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Sample records for cervical locking plate

  1. Cervical spine locking plate fixation for treatment of cervical spondylotic myelopathy in large breed dogs.

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    Trotter, Eric J

    2009-08-01

    To describe indirect decompression by means of cervical spine locking plate (CSLP) fixation with vertebral distraction, discectomy, and cancellous block bone grafting in large breed dogs with single caudal cervical dynamic spondylotic lesions diagnosed by myelography with linear traction to the cervical spine, and contrast-enhanced computed tomography. Prospective clinical study. Dogs (n=12) with caudal cervical spondylotic myelopathy because of a single dynamic, traction-responsive lesion. Single, traction-responsive, caudal cervical spondylotic lesions were treated by vertebral distraction, discectomy, cancellous block bone grafting, and CSLP fixation. Follow-up was obtained by sequential recheck examination by the author or referring veterinarian or by telephone inquiries. Ten dogs had neurologic improvement after surgery. Indirect decompression by maintained distraction with cancellous block grafting and CSLP fixation was readily accomplished with less risk of blood loss or iatrogenic spinal cord injury than that associated with direct (ventral) decompression. There were no complications of graft intrusion, extrusion or subsidence, implant loosening, foraminal impingement, or end-plate failure. Two dogs that had satisfactory short-term recoveries developed clinical signs associated with adjacent segment disease and were euthanatized. At long-term follow-up, 8 dogs had satisfactory function, either a normal gait or one with slight to moderate proprioceptive deficits. CSLP fixation with cancellous block interbody grafting is an effective and perhaps safer method of treating single-level, traction-responsive cervical spondylosis in large breed dogs. CSLP fixation with interbody bone grafting is a viable alternative to other techniques for treatment of single-level, traction-responsive cervical spondylosis.

  2. Distraction-fusion for caudal cervical spondylomyelopathy using an intervertebral cage and locking plates in 14 dogs.

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    Steffen, Frank; Voss, Katja; Morgan, Joe P

    2011-08-01

    To evaluate clinical and radiographic outcome in dogs with caudal cervical spondylomyelopathy (CCSM) treated with an intervertebral fusion cage and locking plates. Prospective clinical study. Large breed dogs (n=14) with CCSM. Dogs had single level cervical spine distraction/fusion performed using an intervertebral cage with a hollow center filled with cancellous autograft and 2 ventrally applied locking plates. Outcome was measured using neurologic scores and radiographic interpretation 6 weeks, 6 months, and 12 months postoperatively. The surgical procedure was well tolerated in all dogs. Final outcome at 12 months was available in 9 dogs. Five dogs were judged excellent, 1 dog was good, 2 dogs were satisfactory, and 2 dogs were poor because of adjacent segment disease. Four dogs died for reasons unrelated to the procedure. Radiographically, implants remained stable over the entire follow-up period. The disc space continued to fill with an immature pattern of new bone, which showed progressive increase in opacity and quantity. Subsidence of the cage (median 2 m) was detected in 9 dogs at 6 weeks and remained unchanged in those that could be followed further. Distraction-fusion of single level CCSM in dogs with a combination of intervertebral cage and ventral locking plates is clinically effective and results in successful bony fusion. © Copyright 2011 by The American College of Veterinary Surgeons.

  3. Cervical spinal locking plate in combination with cortical ring allograft for a one level fusion in dogs with cervical spondylotic myelopathy.

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    Bergman, Robert L; Levine, Jonathan M; Coates, Joan R; Bahr, Anne; Hettlich, Bianca F; Kerwin, Sharon C

    2008-08-01

    To evaluate use of a surgical technique commonly used in humans for treatment of cervical spondylotic myelopathy (CSM) in dogs. Prospective case series. Dogs with CSM (n=10). Dogs weighing >30 kg that had CSM at 1 vertebral articulation were eligible for inclusion. Dogs had vertebral column distraction/fusion performed using a cortical ring allograft, cancellous autograft, and a spinal locking plate. Dogs were evaluated temporally by repeat neurological examinations and by client perception of postsurgical outcome, determined by telephone interview. Nine dogs survived the immediate postoperative period. Seven of 8 dogs had moderate to complete improvement without recurrence (mean follow-up, 2.48 years). The most common postsurgical complications were screw loosening (n=4) and plate shifting (2), neither of which required surgical revision. One dog had pseudoarthrosis that may have negatively impacted outcome. Treatment of single level CSM in dogs with ring allograft and a spinal locking plate system may lead to successful outcomes. The major problems encountered with included cost of the implants and adjusting the system designed for humans to fit the vertebral column of a dog. For dogs with CSM at a single level, the use of a spinal locking plate in combination with a cortical ring allograft can be an effective surgical treatment. Costs of the implants as well as anatomic differences in dogs make this type of surgery less appealing.

  4. A comparison of anterior cervical discectomy and fusion (ACDF) using self-locking stand-alone polyetheretherketone (PEEK) cage with ACDF using cage and plate in the treatment of three-level cervical degenerative spondylopathy: a retrospective study with 2-year follow-up.

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    Chen, Yuqiao; Lü, Guohua; Wang, Bing; Li, Lei; Kuang, Lei

    2016-07-01

    To evaluate the clinical efficacy and radiological outcomes of anterior cervical discectomy and fusion (ACDF) using self-locking polyetheretherketone (PEEK) cages for treatment of three-level cervical degenerative spondylopathy. Twenty-eight patients underwent three-level ACDF using self-locking stand-alone PEEK cages (group A), and 26 patients underwent three-level ACDF using cages and plate fixation (group B) were reviewed retrospectively. Clinical efficacy was evaluated by pre- and post-operative Japanese Orthopedic Association (JOA) scores and Neck Disability Index (NDI). The operation time, blood loss, surgical results according to Odom's criteria and post-operative dysphagia status were also recorded. Radiological outcomes including fusion, cervical Cobb's lordosis, fused segment angle, disc height, and cage subsidence were assessed. Clinical outcome measures such as dysphagia and fusion rate and the results of surgery evaluated according to Odom's criteria were not statistically significant (P > 0.05) between groups. The operation time was shorter and blood loss was less in group A (P  0.05). Post-operative cage subsidence, the loss of disc height, cervical lordosis and the fused segment angle were relatively higher in group A than group B (P < 0.05). ACDF using self-locking stand-alone cages showed similar clinical results as compared to ACDF using cages and plate fixation for the treatment of three-level cervical degenerative spondylopathy. However, potential long-term problems such as cage subsidence, loss of cervical lordosis and fused segment angle post-operatively were shown to be associated with patients who underwent ACDF using self-locking stand-alone cages.

  5. Locking plate osteosynthesis of clavicle fractures

    DEFF Research Database (Denmark)

    Fridberg, Marie; Ban, Ilija; Issa, Zaid

    2013-01-01

    PURPOSE: Locking plate osteosynthesis has become the preferred method for operative treatment of clavicle fractures. The method offers stable fixation, and would theoretically be associated with a low rate of fracture-related complications and reoperations. However, this remains to be explored...... in a large cohort, and our purpose was to assess the overall rates of complications and reoperations following locking plate osteosynthesis of mid-shaft clavicle fractures. METHODS: We identified all locking plate osteosynthesis of mid-shaft clavicle fractures operated upon in our department from January...... 2008 to November 2010 (n = 114). Nine patients did not attend the follow-up at our institution. The study group of 105 fractures (104 patients, 86 males) had a median age of 36 years (14-75 years). Follow-up ranged from 0.5 to 3.5 years. No patients were allowed to load the upper extremity for six...

  6. 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.

  7. [Tibiotalocalcaneal arthrodesis using a humeral locking plate].

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    Cabrera Méndez, M P; Gamba, C; Hernández, E; Molano, J; Andrade, J C

    2016-01-01

    To describe the results of tibiotalocalcáneal arthrodesis (TTC) using a humeral locking plate. A retrospective, observational study was conducted between January 2007 and December 2013 in the Hospital Militar Central de Bogotá. The study included patients with symptomatic osteoarthritis diagnosed clinically and radiologically, and who underwent TTC arthrodesis using a humeral locking plate with a minimum follow up of 6 months. The total number patients was 35, of whom 7 (20%) were women and 28 (80%) men, with a mean age 36.3 years (19.77). 74% with post-traumatic arthritis, most of them secondary to gunshot wounds and fragmentation weapons, and neuropathic in 20%. An autogenous graft was used in 13 cases, and 14 cases using both, with a mean consolidation time of 4.37 months. Complications include, delayed union in 3 cases, and surgical site infection in 4. The postoperative functionality (AOFAS) mean was 66.7/100 points, with a score of 2.35 on a visual analogue pain scale. TTC arthrodesis using a humeral locking plate is a suitable option for fixing this type of arthrodesis, with a low rate of complications, and postoperative results that revealed satisfactory improvement in pain and consolidation. Copyright © 2015 SECOT. Published by Elsevier Espana. All rights reserved.

  8. Locking screw-plate interface stability in carbon-fibre reinforced polyetheretherketone proximal humerus plates.

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    Hak, David J; Fader, Ryan; Baldini, Todd; Chadayammuri, Vivek B S

    2017-09-01

    Carbon-fibre reinforced polyetheretherketone (CFR-PEEK) plates have recently been introduced for proximal humerus fracture treatment. The purpose of this study was to compare the locking screw-plate interface stability in CFR-PEEK versus stainless steel (SS) proximal humerus plates. Locking screw mechanical stability was evaluated independently in proximal and shaft plate holes. Stiffness and load to failure were tested for three conditions: (1) on-axis locking screw insertion in CFR-PEEK versus SS plates, (2) on-axis locking screw insertion, removal, and reinsertion in CFR-PEEK plates, and (3) 10-degree off-axis locking screw insertion in CFR-PEEK plates. Cantilever bending at a rate of 1 mm/minute was produced by an Instron machine and load-displacement data recorded. Shaft locking screw load to failure was significantly greater in CFR-PEEK plates compared to SS plates (746.4 ± 89.7 N versus 596.5 ± 32.6 N, p PEEK plates (p PEEK plates. The mechanical stability of locking screws in CFR-PEEK plates is comparable or superior to locking screws in SS plates.

  9. A retrospective comparison of four plate constructs for first metatarsophalangeal joint fusion: static plate, static plate with lag screw, locked plate, and locked plate with lag screw.

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    Hyer, Christopher F; Scott, Ryan T; Swiatek, Michael

    2012-01-01

    The primary treatment for progressive first metatarsophalangeal (MTP) joint arthritis is arthrodesis. Multiple fixation types have been used to accomplish fusion including plating. There have been no published articles reporting the outcomes of these 4 plate and/or screw constructs. We present our experience with 138 first MTP joint fusions using these constructs. A retrospective comparison and radiographic chart review of 132 patients (138 feet) was performed to compare different constructs in regards to successful union and time to fusion. All operations were performed by 4 fellowship-trained foot and ankle surgeons. The radiographs were independently read by 2 authors not involved in the index procedures. Radiographic fusion was determined by bridging cortices across the joint line. The mean time to union (in days) and rate of fusion were static plate: 59, 95%, static plate with lag screw: 56, 86%, locked plate: 66, 92%, and locked plate with lag screw: 53, 96%. There was not a statistically significant difference between the groups in regards to patient age, time to weight bearing, time to fusion, or rate of fusion. We report on the results of fusion comparing 4 different plate and/or screw constructs for first MTP joint fusion. The data reveal no significant difference in time to fusion or rate of fusion between static and locked plates, with or without a lag screw. Copyright © 2012 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Development and mechanical properties of a locking T-plate

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    Luciane R. Mesquita

    Full Text Available ABSTRACT: This study aimed to develop a locking T-plate and to evaluate its mechanical properties in synthetic models. A titanium 2.7mm T-plate was designed with a shaft containing three locked screw holes and one dynamic compression hole, and a head with two locked screw holes. Forty T-shaped polyurethane blocks, and 20 T-plates were used for mechanical testing. Six bone-plate constructs were tested to failure, three in axial compression and three in cantilever bending. Fourteen bone-plate constructs were tested for failure in fatigue, seven in axial compression and seven in cantilever bending. In static testing higher values of axial compression test than cantilever bending test were observed for all variables. In axial compression fatigue testing all bone-plate constructs withstood 1,000,000 cycles. Four bone-plate constructs failure occurred before 1,000,000 cycles in cantilever bending fatigue testing. In conclusion, the locking T-plate tested has mechanical properties that offer greatest resistance to fracture under axial loading than bending forces.

  11. Complication with Removal of a Lumbar Spinal Locking Plate

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    Brooke Crawford

    2015-01-01

    Full Text Available Introduction. The use of locking plate technology for anterior lumbar spinal fusion has increased stability of the vertebral fusion mass over traditional nonconstrained screw and plate systems. This case report outlines a complication due to the use of this construct. Case. A patient with a history of L2 corpectomy and anterior spinal fusion presented with discitis at the L4/5 level and underwent an anterior lumbar interbody fusion (ALIF supplemented with a locking plate placed anterolaterally for stability. Fifteen months after the ALIF procedure, he returned with a hardware infection. He underwent debridement of the infection site and removal of hardware. Results. Once hardware was exposed, removal of the locking plate screws was only successful in one out of four screws using a reverse thread screw removal device. Three of the reverse thread screw removal devices broke in attempt to remove the subsequent screws. A metal cutting drill was then used to break hoop stresses associated with the locking device and the plate was removed. Conclusion. Anterior locking plates add significant stability to an anterior spinal fusion mass. However, removal of this hardware can be complicated by the inherent properties of the design with significant risk of major vascular injury.

  12. Minimally invasive treatment of distal tibial fractures with locking and non-locking plates.

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    Ozkaya, Ufuk; Parmaksizoglu, Atilla S; Gul, Murat; Sokucu, Sami; Kabukcuoglu, Yavuz

    2009-12-01

    The purpose of this study was to evaluate the clinical performances of stainless steel nonlocking plates and titanium locking plates in minimally invasive medial plating of extra-articular metaphyseal fractures of the distal tibia. Between 2004 and 2006, 43 patients who sustained closed fractures of the distal tibia metaphysis were managed with either a stainless steel nonlocking plate (Group 1, n = 21) or a titanium locking plate (Group 2, n = 22). Clinical and radiographic data were retrospectively reviewed. Function was assessed with use of the American Orthopaedic Foot and Ankle Society ankle-hindfoot instrument. The average followup period was 25 months. The average AOFAS foot and ankle scores in Group 1 and Group 2 at final followup were 85 and 81, respectively. Fracture reduction was anatomical or nearly anatomical without angular displacement in all cases except one patient in Group 2. (p > 0.05) The average time to full, unprotected weightbearing in Group 1 and Group 2 were 15 weeks and 18 weeks, respectively (p plating with titanium locking plates resulted in prolonged secondary healing both in comminuted and simple fracture patterns compared to conventional stainless steel nonlocking plates. We believe that in biological fixation of distal tibial fractures, similarly good results may be obtained with both materials as the locking technology had a greater effect on stability.

  13. Comparison of modern locked plating and antiglide plating for fixation of osteoporotic distal fibular fractures.

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    Switaj, Paul J; Wetzel, Robert J; Jain, Neel P; Weatherford, Brian M; Ren, Yupeng; Zhang, Li-Qun; Merk, Bradley R

    2016-09-01

    Fractures in osteoporotic patients can be difficult to treat because of poor bone quality and inability to gain screw purchase. The purpose of this study is to compare modern lateral periarticular distal fibula locked plating to antiglide plating in the setting of an osteoporotic, unstable distal fibula fracture. AO/OTA 44-B2 distal fibula fractures were created in sixteen paired fresh frozen cadaveric ankles and fixed with a lateral locking plate and an independent lag screw or an antiglide plate with a lag screw through the plate. The specimens underwent stiffness, cyclic loading, and load to failure testing. The energy absorbed until failure, torque to failure, construct stiffness, angle at failure, and energy at failure was recorded. The lateral locking construct had a higher torque to failure (p=0.02) and construct stiffness (p=0.04). The locking construct showed a trend toward increased angle at failure, but did not reach statistical significance (p=0.07). Seven of the eight lateral locking plate specimens failed through the distal locking screws, while the antiglide plating construct failed with pullout of the distal screws and displacement of the fracture in six of the eight specimens. In our study, the newly designed distal fibula periarticular locking plate with increased distal fixation is biomechanically stronger than a non-locking one third tubular plate applied in antiglide fashion for the treatment of AO/OTA 44-B2 osteoporotic distal fibula fractures. V: This is an ex-vivo study performed on cadavers and is not a study performed on live patients. Therefore, this is considered Level V evidence. Copyright © 2015. Published by Elsevier Ltd.

  14. Single cycle to failure in bending of three standard and five locking plates and plate constructs.

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    Blake, C A; Boudrieau, R J; Torrance, B S; Tacvorian, E K; Cabassu, J B; Gaudette, G R; Kowaleski, M P

    2011-01-01

    To evaluate the biomechanical properties of standard and locking plates in bending. We hypothesised that titanium (Ti) constructs would have the greatest deformation and that String of Pearl (SOP) constructs would have the greatest strength and stiffness, and would behave differently compared to plates alone. Dynamic compression plates (DCP), stainless steel (SS) limited contact (LC)-DCP®, Ti LC-DCP, locking compression plates (LCP), 10 mm and 11 mm advanced locking plate system (ALPS 10 / 11), SOP and Fixin plates were evaluated individually and as constructs applied to a validated bone model simulating a bridging osteosynthesis. Bending stiffness and strength were compared using one-way ANOVA with post hoc Tukey, and unpaired t-test (p <0.05). The SOP plates had significantly greater stiffness than all other plates; Ti LC-DCP, ALPS 10 and Fixin plates had significantly lower stiffness than all other plates. The SOP constructs had the highest mean bending stiffness, and strength that was significantly different from only the Ti LC-DCP, ALPS 10 and Fixin constructs. The ALPS 10 constructs had the lowest mean bending stiffness, and strength that was significantly different from only ALPS 11 and SOP constructs. Comparison of bending structural stiffness of plates versus constructs showed a significant difference in all plate pairs except for the DCP and ALPS 10. Due to differing plate construct properties inherent to these diverse implant systems, identical approaches to fracture management and plate application cannot be applied.

  15. Biomechanical comparison of a lateral polyaxial locking plate with a posterolateral polyaxial locking plate applied to the distal fibula.

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    Hallbauer, Jakob; Klos, Kajetan; Rausch, Sascha; Gräfenstein, Andreas; Wipf, Felix; Beimel, Claudia; Hofmann, Gunther; Mückley, Thomas

    2014-09-01

    Polyaxial locking plates are becoming popular for the fixation of distal fibula fractures. This study establishes how construct stiffness and plate loosening, measured as range of motion, differs between lateral and posterolateral plate location. Seven matched pairs of cadaver fibulae were osteotomized in standardized fashion to produce a Weber type B distal fibula fracture. The fragments were fixated with an interfragmentary lag screw and polyaxial locking plates, with one fibula in each pair receiving a posterolateral anti-glide-plate, and the other a lateral neutralization-plate. In a biomechanical test, the bending and torsional stiffnesses of the constructs and the ranges of motion (ROM) were measured and subjected to a paired comparison. The laterally plated group had a higher median (interquartile range) bending stiffness (29.2 (19.7) N/mm) and a smaller range of motion (2.06 (1.99) mm) than the posterolaterally plated group (14.6 (20.6) N/mm, and 4.11 (3.28) mm, respectively); however, the results were not statistically significant (pbending=0.314; pROM=0.325). Similarly, the torsional stiffness did not differ significantly between the two groups (laterally plated: 426 (259) Nmm/°; posterolaterally plated: 248 (399) Nmm/°; ptorsion=0.900). The range of motion measurements between the two groups under torsional loading were also statistically insignificant (laterally plated: 8.88 (6.30) mm; posterolaterally plated: 15.34 (12.64) mm; pROM=0.900). In biomechanical cadaver-model tests of Weber type B fracture fixation with polyaxial locking plates, laterally plated constructs and posterolaterally plated constructs performed without significantly difference. Therefore, other considerations, such as access morbidity, associated injuries, patient anatomy, or surgeon's preference, may guide the choice of plating pattern. Further clinical studies will be needed for the establishment of definitive recommendations. Information on the behavior of polyaxial locking

  16. Displaced proximal humeral fractures: an Indian experience with locking plates

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    Aggarwal Sameer

    2010-08-01

    Full Text Available Abstract Background The treatment of displaced proximal humerus fractures, especially in elderly, remains controversial. The objective of this study was to evaluate functional outcome of locking plate used for fixation of these fractures after open reduction. We also attempted to evaluate the complications and predictors of loss of fixation for such an implant. Methods Over two and a half years, 56 patients with an acute proximal humerus fracture were managed with locking plate osteosynthesis. 47 of these patients who completed a minimum follow up of 1 year were evaluated using Constant score calculation. Statistical analysis was done using SPSS 16 and a p value of less than 0.05 was taken as statistically significant. Results The average follow up period was around 21.5 months. Outcomes were excellent in 17%, good in 38.5%, moderate in 34% while poor in 10.5%. The Constant score was poorer for AO-OTA type 3 fractures as compared to other types. The scores were also inferior for older patients (> 65 years old. Complications included screw perforation of head, AVN, subacromial impingement, loss of fixation, axillary nerve palsy and infection. A varus malalignment was found to be a strong predictor of loss of fixation. Conclusion Locking plate osteosynthesis leads to satisfactory functional outcomes in all the patients. Results are better than non locking plates in osteoporotic fractures of the elderly. However the surgery has steep learning curve and various complications could be associated with its use. Nevertheless we believe that a strict adherence to the principles of locking plate use can ensure good result in such challenging fractures.

  17. OUTCOME OF LOCKING PLATES IN DISTAL TIBIA FRACTURES TREATMENT

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    Lokesh

    2016-05-01

    Full Text Available INTRODUCTION Most of these fractures except intra-articular fractures are treated with interlocking nail. 1,2 These nails are a boon for these fractures. But as the fracture nears to the joint stability the fracture fixation will be compromised due to malreduction and alignment, it leads to increased chances of delayed and nonunion. 3 Locking anatomical plates are evaluated for anatomical and relative stability fixation. Since then most intra and near intra-articular fractures are fixed with these plates with minimally invasive percutaneous plate osteosynthesis method, these plates have given excellent result 4 . But again these plates have some disadvantages 5 . This study is done to see the outcome of locking plates in distal tibia fracture. METHODS This study is done in the Department of Orthopaedics, Bangalore Medical College, Bangalore. This study is done from 2013 to 2015. 30 patients who came to outpatient department were treated with locking plates. All patients above 16 years having distal third tibia fracture are included. All open fractures except type 1 and elderly above 60 years and pathological fractures are excluded in our study. All patients were followed up for initial 5 months, thereafter, once in 3 months, for clinical and radiological evaluation of union status, knee range of motion, ankle range of motion and other complications. Assessment of the patient with functional recovery was done with American Orthopaedic Foot and Ankle Surgery(AOFAS 6 minimum 5 months after injury. RESULTS Majority of the patients are from age group 18-29 years (50%. Average age group was 30 years. Majority of the patients were males 80.6% (25. All fractures were closed fractures except 2 cases which are type 1. There were 12 cases of AO type A, 8 patients were AO type B and 10 patients were type C. Majority of the patients had fracture due to road traffic accidents, 74%. All fractures were united by the end of 20 weeks. There was delayed union in

  18. TIBIOTARSAL COMPRESSION ARTHRODESIS USING A LATERAL LOCKING PLATE

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    Coughlin, Michael J.; Nery, Caio; Baumfeld, Daniel; Jastifer, James

    2015-01-01

    Objectives: Tibiotalar (TT) arthrodesis is still a very important option in the treatment of primary or post-traumatic arthritis of the ankle but persists the controversy regarding the optimal method for the fixation of the arthrodesis site. No matter the implant used, the goal is to obtain a solid, healthy, pain-free fusion. The purpose of the current study is to present the preliminary results of a novel laterally based tibiotalar compression arthrodesis system using a locked plate. Methods: Thirteen consecutive patients with tibiotalar arthritis were submitted to an arthrodesis using a new lateral plating system. The average age was 59.7 years (range 36~72); nine patients were male and four female. Using a cutting guide, the remaining articular surfaces of the tibia and talus were removed. A compression device was applied to avoid malalignment of the ankle and a precontoured lateral locking plate was used to achieve the joint fusion. Results: Both the AOFAS ankle-hindfoot score and the VAS score improved with the surgery. All patients’ ankles fused by 6 months. In all patients we found a very good alignment in the sagittal, coronal and transverse planes. Conclusion: We believe that a combination of a bilateral compression, contoured bony cuts, and lateral locked plating offers a novel, accurate and useful technique for ankle arthrodesis. PMID:27047874

  19. Stifle arthrodesis using a locking plate system in six dogs.

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    Petazzoni, M; Nicetto, T

    2015-01-01

    To describe the use of the Fixin locking plate system for stifle arthrodesis in dogs and to retrospectively report the clinical and radiographic outcomes in six cases. Medical records of dogs that had arthrodesis with the Fixin locking plate system were reviewed. For each patient, data pertaining to signalment and implant used were recorded. Plate series and thickness, number of screws placed, number of cortices engaged, and screw diameters were also recorded. The outcome was determined from clinical and radiographic follow-ups. Radiographic outcomes assessed included the measurement of the postoperative femoral-tibial angle in the sagittal plane. Six dogs met the inclusion criteria for the study. Mean body weight was 13 kg (range: 3 - 34 kg). Radiographic follow-up (mean: 32 weeks, range: 3 - 52 weeks) was available for all dogs. In one case, an intra-operative complication occurred. In another case, a tibial fracture occurred 20 days after surgery. All arthrodeses healed and no implant complication was detected although all cases had mechanical lameness. Stifle arthrodesis can be performed successfully using a Fixin locking plate system.

  20. Delayed anterior cervical plate dislodgement with pharyngeal wall perforation and oral extrusion of cervical plate screw after 8 years: A very rare complication

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    Ravindranath Kapu

    2012-01-01

    Full Text Available We report a patient with congenital anomaly of cervical spine, who presented with clinical features suggestive of cervical compressive spondylotic myelopathy. He underwent C3 median corpectomy, graft placement, and stabilization from C2 to C4 vertebral bodies. Postoperative period was uneventful and he improved in his symptoms. Eight years later, he presented with a difficulty in swallowing and occasional regurgitation of feeds of 2 months duration and oral extrusion of screw while having food. On oral examination, there was a defect in the posterior pharyngeal wall through which the upper end of plate with intact self-locking screw and socket of missed fixation screw was seen. This was confirmed on X-ray cervical spine. He underwent removal of the plate system and was fed through nasogastric tube and managed with appropriate antibiotics. This case is presented to report a very rare complication of anterior cervical plate fixation in the form of very late-onset dislodgement, migration of anterior cervical plate, and oral extrusion of screw through perforated posterior pharyngeal wall.

  1. Outcome of distal end clavicle fractures treated with locking plates

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    Raju Vaishya

    2017-02-01

    Conclusion: The precontoured locking plates with lateral extension may be a good method to fix the fractures of the lateral end clavicle, which provide a stable fixation with good functional outcome with very few instances of stiffness and decreased range of motion of the shoulder with the hook plates and failure of fixation in screw and K-wire fixations. It may well be the answer to the fixation questions of the lateral clavicle fractures, although larger comparative studies between the surgical treatment methods are required to confirm the same.

  2. Use of locking plate and screws for triple pelvic osteotomy.

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    Rose, Scott A; Bruecker, Ken A; Petersen, Steve W; Uddin, Nizam

    2012-01-01

    To evaluate the efficacy and complication rate associated with use of a purpose-specific locking triple pelvic osteotomy (LTPO) plate. Prospective study. Dogs (n = 9; 15 hips). Physical examination, plain film radiography, computed tomography (CT) of the pelvis, and coxofemoral arthroscopy were performed before unilateral triple pelvic osteotomy (TPO) or staged bilateral TPO. Radiographs were taken after each procedure and 3-5, 6-8, and ≥12 weeks postoperatively. Pelvic width was measured at 3 locations to evaluate pelvic canal narrowing. No screw loosening occurred. Complications occurred in only 1 hip (7%) where pullout of the locking plate-screw construct from the caudal iliac segment occurred because of a fracture of the cis-cortex; the dog made a full recovery after a salvage procedure. There was no significant reduction in the cranial pelvic width but a small reduction at the level of the acetabuli and ischiatic tuberosities was noted 3-5 weeks after the 2nd TPO. The LTPO plate was associated with a lower complication rate than previously reported for TPOs using Slocum canine pelvic osteotomy plates (CPOP) and warrants further investigation. Pullout of the caudal plate-screw construct is a complication specific to LTPO implants. Bicortical screw purchase is recommended to prevent fracture of the cis-cortex and implant pullout. © Copyright 2011 by The American College of Veterinary Surgeons.

  3. Relative stability of conventional and locked plating fixation in a model of the osteoporotic femoral diaphysis.

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    Fitzpatrick, Daniel C; Doornink, Josef; Madey, Steven M; Bottlang, Michael

    2009-02-01

    This study investigated the stiffness and strength of bridge plating with uni-cortical and bi-cortical locking plate constructs relative to a conventional, non-locked construct in the osteoporotic femoral diaphysis. Four bridge plating configurations were applied to a validated model of the osteoporotic femoral diaphysis. A non-locked conventional configuration served as baseline. Locked configurations included bi-cortical locked plating, uni-cortical locked plating and mix-mode locked plating, which combined uni and bi-cortical locking screws. For all configurations, an 11-hole plate was applied with 4.5-mm screws placed in the 1st, 3rd, and 5th plate hole. Five specimens of each configuration were dynamically loaded until failure in torsion, axial compression, and bending to determine construct stiffness, strength and failure modes. In torsion and bending, locked plating constructs provided a significantly lower stiffness and strength than the conventional construct. The uni-cortical locked construct was 69% weaker (Ptorsion than the conventional construct, but its torsional strength improved 73% (Pbending and torsion compared to conventional plating. Adding one bi-cortical locked screw to an otherwise uni-cortical construct is recommended to improve torsional strength.

  4. Complications associated with locking plate of proximal humerus fractures

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    Venkat Kavuri

    2018-01-01

    Full Text Available Proximal humerus fractures constitute a significant percentage of fragility fractures. The growing use of locking plate has helped treat this problem, but at the same time has brought about complications. Past systematic reviews have documented these complications, however a large number of recent studies have been published since, reporting their own complication rates with different techniques. This study reviews the current complications associated with locking plate of proximal humerus fractures as well as methods to reduce them. A systematic review, following the PRISMA guidelines, was conducted in November 2013 and repeated in March 2015, using PubMed, Scopus, and Cochrane databases, to evaluate locking plate fixation (and complications of traumatic proximal humerus fractures. Inclusion criteria included adults (>18 years, minimum of 12-month postoperative followup, articles within the last 5 years, and studies with >10 participants. Exclusion criteria included pathologic fractures, cadaveric studies, and nonhuman subjects. Eligible studies were graded using a quality scoring system. Articles with a minimum of 7/10 score were included and assessed regarding their level of evidence per the Journal of Bone and Joint Surgery and Centre for Evidence-Based Medicine guidelines. The initial query identified 51,206 articles from multiple databases. These records were thoroughly screened and resulted in 57 articles, consisting of seven Level 1, three Level 2, 10 Level 3, and 37 Level 4 studies, totaling 3422 proximal humerus fractures treated with locking plates. Intraarticular screw penetration was the most reported complication (9.5%, followed by varus collapse (6.8%, subacromial impingement (5.0%, avascular necrosis (4.6%, adhesive capsulitis (4.0%, nonunion (1.5%, and deep infection (1.4%. Reoperation occurred at a rate of 13.8%. Collapse at the fracture site contributed to a majority of the implant-related complications, which in turn were the

  5. Increased rates of wound complications with locking plates in distal fibular fractures

    NARCIS (Netherlands)

    Schepers, T.; van Lieshout, E. M. M.; de Vries, M. R.; van der Elst, M.

    2011-01-01

    There is a growing use of locking compression plates in fracture surgery. The current study was undertaken to investigate the wound complication rates of locking versus non-locking plates in distal fibular fractures. During a 6-year study period all consecutive, closed distal fibular fractures

  6. Increased rates of wound complications with locking plates in distal fibular fractures

    NARCIS (Netherlands)

    T. Schepers (Tim); E.M.M. van Lieshout (Esther); M.R.D. Vries; M. van der Elst (Maarten)

    2011-01-01

    textabstractIntroduction: There is a growing use of locking compression plates in fracture surgery. The current study was undertaken to investigate the wound complication rates of locking versus non-locking plates in distal fibular fractures. Patients and methods: During a 6-year study period all

  7. Locking plates in distal humerus fractures: study of 43 patients

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    Gupta Rakesh Kumar

    2013-08-01

    Full Text Available 【Abstract】Objective: The treatment of multi-fragmentary, intraarticular fractures of the distal humerus is difficult, even in young patients with bone of good quality. Small distal fragment, diminished bone mineral quality and increased trauma-associated joint destruction make stable joint reconstruction more problematic. The anatomically preshaped locking plates allow angular stable fixation for these complex fractures. We evaluated functional results of patients treated with open reduction and internal fixation with distal humerus locking plates for complex distal hu-merus fractures. Methods: Forty-three consecutive patients with ar-ticular fractures of the distal humerus were treated by open reduction and internal fixation with AO distal humerus plate system and locking reconstruction plates. Forty patients were available for the final outcome analysis. According to AO/ASIF classification, there were 2 cases of type A2, 4 cases of type A3, 1 case of type B1, 1 case of type B2, 14 cases of type C1, 7 cases of type C2 and 11 cases of type C3. Open reduction with triceps splitting technique was used in all patients. The clinical and radiographic follow-up was performed and outcome measures included pain assessment, range of motion, and Mayo elbow performance score. Results: Forty patients were available for the final outcome analysis. There were 29 males and 11 females with an average age of 38.4 years (18-73 years. Clinical and ra-diological consolidation of the fracture was observed in all cases at an average of 11.6 weeks (9-14 weeks. The average follow-up was 12 months (10-18 months. Using the Mayo elbow performance score the results obtained were graded as excellent or good results in 33 patients (82.5%. One pa-tient had superficial infection, and 4 had myositis ossificans. There were no cases of primary malposition or secondary displacement, implant failure or ulnar neuropathy. Conclusion: Anatomically preshaped distal humerus locking

  8. Fractures of the distal tibia treated with polyaxial locking plating.

    Science.gov (United States)

    Gao, Hong; Zhang, Chang-Qing; Luo, Cong-Feng; Zhou, Zu-Bin; Zeng, Bing-Fang

    2009-03-01

    We evaluated the healing rate, complications, and functional outcomes in 32 adult patients with very short metaphyseal fragments in fractures of the distal tibia treated with a polyaxial locking system. The average distance from the distal extent of the fracture to the tibial plafond was 11 mm. All fractures healed and the average time to union was 14 weeks. Six patients (19%) reported occasional local disturbance over the medial malleolus. There were two cases of postoperative superficial infections and evidence of delayed wound healing. Using the American Orthopaedic Foot and Ankle Society ankle score, the average functional score was 87.3 points (of 100 total possible points). Our results show the polyaxial locking plates, which offer more fixation versatility, may be a reasonable treatment option for distal tibia fractures with very short metaphyseal segments.

  9. [Complex reconstruction with internal locking plate fixation for Charcot arthropathy].

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    Ramadani, F; Härägus, H; Radu, P; Trieb, K; Hofstaetter, S

    2015-01-01

    Osteosynthesis and reposition of the Charcot foot is challenging with respect to choice of a proper implant. There is currently no international consensus regarding the optimal implant. Locking plates seem to be an innovative and stable method for reconstruction. The aim of this work is to analyze bone fusion, complications, pseudoarthrosis, and patient satisfaction. This paper presents a retrospective analysis of 63 consecutive Charcot feet treated between 2004 and 2014. The mean follow-up time was 2.4 years. All Charcot feet treated between 2004 and 2014 were Sanders type II or III. A bony fusion was achieved in 50 % of the cases, 26 % had a functional pseudoarthrosis with intact implants and pain-free mobility, and 22 % showed no healing with broken implants. Conclusion Internal fixation with locking plates is superior to screw fixation only with regard to biomechanics. We prefer internal fixation plates to external fixation because of stability even in the case of pseudoathrosis and because of the learning curve.

  10. Medial Column Arthrodesis Using an Anatomic Distal Fibular Locking Plate.

    Science.gov (United States)

    Nasser, Ellianne M; LaPorta, Guido A; Trott, Kasandra

    2015-01-01

    The medial column fusion is performed for a multitude of etiologies, including peritalar subluxation deformity, Charcot arthropathy, trauma, post-traumatic degenerative joint disease, and rheumatoid arthritis. Various surgical techniques have been described for medial column arthrodesis. We describe a new fixation method using an anatomic distal fibular locking plate for medial column arthrodesis. This technique provides a rigid construct in compromised or at risk bone. After a review of the surgical technique, we outline 2 case examples of patients with peritalar subluxation and Charcot arthropathy. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Fracture repair using a polyaxial locking plate system (PAX).

    Science.gov (United States)

    Barnhart, Matthew D; Rides, Cristobal F; Kennedy, Shawn C; Aiken, Sean W; Walls, Charles M; Horstman, Christopher L; Mason, David; Chandler, Jonathon C; Brourman, Jeff D; Murphy, Sean M; Pike, Frederick; Naber, Steven J

    2013-01-01

    To report outcomes and complications of dog and cat fractures treated with the polyaxial locking plate system (PAX). Case series. Dogs (n = 60) and 2 cats. Medical records (December 2009-March 2011) of dogs and cats with fractures treated with the PAX system were reviewed. Cases with adequate follow-up to document a functional union, had surgery performed by an author, had no prior treatment of the fracture(s), and with complete operative records were included. Signalment, body weight, bone(s) fractured, area of bone fractured, fracture classification, concurrent orthopedic injuries, complications, time to functional union, if minimally invasive plate osteosynthesis (MIPO) techniques were used, plate size, number of plates, bone graft use, and ancillary methods of fixation were recorded. Additionally, fracture segment: plate length, screw, number of plate holes, number of empty screw holes overlying/adjacent to the fractures, number of cortices engaged above/below the fracture was evaluated. Variables were evaluated statistically for effect on complications and functional union. Sixty-two animals were included. Mean time to functional union was 7.1 weeks. Complications occurred in 12 animals (19%) and plate failure occurred in 3 (5%). Statistically significant factors that affected time to functional union were the presence of multiple injuries and age. Those associated with complications were double plates and number of cortices engaged above and below fractures. The PAX system allows for multidirectional screw insertion with an overall complication rate and time to functional union similar to other fracture repair implant systems. © Copyright 2012 by The American College of Veterinary Surgeons.

  12. FUNCTIONAL OUTCOME OF PROXIMAL HUMERUS FRACTURES TREATED WITH LOCKING PLATES

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    Lokesh

    2016-05-01

    Full Text Available INTRODUCTION For more displaced fractures and osteopenic bone, techniques of internal fixation, which emphasise less disruptive soft tissue dissection, and minimal fixation with wire and non-absorbable sutures have been successful with a low complication rate. Even AO type buttress plates are being used, but they require more soft tissue dissection and may lead to infection. Management of these fractures is associated with some morbidity and undesirable sequelae. They include complications like avascular necrosis, malunion, non-union, infection, neurovascular injury, loss of motion of shoulder from adhesive capsulitis, chronic oedema, elbow stiffness and atrophy of the soft tissues of the immobilised limb causing significant disability during healing and afterwards. The purpose of this study is to evaluate the functional outcome of the surgical management of fresh displaced three- and four-part proximal humerus fractures with locking plate system. MATERIAL AND METHODS The present study was carried out from August 2012 to December 2014 at Orthopaedic Department in Bangalore Medical College and Hospital. During this period, 25 patients of proximal humerus fractures were treated with locking plates. All patients were followed up for every 4 weeks. Local examination of the affected shoulder for tenderness, instability, deformity and shoulder movements were assessed. X-rays were taken at each visit to know about progressive fracture union and implant position. Rehabilitation of the affected extremity was done according to the stage of fracture union and time duration from surgery. Patients were followed up till radiological union. RESULTS The present study consists of 25 patients of fresh three- and four-part fractures of proximal humerus which were treated surgically with locking plates from August 2012 to December 2014. All the patients were available for follow-up and they were followed every month for first 3 months then once in 3 months. In this

  13. Ankle Arthrodesis Using an Anterior Titanium Dual Locked Plating Construct.

    Science.gov (United States)

    Flint, Wesley W; Hirose, Christopher B; Coughlin, Michael J

    Ankle arthrodesis is currently the reference standard treatment for end-stage tibiotalar arthrosis. The fusion rates have varied in the published data from 59% to 100%. We reviewed 60 cases of consecutive anterior ankle arthrodesis using an anterior dual locked plating construct with respect to the fusion rate, time to fusion, pain relief, and complications. The patients were followed up for a mean of 1.1 years (range 16 weeks to 4 years). We found that our fusion rate was 97% for ankles not requiring structural allograft. The mean interval to fusion was 11.7 weeks, excluding those with a structural allograft. The mean visual analog scale pain scores decreased from 7 preoperatively to 2 at the final follow-up visit. Anterior ankle arthrodesis with dual locked plating provides excellent results with respect to the fusion rate with a low complication rate. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  14. VOLAR LOCKING PLATE OSTEOSYNTHESIS IN DISTAL END RADIUS FRACTURES

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    Gyan Ranjan

    2017-07-01

    Full Text Available BACKGROUND Distal end Radius fractures account for about 20% of all the fracture treated in emergency department of Kosi & Seemanhcal area in Bihar. The majority of osteoporotic fractures occur as a result of fall from standing height on outstretched hand while in young patients, distal end radius fractures are seen secondary to RTA & sports activities. We conducted a study of a small group to evaluate the functional outcome of ORIF & volar locking plate fixation done for distal end radius fractures after one year. MATERIALS AND METHODS Records of 19 men and 41 women aged 17 to 78 years who underwent volar locking plate fixation for distal radial fractures were reviewed. According to AO-Classification of Distal End Radius fractures. 2 Patients had A2 Type of fracture, 3 had A3 Type, both B2 & B3 had 4 cases each, 15 of C1 Type, 21 of C2 type and 11 0f C3 Type. Functional outcome was assessed by using “Demerit point rating system” of Gartland & Werley. In all the patients at their final follow-up visit at 12 months. RESULTS Out of all these 60 patients, 9 cases had 10 complications, 2 cases developed Grade (I Arthritis, 2 cases developed Grade (II arthritis, 1 case developed superficial skin infection with medium nerve compression symptoms, 2 cases developed superficial skin infection which was resolved by continuous dressing on alternate days & 5 cases developed median nerve compression symptoms in which for 2 cases symptoms resolved with time, in rest 3 cases carpal Tunnel Decompression was done. Overall 63.3% result were excellent, 23.3% were good & 13.3% fair outcomes. The residual deformity was 0.70 the subjective score was 1.47 the objective score was 1.70, the total demerit score was as per modification Garland & Werley scoring groups (Mean values was 3.67. In all the cases, stainless steel plate was used. CONCLUSION In distal end radius fractures open reduction and internal fixation with volar locking compression plate followed by

  15. In vitro biomechanical comparison of limited contat dynamic compression plate and locking compression plate.

    Science.gov (United States)

    Aguila, A Z; Manos, J M; Orlansky, A S; Todhunter, R J; Trotter, E J; Van der Meulen, M C H

    2005-01-01

    The locking compression plate (LCP) supports biological osteosynthesis by functioning as an internal fixator, rather than as a full or limited contact bone plate which must be adequately contoured and affixed directly to the bone for stable internal fixation of the fracture. In order to help justify the use of the LCP in our veterinary patients, in vitro biomechanical testing was performed comparing the LCP to the conventional limited contact dynamic compression plate (LC-DCP) in canine femurs. We hypothesized that the LCP construct would be at least as stiff under bending and torsional loads as the LC-DCP. The LCP and LC-DCP were applied over a 20-mm osteotomy gap to contralateroal bones within each pair of 14 femora. Non-destructive four-point bending and torsion, and cyclical testing in torsion were performed. The constructs were then loaded to failure in torsion. In medial-lateral and lateral-medial structural bending, significant differences were not found between the LCP and LC-DCP, however, at the gap, the LCP construct was stiffer than the LC-DCP in lateral-medial bending. Significant differences in behaviour over time were not noted between the plate designs during cyclical testing. When loading the constructs to failure in internal rotation, the LC-DCP failed at a significantly lower twist angle (P = .0024) than the LCP. Based on the similar performance with loading, the locking compression plate is a good alternative implant for unstable diaphyseal femoral fracture repair in dogs.

  16. Biomechanical evaluation of fixation of comminuted olecranon fractures: one-third tubular versus locking compression plating

    NARCIS (Netherlands)

    Buijze, G.A.; Blankevoort, L.; Tuijthof, G.J.M.; Sierevelt, I.N.; Kloen, P.

    2010-01-01

    New concepts in plate fixation have led to an evolution in plate design for olecranon fractures. The purpose of this study was to compare the stiffness and strength of locking compression plate (LCP) fixation to one-third tubular plate fixation in a cadaveric comminuted olecranon fracture model with

  17. Modular cervical plate system for adjacent segment disease.

    Science.gov (United States)

    Hawasli, Ammar H; Cashin, John L; Wright, Neill M

    2018-02-23

    Adjacent-level disease after anterior cervical discectomy and fusion (ACDF) occurs in a significant proportion of patients and frequently requires revision operation. Methods using traditional plates typically require removal of the plate with anecdotally increased operative-time and morbidity. We review our experience in treating symptomatic adjacent-segment disease using both traditional plate removal and modular- plate system which allows for add-on plate components rather than removal of the entire plate. Authors compared 64 patients with revision surgery using modular-plate system for adjacent- segment disease compared to 2-cohorts: (1) patients with traditional plate-removal and (2) patients with no prior plate. Clinical data included demographics, original surgery, presentation, current surgery, use of modular system, need for preoperative computed-topography, operative-time, blood loss, hospital stay, complications, length of dysphagia, neck disability index and time-until-fusion. Modular cervical plate system was utilized to prevent exposure and removal of the entire plate. The terminal portion of the plate was exposed and the distal module was removed. Following the discectomy/arthrodesis, a module-plate extension was added onto the previous plate for extension of the prior instrumentation. Preoperative planning computed-topography was required in 26% of plate-removal and 17% of modular-plate cases. Revision surgery with no prior plate had reduced operative-time (77.0±18.1 min) when compared with plate removal (103.8±46.2 min; p<0.01). Blood-loss was lower for modular-plate system (38.3±20.4 mL) and no prior plate (38.4±12.6 mL) versus plate removal (78.2±65.9 mL, p<0.01). Hospital stay was similar for all groups. No complications were experienced with modular-plate revision but plate removal and revision after no prior plate carried 7.7% and 10.5% complication rates, respectively. There was a trend towards lower dysphagia and neck disability index

  18. Locked plating as an external fixator in treating tibial fractures: A PRISMA-compliant systematic review.

    Science.gov (United States)

    Luo, Peng; Xu, Ding; Wu, Jia; Chen, Yi-Heng

    2017-12-01

    This article is a systematic review of the published literature about the biomechanics, functional outcomes, and complications of a locked plate as an external fixator in treating tibial fractures. We searched the PubMed, Ovid Medline, Embase, ScienceDirect, and Cochrane Library databases to retrieve the relevant studies. Studies published in English and Chinese which assessed adult patients and more than 4 cases who had sustained any type of fresh tibial fracture treated with the external locking plate, provided that they reported functional outcomes, range of motion (ROM), union or complication rates, and the biomechanical studies of external locked plating are also included. The electronic search strategy revealed 248 studies, and 2 studies were identified as relevant through manual search of references. Finally, 12 studies were included in this systematic review. These consist of 3 pure biomechanical studies, 8 case series, and 1 study including both of biomechanics and case series. Due to the heterogeneity of biomechanical studies, we can only conclude that external locked plate shows inferior structural stiffness than internal locked plate. The clinical studies reported that external locked plating gave a satisfactory ROM of the knee and ankle, functional outcomes, union rate, and low complication rate. We can only conclude that external locked plate shows inferior structural stiffness than internal locked plate because of the heterogeneity of biomechanical studies. The clinical studies showed locked plating as an external fixator in treating tibial fractures can be considered as a safe and successful procedure. However, as yet, there is unconvincing evidence that it is superior to standard techniques with regards to clinical and functional outcomes. More and well-designed studies about this technique should be carried out.

  19. Superconstructs in the treatment of charcot foot deformity: plantar plating, locked plating, and axial screw fixation.

    Science.gov (United States)

    Sammarco, V James

    2009-09-01

    Management of Charcot's deformity of the foot and ankle continues to challenge physicians. Medical co-morbidity, peripheral neuropathy, vascular disease, and immune impairment cause severe problems for these patients and, when combined with neuroarthropathy, can lead to amputation. Progressive bony deformity and bone resorption, which may accompany neuroarthropathy, only increase the challenge of surgical treatment. These challenges have led physicians to develop "superconstruct" techniques to improve fixation, whereby fusion is extended beyond the zone of injury to include joints that are not affected, bone resection is performed to shorten the extremity to allow for adequate reduction of deformity without undue tension on the soft tissue envelope, the strongest device is used that can be tolerated by the soft tissue envelope; and the devices are applied in a novel position that maximizes mechanical function. This article reviews three techniques designed to achieve lasting deformity correction and successful arthrodesis: plantar plating, locked plating, and axial screw fixation.

  20. Locking compression plates for pancarpal arthrodesis in a Thoroughbred filly.

    Science.gov (United States)

    Carpenter, Ryan S; Goodrich, Laurie R; Baxter, Gary M; Joyce, Jolynn; Wallis, Tyson W

    2008-08-01

    To report treatment of a comminuted ulnar carpal (UC) bone fracture associated with carpal instability by pancarpal arthrodesis using 2 locking compression plates (LCP). Case report. A 2-year-old Thoroughbred filly. An UC fracture and luxation of the proximal row of carpal bones was diagnosed radiographically. Pancarpal arthrodesis was performed with 2 LCP positioned dorsolaterally and dorsomedially and centered over the carpus through a single skin incision. The filly was maintained in a full limb cast for 15 days, followed by a tube cast for 14 days, and subsequently a full limb bandage with caudal splint for 21 days. Two LCP provided appropriate carpal stability resulting in a pasture sound horse 6 months after surgery. The filly was discharged from the hospital 63 days after surgery, walking well with only a slight mechanical lameness. Use of 2 LCP applied on the dorsomedial and dorsolateral aspect of the carpus can provide carpal stability for pancarpal arthrodesis. Excellent stability of the carpal joints can be achieved with 2 LCP.

  1. Locking plate technology and its use in foot and ankle surgery.

    Science.gov (United States)

    Dial, Dekarlos M; Ryan, Michael

    2011-08-01

    This article discusses the history of conventional plating, plate biomechanics, and screw function to provide better understanding of osseous physiology and biology using locking plates. The peer-reviewed and non-peer-reviewed literature have been researched to decipher and share the most pertinent information on this topic. Copyright © 2011. Published by Elsevier Inc.

  2. Failure of volar locking plate fixation of an extraarticular distal radius fracture: A case report

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    Ozer Kagan

    2010-11-01

    Full Text Available Abstract Background Volar locking plates provide significant structural stability to the distal radius. Failure of a volar locked plating is a rarely reported complication in the literature. Case Presentation A 40 year-old, obese female patient who presented with a displaced extraarticular distal radius fracture, underwent open reduction and internal fixation of the fracture using a volar locking plate. Radiographs taken at 10 weeks postoperatively showed failure of fixation with breakage of the four distal locking screws. A hardware removal was performed at 6 months, and the patient was then lost to follow-up. She presented again at 18 months after the first surgery, with significant pain, and radiographic signs of a radial collapse and a fracture-nonunion. A total wrist fusion was performed as the method of choice at that point in time. Conclusion Volar locked plating represents the new "gold standard" of distal radius fracture fixation. However, despite the stability provided by locking plates, hardware failure may occur and lead to a cascade of complications which will ultimately require a wrist fusion, as outlined in this case report. Additional structural support by bone grafting may be needed in selected cases of volar locked plating, particularly in patients with a high risk of developing a fracture-nonunion.

  3. A biomechanical evaluation of locked plating for distal fibula fractures in an osteoporotic sawbone model.

    Science.gov (United States)

    Bariteau, Jason T; Fantry, Amanda; Blankenhorn, Brad; Lareau, Craig; Paller, David; Digiovanni, Christopher W

    2014-03-01

    Supination external rotation (SER) injuries are commonly fixed with a one third tubular neutralization plate. This study investigated if a combination locked plate with additional fixation options was biomechanically superior in osteoporotic bone and comminuted fracture models. Using an osteoporotic and a comminuted Sawbones model, SER injuries were fixed with a lag screw for simple oblique fibula fractures, and either a one third tubular neutralization plate or a locking plate. Samples were tested in stiffness, peak torque, displacement at failure, and torsion fatigue. There was no statistically significant difference in biomechanical testing for fractures treated with a lag screw and plate. For comminuted fractures, locked plating demonstrated statistically significant stiffer fixation. A combination locked plate is biomechanically superior to a standard one third tubular plate in comminuted SER ankle fractures. There was no biomechanical superiority between locked and one third tubular plates when the fracture was amenable to a lag screw. Copyright © 2013 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  4. Use of locking plates for fixation of the greater trochanter in patients with hip replacement

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    Allison K. Tetreault, BA

    2016-12-01

    Conclusions: Locking plate technology is a successful method of fixation of the greater trochanter in patients with THA. Postoperative trochanteric pain and reoperation for hardware-related issues remain a challenge.

  5. Temporary transarticular stabilization with a locking plate for medial shoulder luxation in a dog.

    Science.gov (United States)

    Post, C; Guerrero, T; Voss, K; Montavon, P M

    2008-01-01

    This report describes the temporary fixation of a traumatic shoulder luxation in a large-breed dog using a 3.5-mm Locking Round-Hole Reconstruction Plate (LRHRP) to provide stable internal splinting, allowing healing of the injured ligaments, joint capsule, glenohumeral ligaments, tendons, and muscles for restoration of joint stability. The use of a temporary plate with a locking system should be considered as an option in the treatment of canine shoulder joint luxations with severe tissue damage.

  6. History of internal fixation with plates (part 2): new developments after World War II; compressing plates and locked plates.

    Science.gov (United States)

    Hernigou, Philippe; Pariat, Jacques

    2017-07-01

    The first techniques of operative fracture with plates were developed in the 19th century. In fact, at the beginning these methods consisted of an open reduction of the fracture usually followed by a very unstable fixation. As a consequence, the fracture had to be opened with a real risk of (sometimes lethal) infection, and due to unstable fixation, protection with a cast was often necessary. During the period between World Wars I and II, plates for fracture fixation developed with great variety. It became increasingly recognised that, because a fracture of a long bone normally heals with minimal resorption at the bone ends, this may result in slight shortening and collapse, so a very rigid plate might prevent such collapse. However, as a consequence, delayed healing was observed unless the patient was lucky enough to have the plate break. One way of dealing with this was to use a slotted plate in which the screws could move axially, but the really important advance was recognition of the role of compression. After the first description of compression by Danis with a "coapteur", Bagby and Müller with the AO improved the technique of compression. The classic dynamic compression plates from the 1970s were the key to a very rigid fixation, leading to primary bone healing. Nevertheless, the use of strong plates resulted in delayed union and the osteoporosis, cancellous bone, comminution, and/or pathological bone resulted in some failures due to insufficient stability. Finally, new devices represented by locking plates increased the stability, contributing to the principles of a more biological osteosynthesis while giving enough stability to allow immediate full weight bearing in some patients.

  7. Metaphyseal locking plate as an external fixator for open tibial fracture: Clinical outcomes and biomechanical assessment.

    Science.gov (United States)

    Ma, Ching-Hou; Wu, Chin-Hsien; Jiang, Jiun-Ru; Tu, Yuan-Kun; Lin, Ting-Sheng

    2017-02-01

    This study aimed to evaluate the outcome of using a metaphyseal locking plate as a definitive external fixator for treating open tibial fractures based on biomechanical experiments and analysis of clinical results. A metaphyseal locking plate was used as an external fixator in 54 open tibial fractures in 52 patients. The mean follow-up was 38 months (range, 20-52 months). Moreover, static axial compression and torsional tests were performed to evaluate the strength of the fixation techniques. The average fracture healing time was 34.5 weeks (range, 12-78 weeks). At 4 weeks postoperatively and at the final follow-up, the average Hospital for Special Surgery knee score was 85 (range, 81-100) and 94 (range, 88-100), respectively, and the American Orthopaedic Foot and Ankle Society score was 88 (range, 80-100) and 96 (range, 90-100), respectively. Based on the static test result, the axial stiffness was significantly different among groups (p=0.002), whereas the torsional stiffness showed no significant difference (p=0.068). Clinical outcomes show that the use of locking plate as a definitive external fixator is an alternative choice for tibial fractures after obtaining appropriate fracture reduction. However, external locked plating constructs were not as strong as standard locked plating constructs. Therefore, the use of external locked plating constructs as a definitive treatment warrants further biomechanical study for construct strength improvement. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Staple versus locking compression plate fixation after lateral closing wedge high tibial osteotomy.

    Science.gov (United States)

    Agarwala, S; Shah, S B

    2008-12-01

    To compare the results of staple versus locking compression plate fixation after closing wedge high tibial osteotomy. A group of 23 patients (24 knees) who underwent box high tibial osteotomy and staple fixation was compared with another group of 19 patients (22 knees) who underwent a similar procedure but with locking compression plate fixation. Both groups were followed up for 3 years. The range of movement, Hospital for Special Surgery (HSS) Knee Score, time to full weight bearing, incidence of delayed union, femorotibial angle, and stage of osteoarthritis were compared. At 6 months after the operation, the median HSS score and the proportion of patients with excellent or good scores were significantly higher in the locking compression plate than the staple fixation group (76 vs 62, p=0.003; 75% vs 42%, p=0.0354), but not at one and 3 years. The range of movement was significantly greater in the locking compression plate fixation group in the short term (6 weeks, 3 and 6 months), but not after one year. The median time to full weight bearing was significantly shorter in the locking compression plate fixation group (86 vs 116 days, perror, in the femorotibial angle or correction loss between the 2 groups. Locking compression plate fixation obviates the use of plaster casts, enables early mobilisation and bone union, and reduces the numbers with delayed union and the time to full weight bearing. Longer-term studies are needed to evaluate its effect on revarisation and arthropathy.

  9. Stabilisation of periarticular fractures and osteotomies with a notched head locking T-plate.

    Science.gov (United States)

    Tan, C J; Johnson, K A

    2016-10-01

    To report the clinical outcomes and complications of small animals that had articular or periarticular fractures or osteotomies stabilised with a notched head locking T-plate. Medical records were searched retrospectively to identify animals that had a notched head locking T-plate used to stabilise a small articular or periarticular bone fragment. Nine dogs and two cats had an articular or periarticular bone fragment stabilised with a 2.0- or 2.4-mm notched head locking T-plate (12 procedures). The median body weight was 4.7 kg. The plate was modified by removing holes in 10/12 procedures and a combination of locking and non-locking screws were used in 7/12 procedures. All fractures or osteotomies progressed to clinical union. There were two intraoperative complications (intra-articular screw placement and overlong screw) and two postoperative complications (skin necrosis and stress protection) This study reports the successful use of a 2.0- or 2.4-mm notched head locking T-plate for articular or periarticular fractures or osteotomies in a variety of small-breed dogs and cats. Care must be taken to prevent inadvertent penetration of the articular surface, particularly in regions such as the proximal tibia. The ability to modify the plate dimensions intraoperatively proved beneficial in most cases. © 2016 Australian Veterinary Association.

  10. First Metatarsophalangeal Joint Arthrodesis: A Retrospective Comparison of Crossed-screws, Locking and Non-Locking Plate Fixation with Lag Screw

    Directory of Open Access Journals (Sweden)

    Leif Claassen

    2017-07-01

    Full Text Available Background:Locking plate fixation is increasingly used for first metatarsophalangeal joint (MTP-I arthrodesis. Still there is few comparable clinical data regarding this procedure. Methods:We retrospectively evaluated 60 patients who received an arthrodesis of the MTP-I between January 2008 and June 2010. With 20 patients each we performed a locking plate fixation with lag screw, arthrodesis with crossed-screwsor with a nonlocking plate with lag screw. Results: There were four non-unions in crossed-screws patients and one nonunion in non-locked plate group. All the patients in locking plate group achieved union. 90% of the patients were completely or mildly satisfied in locking plate group, whereas this rate was 80% for patients in both crossed screws and non-locking plate groups. Conclusions: Use of dorsal plating for arthrodesis of MTP1 joint either locking or non-locking were associated with high union rate and acceptable and comparable functional outcome. Although nonunion rate was high using two crossed screws but functional outcome was not significantly different compare to dorsal plating. Level of evidence:Ш, retrospective comparative study

  11. First Metatarsophalangeal Joint Arthrodesis: A Retrospective Comparison of Crossed-screws, Locking and Non-Locking Plate Fixation with Lag Screw

    Directory of Open Access Journals (Sweden)

    Leif Claassen

    2017-11-01

    Full Text Available Background:Locking plate fixation is increasingly used for first metatarsophalangeal joint (MTP-I arthrodesis. Still there is few comparable clinical data regarding this procedure. Methods:We retrospectively evaluated 60 patients who received an arthrodesis of the MTP-I between January 2008 and June 2010. With 20 patients each we performed a locking plate fixation with lag screw, arthrodesis with crossed-screwsor with a nonlocking plate with lag screw. Results: There were four non-unions in crossed-screws patients and one nonunion in non-locked plate group. All the patients in locking plate group achieved union. 90% of the patients were completely or mildly satisfied in locking plate group, whereas this rate was 80% for patients in both crossed screws and non-locking plate groups. Conclusions: Use of dorsal plating for arthrodesis of MTP1 joint either locking or non-locking were associated with high union rate and acceptable and comparable functional outcome. Although nonunion rate was high using two crossed screws but functional outcome was not significantly different compare to dorsal plating.

  12. Locked versus nonlocked plate fixation for first metatarsophalangeal arthrodesis: a biomechanical investigation.

    Science.gov (United States)

    Hunt, Kenneth J; Barr, Cameron R; Lindsey, Derek P; Chou, Loretta B

    2012-11-01

    First metatarsophalangeal (MTP) arthrodesis using dorsal plate fixation is a common procedure for painful conditions of the great toe. Locked plates have become increasingly common for arthrodesis procedures in the foot, including the hallux MTP joint. The biomechanical advantages and disadvantages of these plates are currently unknown. The purpose of this study was to compare locked and nonlocked plates used for first MTP fusion for strength and stiffness. The first ray of nine matched pairs of fresh-frozen cadaveric feet underwent dissection, preparation with cup-and-cone reamers, and fixation of the MTP joint with a compression screw and either a nonlocked or locked stainless steel dorsal plate. Each specimen was loaded in a cantilever fashion to 90 N at a rate of 3 Hz for a total of 250,000 cycles. The amount of plantar MTP gap was recorded using a calibrated extensometer. Load-to-failure testing was performed for all specimens that endured the entire cyclical loading. Stiffness was calculated from the final load-to-failure test. The locked plate group demonstrated significantly less plantar gapping during fatigue endurance testing from cycle 10,000 through 250,000 (p testing and significantly greater stiffness in load-to-failure testing. As the use of locked plate technology is becoming increasingly common for applications in the foot, a thorough understanding of the biomechanical characteristics of these implants may help optimize their indications and clinical use.

  13. Anterior cervical decompression and fusion with caspar plate fixation

    International Nuclear Information System (INIS)

    Rehman, L.; Akbar, H.; Das, G.; Hashim, A.S.M.

    2013-01-01

    Objective: To evaluate the role of anterior cervical decompression and fixation with Caspar plating in cervical spine injury on neurological outcome. Study Design: A case series. Place and Duration of Study: Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, from July 2008 to March 2011. Methodology: Thirty patients admitted with cervical spine injuries were inducted in the study. All cases were evaluated for their clinical features, level of injury and degree of neurological injury was assessed using Frankel grading. Pre and postoperative record with X-rays and MRI were maintained. Cervical traction was applied to patients with sub-luxation. All patients underwent anterior cervical decompression, fusion and Caspar plate fixation. The follow-up period was 6 months with clinical and radiological assessment. Results: Among 30 patients, 24 (80%) were males and 6 (20%) were females. Age ranged from 15 to 55 years. Causes of injury were road traffic accident (n = 20), fall (n = 8) and assault (n = 2). Commonest mode of injury was road traffic accident (66.6%). Postoperative follow-up showed that pain and neurological deficit were improved in 21 patients. There was no improvement in 7 patients, one patient deteriorated and one expired. All patients developed pain at donor site. Conclusion: Anterior decompression, fusion and fixation with Caspar plate is an effective method with good neurological and radiological outcome. However, it is associated with pain at donor site. (author)

  14. Oesophageal perforation in anterior cervical spine plating: A Case ...

    African Journals Online (AJOL)

    A case report of a 48-year-old man who had a pharyngo-esophageal perforation with instrumentation failure 10 weeks after anterior cervical spine plating is presented and the literature on this issue is reviewed. Diagnosis of the perforation was made late as he had been lost to follow up and he eventually died of severe ...

  15. Locked plating of distal femur fractures leads to inconsistent and asymmetric callus formation.

    Science.gov (United States)

    Lujan, Trevor J; Henderson, Chris E; Madey, Steven M; Fitzpatrick, Dan C; Marsh, J Lawrence; Bottlang, Michael

    2010-03-01

    Locked plating constructs may be too stiff to reliably promote secondary bone healing. This study used a novel imaging technique to quantify periosteal callus formation of distal femur fractures stabilized with locking plates. It investigated the effects of cortex-to-plate distance, bridging span, and implant material on periosteal callus formation. Retrospective cohort study. One Level I and one Level II trauma center. Sixty-four consecutive patients with distal femur fractures (AO types 32A, 33A-C) stabilized with periarticular locking plates. Osteosynthesis using indirect reduction and bridge plating with periarticular locking plates. Periosteal callus size on lateral and anteroposterior radiographs. Callus size varied from 0 to 650 mm2. Deficient callus (20 mm2 or less) formed in 52%, 47%, and 37% of fractures at 6, 12, and 24 weeks postsurgery, respectively. Callus formation was asymmetric, whereby the medial cortex had on average 64% more callus (P=0.001) than the anterior or posterior cortices. A longer bridge span correlated minimally with an increased callus size at Week 6 (P=0.02), but no correlation was found at Weeks 12 and 24 postsurgery. Compared with stainless steel plates, titanium plates had 76%, 71%, and 56% more callus at Week 6 (P=0.04), Week 12 (P=0.03), and Week 24 (P=0.09), respectively. Stabilization of distal femur fractures with periarticular locking plates can cause inconsistent and asymmetric formation of periosteal callus. A larger bridge span only minimally improves callus formation. The more flexible titanium plates enhanced callus formation compared with stainless steel plates.

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

    Science.gov (United States)

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

    2015-01-01

    For talar neck fractures, open reduction and internal fixation have been thought to facilitate revascularization and prevent osteonecrosis. Newer screw systems allow for placement of cannulated headless screws, which provide compression by virtue of a variable pitch thread. The present study compared the biomechanical fixation strength of cannulated headless variable-pitch screw fixation and locking plate fixation. A reproducible talar neck fracture was created in 14 fresh cadaver talar necks. Talar head fixation was then performed using 2 cannulated headless variable-pitch 4-mm/5-mm diameter (4/5) screws (Acutrak; Acumed, Hillsboro, OR) and locking plate fixation. Headless variable-pitch screw fixation had lower failure displacement than did locking plate fixation. No statistically significant differences were found in failure stiffness, yield stiffness (p = .655), yield load (p = .142), or ultimate load between the 2 fixation techniques. Cannulated headless variable-pitch screw fixation resulted in better failure displacement than locking plate fixation in a cadaveric talus model and could be considered a viable option for talus fracture fixation. Headless, fully threaded, variable-pitch screw fixation has inherent advantages compared with locking plate fixation, because it might cause less damage to the articular surface and can compress the fracture for improved reduction. Additionally, plate fixation can increase the risk of avascular necrosis owing to the wider incision and dissection of soft tissues. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Periprosthetic Vancouver type B1 and C fractures treated by locking-plate osteosynthesis

    DEFF Research Database (Denmark)

    Froberg, Lonnie; Troelsen, Anders; Brix, Michael

    2012-01-01

    Historically, the treatment of periprosthetic femoral fractures (PFFs) has been associated with a high frequency of complications and reoperations. The preferred treatment is internal fixation, a revision of the femoral stem, or a combination of both. An improved understanding of plate use during...... internal fixation, and the introduction of locking-plate osteosynthesis may lead to improved outcome. We evaluated the outcome of Vancouver type B1 and C PFFs treated by locking-plate osteosynthesis, by assessing rates of fracture union and reoperations and by analyzing failure cases....

  18. Femoral fracture repair using a locking plate technique in an adult captive polar bear (Ursus maritimus).

    Science.gov (United States)

    Zimmerman, Dawn M; Dew, Terry; Douglass, Michael; Perez, Edward

    2010-02-01

    To report successful femoral fracture repair in a polar bear. Case report. Female polar bear (Ursus maritimus) 5 years and approximately 250 kg. A closed, complete, comminuted fracture of the distal midshaft femur was successfully reduced and stabilized using a compression plating technique with 2 specialized human femur plates offering axial, rotational, and bending support, and allowing the bone to share loads with the implant. Postoperative radiographs were obtained at 11.5 weeks, 11 months, and 24 months. Bone healing characterized by marked periosteal reaction was evident at 11 months with extensive remodeling evident at 24 months. No complications were noted. Distal mid shaft femoral fracture was reduced, stabilized, and healed in an adult polar bear with a locking plate technique using 2 plates. Previously, femoral fractures in polar bears were considered irreparable. Use of 2 plates applied with a locking plate technique can result in successful fracture repair despite large body weight and inability to restrict postoperative activity.

  19. Effect of a locking triple pelvic osteotomy plate on screw loosening in 26 dogs.

    Science.gov (United States)

    Rose, Scott A; Peck, Jeffrey N; Tano, Cheryl A; Uddin, Nizam; de Haan, Jacek J

    2012-01-01

    To evaluate the complication rate of the double (DPO) and triple pelvic osteotomy (TPO) procedure (unilateral and bilateral) with a locking purpose-specific plate. Retrospective case series Dogs (n = 26; 38 hips) Medical records (January 2007-January 2011) of dogs that had unilateral or bilateral DPO or TPO were evaluated. Signalment, age, body weight, estimated preoperative subluxation and reduction angles, lameness, and complications were evaluated. Follow-up radiographs were evaluated for implant loosening or failure, femoral head coverage (FCH), pelvic dimensions, and radiographic evidence of healing. Screw loosening occurred in 1 of 266 (0.4%) screws placed and in 1 of 38 hips (2.6%). The rate of screw loosening was significantly lower than previously reported. Only 1 hip (2.6%) developed a major complication. Minor complications involving implants occurred in 2 hips (5.3%). Three to 5 locking screws were used per plate. There was a significant increase in FCH and Norberg angle (NA) compared with preoperative values. No clinically significant change in pelvic canal dimensions measured at 3 locations was identified. Locking 7-hole TPO plates with 3-5 locking screws resulted in a lower rate of major and minor implant associated complications than the reported complication rate for conventional 6-hole plates. En bloc pullout of the caudal aspect of the plate is an infrequent but repeatable complication associated with the locking TPO implant. © Copyright 2011 by The American College of Veterinary Surgeons.

  20. Fifth metacarpal neck fracture fixation: Locking plate versus K-wire?

    Science.gov (United States)

    Facca, S; Ramdhian, R; Pelissier, A; Diaconu, M; Liverneaux, P

    2010-09-01

    Neck fractures of the fifth metacarpal bone can leave sequelae. Surgery is indicated when the displacement of the head in flexion exceeds 45° and/or rotation is impaired. Among available techniques, non-locking mini-plates have the most drawbacks; recently developed locking plates may, however, challenge the preference for K-wires. The present study compared results between locking plates and intramedullary K-wires. The series comprised 38 fifth metacarpal fractures: 18 were managed by locking plate (group I) and 20 by intramedullary K-wire (group II). Results were analyzed on subjective and objective criteria (pain, DASH, strength, mobility, time off work, radiology). No significant differences were found for pain, DASH, strength, time off work or head displacement at last follow-up. Active mobility, however, was significantly greater in the K-wire group, with mean relative metacarpophalangeal flexion 59% of healthy-side values in group I vs. 98% in group II, and mean relative extension 89% in group I vs. 99% in group II. Group I showed six complications (three cases of stiffness, one of head necrosis, two of delayed consolidation) vs. seven in group II (three cases of wire migration, three of neurologic lesion, one of esthetic blemish). Locking plates with immediate mobilization paradoxically provided poorer mobility at end of follow-up than intramedullary K-wire with 6 weeks' immobilization. The extra cost of locking plates was thus not justified by results. Intramedullary K-wire nailing remains the reference technique for the management of displaced fracture of the fifth metacarpal neck. Level IV continuous prospective comparative study. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  1. Volar locking plate (VLP) versus non-locking plate (NLP) in the treatment of die-punch fractures of the distal radius, an observational study.

    Science.gov (United States)

    Zhang, Xiong; Hu, Chunhe; Yu, Kunlun; Bai, Jiangbo; Tian, Dehu; Xu, Yi; Zhang, Bing

    2016-10-01

    This study aims to evaluate whether volar locking plate was superior over non-locking plate in the treatment of die-punch fractures of the distal radius. A total of 57 patients with closed die-punch fractures of the distal radius were included and analyzed. Of them, 32 were treated by non-locking plate (NLP) and the remaining 25 were treated by volar locking plate (VLP). Preoperative radiographs, computer tomographs and three-dimensional reconstruction, radiographs taken at immediate postoperation and at last follow-up were extracted and evaluated. Patients' electronic medical records were inquired and related demographic and medical data were documented. The documented contents were volar tilt, radial inclination, ulnar variance, grip strength, Disabilities of the Arm, Shoulder, and Hand (DASH) and visual analog scale (VAS) scores and complications. VLP group demonstrated a significantly reduced radial subsidence of 1.5 mm (0.7 versus 2.2 mm), during the interval of bony union (P NLP group. Larger proportion of patients (88% versus 62.5%) in VLP group gained acceptable joint congruity (step-off NLP groups, although the difference did not approach to significance (P = 0.339, 0.372). VLP leaded to significantly better results of reduction maintainance and the final joint congruity than NLP, while reducing overall and major complications. However, the results should be treated in the context of limitations and the clinical significance of the difference required further studies to investigate. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  2. Stability of medial locking plate and compression screw versus two crossed screws for lapidus arthrodesis.

    Science.gov (United States)

    Klos, Kajetan; Gueorguiev, Boyko; Mückley, Thomas; Fröber, Rosemarie; Hofmann, Gunther O; Schwieger, Karsten; Windolf, Markus

    2010-02-01

    Lapidus (first metatarsocuneiform joint) arthrodesis is an established procedure for the management of hallux valgus. This study investigated the utility of fixation with a medial locking plate with adjunct compression screw versus fixation with two crossed screws. Eight pairs of fresh-frozen human specimens were used in a matched pair test. Bone mineral density (BMD) was measured with peripheral quantitative computed tomography (pQCT). Fixation with two 4-mm-diameter crossed screws was compared versus a medial locking plate (X-Locking Plate 2.4/2.7; Synthes, Solothurn, Switzerland) with adjunct 4-mm-diameter compression screw. The specimens were tested in a four-point bending test. Parameters obtained were initial stiffness; plantar joint-line gapping after one cycle, 100 and 1000 cycles; and number of cycles to failure. Failure was defined as more than or equal to 3 mm plantar gapping. The groups did not differ significantly with regard to BMD (p = 0.866) and initial stiffness (p = 0.889). The plate-and-screw construct showed significantly less movement during testing, and significantly (p = 0.001) more cycles to failure than did the crossed-screw construct. There was a significant correlation (crossed-screw construct: p = 0.014; plate-and-screw construct: p = 0.010) between BMD and the number of cycles to failure. Under cyclic loading conditions, the construct using a medial locking plate with adjunct compression screw was superior to the construct using two crossed screws. The medial locking-plate technique described could help shorten the period of nonweightbearing and reduce the risk of non-union.

  3. Bicondylar tibial plateau fracture treated by open reduction and fixation with unilateral locked plating

    Directory of Open Access Journals (Sweden)

    Tien-Ching Lee

    2013-10-01

    Full Text Available The management of bicondylar tibial plateau fractures is challenging. A lateral locking plate offers an alternative method to traditional dual plating to avoid further stripping of soft tissue. Nevertheless, the rate of malreduction and fixation loss remains high. From 2007 to 2009, we performed open reduction and fixation with unilateral locked plating to directly reduce the fracture in 15 patients with bicondylar plateau fracture. The average follow-up duration was 16.2 months (range: 12–30 months, and the average age of the patients was 43 years (range: 19–64 years. All fractures were Orthopaedic Trauma Association type 41-C. Postoperative radiographic alignment was evaluated immediately and at 2–4 weeks, 8–12 weeks, 5–7 months, and 11–13 months. Both Oxford knee score and Hospital for Special Surgery knee score were used to evaluate functional outcomes. The average duration within which union was achieved was 4.8 months (range: 2–10 months. One patient incurred wound dehiscence; however, there was no case of deep infection. Malreduction occurred in one patient (6.7% while fixation loss occurred in three patients (20% with subsidence of the posteromedial fragment and varus malalignment. Despite the malreduction rate being lower in our study than in previous studies involving unilateral locked plating, a high rate of fixation loss was recorded. Per our limited experience, we believe that unilateral locked plating may have limitations in patients with selective patterns of bicondylar tibial plateau fractures.

  4. Lapidus bunionectomy: Early evaluation of crossed lag screws versus locking plate with plantar lag screw.

    Science.gov (United States)

    Saxena, Amol; Nguyen, Aidan; Nelsen, Elise

    2009-01-01

    We compared outcomes of the Lapidus bunionectomy fixated with crossed lag screws versus a locking plate with a plantar lag screw. Forty patients who underwent Lapidus bunionectomy between August 2001 and May 2006 were evaluated in a combined retrospective and prospective fashion. Crossed lag screws were used in 19 of the patients, and a locking plate with a plantar lag screw was used in 21 of the patients. Other than fixation, the only interventional difference pertained to postoperative weight bearing, where those receiving the plate initiated full weight bearing on the operated foot at 4 weeks postoperative, as compared to 6 weeks for those receiving crossed screws. Overall, the mean preoperative AOFAS hallux score was 41.75 +/- 2.52, and the postoperative score was 90.48 +/- 8.41 (P fixation, use of an adjunct Akin osteotomy and surgery performed before 2003 were statistically significantly associated with crossed screw fixation, and the preoperative AOFAS score was statistically significantly higher in the locking plate fixation group. There were no statistically significant differences related to postoperative complications between the 2 fixation groups. In conclusion, the Lapidus bunionectomy fixated with a locking plate and a plantar lag screw allows earlier weight bearing in comparison with crossed lag screws, without a difference in complications. 2.

  5. Biomechanical Performance of Lateral Versus Dual Locking Plates for Calcaneal Fractures.

    Science.gov (United States)

    Maxwell, Abby B; Owen, John R; Gilbert, Todd M; Romash, Michael M; Wayne, Jennifer S; Adelaar, Robert S

    2015-01-01

    Given the high rates of wound complications with a standard lateral extensile incision, small dual incision techniques might result in less soft tissue destruction. The goal of the present study was to compare the biomechanical performance between a single locking plate and a dual locking plating system for an intra-articular calcaneal fracture model. A Sanders IIB type joint depression calcaneal fracture was created in 10 paired, fresh-frozen, cadaveric calcanei (age 47 ± 12, range 35 to 78 years). The calcanei of each pair were randomly assigned for fixation using either a lateral locking reconstruction plate or lateral and medial locking reconstruction plates. The specimens were axially loaded in cyclic fashion for 1000 cycles, followed by load to failure. The relative fragment movement was monitored optically in both the sagittal and the coronal planes. The amount of overall construct displacement increased with cycling, although no difference was found between the plating techniques. For fragment movement during cycling, the lateral joint fragment migrated anteroinferiorly along the fracture line relative to the tuberosity fragment for dual plated specimens by a small, but statistically significant, amount. This same translation was smaller for lateral plated specimens but was not found to be significant. During load to failure testing, no statistically significant differences were found for construct stiffness. A tendency was seen toward more interfragmentary motion in the sagittal plane (lateral joint fragment movement relative to the fracture line), with less movement overall in the coronal plane (anterior fragment translation and twist) for dual plating, although the difference from the lateral plate was not statistically significant. The present study demonstrated that for this calcaneal fracture model, the dual plating technique experienced a small amount of fragment translation during cycling that was significantly different statistically from that

  6. RESULT OF PRE-CONTOURED DISTAL RADIUS INDIAN LOCKING PLATES IN DISTAL RADIUS FRACTURE

    OpenAIRE

    Shaleen; Baljit; Aditya; Parminder; Simarpreet S

    2014-01-01

    BACKGROUND: Fractures of the distal radius are common, open reduction and internal fixation using an interlocking plate system has gained popularity for the treatment of dorsally displaced distal radius fractures. The aim of the study was to assess how adequately distal radial fracture reduction was reproduced and maintained with the pre-contoured distal radius Indian locking plates and to evaluate the functional and radiological results of treating unstable distal radius ...

  7. Minimally invasive osteosynthesis of distal tibial fractures using anterolateral locking plate: Evaluation of results and complications

    OpenAIRE

    Lakhotia, Devendra; Sharma, Gaurav; Khatri, Kavin; Kumar, G.N. Kiran; Sharma, Vijay; Farooque, Kamran

    2016-01-01

    Purpose Soft tissue healing is of paramount importance in distal tibial fractures for a successful outcome. There is an increasing trend of using anterolateral plate due to an adequate soft tissue cover on anterolateral distal tibia. The aim of this study was to evaluate the results and complications of minimally invasive anterolateral locking plate in distal tibial fractures. Methods This is a retrospective study of 42 patients with distal tibial fractures treated with minimally invasive ant...

  8. The mechanical benefit of medial support screws in locking plating of proximal humerus fractures.

    Directory of Open Access Journals (Sweden)

    Wen Zhang

    Full Text Available BACKGROUND: The purpose of this study was to evaluate the biomechanical advantages of medial support screws (MSSs in the locking proximal humeral plate for treating proximal humerus fractures. METHODS: Thirty synthetic left humeri were randomly divided into 3 subgroups to establish two-part surgical neck fracture models of proximal humerus. All fractures were fixed with a locking proximal humerus plate. Group A was fixed with medial cortical support and no MSSs; Group B was fixed with 3 MSSs but without medial cortical support; Group C was fixed with neither medial cortical support nor MSSs. Axial compression, torsional stiffness, shear stiffness, and failure tests were performed. RESULTS: Constructs with medial support from cortical bone showed statistically higher axial and shear stiffness than other subgroups examined (P<0.0001. When the proximal humerus was not supported by medial cortical bone, locking plating with medial support screws exhibited higher axial and torsional stiffness than locking plating without medial support screws (P ≤ 0.0207. Specimens with medial cortical bone failed primarily by fracture of the humeral shaft or humeral head. Specimens without medial cortical bone support failed primarily by significant plate bending at the fracture site followed by humeral head collapse or humeral head fracture. CONCLUSIONS: Anatomic reduction with medial cortical support was the stiffest construct after a simulated two-part fracture. Significant biomechanical benefits of MSSs in locking plating of proximal humerus fractures were identified. The reconstruction of the medial column support for proximal humerus fractures helps to enhance mechanical stability of the humeral head and prevent implant failure.

  9. Plate fixation in periprosthetic femur fractures Vancouver type B1-Trochanteric hook plate or subtrochanterical bicortical locking?

    Science.gov (United States)

    Lenz, Mark; Stoffel, Karl; Kielstein, Heike; Mayo, Keith; Hofmann, Gunther O; Gueorguiev, Boyko

    2016-12-01

    Proximal plate fixation in periprosthetic femur fractures can be improved by plate anchorage in the greater trochanter (lateral tension band principle) or bicortical locking screw placement beside the prosthesis stem in an embracement configuration. Both concepts were compared in a biomechanical test using a femoral hook plate (hook) or a locking attachment plate (LAP). After bone mineral density (BMD) measurement in the greater trochanter, six pairs of fresh frozen human femora were assigned to two groups and instrumented with cemented hip endoprostheses. A transverse osteotomy was set distal to the tip of the prosthesis, simulating a Vancouver B1 fracture. Each pair was instrumented using a plate tensioner with either hook or LAP construct. Cyclic testing (2Hz) with physiologic profile and monotonically increasing load was performed until catastrophic failure. Plate stiffness was compared in a four-point-bending-test. Paired student's-t-test was used for statistical evaluation (pTrochanteric fixation is highly BMD dependent and may be restricted to major greater trochanteric involvement requiring stabilization. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Surgical outcome of displaced middle third clavicular fractures treated with locking compression plate

    Directory of Open Access Journals (Sweden)

    Rakesh Patil

    2014-01-01

    Full Text Available Conservative management of middle third clavicle fracture has been recently reported with suboptimal outcomes. Despite higher nonunion rates in initial open reduction and internal fixation (ORIF, understanding the problem better and taking in accounts of previous shortcomings, such fractures can be optimally treated by ORIF with locking compression plate (LCP. This study aims at investigating the outcome of middle third clavicle fracture treated with locking compression plating in terms of function using constant score union time, complications, and patient satisfaction. Study includes 98 patients with displaced middle third clavicle fracture treated with ORIF with locking compression plate, which had follow-up for at least 1 year. The mean age was 44 years (15-59, 56 were male patients and 42 were female. Right side was involved in 53.9% of cases. All the fractures united with mean time to union of 9.2 weeks except two, in which the procedure was redone with bone grafting to achieve union. The average constant score was 89. Our study shows that displaced midshaft clavicle fracture can be optimally treated with surgical fixation with the locking compression plate to reduce malunion, unsightly deformity and nonunions. We conclude that precontoured LCP as a reliable option for fixing midshaft clavicle fractures.

  11. Bilateral clavicle non-unions treated with anteroinferior locking compression plating (LCP": a case report

    NARCIS (Netherlands)

    Kloen, Peter

    2004-01-01

    The author reports the case of a 30-year-old female patient with bilateral atrophic non-union of the clavicle; the latter both healed after internal fixation with a locking compression plate fixed on the anteroinferior aspect of the clavicle, combined with autologous cancellous bone grafting. The

  12. Comparative analysis of locking plate versus hook plate osteosynthesis of Neer type IIB lateral clavicle fractures.

    Science.gov (United States)

    Erdle, Benjamin; Izadpanah, Kaywan; Jaeger, Martin; Jensen, Patrizia; Konstantinidis, Lukas; Zwingmann, Jörn; Südkamp, Norbert P; Maier, Dirk

    2017-05-01

    Controversy exists on optimal operative treatment of vertically unstable Neer IIB lateral clavicle fractures. Aim of this study was to analyse and compare clinical and radiological results and complications of locking plate osteosynthesis (LPO) versus hook plate osteosynthesis (HPO) with acromioclavicular joint (ACJ) stabilization. The hypothesis was, that HPO would recreate coracoclavicular stability more effectively and potentially lead to a superior outcome. This retrospective, observational cohort study included 32 patients (19 HPO, 13 LPO) with a mean age of 44.1 ± 14.2 years at surgery. The mean follow-up period was 54.2 months (range 25.2-111.4 months). Besides standard radiography, bilateral coracoclavicular distances were assessed by means of preoperative and follow-up stress radiographs after implant removal. Clinical outcome measures included the Constant score (CS), the Oxford shoulder score (OSS), the subjective shoulder value (SSV) and the Taft score (TS). Bone union occurred in all but one patient and proved to occur delayed in five patients (15.6%). Radiographical healing required a mean of 4.2 ± 4.0 months irrespective of the type of osteosynthesis. At follow-up, mean coracoclavicular distance was increased by 34% (±36) without significant differences between both groups. HPO patients obtained a significantly lower TS (HPO: 9.5 ± 1.5 points, LPO: 11.1 ± 1.3 points; p = 0.005). Other mean score values did not differ (CS: 90.1 ± 7.4 points, OSS: 43.2 ± 9.2 points, SSV: 91.1 ± 14.7%). Sixteen patients (50.0%) experienced complications. Overall prevalence of complications was significantly higher in the HPO group (p = 0.014). Both HPO and LPO were equally effective in relation to restoration of vertical stability, overall functional outcome and fracture consolidation in treatment of Neer IIB fractures. Contrary to our hypothesis, HPO was not associated with superior recreation of the coracoclavicular

  13. Parametric study of patient-specific femoral locking plates based on a combined musculoskeletal multibody dynamics and finite element modeling.

    Science.gov (United States)

    Fan, Xunjian; Chen, Zhenxian; Jin, Zhongmin; Zhang, Qida; Zhang, Xuan; Peng, Yinghu

    2018-02-01

    A combined musculoskeletal multibody dynamics and finite element modeling was performed to investigate the effects of design parameters on the fracture-healing efficiency and the mechanical property of a patient-specific anatomically adjusted femoral locking plate. Specifically, the screw type, the thickness and material of the locking plate, the gap between two femoral fragments (fracture gap) and the distance between bone and plate (interface gap) were evaluated during a human walking. We found that the patient-specific locking plate possessed greater mechanical strength and more efficient fracture healing than the corresponding traditional plate. An optimal patient-specific femoral locking plate would consist of bicortical locking screws, Ti-6Al-4V material and 4.75-mm plate thickness with a fracture gap of 2 mm and an interface gap of 1 mm. The developed patient-specific femoral locking plate based on the patient-specific musculoskeletal mechanical environment was more beneficial to fracture rehabilitation and healing. The patient-specific design method provides an effective research platform for designing and optimizing the patient-specific femoral locking plate under realistic in vivo walking conditions, which can be extended to the design of other implants as well as to other physiological loading conditions related to various daily activities.

  14. Single anterior cervical discectomy and fusion (ACDF) using self- locking stand-alone polyetheretherketone (PEEK) cage: evaluation of pain and health-related quality of life.

    Science.gov (United States)

    Kapetanakis, Stylianos; Thomaidis, Tryfon; Charitoudis, George; Pavlidis, Pavlos; Theodosiadis, Panagiotis; Gkasdaris, Grigorios

    2017-09-01

    Anterior cervical discectomy and fusion (ACDF) constitutes the conventional treatment of cervical disc herniation due to degenerative disc disease (DDD). ACDF with plating presents a variety of complications postoperatively and stand-alone cages are thought to be a promising alternative. The aim of this study was firstly, to analyze prospectively collected data from a sample of patients treated with single ACDF using C-Plus self-locking stand-alone PEEK cage system, without the use of plates or screws, in order to evaluate pain levels of patients, utilizing Neck and Arm Pain scale as an expression of visual analogue scale (VAS). Secondly, we aimed to evaluate health-related quality of life, via the short-form 36 (SF-36) and Neck Disability Index (NDI). Thirty-six patients (19 male and 17 female) with mean age 49.6±7 years old who underwent successful single ACDF using self-locking stand-alone PEEK cage for symptomatic cervical DDD were selected for the study. Neck and Arm pain, as well as SF-36 and NDI were estimated preoperatively and 1, 3, 6, and 12 months postoperatively. Patients underwent preoperative and postoperative clinical, neurological and radiological evaluation. The clinical and radiological outcomes were satisfactory after a minimum 1-year follow-up. All results were statistically important (P<0.05), excluding improvement in NDI measured between 6 and 12 months. SF-36, Neck Pain, as well as Arm Pain featured gradual and constant improvement during follow-up, with best scores presenting at 12 months after surgery, while NDI reached its best at 6 months postoperatively. Generally, all scores showed improvement postoperatively during the different phases of the follow-up. Subsequently, ACDF using C-Plus cervical cage constitutes an effective method for cervical disc herniation treatment, in terms of postoperative improvement on pain levels and health-related quality of life and a safe alternative to the conventional method of treatment for cervical DDD.

  15. Computational modelling of long bone fractures fixed with locking plates - How can the risk of implant failure be reduced?

    LENUS (Irish Health Repository)

    Nassiri, M

    2013-03-01

    The Locking Compression Plate (LCP) is part of a new plate generation requiring an adapted surgical technique and new thinking about commonly used concepts of internal fixation using plates. Knowledge of the fixation stability provided by these new plates is very limited and clarification is still necessary to determine how the mechanical stability and the risk of implant failure can best be controlled.

  16. Asymptomatic Flexor Tendon Damages after Volar Locking Plate Fixation of Distal Radius Fractures.

    Science.gov (United States)

    Tokunaga, Susumu; Abe, Yoshihiro

    2017-03-01

    To investigate asymptomatic flexor tendon damages after volar locking plate fixation of distal radius fractures in 32 wrists of 32 patients with distal radius fractures fixed using two plate types. Sixteen patients received the Acu-Loc volar distal radius plate, and the remaining 16 patients received the Aptus distal radius correction plate. The flexor pollicis longus (FPL) tendon and flexor digitorum profundus were evaluated according to intraoperative findings at plate removal. Ultrasonography was used to measure the distance between the FPL tendon and distal edge of the plates (FPL plate distance) before plate removal, the distance between the FPL tendon and distal edge of the radius (FPL radius distance) after plate removal, in the contralateral wrist, and the angle between an extension line of a volar surface line on the proximal FPL tendon and a second volar surface line on the distal FPL tendon (FPL angles). Erosion of the FPL tendon was identified in four wrists, and erosion of the flexor digitorum profundus of the index finger was identified in one wrist. All five cases of wrists with flexor tendon damage had Acu-Loc plates installed. The average FPL angle before plate removal was 15.4° in the wrists with tendon damage, which was statistically significantly larger than the average FPL angle in the wrists without erosion. The type of plate and larger FPL angle on ultrasonography may be the risk factors for flexor tendon damage.

  17. Calcium phosphate cement augmentation after volar locking plating of distal radius fracture significantly increases stability.

    Science.gov (United States)

    Kainz, Hans; Dall'Ara, Enrico; Antoni, Anna; Redl, Heinz; Zysset, Philippe; Weninger, Patrick

    2014-08-01

    Distal radius fractures represent the most common fractures in adults. Volar locking plating to correct unstable fractures has become increasingly popular. Although reasonable primary reduction is possible in most cases, maintenance of reduction until the fracture is healed is often problematic in osteoporotic bone. To our knowledge, no biomechanical studies have compared the effect of enhancement with biomaterial on two different volar fixed-angle plates. Human fresh-frozen cadaver pairs of radii were used to simulate an AO/OTA 23-A3 fracture. In a total of four groups (n = 7 for each group), two volar fixed-angle plates (Aptus 2.5 mm locking fracture plate, Medartis, Switzerland and VA-LCP two-column distal radius plate 2.4, volar, Synthes, Switzerland) with or without an additional injection of a biomaterial (Hydroset Injectable HA Bone Substitute, Stryker, Switzerland) into the dorsal comminution zone were used to fix the distal metaphyseal fragment. Each specimen was tested load-controlled under cyclic loading with a servo-hydraulic material testing machine. Displacement, stiffness, dissipated work and failure mode were recorded. Improved mechanical properties (decreased displacement, increased stiffness, decreased dissipated work) were found in both plates if the biomaterial was additionally injected. Improvement of mechanical parameters after biomaterial injection was more evident in the Synthes plate compared to the Aptus plate. Pushing out of the screws was noticed as a failure mode only in samples lacking supplementary biomaterial. Injection of a biomaterial into the dorsal comminution zone increases stability after volar locking plating of distal radius fractures in vitro.

  18. Comparative study of treatment for distal radius fractures with two different palmar locking plates.

    Science.gov (United States)

    Tanaka, H; Hatta, T; Sasajima, K; Itoi, E; Aizawa, T

    2016-06-01

    Few randomized trials have shown how the placement of a palmar locking plate affects outcomes. The purpose of this study was to compare clinical and radiological outcomes of fixation using locking plates with different concepts for placement relative to the watershed line in a prospective randomized trial. Sixty-four patients with a displaced distal radius fracture were divided into two groups according to the plates used for fixation: distal-type (AcuLoc(TM), Group A) and proximal-type (VariAx(TM), Group V). Wrist function including the range of motion and grip strength was compared at 1, 2, 3 and 6 months postoperatively. Loss of reduction was assessed radiologically. Both groups demonstrated overall satisfactory function at 6 months with no significant difference found between the groups. Minimal loss of reduction was demonstrated in both groups. Internal fixation using the palmar locking plates with two different placements provided satisfactory outcomes at 6-month follow-up, but our results indicate that plates placed distal to the watershed line may delay recovery of wrist motion. © The Author(s) 2016.

  19. Ex vivo biomechanical evaluation of pigeon (Columba livia) cadaver intact humeri and ostectomized humeri stabilized with caudally applied titanium locking plate or stainless steel nonlocking plate constructs.

    Science.gov (United States)

    Darrow, Brett G; Biskup, Jeffrey J; Weigel, Joseph P; Jones, Michael P; Xie, Xie; Liaw, Peter K; Tharpe, Josh L; Sharma, Aashish; Penumadu, Dayakar

    2017-05-01

    OBJECTIVE To evaluate mechanical properties of pigeon (Columba livia) cadaver intact humeri versus ostectomized humeri stabilized with a locking or nonlocking plate. SAMPLE 30 humeri from pigeon cadavers. PROCEDURES Specimens were allocated into 3 groups and tested in bending and torsion. Results for intact pigeon humeri were compared with results for ostectomized humeri repaired with a titanium 1.6-mm screw locking plate or a stainless steel 1.5-mm dynamic compression plate; the ostectomized humeri mimicked a fracture in a thin cortical bone. Locking plates were secured with locking screws (2 bicortical and 4 monocortical), and nonlocking plates were secured with bicortical nonlocking screws. Constructs were cyclically tested nondestructively in 4-point bending and then tested to failure in bending. A second set of constructs were cyclically tested non-destructively and then to failure in torsion. Stiffness, strength, and strain energy of each construct were compared. RESULTS Intact specimens were stiffer and stronger than the repair groups for all testing methods, except for nonlocking constructs, which were significantly stiffer than intact specimens under cyclic bending. Intact bones had significantly higher strain energies than locking plates in both bending and torsion. Locking and nonlocking plates were of equal strength and strain energy, but not stiffness, in bending and were of equal strength, stiffness, and strain energy in torsion. CONCLUSIONS AND CLINICAL RELEVANCE Results for this study suggested that increased torsional strength may be needed before bone plate repair can be considered as the sole fixation method for avian species.

  20. Medial Displacement Calcaneal Osteotomy: A Comparison of Screw Versus Locking Plate Fixation.

    Science.gov (United States)

    Saxena, Amol; Patel, Rajan

    Locking plate fixation is becoming more popular for fixation of lower extremity osteotomies. The present study evaluated locking plate fixation compared with screw fixation in the medial displacement calcaneal osteotomy procedure, measuring the outcomes and rate of hardware removal. The procedure was performed on 30 patients, 31 times, with 17 undergoing single screw fixation and 14 undergoing locking plate fixation. The return to activity was 6.87 ± 1.43 months, including some patients for whom running was their main activity. No malunions, nonunions, displacements, or infections developed. In 3 patients (21.4%), the locking plate was removed compared with 1 patient (5.9%) who required screw removal. The difference was not significant (p = .30). No differences were found in their postoperative American Orthopaedic Foot and Ankle Scale scores (91.9 ± 7.7 with plates versus 94.4 ± 5.8 with screws; p = .36). The Roles and Maudsley scores were the same in the 2 groups preoperatively at 4.0 ± 0.0, with the postoperative scores improving to 1.50 ± 0.5 and 1.41 ± 0.5 for the plate and screw group, respectively (p = .62). No significant increase was seen for patients undergoing hardware removal, regardless of the adjunctive procedure used (i.e., flexor digitorum longus/Kidner, Lapidus or midfoot fusion, subtalar arthroereisis, and endoscopic gastrocnemius recession). The stage of posterior tibialis dysfunction had no significant difference in the postoperative scores. From the results of the present study, we have concluded that using a locking plate or a single screw for fixation of the medial displacement calcaneal osteotomy provides acceptable patient outcomes and that the differences in the rate of hardware removal were not statistically significant between the 2 groups. Copyright © 2016. Published by Elsevier Inc.

  1. Comparison of the effect on bone healing process of different implants used in minimally invasive plate osteosynthesis: limited contact dynamic compression plate versus locking compression plate.

    Science.gov (United States)

    Xue, Zichao; Xu, Haitao; Ding, Haoliang; Qin, Hui; An, Zhiquan

    2016-11-25

    Minimally invasive plate osteosynthesis (MIPO) has been widely accepted because of its satisfactory clinical outcomes. However, the implant construct that works best for MIPO remains controversial. Different plate designs result in different influence mechanisms to blood flow. In this study, we created ulnar fractures in 42 beagle dogs and fixed the fractures using MIPO. The dogs were randomly divided into two groups and were fixed with a limited contact dynamic compression plate (LC-DCP) or a locking compression plate (LCP). Our study showed that with MIPO, there was no significant difference between the LCP and the LC-DCP in terms of fracture fixation, bone formation, or mineralization. Combined with the previous literature, we inferred that the healing process is affected by the quality of fracture reduction more than plate selection.

  2. Results of lapidus arthrodesis and locked plating with early weight bearing.

    Science.gov (United States)

    Sorensen, Matthew D; Hyer, Christopher F; Berlet, Gregory C

    2009-10-01

    In the endeavor toward Lapidus fusion, the authors have studied a new application of locked plating for the first tarsometatarsal joint. The goal was to assess the time to fusion, time to ambulation, rate of delayed union/nonunion, rate of revision, and need for hardware removal following the use of locked-plate technology in the fusion of the first tarsometatarsal joint. The findings denoted an average of 6.95 weeks to radiographic fusion, an average of 2 weeks to ambulation, a 9.52% rate of asymptomatic mal-union, a 0% rate of delayed union or nonunion, and a 0% rate of revision. The rate of need for hardware removal was 4.76%.

  3. Outcome following distally locked volar plating for distal radius fractures with metadiaphyseal involvement.

    Science.gov (United States)

    Matullo, Kristofer S; Dennison, David G

    2015-06-01

    The surgical treatment of metadiaphyseal distal radius fractures may be difficult due to the associated articular or periarticular extension that limits standard fixation techniques. Longer distal radius volar locking plates allow stable fixation of the distal fragments while providing standard plate fixation in the proximal radius. We hypothesize that this plating technique allows adequate fixation to both the distal radius and metadiaphyseal fragments. The purpose of the study is to describe the outcomes, radiographic parameters, secondary surgeries, and complication rate with this device. A retrospective chart review was conducted on adult patients with a distal radius fracture and metadiaphyseal involvement treated with a volar, distally locked plate. All patients were followed up for radiographic union, with a mean time of 219 days (range 38-575). Fracture patterns, outcomes of range of motion, grip strength, and complications, as well as injury, post open reduction and internal fixation (ORIF), and finally, healed radiographic parameters were recorded. Twenty patients with 21 fractures were included. At union, mean radiographic parameters were the following: volar tilt of 8°, radial inclination of 27°, radial height of 14 mm, and ulnar variance of -1 mm. The mean final range of motion was 52° flexion, 50° extension, 68° pronation, and 66° supination. Complications included one infection and one plate removal. Four patients developed a nonunion requiring secondary procedures. There were no incidents of hardware failure or adhesions requiring tenolysis. Distally locked long volar plating for metadiaphyseal distal radius fractures is a safe and effective treatment option for these complex fracture patterns allowing anatomic restoration of the radial shaft and distal radius.

  4. Locking compression plate fixation of radial and tibial fractures in a young dog.

    Science.gov (United States)

    Schwandt, C S; Montavon, P M

    2005-01-01

    A six-month-old, male Bernese Mountain Dog in which radius-ulna and tibia-fibula concomitant fractures were treated each with a 3.5 mm Locking Compression Plate (LCP) is presented. Both fractures were approached and plated medially. The tibial fracture had to be revised with a 4.5 mm intramedullary nail and a new 3.5 mm LCP at the second post-operative day because of fixation breakdown. The follow-up radiographs taken at days 14 and 53 revealed uneventful healing of both fractures. Implants were removed 53 days after surgery.

  5. Use of a locking plate “notched head T-plate®” for the fixation of an ilial body fracture in a dog

    OpenAIRE

    Cassio Ricardo Auada Ferrigno; Paulo Vinícius Tertuliano Marinho; Márcio Poletto Ferreira; Jaqueline França dos Santos; Ísis dos Santos Dal-Bó; Fernanda Paes; Viviane Sanchez Galeazzi

    2016-01-01

    Several types of implants may be used to treat iliac fractures in dogs, of which osteosynthesis with plate is the most described and recommended in the literature. The type of plate and screw are major factors in osteosynthesis success. The use of locking plates has been advocated for this purpose, as they do not allow the plate-bone-screw unit to shift, providing angular stability and rigidity to the system. The present study aimed to describe the unprecedented use of a locking notched head ...

  6. Biomechanical Property of a Newly Designed Assembly Locking Compression Plate: Three-Dimensional Finite Element Analysis

    Directory of Open Access Journals (Sweden)

    Jiang-Jun Zhou

    2017-01-01

    Full Text Available In this study, we developed and validated a refined three-dimensional finite element model of middle femoral comminuted fracture to compare the biomechanical stability after two kinds of plate fixation: a newly designed assembly locking compression plate (NALCP and a locking compression plate (LCP. CT data of a male volunteer was converted to middle femoral comminuted fracture finite element analysis model. The fracture was fixated by NALCP and LCP. Stress distributions were observed. Under slow walking load and torsion load, the stress distribution tendency of the two plates was roughly uniform. The anterolateral femur was the tension stress area, and the bone block shifted toward the anterolateral femur. Maximum stress was found on the lateral border of the number 5 countersink of the plate. Under a slow walking load, the NALCP maximum stress was 2.160e+03 MPa and the LCP was 8.561e+02 MPa. Under torsion load, the NALCP maximum stress was 2.260e+03 MPa and the LCP was 6.813e+02 MPa. Based on those results of finite element analysis, the NALCP can provide adequate mechanical stability for comminuted fractures, which would help fixate the bone block and promote bone healing.

  7. Relationship between axillary nerve and percutaneously inserted proximal humeral locking plate: a cadaver study.

    Science.gov (United States)

    Esenyel, Cem Zeki; Dedeoğlu, Semih; Imren, Yunus; Kahraman, Sinan; Çakar, Murat; Öztürk, Kahraman

    2014-01-01

    The aim of this study was to investigate the relationship between the axillary nerve and the percutaneously inserted proximal humeral locking plate and to evaluate the risk of axillary nerve injury during percutaneous plate insertion. The study included 50 shoulders of 25 fresh frozen cadavers. A 5 cm incision was made from the anterolateral border of the acromion to the arm and a 5-hole 3.5-mm proximal humeral plate was inserted. The axillary nerve was then dissected. Plate holes which crossed the axillary nerve were noted. The distance between the axillary nerve and the lateral edge of the acromion and the length of the arm were measured and their relations evaluated with a correlation test. The average arm length was 319 mm. The average distance between the axillary nerve and the lateral edge of the acromion was 60 mm. There was a significant correlation between the arm length and acromion-axillary nerve distance (paxillary nerve lesions. In 1 case, the distal end of the plate was inserted in the deltoid muscle. No constant relationship between the plate holes and the axillary nerve was detected. There is a risk of axillary nerve injury during percutaneous plate insertion. It must be ensured that the plate is inserted under the deltoid fascia during the surgery. The axillary nerve must be visible during application of the screws due to the impossibility of knowing which holes cross the axillary nerve.

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

    Science.gov (United States)

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

    2015-01-01

    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. 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. 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). 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.

  9. 1st metatarsophalangeal joint fusion: A comparison of non-union and gender differences between locking and non-locking plating systems.

    Science.gov (United States)

    Bass, Edward James; Sirikonda, Siva Prasad

    2015-12-01

    Fusion of the first metatarsophalangeal joint (1st MTPJ) is a common surgical procedure used to treat a variety of diseases and deformities of the forefoot. Fixation methods vary and typically fusion rates are good. The objectives of the study are to demonstrate whether there is any advantage to using locking as opposed to non-locking plates for 1st MTPJ fusion. Additionally the study aims to determine whether there is any difference in non-union rates according to gender. One hundred and seventy two consecutive 1st MTPJ fusions were performed for 153 patients. 40 patients (23%) were male and 132 (77%) female. Twenty patients received Hallu-fix™ plates, 76 Charlotte™ plates and 76 Anchorage™ plates. Postoperative radiographs were reviewed for non-union. Failure rates were compared using Fisher's exact tests (p=0.05). Twelve (6.9%) non-unions were identified. The difference in failure rates between all systems was not statistically significant. However, the difference in fusion rates between males (17.5%) and females (3.8%) was significant. This study finds that 1st MTPJ fusion is an effective method to treat diseases of the 1st MTPJ. Locking plates may offer better fusion rates than their non-locking counterparts. This is especially evident in male patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. OUTCOME OF FRACTURE OF INTRAARTICULAR DISTAL FEMUR TREATED WITH DISTAL FEMUR LOCKING COMPRESSION PLATE

    Directory of Open Access Journals (Sweden)

    Swapna Pran Saikia

    2017-10-01

    Full Text Available BACKGROUND The most challenging fractures faced by orthopaedic surgeons are the distal fractures of femur, especially the intraarticular distal femoral fractures. These fractures have been classified according to Orthopaedic Trauma Association (OTA 33-C3. Distal femoral fractures account to 4-7% of all femoral fractures and are less common compared to hip fractures. The aim of the study is to study the functional outcome of fracture of intraarticular distal femur treated with distal femur locking compression plate. MATERIALS AND METHODS This study is a prospective study, which comprised of 30 patients of intraarticular distal femur fracture AO classification 33-C3 who were treated by locking compression plate at Jorhat Medical College and Hospital, Jorhat, Assam. This study was conducted during February 2015 to April 2017. The functional outcome was studied using Neer’s score, outcome of radiology and complication with fracture fixation using LCP. RESULTS Out of 30 patients, 22 were males (73.3% and 8 were females (26.7%. 18 patients had fracture right hand side and 12 patients had left-handed fractures. A 19 years old was the youngest patient and 72 years was the oldest patient. About 70% patients had sustained road traffic accidents and 10% had sustained fall from a height. Four days was the average trauma to operative interval, 22 patients were operated extensile lateral approach and 8 patients were operated by swashbuckler approach. 12 weeks was the average weightbearing duration, 21 weeks was average time for fracture healing. 10 patients had C1 (33.3%, 12 patients had C2 (40% and 8 patients had C3 (26.7% type of fracture according to AO classification. Among 30 patients, 13 patients have shown excellent results, 7 patients have good results, 5 fair results and 5 poor results. Primary bone grafting was done in 4 patients for severely comminuted type C3 fracture. Secondary bone grafting was done in 2 patients who had delayed union at 4

  11. Dynamic hip screw with locking side plate: a viable treatment option for intertrochanteric fracture

    Directory of Open Access Journals (Sweden)

    Barwar Nilesh

    2014-04-01

    Full Text Available Objective: Dynamic hip screw (DHS is recommended for the fixation of stable intertrochanteric fractures. Its postoperative cut-out rate ranges from 1% to 6%. In osteoporotic bone, normal screws in DHS blade provide less anchorage compared to locking screws. This study aims to compare DHS with locking side plate and conventional side plate. Methods:Fifty consecutive patients with intertrochanteric fractures were randomly allocated for fixation with a standard DHS (group A and locking DHS (Combi plate, group B. We compared the clinical and radiological outcomes for the conventional DHS and locking DHS in intertrochanteric fractures. Functional outcome was evaluated using the Parker mobility score. Results:Coxa valga was found more frequently in group A than in group B (12% vs. 0%, P=0.42. Coxa vara showed the same trend (12% vs. 8%, P=0.81. Rate of restoration of postoperative neck-shaft angle within 20° of sound side was higher in group B (8% cases than in group A (4% cases, P=0.98. The rate of anteversion angle restoration within 10° of sound side was also higher in group B (100% vs. 88%, P=0.85. The average lag screw slippage in group A and group B was 3.2 mm and 4.2 mm, the average fracture union duration was 17.1 weeks and 16.4 weeks, and the mean Parker score was 5.6 and 5.8 respectively. Screw cut-out was seen in one patient in group A. No cut-out was seen in any of the patient in group B. No patient developed deep infection, avascular necrosis, deep vein thrombosis or any other significant complications. Conclusion:The present study demonstrated that treating intertrochanteric fracture with a locking DHS allows sound bone healing and is not associated with any major complications. Although this report is promising, it should be interpreted with caution because only a prospective study with a large sample size would allow definitive conclusion. Key words: Hip fractures; Bone screws; Bone plates

  12. Ankle Arthrodesis: A Retrospective Analysis Comparing Single Column, Locked Anterior Plating to Crossed Lag Screw Technique.

    Science.gov (United States)

    Prissel, Mark A; Simpson, G Alex; Sutphen, Sean A; Hyer, Christopher F; Berlet, Gregory C

    Ankle arthrodesis is performed to eliminate pain due to end-stage osteoarthritis, regardless of etiology. This procedure remains the reference standard treatment for end-stage ankle arthritis, despite recent advancements in total ankle replacement. The objective of the present study was to retrospectively evaluate the radiographic and clinical fusion rates and time to bony fusion for patients who underwent ankle arthrodesis using an anterior approach with a single column locked plate construct versus crossed lag screws. We identified 358 patients who had undergone ankle arthrodesis from January 2003 to June 2013. Of the 358 patients, 83 (23.2%) met the inclusion criteria for the present study. Of the 83 included patients, 47 received locked anterior (or anterolateral) plate fixation, and 36 received crossed lag screw constructs. The overall nonunion rate was 6.0% (n = 5), with 1 nonunion in the anterior plate group (2.1%) and 4 nonunions in the crossed lag screw group (11.1%; p = .217). No differences were identified between the 2 groups for normal talocrural angle [χ 2 (1) = 0.527; p = .468], normal tibial axis/talar ratio [χ 2 (1) = 0.004; p = .952], and lateral dorsiflexion angle (p = .565). Based on our findings in similar demographic groups, ankle arthrodesis using locked anterior plate fixation is a safe technique with similar complication rates and radiographic outcomes to those of crossed lag screws. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Clinical outcome of interprosthetic femoral fractures treated with polyaxial locking plates.

    Science.gov (United States)

    Hoffmann, M F; Lotzien, S; Schildhauer, T A

    2016-04-01

    Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common procedures in the increasing older population. According to the AAOS, approximately 19,200 Americans are actually living with ipsilateral prosthetic hip and knee leading to 240 interprosthetic fractures annually. Few reviews and case reports give an idea of the obvious problem to achieve consolidation in interprosthetic fractures. Preconfigured plates have been shown to be superior compared with other treatments in patients with stable components. Utilization of internal fixators for interprosthetic fractures might be advantageous. The purpose of this study was to evaluate interprosthetic femoral fractures with polyaxial locking plate treatment in regard to surgical procedure, complications, and clinical outcome. Between 2005 and 2012, 143 patients underwent surgical treatment for periprosthetic femur fractures. Thirty-two fractures were identified as interprosthetic fractures. Five patients were excluded. Fractures were classified according to OTA/AO system, Vancouver, Rorabeck, Soenen and Pires. Trauma fellowship trained orthopaedic surgeons performed the surgeries using a NCB-construct (Zimmer Inc., Warshaw, IN). Plate choice was determined according to radiographic classification. Submuscular plate insertion was performed if possible. Complications were recorded concerning infection, union, fixation failure, and revision surgery. Twenty-seven patients were identified. There were 92.6% females. Follow-up by regular outpatient clinic visits was 24 months. Surface replacements were found in 18 TKA. Nine patients had a stemmed femur component of their TKA. 89% healed after the index procedure. Three patients developed a nonunion with 1 construct leading to hardware failure. Previous revision THA or Pires/modified Vancouver classification did not influence nonunion formation, but all patients with nonunion formation were classified as AO/OTA type B (p=0.001). These fractures were treated with

  14. Locking T-Plate Repair of Ilial Fractures in Cats and Small Dogs.

    Science.gov (United States)

    Scrimgeour, Andrew B; Craig, Andrew; Witte, Philip G

    2017-11-01

    Objectives  To assess screw loosening and pelvic narrowing following the use of locking implants to stabilise ilial body fractures in cats and small dogs. Methods  Review of clinical records and post operative and follow up radiography of 12 cats and five small dogs to evaluate accuracy of fracture reduction, screw purchase and subsequent screw loosening and reduction in pelvic diameter. Results  No screw loosening or reduction in pelvic diameter was observed at follow up. Clinical Significance  Locking T-plates may prevent complications reported following the use of conventional implant systems for the repair of ilial fractures in cats and small dogs. Schattauer GmbH Stuttgart.

  15. Complications of appendicular fracture repair in cats and small dogs using locking compression plates.

    Science.gov (United States)

    Vallefuoco, Rosario; Le Pommellet, Helene; Savin, Audrey; Decambron, Adeline; Manassero, Mathieu; Viateau, Véronique; Gauthier, Olivier; Fayolle, Pascal

    2016-01-01

    Our objectives were: 1) to review the complications associated with stabilization of appendicular fractures in cats and small dogs using locking compression plates (LCP), and 2) to identify factors that could influence fixation construct stability. Retrospective clinical study. Medical and radiographic records of cats and small dogs with appendicular fractures treated with LCP were reviewed. Only cases with adequate follow-up to document clinical union and cases for which complications appeared before the clinical union were included. Complications were classified as implant-related complications or other complications. Cases with implant-related complications were compared to cases with non-implant-related complications for differences in signalment (species, age, body weight, multiple fractures), fracture location and type (fractured bone, fracture localization, closed or open fracture), reduction method (open reduction and internal fixation [ORIF] or minimally invasive plate osteosynthesis [MIPO]) and fixation evaluations (implant size, plate-bridging ratio, plate span ratio, working length, plate screw density, number of screws and cortices engaged per plate and per main fragment, ratio between screw and bone diameter at the narrowest aspect of the bone, and presence of ancillary fixation). Seventy-five fractures from 63 cats (64 fractures) and 10 dogs (11 fractures) met the inclusion criteria. Eight humeral, 13 radio-ulnar, 26 femoral, and 28 tibio-fibular fractures were treated. Primary repair of the fracture was performed using 2.0 mm and 2.4 mm LCP in 22 and 53 fractures, respectively. Overall and implant-related complications were encountered in 13 and seven of 75 fractures, respectively. Fixation failure was not significantly associated with any aforementioned factor considered in this study, and in particular, there was no significant difference in the occurrence of fixation failure between fractures stabilized with two, or more than two, bicortical

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

    Directory of Open Access Journals (Sweden)

    TONG Da-ke

    2012-02-01

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

  17. Supraglenoid tubercle fractures repair with transverse locking compression plates in 4 horses.

    Science.gov (United States)

    Ahern, B J; Bayliss, I P M; Zedler, S T; Getman, L M; Richardson, D W

    2017-05-01

    To report on a series of 4 horses with supraglenoid tubercle fractures repaired with locking compression plates. Case series. Four horses ranging in age from 6 weeks to 20 months and weighing from 121 to 425 kg with supraglenoid tubercle fractures of 1 day to 6 weeks in duration. Supraglenoid tubercle fractures were reduced and stabilized with transversely positioned locking compression plate(s) with and without additional tension band wiring. All fractures reached bony union. Two postoperative surgical site infections were managed with drainage and antibiotherapy. Three of the 4 horses continued onto athletic careers including flat racing, dressage, and hunter/jumper competition. The remaining horse was lame for a prolonged period, but was sound at 4 years. The application of one or two, transversely positioned LCPs should be considered for the repair of SGT fractures because of the relative ease of the technique, and its elimination of a biceps brachii tenotomy. All screws can be inserted in a lateral to medial direction without transection or drill penetration of the biceps brachii tendon. SGT fractures of various durations can be repaired in a wide range of horses with transversely positioned LCPs, and allow return to athletic function. © 2017 The American College of Veterinary Surgeons.

  18. A Biomechanical Comparison of Locking Versus Conventional Plate Fixation for Distal Fibula Fractures in Trimalleolar Ankle Injuries.

    Science.gov (United States)

    Nguyentat, Annie; Camisa, William; Patel, Sandeep; Lagaay, Pieter

    2016-01-01

    Previous biomechanical studies have advocated the use of locking plates for isolated distal fibula fractures in osteoporotic bone. Complex rotational ankle injuries involve an increased number of fractures, which can result in instability, potentially requiring the same fixed angle properties afforded by locking plates. However, the mechanical indication for locking plate technology has not been tested in this fracture model. The purpose of the present study was to compare the biomechanical properties of locking and conventional plate fixation for distal fibula fractures in trimalleolar ankle injuries. Fourteen (7 matched pairs) fresh-frozen cadaver leg specimens were used. The bone mineral density of each was obtained using dual x-ray absorptiometry scans. The fracture model simulated an OTA 44-B3.3 fracture. The syndesmosis was not disrupted. Each fracture was fixated in the same fashion, except for the distal fibula plate construct: locking (n = 7) and one-third tubular (n = 7). The specimens underwent axial and torsional cyclic loading, followed by torsional loading to failure. No statistically significant differences were found between the locking and conventional plate constructs during both fatigue and torque to failure testing (p > .05). Our specimen bone mineral density averages did not represent poor bone quality. The clinical implication of the present study is that distal fibular locking plates do not provide a mechanical advantage for trimalleolar ankle injuries in individuals with normal bone density and in the absence of fracture comminution. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Locking compression plate distal ulna hook plate fixation versus intramedullary screw fixation for displaced avulsion fifth Metatarsal Base fractures: a comparative retrospective cohort study

    OpenAIRE

    Xie, Lin; Guo, Xin; Zhang, Shu-Jun; Fang, Zhen-Hua

    2017-01-01

    Background Intramedullary screw (IMS) fixation was wildly used in fifth metatarsal base fractures (FMBFs) and the results were satisfactory. However, in the comminuted osteoporosis or small displaced avulsion FMBFs, anatomical reduction and stable fixation could not be achieved with IMS. The Locking Compression Plate (LCP) distal ulna hook plate fixation was a novel alternative fixation method. The aim of this retrospective cohort study was to determine if LCP distal ulna hook plate fixation ...

  20. Appendicular fracture repair in dogs using the locking compression plate system: 47 cases.

    Science.gov (United States)

    Haaland, P J; Sjöström, L; Devor, M; Haug, A

    2009-01-01

    The locking compression plate (LCP) has combination screw holes, making it possible to use the implant in three different ways; as a pure internal fixator using locking head screws, as a conventional compression plate using compression screws, or as a hybrid of the two. The experience with the LCP system in veterinary fracture repair is limited. The objective of this study was to evaluate the outcome of appendicular fractures in dogs, which were repaired with the LCP system combined with less invasive surgical techniques. Medical records and radiographs from 47 dogs were studied retrospectively. Thirty-four percent of the fractures were simple, six percent wedge and 60% comminuted fractures of the humerus (11 %), radius and ulna (30 %), femur (34 %) and of the tibia and fibula (25 %). The fractures were treated using the LCP as an internal fixator; in some cases as a plate and rod construct. Forty-six of 47 fractures reached radiographic union. Mean healing time of the fractures was seven weeks (95% confidence interval from 5.8 to 8.3 weeks). There were statistically significant differences in healing time between juvenile (age under one year) and adults. Complications in the form of implant failures and infections were encountered in approximately 11% of the cases. All implant failures were due to surgical errors. The LCP system in combination with a less invasive surgical approach was found advantageous in comminuted fractures where the LCP was used as a bridging plate, in situations when exact plate contouring was difficult, and when other implants prevented the use of bi-cortical screws.

  1. Treatment of proximal humeral fractures using anatomical locking plate: correlation of functional and radiographic results

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Tenor Junior

    2016-06-01

    Full Text Available ABSTRACT OBJECTIVE: To correlate the functional outcomes and radiographic indices of proximal humerus fractures treated using an anatomical locking plate for the proximal humerus. METHODS: Thirty-nine patients with fractures of the proximal humerus who had been treated using an anatomical locking plate were assessed after a mean follow-up of 27 months. These patients were assessed using the University of California Los Angeles (UCLA score and their range of motion was evaluated using the method of the American Academy of Orthopedic Surgeons on the operated shoulder and comparative radiographs on both shoulders. The correlation between radiographic measurements and functional outcomes was established. RESULTS: We found that 64% of the results were good or excellent, according to the UCLA score, with the following means: elevation of 124°; lateral rotation of 44°; and medial rotation of thumb to T9. The type of fracture according to Neer's classification and the patient's age had significant correlations with the range of motion, such that the greater the number of parts in the fracture and the greater the patient's age were, the worse the results also were. Elevation and UCLA score were found to present associations with the anatomical neck-shaft angle in anteroposterior view; fractures fixed with varus deviations greater than 15° showed the worst results (p < 0.001. CONCLUSION: The variation in the neck-shaft angle measurements in anteroposterior view showed a significant correlation with the range of motion; varus deviations greater than 15° were not well tolerated. This parameter may be one of the predictors of functional results from proximal humerus fractures treated using a locking plate.

  2. Outcome analysis following removal of locking plate fixation of the proximal humerus

    Directory of Open Access Journals (Sweden)

    Fischer Florian

    2008-10-01

    Full Text Available Abstract Background Concerning surgical management experience with locking plates for proximal humeral fractures has been described with promising results. Though, distinct hardware related complaints after fracture union are reported. Information concerning the outcome after removal of hardware from the proximal humerus is lacking and most studies on hardware removal are focused on the lower extremity. Therefore the aim of this study was to analyze the functional short-term outcome following removal of locking plate fixation of the proximal humerus. Methods Patients undergoing removal of a locking plate of the proximal humerus were prospectively followed. Patients were subdivided into the following groups: Group HI: symptoms of hardware related subacromial impingement, Group RD: persisting rotation deficit, Group RQ: patients with request for a hardware removal. The clinical (Constant-Murley score and radiologic (AP and axial view follow-up took place three and six months after the operation. To evaluate subjective results, the Medical Outcomes Study Short Form-36 (SF-36, was completed. Results 59 patients were included. The mean length of time with the hardware in place was 15.2 ± 3.81 months. The mean of the adjusted overall Constant score before hardware removal was 66.2 ± 25.2% and increased significantly to 73.1 ± 22.5% after 3 months; and to 84.3 ± 20.6% after 6 months (p Conclusion A significant improvement of clinical outcome following removal was found. However, a general recommendation for hardware removal is not justified, as the risk of an anew surgical and anesthetic procedure with all possible complications has to be carefully taken into account. However, for patients with distinct symptoms it might be justified.

  3. A biomechanical comparison of proximal femoral nails and locking proximal anatomic femoral plates in femoral fracture fixation

    Science.gov (United States)

    Ozkan, Korhan; Türkmen, İsmail; Sahin, Adem; Yildiz, Yavuz; Erturk, Selim; Soylemez, Mehmet Salih

    2015-01-01

    Background: The incidence of fractures in the trochanteric area has risen with the increasing numbers of elderly people with osteoporosis. Although dynamic hip screw fixation is the gold standard for the treatment of stable intertrochanteric femur fractures, treatment of unstable intertrochanteric femur fractures still remains controversial. Intramedullary devices such as Gamma nail or proximal femoral nail and proximal anatomic femur plates are in use for the treatment of intertrochanteric femur fractures. There are still many investigations to find the optimal implant to treat these fractures with minimum complications. For this reason, we aimed to perform a biomechanical comparison of the proximal femoral nail and the locking proximal anatomic femoral plate in the treatment of unstable intertrochanteric fractures. Materials and Methods: Twenty synthetic, third generation human femur models, obtained for this purpose, were divided into two groups of 10 bones each. Femurs were provided as a standard representation of AO/Orthopedic Trauma Associationtype 31-A2 unstable fractures. Two types of implantations were inserted: the proximal femoral intramedullary nail in the first group and the locking anatomic femoral plate in the second group. Axial load was applied to the fracture models through the femoral head using a material testing machine, and the biomechanical properties of the implant types were compared. Result: Nail and plate models were locked distally at the same level. Axial steady load with a 5 mm/m velocity was applied through the mechanical axis of femur bone models. Axial loading in the proximal femoral intramedullary nail group was 1.78-fold greater compared to the plate group. All bones that had the plate applied were fractured in the portion containing the distal locking screw. Conclusion: The proximal femoral intramedullary nail provides more stability and allows for earlier weight bearing than the locking plate when used for the treatment of

  4. [Outcomes of minimally invasive plate osteosynthesis (MIPO) with volar locking plates in distal radius fractures: A review].

    Science.gov (United States)

    Liverneaux, P; Ichihara, S; Facca, S; Hidalgo Diaz, J J

    2016-12-01

    Minimally invasive plate osteosynthesis (MIPO) has been used in recent years to treat fractures of the distal radius with volar locking plates. Its advantages are the preservation of the pronator quadratus and good esthetics. The MIPO technique was described originally with two incisions: one distal transverse or longitudinal incision and one proximal longitudinal incision. The trend is now to use a single longitudinal incision less than 20mm long. Functional and radiological outcomes are comparable to those of conventional techniques. The MIPO technique is indicated for extra-articular and intra-articular fractures. Arthroscopy may be used concurrently in the latter case. When the distal radius fracture is associated with a proximal shaft fracture, a double incision is needed to introduce a longer plate. The relative contraindications of the MIPO technique are comminuted intra-articular fractures in osteoporotic elderly patients. If reduction is problematic, a larger incision can easily be made. Copyright © 2016 SFCM. Published by Elsevier Masson SAS. All rights reserved.

  5. Mechanical stability of a locked step-plate versus single compression screw fixation for medial displacement calcaneal osteotomy.

    Science.gov (United States)

    Konan, Sujith; Meswania, Jay; Blunn, Gordon W; Madhav, Rohit T; Oddy, Michael J

    2012-08-01

    Reconstruction of a flatfoot commonly involves a calcaneal Medial Displacement Osteotomy (MDO) to correct hindfoot valgus in combination with soft tissue procedures. We compared fixation of an MDO using either a single, large cannulated screw versus a locking step-plate in load to failure in a cadaveric model. Eight matched pairs of cadaveric limbs were loaded using a mechanical testing rig. Two pairs served as non-operated controls. The remaining paired limbs underwent a 10-mm MDO stabilized either with a single 7-mm screw or a step-plate with four locking screws. One pair was used as a pilot study and the remaining five pairs were loaded up to 4500 N to failure. In the five pairs loaded to failure, the median (with 95% CI) maximum force were 1779 N (1099-2312) and 826 N (288-1607) for the plate and screw, respectively (p = 0.043). With single screw fixation, the tuberosity fragment consistently failed by rotation and angulation into varus. With plate fixation, failure occurred as the screws cut through the internal surfaces of the tuberosity and body with no failure at the screw-plate interface. In this cadaveric model, a locked step-plate supported a significantly higher maximum force than a single large cannulated screw. The magnitude of the load supported by the locking step-plate suggests that allowing early weightbearing post-operation may be safe in clinical practice before union of the osteotomy.

  6. Surgical treatment of cervical unilateral locked facet in a 9-year-old boy: A case report

    Directory of Open Access Journals (Sweden)

    Mutlu Cobanoglu

    2015-01-01

    Full Text Available Most of the cervical spine injuries in the pediatric population are typically seen in the upper cervical region. Unilateral cervical facet dislocation (UFD in subaxial region is a rare injury in pediatric population. In this paper, a rare case of delayed locked UFD in a 9-year-old boy with rare injury mechanism treated surgically is reported. Clinical and radiological findings were described. The patient with C6-7 UFD without neurologic deficit was underwent open reduction and internal fixation via anterior and posterior combined approaches. Significant improvement of pain and free motion in cervical spine was obtained. There was no complication during the follow up. Only three case reports presented about the lower cervical spine injury with UFD under the age of 10 were found in the literature.

  7. Comparative stability of perpendicular versus parallel double-locking plating systems in osteoporotic comminuted distal humerus fractures.

    Science.gov (United States)

    Stoffel, Karl; Cunneen, Sam; Morgan, Robert; Nicholls, Rochelle; Stachowiak, Gwidon

    2008-06-01

    In distal humerus fractures, the restoration of stability is important to allow early mobilization and hence more favorable functional outcomes. In this article, we compare the biomechanical stability of perpendicular and parallel locking plating systems for the internal fixation of AO Type C2 distal humerus fractures in osteoporotic bone. Fractures were simulated in paired cadaveric bones and fixed using either the perpendicular 3.5 mm LCP distal humerus plating system (Synthes; Sydney, Australia) or the parallel Mayo Clinic Congruent elbow plate system (Acumed; Hillsboro, OR), using locking screws in both systems. Both systems were then tested for their stiffness (in compression and internal/external rotation), plastic deformation, and failure in torsion. Comparatively, the parallel locking plate system provided a significantly higher stability in compression (p = 0.005) and external rotation (p = 0.006), and a greater ability (p = 0.005) to resist axial plastic deformation. Stability for both constructs appeared to be dependent on bone quality, however the stability of the perpendicular system was generally more sensitive to bone mineral density, indicating a possible need for additional independent interfragmentary screws. A disadvantage of the parallel locking plate system was wear debris produced by its tapping system. In summary, the biomechanical findings of this study suggest that both locking plate systems allow early mobilization of the elbow in patients with osteoporotic bone following fixation of a comminuted distal humerus fracture. However, the parallel locking system showed improved stability compared with the perpendicular locking system, and therefore may be more indicated. (c) 2008 Orthopaedic Research Society.

  8. Management of Intra-Articular Distal Radius Fractures: Volar or Dorsal Locking Plate-Which Has Fewer Complications?

    Science.gov (United States)

    Abe, Yoshihiro; Tokunaga, Susumu; Moriya, Takuro

    2017-11-01

    The aim of this study was to compare the functional outcomes and complications of volar and dorsal plating for the management of intra-articular distal radius fractures, with special regard to indications for dorsal plating. Furthermore, we examine the rationale for choosing dorsal plating and its frequency of use. Clinical assessments included range of motion measurements at the wrist; grip strength; the Quick Disabilities of the Arm, Shoulder, and Hand score; and the Gartland and Werley score. Clinical results were compared with those achieved using a volarly placed locking plate system. According to Lutsky's plate theory, the rationale for choosing dorsal plating was based on 4 types of pathologic fractures. Of 112 patients, 38 patients were treated with open reduction internal fixation via a dorsal approach and 68 patients were treated using a volar approach. Except for wrist flexion, there were no other statistical differences in the clinical results between groups for both subjective and objective parameters. There were no statistically significant differences in the complication rates between the volar and dorsal plated groups. One serious complication occurred after volar plating. The most common reason for choosing dorsal plating was irreducible dorsal die-punch fractures. The treatment of displaced intra-articular distal radius fractures with a dorsally versus a volarly placed interlocking plate system demonstrated similar clinical results. Postoperative complications were not readily observed in the patients treated with a dorsal locking plate. Certain fracture patterns are more appropriately stabilized using a dorsal plate fixation.

  9. Poor relation between biomechanical and clinical studies for the proximal femoral locking compression plate

    DEFF Research Database (Denmark)

    Viberg, Bjarke; Voergård Rasmussen, Katrine Marie; Overgaard, Søren

    2017-01-01

    Background and purpose — The proximal femur locking compression plate (PF-LCP) is a new concept in the treatment of hip fractures. When releasing new implants onto the market, biomechanical studies are conducted to evaluate performance of the implant. We investigated the relation between biomecha......Background and purpose — The proximal femur locking compression plate (PF-LCP) is a new concept in the treatment of hip fractures. When releasing new implants onto the market, biomechanical studies are conducted to evaluate performance of the implant. We investigated the relation between...... biomechanical and clinical studies on PF-LCP. Methods — A systematic literature search of relevant biomechanical and clinical studies was conducted in PubMed on December 1, 2015. 7 biomechanical studies and 15 clinical studies were included. Results — Even though the biomechanical studies showed equivalent...... or higher failure loads for femoral neck fracture, the clinical results were far worse, with a 37% complication rate. There were no biomechanical studies on pertrochanteric fractures. Biomechanical studies on subtrochanteric fractures showed that PF-LCP had a lower failure load than with proximal femoral...

  10. The use of a single volar locking plate for AO C3-type distal radius fractures.

    Science.gov (United States)

    Earp, Brandon E; Foster, Brian; Blazar, Philip E

    2015-12-01

    A single volar locking plate (VLP) is now frequently used for open reduction and internal fixation (ORIF) of many types of distal radius fractures. Comminuted intra-articular distal radius fractures (AO C3-type) are typically the most challenging to surgically treat. No studies directly address the adequacy of a VLP alone for maintaining reduction of AO C-type fractures. We hypothesized that a single VLP provides an effective method for maintaining reduction for these fractures. We retrospectively evaluated radiographs of a series of AO C-type fractures. Seventy-seven patients with 77 AO C3-type fractures were identified from billing records and were eligible for the study. All patients were treated by fellowship-trained hand surgeons. Radiographs at the time of union were compared to those from immediately postoperatively. Sixty-nine of 77 (89.6 %) fractures treated with VLP fixation alone for AO C3-type distal radius fractures united without loss of reduction. Eight of 77 (10.4 %) patients treated with VLP for AO C3 fractures lost reduction. The most common fracture fragment to lose reduction was the lunate fossa (5 of 8); loss of reduction of the scaphoid fossa die-punch fragment (2 of 8) and the radial styloid (1 of 8) were also seen. The majority (89.6 %) of AO C3-type fractures treated with a single volar locking plate come to union without loss of reduction. Level IV.

  11. Treatment of pes varus using locking plate fixation in seven Dachshund dogs.

    Science.gov (United States)

    Petazzoni, M; Nicetto, T; Vezzoni, A; Piras, A; Palmer, R

    2012-01-01

    To describe the surgical treatment of pes varus in Dachshund dogs by medial opening wedge osteotomy of the distal tibia stabilized with a locking plate system and to retrospectively report the clinical and radiographic outcomes. Lameness in nine limbs of seven Dachshund dogs with pes varus deformity was treated with corrective osteotomy at or near the centre of rotation of angulation as defined by the intersection of the proximal and distal mechanical axes determined on caudo-cranial radiographs. Outcomes evaluated included comparison of pre- and postoperative radiographic measurements of frontal angulation and lameness assessment. Lameness resolved in eight limbs and improved in one limb. All osteotomies healed and no implant complications were detected. Mean preoperative radiographic measurements were: mechanical medial proximal tibial angle (mMPTA) = 91.1° (range 87.6°-95°), mechanical medial distal tibial angle (mMDTA) = 62.1° (range 51.9°-69.6°). Mean postoperative measurements were: mMPTA 92.4° (range 78°-97.5°), mMDTA 81.8° (range 76°-87°). Measurable under- correction was common, though seldom visually or functionally evident. Pes varus deformity in Dachshunds can be treated by medial opening wedge osteotomy of the distal tibia stabilized with a locking plate system. Care to preserve the lateral cortex of the osteotomy may help avoid under-correction.

  12. Minimally invasive osteosynthesis of distal tibial fractures using anterolateral locking plate: Evaluation of results and complications.

    Science.gov (United States)

    Lakhotia, Devendra; Sharma, Gaurav; Khatri, Kavin; Kumar, G-N; Sharma, Vijay; Farooque, Kamran

    2016-01-01

    Soft tissue healing is of paramount importance in distal tibial fractures for a successful outcome. There is an increasing trend of using anterolateral plate due to an adequate soft tissue cover on ante- rolateral distal tibia. The aim of this study was to evaluate the results and complications of minimally invasive anterolateral locking plate in distal tibial fractures. This is a retrospective study of 42 patients with distal tibial fractures treated with minimally invasive anterolateral tibial plating. This study evaluates the bone and soft tissue healing along with emphasis on complications related to bone and soft tissue healing. Full weight bearing was allowed in mean time period of 4.95 months (3-12 months). A major local complication of a wound which required revision surgery was seen in one case. Minor complications were identified in 9 cases which comprised 4 cases of marginal necrosis of the surgical wound, 1 case of superficial infection, 1 case of sensory disturbance over the anterolateral foot, 1 case of muscle hernia and 2 cases of delayed union. Mean distance between the posterolateral and anterolateral incision was 5.7 cm (4.5-8 cm). The minimally invasive distal tibial fixation with anterolateral plating is a safe method of stabilization. Distance between anterolateral and posterolateral incision can be placed less than 7 cm apart depending on fracture pattern with proper surgical timing and technique.

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

    Directory of Open Access Journals (Sweden)

    Jain Saurabh

    2013-12-01

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

  14. A comparison of conventional compression plates and locking compression plates using cantilever bending in an ilial fracture model.

    Science.gov (United States)

    Bruce, C W; Gibson, T W G; Runciman, R J

    2014-01-01

    The purpose of this study was to compare the stiffness, yield load, ultimate load at failure, displacement at failure, and mode of failure in cantilever bending of locking compression plates (LCP) and dynamic compression plates (DCP) in an acute failure ilial fracture model. Our hypothesis was that the LCP would be superior to the DCP for all of these biomechanical properties. Ten pelves were harvested from healthy dogs euthanatized for reasons unrelated to this study and divided into two groups. A transverse osteotomy was performed and stabilized with either a 6-hole DCP applied in compression or a 6-hole LCP. Pelves were tested in cantilever bending at 20 mm/min to failure and construct stiffness, yield load, ultimate load at failure, displacement at failure, and mode of failure were compared. The mean stiffness of DCP constructs (193 N/mm [95% CI 121 - 264]) and of LCP constructs (224 N/mm [95% CI 152 - 295]) was not significantly different. Mean yield load of DCP constructs (900 N [95% CI 649 -1151]) and of LCP constructs (984 N [95% CI 733 -1235]) was not significantly different. No significant differences were found between the DCP and LCP constructs with respect to mode of failure, displacement at failure, or ultimate load at failure. Our study did not demonstrate any differences between DCP and LCP construct performance in acute failure testing in vitro.

  15. Talonavicular joint fixation: a biomechanical comparison of locking compression plates and lag screws.

    Science.gov (United States)

    Granata, Jaymes D; Berlet, Gregory C; Ghotge, Rahul; Li, Yuan; Kelly, Brian; DiAngelo, Denis

    2014-02-01

    Fusion of the talonavicular (TN) joint is an effective treatment for hindfoot pain and deformity. Nonunion in hindfoot fusion procedures is most common in the TN joint. The purpose of this study was to evaluate and compare the mechanical stability of 2 different forms of fixation for isolated fusion of the TN joint. 13 fresh-frozen cadaver foot and ankles were procured and mounted vertically in a robotic biomechanical testing platform and tested before and after operative fixation; 7 specimens received 2 retrograde lag screws (2S), and 6 specimens received a locked compression plate with 1 retrograde lag screw (PS). A constant Achilles tendon load was initially applied followed by internal or external rotation (ER) of the foot and axial compression through the tibia. The relative motion of the talus and navicular bones was tracked using 3-dimensional optoelectric targets. Motion data were recorded in the traditional anatomical reference frame and then transformed into the TN joint frame. In the TN joint frame, relative to the intact (preoperative) state, the plate fixation group PS showed a significant reduction in separation along the long axis of the talus in 3 out of the 4 loading scenarios (P values = .007, .02, and .05). The PS construct also significantly restricted the flexion-extension motion at the joint compared with the 2S construct, during the ER tests (P values = .002 and .001). In our simulated weight-bearing model, a dorsal locked compression plate with 1 retrograde screw was more effective at limiting the 3D motion across the TN joint compared with the traditional construct of 2 retrograde screws.

  16. EFFICACY OF CAGE PLACEMENT WITHOUT PLATE IN PATIENTS WITH CERVICAL MYELOPATHY WITH SINGLE-LEVEL AFFECTION

    Directory of Open Access Journals (Sweden)

    CARLOS ALBERTO ZUÑIGA-MAZÓN

    Full Text Available ABSTRACT Objective: To determine the efficacy of PEEK (Poly-ether-ether-ketone cage without plate for the treatment of single-level cervical spondylosis. Methods: Ten patients with cervical myelopathy data, with a single-level root condition, seen at the outpatient clinic of the Neurosurgery Service, operated in 2016, mean age 53 years, 6 (60% female, 4 (40% obese, 3 (30% smokers. The Cloward technique was used by anterior approach, discectomy, and PEEK cage placement. Results: At six months of surgery, 100% of the patients had increased intervertebral space, with a 100% reduction in osteophytes; only one patient had dysphagia, no patient had lesion of the adjacent segment and 10% had persistent root pathology. Cervical lordosis was observed in 90% of the patients and arthrodesis in 100% of the cases. Conclusions: Anterior approach arthrodesis using PEEK cage without cervical plate is effective as a treatment of cervical myelopathy in a single level.

  17. Risk of axillary nerve injury during percutaneous proximal humerus locking plate insertion using an external aiming guide.

    Science.gov (United States)

    Saran, Neil; Bergeron, Stephane G; Benoit, Benoit; Reindl, Rudolf; Harvey, Edward J; Berry, Gregory K

    2010-10-01

    The purpose of this study was to determine which screws could be safely inserted percutaneously into a proximal humerus locking plate using a new external aiming guide without injuring the axillary nerve. We also sought to evaluate that all the screws could be accurately inserted ina locked position with the external guide. Eight cadaveric specimens were implanted with a proximal humerus locking plate using a minimally invasive direct-lateral deltoid splitting approach using an attached external aiming guide for screw insertion. The anatomic proximity of the axillary nerve to the guidewires and screws was measured following soft tissue dissection and inspection of the nerve. The two superior holes (C1 and C2) were proximal to the axillary nerve with an average distance of 15.1 mm. Screw F was on average 6.6 mm distal to the axillary nerve but within 2 mm of the nerve in two specimens. In all specimens, the locking screws were appropriately seated in a locked position using the external aiming guide. This study suggests that percutaneous fixation of a proximal humerus locking plate with an external aiming guide can be safely used for proximal humerus fractures. The limited number of screws that can be inserted into the proximal fragment using the current external guide arm may compromise fixation of more unstable fractures. Therefore, the indications for percutaneous locking plate fixation of the proximal humerus using an external aiming guide should be limited to stable fracture patterns that can be anatomically reduced. 2010 Elsevier Ltd. All rights reserved.

  18. Biomechanical comparison of locking plate and crossing metallic and absorbable screws fixations for intra-articular calcaneal fractures.

    Science.gov (United States)

    Ni, Ming; Wong, Duo Wai-Chi; Mei, Jiong; Niu, Wenxin; Zhang, Ming

    2016-09-01

    The locking plate and percutaneous crossing metallic screws and crossing absorbable screws have been used clinically to treat intra-articular calcaneal fractures, but little is known about the biomechanical differences between them. This study compared the biomechanical stability of calcaneal fractures fixed using a locking plate and crossing screws. Three-dimensional finite-element models of intact and fractured calcanei were developed based on the CT images of a cadaveric sample. Surgeries were simulated on models of Sanders type III calcaneal fractures to produce accurate postoperative models fixed by the three implants. A vertical force was applied to the superior surface of the subtalar joint to simulate the stance phase of a walking gait. This model was validated by an in vitro experiment using the same calcaneal sample. The intact calcaneus showed greater stiffness than the fixation models. Of the three fixations, the locking plate produced the greatest stiffness and the highest von Mises stress peak. The micromotion of the fracture fixated with the locking plate was similar to that of the fracture fixated with the metallic screws but smaller than that fixated with the absorbable screws. Fixation with both plate and crossing screws can be used to treat intra-articular calcaneal fractures. In general, fixation with crossing metallic screws is preferable because it provides sufficient stability with less stress shielding.

  19. In vitro comparison of bioresorbable and titanium anterior cervical plates in the immediate postoperative condition.

    Science.gov (United States)

    Freeman, Andrew L; Derincek, Alihan; Beaubien, Brian P; Buttermann, Glenn R; Lew, William D; Wood, Kirkham B

    2006-12-01

    Bioresorbable plates have recently been used with anterior cervical discectomy and fusion (ACDF). Compared with metallic plates, bioresorbable plates provide segmental stabilization with minimal imaging artifact, eventual resorption, and increased load sharing. The objectives of the present study were to determine whether a bioresorbable plate can withstand simulated physiologic static and cyclic loading, to compare the reduction in flexibility provided by bioresorbable and titanium plates, and to quantify load sharing between the plate and spine with graft. Sixteen human cervical motion segments were tested to +/-2.5 Nm in flexion-extension, lateral bending, and axial rotation. Range of motion (ROM) was measured (1) in the intact state, (2) with ACDF without plating, (3) after addition of either a bioresorbable or titanium plate, and (4) after 500 cycles of combined flexion-extension and axial torsion. Load sharing was evaluated by applying the same fixed rotation both without and with the plate, and was calculated as the moment resisted by the uninstrumented ACDF expressed as a percentage of the plated ACDF state. No plate failures or graft migration occurred during testing. Compared with the uninstrumented ACDF, bioresorbable plates reduced mean ROM by 49% in flexion-extension and 25% in lateral bending, with very little change in torsion. Titanium plates reduced uninstrumented ACDF ROM by 69% in flexion-extension, 45% in lateral bending, and 27% in torsion. Differences between bioresorbable and titanium plates were significant in flexion-extension and lateral bending. Cyclic loading did not significantly change ROM for either plate. More moment was shared in lateral bending by the spine/graft with bioresorbable plates (78%) compared with titanium plating (63%). Bioresorbable plates contained an intervertebral graft, provided some stabilization, remained intact throughout the simulated immediate postoperative loading, and shared more load with the graft and

  20. Comparative evaluation of 2.0-mm locking plate system vs. 2.0-mm nonlocking plate system for mandibular fractures--a retrospective study.

    Science.gov (United States)

    Kumar, Ish; Singh, Virender; Singh, Anusha; Arora, Varun; Bajaj, Ajay

    2013-12-01

    The purpose of this retrospective study is to evaluate the efficacy of the 2.0-mm locking miniplate/screw system in comparison to the 2.0-mm nonlocking miniplate/screw system in mirror image mandibular fractures. A retrospective clinical trial was reviewed in the Department of Oral and Maxillofacial Surgery, Government Dental College, Pt. B.D. Sharma University of Health Sciences Rohtak for a period of 30 months (June 2007 to December 2009). A total of 30 patient pairs with isolated identical mandibular fracture (single or multiple) having 88 fractures were analyzed. A total of 11 complications that occurred represented 12.5% of the total. Six complications occurred at angle, three in the body and two at parasymphysis. Four complications occurred in the locking group and seven in the nonlocking group, with complication rates accounting for 9% and 16%, respectively. When comparing the overall complication rates according to plates used, the chi-square test showed no statistically significant difference between the locking and nonlocking plates (p > 0.05). Mandible fractures treated with the 2.0-mm locking plates and the 2.0-mm nonlocking plates present similar short-term complication rates.

  1. Initial outcome and efficacy of S3 proximal humerus locking plate in the treatment of proximal humerus fractures

    International Nuclear Information System (INIS)

    Zhang Zhiming; Zhu Xuesong; Bao Zhaohua; Yang Huilin

    2012-01-01

    Objective: to explore the initial outcome and efficacy of S 3 proximal humerus locking plate in the treatment of proximal humerus fractures. Methods: Twenty-two patients with proximal humerus fracture were treated with the S 3 proximal humerus locking plate. Most of the fractures were complex, two-part (n=4), three-part (n=11) and four-part (n=7) fractures according to the Neer classification of the proximal humerus fractures. Results: All patients were followed up for 3∼15 months. There were no complications related to the implant including loosening or breakage of the plate. Good and excellent results were documented in 17 patients fair results in 4 patients according the Neer scores of shoulder. Conclusion: New design concepts of S 3 proximal humerus plate provide the subchondral support and the internal fixation support. With the addition of the proper exercise of the shoulder joint, the outcomes would be satisfied. (authors)

  2. A biomechanical comparison of proximal femoral nails and locking proximal anatomic femoral plates in femoral fracture fixation A study on synthetic bones

    Directory of Open Access Journals (Sweden)

    Korhan Ozkan

    2015-01-01

    Conclusion: The proximal femoral intramedullary nail provides more stability and allows for earlier weight bearing than the locking plate when used for the treatment of unstable intertrochanteric fractures of the femur. Clinicians should be cautious for early weight bearing with locking plate for unstable intertrochanteric femur fractures.

  3. The Advanced Locking Plate System (ALPS): a retrospective evaluation in 71 small animal patients.

    Science.gov (United States)

    Guerrero, Tomás G; Kalchofner, Karin; Scherrer, Nicole; Kircher, Patrick

    2014-02-01

    To evaluate use of the Advanced Locking Plate System (ALPS) in dogs and cats and report outcome. Retrospective case series. Dogs (n = 29) and cats (n = 42). The medical records (April 2007-April 2010) of dogs and cats treated with ALPS were reviewed evaluated. Data retrieved included signalment, indication for surgery, complications, and outcome. ALPS was used for 54 fractures, 12 tarsal or carpal ligament injuries and in 6 cases, to prevent or treat fractures during total hip replacement. Complications needing revision surgery occurred in 4 cases (5.5%): fixation failure was identified in 3 (2 fracture-fixations, 1 pancarpal arthrodesis), and a fracture occurred through a screw hole. The most common complication after tarsal arthrodesis was suture dehiscence. All cases had healed by study end. ALPS offers a reliable alternative for fracture treatment and some other orthopedic conditions in small animals. © Copyright 2014 by The American College of Veterinary Surgeons.

  4. Reverse distal femoral locking compression plate a salvage option in nonunion of proximal femoral fractures

    Directory of Open Access Journals (Sweden)

    Sampat S Dumbre Patil

    2016-01-01

    Full Text Available Background: When primary fixation of proximal femoral fractures with implants fails, revision osteosynthesis may be challenging. Tracts of previous implants and remaining insufficient bone stock in the proximal femur pose unique problems for the treatment. Intramedullary implants like proximal femoral nail (PFN or surface implants like Dynamic Condylar Screw (DCS are few of the described implants for revision surgery. There is no evidence in the literature to choose one implant over the other. We used the reverse distal femur locking compression plate (LCP of the contralateral side in such cases undergoing revision surgery. This implant has multiple options of fixation in proximal femur and its curvature along the length matches the anterior bow of the femur. We aimed to evaluate the efficacy of this implant in salvage situations. Materials and Methods: Twenty patients of failed primary proximal femoral fractures who underwent revision surgery with reverse distal femoral locking plate from February 2009 to November 2012 were included in this retrospective study. There were 18 subtrochanteric fractures and two ipsilateral femoral neck and shaft fractures, which exhibited delayed union or nonunion. The study included 14 males and six females. The mean patient age was 43.6 years (range 22-65 years and mean followup period was 52.1 months (range 27-72 months. Delayed union was considered when clinical and radiological signs of union failed to progress at the end of four months from initial surgery. Results: All fractures exhibited union without any complications. Union was assessed clinically and radiologically. One case of ipsilateral femoral neck and shaft fracture required bone grafting at the second stage for delayed union of the femoral shaft fracture. Conclusions: Reverse distal femoral LCP of the contralateral side can be used as a salvage option for failed fixation of proximal femoral fractures exhibiting nonunion.

  5. Reverse distal femoral locking compression plate a salvage option in nonunion of proximal femoral fractures.

    Science.gov (United States)

    Dumbre Patil, Sampat S; Karkamkar, Sachin S; Patil, Vaishali S Dumbre; Patil, Shailesh S; Ranaware, Abhijeet S

    2016-01-01

    When primary fixation of proximal femoral fractures with implants fails, revision osteosynthesis may be challenging. Tracts of previous implants and remaining insufficient bone stock in the proximal femur pose unique problems for the treatment. Intramedullary implants like proximal femoral nail (PFN) or surface implants like Dynamic Condylar Screw (DCS) are few of the described implants for revision surgery. There is no evidence in the literature to choose one implant over the other. We used the reverse distal femur locking compression plate (LCP) of the contralateral side in such cases undergoing revision surgery. This implant has multiple options of fixation in proximal femur and its curvature along the length matches the anterior bow of the femur. We aimed to evaluate the efficacy of this implant in salvage situations. Twenty patients of failed primary proximal femoral fractures who underwent revision surgery with reverse distal femoral locking plate from February 2009 to November 2012 were included in this retrospective study. There were 18 subtrochanteric fractures and two ipsilateral femoral neck and shaft fractures, which exhibited delayed union or nonunion. The study included 14 males and six females. The mean patient age was 43.6 years (range 22-65 years) and mean followup period was 52.1 months (range 27-72 months). Delayed union was considered when clinical and radiological signs of union failed to progress at the end of four months from initial surgery. All fractures exhibited union without any complications. Union was assessed clinically and radiologically. One case of ipsilateral femoral neck and shaft fracture required bone grafting at the second stage for delayed union of the femoral shaft fracture. Reverse distal femoral LCP of the contralateral side can be used as a salvage option for failed fixation of proximal femoral fractures exhibiting nonunion.

  6. a Lock-Free Material Finite Element for Non-Linear Oscillations of Laminated Plates

    Science.gov (United States)

    SINGH, GAJBIR; VENKATESWARA RAO, G.

    2000-02-01

    The objective of the present paper is to propose an efficient, accurate and robust four-node shear flexible composite plate element with six degrees of freedom per node to investigate the non-linear oscillatory behavior of unsymmetrical laminated plates. The degrees of freedom considered are three displacement (u, v, w) along x-, y- and z -axis, two rotations (θx, θy) abouty - and x -axis and twist θxy. The elementc employs coupled displacement field, which is derived using moment-shear equilibrium and in-plane equilibrium of composite strips along the x - andy -axis. The displacement field so derived not only depend on the element co-ordinates but are a function of extensional, bending-extensional, bending and transverse shear stiffness coefficients as well. A bi-cubic polynomial distribution with 16 generalized undetermined coefficients for the transverse displacement is assumed. The element stiffness and mass matrices are computed numerically by employing 3×3 Gauss Legendre product rules. The element is found to be free of shear locking and does not exhibit any spurious modes. The element is found to be free of shear locking and does not exhibit any spurious modes. In order to compute the non-linear frequencies, linear mode shape corresponding to fundamental frequency is assumed as the spatial distribution and non-linear finite element equations are reduced to a single non-linear second order ordinary differential equation. This equation is solved by employing direct numerical integration method. A series of numerical examples is solved to demonstrate the efficacy of the proposed material finite element.

  7. The Outcome in Early Cases of Treatment of Subtrochanteric Fractures with Proximal Femur Locking Compression Plate

    Directory of Open Access Journals (Sweden)

    U Gunadham

    2014-07-01

    Full Text Available The objective of this study was to evaluate the outcome in early treatment of subtrochanteric fractures with proximal femur locking compression plate (PF-LCP.The patients included in this study were those with subtrochanteric fractures (AO type 32A-C treated with PF-LCP (Synthes between Jan 2009 and Jun 2011. The patient characteristics and details of clinical conditions were obtained from records. Clinical and radiographic follow-ups were done at one, two, four and 6 months intervals, and at one year. The primary outcome studied included fracture union and functional ambulatory status. Twenty-six patients were included in the study, 19 of whom were male with a mean age of 42.4 years. Fourteen patients (53.9% had sustained AO type 32B fractures, the majority in motor vehicle accidents. Twenty-two fractures (84.6% achieved union, while sixpatients (23.1% had complications such as broken plate, varus collapse, and broken screw. Four patients (15.4% underwent a second operation. At the end of the follow-ups, 25 patients (96.2% were community ambulators. We conclude that PF-LCP is an effective alternative treatment for subtrochanteric fractures when properly performed.

  8. EFFECTIVENESS OF LOCKING VERSUS DYNAMIC COMPRESSION PLATES FOR DIAPHYSEAL HUMERUS FRACTURES

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    Penugonda Ravi Shankar

    2015-02-01

    Full Text Available The aim of this study was to compare the effectiveness of locking compression plate (LCP over dynamic compression plate (DCP in the management of diaphyseal fractures of the humerus. 38 patients with diaphyseal fracture of the shaft of the humerus were randomized prospectively and treated by open reduction and internal fixation with LCP or DCP. 11 patients underwent internal fixation by LCP and 27 by DCP. Fixation was done through an anterolateral or posterior approach. The outcome was assessed in terms of the union time, union rate, functional outcome, ROM and the incidence of complications. Functional outcome was assessed using the Romen’s et al series grading system . On comparing the results by tests of significance like Chi - sqare test, there was no significant difference in Romen’s et al scores between the two groups ( P >0.05. Though the average union time and recovery of ROM was found to be better for LCP as compared to DCP, it is not statistically significant. Complications such as infection were found to be higher with DCP as compared to LCP. This study proves that LCP can be considered a better surgical option for the management of diaphyseal fractures of the humerus as it offers a short union time and lower incidence of serious complications like infection. However, there appears to be no difference between the two groups in terms of the rate of union and functional outcome

  9. Locking compression plate osteosynthesis of complicated mandibular fractures in six horses.

    Science.gov (United States)

    Kuemmerle, J M; Kummer, M; Auer, J A; Nitzl, D; Fürst, A E

    2009-01-01

    Complicated mandibular fractures were recognised in one foal, one pony and four horses. The foal was two months old while the adult animals ranged in age from 12 to 24 years. Three horses had a unilateral horizontal ramus fracture. Two fractures were open and one was closed. Comminution was present in one of these patients while the other two horses had marked displacement of the fragments. Two suffered from comminuted fractures of the horizontal and vertical ramus of the mandible. One of these patients had open and infected fractures. One foal had a bilateral horizontal ramus fracture with marked periosteal 'new bone' formation and malalignement which required corrective osteotomy. Each horse underwent locking compression plate (LCP) osteosynthesis consisting of open fracture reduction and application of one to three 4.5/5.0 mm LCP at the ventral, lateral or caudal aspect of the mandible under fluoroscopic control. Two 3.5 mm LCP were used in the foal. Plate fixation was supported by application of a cerclage wire construct between the incisor and premolar teeth in most patients. Complete fracture healing, with an excellent functional and cosmetic outcome, was achieved in all of the patients. Complications encountered included seroma formation, screw and wire breakage, as well as implant and apical tooth root infections. The LCP was removed after fracture healing had occurred in four patients.

  10. Fixation of supraglenoid tubercle fractures using distal femoral locking plates in three Warmblood horses.

    Science.gov (United States)

    Frei, Sina; Fürst, Anton E; Sacks, Murielle; Bischofberger, Andrea S

    2016-05-18

    Three horses that were presented with supraglenoid tubercle fractures were treated with open reduction and internal fixation using distal femoral locking plates (DFLP). Placing the DFLP caudal to the scapular spine in order to preserve the suprascapular nerve led to a stable fixation, however, it resulted in infraspinatus muscle atrophy and mild scapulohumeral joint instability (case 1). Placing the DFLP cranial to the scapular spine and under the suprascapular nerve resulted in a stable fixation, however, it resulted in severe atrophy of the supraspinatus and infraspinatus muscles and scapulohumeral joint instability (case 2). Placing the DFLP cranial to the scapular spine and slightly overbending it at the suprascapular nerve passage site resulted in the best outcome (case 3). Only a mild degree of supraspinatus and infraspinatus muscle atrophy was apparent, which resolved quickly and with no effect on scapulohumeral joint stability. In all cases, fixation of supraglenoid tubercle fractures using DFLP in slightly different techniques led to stable fixations with good long-term outcome. One case suffered from a mild incisional infection and plates were removed in two horses. Placement of the DFLP cranial to the scapular spine and slightly overbending it at the suprascapular nerve passage prevented major nerve damage. Further cases investigating the degree of muscle atrophy following the use of the DFLP placed in the above-described technique are justified to improve patient outcome.

  11. Rapid prototyping to design a customized locking plate for pancarpal arthrodesis in a giant breed dog.

    Science.gov (United States)

    Petazzoni, M; Nicetto, T

    2014-01-01

    This report describes the treatment of traumatic carpal hyperextension in a giant breed dog by pancarpal arthrodesis using a custom-made Fixin locking plate, created with the aid of a three-dimensional plastic model of the bones of the antebrachium produced by rapid prototyping technology. A three-year-old 104 kg male Mastiff dog was admitted for treatment of carpal hyperextension injury. After diagnosis of carpal instability, surgery was recommended. Computed tomography images were used to create a life-size three-dimensional plastic model of the forelimb. The model was used as the basis for constructing a customized 12-hole Fixin locking plate. The plate was used to attain successful pancarpal arthrodesis in the animal. Radiographic examination after 74 and 140 days revealed signs of osseous union of the arthrodesis. Further clinical and radiographic follow-up examination three years later did not reveal any changes in implant position or complications.

  12. Clinical evaluation of a mini locking plate system for fracture repair of the radius and ulna in miniature breed dogs.

    Science.gov (United States)

    Kang, Byung-Jae; Ryu, Hak-Hyun; Park, Sungsu; Kim, Yongsun; Kweon, Oh-Kyeong; Hayashi, Kei

    2016-11-23

    To retrospectively evaluate the effectiveness of a novel 1.2 mm mini locking plate system in treating fractures of the radius and ulna in miniature breed dogs. Medical records and radiographs of miniature breed dogs with fractures treated with a 1.2 mm mini locking plate system were reviewed. The inclusion criteria were: body weight of 2.5 kg or less, transverse or short oblique fracture of the radius and ulna, and treatment with a mini locking plate system as the sole method of fixation. For each patient, data including signalment, time to radiographic union, use of bone graft or other agents, and previous repair attempts were recorded. The outcome and complications were determined from clinical and radiographic follow-up examinations. Fourteen cases with a mean radial width of 4.5 mm (± 0.8 mm) were included into this study. The fractures healed without failure of fixation in all cases. Mean time to adequate radiographic union was 8.4 weeks (± 2.6 weeks). Major complications were not seen in any of the cases, and minor complications occurred in three of the cases. Limb function was graded as 'normal' in 10 cases and 'occasional lameness' in four cases. The mini locking system evaluated in this study was an effective treatment method for radial and ulnar fractures in miniature breed dogs with a radial width smaller than 5.5 mm.

  13. The effect of locked screw angulation on the biomechanical properties of the S.P.S. Free-Block plate.

    Science.gov (United States)

    Merino, M K A; Rahal, S C; Ribeiro, C R; Padovani, C R

    2013-01-01

    Among the locked internal fixators is one denominated S.P.S. (Synthesis Pengo System) Free-Block, which was designed with a locking ring that allows the screw to be locked and positioned obliquely. Due to the paucity of biomechanical studies on this system, the present work aimed to evaluate the influence of locked screw angulation on the resistance of the S.P.S. Free-Block plate. Forty synthetic bone cylinders with 10 mm fracture gap were used. Forty seven-hole 3.5 mm stainless steel plates (two AO-like dynamic compression holes and five locked holes) were assembled according to the orientation of the locked screws: monocortical screws were positioned at 90º to the long axis of the cylinder (Group 1), and monocortical screws were positioned at 70º to its cylinder long axis (Group 2). In both groups, AO-like dynamic compression hole screws were positioned bicortically and neutrally. For each group, six specimens were tested until failure, three in bending and three in compression, to determine the loads for fatigue testing. Subsequently, for each group, 14 specimens were tested for failure - seven by bending and seven in compression. No significant failure differences were observed between Groups 1 and 2 under static-loading or fatigue test. In a fracture gap model the orientation of the locked monocortical screws did not show any influence on the mechanical performance of the S.P.S. Free-Block to tests of axial compression and four-point bending.

  14. Use of a locking plate “notched head T-plate®” for the fixation of an ilial body fracture in a dog

    Directory of Open Access Journals (Sweden)

    Cassio Ricardo Auada Ferrigno

    2016-10-01

    Full Text Available Several types of implants may be used to treat iliac fractures in dogs, of which osteosynthesis with plate is the most described and recommended in the literature. The type of plate and screw are major factors in osteosynthesis success. The use of locking plates has been advocated for this purpose, as they do not allow the plate-bone-screw unit to shift, providing angular stability and rigidity to the system. The present study aimed to describe the unprecedented use of a locking notched head T-plate in the treatment of a caudal body of ilium fracture. A two year old male mongrel dog was attended after falling from a third floor height, with two days of evolution. The animal was in standing position, and during orthopedic examination non-weight bearing lameness of the right hind limb, instability, and crepitus in the right body of ilium, with considerable swelling and pain. The radiographic examination allowed diagnosing a complete fracture of the caudal body of ilium with decrease of the pelvic canal diameter. The patient underwent surgery, and the fracture was stabilized with an LCP notched head T-plate. The patient evolved satisfactorily, with good weight-bearing of the affected limb within 24 hours of surgery, and complete recovery with medical discharge after 60 days of postoperative period, with consolidation of the fracture.

  15. Tibial plateau levelling osteotomy locking-compression plates for stabilisation of canine and feline ilial body fractures.

    Science.gov (United States)

    Guthrie, J W; Kalff, S

    2017-12-12

    To evaluate the clinical and radiographic outcomes following surgical stabilisation of ilial fractures in dogs and cats using a laterally applied Synthes TPLO locking compression plate. Medical records and radiographs of seven dogs and two cats which had undergone surgical repair of an ilial body fracture with a TPLO locking compression plate were reviewed. Long-term clinical follow-up was obtained from an owner or referring veterinarian questionnaire. Fracture reduction was anatomic in six of nine ilia and near-anatomic in three of nine. All but one fracture achieved osseous union by 6 weeks after surgery. No screw loosening or implant-related complications occurred in any patient. There was pelvic canal narrowing in six of nine patients (median reduction in pelvic canal diameter was 4·9%). No intraoperative or postoperative complications were reported. Lateral plating of canine and feline ilial fractures with a Synthes TPLO locking compression plate was associated with a low complication rate and satisfactory radiographic and clinical outcomes in this small case series. © 2017 British Small Animal Veterinary Association.

  16. Biomechanical Comparison of Volar Fixed-Angle Locking Plates for AO C3 Distal Radius Fractures: Titanium Versus Stainless Steel With Compression.

    Science.gov (United States)

    Marshall, Tyler; Momaya, Amit; Eberhardt, Alan; Chaudhari, Nilesh; Hunt, Thomas R

    2015-10-01

    To determine biomechanical differences between a fixed-angle locking volar titanium plate (VariAx; Stryker, Kalamazoo, MI) and a fixed-angle compression locking volar stainless steel plate (CoverLoc Volar Plate; Tornier, Amsterdam, Netherlands) in the fixation of simulated AO C3 distal radius fractures. Eighteen cadaveric upper extremities (9 matched pairs) with an average age of 54 years were tested. A 4-part AO C3 fracture pattern was created in each specimen. The fractures were reduced under direct vision and fixed with either the fixed-angle locking volar titanium plate or the fixed-angle compression locking volar stainless steel plate. Motion tracking analysis was then performed while the specimens underwent cyclic loading. Changes in displacement, rotation, load to failure, and mode of failure were recorded. The fragments, when secured with the fixed-angle compression locking stainless steel construct, demonstrated less displacement and rotation than the fragments secured with the fixed-angle locking titanium plate under physiological loading conditions. In the fixed-angle compression locking stainless steel group, aggregate displacement and rotation of fracture fragments were 5 mm and 3° less, respectively, than those for the fixed-angle locking titanium group. The differences between axial loads at mechanical failure and stiffness were not statistically significant. The compression locking stainless steel group showed no trend in mode of failure, and the locking titanium plate group failed most often by articular fixation failure (5 of 9 specimens). The fixed-angle compression locking stainless steel volar plate may result in less displacement and rotation of fracture fragments in the fixation of AO C3 distal radius fractures than fixation by the fixed-angle locking volar titanium plate. However, there were no differences between the plates in mechanical load to failure and stiffness. Fixation of distal radius AO C3 fracture patterns with the fixed

  17. Loss of implant-bone interface following distal radial locking-plate endoprosthesis limb-sparing surgery in a dog.

    Science.gov (United States)

    Venzin, C; Grundmann, S; Montavon, P M

    2012-01-01

    An eight-year-old, neutered female Rottweiler was presented with lameness of seven days duration. Radiographs were consistent with a distal radial bone tumour. Limb-sparing surgery was performed using a commercially available endoprosthesis with a locking bone plate. Histopathological examination of the resected bone revealed an intraosseous fibrosarcoma, and postoperative adjuvant chemotherapy was initiated three weeks after surgery. Despite initial satisfactory limb function, lameness worsened four months after surgery. Radiographs revealed large areas of bone lysis around the proximal and distal screws, leading to significant resorption of the radius and radial carpal bone with subsequent construct failure. Further treatment was declined by the owner and the dog was subsequently euthanased. This case illustrates that implant failure is not necessarily averted by the use of locking (compared with non-locking) implants combined with an endoprosthesis to treat distal radial tumours in dogs. © 2011 British Small Animal Veterinary Association.

  18. The Clinical and Economic Impact of Generic Locking Plate Utilization at a Level II Trauma Center.

    Science.gov (United States)

    Mcphillamy, Austin; Gurnea, Taylor P; Moody, Alastair E; Kurnik, Christopher G; Lu, Minggen

    2016-12-01

    In today's climate of cost containment and fiscal responsibility, generic implant alternatives represent an interesting area of untapped resources. As patents have expired on many commonly used trauma implants, generic alternatives have recently become available from a variety of sources. The purpose of this study was to examine the clinical and economic impact of a cost containment program using high quality, generic orthopaedic locking plates. The implants available for study were anatomically precontoured plates for the clavicle, proximal humerus, distal radius, proximal tibia, distal tibia, and distal fibula. Retrospective review. Level II Trauma center. 828 adult patients with operatively managed clavicle, proximal humerus, distal radius, proximal tibia, tibial pilon, and ankle fractures. Operative treatment with conventional or generic implants. The 414 patients treated with generic implants were compared with 414 patients treated with conventional implants. There were no significant differences in age, sex, presence of diabetes, smoking history or fracture type between the generic and conventional groups. No difference in operative time, estimated blood loss or intraoperative complication rate was observed. No increase in postoperative infection rate, hardware failure, hardware loosening, malunion, nonunion or need for hardware removal was noted. Overall, our hospital realized a 56% reduction in implant costs, an average savings of $1197 per case, and a total savings of $458,080 for the study period. Use of generic orthopaedic implants has been successful at our institution, providing equivalent clinical outcomes while significantly reducing implant expenditures. Based on our data, the use of generic implants has the potential to markedly reduce operative costs as long as quality products are used. Therapeutic Level III.

  19. Quantification of defects depth in glass fiber reinforced plastic plate by infrared lock-in thermography

    Energy Technology Data Exchange (ETDEWEB)

    Ranjit, Shrestha; Kim, Won Tae [Kongju National University, Cheonan (Korea, Republic of); Choi, Man Yong [Korea Research Institute of Standards and Science, Daejeon (Korea, Republic of)

    2016-03-15

    The increasing use of composite materials in various industries has evidenced the need for development of more effective nondestructive evaluation methodologies in order to reduce rejected parts and to optimize production cost. Infrared thermography is a noncontact, fast and reliable non-destructive evaluation technique that has received vast and growing attention for diagnostic and monitoring in the recent years. This paper describes the quantitative analysis of artificial defects in Glass fiber reinforced plastic plate by using Lockin infrared thermography. The experimental analysis was performed at several excitation frequencies to investigate the sample ranging from 2.946 Hz down to 0.019 Hz and the effects of each excitation frequency on defect detachability. The four point method was used in post processing of every pixel of thermal images using the MATLAB programming language. The relationship between the phase contrast with defects depth and area was examined. Finally, phase contrast method was used to calculate the defects depth considering the thermal diffusivity of the material being inspected and the excitation frequency for which the defect becomes visible. The obtained results demonstrated the effectiveness of Lock-in infrared thermography as a powerful measurement technique for the inspection of Glass fiber reinforced plastic structures.

  20. Biomechanical testing of a hybrid locking plate fixation of equine sesamoid osteotomies.

    Science.gov (United States)

    Almeida da Silveira, E; Levasseur, A; Lacourt, M; Elce, Y; Petit, Y

    2014-01-01

    To compare the biomechanical properties of a hybrid locking compression plate (LCP) construct with the compression screw technique as a treatment for transverse mid-body proximal sesamoid bone fractures. Ten paired forelimbs from abattoir horses were used. The medial proximal sesamoid bone of each limb was osteotomized transversely and randomly assigned, to either repair with a two-hole 3.5 mm LCP or a 4.5 mm cortical screw placed in lag fashion. Each limb was tested biomechanically by axial loading in single cycle until failure. The point of failure was evaluated from the load-displacement curves. Then a gross evaluation and radiographs were performed to identify the mode of failure. The loads to failure of limbs repaired with the hybrid LCP construct (4968 N ± 2167) and the limbs repaired with the screw technique (3009 N ± 1091) were significantly different (p fracture of the apical fragment of the proximal sesamoid bone. The LCP technique has potential to achieve a better fracture stability and healing when applied to mid-body fractures of the proximal sesamoid bone. Further testing, particularly fatigue resistance is required to corroborate its potential as a treatment option for mid-body fractures of the proximal sesamoid bone.

  1. Treatment of Unstable Trochanteric Femur Fractures: Proximal Femur Nail Versus Proximal Femur Locking Compression Plate.

    Science.gov (United States)

    Singh, Ashutosh Kumar; Narsaria, Nidi; G R, Arun; Srivastava, Vivek

    Unstable trochanteric femur fractures are common fractures that are difficult to manage. We conducted a prospective study to compare functional outcomes and complications of 2 different implant designs, proximal femur nail (PFN) and proximal femur locking compression plate (PFLCP), used in internal fixation of unstable trochanteric femur fractures. On hospital admission, 48 patients with unstable trochanteric fractures were randomly assigned (using a sealed envelope method) to treatment with either PFN (24 patients) or PFLCP (24 patients). Perioperative data and complications were recorded. All cases were followed up for 2 years. The groups did not differ significantly (P > .05) in operative time, reduction quality, complications, hospital length of stay, union rate, or time to union. Compared with the PFLCP group, the PFN group had shorter incisions and less blood loss. Regarding functional outcomes, there was no significant difference in mean Harris Hip Score (P = .48) or Palmer and Parker mobility score (P = .58). Both PFN and PFLCP are effective in internal fixation of unstable trochanteric femur fractures.

  2. Use of locking compression plates in ulnar fractures of 18 horses.

    Science.gov (United States)

    Jacobs, Carrie C; Levine, David G; Richardson, Dean W

    2017-02-01

    To describe the outcome, clinical findings, and complications associated with the use of the locking compression plate (LCP) for various types of ulnar fractures in horses. Retrospective case series. Client owned horses (n = 18). Medical records, radiographs, and follow-up for horses having an ulnar fracture repaired using at least 1 LCP were reviewed. Fifteen of 18 horses had fractures of the ulna only, and 3 horses had fractures of the ulna and proximal radius. All 18 horses were discharged from the hospital. Complications occurred in 5 horses; incisional infection (n = 4, 22%), implant-associated infection (n = 2, 11%), and colic (n = 1, 6%). Follow-up was available for all horses at a range of 13-120 months and 15 horses (83%) were sound for their intended purpose and 3 horses (17%) were euthanatized. One horse was euthanatized for complications associated with original injury and surgery. The LCP is a viable method of internal fixation for various types of ulnar fractures, with most horses in this series returning to soundness. © 2017 The American College of Veterinary Surgeons.

  3. Misaligned Versus Straight Placement of Anterior Cervical Plates: A Clinical and Radiologic Outcomes Study.

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    Chin, Kingsley R; Pencle, Fabio J R; Francis, Shannon D; Francis, Chloe A; Seale, Jason A; Hothem, Elijah A

    2017-05-01

    In anterior cervical diskectomy and fusion (ACDF), misaligned plates are concerning because of the risk of screw-and-plate failure; however, these plates also hypothetically have the potential for asymmetric micromotion on the facet and uncovertebral joint. The aim of this study was to determine whether misaligned plate placement during ACDF had clinical benefits compared with straight plate placement. Postoperative AP radiographs of 128 consecutive patients who underwent ACDF with anterior cervical plate (ACP) fixation were reviewed, and plate alignment was assessed. Patients were separated into control group 1 (straight plates) or group 2 (misaligned plates). The mean age of patients was 51.5 ± 0.9 years, and women represented 51% of the total population. There was no significant difference between groups with regard to the preoperative visual analog scale (VAS) and Neck Disability Index (NDI) scores (P = 0.744 and P = 0.943, respectively). At 6 weeks postoperatively, the VAS scores for group 1 decreased from 7.6 ± 0.2 to 4.0 ± 0.2 compared with the scores in group 2, which decreased from 7.7 ± 0.2 to 2.1 ± 0.1, which demonstrated statistical significance (P = 0.019). At 2-year follow-up, no significant difference was demonstrated between the groups' VAS and NDI scores (P = 0.670 and P = 0.266). Misaligned plates have increased torsional strength and are associated with better clinical outcomes compared with those of straight plates in the early postoperative period. After fusion, no significant difference in clinical outcomes between the groups was noted, which may reduce the concerns regarding misaligned plates. Retrospective comparative study.

  4. [Augmentative locking compression plate (LCP) combined with bone graft for the treatment of aseptic femoral shaft nonunion after intramedullary nailing].

    Science.gov (United States)

    Wang, Fei-da; Gao, Yao-zu; Yuan, Wei; Du, Jin-qiang; Wei, Xiao-chun

    2014-10-01

    To investigate the effect of augmentative locking compression plate combined with bone graft in treating aseptic femoral shaft nonunion after intramedullary nailing. Twenty-one cases with aseptic femoral shaft nonunion after intramedullary nailing from January 2007 to January 2013 were treated,including 18 males and 3 females with a mean age of 37.7 years (ranged from 23 to 64 years). The mean period of nonunion after surgery was 23.9 months (ranged from 9 to 62 months). According to Weber-Cech classification,10 of those 21 cases were hypertrophic nonunion,7 were atrophic, and 4 had oligotrophic fracture nonunion. All patients retained the original intramedullary nail, and applied with augmentation plating of 6 to 8 holes locking compression plate, unicortical fixation with 2 to 3 locking screws in the proximal or distal end, with simultaneous autologous iliac bone grafting. After treatment,all patients were allowed to partial weight-bearing until full weight-bearing according to the radiological results. All patients were followed up and were evaluated with clinical and imaging results. All patients were followed up from 8 to 24 months, averaged (13.5±3.5) months,which showed clinical union at 4 to 8 months, averaged (6.0±1.0) months and radiological solid union at 7 to 12 months, averaged (9.1±1.5) months. No such complications as infection,hardware loosening or breaking were found. Augmentative locking compression plate(LCP) combined with bone graft for aseptic femoral shaft nonunion after intramedullary nail has a satisfied clinical efficacy. It's an useful and simple method.

  5. Comparison of tension band wiring and precontoured locking compression plate fixation in Mayo type IIA olecranon fractures.

    Science.gov (United States)

    Schliemann, Benedikt; Raschke, Michael J; Groene, Philipp; Weimann, André; Wähnert, Dirk; Lenschow, Simon; Kösters, Clemens

    2014-03-01

    Aim of the present study was to compare the clinical and radiographic outcome of tension band wiring and precontoured locking compression plate fixation in patients treated surgically for an isolated olecranon fractures type IIA according to the Mayo classification. Of 26 patients presenting with an isolated Mayo type IIA olecranon fracture, 13 underwent fixation with a precontoured locking compression plate (group A), 13 patients were treated with tension band wiring (group B). At a mean follow-up of 43 months, patients were clinically and radiographically re-examined using the DASH score, the Mayo Elbow Performance score (MEPS) and anteroposterior and lateral radiographs. The mean DASH score was 14 points in group A and 12.5 points in group B. Regarding the MEPS, 92% of the patients in group A achieved a good to excellent results in comparison to 77% in group B. No significant differences between the two groups could be detected regarding the clinical and radiographic outcome. Implant-related irritations requiring hardware removal occurred more frequently in group B (12 vs. 7). Procedure and implant related costs were significantly higher in group A. Tension band wiring is still a preferable surgical method to treat simple isolated olecranon fractures. The patient must be informed that in all likelihood implant removal will be required once the fracture has healed. Fixation with precontoured locking compression plates does not provide better functional and radiographic outcome but is more expensive than tension band wiring.

  6. Use of a 1.5 mm butterfly locking plate for stabilization of atlantoaxial pathology in three toy breed dogs.

    Science.gov (United States)

    Dickomeit, M; Alves, L; Pekarkova, M; Gorgas, D; Forterre, F

    2011-01-01

    The objective of this study was to describe the use of a titanium 1.5 mm locking plate in the stabilization of atlantoaxial pathology in three toy breed dogs. Two dogs with atlantoaxial subluxation and another dog with an axial fracture, confirmed by diagnostic imaging, were stabilized via a ventral approach with a 1.5 mm titanium 5-hole locking butterfly-plate. Surgical reduction and stabilization were assessed by computed tomography and radiography after surgery. Follow-up evaluation for resolution of neurological signs and possible complications was performed in all three dogs. For long-term assessment, a telephone follow-up was performed. A considerable improvement of neurological signs occurred within two to four weeks after surgery. An excellent clinical outcome was identified in all three patients. Adequate stabilization and resolution of neurological signs in all three dogs was achieved. The stabilization of atlantoaxial surgical conditions in toy breeds with the 1.5 mm titanium 5-hole butterfly locking plate appears to be an effective means of surgical treatment.

  7. RESULTS OF TREATMENT OF CERVICAL DISCOPATHY WITH PEEK INTERBODY CAGES AT THREE LEVELS WITHOUT PLATE FIXATION

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    Amado González Moga

    Full Text Available ABSTRACT Objective: To present the results of treatment of patients with cervical discopathy by anterior cervical approach, discectomy and placement of a PEEK interbody cage without anterior plate fixation. Methods: Retrospective, cross-sectional study from March 2013 to March 2015. Sixteen patients with radiculopathy or clinical signs of myelopathy were included; all patients underwent cervical surgery through anterior approach, discectomy, and placement of PEEK cages on three levels. Decompression levels were determined according to the correlation between preoperative radiological and clinical findings. Results: Sixteen patients predominantly male were included, with mean age of 50 years at the onset of the condition. Ten patients had involvement of C4-C5, C5-C6, C6-C7 levels, and six patients C3-C4, C4-C5 and C5-C6. Fourteen patients had cervicobrachialgia and two myelopathy. The preoperative visual analog scale average was 8/10 and the average postoperative value at 6 months was 3/10. At 6 months, there was no radiological evidence of recurrence. One patient had non-fatal complications. Conclusions: The treatment of cervical discopathy by anterior approach with interbody fusion with PEEK cage on three levels, with no plate fixation seemed to be safe and effective with better long-term results in terms of pain and myelopathy. The clinical results compare favorably with other similar series and, most importantly, the complications associated with anterior fixation plate are avoided.

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

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    Madhusudhana

    2015-10-01

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

  9. PEEK versus titanium locking plates for proximal humerus fracture fixation: a comparative biomechanical study in two- and three-part fractures.

    Science.gov (United States)

    Schliemann, Benedikt; Seifert, Robert; Theisen, Christina; Gehweiler, Dominic; Wähnert, Dirk; Schulze, Martin; Raschke, Michael J; Weimann, Andre

    2017-01-01

    The high rigidity of metal implants may be a cause of failure after fixation of proximal humerus fractures. Carbon fiber-reinforced polyetheretherketone (PEEK) plates with a modulus similar to human cortical bone may help to overcome this problem. The present study assesses the biomechanical behavior of a PEEK plate compared with a titanium locking plate. Unstable two- and three-part fractures were simulated in 12 pairs of cadaveric humeri and were fixed with either a PEEK or a titanium locking plate using a pairwise comparison. With an optical motion capture system, the stiffness, failure load, plate bending, and the relative motion at the bone-implant interface and at the fracture site were evaluated. The mean load to failure for two- and three-part fracture fixations was, respectively, 191 N (range 102-356 N) and 142 N (range 102-169 N) in the PEEK plate group compared with 286 N (range 191-395 N) and 258 N (range 155-366 N) in the titanium locking plate group. The PEEK plate showed significantly more bending in both the two- and three-part fractures (p PEEK plate showed lower fixation strength and increased motion at the bone-implant interface compared with a titanium locking plate.

  10. High failure rate of trochanteric fracture osteosynthesis with proximal femoral locking compression plate.

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    Wirtz, C; Abbassi, F; Evangelopoulos, D S; Kohl, S; Siebenrock, K A; Krüger, A

    2013-06-01

    Stable reconstruction of proximal femoral (PF) fractures is especially challenging due to the peculiarity of the injury patterns and the high load-bearing requirement. Since its introduction in 2007, the PF-locking compression plate (LCP) 4.5/5.0 has improved osteosynthesis for intertrochanteric and subtrochanteric fractures of the femur. This study reports our early results with this implant. Between January 2008 and June 2010, 19 of 52 patients (12 males, 7 females; mean age 59 years, range 19-96 years) presenting with fractures of the trochanteric region were treated at the authors' level 1 trauma centre with open reduction and internal fixation using PF-LCP. Postoperatively, partial weight bearing was allowed for all 19 patients. Follow-up included a thorough clinical and radiological evaluation at 1.5, 3, 6, 12, 24, 36 and 48 months. Failure analysis was based on conventional radiological and clinical assessment regarding the type of fracture, postoperative repositioning, secondary fracture dislocation in relation to the fracture constellation and postoperative clinical function (Merle d'Aubigné score). In 18 patients surgery achieved adequate reduction and stable fixation without intra-operative complications. In one patient an ad latus displacement was observed on postoperative X-rays. At the third month follow-up four patients presented with secondary varus collapse and at the sixth month follow-up two patients had 'cut-outs' of the proximal fragment, with one patient having implant failure due to a broken proximal screw. Revision surgeries were performed in eight patients, one patient receiving a change of one screw, three patients undergoing reosteosynthesis with implantation of a condylar plate and one patient undergoing hardware removal with secondary implantation of a total hip prosthesis. Eight patients suffered from persistent trochanteric pain and three patients underwent hardware removal. Early results for PF-LCP osteosynthesis show major

  11. [Treatment type C fracture of the distal radius with locking compression plate and external fixators].

    Science.gov (United States)

    Yang, Xiang; Zhao, You-ming; Chen, Lin; Ye, Cong-cong; Guo, Wei-jun; Wang, Bo

    2013-12-01

    To compare efficacy of unilateral external fixators and locking compression plates in treating type C fractures of the distal radius. From January 2009 to June 2010, 76 patients with distal radius fracture were treated with LCP and external fixators, 54 patients were followed up. Among them, 29 cases were male and 25 cases were female with an average age of 45.31 (ranged, 24 to 68) years old. There were 29 patients in LCP group. According to AO classification, 8 cases were type C1, 7 cases were type C2 and 14 cases were type C3. There were 25 cases in external fixators group. According to AO classification, 6 cases were type C1, 8 cases were type C2 and 11 cases were type C3. Radial height, volar tilt and radial inclination were compared, advanced Gartland-Werley scoring were used to assessed wrist joint function after 6 and 12 months' following up. Two cases were suffered from nail infection in external fixators group. Fifty-four patients were followed up from 12 to 24 months with an average of 21.3 months. Radial height was (9.60 +/- 0.72) mm, volar tilt was (9.55 +/- 0.80) degrees and radial inclination was (21.40 +/- 0.78) degrees in LCP group,while those were (9.40 +/- 0.70) mm, (9.47 +/- 0.71) degrees and (21.20 +/- 0.73) degrees in external fixtors group, and with no statistical significance (P>0.05). Advanced Gartland-Werley score after 6 months' following up was 3.31 +/- 1.17 in LCP group, 5.56 +/- 1.58 in external fixtors group, and with significant difference (t=-5.99,Pmeaning (t=-1.55, P>0.05). LCP and external fixtors can receive good curative effects in treating type C distal radius fracture, and LCP can obtain obviously short-term efficacy, while there is no significant difference between two groups in long-term results. For serious distal radius comminuted fracture which unable to plate internal fixation, external fixators is a better choice.

  12. Ex vivo biomechanical comparison of the 2.4 mm uniLOCK reconstruction plate using 2.4 mm locking versus standard screws for fixation of acetabular osteotomy in dogs.

    Science.gov (United States)

    Amato, Nicole S; Richards, Andrew; Knight, Trevor A; Spector, Daniel; Boudrieau, Randy J; Belkoff, Stephen

    2008-12-01

    To compare the accuracy of reduction and the biomechanical characteristics of canine acetabular osteotomies stabilized with locking versus standard screws in a locking plate. Ex vivo biomechanical study. Cadaveric canine hemipelves and corresponding femurs (n=10 paired). Transverse acetabular osteotomies stabilized with 5-hole 2.4 mm uniLOCK reconstruction plates using either 2.4 mm locking monocortical or standard bicortical screw fixation (Synthes Maxillofacial). Fracture reduction was assessed directly (craniocaudal acetabular width measurements and gross observation) and indirectly (impression casts). All constructs were fatigue-tested, followed by acute destructive testing. All outcome measures (mean+/-SD) were evaluated for significance (Plocking -0.4+/-0.4 mm; standard -0.4+/-0.3 mm; P=.76). Grossly, there was no significant difference in the repairs and impression casts did not reveal a significant (P=.75) difference in congruency between the groups. No significant differences were found in fracture gap between groups either dorsally (locking 0.38+/-0.23 mm versus standard 0.22+/-0.05 mm; P=.30) or ventrally (locking 0.80+/-0.79 mm versus standard 0.35+/-0.13 mm; P=.23), and maximum change in amplitude dorsally (locking 0.96+/-2.15 mm versus standard 0.92+/-0.89 mm; P=.96) or ventrally (locking 2.02+/-2.93 mm versus standard 0.15+/-0.81 mm; P=.25). There were no significant differences in stiffness (locking 241+/-46 N/mm versus standard 283+/-209 N/mm; P=.64) or load to failure (locking 1077+/-950 N versus standard 811+/-248 N; P=.49). No significant differences were found between pelves stabilized with locking monocortical screw fixation or standard bicortical screw fixation with respect to joint congruity, displacement of fracture gap after cyclic loading, construct stiffness, or ultimate load to failure. There is no apparent advantage of locking plate fixation over standard plate fixation of 2-piece ex vivo acetabular fractures using the 2.4 mm uniLOCK

  13. Ex vivo cyclic mechanical behaviour of 2.4 mm locking plates compared with 2.4 mm limited contact plates in a cadaveric diaphyseal gap model.

    Science.gov (United States)

    Irubetagoyena, I; Verset, M; Palierne, S; Swider, P; Autefage, A

    2013-01-01

    To compare the mechanical properties of locking compression plate (LCP) and limited contact dynamic compression plate (LC-DCP) constructs in an experimental model of comminuted fracture of the canine femur during eccentric cyclic loading. A 20 mm mid-diaphyseal gap was created in eighteen canine femora. A 10-hole, 2.4 mm stainless steel plate (LCP or LC-DCP) was applied with three bicortical screws in each bone fragment. Eccentric cyclic loadings were applied at 10 Hertz for 610,000 cycles. Quasistatic loading / unloading cycles were applied at 0 and 10,000 cycles, and then every 50,000 cycles. Structural stiffness was calculated as the slope of the linear portion of the load-displacement curves during quasistatic loading / unloading cycles. No bone failure or screw loosening occurred. Two of the nine LCP constructs failed by plate breakage during fatigue testing, whereas no gross failure occurred with the LC-DCP constructs. The mean first stiffness of the LCP constructs over the course of testing was 24.0% lower than that of constructs stabilized by LC-DCP. Construct stiffness increased in some specimens during testing, presumably due to changes in bone-plate contact. The first stiffness of LC-DCP constructs decreased by 19.4% and that of locked constructs by 34.3% during the cycling period. A biphasic stiffness profile was observed: the second stiffness was significantly greater than the first stiffness in both groups, which allowed progressive stabilization at elevated load levels. Because LCP are not compressed to the bone, they may have a longer working length across a fracture, and thus be less stiff. However, this may cause them to be more susceptible to fatigue failure if healing is delayed.

  14. FUNCTIONAL OUTCOME EVALUATION AFTER DISTAL FEMORAL LOCKING PLATE FIXATION OF SUPRACONDYLAR FRACTURES OF FEMUR

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    Kishore Babu S

    2017-10-01

    Full Text Available BACKGROUND Supracondylar fractures of femur have a bimodal distribution. They account for 6% of all femur fractures. Nearly, 50% of distal femur intraarticular fractures are open fractures. Despite many changes and refinements in the surgical treatment of the supracondylar and intercondylar fractures of femur their surgical management remains challenging. Since the introduction of the condylar blade plate to the present retrograde supracondylar nailing and locking condylar plates, these fractures particularly if open and associated with severe fragmentation of the articular cartilage and in the elderly with severe osteoporosis continue to be a major unsolved surgical challenge. Improved imaging facilities rendered surgical results far better than those treated with long periods of traction on bed with accompanying complications. LCP along with isolated 6.5 mm cannulated cancellous screw systems are best suited for with unicondylar fractures of distal femur in young patient with good bone stock. The functional outcome is largely determined by the degree of accompanying soft tissue injury. Presence of a compound fracture leads to a higher incidence of infection. With good preoperative antibiotics and sterile surgical techniques along with stable fixation, infection can be brought under control and a good outcome can be achieved. MATERIALS AND METHODS Thirty supracondylar and intercondylar fractures of femur (Muller’s type ‘A’, type ‘B’ and type ‘C’ fractures, which were treated with open reduction and internal fixation by locking compression plate were included in the study. The study was conducted at the Department of Orthopaedics, King George Hospital, Visakhapatnam, from August 2014 to November 2016. Among 30 patients, 5 patients were lost for follow up due to various reasons leaving 25 fractures from 25 patients for the study. RESULTS There were 16 males and 9 females. Age range was 19 years to 80 years with an average of 44

  15. [Anterior interbody fusion of cervical spine with case-plate PCB].

    Science.gov (United States)

    Radek, M; Radek, A; Zapałowicz, K; Maciejczak, A

    2001-01-01

    Two cases with cervical discopathy and radiculopathy are presented. Discectomy and anterior interbody fusion with cage-plate PCB manufactured by French company Scient'x was performed. Authors present the shape of the implant and technical details of implantation. The paper discusses the advantages of the PCB which simplifies and shortens the operation procedure, minimizes the risk of traditional bone graft harvesting and provides immediate stabilization of the operated segment.

  16. Distraction osteogenesis using combined locking plate and Ilizarov fixator in the treatment of bone defect: A report of 2 cases

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    John Mukhopadhaya

    2017-01-01

    Full Text Available Distraction osteogenesis and bone transport has been used to reconstruct bone loss defect by allowing new bone to form in the gap. Plate-guided bone transport has been successfully described in literature to treat bone loss defect in the femur, tibia, and mandible. This study reports two cases of fracture of femur with segmental bone loss treated with locking plate fixation and bone transport with Ilizarov ring fixator. At the time of docking, when the transport segment is compressed with bone fragment, the bone fragment is fixed with additional locking or nonlocking screws through the plate. The bone defect size was 7 cm in case 1 and 8 cm in case 2 and the external fixation indexes were 12.7 days/cm and 14 days/cm. No shortening was present in either of our cases. The average radiographic consolidation index was 37 days/cm. Both cases achieved infection-free bone segment regeneration and satisfactorily functional outcome. This technique reduces the duration of external fixation during the consolidation phase, allows correction of length and alignment and provides earlier rehabilitation.

  17. Locking plate and screw fixation after tibial plateau leveling osteotomy reduces postoperative infection rate in dogs over 50 kg.

    Science.gov (United States)

    Solano, Miguel A; Danielski, Alan; Kovach, Karla; Fitzpatrick, Noel; Farrell, Michael

    2015-01-01

    To assess the influence of locking plate and screw implants on postoperative infection rate in dogs >50 kg undergoing tibial plateau leveling osteotomy (TPLO). Retrospective case series. Dogs >50 kg (n = 208) that had TPLO. Medical records (January 2003-September 2011) were reviewed for dogs that had TPLO. Type of implant used (locking plate and screw fixation [LP] and dynamic compression plate and screw fixation [NLP]), use of postoperative antibiotics and presence of postoperative infection were recorded. Multivariate analysis was performed. Forty dogs (21.3%) had clinical signs compatible with postoperative infection. A positive microbiology swab was available in 16/40 cases (40%). Administration of postoperative antibiotics was associated with a lower incidence of infection (P = .006) and the use of NLP was associated with a higher incidence of infection (P = .01). Use of LP construct and postoperative antibiotic therapy significantly decreased infection rate in dogs >50 kg that have TPLO. © Copyright 2014 by The American College of Veterinary Surgeons.

  18. STUDY OF FUNCTIONAL OUTCOME OF DISTAL FEMORAL FRACTURES MANAGED WITH LOCKING COMPRESSION PLATE

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    Majji Chandrasekharam Naidu

    2017-12-01

    Full Text Available BACKGROUND We reviewed a series of 30 displaced supracondylar and intercondylar fractures of the distal end of the femur that were treated over a 2 years period by open reduction and internal fixation using the distal femur LCP. A strict rating scale incorporating subjective data and objective motion of the involved knee was used for the results. At a mean follow-up of 2 years, the results in 8 patients were rated excellent, the results in 12 were rated as good, the results in 4 as fair and the results in 1 as poor. Complications were found in 2 patients (6.66%. Complications included postoperative osteomyelitis in one and superficial infection and wound haematoma in one patient. MATERIALS AND METHODS In this study, we have included consecutive 30 supracondylar and intercondylar fractures of femur (both Muller’s type ‘A’, type ‘B’ and type ‘C’ fractures and treated with open reduction and internal fixation by locking compression plate in the Department of Orthopaedics, ACSR GMC, Nellore, from August 2015 to November 2017. RESULTS At a mean follow-up of 2 years, the results in 8 patients were rated excellent, the results in 12 were rated as good, the results in 4 as fair and the results in 1 as poor. Complications were found in 2 patients (6.66%. Complications included postoperative osteomyelitis in one and superficial infection and wound haematoma in one patient. CONCLUSION The goals of treatment are anatomic reduction of the articular surface, restoration of limb alignment, length and rotation and stable fixation that allows for early mobilisation. Nonetheless, internal fixation of the distal femur can be difficult for several reasons- thin cortices, a wide medullary canal, compromised bone stock and fracture comminution that make stable internal fixation often difficult to achieve.3,4 Although, better methods of fixation have dramatically improved clinical results, the operative management of these difficult fractures is not

  19. The Use of the String of Pearls Locking Plate System in the Stabilisation of a Comminuted Calcaneal Fracture in a Giant Breed Dog

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    A. B. Scrimgeour

    2011-01-01

    Full Text Available An eight-year-old male Pyrenean mountain dog was presented with a comminuted fracture of the right calcaneus following motor vehicle trauma. The fracture was stabilised with a plate-rod construct, using the String of Pearls locking plate system and an intramedullary pin. Healing was uncomplicated.

  20. EARLY RESULTS OF UNSTABLE DISTAL RADIUS FRACTURES- ORIF WITH LOCKING COMPRESSION PLATE VERSUS LIGAMENTOTAXIS WITH EXTERNAL FIXATORS

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    Mondeep Gayan

    2017-04-01

    Full Text Available BACKGROUND External Fixation (EF and Open Reduction and Internal Fixation (ORIF have been the traditional surgical modalities for unstable distal radius fractures. The Locking Compression Plates (LCP acting as “internal external fixators” are particularly valuable in difficult situations of fractures. We undertook a study to evaluate the outcome of unstable distal radius fractures treated with ORIF with LCP versus those treated by ligamentotaxis with external fixators. MATERIALS AND METHODS A comparative study was carried out in a tertiary care centre with 30 cases of unstable distal radius fractures (15 cases in each group. In one group, open reduction and internal fixation with distal radius volar locking compression plate was carried out and in the other group ligamentotaxis with external fixator was done. The patients were treated and followed up over a period of one and a half year between June 2011 to November 2012. The fractures were classified according to AO classification (Arbeitsgemeinschaft für Osteosynthesefragen: German for “Association for the Study of Internal Fixation” or AO. The functional results were evaluated at the end of 6 months according to Demerit point system of Gartland and Werley modified by Sarmiento (1975 and the anatomical results as per Lindstrom criteria (1959 modified by Sarmiento (1980. RESULTS Overall 86.66% (13 cases had good-to-excellent anatomical results in external fixator group as compared to 93.33% (14 cases in LCP group. The functional outcome was excellent in 80% (12 and good in 13.33% (2 cases in external fixator group as compared to 66.66% (10 excellent and 26.66% (4 good in LCP group. CONCLUSION Both open reduction and internal fixation with locking compression plate and ligamentotaxis with external fixators are good treatment modalities for unstable distal radius fractures. However, the choice should be guided by the fracture configuration, surgeons’ experience and patient’s profile.

  1. Locking plate versus external fixation for type C distal radius fractures: A meta-analysis of randomized controlled trials

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    Dong Wang

    2018-04-01

    Full Text Available Purpose: Distal radial fracture is one of the most common fractures. Up to now, locking plates (LP and external fixation (EF are two conventional surgical approaches to type C radius fracture. Which method is superior has not yet reached a consensus. We try to assess the clinical effectiveness of the two interventions by this meta-analysis. Methods: We used network to search the PubMed, Embase, and Cochrane Medical Library of randomized controlled clinical trials about the type C distal radius fractures performed according to the search strategy mentioned in Cochrane Handbook 5.1.0 from Jan. 2005 to Jan. 2016. Patients in the experimental group were used LP, in the control group were included EF and other surgical approaches. Publication language was restricted to English. Studies that patient population and surgical indication did not define had been excluded. Studies must report at least one of the outcomes as follow: radial inclination, palmar tilt, ulnar variance, range of wrist flexion and extension, and range of wrist supination and pronation. The trials in which participants included children were excluded. We used Jadad study scores to appraise the study. Results: Seven studies included 162 patients (LP group and 190 patients (EF group. We compared the radial inclination, palmar tilt, ulnar variance, range of wrist flexion and extension, and range of wrist supination and pronation. The radial inclination were revealed a difference favoring LP over EF [WMD = 1.84, 95% CI (0.17, 3.50, p = 0.03] and the palmar tilt and ulnar variance was no significant difference between the two groups [(WMD = 3.61, 95% CI (0.00, 7.23, p = 0.05; WMD = 0.05, 95% CI (−0.99, 1.09, p = 0.93]. The functional activities of range of flexion and extension and range of supination and pronation between the two groups was no difference [WMD = 10.04, 95% CI (−6.88, 26.96, p = 0.24; WMD = 12.53, 95% CI (−9.99, 35.06, p = 0.28]. Conclusion

  2. [Treatment of type C3 distal radius fractures with AO 2.4 mm locking plate system after manipulative reduction].

    Science.gov (United States)

    Zhang, Chuan; Zhang, Zuo-Jun; Wang, Lei; Niu, Su-Ling; Wen, Ya-Fei; Guo, Yan-Xing

    2014-11-01

    To summarize our experiences in the treatment of type C3 (AO/OTA) distal radius fractures fixed with AO 2.4 mm locking plates combined with percutaneous pinning after manipulative reduction. From May 2009 to March 2012, 19 patients (2 cases of both sides) with type C3 (AO/OTA) distal radius fractures were treated with volar locking plates combined with percutaneous pinning for distal radius after manipulative reduction. Among the patients, the average age was (45.3 ± 17.4) years old (ranged, 31 to 66 years old). The fracture were complicated with ulnar styloid fracture in 14 wrists and 6 wrists had distal radioulnar joint instability. All the patients had closed fracture and the mean duration was (6.7 ± 3.5) days (4.5 to 9 days). The Henry approach was applied to expose the fracture site. Joint capsule and ligaments were retained for indirect reduction. After indirect reduction, the poking reduction technique was used to correct the residual compression, and congruence of distal ulnar radial joint was verified under fluorscopic guidance. Styloid process was first pinned percutaneously and then AO 2.4 mm volar locking plate was used to support rigid fixation. The fractures complicated with distal radioulnar joint instability and ulnar styloid fracture were treated with forearm plaster support in supination for 6 weeks. Nineteen patients (21 wrists) were followed up for an average duration of 10.5 months (ranged, 7 to 17 months). Radiographic bone union of distal radius was achieved in all cases, nonunion of the ulnar styloid occurred in 3 cases, and no distal radioulnar joint instability occurred. Tendon irritation was found in 2 cases and disappeared after the internal fixation was removed. The volar tilt, radial angle, radial length, incongruence of articular surface and distal radioulnar joint were observed at the follow-up. According to Batra and Gupta scoring system, 13 wrists were assessed to have a score of more than 80, 5 wrists 70 to 90, 3 wrists less

  3. A biomechanic comparison of an internal radiocarpal-spanning 2.4-mm locking plate and external fixation in a model of distal radius fractures.

    Science.gov (United States)

    Wolf, Jonathon C; Weil, Wayne M; Hanel, Douglas P; Trumble, Thomas E

    2006-12-01

    To compare the biomechanic stability of distal radius fracture fixation with a new internal radiocarpal-spanning 2.4-mm locking plate, which acts as an internal distal radius fixator, versus a standard distal radius external fixator. The number of locking screws necessary for adequate fracture fixation was also assessed. Ten cadaveric specimens were mounted in a loading fixture with cables attached to the 2 flexor and 3 extensor wrist tendons. A 1-cm osteotomy was created to simulate an unstable distal radius fracture. The radiocarpal-spanning locking plate was fixed to the radius and index metacarpal with 4 screws proximally and 4 distally. The specimen was incrementally loaded through the tendons. Motion at the fracture site was determined. Screws were sequentially removed from the construct, the specimen was again incrementally loaded, and fracture motion was measured. The fixation was then changed to an external fixator, and the loading tests were repeated. Fracture fixation with the radiocarpal-spanning 2.4-mm locking plate was significantly more stable with 4 screws proximally and 4 screws distally (4 x 4) and with the 3 x 3 configuration than with the external fixator in both flexion and extension. The 4 x 4 screw configuration was not significantly different from the 3 x 3 screw configuration. The 4 x 4 screw configuration was significantly more stable than the 2 x 2 and 1 x 1 screw configurations in both flexion and extension. All internal fixator configurations and the external fixator showed more fracture displacement at increasingly higher loads. Fracture fixation with the new internal radiocarpal-spanning 2.4-mm locking plate is more stable than with a standard distal radius external fixator. Only three 2.4-mm locking screws proximally and three 2.4-mm locking screws distally are required for adequate fixation of the locking spanning plate.

  4. Zero-Profile Spacer Versus Cage-Plate Construct in Anterior Cervical Diskectomy and Fusion for Multilevel Cervical Spondylotic Myelopathy: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Tong, Min-Ji; Xiang, Guang-Heng; He, Zi-Li; Chen, De-Heng; Tang, Qian; Xu, Hua-Zi; Tian, Nai-Feng

    2017-08-01

    Anterior cervical diskectomy and fusion with plate-screw construct has been gradually applied for multilevel cervical spondylotic myelopathy in recent years. However, long cervical plate was associated with complications including breakage or loosening of plate and screws, trachea-esophageal injury, neurovascular injury, and postoperative dysphagia. To reduce these complications, the zero-profile spacer has been introduced. This meta-analysis was performed to compare the clinical and radiologic outcomes of zero-profile spacer versus cage-plate construct for the treatment of multilevel cervical spondylotic myelopathy. We systematically searched MEDLINE, Springer, and Web of Science databases for relevant studies that compared the clinical and radiologic outcomes of zero-profile spacer versus cage and plate for multilevel cervical spondylotic myelopathy. Risk of bias in included studies was assessed. Pooled estimates and corresponding 95% confidence intervals were calculated. On the basis of predefined inclusion criteria, 7 studies with a total of 409 patients were included in this analysis. The pooled data revealed that zero-profile spacer was associated with a decreased dysphagia rate at 2, 3, and 6 months postoperatively when compared with the cage-plate group. Both techniques had similar perioperative outcomes, functional outcome, radiologic outcome, and dysphagia rate immediately and at >1-year after operation. On the basis of available evidence, zero-profile spacer was more effective in reducing postoperative dysphagia rate for multilevel cervical spondylotic myelopathy. Both devices were safe in anterior cervical surgeries, and they had similar efficacy in improving the functional and radiologic outcomes. More randomized controlled trials are needed to compare these 2 devices. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Mechanical evaluation of posterior wiring as a supplement to anterior cervical plate fixation.

    Science.gov (United States)

    Rao, Raj D; Wang, Mei; Singrakhia, Manoj D; McGrady, Linda M

    2004-10-15

    An in vitro experimental study was performed to examine 3-dimensional biomechanical stability of cervical fixations. To determine whether posterior interspinous wiring contributes to the rigidity of a single-level motion segment that has been plated anteriorly, and to determine the effects of this combined fixation on intradiscal pressure and spinal motion at the adjacent segments. Combined anterior and posterior column fixation is being increasingly used in a variety of clinical situations that do not involve complete disruption of the motion segment. The biomechanical validity of combined anterior posterior fixation in the absence of overt posterior ligamentous disruption has not been studied. Six human fresh-frozen cadaveric cervical spines (C3-T1) were used. Three-dimensional intersegmental motion and intradiscal pressure were measured while the spine was loaded in flexion, extension, lateral bending, and torsion (up to 2.5 Nm). Fixation stability at the operative level (C5-C6) and influence of the fixation on adjacent segments were evaluated after an anterior plating procedure and combined anterior plating and posterior wiring. Comparing the combined approach with anterior plating alone, significant reductions in C5-C6 motion was noted: 49% in flexion (P torsion (P bending was not significant (18% and 12%, respectively). The improved fixation had minimal influence on the adjacent segments. Combined anterior posterior fixation further reduces the segmental motion by almost 50% in flexion and extension, 33% and 39% in torsion, and does not significantly alter intradiscal pressure and spinal motion at adjacent segments.

  6. Minimally invasive plate osteosynthesis of the distal fibula with the locking compression plate: first experience of 20 cases.

    Science.gov (United States)

    Hess, Florian; Sommer, Christoph

    2011-02-01

    The aim of this study was to evaluate the clinical feasibility and the possible complications associated with minimally invasive plate osteosynthesis of the distal fibula. Regional county hospital. All patients with Orthopaedic Trauma Association 42, 43, 44 fractures of the distal tibia requiring plate fixation of the distal fibula were included in this cohort study. A consecutive series of 701 internally fixed fractures of tibia and ankle yielded 20 fibular fractures treated with this technique. Fractures were treated with the minimally invasive plate osteosynthesis technique using an angular stable screw-plate system for the fibula. Clinical and radiologic outcomes at 24 months. Seventeen fractures healed without complication at an average of 9 weeks. Three aseptic nonunions were recorded: one in a pilon fracture (Orthopaedic Trauma Association 43-C3) and one in a distal lower leg fracture (Orthopaedic Trauma Association 43-A3), both with severe closed soft tissue injury (as a result of a crush mechanism). The third one was in an ankle fracture dislocation (OTA 44-C1) with delayed treatment and inadequate reduction of the simple fibula fracture. Although this technique is comparable to minimally invasive plate osteosynthesis in the tibia or femur, it appears to be more difficult as a result of small bone size. As a result, we reserve this technique for selected complex fractures of the distal fibula with critical soft tissue conditions.

  7. Biomechanical properties of orthogonal plate configuration versus parallel plate configuration using the same locking plate system for intra-articular distal humeral fractures under radial or ulnar column axial load.

    Science.gov (United States)

    Kudo, Toshiya; Hara, Akira; Iwase, Hideaki; Ichihara, Satoshi; Nagao, Masashi; Maruyama, Yuichiro; Kaneko, Kazuo

    2016-10-01

    Previous reports have questioned whether an orthogonal or parallel configuration is superior for distal humeral articular fractures. In previous clinical and biomechanical studies, implant failure of the posterolateral plate has been reported with orthogonal configurations; however, the reason for screw loosening in the posterolateral plate is unclear. The purpose of this study was to evaluate biomechanical properties and to clarify the causes of posterolateral plate loosening using a humeral fracture model under axial compression on the radial or ulnar column separately. And we changed only the plate set up: parallel or orthogonal. We used artificial bone to create an Association for the Study of Internal Fixation type 13-C2.3 intra-articular fracture model with a 1-cm supracondylar gap. We used an anatomically-preshaped distal humerus locking compression plate system (Synthes GmbH, Solothurn, Switzerland). Although this is originally an orthogonal plate system, we designed a mediolateral parallel configuration to use the contralateral medial plate instead of the posterolateral plate in the system. We calculated the stiffness of the radial and ulnar columns and anterior movement of the condylar fragment in the lateral view. The parallel configuration was superior to the orthogonal configuration regarding the stiffness of the radial column axial compression. There were significant differences between the two configurations regarding anterior movement of the capitellum during axial loading of the radial column. The posterolateral plate tended to bend anteriorly under axial compression compared with the medial or lateral plate. We believe that in the orthogonal configuration axial compression induced more anterior displacement of the capitellum than the trochlea, which eventually induced secondary fragment or screw dislocation on the posterolateral plate, or nonunion at the supracondylar level. In the parallel configuration, anterior movement of the capitellum or

  8. EVALUATION OF FUNCTIONAL OUTCOME AFTER OPEN REDUCTION AND INTERNAL FIXATION OF DISTAL FEMUR FRACTURES BY LOCKING COMPRESSION PLATE

    Directory of Open Access Journals (Sweden)

    L. Lokanadha Rao

    2016-09-01

    Full Text Available BACKGROUND In the supra and intercondylar fractures of femur particularly with intra articular extension, patient may develop stiffness of knee, shortening, rotational deformities, internal derangement of knee with instability, varus and valgus deformities which affect patient’s routine lifestyle. If these cases were treated with locking compression plate, the results obtained were successful, superior, timesaving providing early ambulation and least disability improving the functional outcome. MATERIALS AND METHODS This is a prospective interventional study. This study includes 25 supracondylar and intercondylar fractures of femur (both Muller’s Type ‘A’, Type B and Type ‘C’ fractures treated with open reduction and internal fixation by Locking Compression Plate in the Department of Orthopaedics, King George Hospital, Visakhapatnam from September 2013 to September 2015. There are 16 males and 9 females with age ranging from 20 to 80 years with an average of 44.6 years. Average age for males is 28.9 years and average age for females is 25 years. 18 fractures were due to road traffic accidents and 6 cases are due to fall from significant heights, 1 case due to simple fall from standing (osteoporosis. 15 cases were in right femur (60% and 10 cases were in left femur (40%. RESULTS 25 cases were included in the study. There is an increase in the rate of union, decreased time taken for union, increased knee range of motion, decreased time for weight-bearing, postoperative complications and duration for hospital stay. CONCLUSION LCP proved to be a good implant which could take the challenges like poor bone stock, severe comminution both metaphyseal and articular and prove successful. The locking head screws distally have prevented varus collapse, even in cases of osteoporosis. The Condylar LCP can be used in either an open or a minimally invasive manner.

  9. Biomechanical comparison of a 3.5-mm conical coupling plating system and a 3.5-mm locking compression plate applied as plate-rod constructs to an experimentally created fracture gap in femurs of canine cadavers.

    Science.gov (United States)

    Tremolada, Giovanni; Lewis, Daniel D; Paragnani, Ken Luka; Conrad, Bryan P; Kim, Stanley E; Pozzi, Antonio

    2017-06-01

    OBJECTIVE To compare stiffness and resistance to cyclic fatigue of two 3.5-mm locking system plate-rod constructs applied to an experimentally created fracture gap in femurs of canine cadavers. SAMPLE 20 femurs from cadavers of 10 mixed-breed adult dogs. PROCEDURES 1 femur from each cadaver was stabilized with a conical coupling plating system-rod construct, and the contralateral femur was stabilized with a locking compression plate (LCP)-rod construct. An intramedullary Steinmann pin was inserted in each femur. A 40-mm gap then was created; the gap was centered beneath the central portion of each plate. Cyclic axial loading with increasing loads was performed. Specimens that did not fail during cyclic loading were subjected to an acute load to failure. RESULTS During cyclic loading, significantly more LCP constructs failed (6/10), compared with the number of conical coupling plating system constructs that failed (1/10). Mode of failure of the constructs included fracture of the medial or caudal aspect of the cortex of the proximal segment with bending of the plate and pin, bending of the plate and pin without fracture, and screw pullout. Mean stiffness, yield load, and load to failure were not significantly different between the 2 methods of stabilization. CONCLUSIONS AND CLINICAL RELEVANCE Both constructs had similar biomechanical properties, but the conical coupling plating system was less likely to fail than was the LCP system when subjected to cyclic loading. These results should be interpreted with caution because testing was limited to a single loading mode.

  10. Compartment syndrome like picture in metaphyseal comminuted fracture of tibia treated by locking plate due to tight closure

    Directory of Open Access Journals (Sweden)

    Prafulla Herode

    2013-01-01

    Full Text Available A 22-year-old male came to casualty on 5 th May 2012 after a fall from motorcycle. He complained of excruciating pain and swelling over right knee. There was an open wound of 7 × 2 cm over supra-patellar region and diffuse swelling over knee joint with severe tenderness over proximal aspect of right tibia. X-ray showed intra-articular fracture of proximal tibia extending to diaphysis classified as type 6 by Schatzker classification for proximal tibia, with fibula shaft transverse fracture. The skin over the fracture was contused. Debridement with primary wound closure was done in emergency. Skeletal traction was applied through a lower tibial Steinman pin. Patient was operated after 15 days when wound healed and swelling subsided. Locking plate was applied on medial aspect using Minimally invasive percutaneous plate osteosysthesis (MIPPO technique. Post-operatively over 4 hours patient developed severe pain and swelling in operated leg which mimicked compartment syndrome. Suture removal was done immediately in the ward from the distal aspect, which relieved the symptoms but lead to exposure of the plate. A rotational flap was done to cover the plate in coordination with a plastic surgeon on the next day.

  11. Locking compression plate stabilization of 20 distal radial and ulnar fractures in toy and miniature breed dogs.

    Science.gov (United States)

    Gibert, S; Ragetly, G R; Boudrieau, R J

    2015-01-01

    To evaluate retrospectively the effectiveness of the Locking Compression Plate® (LCP), in the form of either a straight or notched head T-plate, for the treatment of fractures of the distal radius and ulna in a series of 20 toy and miniature breed dogs. The medical records of toy and miniature breed dogs (plate). Twenty fractures (20 dogs) satisfied the inclusion criteria; eight straight and 12 notched head T-plates were used, either 2.0 mm (n = 13) or 2.4 mm (n = 7). Hybrid fixation was performed in all dogs in one or both fragments. Mean time to radiographic union was 6.9 ± 2.5 weeks (range: 4-12 weeks) in 18/20 dogs with radiographic follow-up. One complication was observed: infection that resolved with antibiotic medication and implant removal. No other major complications occurred by the time of last follow-up. In all cases (mean follow-up: 15 ± 7 months), the reported limb function as evaluated by the referring veterinarian or owner was excellent. The LCP, used as a hybrid construct for the treatment of distal radial and ulnar fractures was shown to yield excellent clinical results with both uncomplicated healing and excellent functional outcomes in this series of toy and miniature breed dogs.

  12. Surgical repair of a severely comminuted maxillary fracture in a dog with a titanium locking plate system.

    Science.gov (United States)

    Illukka, E; Boudrieau, R J

    2014-01-01

    A four-year old male Labrador Retriever was admitted with head trauma after being hit by a car. The dog had sustained multiple nasal, maxillary, and frontal bone fractures that resulted in separation of the maxilla from the base of the skull. A severely comminuted left zygomatic arch fracture was also present. These fractures were all repaired using a point contact, locking titanium plate system, in a single procedure that resulted in excellent postoperative occlusion and immediate function. Healing was uneventful. Full function and excellent cosmetic appearance were evident 13 months after surgery. This case illustrates the ease of repair and the success of treatment of severely comminuted maxillofacial fractures by conforming to basic biomechanical principles taken directly from the human experience and successfully applied to the dog; these included multiple plate application along the buttresses and trusses of the facial skeleton. The plate fixation was applied to bridge the multiple fractures along the most appropriate lines of stress. The small size of the plates, and the ability to easily contour them to adapt to the bone surface in three-dimensions, allowed their placement in the most appropriate positions to achieve sufficient rigidity and lead to uncomplicated healing without any postoperative complications.

  13. Effect of plate working length on plate stiffness and cyclic fatigue life in a cadaveric femoral fracture gap model stabilized with a 12-hole 2.4 mm locking compression plate.

    Science.gov (United States)

    Chao, Peini; Conrad, Bryan P; Lewis, Daniel D; Horodyski, MaryBeth; Pozzi, Antonio

    2013-06-24

    There are several factors that can affect the fatigue life of a bone plate, including the mechanical properties of the plate and the complexity of the fracture. The position of the screws can influence construct stiffness, plate strain and cyclic fatigue of the implants. Studies have not investigated these variables in implants utilized for long bone fracture fixation in dogs and cats. The purpose of the present study was to evaluate the effect of plate working length on construct stiffness, gap motion and resistance to cyclic fatigue of dog femora with a simulated fracture gap stabilized using a 12-hole 2.4 mm locking compression plates (LCP). Femora were plated with 12-hole 2.4 mm LCP using 2 screws per fracture segment (long working length group) or with 12-hole 2.4 mm LCP using 5 screws per fracture segment (a short working length group). Construct stiffness did not differ significantly between stabilization techniques. Implant failure did not occur in any of the plated femora during cycling. Mean ± SD yield load at failure in the short plate working length group was significantly higher than in the long plate working length group. In a femoral fracture gap model stabilized with a 2.4 mm LCP applied in contact with the bone, plate working length had no effect on stiffness, gap motion and resistance to fatigue. The short plate working length constructs failed at higher loads; however, yield loads for both the short and long plate working length constructs were within physiologic range.

  14. A biomechanical comparison of 3.5 locking compression plate fixation to 3.5 limited contact dynamic compression plate fixation in a canine cadaveric distal humeral metaphyseal gap model.

    Science.gov (United States)

    Filipowicz, D; Lanz, O; McLaughlin, R; Elder, S; Werre, S

    2009-01-01

    3.5 locking compression plate (LCP) fixation was compared to 3.5 limited contact dynamic compression plate (LC-DCP) fixation in a canine cadaveric, distal humeral metaphyseal gap model. Thirty paired humeri from adult, large breed dogs were separated into equal groups based on testing: static compression, cyclic compression, and cyclic torsion. Humeral constructs stabilised with LCP were significantly stiffer than those plated with LC-DCP when loaded in static axial compression (P = 0.0004). When cyclically loaded in axial compression, the LCP constructs were significantly less stiff than the LC-DCP constructs (P = 0.0029). Constructs plated with LCP were significantly less resistant to torsion over 500 cycles than those plated with LC-DCP (Plocking plates may be attributed to the stability afforded by the plate-screw interface of locking plates. The LCP constructs demonstrated less stiffness in dynamic testing in this model, likely due to plate-bone offset secondary to non-anatomic contouring and occasional incomplete seating of the locking screws when using the torque-limiting screw driver. Resolution of these aspects of LCP application may help improve the stiffness of fixation in fractures modeled by the experimental set-up of this investigation.

  15. Choosing a proper working length can improve the lifespan of locked plates. A biomechanical study.

    Science.gov (United States)

    Hoffmeier, Konrad L; Hofmann, Gunther O; Mückley, Thomas

    2011-05-01

    It is hypothesized that the working length influences the implants fatigue behavior. However, few studies addressing this issue came to contrary results. Therefore, we tested systematically the influence of working length and implant material on the plate's endurance. We used an artificial model providing the substantial angle and length conditions of a human femur. A fracture gap of 10mm was bridged with identical shaped plate implants made of stainless steel and grade-2 titanium. The fatigue strength was tested for a short, medium and long working length. Aiming at an implant failure within 80,000 loading cycles the upper load threshold was set to 265N for the titanium plates and to 420N for the steel plates. The lower load threshold was -20N for both plates. For the steel plates there was no correlation between fatigue strength and working length. The construct stiffness did not differ at short and medium working length and was reduced by 10% (P=0.047) at long working length. For the titanium plates the fatigue strength tends to increase with the working length but this correlation was not significant (τ=0.417, P=0.051). Further there was a negative correlation between working length and construct stiffness (τ=0.552; P=0.01). The working length has no appreciable effect on the endurance of the steel plates. Compared to the grade 2-titanium plates the stainless steel plates sustain a larger amount of cyclic load. However, for the titanium plates a larger working length tends to improve the endurance. Copyright © 2010 Elsevier Ltd. All rights reserved.

  16. Fixation of lapidus arthrodesis with a plantar interfragmentary screw and medial locking plate: a report of 88 cases.

    Science.gov (United States)

    Cottom, James M; Vora, Anand M

    2013-01-01

    Lapidus arthrodesis is a powerful procedure that can be used to correct pathologic features within the forefoot or midfoot. Many different methods of fixation for this procedure have been reported. The use of plating constructs has been shown to provide increased stability compared with screw-only constructs. The technique we have described consists of a plantar to dorsal retrograde lag screw across the arthrodesis site, coupled with a low-profile medial locking plate. A total of 88 consecutive patients were treated with this modification of the Lapidus procedure by 2 surgeons and were retrospectively evaluated. All patients followed an early postoperative weightbearing protocol. Patient age, gender, follow-up duration, interval to weightbearing and radiographic fusion, preoperative and postoperative intermetatarsal angle, hardware removal, preoperative and postoperative American Orthopaedic Foot and Ankle Society midfoot scores, and adjunct procedures were analyzed. The mean follow-up period was 16.76 ± 5.9 (range 12 to 36) months, and all healed fusions demonstrated radiographic union at a mean of 51 ± 19.1 (range 40 to 89) days. The patients were treated with weightbearing starting a mean of 10.90 ± 4.1 (range 5 to 28) days postoperatively. Complications included 15 patients (17%) requiring hardware removal, 2 cases (2%) of hallux varus, 6 cases (7%) of radiographic recurrent hallux valgus, and 2 patients (2%) with first metatarsocuneiform nonunion. The results of the present study have demonstrated that plantar lag screw fixation with medial locking plate augmentation for Lapidus arthrodesis allows for early weightbearing with satisfactory outcomes, improved clinical and radiographic alignment, and improved American Orthopaedic Foot and Ankle Society scores. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Radiographic outcome and complications of tibial plateau leveling osteotomy stabilized with an anatomically contoured locking bone plate.

    Science.gov (United States)

    Kowaleski, Michael P; Boudrieau, Randy J; Beale, Brian S; Piras, Alessandro; Hulse, Donald; Johnson, Kenneth A

    2013-10-01

    To evaluate the short-term clinical performance of an anatomically pre-contoured, locking plate in dogs undergoing tibial plateau leveling osteotomy (TPLO) for cranial cruciate ligament (CrCL) disease. Prospective, multi-center clinical study. Dogs (n = 56) undergoing TPLO. Signalment and operative data were recorded. Preoperative, postoperative, and follow-up tibial plateau angle (TPA) were measured from radiographic images. Intraoperative and postoperative complications were recorded; the latter were categorized as minor if additional surgery was not necessary, and major if surgery was needed to resolve the complication. Bone healing was scored and change in tibial plateau angle (TPACH ) between postoperative and follow up radiographic images was calculated. Mean (± SD) preoperative TPA was 28.6 ± 3.8°, and mean postoperative TPA was 4.8 ± 1.9°. Four intraoperative complications (7.1%) including 2 cases of intra-articular screw placement, 3 minor postoperative complications (5.4%), and no major or catastrophic postoperative complications occurred. Median bone healing grade was 4/4 (excellent union >75% healing). Mean TPACH was 0.15 ± 1.32°. Use of this anatomically contoured, locking TPLO plate by experienced surgeons is associated with accurate tibial plateau leveling, reliably excellent bone union at follow-up exam, minimal TPACH , and a lower complication rate than previously reported. Confining contouring to the distal shaft of the plate ensures there is precise apposition to the tibial diaphysis and mitigates the risk of intra-articular screw placement. © Copyright 2013 by The American College of Veterinary Surgeons.

  18. Close Intramedullary Interlocking Nailing Versus Locking Compression Plating In the Treatment of Closed Fracture Shaft of the Tibia.

    Science.gov (United States)

    Kundu, I K; Datta, N K; Chowdhury, A Z; Das, K P; Tarik, M M; Faisal, M A

    2016-07-01

    Fracture of tibial shaft is the commonest site of long bone fractures due to its superficial location involving young or middle-age people. Proper management is an important issue regarding the future effective movements. In this study patients were grouped in closed Intra medullary interlocking nailing and locking compression plating. Post-operative follow up at 2 weeks, 6 weeks, 12 weeks and 3 months thereafter up to 6 months were done. Each of the patients was evaluated clinically and radiologically by tucker criteria of Tuker et al. Patients were assessed for pain on full weight bearing and kneeling, shortening and range of motion of knee and ankle joints. Radiological assessment for union of fracture, alignment of fracture and angulations and position of nail and screws and infection were observed during follow up. A total number of 32 patients were selected but only 27 patients were available for follow up for a period of 6 months. They were grouped into Group A, consisting of 15 patients who took the treatment in the form of closed intramedullary interlocking nailing and Group B, consisting of 12 patients those underwent ORIF with locking compression plating. In both of the groups Motor Vehicle Accident was the main mechanism of trauma. Fracture involving the middle 3rd of the tibia is common in both the groups. During post-operative follow up, four patients in Group A complained anterior knee pain, one patient in Group B had superficial infection, most of the patients had no restriction of movement in the ankle and knee joints and a single patient in Group B showed 1.5cm shortening of the lower limb. Period of hospital stay and fracture union time were less in Group A, which was statistically significant. Both groups showed excellent result with minimum complications. So this study permits to conclude that close IM interlocking nailing and open reduction and internal fixation by locking compression plating is equally effective for the management of close

  19. Comparison of the effect on bone healing process of different implants used in minimally invasive plate osteosynthesis: limited contact dynamic compression plate versus locking compression plate

    OpenAIRE

    Xue, Zichao; Xu, Haitao; Ding, Haoliang; Qin, Hui; An, Zhiquan

    2016-01-01

    Minimally invasive plate osteosynthesis (MIPO) has been widely accepted because of its satisfactory clinical outcomes. However, the implant construct that works best for MIPO remains controversial. Different plate designs result in different influence mechanisms to blood flow. In this study, we created ulnar fractures in 42 beagle dogs and fixed the fractures using MIPO. The dogs were randomly divided into two groups and were fixed with a limited contact dynamic compression plate (LC-DCP) or ...

  20. Repair of Y-T humeral fractures in the dog using paired 'String of Pearls' locking plates.

    Science.gov (United States)

    Ness, M G

    2009-01-01

    To describe a technique for treating Y-T humeral fractures using paired string of pearls (SOP) plates and to review the outcome in 13 cases. A series of 13 consecutive Y-T humeral fractures, otherwise known as distal humeral dicondylar fractures, were treated according to a surgical protocol which involved combined medial and lateral surgical approaches, accurate reduction and fixation of the condylar fracture with a single transcondylar lag screw, and then re-alignment and fixation of the diaphyseal fracture using two SOP plates and screws. Functional outcome was recorded as excellent in 10 dogs, good in two and poor in one. Six of the 13 patients were working dogs and of these, five returned to pre-injury levels of activity, including work. Complications requiring additional surgery were seen in four of the 13 cases, and three of these cases had a sub-optimal functional outcome. The results following repair of Y-T fractures using SOP locking plates, placed via combined medial and lateral incisions, compared favourably with those reported for other techniques.

  1. Treatment of midshaft clavicular delayed and non-unions with anteroinferior locking compression plating

    NARCIS (Netherlands)

    Stufkens, S.A.; Kloen, P.

    2010-01-01

    INTRODUCTION: Pain and impaired shoulder function are the predominant symptoms of midshaft clavicle non-unions. Obtaining consolidation and improvement of shoulder function is often successfully achieved with osteosynthesis and bone grafting. Most data in the literature pertain to plate

  2. Functional Outcomes After Temporary Bridging With Locking Plates in Lisfranc Injuries

    NARCIS (Netherlands)

    van Koperen, Paul J.; de Jong, Vincent M.; Luitse, Jan S. K.; Schepers, Tim

    2016-01-01

    The standard operative treatment of Lisfranc fracture dislocations currently consists of open reduction and transarticular fixation. Recently, bridge plating has been used more often. Using joint spanning, the reduced fracture dislocation is temporary stabilized to minimize articular damage. The

  3. Plantar versus dorsomedial locked plating for Lapidus arthrodesis: a biomechanical comparison.

    Science.gov (United States)

    Klos, Kajetan; Simons, Paul; Hajduk, Anne-Sophie; Hoffmeier, Konrad Leopold; Gras, Florian; Fröber, Rosemarie; Hofmann, Gunther O; Mückley, Thomas

    2011-11-01

    Lapidus arthrodesis with a plate and a compression screw is an established procedure in hallux valgus surgery. The present study was performed to investigate the potential benefit of a compression screw combined with a plantarly applied angle-stable, anatomically precontoured plate or a dorsomedially applied angle-stable plate. In six pairs of human cadaver specimens, one specimen each was randomized to receive a dorsomedial H-shaped plate, while the other received a plantar plate. Bone mineral density was measured with peripheral quantitative computed tomography. The specimens were loaded quasi-statically, followed by cyclic loading. Finally, they were loaded to failure. In the static tests, stiffness and range of motion (ROM) data were obtained. In the cyclic tests, the constructs' displacement was studied. In the load-to-failure test, stiffness and maximum load to failure were measured. The two groups did not differ significantly with regard to BMD (p = 0.25). Any significant differences observed were in favor of the plantar constructs, which had greater initial stiffness (p = 0.028) and final stiffness (p = 0.042), a smaller ROM (p = 0.028), and a greater load to failure (p = 0.043). There was no significant difference regarding displacement (p = 0.14). In the static tests, the plantar angle-stable plate construct was superior to the dorsomedial angle-stable plate construct. Plantar plating appears to offer biomechanical benefit. Clinical studies will be required to show whether this translates into earlier resumption of weightbearing and into lower rates of nonunion.

  4. 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. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Fibular allograft and anterior plating for dislocations/fractures of the cervical spine

    Directory of Open Access Journals (Sweden)

    Ramnarain A

    2008-01-01

    Full Text Available Background: Subaxial cervical spine dislocations are common and often present with neurological deficit. Posterior spinal fusion has been the gold standard in the past. Pain and neck stiffness are often the presenting features and may be due to failure of fixation and extension of fusion mass. Anterior spinal fusion which is relatively atraumatic is thus favored using autogenous grafts and cages with anterior plate fixation. We evaluated fresh frozen fibular allografts and anterior plate fixation for anterior fusion in cervical trauma. Materials and Methods: Sixty consecutive patients with single-level dislocations or fracture dislocations of the subaxial cervical spine were recruited in this prospective study following a motor vehicle accident. There were 38 males and 22 females. The mean age at presentation was 34 years (range 19-67 years. The levels involved were C5/6 ( n = 36, C4/5 ( n = 15, C6/7 ( n = 7 and C3/4 ( n = 2. There were 38 unifacet dislocations with nine posterior element fractures and 22 were bifacet dislocations. Twenty-two patients had neurological deficit. Co-morbidities included hypertension ( n = 6, non-insulin-dependent diabetes mellitus ( n = 2 and asthma ( n = 1. All patients were initially managed on skull traction. Following reduction further imaging included Computerized Tomography and Magnetic Resonance Imaging. Patients underwent anterior surgery (discectomy, fibular allograft and plating. All patients were immobilized in a Philadelphia collar for eight weeks (range 7-12 weeks. Eight patients were lost to follow-up within a year. Follow-up clinical and radiological examinations were performed six-weekly for three months and subsequently at three-monthly intervals for 12 months. Pain was analyzed using the visual analogue scale (VAS. The mean follow-up was 19 months (range 14-39 months. Results: Eight lost to followup, hence 52 patients were considered for final evaluation. The neurological recovery was 1.1 Frankel

  6. Functional Outcomes After Temporary Bridging With Locking Plates in Lisfranc Injuries.

    Science.gov (United States)

    van Koperen, Paul J; de Jong, Vincent M; Luitse, Jan S K; Schepers, Tim

    2016-01-01

    The standard operative treatment of Lisfranc fracture dislocations currently consists of open reduction and transarticular fixation. Recently, bridge plating has been used more often. Using joint spanning, the reduced fracture dislocation is temporary stabilized to minimize articular damage. The present study describes the outcomes of patients treated with bridge plating after tarsometatarsal fracture dislocations compared with transarticular screw fixation. A retrospective cohort study was performed. Patients with an isolated tarsometatarsal injury who had been treated operatively from June 2000 to October 2013 were included. The primary functional outcome was measured using the American Orthopaedic Foot and Ankle Society midfoot score and the Foot Function Index. The secondary outcome was patient satisfaction, which was measured using the EuroQol 5 dimensions questionnaire and a visual analog scale. A total of 34 patients were included. Bridge plating was used in 21 patients. In 13 patients, Kirschner wires or transarticular screws or a combination were used. The median follow-up period was 49 (interquartile range 18 to 89) months. The implants were removed in 10 of 13 patients in the transarticular group and 17 of 21 patients in the bridge plating group. The incidence of wound complications was comparable in both groups. The median American Orthopaedic Foot and Ankle Society score was lower in the transarticular group (77 versus 66). The Foot Function Index score was 18 in both groups. Patient satisfaction was 90% in the bridge plating group and 80% in the transarticular group. Bridge plating for Lisfranc injuries led to at least similar results compared with transarticular fixation in terms of functional outcomes and patient satisfaction. Longer follow-up is necessary to determine whether the prevention of secondary damage to the articular surface leads to less post-traumatic arthritis and better functional outcomes. Copyright © 2016 American College of Foot

  7. Biomechanical Comparison of Locking Compression Plate and Limited Contact Dynamic Compression Plate Combined with an Intramedullary Rod in a Canine Femoral Fracture-Gap Model.

    Science.gov (United States)

    Matres-Lorenzo, Luis; Diop, Amadou; Maurel, Nathalie; Boucton, Marie-Charlotte; Bernard, Fabrice; Bernardé, Antoine

    2016-04-01

    To compare the biomechanical properties of locking compression plate (LCP) and a limited contact dynamic compression plate combined with an intramedullary rod (LC-DCP-R) in a cadaveric, canine, femoral fracture-gap model. In vitro biomechanical study; nonrandomized, complete block (dog). Paired cadaveric canine femora (n = 10 dogs). Paired femurs with a mid-diaphyseal 20 mm gap were stabilized with either LCP or LC-DCP-R. Nondestructive testing up to 60% of body weight (BW) was followed by a continuous destructive test. Comparative structural properties, 3-dimensional (3D) interfragmentary motion, and plate linear strain were evaluated. Paired comparisons were made between LCP and LC-DCP-R. Stiffness after nondestructive testing was significantly lower for LCP with a mean (95% confidence interval [CI]) of 61 N/mm (46-76) versus 89 N/mm (67-110) for LC-DCP-R (P = .0072). Ultimate load to failure was significantly lower for LCP with a median (interquartile range [IQR]) of 270 N (247-286) versus 371.5 (353-385) for LC-DCP-R (P = .002). Axial motion at 60% BW was significantly higher for LCP with a median (IQR) of 1.01 mm (0.71-1.26) versus 0.36 mm (0.20-0.49) for LC-DCP-R (P = .002). Shear motion was significantly higher for LCP with a median (IQR) of 1.18 (0.78-1.58) versus 0.72 mm (0.45-1.00) for LC-DCP-R (P = .018). Strain was significantly higher for mid-LCP surface with a mean (95%CI) at 60% BW of 979 μdef (579-1378) versus 583 μdef (365-801) at mid-LC-DCP-R surface (P = .0153). The elastic limit strain of the plates was not different and was reached at a mean (95%CI) load of 241 N (190-292) for LCP versus 290 N (245-336) for LC-DCP-R (P = .12). The LC-DCP-R showed higher stiffness and resistance to failure, lower interfragmentary motion, and lower plate strain and stress compared to LCP. © Copyright 2016 by The American College of Veterinary Surgeons.

  8. A Biomechanical Comparison of 3.5 Locking Compression Plate Fixation to 3.5 Limited Contact Dynamic Compression Plate Fixation in a Canine Cadaveric Distal Humeral Metaphyseal Gap Model

    OpenAIRE

    Filipowicz, Dean

    2008-01-01

    Objective- To compare the biomechanical properties of 3.5 locking compression plate (LCP) fixation to 3.5 limited contact dynamic compression plate (LC-DCP) fixation in a canine cadaveric, distal humeral metaphyseal gap model in static axial compression and cyclic axial compression and torsion. Study Design- Biomechanical in vitro study. Sample Population- 30 paired humeri from adult, medium to large breed dogs. Methods- Testing was performed monotonically to failure in axial compres...

  9. Biomechanical Comparison of Cadaveric and Commercially Available Synthetic Osteoporotic Bone Analogues in a Locked Plate Fracture Model Under Torsional Loading.

    Science.gov (United States)

    Becker, Edward H; Kim, Hyunchul; Shorofsky, Michael; Hsieh, Adam H; Watson, Jeffrey D; OʼToole, Robert V

    2017-05-01

    Biomechanical studies of osteoporotic bone have used synthetic models rather than cadaveric samples because of decreased variability, increased availability, and overall ease of the use of synthetic models. We compared the torsional mechanical properties of cadaveric osteoporotic bone with those of currently available synthetic osteoporotic bone analogues. We tested 12 osteoporotic cadaveric humeri and 6 specimens each of 6 types of synthetic analogues. A 5-mm fracture gap model and posterior plating technique with 4.5-mm narrow 10-hole locking compression plate were used. Torque was applied to a peak of ±10 N·m for 1000 cycles at 0.3 Hz. Data were continuously collected during cyclical and ramped loading with a servohydraulic materials testing system. Cadaveric bone had a 17% failure rate before completing 1000 cycles. Three osteoporotic bone models had 100% failure (P Osteoporotic bone analogues had torsional mechanical properties different from those of osteoporotic cadaveric specimens. The differences between osteoporotic cadaveric humeri and synthetic osteoporotic bone analogues ranged from profound with complete catastrophic failure after a few cycles to subtler differences in stiffness and strain hardening. These findings suggest that different bone analogue models vary substantially in their torsional mechanical properties and might not be appropriate substitutes for cadaveric bone in biomechanical studies of osteoporotic bone.

  10. Usefulness of polyetheretherketone (PEEK) cage with plate augmentation for anterior arthrodesis in traumatic cervical spine injury.

    Science.gov (United States)

    Song, Kyung-Jin; Choi, Byung-Wan; Kim, Gyu-Hyung; Song, Ji-Hun

    2010-01-01

    Even though many clinical reports about cages have been documented in patients with degenerative disorders, reports were scarce for traumatic injury cases, and those cases using metal cages were restricted to only one-level injury. To evaluate the usefulness of polyetheretherketone (PEEK) cage and plate construction in anterior interbody fusions (AIF) for traumatic cervical spine injuries by analyzing radiographic changes and clinical outcomes. Retrospective study. Fifty-eight patients (91 levels) underwent cage and plate construction for treatment of traumatic cervical spine injury. The fusion rate, fusion time, changes of Cobb angle, subsidence rate, and adjacent level changes were assessed as a radiographic outcome. Clinical analysis includes the recovery rate on the American Spinal Injury Association (ASIA) impairment scale and the presence of the complications. We evaluated 58 patients (91 levels) who underwent surgery and had at least 24 months in follow-up study. Radiographic evaluation included the assessment of interbody fusion rate, fusion time, changes of Cobb angle, subsidence rate, and adjacent level changes. Clinical assessment was done by analyzing recovery state of ASIA impairment scale from preoperative period to the last follow-up and by evaluating complications. Fifty-four cases showed bony fusion within 3 months after the surgery. The mean Cobb angle between the vertebral bodies was 2.54 degrees before operation, 9.13 degrees after operation, and 8.39 degrees at the latest follow-up. The mean intervertebral disc height was increased by 3.01 mm after the operation, but the mean height was 2.17 mm shorter at the last follow-up than after postoperation. In terms of clinical results, five Grade A cases and one Grade B case as assessed by the ASIA impairment scale were unchanged until the last follow-up. Twenty-three cases of Grade C, 16 cases of Grade D, and 13 cases of Grade E improved to seven cases, 26 cases, and 19 cases, respectively. Three

  11. Adjacent segment pathology following anterior decompression and fusion using cage and plate for the treatment of degenerative cervical spinal diseases.

    Science.gov (United States)

    Song, Kyung-Jin; Choi, Byung-Wan; Kim, Jong-Kil

    2014-12-01

    Retrospective study. To analyze the incidence and prevalence of clinical adjacent segment pathology (CASP) following anterior decompression and fusion with cage and plate augmentation for degenerative cervical diseases. No long-term data on the use of cage and plate augmentation have been reported. The study population consisted of 231 patients who underwent anterior cervical discectomy and fusion (ACDF) with cage and plate for degenerative cervical spinal disease. The incidence and prevalence of CASP was determined by using the Kaplan-Meier survival analysis. To analyze the factors that influence CASP, data on preoperative and postoperative sagittal alignment, spinal canal diameter, the distance between the plate and adjacent disc, extent of fusion level, and the presence or absence of adjacent segment degenerative changes by imaging studies were evaluated. CASP occurred in 15 of the cases, of which 9 required additional surgery. At 8-year follow-up, the average yearly incidence was 1.1%. The rate of disease-free survival based on Kaplan-Meier survival analysis was 93.6% at 5 years and 90.2% at 8 years. No statistically significant differences in CASP incidence based on radiological analysis were observed. Significantly high incidence of CASP was observed in the presence of increased adjacent segment degenerative changes (pdegenerative cervical disease is associated with a lower incidence in CSAP by 1.1% per year, and the extent of preoperative adjacent segment degenerative changes has been shown as a risk factor for CASP.

  12. A biomechanical comparison between locked 3.5-mm plates and 4.5-mm plates for the treatment of simple bicondylar tibial plateau fractures: is bigger necessarily better?

    Science.gov (United States)

    Hasan, Saqib; Ayalon, Omri B; Yoon, Richard S; Sood, Amit; Militano, Ulises; Cavanaugh, Mark; Liporace, Frank A

    2014-06-01

    Evolution of periarticular implant technology has led to stiffer, more stable fixation constructs. However, as plate options increase, comparisons between different sized constructs have not been performed. The purpose of this study is to biomechanically assess any significant differences between 3.5- and 4.5-mm locked tibial plateau plates in a simple bicondylar fracture model. A total of 24 synthetic composite bone models (12 Schatzker V and 12 Schatzker VI) specimens were tested. In each group, six specimens were fixed with a 3.5-mm locked proximal tibia plate and six specimens were fixed with a 4.5-mm locking plate. Testing measures included axial ramp loading to 500 N, cyclic loading to 10,000 cycles and axial load to failure. In the Schatzker V comparison model, there were no significant differences in inferior displacement or plastic deformation after 10, 100, 1,000 and 10,000 cycles. In regards to axial load, the 4.5-mm plate exhibited a significantly higher load to failure (P = 0.05). In the Schatzker VI comparison model, there were significant differences in inferior displacement or elastic deformation after 10, 100, 1,000, and 10,000 cycles. In regards to axial load, the 4.5-mm plate again exhibited a higher load to failure, but this was not statistically significant (P = 0.21). In the advent of technological advancement, periarticular locking plate technology has offered an invaluable option in treating bicondylar tibial plateau fractures. Comparing the biomechanical properties of 3.5- and 4.5-mm locking plates yielded no significant differences in cyclic loading, even in regards to elastic and plastic deformation. Not surprisingly, the 4.5-mm plate was more robust in axial load to failure, but only in the Schatzker V model. In our testing construct, overall, without significant differences, the smaller, lower-profile 3.5-mm plate seems to be a biomechanically sound option in the reconstruction of bicondylar plateau fractures.

  13. Tibial plateau levelling osteotomy in 69 small breed dogs using conically coupled 1.9/2.5 mm locking plates. A clinical and radiographic retrospective assessment.

    Science.gov (United States)

    Cosenza, G; Reif, U; Martini, F M

    2015-01-01

    To report clinical experiences with the tibial plateau levelling osteotomy (TPLO) procedure in small breed dogs with cranial cruciate ligament (CCL) disease using specific, conically coupled, 1.9/2.5 mm locking plates and evaluating short-term complications and outcome. Medical records of small breed dogs (locking plates were reviewed retrospectively. The preoperative, postoperative and six to eight weeks postoperative tibial plateau angle (TPA) measurements were determined from the radiographic images. Lameness evaluation was assessed subjectively preoperatively and six to eight weeks postoperatively. Sixty-nine small breed dogs (n = 79 stifles) were included in the study. Mean (± SD) preoperative TPA was 29.0 ± 3.4°, postoperative TPA was 5.8 ± 2.5°, and six to eight weeks postoperative TPA was 7.3 ± 4.1°. Sixteen complications occurred in 12 out of 79 TPLO procedures: three were intra-operative (intra-articular screw placement) and 13 were postoperative complications, of which nine were identified as minor complications not requiring surgical reintervention, and four as major complications requiring additional surgical intervention, including tibial tuberosity fracture (n = 1), osteomyelitis (n = 1), screw failure (n = 1), and plate breakage (n = 1). Lameness scores by clinical assessment reduced from a median value of 3/4 preoperatively to 1/4 at six to eight weeks postoperatively. 1.9/2.5 mm locking plates appear to be a valid choice of implant for the stabilization of unilateral TPLO in small breed dogs.

  14. Locking compression plate versus revision-prosthesis for Vancouver type B2 periprosthetic femoral fractures after total hip arthroplasty.

    Science.gov (United States)

    Joestl, Julian; Hofbauer, Marcus; Lang, Nikolaus; Tiefenboeck, Thomas; Hajdu, Stefan

    2016-04-01

    Revision arthroplasty is currently the recommended treatment for periprosthetic femoral fractures after primary total hip arthroplasty (THA) and stem loosening (Vancouver B2). However, open reduction and internal fixation (ORIF) utilizing locking compression plate (LCP) might be an effective treatment with a reduced surgical time and less complex procedure in a typically elderly patient collective with multiple comorbidities. The purpose of this study was to compare the functional and radiographic outcomes in two cohorts with Vancouver B2 periprosthetic femoral fractures after primary THA, treated either by ORIF with LCP fixation, or by revision arthroplasty utilizing a non-cemented long femoral stem. 36 patients with Vancouver B2 periprosthetic femoral fractures following THA, who had been treated between 2000 and 2014, were reviewed. Eight fractures were treated with LCP fixation, fourteen fractures with the first-generation revision prosthesis (Helios), and fourteen fractures with the second-generation revision prosthesis (Hyperion). The patients were assessed clinically with the Parker mobility score and radiographically. A total of ten males and 26 females formed the basis of this report with an average age of 81 years (range, 64 to 96 years). All fractures treated with LCP fixation alone healed uneventfully and there were no signs of secondary stem migration, malalignement or plate breakage. The average surgical time was shorter in the ORIF cohort; however, the results were not statistically significant. The postoperative Parker mobility score at latest follow-up showed no difference between the groups. According to the results of the current study, we conclude that the use of LCP fixation can be a sufficient option for the treatment of Vancouver B2 periprosthetic femoral fractures correspondingly with femoral stem loosening. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. The outcome of super-cutaneous locked plate fixation with percutaneous reduction of displaced intra-articular calcaneal fractures.

    Science.gov (United States)

    El-Desouky, Ihab I; Abu Senna, Wissam

    2017-02-01

    Supercutaneous (external) fixation with locking plate is utilized for fixation of long bone fractures. One retrospective study for open reduction and supercutaneous fixation of the calcaneus is reported. We prospectively evaluated the use of this method of fixation combined with percutaneous reduction. Between January 2014 and June 2015, 32 displaced calcaneus fractures in 30 patients were stabilized with percutaneous reduction and super-cutaneous fixation. They were 24 males and six females. The mean age was 37.9±5.7 years (21-55). All cases were closed. The time to surgery, complications, radiographic alignment, and time to radiographic union were recorded. Clinical results at the final follow-up were assessed by evaluating Bohler's angles for the radiographic alignment, and the system of the American Orthopedic Foot and Ankle Society (AOFAS) for the functional outcome. According to the Sanders' classification, two cases were type II, 17 cases were type III and 13 cases were type IV. The preoperative average Bohler's angle was 10.57°±4.8. The postoperative X-ray films demonstrated that the average Bohler's angle improved to 29.07°±5.9 (pfracture is an effective method in type II and III and can be effective with type IV but with less favorable results. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Ultrathin quartz plate-based multilayer MoS2 for passively mode-locked fiber lasers (invited)

    Science.gov (United States)

    Jiang, Zike; Li, Jiarong; Chen, Hao; Wang, Jinzhang; Zhang, Wenfei; Yan, Peiguang

    2018-01-01

    We have grown ultrathin quartz plate-based multilayer molybdenum disulfide (MoS2) by chemical vapor deposition (CVD). When employed as saturable absorber (SA), the prepared MoS2 device exhibits remarkable merits (e.g. uniform thickness, high quality of crystal lattice high damage threshold easy fabrication and good practicability). The modulation depth, saturable intensity, and non-saturable loss of this SA device are measured to be 16.1%, 0.438 MW/cm2 and 44.6% respectively. By incorporating the SA into a typical ring cavity erbium-doped fiber laser, stable passive soliton mode-locked pulse is achieved with the repetition frequency of 0.987 MHz, the signal noise ratio (SNR) of 71.4 dB and the pulse duration of 2.17 ps. The experimental results demonstrate our MoS2-SA device to be an effective mode locker, and it is promising to be used in ultrafast photonics.

  17. Effect of four-corner fusion with locking plate without bone graft on functional recovery of the wrist: New treatment guidelines

    OpenAIRE

    Tielemans, Alexandre; Van Innis, Fernand; Troussel, Serge; Detrembleur, Christine; Libouton, Xavier; Lequint, Thierry

    2017-01-01

    We assessed the effect of four-corner intercarpal fusion with locking plate without bone graft on daily activities and pain in patients with stage II and III scapholunate advanced collapse and scaphoid nonunion. Twenty-one patients who underwent four-corner fusion with scaphoidectomy without bone graft were evaluated with the Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Visual Analog Scale (VAS) pain scores before and 16 months after surgery. We also compared postoperative grip ...

  18. Four-corner fusion: comparison of patient satisfaction and functional outcome of conventional K-wire technique vs. a new locking plate.

    Science.gov (United States)

    Hernekamp, J F; Reinecke, A; Neubrech, F; Bickert, B; Kneser, U; Kremer, T

    2016-04-01

    Four-corner fusion is a standard procedure for advanced carpal collapse. Several operative techniques and numerous implants for osseous fixation have been described. Recently, a specially designed locking plate (Aptus©, Medartis, Basel, Switzerland) was introduced. The purpose of this study was to compare functional results after osseous fixation using K-wires (standard of care, SOC) with four-corner fusion and locking plate fixation. 21 patients who underwent four-corner fusion in our institution between 2008 and 2013 were included in a retrospective analysis. In 11 patients, osseous fixation was performed using locking plates whereas ten patients underwent bone fixation with conventional K-wires. Outcome parameters were functional outcome, osseous consolidation, patient satisfaction (DASH- and Krimmer Score), pain and perioperative morbidity and the time until patients returned to daily work. Patients were divided in two groups and paired t-tests were performed for statistical analysis. No implant related complications were observed. Osseous consolidation was achieved in all cases. Differences between groups were not significant regarding active range of motion (AROM), pain and function. Overall patient satisfaction was acceptable in all cases; differences in the DASH questionnaire and the Krimmer questionnaire were not significant. One patient of the plate group required conversion to total wrist arthrodesis without implant-related complications. Both techniques for four-corner fusion have similar healing rates. Using the more expensive locking implant avoids a second operation for K-wire removal, but no statistical differences were detected in functional outcome as well as in patient satisfaction when compared to SOC.

  19. Treatment of type 2 and 4 olecranon fractures with locking compression plate (LCP) osteosynthesis in horses: a prospective study (2002-2008)

    OpenAIRE

    Jackson, M; Kummer, M; Auer, J; Hagen, R; Fürst, A

    2011-01-01

    This prospective study describes a series of 18 olecranon fractures in 16 horses that were treated with locking compression plates (LCP). Twelve of the 18 fractures were simple (type 2), whereas six were comminuted (type 4). Six fractures were open and 12 were closed. Each horse underwent LCP osteosynthesis consisting of open reduction and application of one or two LCP. Complete fracture healing was achieved in 13 horses. Three horses had to be euthanatized: two because of severe infection an...

  20. [Application of the expanding forming under the plate through cervical spatium intermusculare approach in treating multi-segmental myelopathic cervical spondylosis].

    Science.gov (United States)

    Zhan, Bei-lei; Ye, Zhou

    2015-09-01

    To investigate the application of the expanding forming under the plate through cervical spatium intermusculare approach to treat multi-segmental myelopathic cervical spondylosis. From July 2005 to June 2013, 25 patients with multi-segmental myelopathic cervical spondylosis were treated by the expanding forming under the plate through cervical spatium intermusculare approach including 16 males and 9 females with an average age of 56.5 years old ranging from 35 to 78 years old. Among them, 10 cases were onset without causes slowly, 7 cases were onset without causes suddenly, 8 cases were onset after mild trauma or tired. JOA scoring, incidence of postoperative axial symptoms and imaging studies were used to evaluate the effect. Twenty-five cases were followed up for 6 months to 7 years and 6 months with an average of 2 years and 9 months. There were no infection, cerebrospinal fluid leakage after the operation, and complications such as nerve damage were occurred. The operation time was 120 to 150 min, the bleeding was 300 to 500 ml. Imaging examination showed vertebral canal sagittal diameter increased, the vertebral canal increased significantly in the cross sectional area of the spinal cord, cervical curvature was straighten in 4 cases (2 cases of them became normal sequence). There were no more cases of cervical protruding and segmental instability increased. Postoperative walking ability enhanced, the finger activity of majority of patients improved on flexibility, grip strength, and accuracy of using chopsticks improved, numbness and chest waist band feeling had different degree of reduce, preoperative urine impairment were improved to varying degrees. Preoperative JOA scores were 3 to 13 points with an average of (8.86 ± 4.25) points; Postoperative 12 months' JOA scores were 7 to 17 points with an average of (13.76 ± 3.56) points, period was 60.19% in average, JOA score had statistically difference between before and after operation (P spondylosis, through

  1. [Retrospective analysis of AO 42A-B type tibia fractures treated with percutaneus locked plating and intramedullary nailing].

    Science.gov (United States)

    Bilgili, Fuat; Kılıç, Ayhan; Sökücü, Sami; Parmaksızoğlu, Atilla Sancar; Çepni, Kamil Serdar; Kabukçuoğlu, Yavuz Selim

    2016-01-01

    In this study, the results of AO 42A and 42B type tibia fractures treated with intramedullary nail (IMN) and percutaneus locking plate (PLP) were evaluated. The complications were examined, and it was questioned whether the type of fixation had an effect on union time and functional results. Forty-two patients with extraarticular distal tibial fractures were enrolled in this retrospective study. Eighteen patients were treated with closed IMN (Group I) and 24 patients were treated with PLP fixation (Group II). Mean age was 41 (range: 16-70) years; thirty-two of the patients were men. Fractures were classified according to the AO classification system. Union time, functional results and complications (malunion, malalignment, infection) were compared. The American Orthopaedic Foot and Ankle Surgery (AOFAS) scoring was used to compare functional results. The average follow-up period was 20 (12-32) months for Group I and 23 (13-36) months for Group II. The average union time was 16 (12-24) weeks in Group I and 19 (range: 16-24) weeks in Group II (p=0.002). The AOFAS scoring was 85 (range: 69-100) points in Group I and 81 (range: 60-95) points in Group II. The difference in AOFAS scoring was not significant (p=0.06). Two patients had nonunion in Group II. Two patients in Group I and three patients in Group II had malalignment. We suggest that IMN can provide early healing time. Although it is not statistically significant, complication rate was lower and functional results were better in patients treated with IMN.

  2. Biomechanical Comparison of Locking Compression Plate versus Positive Profile Pins and Polymethylmethacrylate for Stabilization of the Canine Lumbar Vertebrae.

    Science.gov (United States)

    Sturges, Beverly K; Kapatkin, Amy S; Garcia, Tanya C; Anwer, Cona; Fukuda, Shimpei; Hitchens, Peta L; Wisner, Tristan; Hayashi, Kei; Stover, Susan M

    2016-04-01

    To compare the stiffness, angular deformation, and mode of failure of lumbar vertebral column constructs stabilized with bilateral pins and polymethylmethacrylate (Pin-PMMA) or with a unilateral (left) locking compression plate (LCP) with monocortical screws. Ex vivo biomechanical, non-randomized. Cadaveric canine thoracolumbar specimens (n=16). Thoracolumbar (T13-L3) vertebral specimens had the L1-L2 vertebral motion unit stabilized with either Pin-PMMA or LCP. Stiffness in flexion, extension, and right and left lateral bending after nondestructive testing were compared between intact (pretreated) specimens and Pin-PMMA, and LCP constructs. The Pin-PMMA and LCP constructs were then tested to failure in flexion and left lateral bending. Both the Pin-PMMA and LCP constructs had reduced range of motion at the stabilized L1-L2 vertebral motion unit compared to intact specimens. The Pin-PMMA constructs had less range of motion for the flexion elastic zone than LCP constructs. The Pin-PMMA constructs were stiffer than intact specimens in flexion, extension, and lateral bending, and stiffer than LCP constructs in flexion and left lateral bending. The Pin-PMMA constructs had less angular deformation at construct yield and lower residual deformation at L1-L2 than LCP constructs after destructive testing to failure in flexion. The Pin-PMMA constructs were stiffer, stronger, and had less deformation at yield than LCP constructs after destructive testing to failure in lateral bending. Most constructs failed distant to the implant and fixation site. Pin-PMMA constructs had greater lumbar vertebral stiffness and reduced ROM than LCP constructs; however, both Pin-PMMA and LCP constructs were stronger than intact specimens. © Copyright 2016 by The American College of Veterinary Surgeons.

  3. Cervicitis

    Science.gov (United States)

    ... intercourse or during a cervical exam, and abnormal vaginal discharge. However, it's also possible to have cervicitis and ... symptoms, they may include: Large amounts of unusual vaginal discharge Frequent, painful urination Pain during intercourse Bleeding between ...

  4. Outcome of Repair of Distal Radial and Ulnar Fractures in Dogs Weighing 4 kg or Less Using a 1.5-mm Locking Adaption Plate or 2.0-mm Limited Contact Dynamic Compression Plate.

    Science.gov (United States)

    Nelson, Thomas A; Strom, Adam

    2017-11-01

    Objectives  Retrospective evaluation of repairing distal radial and ulnar fractures in small breed dogs with the Synthes 1.5-mm locking Adaption plate system and compare results in a similar group of patients repaired with the Synthes 2.0-mm limited contact-dynamic compression plate (LC-DCP). Methods  Electronic medical records from one specialty referral centre were reviewed from March 21, 2010, to October 9, 2015, for patients weighing less than or equal to 4 kg that had a distal one-third radial and ulnar fracture repaired with a Synthes 1.5-mm locking adaption plate or Synthes 2.0-mm LC-DCP. Further inclusion criteria included application of the plate to the cranial surface of the radius via open reduction and internal fixation. Results  Six 1.5-mm Adaption plates and 7 2.0-mm LC-DCPs were used to repair 13 distal radial and ulnar fractures in 12 dogs. There were three major complications in the 1.5-mm adaption plate group (one plate fracture, one screw pull-out and one fracture through a distal screw hole) and one major complication in the 2.0-mm LC-DCP group due to a re-fracture. All patients without a complication had good or excellent functional outcome. Clinical Significance  The authors recommend that the 1.5-mm Adaption plate be used only when a 2.0-mm LC-DCP would not allow for a minimum of two screws in the distal segment and at the discretion of the surgeon. Schattauer GmbH Stuttgart.

  5. Cervical spinal cord compression from delayed epidural scar tissue formation around plate lead for SCS. Case report and literature review.

    Science.gov (United States)

    Guzzi, G; Volpentesta, G; Chirchiglia, D; Della Torre, A; Lavano, F; Lavano, A

    2015-10-02

    Cervical spinal compression is a serious and rare complication of spinal cord stimulation (SCS) that can occur using leads placed via open surgical approach. The present report describe a case of cervical plate lead implant that developed spinal and radicular compression symptoms after seven years due to the growth of fibrotic epidural mass at the level of lead. A review of literature is provided. A 59-year-old woman with 3-year history of left arm post-traumatic complex regional pain syndrome (CRPS) was treated with SCS performed with the implant of paddle lead in the epidural space from C3-C5. Seven years later she reported progressive paresthesia along the spine and the limbs, gait ataxia with sensation of weakness in the legs, increased muscle tone and tendon reflexes in the lower extremities and decrease in effectiveness of stimulation. Cervical CT showed a tissue mass into the cervical canal posteriorly to the lead. This finding was confirmed by MR performed after lead removal that also allowed to document the amount of spinal cord compression. The patient underwent C4-C5-C6 laminectomy and a thick scar was removed from the dura. After surgery there was progressive and incomplete improvement of neurological signs but symptoms related to algodystrophy recurred partly. The formation of hypertrophic epidural scar tissue at the level of lead implant must be taken into consideration in presence of the onset of progressive cervical myelopathy in patient treated with SCS using laminectomy lead.

  6. [The clinical value of end plate rings in preventing subsidence of titanium cage in anterior cervical corpectomy and fusion surgery].

    Science.gov (United States)

    He, Lei; Qian, Yu; Jin, Yi-Jun; Fan, Liang; Lü, Zuo

    2014-09-01

    To evaluate the clinical results of using end plate rings in preventing subsidence of titanium cage in anterior cervical corpectomy and fusion (ACCF) surgery. The clinical data of 71 patients with cervical spondylotic myelopathy underwent ACCF in single segment from February 2008 to February 2011 were retrospectively analyzed. There were 38 males and 33 females, aged from 39 to 74 years old with a mean of 53.8 years. Thirty-three were used end plate rings and thirty-eight were not used (end plate rings group and no end plate ring group, respectively). The Japanese Orthopaedic Association (JOA) score, Odom's scale, imaging data were used to evaluate the clinical effects. Imaging data including Cobb angle of fusion segment, intervertebral height of anterior border (Da) and posterior border (Dp), the mean intervertebral height (Dm). All patients were followed up from 13 to 34 months with an average of 19.5 months. Between two groups, there was no significant difference in Cobb angle of fusion segment and the mean intervertebral height (Dm) before surgery and one week after surgery. Whereas, one year after surgery, the Cobb angle of end plate ring group was (9.4 ± 3.8) degrees, and contral group was (7.5 ± 3.9) degrees, which was significantly lower than that of end plate ring group. Meanwhile, the Dm of end plate ring group was (57.3 ± 2.2) mm, and no end ring group was (55.2 ± 2.6) mm which was significantly lower than that of end plate ring group. The subsidence in end plate ring group was 57.6%, and was 78.9% in no end plate ring group. There was no significant difference in JOA score before and after surgery between two groups. At 1 year after operation, 90.9% (30/33) got excellent or good results in end plate ring group, 89.5% (33/38) got excellent or good results in contral group. The use of end plate rings could not completely prevent the subsidence of titanium cage, however, which can decrease the occurrence rate of the subsidence and lessen its degree.

  7. Advantage and limitations of a minimally-invasive approach and early weight bearing in the treatment of tibial shaft fractures with locking plates.

    Science.gov (United States)

    Adam, P; Bonnomet, F; Ehlinger, M

    2012-09-01

    Intramedullary nailing is a common method of treating tibial shaft fractures. However, precise control of reduction at the proximal and distal quarters is difficult to achieve. The purpose of this study was to assess the results of plating using locking screws and the feasibility of a minimally-invasive approach. All patients with tibial shaft fracture treated by means of locking plates from January 2004 to October 2006. Thirty-two fractures were treated in 32 patients with a mean age of 43.8 years. Internal fixation with a locking plate and screw construct, using a minimally-invasive or standard approach. Surgical approach, time to weight bearing, complications and their type, time to bone union, alignment in the frontal and sagittal planes on anteroposterior and lateral radiographs. The minimally-invasive approach was performed in 28 cases and immediate full weight bearing allowed in 25 cases. At a mean follow-up of 27 months, two patients had died and two patients were lost to follow-up. The mean time to bone union was 9.1 weeks. Four cases had a complicated course: one infection, one compartment syndrome, one hardware breakage and one pseudarthrosis. Six cases ended up with valgus malunion exceeding 5° in the frontal plane, already present at the time of surgery. Where a minimally-invasive approach can be performed, immediate pain-free weight bearing can be allowed without further displacement at follow-up. The observed rate of malunion underlines the need for adequate reduction and shows that the rationale for success does not solely depend on the plate anatomic design but also on the skills of the operating surgeon. Level I university regional hospital Cohort study. Copyright © 2012. Published by Elsevier Masson SAS.

  8. A biomechanical comparison study of a modern fibular nail and distal fibular locking plate in AO/OTA 44C2 ankle fractures.

    Science.gov (United States)

    Switaj, Paul J; Fuchs, Daniel; Alshouli, Mohammed; Patwardhan, Avinash G; Voronov, Leonard I; Muriuki, Muturi; Havey, Robert M; Kadakia, Anish R

    2016-09-15

    A lateral approach with open reduction and internal fixation with a plate is a very effective technique for the majority of distal fibular fractures. However, this open approach for ankle fixation may be complicated by wound dehiscence and infection, especially in high-risk patients. An alternative to plating is an intramedullary implant, which allows maintenance of length, alignment, and rotation and which allows for decreased soft tissue dissection. While there has been clinical data suggesting favorable short-term outcomes with these implants, there is no current biomechanical literature investigating this technology in this particular fracture pattern. This study sought to biomechanically compare an emerging technology with an established method of fixation for distal fibular fractures that traditionally require an extensive exposure. Ten matched cadaveric pairs from the proximal tibia to the foot were prepared to simulate an Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) 44C2 ankle fracture and randomized to fixation with a distal fibular locking plate or intramedullary fibular rod. A constant 700-N axial load was applied, and all specimens underwent testing for external rotation stiffness, external rotation cyclic loading, and torque to failure. The syndesmotic diastasis, stiffness, torque to failure, angle at failure, and mode of failure were obtained from each specimen. There was no significant difference in syndesmotic diastasis during cyclic loading or at maximal external rotation between the rod and plate groups. Post-cycle external rotation stiffness across the syndesmosis was significantly higher for the locking plate than the fibular rod. There was no significant difference between the rod and plate in torque at failure or external rotation angle. The majority of specimens had failure at the syndesmotic screw. In the present cadaveric study of an AO/OTA 44C2 ankle fracture, a modern fibular rod demonstrated less

  9. Biomechanical comparison of two locking plate constructs under cyclic torsional loading in a fracture gap model. Two screws versus three screws per fragment.

    Science.gov (United States)

    Bilmont, A; Palierne, S; Verset, M; Swider, P; Autefage, A

    2015-01-01

    The number of locking screws required per fragment during bridging osteosynthesis in the dog has not been determined. The purpose of this study was to assess the survival of two constructs, with either two or three screws per fragment, under cyclic torsion. Ten-hole 3.5 mm stainless steel locking compression plates (LCP) were fixed 1 mm away from bone surrogates with a fracture gap of 47 mm using two bicortical locking screws (10 constructs) or three bicortical locking screws (10 constructs) per fragment, placed at the extremities of each LCP. Constructs were tested in cyclic torsion (range: 0 to +0.218 rad) until failure. The 3-screws constructs (29.65 ± 1.89 N.m/rad) were stiffer than the 2-screws constructs (23.73 ± 0.87 N.m/rad), and therefore, were subjected to a greater torque during cycling (6.05 ± 1.33 N.m and 4.88 ± 1.14 N.m respectively). The 3-screws constructs sustained a significantly greater number of cycles (20,700 ± 5,735 cycles) than the 2-screws constructs (15,600 ± 5,272 cycles). In most constructs, failure was due to screw damage at the junction of the shaft and head. The remaining constructs failed because of screw head unlocking, sometimes due to incomplete seating of the screw head prior to testing. Omitting the third innermost locking screw during bridging osteosynthesis led to a reduction in fatigue life of 25% and construct stiffness by 20%. Fracture of the screws is believed to occur sequentially, starting with the innermost screw that initially shields the other screws.

  10. The service impact of failed locking plate fixation of distal tibial fractures: a service and financial evaluation at a major trauma centre.

    Science.gov (United States)

    Kent, Michael; Mumith, Aadil; McEwan, Jo; Hancock, Nicholas

    2015-12-01

    The surgical treatment of distal tibial fractures is challenging and controversial. Recently, locking plate fixation has become popular, but the outcomes of this treatment are mixed with complication rates as high as 50 % in the published literature. There are no reports specifically relating to the financial and resource costs of failed treatment in the literature. Retrospective service analysis of patients who had undergone locking plate fixation of a distal third tibial fracture between 2008 and 2011 with at least 12 months follow-up. Rates of readmission, reoperation, bony union and infection were ascertained. The financial and resource (hospital stay and number of outpatient appointments) implications of failed treatment were calculated. Forty-two patients were identified. There were 31 type A fractures, one type B fracture and 10 type C fractures. Three injuries were open. Twenty patients were treated with minimally invasive percutaneous osteosynthesis (MIPO). The readmission and reoperation rates were 26 % (n = 11) and 19 % (n = 8), respectively. A total of 89 % of readmissions were due to infection. All patients had received appropriate antibiotic regimens. The average costs of successful and failed treatment were £ 5538 and £ 18,335, respectively. The average time to union was 24.5 weeks. The rate of non-union was 21 % (n = 9). The rate of infection was 28 % (n = 12), with all patients with open fracture incurring an infection. Tourniquet time had no effect on the incidence of complications. Smokers were more likely to incur a complication (p service following failure of locking plate treatment of these fractures, but the outcomes were similar to series published in the literature. Readmission rates were high following these injuries, and failed treatment was costly and had a significant impact on hospital resources. The implementation of major trauma networks and centralised subspecialised units should improve quality and value for money.

  11. Externalised locking compression plate as an alternative to the unilateral external fixator: a biomechanical comparative study of axial and torsional stiffness.

    Science.gov (United States)

    Ang, B F H; Chen, J Y; Yew, A K S; Chua, S K; Chou, S M; Chia, S L; Koh, J S B; Howe, T S

    2017-04-01

    External fixators are the traditional fixation method of choice for contaminated open fractures. However, patient acceptance is low due to the high profile and therefore physical burden of the constructs. An externalised locking compression plate is a low profile alternative. However, the biomechanical differences have not been assessed. The objective of this study was to evaluate the axial and torsional stiffness of the externalised titanium locking compression plate (ET-LCP), the externalised stainless steel locking compression plate (ESS-LCP) and the unilateral external fixator (UEF). A fracture gap model was created to simulate comminuted mid-shaft tibia fractures using synthetic composite bones. Fifteen constructs were stabilised with ET-LCP, ESS-LCP or UEF (five constructs each). The constructs were loaded under both axial and torsional directions to determine construct stiffness. The mean axial stiffness was very similar for UEF (528 N/mm) and ESS-LCP (525 N/mm), while it was slightly lower for ET-LCP (469 N/mm). One-way analysis of variance (ANOVA) testing in all three groups demonstrated no significant difference (F(2,12) = 2.057, p = 0.171).There was a significant difference in mean torsional stiffness between the UEF (0.512 Nm/degree), the ESS-LCP (0.686 Nm/degree) and the ET-LCP (0.639 Nm/degree), as determined by one-way ANOVA (F(2,12) = 6.204, p = 0.014). A Tukey post hoc test revealed that the torsional stiffness of the ESS-LCP was statistically higher than that of the UEF by 0.174 Nm/degree (p = 0.013). No catastrophic failures were observed. Using the LCP as an external fixator may provide a viable and attractive alternative to the traditional UEF as its lower profile makes it more acceptable to patients, while not compromising on axial and torsional stiffness. Cite this article: B. F. H. Ang, J. Y. Chen, A. K. S. Yew, S. K. Chua, S. M. Chou, S. L. Chia, J. S. B. Koh, T. S. Howe. Externalised locking compression plate as an alternative to the

  12. A biomechanical comparison of conventional dynamic compression plates and string-of-pearls™ locking plates using cantilever bending in a canine Ilial fracture model.

    Science.gov (United States)

    Kenzig, Allison R; Butler, James R; Priddy, Lauren B; Lacy, Kristen R; Elder, Steven H

    2017-07-13

    Fracture of the ilium is common orthopedic injury that often requires surgical stabilization in canine patients. Of the various methods of surgical stabilization available, application of a lateral bone plate to the ilium is the most common method of fixation. Many plating options are available, each having its own advantages and disadvantages. The purpose of this study was to evaluate the biomechanical properties of a 3.5 mm String-of-Pearls™ plate and a 3.5 mm dynamic compression plate in a cadaveric canine ilial fracture model. Hemipelves were tested in cantilever bending to failure and construct stiffness, yield load, displacement at yield, ultimate load, and mode of failure were compared. The mean stiffness of dynamic compression plate (116 ± 47 N/mm) and String-of-Pearls™ plate (107 ± 18 N/mm) constructs, mean yield load of dynamic compression plate (793 ± 333 N) and String-of-Pearls™ plate (860 ± 207 N) constructs, mean displacement at yield of dynamic compression plate (8.6 ± 3.0 mm) and String-of-Pearls™ plate (10.2 ± 2.8 mm) constructs, and ultimate load at failure of dynamic compression plate (936 ± 320 N) and String-of-Pearls™ plate (939 ± 191 N) constructs were not significantly different. No differences were found between constructs with respect to mode of failure. No significant biomechanical differences were found between String-of-Pearls™ plate and dynamic compression plate constructs in this simplified cadaveric canine ilial fracture model.

  13. Cage subsidence after anterior cervical discectomy and fusion using a cage alone or combined with anterior plate fixation.

    Science.gov (United States)

    Pinder, E M; Sharp, D J

    2016-04-01

    To compare the extent of cage subsidence after anterior cervical discectomy and fusion (ACDF) using a cage alone or combined with anterior plate fixation, and to assess the effect of end plate removal on cage subsidence. Records of 23 men and 13 women aged 32 to 82 (mean, 54) years who underwent ACDF for 61 levels using the Solis cage alone (n=46) or combined with anterior plate fixation (n=15) were reviewed. The extent of cage subsidence was determined by comparing immediately postoperative (within one week) with final follow-up radiographs. Cage subsidence was defined as the sum subsidence of the superior and inferior part of the cage into the vertebral body. Mild and major cage subsidence was defined as ≤2 mm and >2 mm, respectively. Patients who underwent ACDF using a cage alone or combined with anterior plate fixation were comparable in terms of age, gender, follow-up duration, and number of levels decompressed. Cage subsidence occurred in 33 (54%) of the 61 levels decompressed. In the cage alone group, the extent of cage subsidence was greater (1.68 vs. 0.57 mm, p=0.039) and the rate of major cage subsidence was higher (28% vs. 7%, p=0.08). The inferior part of the cage was more vulnerable to subsidence compared with the superior part (median subsidence: 3.0 vs. 1.4 mm, psubsidence occurred more often when the end plate was removed rather than preserved (58% vs. 18%, psubsidence was greater after ACDF with cage alone. Cage subsidence occurred more often when the end plate was removed. Additional anterior plate fixation is recommended when the end plate is removed.

  14. Effect of four-corner fusion with locking plate without bone graft on functional recovery of the wrist: New treatment guidelines.

    Science.gov (United States)

    Tielemans, A; Van Innis, F; Troussel, S; Detrembleur, C; Libouton, X; Lequint, T

    2017-06-01

    We assessed the effect of four-corner intercarpal fusion with locking plate without bone graft on daily activities and pain in patients with stage II and III scapholunate advanced collapse and scaphoid nonunion. Twenty-one patients who underwent four-corner fusion with scaphoidectomy without bone graft were evaluated with the Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Visual Analog Scale (VAS) pain scores before and 16 months after surgery. We also compared postoperative grip strength between the operated and the healthy side. A principal component analysis was used to establish the relationship between functional benefit, immobilization period and number of physiotherapy sessions. We compared our results with published data. VAS and QuickDASH scores improved significantly. Loss of strength was observed postoperatively. QuickDASH score improved the most with a short immobilization period. No significant difference was found relative to the literature for follow-up time, range of motion, grip strength and QuickDASH score. All patients had bone fusion after 1 year. Four-corner fusion with locking plate is a procedure that reduces pain and improves functional scores. Our results are equal to those reported in the literature with bone graft. The union rate seemed high despite the absence of bone graft but was only assessed by x rays. This study allowed us to establish a treatment guideline: a shorter immobilization leads to better recovery. Copyright © 2017. Published by Elsevier Masson SAS.

  15. A COMPARATIVE STUDY OF PROXIMAL FEMUR LOCKING COMPRESSION PLATE VERSUS PROXIMAL FEMORAL NAILING IN THE MANAGEMENT OF COMMINUTED TROCHANTERIC AND SUBTROCHANTERIC FRACTURE

    Directory of Open Access Journals (Sweden)

    Satish Koti

    2016-11-01

    Full Text Available BACKGROUND Fractures of proximal femur and hip are relatively common injuries in elderly individuals constituting 11.6% of total fractures. The latest implant for management of intertrochanteric fracture is Proximal Femoral Locking Compression Plate (PF-LCP. In this study, we compare the clinical outcome of fractures treated by proximal femoral nail with that of proximal femur locking compression plate. MATERIALS AND METHODS The present study consists of 24 elderly patients of peritrochanteric factures of femur satisfying the inclusion criteria who were treated with PF-LCP or PFN in Department of Orthopaedics, S.V.R.R.G.G.H, Tirupati, during a period between December 2013 to October 2015. RESULTS 24 cases were treated with PF-LCP or PFN in a randomised pattern who satisfied inclusion criteria. Intraoperative complication were found to be more with PF-LCP in contrast to PFN. Postoperative rehabilitation was easier with PFN though not statistically significant functional and anatomical outcomes were found to be better with PFN. CONCLUSION Both PFN and PF-LCP have good effectiveness in the treatment of intertrochanteric fractures with the lateral unsubstantial femoral wall in the elderly patients. Each has its own advantages and disadvantages. Further studies with large number of patients and long-term follow up is needed to determine the optimal implant for the internal fixation of comminuted pertrochanteric femoral fractures.

  16. Experiences using the Fixin locking plate system for the stabilization of appendicular fractures in dogs: a clinical and radiographic retrospective assessment.

    Science.gov (United States)

    Nicetto, T; Petazzoni, M; Urizzi, A; Isola, M

    2013-01-01

    To retrospectively evaluate the stabilization of appendicular fractures in dogs using the Fixin locking plate system. Medical records and radiographs of dogs with fractures stabilized with the Fixin system in the period from May 2005 to September 2010 were reviewed. For each patient, data pertaining to signalment, the nature of the fracture, implants used, and evidence of fracture healing were recorded. The outcome and complications were determined from clinical and radiographic follow-up examinations. Limb function was evaluated between 40 days and 90 days postoperatively. Owners of pets with complications were contacted by phone for long-term follow-up. Eighty-two fractures in seventy-five dogs met the inclusion criteria for the study. Radiographic re-examinations were carried out between eight days to two years (median 60 days) following surgery. Seventy-three out of 82 fractures (89%) reached union without complications. Major complications were seen in six dogs (7%). Limb function was graded as 'normal' in 73/75 (97%) dogs and 'mild lameness' in 2/75 (3%) cases. Despite a modest complication rate, the Fixin locking bone plating system appears to be an acceptable choice of implant for the stabilization of appendicular fractures in dogs.

  17. Short-term outcome and complications of TPLO using anatomically contoured locking compression plates in small/medium-breed dogs with "excessive" tibial plateau angle.

    Science.gov (United States)

    Barnes, D C; Trinterud, T; Owen, M R; Bush, M A

    2016-06-01

    To report short-term radiographic and clinical outcome and complications following tibial plateau levelling osteotomy for the treatment of cranial cruciate ligament insufficiency in dogs less than 18·1 kg with tibial plateau angle greater than 35° using anatomically contoured six-hole locking compression plates. Retrospective data were collected on: preoperative, postoperative and follow-up tibial plateau angles, plateau segment rotation, tibial tuberosity width and length of the cranial aspect of tibial tuberosity segment from the patellar tendon insertion and rotation of the tibial plateau below the level of the insertion of the patellar ligament. In 26 small dogs (29 stifles in total), mean preoperative, postoperative and follow-up tibial plateau angles were 38·2°, 4·8°, and 4·4°, respectively. Documented postoperative complications were limited to patellar tendinopathy in a single case (3·4%) and tibial tuberosity or fibula fracture were not observed. Short-term radiographic and clinical outcome of tibial plateau levelling osteotomy stabilised with anatomically contoured six-hole locking compression plates for the treatment of small dogs with large tibial plateau angle suggests a very low risk of complications. Rotation beyond the "safe point" is necessary to perform full rotation in some cases, but does not appear to incur an increased risk of tibial tuberosity fracture. © 2016 British Small Animal Veterinary Association.

  18. Complex angular and torsional deformities (distal femoral malunions). Preoperative planning using stereolithography and surgical correction with locking plate fixation in four dogs.

    Science.gov (United States)

    DeTora, Michael D; Boudrieau, Randy J

    2016-09-20

    To describe the surgical technique of complex distal femoral deformity correction with the aid of stereolithography apparatus (SLA) biomodels, stabilized with locking plate fixation. Full-size replica epoxy bone biomodels of the affected femurs (4 dogs/ 5 limbs) were used as templates for surgical planning. A rehearsal procedure was performed on the biomodels aided by a guide wire technique and stabilized with locking plate fixation. Surgery performed in all dogs was guided by the rehearsal procedure. All pre-contoured implants were subsequently used in the definitive surgical procedure with minimal modification. All dogs had markedly improved, with near normal functional outcomes; all but one had a mild persistent lameness at the final in-hospital follow-up examination (mean: 54.4 weeks; range: 24-113 weeks after surgery). All femurs healed without complications (mean: 34 weeks, median: 12 weeks; range: 8-12 weeks for closing osteotomies, and 26-113 weeks for opening wedge osteotomies). Long-term follow-up examination (mean: 28.6 months; range: 5-42 months) revealed all but one owner to be highly satisfied with the outcome. Complications were observed in two dogs: prolonged tibiotarsal joint decreased flexion that resolved with physical therapy. In one of these dogs, iatrogenic transection of the long digital extensor tendon was repaired, and the other had a peroneal nerve neurapraxia. Stereolithography apparatus biomodels and rehearsal surgery simplified the definitive surgical corrections of complex femoral malunions and resulted in good functional outcomes.

  19. Biomechanical comparison of the stable efficacy of two anterior plating systems.

    Science.gov (United States)

    Yang, Saiwei; Wang, Lee-Wei

    2003-07-01

    To compare the immediate stable efficacy and load sharing effect of two types of anterior cervical screw-plating instrumentations: the Morscher Synthes titanium locking screw-plate system and the Caspar trapezoidal screw-plate system. Fresh porcine cervical spines with intact, two surgery unstable models, and then reconstructed with or without screw-plating instruments were compared in three physiological loading conditions. Two markedly instrumentation systems--Morscher Synthes titanium cervical locking screw-plate and Caspar trapezoidal screw-plate systems are commonly used in management of complex cervical spine disorders. Although the biomechanical study showed that the lower cost Caspar system performed superior in extension before and after plate fatigue, the clinic evaluations of two systems were contradictory. So (1) does the titanium cervical locking plate system pay for its higher cost? and (2) what is the load sharing character of strut graft in one level corpectomy? Eight fresh ligamentous porcine cervical spines from C3 to C7 were undergone axial compression, rotation and sagittal flexion tests. The biomechanical experiment was sequentially repeated for the intact, C5-6 discectomy, C5 corpectomy, and then stabilized by either type of plate fixation devices with or without polymethylmethacrylate bone cement grafting. Strains measured by an extensometer across the operated motion segment were used as the index of stability. Analysis of the strain data showed both types of anterior fixation plate systems provided adequate-restored stability for the spinal column only aided with polymethylmethacrylate construction. Statistically, there was no significant difference in biomechanical evaluation for the stability effect between much cost Morscher Synthes plate and Caspar plate system (pfailure. Statistically both systems showed similar stable efficacy, however, the Morscher Synthes cervical locking plate system might provide better stable effect in higher

  20. Cervicitis

    Science.gov (United States)

    ... a sexually transmitted infection, such as chlamydia or gonorrhea. Cervicitis can develop from noninfectious causes, too. Successful ... result from common sexually transmitted infections (STIs), including gonorrhea, chlamydia, trichomoniasis and genital herpes. Allergic reactions. An ...

  1. Fuel lock down device

    International Nuclear Information System (INIS)

    Bevilacqua, F.; Groves, M.D.

    1979-01-01

    Disclosed is a lock down device for restraining a nuclear fuel assembly against hydraulic flow forces having cantilever leaf springs on the fuel assembly lower end fitting which lock into recesses in the fuel alignment pins located on the core support plate

  2. Deep surgical site infection after anterior decompression and fusion with plate fixation for cervical spondylotic radiculopathy or myelopathy.

    Science.gov (United States)

    Guo, Qunfeng; Zhang, Mei; Wang, Liang; Lu, Xuhua; Ni, Bin

    2016-02-01

    To analyze the diagnosis and management of deep surgical site infection (SSI) with implant involved after anterior decompression and fusion for cervical spondylotic radiculopathy/myelopathy (CSR/CSM). Data of the patients who underwent anterior cervical decompression and fusion with plate fixation due to CSR/CSM were retrospectively reviewed. Cases with postoperative deep SSI with implant involved were identified and analyzed. A total of 1287 patients were finally included. Five patients (0.4%) were found to be with deep SSI. Bone fusion was not obtained when SSI was confirmed in each patient. Three cases were cured using one or two debridement and postoperative antibiotic therapy. Two cases with delayed diagnosis needed anterior implants removal, interbody fusion with autologous iliac bone and posterior lateral mass screw fixation at the first/second debridement. One of the two patients developed esophagus perforation after a second debridement and experienced one-month open drainage. All of the patients were cured without relapse of infection. For early deep SSI after anterior cervical decompression and fusion, surgical debridement was effective to eradicate infection. But for cases with delayed diagnosis, anterior debridement with prophylactic implant removal and posterior reconstruction was an ideal option. Esophagus perforation complicated with multiple debridements should be paid attention to and avoided. Copyright © 2015. Published by Elsevier B.V.

  3. Societal costs in displaced transverse olecranon fractures: using decision analysis tools to find the most cost-effective strategy between tension band wiring and locked plating.

    Science.gov (United States)

    Francis, Tittu; Washington, Travis; Srivastava, Karan; Moutzouros, Vasilios; Makhni, Eric C; Hakeos, William

    2017-11-01

    Tension band wiring (TBW) and locked plating are common treatment options for Mayo IIA olecranon fractures. Clinical trials have shown excellent functional outcomes with both techniques. Although TBW implants are significantly less expensive than a locked olecranon plate, TBW often requires an additional operation for implant removal. To choose the most cost-effective treatment strategy, surgeons must understand how implant costs and return to the operating room influence the most cost-effective strategy. This cost-effective analysis study explored the optimal treatment strategies by using decision analysis tools. An expected-value decision tree was constructed to estimate costs based on the 2 implant choices. Values for critical variables, such as implant removal rate, were obtained from the literature. A Monte Carlo simulation consisting of 100,000 trials was used to incorporate variability in medical costs and implant removal rates. Sensitivity analysis and strategy tables were used to show how different variables influence the most cost-effective strategy. TBW was the most cost-effective strategy, with a cost savings of approximately $1300. TBW was also the dominant strategy by being the most cost-effective solution in 63% of the Monte Carlo trials. Sensitivity analysis identified implant costs for plate fixation and surgical costs for implant removal as the most sensitive parameters influencing the cost-effective strategy. Strategy tables showed the most cost-effective solution as 2 parameters vary simultaneously. TBW is the most cost-effective strategy in treating Mayo IIA olecranon fractures despite a higher rate of return to the operating room. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  4. Management of unstable pertrochanteric fractures with proximal femoral locking compression plates and affect of neck-shaft angle on functional outcomes.

    Science.gov (United States)

    Kovalak, Emrah; Ermutlu, Cenk; Atay, Tolga; Başal, Özgür

    2017-01-01

    Management of unstable pertrochanteric fractures remains a challenge with various implant choices. Intramedullary devices are usually preferred for the management of the unstable fractures. When nailing is unsuitable for the configuration of the fracture extra medullary procedures are preferred. PFLCP is a contact limited implant that allows multiple angularly stable fixations with preserving more bone stock after implantation as an extramedullary implant. There are only a few reports in the literature about the osteosynthesis of unstable trochanteric fractures with proximal femoral locking compression plates and their results are conflicting. In the present study we aimed to evaluate the functional and radiological outcomes of proksimal femoral locking compression plates in open reduction and internal fixation of AO/OTA 31A2-2 and 3 fractures. Patients older than 18 years of age with a minimum follow-up time of 1 year matching the inclusion criteria retrospectively evaluated. Patients' demographics, Singh index, intra and post-operative data, mobilization and union time gathered from the patients' files. Baumgaertner modified criteria of fracture reduction was used to assess the post-operative reduction quality. Early and last follow-up radiographs were used to evaluate malunion and change in neck- shaft angle. Final clinical outcome was assessed using the Harris Hip scoring system. 18 male and 13 female patients with the mean age of 74 (46-88) met the inclusion criteria. Reduction quality according to Baumgaertner modified criteria was good in 25 patients and acceptable in 6. Mean union time was 21.53 ± 4.18 weeks. There was neither non-union nor malunion. The mean neck-shaft angle change was -3.1° ± 2.16°. The mean HHS was 77.90 ± 4.84 and there was no significance in HHS according to reduction quality and change in neck-shaft angle (p = 0.385, p = 0.0059). HHS was negatively correlated with age, mobilization time and, longer union time (p

  5. Cost-Utility Analysis of Anterior Cervical Discectomy and Fusion With Plating (ACDFP) Versus Posterior Cervical Foraminotomy (PCF) for Patients With Single-level Cervical Radiculopathy at 1-Year Follow-up.

    Science.gov (United States)

    Alvin, Matthew D; Lubelski, Daniel; Abdullah, Kalil G; Whitmore, Robert G; Benzel, Edward C; Mroz, Thomas E

    2016-03-01

    A retrospective 1-year cost-utility analysis. To determine the cost-effectiveness of anterior cervical discectomy and fusion with plating (ACDFP) in comparison with posterior cervical foraminotomy (PCF) for patients with single-level cervical radiculopathy. Cervical radiculopathy due to cervical spondylosis is commonly treated by either PCF or ACDFP for patients who are refractory to nonsurgical treatment. Although some have suggested superior outcomes with ACDFP as compared with PCF, the former is also associated with greater costs. The present study analyzes the cost-effectiveness of ACDFP versus PCF for patients with single-level cervical radiculopathy. Forty-five patients who underwent ACDFP and 25 patients who underwent PCF for single-level cervical radiculopathy were analyzed. One-year postoperative health outcomes were assessed based on Visual Analogue Scale, Pain Disability Questionnaire, Patient Health Questionnaire, and EuroQOL-5 Dimensions questionnaires to analyze the comparative effectiveness of each procedure. Direct medical costs were estimated using Medicare national payment amounts and indirect costs were based on patient missed work days and patient income. Postoperative 1-year cost/utility ratios and the incremental cost-effectiveness ratio (ICER) were calculated to assess for cost-effectiveness using a threshold of $100,000/QALY gained. The 1-year cost-utility ratio for the PCF cohort was significantly lower ($79,856/QALY gained) than that for the ACDFP cohort ($131,951/QALY gained) (P<0.01). In calculating the 1-year ICER, as the ACDFP cohort showed lower QALY gained than the PCF cohort, the ICER was negative and is not reported, meaning that ACDFP was dominated by PCF. Statistically significant and clinically relevant improvements (through minimum clinically important differences) were seen in both cohorts. Although both cohorts showed improved health outcomes, ACDFP was not cost-effective relative to the threshold of $100,000/QALY gained at 1

  6. Repair of long-bone fractures in cats and small dogs with the Unilock mandible locking plate system.

    Science.gov (United States)

    Voss, K; Kull, M; Hässig, M; Montavon, P

    2009-01-01

    To retrospectively evaluate stabilisation of long-bone fractures in cats and small dogs using the Unilock system. Medical histories and radiographs of consecutive patients with long-bone fractures stabilised with the Unilock system were reviewed. Cases with follow-up radiographs taken at least four weeks postoperatively were included. Signalment of the patient, fracture localisation and type, primary fracture repair or revision surgery, single or double plating, and complications for each patient were noted. Additionally, implant size, number of screws, number of cortices engaged with screws, and number of empty holes across the fracture were evaluated in fractures where a single plate had been applied. Eighteen humeral, 18 radial, 20 femoral, and 10 tibial fractures were treated. The Unilock system was used for primary repair in 44 fractures and for revision surgery in 22 fractures. Two plates were applied in 17 fractures, and a single plate was applied in 49 fractures. Follow-up radiographs were taken four to 109 weeks postoperatively. Complications were seen in 12 animals and 13 fractures (19.7%). Fixation failure occurred in seven fractures (10.6%). Cases with a single plate that suffered fixation failure had thinner screws in relation to bone diameter than cases with double plates, and more screws in a main fragment than those without fixation failure. The Unilock system is a suitable implant for fracture fixation of long bones in cats and small dogs.

  7. Biomechanical comparison of a locking compression plate combined with an intramedullary pin or a polyetheretherketone rod in a cadaveric canine tibia gap model.

    Science.gov (United States)

    Beierer, Lucas H; Glyde, Mark; Day, Robert E; Hosgood, Giselle L

    2014-11-01

    To compare the biomechanical properties of a 10-hole 3.5 mm locking compression plate (LCP) with 2 proximal and 2 distal bicortical locked screws reinforced with either a Steinmann pin of 30-40% the medullary diameter or a poly-ether-ether-ketone (PEEK) rod of ∼75% the medullary diameter in a cadaveric tibia gap model. Ex vivo study. Cadaveric canine tibias (n = 8 pair). Each construct had a 10-hole 3.5 mm LCP with 2 screws per fracture fragment using a comminuted tibia gap model. The Steinmann pin constructs had a 2.4 mm intramedullary pin whereas the PEEK-rod constructs had a 6 mm intramedullary PEEK rod placed. Biomechanical testing included non-destructive bi-planar 4 point bending, torsion testing, and destructive axial compression. Testing produced the responses of failure load (N) in axial compression, stiffness (N/mm or N/°) in axial compression, torsion, lateral-medial, and caudal-cranial 4 point bending. Screw position within the PEEK-rods was determined after explantation. The PEEK-rod constructs were significantly stiffer in axial compression (P bending (P torsional loading (P bending (P = .32). The PEEK-rod constructs failed at a significantly higher load than the Steinmann pin constructs (P bending, axial compression, and torsion when compared with Steinmann pin constructs. © Copyright 2014 by The American College of Veterinary Surgeons.

  8. Treatment of type 2 and 4 olecranon fractures with locking compression plate osteosynthesis in horses: a prospective study (2002-2008).

    Science.gov (United States)

    Jackson, M; Kummer, M; Auer, J; Hagen, R; Fuerst, A

    2011-01-01

    This prospective study describes a series of 18 olecranon fractures in 16 horses that were treated with locking compression plates (LCP). Twelve of the 18 fractures were simple (type 2), whereas six were comminuted (type 4). Six fractures were open and 12 were closed. Each horse underwent LCP osteosynthesis consisting of open reduction and application of one or two LCP. Complete fracture healing was achieved in 13 horses. Three horses had to be euthanatized: two because of severe infection and one because of a comminuted radial fracture 11 days after fixation of the olecranon fracture. Complications encountered after discharge of the horses from the Equine Hospital at the Vetsuisse Faculty (University of Zurich) included implant infection (n=2) and lameness (n=3), which were successfully treated with implant removal. Despite being easier to use, LCP osteosynthesis resulted in a clinical outcome similar to DCP osteosynthesis.

  9. Fracture severity of distal radius fractures treated with locking plating correlates with limitations in ulnar abduction and inferior health-related quality of life

    Directory of Open Access Journals (Sweden)

    Tsitsilonis, Serafim

    2016-07-01

    Full Text Available Introduction/background: The operative treatment of distal radius fractures has significantly increased after the introduction of locking plates. The aim of the present study was the evaluation of health-related quality of life, functional and radiological outcome of patients with distal radius fractures treated with the locking compression plate (LCP.Materials and methods: In the present study 128 patients (130 fractures that were operatively treated with the LCP (2.4 mm/3.5 mm, Synthes were retrospectively evaluated. Mean follow-up was (SD 10.6. The fractures were radiographically evaluated (radial inclination, palmar tilt, ulnar variance pre-, postoperatively and at the last follow-up visit. Range of motion (ROM was documented. Grip strength was assessed with the use of a JAMAR dynamometer. The score for disabilities of the arm, shoulder and hand (DASH and the Gartland-Werley score (GWS were evaluated. Health-associated quality of life was assessed with use of SF-36 Health Survey.Results: Postoperative reduction was excellent; at the last follow-up visit only minimal reduction loss was observed. Except for pronation, a statistically significant decrease of ROM was present; in most cases that was not disturbing for the patients. The injured side achieved 83.9% of grip strength of the intact side. Mean DASH was 18.9 and mean GWS was 3.5. Health-associated quality of life was generally not compromised. However, limitations in ulnar abduction correlated with inferior quality of life. Fracture severity correlated with inferior quality of life, despite the absence of correlation with the functional and radiological outcome. Complication rate was low.Conclusions: Fracture severity seems to affect ulnar abduction and therefore patient quality of life, despite almost anatomical reduction; the objective and subjective scores were in most cases excellent. Modern everyday activities, such as keyboard typing, could be associated with the present results.

  10. Zero-profile implant versus conventional cage-plate implant in anterior cervical discectomy and fusion for the treatment of degenerative cervical spondylosis: a meta-analysis.

    Science.gov (United States)

    Shao, Haiyu; Chen, Jinping; Ru, Bin; Yan, Feifei; Zhang, Jun; Xu, Shaonan; Huang, Yazeng

    2015-09-17

    Zero-profile implant has become more and more popular in anterior cervical discectomy and fusion (ACDF) for the treatment of degenerative cervical spondylosis. However, there was no enough evidence judging its efficiency and safety. The aim of this analysis was to evaluate the efficacy and safety of Zero-profile implant compared with conventional cage-plate (CCP) in ACDF. All studies directly comparing the outcomes between the Zero-profile implant and CCP implant in ACDF were included, and the search strategy followed the requirements of the Cochrane Library Handbook. Two of the authors extracted relevant data and checked the accuracy independently using standardized data collection form. Seven studies involving 560 patients were included, 262 in the Zero-profile group and 298 in the CCP group. Zero-profile implant had a lower rate of postoperative dysphagia at 2 weeks, 6 months, and 1 year (p = 0.0002, p = 0.008, and p = 0.001, respectively) than CCP implant. Zero-profile also reduced blood loss (p = 0.0001), while operation time and incidence of postoperative transient dysphagia had no statistical significance (p = 0.92, p = 0.42, respectively) between two groups. Based on the results of our analysis, the application of Zero-profile implant in ACDF had a lower rate of postoperative dysphagia at 2 weeks, 6 months, and 1 year than CCP implant. Zero-profile implant also had fewer blood loss during operation. More rigorous and adequately powered prospective randomized controlled trials with larger sample size are required to elucidate a more objective outcome.

  11. Treatment of Non Unions of Subtrochanteric Fractures Using an Anatomical Proximal Femur Locked Compression Plate - A Prospective Study of 13 Patients.

    Science.gov (United States)

    Balasubramanian, Navin; Babu, Ganesh; Prakasam, Sindhuja

    2016-01-01

    Subtrochanteric fractures have a bimodal age distribution. They are mostly due to high violence trauma in the younger age group. They almost always require open reduction and internal fixation. Due to the increase in the emergence of native bone setters, these fractures are increasingly been managed by these spurious bone setters using native splints. As a result, non-union rate is high among such patients. These patients definitely need open reduction with internal fixation +/- bone grafting. The choice of implants used can be either a dynamic condylar screw plate (DCS) orproximal femoral nail (PFN). Here we have used a surgical grade 316 L stainless steel proximal femoral anatomical locked compression plate (PF-LCP). We analyzed 13 patients with established non unions of subtrochanteric fractures treated in our centre by the use of the PF-LCP. There were 10 males and 3 females. The average age was 48.23 years. All our patients were followed up by serial radiographs at 6, 12, 18, 24 weeks and thereafter at 6 months interval. Union was achieved in 11 out of 13 patients at 12 weeks whereas two patients had delayed union which eventually healed at 18 weeks and 24 weeks. The average Harris hip score at 1 year follow-up was excellent in eight, good in four and fair in one patient respectively. We conclude that in complicated non-unions, the use of PF-LCP has a definite positive role in the management of such cases.

  12. Tibiotarsal compression arthrodesis using a lateral locking plate Artrodese tibiotársica compressiva com o uso de placa bloqueada lateral

    Directory of Open Access Journals (Sweden)

    Michael J. Coughlin

    2012-10-01

    Full Text Available OBJECTIVES: Tibiotalar (TT arthrodesis is still a very important option in the treatment of primary or post-traumatic arthritis of the ankle but persists the controversy regarding the optimal method for the fixation of the arthrodesis site. No matter the implant used, the goal is to obtain a solid, healthy, pain-free fusion. The purpose of the current study is to present the preliminary results of a novel laterally based tibiotalar compression arthrodesis system using a locked plate. METHODS: Thirteen consecutive patients with tibiotalar arthritis were submitted to an arthrodesis using a new lateral plating system. The average age was 59.7 years (range 36~72; nine patients were male and four female. Using a cutting guide, the remaining articular surfaces of the tibia and talus were removed. A compression device was applied to avoid malalignment of the ankle and a precontoured lateral locking plate was used to achieve the joint fusion. RESULTS: Both the AOFAS ankle-hindfoot score and the VAS score improved with the surgery. All patients' ankles fused by 6 months. In all patients we found a very good alignment in the sagittal, coronal and transverse planes. CONCLUSION: We believe that a combination of a bilateral compression, contoured bony cuts, and lateral locked plating offers a novel, accurate and useful technique for ankle arthrodesis.OBJETIVOS: A artrodese tibiotársica (TT continua sendo uma importante opção no tratamento da artrose primária ou pós-traumática do tornozelo mas persiste ainda a controvérsia sobre o melhor método de fixação do foco de artrodese. Independentemente do tipo de material utilizado, o objetivo maior é a obtenção da fusão articular sólida, saudável e indolor. O propósito do presente estudo é apresentar os resultados preliminares de um novo sistema de placa bloqueada lateral compressiva para a artrodese do tornozelo. MÉTODO: Treze pacientes consecutivos portadores de artrose tibiotársica foram

  13. [Locked plating with minimally invasive percutaneous plate osteosynthesis versus intramedullary nailing of distal extra-articular tibial fracture: a retrospective study].

    Science.gov (United States)

    Yao, Qi; Ni, Jie; Peng, Li-bin; Yu, Da-xin; Yuan, Xiao-ming

    2013-12-17

    To compare the efficacies of minimally invasive plate osteosynthesis (MIPPO) and interlocking intramedullary nailing (IMN) in the treatment of extra-articular fractures of distal tibia. Retrospective reviews were conducted for 126 patients with extra-articular distal tibia fractures. Treatment was either MIPPO (n = 61) or IMN (n = 65). The outcomes were assessed by comparing operating duration, time to union, the last follow-up American Orthopedic Foot and Ankle Society (AOFAS) score and complication rate. The average follow-up period was 23.7 (12-53) months. In the minimally invasive plate osteosynthesis group, there were deep infections (n = 2), superficial infections (n = 5), delayed union (n = 2), malunion (n = 2) and knee joint pain (n = 10) were observed. In addition, the average operating duration (85.9 ± 18.9 min), average time to union (17.3 ± 3.8 weeks) and average AOFAS (83.2 ± 11.9) were analyzed. In the interlocking intramedullary nailing group, there were delayed union (n = 3), malunion (n = 12) and knee joint pain (n = 22). And the average operating duration (83.3 ± 15.7 min), average time to union (16.5 ± 3.1 weeks) and average AOFAS (84.9 ± 12.0) were analyzed. No statistical significance existed in operating duration, time to union and the last follow-up AOFAS between two groups (P > 0.05). However, the rates of malformation and knee joint pain were higher in the intramedullary nail group than those in the plate group. And the difference was statistically significant (P = 0.015, P = 0.025). Both MIPPO and IMN are effective for extra-articular fractures of distal tibia. However, the former has the advantage of lowers rate of malformation and knee joint pain. Therefore a surgeon should consider the degree of injury while managing extra-articular fracture of distal tibia.

  14. Effect of plate working length on plate stiffness and cyclic fatigue life in a cadaveric femoral fracture gap model stabilized with a 12-hole 2.4?mm locking compression plate

    OpenAIRE

    Chao, Peini; Conrad, Bryan P; Lewis, Daniel D; Horodyski, MaryBeth; Pozzi, Antonio

    2013-01-01

    Background There are several factors that can affect the fatigue life of a bone plate, including the mechanical properties of the plate and the complexity of the fracture. The position of the screws can influence construct stiffness, plate strain and cyclic fatigue of the implants. Studies have not investigated these variables in implants utilized for long bone fracture fixation in dogs and cats. The purpose of the present study was to evaluate the effect of plate working length on construct ...

  15. Stress Orientations and Strain Rates in the Upper Plate of a `Locked' subduction zone, at southernmost North Island, New Zealand

    Science.gov (United States)

    Evanzia, D. A. D.; Lamb, S. H.; Savage, M. K.

    2017-12-01

    The southern North Island, New Zealand is located at the southern Hikurangi Margin, where the Pacific Plate is obliquely subducting westward underneath the Australian Plate. The orientations of the principle stresses in the overriding plate are determined from microseismic focal mechanisms detected and located using the temporary SAHKE and permanent GeoNet seismic array operating during 2009-2010. The microseismic earthquakes are located with the NonLinLoc method, using a New Zealand specific 3D velocity model; only those earthquakes located above the modelled subduction plate interface are used. Strain rate parameters calculations are calculated using cGPS velocities from 56 stations located from the central North Island to the northernmost South Island, New Zealand. In the region west of the Tararua-range-bounding Wairarapa fault (the Western region), the orientations of stresses indicate a normal regime (S1: vertical; S2 & S3: horizontal), with SHmax trending ENE. In the Central Basin region (east of the Wairarapa fault) the orientations of the stresses indicate a reverse regime (S3: vertical; S1 & S2: horizontal), with SHmax orientated NW. The low seismicity rates in the Eastern region make the results unreliable. There is a distinct difference between the strain rate and vorticity on either side the Wairarapa fault. Strain rate and vorticity rates increase west and decreased east of the Wairarapa; this correlates well with the pattern of observed seismicity. The southern North Island is predominately contracting, except for a region on the West coast, where some expansion is occurs. This pattern of expansion in the West and contraction in the center of the study area, calculated from cGPS, is similar the stress inversion results calculated from focal mechanisms. These similarities suggest that the present stress and strain rates are collinear, as occurs in isotropic media.

  16. Repair of long-bone fractures in cats and small dogs with the Unilock mandible locking plate system

    OpenAIRE

    Voss, K; Kull, M A; Haessig, M; Montavon, P M

    2009-01-01

    Objectives: To retrospectively evaluate stabilisation of long-bone fractures in cats and small dogs using the Unilock system. Methods: Medical histories and radiographs of consecutive patients with long-bone fractures stabilised with the Unilock system were reviewed. Cases with follow-up radiographs taken at least four weeks postoperatively were included. Signalment of the patient, fracture localisation and type, primary fracture repair or revision surgery, single or double plating, and compl...

  17. Artrodese cervical anterior em três e quatro níveis com dispositivo intersomático não associado à placa cervical Artrodesis cervical anterior en tres y cuatro niveles con dispositivo intersomático no asociado a placa cervical Anterior cervical arthrodesis for three and four levels using stand-alone interbody cages without cervical plates

    Directory of Open Access Journals (Sweden)

    Marcel Luiz Benato

    2009-06-01

    en tercer y cuarto niveles; dolor axial y/o irradiada; con mínimo seis meses de postoperatorio. El criterio de exclusión fue la presencia de inestabilidad cervical traumática. Fueron evaluadas las tasas de consolidación, la presencia de síntomas, la tasa de complicaciones y la posición de los dispositivos intersomáticos (subsidente después de seis meses. RESULTADOS: todos los pacientes obtuvieron consolidación en tres meses, sin embargo, dos pacientes presentaron el fenómeno de subsidente, o sea, migración con consolidación en cifosis, sin alterar los resultados clínicos y la consolidación de la artrodesis a los seis meses de postoperatorio. Los pacientes presentaron mejoría del dolor preoperatorio y solo tres (15% presentaron dolor residual. No hubo complicaciones mayores. El tiempo de hospitalización fue de dos días. No fue utilizada inmovilización rígida en el postoperatorio. CONCLUSIÓN: fue obtenida consolidación con esta técnica en todos los casos. La técnica se mostró segura y promovió buenos resultados radiológicos y clínicos.evaluate the rates of fusion of the anterior cervical discectomy and arthrodesis for three and four levels using interbody cages (stand-alone without cervical plates six months after post-operative. METHODS: from November 2005 to July 2008, 20 patients were treated as proposed. The inclusion criteria were: cervical degenerative disease of three and four levels; axial and/or irradiated pain at least six months of follow-up. The exclusion criteria were: cervical traumatic instability. The fusion rate, clinical symptoms, rate of complications and the implant position were evaluated six months after post-operative. RESULTS: results were favorable in 100% of the patients, with residual pain in two cases. Fusion was found in 100% of the patients, except for two cases with minimum subsidence and fusion in a slight kyphotic position. There were not significant complications. The discharge of the hospital was performed

  18. Comparison of a Stand-Alone Anchored Spacer Versus Plate-Cage Construct in the Treatment of Two Noncontiguous Levels of Cervical Spondylosis: A Preliminary Investigation.

    Science.gov (United States)

    Shi, Sheng; Zheng, Shuang; Li, Xin-Feng; Yang, Li-Li; Liu, Zu-De; Yuan, Wen

    2016-05-01

    The application of stand-alone anchored spacer (SAAS) in anterior cervical discectomy and fusion (ACDF) has been proven to be safe and effective to treat cervical spondylosis. Skip-level ACDF with SAAS, fusing only the involved levels without anterior plates, may be the optimal treatment. The aim of the study was to compare the clinical outcomes, radiologic results of SAAS, and plate-cage construct in the treatment of 2 noncontiguous levels of cervical spondylosis. A total of 65 patients with 2 noncontiguous levels of cervical spondylosis were included in the retrospective review of prospective collected data. The clinical and radiologic outcomes were assessed with the Japanese Orthopaedic Association score, Neck Disability Index, cervical alignment, and range of motion and disc height of intermediate segment, respectively. All the aforementioned parameters were compared before and after surgery in the respective group, which also were compared between the 2 groups. Complications also were recorded, and correlations between the surgical outcome and various factors were analyzed. No significant differences existed in clinical results between the 2 groups (P > 0.05). In addition, no statistical significance was observed in fusion rate, cervical alignment, and range of motion and disc height of intermediate segment, dysphagia, and hoarseness (P > 0.05). Preoperative Japanese Orthopaedic Association score and high-intensity signal in T2-weighted images were important predictors for surgical outcome. Skip-level ACDF with SAAS is a safe and effective treatment of 2 noncontiguous levels of cervical spondylosis without obvious contraindications, which can keep the IS intact, and have a low impact on the IS. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. A prospective randomized trial comparing anterior cervical discectomy and fusion versus plate-only open-door laminoplasty for the treatment of spinal stenosis in degenerative diseases.

    Science.gov (United States)

    Jiang, Yun-Qi; Li, Xi-Lei; Zhou, Xiao-Gang; Bian, Chong; Wang, Han-Ming; Huang, Jian-Ming; Dong, Jian

    2017-04-01

    For three or more involved cervical levels, there is a debate over which approach yields the best outcomes for the treatment of multilevel cervical degenerative disease. Our objective is to compare the radiological and clinical outcomes of two treatments for multilevel cervical degenerative disease: anterior cervical discectomy and fusion (ACDF) versus plate-only open-door laminoplasty (laminoplasty). Patients were randomized on a 1:1 randomization schedule with 17 patients in the ACDF group and 17 patients in the laminoplasty group. Clinical outcomes were assessed by a visual analog scale (VAS), Japanese Orthopedic Association (JOA) scores, operative time, blood loss, rates of complications, drainage volume, discharge days after surgery, and complications. The cervical spine curvature index (CI) and range of motion (ROM) were assessed with radiographs. The mean VAS score, the mean JOA score, and the rate of complications did not differ significantly between groups. The laminoplasty group had greater blood loss, a longer operative time, more drainage volume, and a longer hospital stay than the ACDF group. There were no significant differences in the CI and ROM between the two groups at baseline and at each follow-up time point. ROM in both groups decreased significantly after surgery. Both ACDF and laminoplasty are effective and safe treatments for multilevel cervical degenerative disease. ACDF causes fewer traumas than laminoplasty.

  20. Comparison of the mechanical behaviors of semicontoured, locking plate-rod fixation and anatomically contoured, conventional plate-rod fixation applied to experimentally induced gap fractures in canine femora.

    Science.gov (United States)

    Goh, Clara S S; Santoni, Brandon G; Puttlitz, Christian M; Palmer, Ross H

    2009-01-01

    To compare the mechanical behaviors of a semicontoured, locking compression plate-rod (LCP-rod) construct and an anatomically contoured, limited-contact dynamic compression plate-rod (LC-DCP-rod) construct applied to experimentally induced gap fractures in canine femora. 16 femora from 8 cadaveric dogs. 8 limbs from 8 dogs were assigned to the LCP-rod construct group or the LC-DCP-rod construct group. In each femur, a 39-mm mid-diaphyseal ostectomy was performed at the same plate location and the assigned construct was applied. Construct stiffness and ostectomy gap subsidence were determined before and after cyclic axial loading (6,000 cycles at 20%, 40%, and 60% of live body weight [total, 18,000 cycles]). Three constructs from each group further underwent 45,000 cycles at 60% of body weight (total, 63,000 cycles). Following cyclic loading, mode of failure during loading to failure at 5 mm/min was recorded for all constructs. After 18,000 or 63,000 cycles, construct stiffness did not differ significantly between construct groups. No implant failure occurred in any construct that underwent 63,000 cycles. In both construct groups, ostectomy gap subsidence similarly increased as axial load increased but did not change after 18,000 cycles. Mean +/- SEM loads at failure in the LCP-rod (1,493.83 +/- 200.12 N) and LC-DCP-rod (1,276.05 +/- 156.11 N) construct groups were not significantly different. The primary failure event in all constructs occurred at the screw hole immediately distal to the ostectomy. Biomechanically, the semicontoured LCP-rod construct is similar to the anatomically contoured LC-DCP-rod system.

  1. A new, low cost, locking plate for the long-term fixation of a critical size bone defect in the ratfemur: in vivo performance, biomechanical and finite element analysis.

    Science.gov (United States)

    Mataliotakis, George I; Tsouknidas, Alexander; Panteliou, Sofia; Vekris, Marios D; Mitsionis, Grigorios I; Agathopoulos, Simeon; Beris, Alexander E

    2015-01-01

    The optimum fixation device for the critical size bone defect is not established yet. A reliable, feasible and low-cost fixation device for the long-term maintenance of a critical bone defect. A custom-made plate made of poly-methyl-methacrylate was used for the fixation of a critical defect of rats' femurs. The screws were securely fixing both on the plate and the bone. A three point bending test, aimed to resemble the in vivo loading pattern, a Finite Element Analysis and a 24-week in vivo monitoring of the integrity of the plate fixation were utilized. The plate has linear and reproducible behavior. It presents no discontinuities in the stress field of the fixation. Its properties are attributed to the material and the locking principle. It fails beyond the level of magnitude of the normal ambulatory loads. In vivo, 100% of the plates maintained the bone defect intact up to 12 weeks and 85% of them at 24 weeks. This novel locking plate shows optimal biomechanical performance and reliability with high long-term in vivo survival rate. It is fully implantable, inexpensive and easily manufactured. It can be qualified for long term critical defect fixation in bone regeneration studies.

  2. PLATE

    DEFF Research Database (Denmark)

    Kling, Joyce; Hjulmand, Lise-Lotte

    2008-01-01

    ’s level of English is sufficient for the increasing number of courses offered in English each semester. This paper addresses these concerns and describes a pilot project initiated in 2003 at CBS to gauge the overall English language proficiency of those teaching content courses in English. Through...... the Project in Language Assessment for Teaching in English (PLATE) language professionals from CBS’s Language Center observe teachers and provide feedback using evaluation criteria from the Common European Framework for Reference (CEFR) supplemented by some additional criteria which take the LSP nature...... of academic teaching and lecturing into account....

  3. Minimally invasive opening wedge tibia outpatient osteotomy, using screw-to-plate locking technique and a calcium phosphate cement.

    Science.gov (United States)

    Schwartz, Claude

    2018-01-10

    Medial knee osteoarthritis on angular varus deformity of a lower limb is very common. Open-wedge high tibial osteotomy is a treatment of choice if cartilage is not excessively worn (Allback 1 or 2). The technique based on a plate fixation and the bone defect filled with calcium phosphate cement is thoroughly described. Data at 1, 3, 6 months and 1 year of a 19 cases continuous and prospective series are collected and analysed. Mean age at the time of operation was 55 years. The average preoperative varus deformity was 5° and corrected to an average postoperative valgus of 4° (range 3°-6°). Each control includes the collection of eventual complications, the measurement of health status (quality of life and functional scores) and antero-posterior and lateral X-rays. All osteotomies were considered healed at 6 weeks without any correction loss except one, probably result of a technical error. There was no difference in clinical and functional results between the group and the literature, but the final result occurred earlier in the treatment when the bone defect was filled with either calcium phosphate cement. Faster recovery involved no specific complication and enabled outpatient treatment in a majority of patients.

  4. [Results to 4-year follow-up of the treatment of the cervical stenosis by corpectomy, titanium mesh cage and anterior plate fixation].

    Science.gov (United States)

    Reyes Sánchez, Alejandro Antonio; Gameros Castañeda, Luis Alberto; Obil Chavarría, Claudia; Alpizar Aguirre, Armando; Zárate Kalfópulos, Barón; Rosales-Olivares, Luis Miguel

    Cervical spondylotic myelopathy is caused by cervical stenosis. Several techniques have been described for the treatment of multilevel disease, such as the anterior corpectomy with titanium mesh cage and anterior cervical plate placement, which has the advantage of performing a wider decompression and using the same bone as graft. However, it has caused controversy since the collapse of the mesh cage continues being a major limitation of this procedure. A prospective 4-year follow-up study was conducted in 7 patients diagnosed with cervical stenosis, who were treated surgically by one level corpectomy with titanium mesh cage and anterior cervical plate placement, evaluating them by radiographs and clinical scales. 7 patients, 5 women and 2 males were studied. The most common level was C5 corpectomy (n=4). The Neck Disability Index (NDI) preoperative average was 30.01±24.32 and 4-year postoperative 16.90±32.05, with p=0.801. The preoperative and 4-year postoperative Nürick was 3.28± 48 and 3.14±1.21 respectively, with p=0.766. Preoperative lordosis was 14.42±8.03 and 4-year postoperative 17±11.67 degrees, with p=0.660. The immediate postoperative and 4-year postoperative subsidence was 2.69±2.8 and 6.11±1.61 millimeters respectively, with p=0.0001. Despite the small sample, the subsidence of the mesh cage is common in this procedure. No statistically significant changes were observed in the lordosis or Nürick scale and NDI. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  5. A CLINICAL STUDY OF PROXIMAL FEMUR LOCKING COMPRESSION PLATE (LCP - PF IN THE MANAGEMENT OF COMMUNITED INTERTROCHANTERIC AND SUBTROCHANTERIC FRACTURES OF THE FEMUR

    Directory of Open Access Journals (Sweden)

    Hari Babu

    2015-10-01

    Full Text Available Fractures of proximal femur and hip are relatively common injuries in elderly individuals . The incidence of peritrochanteric and intertrochanteric fracture is also increasing among young population, who sustain high energy trauma Rigid Internal fixation and early mobilization has been the standard method of treatment. A combination of orthopaedic surgery and early postoperative physiotherapy and ambulation is the best approach. The overall goal in the treatment of hip fractures is to return the patient to pre - morbid level of function. AIMS & OBJECTIVE : To analyse the anatomical and f unctional outcome of the treatment with LCP - Proximal femur. METHODOLOGY : The present study consists of 12 adult patients of peritrochanteric factures of femur satisfying the inclusion criteria , treated with Proximal Femoral Locking Compression Plate at S. V. R. R . Govt . General Hospital, Tirupati during the period of nov 2013 to Oct 2015. INCLUSION CRITERIA : Age >18years , comminuted trochanteric and sub trochanteric fractures , Signed written informed consent . EXCLUSION CRITERIA: Inter trochanteric fractures involving piriformis fossa , Compound fractures . Pathological fractures . Any displacement of a femoral neck fracture . A ssociated malignancy. RESULTS : Average age incidence in the present study was 62.7 years. , Predominantly males (75% were affected. , Most cases occurred after a fall 10 (50% cases which was statistically significant , Right side involvement was more common. , Average post - operative stay was 13.5 days. , Out of the 12 cases, evaluated using Salvati - Wilson scoring : 3 cases (25% had good, 8 cases (66.67% fair, 1 case (8.33% had poor score , Average weight bearing time was14.5 weeks , Average union rate was 19.45 weeks.

  6. Biomechanical comparison between pins and polymethylmethacrylate and the SOP locking plate system to stabilize canine lumbosacral fracture-luxation in flexion and extension.

    Science.gov (United States)

    Nel, Johannes J; Kat, Cor-Jacques; Coetzee, Gert L; van Staden, Paul J

    2017-08-01

    To determine the stability of a simulated complete L7-S1 fracture-luxation immobilized with SOP locking plate system, compared to pins and polymethylmethacrylate (PMMA). In vitro biomechanical study. Cadaver specimens of 18 skeletally mature large-breed dogs. Specimens were randomly stabilized with one of the two fixation techniques. Lumbosacral spine specimens (L5-S3) were subjected to a bending moment applied to the caudal and cranial ends of the specimen. The biomechanical parameters (ie, range of motion [ROM], neutral zone [NZ], and elastic zone stiffness [EZS]) were compared between fixation techniques. No difference was found between the means of the NZ in flexion (P = .3458), extension (P = .1255), and total value (P = .3458) of L7-S1 stabilized with the two fixation techniques. Mean ROM in flexion (P = .2386), extension (P = .1255), and mean of EZS in extension (P = .4094) did not differ between fixations. The only significant differences were in the means of total ROM and means of the EZS in flexion, with the means being smaller with SOP fixation. The stability of the two fixation techniques in flexion and in extension was similar for the L7-S1 and adjacent L5-L6 junctions, while the mean of ROM of L6-L7 in flexion was smaller with SOP fixation. Stability of the resulting construct should be considered when selecting an implant. Our results provide evidence that fixation via pin-PMMA or SOP provide similar stability for L7-S1 fracture-luxation. In this context, other factors become more important in selecting the fixation method. © 2017 The American College of Veterinary Surgeons.

  7. Biomechanical comparison of pin and tension-band wire fixation with a prototype locking plate fixation in a transverse canine patellar fracture model.

    Science.gov (United States)

    Gibert, Sophie; Kowaleski, Michael P; Matthys, Romano; Nützi, Reto; Serck, Boris; Boudrieau, Randy J

    2016-01-01

    To compare a locking plate (LP) with pin and tension-band wire (pin/TBW) for fixation of mid-patellar transverse fractures. Cadaveric canine stifle joints from 10 adult mixed breed dogs (23-36 kg) were used. Mid-patellar transverse osteotomies were randomly stabilized (in pairs) with either pin/TBW or a prototype LP. Cyclic loads (1 Hz, 500 cycles) at 100% body weight (90°-135° stifle joint extension), were applied. Survival or failure of constructs was defined as <2 mm fracture gap distraction at 500 cycles, or ≥2 mm fracture gap distraction at the number of cycles sustained, respectively. Number of cycles at failure and distraction gap were compared with a paired Student's t-test, and a survival analysis performed with a Mantel-Cox test. All constructs that survived cyclic testing were tested in single cycle load to failure (1.0 mm/sec; 110° stifle joint extension); yield strength was compared with a Wilcoxon rank sum test. Significance was set at p <0.05. All 10/10 LP and three out of 10 pin/TBW fixations survived cyclic testing. Survival analysis, number of cycles at failure, and distraction gap all were significantly different between the two groups (p = 0.0011, p = 0.0013, and p <0.0001, respectively). Construct yield strength was not significantly different (p = 0.1273). The failure mode with pin/TBW was consistently similar to failures observed clinically. The LP demonstrated consistent, reliable and stable fixation.

  8. Cervical Distraction-Stabilization Using an Intervertebral Spacer Screw and String-of Pearl (SOP™) Plates in 16 Dogs With Disc-Associated Wobbler Syndrome.

    Science.gov (United States)

    Solano, Miguel A; Fitzpatrick, Noel; Bertran, Judith

    2015-07-01

    To retrospectively investigate a novel surgical technique using the Fitz Intervertebral Traction Screw (FITS) combined with string-of-pearl (SOP™) locking plates for the treatment of Disc Associated Wobbler Syndrome (DAWS). Case series (n = 16). Ventral approach and fenestration of the affected disc(s), nuclear extirpation, and insertion of the FITS device to the level of the dorsal annulus was followed by application of one or two 3.5 mm SOP™ plates. Autogenous cancellous bone graft was placed between adjacent vertebrae. Long-term followup (>12months) via telephone or examination was attempted for all dogs. Case records of 16 dogs were reviewed. All dogs had Type II disc disease with a single site in 13 dogs and multiple sites in 3 dogs. Mean ± SD age was 75 ± 38 months and body weight was 34 ± 7 kg. Fifteen of the 16 dogs had significantly improved neurologic status (P =.01) at 6 weeks. Seven of the 16 dogs were examined at 24-36 months with 6 considered normal and 1 had mild ataxia. Postoperative radiographic intervertebral distraction was significant (P = .01). Radiographic bridging was recorded in 10/16 dogs at 6 weeks and in 7 dogs available for follow-up at 5-36 months. Computed tomography in 3 dogs at 24-36 months and postmortem with histology in 1 dog confirmed bone-bridging. Complications were not considered clinically significant and included implant loosening (2 dogs, both single plates) and minor end-plate subsidence (8 dogs). Application of the FITS device in combination with 2 ventral SOP™ locking plates and autogenous cancellous bone graft was associated with excellent outcomes in dogs treated for DAWS in this small case series. © Copyright 2015 by The American College of Veterinary Surgeons.

  9. 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

  10. Tibial plateau leveling osteotomy in small breed dogs with high tibial plateau angles using a 4-hole 1.9/2.5 mm locking T-plate.

    Science.gov (United States)

    Witte, Philip G; Scott, Harry W

    2014-07-01

    To report clinical experiences with tibial plateau leveling osteotomy (TPLO) to address cranial cruciate ligament (CCL) disease in small breed dogs with high tibial plateau angles (TPA) using a specific 4-hole locking T-plate. Retrospective case series. Small breed dogs (30°): n = 19 (29 CCL ruptures). TPLO was performed by standard technique using a 1.9/2.5 mm 4-hole locking T-plate. Preoperative, immediate postoperative, and 6-8 weeks postoperative TPA were measured from radiographs. Lameness was scored subjectively preoperatively and 6-8 weeks postoperatively. Mid to long term follow-up was by client telephone questionnaire (mean, 12.1 months after surgery). Mean ± SD preoperative TPA was 37.0 ± 4.9°, immediate postoperative TPA, 6.4 ± 2.8° and 6-8 weeks postoperative TPA, 8.0 ± 4.9°. Postoperative complications occurred in 4 dogs (13.8%) all of which had been operated as single-session bilateral procedures. Three stifles had failure of a single screw and postoperative increase in TPA. Periprosthetic infection necessitated plate removal in 1 dog. Lameness scores by veterinary assessment reduced from mean 3.4/5 preoperatively to 0.4/5 at 6-8 weeks postoperatively. Mid to long-term follow-up revealed no lameness by owner assessment. A 4-hole 1.9/2.5 mm locking T-plate may be used in the stabilization of unilateral TPLO in small breed dogs with high TPA. © Copyright 2014 by The American College of Veterinary Surgeons.

  11. Corrective osteotomy for procurvatum deformity caused by distal femoral physeal fracture malunion stabilised with String-of-Pearls locking plates: results in two dogs and a review of the literature.

    Science.gov (United States)

    Kim, S E; Lewis, D D

    2014-03-01

    This report describes the treatment of severe procurvatum because of distal femoral physeal fracture malunion in two skeletally immature dogs. Both dogs presented with severe right hindlimb lameness and markedly reduced stifle extension at less than 5 months of age. Severe distal femoral procurvatum and mild-to-moderate femoral shortening secondary to distal femoral physeal fracture malunion were evident on radiographs. The sagittal plane deformities were addressed with a caudal opening-wedge osteotomy in one dog and cranial closing wedge ostectomy in the other dog. String-of-Pearls locking plates were used to stabilise the osteotomies. Functional stifle extension range of motion and femoral length were improved post surgery in both dogs. Explantation of the plates was required in both dogs because of local soft tissue irritation. Both dogs had excellent outcomes based on subjective and objective measures (pressure sensitive walkway, force platform analysis) when assessed at skeletal maturity. Corrective osteotomy stabilised with String-of-Pearls locking plates is a viable treatment option for improving limb function in dogs with severe procurvatum deformities caused by distal femoral physeal fracture malunion. © 2014 Australian Veterinary Association.

  12. Automatic locking radioisotope camera lock

    International Nuclear Information System (INIS)

    Rosauer, P.J.

    1978-01-01

    The lock of the present invention secures the isotope source in a stored shielded condition in the camera until a positive effort has been made to open the lock and take the source outside of the camera and prevents disconnection of the source pigtail unless the source is locked in a shielded condition in the camera. It also gives a visual indication of the locked or possible exposed condition of the isotope source and prevents the source pigtail from being completely pushed out of the camera, even when the lock is released. (author)

  13. Hemiarthroplasty versus angle-stable locking compression plate osteosynthesis in the treatment of three- and four-part fractures of the proximal humerus in the elderly: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Verbeek Paul A

    2012-02-01

    Full Text Available Abstract Background The optimal surgical management of dislocated three- and four-part fractures of the proximal humerus in elderly patients remains unclear. Most used techniques are hemiarthroplasty and angle-stable locking compression plate osteosynthesis. In the current literature there is no evidence available presenting superior results between hemiarthroplasty and angle-stable locking compression plate osteosynthesis in terms of speed of recovery, pain, patient satisfaction, functional outcome, quality of life or complications. Methods/Design A randomized controlled multicenter trial will be conducted. Patients older than 60 years of age with a dislocated three- or four-part fracture of the proximal humerus as diagnosed by X-rays and CT-scans will be included. Exclusion criteria are a fracture older than 14 days, multiple comorbidity, multitrauma, a pathological fracture, previous surgery on the injured shoulder, severely deranged function caused by a previous disease, "head-split" proximal humerus fracture and unwillingness or inability to follow instructions. Participants will be randomized between surgical treatment with hemiarthroplasty and angle-stable locking compression plate osteosynthesis. Measurements will take place preoperatively and 3 months, 6 months, 9 months, 12 months and 24 months postoperatively. Primary outcome measure is speed of recovery of functional capacity of the affected upper limb using the Disabilities of Arm, Shoulder and Hand score (DASH. Secondary outcome measures are pain, patient satisfaction, shoulder function, quality of life, radiological evaluation and complications. Data will be analyzed on an intention-to-treat basis, using univariate and multivariate analyses. Discussion Both hemiarthroplasty and angle-stable locking compression plate osteosynthesis are used in the current treatment of dislocated three-and four-part fractures of the proximal humerus. There is a lack of level-1 studies comparing

  14. Comparison of a zero-profile anchored spacer (ROI-C) and the polyetheretherketone (PEEK) cages with an anterior plate in anterior cervical discectomy and fusion for multilevel cervical spondylotic myelopathy.

    Science.gov (United States)

    Liu, Yijie; Wang, Heng; Li, Xuefeng; Chen, Jie; Sun, Han; Wang, Genlin; Yang, Huilin; Jiang, Weimin

    2016-06-01

    We aimed to analyze the clinical and radiographic efficacy of a new zero-profile anchored spacer called the ROI-C in anterior discectomy and fusion (ACDF) for multilevel cervical spondylotic myelopathy (MCSM). We retrospectively reviewed the clinical, radiological outcomes and complications of multilevel ACDF with the ROI-C or with the polyetheretherketone (PEEK) cages with an anterior plate. From April 2011 to April 2014, 60 patients with MCSM were operated on using ACDF, with the ROI-C in 28 patients and PEEK cages with an anterior plate in 32 patients. The operative time, intraoperative blood loss, and clinical and radiological results were compared between the ROI-C group and the cage-plate group. The mean follow-up time was 23.8 ± 6.6 months, ranging from 12 to 36 months. At the first month and the last follow-up, the neck disability index (NDI) scores were decreased, and the Japanese Orthopedic Association (JOA) scores were significantly increased, compared with the presurgical measurements in both groups. There were no significant differences in NDI scores or JOA scores between the two groups (P > 0.05), but there were significant differences in the operation time, blood loss and the presence of dysphagia (P PEEK cage with an anterior plate.

  15. Optimized image processing with modified preprocessing of image data sets of a transparent imaging plate by way of the lateral view of the cervical spine

    International Nuclear Information System (INIS)

    Reissberg, S.; Hoeschen, C.; Redlich, U.; Scherlach, C.; Preuss, H.; Kaestner, A.; Doehring, W.; Woischneck, D.; Schuetze, M.; Reichardt, K.; Firsching, R.

    2002-01-01

    Purpose: To improve the diagnostic quality of lateral radiographs of the cervical spine by pre-processing the image data sets produced by a transparent imaging plate with both-side reading and to evaluate any possible impact on minimizing the number of additional radiographs and supplementary investigations. Material and Methods: One hundred lateral digital radiographs of the cervical spine were processed with two different methods: processing of each data set using the system-imminent parameters and using the manual model. The difference between the two types of processing is the level of the latitude value. Hard copies of the processed images were judged by five radiologists and three neurosurgeons. The evaluation applied the image criteria score (ICS) without conventional reference images. Results: In 99% of the lateral radiographs of the cervical spine, all vertebral bodies could be completed delineated using the manual mode, but only 76% of the images processed by the system-imminent parameters showed all vertebral bodies. Thus, the manual mode enabled the evaluation of up to two additional more caudal vertebral bodies. The manual mode processing was significantly better concerning object size and processing artifacts. This optimized image processing and the resultant minimization of supplementary investigations was calculated to correspond to a theoretical dose reduction of about 50%. (orig.) [de

  16. Air lock

    International Nuclear Information System (INIS)

    Palkovich, P.; Gruber, J.; Madlener, W.

    1974-01-01

    The patent refers to an air lock system preferably for nuclear stations for the transport of heavy loads by means of a trolley on rails. For opening and closing of the air lock parts of the rails are removed, e.g. by a second rail system perpendicular to the main rails. (P.K.)

  17. Locking support for nuclear fuel assemblies

    Science.gov (United States)

    Ledin, Eric

    1980-01-01

    A locking device for supporting and locking a nuclear fuel assembly within a cylindrical bore formed by a support plate, the locking device including a support and locking sleeve having upwardly extending fingers forming wedge shaped contact portions arranged for interaction between an annular tapered surface on the fuel assembly and the support plate bore as well as downwardly extending fingers having wedge shaped contact portions arranged for interaction between an annularly tapered surface on the support plate bore and the fuel assembly whereby the sleeve tends to support and lock the fuel assembly in place within the bore by its own weight while facilitating removal and/or replacement of the fuel assembly.

  18. Locking devise for oil platforms

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, P.-A.; Naudin, J.-C.

    1987-10-20

    A self-raising oil well platform comprises a shell mounted to be movable along legs by means of raising mechanisms comprising output gear pinions cooperative with racks mounted on at least a part of the length of the legs. The locking device for such a platform comprises a toothed member forming a counter-rack mounted on the shell of the platform, means for shifting the toothed member transversely of the direction of the rack with which the device is associated for engaging or disengaging the teeth of the toothed member in the teeth of the rack, clamping plates connected to the toothed member and clamping counter-plates connected to the platform, and means for clamping the plates and counter-plates together so as to lock the toothed member in position in the rack. 4 figs.

  19. Internal Fixation of Cervical Fractures in Three Horses.

    Science.gov (United States)

    Rossignol, Fabrice; Brandenberger, Olivier; Mespoulhes-Rivière, Céline

    2016-01-01

    To describe the surgical treatment outcome of cervical fractures in 3 horses. Case report. Three client-owned horses with cervical vertebral fractures. Three horses were refered for neck stiffness, pain, and ataxia after a cervical trauma because of a fall. Radiographic examination showed an oblique displaced fracture of the caudal aspect of the body of the second cervical vertebra (C2) in horse 1, an oblique displaced fracture of the caudal aspect of C4 involving the disc between C4 and C5 in horse 2, and a displaced transverse fracture of the body of the axis (C2) extending to the lateral arches and involving the vertebral canal in horse 3. In horse 1, the fracture was reduced and stabilized using a 14-hole narrow DCP plate, applied ventrally, and fixed with cancellous screws. A cervical fusion was performed. In horses 2 and 3, fracture fixation was performed using a 5-hole narrow LCP and 5 mm locking screws. All horses showed improvement and returned to full activity. The fracture healed in all horses. Internal fixation of cervical fracture in these horses was associated with minimal complications, and was associated with healing and a highly functional outcome in all horses. The LCP was preferred and would be recommended for ventral stabilization of selected cases of vertebral fractures. © Copyright 2015 by The American College of Veterinary Surgeons.

  20. Congenital cervical kyphosis in two young sighthounds.

    Science.gov (United States)

    Forterre, F; Casoni, D; Tomek, A; Karli, P; Howard, J; Precht, C

    2015-01-01

    Cervical vertebral (C) malformation is rarely reported in large breed dogs. Congenital cervical kyphosis (CCK) may result from defects of vertebral segmentation, failure of formation or both. This report describes two cases of C3-C4 CCK in young sighthounds, treated surgically. An 18-month-old female Deerhound and a six-week-old female Borzoi dog were presented because of the complaints of reluctance to exercise and signs of of neck pain. Both dogs were neurologically normal. Diagnostic imaging revealed C3-C4 deformity, moderate kyphosis, and spinal canal stenosis associated with chronic spinal cord pressure atrophy. Both dogs underwent surgical treatment. A staged two-step surgery starting with dorsal decompression was elected in the Deerhound. After the first surgical procedure, the dog developed focal myelomalacia and phrenic nerve paralysis and was euthanatized. A ventral distraction-fusion technique with two locking plates was performed in the Borzoi. This patient recovered uneventfully and long-term follow-up computed tomography revealed complete spondylodesis. Until now, CCK has only been described in sighthounds. Congenital cervical kyphosis might be considered a differential diagnosis in these breeds that are presented with signs of cervical pain. Ventral realignment-fusion and bone grafting may be considered for surgical treatment, although the earliest age at which this procedure can and should be performed remains unclear.

  1. Cervical subluxation associated with posterior cervical hemivertebra.

    Science.gov (United States)

    Otero-López, R; Rivero-Garvía, M; Márquez-Rivas, J; Valencia, J

    2016-02-01

    Hemivertebrae, associated with a failure in the formation and fusion of vertebral body ossification nuclei, are a common cause of thoracic or lumbar scoliosis. A cervical location is rare and even rarer as a cause of cervical subluxation in flexion and extension (for which only one previous case has been found). We report on the case of a 7-year-old female patient, who was examined for a cervical fusion defect, consisting of a posterior C4 hemivertebra and a left hemiblock from C5 to C7. After performing surgery consisting of a C4 corpectomy and anterior fixation with intersomatic graft and plate, adequate cervical stabilization with only a self-limiting left C6 brachialgia and ipsilateral Horner syndrome occurs in the postoperative period. Posterior cervical hemivertebra associated with instability is a very rare finding. The anterior approach with corpectomy and anterior plate enables suitable stabilization.

  2. Evaluation of Three Human Cervical Fusion Implants for Use in the Canine Cervical Vertebral Column.

    Science.gov (United States)

    Morrison, Emily J; Litsky, Alan S; Allen, Matthew J; Fosgate, Geoffrey T; Hettlich, Bianca F

    2016-10-01

    To assess technical feasibility and mechanical properties of 3 locking plate designs (Zero-P, Zero-P VA, and Uniplate 2) for use in the canine cervical spine. Prospective ex vivo study. Cadaver cervical spines from skeletally mature large breed dogs (n = 18). Specimens were screened using radiography and allocated into balanced groups based on bone density. Stiffness of intact C4-C5 vertebral motion units was measured in extension, flexion, and lateral bending using nondestructive 4-point bend testing. Uniplate 2 was then implanted at C4-C5 and mechanical testing was repeated. Mechanical test data were compared against those from 6 spines implanted with monocortical screws, an allograft ring spacer, and PMMA. The Zero-P and Zero-P VA systems could not be surgically implanted due to anatomical constraints in the vertebral column sizes of the canine cervical spines used in this study. Fixation with Uniplate 2 or with screws/PMMA significantly increased stiffness of the C4-C5 vertebral motion units compared to unaltered specimens (P dogs requiring cervical fusion. © Copyright 2016 by The American College of Veterinary Surgeons.

  3. Tratamento das fraturas femorais subtrocantéricas com placas de bloqueio lateral da parte proximal do fêmur The treatment of femoral subtrochanteric fractures with the proximal lateral femur locking plates

    Directory of Open Access Journals (Sweden)

    Sun-Jun Hu

    2012-12-01

    Full Text Available OBJETIVO: Estudar o desfecho de fraturas subtrocantéricas de quadril tratadas com placa de bloqueio lateral da parte proximal do fêmur. MÉTODO: Revisamos retrospectivamente os resultados clínicos de 48 casos de fraturas subtrocantéricas tratadas com placas de bloqueio lateral da parte proximal do fêmur de janeiro de 2008 a maio de 2010. Registrou-se o progresso da consolidação da fratura, assim como a ocorrência de complicações. A função da articulação do quadril foi avaliada pelo índice social de Harris e o escore de mobilidade de Parker-Palmer, um ano após a cirurgia. RESULTADO: Quarenta e cinco pacientes foram acompanhados até a união da fratura ou a revisão da cirurgia. Entre os 45 pacientes, 43 atingiram a união da fratura sem outra intervenção. Trinta e oito fraturas consolidaram sem perda da posição no acompanhamento de um ano. Não houve casos de perfuração da cabeça do fêmur pelo parafuso. O escore médio do índice social de Harris foi 86,5 ± 9,8 (73 ~95. A média do escore de mobilidade de Parker e Palmer foi 7,4 ± 2,1 (3~ 9. CONCLUSÃO: A placa de bloqueio lateral da parte proximal do fêmur é o tipo de fixação interna estável e efetiva para tratar as fraturas subtrocantéricas de quadril e tem a vantagem de fixação estável, em especial em fratura da parede lateral do fêmur. Nível de evidência IV, Série de Casos.OBJECTIVE: To study the outcome of subtrochanteric hip fractures treated by using a proximal lateral femur locking plate. METHOD: We retrospectively reviewed the clinical results of 48 cases of femoral subtrochanteric fractures treated with proximal lateral femur locking plates from Jan 2008 to May 2010. The progress of fracture healing, as well as the occurrence of complications, was recorded. The function of the hip joint was evaluated by Harris social index and the Parker and Palmer mobility score at 1 year after the operation. RESULT: 45 patients were followed up until fracture

  4. Features of Three- and Four-Part Proximal Humeral Fractures and Outcome of Internal Fixation Using the Philos® Locking Plate

    Directory of Open Access Journals (Sweden)

    Ali Sadighi

    2017-03-01

    Full Text Available Background: Proximal humeral fractures are among common types of fractures and remain a challenging issue for surgical management. This study aimed to assess the clinical outcomes and complication rates of three- vs. four-part proximal humeral fractures, treated with internal fixation using the Philos® plate. Material and Methods: In this cohort study, a total of 30 consecutive patients with three-part or four-part proximal humeral fractures based on the Neer classification were included. Surgical treatment was performed with open reduction and internal fixation using the Philos® plate. The constant score was evaluated 6 months later in follow-up. The P<0.05 was considered significant. Results: Four-part fractures were mainly caused by trauma from above, while insults of opposite direction were responsible for more than half of 3 part fractures (P=0.01. Open fractures were only observed in patients with a four-part fracture (P=0.018. No significant differences were noticed regarding gender, cause, and side of the fracture. The presence of other fractures, fracture of the implant, reduction loss, avascular necrosis (AVN of humerus head, rotator cuff injury, and revision surgery were significantly higher in patients with four-part fractures. The mean constant score was 81.40±11.61 and 65.09±16.09 for three-part and four-part fractures, respectively (P=0.006. Conclusion: Open reduction and internal fixation with Philos® plate yield acceptable results in both types of fractures, however, the prognosis of this intervention is poorer four-part fractures.

  5. String-of-pearls locking plate and cerclage wire stabilization of periprosthetic femoral fractures after total hip replacement in six dogs.

    Science.gov (United States)

    Fitzpatrick, Noel; Nikolaou, Christos; Yeadon, Russell; Hamilton, Michael

    2012-01-01

    To report use of, and outcome after, string-of-pearls (SOP™) plate and multiple cerclage wire fixation for treatment of periprosthetic femoral fractures (PFF) associated with total hip replacement (THR) in dogs. Case series. Dogs (n=6) with PFF after THR. Clinical records (2005-2010) and radiographic evaluations of dogs that had PFF associated with THR, treated with a SOP™ plate and cerclage wires were retrospectively reviewed. Clinical and radiographic postoperative assessments were performed 4, 12, and 24 weeks postoperatively. Telephone follow-up was performed >12 months postoperatively. Three fractures occurred intraoperatively and 3 occurred postoperatively. One SOP™ failed at 2 weeks necessitating revision using 2 parallel SOP™ implants. One dog was euthanatized because of quadriceps muscle tie-down at 6 weeks. Other dogs were free of lameness with full range of motion of the stifle and hip joints at final clinical examination, and positive outcomes were maintained at >12 month telephone questionnaire. There was no evidence of implant failure and positive evidence of fracture healing at final radiographic follow-up. Stabilization resulted in bone healing in 5 dogs; failure in 1 dog may be attributable to technical error. Optimal technical guidelines for use of the SOP™ in this circumstance are unknown, particularly where fracture configuration varies. © Copyright 2011 by The American College of Veterinary Surgeons.

  6. Automatic locking orthotic knee device

    Science.gov (United States)

    Weddendorf, Bruce C. (Inventor)

    1993-01-01

    An articulated tang in clevis joint for incorporation in newly manufactured conventional strap-on orthotic knee devices or for replacing such joints in conventional strap-on orthotic knee devices is discussed. The instant tang in clevis joint allows the user the freedom to extend and bend the knee normally when no load (weight) is applied to the knee and to automatically lock the knee when the user transfers weight to the knee, thus preventing a damaged knee from bending uncontrollably when weight is applied to the knee. The tang in clevis joint of the present invention includes first and second clevis plates, a tang assembly and a spacer plate secured between the clevis plates. Each clevis plate includes a bevelled serrated upper section. A bevelled shoe is secured to the tank in close proximity to the bevelled serrated upper section of the clevis plates. A coiled spring mounted within an oblong bore of the tang normally urges the shoes secured to the tang out of engagement with the serrated upper section of each clevic plate to allow rotation of the tang relative to the clevis plate. When weight is applied to the joint, the load compresses the coiled spring, the serrations on each clevis plate dig into the bevelled shoes secured to the tang to prevent relative movement between the tang and clevis plates. A shoulder is provided on the tang and the spacer plate to prevent overextension of the joint.

  7. Intermittent internal fixation with a locking plate to preserve epiphyseal growth function during limb-salvage surgery in a child with osteosarcoma of the distal femur: a case report.

    Science.gov (United States)

    Mei, Jiong; Ni, Ming; Jia, Guang-Yao; Chen, Yan-Xi; Zhu, Xiao-Zhong

    2015-05-01

    Limb shortening is a problem associated with surgery for osteosarcoma of the lower extremity in adolescents, as the tumors frequently occur near the epiphysis. Herein we report the use of a less invasive stabilization system (LISS) and an intermittent fixation method to preserve the growth function of epiphysis in an 11-year-old patient with an osteosarcoma of the distal femur.The 11-year-old male presented with left knee enlargement and pain for 2 weeks, and magnetic resonance imaging (MRI) and biopsy were consistent with osteosarcoma of the left distal femur. After preoperative chemotherapy, en bloc tumor resection was performed with margins based on MRI findings preserving the epiphyseal growth plate, the tumor cavity was filled with inactivated bone and bone cement, and a LISS was used to stabilize the femur. Aggressive postoperative chemotherapy was given. Approximately 105 weeks after surgery radiography showed that the distal end of the plate had moved superior to the epiphysis along with bone growth. Locking screws were placed in the distal part of the LISS plate to stabilize the re-implanted bone, and external fixation was not needed.The patient was able to walk with the crutches 1 week postoperatively, and bear weight on the extremity 6 weeks postoperatively. At 6 years after surgery, the patient's height had increased 52 cm, shortening of the affected limb was only 1 cm, and the circumference of the affected limb was 2 cm smaller than that of the contralateral limb. There was no significant discomfort in the affected limb, and there was no gait abnormality. The patient could jump and run, and could participate in sports including basketball and badminton to the same degree as his peers.In summary, the novel method of bone reconstruction and fixation provided good results in a child with an osteosarcoma of the distal femur. This fixation method preserves the osteogenic function of the epiphysis and restored bone integrity simultaneously, and

  8. Study of transient flow in fuel element of tubular plates. Accident: Shaft locking of primary cooling pump without opening the emergency gate; Estudio del regimen transitorio en el elemento combustible de placas tubulares. Accidente: Agarrotamiento de la bomba. No se abre la compuerta

    Energy Technology Data Exchange (ETDEWEB)

    Aguilas, F.; Moneva, M. A.; Garcia Ramirez, L.; Lopez Jimenez, J.; Diaz Diaz, J.

    1971-07-01

    It is analysed the thermal distribution of a fuel element of tubular plates irradiated in the JEN-1 reactor in the case of shaft locking of the primary cooling pump without opening the emergency gate. The fuel element hottest channel is studied in the position of maximum neutronic flux for three reactor power levels: 3 Hw (maximum reactor power), 2 Mw and 1 Hw. (Author) 8 refs.

  9. A biomechanical comparison of one-third tubular plates versus periarticular plates for fixation of osteoporotic distal fibula fractures.

    Science.gov (United States)

    Davis, Adrian T; Israel, Heidi; Cannada, Lisa K; Bledsoe, J Gary

    2013-09-01

    The purpose of this study was to test the biomechanical properties of locking and nonlocking plates using one-third tubular and periarticular plate designs in an osteoporotic distal fibula fracture model. Twenty-four cadaveric specimens, whose bone mineral densities were obtained using dual x-ray absorptiometry scans, were tested. The fracture model simulated an OTA 44-B2.1 fracture. The constructs included (1) nonlocking one-third tubular plate, (2) locking one-third tubular plate, (3) nonlocking periarticular plate, and (4) locking periarticular plate. The specimens underwent axial loading followed by torsional loading to failure. Statistical analysis was performed using Kruskal-Wallis testing and further analysis with Mann-Whitney testing. The periarticular plates had greater rotational stiffness compared with the one-third tubular plates (P = 0.04). The nonlocking plates had greater torque to failure than the locking plates (P = 0.01). The nonlocking one-third tubular plate had greater torque to failure than the locking one-third tubular plate (P = 0.03). No significant differences were found in any of the comparisons regarding axial stiffness. In biomechanical testing using an osteoporotic model of OTA 44-B2.1 fractures, periarticular plates were superior to one-third tubular plates in rotational stiffness only. Locking plates did not outperform their nonlocking counterparts. Periarticular plates should be considered when treating osteoporotic distal fibula fractures, but one-third tubular plates and nonlocking plates provide adequate fixation for these injuries.

  10. Using paleomagnetism to expand the observation time window of plate locking along subduction zones: evidence from the Chilean fore-arc sliver (38°S - 42°S)

    Science.gov (United States)

    Hernandez-Moreno, Catalina; Speranza, Fabio; Di Chiara, Anita

    2017-04-01

    fore-arc sliver undergoing CW rotations is a function of plate coupling along the subduction zone interface. Zones of high coupling enhance stress normal to the LOFZ, induce high LOFZ strength, and yield a wide deformation zone characterized by CW rotations. Conversely, low coupling imply a weak LOFZ, a lack of CW rotations, and a fore arc entirely dominated by CCW rotations related to sinistral fault kinematics. Our locking inferences are in good agreement with those recently derived by GPS analysis and indicate that seismotectonic segment coupling has remained virtually unchanged during the last 5Ma.

  11. Cervical Spondylosis

    Science.gov (United States)

    ... Request an Appointment at Mayo Clinic Causes Cervical spondylosis Cervical spondylosis Cervical spondylosis is degeneration of the bones and ... Related Symptom Checker Numbness in hands Numbness Cervical spondylosis Symptoms & causes Diagnosis & treatment Doctors & departments Advertisement Mayo ...

  12. Plate osteosynthesis of simple forearm fractures : LCP versus DC plates

    NARCIS (Netherlands)

    Stevens, Charles Tjerk; Ten Duis, Henk Jan

    The aim of this study was to compare the time to radiological bony union of simple A-type fractures of the forearm, treated with either a locking compression plate (LCP) or a dynamic compression plate (DCP). For each fracture, the relation between the use of compression and radiological healing time

  13. A locking device for fuel bundles of power nuclear reactors

    International Nuclear Information System (INIS)

    Long, John; Flora, B.S.

    1974-01-01

    The present invention relates to a locked assembly associated by brace rods and easily dismountable. It comprises a locking sleeve provided with lugs engaged in bores of the upper plate, said sleeve being biassed towards said plate by a spring. For dismounting the bundle, the plate is pushed against the action of the springs and each sleeve, provided with flat faces is pivoted until it reaches the unlocking position. A guide member prevents each brace rod from being unscrewed from the lower plate. This can be applied to the remote dis-assembling of the fuel rods of a power reactor [fr

  14. Rotationally Stable Screw-Anchor With Locked Trochanteric Stabilizing Plate Versus Proximal Femoral Nail Antirotation in the Treatment of AO/OTA 31A2.2 Fracture: A Biomechanical Evaluation.

    Science.gov (United States)

    Knobe, Matthias; Nagel, Philipp; Maier, Klaus-Jürgen; Gradl, Gertraud; Buecking, Benjamin; Sönmez, Tolga T; Modabber, Ali; Prescher, Andreas; Pape, Hans-Christoph

    2016-01-01

    Third-generation cephalomedullary nails currently represent the gold standard in the treatment of unstable trochanteric femur fractures. Recently, an extramedullary rotationally stable screw-anchor system (RoSA) has been developed. It was designed to combine the benefits of screw and blade and to improve stability using a locked trochanteric stabilizing plate (TSP). The purpose of this study was to compare the biomechanical behavior of RoSA/TSP and the proximal femoral nail antirotation (PFNA). Standardized AO/OTA 31A2.2 fractures were induced by an oscillating saw in 10 paired human specimens (n = 20; mean age = 85 years; range: 71-96 years). The fractures were stabilized by either the RoSA/TSP (Koenigsee Implants, Allendorf, Germany) or the PFNA (DePuy Synthes, Zuchwil, Switzerland). Femurs were positioned in 25 degrees of adduction and 10 degrees of posterior flexion and were cyclically loaded with axial sinusoidal pattern at 0.5 Hz, starting at 300 N, with stepwise increase by 300 N every 500 cycles until bone-implant failure occurred. After every load step, the samples were measured visually and radiographically. Femoral head migration was assessed. The stiffness at the load up to the clinically relevant load step of 1800 N (639 ± 378 N/mm (RoSA/TSP) vs. 673 ± 227 N/mm (PFNA); P = 0.542) was comparable, as was the failure load (3000 ± 787 N vs. 3780 ± 874 N; P = 0.059). Up to 1800 N, no femoral head rotation, head migration, or femoral neck shortening were observed either for RoSA/TSP or PFNA. Whereas failure of the PFNA subsumed fractures of the greater trochanter and the lateral wall, a posterior femoral neck fracture with a significantly increased femoral neck shortening (1.7 mm vs. 0 mm; P = 0.012) was the cause of failure with RoSA/TSP. This specific kind of failure was induced by a femoral neck weakening caused by the posterior TSP stabilizing screw. There was no significant difference in biomechanical properties between the RoSA/TSP and the PFNA for

  15. A technical case report on use of tubular retractors for anterior cervical spine surgery.

    Science.gov (United States)

    Kulkarni, Arvind G; Patel, Ankit; Ankith, N V

    2017-12-19

    The authors put-forth this technical report to establish the feasibility of performing an anterior cervical corpectomy and fusion (ACCF) and a two-level anterior cervical discectomy and fusion (ACDF) using a minimally invasive approach with tubular retractors. First case: cervical spondylotic myelopathy secondary to a large postero-inferiorly migrated disc treated with corpectomy and reconstruction with a mesh cage and locking plate. Second case: cervical disc herniation with radiculopathy treated with a two-level ACDF. Both cases were operated with minimally invasive approach with tubular retractor using a single incision. Technical aspects and clinical outcomes have been reported. No intra or post-operative complications were encountered. Intra-operative blood loss was negligible. The patients had a cosmetic scar on healing. Standard procedure of placement of tubular retractors is sufficient for adequate surgical exposure with minimal invasiveness. Minimally invasive approach to anterior cervical spine with tubular retractors is feasible. This is the first report on use of minimally invasive approach for ACCF and two-level ACDF.

  16. Comparison of zero-profile anchored spacer versus plate-cage construct in treatment of cervical spondylosis with regard to clinical outcomes and incidence of major complications: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Liu WJ

    2015-09-01

    Full Text Available Weijun Liu,1,* Ling Hu,2,* Junwen Wang,1 Ming Liu,1 Xiaomei Wang3 1Department of Orthopedics, Pu Ai Hospital, Affiliated to Tongji Medical College, Huazhong University of Science and Technology, 2Department of Anesthesiology, Tianyou Hospital, Affiliated to Wuhan University of Science and Technology, 3Department of Biological Science and Technology, Wuhan Bioengineering Institute, Wuhan, People’s Republic of China *These authors contributed equally to this work Purpose: Meta-analysis was conducted to evaluate whether zero-profile anchored spacer (Zero-P could reduce complication rates, while maintaining similar clinical outcomes compared to plate-cage construct (PCC in the treatment of cervical spondylosis. Methods: All prospective and retrospective comparative studies published up to May 2015 that compared the clinical outcomes of Zero-P versus PCC in the treatment of cervical spondylosis were acquired by a comprehensive search in PubMed and EMBASE. Exclusion criteria were non-English studies, noncomparative studies, hybrid surgeries, revision surgeries, and surgeries with less than a 12-month follow-up period. The main end points including Japanese Orthopedic Association (JOA and Neck Disability Index (NDI scores, cervical lordosis, fusion rate, subsidence, and dysphagia were analyzed. All studies were analyzed with the RevMan 5.2.0 software. Publication biases of main results were examined using Stata 12.0. Results: A total of 12 studies were included in the meta-analysis. No statistical difference was observed with regard to preoperative or postoperative JOA and NDI scores, cervical lordosis, and fusion rate. The Zero-P group had a higher subsidence rate than the PCC group (P<0.05, risk difference =0.13, 95% confidence interval [CI] 0.00–0.26. However, the Zero-P group had a significantly lower postoperative dysphagia rate than the PCC group within the first 2 weeks (P<0.05, odds ratio [OR] =0.64, 95% CI 0.45–0.91, at the 6th month [P

  17. Modified anterior-only reduction and fixation for traumatic cervical facet dislocation (AO type C injuries).

    Science.gov (United States)

    Kanna, Rishi M; Shetty, Ajoy P; Rajasekaran, S

    2017-12-26

    Surgical reduction of uni and bi-facetal dislocations of the cervical spine (AO type C injuries) can be performed by posterior, anterior or combined approaches. Ease of access, low infection rates and less risks of neurological worsening has popularized anterior approach. However, the reduction of locked cervical facets can be intricate through anterior approach. We analyzed the safety, efficacy and outcomes at a minimum 1 year, of a novel anterior reduction technique for consecutively treated cervical facet dislocations. Patients with single level traumatic sub-axial cervical dislocation (n = 39) treated by this modified anterior technique were studied. The technique involved standard Smith-Robinson approach, discectomy beyond PLL, use of inter-laminar distracter to distract while Caspar pins were used as "joysticks" (either flexion-extension or lateral rotation moments are provided), to reduce the sub-luxed facets. Among 51 patients with cervical type C injury treated during the study period, 4 patients who had spontaneous reduction and 8 treated by planned global fusion were excluded. 39 patients of mean age 49.9 years were studied. The levels of injury included (C3-4 = 2, C4-5 = 5, C5-6 = 20, C6-7 = 12). 18 were bi-facetal and 21 were uni-facetal dislocation. One facet was fractured in 17 and both in 5 patients. 30% (n = 13) had a concomitant disc prolapse. The neurological status was as follows: 9 ASIA A, 9 ASIA C, 13 ASIA D and 8 ASIA E. All the patients were successfully reduced by this technique and fixed with anterior locking cervical locking plates. No supplemental posterior surgery was performed. 22 patients with incomplete deficit showed recovery. The mean follow-up was 14.3 months and there was no implant failure except one patient who had partial loss of the reduction. Patients with traumatic sub-axial cervical dislocation (AO type C injuries) can be safely and effectively reduced by this technique. Other advantages include minimal

  18. Corpectomia cervical anterior e fixação com placa: análise retrospectiva Corporectomía cervical anterior y fijación con placa: un análisis retrospectivo Anterior cervical corpectomy and plate fixation: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Marcos André Sonagli

    2012-09-01

    rayos X de dos años de después de la cirugía. RESULTADOS: Veintiún pacientes fueron evaluados. De acuerdo con la clasificación AO, 14 estaban en el grupo A, 3 en el B y en el C. 4 En total, siete pacientes tenían déficit neurológico inicial completo (Frankel A y mantuvieron el déficit neurológico después de dos años. De los 6 pacientes que tenían déficit neurológico inicial incompleto (Frankel B, C y D, el 33% (2 de 6 mostraron una mejoría en el nivel de escala de Frankel y el 50% (3 de 6 de estas ha progresado hasta la recuperación completa (Frankel E. Los 8 pacientes sin lesión neurológica inicial (Frankel E no se vieron afectados por déficit neurológico después de dos años. Tres complicaciones clínicas fueron observadas: una fístula, un aflojamiento aséptico del implante y una infección en la zona donante del injerto. Todos los pacientes alcanzaron una consolidación de injerto óseo. CONCLUSIÓN: la corporectomía cervical en el tratamiento de las fracturas por estallido permite la recuperación neurológica de pacientes con lesión incompleta y tiene bajas tasas de complicación.OBJECTIVE: To evaluate the clinical and radiographic results of patients who underwent corpectomy and cervical plate fixation surgery with two years of follow-up. METHODS: Retrospective analysis from 2003 to 2009. We evaluated the fracture type (AO classification, the degree of neurological deficit (initial and after two years - Frankel scale, the complication rate and the rate of bone graft incorporation (according to X-rays two years after surgery. RESULTS: 21 patients were evaluated. According to the AO classification: 14 were in group A, 3 in B and 4 in C. Overall, seven patients had initial complete neurological deficit (Frankel A and remained with neurological complete deficit after two years of follow-up. Of the 6 patients who had incomplete initial neurological deficit (Frankel B, C and D, 33% (2 of 6 showed an improvement on the Frankel scale level and 50

  19. Avaliacão da placa vertebral terminal na coluna cervical em diferentes faixas etárias e sua correlação com a espessura do disco intervertebral Evaluation of terminal vertebral plate on cervical spine at different age groups and its correlation with intervertebral disc thickness

    Directory of Open Access Journals (Sweden)

    Juliano Silveira Luiz Vieira

    2009-02-01

    Full Text Available OBJETIVO: Avaliar por meio de histomorfometria, a espessura da placa vertebral terminal, a espessura do disco intervertebral e a sua correlação nas diferentes faixas etárias, tentando identificar a sua correlação. MÉTODOS: Foram avaliados os segmentos cervicais C4-C5 e C5-C6 de 50 cadáveres humanos , de ambos os sexos, divididos em 5 grupos com intervalo de faixa etária de 10 anos, a partir dos 21 anos de idade. A avaliação da espessura da PVT e do disco intervertebral foi realizada por meio de avaliação histomorfométrica dos cortes histológicos corados pela hematoxilina e eosina. A espessura da PVT inferior de C4, PVT superior de C5, PVT inferior de C5 e PVT superior de C6 foram comparadas entre si e também com a espessura do disco intervertebral interposto entre as respectivas PVT. RESULTADOS: A espessura das placas vertebrais terminais adjacentes ao mesmo DI não apresentou diferença estatística. No entanto, a comparação da espessura das placas vertebrais superior e inferior da mesma vértebra cervical (C5, apresentou diferença estatística em todas as faixas etárias avaliadas. Foi observado coeficiente de correlação estatística, maior que 80%, entre a espessura daplaca vertebral terminal e o disco intervertebral adjacente, com proporcional redução de espessura de ambas estruturas, nos diferentes níveis cervicais avaliados, e também nas diferentes faixas etárias avaliadas. CONCLUSÃO: A placa vertebral terminal apresenta correlação morfológica com o disco intervertebral ao qual entra em contato, e não apresenta correlação com a placa vertebral terminal da mesma vértebra.OBJECTIVE: To evaluate, by means of histomorphometry, terminal vertebral plate thickness, intervertebral disc thickness and its correlation on different age groups, seeking to identify its correlation. METHODS: C4-C5 and C5-C6 cervical segments removed from human cadavers of both genders were assessed and divided into five groups of 10-year

  20. Resultados clínicos e radiológicos en serie de artrodesis cervical anterior con caja de fusión intersomática y placa Resultados clínicos e radiológicos em série de artrodese cervical anterior com dispositivo de fusão intersomática e placa Clinical and radiologica outcomes in series of anterior cervical fusion with intersomatic cage and plate

    Directory of Open Access Journals (Sweden)

    Lyonel Beaulieu Lalanne

    2012-06-01

    pacientes submetidos a artrodese cervical anterior com dispositivo de fusão intersomática (CAGE e placa. MÉTODOS: Análise retrospectiva de série de pacientes submetidos a artrodese cervical anterior com dispositivo de fusão intersomática e placa entre 2004 e 2009. Revisão de fichas clínicas e radiografias, registro de idade, sexo, diagnósticos, nível operado, complicações, evolução clínica e radiológica. Técnica cirúrgica de Smith-Robinson. Os dispositivos de fusão intersomática foram preenchidos com substitutos ósseos. A deambulação ocorreu 12 horas depois da cirurgia, alta às 48 horas, colar cervical intermitente por 2 semanas. Avaliação clínica pelos critérios de Odom. Acompanhamento de 17 a 78 meses. RESULTADOS: Diagnósticos: hérnia de núcleo pulposo (HNP cervical, 44 (71%, mielopatia, 11 (17,7%, fratura 7 (11,3%. Nível 1: 44 (71%, Nível 2: 15 (24,2%, Nível 3: (4,8%. O nível C5-C6 incluiu 92% dos casos. Alívio da dor radicular: 60 (97%. Recuperação do déficit neurológico: 59 (95,2%. Alívio da mielopatia: 8/11 pacientes (73%. Alívio da dor cervical: 56 (90%. Resultados clínicos: 91,9% excelentes e bons. Complicações (12,9%: 4 disfagias transitórias (6,5%, 1 disfagia permanente (1,6%, 2 disfonias transitórias (3,3%, 1 subsidência com afrouxamento do implante e fratura assintomática da placa (1,6%. Não houve pseudoartrose. CONCLUSÕES: Esta série apresenta bons resultados clínicos, com alivio da dor e recuperação neurológica comparáveis aos encontrados na literatura. O uso da caixa de fusão intersomática evita complicações na região doadora e quando é associado à placa cervical anterior permite fixação intersomática imediata, proporcionando suporte estrutural adequado, com bons resultados e sem complicações a longo prazo.OBJECTIVES: To analyze the clinical and radiological results of a series of patients undergoing anterior cervical arthrodesis with cage and plate. METHODS: Retrospective analysis of

  1. Protective air lock

    International Nuclear Information System (INIS)

    Evans, H.W.

    1976-01-01

    A device suitable for preventing escape and subsequent circulation of toxic gases is described. An enclosure is sealed by a surrounding air lock, and an automatic mechanism partially evacuates the enclosure and air lock. The enclosure ventilating mechanism can be disconnected so that a relatively undisturbed atmosphere is created in the enclosure

  2. Holberg, lecteur de Locke

    DEFF Research Database (Denmark)

    Schøsler, Jørn

    2009-01-01

      En undersøgelse af John Lockes modtagelse i dansk Oplysningsfilosofi med særligt henblik på Holberg......  En undersøgelse af John Lockes modtagelse i dansk Oplysningsfilosofi med særligt henblik på Holberg...

  3. Locke (adversaires de)

    DEFF Research Database (Denmark)

    Schøsler, Jørn

    2017-01-01

    den apologetiske kritik af John Locke i den franske modoplysning centreret om 'medødte idéer' og den 'tænkende materie'.......den apologetiske kritik af John Locke i den franske modoplysning centreret om 'medødte idéer' og den 'tænkende materie'....

  4. Complicações determinadas por placas de cloreto de polivinila (PVC na estabilização da porção cervical caudal da coluna vertebral de cães Complications determined by polyvinylchloride (PVC plates in the stabilization of caudal cervical vertebral column of dogs

    Directory of Open Access Journals (Sweden)

    Mônica Vicky Bahr Arias

    2003-12-01

    Full Text Available Em 10 cães com peso médio de 14,6kg, as vértebras cervicais 5 e 6 foram cirurgicamente desestabilizadas através da secção do disco intervertebral e, em seguida, estabilizadas com placas ortopédicas confeccionadas com PVC de 2mm de espessura, para após 180 dias, proceder-se ao estudo histológico do tecido ósseo e conjuntivo circunvizinho. Constatou-se que o PVC causou alterações ósseas que podem ter favorecido o afrouxamento dos parafusos e a falha do implante. O material induziu ainda à formação de granuloma de corpo estranho e a reações inflamatórias locais que podem ter causado degradação do material implantado. Assim, placas de PVC, apesar de proporcionarem estabilidade e alinhamento da coluna vertebral, não satisfazem a maioria das propriedades necessárias a um biomaterial, não sendo recomendadaa a sua utilização em ortopedia veterinária.In ten dogs with an average mean weight of 14,6 kg, the cervical vertebra 5 and 6 were destabilized and fixed with plates of 2mm of thickness. The purpose of this work was to verify the effect of orthopedic PVC plates on the internal stabilization of the caudal cervical spine of dogs by studying the occurrence of alterations in the bone tissue and fibrous tissue adjacent to the plate after 180 days of permanence of the material in the dogs' organism. PVC causes progressive bone alterations, which, in the long term, could promote the loosening of the screws and failure of the implant. It also induces the formation of foreign body granuloma and inflammatory reactions which could cause degradation of the implant. Thus, PVC plates do not satisfy the majority of properties required of a biomaterial, its use not being recommended in veterinary orthopedics.

  5. Avaliação do tratamento da discopatia degenerativa cervical pela artrodese via anterior utilizando placas associadas a cages ou cages em peek isoladamente Evaluación del tratamiento de la enfermedad degenerativa del disco cervical por la artrodesis anterior utilizando placas asociadas con jaulas o jaulas en peec, aisladamente Evaluation of cervical degenerative disc disease treatment by anterior arthrodesis using plates associated with cages or cages in peek alone

    Directory of Open Access Journals (Sweden)

    André Rafael Hübner

    2011-01-01

    por el método de fijación con placas asociadas a jaulas - Grupo I - y 35 con las jaulas en PEEK, aisladamente - Grupo II. Se recolectarondatos de historial clínico, examen físico, puntuaciones de dolor (escala visual y analógica del dolor-EVA y función (criterios de Odom, SF-36, Índice de Discapacidad Cervical del pre y posoperatorio y exámenes de imagen. RESULTADOS: Se encontró un predominio de pacientes de sexo femenino en ambos grupos, con una edad promediode 55 años en el Grupo I y de 47 en el Grupo II. Ambos grupos mostraron una distribución similar en el número de niveles operados, así como de las complicaciones encontradas y de las puntuaciones de dolor, índice de discapacidad cervical y SF36 para el pre y posoperatorio. Hubo 97,1% para la fusión y 94,3% de buenos resultados en el Grupo I y el 100% de fusión, con 97% de buenos resultados en el Grupo II. CONCLUSIONES: El estudio comparativo de la utilización de placas con jaulas y estas en PEEK, aisladamente, presentó resultados similares y satisfactorios para los grupos estudiados, sin mostrar superioridad o inferioridad de un método sobre otro.OBJECTIVES: To comparatively evaluate the treatment of cervical degenerative disc disease by anterior approach using plates associated or cages and PEEK device alone. METHODS: A retrospective study comparing two groups of patients treated by anterior arthrodesis was performed. Seventy patients were randomly selected, 35 operated using plates associated with cages - Group I - and 35 with cages in PEEK alone - Group II. Medical history was obtained as well as physical examination, pain scores (pain visual analogue score and function scores (Odom's criteria, SF-36, Neck Disability Index and the pre and postoperative imaging studies. RESULTS: There was a predominance of female patients in both groups, with a mean age of 55 years in Group I and 47 in Group II. Both groups showed a similar distribution of the number of levels operated, as well as the

  6. Cervical Cancer

    Science.gov (United States)

    ... the place where a baby grows during pregnancy. Cervical cancer is caused by a virus called HPV. The ... for a long time, or have HIV infection. Cervical cancer may not cause any symptoms at first. Later, ...

  7. Cervical Dysplasia

    Science.gov (United States)

    ... pass through. Cervical dysplasia is detected in a pap test (pap smear), and diagnosed in a biopsy. Abnormal ... American Academy of Family Physicians (AAFP) recommends routine pap tests to diagnose cervical cancer early. You can check ...

  8. Cervical cancer

    Science.gov (United States)

    ... bleeding between periods, after intercourse, or after menopause Vaginal discharge that does not stop, and may be pale, ... Instructions Hysterectomy - abdominal - discharge Hysterectomy - laparoscopic - ... Images Cervical cancer Cervical neoplasia ...

  9. LOCKS AND KEYS SERVICE

    CERN Multimedia

    Locks and Keys Service

    2002-01-01

    The Locks and Keys service (ST/FM) will move from building 55 to building 570 from the 2nd August to the 9th August 2002 included. During this period the service will be closed. Only in case of extreme urgency please call the 164550. Starting from Monday, 12th August, the Locks and Keys Service will continue to follow the activities related to office keys (keys and locks) and will provide the keys for furniture. The service is open from 8h30 to 12h00 and from 13h00 to 17h30. We remind you that your divisional correspondents can help you in the execution of the procedures. We thank you for your comprehension and we remain at your service to help you in solving all the matters related to keys for offices and furniture. Locks and Keys Service - ST Division - FM Group

  10. Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2007-03-06

    Did you know that cervical cancer rates differ by race/ethnicity and region? Or that cervical cancer can usually be prevented if precancerous cervical lesions are found by a Pap test and treated? Find out how getting regular Pap tests can save a woman's life.  Created: 3/6/2007 by National Breast and Cervical Cancer Early Detection Program.   Date Released: 4/25/2007.

  11. Locke and botany.

    Science.gov (United States)

    Anstey, Peter R; Harris, Stephen A

    2006-06-01

    This paper argues that the English philosopher John Locke, who has normally been thought to have had only an amateurish interest in botany, was far more involved in the botanical science of his day than has previously been known. Through the presentation of new evidence deriving from Locke's own herbarium, his manuscript notes, journal and correspondence, it is established that Locke made a modest contribution to early modern botany. It is shown that Locke had close and ongoing relations with the Bobarts, keepers of the Oxford Botanic Garden, and that Locke distributed seeds and plant parts to other botanists, seeds of which the progeny almost certainly ended up in the most important herbaria of the period. Furthermore, it is claimed that the depth of Locke's interest in and practice of botany has a direct bearing on our understanding of his views on the correct method of natural philosophy and on the interpretation of his well known discussion of the nature of species in Book III of his Essay concerning human understanding.

  12. Concept of variable angle locking--evolution and mechanical evaluation of a recent technology.

    Science.gov (United States)

    Lenz, Mark; Wahl, Dieter; Gueorguiev, Boyko; Jupiter, Jesse B; Perren, Stephan Marcel

    2015-07-01

    Applications for fracture-adapted screw positioning offered by variable angle locking screws are increasing. The locking strength of the variable angle locking mechanism at different insertion angles was compared to conventional fixed angle locking screws. Stainless steel (S) and titanium (Ti) variable and fixed angle 2.4 mm locking screws, inserted at different inclinations (0°-15°), and locked at 0.8 Nm were subjected to a load-to-failure test. Ultimate failure moment at the screw-head interface and failure mode of the screws were determined. Significant differences were detected by one-way ANOVA (p 2° did not lock properly in the plate hole, providing insufficient locking strength. Variable angle locking screws offer a stable head-locking mechanism at different inclinations, comparable to the locking strength of orthogonal inserted fixed angle locking screws. Marginal inclinations >15° should be used with care. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  13. Pressure locking test results

    International Nuclear Information System (INIS)

    DeWall, K.G.; Watkins, J.C.; McKellar, M.G.; Bramwell, D.

    1996-01-01

    The U.S. Nuclear Regulatory Commission (NRC), Office of Nuclear Regulatory Research, is funding the Idaho National Engineering Laboratory (INEL) in performing research to provide technical input for their use in evaluating responses to Generic Letter 95-07, open-quotes Pressure Locking and Thermal Binding of Safety-Related Power-Operated Gate Valves.close quotes Pressure locking and thermal binding are phenomena that make a closed gate valve difficult to open. This paper discusses only the pressure locking phenomenon in a flexible-wedge gate valve; we will publish the results of our thermal binding research at a later date. Pressure locking can occur when operating sequences or temperature changes cause the pressure of the fluid in the bonnet (and, in most valves, between the discs) to be higher than the pressure on the upstream and downstream sides of the disc assembly. This high fluid pressure presses the discs against both seats, making the disc assembly harder to unseat than anticipated by the typical design calculations, which generally consider friction at only one of the two disc/seat interfaces. The high pressure of the bonnet fluid also changes the pressure distribution around the disc in a way that can further contribute to the unseating load. If the combined loads associated with pressure locking are very high, the actuator might not have the capacity to open the valve. The results of the NRC/INEL research discussed in this paper show that the relationship between bonnet pressure and pressure locking stem loads appears linear. The results also show that for this valve, seat leakage affects the bonnet pressurization rate when the valve is subjected to thermally induced pressure locking conditions

  14. Pressure locking test results

    Energy Technology Data Exchange (ETDEWEB)

    DeWall, K.G.; Watkins, J.C.; McKellar, M.G.; Bramwell, D. [Idaho National Engineering Lab., Idaho Falls, ID (United States)] [and others

    1996-12-01

    The U.S. Nuclear Regulatory Commission (NRC), Office of Nuclear Regulatory Research, is funding the Idaho National Engineering Laboratory (INEL) in performing research to provide technical input for their use in evaluating responses to Generic Letter 95-07, {open_quotes}Pressure Locking and Thermal Binding of Safety-Related Power-Operated Gate Valves.{close_quotes} Pressure locking and thermal binding are phenomena that make a closed gate valve difficult to open. This paper discusses only the pressure locking phenomenon in a flexible-wedge gate valve; the authors will publish the results of their thermal binding research at a later date. Pressure locking can occur when operating sequences or temperature changes cause the pressure of the fluid in the bonnet (and, in most valves, between the discs) to be higher than the pressure on the upstream and downstream sides of the disc assembly. This high fluid pressure presses the discs against both seats, making the disc assembly harder to unseat than anticipated by the typical design calculations, which generally consider friction at only one of the two disc/seat interfaces. The high pressure of the bonnet fluid also changes the pressure distribution around the disc in a way that can further contribute to the unseating load. If the combined loads associated with pressure locking are very high, the actuator might not have the capacity to open the valve. The results of the NRC/INEL research discussed in this paper show that the relationship between bonnet pressure and pressure locking stem loads appears linear. The results also show that for this valve, seat leakage affects the bonnet pressurization rate when the valve is subjected to thermally induced pressure locking conditions.

  15. Biomechanical comparison of orthogonal versus parallel double plating systems in intraarticular distal humerus fractures

    Directory of Open Access Journals (Sweden)

    Ata C. Atalar

    2017-01-01

    Conclusion: Our study showed that both plating systems had similar biomechanical stabilities when anatomic plates with distal locking screws were used in intraarticular distal humerus fractures in artificial humerus models.

  16. Long term outcome of anterior cervical discectomy and fusion using coral grafts.

    Science.gov (United States)

    Ramzi, Najib; Ribeiro-Vaz, Geraldo; Fomekong, Edward; Lecouvet, Frédéric E; Raftopoulos, Christian

    2008-12-01

    To determine the long term efficacy of coral grafts in anterior cervical discectomy and fusion. In this prospective longitudinal study, All patients presenting with myelopathy and/or radiculopathy due to discal hernia or cervical spondylosis underwent anterior cervical microdiscectomy, arthrodesis with coral, and stabilization with anterior cervical locking plates. Clinical and radiological post-operative evaluations were performed at 2 days, 3, 6, and 12 months, and then yearly. The visual analogue scale was used for the evaluation of pain. Fusion was defined as the absence of motion on dynamic imaging combined with the disappearance of radio-lucent lines around the graft. The mean follow-up period was 44 months. In 83.3%, 91.2% and 93.7% of patients there was a satisfactory outcome for neck pain, arm pain, and motor deficit, respectively. The overall complication rate was 17.5%, all of which were transient. Additional surgery was required in nine cases. The occurrence of complications is correlated with less satisfactory outcomes for both neck and arm pain. While 95.5% of patients expressed overall satisfaction with their surgery, 70.5% stated that they had returned to their previous activities. The fusion rate was 45%; which was not correlated with clinical outcome and more likely in patients with of cervical spondylosis and one-level arthrodesis. Despite satisfactory clinical results and a long follow-up period, coral implants yield low fusion rates, particularly in patients with discal hernia of two-level arthrodesis. The use of coral grafts cannot be recommended when fusion is one of the post-operative endpoints.

  17. Injection locking of excimer lasers

    International Nuclear Information System (INIS)

    Bigio, I.J.; Slatkine, M.

    1981-01-01

    Reliable injection locking of high-power unstable resonator excimer lasers can be achieved with extremely low reference oscillator power. The criteria for injection locking are discussed and experimental results are given

  18. Reasoning about Java's Reentrant Locks

    NARCIS (Netherlands)

    Haack, C.; Huisman, Marieke; Hurlin, C.; Ramalingam, G.

    2008-01-01

    This paper presents a verification technique for a concurrent Java-like language with reentrant locks. The verification technique is based on permission-accounting separation logic. As usual, each lock is associated with a resource invariant, i.e. when acquiring the lock the resources are obtained

  19. Positioning and locking apparatus

    Science.gov (United States)

    Hayward, M.L.; Harper, W.H.

    1985-06-19

    A positioning and locking apparatus including a fixture having a rotatable torque ring provided with a plurality of cam segments for automatically guiding a container into a desired location within the fixture. Rotation of the ring turns the container into a final position in pressure sealing relation against a hatch member.

  20. Bicycle Parking and Locking

    DEFF Research Database (Denmark)

    Larsen, Jonas

    2017-01-01

    Cars, trains, and bicycles are designed to be on the move. Mobilities studies have theorized and analyzed these modes of transport as powerful entities slicing through, and speeding-up, cities. Yet they also stand still, being parked and locked, immobilized and secured, until their next trip...

  1. Locks and Keys Service

    CERN Multimedia

    Claude Ducastel

    The GS-LS-SEM section is pleased to inform you that as from Monday 30 November 2009, the opening hours of the Locks and Keys service will be the following: 08h30 - 12h30 / 13h30 - 16:30, Mondays to Fridays. GS-SEM-LS 73333

  2. Locked nucleic acid

    DEFF Research Database (Denmark)

    Jepsen, Jan Stenvang; Sørensen, Mads D; Wengel, Jesper

    2004-01-01

    Locked nucleic acid (LNA) is a class of nucleic acid analogs possessing very high affinity and excellent specificity toward complementary DNA and RNA, and LNA oligonucleotides have been applied as antisense molecules both in vitro and in vivo. In this review, we briefly describe the basic...

  3. Hydraulic Structures : Locks

    NARCIS (Netherlands)

    Molenaar, W.F.

    These lecture notes on locks are part of the study material belonging to the course 'Hydraulic Structures 1' (code CT3330), part of the Bachelor of Science and the Master of Science, the Hydraulic Engineering track, for civil engineering students at Delft University of Technology. Many of the

  4. Avaliação das complicações do tratamento cirúrgico das fraturas da extremidade proximal do úmero com "placa bloqueada" Evaluation of the complications of surgical treatment of fractures of the proximal extremity of the humerus using a locking plate

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2012-10-01

    Full Text Available OBJETIVO: Avaliar as complicações do tratamento cirúrgico dos pacientes com fratura da extremidade proximal do úmero com "placa bloqueada". MÉTODOS: Entre julho de 2004 e dezembro de 2009, foram tratados 56 pacientes com fratura da extremidade proximal do úmero com a placa Philos®. Dezenove pacientes eram do sexo masculino e 37 do feminino, com média de idade de 62 anos, variando de 30 a 92 anos. Todos os casos tinham tempo de seguimento mínimo, no período pós-operatório, de 12 meses. Treze fraturas foram classificadas como em duas partes, 28 em três, oito em quatro e sete como fraturas epifisárias. RESULTADOS: Dos pacientes operados, 26 foram considerados como tendo obtido resultado excelente, 12 como bom, 10 como regular e oito como ruim, conforme o escore de UCLA. Trinta complicações ocorreram em 20 pacientes (35,7%, sendo a mais frequente a redução inadequada da fratura que ocorreu em oito casos. O impacto subacromial causado pela placa ocorreu em sete casos, enquanto a fixação inadequada da fratura em seis. Outras complicações como pseudoartrose, capsulite adesiva, necrose avascular, perda da redução em varo e infecção também foram verificadas. CONCLUSÃO: Os resultados funcionais do tratamento das fraturas da extremidade proximal do úmero com a "placa bloqueada" dependem da correta redução anatômica da fratura e fixação estável do implante. Complicações ainda são frequentes, principalmente devido à dificuldade técnica intraoperatória, à gravidade da fratura e à eventual inexperiência do cirurgião.OBJECTIVE: To evaluate the complications from surgical treatment using a locking plate among patients with fractures of the proximal extremity of the humerus. METHODS: Between July 2004 and December 2009, 56 patients with fractures of the proximal extremity of the humerus were treated using the PHILOS® plate. There were 19 male patients and 37 female patients, with a mean age of 62 years (range: 30 to

  5. Innovation and Lock-in

    DEFF Research Database (Denmark)

    Cantner, Uwe; Vannuccini, Simone

    2016-01-01

    This study focuses on a well-known but yet elusive concept: (technological) lock-in. We summarize what is known about the nature of lock-in and offer a critical view on history-dependent processes based on recent contributions to the literature. We discuss if lock-ins are really inescapable......, especially when innovation is concerned. Also, we address the question if lock-in is a well-defined concept at all. To offer a fresh view on lock-in and to tackle the issues just raised, we employ the replicator dynamics model. By making a parallel between monopolization in the replicator dynamics...... and the occurrence of lock-ins, we show that the convergence of a system to a given outcome can be reversed, under certain conditions. We highlight the need for a more precise demarcation of the conceptual boundaries of lock-in and path dependence, both from the formal and the empirical side, and suggest...

  6. Implant Material, Type of Fixation at the Shaft, and Position of Plate Modify Biomechanics of Distal Femur Plate Osteosynthesis.

    Science.gov (United States)

    Kandemir, Utku; Augat, Peter; Konowalczyk, Stefanie; Wipf, Felix; von Oldenburg, Geert; Schmidt, Ulf

    2017-08-01

    To investigate whether (1) the type of fixation at the shaft (hybrid vs. locking), (2) the position of the plate (offset vs. contact) and (3) the implant material has a significant effect on (a) construct stiffness and (b) fatigue life in a distal femur extraarticular comminuted fracture model using the same design of distal femur periarticular locking plate. An extraarticular severely comminuted distal femoral fracture pattern (OTA/AO 33-A3) was simulated using artificial bone substitutes. Ten-hole distal lateral femur locking plates were used for fixation per the recommended surgical technique. At the distal metaphyseal fragment, all possible locking screws were placed. For the proximal diaphyseal fragment, different types of screws were used to create 4 different fixation constructs: (1) stainless steel hybrid (SSH), (2) stainless steel locked (SSL), (3) titanium locked (TiL), and (4) stainless steel locked with 5-mm offset at the diaphysis (SSLO). Six specimens of each construct configuration were tested. First, each specimen was nondestructively loaded axially to determine the stiffness. Then, each specimen was cyclically loaded with increasing load levels until failure. Construct Stiffness: The fixation construct with a stainless steel plate and hybrid fixation (SSH) had the highest stiffness followed by the construct with a stainless steel plate and locking screws (SSL) and were not statistically different from each other. Offset placement (SSLO) and using a titanium implant (TiL) significantly reduced construct stiffness. Fatigue Failure: The stainless steel with hybrid fixation group (SSH) withstood the most number of cycles to failure and higher loads, followed by the stainless steel plate and locking screw group (SSL), stainless steel plate with locking screws and offset group (SSLO), and the titanium plate and locking screws group (TiL) consecutively. Offset placement (SSLO) as well as using a titanium implant (TiL) reduced cycles to failure. Using the

  7. Osteossíntese das fraturas da extremidade proximal do úmero com sistema de placa de ângulo fixo com parafusos bloqueados: técnica e resultados Osteosynthesis of proximal humeral end fractures with fixed angle plate and locking screws: technique and results

    Directory of Open Access Journals (Sweden)

    Marcio Cohen

    2009-04-01

    Full Text Available OBJETIVO: Descrever os resultados do tratamento cirúrgico das fraturas da extremidade proximal do úmero com a placa de sistema bloqueado Philos. MÉTODOS: Entre março de 2003 e outubro de 2004 foram avaliados, de forma prospectiva, 24 de 26 pacientes com fratura da extremidade proximal do úmero tratados com a placa Philos. A média de seguimento foi de 12 meses e da idade dos pacientes, de 57 anos. Seis pacientes tinham fraturas em quatro partes, 11 em três partes e nove em duas partes. A avaliação clínica foi feita por meio dos critérios da University of California at Los Angeles (UCLA. RESULTADOS: A média do escore da UCLA foi de 30 pontos (17-35. Todas as fraturas consolidaram. Em três pacientes a fratura consolidou em varo. Nesses, o índice da UCLA médio foi de 27 pontos. CONCLUSÃO: A osteossíntese com a placa Philos permite fixação estável com bom resultado funcional.OBJECTIVE: Describe the results of proximal humeral fractures surgically treated with the Philos locking plate system. METHOD: Between March 2003 and October 2004 we prospectively reviewed 24 of 26 patients with proximal humerus fractures treated with a Philos plate. The mean follow-up time was 12 months and the mean age of patients was 57 years. Six patients had four-part proximal humerus fractures, 11 patients had three-part proximal humerus fractures, and nine patients had two-part proximal humerus fractures. Clinical evaluation was performed using the University of California at Los Angeles (UCLA criteria. RESULTS: The mean UCLA score was 30 points (17-34. All fractures showed union. Three patients showed fracture union at varus position. The mean UCLA score for these patients was 27 points. CONCLUSION: Osteosynthesis with Philos plate provides a stable fixation method with good functional outcome.

  8. Data port security lock

    Science.gov (United States)

    Quinby, Joseph D [Albuquerque, NM; Hall, Clarence S [Albuquerque, NM

    2008-06-24

    In a security apparatus for securing an electrical connector, a plug may be fitted for insertion into a connector receptacle compliant with a connector standard. The plug has at least one aperture adapted to engage at least one latch in the connector receptacle. An engagement member is adapted to partially extend through at least one aperture and lock to at least one structure within the connector receptacle.

  9. Avoiding lock-in

    DEFF Research Database (Denmark)

    Henriksen, Ingrid

    1999-01-01

    The paper investigates the initial phase of the cooperative organisation of agricultural processing firms in Denmark. It argues that the variations observed can be explained within the framework of the theory of industrial organisation. The focus is on the success of cooperative creameries. In 19...... of gathering information and of preserving and transporting a perishable product, were ideally suited to overcome the problems of potential lock-in and of asymmetric information...

  10. Cold plate

    Energy Technology Data Exchange (ETDEWEB)

    Marroquin, Christopher M.; O' Connell, Kevin M.; Schultz, Mark D.; Tian, Shurong

    2018-02-13

    A cold plate, an electronic assembly including a cold plate, and a method for forming a cold plate are provided. The cold plate includes an interface plate and an opposing plate that form a plenum. The cold plate includes a plurality of active areas arranged for alignment over respective heat generating portions of an electronic assembly, and non-active areas between the active areas. A cooling fluid flows through the plenum. The plenum, at the non-active areas, has a reduced width and/or reduced height relative to the plenum at the active areas. The reduced width and/or height of the plenum, and exterior dimensions of cold plate, at the non-active areas allow the non-active areas to flex to accommodate surface variations of the electronics assembly. The reduced width and/or height non-active areas can be specifically shaped to fit between physical features of the electronics assembly.

  11. Plating laboratory

    International Nuclear Information System (INIS)

    Seamster, A.G.; Weitkamp, W.G.

    1984-01-01

    The lead plating of the prototype resonator has been conducted entirely in the plating laboratory at SUNY Stony Brook. Because of the considerable cost and inconvenience in transporting personnel and materials to and from Stony Brook, it is clearly impractical to plate all the resonators there. Furthermore, the high-beta resonator cannot be accommodated at Stony Brook without modifying the set up there. Consequently the authors are constructing a plating lab in-house

  12. Tangential Bicortical Locked Fixation Improves Stability in Vancouver B1 Periprosthetic Femur Fractures: A Biomechanical Study.

    Science.gov (United States)

    Lewis, Gregory S; Caroom, Cyrus T; Wee, Hwabok; Jurgensmeier, Darin; Rothermel, Shane D; Bramer, Michelle A; Reid, John Spence

    2015-10-01

    The biomechanical difficulty in fixation of a Vancouver B1 periprosthetic fracture is purchase of the proximal femoral segment in the presence of the hip stem. Several newer technologies provide the ability to place bicortical locking screws tangential to the hip stem with much longer lengths of screw purchase compared with unicortical screws. This biomechanical study compares the stability of 2 of these newer constructs to previous methods. Thirty composite synthetic femurs were prepared with cemented hip stems. The distal femur segment was osteotomized, and plates were fixed proximally with either (1) cerclage cables, (2) locked unicortical screws, (3) a composite of locked screws and cables, or tangentially directed bicortical locking screws using either (4) a stainless steel locking compression plate system with a Locking Attachment Plate (Synthes) or (5) a titanium alloy Non-Contact Bridging system (Zimmer). Specimens were tested to failure in either axial or torsional quasistatic loading modes (n = 3) after 20 moderate load preconditioning cycles. Stiffness, maximum force, and failure mechanism were determined. Bicortical constructs resisted higher (by an average of at least 27%) maximum forces than the other 3 constructs in torsional loading (P steel construct in axial loading. Proximal fixation stability is likely improved with the use of bicortical locking screws as compared with traditional unicortical screws and cable techniques. In this study with a limited sample size, we found the addition of cerclage cables to unicortical screws may not offer much improvement in biomechanical stability of unstable B1 fractures.

  13. Cervical corpectomy with preserved posterior vertebral wall for cervical spondylotic myelopathy: a randomized control clinical study.

    Science.gov (United States)

    Ying, Zhang; Xinwei, Wang; Jing, Zhang; Shengming, Xu; Bitao, Lv; Tao, Zhang; Wen, Yuan

    2007-06-15

    Cervical corpectomy with preserved posterior vertebral wall (CPW) had been performed by the senior author (Y.W.) since 1999. A prospective study had been conducted to evaluate the efficacy of CPW since 2001. To validate the clinical outcome of CPW against conventional corpectomy (CC). Anterior surgical managements of cervical spondylotic myelopathy (CSM) include discectomy and corpectomy. Both have significant disadvantages, including low fusion rates and residual symptoms. A procedure incorporating multilevel discectomy, corpectomy with preserved posterior vertebral wall, autograft and plating was described. By keeping the posterior vertebral wall (PW), infringement of the vein plexus and spinal canal was avoided and more fusion site was available. From March 2001 to March 2004, 178 cases of CSM were randomized to undergo CPW (n = 89) or CC (n = 89). Arthrodesis was done with autogenous iliac bone graft or titanium cage supplemented with anterior self-lock plates in both groups. Operation time, blood loss, days of hospitalization, the numbers and types of complications, and preoperative and postoperative JOA scores were recorded. Fusion rate, segmental lordosis, and disc height were assessed by roentgenography. Three-dimensional reconstructions of CT scan were used to confirm fusion evidence. Average operation time and blood loss decreased significantly in the CPW group (98.06 +/- 19.42 minutes, and 131.69 +/- 62.41 mL) as compared with those in the CC group (108.45 +/- 22.35 minutes, and 181.57 +/- 82.10 mL) (P < 0.05). There were 2 cases of epidural bleeding and 1 case of CSF leak in the CC group. Other complications were minor. JOA improvement scores were similar in both groups. Roentgenograms showed that the fusion rate was 100% at 6 months postoperatively in both groups. CT scans showed that PW fused with grafts and bone dust in cages. Improvement in segmental lordosis and disc height was similar in both groups. CPW is a feasible procedure for anterior

  14. Cervical Cancer

    Science.gov (United States)

    ... 800-762-2264 Foundation for Women's Cancer Phone Number: 800-444-4441 Previous Page Next Page Cervical cancer fact sheet (PDF, 162 KB) Female reproductive system Related information Human papillomavirus (HPV) and genital ...

  15. Cervical Cancer

    Science.gov (United States)

    ... I find more information about cervical and other gynecologic cancers? Centers for Disease Control and Prevention: 800-CDC-INFO or www. cdc. gov/ cancer/ gynecologic National Cancer Institute: 800-4-CANCER or www. ...

  16. Cervical Cerclage

    Science.gov (United States)

    ... and Gynecology. 2014;123:372. Cervical cerclage About Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  17. Cervical Cap

    Science.gov (United States)

    ... p020041. Accessed Nov. 11, 2014. Cervical cap About Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  18. Cervical Laminoplasty

    Science.gov (United States)

    ... Nerve Tests: EMG, NCV and SEEP Alternative Medicine Acupuncture Herbal Supplements Surgical Options Anterior Cervical Fusion Artifical ... tasks. A NASS physician can perform a thorough history to evaluate your symptoms and any recent changes. ...

  19. Cervical Cap

    Science.gov (United States)

    ... weeks after delivery Can be inserted hours before sex and remain in place for up to 48 hours Doesn't require a partner's cooperation Poses few if any side effects The cervical cap isn't appropriate for everyone, ...

  20. Cervical Stenosis

    Science.gov (United States)

    ... Drug Interactions Pill Identifier Commonly searched drugs Aspirin Metformin Warfarin Tramadol Lactulose Ranitidine News & Commentary Recent News ... D May Affect Breast Cancer Survival (Video) Ectopic Pregnancy (Video) Assisted Delivery Additional Content Medical News Cervical ...

  1. Cervical Myomas

    Science.gov (United States)

    ... Drug Interactions Pill Identifier Commonly searched drugs Aspirin Metformin Warfarin Tramadol Lactulose Ranitidine News & Commentary Recent News ... D May Affect Breast Cancer Survival (Video) Ectopic Pregnancy (Video) Assisted Delivery Additional Content Medical News Cervical ...

  2. 49 CFR 236.338 - Mechanical locking required in accordance with locking sheet and dog chart.

    Science.gov (United States)

    2010-10-01

    ... locking sheet and dog chart. 236.338 Section 236.338 Transportation Other Regulations Relating to... in accordance with locking sheet and dog chart. Mechanical locking shall be in accordance with locking sheet and dog chart currently in effect. ...

  3. Tratamento cirúrgico das fraturas do rádio distal com placa volar bloqueada: correlação dos resultados clínicos e radiográficos Surgical treatment of distal radius fractures with a volar locked plate: correlation of clinical and radiographic results

    Directory of Open Access Journals (Sweden)

    Claudio Roberto Martins Xavier

    2011-10-01

    Full Text Available OBJETIVO: Analisar e correlacionar os resultados clínicos e radiográficos de pacientes com fratura do rádio distal submetidos ao tratamento cirúrgico com placa volar bloqueada de ângulo fixo. MÉTODOS: Avaliou-se 64 pacientes com fraturas do rádio distal submetidos ao tratamento cirúrgico com placa volar bloqueada de rádio distal, com mínimo de seis meses de acompanhamento pós-operatório. Foram submetidos a exame físico com medida do arco de movimento e força de preensão, ao questionário Disabilities of the Arm, Shoulder, and Hand (DASH e a exames radiográficos. RESULTADOS: No exame físico dos pacientes houve redução de todas as medidas de amplitude de movimento. A força de preensão em kgf medida foi em média 85,8% do valor obtido em relação ao lado não acometido. O valor médio do DASH foi de 15,99. As perdas de extensão e de força de preensão tiveram relação significativa com um DASH inferior. Nas radiografias, as médias dos valores, quando comparados ao do lado não fraturado, foram 84,0% da inclinação radial, 85,4% do comprimento radial e 86,8% do desvio volar do rádio. Perda de comprimento radial se relacionou com perda de extensão e força de preensão. Conclusão: A diminuição da amplitude do movimento está associada à perda do comprimento radial na radiografia. Os resultados subjetivos dos pacientes (DASH são modificados pela amplitude de extensão e força de preensão, porém não se relacionam com medidas radiográficas.OBJECTIVES: To analyze and correlate the clinical and radiographic results from patients with distal radius fractures who underwent surgical treatment with a fixed-angle volar locked plate. METHODS: Sixty-four patients with distal radius fractures were evaluated. They all underwent surgical treatment with a volar locked plate for the distal radius, with a minimum of six months of postoperative follow-up. They underwent a physical examination that measured range of motion and grip

  4. Complications of Minimally Invasive Percutaneous Plating for Distal Tibial Fractures

    OpenAIRE

    Muzaffar, Nasir; Bhat, Rafiq; Yasin, Mohammad

    2016-01-01

    Background The management of distal tibia fractures continues to remain a source of controversy and debate. Objectives The aim of this study was to evaluate the various complications of minimally invasive percutaneous plate osteosynthesis (MIPPO) using a locking plate for closed fractures of distal tibia in a retrospective study. Patients and Methods Twenty-five patients with dista...

  5. 49 CFR 236.330 - Locking dog of switch-and-lock movement.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Locking dog of switch-and-lock movement. 236.330 Section 236.330 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD... Rules and Instructions § 236.330 Locking dog of switch-and-lock movement. Locking dog of switch-and-lock...

  6. Assumed strain distributions for a finite strip plate bending element using Mindlin-Reissner plate theory

    Science.gov (United States)

    Chulya, Abhisak; Mullen, Robert L.

    1989-01-01

    A linear finite strip plate element based on Mindlin-Reissner plate theory is developed. The analysis is suitable for both thin and thick plates. In the formulation, new transverse shear strains are introduced and assumed constant in each two-node linear strip. The element stiffness matrix is explicitly formulated for efficient computation and computer implementation. Numerical results showing the efficiency and predictive capability of the element for the analysis of plates are presented for different support and loading conditions and a wide range of thicknesses. No sign of shear locking is observed with the newly developed element.

  7. Cervical thymoma

    Directory of Open Access Journals (Sweden)

    Abrão Rapoport

    1999-05-01

    Full Text Available CONTEXT: Cervical thymoma is a primitive thymic neoplasia. It is very rare. This disease presents higher incidence in female patients in their 4th to 6th decade of life. We present a case report of a cervical thymoma CASE REPORT: 54-year-old female patient, caucasian, with no history of morbidity, presenting a left cervical nodule close to the thyroid gland. During the 30 months of investigation a left cervical nodule grew progressively next to the thyroid while the patient showed no symptoms, making accurate diagnosis difficult. Tests on her thyroid function did not show changes, nor were there changes in any subsidiary tests. The diagnosis of the disease was made intra-operatively through total thyroid individualization. The results were confirmed by the histological findings from the ressected material. Cervical thymoma is a very rare disease, with difficult preoperatory diagnosis. Some additional study methods which are employed today are thallium 201, technetium 99 and iodine 131 scintigraphy, magnetic nuclear resonance and especially histopathological findings and classification.

  8. Breaking Carbon Lock-in

    DEFF Research Database (Denmark)

    Driscoll, Patrick Arthur

    2014-01-01

    This central focus of this paper is to highlight the ways in which path dependencies and increasing returns (network effects) serve to reinforce carbon lock-in in large-scale road transportation infrastructure projects. Breaking carbon lock-in requires drastic changes in the way we plan future...

  9. The evaluation of the bone graft survival status in titanium cervical ...

    African Journals Online (AJOL)

    ONOS

    2010-08-09

    Aug 9, 2010 ... To find a better way to evaluate the bone graft survival status in cervical cages, forty-one patients suffering from one-level cervical spondylosis were enrolled in this study. All underwent anterior cervical decompression and fusion with titanium cage and plate. When followed up, another 21 patients were.

  10. The evaluation of the bone graft survival status in titanium cervical ...

    African Journals Online (AJOL)

    To find a better way to evaluate the bone graft survival status in cervical cages, forty-one patients suffering from one-level cervical spondylosis were enrolled in this study. All underwent anterior cervical decompression and fusion with titanium cage and plate. When followed up, another 21 patients were confirmed as ...

  11. Hydraulic Evaluation of Culvert Valves at Eisenhower and Snell Locks, St. Lawrence Seaway

    Science.gov (United States)

    2015-06-01

    ER D C/ CH L TR -1 5- 7 Hydraulic Evaluation of Culvert Valves at Eisenhower and Snell Locks, St. Lawrence Seaway Co as ta l a nd H...client/default. ERDC/CHL TR-15-7 June 2015 Hydraulic Evaluation of Culvert Valves at Eisenhower and Snell Locks, St. Lawrence Seaway...ERDC/CHL TR-15-7 ii Abstract The aged, double-skin-plate valves of the Eisenhower and Snell Locks on the St. Lawrence Seaway are being replaced

  12. Payload Launch Lock Mechanism

    Science.gov (United States)

    Young, Ken (Inventor); Hindle, Timothy (Inventor)

    2014-01-01

    A payload launch lock mechanism includes a base, a preload clamp, a fastener, and a shape memory alloy (SMA) actuator. The preload clamp is configured to releasibly restrain a payload. The fastener extends, along an axis, through the preload clamp and into the base, and supplies a force to the preload clamp sufficient to restrain the payload. The SMA actuator is disposed between the base and the clamp. The SMA actuator is adapted to receive electrical current and is configured, upon receipt of the electrical current, to supply a force that causes the fastener to elongate without fracturing. The preload clamp, in response to the fastener elongation, either rotates or pivots to thereby release the payload.

  13. Cervical Spondylosis and Hypertension

    OpenAIRE

    Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

    2015-01-01

    Abstract Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully w...

  14. Spondilitis Tuberkulosa Cervical

    Directory of Open Access Journals (Sweden)

    Roni Eka Saputra

    2015-05-01

    Full Text Available Abstrak Spondilitis tuberkulosa servikalis adalah penyakit yang cukup jarang dijumpai, hanya berkisar 2-3% dariseluruh kasus spondilitis tuberkulosa. Gambaran klinis sangat bervariasi, mulai dari gejala ringan dan tidak spesifikhingga komplikasi neurologis yang berat. Seorang wanita berusia 29 tahun datang dengan keluhan lemah keempatanggota gerak yang semakin memberat dalam 10 hari terakhir yang didahului oleh nyeri leher yang menjalar ke bahudan lengan sejak 6 bulan sebelumnya. Nyeri awalnya dirasakan sebagai keterbatasan gerakan leher saat menolehkesamping kiri dan kanan serta menundukkan kepala. Nyeri dirasakan semakin berat dengan pergerakan danberkurang jika istirahat. Pasien mengalami penurunan berat badan sejak 2 bulan terakhir. Tidak dijumpai riwayat batukatau nyeri dada. Pemeriksaan neurologis menunjukkan kelemahan  pada keempat ekstremitas. Hasil laboratoriumditemukan peningkatan Laju Endap Darah (LED. Rontgen foto toraks dalam batas normal. Roentgen foto cervicalmenunjukkan destruksi setinggi C5. MRI cervical menunjukkan destruksi pada korpus C5-6 dengan penyempitan padadiscus intervertebrae C5-6 disertai dengan  massa/abses paravertebral dengan penekanan ke posterior. MRI Thorakaltampak destruksi corpus verebre T4,5 dengan diskus intervertebralis yang menyempit. Sugestif suatu spondilitistuberkulosa. Pasien dilakukan tindakan pembedahan anterior corpectomi melalui microscopic surgery dengan graftdari iliac sinistra, serta insersi anterior plate 1 level. Hasil pemeriksaan patologi anatomi menunjukkan spodilitis TBCkaseosa. Pada spondilitis vertebre T4,5 dilakukan laminectomi, debridement costotrasversektomi, dan stabilisasidengan pedicle screw T2, T3, dan T5. Pasien diterapi dengan obat antituberkulosis. Keadaan pasien saat ini, pasiensudah bisa beraktifitas normal dengan motorik dan sensorik baik. Spondilitis tuberkulosa merupakan bentuktuberkulosa tulang yang paling sering dijumpai. Spondilitis tuberkulosa cervical berkisar 2

  15. Investigation of vertebral ''end plate sclerosis''

    International Nuclear Information System (INIS)

    Lee, S.W.; Mathie, A.G.; Jackson, J.E.; Hughes, S.P.F.

    2001-01-01

    To evaluate the association between vertebral ''end plate sclerosis'' and neck pain. A retrospective study was carried out of lateral cervical spine radiographs with a Picture Archive and Communication System (PACS). Two hundred patients' files were randomly assessed, comprising four equal groups, A to D. The mean ages of the patients were 62±7.4 years, 61±7.5 years, 40±5.6 years and 23±5.6 years respectively. In group A, all patients had symptoms of neck pain and a radiographic diagnosis of ''end plate sclerosis'' of the cervical spine. In groups B to D, asymptomatic patients were recruited and their age groups were 50-69, 30-49 and 10-29 years respectively. Using the PACS, the radiographic density and the sagittal diameter, thickness and area of the end plates at the C5 level were measured. Results and conclusions: No significant differences were found in the radiographic density of the end plates either between the symptomatic and asymptomatic groups (groups A and B), or between different age groups (groups B, C and D). A significant increase in end plate area and thickness was found, however, in both group B (P<0.005) and group C (P<0.01) in comparison with group D. This indicates that the extent of end plate sclerosis increases with age. Our results suggest that the radiographic density of cervical vertebral end plates correlates neither with neck pain nor with increasing age. The radiological sign of ''end plate sclerosis'' may be over-reported, further limiting its value in the assessment of patients with cervical spondylosis. (orig.)

  16. Is John Locke a democrat?

    DEFF Research Database (Denmark)

    Svensson, Palle

      Over recent years there has been a tendency to present John Locke as an equalitarian democrat (Ashcraft) and being close to the political views of the levellers (Waldron). This is not a completely new interpretation (Kendall, 1941), but contrasts with the prevalent view presented in textbooks...... (Holden, Held, Ball and Dagger) and monographs on Locke (Dunn, Parry, Marshall). In this paper a new approach to the democratic character of John Locke's political theory is suggested, as his Second Treatise is analysed with Robert A. Dahl's conceptual framework on assumptions for a democratic order...

  17. 49 CFR 236.765 - Locking, mechanical.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Locking, mechanical. 236.765 Section 236.765 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Locking, mechanical. An arrangement of locking bars, dogs, tappets, cross locking and other apparatus by...

  18. Research of mechanism of density lock

    International Nuclear Information System (INIS)

    Wang Shengfei; Yan Changqi; Gu Haifeng

    2010-01-01

    Mechanism of density lock was analyzed according to the work conditions of density lock. The results showed that: the stratification with no disturbance satisfied the work conditions of density lock; fluids between the stratification were not mixed at the condition of connected to each other; the density lock can be open automatically by controlled the pressure balance at the stratification. When disturbance existed, the stratification might be broken and mass would be transferred by convection. The stability of stratification can be enhanced by put the special structure in density lock to ensure the normal work of density lock. At last, the minimum of heat loss in density lock was also analyzed. (authors)

  19. Escaping carbon lock-in

    International Nuclear Information System (INIS)

    Unruh, G.C.

    2002-01-01

    This article explores the climate policy implications of the arguments made in ''Understanding carbon lock-in'' (Unruh, 2000), which posited that industrial countries have become locked-into fossil fuel-based energy systems through path dependent processes driven by increasing returns to scale. Carbon lock-in arises through technological, organizational, social and institutional co-evolution, ''culminating'' in what was termed as techno-institutional complex (TIC). In order to resolve the climate problem, an escape from the lock-in condition is required. However, due to the self-referential nature of TIC, escape conditions are unlikely to be generated internally and it is argued here that erogenous forces are probably required. (author)

  20. John locke on personal identity.

    Science.gov (United States)

    Nimbalkar, Namita

    2011-01-01

    John Locke speaks of personal identity and survival of consciousness after death. A criterion of personal identity through time is given. Such a criterion specifies, insofar as that is possible, the necessary and sufficient conditions for the survival of persons. John Locke holds that personal identity is a matter of psychological continuity. He considered personal identity (or the self) to be founded on consciousness (viz. memory), and not on the substance of either the soul or the body.

  1. Cervical Spondylosis and Hypertension

    Science.gov (United States)

    Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

    2015-01-01

    Abstract Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully with anterior cervical discectomy and fusion. Stimulation of sympathetic nerve fibers in pathologically degenerative disc could produce sympathetic excitation, and induce a sympathetic reflex to cause cervical vertigo and hypertension. In addition, chronic neck pain could contribute to hypertension development through sympathetic arousal and failure of normal homeostatic pain regulatory mechanisms. Cervical spondylosis may be one of the causes of secondary hypertension. Early treatment for resolution of symptoms of cervical spondylosis may have a beneficial impact on cardiovascular disease risk in patients with cervical spondylosis. PMID:25761188

  2. Cervical Cancer Screening

    Science.gov (United States)

    ... cervical cytology (also called the Pap test or Pap smear) and, for some women, testing for human papillomavirus (HPV) . How does cervical cancer occur? Cancer occurs when cervical cells become abnormal ...

  3. Cervical Cancer Screening

    Science.gov (United States)

    ... Cancer Treatment Screening for cervical cancer using the Pap test has decreased the number of new cases of ... their chance of dying from cervical cancer . A Pap test is commonly used to screen for cervical cancer. ...

  4. Cervical radiculopathy.

    Science.gov (United States)

    Corey, Deanna Lynn; Comeau, Douglas

    2014-07-01

    Cervical radiculopathy is the result of irritation and/or compression of nerve root as it exits the cervical spine. Pain is a common presenting symptom and may be accompanied by motor or sensory deficits in areas innervated by the affected nerve root. Diagnosis is suggested by history and corresponding physical examination findings. Confirmation is achieved with MRI. A multimodal approach to treatment helps patients improve. Medications may be used to alleviate symptoms and manage pain. Physical therapy and manipulation may improve neck discomfort. Guided corticosteroid injections and selected nerve blocks may help control nerve root pain. Most patients improve with a conservative, nonoperative treatment course. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Lateral cervical puncture for cervical myelography

    International Nuclear Information System (INIS)

    Seol, Hae Young; Cha, Sang Hoon; Kim, Yoon Hwan; Suh, Won Hyuck

    1985-01-01

    Eleven cervical myelograms were performed by lateral cervical puncture using Metrizamide. So, following results were obtained: 1. Site of lateral cervical puncture; Posterior one third of bony cervical canal at C 1-2 level. 2. Advantages as compared with lumbar puncture for cervical myelograms; 1) Small amount of contrast media 2) Excellent image 3) Less position charge 4) Short time 5) Well visualization of superior margin of obstructive lesion in spinal canal 3. Cessation of lateral cervical puncture, when; 1) Pain during injection of contrast media 2) Localized collection of contrast media

  6. Comparison of tibial plateau angle changes after tibial plateau leveling osteotomy fixation with conventional or locking screw technology.

    Science.gov (United States)

    Conkling, Amanda L; Fagin, Bennett; Daye, R Mark

    2010-06-01

    To compare the effects of locking and conventional screws on postoperative tibial plateau angle (TPA), osteotomy healing, and complication rate after tibial plateau leveling osteotomy (TPLO) in dogs treated for naturally occurring cranial cruciate ligament (CCL) rupture. Prospective clinical study. Dogs (n=118) with CCL rupture. Dogs (> or =20 kg) with unilateral CCL rupture and sufficient bone stock for TPLO and use of a 3.5-mm-broad or -narrow TPLO plate were sequentially allocated to have plate fixation with locking or conventional screws. Data analyzed included breed, age, sex, body weight, body condition score, limb operated, implants used, meniscal status, operative time, and days to recheck. Preoperative, immediate postoperative, and 8-week recheck mediolateral radiographs were reviewed, and TPA, complications, and healing status were evaluated. Stifles in the locking screw group had significantly less change in postoperative TPA than stifles in the conventional screw group. Locking screw fixation also had significantly higher grades of osteotomy healing, assessed on a mediolateral radiographic view. TPLO plates secured with locking screws are acceptable when compared with those secured with conventional screws; osteotomy healing is improved and TPA better conserved when using locking screws. Locking screw fixation serves to increase stabilization of TPA during TPLO healing and provides improved radiographic evidence of osteotomy healing.

  7. Screw Versus Plate Fixation for Chevron Osteotomy: A Retrospective Study.

    Science.gov (United States)

    Andrews, Boyd J; Fallat, Lawrence M; Kish, John P

    2016-01-01

    The chevron osteotomy is a popular procedure used for the correction of moderate hallux abducto valgus deformity. Fixation is typically accomplished with Kirschner wires or bone screws; however, in cystic or osteoporotic bone, these could be inadequate, resulting in displacement of the capital fragment. We propose using a locking plate and interfragmental screw for fixation of the chevron osteotomy that could reduce the healing time and decrease the incidence of displacement. We performed a retrospective cohort study for chevron osteotomies on 75 feet (73 patients). The control groups underwent fixation with 1 screw in 30 feet (40%) and 2 screws in 30 feet (40%). A total of 15 feet (20%) were included in the locking plate and interfragmental screw group. The patients were followed up until bone healing was achieved at a median of 7 (range 6 to 14) weeks. Our hypothesis was that those treated with the locking plate and interfragmental screw would have a faster healing time and fewer incidents of capital fragment displacement compared with the 1- or 2-screw groups. The corresponding mean intervals to healing for the 1-screw group was 7.71 ± 1.28 (range 6 to 10) weeks, for the 2-screw group was 7.27 ± 1.57 (range 6 to 14) weeks, and for the locking plate and interfragmental screw group was 7.01 ± 1.00 (range 6 to 9) weeks. One case of capital fragment displacement occurred in the single screw group and one in the 2-screw group. No displacement occurred in the locking plate and interfragmental screw group. Neither finding was statistically significant. However, we believe the locking plate and interfragmental screw could be a viable option in patients with osteoporotic and cystic bone changes for correction of hallux abducto valgus. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Cervical Laminoplasty for Multilevel Cervical Myelopathy

    Directory of Open Access Journals (Sweden)

    Murali Krishna Sayana

    2011-01-01

    Full Text Available Cervical spondylotic myelopathy can result from degenerative cervical spondylosis, herniated disk material, osteophytes, redundant ligamentum flavum, or ossification of the posterior longitudinal ligament. Surgical intervention for multi-level myelopathy aims to decompress the spinal cord and maintain stability of the cervical spine. Laminoplasty was major surgical advancement as laminectomy resulted in kyphosis and unsatisfactory outcomes. Hirabayashi popularised the expansive open door laminoplasty which was later modified several surgeons. Laminoplasty has changed the way surgeons approach multilevel cervical spondylotic myelopathy.

  9. Medicine in John Locke's philosophy.

    Science.gov (United States)

    Sanchez-Gonzalez, M A

    1990-12-01

    John Locke's philosophy was deeply affected by medicine of his times. It was specially influenced by the medical thought and practice of Thomas Sydenham. Locke was a personal friend of Sydenham, expressed an avid interest in his work and shared his views and methods. The influence of Sydenham's medicine can be seen in the following areas of Locke's philosophy: his "plain historical method"; the emphasis on observation and sensory experience instead of seeking the essence of things; the rejection of hypotheses and principles; the refusal of research into final causes and inner mechanisms; the ideal of irrefutable evidence and skepticism on the possibilities of certainty in science. The science which for Locke held the highest paradigmatic value in his theory of knowledge was precisely medicine. To a great extent, Locke's Essay on Human Understanding can be understood as an attempt to justify, substantiate, and promote Sydenham's medical method. This method, generalized, was then proposed as an instrument for the elaboration of all natural sciences.

  10. The healing philosopher: John Locke's medical ethics.

    Science.gov (United States)

    Short, Bradford William

    2004-01-01

    This article examines a heretofore unexplored facet of John Locke's philosophy. Locke was a medical doctor and he also wrote about medical issues that are controversial today. Despite this, Locke's medical ethics has yet to be studied. An analysis of Locke's education and his teachers and colleagues in the medical profession, of the 17th century Hippocratic Oath, and of the reaction to the last recorded outbreak of the bubonic plague in London, shines some light on the subject of Locke's medical ethics. The study of Locke's medical ethics confirms that he was a deontologist who opposed all suicide and abortion through much of pregnancy.

  11. Headache of cervical origin

    International Nuclear Information System (INIS)

    Burguet, J.L.; Wackenheim, A.

    1984-01-01

    The authors recall cervical etiologies of headache. They distinguish on the one hand the cervico-occipital region with minor and major malformations and acquired lesions, and on the other hand the middle and inferior cervical segment. They also recall the original structuralist analysis of the cervical spine and give the example of the ''cervical triplet''. (orig.) [de

  12. CAD-CAM plates versus conventional fixation plates for primary mandibular reconstruction: A biomechanical in vitro analysis.

    Science.gov (United States)

    Rendenbach, Carsten; Sellenschloh, Kay; Gerbig, Lucca; Morlock, Michael M; Beck-Broichsitter, Benedicta; Smeets, Ralf; Heiland, Max; Huber, Gerd; Hanken, Henning

    2017-11-01

    CAD/CAM reconstruction plates have become a viable option for mandible reconstruction. The aim of this study was to determine whether CAD/CAM plates provide higher fatigue strength compared with conventional fixation systems. 1.0 mm miniplates, 2.0 mm conventional locking plates (DePuy Synthes, Umkirch, Germany), and 2.0 mm CAD/CAM plates (Materialise, Leuven, Belgium/DePuy Synthes) were used to reconstruct a polyurethane mandible model (Synbone, Malans, CH) with cortical and cancellous bone equivalents. Mastication was simulated via cyclic dynamic testing using a universal testing machine (MTS, Bionix, Eden Prairie, MN, USA) until material failure reached a rate of 1 Hz with increasing loads on the left side. No significant difference was found between the groups until a load of 300 N. At higher loads, vertical displacement differed increasingly, with a poorer performance of miniplates (p = 0.04). Plate breakage occurred in miniplates and conventional locking plates. Screw breakage was recorded as the primary failure mechanism in CAD/CAM plates. Stiffness was significantly higher with the CAD/CAM plates (p = 0.04). CAD/CAM plates and reconstruction plates provide higher fatigue strength than miniplates, and stiffness is highest in CAD/CAM systems. All tested fixation methods seem sufficiently stable for mandible reconstruction. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  13. Automatic locking knee brace joint

    Science.gov (United States)

    Weddendorf, Bruce (Inventor)

    1995-01-01

    This invention is an apparatus for controlling the pivotal movement of a knee brace comprising a tang-and-clevis joint that has been uniquely modified. Both the tang and the clevis have a set of teeth that, when engaged, can lock the tang and the clevis together. In addition, the tang is biased away from the clevis. Consequently, when there is no axial force (i.e., body weight) on the tang, the tang is free to pivot within the clevis. However, when an axial force is exerted on the tang, the tang is pushed into the clevis, both sets of teeth engage, and the tang and the clevis lock together.

  14. Locking mechanism for orthopedic braces

    Science.gov (United States)

    Chao, J. I.; Epps, C. H., Jr.

    1981-01-01

    An orthopedic brace locking mechanism is described which under standing or walking conditions cannot be unlocked, however under sitting conditions the mechanism can be simply unlocked so as to permit bending of the patient's knee. Other features of the device include: (1) the mechanism is rendered operable, and inoperable, dependent upon the relative inclination of the brace with respect to the ground; (2) the mechanism is automatically locked under standing or walking conditions and is manually unlocked under sitting conditions; and (3) the mechanism is light in weight and is relatively small in size.

  15. Cervical Adjacent Segment Disease

    OpenAIRE

    Özbek, Zühtü; Özkara, Emre; Yağmur, İpek; Arslantaş, Ali

    2017-01-01

    Cervical adjacent segment disease; is the general name ofdisc pathologies that develop in adjacent levels after cervical surgery. If thecervical adjacent segment disease that do not require reoperation and it doesnot cause clinical signs is called radiological cervical adjacent segmentpathology, but those causing radiculopathy, myelopathy or instability is calledclinic cervical adjacent segment pathology. The incidence of cervical adjacentsegment disease in 10-year follow-up is 2.4% -2.9%. Wh...

  16. 49 CFR 236.762 - Locking, indication.

    Science.gov (United States)

    2010-10-01

    ... Locking, indication. Electric locking which prevents manipulation of levers that would result in an unsafe... corresponding to that of its controlling lever, or which directly prevents the operation of a signal, switch, or...

  17. 49 CFR 236.105 - Electric lock.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Electric lock. 236.105 Section 236.105 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION...: All Systems Inspections and Tests; All Systems § 236.105 Electric lock. Electric lock, except forced...

  18. 49 CFR 236.761 - Locking, electric.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Locking, electric. 236.761 Section 236.761 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Locking, electric. The combination of one or more electric locks and controlling circuits by means of...

  19. 49 CFR 236.757 - Lock, electric.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Lock, electric. 236.757 Section 236.757... Lock, electric. A device to prevent or restrict the movement of a lever, a switch or a movable bridge, unless the locking member is withdrawn by an electrical device, such as an electromagnet, solenoid or...

  20. Phase locking between Josephson soliton oscillators

    DEFF Research Database (Denmark)

    Holst, T.; Hansen, Jørn Bindslev; Grønbech-Jensen, N.

    1990-01-01

    We report observations of phase-locking phenomena between two Josephson soliton (fluxon) oscillators biased in self-resonant modes. The locking strength was measured as a function of bias conditions. A frequency tunability of the phase-locked oscillators up to 7% at 10 GHz was observed. Two coupled...

  1. Bilateral locked facets in the thoracic spine

    NARCIS (Netherlands)

    M.H.A. Willems; Braakman, R. (Reinder); B. van Linge (Bert)

    1984-01-01

    textabstractTwo cases of traumatic bilateral locked facets in the thoracic spine are reported. Both patients had only minor neurological signs. They both made a full neurological recovery after surgical reduction of the locked facets. Bilateral locked facets are very uncommon in the thoracic spine.

  2. 49 CFR 236.768 - Locking, time.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Locking, time. 236.768 Section 236.768... Locking, time. A method of locking, either mechanical or electrical, which, after a signal has been caused to display an aspect to proceed, prevents, until after the expiration of a predetermined time...

  3. Advances phase-lock techniques

    CERN Document Server

    Crawford, James A

    2008-01-01

    From cellphones to micrprocessors, to GPS navigation, phase-lock techniques are utilized in most all modern electronic devices. This high-level book takes a systems-level perspective, rather than circuit-level, which differentiates it from other books in the field.

  4. Coupled optical resonance laser locking

    CSIR Research Space (South Africa)

    Burd, CC

    2014-10-01

    Full Text Available We have demonstrated simultaneous laser frequency stabilization of a UV and IR laser, to coupled transitions of ions in the same spectroscopic sample, by detecting only the absorption of the UV laser. Separate signals for locking the different...

  5. Tidal locking of habitable exoplanets

    Science.gov (United States)

    Barnes, Rory

    2017-12-01

    Potentially habitable planets can orbit close enough to their host star that the differential gravity across their diameters can produce an elongated shape. Frictional forces inside the planet prevent the bulges from aligning perfectly with the host star and result in torques that alter the planet's rotational angular momentum. Eventually the tidal torques fix the rotation rate at a specific frequency, a process called tidal locking. Tidally locked planets on circular orbits will rotate synchronously, but those on eccentric orbits will either librate or rotate super-synchronously. Although these features of tidal theory are well known, a systematic survey of the rotational evolution of potentially habitable exoplanets using classic equilibrium tide theories has not been undertaken. I calculate how habitable planets evolve under two commonly used models and find, for example, that one model predicts that the Earth's rotation rate would have synchronized after 4.5 Gyr if its initial rotation period was 3 days, it had no satellites, and it always maintained the modern Earth's tidal properties. Lower mass stellar hosts will induce stronger tidal effects on potentially habitable planets, and tidal locking is possible for most planets in the habitable zones of GKM dwarf stars. For fast-rotating planets, both models predict eccentricity growth and that circularization can only occur once the rotational frequency is similar to the orbital frequency. The orbits of potentially habitable planets of very late M dwarfs ([InlineEquation not available: see fulltext.]) are very likely to be circularized within 1 Gyr, and hence, those planets will be synchronous rotators. Proxima b is almost assuredly tidally locked, but its orbit may not have circularized yet, so the planet could be rotating super-synchronously today. The evolution of the isolated and potentially habitable Kepler planet candidates is computed and about half could be tidally locked. Finally, projected TESS planets

  6. 49 CFR 236.766 - Locking, movable bridge.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Locking, movable bridge. 236.766 Section 236.766... Locking, movable bridge. The rail locks, bridge locks, bolt locks, circuit controllers, and electric locks used in providing interlocking protection at a movable bridge. ...

  7. Cervicitis of unknown etiology.

    Science.gov (United States)

    Taylor, Stephanie N

    2014-07-01

    Cervicitis has been described by some as the female counterpart of urethritis in men. Over the years a number of clinical and microscopy-based definitions have been suggested in the literature. Clinical manifestations include mucopurulent discharge from the cervix, cervical friability (easy bleeding from the cervix with passage of a swab) and cervical ectopy. Microscopic definitions involving the use of Gram stain of cervical secretions have included either more than 10 white blood cells (WBCs) or more than 30 WBCs per high-power field. Combinations of these clinical and microscopic findings have been used in attempts to increase the accuracy of cervicitis diagnosis. When cervicitis was initially recognized as a clinical entity, several investigators reported the primary pathogens causing cervicitis as Neisseria gonorrhoeae and Chlamydia trachomatis. It is now well established that most cases of cervicitis are not caused by these two organisms. Most cases of cervicitis are of unknown etiology.

  8. Cervical cancer - screening and prevention

    Science.gov (United States)

    Cancer cervix - screening; HPV - cervical cancer screening; Dysplasia - cervical cancer screening; Cervical cancer - HPV vaccine ... Almost all cervical cancers are caused by HPV (human papilloma virus). HPV is a common virus that spreads through sexual contact. Certain ...

  9. Active locking and entanglement in type II optical parametric oscillators

    Science.gov (United States)

    Ruiz-Rivas, Joaquín; de Valcárcel, Germán J.; Navarrete-Benlloch, Carlos

    2018-02-01

    Type II optical parametric oscillators are amongst the highest-quality sources of quantum-correlated light. In particular, when pumped above threshold, such devices generate a pair of bright orthogonally-polarized beams with strong continuous-variable entanglement. However, these sources are of limited practical use, because the entangled beams emerge with different frequencies and a diffusing phase difference. It has been proven that the use of an internal wave-plate coupling the modes with orthogonal polarization is capable of locking the frequencies of the emerging beams to half the pump frequency, as well as reducing the phase-difference diffusion, at the expense of reducing the entanglement levels. In this work we characterize theoretically an alternative locking mechanism: the injection of a laser at half the pump frequency. Apart from being less invasive, this method should allow for an easier real-time experimental control. We show that such an injection is capable of generating the desired phase locking between the emerging beams, while still allowing for large levels of entanglement. Moreover, we find an additional region of the parameter space (at relatively large injections) where a mode with well defined polarization is in a highly amplitude-squeezed state.

  10. Jaw locking after maxillofacial trauma

    Directory of Open Access Journals (Sweden)

    David B. Kamadjaja

    2007-09-01

    Full Text Available The purpose of this report is to present two cases of jaw locking with two different etiologies. In case #1, jaw locking occured 5.5 months after a surgical reduction and internal fixation on the fractured maxilla and mandible. Some plain radiographic x-ray were made but failed to give adequate information in establishing the cause of trismus. The three dimensional computed tomography (3D-CT was finally made and able to help guide the pre-operative diagnosis and treatment. Two-steps gap arthroplasty were done comprising a gap arthroplasty leading to acceptable outcome. An adult patient in case #2 with a history of trauma at his childhood and bird-like face apprearance clinically, was unable to open the mouth since the time of accident. The patient was diagnosed with bilateral ankylosis of temporomandibular joints. One side (right gap arthroplasty was done and resulted in normal mouth opening.

  11. Unusual Cause of Knee Locking

    OpenAIRE

    Huri, Gazi; Biçer, Omer Sunkar

    2013-01-01

    We report a case of partial intrasubstance tear of popliteus tendon as an unusual cause of pseudolocking of the knee. A 13-year-old semiprofessional soccer player applied to our clinic with a locked right knee in spite of the therapy applied (cold pack, NSAID, and immobilization) in another institution 20 days after the injury. Significant extension loss was observed in his right knee with 30??90??ROM. Magnetic resonance imaging (MRI) and arthroscopy confirmed the intrasubstance tear of popli...

  12. Cervical Cancer Screening

    Science.gov (United States)

    ... Cancer found early may be easier to treat. Cervical cancer screening is usually part of a woman's health ... may do more tests, such as a biopsy. Cervical cancer screening has risks. The results can sometimes be ...

  13. Cervical spondylosis (image)

    Science.gov (United States)

    Cervical spondylosis is a disorder that results from abnormal growth of the bones of the neck and degeneration and ... neck pain is a key indication of cervical spondylosis. It may be the only symptom in many ...

  14. Cervical Cancer Stage IIIA

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IIIA Add to My Pictures View /Download : ... 1275x1275 View Download Large: 2550x2550 View Download Title: Cervical Cancer Stage IIIA Description: Stage IIIA cervical cancer; drawing ...

  15. Cervical Cancer Stage IVA

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IVA Add to My Pictures View /Download : ... 1575x1200 View Download Large: 3150x2400 View Download Title: Cervical Cancer Stage IVA Description: Stage IVA cervical cancer; drawing ...

  16. Cervical Cancer Stage IVB

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IVB Add to My Pictures View /Download : ... 1200x1305 View Download Large: 2400x2610 View Download Title: Cervical Cancer Stage IVB Description: Stage IVB cervical cancer; drawing ...

  17. Cervical Cancer Stage IIIB

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IIIB Add to My Pictures View /Download : ... 1425x1326 View Download Large: 2850x2651 View Download Title: Cervical Cancer Stage IIIB Description: Stage IIIB cervical cancer; drawing ...

  18. Cervical Cancer Stage IB

    Science.gov (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IB Add to My Pictures View /Download : ... 1613x1200 View Download Large: 3225x2400 View Download Title: Cervical Cancer Stage IB Description: Stage IB1 and IB2 cervical ...

  19. Cervical Cancer Stage IA

    Science.gov (United States)

    ... historical Searches are case-insensitive Cervical Cancer Stage IA Add to My Pictures View /Download : Small: 720x576 ... Large: 3000x2400 View Download Title: Cervical Cancer Stage IA Description: Stage IA1 and IA2 cervical cancer; drawing ...

  20. 2010 Maule earthquake slip correlates with pre-seismic locking of Andean subduction zone.

    Science.gov (United States)

    Moreno, Marcos; Rosenau, Matthias; Oncken, Onno

    2010-09-09

    The magnitude-8.8 Maule (Chile) earthquake of 27 February 2010 ruptured a segment of the Andean subduction zone megathrust that has been suspected to be of high seismic potential. It is the largest earthquake to rupture a mature seismic gap in a subduction zone that has been monitored with a dense space-geodetic network before the event. This provides an image of the pre-seismically locked state of the plate interface of unprecedentedly high resolution, allowing for an assessment of the spatial correlation of interseismic locking with coseismic slip. Pre-seismic locking might be used to anticipate future ruptures in many seismic gaps, given the fundamental assumption that locking and slip are similar. This hypothesis, however, could not be tested without the occurrence of the first gap-filling earthquake. Here we show evidence that the 2010 Maule earthquake slip distribution correlates closely with the patchwork of interseismic locking distribution as derived by inversion of global positioning system (GPS) observations during the previous decade. The earthquake nucleated in a region of high locking gradient and released most of the stresses accumulated in the area since the last major event in 1835. Two regions of high seismic slip (asperities) appeared to be nearly fully locked before the earthquake. Between these asperities, the rupture bridged a zone that was creeping interseismically with consistently low coseismic slip. The rupture stopped in areas that were highly locked before the earthquake but where pre-stress had been significantly reduced by overlapping twentieth-century earthquakes. Our work suggests that coseismic slip heterogeneity at the scale of single asperities should indicate the seismic potential of future great earthquakes, which thus might be anticipated by geodetic observations.

  1. On a Four-Node Quadrilateral Plate for Laminated Composites

    Directory of Open Access Journals (Sweden)

    João Elias Abdalla Filho

    Full Text Available Abstract An assessment of the efficiency and convergence characteristics of a four-node quadrilateral plate finite element in the analysis of laminated composites is performed. The element, which is suitable for global response analysis, is developed in the framework of the strain gradient notation such that its modeling capabilities as well as modeling deficiencies can be physically interpreted by the analyst during the formulation process. Thus, shear locking typically encountered in four-noded plate elements is identified as caused by spurious terms which appear in the shear strain polynomial expansions. These identified spurious terms are removed a priori such that shear locking does not occur during numerical analysis and numerical remedies do not need to be applied. Stress solutions for different laminated plates are presented to demonstrate that the corrected model converges well to reference solutions.

  2. Minimally invasive percutaneous plate fixation of distal tibia fractures.

    LENUS (Irish Health Repository)

    Bahari, Syah

    2007-10-01

    We report a series of 42 patients reviewed at a mean of 19.6 months after treatment of distal tibial and pilon fractures using the AO distal tibia locking plate with a minimally invasive percutaneous plate osteosynthesis (MIPPO) technique. Mean time to union was 22.4 weeks. All fractures united with acceptable alignment and angulation. Two cases of superficial infection were noted, with one case of deep infection. Mean SF36 score was 85 and mean AOFAS score was 90 at a mean of 19 months follow-up. We report satisfactory outcomes with the use of the AO distal tibia locking plate in treatment of unstable distal tibial fractures. Eighty-nine percent of the patients felt that they were back to their pre injury status and 95% back to their previous employment.

  3. Optimal database locks for efficient integrity checking

    DEFF Research Database (Denmark)

    Martinenghi, Davide

    2004-01-01

    the execution of update transactions. Several methods for efficient integrity checking and enforcing exist. We show in this paper how to apply one such method to automatically extend update transactions with locks and simplified consistency tests on the locked entities. All schedules produced in this way...... are conflict serializable and preserve consistency. For certain classes of databases we also guarantee that the amount of locked database entities is minimal....

  4. Microcontroller-based locking in optics experiments

    International Nuclear Information System (INIS)

    Huang, K.; Le Jeannic, H.; Ruaudel, J.; Morin, O.; Laurat, J.

    2014-01-01

    Optics experiments critically require the stable and accurate locking of relative phases between light beams or the stabilization of Fabry-Perot cavity lengths. Here, we present a simple and inexpensive technique based on a stand-alone microcontroller unit to perform such tasks. Easily programmed in C language, this reconfigurable digital locking system also enables automatic relocking and sequential functioning. Different algorithms are detailed and applied to fringe locking and to low- and high-finesse optical cavity stabilization, without the need of external modulations or error signals. This technique can readily replace a number of analog locking systems advantageously in a variety of optical experiments

  5. Safety lock for radiography exposure device

    International Nuclear Information System (INIS)

    Gaines, T.M.

    1982-01-01

    A safety lock for securing a radiation source in a radiography exposure device is disclosed. The safety lock prevents the inadvertent extension of the radiation source from the exposure device. The exposure devices are used extensively in industry for nondestructive testing of metal materials for defect. Unnecessary exposure of the radiographer or operator occurs not infrequently due to operator's error in believing that the radiation source is secured in the exposure device when, in fact, it is not. The present invention solves this problem of unnecessary exposure by releasingly trapping the radiation source in the shield of the radiography exposure device each time the source is retracted therein so that it is not inadvertently extended therefrom without the operator resetting the safety lock, thereby releasing the radiation source. Further, the safety lock includes an indicator which indicates when the source is trapped in the exposure device and also when it is untrapped. The safety lock is so designed that it does not prevent the return of the source to the trapped, shielded position in the exposure device. Further the safety lock includes a key means for locking the radiation source in the trapped position. The key means cannot be actuated until said radiation source is in said trapped position to further insure the safety lock cannot be inadvertently locked with the source untrapped and thus still extendable from the exposure device

  6. Double pass locking and spatial mode locking for gravitational wave detectors

    CERN Document Server

    Cusack, B J; Slagmolen, B; Vine, G D; Gray, M B; McClelland, D E

    2002-01-01

    We present novel techniques for overcoming problems relating to the use of high-power lasers in mode cleaner cavities for second generation laser interferometric gravitational wave detectors. Rearranging the optical components into a double pass locking regime can help to protect locking detectors from damage. Modulator thermal lensing can be avoided by using a modulation-free technique such as tilt locking, or its recently developed cousin, flip locking.

  7. A retrospective study of tibial plateau translation following tibial plateau levelling osteotomy stabilisation using three different plate types.

    Science.gov (United States)

    Woodbridge, N; Corr, S A; Grierson, J; Arthurs, G

    2011-01-01

    To retrospectively evaluate mediolateral translation of the proximal tibial segment (tibial plateau) after tibial plateau levelling osteotomy (TPLO), stabilised with three types of plate. Pre- and postoperative radiographs of 79 dogs that had TPLO surgery using three different types of plates were reviewed. Two plate types incorporated non-locking screws: Slocum (22 cases) and Orthomed Delta (33 cases) plates. The third plate type incorporated locking screws: Synthes TPLO Locking Compression Plate (LCP) (24 cases). The radiographs were viewed by three Diplomate surgeons who were blinded to the type of implant used. Medial or lateral translation of the proximal tibial plateau relative to the tibial diaphysis was assessed and measured at the lateral tibial cortex at the osteotomy site. Mean lateral translation of the tibial plateau was significantly greater when using the Synthes TPLO LCP with locking screws (+2.1 mm) compared to the non-locking Slocum (+0.4 mm) or Orthomed Delta (0.0 mm) plates. The use of the Synthes TPLO LCP will maintain a malalignment of the tibial plateau. Accurate alignment of the tibial plateau must be ensured prior to application of the Synthes TPLO LCP.

  8. Create Your Plate

    Medline Plus

    Full Text Available ... Pacific Islanders American Indian/Alaska Native Programs Older Adults Family Link Diabetes EXPO Upcoming Diabetes EXPOs EXPO ... Plate! Click on the plate sections below to add your food choices. Reset Plate Share Create Your ...

  9. 49 CFR 236.764 - Locking, lever operated.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Locking, lever operated. 236.764 Section 236.764... Locking, lever operated. The mechanical locking of an interlocking machine which is actuated by means of the lever. ...

  10. Outcome of treatment of cervical spine tuberculosis at the King ...

    African Journals Online (AJOL)

    Pancervical ankylosis was seen in three cases (9%) and was symptomatic in one (3%) of these cases. Other complications included esophageal injury, graft fracture, screw loosening, screw malposition and plate fixation failure (2.5% in each case). Conclusion: The results of treatment of cervical spine tuberculosis are good.

  11. outcome of treatment of cervical spine tuberculosis at the king ...

    African Journals Online (AJOL)

    2012-09-06

    Sep 6, 2012 ... cases. Other complications included esophageal injury, graft fracture, screw loosening, screw malposition and plate fixation failure (2.5% in each case). Conclusion:The results of treatment of cervical spine tuberculosis are good. The most common complication is adjacent segment degeneration, which ...

  12. Cervical epidural hematoma: Following interlaminar cervical epidural steroid injection

    Directory of Open Access Journals (Sweden)

    Dwarkadas Kanhayalal Baheti

    2015-01-01

    Full Text Available Cervical epidural steroid injection is a common procedure performed for patients with cervical radiculopathy. Cervical epidural hematoma is a rare but known complication of Intervention Pain Treatment Procedure (IPTP in healthy patients without coagulopathy. We report a case of cervical epidural hematoma as a complication of cervical epidural steroid injection in an elderly patient with cervical radiculopathy; resulting in right upper limb motor sensory deficit. Patient responded to conservative management and surgery was not performed since symptoms progressively improved.

  13. Express consent and full membership in Locke

    NARCIS (Netherlands)

    den Hartogh, G.A.

    1990-01-01

    It seems mysterious why Locke required express consent as a condition of full membership of civil society. It is suggested this requirement be interpreted as a political programme. In a draft of a pamphlet of 1690 Locke criticizes the oath of allegiance required after the Glorious Revolution for not

  14. Outer Rail for Wall Plate Covering

    DEFF Research Database (Denmark)

    2013-01-01

    The outer rail retains two lateral screw webs of an intermediate rail to construct a base for wall plate covering. Two retention devices are disposed oppositely on respective inner sides of each retention web for retaining a respective screw web of the intermediate rail. Each retention device...... including an abutment part, which extends inwards from the inner side of the retention web such as to form an abutment surface for the respective screw web when the latter is positioned to be retained in the retention device, and extends from the abutment part into a locking part, which extends at an angle...

  15. An automatic mode-locked system for passively mode-locked fiber laser

    Science.gov (United States)

    Li, Sha; Xu, Jun; Chen, Guoliang; Mei, Li; Yi, Bo

    2013-12-01

    This paper designs and implements one kind of automatic mode-locked system. It can adjust a passively mode-locked fiber laser to keep steady mode-locked states automatically. So the unsteadiness of traditional passively mode-locked fiber laser can be avoided. The system transforms optical signals into electrical pulse signals and sends them into MCU after processing. MCU calculates the frequency of the signals and judges the state of the output based on a quick judgment algorithm. A high-speed comparator is used to check the signals and the comparison voltage can be adjusted to improve the measuring accuracy. Then by controlling two polarization controllers at an angle of 45degrees to each other, MCU extrudes the optical fibers to change the polarization until it gets proper mode-locked output. So the system can continuously monitor the output signal and get it back to mode-locked states quickly and automatically. States of the system can be displayed on the LCD and PC. The parameters of the steady mode-locked states can be stored into an EEPROM so that the system will get into mode-locked states immediately next time. Actual experiments showed that, for a 6.238MHz passively mode-locked fiber lasers, the system can get into steady mode-locked states automatically in less than 90s after starting the system. The expected lock time can be reduced to less than 20s after follow up improvements.

  16. Commonwealth Edison Company pressure locking test report

    International Nuclear Information System (INIS)

    Bunte, B.D.; Kelly, J.F.

    1996-01-01

    Pressure Locking is a phenomena which can cause the unseating thrust for a gate valve to increase dramatically from its typical static unseating thrust. This can result in the valve actuator having insufficient capability to open the valve. In addition, this can result in valve damage in cases where the actuator capability exceeds the valve structural limits. For these reasons, a proper understanding of the conditions which may cause pressure locking and thermal binding, as well as a methodology for predicting the unseating thrust for a pressure locked or thermally bound valve, are necessary. This report discusses the primary mechanisms which cause pressure locking. These include sudden depressurization of piping adjacent to the valve and pressurization of fluid trapped in the valve bonnet due to heat transfer. This report provides a methodology for calculating the unseating thrust for a valve which is pressure locked. This report provides test data which demonstrates the accuracy of the calculation methodology

  17. Commonwealth Edison Company pressure locking test report

    Energy Technology Data Exchange (ETDEWEB)

    Bunte, B.D.; Kelly, J.F.

    1996-12-01

    Pressure Locking is a phenomena which can cause the unseating thrust for a gate valve to increase dramatically from its typical static unseating thrust. This can result in the valve actuator having insufficient capability to open the valve. In addition, this can result in valve damage in cases where the actuator capability exceeds the valve structural limits. For these reasons, a proper understanding of the conditions which may cause pressure locking and thermal binding, as well as a methodology for predicting the unseating thrust for a pressure locked or thermally bound valve, are necessary. This report discusses the primary mechanisms which cause pressure locking. These include sudden depressurization of piping adjacent to the valve and pressurization of fluid trapped in the valve bonnet due to heat transfer. This report provides a methodology for calculating the unseating thrust for a valve which is pressure locked. This report provides test data which demonstrates the accuracy of the calculation methodology.

  18. Phase-locked Josephson soliton oscillators

    DEFF Research Database (Denmark)

    Holst, T.; Hansen, Jørn Bindslev; Grønbech-Jensen, N.

    1991-01-01

    Detailed experimental characterization of the phase-locking at both DC and at microwave frequencies is presented for two closely spaced Josephson soliton (fluxon) oscillators. In the phase-locked state, the radiated microwave power exhibited an effective gain. With one common bias source, a frequ......Detailed experimental characterization of the phase-locking at both DC and at microwave frequencies is presented for two closely spaced Josephson soliton (fluxon) oscillators. In the phase-locked state, the radiated microwave power exhibited an effective gain. With one common bias source......, a frequency tunability of the phase-locked oscillators up to 7% at 10 GHz was observed. The interacting soliton oscillators were modeled by two inductively coupled nonlinear transmission lines...

  19. Risks of Cervical Cancer Screening

    Science.gov (United States)

    ... Cancer Treatment Screening for cervical cancer using the Pap test has decreased the number of new cases of ... their chance of dying from cervical cancer . A Pap test is commonly used to screen for cervical cancer. ...

  20. Function Test of an Automatic Locking and Unlocking System for Passive Damper by using Parabolic Flight

    Science.gov (United States)

    Sakurai, M.; Yoshihara, S.; Ohnishi, M.; Watanabe, K.; Sekiya, T.

    2002-01-01

    existence of residual acceleration has been reported.The acceleration is called "g-jitter".In a lot of experiments carried out in space, the adverse influence of the g-jitter on their results has been found out.To understand the effect of g-jitter on fluid phenomena, we are making preparation to orbital experiment as a post-JUSTSAP. In the experiment, the information to understand the influence of the g-jitter on diffusion phenomena will be obtained by comparing diffusion process in two containers. One container is isolated from the g-jitter using a passive damper and the other is not. To avoid the strong accelerations during launch giving damage to the passive damper, an automatic locking and unlocking system for the passive damper must be applied to the experimental apparatus. To increase flight opportunity of the experiment, the apparatus is designed as a small, light, self-controlled and self-powered system.In order to test the function of the apparatus, we have carried out parabolic flight experiments as preparations for the orbital experiment. mol/l), ethanol (0.7%) and NaCl (0.02 mol/l) is set on the upper base plate, which has the passive damper and the locking-unlocking system.The other container is directly set on the lower base plate.The passive damper comprises of flexible membranes and thin-metal plate and connecting rods. The damping is performed under micro-gravity condition by utilizing the non-linear elasticity of flexible membranes. The CPU unit on the upper base plate has 8 channels of A/D converter to measure 3-dimensional vibrations and 8 relays to control all experimental procedures, that is, locking, unlocking, heating, recording and so on. The power unit provides electricity to the CPU unit, the locking-unlocking system and heaters. A digital camera records diffusion of color in both cells simultaneously. color between pH8.3 and pH10. airplane vibrations were directly translated to the experimental container.During a parabolic flight, a

  1. Etiology of cervical inflammation.

    Science.gov (United States)

    Paavonen, J; Critchlow, C W; DeRouen, T; Stevens, C E; Kiviat, N; Brunham, R C; Stamm, W E; Kuo, C C; Hyde, K E; Corey, L

    1986-03-01

    We studied the relationships of selected microbial, clinical, demographic, and behavioral variables to mucopurulent cervicitis in two clinical settings, a sexually transmitted disease clinic and a student health clinic. From each clinic, we studied a group of women referred for suspected mucopurulent cervicitis and a representative sample of other women attending the clinic. After the women were stratified by patient group and summary odds ratios for all groups were obtained, mucopurulent cervicitis was most strongly associated with the isolation of Chlamydia trachomatis; other variables associated with mucopurulent cervicitis included the isolation of Ureaplasma urealyticum, Gardnerella vaginalis, and Trichomonas vaginalis, the presence of serum antibody to C. trachomatis, the clinical diagnosis of bacterial vaginosis, and oral contraceptive use (positive associations) or isolation of yeast (negative association). After adjustment for cervical culture results for C. trachomatis, mucopurulent cervicitis was positively associated with oral contraceptive use (p = 0.02) and isolation of U. urealyticum (p = 0.02) and negatively associated with isolation of yeast (p = 0.03). Among women with a positive cervical culture for C. trachomatis, isolation of U. urealyticum was significantly associated with mucopurulent cervicitis, while among the subgroup of women with a negative cervical culture for C. trachomatis and positive serum antibody to C. trachomatis, oral contraceptive use was strongly associated with mucopurulent cervicitis. These results confirm that in both clinical settings C. trachomatis is the major cause of mucopurulent cervicitis. The roles of U. urealyticum, T. vaginalis, G. vaginalis, bacterial vaginosis, and oral contraceptive use in the etiology of mucopurulent cervicitis deserve further study.

  2. Cervical Total Disc Arthroplasty

    OpenAIRE

    Basho, Rahul; Hood, Kenneth A.

    2012-01-01

    Symptomatic adjacent segment degeneration of the cervical spine remains problematic for patients and surgeons alike. Despite advances in surgical techniques and instrumentation, the solution remains elusive. Spurred by the success of total joint arthroplasty in hips and knees, surgeons and industry have turned to motion preservation devices in the cervical spine. By preserving motion at the diseased level, the hope is that adjacent segment degeneration can be prevented. Multiple cervical disc...

  3. A radiological study on the cervical spine in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Taketomi, Eiji; Sakoh, Takashi; Sunahara, Nobuhiko [Kagoshima Univ. (Japan). Faculty of Medicine

    1995-03-01

    The cervical spine was examined with the magnetic resonance imaging (MRI) and the conventional roentgenograms in 95 patients with rheumatoid arthritis. The MRI findings of upper cervical disorders were compared with various values determined in roentgenograms: the atlanto-dental interval (ADI), the space available for the spinal cord (SAC), and the Ranawat and Redlund-Johnell values. In patients with vertical setting (VS), MRI showed medullary compression in all those with abnormal Redlund-Johnell values and Ranawat values of 7 mm or less. In patients with anterior atlanto-axial subluxation, compression of the upper cervical cord was observed in all patients with SAC of 13 mm or less. In subaxial lesion of the cervical spine, MRI was found to be as good as roentgenograms in evaluating plate erosion and disc space narrowing and MRI showed extradural pannus. (author).

  4. Unusual Cause of Knee Locking

    Directory of Open Access Journals (Sweden)

    Gazi Huri

    2013-01-01

    Full Text Available We report a case of partial intrasubstance tear of popliteus tendon as an unusual cause of pseudolocking of the knee. A 13-year-old semiprofessional soccer player applied to our clinic with a locked right knee in spite of the therapy applied (cold pack, NSAID, and immobilization in another institution 20 days after the injury. Significant extension loss was observed in his right knee with 30∘–90∘ ROM. Magnetic resonance imaging (MRI and arthroscopy confirmed the intrasubstance tear of popliteus tendon and synovitis. The ruptured part of the tendon was debrided, and the inflammatory tissue around the tendon, which may lead to pseudolocking, was gently removed with a shaver in order to regain the normal ROM. The patient was discharged with full ROM and weight bearing first day after the surgery. To our knowledge, this is the first case demonstrating intrasubstance tear of popliteus tendon causing pseudolocking of the knee.

  5. Neglected locked vertical patellar dislocation

    Directory of Open Access Journals (Sweden)

    Rakesh Kumar Gupta

    2012-01-01

    Full Text Available Patellar dislocations occurring about the vertical and horizontal axis are rare and irreducible. The neglected patellar dislocation is still rarer. We describe the clinical presentation and management of a case of neglected vertical patellar dislocation in a 6 year-old boy who sustained an external rotational strain with a laterally directed force to his knee. Initially the diagnosis was missed and 2 months later open reduction was done. The increased tension generated by the rotation of the lateral extensor retinaculum kept the patella locked in the lateral gutter even with the knee in full extension. Traumatic patellar dislocation with rotation around a vertical axis has been described earlier, but no such neglected case has been reported to the best of our knowledge.

  6. Unusual cause of knee locking.

    Science.gov (United States)

    Huri, Gazi; Biçer, Omer Sunkar

    2013-01-01

    We report a case of partial intrasubstance tear of popliteus tendon as an unusual cause of pseudolocking of the knee. A 13-year-old semiprofessional soccer player applied to our clinic with a locked right knee in spite of the therapy applied (cold pack, NSAID, and immobilization) in another institution 20 days after the injury. Significant extension loss was observed in his right knee with 30°-90° ROM. Magnetic resonance imaging (MRI) and arthroscopy confirmed the intrasubstance tear of popliteus tendon and synovitis. The ruptured part of the tendon was debrided, and the inflammatory tissue around the tendon, which may lead to pseudolocking, was gently removed with a shaver in order to regain the normal ROM. The patient was discharged with full ROM and weight bearing first day after the surgery. To our knowledge, this is the first case demonstrating intrasubstance tear of popliteus tendon causing pseudolocking of the knee.

  7. Effect of posterior subsidence on cervical alignment after anterior cervical corpectomy and reconstruction using titanium mesh cages in degenerative cervical disease.

    Science.gov (United States)

    Jang, Jae-Won; Lee, Jung-Kil; Lee, Jung-Heon; Hur, Hyuk; Kim, Tae-Wan; Kim, Soo-Han

    2014-10-01

    Subsidence after anterior cervical reconstruction using a titanium mesh cage (TMC) has been a matter of debate. The authors investigated and analyzed subsidence and its effect on clinical and radiologic parameters after cervical reconstruction using a TMC for degenerative cervical disease. Thirty consecutive patients with degenerative cervical spine disorders underwent anterior cervical corpectomy followed by reconstruction with TMC. Twenty-four patients underwent a single-level corpectomy, and six patients underwent a two-level corpectomy. Clinical outcomes were assessed using a Visual Analogue Scale (VAS), the Japanese Orthopedic Association (JOA) score and the Neck Disability Index (NDI). Fusion status, anterior and posterior subsidence of the TMC, segmental angle (SA) and cervical sagittal angle (CSA) were assessed by lateral and flexion-extension radiographs of the neck. The mean follow-up period was 27.6 months (range, 24 to 49 months). The VAS, NDI and JOA scores were all significantly improved at the last follow-up. No instances of radiolucency or motion-related pseudoarthrosis were detected on radiographic analysis, yielding a fusion rate of 100%. Subsidence occurred in 28 of 30 patients (93.3%). The average anterior subsidence of the cage was 1.4 ± 0.9 mm, and the average posterior subsidence was 2.9 ± 1.2 mm. The SA and CSA at the final follow-up were significantly increased toward a lordotic angle. Anterior cervical reconstruction using TMC and plating in patients with cervical degenerative disease provides good clinical and radiologic outcomes. Cage subsidence occurred frequently, especially at the posterior part of the cage. Despite the prominent posterior subsidence of the TMC, SA and CSA were improved on final follow-up radiographs, suggesting that posterior subsidence may contribute to cervical lordosis. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Anterior cervical debridement and strut-grafting for osteomyelitis of the cervical spine.

    Science.gov (United States)

    Stone, J L; Cybulski, G R; Rodriguez, J; Gryfinski, M E; Kant, R

    1989-06-01

    A retrospective review of the surgical experience in treating 18 patients with osteomyelitis of the cervical spine is reported. The patients ranged in age from 20 to 60 years and all complained of neck pain upon admission. Ten patients had a prior history of intravenous drug abuse, three had previously suffered penetrating injuries of the neck, and one had an extraspinal site of osteomyelitis. Bacteria were isolated in 13 cases and tuberculosis in three. Neurological abnormalities were present in over one-half of the patients, consisting of myelopathy (nine cases) or radiculopathy (four cases). Plain cervical spine films and polytomography demonstrated vertebral and end-plate destruction, spinal instability, and increased paravertebral soft-tissue shadow in all cases. Computerized tomography and, more recently, magnetic resonance imaging have proven helpful in detecting bone involvement and the presence of epidural extension associated with cervical osteomyelitis. The risk of vertebral body collapse, kyphosis, and myelopathy in the osteomyelitic cervical spine has standardized the management of this problem in this institution to consist of skeletal traction, needle aspiration or blood culture for organism identification, anterior cervical debridement, autogenous iliac graft fusion, and intravenous administration of antibiotics. Spinal stability and neurological improvement were achieved in all 18 patients.

  9. Cervical chordoma managed with multidisciplinary surgical approach.

    Science.gov (United States)

    Ahsan, Farhan; Inglis, Tom; Allison, Robert; Inglis, Grahame S

    2011-05-01

    This paper describes the interdisciplinary management of a 62-year-old man who presented with a cervical chordoma of C2/3. This is a rare neoplasm of the axial skeleton which is usually treated surgically. This is technically challenging due to the surrounding anatomy and requirement for wide exposure. A number of surgical approaches have been described to access the clivus and upper cervical spine. This case involved both the Orthopaedic and Otolaryngology Head and Neck Surgery departments. Trotter's surgical technique was used to gain access for excision of the cervical chordoma and there was collaboration with an Orthopaedic Biotechnology Company in which a bio-model of the spine was created and a corpectomy cage specific to the patient developed. This approach allowed excellent visualisation of the tumour and the unique cage and plate achieved immediate stability and long term fusion. An interdisciplinary approach should be used in the management of upper cervical chordomas to facilitate tumour resection and reduce the potential for recurrence. © 2010 The Authors. ANZ Journal of Surgery © 2010 Royal Australasian College of Surgeons.

  10. Adjacent Segment Pathology after Anterior Cervical Fusion.

    Science.gov (United States)

    Chung, Jae Yoon; Park, Jong-Beom; Seo, Hyoung-Yeon; Kim, Sung Kyu

    2016-06-01

    Anterior cervical fusion has become a standard of care for numerous pathologic conditions of the cervical spine. However, subsequent development of clinically significant disc disease at levels adjacent to fused discs is a serious long-term complication of this procedure. As more patients live longer after surgery, it is foreseeable that adjacent segment pathology (ASP) will develop in increasing numbers of patients. Also, ASP has been studied more intensively with the recent popularity of motion preservation technologies like total disc arthroplasty. The true nature and scope of ASP remains poorly understood. The etiology of ASP is most likely multifactorial. Various factors including altered biomechanical stresses, surgical disruption of soft tissue and the natural history of cervical disc disease contribute to the development of ASP. General factors associated with disc degeneration including gender, age, smoking and sports may play a role in the development of ASP. Postoperative sagittal alignment and type of surgery are also considered potential causes of ASP. Therefore, a spine surgeon must be particularly careful to avoid unnecessary disruption of the musculoligamentous structures, reduced risk of direct injury to the disc during dissection and maintain a safe margin between the plate edge and adjacent vertebrae during anterior cervical fusion.

  11. Adjacent Segment Pathology after Anterior Cervical Fusion

    Science.gov (United States)

    Chung, Jae Yoon; Park, Jong-Beom; Seo, Hyoung-Yeon

    2016-01-01

    Anterior cervical fusion has become a standard of care for numerous pathologic conditions of the cervical spine. However, subsequent development of clinically significant disc disease at levels adjacent to fused discs is a serious long-term complication of this procedure. As more patients live longer after surgery, it is foreseeable that adjacent segment pathology (ASP) will develop in increasing numbers of patients. Also, ASP has been studied more intensively with the recent popularity of motion preservation technologies like total disc arthroplasty. The true nature and scope of ASP remains poorly understood. The etiology of ASP is most likely multifactorial. Various factors including altered biomechanical stresses, surgical disruption of soft tissue and the natural history of cervical disc disease contribute to the development of ASP. General factors associated with disc degeneration including gender, age, smoking and sports may play a role in the development of ASP. Postoperative sagittal alignment and type of surgery are also considered potential causes of ASP. Therefore, a spine surgeon must be particularly careful to avoid unnecessary disruption of the musculoligamentous structures, reduced risk of direct injury to the disc during dissection and maintain a safe margin between the plate edge and adjacent vertebrae during anterior cervical fusion. PMID:27340541

  12. Obituary: Martha Locke Hazen, 1931-2006

    Science.gov (United States)

    Williams, Thomas R.; Willson, Lee Anne

    2007-12-01

    Longtime Harvard Curator of Astronomical Photographs and AAVSO officer Martha Hazen passed away on 23 December 2006 at Hingham, Massachusetts, after a short illness due to acute myelogenous leukemia. One of four children of Harold Locke and Katherine (neé Salisbury) Hazen, Martha was born in Cambridge, Massachusetts, on 15 July 1931, and raised in the Town of Belmont, near Cambridge, where she lived for most of her life. Her father coined the term "servo-mechanism" while serving as an engineering professor and dean for graduate students at the Massachusetts Institute of Technology. Her mother majored in chemistry at Mount Holyoke College. After receiving an A.B. in astronomy from Mount Holyoke College in 1953, Martha earned a Ph.D. in astronomy in 1958 from the University of Michigan, defending a dissertation on the distribution of intensity in elliptical galaxies in the Virgo cluster. Martha's marriage to William Liller in 1959, and the births of two children, inevitably slowed down her progress in observational astronomy. As a research fellow of the Harvard College Observatory, Martha continued to observe two to three weeks a year in Chile, and to reduce those observations and publish the results for sixteen years. Martha's first publication, at least as far as Astrophysics Data System includes the literature, was with Alice Farnsworth on the 1952 occultations of stars by the Moon, published in the Astronomical Journal (1953). In 1958 she joined L. R. Doherty and D. H. Menzel on a short note about the calculation of line profiles in a stratified atmosphere, her only theory paper. Martha's most cited paper is "The Distribution of Intensity in Elliptical Galaxies of the Virgo Cluster," (ApJ, 132, p.306, 1960). There she acknowledges Allan Sandage for suggesting the problem and providing some of the data. Her second most cited paper is "Photometric histories of QSOs - Two QSOs with large light amplitude," (Liller, M. H. & Liller, W., ApJ (Letters), 199, p. L133-L

  13. No Snowball on Habitable Tidally Locked Planets

    Energy Technology Data Exchange (ETDEWEB)

    Checlair, Jade; Abbot, Dorian S. [Department of the Geophysical Sciences, University of Chicago, 5734 South Ellis Avenue, Chicago, IL 60637 (United States); Menou, Kristen, E-mail: jadecheclair@uchicago.edu [Centre for Planetary Sciences, Department of Physical and Environmental Sciences, University of Toronto at Scarborough, Toronto, ON M1C 1A4 (Canada)

    2017-08-20

    The TRAPPIST-1, Proxima Centauri, and LHS 1140 systems are the most exciting prospects for future follow-up observations of potentially inhabited planets. All of the planets orbit nearby M-stars and are likely tidally locked in 1:1 spin–orbit states, which motivates the consideration of the effects that tidal locking might have on planetary habitability. On Earth, periods of global glaciation (snowballs) may have been essential for habitability and remote signs of life (biosignatures) because they are correlated with increases in the complexity of life and in the atmospheric oxygen concentration. In this paper, we investigate the snowball bifurcation (sudden onset of global glaciation) on tidally locked planets using both an energy balance model and an intermediate-complexity global climate model. We show that tidally locked planets are unlikely to exhibit a snowball bifurcation as a direct result of the spatial pattern of insolation they receive. Instead, they will smoothly transition from partial to complete ice coverage and back. A major implication of this work is that tidally locked planets with an active carbon cycle should not be found in a snowball state. Moreover, this work implies that tidally locked planets near the outer edge of the habitable zone with low CO{sub 2} outgassing fluxes will equilibrate with a small unglaciated substellar region rather than cycling between warm and snowball states. More work is needed to determine how the lack of a snowball bifurcation might affect the development of life on a tidally locked planet.

  14. No Snowball on Habitable Tidally Locked Planets

    Science.gov (United States)

    Checlair, Jade; Menou, Kristen; Abbot, Dorian S.

    2017-08-01

    The TRAPPIST-1, Proxima Centauri, and LHS 1140 systems are the most exciting prospects for future follow-up observations of potentially inhabited planets. All of the planets orbit nearby M-stars and are likely tidally locked in 1:1 spin–orbit states, which motivates the consideration of the effects that tidal locking might have on planetary habitability. On Earth, periods of global glaciation (snowballs) may have been essential for habitability and remote signs of life (biosignatures) because they are correlated with increases in the complexity of life and in the atmospheric oxygen concentration. In this paper, we investigate the snowball bifurcation (sudden onset of global glaciation) on tidally locked planets using both an energy balance model and an intermediate-complexity global climate model. We show that tidally locked planets are unlikely to exhibit a snowball bifurcation as a direct result of the spatial pattern of insolation they receive. Instead, they will smoothly transition from partial to complete ice coverage and back. A major implication of this work is that tidally locked planets with an active carbon cycle should not be found in a snowball state. Moreover, this work implies that tidally locked planets near the outer edge of the habitable zone with low CO2 outgassing fluxes will equilibrate with a small unglaciated substellar region rather than cycling between warm and snowball states. More work is needed to determine how the lack of a snowball bifurcation might affect the development of life on a tidally locked planet.

  15. No Snowball on Habitable Tidally Locked Planets

    International Nuclear Information System (INIS)

    Checlair, Jade; Abbot, Dorian S.; Menou, Kristen

    2017-01-01

    The TRAPPIST-1, Proxima Centauri, and LHS 1140 systems are the most exciting prospects for future follow-up observations of potentially inhabited planets. All of the planets orbit nearby M-stars and are likely tidally locked in 1:1 spin–orbit states, which motivates the consideration of the effects that tidal locking might have on planetary habitability. On Earth, periods of global glaciation (snowballs) may have been essential for habitability and remote signs of life (biosignatures) because they are correlated with increases in the complexity of life and in the atmospheric oxygen concentration. In this paper, we investigate the snowball bifurcation (sudden onset of global glaciation) on tidally locked planets using both an energy balance model and an intermediate-complexity global climate model. We show that tidally locked planets are unlikely to exhibit a snowball bifurcation as a direct result of the spatial pattern of insolation they receive. Instead, they will smoothly transition from partial to complete ice coverage and back. A major implication of this work is that tidally locked planets with an active carbon cycle should not be found in a snowball state. Moreover, this work implies that tidally locked planets near the outer edge of the habitable zone with low CO 2 outgassing fluxes will equilibrate with a small unglaciated substellar region rather than cycling between warm and snowball states. More work is needed to determine how the lack of a snowball bifurcation might affect the development of life on a tidally locked planet.

  16. An auto-locked diode laser system for precision metrology

    Science.gov (United States)

    Beica, H. C.; Carew, A.; Vorozcovs, A.; Dowling, P.; Pouliot, A.; Barron, B.; Kumarakrishnan, A.

    2017-05-01

    We present a unique external cavity diode laser system that can be auto-locked with reference to atomic and molecular spectra. The vacuum-sealed laser head design uses an interchangeable base-plate comprised of a laser diode and optical elements that can be selected for desired wavelength ranges. The feedback light to the laser diode is provided by a narrow-band interference filter, which can be tuned from outside the laser cavity to fineadjust the output wavelength in vacuum. To stabilize the laser frequency, the digital laser controller relies either on a pattern-matching algorithm stored in memory, or on first or third derivative feedback. We have used the laser systems to perform spectroscopic studies in rubidium at 780 nm, and in iodine at 633 nm. The linewidth of the 780-nm laser system was measured to be ˜500 kHz, and we present Allan deviation measurements of the beat note and the lock stability. Furthermore, we show that the laser system can be the basis for a new class of lidar transmitters in which a temperature-stabilized fiber-Bragg grating is used to generate frequency references for on-line points of the transmitter. We show that the fiber-Bragg grating spectra can be calibrated with reference to atomic transitions.

  17. Traumatic knee extension deficit (the locked knee)

    DEFF Research Database (Denmark)

    Helmark, I C; Neergaard, K; Krogsgaard, M R

    2007-01-01

    . Evaluating MRI, all grade-3 meniscal lesions were considered able to cause a mechanical block as well as acute partial or total anterior cruciate ligament (ACL)-ruptures. ACL-ruptures with an old appearance were not considered able to cause locking. Assuming that arthroscopy was the gold standard......, the following results were calculated for the overall appearance of a lesion able to cause locking: Positive predictive value = 0.85, negative predictive value = 0.77, sensitivity = 0.95, specificity = 0.53. Two knees were erroneously evaluated with no mechanical locking at MRI (one bucket-handle lesion and one...

  18. Collet lock joint for space station truss

    Science.gov (United States)

    Wesselski, Clarence J. (Inventor)

    1988-01-01

    A lock joint for a Space Station has a series of struts joined together in a predetermined configuration by node point fittings. The fittings have removeable inserts. The lock joint has an elongated housing connected at one end to a strut. A split-fingered collet is mounted within the housing to insure reciprocal movement. A handle on the housing is connected to the collet for moving the collet into the insert where the fingers of the collet expand to lock the joint to the fitting.

  19. Correlations between locked modes and impurity influxes

    Energy Technology Data Exchange (ETDEWEB)

    Fishpool, G.M. [Commission of the European Communities, Abingdon (United Kingdom). JET Joint Undertaking; Lawson, K.D. [UKAEA Culham Lab., Abingdon (United Kingdom)

    1994-07-01

    An analysis of pulses that were disturbed by medium Z impurity influxes (Cl, Cr, Fe and Ni) recorded during the 91/92 JET operations, has demonstrated that such influxes can result in MHD modes which subsequently ``lock``. A correlation is found between the power radiated by the influx and the time difference between the start of the influx and the beginning of the locked mode. The growth in the amplitude of the locked mode itself can lead to further impurity influxes. A correlation is noted between intense influxes (superior to 10 MW) and the mode ``unlocking``. (authors). 4 refs., 4 figs.

  20. Cervical spondylotic myelopathy

    African Journals Online (AJOL)

    Although spondylotic changes of the cervical spine occur in more than half of patients over 50, less than a ... acquired narrowing of the cervical spinal canal, with subsequent mechanical and ischaemic insults to the ... event, such as a hyperextension injury after a fall. Neck pain or stiffness and gait abnormalities are common ...

  1. Cervical Cancer Prevention

    Science.gov (United States)

    ... term pregnancies have an increased risk of cervical cancer. Using oral contraceptives for a long time Among women who are ... a 10 year period, the risk of cervical cancer returns to that of women who never used oral contraceptives. Smoking cigarettes Among women who are infected with ...

  2. SCREENING FOR CERVICAL CANCER

    African Journals Online (AJOL)

    Enrique

    CANCER SCREENING. February 2004 Vol.22 No.2 CME 63. Cervical cancer remains a major health concern worldwide, especially in devel- oping countries. It is the commonest malignancy among black women in South. Africa. The quoted incidence of cervical cancer is approximately 30/100 000 women.1 Mortality is ...

  3. SCREENING FOR CERVICAL CANCER

    African Journals Online (AJOL)

    Enrique

    Cervical cancer remains a major health concern worldwide, especially in devel- oping countries. It is the commonest malignancy ... Based on data from Cali, Colombia, the impact of starting cervical screening at different ages shows that starting .... vated blue-white light is attached to the inner aspect of the upper speculum.

  4. Case Report: Cervical Ectopic Pregnancy presenting as Cervical ...

    African Journals Online (AJOL)

    Cervical pregnancy is a rare but serious type of ectopic pregnancy in which the implantation site is within the cervical mucosa that lines the endocervical canal. This is a rare cervical ectopic pregnancy wrongly diagnosed as a cervical fi broid by clinicoradiological examination. The actual diagnosis was revealed by ...

  5. Dynamic plate osteosynthesis for fracture stabilization: how to do it

    Directory of Open Access Journals (Sweden)

    Juerg Sonderegger

    2010-01-01

    Full Text Available Plate osteosynthesis is one treatment option for the stabilization of long bones. It is widely accepted to achieve bone healing with a dynamic and biological fixation where the perfusion of the bone is left intact and micromotion at the fracture gap is allowed. The indications for a dynamic plate osteosynthesis include distal tibial and femoral fractures, some midshaft fractures, and adolescent tibial and femoral fractures with not fully closed growth plates. Although many lower limb shaft fractures are managed successfully with intramedullary nails, there are some important advantages of open-reduction-and-plate fixation: the risk of malalignment, anterior knee pain, or nonunion seems to be lower. The surgeon performing a plate osteosynthesis has the possibility to influence fixation strength and micromotion at the fracture gap. Long plates and oblique screws at the plate ends increase fixation strength. However, the number of screws does influence stiffness and stability. Lag screws and screws close to the fracture site reduce micromotion dramatically. Dynamic plate osteosynthesis can be achieved by applying some simple rules: long plates with only a few screws should be used. Oblique screws at the plate ends increase the pullout strength. Two or three holes at the fracture site should be omitted. Lag screws, especially through the plate, must be avoided whenever possible. Compression is not required. Locking plates are recommended only in fractures close to the joint. When respecting these basic concepts, dynamic plate osteosynthesis is a safe procedure with a high healing and a low complication rate. 

  6. A fast-locking PLL with all-digital locked-aid circuit

    Science.gov (United States)

    Kao, Shao-Ku; Hsieh, Fu-Jen

    2013-02-01

    In this article, a fast-locking phase-locked loop (PLL) with an all-digital locked-aid circuit is proposed and analysed. The proposed topology is based on two tuning loops: frequency and phase detections. A frequency detection loop is used to accelerate frequency locking time, and a phase detection loop is used to adjust fine phase errors between the reference and feedback clocks. The proposed PLL circuit is designed based on the 0.35 µm CMOS process with a 3.3 V supply voltage. Experimental results show that the locking time of the proposed PLL achieves a 87.5% reduction from that of a PLL without the locked-aid circuit.

  7. 27 CFR 19.282 - Breaking Government locks.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Breaking Government locks... Breaking Government locks. Where affixed, Government locks shall not be removed without the authorization... obtain authorization from an appropriate TTB officer, Government locks may be removed, by the proprietor...

  8. On a Four-Node Quadrilateral Plate for Laminated Composites

    OpenAIRE

    Abdalla Filho, João Elias; Belo, Ivan Moura; Dow, John Otto

    2017-01-01

    Abstract An assessment of the efficiency and convergence characteristics of a four-node quadrilateral plate finite element in the analysis of laminated composites is performed. The element, which is suitable for global response analysis, is developed in the framework of the strain gradient notation such that its modeling capabilities as well as modeling deficiencies can be physically interpreted by the analyst during the formulation process. Thus, shear locking typically encountered in four-n...

  9. Improved finite strip Mindlin plate bending element using assumed shear strain distributions

    Science.gov (United States)

    Chulya, Abhisak; Thompson, Robert L.

    1988-01-01

    A linear finite strip plate element based on Mindlin/Reissner plate theory is developed. The analysis is suitable for both thin and thick plates. In the formulation new transverse shear strains are introduced and assumed constant in each two-code linear strip. The element stiffness matrix is explicitly formulated for efficient computation and computer implementation. Numerical results showing the efficiency and predictive capability of the element for the analysis of plates are presented for different support and loading conditions and a wide range of thicknesses. No sign of shear locking phenomenon was observed with the newly developed element.

  10. Improving generalized inverted index lock wait times

    Science.gov (United States)

    Borodin, A.; Mirvoda, S.; Porshnev, S.; Ponomareva, O.

    2018-01-01

    Concurrent operations on tree like data structures is a cornerstone of any database system. Concurrent operations intended for improving read\\write performance and usually implemented via some way of locking. Deadlock-free methods of concurrency control are known as tree locking protocols. These protocols provide basic operations(verbs) and algorithm (ways of operation invocations) for applying it to any tree-like data structure. These algorithms operate on data, managed by storage engine which are very different among RDBMS implementations. In this paper, we discuss tree locking protocol implementation for General inverted index (Gin) applied to multiversion concurrency control (MVCC) storage engine inside PostgreSQL RDBMS. After that we introduce improvements to locking protocol and provide usage statistics about evaluation of our improvement in very high load environment in one of the world’s largest IT company.

  11. Observation of Frequency Locked Coherent Transition Radiation

    CERN Document Server

    Marsh, Roark A; Temkin, Richard J

    2005-01-01

    Measurements of frequency locked, coherent transition radiation (CTR) were performed at the 17 GHz high-gradient accelerator facility built by Haimson Research Corporation at MIT PSFC. CTR produced from a metallic foil placed in the beam path was extracted through a window, and measured with a variety of detectors, including: diode, Helium cooled Si Bolometer, and double heterodyne receiver system. The angular energy distribution measured by the diode and bolometer are in agreement and consistent with calculations for a 15 MeV 200 mA 110 ns beam of 1 ps bunches. Heterodyne receiver measurements were able to show frequency locking, namely inter-bunch coherence at integer multiples of the accelerator RF frequency of 17.14 GHz. At the locked frequencies the power levels are enhanced by the number of bunches in a single beam pulse. The CTR was measured as a comb of locked frequencies up to 240 GHz, with a bandwidth of 50 MHz.

  12. QPSK regeneration without active phase-locking

    DEFF Research Database (Denmark)

    Kjøller, Niels-Kristian; Da Ros, Francesco; Røge, Kasper Meldgaard

    2016-01-01

    QPSK regeneration without active phase stabilization is investigated in numerical simulations. We propose an improved scheme for phase-locking free QPSK regeneration showing significant improvements in the error vector magnitude of the signal....

  13. Automatic NMR field-frequency lock-pulsed phase locked loop approach.

    Science.gov (United States)

    Kan, S; Gonord, P; Fan, M; Sauzade, M; Courtieu, J

    1978-06-01

    A self-contained deuterium frequency-field lock scheme for a high-resolution NMR spectrometer is described. It is based on phase locked loop techniques in which the free induction decay signal behaves as a voltage-controlled oscillator. By pulsing the spins at an offset frequency of a few hundred hertz and using a digital phase-frequency discriminator this method not only eliminates the usual phase, rf power, offset adjustments needed in conventional lock systems but also possesses the automatic pull-in characteristics that dispense with the use of field sweeps to locate the NMR line prior to closure of the lock loop.

  14. Validation of Modeling Flow Approaching Navigation Locks

    Science.gov (United States)

    2013-08-01

    USACE, Pittsburgh District ( LRP ) requested that the US Army Engineer Research and Development Center, Coastal and ERDC/CHL TR-13-9 2 Hydraulics...approaching the lock and dam. The second set of experiments considered a design, referred to as Plan B lock approach, which contained the weir field in...conditions and model parameters A discharge of 1.35 cfs was set as the inflow boundary condition at the upstream end of the model. The outflow boundary was

  15. Complications of Minimally Invasive Percutaneous Plating for Distal Tibial Fractures.

    Science.gov (United States)

    Muzaffar, Nasir; Bhat, Rafiq; Yasin, Mohammad

    2016-07-01

    The management of distal tibia fractures continues to remain a source of controversy and debate. The aim of this study was to evaluate the various complications of minimally invasive percutaneous plate osteosynthesis (MIPPO) using a locking plate for closed fractures of distal tibia in a retrospective study. Twenty-five patients with distal tibial fractures, treated by minimally invasive percutaneous plate osteosynthesis, were evaluated in a retrospective study. We studied the rate, probable etiological factors and preventive and corrective measures of various complications associated with minimally invasive plating of distal tibia. Mean age of the patients was 41.16 years (range 22 - 65). There were 13 male and 12 female patients. All fractures united at an average duration of 16.8 weeks. There were two cases of superficial and two cases of deep infection, and deep infections required removal of hardware for cure. There were four cases of ankle stiffness, most of them occurring in intra-articular fractures, three cases of palpable implant, three cases of malunion, one case of loss of reduction and one patient required reoperation. The average AO foot and ankle score was 83.6. We found MIPPO using locking plate to be a safe and effective method for the treatment of distal tibial fractures in properly selected patients yet can result in a variety of complications if proper precautions before, during and after surgery are not taken care of.

  16. Risk factors for the development of adjacent segment disease following anterior cervical arthrodesis for degenerative cervical disease: comparison between fusion methods.

    Science.gov (United States)

    Song, Ji-Soo; Choi, Byung-Wan; Song, Kyung-Jin

    2014-05-01

    This study aimed to determine the risk factors for developing adjacent segment disease (ASDz) after anterior cervical arthrodesis for the treatment of degenerative cervical disease by analyzing patients treated with various fusion methods. We enrolled 242 patients who had undergone anterior cervical fusion for degenerative cervical disease, and had at least 5years of follow-up. We evaluated the development of ASDz and the rate of revision surgery. To identify the risk factors for ASDz, the sagittal alignment, spinal canal diameter, range of motion of the cervical spine, number of fusion segments, and fusion methods were evaluated. The patients were divided into three groups according to the fusion method: Group A contained patients who had received autogenous bone graft only (53 patients), Group B contained patients who received autogenous bone graft and plate augmentation (62 patients), and Group C contained patients who underwent cage and plate augmentation (127 patients). ASDz occurred in 33 patients, of whom 19 required additional surgery. The risk of developing ASDz was significantly higher in male patients (p=0.043), patients whose range of motion of the cervical spine was >30° (p=0.027), and patients with spinal canal stenosis (p=0.010). The rate of development of ASDz was not different depending on the number of fusion segments. The rate of development of ASDz was 41.5% in Group A, 9.6% in Group B, and 5.51% in Group C (p=0.03). In patients who underwent anterior cervical arthrodesis for degenerative disease, the occurrence of ASDz was related to age, the cervical spine range of motion, and spinal canal stenosis. Additional plate augmentation for anterior cervical arthrodesis surgery can lower the rate of ASDz development. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. An elastic plate model for interseismic deformation in subduction zones

    Science.gov (United States)

    Kanda, Ravi V. S.; Simons, Mark

    2010-03-01

    Geodetic observations of interseismic surface deformation in the vicinity of subduction zones are frequently interpreted using simple kinematic elastic dislocation models (EDM). In this theoretical study, we develop a kinematic EDM that simulates plate subduction over the interseismic period (the elastic subducting plate model (ESPM)) having only 2 more degrees of freedom than the well-established back slip model (BSM): an elastic plate thickness and the fraction of flexural stresses due to bending at the trench that are released continuously. Unlike the BSM, in which steady state deformation in both plates is assumed to be negligible, the ESPM includes deformation in the subducting and overriding plates (owing to plate thickness), while still preserving the correct sense of convergence velocity between the subducting and overriding plates, as well as zero net steady state vertical offset between the two plates when integrated over many seismic cycles. The ESPM links elastic plate flexure processes to interseismic deformation and helps clarify under what conditions the BSM is appropriate for fitting interseismic geodetic data at convergent margins. We show that the ESPM is identical to the BSM in the limiting case of zero plate thickness, thereby providing an alternative motivation for the BSM. The ESPM also provides a consistent convention for applying the BSM to any megathrust interface geometry. Even in the case of nonnegligible plate thickness, the deformation field predicted by the ESPM reduces to that of the BSM if stresses related to plate flexure at the trench are released either continuously and completely at shallow depths during the interseismic period or deep in the subduction zone (below ˜100 km). However, if at least a portion of these stresses are not continuously released in the shallow portion of the subduction zone (via seismic or aseismic events), then the predicted surface velocities of these two models can differ significantly at horizontal

  18. An efficient Mindlin finite strip plate element based on assumed strain distribution

    Science.gov (United States)

    Chulya, Abhisak; Thompson, Robert L.

    1988-01-01

    A simple two node, linear, finite strip plate bending element based on Mindlin-Reissner plate theory for the analysis of very thin to thick bridges, plates, and axisymmetric shells is presented. The new transverse shear strains are assumed for constant distribution in the two node linear strip. The important aspect is the choice of the points that relate the nodal displacements and rotations through the locking transverse shear strains. The element stiffness matrix is explicitly formulated for efficient computation and ease in computer implementation. Numerical results showing the efficiency and predictive capability of the element for analyzing plates with different supports, loading conditions, and a wide range of thicknesses are given. The results show no sign of the shear locking phenomenon.

  19. Create Your Plate

    Medline Plus

    Full Text Available ... Student Resources History of Diabetes Resources for School Projects How to Reference Our Site Diabetes Basics Myths ... Your Plate It's simple and effective for both managing diabetes and losing weight. Creating your plate lets ...

  20. Create Your Plate

    Medline Plus

    Full Text Available ... Planning Meals Diabetes Meal Plans Create Your Plate Gluten Free Diets Meal Planning for Vegetarian Diets Cook ... Create Your Plate Meal Planning for Vegetarian Diets Gluten Free Diets Holiday Meal Planning Cook with Heart- ...

  1. Create Your Plate

    Medline Plus

    Full Text Available ... Your Plate Gluten Free Diets Meal Planning for Vegetarian Diets Cook with Heart-Healthy Foods Holiday Meal ... Healthy Diet Create Your Plate Meal Planning for Vegetarian Diets Gluten Free Diets Holiday Meal Planning Cook ...

  2. Create Your Plate

    Medline Plus

    Full Text Available ... Your Plate It's simple and effective for both managing diabetes and losing weight. Creating your plate lets you still choose the foods you want, but changes the portion sizes so you are getting larger ...

  3. Williamson Polishing & Plating Site

    Science.gov (United States)

    Williamson Polishing & Plating Co. Inc. was a plating shop located in the Martindale-Brightwood neighborhood of Indianapolis. The facility conducted job shop polishing and electroplating services. The vacant site contains a 14,651-square-foot building.

  4. Cervical intervertebral disc replacement.

    Science.gov (United States)

    Cason, Garrick W; Herkowitz, Harry N

    2013-02-06

    Symptomatic adjacent-level disease after cervical fusion has led to the development and testing of several disc-replacement prostheses. Randomized controlled trials of cervical disc replacement (CDR) compared with anterior cervical discectomy and fusion (ACDF) have demonstrated at least equivalent clinical results for CDR with similar or lower complication rates. Biomechanical, kinematic, and radiographic studies of CDR reveal that the surgical level and adjacent vertebral level motion and center of rotation more closely mimic the native state. Lower intradiscal pressures adjacent to CDR may help decrease the incidence of adjacent spinal-level disease, but long-term follow-up is necessary to evaluate this theory.

  5. Vibration of plates

    CERN Document Server

    Chakraverty, Snehashish

    2008-01-01

    Plates are integral parts of most engineering structures and their vibration analysis is required for safe design. This work provides a comprehensive introduction to vibration theory and analysis of two-dimensional plates. It offers information on vibration problems along with a discussion of various plate geometries and boundary conditions.

  6. Assessment of Optimum Value for Dip Angle and Locking Rate Parameters in Makran Subduction Zone

    Science.gov (United States)

    Safari, A.; Abolghasem, A. M.; Abedini, N.; Mousavi, Z.

    2017-09-01

    Makran subduction zone is one of the convergent areas that have been studied by spatial geodesy. Makran zone is located in the South Eastern of Iran and South of Pakistan forming the part of Eurasian-Arabian plate's border where oceanic crust in the Arabian plate (or in Oman Sea) subducts under the Eurasian plate ( Farhoudi and Karig, 1977). Due to lack of historical and modern tools in the area, a sampling of sparse measurements of the permanent GPS stations and temporary stations (campaign) has been conducted in the past decade. Makran subduction zone from different perspectives has unusual behaviour: For example, the Eastern and Western parts of the region have very different seismicity and also dip angle of subducted plate is in about 2 to 8 degrees that this value due to the dip angle in other subduction zone is very low. In this study, we want to find the best possible value for parameters that differs Makran subduction zone from other subduction zones. Rigid block modelling method was used to determine these parameters. From the velocity vectors calculated from GPS observations in this area, block model is formed. These observations are obtained from GPS stations that a number of them are located in South Eastern Iran and South Western Pakistan and a station located in North Eastern Oman. According to previous studies in which the locking depth of Makran subduction zone is 38km (Frohling, 2016), in the preparation of this model, parameter value of at least 38 km is considered. With this function, the amount of 2 degree value is the best value for dip angle but for the locking rate there is not any specified amount. Because the proposed model is not sensitive to this parameter. So we can not expect big earthquakes in West of Makran or a low seismicity activity in there but the proposed model definitely shows the Makran subduction layer is locked.

  7. OUTCOME OF DISTAL TIBIA FRACTURE BY NAIL OR PLATE (MIPPO)- A COMPARATIVE STUDY

    OpenAIRE

    Madhuchandra R; Chandrashekhar Mudgal; Sandeep; Amol Shivaji Chavan

    2017-01-01

    BACKGROUND Distal tibial fracture often present a challenge to the orthopaedic surgeon. The best option for surgical management of distal tibial fracture is still unclear, whether nail or plate. MATERIALS AND METHODS The study consists of 24 patients of distal tibial fracture treated either with reamed intramedullary nails or locked plating/MIPPO with open reduction method or minimally-invasive techniques. RESULTS 24 patients included in the present study were divided i...

  8. Computation of the lock-in ranges of phase-locked loops with PI filter

    OpenAIRE

    Aleksandrov, Konstantin D.; Kuznetsov, Nikolay; Leonov, Gennady A.; Neittaanmäki, Pekka; Yuldashev, Marat V.; Yuldashev, Renat V.

    2016-01-01

    In the present work the lock-in range of PLL-based circuits with proportionallyintegrating filter and sinusoidal phase-detector characteristics are studied. Considered circuits have sinusoidal phase detector characteristics. Analytical approach based on the methods of phase plane analysis is applied to estimate the lock-in ranges of the circuits under consideration. Obtained analytical results are compared with simulation results.

  9. Partial-depth lock-release flows

    Science.gov (United States)

    Khodkar, M. A.; Nasr-Azadani, M. M.; Meiburg, E.

    2017-06-01

    We extend the vorticity-based modeling concept for stratified flows introduced by Borden and Meiburg [Z. Borden and E. Meiburg, J. Fluid Mech. 726, R1 (2013), 10.1017/jfm.2013.239] to unsteady flow fields that cannot be rendered quasisteady by a change of reference frames. Towards this end, we formulate a differential control volume balance for the conservation of mass and vorticity in the fully unsteady parts of the flow, which we refer to as the differential vorticity model. We furthermore show that with the additional assumptions of locally uniform parallel flow within each layer, the unsteady vorticity modeling approach reproduces the familiar two-layer shallow-water equations. To evaluate its accuracy, we then apply the vorticity model approach to partial-depth lock-release flows. Consistent with the shallow water analysis of Rottman and Simpson [J. W. Rottman and J. E. Simpson, J. Fluid Mech. 135, 95 (1983), 10.1017/S0022112083002979], the vorticity model demonstrates the formation of a quasisteady gravity current front, a fully unsteady expansion wave, and a propagating bore that is present only if the lock depth exceeds half the channel height. When this bore forms, it travels with a velocity that does not depend on the lock height and the interface behind it is always at half the channel depth. We demonstrate that such a bore is energy conserving. The differential vorticity model gives predictions for the height and velocity of the gravity current and the bore, as well as for the propagation velocities of the edges of the expansion fan, as a function of the lock height. All of these predictions are seen to be in good agreement with the direct numerical simulation data and, where available, with experimental results. An energy analysis shows lock-release flows to be energy conserving only for the case of a full lock, whereas they are always dissipative for partial-depth locks.

  10. Nongonococcal and Nonchlamydial Cervicitis.

    Science.gov (United States)

    Nyirjesy, Paul

    2001-12-01

    Cervicitis encompasses a variety of gynecologic conditions. Although inflammation on a Papanicolaou smear may be indicative of true cervical inflammation, establishing a diagnosis of mucopurulent cervicitis (MCP) is more clinically useful. MCP seems to be analogous to nongonococcal urethritis in men. Many cases of MCP are related to Chlamydia trachomatis infection, but the majority of cases have other potential causes. Other possible pathogens include Neisseria gonorrhoeae, Trichomonas vaginalis, Ureaplasma urealyticum, Mycoplasma genitalium, herpes simplex virus, and cytomegalovirus. Many cases may be related to cervical ectopy. MCP is a marker for endometritis, salpingitis, and adverse pregnancy outcomes. Given the current shortcomings in our understanding of this disease, an empiric approach to evaluation and treatment is suggested.

  11. Immunotherapy for Cervical Cancer

    Science.gov (United States)

    In an early phase NCI clinical trial, two patients with metastatic cervical cancer had a complete disappearance of their tumors after receiving treatment with a form of immunotherapy called adoptive cell transfer.

  12. Screening for Cervical Cancer

    Science.gov (United States)

    ... cervical cancer: • Cytology: This test, also called a Pap test or Pap smear, looks for abnormal changes in ... women ages 21 to 65, screening with a Pap test every 3 years has the highest benefits with ...

  13. Surgical management of C-type subaxial cervical fractures using cervical traction followed by anterior cervical discectomy and fusion within 12 h after the trauma.

    Science.gov (United States)

    Donnarumma, Pasquale; Bozzini, Vincenzo; Rizzi, Gaetano; Berardi, Arturo; Merlicco, Gaetano

    2017-01-01

    This was a retrospective cohort study. To report our 10-year experience of closed reduction using Crutchfield traction followed by anterior cervical discectomy and fusion within 12 h from injury for C-type subaxial cervical fractures (according to the AOSpine classification system). Clinical records and neuroimaging were retrospectively reviewed. Surgical details were provided. A total of 22 patients were included in the study. The cervical fracture was diagnosed after whole-body computed tomography scan on admission in all cases. Crutchfield traction was applied within 1-5 h from the diagnosis. Surgery consisting of anterior microdiscectomy and fusion with interbody cage and plating was performed 6-12 h after traction positioning. Most patients (19, 86%) had spinal cord injury: 7 were Frankel A (31%), 3 Frankel B (14%), 6 Frankel C (27%), 3 Frankel D (14%), and 3 Frankel E (14%). No neurologic deterioration was observed after the treatment. In 10 cases (45%), neurological symptoms improved 1 year after the trauma. Two patients (10%) died for complication related to spinal cord transition or other organ damage. Early reduction gives the best chance of recovery for patients affected by C-type subaxial cervical fracture. Rapid traction is more often successful and safer than manipulation under anesthesia. After close reduction achieving, anterior microdiscectomy, cage, and plating implant seem to be safe and effective with a low rate of complications.

  14. Dolor cervical incoercible

    Directory of Open Access Journals (Sweden)

    Adrián F Narváez-Muñoz

    2014-03-01

    Astrocytomas are relatively common glial neoplasm of the central nervous system, but only a small percentage of them are located in the spinal cord, with a predilection for the cervical and dorsal regions. In most cases, extend longitudinally, affecting several cord segments. Pain is a frequent symptom of local character bone segments involving the tumor, associated with sensory deficit and / or motor. The following is the case of a 60 year old woman with cervical cord astrocytoma extended to the brainstem.

  15. A prospective randomized study of operative treatment for noncomminuted humeral shaft fractures: conventional open plating versus minimal invasive plate osteosynthesis.

    Science.gov (United States)

    Kim, Ji Wan; Oh, Chang-Wug; Byun, Young-Soo; Kim, Jung Jae; Park, Ki Chul

    2015-04-01

    To compare the clinical and radiologic results of conventional open plating (COP) and minimally invasive plate osteosynthesis (MIPO) in the treatment of noncomminuted humeral shaft fractures. Randomized prospective study. Five level 1 trauma centers. Sixty-eight consecutive patients were randomized into 2 study groups: those treated by COP (COP group; n = 32) and those treated by MIPO (MIPO group; n = 36). Simple humeral shaft fractures (AO/OTA classification types A and B) were reduced by open reduction or closed reduction and fixed with a narrow 4.5/5.0 locking compression plate, metaphyseal locking compression plate, or proximal humeral internal locking system plate to the anterior lateral aspect of the humerus. Fracture healing time, operative time, radiation exposure time, and intraoperative nerve injury. To assess shoulder and elbow function, we used the University of California, Los Angeles (UCLA) scoring system and the Mayo elbow performance index, including the range of motion and pain. Radiographic measurements included fracture alignment, delayed union, and nonunion. Thirty-one fractures (97%) healed in the COP group within 16 weeks, whereas 36 fractures (100%) were healed in the MIPO group by 15 weeks. No significant difference was observed in the operative time or complication rates. In both groups, all fractures achieved union without malunion and with excellent functional outcomes by definition of the Mayo elbow performance index and UCLA scoring system. This study confirmed a high overall rate of union and excellent functional outcomes in both MIPO and COP groups. MIPO is equivalent to COP as a safe and effective method for simple types of humeral shaft fractures when surgery is indicated, and the surgeon is experienced in the technique. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

  16. Biomechanical comparison of orthogonal versus parallel double plating systems in intraarticular distal humerus fractures.

    Science.gov (United States)

    Atalar, Ata C; Tunalı, Onur; Erşen, Ali; Kapıcıoğlu, Mehmet; Sağlam, Yavuz; Demirhan, Mehmet S

    2017-01-01

    In intraarticular distal humerus fractures, internal fixation with double plates is the gold standard treatment. However the optimal plate configuration is not clear in the literature. The aim of this study was to compare the biomechanical stability of the parallel and the orthogonal anatomical locking plating systems in intraarticular distal humerus fractures in artificial humerus models. Intraarticular distal humerus fracture (AO13-C2) with 5 mm metaphyseal defect was created in sixteen artificial humeral models. Models were fixed with either orthogonal or parallel plating systems with locking screws (Acumed elbow plating systems). Both systems were tested for their stiffness with loads in axial compression, varus, valgus, anterior and posterior bending. Then plastic deformation after cyclic loading in posterior bending and load to failure in posterior bending were tested. The failure mechanisms of all the samples were observed. Stiffness values in every direction were not significantly different among the orthogonal and the parallel plating groups. There was no statistical difference between the two groups in plastic deformation values (0.31 mm-0.29 mm) and load to failure tests in posterior bending (372.4 N-379.7 N). In the orthogonal plating system most of the failures occurred due to the proximal shaft fracture, whereas in the parallel plating system failure occurred due to the shift of the most distal screw in proximal fragment. Our study showed that both plating systems had similar biomechanical stabilities when anatomic plates with distal locking screws were used in intraarticular distal humerus fractures in artificial humerus models. Copyright © 2016 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

  17. [Cervical discopathy, cervical migraine and vertebrobasilar arterial insufficiency: Clinical correlations].

    Science.gov (United States)

    Domzał, T; Zaleska, B; Kwasucki, J

    1978-01-01

    The pathogenesis of cervical migraine may suggest that a connection exists between it and cervical discopathy and also vertebrobasilar arterial insufficiency. This correlation was studied in a group of 103 patients subjected to clinical observations. In 83 of them cervical discopathy was found, in 69 cervical migraine and in 40 vertebrobasilar insufficiency were present. Among those with discopathy migraine was present in 63.6% of cases, and vertebrobasilar insufficiency in 31%. In patients with cervical migraine degenerative changes of the type of cervical discopathy were present in 90% of cases, although in only 56.5% of cases clinical signs were present connected with these changes. Vertebrobasilar insufficiency was present in 45% of patients with cervical migraine, that is more frequently than in discopathy. In the group with vertebrobasilar insufficiency radiological changes in the cervical spine were present in 77.5% of cases and the same proportion of patients in this group had cervical migraine. These numbers confirm the connection between cervical migraine and radiological changes and clinical manifestations of discopathy, and they indicate also that cervical migraine may be a successive stage of vascular changes leading to circulatory failure in the area supplied by vertebral arteries. This failure may have a different course and pathological mechanism. In 12.5% of patients in this group no cervical migraine or radiological changes were demonstrated. The term "cervical migraine" seems inappropriate since this type of headache has another substrate and mechanism than true migraine.

  18. Radiation Therapy Plus Cisplatin and Gemcitabine in Treating Patients With Cervical Cancer

    Science.gov (United States)

    2014-12-23

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  19. Minimally invasive central corpectomy for ossified posterior longitudinal ligament in the cervical spine.

    Science.gov (United States)

    Hirano, Yoshitaka; Mizuno, Junichi; Nakagawa, Hiroshi; Itoh, Yasunobu; Kubota, Keiichi; Watanabe, Sadayoshi; Matsuoka, Hidenori; Numazawa, Shinichi; Tomii, Masato; Watanabe, Kazuo

    2011-01-01

    Minimally invasive central corpectomy (MICC) for cervical segmental ossified posterior longitudinal ligament (OPLL) is described. The procedure of MICC includes upper- or lower-half central corpectomy of the involved cervical spine, transdiscal decompression of the adjacent disc level, dissection and partial removal of the OPLL, removal of the OPLL behind the vertebral body via these windows, and fusion with cylindrical titanium cages. Anterior plate fixation is not necessary. From January 2008 to December 2009 we surgically treated three patients with cervical OPLL by MICC. All three patients showed remarkable improvement of their symptoms within a few days after the operation. No neurological or radiological complication was observed during that period. MICC is beneficial in avoiding complete corpectomy and long fusion, usage of an anterior plate, and usage of a large external orthosis. MICC also reduces the risk of postoperative esophageal perforation due to a screw backing out of the plate. 2010 Elsevier Ltd. All rights reserved.

  20. Using river locks to teach hydrodynamic concepts

    International Nuclear Information System (INIS)

    Carvalho-Santos, Vagson L; Mendes, Thales C; Silva, Enisvaldo C; Rios, Márcio L; Silva, Anderson A P

    2013-01-01

    In this work, the use of a river lock as a non-formal setting for teaching hydrodynamical concepts is proposed. In particular, we describe the operation of a river lock situated at the Sobradinho dam, on the São Francisco River (Brazil). A model to represent and to analyse the dynamics of river lock operation is presented and we derive the dynamical equations for the rising of the water column as an example to understand the Euler equation. Furthermore, with this activity, we enable the integration of content initially introduced in the classroom with practical applications, thereby allowing the association of physical themes to content relevant in disciplines such as history and geography. In addition, experiences of this kind enable teachers to talk about the environmental and social impacts caused by the construction of a dam and, consequently, a crossover of concepts has been made possible, leading to more meaningful learning for the students. (paper)

  1. John Locke and the right to resistance

    Directory of Open Access Journals (Sweden)

    Jovanov Ilija D.

    2015-01-01

    Full Text Available John Locke was a great thinker and many works have been devoted to clear up his theories. One of the most significant, stated in his principal work, Two Treatises of Government, is the theory of the right to resistance. It was a bit revolutionary then, and to a large extent it is today. Domination of legal positivism is negation of that, by Locke, natural right. However, the fact is that in recent times the resistance to the established power occurs in a number of countries and in different forms, so that the idea of the right to resistance becomes live question again. In this regard it is interesting to consider Locke's viewpoint on this important issue and to determine whether his theory on the resistance is applicable in modern societies.

  2. Preliminary experience of titanium mesh cages for pathological fracture of middle and lower cervical vertebrae.

    Science.gov (United States)

    Chuang, Hao-Che; Wei, Sung-Tai; Lee, Han-Chung; Chen, Chun-Chung; Lee, Wen-Yuen; Cho, Der-Yang

    2008-11-01

    The advantages and disadvantages of titanium mesh cages (TMCs) assisted by anterior cervical plates (ACPs) for interbody fusion following cervical corpectomy were investigated. Between January 2002 and September 2006, 17 patients with cervical radiculomyelopathy caused by metastasis-induced pathologic fractures were selected for anterior corpectomy. TMCs were inserted into the post-corpectomy defect and stabilized by placement of ACPs filled with Triosite. Post-operative plain X-ray films indicated maintenance of spinal stability. No ceramic, donor site or surgery-related complications were observed. True trabeculation was observed in axial and reconstructive CT scans in all surviving patients one year after surgery. Neurological recovery, pain control, and good quality of life were achieved. Short hospital stays, minimal blood loss, short operation times and brief periods of bed confinement were also observed. We conclude that a TMC assisted by an ACP is safe and effective for interbody fusion following cervical corpectomy for pathological fractures resulting from cervical vertebral metastases.

  3. Cervical syphilitic lesions mimicking cervical cancer: a rare case report

    Directory of Open Access Journals (Sweden)

    Xiaoqing Zhu

    2015-02-01

    Full Text Available A woman presented to the hospital due to postcoital vaginal bleeding. The patient was initially diagnosed with cervical carcinoma by clinicians at a local hospital. However, a biopsy of the cervical lesions revealed chronic inflammation and erosion of the cervical mucosa, and the rapid plasma reagin ratio titer was 1:256. The patient was eventually diagnosed with syphilitic cervicitis and treated with minocycline 0.1 g twice a day. The patient was cured with this treatment.

  4. 60-GHz CMOS phase-locked loops

    CERN Document Server

    Cheema, Hammad M; van Roermund, Arthur HM

    2010-01-01

    The promising high data rate wireless applications at millimeter wave frequencies in general and 60 GHz in particular have gained much attention in recent years. However, challenges related to circuit, layout and measurements during mm-wave CMOS IC design have to be overcome before they can become viable for mass market. ""60-GHz CMOS Phase-Locked Loops"" focusing on phase-locked loops for 60 GHz wireless transceivers elaborates these challenges and proposes solutions for them. The system level design to circuit level implementation of the complete PLL, along with separate implementations of i

  5. Drag and Torque on Locked Screw Propeller

    Directory of Open Access Journals (Sweden)

    Tomasz Tabaczek

    2014-09-01

    Full Text Available Few data on drag and torque on locked propeller towed in water are available in literature. Those data refer to propellers of specific geometry (number of blades, blade area, pitch and skew of blades. The estimation of drag and torque of an arbitrary propeller considered in analysis of ship resistance or propulsion is laborious. The authors collected and reviewed test data available in the literature. Based on collected data there were developed the empirical formulae for estimation of hydrodynamic drag and torque acting on locked screw propeller. Supplementary CFD computations were carried out in order to prove the applicability of the formulae to modern moderately skewed screw propellers.

  6. Locke y la adulación

    OpenAIRE

    Tomás Chuaqui H.

    2004-01-01

    En este artículo se verifica la relevancia de un vicio político específico, la adulación, en las ideas de John Locke. Se muestra que para Locke la adulación proviene de agentes ilustrados que incitan a los aspirantes al poder recurriendo al orgullo que típicamente los caracteriza. Este vicio político, por ende, hace peligrar a los regímenes de poderes limitados y desconcentrados, ya que induce, a través del cultivo del orgullo, un deseo desmedido por el poder y el dominio sobre otros. Así, se...

  7. Progress as Compositional Lock-Freedom

    DEFF Research Database (Denmark)

    Carbone, Marco; Dardha, Ornela; Montesi, Fabrizio

    2014-01-01

    such definition to capture a more intuitive notion of context adequacy for checking progress. Interestingly, our new catalysers lead to a novel characterisation of progress in terms of the standard notion of lock-freedom. Guided by this discovery, we also develop a conservative extension of catalysers that does...... not depend on types, generalising the notion of progress to untyped session-based processes. We combine our results with existing techniques for lock-freedom, obtaining a new methodology for proving progress. Our methodology captures new processes wrt previous progress analysis based on session types....

  8. Locke and the education of the adolescent

    Directory of Open Access Journals (Sweden)

    Francisco T. Baciero Ruiz

    2008-12-01

    Full Text Available John Locke has been considered one of the leading figures in the His- tory of Philosophy, specially for his two famous treatises An Essay concerning Human understanding and Two Treatises on Government. None the less his work in Pedagogy, Some thougths concerning Education, is no less important, and provides the leading strings of that what ought to be the education of the gentleman, whose unavoidable foundation must be a solid education in virtue grounded in the moral principles of Christianity. Key words: Locke, Moral education, Spanish authors of the XVIth century. 

  9. Implementation of Digital Lock-in Amplifier

    Science.gov (United States)

    Bhattacharyya, Sabyasachi; Nasir Ahmed, Ragib; Bijoy Purkayastha, Basab; Bhattacharyya, Kaustubh

    2016-10-01

    The recovery of signal under the presence of noise is utmost essential for proper communication. The signals corrupted due to noise can be recovered using various techniques. However the weak signals are more prone to noise and hence they can be easily degraded due to noise. In such cases, a digital lock-in amplifier becomes an essential device for recovery of such weak signals. Keeping the cost, speed and other considerations, we will present the implementation of digital lock-in amplifier and how it recovers the weak signal under extreme noisy conditions.

  10. Mode-locked silicon evanescent lasers.

    Science.gov (United States)

    Koch, Brian R; Fang, Alexander W; Cohen, Oded; Bowers, John E

    2007-09-03

    We demonstrate electrically pumped lasers on silicon that produce pulses at repetition rates up to 40 GHz. The mode locked lasers generate 4 ps pulses with low jitter and extinction ratios above 18 dB, making them suitable for data and telecommunication transmitters and for clock generation and distribution. Results of both passive and hybrid mode locking are discussed. This type of device could enable new silicon based integrated technologies, such as optical time division multiplexing (OTDM), wavelength division multiplexing (WDM), and optical code division multiple access (OCDMA).

  11. January Monthly Spotlight: Cervical Health and Cervical Cancer Disparities

    Science.gov (United States)

    In January, CRCHD joins the nation in raising awareness for Cervical Health and Cervical Cancer Disparities. This month we share a special focus on NCI/CRCHD research programs that are trying to reduce cervical cancer disparities in underserved communities and the people who are spreading the word about the importance of early detection.

  12. Is there a benefit of proximal locking screws in osteoporotic distal radius fractures? - A biomechanical study.

    Science.gov (United States)

    Bockmann, Benjamin; Budak, Can; Figiel, Jens; Lechler, Philipp; Bliemel, Christopher; Debus, Florian; Schwarting, Tim; Oberkircher, Ludwig; Frink, Michael

    2016-08-01

    The distal radial fracture is a common fracture and frequently seen in geriatric patients. During the last years, volar plating has become a popular treatment option. While the application of locking screws at the distal fragment is widely accepted, there is no evidence for their use at the radial shaft. In six osteoporotic pairs of matched human cadaver radii an extra-articular model creating an AO 23-A2.1 fracture was employed. Osteosynthesis were performed using the APTUS 2.5 Adaptive TriLock Distal Radius System (Medartis AG) with locking (LS) or non-locking screws (NLS) for proximal fixation. Biomechanical testing was performed in a staircase fashion: starting with 50 cycles at 200N, the load was continuously increased by 50N every 80 cycles up to a maximum force of 400N. Finally, load to failure was analyzed with failure defined as sudden loss of force measured (20%) or major deformation of the radii (10mm). At 200N, 250N, 300N, 400N and load to failure, the NLS group showed a higher degree of elastic modulus. In contrast, the LS group showed higher elastic modulus at 350N. Maximum force was higher in the LS group without reaching statistical significance. Reasons for loss of fixation were longitudinal shaft fractures, horizontal peri-implant fractures and distal cutting out. No difference was seen between the two groups concerning the development of the above mentioned complications. Our study did not show biomechanical superiority for distal radius fracture fixation by using locking screws in the proximal holes in an osteoporotic cadaver study. At load to failure, longitudinal shaft fractures and peri-implant fractures seemed to be a more relevant problem rather than failure of the proximal fixation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Cervical Stenosis, Myelopathy and Radiculopathy

    Science.gov (United States)

    ... FIND A SPECIALIST Conditions Cervical Stenosis, Myelopathy and Radiculopathy Raj Rao MD Raj Rao MD Updated 5/ ... of the spinal cord within the neck. Cervical radiculopathy refers to a loss of function in a ...

  14. Biomechanical investigation of an alternative concept to angular stable plating using conventional fixation hardware

    Directory of Open Access Journals (Sweden)

    Radtke Roman

    2010-05-01

    Full Text Available Abstract Background Angle-stable locking plates have improved the surgical management of fractures. However, locking implants are costly and removal can be difficult. The aim of this in vitro study was to evaluate the biomechanical performance of a newly proposed crossed-screw concept ("Fence" utilizing conventional (non-locked implants in comparison to conventional LC-DCP (limited contact dynamic compression plate and LCP (locking compression plate stabilization, in a human cadaveric diaphyseal gap model. Methods In eight pairs of human cadaveric femora, one femur per pair was randomly assigned to receive a Fence construct with either elevated or non-elevated plate, while the contralateral femur received either an LCP or LC-DCP instrumentation. Fracture gap motion and fatigue performance under cyclic loading was evaluated successively in axial compression and in torsion. Results were statistically compared in a pairwise setting. Results The elevated Fence constructs allowed significantly higher gap motion compared to the LCP instrumentations (axial compression: p ≤ 0.011, torsion p ≤ 0.015 but revealed similar performance under cyclic loading (p = 0.43. The Fence instrumentation with established bone-plate contact revealed larger fracture gap motion under axial compression compared to the conventional LC-DCP osteosynthesis (p ≤ 0.017. However, all contact Fence specimens survived the cyclic test, whereas all LC-DCP constructs failed early during torsion testing (p Conclusions Even though accentuated fracture gap motion became obvious, the "Fence" technique is considered an alternative to cost-intensive locking-head devices. The concept can be of interest in cases were angle-stable implants are unavailable and can lead to new strategies in implant design.

  15. Gradual unlocking of plate boundary controlled initiation of the 2014 Iquique earthquake.

    Science.gov (United States)

    Schurr, Bernd; Asch, Günter; Hainzl, Sebastian; Bedford, Jonathan; Hoechner, Andreas; Palo, Mauro; Wang, Rongjiang; Moreno, Marcos; Bartsch, Mitja; Zhang, Yong; Oncken, Onno; Tilmann, Frederik; Dahm, Torsten; Victor, Pia; Barrientos, Sergio; Vilotte, Jean-Pierre

    2014-08-21

    On 1 April 2014, Northern Chile was struck by a magnitude 8.1 earthquake following a protracted series of foreshocks. The Integrated Plate Boundary Observatory Chile monitored the entire sequence of events, providing unprecedented resolution of the build-up to the main event and its rupture evolution. Here we show that the Iquique earthquake broke a central fraction of the so-called northern Chile seismic gap, the last major segment of the South American plate boundary that had not ruptured in the past century. Since July 2013 three seismic clusters, each lasting a few weeks, hit this part of the plate boundary with earthquakes of increasing peak magnitudes. Starting with the second cluster, geodetic observations show surface displacements that can be associated with slip on the plate interface. These seismic clusters and their slip transients occupied a part of the plate interface that was transitional between a fully locked and a creeping portion. Leading up to this earthquake, the b value of the foreshocks gradually decreased during the years before the earthquake, reversing its trend a few days before the Iquique earthquake. The mainshock finally nucleated at the northern end of the foreshock area, which skirted a locked patch, and ruptured mainly downdip towards higher locking. Peak slip was attained immediately downdip of the foreshock region and at the margin of the locked patch. We conclude that gradual weakening of the central part of the seismic gap accentuated by the foreshock activity in a zone of intermediate seismic coupling was instrumental in causing final failure, distinguishing the Iquique earthquake from most great earthquakes. Finally, only one-third of the gap was broken and the remaining locked segments now pose a significant, increased seismic hazard with the potential to host an earthquake with a magnitude of >8.5.

  16. Marmet Locks and Dam, Kanawha River, West Virginia

    Science.gov (United States)

    2015-07-01

    11 Figure 9. ROV used in Marmet Lock Stoney gate valves and...culvert tunnels inspection. ................. 12 Figure 10. ROV being attached to tether...12 Figure 11. ROV entering valve well to Marmet Lock Stoney gate valves and culvert tunnels

  17. A hydraulic assist for a manual skyline lock

    Science.gov (United States)

    Cleveland J. Biller

    1977-01-01

    A hydraulic locking mechanism was designed to replace the manual skyline lock on a small standing skyline with gravity carriage. It improved the efficiency of the operation by reducing setup and takedown times and reduced the hazard to the crew.

  18. "Thoughts Concerning Education": John Locke On Teaching Speech

    Science.gov (United States)

    Baird, John E.

    1971-01-01

    Locke's suggestions for more effective speech instruction have gone largely unnoticed. Consequently, it is the purpose of this article to consider John Locke's criticisms, theory and specific methods of speech education. (Author)

  19. Robust tilt and lock mechanism for hopping actuator

    Energy Technology Data Exchange (ETDEWEB)

    Salton, Jonathan R.; Buerger, Stephen; Dullea, Kevin J.; Marron, Lisa C.; Salisbury, Curt Michael; Spletzer, Barry Louis

    2017-02-07

    A tilt and lock apparatus that includes a tilt servomechanism, a spiral torsion spring, a lock wheel, and a lock hook is described herein. The spiral torsion spring is mechanically coupled to the tilt servomechanism and the lock wheel (which includes an opening). When a shaft is positioned through the opening, rotation of the lock wheel is in unison with rotation of the shaft. An external surface of the lock wheel includes one or more grooves. The lock hook includes a head that engages and disengages the grooves. The lock wheel is stationary when the head engages one of the grooves and is rotatable when the head disengages the grooves. The head and the grooves are geometrically aligned when engaged to prevent creation of a force that acts to disengage the head responsive to an applied force acting on the shaft.

  20. A formal reduction for lock-free parallel algorithms

    NARCIS (Netherlands)

    Gao, H.; Hesselink, W.H.; Alur, R; Peled, DA

    2004-01-01

    On shared memory multiprocessors, synchronization often turns out to be a performance bottleneck and the source of poor fault-tolerance. Lock-free algorithms can do without locking mechanisms, and are therefore desirable. Lock-free algorithms are hard to design correctly, however, even when

  1. 14 CFR 23.679 - Control system locks.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Control system locks. 23.679 Section 23.679... STANDARDS: NORMAL, UTILITY, ACROBATIC, AND COMMUTER CATEGORY AIRPLANES Design and Construction Control Systems § 23.679 Control system locks. If there is a device to lock the control system on the ground or...

  2. Locke on Education and the Rights of Parents

    Science.gov (United States)

    Tuckness, Alex

    2010-01-01

    John Locke is often taken to be a staunch defender of parents' rights in the realm of education. In fact, Locke's pedagogical reasons for preferring home education to school education do not necessarily apply to similar choices in modern contexts. Locke's political argument for defining education as a duty of parents rather than the state does not…

  3. Lock-free dynamic hash tables with open addressing

    NARCIS (Netherlands)

    Gao, H.; Groote, J.F.; Hesselink, W.H.

    We present an efficient lock-free algorithm for parallel accessible hash tables with open addressing, which promises more robust performance and reliability than conventional lock-based implementations. “Lock-free” means that it is guaranteed that always at least one process completes its operation

  4. Theory of Passively Mode-Locked Photonic Crystal Semiconductor Lasers

    DEFF Research Database (Denmark)

    Heuck, Mikkel; Blaaberg, Søren; Mørk, Jesper

    2010-01-01

    We report the first theoretical investigation of passive mode-locking in photonic crystal mode-locked lasers. Related work has investigated coupled-resonator-optical-waveguide structures in the regime of active mode-locking [Opt. Express 13, 4539-4553 (2005)]. An extensive numerical investigation...

  5. ANTEROINFERIOR PLATING OF DISPLACED MIDDLE THIRD FRACTURE OF CLAVICLE

    Directory of Open Access Journals (Sweden)

    Shashi Kumar

    2016-05-01

    Full Text Available PURPOSE Even though clavicle fractures have a good union rate conservatively, there are several indications for surgical management. Among the surgical techniques open reduction and plate fixation have been used extensively. Although most surgeons prefer a superior plating technique, an anteroinferior plate location seems to be more advantageous considering the position and reduction of fragments. MATERIAL AND METHODS Fifteen consecutive patients with displaced middle-third fracture, delayed unions and non-unions of the clavicle underwent open reduction and internal fixation using an anteroinferior 3.5 mm reconstruction locking compression plate and screws. Patients were evaluated using patient symptoms, clinical signs and radiographic union, the Short Form-36 (SF-36, the American Shoulder and Elbow Surgeons Shoulder Assessment (ASES, and Constant Shoulder Score (CSS outcomes questionnaire. RESULTS The mean age of the patients was 34.6 years (range 19 to 53 years and all of them (n=15 were males. All patients were satisfied with their shoulder and upper extremity function as well as cosmesis from first week of surgery and were able to carry out their activities of daily living. Mean union time (absence of clinical tenderness and time for radiological union of fracture was 14.6 weeks, range being 12 to 21 weeks. ASES score was 89. Constant shoulder score was 84 at the latest follow-up. CONCLUSIONS Anteroinferior plating of acute displaced middle-third fractures of the clavicle and non-union using 3.5 mm reconstruction locking compression plate typically results in early healing, few complications and an excellent return of function. Advantages of this technique include stable bony fixation with screws directed away from potentially dangerous infraclavicular structures, minimal or no incidence of implant prominence problems and good patient compliance. Further, we would like to emphasise the fact that reduction of small inferior fragments in

  6. Lock-free parallel garbage collection

    NARCIS (Netherlands)

    H. Gao; J.F. Groote (Jan Friso); W.H. Hesselink (Wim)

    2005-01-01

    htmlabstract This paper presents a lock-free parallel algorithm for mark&sweep garbage collection (GC) in a realistic model using synchronization primitives compare-and-swap (CAS) and load-linked/store-conditional (LL/SC) offered by machine architectures. Mutators and collectors can simultaneously

  7. 49 CFR 236.742 - Dog, locking.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Dog, locking. 236.742 Section 236.742 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION..., MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Definitions § 236.742 Dog...

  8. Lock-free parallel garbage collection

    NARCIS (Netherlands)

    Gao, H.; Groote, J.F.; Hesselink, W.H.; Pan, Y; Chen, D; Guo, M; Cao, JN; Dongarra, J

    2005-01-01

    This paper presents a lock-free parallel algorithm for garbage collection in a realistic model using synchronization primitives offered by machine architectures. Mutators and collectors can simultaneously operate on the data structure. In particular no strict alternation between usage and cleaning

  9. A New Perspective on Job Lock

    Science.gov (United States)

    Huysse-Gaytandjieva, Anna; Groot, Wim; Pavlova, Milena

    2013-01-01

    This paper analyses the situation when employees fail to adapt to overall job dissatisfaction. By combining the existing knowledge in economics on job lock and in psychology on employees' feeling of being "stuck" at work, the paper explains why some employees fail to adapt when dissatisfied with their job. Thus, the paper aims to expand…

  10. 49 CFR 236.706 - Bed, locking.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Bed, locking. 236.706 Section 236.706 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RULES, STANDARDS, AND INSTRUCTIONS GOVERNING THE INSTALLATION, INSPECTION...

  11. 49 CFR 236.705 - Bar, locking.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Bar, locking. 236.705 Section 236.705 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RULES, STANDARDS, AND INSTRUCTIONS GOVERNING THE INSTALLATION, INSPECTION...

  12. 49 CFR 236.760 - Locking, approach.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Locking, approach. 236.760 Section 236.760 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RULES, STANDARDS, AND INSTRUCTIONS GOVERNING THE INSTALLATION, INSPECTION...

  13. 49 CFR 236.377 - Approach locking.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Approach locking. 236.377 Section 236.377 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RULES, STANDARDS, AND INSTRUCTIONS GOVERNING THE INSTALLATION, INSPECTION...

  14. An Assertional Characterization of Serializability and Locking.

    Science.gov (United States)

    1988-02-09

    to guarantee only serial schedules for the model used in [EGLT76). The necessity of two-phase locking in the absence of restrictions on transaction...cen d (2.2)). dACa ensures that states in which different sets of transactinss have completed are udistinguishable. AC2 ensures that consistent states

  15. Aircraft Detectors, Trap Triggers and Combination Locks

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 5; Issue 2. Aircraft Detectors, Trap Triggers and Combination Locks - Functional Diversity of Insect Mechanosensory Hairs. Jürgen Tautz. General Article Volume 5 Issue 2 February 2000 pp 32-38 ...

  16. Locks & keys service moves to building 55

    CERN Multimedia

    2012-01-01

    Please note that as of July 12 Locks & keys service will be at building 55 second floor. The opening hours are as follows: 08:30 am to 12:30 pm - 1:30 pm to 5:30 pm. The procedures and rules relating to applications for key and cylinder have not changed. GI-IS Group

  17. Junior High School Tardy Lock Out.

    Science.gov (United States)

    Scott, Carolyn A.

    This study describes and evaluates an experimental program for reducing tardiness in a rural junior high school. The subject school housed approximately 1,500 seventh- and eighth-grade students. Under the "Lock Out Program," first-time tardy students were given a one-day work detail in the cafeteria for 15 minutes of their lunch period.…

  18. "Locke, penseur subversif dans les manuscrits clandestins"

    DEFF Research Database (Denmark)

    Schøsler, Jørn

    2007-01-01

    Der gives en analyse af John Lockes subversive indflydelse på den franske Oplysning via de hemmeligt cirkulerende manuskripter fra århundredets begyndelse med kredsen omkring grev Boulainvillers ("Coterie Boulainviller") til århundredets slutning med kredsen omkring baron d'Holbach og Naigeon....

  19. A locked nucleic Acid-based nanocrawler

    DEFF Research Database (Denmark)

    Astakhova, I Kira; Pasternak, Karol; Campbell, Meghan A

    2013-01-01

    Herein we introduce a novel fluorescent LNA/DNA machine, a nanocrawler, which reversibly moves along a directionally polar complementary road controlled by affinity-enhancing locked nucleic acid (LNA) monomers and additional regulatory strands. Polyaromatic hydrocarbon (PAH) dyes attached to 2...

  20. Risk factors for postoperative subsidence of single-level anterior cervical discectomy and fusion: the significance of the preoperative cervical alignment.

    Science.gov (United States)

    Lee, Young-Seok; Kim, Young-Baeg; Park, Seung-Won

    2014-07-15

    Retrospective cohort study. To investigate and analyze the preoperative risk factors affecting subsidence after anterior cervical discectomy and fusion (ACDF) to reduce subsidence. Subsidence after ACDF may be caused by various risk factors, although the related information is scarce. Seventy-eight patients who underwent single-level ACDF between 2005 and 2011 were included. Patients were categorized into the subsidence (n = 26) and nonsubsidence groups (n = 52). Preoperative factors such as age, sex, operative level, bone mineral density, cervical alignment, segmental sagittal angle, and anterior/posterior disc height were assessed. The use of plates and the anterior/posterior disc height gap were examined as perioperative factors. The clinical outcome was assessed using a visual analogue scale for neck and arm pain. Subsidence occurred in 26 (33.3%) of 78 patients. A significant difference was found in clinical outcomes between the subsidence and nonsubsidence groups (P subsidence group. The mean time to subsidence was 4.8 months. Logistic regression analysis revealed that cervical alignment (P = 0.017), age (P = 0.022), and use of plates (P = 0.041) affected subsidence. In patients who received a stand-alone cage, the risk of subsidence was significantly greater in the kyphotic angle group than in the lordotic angle group (odds ratio = 13.56; P subsidence are cervical alignment, age, and use of plates. Our data suggest that surgeons should consider the kyphotic curvature and/or age when deciding on the use of plates.