudinal stiffness, but this system showed weak resistance against transverse displacement. PMID:18789446

  3. Initial stability of cementless acetabular cups: press-fit and screw fixation interaction—an in vitro biomechanical study

    OpenAIRE

    Tabata, Tomonori; Kaku, Nobuhiro; Hara, Katsutoshi; Tsumura, Hiroshi

    2014-01-01

    Background Press-fit and screw fixation are important technical factors to achieve initial stability of a cementless acetabular cup for good clinical results of total hip arthroplasty. However, how these factors affect one another in initial cup fixation remains unclear. Therefore, this study aimed to evaluate the mutual influence between press-fit and screw fixation on initial cup stability. Methods Foam bone was subjected to exact hemispherical-shape machining to diameters of 48, 48.5 and 4...

  4. 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

  5. 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

  6. 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.

  7. Augmented fixation of mandibular fractures with a threaded Kirschner wire.

    Science.gov (United States)

    Coniglio, J U; Norante, J D

    1989-06-01

    The maxillofacial surgeon uses a variety of techniques when treating mandibular fractures. The aim of treatment is to restore structure and function while minimizing morbidity. This requires adequate anatomic reduction and immobilization. The surgeon's choice of techniques should be safe, simple, economic, and effective. In this article, we discuss a previously described, yet little known, technique that fulfilled these criteria. The technique of augmented fixation of mandibular fractures using a threaded basal Kirschner wire was successfully used in seven patients. It offered the distinct advantage of rigid basal fixation that augmented interosseous and maxillomandibular fixation techniques. It was especially effective in stabilizing and promoting bone healing in unfavorable comminuted parasymphyseal fractures. Its ease and rapidity of application from readily available materials made it an effective alternate to elaborate techniques such as compression-plating systems. PMID:2719828

  8. 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

  9. 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

  10. 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.

  11. 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

  12. 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.

  13. 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,

  14. 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...

  15. Fixation by active accommodation

    Science.gov (United States)

    Pahlavan, Kourosh; Uhlin, Tomas; Eklundh, Jan-Olof

    1992-11-01

    The field of computer vision has long been interested in disparity as the cue for the correspondence between stereo images. The other cue to correspondence, blur, and the fact that vergence is a combination of the two processes, accommodative vergence and disparity vergence, have not been equally appreciated. Following the methodology of active vision that allows the observer to control all his visual parameters, it is quite natural to take advantage of the powerful combination of these two processes. In this article, we try to elucidate such an integration and briefly analyze the cooperation and competition between accommodative vergence and disparity vergence on one hand and disparity and blur stimuli on the other hand. The human fixation mechanism is used as a guide-line and some virtues of this mechanism are used to implement a model for vergence in isolation. Finally, some experimental results are reported.

  16. 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

  17. 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

  18. 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.

  19. 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。

  20. 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

  1. 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

  2. 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.

  3. Biomechanical Comparison of 2 Different Locking Plate Fixation Methods in Vancouver B1 Periprosthetic Femur Fractures

    OpenAIRE

    Pletka, Joshua D.; Marsland, Daniel; Belkoff, Stephen M.; Mears, Simon C.; Kates, Stephen L.

    2011-01-01

    Locking plates are commonly used to treat fractures around a well-fixed femoral component. The optimal construct should provide sufficient fixation while minimizing soft-tissue dissection. The purpose of the current study was to determine whether plate length, working length, or bone mineral density affects survival of locking plate fixation for Vancouver type B1 periprosthetic hip fractures. A transverse osteotomy was created just distal to cemented femoral prostheses in 9 pairs of cadaveric...

  4. 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.

  5. Prediction at long-term condyle screw fixation of temporomandibular joint implant: A numerical study.

    Science.gov (United States)

    Ramos, A; Duarte, R J; Mesnard, M

    2015-05-01

    The fixation of commercial temporomandibular joint (TMJ) implant is accomplished by using screws, which, in some cases, can lead to loosening of the implant. The aim of this study was to predict the evolution of fixation success of a TMJ. Numerical models using a Christensen TMJ implant were developed to analyze strain distributions in the adjacent mandibular bone. The geometry of a human mandible was developed based on computed tomography (CT) scans from a cadaveric mandible on which a TMJ implant was subsequently placed. In this study, the five most important muscle forces acting were applied and the anatomical conditions replicated. The evolution of fixation was defined according to bone response methodology focused in strain distribution around the screws. Strain and micromotions were analyzed to evaluate implant stability, and the evolution process conduct at three different stages: start with all nine screws in place (initial stage); middle stage, with three screws removed (middle stage), and end stage, with only three screws in place (final stage). With regard to loosening, the implant success fixation changed the strains in the bone between 21% and 30%, when considering the last stage. The most important screw positions were #1, #7, and #9. It was observed that, despite the commercial Christensen TMJ implant providing nine screw positions for fixation, only three screws were necessary to ensure implant stability and fixation success. PMID:25819477

  6. 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

  7. 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...

  8. The use of a resorbable augmentation device to secure plating of osteoporotic bones : An in vitro study

    OpenAIRE

    P Mainil-Varlet; Cordey, J.; Landolt, M.; Gogolewski, S

    1997-01-01

    Osteotomies in porotic human cadaveric humeri were fixed with metallic plates and screws in 3 experimental groups. In group I, osteotomies of the 3 arbitrarily chosen humeri were plated without reinforcement. The osteotomies of the contralateral 3 humeri were plated after reinforcement with a poly(L-lactide) augmentation device. In group II, osteotomies on one side were plated without reinforcement, but those of the contralateral humeri were plated after reinforcement ...

  9. 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 ...

  10. Bone Grafts

    Science.gov (United States)

    A bone graft transplants bone tissue. Surgeons use bone grafts to 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 ...

  11. Bone Anchored Hearing Treatment Procedure

    Medline Plus

    Full Text Available ... transmitted very efficiently through the head using bone conduction. The Baha device uses sound vibrations, and those ... changed from a normal soundwave into a bone conduction vibration, and that is what is passed then ...

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. Bone densitometer

    International Nuclear Information System (INIS)

    In an x-ray bone densitometer, special calibration techniques are employed to accommodate variations. In one aspect, a bone-like calibration material is interposed and the system determines the calibration data from rays passing only through flesh. In another aspect, a rotating device carries the calibration material through the beam. The specific densitometer shown uses an x-ray tube operated at two different voltages to generate a pencil beam, the energy levels of the x-ray photons being a function of the voltage applied. An integrating detector is timed to integrate the detected signal of the patient-attenuated beam over each pulse, the signals are converted to digital values and a digital computer converts the set of values produced by the raster scan into a representation of the bone density of the patient. Multiple reference detectors with differing absorbers are used by the system to continuously correct for variation in voltage and current of the x-ray tube. Calibration is accomplished by the digital computer on the basis of passing the pencil beam through known bone-representing substance as the densitometer scans portions of the patient having bone and adjacent portions having only flesh. A set of detected signals affected by the calibration substance in regions having only flesh is compared by the computer with a set of detected signals unaffected by the calibration material

  17. 21 CFR 892.1180 - Bone sonometer.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Bone sonometer. 892.1180 Section 892.1180 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1180 Bone sonometer. (a) Identification. A bone sonometer is...

  18. 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...

  19. 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...

  20. Volar, Intramedullary, and Percutaneous Fixation of Distal Radius Fractures.

    Science.gov (United States)

    Alluri, Ram; Longacre, Matthew; Pannell, William; Stevanovic, Milan; Ghiassi, Alidad

    2015-11-01

    Background The management of extra-articular distal radius fractures is highly variable, with no clear consensus regarding their optimal management. Purpose To assess comparatively the biomechanical stability of Kirschner wire (K-wire) fixation, volar plating, and intramedullary nailing for unstable, extra-articular distal radius fractures with both (1) constant and (2) cyclical axial compression, simulating forces experienced during early postoperative rehabilitation. Methods Twenty-six volar locking plate, intramedullary nail, and K-wire bone-implant constructs were biomechanically assessed using an unstable extra-articular distal radius bone model. Bone implant models were created for each type of construct. Three samples from each construct underwent compressive axial loading until fixation failure. The remaining samples from each construct underwent fatigue testing with a 50-N force for 2,000 cycles followed by repeat compressive axial loading until fixation failure. Results Axial loading revealed the volar plate was significantly stiffer than the intramedullary nail and K-wire constructs. Both the volar plate and intramedullary nail required greater than 300 N of force for fixation failure, while the K-wire construct failed at less than 150 N. Both the volar plate and intramedullary nail demonstrated less than 1 mm of displacement during cyclic loading, while the K-wire construct displaced greater than 3 mm. Postfatigue testing demonstrated the volar plate was stiffer than the intramedullary nail and K-wire constructs, and both the volar plate and intramedullary nail required greater than 300 N of force for fixation failure while the K-wire construct failed at less than 150 N. Conclusions Volar plating of unstable extra-articular distal radius fractures is biomechanically stiffer than K-wire and intramedullary fixation. Both the volar plate and intramedullary nail demonstrated the necessary stability and stiffness to maintain anatomic

  1. 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

  2. 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

  3. 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

  4. 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.

  5. 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.

  6. Systemic alendronate treatment improves fixation of press-fit implants: a canine study using nonloaded implants

    DEFF Research Database (Denmark)

    Jensen, Thomas B; Bechtold, Joan E; Chen, Xinqian; Søballe, Kjeld

    2007-01-01

    Bone resorption associated with local trauma occurring during insertion of joint prostheses is recognized as an early event. Being an osteoclastic inhibitor, alendronate is a potential candidate means to decrease early periprosthetic bone resorption and thereby improve implant fixation. We...... investigated the influence of oral alendronate treatment on early implant fixation in two implant interface settings representing sites of an implant that are in contact with surrounding bone, and other sites without intimate bone contact. One plasma-sprayed cylindrical titanium implant (6 mm diameter) was...... inserted into each proximal tibia of 16 dogs. On one side the implant was inserted press-fit whereas on the contralateral side, the implants were surrounded by a 2 mm concentric gap. Oral alendronate (0.5 mg/kg/day) was given 2 weeks following surgery to eight dogs. The dogs were euthanized after 10 weeks...

  7. 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 ...

  8. 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 ...

  9. Orthopaedic Interface Tissue Engineering for the Biological Fixation of Soft Tissue Grafts

    OpenAIRE

    Moffat, Kristen L.; Wang, I-Ning Elaine; Rodeo, Scott A.; Lu, Helen H.

    2009-01-01

    Interface tissue engineering is a promising new strategy aimed at the regeneration of tissue interfaces and ultimately enabling the biological fixation of soft tissue grafts utilized in orthopaedic repair and sports medicine. Many ligaments and tendons with direct insertions into subchondral bone exhibit a complex enthesis consisting of several distinct yet continuous regions of soft tissue, noncalcified fibrocartilage, calcified fibrocartilage and bone. Regeneration of this multi-tissue inte...

  10. Fracture union and complication following internal fixation of clavicle by plate and screw

    OpenAIRE

    Bishnu Prasad Patro; Saroj Kumar Patra; Subrat Mohapatra

    2016-01-01

    Background: Among all long bones clavicle is the only bone placed horizontally and has membranous ossification. Clavicle fractures accounting for about 2.6% of total body fractures and 34% to 45% of total shoulder girdle injuries in adults. Most fractures occur in middle third of clavicle and common in young male patients. It has wide range of management from conservative to variant internal fixation. Each procedure has its own outcome and complications. We tried to find out the outcome and c...

  11. Bone Anchored Hearing Treatment Procedure

    Medline Plus

    Full Text Available ... appropriately. The way the device works is it uses the fact that sound is transmitted very efficiently ... the head using bone conduction. The Baha device uses sound vibrations, and those vibrations then are passed ...

  12. 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

  13. Stabilisation of a mandibular fracture in a cow by means of a pinless external fixator

    International Nuclear Information System (INIS)

    A four months pregnant, four-year-old Brown Swiss cow with mandibular fractures of the right horizontal ramus and the symphysis was treated surgically with a new pinless external fixator. Healing was complicated by the sequestration of bone at the fracture site. After the sequestrum had been removed a radiographic examination revealed that the fracture had healed completely

  14. 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.

  15. 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.

  16. 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...

  17. 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...

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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 ...

  3. 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

  4. 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

  5. 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

  6. Scaphoid Fracture Fixation with an Acutrak(®) Screw.

    Science.gov (United States)

    Loving, Vilert A; Richardson, Michael L

    2006-01-01

    We report a case of fixation of a scaphoid fracture using an Acutrak(®) screw. This screw is cannulated and headless, which allows it to be implanted below the surface of the bone. It uses the same concept of variable thread pitch as the Herbert screw, but unlike the Herbert screw, is fully threaded, with continuously varying pitch along its length. This variable pitch creates constant compression across a fracture as the screw is advanced, and gives the screw its unique appearance. This feature may improve internal holding power, as well as allow a fracture or osteotomy site to lie anywhere along the length of the screw. PMID:27298683

  7. 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...

  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. Whole Animal Perfusion Fixation for Rodents

    OpenAIRE

    Gage, Gregory J.; Kipke, Daryl R.; Shain, William

    2012-01-01

    The goal of fixation is to rapidly and uniformly preserve tissue in a life-like state. While placing tissue directly in fixative works well for small pieces of tissue, larger specimens like the intact brain pose a problem for immersion fixation because the fixative does not reach all regions of the tissue at the same rate 5,7. Often, changes in response to hypoxia begin before the tissue can be preserved 12. The advantage of directly perfusing fixative through the circulatory system is that t...

  10. 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

  11. 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

  12. 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

  13. 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.

  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. Experimental and Numerical Modeling of Screws Used for Rigid Internal Fixation of Mandibular Fractures

    Directory of Open Access Journals (Sweden)

    Bret Baack

    2008-05-01

    Full Text Available Experimental and numerical methods are used to explore the stresses generated around bone screws used in rigid internal fixation of mandibular fractures. These results are intended to aid in decisions concerning both the design and the use of these bone screws. A finite element (FE model of a human mandible is created with a fixated fracture in the parasymphyseal region. The mandibular model is anatomically loaded, and the forces exerted by the fixation plate onto the simplified screws are obtained and transferred to another finite element submodel of a screw implant embedded in a trilaminate block with material properties of cortical and cancellous bone. The stress in the bone surrounding the screw implant is obtained and compared for different screw configurations. The submodel analyses are further compared to and validated with simple axial experimental and numerical screw pull-out models. Results of the screw FE analysis (FEA submodel show that a unicortical screw of 2.6 mm major diameter and 1.0 mm pitch will cause less bone damage than a bicortical screw of 2.3 mm major diameter and 1.0 mm pitch. The results of this study suggest that bicortical drilling can be avoided by using screws of a larger major diameter.

  16. Reconstructive procedures on lower extremities using Mitković external fixation system

    Directory of Open Access Journals (Sweden)

    Abdala K.

    2005-01-01

    Full Text Available The results of limb lengthening, correction of limb deformities and solving of bone loss, by the use of Mitković external fixation system and minimally invasive technique on the series of 96 operations in 89 patients are shown. Only lower extremities were included in this series. The advantages of this external fixation system in comparison to other systems are pointed out. The main advantages are the optimal biomechanical conditions including unilateral but 3-dimensional frame, which provides conditions very similar to natural biomechanical features of the human long bones, simplicity of application and low cost. The received result was excellent or very good in 98.4%. Maximal limb lengthening was 18 cm (at the same time in the femur and the tibia. Angular deformity correction is extremely simplified with minimized possibility of complications. The frame for bone transport is very simple. It can be concluded that presented methods are suitable for routine use.

  17. 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

  18. 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

  19. 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.

  20. 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

  1. Fixation method does not affect restoration of rotation center in hip replacements: A single-site retrospective study

    Directory of Open Access Journals (Sweden)

    Wegner Alexander

    2012-06-01

    Full Text Available Abstract Background Aseptic loosening is one of the greatest problems in hip replacement surgery. The rotation center of the hip is believed to influence the longevity of fixation. The aim of this study was to compare the influence of cemented and cementless cup fixation techniques on the position of the center of rotation because cemented cup fixation requires the removal of more bone for solid fixation than the cementless technique. Methods We retrospectively compared pre- and post-operative positions of the hip rotation center in 25 and 68 patients who underwent artificial hip replacements in our department in 2007 using cemented or cementless cup fixation, respectively, with digital radiographic image analysis. Results The mean horizontal and vertical distances between the rotation center and the acetabular teardrop were compared in radiographic images taken pre- and post-operatively. The mean horizontal difference was −2.63 mm (range: -11.00 mm to 10.46 mm, standard deviation 4.23 mm for patients who underwent cementless fixation, and −2.84 mm (range: -10.87 to 5.30 mm, standard deviation 4.59 mm for patients who underwent cemented fixation. The mean vertical difference was 0.60 mm (range: -20.15 mm to 10.00 mm, standard deviation 3.93 mm and 0.41 mm (range: -9.26 mm to 6.54 mm, standard deviation 3.58 mm for the cementless and cemented fixation groups, respectively. The two fixation techniques had no significant difference on the position of the hip rotation center in the 93 patients in this study. Conclusions The hip rotation center was similarly restored using either the cemented or cementless fixation techniques in this patient cohort, indicating that the fixation technique itself does not interfere with the position of the center of rotation. To completely answer this question further studies with more patients are needed.

  2. 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

  3. The effects of fixation of the ulna to the radius in young foals

    International Nuclear Information System (INIS)

    The effects of radioulnar fixation were studied in 21 Quarter horse foals by applying a bone plate to the caudal aspect of the proximal part of the ulna, with screws engaging both the radius and the ulna. The plates were applied at 1 month of age in six foals (group I), 5 months of age in six foals (group II), and 7 months of age in three foals (group III). Six foals underwent sham operations at 1 month of age to serve as controls (group IV). Ulnar dysplasia and elbow subluxation developed in all treated foals. The magnitude of ulnar dysplasia was inversely related to the patient's age at fixation and was accompanied by degenerative joint disease and lameness in foals undergoing fixation at 1 and 5 months of age. Removal of the fixation appliances 16 weeks after implantation in three foals from each of groups I and II failed to reverse the degree of ulnar dysplasia. Although foals undergoing fixation at 7 months of age (group III) were not lame, radiographic evidence of subluxation and subtle degenerative changes in the articular cartilage of the treated elbow did develop. Recommendations for avoidance of radioulnar fixation were developed from these observations

  4. 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

  5. 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

  6. 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

  7. Non cemented hip implants. Failures of biologically fixed devices: causes and treatment.

    Science.gov (United States)

    Letournel, E

    1987-01-01

    Complications of cementless prostheses are similar to those presented by the cemented ones. They are all the consequence of a failure (lack) of the bony fixation, which may be primary (the components never become fixed) or secondary (the components lose their bony attachments that were initially achieved). The bony fixation is often very difficult to assess, and a localized radiolucent line is always a bad indication. Failure of fixation may be partial or total for one or both components. Removal of distal broken cementless stems is much more difficult than for the cemented ones. Loosening may damage the bone at least as much as a mobile cemented mantle, and bone grafting at revision is often needed. Revisions for loosening of uncemented prostheses are at least as difficult as for the cemented ones. The lifetime of the Judet prosthesis has been shortened by an initially poor manufacturing process. Perhaps this has allowed us to get information about the outcome of uncemented prostheses in a shorter period. Finally, I believe in the concept of uncemented prostheses because their possible fixation by bony ingrowth is proved, but the definitive solutions have to be found and improvements are needed: A screwed socket appears to be good. A better plastic than HDP with less wearability and better mechanical properties is needed. A stem better adapted to the shape of the medullary canal bedding would probably facilitate bony ingrowth. The kind of porosity does not affect many things in my experience. Failures of prostheses that are no longer commonly used today have been reported. These were state-of-the-art devices 10 years ago--perhaps that is good food for thought. PMID:3818352

  8. 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.

  9. WRIST ARTHRODESIS WITH MINIMAL FIXATION PRESERVING THE CARPOMETACARPAL JOINTS

    Science.gov (United States)

    Pardini, Arlindo Gomes; Pádua Gonçalves, Rodolfo Fonseca; Freitas, Afrânio Donato; Chaves, Antonio Barbosa

    2015-01-01

    Objective: Wrist arthrodesis is a surgical procedure that should always be considered in cases of pathological conditions in which anatomical and functional structures are altered. In general, the results are very satisfactory, particularly for pain relief, and in the majority of cases, there is considerable functional improvement. Various techniques have been described, with different methods of internal fixation, most of which include the carpometacarpal joints in the fusion. The objective of this study was to evaluate the results from wrist arthrodesis using a technique that is simpler, more biological, less expensive, and does not involve the carpometacarpal joints. Methods: Fifteen patients with wrist arthrodesis were evaluated (six with sequelae from trauma, four with rheumatoid arthritis, three with Kienbock grade IV, one with Preiser and one with panarthrosis). The technique consisted of using an iliac bone plate and internal fixation with Kirschner wires, avoiding the carpometacarpal joints. Results: The evaluation was based on consolidation time (93% in seven weeks); movements of the fingers and pronosupination; pinch and grasp strength; functional evaluation through the DASH, pain and patient satisfaction questionnaires. In general, the results were similar to those of other, more aggressive techniques, and the non-inclusion of the carpometacarpal joints did not affect the final result. Conclusion: Wrist arthrodesis with fixation using Kirschner wires and an iliac bone plate, preserving the carpometacarpal joints, gives good or excellent results that are not inferior to those of other techniques that have been described. However, it presents major advantages over other methods: it is less aggressive and cheaper, and does not have the inconvenience and complications associated with the use of plates and screws. PMID:27022522

  10. Embalmed and fresh frozen human bones in orthopedic cadaveric studies: which bone is authentic and feasible?

    OpenAIRE

    Topp, Tobias; Müller, Thorben; Huss, Sebastian; Kann, Peter Herbert; Weihe, Eberhard; Ruchholtz, Steffen; Zettl, Ralph Peter

    2012-01-01

    Background and purpose The most frequently used bones for mechanical testing of orthopedic and trauma devices are fresh frozen cadaveric bones, embalmed cadaveric bones, and artificial composite bones. Even today, the comparability of these different bone types has not been established. Methods We tested fresh frozen and embalmed cadaveric femora that were similar concerning age, sex, bone mineral density, and stiffness. Artificial composite femora were used as a reference group. Testing para...

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    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...... Technological Institute, Denmark). The granules were coated with poly-lactic acid (PLA) 12%, in order to increase the mechanical strength of the material (Phusis, France). Scaffold granules (Ø~900-1400 µm, 80% porosity) in group 2 consisted of pure HA/β-TCP (FinCeramica, Italy). For both groups, cells were...

  12. Overcoming fixation with repeated memory suppression.

    Science.gov (United States)

    Angello, Genna; Storm, Benjamin C; Smith, Steven M

    2015-01-01

    Fixation (blocks to memories or ideas) can be alleviated not only by encouraging productive work towards a solution, but, as the present experiments show, by reducing counterproductive work. Two experiments examined relief from fixation in a word-fragment completion task. Blockers, orthographically similar negative primes (e.g., ANALOGY), blocked solutions to word fragments (e.g., A_L_ _GY) in both experiments. After priming, but before the fragment completion test, participants repeatedly suppressed half of the blockers using the Think/No-Think paradigm, which results in memory inhibition. Inhibiting blockers did not alleviate fixation in Experiment 1 when conscious recollection of negative primes was not encouraged on the fragment completion test. In Experiment 2, however, when participants were encouraged to remember negative primes at fragment completion, relief from fixation was observed. Repeated suppression may nullify fixation effects, and promote creative thinking, particularly when fixation is caused by conscious recollection of counterproductive information. PMID:24575886

  13. 21 CFR 892.1170 - Bone densitometer.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Bone densitometer. 892.1170 Section 892.1170 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1170 Bone densitometer. (a) Identification. A...

  14. Outcome comparison of Lisfranc injuries treated through dorsal plate fixation versus screw fixation

    OpenAIRE

    Hu, Sun-jun; Chang, Shi-Min; Li, Xiao-Hua; Yu, Guang-rong

    2014-01-01

    OBJECTIVE: The objective of this prospective study was to test whether the treatment of Lisfranc injuries with open reduction and dorsal plate fixation would have the same or better functional outcomes as treatment with standard trans-articular screw fixation. METHODS: Sixty patients with primarily isolated Lisfranc joint injury were treated by open reduction and dorsal plate fixation or standard screw fixation. The patients were followed on average for 31 months. Evaluation was performed wit...

  15. 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...

  16. Demineralized Bone Matrix Add-On for Acceleration of Bone Healing in Atypical Subtrochanteric Femoral Fracture: A Consecutive Case-Control Study

    OpenAIRE

    Noratep Kulachote; Paphon Sa-ngasoongsong; Norachart Sirisreetreerux; Pongsthorn Chanplakorn; Praman Fuangfa; Chanyut Suphachatwong; Wiwat Wajanavisit

    2016-01-01

    Background. Delayed union and nonunion are common complications in atypical femoral fractures (AFFs) despite having good fracture fixation. Demineralized bone matrix (DBM) is a successfully proven method for enhancing fracture healing of the long bone fracture and nonunion and should be used in AFFs. This study aimed to compare the outcome after subtrochanteric AFFs (ST-AFFs) fixation with and without DBM. Materials and Methods. A prospective study was conducted on 9 ST-AFFs patients using DB...

  17. Suture Button Fixation Treatment of Chronic Lisfranc Injury in Professional Dancers and High-Level Athletes.

    Science.gov (United States)

    Charlton, Timothy; Boe, Chelsea; Thordarson, David B

    2015-12-01

    Chronic Lisfranc injury is a subtle and severe injury in high-level athletes, including dancers. This patient population is generally intolerant of intra-articular screw fixation and can develop significant post-traumatic arthritis with potentially career ending complications. Flexible fixation with suture-button devices provides potential restoration of physiologic motion at the joint, with appropriate support for healing that may facilitate return to en pointe activities for dancers. We hypothesized that the suture-button device would restore motion at the Lisfranc joint and allow for return to activities in this particular population without the limitations and complications of rigid fixation. We operated on seven dancers and high-level athletes with diagnosed Lisfranc injuries by installing a suture-button device. All patients had failed conservative management after late presentation. They were allowed to return to sport in 6 months, preoperative and postoperative American Orthopaedic Foot and Ankle Score (AOFAS) foot scores were obtained, and patients were followed for a minimum of 15 months. All seven returned to full activities in 6 months, with radiographic evidence of fixation and no complications to date. AOFAS foot scores improved from an average of 65 preoperatively to an average of 97 postoperatively at latest follow-up. It is concluded that flexible fixation with suture-button type device represents a viable alternative to screw fixation or fusion that may allow dancers and athletes to return to previous levels of activity after Lisfranc injury. This case series represents to our knowledge the first application of this device to a unique population that requires flexibility at the Lisfranc joint for performance. PMID:26641700

  18. Evaluation in effects of poly (L-lactide) miniplates for internal fixation of mandibular fracture

    International Nuclear Information System (INIS)

    Objective: To investigate the internal fixation effects of poly (L-lactide) (PLLA) miniplates on the mandibular fracture in dogs. Methods: A total of 12 dogs were involved in the study. After mandibular fracture models were created on both sides, one side of the mandibular was fixed with PLLA miniplates and the other side was fixed with titanium plates as control. The dogs were sacrificed separately at 1, 3, 6, 12 months after operation, three animals at each time. Gross observation, radiography and histopathological examination were performed. Results: All of the dogs were alive and fracture fixation of both sides was excellent after the operation. Gross observation:in 1 month group, the fracture line and some bony callus could be seen on both sides; in 3 months group, both sides had become into bone union; in 6 months group, both sides had become into bone union completely; in 12 months group, the fracture lines on both sides were difficult to be seen. Radiography examination:in 1 month group, the fracture lines and the screw holes could be seen on both sides; in 3 months group, the fracture lines turned ambiguity; in 6 months group, the line on the experimental side was difficult to be seen but the line on the control side disappeared; in 12 months group, the fracture lines on both sides disappeared. Histopathology examination: in 1 month group, there were lots of collagen fibers and a little bone trabecula on both sides; in 3 months group, the trabecula on the experimental side were much more than the other side; in 6 months group, the bone trabecula on both sides looked like the normal bone tissue; in 12 months group, the bone trabecula became into nomal tissue. Conclusion: The effect of PLLA miniplates for internal fixation of mandibular fracture is safety, the PLLA miniplate can maintain the stability of the bone fracture during the healing process. (authors)

  19. 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.

  20. 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.

  1. 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

  2. Fixation Status of Acid Soils

    International Nuclear Information System (INIS)

    Six acid soil series from different benchmark sites; Rangsit soil (Sulfic Tropaquepts) (two acid sulfate soils), Pakchong soil (Oxic Paleustults) Korat soil (Oxic Paleustults), Warin soil (Oxic Paleustults), Mae Taeng soil (Typic paleustults) and Boundary grey soil and two Thai phosphate rocks (P R) (Lampun P R and Ratchabuie P R) had been characterized in the laboratory by isotope techniques (E, value Part 1). Triple superphosphate (TSP) was used as a standard fertilizer. R P and TSP with 50 mg P Kg-1 soil were incubated for 30 days to examine the fixing capacity of the acid soils. The results showed that Rangsit Soil which is acid sulfate had high fixing capacity. Pakchong soil retained higher P fixation ability than Korat and Warin soil series. The highest fixation capacity among 7 acid soils were Grey Soil and Mae Taeng soil series. The solubility of TSP was decreased when incorporated with soil after incubation for 30 days. P R from Ratchaburi showed higher effectiveness than Lamphun P R

  3. 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.

  4. Bone Cancer

    Science.gov (United States)

    Cancer that starts in a bone is uncommon. Cancer that has spread to the bone from another ... more common. There are three types of bone cancer: Osteosarcoma - occurs most often between ages 10 and ...

  5. Bone Cancer

    Science.gov (United States)

    Cancer that starts in a bone is uncommon. Cancer that has spread to the bone from another part of the body is more common. There are three types of bone cancer: Osteosarcoma - occurs most often between ages 10 ...

  6. Bone Diseases

    Science.gov (United States)

    Your bones help you move, give you shape and support your body. They are living tissues that rebuild constantly ... childhood and your teens, your body adds new bone faster than it removes old bone. After about ...

  7. 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

  8. Visual Field Screening System by Using Overlapped Fixation Patterns

    Science.gov (United States)

    Kotani, Kentaro; Yoshikawa, Ryota; Tamura, Toshiki; Asao, Takafumi; Sugiyama, Tetsuya; Ueki, Mari; Kojima, Shota; Shibata, Maho; Ikeda, Tsunehiko

    This study introduces a novel technique for estimating visual field by using overlapped fixation patterns obtained by amounts of displacement in voluntary eye movements during searching-tracking trials, as an alternative screening medical device for visual field examination. Proposed system was evaluated by glaucoma patients, in order to study whether or not the proposed system can be used as a visual field detection device for screening. As a result, the proposed system detected the visual field abnormality to a certain extent. However, there were some cases that detection of Mariotte blind spots was inaccurately performed. The experimental results revealed that there was room to reconsider our understanding regarding the effect of ptosis, overlapped with eye sight as well as calibration of the display position to the correct location to be examined. Results of the evaluation experiment indicated that this proposed system has a potential to be used as a visual field examination device for screening.

  9. Outcomes of Ilizarov ring fixation in recalcitrant infected tibial non-unions – a prospective study

    Science.gov (United States)

    Madhusudhan, Thayur R; Ramesh, Balasundaram; Manjunath, KS; Shah, Harshad M; Sundaresh, Dabir C; Krishnappa, N

    2008-01-01

    Background Infected non-union of long bones is a problem in the developing countries. Persistent infection, deformity, shortening, bone loss, joint stiffness and disability complicate the non-union. Secondary procedures are often required for correction of bone defects and deformity. Ilizarov method addresses all the above problems simultaneously and offers a panacea for infected non-unions. The stability of the fixation and provision for bone transport allows bridging of bone defects, limb lengthening, early weight bearing ambulation and joint mobilisation. Aim of the study To know the suitability of this procedure in recalcitrant infected tibial non-unions in the Indian population and the influence of socio-economic factors in the functional outcome. Method of study This was a 3-year prospective study in 22 consecutive patients with an average follow up of 13 months following fracture union. The results were analysed using the ASAMI scoring system. Results Of 22 patients in the study, 13 patients who underwent external bone transport, had an average bone gap of 4 cms [2–11 cms] with an average duration of fixation of 9.3 months [6.5–13 months]. There were 4 excellent, 3 good, 4 fair and 2 poor bony results and 1 excellent, 3 good, 6 fair and 2 poor results. 1 patient was lost for follow up at final functional analysis. 9 patients who underwent internal bone transport had an average bone gap of 5.4 cms [1.5–9 cms] with an average duration of fixation of 8.5 months [4–11 months]. There were 3 good 4 fair and 2 poor bony results and 1 good, 3 fair, and 2 poor functional results. Good to excellent results were witnessed in well-motivated patients with adequate social and financial support. Patients with fair to poor results preferred amputation to limb salvage despite the fact that they retained their limbs. Conclusion Treatment of infected non-unions of Tibia with Ilizarov ring fixation is effective but for optimal results the treatment needs to be

  10. Outcomes of Ilizarov ring fixation in recalcitrant infected tibial non-unions – a prospective study

    Directory of Open Access Journals (Sweden)

    Shah Harshad M

    2008-07-01

    Full Text Available Abstract Background Infected non-union of long bones is a problem in the developing countries. Persistent infection, deformity, shortening, bone loss, joint stiffness and disability complicate the non-union. Secondary procedures are often required for correction of bone defects and deformity. Ilizarov method addresses all the above problems simultaneously and offers a panacea for infected non-unions. The stability of the fixation and provision for bone transport allows bridging of bone defects, limb lengthening, early weight bearing ambulation and joint mobilisation. Aim of the study To know the suitability of this procedure in recalcitrant infected tibial non-unions in the Indian population and the influence of socio-economic factors in the functional outcome. Method of study This was a 3-year prospective study in 22 consecutive patients with an average follow up of 13 months following fracture union. The results were analysed using the ASAMI scoring system. Results Of 22 patients in the study, 13 patients who underwent external bone transport, had an average bone gap of 4 cms [2–11 cms] with an average duration of fixation of 9.3 months [6.5–13 months]. There were 4 excellent, 3 good, 4 fair and 2 poor bony results and 1 excellent, 3 good, 6 fair and 2 poor results. 1 patient was lost for follow up at final functional analysis. 9 patients who underwent internal bone transport had an average bone gap of 5.4 cms [1.5–9 cms] with an average duration of fixation of 8.5 months [4–11 months]. There were 3 good 4 fair and 2 poor bony results and 1 good, 3 fair, and 2 poor functional results. Good to excellent results were witnessed in well-motivated patients with adequate social and financial support. Patients with fair to poor results preferred amputation to limb salvage despite the fact that they retained their limbs. Conclusion Treatment of infected non-unions of Tibia with Ilizarov ring fixation is effective but for optimal results the

  11. 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.

  12. 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

  13. Process for fixation of radioactive waste

    International Nuclear Information System (INIS)

    Fixation of radioactive waste comprises mixing of the water saturated waste with a resin and a monomer in order to form an emulsion. By addition of a hydraulic binder, formation of concrete is achieved. This process enables the fixation of the waste in a stable manner without release of radioactivity

  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. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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...

  20. 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.

  1. 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

  2. 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.)

  3. Temporomandibular joint ankylosis fixation technique with ultra thin silicon sheet

    Directory of Open Access Journals (Sweden)

    G S Kalra

    2011-01-01

    Full Text Available Background: Temporomandibular joint ankylosis is a highly distressing condition in which the joint space is obliterated by scar tissue and the patient has an inability to open the mouth. Different autogenous and alloplastic interposition materials have been used after the resection of the ankylotic bone to achieve desirable and long lasting results. The recurrence of disease is most distressing for both patients and surgeon. We have been using ultra thin silicon sheet as our preferred material for providing proper fixation and cover to the joint. We have been encouraged by good patient compliance, no implant extrusion and favourable outcome. Materials and Methods: The clinical study included 80 patients with temporomandibular joint ankylosis, treated between April 2001 and March 2009. In all patients, temporomandibular joint ankylosis had resulted following trauma. Diagnosis was based on clinical assessment supplemented by radiographic examination consisting of a panoramic radiograph, axial and coronal computer tomography. The technique of using ultra thin silicon sheet covering whole of the joint space fixed with non-absorbable nylon 3-0 suture both medially to medial pterygoid muscle and laterally to periosteum of zygomatic arch was employed in all patients. Results: A total of 80 patients were in this study (59 males and 21 females. The aetiology of temporomandibular joint ankylosis was post-traumatic in all cases. The patients′ age ranged from 5 to 45 years. The disease was unilateral in 61 cases and bilateral in 19 cases. Twelve patients, who had previous surgery done in the form of gap arthroplasty in 6 cases, costochondral graft in 4 cases and temporalis muscle in 2 cases, presented with recurrence on the same side. The pre-op inter-incisal mouth opening ranged from 4 to 12 mm. The intraoperative inter-incisal mouth opening ranged from 28 to 46 mm. An additional procedure was done in 13 patients, including placement of costochondral

  4. Allogenic bone rods with freeze drying and gamma rays irradiation for treatment of fracture

    International Nuclear Information System (INIS)

    Opened reduction and internal fixation are the usual treatment of fracture, but both methods need a second operation for removal implants. The benefits of the bone rods are that they can avoid the removement of internal fixation and will be absorbed spontaneously. The bone rods are made of allogeneic compact bones with freeze-drying and gamma rays irradiation supplied by Shanxi Provincial Tissue Bank. The purpose of this study is to evaluate allograft reaction, the stability of the internal fixation, osteoinduction in the treatment of fracture using allogeneic bone rods with freeze drying and gamma rays irradiation. From May 1997 to May 1998, fourteen cases (male 12, female 2) of treatment were reviewed. The mean age was 37.3 (21-5 1). There were 3 medial malleolus fractures, 7 tibia and fibula fractures, 1 ulna and radius fracture, 1 lateral condyle of humerus fracture. The clinical results were satisfactory. Because the strength of the bone rods are weaker than that of screws, the bone rods are only indicated in the fixation of cancellous bones fracture and unloaded bone fracture. It can be used as a supplementary fixation of loaded bone. It is not indicated for fixation of comminuted fracture. More than two bone rods may be used in the fixation of fracture in order to get stability of the fracture and decrease stress between rods which will prevent the break of the bone rods. Allogeneic bone rods with freeze-drying and gamma rays irradiation can be used as implants of non-immunogenicity. There are no allograft reactions in all cases (including fever, leukocytosis, exudation or swelling in the wound). Although plenty of experimental studies have showed that freeze drying with gamma rays irradiation (below 50 KGy) would not destroy BMP of bone allograft, but there is no osteoinduction in our cases. The healing of a fracture and bridging external callus are similar as other operations. This new technique may have the following advantages compare with the screws: 1

  5. 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.

  6. 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...

  7. 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

  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. 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...

  11. 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...

  12. 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 ...

  13. 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.

  14. 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 ...

  15. 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)

  16. Volumetric analysis of corticocancellous bones using CT data

    International Nuclear Information System (INIS)

    To present a method for an automated volumetric analysis of corticocancellous bones such as the superior pubic ramus using CT data and to assess the reliability of this method. Computed tomography scans of a consecutive series of 250 patients were analyzed. A Hounsfield unit (HU) thresholding-based reconstruction technique (''Vessel Tracking,'' GE Healthcare) was used. A contiguous space of cancellous bone with similar HU values between the starting and end points was automatically identified as the region of interest. The identification was based upon the density gradient to the adjacent cortical bone. The starting point was defined as the middle of the parasymphyseal corticocancellous transition zone on the axial slice showing the parasymphyseal superior pubic ramus in its maximum anteroposterior width. The end point was defined as the middle of the periarticular corticocancellous transition zone on the axial slice showing the quadrilateral plate as a thin cortical plate. The following parameters were automatically obtained on both sides: length of the center line, volume of the superior pubic ramus between the starting point and end point, minimum, maximum and mean diameter perpendicular to the center line, and mean cross-sectional area perpendicular to the center line. An automated analysis without manual adjustments was successful in 207 patients (82.8%). The center line showed a significantly greater length in female patients (67.6 mm vs 65.0 mm). The volume was greater in male patients (21.8 cm3 vs 19.4 cm3). The intersite reliability was high with a mean difference between the left and right sides of between 0.1% (cross-sectional area) and 2.3% (volume). The method presented allows for an automated volumetric analysis of a corticocancellous bone using CT data. The method is intended to provide preoperative information for the use of intramedullary devices in fracture fixation and percutaneous cement augmentation techniques. (orig.)

  17. Volumetric analysis of corticocancellous bones using CT data

    Energy Technology Data Exchange (ETDEWEB)

    Krappinger, Dietmar; Linde, Astrid von; Rosenberger, Ralf; Blauth, Michael [Medical University Innsbruck, Department of Trauma Surgery and Sports Medicine, Innsbruck (Austria); Glodny, Bernhard; Niederwanger, Christian [Medical University Innsbruck, Department of Radiology I, Innsbruck (Austria)

    2012-05-15

    To present a method for an automated volumetric analysis of corticocancellous bones such as the superior pubic ramus using CT data and to assess the reliability of this method. Computed tomography scans of a consecutive series of 250 patients were analyzed. A Hounsfield unit (HU) thresholding-based reconstruction technique (''Vessel Tracking,'' GE Healthcare) was used. A contiguous space of cancellous bone with similar HU values between the starting and end points was automatically identified as the region of interest. The identification was based upon the density gradient to the adjacent cortical bone. The starting point was defined as the middle of the parasymphyseal corticocancellous transition zone on the axial slice showing the parasymphyseal superior pubic ramus in its maximum anteroposterior width. The end point was defined as the middle of the periarticular corticocancellous transition zone on the axial slice showing the quadrilateral plate as a thin cortical plate. The following parameters were automatically obtained on both sides: length of the center line, volume of the superior pubic ramus between the starting point and end point, minimum, maximum and mean diameter perpendicular to the center line, and mean cross-sectional area perpendicular to the center line. An automated analysis without manual adjustments was successful in 207 patients (82.8%). The center line showed a significantly greater length in female patients (67.6 mm vs 65.0 mm). The volume was greater in male patients (21.8 cm{sup 3} vs 19.4 cm{sup 3}). The intersite reliability was high with a mean difference between the left and right sides of between 0.1% (cross-sectional area) and 2.3% (volume). The method presented allows for an automated volumetric analysis of a corticocancellous bone using CT data. The method is intended to provide preoperative information for the use of intramedullary devices in fracture fixation and percutaneous cement augmentation techniques

  18. 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.

  19. 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

  20. Kennedy Space Center Fixation Tube (KFT)

    Science.gov (United States)

    Richards, Stephanie E.; Levine, Howard G.; Romero, Vergel

    2016-01-01

    Experiments performed on the International Space Station (ISS) frequently require the experimental organisms to be preserved until they can be returned to earth for analysis in the appropriate laboratory facility. The Kennedy Fixation Tube (KFT) was developed to allow astronauts to apply fixative, chemical compounds that are often toxic, to biological samples without the use of a glovebox while maintaining three levels of containment (Fig. 1). KFTs have been used over 200 times on-orbit with no leaks of chemical fixative. The KFT is composed of the following elements: a polycarbonate main tube where the fixative is loaded preflight, the sample tube where the plant or other biological specimens is placed during operations, the expansion plug, actuator, and base plug that provides fixative containment (Fig. 2). The main tube is pre-filled with 25 mL of fixative solution prior to flight. When actuated, the specimen contained within the sample tube is immersed with approximately 22 mL (+/- 2 mL) of the fixative solution. The KFT has been demonstrated to maintain its containment at ambient temperatures, 4degC refrigeration and -100 C freezing conditions.

  1. 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.)

  2. 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)

  3. 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.

  4. Biomechanical analysis of tibia – double threaded screw fixation

    Directory of Open Access Journals (Sweden)

    W. Walke

    2008-03-01

    Full Text Available Purpose: The aim of the work was determination of biomechanical characteristics of a tibia – double threaded screw system with the use of finite element method.Design/methodology/approach: Geometrical model of the tibia was worked out on the basis of data from computer tomography of real bone. Geometrical model of the double threaded screw was prepared in ANSYS v. 11. Meshing was realized with the use of SOLID95 elements, applied in analyses of volumes. The model was loaded with forces in the range F = 100-2000 N.Findings: Initial biomechanical analysis, carried out with the use of finite element method, showed usefulness of the analyzed form of the double threaded screw made of Ti6Al4V alloy in fractured tibia treatment.Research limitations/implications: Due to applied simplifications of the tibia – double threaded screw fixation model, the analysis results should be experimentally verified in laboratory conditions.Originality/value: The obtained biomechanical characteristics of the tibia – double threaded screw system (u = f(F, σmax = f(F are the basis for selection of degree of strain hardening of the applied metallic biomaterial and optimization of geometrical features of the analyzed form of implant. Appropriate selection of mechanical properties and geometrical features of the implant is the main factor determining a stability of the fixation.

  5. 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

  6. 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 ...

  7. The use of augmentation techniques in osteoporotic fracture fixation.

    Science.gov (United States)

    Kammerlander, Christian; Neuerburg, Carl; Verlaan, Jorrit-Jan; Schmoelz, Werner; Miclau, Theodore; Larsson, Sune

    2016-06-01

    There are an increasing number of fragility fractures, which present a surgical challenge given the reduced bone quality of underlying osteoporosis. Particularly in aged patients, there is a need for early weight bearing and mobilization to avoid further complications such as loss of function or autonomy. As an attempt to improve fracture stability and ultimate healing, the use of biomaterials for augmentation of osseous voids and fracture fixation is a promising treatment option. Augmentation techniques can be applied in various locations, and fractures of the metaphyseal regions such as proximal humerus, femur, tibia and the distal radius remain the most common areas for its use. The current review, based on the available mechanical and biological data, provides an overview of the relevant treatment options and different composites used for augmentation of osteoporotic fractures. PMID:27338226

  8. Neural correlates of fixation duration in natural reading: Evidence from fixation-related fMRI.

    Science.gov (United States)

    Henderson, John M; Choi, Wonil; Luke, Steven G; Desai, Rutvik H

    2015-10-01

    A key assumption of current theories of natural reading is that fixation duration reflects underlying attentional, language, and cognitive processes associated with text comprehension. The neurocognitive correlates of this relationship are currently unknown. To investigate this relationship, we compared neural activation associated with fixation duration in passage reading and a pseudo-reading control condition. The results showed that fixation duration was associated with activation in oculomotor and language areas during text reading. Fixation duration during pseudo-reading, on the other hand, showed greater involvement of frontal control regions, suggesting flexibility and task dependency of the eye movement network. Consistent with current models, these results provide support for the hypothesis that fixation duration in reading reflects attentional engagement and language processing. The results also demonstrate that fixation-related fMRI provides a method for investigating the neurocognitive bases of natural reading. PMID:26151101

  9. Modified arthroscopic suture fixation of a displaced tibial eminence fracture.

    Science.gov (United States)

    Lehman, Ronald A; Murphy, Kevin P; Machen, M Shaun; Kuklo, Timothy R

    2003-02-01

    This study describes a new arthroscopic method using a whip-stitch technique for treating a displaced type III tibial eminence fracture. A 12-year-old girl who sustained a displaced type III tibial eminence fracture was treated with arthroscopic fixation using the Arthrosew disposable suture device (Surgical Dynamics, Norwalk, CT) to place a whip stitch into the anterior cruciate ligament (ACL). The Arthrex ACL guide (Arthrex, Naples, FL) was used to reduce the avulsed tibial spine fragment. Sutures were then passed through the tibial tunnel and secured over a bony bridge with the knee in 20 degrees of flexion. At 9 months, the patient has a full range of motion with normal Lachman and anterior drawer testing, and she has returned to competitive basketball. Radiographs show complete fracture healing. KT-1000 and isokinetic testing at 9-month follow-up show only minimal side-to-side differences. The Arthrosew device provides a significant advantage in the treatment of type III and IV fractures of the tibial eminence by obtaining arthroscopic fixation within the substance of the ACL, thus obviating arthrotomy and hardware placement. This technique also restores the proper length and tension to the ACL, and provides a simplified, reproducible method of treatment for this injury. PMID:12579135

  10. 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

  11. Fixation of Selenium by Clay Minerals and Iron Oxides

    DEFF Research Database (Denmark)

    Hamdy, A. A.; Nielsen, Gunnar Gissel

    1977-01-01

    In studying Se fixation, soil components capable of retaining Se were investigated. The importance of Fe hydrous oxides in the fixation of Se was established. The clay minerals common to soils, such as kaolinite, montmorillonite and vermiculite, all exhibited Se fixation, but greater fixation...

  12. 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

  13. 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 ...

  14. 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.

  15. 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.

  16. Tamponade following sternoclavicular dislocation surgical fixation.

    Science.gov (United States)

    Bensafi, H; Laffosse, J-M; Taam, S A; Molinier, F; Chaminade, B; Puget, J

    2010-05-01

    The authors report a case of posterior sternoclavicular dislocation surgically reduced and stabilized with tenodesis, according to the Burrows technique completed by temporary wire fixation. The patient presented postoperative pericardiac tamponade appearing progressively from brachiocephalic blood vessels bleeding. Emergency drainage was surgically placed associated with removal of the material, thus curing the patient. This complication, although exceptional, formally contraindicates the use of wire fixation in surgery of the sternoclavicular joint. PMID:20488152

  17. 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)

  18. 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...

  19. 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

  20. 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

  1. Maxwellian Eye Fixation during Natural Scene Perception

    Directory of Open Access Journals (Sweden)

    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.

  2. 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

  3. Surgical Management of Charcot Deformity for the Foot and Ankle-Radiologic Outcome After Internal/External Fixation.

    Science.gov (United States)

    Ettinger, Sarah; Plaass, Christian; Claassen, Leif; Stukenborg-Colsman, Christina; Yao, Daiwei; Daniilidis, Kiriakos

    2016-01-01

    Charcot neuropathy (CN) is a severe joint disease that makes surgical planning very challenging, because it is combined with ankle instability, serious deformities, and recurrent ulceration. The aim of the present study was to examine the rate of bone fusion after external or internal fixation in patients with CN. We retrospectively examined 58 patients with CN who had undergone reconstruction of the ankle either with tibiotalocalcaneal or tibiocalcaneal arthrodesis. The mean age was 59.1 (range 26 to 81) years at surgery. Of the 58 patients, 38 were treated using intramedullary nail arthrodesis and 19 using an external fixator (1 patient received neither). At a mean follow-up period of 31.3 (range 12 to 57) months, limb salvage and bone fusion had been achieved in 94.83%. The mean time to bone fusion was 12 (range 6 to 18) months. Three patients (5.2%) required a more proximal amputation. All but these 3 patients gained independent mobilization in custom feet orthoses or off the shelf orthoses. Of the 58 patients in the present cohort, 56 (96.6%) would undergo surgery again. In conclusion, internal and external fixation both lead to promising results in the treatment of CN. Internal fixation should be preferred when no indications of ulcer or infection are present. PMID:26898396

  4. 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...

  5. Reinforcement of bone cement around prostheses by pre-coated wire coil: a preliminary study.

    Science.gov (United States)

    Kim, J K; Park, J B

    1994-01-01

    The longevity of the cemented total hip joint replacement depends on the integrity of the cement fixation with respect to the interfaces of the metal stem and bone, and stress/strain transmission and its distribution. A simple coil made of stainless steel wires was placed around a tapered stem in a simulated cement mantle to counteract the radial- and hoop-stress and static push-out mechanical tests were performed. The results show statistically significant increases in ultimate strain (+17.62%), ultimate load (+110.34%), stiffness (+117.63%), and fracture toughness (+153.63%) exhibited by the wire reinforcement over the control. Precoating with thin layer of polymethylmethacrylate may also enhance the mechanical properties of the reinforced cement mantle. This simple device may contribute to the longevity of the cement mantle by virtue of the enhanced mechanical properties, which in turn will be able to absorb more energy transmitted through the metal stem. PMID:8000291

  6. 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

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

    Directory of Open Access Journals (Sweden)

    Dominik Seybold

    2011-01-01

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

  8. Bone tumor

    Science.gov (United States)

    ... physical exam. Tests that may be done include: Alkaline phosphatase blood level Bone biopsy Bone scan Chest x- ... also affect the results of the following tests: Alkaline phosphatase isoenzyme Blood calcium level Parathyroid hormone Blood phosphorus ...

  9. INTRA MEDULLARY FIXATION OF SUB TROCHANTERIC FRACTURERS WITH LONG PROXIMAL FEMORAL NAIL & STAINLESS STEEL WIRE FIXATION: A STUDY

    Directory of Open Access Journals (Sweden)

    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

  10. 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

    Directory of Open Access Journals (Sweden)

    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-displaced fracture of the distal radius, requiring operative fixation are potentially eligible to take part in this study. A total of 390 consenting patients will be randomly allocated to either K-wire fixation or locking-plate fixation. The surgery will be performed in trauma units across the UK using the preferred technique of the treating surgeon. Data regarding wrist function, quality of life, complications and costs will be collected at six weeks and three, six and twelve months following the injury. The primary outcome measure will be wrist function with a parallel economic analysis. Discussion This pragmatic, multi-centre trial is due to deliver results in December 2013. Trial registration Current Controlled Trials ISRCTN31379280 UKCRN portfolio ID 8956

  11. Nitrogen fixation in trees - 1

    Energy Technology Data Exchange (ETDEWEB)

    Dobereiner, J.; Gauthier, D.L.; Diem, H.G.; Dommergues, Y.R.; Bonetti, R.; Oliveira, L.A.; Magalhaes, F.M.M.; Faria, S.M. de; Franco, A.A.; Menandro, M.S.

    1984-01-01

    Six papers are presented from the symposium. Dobereiner, J.; Nodulation and nitrogen fixation in leguminous trees, 83-90, (15 ref.), reviews studies on Brazilian species. Gauthier, D.L., Diem, H.G., Dommergues, Y.R., Tropical and subtropical actinorhizal plants, 119-136, (Refs. 50), reports on studies on Casuarinaceae. Bonetti, R., Oliveira, L.A., Magalhaes, F.M.M.; Rhizobium populations and occurrence of VA mycorrhizae in plantations of forest trees, 137-142, (Refs. 15), studies Amazonia stands of Cedrelinga catenaeformis, Calophyllum brasiliense, Dipteryx odorata, D. potiphylla, Carapa guianensis, Goupia glabra, Tabebuia serratifolia, Clarisia racemosa, Pithecellobium racemosum, Vouacapoua pallidior, Eperua bijuga, and Diplotropis species. Nodulation was observed in Cedrelinga catenaeformis and V. pallidior. Faria, S.M. de, Franco, A.A., Menandro, M.S., Jesus, R.M. de, Baitello, J.B.; Aguiar, O.T. de, Doebereiner, J; survey of nodulation in leguminous tree species native to southeastern Brazil, 143-153, (Refs. 7), reports on 119 species, with first reports of nodulation in the genera Bowdichia, Poecilanthe, Melanoxylon, Moldenhaurea (Moldenhawera), and Pseudosamanea. Gaiad, S., Carpanezzi, A.A.; Occurrence of Rhizobium in Leguminosae of silvicultural interest for south Brazil, 155-158, (Refs. 2). Nodulation is reported in Mimosa scabrella, Acacia mearnsii, A. longifolia various trinervis, Enterolobium contortisiliquum, and Erythrina falcata. Magalhaes, L.M.S., Blum, W.E.H., Nodulation and growth of Cedrelinga catanaeformis in experimental stands in the Manaus region - Amazonas, 159-164, (Refs. 5). Results indicate that C. catenaeformis can be used in degraded areas of very low soil fertility.

  12. 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.

  13. 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

  14. 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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

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

    2014-09-01

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

  16. 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

  17. MRI analysis of the ISOBAR TTL internal fixation system for the dynamic fixation of intervertebral discs: a comparison with rigid internal fixation

    OpenAIRE

    Gao, Jun; Zhao, Weihua; Zhang, Xi; Nong, Luming; Zhou, Dong; Lv, Zhengxiang; Sheng, Yonghua; Wu, Xingbiao

    2014-01-01

    Objectives Using magnetic resonance imaging (MRI), we analyzed the efficacy of the posterior approach lumbar ISOBAR TTL internal fixation system for the dynamic fixation of intervertebral discs, with particular emphasis on its effects on degenerative intervertebral disc disease. Methods We retrospectively compared the MRIs of 54 patients who had previously undergone either rigid internal fixation of the lumbar spine or ISOBAR TTL dynamic fixation for the treatment of lumbar spondylolisthesis....

  18. Evaluation of four methods for cytomegalovirus antibody detection for use by a bone marrow transplantation service.

    OpenAIRE

    Leland, D S; Barth, K A; Cunningham, E B; Jansen, J; Tricot, G J; French, M L

    1989-01-01

    Four methods, latex agglutination, indirect fluorescent antibody, enzyme immunoassay, and complement fixation, were compared for cytomegalovirus antibody screening and for pre- and posttransplant determinations on bone marrow transplant recipients. Latex agglutination was most sensitive (98%) and specific (97%) for screening and pretransplant determinations and was quickest and easiest to perform. In posttransplant sera from allogeneic bone marrow transplant recipients, all methods except com...

  19. An injectable calcium phosphate cement for the local delivery of paclitaxel to bone

    NARCIS (Netherlands)

    Lopez-Heredia, M.A.; Kamphuis, G.J.; Thune, P.C.; Oner, F.C.; Jansen, J.A.; Walboomers, X.F.

    2011-01-01

    Bone metastases are usually treated by surgical removal, fixation and chemotherapeutic treatment. Bone cement is used to fill the resection voids. The aim of this study was to develop a local drug delivery system using a calcium phosphate cement (CPC) as carrier for chemotherapeutic agents. CPC cons

  20. Changes of blood circulation of the extremity after external fixation for tibia shaft defect: an experimental study

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To assess and compare two approaches, end to endcompression with lengthening (EECL) and segmental bone transport by lengthening (STBL), for long tubular bone defect and nonunion.Methods: Ten goats were used to establish the bone defect model of the mid-tibia. The bone defect ends were shortened step by step with a sulcated half-ring external fixator. Changes of the blood flow of the distal extremity were measured with pulse-Doppler monitor and angiography.Results: The blood flow in the distal extremity was not affected when bone defect was less than 15% of the original length. Blood circulatory disorder would appear in the distal extremity when bone defect ranged 15%-20% of the original length. The necrosis would appear in the extremity because of the blood circulatory obstacle when bone defect was more than 20% of the original length.Conclusions: EECL is an appropriate alternative of treatments if bone defect is less than 15%; while SBTL may be feasible if bone defect is over 20% of the original length. When bone defect ranges between 15% and 20%, EECL should be applied with great care on condition of keeping watch on the extremity circulation with pulse-Doppler monitor.

  1. Surface Accelerometer Fixation Method Affects Leg Soft Tissue Motion Following Heel Impacts

    Directory of Open Access Journals (Sweden)

    Jennifer M. Stefanczyk

    2013-10-01

    Full Text Available Surface-mounted accelerometers (SMA secured tightly to body segments with an elastic strap, are commonly used to quantify the impact response of bone.  However, the effect that this type of fixation has on segment soft tissue motion relative to bone has yet to be determined.  Heel impacts were collected from 20 participants using a human pendulum apparatus, with (strap and without (no strap a SMA attached to the proximal tibia.  Leg soft tissue motion was quantified using digital image analysis software which monitored positions of skin markers from a series of high speed photographs.  The strap was found to alter the natural physiological motion of the soft tissue, with significant displacement, velocity and sex differences occurring within the most proximal regions.  Future research should evaluate alternative methods for quantifying bone and soft tissue response to impact concurrently, to advance our understanding of impact-related injury mechanisms.

  2. Standard bone healing stages occur during delayed bone healing, albeit with a different temporal onset and spatial distribution of callus tissues

    OpenAIRE

    Peters, Anja; Schell, Hanna; Bail, Hermann J.; Hannemann, Marion; Schumann, Tanja; Duda, Georg N; Lienau, Jasmin

    2010-01-01

    Bone healing is considered as a recapitulation of a developmental program initiated at the time of injury. This study tested the hypothesis that in delayed bone healing the regular cascade of healing events, including remodeling of woven to lamellar bone, would be similar compared to standard healing, although the temporal onset would be delayed. A tibial osteotomy was performed in sheep and stabilized with a rotationally unstable fixator leading to delayed healing....

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

    Science.gov (United States)

    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 pullouts 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 (age) of the animal, the level of the vertebrae (lumbar or thoracic) and the type of screw anchorage (mono- or bi-cortical) on pedicle screw pullouts. Among the 80 pig vertebrae (90- and 140-day-old) tested in this study, the average screw pullout forces ranged between 419.9N and 1341.2N. In addition, statistical differences were found between test groups, pointing out the influence of the three parameters stated above. We found that the the more caudally the screws are positioned (lumbar level), the greater their pullout resistance is, moreover, screw stability increases with the age, and finally, the screws implanted with a mono-cortical anchorage sustained lower pullout forces than those implanted with a bi-cortical anchorage. We conclude that the best anchorage can be obtained with older animals, using a lumbar fixation and long screws traversing the vertebra and inducing bi-cortical anchorage. In very young animals, pedicle screw fixations need to be bi-cortical and more numerous to prevent pullout. PMID:26451947

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

    Directory of Open Access Journals (Sweden)

    Sophie Le Cann

    Full Text Available 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 pullouts 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 (age of the animal, the level of the vertebrae (lumbar or thoracic and the type of screw anchorage (mono- or bi-cortical on pedicle screw pullouts. Among the 80 pig vertebrae (90- and 140-day-old tested in this study, the average screw pullout forces ranged between 419.9N and 1341.2N. In addition, statistical differences were found between test groups, pointing out the influence of the three parameters stated above. We found that the the more caudally the screws are positioned (lumbar level, the greater their pullout resistance is, moreover, screw stability increases with the age, and finally, the screws implanted with a mono-cortical anchorage sustained lower pullout forces than those implanted with a bi-cortical anchorage. We conclude that the best anchorage can be obtained with older animals, using a lumbar fixation and long screws traversing the vertebra and inducing bi-cortical anchorage. In very young animals, pedicle screw fixations need to be bi-cortical and more numerous to prevent pullout.

  5. A Case Report of Multiple Aneurysmal Bone Cysts

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ Case Report A 30-year old male patient, admitted in our hospital for a fracture of the upper end of the left humerus in February, 2006, received treatment with curettage of the lesion in combination with an autologous bone graft from the right ilium plus internal fixation. A post-operative pathological examination indicated that there was a simple bone cyst in the area of the fracture, with a satisfactory postoperative recovery.

  6. Thermoplastic polymeric adhesive for structural bonding applications for orthopaedic devices

    International Nuclear Information System (INIS)

    The orthopaedics industry has witnessed tremendous growth in recent years primarily due to the introduction of high performance, porous coated implants. These devices have eliminated the need for the use of bone cement for in vivo implant fixation, replacing it with the ingrowth of bone into the porous surfaces. The metallurgical bonding processes used for attaching the porous to the implant body introduce some undesirable effect i.e., the reduction of the fatigue strength of the implant due to the ''notches'' created and also due to the high temperature exposure during the sintering operations. This paper describes the development of a thermoplastic polymeric adhesive based structural bonding technique. The high performance polymeric adhesive is fully characterized with respect to its intended application. The design of the porous layer is optimized to achieve a reliable bond to the implant. A thermal heating/cooling process was developed to control the final polymer morphology. Static and fatigue tests were conducted to fully characterize the adhesive bond strength. A ring shear test method was developed to determine the shear strength of the bond interface. Besides the characterization of the adhesive bond, the joints will be analyzed using finite element models. The correlation between the analytical models and the

  7. Evaluation of cranial bone transport distraction with and without adipose grafting.

    Science.gov (United States)

    Koch, Felix P; Yuhasz, Mikell M; Travieso, Rob; Wong, Kenneth; Clune, James; Zhuang, Zhen W; Van Houten, Joshua; Steinbacher, Derek M

    2014-05-01

    Transport distraction osteogenesis (DO) can be used to autologously reconstitute calvarial defects. The purpose of this study is to histomorphologically interrogate osteogenic formation during cranial transport distraction using a novel device. We also evaluate the effect of fat grafting on the regenerate and soft-tissue stability during distraction. This study was approved by Yale IACUC. Ten male New Zealand white rabbits (3 mo; 3.5 kg) were used (8 treatment, 2 control). A 16 × 16 mm defect was created abutted by a 10 × 16 mm transport disc. The device was fixated anterioposteriorly. Four animals were fat-grafted using 2 mL of subdermal intrascapular fat deposited along the distraction site. Latency (1 d), active distraction (12-14 d) (1.5 mm/d), and consolidation (4 wk) followed. Calcein and xylene orange fluorochromes were injected subcutaneously during and post-distraction to mark sites of bone formation. Following sacrifice, osteogenesis was assessed using microCT, histology, and fluorescence. Treatment animals demonstrated regenerate bone between distracted segments on microCT. MicroCT analysis of non-fat-grafted and fat-grafted animals revealed a mean density of 2271.95 mgHA/ccm and 2254.27 mgHA/ccm (P = 0.967), respectively, and defect bone versus total volume (BV/TV) of 0.0999 and 0.0766 (P = 0.5979), respectively. Controls had minimal reossification. Histologically, mean densities measured 43.63% and 8.19%, respectively. Fluorescence revealed ossification from the callus as well as from dura and periosteum in the cranial defect. Transport distraction is effective to reconstruct critically sized rabbit calvarial defects. Regenerate bone arises predominantly from the callus with contribution from surrounding dura and periosteum. Adipose grafting is well tolerated but does not enhance osseous regeneration. PMID:24820707

  8. 椎弓根螺钉内固定材料置入并植骨融合后路矫正治疗重度僵硬性青少年特发性脊柱侧凸20例%Posterior correction using pedicle screw fixation combined with bone grafting and fusion for treatment of severe and rigid adolescent idiopathic scoliosis in 20 cases

    Institute of Scientific and Technical Information of China (English)

    臧危平; 刘祖德; 李展春; 冯宇; 张磊

    2008-01-01

    主弯平均Cobb角从术前的82°(75o~ 92o)矫正到31°(22°~37°),平均矫正率为62%.③双肩高度差及住院时间:术后脊柱侧位片均显示患者胸腰椎基本恢复正常后凸及前凸,平均双肩高度差为7.5 mm(0~11 mm),患者住院日为8~11 d, 平均9 d.④随访结果:所有患者均获术后4年随访,所有侧凸主弯矫正角度未发生丢失,固定节段全部融合,无断钉、断棒发生.结论:单纯后路椎弓根螺钉内固定材料置入并植骨融合术能有效治疗主弯在75o~92o,柔韧性≥ 20%的重度僵硬性青少年特发性脊柱侧凸.%BACKGROUND: Traditional anterior release followed by posterior correction and fusion is frequently used to treat severe and rigid adolescent idiopathic scoliosis, which is considered as Cobb angle of the major curve > 65° and flexibility < 34.5%; however, there are a great majority of complications. Whether isolated posterior correction using pedicle screw fixation combining with bone grafting and fusion may provide better effects on severe and rigid adolescent idiopathic scoliosis needs to be further studied.OBJECTIVE: To evaluate isolated posterior correction using pedicle screw fixation combining with bone grafting and fusion for the treatment of severe and rigid adolescent idiopathic scoliosis. DESIGN: Case analysis.SETTING: Department of Orthopaedics, Renji Hospital, Medical College of Shanghai Jiao Tong University.PARTICIPANTS: Twenty patients with severe and rigid adolescent idiopathic scoliosis, including 8 males and 12 females, were selected from Department of Orthopaedics, Renji Hospital, Medical College of Shanghai Jiaotong University from June 1999 to August 2005. They were 12-18 years old, and the mean age was 14.6 years. All patients were finally diagnosed as X-ray of whole spine. According to King-Moe criteria, patients were classified into type Ⅰ(n =4), type Ⅱ(n =6), type Ⅲ (n =5), type Ⅳ(n =3) and type Ⅴ(n =2). Before surgery, mean Cobb angle of the major curve was 82

  9. Chemical and physical basics of routine formaldehyde fixation

    Directory of Open Access Journals (Sweden)

    Rooban Thavarajah

    2012-01-01

    Full Text Available Formaldehyde is the widely employed fixative that has been studied for decades. The chemistry of fixation has been studied widely since the early 20 th century. However, very few studies have been focused on the actual physics/chemistry aspect of process of this fixation. This article attempts to explain the chemistry of formaldehyde fixation and also to study the physical aspects involved in the fixation. The factors involved in the fixation process are discussed using well documented mathematical and physical formulae. The deeper understanding of these factors will enable pathologist to optimize the factors and use them in their favor.

  10. Chemical and physical basics of routine formaldehyde fixation.

    Science.gov (United States)

    Thavarajah, Rooban; Mudimbaimannar, Vidya Kazhiyur; Elizabeth, Joshua; Rao, Umadevi Krishnamohan; Ranganathan, Kannan

    2012-09-01

    Formaldehyde is the widely employed fixative that has been studied for decades. The chemistry of fixation has been studied widely since the early 20(th) century. However, very few studies have been focused on the actual physics/chemistry aspect of process of this fixation. This article attempts to explain the chemistry of formaldehyde fixation and also to study the physical aspects involved in the fixation. The factors involved in the fixation process are discussed using well documented mathematical and physical formulae. The deeper understanding of these factors will enable pathologist to optimize the factors and use them in their favor. PMID:23248474

  11. Clinical and radiographic evaluation of biodegradable bone plates in the treatment of mandibular body fractures

    Directory of Open Access Journals (Sweden)

    Sherin Kamal Elhalawany

    2015-01-01

    Full Text Available Background: Many different systems are available for the treatment of fractures ranging from the heavy compression plates for mandibular reconstruction to low profile plates for mid-facial fixation, and are made either from stainless steel, titanium or vitallium. Recently, biodegradable, self-reinforced polylactide plates and screws have been used for the internal fixation of fractures of the mandible with good results. Aim of this study: This study evaluated clinically the biodegradable bone plates for treatment of mandibular body fracture and to evaluate bone healing during the follow-up period using digital radiography. Materials and Methods : Eight patients had been suffered from mandibular body fractures were treated using Inion CPS TM bioresorbable fixation system and the healing process were followed up using digitised panoramic radiography at first week and after 1, 3 and 6 months. Results: Clinical examination of fractured segments revealed stable fixation across the fracture sites while visual and quantitative assessment of radiograph showed healing process was comparable with results previously reported by titanium bone plates. Conclusion: Open reduction and internal fixation of mandibular fractures using bioresorbable fixation system with a brief period of inter-maxillary fixation have evolved to the point where the physical properties are sufficient to withstand the post-operative loads required for fracture repair of mandibular body fractures. The foreign body reaction is a major material-related problem which requires further studies.

  12. Breast specimen shrinkage following formalin fixation

    Directory of Open Access Journals (Sweden)

    Horn CL

    2014-02-01

    Full Text Available Christopher L Horn, Christopher Naugler Department of Pathology and Laboratory Medicine, University of Calgary, and Calgary Laboratory Services, Calgary, AB, Canada Abstract: Accurate measurement of primary breast tumors and subsequent surgical margin assessment is critical for pathology reporting and resulting patient therapy. Anecdotal observations from pathology laboratory staff indicate possible shrinkage of breast cancer specimens due to the formalin fixation process. As a result, we conducted a prospective study to investigate the possible shrinkage effects of formalin fixation on breast cancer specimens. The results revealed no significant changes in tumor size, but there were significant changes in the distance to all surgical resection margins from the unfixed to fixed state. This shrinkage effect could interfere with the accuracy of determining distance to margin assessment and tumor-free margin assessment. Thus, changes in these measurements due to the formalin fixation process have the potential to alter treatment options for the patient. Keywords: breast margins, formalin, shrinkage, cancer

  13. Transarticular screw fixation using neuronavigation: Technique

    Directory of Open Access Journals (Sweden)

    Dwarakanath Srinivas

    2007-01-01

    Full Text Available Background: Transarticular screw placement needs highly accurate imaging. We assess the efficacy and accuracy of C1-C2 transarticular screw fixation using neuronavigation and also cast a technical note on the procedure. Materials and Methods: This study included a total of nine patients who underwent transarticular screw fixation using the neuronavigation system. A total of 15 screws were placed. All patients underwent postoperative CT scan with 3-Dimensional (3-D reconstruction to check for the accuracy of implantation. Results: One patient had encroachment of the transverse foramen but there was no vertebral artery injury. There were no clinical complications or adverse sequelae. Conclusion: Neuronavigation is extremely helpful in C1-C2 transarticular screw fixation and gives excellent accuracy.

  14. Combined Percutaneous Iliosacral Screw Fixation With Sacroplasty Using Resorbable Calcium Phosphate Cement for Osteoporotic Pelvic Fractures Requiring Surgery.

    Science.gov (United States)

    Collinge, Cory A; Crist, Brett D

    2016-06-01

    Osteoporotic sacral fractures, including acute and chronic insufficiency fractures, are increasing in frequency and present a number of management problem. Many of these patients are treated nonoperatively with relative immobility (eg, bedrest, wheelchair, or weight-bearing restrictions) and analgesics, which likely make the osteoporotic component worse. Surgery in this patient population may be desirable in some cases with the goals of improving mobility, relieving pain, and healing in an aligned position while minimizing deformity progression. However, internal fixation of the osteoporotic pelvis can be difficult. Large unicortical lag screws are the workhorse of posterior pelvic fixation, and yet fixation in cancellous bone corridors of an osteoporotic sacrum seems unlikely to achieve optimal fixation. As a result, the operative management and clinical results of these difficult injuries may not be uniformly successful. The authors present a technique for treating osteoporotic patients with a sacral fracture when operative treatment is indicated using percutaneous screw fixation combined with screw augmentation using a resorbable calcium phosphate bone substitute or "cement." The guide wire for a 7.3-mm or other large cannulated lag screw is fully inserted along the desired bony sacral corridor as is standard. The lag screw is then inserted over the wire to the depth where cement is desired. The guide wire is removed, and the aqueous calcium phosphate is injected through the screw's cannulation. For acute fractures, cement was applied to the areas distant to the fracture; whereas in insufficiency fractures, the cement was inserted along most of the screw path. The guide wire then can be reinserted and the lag screw fully inserted. The rationale for using these 2 modalities is their synergistic effect: the cannulated screw provides typical screw fixation and also a conduit for cement application. The cement augments the lag screw's purchase in osteoporotic bone

  15. Bone uptake of rare earths and transuranic elements

    International Nuclear Information System (INIS)

    In the first part of this paper formation conditions of citric complexes of rare earths and transuranic elements are presented. In the second part, role of binding proteins in plasma is emphasized. Finally biological behaviour of the injected elements is evidenced. A general mechanism for fixation of these elements in bone and liver is proposed

  16. The effect on implant fixation of soaking tricalcium phosphate granules in bisphosphonate

    DEFF Research Database (Denmark)

    Jakobsen, Thomas; Baas, Jørgen; Bechtold, Joan E;

    2012-01-01

    biomechanical implant fixation and osseointegration of experimental implant grafted with β-TCP granules (Conduit) could be improved by soaking the β-TCP granules in bisphosphonate (zoledronate). In 10 dogs, a pair of titanium coated implants surrounded by a 2.5 mm gap was inserted into the proximal part of each...... tibia. The gap was grafted with β-TCP granules either soaked with zoledronate or saline. At 12 weeks, the implants were evaluated with biomechanical push-out test and histomorphometrical analysis. We found that bisphosphonate increased one of the three biomechanical parameters, but found no difference...... in the amount of new bone or β-TCP granules between the two treatment groups. This study indicates that local treatment of β-TCP granules with zoledronate not only has the potential to increase implant fixation but also calls for further experimental research in order to optimize the dose of zoledronate....

  17. A preliminary study of bending stiffness alteration in shape changing nitinol plates for fracture fixation.

    Science.gov (United States)

    Olender, Gavin; Pfeifer, Ronny; Müller, Christian W; Gösling, Thomas; Barcikowski, Stephan; Hurschler, Christof

    2011-05-01

    Nitinol is a promising biomaterial based on its remarkable shape changing capacity, biocompatibility, and resilient mechanical properties. Until now, very limited applications have been tested for the use of Nitinol plates for fracture fixation in orthopaedics. Newly designed fracture-fixation plates are tested by four-point bending to examine a change in equivalent bending stiffness before and after shape transformation. The goal of stiffness alterable bone plates is to optimize the healing process during osteosynthesis in situ that is customized in time of onset, percent change as well as being performed non-invasively for the patient. The equivalent bending stiffness in plates of varying thicknesses changed before and after shape transformation in the range of 24-73% (p values inertia. PMID:21286815

  18. External fixation of complex femoral shaft fractures

    OpenAIRE

    Zlowodzki, M; Prakash, J. S.; Aggarwal, N. K.

    2006-01-01

    Conversion of temporary external fixation to an intramedullary nail within the first 2 weeks after a femoral shaft fracture is standard practice. However, due to financial constraints, in large parts of the world external fixation of femoral shaft fractures is often the definitive treatment. Out of 60 fractures, 47 were followed-up for a minimum period of 39 weeks. The average follow-up time was 75 weeks. Fourteen fractures were closed, and 33 open. Forty-four fractures united at an average o...

  19. No effect of platelet-rich plasma with frozen or processed bone allograft around noncemented implants

    DEFF Research Database (Denmark)

    Jensen, T B; Rahbek, O; Overgaard, S; Søballe, Kjeld

    2005-01-01

    We compared processed morselized bone allograft with fresh-frozen bone graft around noncemented titanium implants. Also, the influence of platelet-rich plasma (PRP) in combination with bone allograft was evaluated. Analysis was based on implant fixation and histomorphometry. PRP was prepared by...... isolating the buffy coat from autologous blood samples. Bone allograft was used fresh-frozen or processed by defatting, freeze drying, and irradiation. Cylindrical hydroxyapatite-coated titanium implants were inserted bilaterally in the femoral condyles of eight dogs. Each implant was surrounded by a 2.5-mm...... bone allograft processing. Even though the level of platelet in PRP was 7.7 times that found in whole blood, we found no improvement of bone formation or implant fixation by adding PRP....

  20. Is mask-based stereotactic head-and-neck fixation as precise as stereotactic head fixation for precision radiotherapy?

    International Nuclear Information System (INIS)

    -and-neck fixation allows accurate and reproducible fixation of patients. For intensity-modulated radiation therapy in the upper head-and-neck region, the application of reduced margins around 2-3 mm, which has an implication on organ sparing, is enabled by such an immobilization device

  1. Failed operative treatment in two cases of pseudarthrosis of the clavicle using internal fixation and bovine cancellous xenograft (Tutobone).

    Science.gov (United States)

    Elliot, Robin R; Richards, Robert H

    2011-09-01

    The most commonly reported technique of reconstructive surgery for congenital pseudarthrosis of the clavicle involves resection of the pseudarthrosis, insertion of autologous iliac crest bone graft and internal fixation. In an attempt to avoid the potential complications of iliac crest bone graft harvest we used bovine cancellous xenograft (Tutobone). Two cases of pseudarthrosis of the clavicle treated with resection of the pseudarthrosis, Tutobone graft and internal fixation are presented. Both cases resulted in treatment failures, which were associated with significant osteolysis and failure of incorporation of the graft material. This required removal of the loose metal work and debridement of the failed graft material. We would caution surgeons against the use of Tutobone as a graft material in the surgical management of pseudarthrosis of the clavicle. The level of evidence was level IV case series. PMID:21537200

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

    International Nuclear Information System (INIS)

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

  3. External fixation for the treatment of open fractures of the proximal humerus caused by firearms

    OpenAIRE

    Mirić Dragan; Senohradski Kenan; Starčević Branislav; Đorđević Zoran

    2004-01-01

    Nine patients with open fractures of the proximal humerus were treated using an external fixation device. All of them had grade III open fractures resulting from high-velocity missile and explosive injuries with massive foreign body contamination. Radial nerve injury was present in five and two multiply injuried patients with thoracic wall and abdominal viscera were present. There were no major arterial injuries. Chronic osteitis with fistula and sequestra developed in one. There were no nonu...

  4. Fibrin sealant for mesh fixation in laparoscopic umbilical hernia repair

    DEFF Research Database (Denmark)

    Eriksen, J R; Bisgaard, T; Assaadzadeh, S;

    2013-01-01

    Fibrin sealant for mesh fixation has significant positive effects on early outcome after laparoscopic ventral hernia repair (LVHR) compared with titanium tacks. Whether fibrin sealant fixation also results in better long-term outcome is unknown.......Fibrin sealant for mesh fixation has significant positive effects on early outcome after laparoscopic ventral hernia repair (LVHR) compared with titanium tacks. Whether fibrin sealant fixation also results in better long-term outcome is unknown....

  5. Comparison of several fixation methods for cytomegalovirus antigenemia assay.

    OpenAIRE

    Pérez, J.L.; De Oña, M; Niubò, J; Villar, H.; Melón, S.; García, A.; Martín, R.

    1995-01-01

    Two fixation methods based on formaldehyde or acetone for qualitative cytomegalovirus antigenemia assay were evaluated on 405 consecutive blood samples. Cytomegalovirus was detected in 40 samples by the antigenemia assay: 36 were detected by formaldehyde fixation; 22, by acetone; and 18, by both methods. Differences were statistically significant (P = 0.0043). In addition, four fixation methods (two based on formalin [with and without permeabilization] and two using acetone at different fixat...

  6. Lengthening of the first metatarsal bone. A case of congenital shortening

    OpenAIRE

    Amillo, S.; Gil-Albarova, J. (Jorge); Pampliega, T. (Tomás)

    1991-01-01

    A 14-year-old boy had a congenital shortening of the first right metatarsal bone, with overloading of the central metatarsals and medial deviation of the second toe. A percutaneous osteotomy and slow distraction by an external fixator for 10 weeks lengthened the bone from 32 mm to 60 mm. After the distraction, a bone graft was performed, and tenotomies and a capsulotomy corrected a threatening subluxation. Consolidation of the lengthening focus required 16 weeks.

  7. Are open-fit hearing aids a possible alternative to bone-anchored hearing devices in patients with mild to severe hearing loss? A preliminary trial

    Directory of Open Access Journals (Sweden)

    Amberley V. Ostevik

    2013-08-01

    Full Text Available Open-fit hearing aids (OFHAs may be of benefit for some individuals with chronic outer and middle ear conditions for which boneanchored hearing devices (BAHDs are normally recommended. The purpose of this study was to compare performance between OFHAs and BAHDs. A Starkey Destiny 800 OFHA was fit on eight adult BAHD users and speech perception measures in quiet and in background noise were compared under two different test conditions: i BAHD only and ii OFHA only. Equivalent outcome measure performance between these two conditions suggests that the OFHA was able to provide sufficient amplification for mild to moderate degrees of hearing loss (pure-tone averages (PTAs less than 47 dB HL. The improved speech perception performances and increased loudness ratings observed for several of the participants with moderately-severe to severe degrees of hearing loss (PTAs of 47 dB HL or greater in the BAHD only condition suggest that the OFHA did not provide sufficient amplification for these individuals. Therefore, OFHAs may be a successful alternative to the BAHD for individuals with no more than a moderate conductive hearing loss who are unable or unwilling to undergo implant surgery or unable to wear conventional hearing aids due to allergies, irritation, or chronic infection associated with the ear being blocked with a shell or earmold.

  8. Heterotrophic fixation of CO2 in soil

    Czech Academy of Sciences Publication Activity Database

    Šantrůčková, Hana; Bird, M. I.; Elhottová, Dana; Novák, Jaroslav; Picek, T.; Šimek, Miloslav; Tykva, Richard

    2005-01-01

    Roč. 49, č. 2 (2005), s. 218-225. ISSN 0095-3628 R&D Projects: GA ČR(CZ) GA206/02/1036; GA AV ČR(CZ) IAA6066901 Institutional research plan: CEZ:AV0Z60660521 Keywords : heterotrophic fixation * CO2 * soil Subject RIV: EH - Ecology, Behaviour Impact factor: 2.674, year: 2005

  9. 15N in biological nitrogen fixation studies

    International Nuclear Information System (INIS)

    A bibliography with 298 references on the use of the stable nitrogen isotope 15N in the research on the biological fixation of dinitrogen is presented. The literature pertaining to this bibliography covers the period from 1975 to the middle of 1985. (author)

  10. Fixation and hydrogenation of CO2

    International Nuclear Information System (INIS)

    The aim of this study is to describe the fixation and the utilisation of carbon dioxide to prevent the global warming. The hydrogenation of carbon dioxide is studied to convert it into valuable materials such as methanol or hydrocarbon by using new catalysts. (TEC). 13 refs., 3 figs., 1 tab

  11. Bone mineralization pathways during the rapid growth of embryonic chicken long bones.

    Science.gov (United States)

    Kerschnitzki, Michael; Akiva, Anat; Ben Shoham, Adi; Asscher, Yotam; Wagermaier, Wolfgang; Fratzl, Peter; Addadi, Lia; Weiner, Steve

    2016-07-01

    The uptake and transport of ions from the environment to the site of bone formation is only partially understood and, for the most part, based on disparate observations in different animals. Here we study different aspects of the biomineralization pathways in one system, the rapidly forming long bones of the chicken embryo. We mainly used cryo-fixation and cryo-electron imaging to preserve the often unstable mineral phases in the tissues. We show the presence of surprisingly large amounts of mineral particles located inside membrane-delineated vesicles in the bone forming tissue between the blood vessels and the forming bone surface. Some of these particles are also located inside mitochondrial networks. The surfaces of the forming bones in the extracellular space contain abundant aggregates of amorphous calcium phosphate particles, but these are not enveloped by vesicle membranes. In the bone resorbing region, osteoclasts also contain many particles in both mitochondrial networks and within vesicles. Some of these particles are present also between cells. These observations, together with the previously reported observation that CaP mineral particles inside membranes are present in blood vessels, leads us to the conclusion that important components of the bone mineralization pathways in rapidly forming chicken bone are dense phase mineral particles bound within membranes. It remains to be determined whether these mineral particles are transported to the site of bone formation in the solid state, fluid state or dissolve and re-precipitate. PMID:27108185

  12. Theory and practice of combining coagulant fixation and microwave histoprocessing

    NARCIS (Netherlands)

    Boon, M. E.; Kok, L. P.

    2008-01-01

    The German, F. Blum, introduced formalin as a fixative in 1893. Formalin rapidly became popular for hardening and preserving gross human and animal specimens. As a result, microscopy for diagnostic pathology by combining paraffin embedding and formalin fixation was developed. Alcohol-based fixatives

  13. EFFECT OF EMBEDDING METHODS VERSUS FIXATIVE TYPE ON KARYOMETRIC MEASURES

    NARCIS (Netherlands)

    BOON, ME; VANDERPOEL, HG; TAN, CJA; KOK, LP

    1994-01-01

    The influence of fixation and embedding methods in seven urologic tumor samples was studied karyometrically for 12 preparatory techniques. Routine histologic formalin fixation was compared with Carbowax and Kryofix fixatives. Also, histologic material was studied embedded in paraffin and plastic (GM

  14. Effect of local TGF-β1 and IGF-1 release on implant fixation: comparison with hydroxyapatite coating

    OpenAIRE

    Lamberg, Anders; Bechtold, Joan E.; Baas, Jørgen; Søballe, Kjeld; Elmengaard, Brian

    2009-01-01

    Background and purpose Hydroxyapatite (HA) coating stimulates the osseointegration of cementless orthopedic implants. Recently, locally released osteogenic growth factors have also been shown experimentally to stimulate osseointegration so that bone fills gaps around orthopedic implants. Here, we have compared the effect of local release of TGF-β 1 and IGF-1 with that of hydroxyapatite coating on implant fixation. Method Weight-bearing implants with a 0.75-mm surrounding gap were inserted bil...

  15. [Three-dimensional Finite Element Analysis of Biomechanical Effect of Rigid Fixation and Elastic Fixation on Lumbar Interbody Fusion].

    Science.gov (United States)

    Wei, Jiangbo; Song, Yueming; Liu, Limin; Zhou, Chunguan; Yang, Xi

    2015-04-01

    This study was aimed to compare the mechanical characteristics under different physiological load conditions with three-dimensional finite element model of rigid fixation and elastic fixation in the lumbar. We observed the stress distribution characteristics of a sample of healthy male volunteer modeling under vertical, flexion and extension torque situation. The outcomes showed that there existed 4-6 times pressure on the connecting rod of rigid fixation compared with the elastic fixations under different loads, and the stress peak and area of force on elastic fixation were much higher than that of the rigid fixations. The elastic fixation has more biomechanical advantages than rigid fixation in promoting interbody lumbar fusion after surgery. PMID:26211247

  16. A new technique for fixation of the foot with the Ilizarov fixator

    OpenAIRE

    Kabukcuoglu, Yavuz; Kucukkaya, Metin; Demir, Bilal; Kuzgun, Unal

    2004-01-01

    Circular external fixators which are very often used in Orthopaedic and Traumatologic practice, sometimes ankle and foot may need to be included in fixator. Kirschner wires (K wire) are generally used by Russian and some western researchers for this purpose. But this procedure generates some problems for both patients and Surgeons. Major problems are easy contamination of wire, difficulty to wear shoes, difficulty to obtain clear radiological images with wires. We have been using Schanz pin i...

  17. Characterization for Soil Fixation by Polyelectrolyte Complex

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yong Suk; Kwon, Sang Woon; Yang, Heeman; Lee, Kune Woo; Seo, Bumkyoung; Moon, Jei Kwon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2014-05-15

    According to report, the radioactivity bulk (approx. 95%) is localized within topsoil. Therefore soil surface on topsoil should be fixed to prevent the spreading of the contaminated soils with Cs-137 by wind and water erosion. Many methods have been developing for soil fixation to remove radioactive contaminants in soil and prevent to diffuse radioactive materials. Various materials have been also used as fixatives such as clays, molecular sieves, polymer, and petroleum based products. One of the methods is a soil fixation or solidification using polyelectrolyte. Polyelectrolytes have many ionic groups and make into the polyelectrolyte complex (PEC) due to electrostatic interaction of polyanion and polycation in an aqueous solution. It can be avoids using the chemical cross-linking agents, and reducing the possible toxicity and other undesirable effects of the reagents. PEC can fix soil particles by flocculation and formation of crust between soil. The method can also prevent a spread of radioactive material by floating on a soil surface. Recently, PEC used for the solidification of soil near the Fukushima nuclear power plant in Japan. The decontamination efficiency of the surface soils reached 90%, and dust release was effectively suppressed during the removal of surface soils. In this study, it was investigated the fixation of the soil by PEC to avoid the spread of the contamination in addition to the separation of soil and PEC. The physicochemical properties of polyelectrolyte complex solution and the stability of fixed soil by PEC were investigated. The mode of the addition is important to prepare the polyelectrolytes complex without PAA agglomerate. The concentration of salt in the polyelectrolyte complex solution is a very important parameter for the soil fixation.

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

    Directory of Open Access Journals (Sweden)

    Min Li

    2014-04-01

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

  19. Talking Bones.

    Science.gov (United States)

    Johnson, Jaclyn; Kassing, Sharon

    2002-01-01

    Describes cooperation with the Saint Louis Zoo to provide opportunities for elementary school students to learn about bones, how animals move, what they eat, and how much they grow. Uses biofacts which include bones, skulls, and other parts to make the laboratory a hands-on experience for students. (YDS)

  20. Bone Markers

    Science.gov (United States)

    ... bone turnover: C-telopeptide (C-terminal telopeptide of type 1 collagen (CTx)) – a marker for bone resorption. It is ... resorption include: N-telopeptide (N-terminal telopeptide of type 1 collagen (NTx)) – a peptide fragment from the amino terminal ...

  1. Failure load of patellar tendon grafts at the femoral side: 10- versus 20-mm-bone blocks.

    Science.gov (United States)

    Meuffels, Duncan E; Niggebrugge, Marnix J N; Verhaar, Jan A N

    2009-02-01

    The aim of the study was to investigate whether use of short bone blocks is safe in anterior cruciate ligament (ACL) reconstruction. Our hypothesis was that the smaller 10-mm-length bone blocks will fail at lower loads than 20-mm-bone blocks. Ten paired human cadaver knees were randomly assigned to the 10- or 20-mm group (group 1 and 2) and underwent bone-patellar tendon-bone femoral fixation with interference screw. Tensile tests were performed using a tensile testing machine (Instron). Stiffness, failure load and failure mode were recorded. Median stiffness was 72 N/mm (16-103) for 10-mm-bone blocks and 91 N/mm (40-130) for 20-mm-bone blocks. Median failure loads were 402 N (87-546) for 10-mm-long bone block and 456 N (163-636) for 20-mm-bone blocks. There was no statistically significant difference between groups (P = 0.35). All bone-patellar tendon-bone grafts were pulled out of the femoral tunnel with interference screw, due to slippage. We concluded that a 10-mm-long bone block was not significantly weaker than a 20-mm-long bone block. Failure loads of a 10-mm-bone block exceeded loading values at passive and active extension of the knee under normal conditions. Ten millimetre bone blocks offered sufficient fixation strength in ACL reconstruction. PMID:18839146

  2. Bone densitometry

    DEFF Research Database (Denmark)

    Ravn, Pernille; Alexandersen, P; Møllgaard, A

    1999-01-01

    The bisphosphonates have been introduced as alternatives to hormone replacement therapy (HRT) for the treatment and prevention of postmenopausal osteoporosis. The expected increasing application in at clinical practice demands cost-effective and easily handled methods to monitor the effect on bone....... The weak response at the distal forearm during antiresorptive treatment has restricted the use of bone densitometry at this region. We describe a new model for bone densitometry at the distal forearm, by which the response obtained is comparable to the response in other regions where bone densitometry...... is much more expensive and technically complicated. By computerized iteration of single X-ray absorptiometry forearm scans we defined a region with 65% trabecular bone. The region was analyzed in randomized, double-masked, placebo- controlled trials: a 2-year trial with alendronate (n = 69), a 1-year...

  3. FUNCTIONAL OUTCOME OF ARTHROSCOPY ASSISTED ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING BONE PATELLAR TENDON BONE AUTOGRAFT

    Directory of Open Access Journals (Sweden)

    Vinod Kumar

    2015-04-01

    Full Text Available INTRODUCTION: The anterior cruciate ligament (ACL is one of the most frequently injured ligaments in the human body. 1 The Anterior Cruciate ligament (ACL is the primary stabilizer of the knee and prevents the knee against anterior translation. 2 It is also important in counteracting rotational and valgus stress. 1 The middle third of the patellar tendon autograft for ACL reconstruction can be readily procured and firmly fixed. 3 It can tolerate the loads produced by an intensive rehabilitation programme. 3 Fixation of bone plugs using interference screws provides sufficient stability to meet the demand of a vigorous postoperative protocol. 3 It remains the gold standard for ACL reconstruction. 3 This study is to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction using bone patellar tendon bone autograft. METHODS: This study was conducted in Kempegowda Institute of Medical Sciences Hospital from November 2012 to April 2014. During this period 20 cases of adult patients with ACL deficient patients were selected according to the inclusion criteria. Study aims to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction using bone - patellar tendon - bone autograft in terms of range of motion, postoperative knee stability, graft site morbidity and subjective knee functions. RESULTS: Results of our study showed that arthroscopy assisted anterior cruciate ligament reconstruction with bone - patellar tendon - bone autograft could effectively improve knee stability and functions after surgery without any complication. CONCLUSION : Arthroscopy assisted anterior cruciate l igament reconstruction with bone - patellar tendon - bone autograft is an excellent treatment option for anterior cruciate ligament deficient knees. It provides a stable knee and reduces postoperative morbidity and enables early rehabilitation. The functional outcome of arthroscopy assisted anterior

  4. 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

    acid and HA particles (n = 8), or (4) hyaluronic acid and PE particles (n = 8). After 4 weeks, the animals were killed. The implant interface was evaluated by pushout testing until failure and by histomorphometry. Both HA and PE particles were found to be phagocytosed by macrophage-like cells in the...... the mechanical fixation and gap healing around experimental HA implants. Nonloaded implants (n = 30) were inserted bilaterally into the proximal tibia of 15 dogs with a 2-mm gap to the bone. The peri-implant gap was either (1) empty (n = 6) or filled with (2) hyaluronic acid (n = 8), (3) hyaluronic...

  5. The Effects of Campus Bump on Drivers’ Fixation Dispersion and Speed Reduction

    Directory of Open Access Journals (Sweden)

    Qian Xu

    2015-01-01

    Full Text Available To evaluate the effects of campus speed bumps on drivers’ speed and fixation distribution, a quasinaturalistic driving test was conducted on a Chinese campus. Seven randomly selected drivers, wearing the Dikablis eye tracking devices, were required to drive an OPEL SUV passing the speed bumps. The area close to the bump was divided into ten subsegments (15 m for each one. The degree of fixation dispersion within each subsegment was defined as the distance from each subcenter to the whole fixation center. All traffic data were recorded using mounted camera, and the trajectories were extracted in Matlab. The speed and trajectory data was divided into two groups: the before group for bump-free case and the after group for a 5 cm bump case. The observational before-after analysis shows statistical significance between the two cases. The individual vehicular speed analysis reveals that bump reduces nearly 60% of vehicles’ speeds to a certain extent within the distance from 30 m upstream to 15 m downstream. The drivers’ fixation points begin to disperse 30–45 m before they see the bump, and it falls back to normal level 15–30 m downstream of the bump. These findings will help engineers install speed bumps at the most appropriate locations.

  6. Treatment of delayed proximal interphalangeal joint fractures with a handmade dynamic external fixator

    Directory of Open Access Journals (Sweden)

    Ali Gulec

    2015-04-01

    Methods: A retrospective study was conducted in patients treated with a handmade dynamic external fixator for PIP joint fractures in the Orthopaedic Department at the Selcuk University Medical Faculty Hospital. The results of 12 cases were examined in which treatment had been neglected for various reasons, with at least 10 days passing since the injury occurred. Results: The cases included 1 female and 11 males with a mean age of 25.9 years. The mean time from injury to operation was 12.1 days. The device was left in the finger for a mean of 32.9 days. At the final follow-up examination, 7 patients had full ROM, while 4 patients had full extension, but flexion was restricted, ranging from 5 and deg; to 15 and deg;, and in 1 case both extension and flexion restriction were 15 and deg;. The mean follow-up period was 13.7 months, during which no patient reported any pain, nor were there any findings of osteomyelitis, as determined radiologically or clinically. Conclusion: Treatment with an external fixator is a method that is quick, inexpensive and easy to apply. Fixation using a handmade dynamic external fixator for the treatment of PIP fractures is safe and technically simple. Additional extensive studies are required on this subject. [Hand Microsurg 2015; 4(1.000: 1-7

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

    LENUS (Irish Health Repository)

    McGreal, G

    2012-02-03

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

  8. Analysis of medical device materials with the local electrode atom probe

    International Nuclear Information System (INIS)

    Full text: As medical technology advances towards microsurgical and minimally invasive techniques, there is a drive to produce ever-smaller devices that demand higher material performance and hence enhanced nano and micro-scale control of material structure. These devices are made from stainless steel alloys, Nitinol, titanium, CoCrMo, and non-metals such as pyrolytic carbon and silicon. These applications are made possible due to suitable physical and mechanical properties, good corrosion resistance in biological environments, reasonable biocompatibility, and good manufacturability. With respect to the metals, the nano-structure and composition of the material surface, typically an oxide, is especially critical since biological responses and corrosion occur at the material-environment interface. Thus, there is an increasing need to understand the 3-D structure and composition of metallic biomaterials at the atomic scale. Three-dimensional atom probe microscopy can uniquely provide such atomic-level structural information. In the present study several of these medical device materials were examined. These include a 316L stainless steel alloy which is widely used in implanted spinal fixation devices, bone screws, cardiovascular and neurological stents, a cast CoCrMo acetabular hip cup of a Cormet metal-on-metal Hip Resurfacing System (Corin Group, Cirencester, England) that was rejected for clinical use, Nitinol wires specimens such as are used for stents and guide wires, and low temperature pyrolytic carbon as used in clinical heart valve prosthetics. (author)

  9. Augmentation of tendon-to-bone healing.

    Science.gov (United States)

    Atesok, Kivanc; Fu, Freddie H; Wolf, Megan R; Ochi, Mitsuo; Jazrawi, Laith M; Doral, M Nedim; Lubowitz, James H; Rodeo, Scott A

    2014-03-19

    Tendon-to-bone healing is vital to the ultimate success of the various surgical procedures performed to repair injured tendons. Achieving tendon-to-bone healing that is functionally and biologically similar to native anatomy can be challenging because of the limited regeneration capacity of the tendon-bone interface. Orthopaedic basic-science research strategies aiming to augment tendon-to-bone healing include the use of osteoinductive growth factors, platelet-rich plasma, gene therapy, enveloping the grafts with periosteum, osteoconductive materials, cell-based therapies, biodegradable scaffolds, and biomimetic patches. Low-intensity pulsed ultrasound and extracorporeal shockwave treatment may affect tendon-to-bone healing by means of mechanical forces that stimulate biological cascades at the insertion site. Application of various loading methods and immobilization times influence the stress forces acting on the recently repaired tendon-to-bone attachment, which eventually may change the biological dynamics of the interface. Other approaches, such as the use of coated sutures and interference screws, aim to deliver biological factors while achieving mechanical stability by means of various fixators. Controlled Level-I human trials are required to confirm the promising results from in vitro or animal research studies elucidating the mechanisms underlying tendon-to-bone healing and to translate these results into clinical practice. PMID:24647509

  10. Comparison of the effect of posterior lumbar interbody fusion with pedicle screw fixation and interspinous fixation on the stiffness of adjacent segments

    Institute of Scientific and Technical Information of China (English)

    LI Chun-de; SUN Hao-lin; LU Hong-zhang

    2013-01-01

    Background Adjacent segment degeneration could seriously affect the long-term prognosis of lumbar fusion.Dynamicfixation such as the interspinous fixation,which is characterized by retaining the motion function of the spinal segment,has obtained satisfactory short-term effects in the clinical setting.But there are few reports about the biomechanicalexperiments on whether dynamic fixation could prevent adjacent segment degeneration.Methods The surgical segments of all 23 patients were L4/5.Thirteen patients with disc herniation of L4/5 underwentWallis implantation surgery,and 10 patients with spinal stenosis of L4/5 underwent posterior lumbar interbody fusion(PLIF).L3-S1 segmental stiffness and displacement were measured by a spine stiffness gauge (SSG) device duringsurgery when the vertebral plate was exposed or during spinal decompression or internal fixation.Five fresh,frozencadavers were used in the self control experiment,which was carried out in four steps:exposure of the vertebral plate,decompression of the spinal canal,implantation of a Wallis fixing device,and PLIF of L4/5 after removing the Wallis fixingdevice.Then,L3-S1 segment stiffness was measured by an SSG device.Results The experiments showed that the average stiffness of the L4/5 segment was (37.1±8.9) N/mm after exposure of the vertebral plate,while after spinal decompression,the average stiffness fell to (26.2±7.1) N/mm,decreasing by 25.8% (P <0.05).For the adjacent segments L3/4 and L5/S1,their stiffness showed no significant difference between the L4/5 segment decompression and the exposure of the vertebral plate (P >0.05).After Wallis implantation of L4/5,the stiffness of the cephalic adjacent segment L3/4 was (45.8±10.7) N/mm,which was 20.5% more than that after the exposure of the vertebral plate (P <0.05); after L4/5 PLIF surgery,the stiffness of L3/4 was (35.3±10.7) N/mm and was decreased by 12.4% more than that after the exposure of the vertebral plate (P <0.05).The

  11. Fixation stability dictates the differentiation pathway of periosteal progenitor cells in fracture repair.

    Science.gov (United States)

    Hagiwara, Yusuke; Dyment, Nathaniel A; Jiang, Xi; Jiang Ping, Huang; Ackert-Bicknell, Cheryl; Adams, Douglas J; Rowe, David W

    2015-07-01

    This study compared fracture repair stabilized by intramedullary pin (IMP) or external fixation (EF) in GFP reporter mice. A modified IMP was used as control while EF utilized six needles inserted transversely through the tibia and into a segment of a syringe barrel. X-rays taken at days 0, 14, and 35 showed that IMP resulted in significant three-dimensional deformity with a large callus while EF showed minimal deformity and callus formation. Cryohistological analysis of IMP at day 14 confirmed a large ColX-RFPchry+ callus surrounded by woven bone (Col3.6-GFPcyan) and TRAP+ osteoclasts with mature bone (hOC-GFPtpz) at the base. By day 35, cartilaginous components had been resorbed and an outer cortical shell (OCS) showed evidence of inward modeling. In contrast, the EF at day 14 showed no evidence of cartilage formation. Instead, periosteal-derived osteoblasts (Col3.6-GFPcyan) entered the fracture cleft and formed woven bone that spanned the marrow space. By day 35, mature bone had formed that was contiguous with the opposing cortical bone. Fracture site stability greatly affects the cellular response during repair and must be considered in the preclinical models that test therapies for improving fracture healing. PMID:25639792

  12. Difficulties in the fixation of prostheses for voice rehabilitation after laryngectomy.

    Science.gov (United States)

    Ten Hallers, E J O; Marres, H A M; Rakhorst, G; Hagen, R; Staffieri, A; Van Der Laan, B F A M; Van Der Houwen, E B; Verkerke, G J

    2005-08-01

    In most patients with advanced or recurrent laryngeal or hypopharyngeal cancer, total laryngectomy is indicated. This means the loss of three main functions: phonation; respiration; and the prevention of aspiration during deglutition. Laryngectomy patients have various options to restore phonation: an oesophageal voice; an electrolaryngeal voice; or a tracheo-oesophageal voice. In the last case a silicone rubber shunt valve is placed in the tracheo-oesophageal wall and phonation is generated when exhaled air is forced through the oesophagus and neopharynx. This method is widely applied in Western Europe. In this paper we review the literature on fixation problems with shunt valves, tracheostoma valves and heat and moisture exchange (HME) filters. Tracheo-oesophageal speech without a valve is not considered. Despite 22 years of experience with the implantation of tracheo-esophageal shunt valves and many improvements in the design, problems still remain, such as biofilm formation with subsequent leakage through the valve, the need for frequent and inconvenient replacements, fistula enlargement leading to leakage around the device and reduced fixation, and infections. The high cost of shunt valves is a drawback to their use worldwide. To enable hands-free speech, different types of tracheostoma valve have been developed. These valves are fixed to the skin or to the tracheostoma by means of an intra-tracheal device. An HME filter is used to protect the airway and maintain physiological balance. Such devices are only suitable for a selected group of patients as fixation to the skin or trachea can be a major problem. Speaking and coughing cause pressure increases, which often result in mucous leakage and disconnection of the valve and/or HME filter. Recommendations are made for future improvements in fixation techniques. PMID:16158525

  13. Application of alternative fixatives to formalin in diagnostic pathology

    Directory of Open Access Journals (Sweden)

    L. Benerini Gatta

    2012-05-01

    Full Text Available Fixation is a critical step in the preparation of tissues for histopathology. The objective of this study was to investigate the effects of different fixatives vs formalin on proteins and DNA, and to evaluate alternative fixation for morphological diagnosis and nucleic acid preservation for molecular methods. Forty tissues were fixed for 24 h with six different fixatives: the gold standard fixative formalin, the historical fixatives Bouin and Hollande, and the alternative fixatives Greenfix, UPM and CyMol. Tissues were stained (Haematoxylin-Eosin, Periodic Acid Schiff, Trichromic, Alcian-blue, High Iron Diamine, and their antigenicity was determined by immunohistochemistry (performed with PAN-CK, CD31, Ki-67, S100, CD68, AML antibodies. DNA extraction, KRAS sequencing, FISH for CEP-17, and flow cytometry analysis of nuclear DNA content were applied. For cell morphology the alternative fixatives (Greenfix, UPM, CyMol were equivalent to formalin. As expected, Hollande proved the best fixative for morphology. The morphology obtained with Bouin was comparable to that with formalin. Hollande was the best fixative for histochemistry. Bouin proved equivalent to formalin. The alternative fixatives were equivalent to formalin, although with greater variability in haematoxylin-eosin staining. It proved possible to obtain immunohistochemical staining largely equivalent to that following formalin-fixation with the following fixatives: Greenfix, Hollande, UPM and CyMol. The tissues fixed in Bouin did not provide results comparable to those obtained with formalin. The DNA extracted from samples fixed with alternative fixatives was found to be suitable for molecular analysis.

  14. The use of implantable bone stimulators in nonunion treatment.

    Science.gov (United States)

    Hughes, Michael S; Anglen, Jeffrey O

    2010-03-01

    Delayed or failure of bone healing in fracture, osteotomy, and arthrodesis patients continues to be a clinical dilemma. Electromagnetic stimulation is 1 modality demonstrated in many studies to aid bone healing; however, relatively few studies depict the use and complications associated with direct current implantable bone stimulators. Over a 9-year period, we studied a consecutive series of 120 adult patients who underwent implantation of a direct current bone stimulator. The goals of this study were to determine the time until healing, the presence of infection, and the need for additional nonunion surgery or salvage procedure following internal bone stimulator placement for nonunion treatment. Of the factors affecting the time until healing, tobacco smoking was a significant factor associated with increased time until healing. Tobacco smoking and duration of nonunion prior to implantable bone stimulator placement were both significant factors in the need for revision nonunion surgery or salvage procedure after implantable bone stimulator placement. Deep soft tissue infection or osteomyelitis was a significant factor predicting prolonged time to healing, subsequent infection following implantable bone stimulator placement, and the need for revision or salvage surgery. With the relative lack of complications directly attributable to electromagnetic implantable bone stimulators, their use may be an effective adjuvant to stable internal fixation and autogenous bone grafting in healing nonunions. However, the use of implantable bone stimulators in patients with nonunion prior to deep soft tissue infection or osteomyelitis exhibited an increased rate of postoperative infection in this study. PMID:20349861

  15. Fixation of tritium gas by rats

    International Nuclear Information System (INIS)

    The oxidation rate of tritium gas (HT) in the rat was determined using a one-way circuit inhalation apparatus. To eliminate tritiated water (HTO) produced by the apparatus, three traps (a -600C cold trap, a silica gel column and molecular sieves) were used. The oxidation rate was found to be 15.2 Bq per kg of blood per hour for each Bq or HT per ml of inhaled air. This rate was approximately one-third that obtained previously by other workers using a closed circuit inhalation system. No significant differences in tritium concentration were detected between blood and tissues. The fixation of HT by rat faecal suspension under aerobic and anaerobic conditions was determined. Fixation under anaerobic conditions was greater than under aerobic conditions. (author)

  16. Nitrogen fixation improvement in Faidherbia albida

    International Nuclear Information System (INIS)

    A greenhouse experiment investigated growth, N accumulation and N2 fixation (using the 15N-dilution method) by Faidherbia albida in comparison with three species of Acacia, with Parkia biglobosa and Tamarindus indica as non-fixing reference plants. Faidherbia albida was mediocre in comparison with A. seyel, therefore seven provenances of the former were examined in a second pot experiment to investigate within-species variability for the same performance components; a provenance from Kabrousse, Senegal, showed particular promise in terms of dry weight and N accumulation, and fixation of N. This promise was confirmed with a 15-month field experiment, but revealed that there is opportunity for further improvement in N2-fixing ability. Faidherbia albida is a slow-growing tree, therefore further field experiments with provenance Kabrousse should be longer term in scope. The data indicate that trenching of the 15N-labelled area may not be necessary. (author)

  17. Computational analyses of small endosseous implants in osteoporotic bone

    Directory of Open Access Journals (Sweden)

    AJ Wirth

    2010-07-01

    Full Text Available For many years orthopedic implants were developed for patients with good bone stock. Recently it has become clear that these implants have a decreased performance when implanted in bone with low density, such as in osteoporosis. Reduced performance in osteoporotic bone is not unexpected because of the reduced quality of the peri-implant bone and the reduced bone-implant contact area. Nevertheless, the precise failure mechanisms are not well understood. Although experimental testing is considered the gold standard to determine implant fixation, it is hampered by many limitations. Computational models could potentially aid in obtaining a better understanding of implant fixation as they allow analyzing the mechanical interaction between implants and peri-implant tissues. This article provides a review of the existing finite element models of small endosseous implants in bone. The aim is to analyze the potential of such models to aid the understanding of implant failure mechanisms with the goal of improving implant performance in low quality bone.

  18. Complications of massive allograft reconstruction for bone tumors

    Directory of Open Access Journals (Sweden)

    Abolhasan Borjian

    2006-11-01

    Full Text Available BACKGROUND: Since the evolution of multi-drug chemotherapy and radiotherapy and new sophisticated surgical techniques, limb salvage and reconstruction, rather than amputation, has become the preferred treatment for patients with bone tumors. One option is allograft replacement. Although allograft has several advantages, it is not without complications. This study was performed to observe these complications in a group of patients treated with allograft replacement for bone tumor resection. The purpose was to gain an overview of the factors predisposing to these complications to minimize their occurrence. METHODS: This retrospective study was performed on patients with benign aggressive and malignant bone tumors undergoing limb reconstruction with allograft between 1997 and 2005 in Al-Zahra and Kashani Hospitals in Isfahan, Iran. Data was collected from patient files, clinical notes, radiographs and a recent physical examination. Complications including local recurrence, fracture of allograft, fixation failure, nonunion, infection, skin necrosis and neurological damage were recorded. RESULTS: Sixty patients including 39 males and 21 females were studied. The mean age of patients was 23 ± 11.7 years. The mean follow-up interval was 28.1 ± 12.4 months (mean ± SD. Complications were allograft fracture in 20%, local recurrence in 16%, fixation failure in 11%, nonunion in 6%, infection in 6%, skin necrosis in 6%, and peroneal nerve palsy in 1% of cases. Most local recurrences (60% were those with a mal-performed biopsy. Most allograft fractures occurred when a short plate was used. CONCLUSIONS: Allograft replacement for bone tumors remains a valid option. To avoid complications, biopsy should be done by a trained surgeon in bone oncology. A long plate is recommended for fixation. Sterility and graft processing must be optimal. Autogenous bone graft must be added at host-allograft junction. KEY WORDS: Bone tumors, bone allograft, limb

  19. Femoral neck shortening after internal fixation

    OpenAIRE

    LIU, YUE; AI, Zi Sheng; Shao, Jin; Yang, Tieyi

    2014-01-01

    Objective: The aim of this study was to assess the factors affecting femoral neck shortening after internal fixation of femoral neck fractures. Methods: Eighty-six patients with femoral neck fractures were treated using three parallel cannulated screws between May 2004 and January 2011. The shortening of the femoral neck in the horizontal (X), vertical (Y), and along the resultant along the (Z) vector (XÆ, YÆ, ZÆ) was measured on anteroposterior radiographs corrected by screw diameter and ...

  20. Bone Tumor

    Science.gov (United States)

    ... the knee in either the femur (thigh) or tibia (shinbone). Other common locations include the hip and ... bone that is weakened by a tumor to fracture, or break. This may be severely painful. Occasionally, ...