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Sample records for plate fixation sixty-two

  1. 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.

  2. 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.

  3. Computational investigations of mechanical failures of internal plate fixation.

    Science.gov (United States)

    Chen, G; Schmutz, B; Wullschleger, M; Pearcy, M J; Schuetz, M A

    2010-01-01

    This paper investigated the biomechanics of two clinical cases of bone fracture treatments. Both fractures were treated with the same locking compression plate but with different numbers of screws as well as different plate materials. The fracture treated with 12 screws (rigid fixation) failed at 7 weeks with the plate breaking; the fracture with six screws (flexible fixation) endured the entire healing process. It was hypothesized that the plate failure in the unsuccessful case was due to the material fatigue induced by stress concentration in the plate. As the two clinical cases had different fracture locations and different plate materials, finite element simulations were undertaken for each fractured bone fixed by both a rigid and a flexible method. This enabled comparisons to be made between the rigid and flexible fixation methods. The fatigue life was assessed for each fixation method. The results showed that the stress in the rigid fixation methods could be significantly higher than that in flexible fixation methods. The fatigue analyses showed that, with the stress level in flexible fixation (i.e. with fewer screws), the plate was able to endure 2000 days, and that the plate in rigid fixation could fail by fatigue fracture in 20 days. The paper concludes that the rigid fixation method resulted in serious stress concentrations in the plate, which induced fatigue failure. The flexible fixation gave sufficient stability and was better for fracture healing.

  4. Operative Cost Comparison: Plating Versus Intramedullary Fixation for Clavicle Fractures.

    Science.gov (United States)

    Hanselman, Andrew E; Murphy, Timothy R; Bal, George K; McDonough, E Barry

    2016-09-01

    Although clavicle fractures often heal well with nonoperative management, current literature has shown improved outcomes with operative intervention for specific fracture patterns in specific patient types. The 2 most common methods of midshaft clavicle fracture fixation are intramedullary and plate devices. Through retrospective analysis, this study performed a direct cost comparison of these 2 types of fixation at a single institution over a 5-year period. Outcome measures included operative costs for initial surgery and any hardware removal surgeries. This study reviewed 154 patients (157 fractures), and of these, 99 had intramedullary fixation and 58 had plate fixation. A total of 80% (79 of 99) of intramedullary devices and 3% (2 of 58) of plates were removed. Average cost for initial intramedullary placement was $2955 (US dollars) less than that for initial plate placement (Pcost for removal was $1874 less than that for plate removal surgery (P=.2). Average total cost for all intramedullary surgeries was $1392 less than the average cost for all plating surgeries (Pcost for all intramedullary surgeries requiring plate placement and removal was $653 less than the average cost for all plating surgeries that involved only placement (P=.04). Intramedullary fixation of clavicle fractures resulted in a statistically significant cost reduction compared with plate fixation, despite the incidence of more frequent removal surgeries. [Orthopedics.2016; 39(5):e877-e882.].

  5. Biomechanical analysis of titanium fixation plates and screws in ...

    African Journals Online (AJOL)

    Key words: Bone plates, bone screws, finite element analysis, jaw fixation techniques, mandible, mandibular .... model is built up, in similar way to building block construction, .... shows advantages, such as granting intraoral route, minimal.

  6. Minimally invasive plate internal fixation for calcaneal fractures

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

  7. Outcome Analysis of Locking Plate Fixation in Proximal Humerus Fracture

    Science.gov (United States)

    Pathak, Abhishek; Gaur, Sanjiv

    2016-01-01

    Introduction Proximal humerus fractures account for approximately 5% of all fractures. Stable minimally displaced fractures can be treated nonoperatively but the management of displaced fractures remain controversial with various modalities of treatment available. Locking plates provide stable fixation and enable early postoperative mobilization specially in osteoporotic proximal humerus fracture. Aim To evaluate the functional outcome of locking plate fixation and to compare the results of two approaches used for fixation. Materials and Methods This prospective study was conducted at a tertiary level hospital between September 2011 to December 2013. PHILOS plates were used for internal fixation of displaced proximal humerus fractures Neer’s type 2 part, 3 part and 4 part fractures on 26 patients (M/F ratio 1.36:1; mean age 46 years). According to Neer classification, 5,12 and 9 patients had displaced 2, 3 and 4 part fractures respectively. Deltopectoral and deltoid splitting approaches were used for fixation on 13 patients each. Functional outcome was assessed using Constant-Murley shoulder score. Graphpad software version 6.0 was used with Chi-square test and Fisher-exact test are used to compare data. The p-value .05) and all fractures were united. Conclusion Our study demonstrates that locking plate fixation gives good functional outcomes in treatment of proximal humerus fractures. There was no significant difference in the two approaches used for exposure. Our results are comparable to various studies conducted by other authors which states that locking plates provide better functional and radiological outcomes as compared to other fixation methods like Tension band wiring, percutaneous K-wire fixation, non-locking plates, intramedullary nails. PMID:27656515

  8. Plate fixation or intramedullary fixation of humeral shaft fractures

    NARCIS (Netherlands)

    Heineman, D.J.; Poolman, R.W.; Sean, S.E.N.; Ponsen, K.J.; Bhandari, M.

    2010-01-01

    Methods We performed a literature search from 1967 to November 2007 in the main medical search engines and selected 4 randomized trials that compared nails and plates in patients with humeral shaft fractures and that reported on complications due to surgery. We statistically pooled patient data

  9. Mini-plate fixation versus suture suspensory fixation in cervical laminoplasty

    Science.gov (United States)

    Liu, Feng-Yu; Ma, Lei; Huo, Li-Shuang; Cao, Yan-Xiang; Yang, Da-Long; Wang, Hui; Yang, Si-Dong; Ding, Wen-Yuan

    2017-01-01

    Abstract Background: Both the mini-plate fixation and suture suspensory fixation techniques are extensively applied in cervical laminoplasty, but which technique is superior has not been ascertained. The purpose of this meta-analysis is to compare the results between mini-plate fixation and suture suspensory fixation in cervical laminoplasty for the patients with multilevel cervical compressive myelopathy. Methods: PubMed, Embase, the Cochrane library, CNKI, and WANFANG were searched for studies that compared mini-plate fixation and suture suspensory fixation in cervical laminoplasty up to November 1, 2016. We calculated odds ratio (OR) with 95% confidence interval (CI) for dichotomous outcomes and mean difference (MD) with 95% CI for continuous outcomes. Review Manager 5.3 was used for the statistical analyses. Results: A total of 25 studies, involving 1603 participants, were included in this review. The results of this meta-analysis indicated that there were statistically significant differences in postoperative Japanese Orthopedic Association (JOA) scores (MD = 0.67, 95% CI: 0.34–0.99, P statistically significant difference in C5 palsy (OR = 0.82, 95% CI: 0.37–1.84, P = 0.63). Conclusions: As compared with suture suspensory fixation, mini-plate fixation in cervical laminoplasty appears to achieve better clinical and radiographic outcomes with fewer surgical complications. However, mini-plate fixation is associated with bigger surgical trauma. This conclusion should be interpreted cautiously and more high-quality, randomized controlled trials are needed in the future. PMID:28151906

  10. Reconstruction plate fixation of subtrochanteric femoral fractures in children.

    Science.gov (United States)

    El-Sayed, Moustafa; Abulsaad, Mazen; El-Hadidi, Mahmoud; El-Adl, Wael; El-Batouty, Magdy

    2007-08-01

    Pediatric subtrochanteric femoral fractures are rare and have received limited attention in the literature Treatment is controversial. Different treatment options are used: skin traction, 90/90 skeletal traction, spica casting, cast bracing, internal fixation and external fixation. The aim of this study is to present our results with internal fixation of subtrochanteric femoral fractures in children using a reconstruction plate. Between 2000 and 2004, eighteen patients with closed subtrochanteric femoral fractures were treated in the Mansoura Emergency Hospital. The average age at the time of injury was 8.2 years (range 5.3 years to 11.5 years). Pathological fractures and fractures associated with neuromuscular diseases were excluded from this study. Eight patients had head injuries and/or multiple injuries. In all cases a single 4.5 mm contoured reconstruction plate was used and a 6.5 mm cancellous screw was inserted through the plate into the femoral neck. Average follow-up was 38 months (range, 12 to 47 months). All fractures united with anatomical alignment within an average of 8 weeks (range 6 to 12 weeks). There were no deep infections and no significant limb length discrepancies. At the latest follow-up, no patient had any restriction of activities. Internal fixation with a reconstruction plate appears as a good treatment option for children with subtrochanteric femoral fractures.

  11. The role of minimally invasive plate osteosynthesis in rib fixation : A review

    NARCIS (Netherlands)

    Bemelman, Michael; Van Baal, Mark; Yuan, Jian Zhang; Leenen, Luke|info:eu-repo/dai/nl/071390596

    2016-01-01

    More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950's, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft für osteosynthesefragen/Association for the Study of Internal Fixation.

  12. Stability of extraoral vertical ramus osteotomy: plate fixation versus maxillomandibular/skeletal suspension wire fixation.

    Science.gov (United States)

    Mobarak, K A; Krogstad, O; Espeland, L; Lyberg, T

    2000-01-01

    The objective of this cephalometric study was to evaluate skeletal stability and time course of postoperative changes in 2 groups of mandibular prognathism patients following extraoral oblique vertical ramus osteotomy (VRO). One group (n = 22) received maxillomandibular fixation and skeletal suspension wires (MMF group) for a period of 8 weeks. In the other group (n = 22), the segments were rigidly fixed with plates and the patients were allowed to function immediately after surgery. Lateral cephalograms were taken on 5 occasions: immediately presurgical, immediately postsurgical, 8 weeks postsurgical, 6 months postsurgical, and 1 year postsurgical. During the first 8 weeks after surgery, the MMF group demonstrated posterior movement of the mandible, with an increase in mandibular plane angle, shortening of the rami, and dental compensations. Upon release of MMF and skeletal suspension wiring, a small anterior relapse tendency was observed, but the net setback 1 year after surgery was still greater than the actual surgical setback. In the plate fixation group, postoperative changes were mainly in the form of a small anterior relapse tendency in the range of 10% of the surgical setback. The results indicate that the use of plate fixation with VRO, while eliminating the inconvenience for the patient of several weeks of MMF and preventing the early side effects observed in the MMF group, also resulted in a more predictable surgical procedure, with excellent stability 1 year after surgery.

  13. Arthroscopic evaluation for omalgia patients undergoing the clavicular hook plate fixation of distal clavicle fractures

    OpenAIRE

    2014-01-01

    Background The aim of this study is to investigate the anatomic changes in the shoulder joints responsible for omalgia after the clavicular hook plate fixation under arthroscope. Methods Arthroscopic examination was carried out for 12 omalgia patients who underwent clavicular hook plate fixation due to distal clavicle fractures. Functional outcome of shoulder was measured by the Japanese Orthopaedic Association (JOA) score before and after the withdrawal of the fixation plate. Results The rot...

  14. FUNCTIONAL OUTCOME OF PHILOS PLATE FIXATION FOR PROXIMAL HUMERUS FRACTURES

    Directory of Open Access Journals (Sweden)

    Ch. Venkateswarlu

    2016-01-01

    Full Text Available INTRODUCTION Treating a proximal humerus fracture remained a challenging problem until proximal humeral internal locking system has been developed. Our study aims at evaluating the functional outcome of 30 consecutive patients with proximal humeral fracture treated by Philos plate fixation; 30 patients with proximal humeral fractures who attended our hospital between December 2013 and December 2015 were included in the study; 18 women and 12 men with a mean age of 47.5years (30-60 years are included. Data was collected prospectively and outcomes were assessed using constant shoulder score. The mean follow-up period was 12 months (6-18 months. Mean union time of all the fractures was 11.4 weeks (8-20 weeks. The mean constant shoulder score at final review was 70.5 (52-92. Philos plate provides stable fracture fixation for proximal humerus fracture in both young and elderly patients, which enables for early mobilisation and achieves acceptable functional results.

  15. Caspar plate fixation for the treatment of complex hangman's fractures.

    Science.gov (United States)

    Tuite, G F; Papadopoulos, S M; Sonntag, V K

    1992-05-01

    This report details our recent experience with the surgical treatment of complex hangman's fractures after failure of closed reduction and immobilization in external orthosis. We have successfully treated hangman's fractures in 5 patients with anterior Caspar plate stabilization and C2-C3 interbody fusion. The specific anatomical features of these fractures were complex, rendering the spines of the patients highly unstable. The patients were considered surgical candidates when reduction could not be achieved or maintained with axial traction or halo immobilization. Each patient underwent anterior C2-C3 interbody bone fusion and Caspar plating from C2 to C3. All patients achieved adequate intraoperative reduction and were immobilized postoperatively with a halo vest. The follow-up period ranged from 3 to 28 months and provided a 100% fusion rate with no complications related to plating or nonunion. Our initial experience indicates that anterior C2-C3 interbody bone fusion and Caspar plate fixation is a suitable treatment option for patients with complex hangman's fractures who are not successfully managed nonoperatively.

  16. Transoral atlantoaxial reduction plate fixation for irreducible atlantoaxial dislocation

    Institute of Scientific and Technical Information of China (English)

    YIN Qing-shui; AI Fu-zhi; ZHANG Kai; CHANG Yun-bing; XIA Hong; WU Zeng-hui; QUAN Ri; MAI Xiao-hong; LIU Jing-fa

    2006-01-01

    Objective:To design a clinically applicable transoralpharyngeal atlantoaxial reduction plate (TARP),introduce the operation procedure, and evaluate its preliminary clinical effects.Methods: A novel TARP system, including butterfly titanium alloy plate, self-locking screws, atlantoaxial reductor and other operational instruments was developed.This system was applied clinically on five patients with irreducible atlantoaxial dislocation of congenital or traumatic origin. During operation, the reduction was completed by the combined action of the plate and the atlantoaxial reductor after transoral joint release and cord decompression. Bone graft granules were implanted between the bilateral atlantoaxial joints and TARP was used to immobilize subsequently the atlas and axis.Results: Clinical application demonstrated that TARP could induce instant reduction and that the method was operationally feasible and its postoperational effect was satisfactory.Conclusions: The design of TARP is novel. The operational procedure is simple and easy to use.Furthermore, instant reduction can be completed during the operation and the fixation is relatively stable. TARP is an ideal alternative for irreducible atlantoaxial dislocation and may have excellent prospects for further clinical applications.

  17. [Angle-fixed plate fixation or double-plate osteosynthesis in fractures of the proximal humerus: a biomechanical study].

    Science.gov (United States)

    Hessmann, Martin H; Korner, Jan; Hofmann, Alexander; Sternstein, Werner; Rommens, Pol M

    2008-06-01

    Internal fixation of fractures of the proximal humerus needs a high stability of fixation to avoid secondary loss of fixation. This is especially important in osteoporotic bone. In an experimental study, the biomechanical properties of the angle-fixed Philos plate (internal fixator) and a double-plate osteosynthesis using two one-third tubular plates were assessed. The fracture model was an unstable three-part fracture (AO type B2). Eight pairs of human cadaveric humeri were submitted to axial load and torque. In the first part of the study, it was assessed to which degree the original stiffness of the humeri could be restored after the osteotomy by the osteosynthesis procedure. Subsequently, subsidence during 200 cycles of axial loading and torque was analysed. During axial loading, the Philos plate was significantly stiffer and showed less irreversible deformation. Two double-plate fixations, but none of the Philos plate osteosynthesis, failed. During torsion, there were no significant differences between the two implants. From the biomechanical point of view, the angle-fixed Philos plate represents the implant of choice for the surgical fixation of highly unstable three-part fractures of the proximal humerus, as the internal fixator system is characterised by superior biomechanical properties.

  18. Clinical Analysis of Internal Fixation Treatment of Intra-articular Calcaneal Fractures with Titanium Plate.

    Science.gov (United States)

    Chen, Xiao-Dong; Zhang, Chang-Chun; Li, Zhao-Cheng; Zhang, Heng; Zhou, Xin-She; Deng, Min

    2015-05-01

    To explore the clinical effect of internal fixation treatment of intra-articular calcaneal fractures with titanium plate, we used open reduction and internal fixation with titanium plate to 48 treated feet from 42 patients with intra-articular calcaneal fractures. The efficacy of surgical treatment was evaluated based on assessment of pain, function, and line of force aspects according to the American Orthopedic Foot and Ankle Society scoring system. Our data show that internal fixation with titanium plate is an effective treatment for calcaneal fractures. It provides satisfactory reduction, reliable fixation, and early rehabilitation.

  19. Plate fixation of paediatric fractures of the distal tibia and fibula.

    Science.gov (United States)

    He, Bingshu; Wang, Jun

    2012-10-01

    The role of surgery in the management of paediatric long-bone shaft fractures remains a matter of debate. We present a series of paediatric patients with unstable fractures of the distal tibia and fibula, treated with titanium plate fixation. Excellent results were obtained after plate fixation.

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

    Directory of Open Access Journals (Sweden)

    Gediminas Gaidulis

    2015-03-01

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

  1. The anatomical study of transoral atlantoaxial reduction plate internal fixation

    Institute of Scientific and Technical Information of China (English)

    AI Fu-zhi; YIN Qing-shui; WANG Zhi-yun; XIA Hong; CHANG Yun-bing; WU Zeng-hui; LIU Jing-fa

    2006-01-01

    Objective:To study relevant anatomical features of the structures involved in transoral atlanto-axial reduction plate (TARP) internal fixation through transoral approach for treating irreducible atlanto-axial dislocation and providing anatomical basis for the clinical application of TARP.Methods: Ten fresh craniocervical specimens were microsurgically dissected layer by layer through transoral approach. The stratification of the posterior pharyngeal wall, the course of the vertebral artery, anatomical relationships of the adjacent structures of the atlas and axis, and the closely relevant anatomical parameters for TARP internal fixation were measured.Results: The posterior pharyngeal wall consisted of two layers and two interspaces: the mucosa, prevertebral fascia, retropharyngeal space, and prevertebral space. The range from the anterior edge of the foramen magnum to C3could be exposed by this approach. The thickness of the posterior pharyngeal wall was (3.6 ± 0.3) mm (ranging2.9-4.3 mm) at the anterior tubercle of C1,(6.1 ± 0.4) mm ( ranging 5.2-7.1 mm) at the lateral mass of C1 and (5.5±0.4) mm (ranging4.3-6.5 mm) at the central part of C2, respectively. The distance from the incisor tooth to the anterior tubercle of C1, C1 screw entry point, and C2 screw entry point was ( 82. 5 ± 7. 8 ) mm ( ranging 71.4-96. 2 mm), ( 90. 1 ± 3. 8 ) mm ( ranging82.2-96. 3 mm), and ( 89.0 ± 4.1 ) mm ( ranging 81.3-95.3 mm), respectively. The distance between the vertebral artery at the atlas and the midline was (25.2 ±2.3) mm (ranging 20.4-29.7 mm) and that between the vertebral artery at the axis and the midline was ( 18.4 ±2.6) mm ( ranging 13. 1-23.0 mm). The allowed width of the atlas and axis for exposure was (39. 4 ± 2. 2 ) mm( ranging 36.2-42.7 mm) and ( 39.0 ± 2. 1 ) mm ( ranging35.8-42. 3 mm), respectively. The distance (a) between the two atlas screw insertion points (center of anterior aspect of C1 lateral mass) was (31.4 ± 3.3 ) mm ( ranging25.4-36.6 mm

  2. Finite element analysis of the stability of combined plate internal fixation in posterior wall fractures of acetabulum.

    Science.gov (United States)

    Liu, Xi-Ming; Pan, Chang-Wu; Wang, Guo-Dong; Cai, Xian-Hua; Chen, Lei; Meng, Cheng-Fei; Huang, Jin-Cheng

    2015-01-01

    This study aims to explore the mechanical stability of combined plate internal fixation in posterior wall fractures of the acetabulum. The fracture and internal fixation models were established in this study and they were divided into four kinds of internal fixation models, finite element analysis was performed. The four groups were 2 mini-plates and 1 reconstruction plate fixation (A), Reconstruction plate internal fixation group (B), 2 screws internal fixation group (C) and mini-plates internal fixation group (D). The displacement of each node was measured and evaluated. There was no distortion in the geometric shape of the finite element model. The results of stress showed that it was less in the anterior pelvic ring and distributed uniform in labrum acetabulare; the stress was bigger in the upper and middle of sacroiliac joint and sciatic notch in sitting position. Combined plate internal fixation for posterior wall fractures of acetabular were stable and reliable, it is better than the other three methods.

  3. Augmentation plating in hypertrophic non-union after nail fixation of femoral shaft fracture compared with exchange plating

    Institute of Scientific and Technical Information of China (English)

    Jiang Liangjun; Pan Zhijun; Zheng Qiang

    2014-01-01

    Background Augmentation plating has been used successfully to treat hypertrophic non-union after nail fixation.This study compared the efficacy of augmentation plating and exchange plating for treating hypertrophic non-union of femoral shaft fracture after intramedullary nail fixation.Methods A total of 12 patients received augmentation plating and 15 patients received exchange plating as treatment for femoral shaft hypertrophic non-union.The procedures were conducted at our medical centre between January 2005and January 2012.Clinical follow-up was conducted at 2 weeks,1 month and then monthly until union was achieved to compare union time,operation time,bleeding and complications between the two groups.Results All patients underwent follow-up examinations until fracture union was achieved.The average length of followup time after the second treatment was (18.37±3.28) months.The time needed for union was (4.17±0.94) months in the augmentation plating group and (5.33±1.72) months in the exchange plating group.The operation time was (90.00±17.58) minutes in the augmentation plating group and (160.00±25.35) minutes in the exchange plating group.The amount of blood loss during the operation was (270.00±43.32) ml in the augmentation plating group and (530.00±103.65) ml in the exchange plating group.Both groups showed significant difference (P <0.05) in their results.No complications were reported after the second operation.Conclusions Augmentation plating after nail fixation could remove local rotation instability,facilitate simple operation,create minimal damage and enable exercise for early functional recovery.Therefore,augmentation plating is excellent for treating hypertrophic non-union after nail fixation in femoral shaft fracture.

  4. The relationship between interfragmentary movement and cell differentiation in early fracture healing under locking plate fixation.

    Science.gov (United States)

    Miramini, Saeed; Zhang, Lihai; Richardson, Martin; Mendis, Priyan; Oloyede, Adekunle; Ebeling, Peter

    2016-03-01

    Interfragmentary movement (IFM) at the fracture site plays an important role in fracture healing, particularly during its early stage, via influencing the mechanical microenvironment of mesenchymal stem cells within the fracture callus. However, the effect of changes in IFM resulting from the changes in the configuration of locking plate fixation on cell differentiation has not yet been fully understood. In this study, mechanical experiments on surrogate tibia specimens, manufactured from specially formulated polyurethane, were conducted to investigate changes in IFM of fractures under various locking plate fixation configurations and loading magnitudes. The effect of the observed IFM on callus cell differentiation was then further studied using computational simulation. We found that during the early stage, cell differentiation in the fracture callus is highly influenced by fracture gap size and IFM, which in turn, is highly sensitive to locking plate fixation configuration. The computational model predicted that a small gap size (e.g. 1 mm) under a relatively flexible configuration of locking plate fixation (larger bone-plate distances and working lengths) could experience excessive strain and fluid flow within the fracture site, resulting in excessive fibrous tissue differentiation and delayed healing. By contrast, a relatively flexible configuration of locking plate fixation was predicted to improve cartilaginous callus formation and bone healing for a relatively larger gap size (e.g. 3 mm). If further confirmed by animal and human studies, the research outcome of this paper may have implications for orthopaedic surgeons in optimising the application of locking plate fixations for fractures in clinical practice.

  5. A review of locking compression plate biomechanics and their advantages as internal fixators in fracture healing.

    Science.gov (United States)

    Miller, Danielle L; Goswami, Tarun

    2007-12-01

    Metallic implants are often involved in the open reduction and internal fixation of fractures. Open reduction and internal fixation is commonly used in cases of trauma when the bone cannot be healed using external methods such as casting. The locking compression plate combines the conventional screw hole, which uses non-locking screws, with a locking screw hole, which uses locking head screws. This allows for more versatility in the application of the plate. There are many factors which affect the functionality of the plate (e.g., screw placement, screw choice, length of plate, distance from bone, etc.). This paper presents a review of the literature related to the biomechanics of locking compression plates and their use as internal fixators in fracture healing. Furthermore, this paper also addresses the materials used for locking compression plates and their mechanical behavior, parameters that control the overall success, as well as inherent bone quality results.

  6. Current Evidence: Plate Versus Intramedullary Nail for Fixation of Distal Tibia Fractures in 2016.

    Science.gov (United States)

    Vallier, Heather A

    2016-11-01

    Displaced distal tibia shaft fractures are effectively treated with standard plates and intramedullary nails. Plate fixation performed with meticulous soft tissue handling results in minimal risks of infection and poor wound healing. Standard plates have high rates of primary union, whereas locking plates may delay union because of increased stiffness. Tibial healing may also be delayed after plating of the fibula, although fibula reduction and fixation may aid accuracy of reduction of the tibia. Malalignment occurs more often with infrapatellar intramedullary nailing versus plates, and early results of suprapatellar nailing appear promising in minimizing intraoperative malalignment. Long-term function after fixation of the distal tibia is good for most, with poor outcomes often associated with baseline social and mental health issues.

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

    Science.gov (United States)

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

    2016-01-01

    More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950’s, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft für osteosynthesefragen/Association for the Study of Internal Fixation. Since the introduction of plate fixation for fractures, several plates and screws have been developed, all with their own characteristics. To accomplice more fracture stability, it was thought the bigger the plate, the better. The counter side was a compromised blood supply of the bone, often resulting in bone necrosis and ultimately delayed or non-union. With the search and development of new materials and techniques for fracture fixation, less invasive procedures have become increasingly popular. This resulted in the minimally invasive plate osteosynthesis (MIPO) technique for fracture fixation. With the MIPO technique, procedures could be performed with smaller incisions and thus with less soft tissue damage and a better preserved blood supply. The last 5 years rib fixation has become increasingly popular, rising evidence has become available suggesting that surgical rib fixation improves outcome of patients with a flail chest or isolated rib fractures. Many surgical approaches for rib fixation have been described in the old literature, however, most of these techniques are obscure nowadays. Currently mostly large incisions with considerable surgical insult are used to stabilize rib fractures. We think that MIPO deserves a place in the surgical treatment of rib fractures. We present the aspects of diagnosis, preoperative planning and operative techniques in regard to MIPO rib fixation. PMID:26889439

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

    Science.gov (United States)

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

    2016-02-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Biomechanical Evaluation of the Fixation Methods for Transcondylar Fracture of the Humerus:ONI Plate Versus Conventional Plates and Screws

    Directory of Open Access Journals (Sweden)

    Shimamura,Yasunori

    2010-04-01

    Full Text Available

    We biomechanically evaluated the bone fixation rigidity of an ONI plate (Group I during fixation of experimentally created transcondylar humerus fractures in cadaveric elbows, which are the most frequently observed humeral fractures in the elderly, and compared it with the rigidity achieved by 3 conventional fixation methods:an LCP reconstruction plate 3.5 using a locking mechanism (Group II, a conventional reconstruction plate 3.5 (CRP with a cannulated cancellous screw (Group III, and a CRP with 2 cannulated cancellous screws (CS in a crisscross orientation (Group IV. In the axial loading test, the mean failure loads were:Group I, 98.9+/-32.6;Group II, 108.5+/-27.2;Group III, 50.0+/-7.5;and Group IV, 34.5+/-12.2 (N. Group I fixations failed at a significantly higher load than those of Groups III and IV (p0.05. In the extension loading test, the mean failure loads were:Group I, 34.0+/-12.4;Group II, 51.0+/-14.8;Group III, 19.3+/-6.0;and Group IV, 14.7+/-3.1 (N. Group IV fixations showed a significantly lower failure load than those of Group I (p0.05. The fixation rigidities against mechanical loading by the ONI plate and LCP plate were comparable. These results suggested that an ONI system might be superior to the CRP and CS method, and comparable to the LCP method in terms of fixation rigidity for distal humerus fractures.

  11. Management of extra-articular fractures of the distal tibia: intramedullary nailing versus plate fixation.

    Science.gov (United States)

    Casstevens, Chris; Le, Toan; Archdeacon, Michael T; Wyrick, John D

    2012-11-01

    Intramedullary nailing and plate fixation represent two viable approaches to internal fixation of extra-articular fractures of the distal tibia. Although both techniques have demonstrated success in maintaining reduction and promoting stable union, they possess distinct advantages and disadvantages that require careful consideration during surgical planning. Differences in soft-tissue health and construct stability must be considered when choosing between intramedullary nailing and plating of the distal tibia. Recent advances in intramedullary nail design and plate-and-screw fixation systems have further increased the options for management of these fractures. Current evidence supports careful consideration of the risk of soft-tissue complications, residual knee pain, and fracture malalignment in the context of patient and injury characteristics in the selection of the optimal method of fixation.

  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

    2017-09-01

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

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    MY Loqman

    2010-05-01

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

  14. A Novel Computer-Aided Approach for Parametric Investigation of Custom Design of Fracture Fixation Plates.

    Science.gov (United States)

    Chen, Xiaozhong; He, Kunjin; Chen, Zhengming

    2017-01-01

    The present study proposes an integrated computer-aided approach combining femur surface modeling, fracture evidence recover plate creation, and plate modification in order to conduct a parametric investigation of the design of custom plate for a specific patient. The study allows for improving the design efficiency of specific plates on the patients' femur parameters and the fracture information. Furthermore, the present approach will lead to exploration of plate modification and optimization. The three-dimensional (3D) surface model of a detailed femur and the corresponding fixation plate were represented with high-level feature parameters, and the shape of the specific plate was recursively modified in order to obtain the optimal plate for a specific patient. The proposed approach was tested and verified on a case study, and it could be helpful for orthopedic surgeons to design and modify the plate in order to fit the specific femur anatomy and the fracture information.

  15. A Novel Computer-Aided Approach for Parametric Investigation of Custom Design of Fracture Fixation Plates

    Science.gov (United States)

    2017-01-01

    The present study proposes an integrated computer-aided approach combining femur surface modeling, fracture evidence recover plate creation, and plate modification in order to conduct a parametric investigation of the design of custom plate for a specific patient. The study allows for improving the design efficiency of specific plates on the patients' femur parameters and the fracture information. Furthermore, the present approach will lead to exploration of plate modification and optimization. The three-dimensional (3D) surface model of a detailed femur and the corresponding fixation plate were represented with high-level feature parameters, and the shape of the specific plate was recursively modified in order to obtain the optimal plate for a specific patient. The proposed approach was tested and verified on a case study, and it could be helpful for orthopedic surgeons to design and modify the plate in order to fit the specific femur anatomy and the fracture information. PMID:28203270

  16. Biomechanical Evaluation of Plate Versus Lag Screw Only Fixation of Distal Fibula Fractures.

    Science.gov (United States)

    Misaghi, Amirhossein; Doan, Josh; Bastrom, Tracey; Pennock, Andrew T

    2015-01-01

    Traditional fixation of unstable Orthopaedic Trauma Association type B/C ankle fractures consists of a lag screw and a lateral or posterolateral neutralization plate. Several studies have demonstrated the clinical success of lag screw only fixation; however, to date no biomechanical comparison of the different constructs has been performed. The purpose of the present study was to evaluate the biomechanical strength of these different constructs. Osteotomies were created in 40 Sawbones(®) distal fibulas and reduced using 1 bicortical 3.5-mm stainless steel lag screw, 2 bicortical 3.5-mm lag screws, 3 bicortical 3.5-mm lag screws, or a single 3.5-mm lag screw coupled with a stainless steel neutralization plate with 3 proximal cortical and 3 distal cancellous screws. The constructs were tested to determine the stiffness in lateral bending and rotation and failure torque. No significant differences in lateral bending or rotational stiffness were detected between the osteotomies fixed with 3 lag screws and a plate. Constructs fixed with 1 lag screw were weaker for both lateral bending and rotational stiffness. Osteotomies fixed with 2 lag screws were weaker in lateral bending only. No significant differences were found in the failure torque. Compared with lag screw only fixation, plate fixation requires larger incisions and increased costs and is more likely to require follow-up surgery. Despite the published clinical success of treating simple Orthopaedic Trauma Association B/C fractures with lag screw only fixation, many surgeons still have concerns about stability. For noncomminuted, long oblique distal fibula fractures, lag screw only fixation techniques offer construct stiffness similar to that of traditional plate and lag screw fixation.

  17. Multiplanar Fixation for Patella Fractures Using a Low-Profile Mesh Plate.

    Science.gov (United States)

    Lorich, Dean G; Warner, Stephen J; Schottel, Patrick C; Shaffer, Andre D; Lazaro, Lionel E; Helfet, David L

    2015-12-01

    Patella fractures are challenging orthopaedic injuries. Many commonly used fixation techniques can be ineffective and lead to poor clinical outcomes even with satisfactory reductions and fracture healing. In this investigation, we present the technique of cage plate fixation of patella fractures and the clinical outcomes of 9 initial patients surgically treated at our institution. This technique allows direct visualization of the articular reduction, provides multiplanar fixation, effectively stabilizes inferior pole comminution, and reduces the risk of patella vascular disruption. Using this technique, we have achieved excellent functional and radiographic outcomes.

  18. Fixator-assisted tibial lengthening over a plate in a patient with sequelae of poliomyelitis.

    Science.gov (United States)

    Tosun, Haci Bayram; Serbest, Sancar; Uludag, Abuzer; Gumustas, Seyitali; Celik, Suat

    2016-11-01

    There are many techniques for limb lengthening. Lengthening over a plate is an alternative choice of fixation in children or when nailing is difficult. We present a new technique for tibial lengthening with using a monolateral external fixator over a lengthening plate.Lengthening over an intramedullary nail is a commonly used method in patients with short stature or limb-length discrepancy. However, in patients with a narrow and excessively sclerotic intramedullary cavity in the pediatric age group where the skeletal system has not yet fully developed, difficulties have been observed in lengthening methods with nailing.Therefore, in these cases, the use of lengthening techniques over a plate is an alternative treatment option. Nevertheless, in lengthening techniques over a plate, if one side of the osteotomy area cannot be fixed, associated mechanical axis problems have been reported.We applied tibia lengthening with external fixator assistance over a custom-made lengthening plate in a patient with sequelae of poliomyelitis. This new lengthening technique applied over a plate could be the solution to the problems observed in other lengthening techniques over a plate.

  19. Dose distribution near thin titanium plate for skull fixation irradiated by a 4-MV photon beam

    Directory of Open Access Journals (Sweden)

    Shimozato Tomohiro

    2010-01-01

    Full Text Available To investigate the effects of scattered radiation when a thin titanium plate (thickness, 0.05 cm used for skull fixation in cerebral nerve surgery is irradiated by a 4-MV photon beam. We investigated the dose distribution of radiation inside a phantom that simulates a human head fitted with a thin titanium plate used for post-surgery skull fixation and compared the distribution data measured using detectors, obtained by Monte Carlo (MC simulations, and calculated using a radiation treatment planning system (TPS. Simulations were shown to accurately represent measured values. The effects of scattered radiation produced by high-Z materials such as titanium are not sufficiently considered currently in TPS dose calculations. Our comparisons show that the dose distribution is affected by scattered radiation around a thin high-Z material. The depth dose is measured and calculated along the central beam axis inside a water phantom with thin titanium plates at various depths. The maximum relative differences between simulation and TPS results on the entrance and exit sides of the plate were 23.1% and − 12.7%, respectively. However, the depth doses do not change in regions deeper than the plate in water. Although titanium is a high-Z material, if the titanium plate used for skull fixation in cerebral nerve surgery is thin, there is a slight change in the dose distribution in regions away from the plate. In addition, we investigated the effects of variation of photon energies, sizes of radiation field and thickness of the plate. When the target to be irradiated is far from the thin titanium plate, the dose differs little from what it would be in the absence of a plate, though the dose escalation existed in front of the metal plate.

  20. 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.

  1. 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.

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

    Science.gov (United States)

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

    2015-01-01

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

  3. Clinical evaluation of locking compression plate fixation for comminuted olecranon fractures

    NARCIS (Netherlands)

    Buijze, G.; Kloen, P.

    2009-01-01

    BACKGROUND: In patients managed with plate fixation for the treatment of an olecranon fracture, the placement of an axial intramedullary screw may obstruct the placement of bicortical screws in the ulnar shaft. To overcome this problem, unicortical screws can be applied with use of a contoured locki

  4. The plate fixation in the treatment of complex forearm open fractures

    Directory of Open Access Journals (Sweden)

    Meric Ugurlar

    2017-04-01

    Conclusion: In high nergy traumas of the upper extremity associated with complex injuries and Type-IIIC forearm fractures, severity of soft tissue injuries determined the functional results in patients, demonstrating it is possible to achieve a safe and efficient fixation with immediate plate-screw osteosynthesis. [Hand Microsurg 2017; 6(1.000: 1-8

  5. Closed treatment of condylar fractures by intermaxillary fixation with thermoforming plates.

    Science.gov (United States)

    Terai, Haruhiko; Shimahara, Masashi

    2004-02-01

    We report a new intermaxillary fixation (IMF) method for condylar fractures using a thermoforming plate. Fifteen cases of condylar fracture were selected and thermoforming plates were applied. The patient's recover was uneventful in all 15 cases, and the period of IMF ranged from 7 to 17 days, (mean 12) for the following 7 days IMF was used only at night together with functional jaw training during the day. The outcome was good. IMF using a thermoforming plate may be a useful technique for selected condylar fractures.

  6. One size does not fit all: distal radioulnar joint dysfunction after volar locking plate fixation.

    Science.gov (United States)

    Jones, Christopher W; Lawson, Richard D

    2014-02-01

    Background Fractures of the distal radius are among the most common injuries treated by orthopedic surgeons worldwide. Failure to restore distal radius alignment can lead to fracture malunion and poor clinical outcomes, including distal radioulnar joint (DRUJ) instability and limitation of motion. Case Description We present a unique case of DRUJ dysfunction following volar plate fixation of bilateral distal radius fractures and analyze the biomechanical causes of this complication. As a result of a relatively excessive tilt of the precontoured locking plate (in comparison to the patient's particular anatomy), the fracture on one side was "over-reduced," disrupting the biomechanics of the DRUJ, causing a supination block. Clinical Relevance Volar locking plates are not a panacea to all distal radius fractures. Plate selection and fixation technique must include consideration of patient anatomy. Robust plates offer the advantage of providing rigid fixation but can be difficult to contour when reconstructing normal anatomy. Restoration of patient-specific anatomy is crucial to the management of distal radius fractures.

  7. Pin guidance of reconstruction plate contour: an expanded role of external fixation.

    Science.gov (United States)

    Jaquet, Yves; Higgins, Kevin M; Enepekides, Danny J

    2011-09-01

    This article presents a modification of intraoperative external fixation for mandibular reconstruction with free tissue flaps. This technique is indicated when preregistration of the reconstruction plate is not possible due to transmandibular tumor extension. Once standard external fixation has been carried out and prior to segmental mandibulectomy, additional pins are fixed to the connecting rod that delineate the mandibular contour in three-dimensional (3D) space. Following mandibulectomy, these pins allow accurate contouring of the reconstruction plate and improved restoration of mandibular contour, projection, and dental occlusion. A step-by-step description of the technique using models and intraoperative photos is presented. This method of mandibular reconstruction is a simple and time-effective alternative to intraoperative computer navigation and 3D modeling in select cases of oral carcinoma where tumor infiltration of the outer mandibular cortex precludes prebending of the reconstruction plates.

  8. Cubitus varus in adults correction with lateral closing wedge osteotomy and fixation with posterior plating

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    S Pandey

    2012-09-01

    Full Text Available To share the result of lateral closing wedge osteotomy and fixation with posterior reconstruction plate in correction of cubitus varus in adults. It is a retrospective case analysis of 8 cases of cubitus varus in adult treated with lateral closing wedge osteotomy through posterior triceps retracting approach. Internal fixation was done with two posterior reconstruction plates. All cases were from 15 to 29 years of age (mean 22.3 with 3 female and 5 male. All had cubitus varus ranging from 15- 28 deg (mean 20.16 deg due to childhood malunited supracondylar fracture of humerus. Indication for operation was cosmetic reason only. Follow up duration was 4-22 months (mean 12.5 months. All the osteotomy united clinically in mean duration of 9 weeks ( range 8-12 weeks with mean carrying angle 8.33 degree in postoperative phase. There was no loss of motion, no loss of fixation, no surgical site infection, nonunion or neurovascular deficit. Lateral closing wedge corrective osteotomy and fixation with posterior reconstruction plate is easy technique with satisfactory result in correction of cubitus varus in adults. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-2, 49-53 DOI: http://dx.doi.org/10.3126/jcmsn.v8i2.6839

  9. Early outcomes of proximal humerus fracture fixation with locking plate and intramedullary fibular strut graft.

    Science.gov (United States)

    Tan, Edwin; Lie, Denny; Wong, M K

    2014-09-01

    Proximal humerus fractures are commonly encountered in elderly patients. Surgical treatment demonstrates high complication rates, including varus construct collapse and screw cutout. In this study, the authors evaluate the clinical outcome of locking plate fixation with intramedullary fibular strut graft augmentation as a primary surgical treatment in the prevention of early collapse and screw cutout. A total of 9 patients were evaluated. Surgery was performed for displaced proximal humerus fractures between April and December 2011. Patients were either class 2, 3, or 4, according to Neer classification. Mean patient age was 75.4 years. Preoperative and immediate, 6-week, and 3-month postoperative radiographs were evaluated. Head-shaft angles were measured to assess for varus collapse and displacement. Range of motion, complication rates, and functional recovery were also evaluated. Patients underwent open reduction and internal fixation with placement of an intramedullary fibular strut graft. Fixation was achieved with a Philos plate (Synthes, Oberdorf, Switzerland). Reduction and fixation were evaluated with radiographs. Passive exercises and range of motion were allowed immediately postoperatively, and all patients achieved active abduction and forward flexion 6 weeks postoperatively. Shoulder radiographs taken 12 weeks postoperatively revealed no loss of reduction or screw cutout. The introduction of the locking plate has improved outcomes. The addition of an intramedullary strut graft has shown improved preliminary results. Maintained reduction was observed in all 9 patients in the early postoperative period, and good functional motion was achieved. No incidence of screw cutout was recorded.

  10. Finite Element-Derived Surrogate Models of Locked Plate Fracture Fixation Biomechanics.

    Science.gov (United States)

    Wee, Hwabok; Reid, J Spence; Chinchilli, Vernon M; Lewis, Gregory S

    2017-03-01

    Internal fixation of bone fractures using plates and screws involves many choices-implant type, material, sizes, and geometric configuration-made by the surgeon. These decisions can be important for providing adequate stability to promote healing and prevent implant mechanical failure. The purpose of this study was to develop mathematical models of the relationships between fracture fixation construct parameters and resulting 3D biomechanics, based on parametric computer simulations. Finite element models of hundreds of different locked plate fixation constructs for midshaft diaphyseal fractures were systematically assembled using custom algorithms, and axial, torsional, and bending loadings were simulated. Multivariate regression was used to fit response surface polynomial equations relating fixation design parameters to outputs including maximum implant stresses, axial and shear strain at the fracture site, and construct stiffness. Surrogate models with as little as three regressors showed good fitting (R (2) = 0.62-0.97). Inner working length was the strongest predictor of maximum plate and screw stresses, and a variety of quadratic and interaction terms influenced resulting biomechanics. The framework presented in this study can be applied to additional types of bone fractures to provide clinicians and implant designers with clinical insight, surgical optimization, and a comprehensive mathematical description of biomechanics.

  11. Fixation of Intertrochanteric Valgus Osteotomy with T Plate in Treatment of Developmental Coxa Vara.

    Science.gov (United States)

    Elzohairy, Mohamed Mansour; Khairy, Hosam Mohamed

    2016-09-01

    Although the valgus subtrochanteric osteotomy is considered as a standard surgical treatment for coxa vara, there is no consensus on the optimal method of fixation and osteotomy technique. Fixation of the osteotomy has been achieved by various methods including external fixation and internal fixation with pins and cerclage and a variety of plates. The aim of this study is the evaluation of the results of developmental coxa treated by Y intertrochanteric valgus osteotomy fixed with a T-buttress plate compared with other methods of fixation in the literature. Eighteen corrective valgus intertrochanteric femoral osteotomies were performed in 18 patients (18 hips) for treatment of unilateral developmental coxa vara deformity and fixed with a T plate. There were 12 males and 6 females. The right hip was affected in 10 patients and the left hip in 8 patients. Clinically, patients were evaluated by Larson hip score. Radiographically, anteroposterior view of the pelvis and frog leg lateral views of the affected hip were taken preoperatively and compared with the findings at the final follow-up. The average follow-up was 29 months (range, 24 to 36 months). Clinical results showed improvement of the mean Larson hip score from 57.8 to 97.0 (p osteotomies were completely united in 2.4 months (range, 2 to 3 months) with the achievement of the planned correction angle. The average correction of Hilgenreiner's epiphyseal angle improved from 78.2° to 27.8° (p osteotomy of the proximal femur fixed with a T plate may be efficient for treatment of developmental coxa vara. With careful planning, it can result in a low complication rate and insignificant or minimal recurrence rate.

  12. Late extensor pollicis longus rupture following plate fixation in Galeazzi fracture dislocation

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    Dhananjaya Sabat

    2014-01-01

    Full Text Available Late rupture of extensor pollicis longus (EPL tendon after Galeazzi fracture dislocation fixation is an unknown entity though it is a well-established complication following distal radius fractures. We report the case of a 55-year old male who presented with late EPL tendon rupture 4 months following internal fixation of Galeazzi fracture dislocation with a Locking Compression Plate (LCP. He was managed with extensor indicis proprius (EIP transfer to restore thumb extension. At 4 years followup, functional result of the transfer was good. We identify possible pitfalls with this particular patient and discuss how to avoid them in future.

  13. Late extensor pollicis longus rupture following plate fixation in Galeazzi fracture dislocation.

    Science.gov (United States)

    Sabat, Dhananjaya; Dabas, Vineet; Dhal, Anil

    2014-07-01

    Late rupture of extensor pollicis longus (EPL) tendon after Galeazzi fracture dislocation fixation is an unknown entity though it is a well-established complication following distal radius fractures. We report the case of a 55-year old male who presented with late EPL tendon rupture 4 months following internal fixation of Galeazzi fracture dislocation with a Locking Compression Plate (LCP). He was managed with extensor indicis proprius (EIP) transfer to restore thumb extension. At 4 years followup, functional result of the transfer was good. We identify possible pitfalls with this particular patient and discuss how to avoid them in future.

  14. Novel use of hand fracture fixation plates in the surgical stabilisation of flail chest.

    LENUS (Irish Health Repository)

    Dunlop, Rebecca L E

    2010-01-01

    Plastic surgeons specialize in working closely with other surgical colleagues to help solve clinical problems. In this case, we performed surgical stabilisation of a large flail chest fragment in conjunction with the cardiothoracic surgical team, using the mini-plating set more commonly used for hand fracture fixation. The use of this fixation system for flail chest has not previously been described, but offers advantages over other reported methods, primarily by dispensing with the need for an extensive thoracotomy incision and by providing robust stabilisation without the presence of prominent hardware.

  15. Early rehabilitation following less invasive surgical stabilisation plate fixation for distal femoral fractures.

    Science.gov (United States)

    Smith, T O; Hedges, C; MacNair, R; Schankat, K

    2009-06-01

    The less invasive surgical stabilisation (LISS) plate fixation method is an orthopaedic procedure for the fixation of distal femoral fractures. Early physiotherapy treatments of motion and mobilisation have been advocated following this procedure. This article critically appraises the evidence base assessing the early rehabilitation of patients following LISS fixation for distal femoral fractures. A review of EMBASE, Medline, CINAHL and AMED, and a hand search were undertaken. Two independent reviewers identified all eligible articles. Two reviewers extracted the data, which were verified by a third reviewer. All included articles were critically appraised by two independent reviewers using the Critical Appraisal Skills Programme tool. Seventeen case series assessing 508 patients with 535 fractures were reviewed. No clinical trials comparing physiotherapy programmes were identified. The review identified that following LISS fixation for distal femoral fractures, patients begin range-of-motion exercises immediately and are initially required to restrict weight-bearing following surgery. It remains unclear whether casts, braces or immobilisation aids are applied during the initial postoperative period. The efficacy of different physiotherapy protocols following LISS fixation for distal femoral fractures remains unclear. Further well-designed randomised controlled trials are required to compare different postoperative physiotherapy rehabilitation programmes for patients following LISS fixation of distal femoral fractures in order to determine the optimal postoperative management for this complex patient group.

  16. Fixation of multifragmentary patella fractures using a bilateral fixed-angle plate.

    Science.gov (United States)

    Thelen, Simon; Betsch, Marcel; Schneppendahl, Johannes; Grassmann, Jan; Hakimi, Mohssen; Eichler, Christian; Windolf, Joachim; Wild, Michael

    2013-11-01

    This biomechanical study is the first to compare 3 fixation methods-bilateral fixed-angle plate, modified anterior tension wiring, and cannulated lag screws with anterior tension wiring-in multifragmentary distal patella fractures. A T-shaped 3-part fracture simulating a multifragmentary articular distal patella fracture (AO/OTA 34-C2.2) was created in 18 human cadaver knee specimens. Three groups were created using homogenous ages and bone mineral densities based on the fixation method received. Repetitive testing over 100 cycles was performed by moving the knee against gravity from 90° flexion to full extension. Failure was defined as fracture displacement greater than 2 mm. In all patellae using fixed-angle plates, an anatomical fracture reduction could be maintained throughout cyclic testing, whereas anterior tension wiring and lag screws with tension wiring showed significant fracture displacement after 100 cycles, with mean fracture gaps of 2.0±1.3 and 1.9±1.6 mm, respectively. The differences in fracture gaps between the fixed-angle plate group and the other 2 groups were statistically significant. In both groups using tension wiring, half of the constructs (3 of 6 in each group) failed due to a fracture displacement greater than 2 mm. The bilateral fixed-angle plate was the only fixation method that sustainably stabilized a multifragmentary articular distal patella fracture during cyclic loading when compared with modified anterior tension wiring and cannulated lag screws with anterior tension wiring.

  17. Comparison of crossed screw versus plate fixation for radial neck fractures.

    Science.gov (United States)

    Gutowski, Christina J; Darvish, Kurosh; Ilyas, Asif M; Jones, Christopher M

    2015-11-01

    Fixation of radial neck fractures can be achieved with a plate and screw construct or, in absence of comminution, with two obliquely-oriented screws. This study investigated the mechanical properties, specifically the stiffness and load to failure, of these two fixation strategies in a cadaver model. Ten matched-pair radii were removed from fresh cadaver arms. A transverse osteotomy was created at the neck of each radius. Right-sided radii were fixed with two oblique headless compression screws; left-sided radii were fixed with a radial neck plate. The distal aspect of each radius was potted in urethane casting resin. The radial head was loaded in shear in 4 different planes (medial to lateral, lateral to medial, posterior to anterior, and anterior to posterior) using an Instron machine. Stiffness and load to failure were recorded. The stiffness of both constructs was similar in all planes except for loading from medial to lateral where the screw construct was 1.8 times stiffer. Average ultimate failure occurred at 229N for the screws and 206N for the plate. Failure strength was not statistically different. However, mode of failure differed for both fixation constructs, the plate failed in bending while the screws failed by pullout and fracture. The two strategies provide similar strength and stiffness for the fixation of transverse, non-comminuted radial neck fractures. While plate and screw constructs are more appropriate for axially unstable or comminuted fractures, two oblique screws might be preferred for simple transverse neck fractures since this strategy requires less exposure and the implant is buried. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. A parametric approach to construct femur models and their fixation plates

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    Xiaozhong Chen

    2016-05-01

    Full Text Available Although anatomic plates reflect an important breakthrough in the treatment of distal femur fractures, there are still some patients experiencing healing complications. For individual differences in bone morphology and fractures, the development of patient specific plates is very complex and needs a long cycle. In this study, a parametric approach was proposed to conveniently construct femur models and design their fixation plates. First, the typical femur anatomy was described with the average femur model. Second, five surface features were defined to represent the femur surface model by setting up parameterization and parameter constraints. Third, according to the fracture information of a specific patient, customized plate surface with a suitable contour was created from the reconstructed femur model. Finally, the femur plate was represented by feature parameterization, and the hierarchical constraints between femur parameters and plate parameters were built to construct a plate model. The experimental results showed that the proposed method could effectively represent femur surface shape features and intuitively construct and edit individualized plates with high-level parameters. The method is competitive in time saving and design convenience and may provide a basic tool for digital restoration of incomplete femurs and the design of patient specific femur plates.

  19. Distal tibial fracture: An ideal indication for external fixation using locking plate

    Institute of Scientific and Technical Information of China (English)

    Jing-wei Zhang; Nabil A.Ebraheim; Ming Li; Xian-Feng He; Joshua Schwind; Li-Mei Zhu; Yi-Hui Yu

    2016-01-01

    Objective:To evaluate the feasibility and efficiency of one-stage external fixation by using locking plate in distal tibial fractures.Methods:In this non-control prospective study,28 patients with distal tibial fractures were included and underwent one-stage external fixation by using locking plate.There were 21 males and 7 females,with a mean age of 43 years (19-63).According to AO/OTA fracture classification,there were 9 cases of Type A1,9 of Type A2,10 of Type A3 fractures.There were 21 close and 7 open fractures.The locking plate was placed on the anteromedial aspect of the tibia with 4-5 bicortical screws inserted in both distal metaphysis and diaphysis.The radiographic and clinic results were evaluated.Results:All patients were followed up for the average of 16 months (ranging from 12 to 21 months).The average surgery duration was 38 (25-60) minutes.The mean time to fracture healing were 14.6 ± 2.67,17.5 ± 3.66,and 18.4 ± 3.37 (p < 0.05) weeks in type A1,A2,and A3 fractures respectively.By the end of the follow-ups,the mean AOFAS score were 96.11 ± 2.32,92.67 ± 1.80 and 92.00 ± 2.06 (p > 0.05) in type A1,A2,and A3 fractures respectively.None of nonunion,deep infection,or breakage of screw or plate were observed.Conclusions:Distal tibial fracture was the ideal indication for external fixation using locking plate.The external plating is characterized by ease of performance,less invasive,fewer soft tissue impingement,improved cosmesis,and convenient for removal.

  20. Distal Femoral Osteotomy in Genovalgum: Internal Fixation with Blade Plate Versus Casting

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    Hadi Makhmalbaf

    2014-10-01

    Methods:   In a non-randomized prospective study, after distal femoral osteotomy with the zigzag method, patients were divided into two groups: long leg casting, and internal fixation with blade plate. For all patients, questionnaires    were filled to obtain data. Information such as range of motion, tibiofemoral anatomical angle and complications were recorded.     Results:   38 knees with valgus deformity underwent distal femoral supracondylar osteotomy. (8 with plaster cast and  30 with internal fixation using a blade plate. Preoperative range of motion was 129±6° and six months later it was  120±14°. The preoperative tibiofemoral angle was 32±6°; postoperative tibiofemoral angles were 3±3°, 6±2°, and 7±3° just after operation, six months, and two years later, respectively. Although this angle was greater among the group stabilized with a cast, this difference was not statistically significant. In postoperative complications, over-correction  was found in five, recorvatom deformity in one, knee stiffness in three and superficial wound infection was recorded in three knees.     Conclusions:   There is no prominent difference in final range of motion and alignment whether fixation is done with casting or internal fixation. However, the complication rate seems higher in the casting method.    

  1. A novel combined method of osteosynthesis in treatment of tibial fractures: a comparative study on sheep with application of rod-through-plate fixator and bone plating.

    Science.gov (United States)

    Tralman, G; Andrianov, V; Arend, A; Männik, P; Kibur, R T; Nõupuu, K; Uksov, D; Aunapuu, M

    2013-04-01

    The study compares the efficiency of a new bone fixator combining periostal and intramedullary osteosynthesis to bone plating in treatment of tibial fractures in sheep. Experimental osteotomies were performed in the middle third of the left tibia. Animals were divided into two groups: in one group (four animals) combined osteosynthesis (rod-through-plate fixator, RTP fixator) was applied, and in the other group (three animals) bone plating was used. The experiments lasted for 10 weeks during which fracture union was followed by radiography, and the healing process was studied by blood serum markers reflecting bone turnover and by histological and immunohistochemical investigations. In the RTP fixator group, animals started to load body weight on the operated limbs the next day after the surgery, while in the bone plating group, this happened only on the seventh day. In the RTP fixator group, consolidation of fractures was also faster, as demonstrated by radiographical, histological, and immunohistochemical investigations and in part by blood serum markers for bone formation. It can be concluded that application of RTP fixation is more efficient than plate fixation in the treatment of experimental osteotomies of long bones in sheep.

  2. Salter-Harris II forearm fracture reduction and fixation using a buttress plate.

    Science.gov (United States)

    Barnes, Jonathan; Webb, Mark; v Fearon, Paul

    2014-01-31

    Distal radius fractures are common injuries in children. Those that affect the growth plate (physis) need to be managed carefully as inadequate management may lead to long-term deformity and a reduction in function. However, different management strategies all have drawbacks and controversy exists over how best to manage these cases. This is the case of a 13-year-old girl who presented with a Salter Harris II fracture, which was managed using a novel approach of utilising a T plate in a buttress mode to stabilise the fracture after anatomical reduction. This provided effective fracture fixation and should allow good bone healing without causing any iatrogenic growth plate damage and without fixing a plate across the physis, which may need removal in the future.

  3. Biomechanical Assessment of Locked Plating for the Fixation of Patella Fractures.

    Science.gov (United States)

    Wurm, Simone; Augat, Peter; Bühren, Volker

    2015-09-01

    To analyze the mechanical stability of locked plating in comparison with tension-band wiring for the fixation of fractures of the patella. Biomechanical tests were performed on artificial foam patella specimens comparing an angular stable plate and monocortical screws with tension-band wiring. Tests were performed under combined tension and bending until failure simulating physiological loading of the tibia during walking. Tension-band wiring failed at 66% of the failure load of plating (1052 N, P = 0.002) and had 5 times larger fracture gap displacements (P = 0.002). Based on the biomechanical advantages, locked plating of the patella may constitute a reasonable alternative in the treatment of patella fractures.

  4. Posterior acetabular column and quadrilateral plate fractures: fixation with tension band principles.

    Science.gov (United States)

    Aly, Tarek A; Hamed, Hany

    2013-07-01

    Acetabular fractures can be classified into 5 simple and 5 associated fracture patterns. A significant amount of variation and complexity exists in these fractures patterns. Fractures of the posterior wall are the most common acetabular fractures. Comminution of the quadrilateral plate adds to fracture instability, and more rigid and stable internal fixation is mandatory. The goal of this study was to assess the results of reconstruction of comminuted posterior wall fractures of the acetabulum associated with quadrilateral plate fractures using the tension band technique. Twelve patients (9 men and 3 women) were included in the study. Mean patient age was 38.6 years (range, 24-47 years). Minimum follow-up was more than 2 years postoperatively. Reconstruction of the fracture included anatomic reduction of the fracture and fixation with a buttress plate for the posterior column and a prebent one-third tubular plate for the quadrilateral plate fracture. Clinical results were excellent in 58% of patients and good in 17% of patients. Radiologic results were excellent in 50% of patients and good in 17% of patients. Radiologically, based on the fracture gap postoperatively, 8 (66%) patients showed anatomic reduction, 2 (17%) showed good reduction, and 2 (17%) showed poor reduction. The study confirms that this method of reconstruction facilitates accurate and firm reduction of displaced posterior wall fractures of the acetabulum.

  5. Arthrodesis of the Trapeziometacarpal Joint Using a Chevron Osteotomy and Plate Fixation

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    G. Shyamalan

    2014-01-01

    Full Text Available Introduction. Trapeziometacarpal (TM osteoarthritis is common. Despite the availability of numerous surgical options, none has been definitively proven to be superior. This study aims to determine the union rate and key strength following arthrodesis using a chevron osteotomy and plate fixation. Methods. 32 consecutive cases of TM joint arthrodesis performed between 2001 and 2006 were retrospectively identified. A chevron osteotomy was used to resect joint surfaces and fixation obtained using an AO mini T-plate. The patients were followed up for a mean of 65 months. Outcomes included visual analogue pain score, patient satisfaction, pinch strength, radiographic union, radiographic signs of scaphotrapezial arthritis, and complications. Results. The 32 cases included 16 females and 8 males with an average age of 56 years. Overall there was a 90% patient satisfaction rate. Average key pinch strength was 8.4 kg and pain score was 2.5. The union rate was 94%, and the two patients with nonunion underwent successful revision surgery. Only one case of radiographic progression of scaphotrapezoid arthritis was identified during followup. Conclusion. TM joint arthrodesis using a chevron osteotomy and plate fixation has high patient satisfaction and low nonunion rates. The authors endorse this technique in the management of TM joint osteoarthritis.

  6. 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.

  7. The calcar screw in angular stable plate fixation of proximal humeral fractures - a case study

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    Simmen Hans-Peter

    2011-09-01

    Full Text Available Abstract Background With new minimally-invasive approaches for angular stable plate fixation of proximal humeral fractures, the need for the placement of oblique inferomedial screws ('calcar screw' has increasingly been discussed. The purpose of this study was to investigate the influence of calcar screws on secondary loss of reduction and on the occurrence of complications. Methods Patients with a proximal humeral fracture who underwent angular stable plate fixation between 01/2007 and 07/2009 were included. On AP views of the shoulder, the difference in height between humeral head and the proximal end of the plate were determined postoperatively and at follow-up. Additionally, the occurrence of complications was documented. Patients with calcar screws were assigned to group C+, patients without to group C-. Results Follow-up was possible in 60 patients (C+ 6.7 ± 5.6 M/C- 5.0 ± 2.8 M. Humeral head necrosis occurred in 6 (C+, 15.4% and 3 (C-, 14.3% cases. Cut-out of the proximal screws was observed in 3 (C+, 7.7% and 1 (C-, 4.8% cases. In each group, 1 patient showed delayed union. Implant failure or lesions of the axillary nerve were not observed. In 44 patients, true AP and Neer views were available to measure the head-plate distance. There was a significant loss of reduction in group C- (2.56 ± 2.65 mm compared to C+ (0.77 ± 1.44 mm; p = 0.01. Conclusions The placement of calcar screws in the angular stable plate fixation of proximal humeral fractures is associated with less secondary loss of reduction by providing inferomedial support. An increased risk for complications could not be shown.

  8. Use of self-tapping metal screws for temporary fixation of a resorbable plate system in maxillofacial surgery.

    Science.gov (United States)

    Iwai, Toshinori; Omura, Susumu; Aoki, Noriaki; Tohnai, Iwai

    2015-05-01

    Resorbable plate systems have been used in maxillofacial surgery to obviate the need for plate removal. However, resorbable plates and screws are very costly, and refixation with additional screws may be necessary when reduction or repositioning of the bone segment is inaccurate. Here we report the use of self-tapping metal screws for temporary fixation of a resorbable plating system in maxillofacial surgery to avoid the use of additional screws following inaccurate fixation or the reuse of resorbable screws, which may result in loosening.

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

    Science.gov (United States)

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

    2011-10-01

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

  10. Morphological analysis of acromion and hook plate for the fixation of acromioclavicular joint dislocation.

    Science.gov (United States)

    Yoon, Jong Pil; Lee, Yeon Soo; Song, Geun Soo; Oh, Joo Han

    2017-03-01

    Acromioclavicular (AC) joint dislocation is a common sports injury. Hook plate fixation is currently widely used to treat this injury, as it can promote the natural healing of the ligament with good clinical outcomes. However, subacromial erosion and impingement are frequently observed post-operatively. It was hypothesized that the morphology and the contact characteristics between the hook portion and the acromion are the main causes of complications after hook plate fixation with the currently available commercial designs. Three-dimensional reconstructed models of the AC joint obtained from the computed tomographic scans of 23 male and 23 female patients (mean age, 61.1 ± 6.3 years) were evaluated, and multiple anatomical parameters were measured. For the subacromial positioning of the hook plate, an actual hook plate (Synthes Inc., West Chester, PA, USA) was scanned, and the contact between the hook plate and the acromion was estimated. The thicknesses of the acromion and distal clavicle were 9.7 ± 1.5 mm (10.7 mm in men; 8.6 mm in women) and 11.3 ± 1.6 mm (11.6 mm in men; 10.0 mm in women), respectively. The width of the acromion was 28.5 ± 3.6 mm. The mean inclination angle between the hook plate and the acromion was 29.3° ± 9.7° (27.9° in men; 30.6° in women). The hook plate made a point contact with the acromion at 9.2 ± 3.3 mm (31.5 %) from the lateral end of the acromion. The results revealed that the hook made a pinpoint contact with the undersurface of the acromion, and this might explain why complications commonly occur after hook plate fixation. The force concentration phenomenon associated with the hook plate of existing designs results from cases of morphological mismatch, such as excessive inclination and improper occupation of the subacromial space.

  11. Comparisons of front plate, percutaneous sacroiliac screws, and sacroiliac anterior papilionaceous plate in fixation of unstable pelvic fractures.

    Science.gov (United States)

    Gu, Ronghe; Huang, Weiguo; Yang, Lijing; Liu, Huijiang; Xie, Kegong; Huang, Zonggui

    2017-09-01

    This observational study was aimed at comparing the clinical efficacy of sacroiliac anterior plate fixation (SAPF), sacroiliac anterior papilionaceous plate (SAPP), and percutaneous sacroiliac screw internal fixation (PSCIF) introduced for patients with unstable pelvic fracture. Seventy-eight patients with unstable pelvic fracture (Tile type B or C) were recruited. Twenty-six patients underwent SAPF, 26 underwent SAPP, and 26 underwent PSCIF. Matta scores were calculated to evaluate the reduction of pelvic fractures, and Majeed scores were applied for the assessment of functional recoveries after surgery. Other perioperative clinical indicators were also recorded, including operation time, bleeding status, length of incision, ambulation time, fracture healing time, and incision infection. Total operation time of PSCIF was remarkably shorter than that of SAPF and SAPP (P SAPP group was almost 26∼29 times as high as that of PSCIF group (P SAPP resulted in significant blood loss compared with SAPF (P SAPP and PSCIF (P SAPP groups than in the PSCIF group (P SAPP was associated with fewer complications than SAPF, and complications were barely observed in the PSCIF group. PSCIF may be more appropriate for patients with unstable pelvic fractures in comparison with SAPP and SAPF. Besides, SAPP is likely to be more efficacious than SAPF especially for Tile C patients.

  12. Fixation of Intertrochanteric Valgus Osteotomy with T Plate in Treatment of Developmental Coxa Vara

    Science.gov (United States)

    Khairy, Hosam Mohamed

    2016-01-01

    Background Although the valgus subtrochanteric osteotomy is considered as a standard surgical treatment for coxa vara, there is no consensus on the optimal method of fixation and osteotomy technique. Fixation of the osteotomy has been achieved by various methods including external fixation and internal fixation with pins and cerclage and a variety of plates. The aim of this study is the evaluation of the results of developmental coxa treated by Y intertrochanteric valgus osteotomy fixed with a T-buttress plate compared with other methods of fixation in the literature. Methods Eighteen corrective valgus intertrochanteric femoral osteotomies were performed in 18 patients (18 hips) for treatment of unilateral developmental coxa vara deformity and fixed with a T plate. There were 12 males and 6 females. The right hip was affected in 10 patients and the left hip in 8 patients. Clinically, patients were evaluated by Larson hip score. Radiographically, anteroposterior view of the pelvis and frog leg lateral views of the affected hip were taken preoperatively and compared with the findings at the final follow-up. Results The average follow-up was 29 months (range, 24 to 36 months). Clinical results showed improvement of the mean Larson hip score from 57.8 to 97.0 (p < 0.001). Radiological results showed that all osteotomies were completely united in 2.4 months (range, 2 to 3 months) with the achievement of the planned correction angle. The average correction of Hilgenreiner's epiphyseal angle improved from 78.2° to 27.8° (p < 0.001) at the final follow-up. The femoral neck shaft angle was improved from 93.7° to 129.9° (p < 0.001) at the final follow-up. Shortening of the affected limb was corrected from 2.8 cm to 1.3 cm (p < 0.001) at the last follow-up. No major serious complications were recorded in the present study. Conclusions Intertrochanteric valgus osteotomy of the proximal femur fixed with a T plate may be efficient for treatment of developmental coxa vara

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

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

    Science.gov (United States)

    Mulders, Marjolein A M; Walenkamp, Monique M J; Goslings, J Carel; Schep, Niels W L

    2016-02-09

    Of all distal radius fractures, 25 % are complete articular fractures (AO/OTA type C fractures). Two thirds of those fractures are displaced and require reduction. According to several International Guidelines, adequately reduced intra-articular distal radius fractures are best treated non-operatively with plaster immobilisation, while surgical fixation is suggested only when the articular step exceeds 2 mm after reduction. However, these recommendations are based on studies that did not differentiate between intra- and extra-articular distal radius fractures. Thus, no clear consensus about the best treatment for patients with displaced intra-articular distal radius fractures can be reached. Despite the lack of evidence, an increase in internal fixation of intra-articular distal radius fractures has been observed over the last decade. The aim of this study is to determine the difference in functional outcome following open reduction and plate fixation compared with non-operative treatment with closed reduction and plaster immobilisation in patients with a displaced intra articular distal radius fracture. This multicentre randomised controlled trial will randomise between open reduction and internal plate fixation (intervention group) and closed reduction and plaster immobilisation (control group). All consecutive adult patients from 18 to 65 years with a displaced intra-articular distal radius fracture (AO/OTA type C), which has been adequately reduced at the Emergency Department according to the Dutch National Guidelines, are eligible for inclusion in this study. The primary outcome is function and pain of the wrist assessed with the Patient-Rated Wrist Evaluation score (PRWE). Secondary outcomes are the Disability of the Arm, Shoulder and Hand score (DASH), pain, quality of life (SF-36), range of motion, grip strength, radiological parameters, complications, crossovers and cost-effectiveness of both treatments. A total of 90 patients will be included in this

  15. Open Reduction and Internal Fixation of Displaced Calcaneum, Intra-Articular Fractures by Locking Calcaneal Plate

    Science.gov (United States)

    Santosha; Singh, Arambam Mahendra; Waikhom, Sanjib; Pakhrin, Vishal; Mukherjee, Sagnik; Debbarma, Rajkumar; Prashant, Prabhu Shrinivas

    2016-01-01

    Introduction Calcaneal fractures constitute the most common fractures in hindfoot. Lots of controversies exist in the management of calcaneal fractures but now-a-days, it is preferable to perform open reduction and internal fixation and early mobilizatation. Aim To evaluate the functional outcome after open reduction and internal fixation of displaced intra-articular fractures of the calcaneum by locking calcaneal plate. Materials and Methods The study was conducted in the Department of Orthopaedic Surgery from September 2013 to April 2016. Thirty intra-articular fractures of the calcaneum were treated by locking calcaneal plate. Patients were followed up for a period of 24 months. Bohler’s angle was measured in preoperative, immediate Post-operative period and after 2 years, follow-up was compared. Results were evaluated according to American Orthopaedic Foot and Ankle Society (AOFAS) Score. Results After 24 months of follow-up, all 24 patients were available for evaluation. Radiological union was achieved in a mean time of 12.5 weeks. Mean duration of hospital stay was 21 days. Bohler’s angle was significantly higher after 2 years of follow-up when compared with preoperative x-ray. According to the AOFAS, Ankle–Hind foot Scale outcome score results were excellent in 43.3% of the patients, good in 33.3%, fair in 10%, and poor in 13.3% of patients. The mean AOFAS score was 79.9 (Range 49-96). Conclusion Open reduction and internal fixation of intra-articular fractures of the calcaneum with locking calcaneal plate gives good results. Maintenance of calcaneal height and Bohler’s angle helps to decrease the incidence of subtalar arthritis. PMID:28208957

  16. 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

  17. Comparison of results between hook plate fixation and ligament reconstruction for acute unstable acromioclavicular joint dislocation.

    Science.gov (United States)

    Yoon, Jong Pil; Lee, Byoung-Joo; Nam, Sang Jin; Chung, Seok Won; Jeong, Won-Ju; Min, Woo-Kie; Oh, Joo Han

    2015-03-01

    In the present study, we aimed to compare clinical and radiographic outcomes between hook plate fixation and coracoclavicular (CC) ligament reconstruction for the treatment of acute unstable acromioclavicular (AC) joint dislocation. Forty-two patients who underwent surgery for an unstable acute dislocation of the AC joint were included. We divided them into two groups according to the treatment modality: internal fixation with a hook plate (group I, 24 cases) or CC ligament reconstruction (group II, 18 cases). We evaluated the clinical outcomes using a visual analog scale (VAS) for pain and Constant-Murley score, and assessed the radiographic outcomes based on the reduction and loss of CC distance on preoperative, postoperative, and final follow-up plain radiographs. The mean VAS scores at the final follow-up were 1.6 ± 1.5 and 1.3 ± 1.3 in groups I and II, respectively, which were not significantly different. The mean Constant-Murley scores were 90.2 ± 9.9 and 89.2 ± 3.5 in groups I and II, respectively, which were also not significantly different. The AC joints were well reduced in both groups, whereas CC distance improved from a mean of 215.7% ± 50.9% preoperatively to 106.1% ± 10.2% at the final follow-up in group I, and from 239.9% ± 59.2% preoperatively to 133.6% ± 36.7% at the final follow-up in group II. The improvement in group I was significantly superior to that in group II (p < 0.001). Furthermore, subluxation was not observed in any case in group I, but was noted in six cases (33%) in group II. Erosions of the acromion undersurface were observed in 9 cases in group I. In cases of acute unstable AC joint dislocation, hook plate fixation and CC ligament reconstruction yield comparable satisfactory clinical outcomes. However, radiographic outcomes based on the maintenance of reduction indicate that hook plate fixation is a better treatment option.

  18. A new technique of fixation of radial head fractures using a modified tubular plate

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    Guha A

    2004-04-01

    Full Text Available Radial head fractures are fairly common, occurring in 17-44% of all elbow injuries. Mason Type 2 fractures may be fixed using mini fragment screws, this fixation often needing augmentation with a plate to make the construct rotationally stable. However, the drill holes needed to fix the plate to the radial head, carry the risk of inflicting more injury to the fractured fragments. In our case, the radial head fracture was fixed with a modified one-third tubular plate. The plate was cut through the distal hole and the two cut ends were bent into hooks. These two hooks were engaged into two breaches made on the margin of the radial head and this provided rotational stability to the head without causing further damage. The fracture healed well and the patient regained full movement in the elbow. We conclude that this method may be used to fix fractures of the radial head, which require additional support with a plate.

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

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

    2012-01-01

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

  20. Biomechanical Study of the Fixation Strength of Anteromedial Plating for Humeral Shaft Fractures

    Institute of Scientific and Technical Information of China (English)

    Yin-Feng Zheng; Jun-Lin Zhou; Xiao-Hong Wang; Lei Shan; Yang Liu

    2016-01-01

    Background:Open reduction and internal fixation with plate and screws are the gold standard for the surgical treatment of humeral shaft fractures,this study was to compare the mechanical properties of anteromedial,anterolateral,and posterior plating for humeral shaft fractures.Methods:A distal third humeral shaft fracture model was constructed using fourth-generation sawbones (#3404,composite bone).Atotal of 24 sawbones with a distal third humeral shaft fracture was randomly divided into three Groups:A,B,and C (n =8 in each group) for anteromedial,anterolateral,and posterior plating,respectively.All sawbones were subjected to horizontal torsional fatigue tests,horizontal torsional and axial compressive fatigue tests,four-point bending fatigue tests in anteroposterior (AP) and mediolateral (ML) directions and horizontal torsional destructive tests.Results:In the horizontal torsional fatigue tests,the mean torsional angle amplitude in Groups A,B,and C were 6.12°,6.53°,and 6.81°.In horizontal torsional and axial compressive fatigue tests,the mean torsional angle amplitude in Groups A,B,and C were 5.66°,5.67°,and 6.36°.The mean plate displacement amplitude was 0.05 mm,0.08 mm,and 0.10 mm.Group A was smaller than Group C (P < 0.05).In AP four-point bending fatigue tests,the mean plate displacement amplitude was 0.16 mm,0.13 mm,and 0.20 mm.Group B was smaller than Group C (P < 0.05).In ML four-point bending fatigue tests,the mean plate displacement amplitude were 0.16 mm,0.19 mm,and 0.17 mm.In horizontal torsional destructive tests,the mean torsional rigidity in Groups A,B,and C was 0.82,0.75,and 0.76 N.m/deg.The yielding torsional angle was 24.50°,25.70°,and 23.86°.The mean yielding torque was 18.46,18.05,and 16.83 N·m,respectively.Conclusions:Anteromedial plating was superior to anterolateral or posterior plating in all mechanical tests except in AP four-point bending fatigue tests compared to the anterolateral plating group.We can suggest that

  1. Biomechanical evaluation of fracture fixation constructs using a variable-angle locked periprosthetic femur plate system.

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    Hoffmann, Martin F; Burgers, Travis A; Mason, James J; Williams, Bart O; Sietsema, Debra L; Jones, Clifford B

    2014-07-01

    In the United States there are more than 230,000 total hip replacements annually, and periprosthetic femoral fractures occur in 0.1-4.5% of those patients. The majority of these fractures occur at the tip of the stem (Vancouver type B1). The purpose of this study was to compare the biomechanically stability and strength of three fixation constructs and identify the most desirable construct. Fifteen medium adult synthetic femurs were implanted with a hip prosthesis and were osteotomized in an oblique plane at the level of the implant tip to simulate a Vancouver type B1 periprosthetic fracture. Fractures were fixed with a non-contact bridging periprosthetic proximal femur plate (Zimmer Inc., Warsaw, IN). Three proximal fixation methods were used: Group 1, bicortical screws; Group 2, unicortical screws and one cerclage cable; and Group 3, three cerclage cables. Distally, all groups had bicortical screws. Biomechanical testing was performed using an axial-torsional testing machine in three different loading modalities (axial compression, lateral bending, and torsional/sagittal bending), next in axial cyclic loading to 10,000 cycles, again in the three loading modalities, and finally to failure in torsional/sagittal bending. Group 1 had significantly greater load to failure and was significantly stiffer in torsional/sagittal bending than Groups 2 and 3. After cyclic loading, Group 2 had significantly greater axial stiffness than Groups 1 and 3. There was no difference between the three groups in lateral bending stiffness. The average energy absorbed during cyclic loading was significantly lower in Group 2 than in Groups 1 and 3. Bicortical screw placement achieved the highest load to failure and the highest torsional/sagittal bending stiffness. Additional unicortical screws improved axial stiffness when using cable fixation. Lateral bending was not influenced by differences in proximal fixation. To treat periprosthetic fractures, bicortical screw placement should be

  2. Plate selection for fixation of extra-articular distal humerus fractures: a biomechanical comparison of three different implants.

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    Scolaro, John A; Hsu, Jason E; Svach, David J; Mehta, Samir

    2014-12-01

    Operative fixation of extra-articular distal humerus using a single posterolateral column plate has been described but the biomechanical properties or limits of this technique is undefined. The purpose of this study was to evaluate the mechanical properties of distal humerus fracture fixation using three standard fixation constructs. Two equal groups were created from forty sawbones humeri. Osteotomies were created at 80mm or 50mm from the tip of the trochlea. In the proximal osteotomy group, sawbones were fixed with an 8-hole 3.5mm LCP or with a 6-hole posterolateral plate. In the distal group, sawbones were fixed with 9-hole medial and lateral 3.5mm distal humerus plates and ten sawbones were fixed with a 6-hole posterolateral plate. Biomechanical testing was performed using a servohydraulic testing machine. Testing in extension as well as internal and external rotation was performed. Destructive testing was also performed with failure being defined as hardware pullout, sawbone failure or cortical contact at the osteotomy. In the proximal osteotomy group, the average bending stiffness and torsional stiffness was significantly greater with the posterolateral plate than with the 3.5mm LCP. In the distal osteotomy group, the average bending stiffness and torsional stiffness was significantly greater with the posterolateral plate than the 3.5mm LCP. In extension testing, the yield strength was significantly greater with the posterolateral plate in the proximal osteotomy specimens, and the dual plating construct in the distal osteotomy specimens. The yield strength of specimens in axial torsion was significantly greater with the posterolateral plate in the proximal osteotomy specimens, and the dual plating construct in the distal osteotomy specimens. Limited biomechanical data to support the use of a pre-contoured posterolateral distal humerus LCP for fixation of extra-articular distal humerus exists. We have found that this implant provided significantly greater

  3. 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.

  4. STUDY OF FUNCTIONAL OUTCOME OF DISTAL FEMUR FRACTURES TREATED BY OPEN REDUCTION AND INTERNAL FIXATION WITH LOCKING COMPRESSION PLATE

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    Sahaya R

    2016-04-01

    Full Text Available BACKGROUND Distal femur fractures account for about 7% of all femur fractures. These fractures can lead to knee stiffness and have the tendency to collapse into varus. The management of distal femur fractures has seen a paradigm shift from nonoperative measures to biological fixation and evolution of modern implants like Locking Compression Plate has been used in current times. With the use of Locking Compression Plate double plating can be avoided. In our study, we have evaluated the short-term Functional Outcome of patients who underwent open reduction internal fixation with Locking Compression Plate using Sander’s criteria. Ours is both prospective and retrospective study of 20 patients with distal femur fractures treated operatively from April 2013 to October 2015. Our surgical modality of treatment is open reduction and internal fixation with locking compression plate using standard lateral approach. We have used AO classification to classify the distal femur fractures. With the results of our study, we have come to a conclusion that locking compression plate is a best option for both intra-articular and extra-articular distal femur fractures. It avoids the use of dual plating of distal femur which requires extensive soft tissue stripping in both sides, resulting in reduced blood supply, potential non-union and implant failure. Locking Compression Plate also helps in anatomical reduction of comminuted intra-articular fractures and it could also be used effectively in osteoporotic bone.

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

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    Dominik Seybold

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Saurabh Jain; Anil Kumar Jain; Ish Kumar

    2013-01-01

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

  7. Influence of hooks and a lag screw on internal fixation plates for lateral malleolar fracture: a biomechanical and ergonomic study.

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    Sakai, Rina; Uchino, Masataka; Yoneo, Terumasa; Ohtaki, Yasuaki; Minehara, Hiroaki; Matsuura, Terumasa; Gomi, Tsutomu; Ujihira, Masanobu

    2017-02-23

    For internal fixation of AO classification Type B lateral malleolar fracture, insertion of lag screws into the fracture plane and fixation with a one-third tubular plate as a neutralization plate are the standard treatment procedures. The one-third tubular plate is processed to a hook shape and hung on the distal end of the fibula. In this study, to compare the function of the hook and lag screws of a one-third tubular plate and LCP for osteosynthesis of lateral malleolar fracture, mechanical indices of internal fixation were compared among the one-third tubular plates with lag screws with and without the hook and a locking compression plate. As mechanical tests, a compression test was performed in which compression in the bone axis direction produced by supporting the body weight was simulated, and a torsion test was performed in which external rotation of the bone axis caused by plantar flexion of the ankle joint was simulated. Muscle strength during walking and the force and torque acting on the ankle and knee joints were determined using inverse dynamic analysis. Finite element analysis was performed to analyze the function of hooks and lag screws. The joint reaction force determined by inverse dynamic analysis was adopted as the loading condition of finite element analysis. A stiffness equivalent to that of healthy bone could be achieved by all three internal fixations. It was clarified that the presence of the hook does not make a difference in stiffness. Displacement of the one-third tubular plate was small regardless of the presence or absence of the hook compared with those of locking compression plates. The presence of the hook did not make any difference in stiffness, suggesting that active preparation of the hook is unnecessary. We also clarified that lag screws inhibit displacement.

  8. Distal tibial fracture treated by minimally invasive plate osteosynthesis after external fixation Retrospective clinical and radiographic assessment

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    Al. Șerban

    2014-02-01

    Full Text Available Fractures of the horizontal surface of the distal tibia are known commonly as pylon or plafond fractures, and represent 1-5% of lower extremity fractures, 7-10% of all tibial fractures. The protocol consisted of immediate (within eight to 24 hours open reduction and internal fixation of the fibula, using a fibular plate or one third tubular plate and application of an external fixator spanning the ankle joint. In the second stage, the treatment of proximal and distal tibial fractures with close reduction and MIPPO technique can preserve soft tissue, simplify operative procedure and decrease wound, obtain rigid internal fixation and guarantee early function exercises of ankle joint. In this study we evaluated 22 patients treated in Clinical Emergency Hospital Constanta between April 2012 - July 2013 diagnosed with multifragmentary fractures of the distal tibia. This study evaluates the treatment of complex fractures of distal tibia with locked plate after external fixation. There were 17 males and 5 females of mean age 51,7 years (31-68. The mean follow-up period was 14 weeks. (Ranging from 9-16 weeks. All patients were fully weight bearing at 16 weeks (ranging 9-16 weeks showing radiological union. There were no cases of failures of fixation, or rotational misalignment. No significant complication was observed in our patients. MIPO is an effective method of treatment for distal tibial fractures, reduce surgical trauma and maintain a more biologically favorable environment for fracture healing, reducing risks of infection and nonunion.

  9. Bicortical screw fixation of distal fibula fractures with a lateral plate: an anatomic and biomechanical study of a new technique.

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    Milner, Brenton F; Mercer, Deana; Firoozbakhsh, Keikhosrow; Larsen, Kenna; Decoster, Thomas A; Miller, Richard A

    2007-01-01

    One of the potential drawbacks of lateral plating of distal fibula fractures is less than satisfactory fixation of unicortical screws commonly placed in the distal fragment to avoid implant penetration of the ankle joint. This study examines the anatomy of the distal fibula, proposes new techniques for bicortical screw fixation and radiographic evaluation of screw placement, and compares pullout strength of unicortical versus bicortical screws in this area. Sixteen pairs of human cadaver feet were used in this study. It was found that a large percentage of the surface area of the distal fibula is nonarticular and that the distal fibula could be divided into 3 zones with distinct anatomic features. Zone I is defined as the distal most 1.5 cm of the fibula, zone II is the next 1 cm of fibula proximal to zone I, and zone III is defined as the fibula above the ankle joint, starting at just over 2.5 cm proximal to the tip of the fibula. We determined a safe corridor for bicortical screw placement by means of a lateral plate in each zone. An improved radiographic view is described for confirmation of extraarticular screw placement. Screw pullout testing was performed on 8 pairs of fresh-frozen human cadaver fibulas. In both zone I and zone II, the bicortical screw fixation was significantly stronger than the unicortical screw fixation. In zone I, the average pullout strength for the bicortical screw fixation was 2.3 times higher than the unicortical screw fixation. In zone II, the average pullout strength for the bicortical screw fixation was 3.3 times higher than the unicortical screw fixation. This study shows that not only is bicortical screw placement in the distal fibula technically feasible, but it is also biomechanically stronger than unicortical placement in this area.

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

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

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    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.

  12. Complex fractures of the proximal humerus in the elderly--outcome and complications after locking plate fixation.

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    Schliemann, B; Siemoneit, J; Theisen, Ch; Kösters, C; Weimann, A; Raschke, M J

    2012-05-01

    Open reduction and internal fixation (ORIF) with locking plates or primary arthroplasty remains a controversial issue in the management of complex proximal humerus fractures. Aim of this study was to evaluate the surgeon- and patient-based outcome of patients older than 65 years who underwent ORIF using locking plate fixation of a 3- or 4-part fracture of the proximal humerus. Twenty-seven patients older than 65 years were treated with locking plate fixation (PHILOS, Fa. Synthes, Umkirch, Germany). At an average follow-up of 44 months, the clinical and the subjective outcome were evaluated, and complications were analyzed. The mean age- and gender-related Constant score was 70% (30–100%) compared with 92% (47–108%) of the contralateral non-injured shoulder. The mean DASH score was 29 points (0–71). Five patients (18.5%) showed clinical signs of an impingement, which was related to malpositioning of the plate in 3 cases. Screw cutout was seen in 22.2% (6 patients). Avascular necrosis of the head or the tubercula was found in 8 patients (29.6%). The revision rate was 29.6%. However, the patients considered the functional status of their shoulder as “good” or “satisfactory.” The functional and patient-orientated results of the locking plate fixation of complex displaced proximal humerus fractures in the elderly are comparable to those of primary arthroplasty and minimally invasive treatment. Proper surgical technique (screw length, plate position) is mandatory for reducing the revision rate.

  13. 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

  14. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

  16. Clinical and radiological outcome after mini-open Latarjet technique with fixation of coracoid with Arthrex wedge mini-plate.

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    Chaudhary, Deepak; Goyal, Ankit; Joshi, Deepak; Jain, Vineet; Mohindra, Mukul; Mehta, Nitin

    2016-01-01

    Technical faults leading to coracoid fractures during screw insertion and coracoid graft osteolysis are concerns with standard screw fixation techniques in Latarjet procedure. The purpose of this study is to share our experience using Arthrex wedge profile plate with mini-open technique for graft fixation, that ensures better load distribution between coracoid graft and glenoid. We did retrospective analysis of 24 patients with recurrent anterior shoulder instability after failed arthroscopic Bankart's repair. Arthroscopic examination of affected shoulder was done in lateral position before making patient supine for open Latarjet. A low profile wedge plate (Arthrex) with two screws was used for the procedure. CT analysis was performed post-operatively at 6 months to see graft union and results were evaluated using the Rowe and Walch Duplay score. Mean follow-up time was 26 months. Postoperatively, mean forward elevation was 170.6 + 4.6° (loss of average 5.9°) and mean external rotation was 42.5 + 5.3° (loss of average 3.1°). All patients returned to their previous occupation. None reported to be having any recurrent subluxation. Functional assessment done using Rowe score and Walch Duplay score showed statistically significant improvement (p value 0.034). There were no implant-related complications and no case of coracoid graft osteolysis. Mini-open Latarjet with graft fixation with Arthrex mini-plate provides satisfactory outcome in patients who require reoperation due to dramatic bone loss and failed soft tissue reconstruction. The modified incision improves exposure enabling plate fixation and the secure fixation accelerates rehabilitation.

  17. Management of metastatic tumors to the spine using simple plate fixation.

    Science.gov (United States)

    Timlin, M; Thalgott, J; Ameriks, J; Jordan, F; Kabins, M; Gardner, V; Fritts, K

    1995-08-01

    Frequency of metastasis to the spine in the population of patients suffering from malignant disease is a significant clinical problem, as these patients present with intractable pain and neurologic impairment. The sequelae of metastatic tumors to the spinal column significantly decrease the quality of the patient's life. With the advent of modern chemotherapeutic regimens in metastatic disease, patients with metastatic tumors are living longer and more productive lives. The goal of surgical management of this problem is to increase the quality of the patient's life, and not longevity. The immediate technical goals are resection of the pathological segment, restoration of load bearing capacity for mobilization of the patient, and decompression of compromised neural structures, as well as maintenance of spinal stability to decrease pain and increase the patient's quality of life during the terminal stages. This is a series of 28 patients with metastatic tumors to the spine, with an average age of 61.5 years, ranging from 25-81 years of age. Within this population there were 11 different tumor types. The postoperative survivorship was an average of 6.4 months. Twenty patients in this series had an anterior procedure alone using a combination of Methylmethacrylate and inexpensive plate fixation. Six patients required an anterior/posterior procedure for circumferential spinal compression and instability. These techniques provide immediate spinal stability for rapid mobilization of the patient. Twenty-four patients in the series had significant pain relief, and 17 experienced neurologic improvement.(ABSTRACT TRUNCATED AT 250 WORDS)

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

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    Chris Dillingham

    2011-01-01

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

  19. Video-assisted ALIF with cage and anterior plate fixation for L5-S1 spondylolisthesis.

    Science.gov (United States)

    Aunoble, Stephane; Hoste, David; Donkersloot, Peter; Liquois, Frederic; Basso, Yann; Le Huec, Jean-Charles

    2006-10-01

    Spondylolysis and spondylolisthesis grade 0, 1, and 2 are mainly asymptomatic but with aging process and different factors some back pain can occur and lead to chronic low back pain. The conservative treatment with physiotherapy and steroid injection is the gold standard but in some cases is not efficient enough and a surgical treatment is proposed. The goal of this study is to propose a new technique to treat grade 0, 1, and 2 spondylolisthesis with an anterior video-assisted fusion and stabilization. Twenty patients with chronic low back pain since more than 2 years and resistant to conservative therapy were included in this protocol. Clinical signs and radicular pain were noted. They were evaluated preoperatively and postoperatively until the last follow up using Oswestry score and visual analog score (VAS) for leg and back pain. X-rays showed grade 0 (8 cases), 1 (10 cases), and 2 (2 cases) spondylolisthesis according to Meyerding classification with disc collapse (bulging disc). MRI showed in all cases a disc degeneration with at least black disc and/or endplates changes with Modic I or II. All patients were operated using an anterior video-assisted retroperitoneal approach, with discectomy and fusion using an anterior impacted cage filled with autologous cancellous bone from the iliac crest and an anterior fixation with a triangular plate (Pyramid, Medtronic, Memphis). The follow up at 3, 6, 12, and 24 months was done with clinical and radiologic evaluation. In case of problem a computed tomography scan was performed. There were 11 women and 9 men, with and average age of 39 years old and a BMI of 25.6. All spondylolistheses occurred at level L5. The average slippage was 19%. All L5S1 discs were black, 8 had a Modic I changes in the endplates and 2 had Modic II. The shape of L5 vertebra was abnormal (trapezoidal) in 7 cases. All anterior approaches were performed without vascular, urologic, or digestive complication. Blood loss was inferior to 100 mL. All

  20. Treatment of Displaced Sacroiliac Fracture Using the Lateral Window for Short Plate Buttress Reduction and Percutaneous Sacroiliac Screw Fixation.

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    Colin Murphy

    2016-04-01

    Full Text Available Fractures through the sacroiliac joint are very challenging to treat, technically difficult to reduce through closed methods on account of the multiaxial displacement of fractures fragments, frequently occur in very unwell patients, and have poor outcomes if malreduction is present. We describe a technique utilising the lateral window and a short buttress plate to reduce and stabilize the fragments prior to percutaneous fixation with sacroiliac screws.

  1. Prospective blind comparative clinical study of two point fixation of zygomatic complex fracture using wire and mini plates

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    Gandi Lakshmi N

    2012-03-01

    Full Text Available Abstract Background The zygomatic maxillary complex (ZMC fractures are one of the most frequent injuries of the facial skeleton due to its position and facial contour. Assaults, road traffic accidents and falls are the principal etiologic factors that may cause fractures of zygomatic bone. The different fixation methods are applied to treat the zygomatic bone fractures, with many more classifications which have been described in the literature for the ease of management. The type of the fracture, its severity and associated facial fractures usually interferes the treatment modality. Purpose of study The aim of this paper is to show the results of 18yrs prospective blind comparative study using wire and plate osteosynthesis which needed open reduction and internal fixation involving Type II to Type IV Spissel and Schroll ZMC fractures. Materials and methods Total 80 cases included in the study out of 1780 ZMC cases which were treated using wire and plate osteosynthesis over a period of 18 yrs, involving only Type II to Type IV Spissel and Schroll ZMC fractures. Other types excluded from study to prevent observer bias. All the fixations carried out through Standard Dingman's incision using stainless steel 26 gauze wire and titanium 1.5 mm mini plate system under general anesthesia by single maxillofacial surgeon and evaluated by another maxillofacial surgeon who is blinded for surgical procedure after 2 and 4 wks of follow-up for facial symmetry, wound healing, functional assessment (mouth opening, diplopia, and sensory disturbance. All the data tabulated in Excel software (Microsoft for statistical analysis. P-value calculated to know the Significance of treatment modality in all aspects. Results Result shows no significant p-values indicating both the operating techniques are equally efficient in the surgical management of ZMC fracture. Conclusion Osteosynthesis by mini plates is simple, logical and effective treatment compared to wire

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

    Science.gov (United States)

    Giacomo, Giovanni Di; Costantini, Alberto; de Gasperis, Nicola; De Vita, Andrea; Lin, Bernard K H; Francone, Marco; Beccaglia, Mario A Rojas; Mastantuono, Marco

    2013-01-01

    One of the reason for Latarjet procedure failure may be coracoid graft osteolysis. In this study, we aimed to understand if a better compression between the coracoid process and the glenoid, using a mini-plate fixation during the Latarjet procedure, could reduce the amount of coracoid graft osteolysis. A computed tomography scan analysis of 26 prospectively followed-up patients was conducted after modified Latarjet procedure using mini-plate fixation technique to determine both the location and the amount of coracoid graft osteolysis in them. We then compared our current results with results from that of our previous study without using mini-plate fixation to determine if there is any statistical significant difference in terms of corcacoid bone graft osteolysis between the two surgical techniques. The most relevant osteolysis was represented by the superficial part of the proximal coracoid, whereas the deep part of the proximal coracoid graft is least involved in osteolysis and has best bone healing. The current study showed a significant difference only for the deep part of the distal coracoid with our previous study (P Latarjet procedure. Our study suggests that there is a significant difference only for the deep part of the distal coracoid in terms of osteolysis. At clinical examination, this difference did not correspond with any clinical findings. Level 4. Prospective case series, Treatment study.

  3. Radiation-Associated Fracture Nonunion of the Clavicle Treated with Locking Plate Fixation and Autologous Bone Grafting

    Directory of Open Access Journals (Sweden)

    Takahiro Niikura

    2012-01-01

    Full Text Available We describe a case of radiation-associated fracture nonunion of the clavicle, which was treated by locking plate fixation and autologous bone grafting. The patient was a 67-year old man who received 70 Gy radiation therapy to treat nasopharyngeal carcinoma. Eight years later, he suffered a pathological fracture of the right clavicle. One year after the fracture, surgical treatment was performed due to persistent pain and weakness. Radiographs demonstrated atrophic nonunion. Bone scan demonstrated hot uptake at both ends of the fractured bone. MRI demonstrated a formation of pseudoarthrosis with fluid collection and suggested bone marrow edema at both ends of the fracture fragments. In surgery, fibrous pseudoarthrosis tissue was excised and both ends of the fracture fragments were refreshed to identify bleeding. Open reduction and internal fixation using a 7-hole locking plate and autologous bone grafting were performed. Successful bony union was obtained 1 year postoperatively, and no adverse events were observed up to 52 months after the operation. Our case suggests that a locking plate provides sufficient fixation and autologous bone grafting is effective in enhancing bone healing in a radiation-associated fracture nonunion of the clavicle in which it is difficult to achieve bony union.

  4. SEGMENTAL FRACTURE OF PROXIMAL SHAFT FEMUR OF POLIO AFFECTED PARALYTIC LIMB TREATED WITH 95 DEGREE ANGLED PLATE FIXATION BY MIPO TECHNIQUE

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    Rajan

    2014-11-01

    Full Text Available Subtrochanteric fractures extending below lesser trochanter are always difficult to treat and their higher incidence of unsatisfactory results are noted after operative treatment. There are various implants available for fixation but in this study we did 95 DEG ANGLED PLATE FIXATION BY MIPO TECHNIQUE

  5. Are Biodegradable Plates Applicable in Endoscope-Assisted Open Reduction and Internal Fixation of Mandibular Subcondyle Fractures?

    Science.gov (United States)

    Son, Jang-Ho; Ha, Jinhee; Cho, Yeong-Cheol; Sung, Iel-Yong

    2017-08-01

    To investigate whether biodegradable plates are applicable in endoscope-assisted open reduction and internal fixation (EAORIF) of mandibular subcondyle fractures. This retrospective case-series study included patients with mandibular subcondyle fractures treated with EAORIF using an unsintered hydroxyapatite particles/poly-l-lactide biodegradable plate system, with at least 6 months of clinical follow-up data available. The outcome variables were fracture healing with postoperative stability and postoperative complications. Other variables included age, gender, fracture site, cause of injury, accompanying mandibular fracture, total follow-up period, fracture classification, extent of displacement, preoperative status of occlusion, preoperative mandibular movements, fixation materials in accompanying mandibular fracture, location and number of fixation plates, periods of intermaxillary fixation/elastic bands, and postoperative mandibular movements. Fracture healing in these patients was assessed by comparing the immediate postoperative cone-beam computed tomography (CBCT) images with those obtained at least 3 months after surgery. A total of 11 patients, 9 male and 2 female, with a mean ± standard deviation age of 35.3 ± 15.9 years, were included. The mean follow-up period was 18.8 ± 7.8 months. Four patients had an accompanying mandibular fracture. Two 4-hole, 2.0-mm biodegradable plates were fixed with 6-mm screws along the posterior border of the mandibular ramus and near the sigmoid notch. Complete bone formation around the fracture lines or fading of the fracture lines, with no change in the position of the fractured segments, was observed on the postoperative CBCT images at 3 months. With the exception of 2 patients, no patient complained of plate palpability, deviation in occlusion, or discomfort during the postoperative follow-up period. EAORIF using biodegradable plates for mandible subcondylar fractures is a stable and reliable method, with

  6. 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.

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

    Science.gov (United States)

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

    2008-10-01

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

  8. Investigation of the mechanical properties and failure modes of hybrid natural fiber composites for potential bone fracture fixation plates.

    Science.gov (United States)

    Manteghi, Saeed; Mahboob, Zia; Fawaz, Zouheir; Bougherara, Habiba

    2017-01-01

    The purpose of this study is to investigate the mechanical feasibility of a hybrid Glass/Flax/Epoxy composite material for bone fracture fixation such as fracture plates. These hybrid composite plates have a sandwich structure in which the outer layers are made of Glass/Epoxy and the core from Flax/Epoxy. This configuration resulted in a unique structure compared to prior composites proposed for similar clinical applications. In order to evaluate the mechanical properties of this hybrid composite, uniaxial tension, compression, three-point bending and Rockwell Hardness tests were conducted. In addition, water absorption tests were performed to investigate the rate of water absorption for the specimens. This study confirms that the proposed hybrid composite plates are significantly more flexible axially compared to conventional metallic plates. Furthermore, they have considerably higher ultimate strength in tension, compression and flexion. Such high strength will ensure good stability of bone-implant construct at the fracture site, immobilize adjacent bone fragments and carry clinical-type forces experienced during daily normal activities. Moreover, this sandwich structure with stronger and stiffer face sheets and more flexible core can result in a higher stiffness and strength in bending compared to tension and compression. These qualities make the proposed hybrid composite an ideal candidate for the design of an optimized fracture fixation system with much closer mechanical properties to human cortical bone.

  9. The effect of posterior spinal fixation with acrylic cement on the vertebral growth plate and intervertebral disc in dogs.

    Science.gov (United States)

    Moon, M S; Ok, I Y; Ha, K Y

    1986-01-01

    We have attempted to clarify the serial histological changes in the growing spine of dogs following posterior fixation with acrylic cement. Twenty-four male mongrel dogs aged 8 weeks were used for the study. The lumbar spine from L.3 to L.5 was fixed posteriorly with acrylic cement. Three dogs were then sacrificed every four weeks up to 32 weeks, and the histological changes of the vertebral disc, growth plate and vertebral bodies were observed by light microscopy. Thinning of the growth plate and distortion of the cartilage columns has been demonstrated, but premature fusion of the growth plate did not result and vertebral body growth continued. Anterior wedging of the intervertebral disc was seen with some thinning of the bony trabeculae of the vertebral body. Degeneration of the nucleus pulposus resulted, with replacement by fibrous tissue. The normal horizontal arrangement of the fibres of the annulus fibrosus altered to a vertical configuration by 32 weeks.

  10. Hook plate fixation for acute acromioclavicular dislocations without coracoclavicular ligament reconstruction: a functional outcome study in military personnel.

    Science.gov (United States)

    Kumar, Narinder; Sharma, Vyom

    2015-08-01

    The aim of our study was to evaluate the shoulder function after clavicular hook plate fixation of acute acromioclavicular dislocations (Rockwood type III) in a population group consisting exclusively of high-demand military personnel. This prospective study was carried out at a tertiary care military orthopaedic centre during 2012-2013 using clavicular hook plate for management of acromioclavicular injuries without coracoclavicular ligament reconstruction in 33 patients. All patients underwent routine implant removal after 16 weeks. The functional outcome was assessed at 3, 6 and 12 months after hook plate removal and 2 years from the initial surgery using the Constant Murley and UCLA Scores. All the patients were male serving soldiers and had sustained acromioclavicular joint dislocation (Rockwood type III). Mean age of the patient group was 34.24 years (21-55 years). The mean follow-up period in this study was 23.5 months (20-26 months) after hook plate fixation and an average of 19.9 months (17-22 months) after hook plate removal. The average Constant Score at 3 months after hook plate removal was 60.3 as compared to 83.7 and 90.3 at 6 months and 1 year, respectively, and an average of 91.8 at the last follow-up that was approximately 2 years after initial surgery which was statistically significant (p value acromioclavicular dislocations producing excellent medium-term functional results in high-demand soldiers.

  11. Biomechanical Study of the Fixation Strength of Anteromedial Plating for Humeral Shaft Fractures

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    Yin-Feng Zheng

    2016-01-01

    Conclusions: Anteromedial plating was superior to anterolateral or posterior plating in all mechanical tests except in AP four-point bending fatigue tests compared to the anterolateral plating group. We can suggest that anteromedial plating is a clinically safe and effective way for humeral shaft fractures.

  12. Biomechanical comparison of anterior Caspar plate and three-level posterior fixation techniques in a human cadaveric model.

    Science.gov (United States)

    Traynelis, V C; Donaher, P A; Roach, R M; Kojimoto, H; Goel, V K

    1993-07-01

    Traumatic cervical spine injuries have been successfully stabilized with plates applied to the anterior vertebral bodies. Previous biomechanical studies suggest, however, that these devices may not provide adequate stability if the posterior ligaments are disrupted. To study this problem, the authors simulated a C-5 teardrop fracture with posterior ligamentous instability in human cadaveric spines. This model was used to compare the immediate biomechanical stability of anterior cervical plating, from C-4 to C-6, to that provided by a posterior wiring construct over the same levels. Stability was tested in six modes of motion: flexion, extension, right and left lateral bending, and right and left axial rotation. The injured/plate-stabilized spines were more stable than the intact specimens in all modes of testing. The injured/posterior-wired specimens were more stable than the intact spines in axial rotation and flexion. They were not as stable as the intact specimens in the lateral bending or extension testing modes. The data were normalized with respect to the motion of the uninjured spine and compared using repeated measures of analysis of variance, the results of which indicate that anterior plating provides significantly more stability in extension and lateral bending than does posterior wiring. The plate was more stable than the posterior construct in flexion loading; however, the difference was not statistically significant. The two constructs provide similar stability in axial rotation. This study provides biomechanical support for the continued use of bicortical anterior plate fixation in the setting of traumatic cervical spine instability.

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

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    Brown Jaclyn

    2011-09-01

    Full Text Available Abstract Background Fractures of the distal radius are extremely common injuries in adults. However, the optimal management remains controversial. In general, fractures of the distal radius are treated non-operatively if the bone fragments can be held in anatomical alignment by a plaster cast or orthotic. However, if this is not possible, then operative fixation is required. There are several operative options but the two most common in the UK, are Kirschner-wire fixation (K-wires and volar plate fixation using fixed-angle screws (locking-plates. The primary aim of this trial is to determine if there is a difference in the Patient-Reported Wrist Evaluation one year following K-wire fixation versus locking-plate fixation for adult patients with a dorsally-displaced fracture of the distal radius. Methods/design All adult patients with an acute, dorsally-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

  14. Comparison of postoperative changes in the distal and proximal segments between conventional and sliding mini-plate fixation following mandibular setback

    Science.gov (United States)

    Kim, Seong-Sik; Kwak, Kyoung-Ho; Ko, Ching-Chang; Park, Soo-Byung; Son, Woo-Sung

    2016-01-01

    Objective The purpose of the present study was to evaluate the postoperative three-dimensional (3D) changes in the proximal segments after mandibular setback sagittal split ramus osteotomy and to compare the changes between the conventional mini-plate fixation and semi-rigid sliding plate fixation. Methods Cone-beam computed tomography (CBCT) images were used to evaluate the postoperative 3D changes in the proximal segments during the healing process. CBCT images were superimposed using the symphysis and the lower anterior mandible as references. Results There were no statistically significant differences between the conventional mini-plate and semi-rigid sliding plate groups (p > 0.05). With respect to the distribution of changes greater than 2 mm in the landmarks, the right condylion, right coronoid process, and left condylion showed ratios of 55.6%, 50.0%, and 44.4%, respectively, in the semi-rigid sliding plate group; however, none of the landmarks showed ratios greater than 30% in the conventional mini-plate group. Conclusions There were no statistically significant differences in postoperative changes in the segments between the conventional mini-plate and semi-rigid sliding plate groups. Nevertheless, while selecting the type of fixation technique, clinicians should consider that landmarks with greater than 2 mm changes were higher in the semi-rigid sliding plate group than in the conventional mini-plate group. PMID:27896211

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

    Directory of Open Access Journals (Sweden)

    Giovanni Di Giacomo

    2013-01-01

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

  16. Open-wedge osteotomy using an internal plate fixator in patients with medial-compartment gonarthritis and varus malalignment

    DEFF Research Database (Denmark)

    Niemeyer, Philipp; Schmal, Hagen; Hauschild, Oliver

    2010-01-01

    PURPOSE: Our purpose was to evaluate the 3-year clinical results of patients with medial-compartment osteoarthritis of the knee and varus malalignment who underwent open-wedge high tibial osteotomy (HTO) with an internal plate fixator (TomoFix; Synthes, Solothurn, Switzerland). Clinical results...... of patients reported discomfort related to the implant at some point during the follow-up period (40.6%). CONCLUSIONS: Open-wedge osteotomy by use of the TomoFix system leads to reliable 3-year results. Results do not depend on the severity of medial cartilage defects, whereas partial-thickness defects...

  17. Computer-assisted preoperative simulation for positioning of plate fixation in Lefort I osteotomy: A case report

    Directory of Open Access Journals (Sweden)

    Hideyuki Suenaga

    2016-06-01

    Full Text Available Computed tomography images are used for three-dimensional planning in orthognathic surgery. This facilitates the actual surgery by simulating the surgical scenario. We performed a computer-assisted virtual orthognathic surgical procedure using optically scanned three-dimensional (3D data and real computed tomography data on a personal computer. It helped maxillary bone movement and positioning and the titanium plate temporary fixation and positioning. This simulated the surgical procedure, which made the procedure easy, and we could perform precise actual surgery and could forecast the postsurgery outcome. This simulation method promises great potential in orthognathic surgery to help surgeons plan and perform operative procedures more precisely.

  18. Computer-assisted preoperative simulation for positioning of plate fixation in Lefort I osteotomy: A case report.

    Science.gov (United States)

    Suenaga, Hideyuki; Taniguchi, Asako; Yonenaga, Kazumichi; Hoshi, Kazuto; Takato, Tsuyoshi

    2016-06-01

    Computed tomography images are used for three-dimensional planning in orthognathic surgery. This facilitates the actual surgery by simulating the surgical scenario. We performed a computer-assisted virtual orthognathic surgical procedure using optically scanned three-dimensional (3D) data and real computed tomography data on a personal computer. It helped maxillary bone movement and positioning and the titanium plate temporary fixation and positioning. This simulated the surgical procedure, which made the procedure easy, and we could perform precise actual surgery and could forecast the postsurgery outcome. This simulation method promises great potential in orthognathic surgery to help surgeons plan and perform operative procedures more precisely.

  19. CLINICAL OUTCOMES OF LOCKING COMPRESSION PLATE FIXATION THROUGH MINIMALLY INVASIVE PERCUTANEOUS PLATE OSTEOSYNTHESIS IN THE TREATMENT OF DISTAL TIBIAL FRACTURE

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    Venkateswara Rao

    2015-07-01

    Full Text Available BACKGROUND: Distal diametaphyseal tibia fracture though requires operative treatment is difficult to manage. Conventional osteosynthesis is not suitable because distal tibia is subcutaneous bone with poor vascularity. Closed reduction and minimally invasive percutaneous plate osteosynthes is with locking compression plate (LCP has emerged as an alternative treatment option because it respects biology of distal tibia and fracture hematoma and also provides biomechanica l ly stable construct. OBJECTIVES: To find out suitability of minimally invasive percutaneous plate osteosynthesis with Locking compression plate for distal diametaphyseal tibia fracture including union time and complications. METHODS: Twenty patients with closed distal tibia fracture with or without intra articular extension (AO classification type - A1, type - A2, type - A3 treated with minimally invasive percutaneous plate osteosynthesis with Locking compression plate were prospectively followed for average duration of 12 months. RESULTS: Ave rage duration of injury - surgery interval was 4.5 days (Range 3 - 7 days all fractures got united with an average duration of 23.5 weeks (range17 - 30weeks. No non - union or mal - union were found. There was one superficial infection found which healed with exte nded period of intravenous antibiotics.

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

    Science.gov (United States)

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

    2012-05-01

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

  1. The use of a T-shaped contoured unilocking titanium radial plate for prophylactic internal fixation of the radial osteocutaneous donor site.

    Science.gov (United States)

    Avery, C M E; Parmar, S; Martin, Tim

    2010-12-01

    The radial osteocutaneous flap retains a limited role in reconstructive maxillofacial surgery The application of prophylactic internal fixation, using straight 3.5 mm plates, has become established to substantially reduce the incidence of fracture at the radial donor site. New lower profile T-shaped 2.4 mm plates and anatomically contoured 3.5 mm plates are now available, both with unilocking screw fixation systems. These plates are easy to apply and allow the removal of up to 50% of the circumference of the radial bone, including the maximum amount of good quality bone from the distal radius. Although there have been no reports of complications as a result of a stress shielding effect with larger plates these refinements in plate design should lessen any remaining concerns.

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

    NARCIS (Netherlands)

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

    1996-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jaiswal Atin

    2013-12-01

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

  4. Angular-stable locking plate fixation of tibial plateau fractures-clinical and radiological midterm results in 101 patients

    Directory of Open Access Journals (Sweden)

    Sven Mardian

    2015-01-01

    Full Text Available Background: Articular reconstruction and stable fixation of tibial plateau fractures and its various subtypes continue to represent a surgical challenge. Only few trials have studied results following angular stable plate fixation. The present study aimed to investigate the clinical, radiological, functional and quality of life results following tibial plateau fractures using angular stable plate fixation. Materials and Methods: 101 patients were retrospectively studied using functional (ROM; KSS; VAS, radiographic (osteoarthritis score, loss of reduction and quality of life (WOMAC; Lysholm scores. There were 46 males and 55 females. The average of patients was 51 years (range 22-77 years. Study groups were assigned according to the AO fracture classification. Results: Mean followup was 57 ± 30 months. Fracture type distribution revealed a significantly (P < 0.001 increased number of type B- (62.4% compared to C-fractures. Functional assessment showed a significantly better total KSS (84.1 ± 15.6 vs. 74.7 ± 18.0; P = 0.01 as well as ROM (active: 124°±17° vs. 116°±15°, P = 0.014; passive: 126°±18° vs. 118 ± 14°, P = 0.017 in the B-fracture group. VAS was found to be markedly higher (P = 0.0039 following type C-fractures. Rating osteoarthritis secondary to a tibial plateau fracture as a function of injury severity (r = 0.485; P < 0.001 and relating the loss of reduction to the grade of evolving osteoarthritis (r = 0.643;P < 0.001 a positive correlation was found. Quality of life showed significantly improved results for Lysholm score (P = 0.004 following B-fractures with low overall values for the WOMAC score. Conclusion: Presented data provide sufficient evidence that anatomic restoration of tibial plateau fractures with angular stable plate fixation result in decreased loss of reduction and declined incidence of posttraumatic osteoarthritis, thereby providing acceptable mid to long term outcome.

  5. Fixation of 3- and 4-part proximal humerus fractures using the PHILOS plate: mid-term results.

    Science.gov (United States)

    Gaheer, Rajinder Singh; Hawkins, Amanda

    2010-09-07

    Treatment of unstable, displaced, and comminuted fractures of the proximal humerus remains challenging, and optimal treatment continues to be controversial. Fifty-six patients with displaced 3- and 4-part fractures of the proximal humerus had open reduction and internal fixation using the proximal humeral internal locking system (PHILOS) plate (Synthes, Stratec Medical Ltd, Mezzovico, Switzerland). Data were collected retrospectively, and clinical and radiological outcomes were assessed. Mean follow-up was 40 months (range, 18-62 months). The study shows that the PHILOS plate gives good results in the treatment of displaced 3- and 4-part fractures of the proximal humerus. Good fracture stability can be achieved early, allowing early mobilization without compromising fracture union. Most importantly, it requires minimal soft tissue dissection, does not need contouring, and gives good stability. No differences were observed in the functional outcomes of patients younger and older than 65 years. Few complications were associated with the plate, and the number of ≥2 surgeries was minimal. The complications noted were 1 case each of superficial wound infection, failure of the plate, and persistent stiffness. One patient had screw perforation of the humeral head articular surface, and 1 had subacromial impingement. Of the 32 patients who had been in active employment before the injury, 28 returned to their previous occupation.

  6. A Novel Shape Memory Plate Osteosynthesis for Noninvasive Modulation of Fixation Stiffness in a Rabbit Tibia Osteotomy Model

    Directory of Open Access Journals (Sweden)

    Christian W. Müller

    2015-01-01

    Full Text Available Nickel-titanium shape memory alloy (NiTi-SMA implants might allow modulating fracture healing, changing their stiffness through alteration of both elastic modulus and cross-sectional shape by employing the shape memory effect (SME. Hypotheses: a novel NiTi-SMA plate stabilizes tibia osteotomies in rabbits. After noninvasive electromagnetic induction heating the alloy exhibits the SME and the plate changes towards higher stiffness (inverse dynamization resulting in increased fixation stiffness and equal or better bony healing. In 14 rabbits, 1.0 mm tibia osteotomies were fixed with our experimental plate. Animals were randomised for control or induction heating at three weeks postoperatively. Repetitive X-ray imaging and in vivo measurements of bending stiffness were performed. After sacrifice at 8 weeks, macroscopic evaluation, µCT, and post mortem bending tests of the tibiae were carried out. One death and one early implant dislocation occurred. Following electromagnetic induction heating, radiographic and macroscopic changes of the implant proved successful SME activation. All osteotomies healed. In the treatment group, bending stiffness increased over time. Differences between groups were not significant. In conclusion, we demonstrated successful healing of rabbit tibia osteotomies using our novel NiTi-SMA plate. We demonstrated shape-changing SME in-vivo through transcutaneous electromagnetic induction heating. Thus, future orthopaedic implants could be modified without additional surgery.

  7. In vivo analysis of acromioclavicular joint motion after hook plate fixation using three-dimensional computed tomography.

    Science.gov (United States)

    Kim, Yoon Sang; Yoo, Yon-Sik; Jang, Seong Wook; Nair, Ayyappan Vijayachandran; Jin, Hyonki; Song, Hyun-Seok

    2015-07-01

    The clavicle hook plate can be used to treat acromioclavicular and coracoclavicular ligament injury or distal clavicular fracture with comminution. However, the hook plate can induce subacromial impingement, resulting in discomfort from the hardware. Our inclusion criteria were (1) men and women aged older than 20 years and (2) the presence of comminuted distal clavicular fractures (Neer type IIB) fixed with a hook plate (Synthes, Oberdorf, Switzerland). Three-dimensional computed tomography was obtained before removal of the hook plate. Seven patients were enrolled prospectively. The mean age was 42 years (range, 24-60 years). Zero degree images and abduction images were obtained. The sagittal cut surface was obtained 5 mm medial from the distal clavicle. The equator of the cut surface of the clavicle was compared with the full abduction model to analyze rotation. The center of the cut surface of the clavicle was compared with the full abduction model to analyze translation. The average difference in rotation of the distal clavicle between both shoulders was 16° (range, 3°-22°; P = .001). The mean difference in anterior translation of the distal clavicle was 2.2 mm (range, -0.7 to 5.6 mm; P = .030). Hook plate fixation at the acromioclavicular joint causes decreased internal rotation and increased anterior translation of the distal clavicle with respect to the medial acromion, indicating that the scapula relative to the thorax has decreased posterior tilting and increased external rotation in shoulders fixed using a hook plate. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  8. Biomechanical interactions of different mini-plate fixations and maxilla advancements in the Le Fort I Osteotomy: a finite element analysis.

    Science.gov (United States)

    Huang, Shao-Fu; Lo, Lun-Jou; Lin, Chun-Li

    2016-12-01

    This study investigates the biomechanical interaction of different mini-plate fixation types (shapes/sizes and patterns) with segmental advancement levels on the Le Fort I osteotomy using the non-linear finite element (FE) approach. Nine models were generated under a standard 1-piece LeFort I osteotomy for advancement with 3, 6 and 9 mm distances and four mini-plates with three fixation patterns including LL, LI, and II patterns placed on the maxillae models by integrating computed tomography images and computer-aided design system. The axial and oblique occlusal forces were 250 N applied to each premolar/molar and 125 N applied at 30° inclination to the tooth long axis and from palatal to buccal, respectively. The relative micro-movement values between the two maxillary bone segments and maximum mini-plate stress increased obviously with maxilla advancement increment and the increasing trend can be fitted by exponential curve. The corresponding values in II mini-plate fixation presented apparently high values in all simulated cases. The mini-plate stress concentration locations were found at the bending regions to increase high fracture risk. The mini-plate yield strength can be mapped to a critical (limited) advancement for three types of fixations for safe consideration. This study concluded that L-shaped mini-plates with lateral fixation are recommended to provide better stability. The risk for mini-plate fracture and bone relapse increases when maxillary advancement is larger than a critical value of 5 mm in the Le Fort I osteotomy.

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

    NARCIS (Netherlands)

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

    2001-01-01

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

  10. Biomechanical comparison of dynamic condylar screw and locking compression plate fixation in unstable distal femoral fractures: An in vitro study

    Directory of Open Access Journals (Sweden)

    Ashutosh Kumar Singh

    2013-01-01

    Full Text Available Background: Distal femur fractures are difficult to manage and the selection of implant for internal fixation remains controversial. The objective of this study is to establish the relative strength of fixation of a distal femoral locking plate (DFLP compared with the dynamic condylar screw (DCS in the distal femur fractures. Materials and Methods: Study was conducted on 16 freshly harvested cadaveric distal femoral specimens, eight implanted with DCS and other eight with DFLP. The construct was made unstable by removing a standard sized medial wedge of 1 cm base (gap-osteotomy beginning 6 cm proximal to the lateral joint line in distal metaphyseal region with the loss of medial buttress. Fatigue test was conducted under load control mode at the frequency of I Hz. Specimens were subjected to cyclic loading of 2 kN, under observation for 50,000 cycles or until failure/cutout, which ever occurred earlier. Results: In DFLP group, there was no implant failure and the average number of cycles sustained was 50,000. Six out of eight specimens completed 50,000 cycles and two failed in DCS group. The average number of cycles sustained by DCS was 46150. Though the bone quality as assessed by dual energy X-ray absorptiometry DEXA was comparable in both DFLP and DCS group ( P = 0.06, none failed in DFLP group and subsidence was 1.02 ± 0.34 mm (range: 0.60-1.32 mm, which was significantly 43% lower ( P = 0.006 than subsidence in DCS group (1.82 ± 0.58; range: 1.20-3.08 mm. The average stiffness of DCS group was 52.8 ± 4.2 N/mm, which was significantly lower than average stiffness of locked condylar plate group (71.2 ± 5.1 N/mm ( P = 0.02. Conclusions: DFLP fixation of the distal femur fractures resulted in stronger construct than the DCS fixation in both cyclic loading and ultimate strength in biomechanical testing of a simulated A3 distal femur fracture.

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

    Directory of Open Access Journals (Sweden)

    S. Hashmi

    2013-03-01

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

  12. Functional Rehabilitation With a Foot Plate Modification for Circular External Fixation

    Science.gov (United States)

    2013-04-05

    neurologic injury,3,5,6,16,19 multiple studies3,5 have suggested that weight bearing in an ankle-spanning circular external fix- ator must be delayed until...the patient has radiographic evi- dence of healing. In the past, many limb salvage patients at our institution witnessed their amputee counterparts...Only 1 patient was able to truly run in his circular exter- nal fixator. There were multiple complications documented that hin- dered the rehabilitation

  13. Cranial fixation plates in cerebral magnetic resonance imaging: a 3 and 7 Tesla in vivo image quality study.

    Science.gov (United States)

    Chen, Bixia; Schoemberg, Tobias; Kraff, Oliver; Dammann, Philipp; Bitz, Andreas K; Schlamann, Marc; Quick, Harald H; Ladd, Mark E; Sure, Ulrich; Wrede, Karsten H

    2016-06-01

    This study assesses and quantifies impairment of postoperative magnetic resonance imaging (MRI) at 7 Tesla (T) after implantation of titanium cranial fixation plates (CFPs) for neurosurgical bone flap fixation. The study group comprised five patients who were intra-individually examined with 3 and 7 T MRI preoperatively and postoperatively (within 72 h/3 months) after implantation of CFPs. Acquired sequences included T1-weighted magnetization-prepared rapid-acquisition gradient-echo (MPRAGE), T2-weighted turbo-spin-echo (TSE) imaging, and susceptibility-weighted imaging (SWI). Two experienced neurosurgeons and a neuroradiologist rated image quality and the presence of artifacts in consensus reading. Minor artifacts occurred around the CFPs in MPRAGE and T2 TSE at both field strengths, with no significant differences between 3 and 7 T. In SWI, artifacts were accentuated in the early postoperative scans at both field strengths due to intracranial air and hemorrhagic remnants. After resorption, the brain tissue directly adjacent to skull bone could still be assessed. Image quality after 3 months was equal to the preoperative examinations at 3 and 7 T. Image quality after CFP implantation was not significantly impaired in 7 T MRI, and artifacts were comparable to those in 3 T MRI.

  14. Analysis of Orbital Volume Measurements Following Reduction and Internal Fixation Using Absorbable Mesh Plates and Screws for Patients With Orbital Floor Blowout Fractures.

    Science.gov (United States)

    Hwang, Won Joo; Lee, Do Heon; Choi, Won; Hwang, Jae Ha; Kim, Kwang Seog; Lee, Sam Yong

    2017-08-22

    Hinge-shaped fractures are common type of orbital floor blowout fractures, for which reduction and internal fixation is ideal. Nonetheless, orbital floor reconstruction using alloplastic materials without reducing the number of bone fragments is the most frequently used procedure. Therefore, this study analyzed and compared the outcomes between open reduction and internal fixation using absorbable mesh plates and screws, and orbital floor reconstruction, by measuring the orbital volume before and after surgery. Among patients with orbital floor blowout fractures, this study was conducted on 28 patients who underwent open reduction and internal fixation, and 27 patients who underwent orbital floor reconstruction from December 2008 to September 2015. The mechanism of injury, ophthalmic symptoms before and after surgery, and the degree of enophthalmos were examined; subsequently, the volumes of the affected and unaffected sides were measured before and after surgery based on computed tomography images. This study compared the degree of recovery in the correction rate of the orbital volume, ophthalmic symptoms, and enophthalmos between the 2 groups. The patients who underwent open reduction and internal fixation, and the patients who underwent orbital floor reconstruction showed average correction rates of 100.36% and 105.24%, respectively. Open reduction and internal fixation showed statistically, significantly superior treatment outcomes compared with orbital floor reconstruction. The ophthalmic symptoms and incidence of enophthalmos completely resolved in both groups. For orbital floor blowout fractures, open reduction and internal fixation using absorbable mesh plates and screws was a feasible alternative to orbital floor reconstruction.

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  17. Open reduction and Internal Fixation of Displaced Proximal Humerus Fractures with AO Stainless Steel T-Plate

    Directory of Open Access Journals (Sweden)

    Hussain S

    2014-03-01

    Full Text Available Background: Proximal humeral fractures are considered the last unsolved fractures in orthopaedics. The treatment is controversial and various operative modalities have been reported in the literature. The aim of the present study was to evaluate functional outcome and complication rate after open reduction and internal fixation of displaced proximal humerus fractures by proximal humerus AO stainless steel Tplate. Twenty-five (25 patients with displaced proximal humerus fractures treated with proximal humerus T-plate between May 2005 and June 2008 were included in the study. Fractures were classified according to the Neer classification into displaced 2-part, 3-part, and 4-part fractures. Patients were followed-up for a minimum period of two years. Functional evaluation was done according to the Neer scoring system. Scores were compared with other studies in the literature using similar implant. Twenty patients had 2-part fracture, four had 3-part fracture, and one had 4-part fracture. Eighty-eight [88% (n = 22] patients had good to excellent result, eight [8% (n = 2] had fair, and four [4% (n = 1] had poor result. Difference in Neer’s score between 2-part and 3-part fractures was not significant. Complications encountered in this series were screw backout in 8% (n = 2, superficial infection in 12% (n= 3, and avascular necrosis in 4% (n = 1 of cases. We conclude that proximal humerus AO T- plate is a cheap and easily available implant, aspects which are particularly relevant in third world countries like India. It gives reliable fixation for 2-part and 3-part fractures. Its use in more complicated fracture patterns of 4-part fractures is not recommended.

  18. Complications and functional outcome after fixation of distal tibia fractures with locking plate - A multicentre study

    DEFF Research Database (Denmark)

    Viberg, Bjarke; Kleven, Silje; Hamborg-Petersen, Ellen

    2016-01-01

    and X-ray images for 6 hospitals (1 level 1, 5 level 2) in the Region of Southern Denmark. Between January 2007 and April 2011 70 consecutive patients with 71 distal tibia fractures were treated with low-profile locking plate were included. The proportion of post-operative complications, classified......INTRODUCTION: The aim of this study was to evaluate the proportion of complications and the functional outcome following ORIF with low-profile locking plates in patients with distal tibia fractures. METHOD: Retrospective data was retrieved using county databases, operation books, health record...... score was 73. Thirty-three percent of working patients had not returned to work as a result of the fracture. CONCLUSIONS: Our study suggest that treatment of distal tibia fractures with low-profile locking plates might have a higher proportion of complications and worse functional outcome than...

  19. Comparison of nail-plate fixation and Ender's nailing for intertrochanteric fractures.

    Science.gov (United States)

    Hall, G; Ainscow, D A

    1981-02-01

    Two comparable groups of patients with fractures of the trochanteric region of the femur were studied. One hundred and sixty-five fractures had been fixed with conventional nail-plates and 132 with Ender's nails. Ender's nails gave superior results in the treatment of trochanteric fractures. The operation was quicker and less traumatic than that using conventional nail-plates and both the mortality rate and the time in hospital were reduced. More patients in the group with Ender's nails who were initially independent returned to an independent existence.

  20. 钢板内固定与外固定架治疗跟骨骨折效果比较%PLATE INTERNAL FIXATION VERSUS EXTERNAL FIXATOR IN THE TREATMENT OF CALCANEAL FRACTURES

    Institute of Scientific and Technical Information of China (English)

    李玉椿; 杨斌; 王振宇

    2012-01-01

    目的 分析比较切开复位钢板内固定和闭合复位外固定架治疗跟骨骨折的效果.方法 钢板内固定组43侧,采用切开复位钢板内固定治疗;外固定架组19侧,采用闭合复位外固定治疗,术后测量Bohler角,按Marry Land评分系统进行效果评定.结果 钢板内固定组优34侧,良6侧,可3侧,优良率93%;外固定架组优14侧,良5侧,优良率100%.两种治疗方法疗效比较差异无显著性(P>0.05).钢板内固定组术后2例出现切口拐角处感染不愈合,1例深部感染.结论 两种方法治疗跟骨关节内骨折均取得满意的疗效,但外固定架治疗跟骨骨折简单易行,降低了手术切口不愈合及神经肌腱损伤的风险,是一种可靠的治疗办法.%Objective To compare the effectiveness between open reduction plus plate internal fixation and closed reduction plus external fixator in the treatment of calcaneal fractures. Methods Forty-three patients with calcaneal fractures were treated with open reduction and internal plate fixation, and 19 received closed reduction plus external fixation. Postoperatively, the Bohler Angle was measured, and the efficacy was assessed according to Marry Land scoring system. Results In plate fixation group: 34 were excellent, six were good, and three were improved, the excellent and good rate being 93%. In external fixation group, 14 were excellent and five were good, the excellent and good rate being 100%. The difference between the two groups was no significant in regard to the two methods of therapy (P>0. 05). In plate fixation group, postoperative infection occurred in two cases and did not heal, one with deep-part infection. Conclusion Both therapies can obtain satisfactory for intra-articular fracture of calcis, but external fixation is simple and easy to perform, being a reliable therapy, which decreases the risk of wound disunion, and injury of nerve and tendon.

  1. Anterior discectomies and interbody cage fusion without plate fixation for 5-level cervical degenerative disc disease: A 5-year follow-up

    Directory of Open Access Journals (Sweden)

    Cheng-Wei Chu

    2011-11-01

    Full Text Available Anterior discectomy and interbody fusion have been proven to be a safe and effective procedure for the treatment of cervical degenerative disc disease. Clinical results for 1- to 4-level interbody cage fusion without plate fixation are encouraging. Five-level cervical interbody cage fusion without plate fixation has not yet been previously reported. We report a 63-year-old female patient suffering from severe pain of the bilateral shoulders and left upper extremity with numbness and weakness of legs. Magnetic resonance imaging showed cervical degenerative disc herniation with cord compression between the levels of C2 and C7. Anterior cervical discectomy and interbody cage fusion without plate fixation were performed. Pain and neurological function improved dramatically after surgery. Asymptomatic subsidence of the cage occurred at the level of C6-7 two months postoperatively with no further progression of subsidence 5 years postoperatively. Good stability of the cages was seen on flexion and extension radiographs 5 years postoperatively. We report the first case with good long-term results of 5-level interbody cage fusion without plate fixation for anterior cervical degenerative disc surgery.

  2. The finite element analysis and clinical significance of through the mouth atlanto-axial vertebral anterior plate fixation

    Institute of Scientific and Technical Information of China (English)

    LI Xiaohe; LI Zhijun; GAO Shang

    2015-01-01

    Objective:To analysis through the mouth atlanto-axial vertebral anterior plate fixation in finite element for the development of the segmental anterior fixation surgery and to provide the reference of inner plant im-provement. Methods:One case, male, 36 years old, 64 kg weight was randomly selected from January 2014 to our hospital to check no-skull - atlanto-axial vertebral disease . It was scanned by 0. 625 mm thin layer, Image data were rebuilted in the Mimics 16. 01 software, Pro/ENGINEER 4. 0 software was used to rebuilt atlanto-axial vertebral anterior plate, After reconstruction of steel screw 3 d model according to the classic through the mouth , the model was imported into Mimics 16. 01 and the model surface was meshed and material was assigned, The mod-el was forced 80 N vertical loading, the surface was applied 15 nm torque, to simulat three motion state example, forward bends, stretch, side-bending, The stress and deformation of screw and rod were measured. Results: At-lanto-axial vertebral three-dimensional reconstruction model were divided into 14 514 individual grid, 7 257 nodes, the model was loaded, The stress of upper screw root in bend was biggest (62. 34 ±5. 52) Mpa (F=73. 23, P<0. 05, the difference was statistically significant). A screw of the root and the top, lateral stress was the largest, respectively were (78. 42 ± 5. 5. 14) Mpa (F=112. 32, P<0. 05);(95. 48 ± 7. 12 Mpa (F=62. 32, P<0. 05), the difference was statistical significance; Under three different motion state and a screw root stress, Upper screw root stress in bending forward was greater than the lower (forward bends, stretch and lateral bending state , t value were 12. 2, 9. 23, 22. 98, P<0. 05, differences were statistically significant), and in the lateral current screw root stress was greater than the upper; In the same movement state, the top was greater than the root, the differences were statistically significant (forward bends, stretch and lateral bending state after

  3. THE FUNCTIONAL OUTCOME OF LOCKING VS NON-LOCKING DUAL PLATE FIXATION IN INTRAARTICULAR FRACTURE DISTAL END HUMERUS: A RETROSPECTIVE COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Manish Bairagi

    2016-07-01

    Full Text Available BACKGROUND Despite all advances in treatment, it is a challenge to most of the orthopaedic surgeons to give better result in the management of distal end humerus intra-articular fractures, because it has complex anatomy. This study has been done to evaluate the functional outcome of double plate fixation with right angle to each other for intra-articular fracture of distal end humerus and compared with locking vs non-locking plate fixation. AIM This study has been done to evaluate the functional outcome of double plate fixation with right angle to each other for intraarticular fracture of distal end humerus with comparison of locking and non-locking plate fixation. METHODS This is retrospective comparative study done between 2006 and 2014 in the Department of Orthopaedics, G.R. Medical College and J.A. Group of Hospital, Gwalior (M.P., India. All patients who were presented to Department of Orthopaedics with intra-articular fracture, distal end humerus fracture, medically fit patient who were of age group between 18-80 years of age with close or type 1 GA (Gustilo Anderson compound fracture and fracture type AO type C were included. Other patients who sustained GA type 2 and 3, severely comminuted and severe osteoporotic bone were excluded. RESULT A total no. of 60 patients. The age of patients ranged from 22 to 65 years. To classifying according to AO classification, 15 cases were of type C1, 39 were of type C2 and 06 were of type C3. The results were rated using Jupiter’s criteria as excellent in 26 (43.3% cases, good in 16 (26.7%, fair in 11 (18.3% cases and poor in 07 (11.7%. CONCLUSION Double plate fixation is standard and effective method of treating intra-articular fracture of distal humerus, the method gives a stable fixation and allow early mobilization of elbow joint without risk of implant failure. In the study, there is no much advantage from the locking plate fixation in comparison with the non-locking plates.

  4. 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.

  5. Metaphyseal locking plate as a definitive external fixator for treating open tibial fractures--clinical outcome and a finite element study.

    Science.gov (United States)

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

    2013-08-01

    We evaluated both the outcome of using a locking plate as a definitive external fixator for treating open tibial fractures and, using finite element analysis, the biomechanical performance of external and internal metaphyseal locked plates in treating proximal tibial fractures. Eight open tibial patients were treated using a metaphyseal locked plate as a low-profile definitive external fixator. Then, finite element models of internal (IPF) as well as two different external plate fixations (EPFs) for proximal tibial fractures were reconstructed. The offset distances from the bone surface to the EPFs were 6 cm and 10 cm. Both axial stiffness and angular stiffness were calculated to evaluate the biomechanical performance of these three models. The mean follow-up period was 31 months (range, 18-43 months). All the fractures united and the mean bone healing time was 37.5 weeks (range, 20-52 weeks). All patients had excellent or good functional results and were walking freely at the final follow-up. The finite element finding revealed that axial stiffness and angular stiffness decreased as the offset distance from the bone surface increased. Compared to the IPF models, in the two EPF models, axial stiffness decreased by 84-94%, whereas the angular stiffness decreased by 12-21%. The locking plate used as a definitive external fixator provided a high rate of union. While the locking plate is not totally rigid, it is clinically stable and may be advisable for stiffness reduction of plating constructs, thus promoting fracture healing by callus formation. Our patients experienced a comfortable clinical course, excellent knee and ankle joint motion, satisfactory functional results and an acceptable complication rate.

  6. Efficacy of radial styloid targeting screws in volar plate fixation of intra-articular distal radial fractures: a biomechanical study in a cadaver fracture model

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    Yamashita Toshihiko

    2010-12-01

    Full Text Available Abstract Background The locking screws target the radial styloid, theoretically provide greater stability against radial styloid fragment. However, it is unknown whether the radial styloid locking screws increased the stability of the volar plating system fixation along the entire distal radius or not. In this study, we evaluated the stability of the volar plating system fixation with or without the radial styloid screws using a biomechanical study in a cadaver fracture model. Methods Six matched pairs of fresh-frozen human cadaver wrists complete from the proximal forearm to the metacarpal bones were prepared to simulate standardized 3-part intra-articular and severe comminuted fractures. Specimens were fixed using the volar plating system with or without 2 radial styloid screws. Each specimen was loaded at a constant rate of 20 mm/min to failure. Load data was recorded and, ultimate strength and change in gap between distal and proximal fragments were measured. Data for ultimate strength and screw failure after failure loading were compared between the 2 groups. Results The average ultimate strength at failure of the volar plate fixation with radial styloid screws (913.5 ± 157.1 N was significantly higher than that without them (682.2 ± 118.6 N. After failure loading, the average change in gap between the ulnar and proximal fragment was greater than that between the radial and proximal fragment. The number of bent or broken screws in ulnar fragment was higher than that in radial fragment. The number of specimens with bent or broken screws in cases with radial styloid screws was fewer than that in the fixation without radial styloid screws group. Conclusion The ulnar fragment is more intensively stressed than the radial fragment under axial loading of distal radius at full wrist extension. The radial styloid screws were effective in stable volar plate fixation of distal radial fractures.

  7. Outcome Analysis of Intra-Articular Scapula Fracture Fixation with Distal Radius Plate: A Multicenter Prospective Study

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    Panigrahi

    2016-08-01

    Full Text Available Background Scapula fractures occur in approximately 1% of all fractures and constitute about 3% - 5% of all injuries of the shoulder joint. Objectives This study aimed to evaluate the clinical outcomes of 20 surgically treated patients with displaced glenoid fractures after stabilization with distal radius plate. Methods Between 2012 and 2015, at 2 centers (HMCH & SHCE of Bhubaneswar Odisha, we stabilized 20 scapular intra-articular fractures surgically with distal radius locking plate and studied the outcome of the surgeries. The outcome of the 20 fractures was determined using the Constant and Murley score. Both shoulders were assessed and the score on the injured side was given as a percentage of that on the uninjured side. Results The median score was 88% (mean 65%, range 30 to 100. The median score for strength was 21/25 (mean 19, range 0 to 25 and that for pain 11/15 (mean 11, range 5 to 15. The median functional score was 16/20 (mean 15, range 0 to 20. The mean range of active abduction of the shoulder was 135° (20 to 180, the mean range of flexion 138° (20 to 180 and the mean range of external rotation 38° (0 to 100. Five patients showed excellent result; 11 patients showed good result; three patients showed fair result and one patient had poor outcome according to the Constant-Murley score. A superficial infection settled with antibiotics after operation in one patient whose score at final follow-up was 96%. In one patient, delayed healing was reported because of infection. One patient with stiffness of the shoulder at six weeks underwent manipulation under anesthesia with a follow-up score of 81%. Conclusions Various fixation modalities have been described in the literature, however fixation of intra-articular fracture of glenoid with distal radius locking plate for articular reconstruction in the presented series provides good functional outcome with early restoration of the range of motion of the shoulder.

  8. Screw augmentation reduces motion at the bone-implant interface: a biomechanical study of locking plate fixation of proximal humeral fractures.

    Science.gov (United States)

    Schliemann, Benedikt; Seifert, Robert; Rosslenbroich, Steffen B; Theisen, Christina; Wähnert, Dirk; Raschke, Michael J; Weimann, Andre

    2015-12-01

    Shear forces at the bone-implant interface lead to a loss of reduction after locking plate fixation of proximal humeral fractures. The aim of the study was to analyze the roles of medial support screws and screw augmentation in failure loads and motion at the bone-implant interface after locking plate fixation of proximal humeral fractures. Unstable 3-part fractures were simulated in 6 pairs of cadaveric humeri and were fixed with a DiPhos-H locking plate (Lima Corporate, Udine, Italy). An additional medial support screw was implanted in 1 humerus of every donor. The opposite humerus was stabilized with a medial support screw and additional bone cement augmentation of the 2 anteriorly directed head screws. Specimens were loaded in the varus bending position. Stiffness, failure loads, plate bending, and the motion at the bone-implant interface were evaluated using an optical motion capture system. The mean load to failure was 669 N (standard deviation [SD], 117 N) after fixation with medial support screws alone and 706 N (SD, 153 N) after additional head screw augmentation (P = .646). The initial stiffness was 453 N/mm (SD, 4.16 N/mm) and 461 N/mm (SD, 64.3 N/mm), respectively (P = .594). Plate bending did not differ between the 2 groups. However, motion at the bone-implant interface was significantly reduced after head screw augmentation (P Board of Trustees. Published by Elsevier Inc. All rights reserved.

  9. Number and locations of screw fixation for volar fixed-angle plating of distal radius fractures: biomechanical study.

    Science.gov (United States)

    Mehling, Isabella; Müller, Lars P; Delinsky, Katharina; Mehler, Dorothea; Burkhart, Klaus J; Rommens, Pol M

    2010-06-01

    To compare the biomechanical properties of different numbers and locations of screws in a multidirectional volar fixed-angle plate in a distal radius osteotomy cadaver model. We created an extra-articular fracture in 16 pairs of fresh-frozen human cadaver radiuses. The 32 specimens were randomized into 4 groups. All fractures were fixated with a multidirectional volar fixed-angle plate. We tested 4 different screw-placement options in the distal fragment. The distal fragment was fixed with 4 locking screws in the distal row of the plate in group a, and with 4 locking screws alternately in the distal and proximal rows in group b. In group c, 3 locking screws were used in the proximal row; in group d, 7 locking screws were used, filling all screw holes in the distal and proximal rows of the plate. The proximal fragment was fixed with 3 screws. The specimens were loaded with 80 N under dorsal and volar bending and with 250 N axial loading. Finally, load to failure tests were performed. Group d had the highest mean stiffness, 429 N/mm under axial compression, and was statistically significantly stiffer than the other groups. Group b had a mean stiffness of 208 N/mm, followed by group a, with 177 N/mm. Group c showed only a mean stiffness of 83 N/mm under axial compression. There were no statistically significant differences under dorsal and volar bending. In this model of distal radial fractures, there was a difference regarding the stiffness and the placement of screws in the distal rows of a volar fixed-angle plate. Inserting screws in all available holes in the distal fragment offered the highest stability. Using only the proximal row with 3 screws created an unstable situation. Based on these findings, we recommend placing at least 4 screws in the distal fragment and assigning at least 2 screws to the distal row of the multidirectional screw-holes. Copyright 2010 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

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

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    Biju

    2015-05-01

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

  11. Distal Femoral Locking Compression Plate Fixation in Distal Femoral Fractures: Early Results

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    EJ Yeap

    2007-05-01

    Full Text Available We conducted a retrospective review on eleven patients who were treated for Type A and C distal femoral fractures (based on AO classification between January 2004 and December 2004. All fractures were fixed with titanium distal femoral locking compression plate. The patient’s ages ranged from 15 to 85 with a mean of 44. Clinical assessment was conducted at least 6 months post-operatively using the Schatzker scoring system. Results showed that four patients had excellent results, four good, two fair and one failure.

  12. [Humerus varus: correction by proximal valgus osteotomy with precontourned plate fixation in children].

    Science.gov (United States)

    Tallón-López, J; Domínguez-Amador, J J; Andrés-García, J A

    2014-01-01

    Varus deformity of the proximal humerus in children is a little known pathology due to its low incidence of presentation. Progress has been made in recent years in understanding the possible etiology and pathophysiological causes. Radiological criteria for diagnosis and functional impairment that occurs have also been defined. However, there are few reports in the literature about the surgical treatment of this deformity in children. In this paper we present a case of surgical treatment of this deformity by corrective osteotomy fixed with precontoured external maleolar plate osteosynthesis. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

  13. Hybrid Decompression and Fixation Technique Versus Plated 3-Vertebra Corpectomy for 4-Segment Cervical Myelopathy: Analysis of 81 Cases With a Minimum 2-Year Follow-Up.

    Science.gov (United States)

    Odate, Seiichi; Shikata, Jitsuhiko; Kimura, Hiroaki; Soeda, Tsunemitsu

    2016-07-01

    A retrospective comparative study. The purpose of this study was to compare the stability and outcomes of a hybrid technique with those of a 3-vertebra corpectomy in the management of 4-segment cervical myelopathy. Patients with primarily ventral disease and loss of cervical lordosis are considered good candidates for anterior surgery. Cervical corpectomy is commonly performed in patients with multilevel cervical myelopathy. Corpectomies including >3 vertebraes entail an extremely high risk of reconstruction failure. To avoid the need to perform a 3-vertebra corpectomy, we use a hybrid decompression and fixation technique. This hybrid technique is a technique to obtain optimum decompression and fixation in patients with multilevel cervical myelopathy. A total of 81 patients with multilevel cervical myelopathy who underwent 4-segment cervical fixation with a minimum 2-year follow-up were included. The hybrid technique involved combining a plated 2-vertebra corpectomy and single-level discectomy with stand-alone cage fixation. This technique was performed in 39 patients, and the plated 3-vertebra corpectomy was performed in 42 patients. Nine patients (21%) who underwent the plated 3-vertebra corpectomy were treated with halo immobilization, but no patient in the hybrid group required this treatment (P=0.002). There were fewer instances of reconstruction failure in the hybrid group than in the 3-vertebra corpectomy group (0% vs. 10%, respectively; P=0.048) and fewer instances of C5 palsy (3% vs. 17%, respectively; P vertebra corpectomy for 4-segment cervical fixation: a shorter graft bone and plate are required; the fixed segment has greater initial stability; postoperative external immobilization is simplified; and the risk of reconstruction failure and postoperative C5 palsy is reduced markedly.

  14. Sixty-two severe and critical patients with 2009 influenza A (H1N1) in Shanghai, China

    Institute of Scientific and Technical Information of China (English)

    LIU Li; ZHANG Ren-fang; LU Hong-zhou; LU Shui-hua; HUANG Qin; XIONG Yan-ying; XI Xiu-hong; ZHANG Zhi-yong

    2011-01-01

    Background Pandemic influenza A (H1N1) emerged rapidly in China in May 2009. Preliminary comparisons with seasonal influenza suggest that pandemic 2009 influenza A (H1N1) disproportionately affects younger ages and causes generally mild disease. To characterize disease progress, comorbidities, and treatment outcomes among consecutive severe and critically ill patients in a hospital served as a reference center for the care of patients with H1N1 in Shanghai,China.Methods A retrospective study on 62 severe and critically ill patients with 2009 influenza A (H1N1) was conducted in Shanghai Public Health Clinical Center. Demographic data, symptoms, comorbidities, disease progression, treatments,and clinical outcomes were collected for analysis.Results Sixty-two severe or critically ill patients were admitted to the hospital with confirmed 2009 influenza A (H1N1) infection. The median age of the study cohort was 40 years old with a range from 18 years to 75 years, and 67.7% were males. All patients presented with fever and respiratory symptoms. At presentation, 34 patients (54.8%) had comorbidities such as smoking (29.0%), hypertension (29.0%) and hepatitis B virus infection (9.7%). The median time from symptom onset to hospital admission was 6 days (interquartile-range 3-14 days) and 23 critically ill patients were admitted to Intensive Care Unit after admission. All the patients received neuraminidase inhibitors (oseltaminir), while 60 patients (96.7%) were treated with antibiotics, and 39 (62.9%) with corticosteroids. Twenty-three critical cases received noninvasive mechanical ventilation on the first day of admission, and 3 of them ultimately required invasive ventilation.Four death reports (6.5%) were filed within the first 14 days from the onset of critical illness with the primary causes of severe acute respiratory distress syndrome, hypoxemia, or complications, secondary infection and sepsis,pyopneumothorax and stroke.Conclusions Severe illness from 2009

  15. Complications and functional outcome after fixation of distal tibia fractures with locking plate - A multicentre study

    DEFF Research Database (Denmark)

    Viberg, Bjarke; Kleven, Silje; Hamborg-Petersen, Ellen;

    2016-01-01

    INTRODUCTION: The aim of this study was to evaluate the proportion of complications and the functional outcome following ORIF with low-profile locking plates in patients with distal tibia fractures. METHOD: Retrospective data was retrieved using county databases, operation books, health record...... as minor and major complications, was retrieved from electronic health records and patient interviews. Long-term functional outcome assessed by EuroQol EQ-5D-5L questionnaire, AOFAS Ankle-Hindfoot scale, and return to pre-injury job function through patient interview and examination. RESULTS: There were 32...... 43A, 5 43B and 34 43C-fractures, 12 open and 10 high-energy fractures. Forty-nine cases (69%) experienced complications during the follow-up time, of which 34 were minor complications and 15 were major complications. Median EQ-5D-5L index value was 0.76, median EQ VAS-score was 80, and median AOFAS...

  16. Radiographic evaluation of fracture healing after rigid plate fixation. Experiments in the rabbit

    Energy Technology Data Exchange (ETDEWEB)

    Paavolainen, P.; Karaharju, E.; Slaetis, P.; Waris, P. (Helsinki Univ. Central Hospital (Finland). Meilahti Clinic)

    1981-01-01

    Experimental osteotomies were made in 35 rabbit tibio-fibular bones and fixed with rigid stainless steel osteosynthesis plates (DCP/ASIF). The radiographic and histopathologic appearances in the healing osteotomies and adjacent bone were analysed at intervals from 3 up to 24 weeks postoperatively. Radiologically the osteotomy had closed at 9 weeks and microscopically this could be confirmed as longitudinal orientation of the cutter heads across the osteotomy gap with longitudinal orientation of the bone structure. The healing of the osteotomy was accompanied by gross structural changes in the adjacent cortical bone with loss of intracortical and subendosteal osteons, cementing lines and intermediate tissue between the osteons. This was characterized by decreasing attenuation of the cortical bone after healing of the osteotomy and should clinically be regarded as an indication for removal of the implant.

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

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    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.

  18. Conservative treatment, plate fixation, or prosthesis for proximal humeral fracture. A prospective randomized study

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    Launonen Antti P

    2012-09-01

    Full Text Available Abstract Background Proximal humerus fracture is the third most common fracture type after hip and distal radius fracture in elderly patients. A comprehensive study by Palvanen et al. demonstrated an increase in the annual fracture rate of 13.7% per year over the past 33 years. Should this trend continue, the fracture rate would triple over the next three decades. The increasing incidence of low-energy fractures raises questions about the optimal treatment in terms of functional outcome, pain, and rehabilitation time, as well as the economical impact. Despite the high incidence and costs of proximal humerus fractures, there is currently no valid scientific evidence for the best treatment method. Several publications, including a Cochrane review outline the need for high-quality, well-designed randomized controlled trials. Methods/Design The study is a prospective, randomized, national multi-center trial. The hypothesis of the trial is that surgical treatment of displaced proximal humerus fractures achieves better functional outcome, pain relief, and patient satisfaction compared to conservative treatment. The trial is designed to compare conservative and surgical treatment of proximal humerus fractures in patients 60 years and older. The trial includes two strata. Stratum I compares surgical treatment with locking plates to conservative treatment for two-part fractures. Stratum II compares multi-fragmented fractures, including three- and four-part fractures. The aim of Stratum II is to compare conservative treatment, surgical treatment with the Philos locking plate, and hemiarthroplasty with an Epoca prosthesis. The primary outcome measure will be the Disabilities of the Arm, Shoulder and Hand (DASH score and the secondary outcome measures will be the EuroQol-5D (EQ-5D value, OSS, Constant-Murley Score, VAS, and 15D. Recruiting time will be 3 years. The results will be analyzed after the 2-year follow-up period. Discussion This publication

  19. Functional Recovery Following Pertrochanteric Hip Fractures Fixated with the Dynamic Hip Screw vs. the Percutaneous Compression Plate

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    Yocheved Laufer

    2005-01-01

    Full Text Available The Dynamic Hip Screw (DHS is currently the most frequently used implant for the treatment of pertrochanteric hip fractures. The Percutaneous Compression Plate (PCCP is a recently developed, alternative device that involves minimal invasive surgery. The objective of the present study was to compare functional recovery following these two surgical procedures. A total of 76 consecutive elderly subjects (mean age and standard deviation, 80.6 ± 5.5 following pertrochanteric hip fracture fixation were evaluated prospectively. Functional recovery was assessed 3 and 12 weeks and 2 years following surgery. Differences between groups 3 weeks postsurgery were found only in pain level during ambulation and in the weight-bearing capability of the operated extremity, which were both in favor of the PCCP. By 3 months, both groups had improved in all measures, but did not reach their preinjury level of independence. However, the PCCP group ambulated with fewer assistive devices and demonstrated better recovery of basic activities of daily living (BADL. While the majority of the subjects from both groups ambulated independently 2 years postsurgery, the PCCP group exhibited less pain during ambulation, was more independent in ADL, and required fewer assistive devices for ambulation. To summarize, the PCCP presents enhanced short- and long-term recovery of functional abilities in comparison to DHS. However, given the limited number of patients, further studies are necessary to substantiate these results.

  20. Recurrent sternal infection following treatment with negative pressure wound therapy and titanium transverse plate fixation.

    Science.gov (United States)

    Gaudreau, Geneviève; Costache, Victor; Houde, Chanel; Cloutier, Daniel; Montalin, Livia; Voisine, Pierre; Baillot, Richard

    2010-04-01

    To provide a definition for recurrent sternal infection (RSI), analyse the risk factors and describe the management of this complication following treatment of deep sternal wound infection (DSWI) with horizontal titanium sternal osteosynthesis and coverage with pectoralis major myocutaneous flaps. Between 2002 and 2007, 10665 patients were submitted to open-heart surgery (OHS) in our institution, of whom 149 (1.4%) developed a DSWI. Negative pressure wound therapy (NPWT) followed by sternal osteosynthesis with musculocutaneous coverage was used in 92 (61.7%) patients. A retrospective review was done using a prospectively maintained database to identify risk factors for recurrent infection in this group of patients. Of the 92 patients who underwent sternal osteosynthesis, nine (9.8%) developed recurrent sternal infection requiring hardware removal. Univariate analysis showed that preoperative methicillin-resistant Staphylococcus aureus (MRSA) status (33.3% vs 6.1%; p=0.03) and prolonged intubation time in ICU (44.4% vs 14.6%; pMRSA preoperative status as a significant predictor of RSI and/or persistent infection. Chest-wall integrity in patients with RSI can be maintained after hardware removal, even after only a few weeks following initial plating. Copyright (c) 2009 European Association for Cardio-Thoracic Surgery. All rights reserved.

  1. Mini-plate versus Kirschner wire internal fixation for treatment of metacarpal and phalangeal fractures in Chinese Han population: a meta-analysis.

    Science.gov (United States)

    Xu, Jiaming; Zhang, Changqing

    2014-04-11

    This meta-analysis aimed to compare the therapeutic effect of mini-plate versus Kirschner wire (K-wire) internal fixation on the treatment of metacarpal and phalangeal fractures among Chinese Han population. Databases of China National Knowledge Infrastructure (CNKI), Wanfang, Chinese VIP, PubMed, and Embase were retrieved for studies on mini-plate (case group) versus K-wire (control group) internal fixation for the treatment of metacarpal and phalangeal fractures among Chinese Han population. The odds ratio (OR) and standardized mean difference (SMD) at 95% confidence interval (CI) were used for estimating the effects of dichotomous data and continuous data, respectively. All statistical analyses were performed by Review Manager 5.2 software. A total of 18 studies involving 1,375 metacarpal or phalangeal fracture patients (709 cases and 666 controls) were included in the meta-analysis. There were significant differences in fracture healing time (SMD = -1.28; 95% CI: -1.81, -0.76), postoperative infection rate (OR = 0.25; 95% CI: 0.16, 0.39), complication incidence (OR = 0.24; 95% CI: 0.15, 0.38), and surgery time (SMD = 1.57; 95% CI: 0.76, 2.37) between the case and the control group, while no significant difference was found in hospital stays between these two groups (SMD = 0.43; 95% CI: -0.34, 1.20; P = 0.27). For the treatment of metacarpal or phalangeal fracture among Chinese Han population, mini-plate has advantages of shorter healing time and lower infection rate and complication incidence compared with K-wire internal fixation, while a longer surgery time than K-wire. In conclusion, mini-plate is prior than K-wire internal fixation for the treatment of metacarpal or phalangeal fracture among Chinese Han population.

  2. Novel pedicle screw and plate system provides superior stability in unilateral fixation for minimally invasive transforaminal lumbar interbody fusion: an in vitro biomechanical study.

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    Jie Li

    Full Text Available This study aims to compare the biomechanical properties of the novel pedicle screw and plate system with the traditional rod system in asymmetrical posterior stabilization for minimally invasive transforaminal lumbar interbody fusion (MI-TLIF. We compared the immediate stabilizing effects of fusion segment and the strain distribution on the vertebral body.Seven fresh calf lumbar spines (L3-L6 were tested. Flexion/extension, lateral bending, and axial rotation were induced by pure moments of ± 5.0 Nm and the range of motion (ROM was recorded. Strain gauges were instrumented at L4 and L5 vertebral body to record the strain distribution under flexion and lateral bending (LB. After intact kinematic analysis, a right sided TLIF was performed at L4-L5. Then each specimen was tested for the following constructs: unilateral pedicle screw and rod (UR; unilateral pedicle screw and plate (UP; UR and transfacet pedicle screw (TFS; UP and TFS; UP and UR.All instrumented constructs significantly reduced ROM in all motion compared with the intact specimen, except the UR construct in axial rotation. Unilateral fixation (UR or UP reduced ROM less compared with the bilateral fixation (UP/UR+TFS, UP+UR. The plate system resulted in more reduction in ROM compared with the rod system, especially in axial rotation. UP construct provided more stability in axial rotation compared with UR construct. The strain distribution on the left and right side of L4 vertebral body was significantly different from UR and UR+TFS construct under flexion motion. The strain distribution on L4 vertebral body was significantly influenced by different fixation constructs.The novel plate could provide sufficient segmental stability in axial rotation. The UR construct exhibits weak stability and asymmetrical strain distribution in fusion segment, while the UP construct is a good alternative choice for unilateral posterior fixation of MI-TLIF.

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

    Science.gov (United States)

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

    2015-04-01

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

  4. The Clinical Usefulness of Ultrasound-Aided Fixation Using an Absorbable Plate System in Patients with Zygomatico-Maxillary Fracture

    Directory of Open Access Journals (Sweden)

    Jong Hun Lee

    2013-07-01

    Full Text Available Background  Ultrasound-aided fixation is a recently developed alternative method of treatment of zygomatico-maxillary (ZM fracture, and it can resolve the problems of excessivetorsion force and subsequent fractures of screws. We conducted this study to evaluate theclinical usefulness of ultrasound-aided fixation as compared with the conventional fixationmethod using a drill and an expanderin patientswith ZMfracture.Methods  We conducted a retrospective study in 35 patientswith ZMfracturewho had beentreated at our hospital during a period ranging fromMarch of 2008 toDecember of 2010. Wedivided them into two groups: an ultrasound-aided fixation group, comprising 13 patientswho underwent ultrasound-aided fixation (SonicWeld Rx, KLS Martin, and a conventionalgroup, comprising 22 patients who underwent conventional fixation (Biosorb FX, LinvatecBiomaterials Ltd.. We compared such variables as sex, direction, age at operation, follow-upperiod, operation duration, number of fixed holes, and time to discharge between the twogroups.Results  The ultrasound-aided fixation reduced the operation duration by about 30 minutesas comparedwith that of conventional fixation. Therewas no significant difference in followup period, number of fixed holes, ortime to discharge between the two groups. Furthermore,therewere no complicationsin either group.Conclusions  The ultrasound-aided fixation offractured ZMbone using an absorbable implantsystemissafe and effective in promptly reducing the bone fracture and providing satisfactorycosmetic outcomes overtime.

  5. 髓内固定与钉板固定治疗股骨粗隆间骨折的疗效比较%A comparison study of intramedullary fixation and screw-plate fixation treatment on intertrochanteric fracture

    Institute of Scientific and Technical Information of China (English)

    孔祥安; 董力军; 金韡

    2014-01-01

    目的:对比观察两种方法(髓内固定系统和钉板固定系统)治疗股骨粗隆间骨折的临床疗效,为临床推广作出指导。方法选择53例股骨粗隆间骨折患者为研究对象,按手术方法分为髓内组和钉板组,髓内组采用髓内固定系统治疗,钉板组采用钉板固定系统治疗,比较两组患者术中、术后的各项指标以及治疗后的临床疗效。结果①两组患者术中、术后各项指标的比较:髓内组术中、术后各项指标均优于钉板组,其结果比较差异有统计学意义(P<0.05);②两组患者临床疗效的比较:髓内组的优良率为88.89%,钉板组的优良率为88.57%,其结果比较差异无统计学意义( P>0.05)。结论髓内固定系统和钉板固定系统治疗股骨粗隆间骨折的临床疗效均较好,但髓内固定系统具有切口小、出血少和恢复快等优势。%Objective To explore two different internal fixation methods ,intramedullary fixation system and screw -plate fixation system for the treatment of intertrochanteric fractures ,in order to direct the clinical application .Methods From Jan.2007 to May 2013,53 cases of intertrochanteric fractures were retrospectively studied ,and the patients were divided into two groups:the intramedullary fixation group and the screw-plate fixation group .Procedure related index and postoperative recover situation of the two groups were compared .Results ①Procedure related index in the intramedullary fixation group were better than those of the screw -plate fixation group with a statistically signifi-cant difference(P0.05).Conclusion Both of the two treatment methods for intertrochanteric fractures can get excellent clinical efficacy .However,the intramedullary fixation system has advantages in smaller surgical injury ,less blood loss and faster recovery ,which is worth clinical application .

  6. The Use of Calcaneal Anatomic Plate in Arthroscopically-assisted Open Reduction and Internal Fixation of Intra-articular Calcaneal Fractures

    Institute of Scientific and Technical Information of China (English)

    WANG Hong; ZHANG Qingsong; DUAN Deyu; YAN Lijun

    2006-01-01

    To discuss and evaluate the method and effect of using calcaneal anatomic plate in treatment of intra-articular fractures of the calcaneus with assistant of arthroscope, 86 intra-articular fractures of the calcaneus in 78 patients were reduced by open reduction, and rigid fixation was made with calcaneal anatomic plate under assistant of arthroscope. The average follow-up duration was 18 months (range 12-30 months). The effect of treatment was evaluated according to AOFAS and X-ray before and after operation. The results showed that 86 patients have obtained satisfactory reduction according to X-ray, and there was significant difference before and after operation (P<0.01), the total excellent and fine rate was 91.86 %. Treating intra-articular fractures of the calcaneus with calcaneal anatomic plate under arthroscope may provide more chance to achieve anatomical reconstruction, which can lead to satisfied recovery of function and few complication.

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

    Institute of Scientific and Technical Information of China (English)

    管志海; 王勤业; 王以进; 罗亚平; 常小波; 冯夏莺

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    K T Madhukar

    2012-01-01

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

  9. Anterior subaxial cervical spine fixation using a plate with single screw per vertebral body: A simple and efficient construct - Clinical series and a cadaver study

    Directory of Open Access Journals (Sweden)

    Vannemreddy Prasad

    2009-01-01

    Full Text Available Objective: To report our experience with a novel construct for traumatic and nontraumatic cervical spine lesions that was validated by biomechanical studies of cadaver cervical spine. Study Design: Consecutive cases of anterior cervical spine fixation performed over six years reviewed for stability offered by a construct comprising of a plate fixed by a single screw to each vertebral body. Setting: A university hospital and a biomechanical lab. Materials and Methods: Data were coded and entered into a statistical worksheet for multivariate analysis. Cadaver spine models applied for biomechanical study of stability. Results: Total of 103 cases reviewed; 86 with single-level disease; traumatic in 66 (64% cases and degenerative in 33 (32% cases, including hard disks, OPLL, and spondylitis (4% with other causes. Fixation was with diskectomy in 59 and with corpectomy in 40. A bone graft was utilized for fusion in 87 and a bone-filled titanium spacer in 13. A single screw was placed in each vertebral body with a locking plate (having linear arrangement of holes. This construct remained strong in 95% of cases at the end of 6-24 months. Five cases failed requiring reoperation. Five patients with cervical spinal cord injury (SCI died. On statistical analysis, construct was stronger with diskectomy compared with corpectomy. Construct used on cadavers confirmed the biomechanical stability in short segment fixation (C5-6. Conclusion: A conservative construct utilizing a single screw per vertebral body and a one-holed plate system appears to be strong enough to afford stability in both traumatic and nontraumatic lesions of subaxial cervical spine, comparable to others.

  10. 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.

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

    Institute of Scientific and Technical Information of China (English)

    李忠哲; 易传军; 胡琪; 田光磊

    2009-01-01

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

  12. Clavicle hook plate fixation for displaced lateral-third clavicle fractures (Neer type II): a functional outcome study.

    LENUS (Irish Health Repository)

    Good, Daniel W

    2012-08-01

    Controversy exists with the use of the acromioclavicular hook plate for the treatment of lateral-third clavicle fractures (Neer type II). This is thought to stem from problems associated with the hook plate causing impingement symptoms, which can cause long-term limitation of movement and pain. Our aim was to evaluate the functional outcomes of patients with lateral-third clavicle fractures treated with the hook plate.

  13. Comparison of functional outcomes of total elbow arthroplasty vs plate fixation for distal humerus fractures in osteoporotic elbows.

    Science.gov (United States)

    Egol, Kenneth A; Tsai, Peter; Vazques, Oscar; Tejwani, Nirmal C

    2011-02-01

    Treating intra-articular fractures about the osteoporotic distal humerus poses a significant challenge. The purpose of this retrospective study was to evaluate functional outcomes for distal humeral fractures treated with total elbow arthroplasty (TEA) or open reduction and internal fixation (ORIF) in a nonarthritic elderly population with osteoporosis. We reviewed the records of all women older than age 60 who had undergone surgical treatment for intraarticular distal humerus fractures (Orthopaedic Trauma Association types 13B and 13C) by 1 of 2 surgeons. Demographic and operative data were obtained, charts were reviewed, and patients were asked to have their outcomes evaluated with the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and the Mayo Elbow Performance Index (MEPI). Twenty-two patients (23 elbows) were identified, and 2 of these (3 elbows) were excluded. Of the remaining 20 patients, 9 had undergone cemented, semiconstrained TEA as initial treatment, and 11 had undergone ORIF. These 2 groups were compared. Mean follow-up was 14.8 months (range, 6-38 months). There were no significant differences between the TEA and ORIF groups with respect to demographic factors. Final elbow range of motion was 92° flexion-extension arc (arthroplasty group) and 98° (fixation group). Two patients in the arthroplasty group and 2 in the fixation group died. For the remaining patients, mean DASH scores were 30.2 (arthroplasty) and 32.1 (fixation), and mean MEPI scores were 79 (arthroplasty) and 85 (fixation). These differences were not statistically significant. Four TEAs developed radiographic loosening by a mean of 15 months, and 1 of these underwent revision with good outcome. Ten of the 11 fractures in the fixation group healed radiographically; the 1 nonunion with collapse continued to be asymptomatic. Two patients in the fixation group underwent contracture release after union for limited elbow range of motion. Many factors come into play in the

  14. Clinical and radiological results of fixation of acromioclavicular joint dislocation by hook plates retained for more than five months.

    Science.gov (United States)

    Jafary, Dawood; Keihan Shokouh, Hassan; Najd Mazhar, Farid; Shariat Zadeh, Human; Mochtary, Tahmineh

    2014-04-01

    Hook plates are used to treat acromioclavicular joint dislocations. Our study took into consideration the patients' outcome following treatment with clavicular hook plates retained for more than five months. Our aim was to assess the response to treatment of acromioclavicular joint dislocation by clavicular hook plate when retained for more than five months. We treated 24 patients who had acromioclavicular joint dislocation with a clavicular hook plate between 2008 and 2012 at our hospital. We did not repair the coracoclavicular ligament. In all patients, the plate remained more than five months because they did not come back at the recommended time for removal of their plates. The follow-up period ranged from five to thirty three months with a mean of nineteen months. The main complication was osteolysis that was seen in two patients. The mean constant score was 94.5 ± 8.77 out of 100 with a range between 70 and 100. Our study showed that the use of clavicular hook plates was a good treatment option for acromioclavicular joint dislocation. However, scores were lower in case of prolonged presence of plates.

  15. Hook plate fixation of acute displaced lateral clavicle fractures: mid-term results and a brief literature overview

    Directory of Open Access Journals (Sweden)

    Tiren Davut

    2012-01-01

    Full Text Available Abstract Background The clavicle hook plate achieves like most other operative techniques, a high percentage of union and a low percentage of complications however concerns about long term complications still exist, particularly the involvement of the acromioclavicular joint. Methods To evaluate the results and long term effects in use of this plate we performed a retrospective analysis with a mean follow up of 65 months (5.4 years of 28 consecutive patients with acute displaced lateral clavicle fractures, treated with the clavicle hook plate. Results Short term functional results in all patients were good to excellent. All but one patient had a united fracture (96%. Nine patients (32% developed impingement symptoms and in 7 patients (25% subacromial osteolysis was found. These findings resolved after plate removal. Twenty-four patients were re-evaluated at a mean follow-up period of 5.4 years. The Constant-Murley score was 97 and the DASH score was 3.5. Four patients (14% developed acromioclavicular joint arthrosis of which one was symptomatic. Three patients (11% had extra articular ossifications of which one was symptomatic. There was no relation between the impingement symptoms, subacromial osteolysis and development of acromioclavicular joint arthrosis or extra articular ossifications. Conclusions The clavicle hook plate is a good primary treatment option for the acute displaced lateral clavicle fracture with few complications. At mid term the results are excellent and no long term complications can be addressed to the use of the plate.

  16. Transarticular fixation by hook plate versus coracoclavicular stabilization by single multistrand titanium cable for acute Rockwood grade-V acromioclavicular joint dislocation: a case-control study.

    Science.gov (United States)

    Gao, You-Shui; Zhang, Yue-Lei; Ai, Zi-Sheng; Sun, Yu-Qiang; Zhang, Chang-Qing; Zhang, Wei

    2015-11-19

    Hook plate (HP) is popularly used for acute and severely displaced acromioclavicular (AC) dislocations. However, subacromial impingement and acromion osteolysis induced by transarticular fixation are notorious. The current case-control study was to compare transarticular fixation by HP to coracoclavicular (CC) stabilization by single multistrand titanium cable (MSTC). Between January 2006 and August 2009, 24 patients with acute AC dislocations were surgically treated by open reduction and transarticular fixation with HP. These patients were matched to a series of 24 patients, who were managed by CC stabilization with MSTC in the same period. All AC dislocations were graded as Rockwood type V. Implant was removed 8-12 months after the primary operation in all patients, and 12 months at least were needed to assess the maintenance of AC joint. Functional results were evaluated before implant removal as well as in the last follow-up based on Constant-Murley criteria. There were no differences of demographic data including age, dominant gender and side, injury-to-surgery interval, operation time and follow-up period. In terms of functionality, Constant score was 95.8 ± 4.1 in MSTC group, while 76.7 ± 8.0 in HP group before implant removal (P acromioclavicular joint presented in 16 patients (66.7%) in patients treated by HP, while it was found in only 3 patients (12.5%) treated by MSTC (P acromioclavicular dislocation both before and after removal of the implant. Hardware removal is of great benefits for functional improvement in patients treated by HP.

  17. [Comparative serology in typhoid fever in children. II. Comparison of a microhemagglutination plate technic with Ruiz-Castañeda surface fixation].

    Science.gov (United States)

    Alvarado-Alemán, F; González-Quijano, M; Rodríguez-Solis, B; Ramírez-Vidals, A; Isibasi, A; Kumate, J

    1989-02-01

    Two lipopolysaccharide antigens that differ by the technique of preparation from S. typhi, one named crude is easily extracted, the other one is water-phenol extracted. Both were adsorbed by papain and cysteine to lamb erythrocyte surfaces, fixed then by glutaraldehyde and used in a plate microhemagglutination test (MHA). The MHA test was done with 30 sera from children with S. typhi blood isolates. The same number of control sera were tested for comparison. The crude LPS antigen showed better sensitivity: 73% versus 53% of the water-phenol extracted one despite a high index correlation (r = 0.88). The latest one was evaluated in a prospective study, using it during a six-month period in an emergency room with S. typhi blood isolated sera. The MHA test was compared with the surface fixation test. Both assays showed similar sensitivity and a specificity of 91 and 100%, respectively.

  18. [Unstable fracture of the distal radius and its treatment: comparison of three techniques: external fixation, intramedullary pinning and AO plates].

    Science.gov (United States)

    Sennwald, G R; Della Santa, D

    2001-06-01

    This retrospective study compares 94 distal radius fractures. Sixty one women (median age 66) and 33 men (median age 42) were reviewed clinically and radiologically by a surgeon not involved in treatment. Fractures were classified into three AO groups. Standard X-rays were used for radiological evaluation. Fractures of the distal ulna were evaluated separately. Chi-square tests, Wilcoxon, Mann-Whitney and Fisher's tests were used for statistical evaluation. Women presented mainly "A" type fractures. They were treated by intramedullary pinning. Forty two fractures were grafted, using autogenous bone for young patients and bone substitute for the elderly. Twelve scapholunate dissociations were recorded, all but one were detected in women, 50 years of age or more. Four were painfree, two presented climatic pain and six claimed pain during effort; none had snapping. Radio-ulnar laxity was similar with or without styloid fractures. External fixator and autogenous grafts appeared the most efficient technique for maintaining radial length. Ulnar head fractures were related to a significant higher incidence of sympathetic dystrophy with reduced prono-supination, a correlation not previously noted to your knowledge. This suggests that radius and ulnar head fracture should be classified independently. The amount of pain was not related to classification, internal fixation or gender.

  19. Acute high-grade acromioclavicular joint injuries treatment: Arthroscopic non-rigid coracoclavicular fixation provides better quality of life outcomes than hook plate ORIF.

    Science.gov (United States)

    Natera-Cisneros, L; Sarasquete-Reiriz, J; Escolà-Benet, A; Rodriguez-Miralles, J

    2016-02-01

    Treatment of acute high-grade acromioclavicular joint (ACJ) injuries with metal hardware alters the biomechanics of the ACJ, implying a second surgery for hardware removal. The period during which the plate is present involves functional limitations, pain and a risk factor for the development of hardware-related-injuries. Arthroscopy-assisted procedures compared to open-metal hardware techniques offer: less morbidity, the possibility to treat associated lesions and no need for a second operation. The aim was to compare the Quality of life (QoL) of patients with acute high-grade ACJ injuries (Rockwood grade III-V), managed arthroscopically with a non-rigid coracoclavicular (CC) fixation versus the QoL of patients managed with a hook plate, 24 months or more after their shoulder injury. A retrospective revision of high-grade ACJ injuries managed in three institutions was performed. Patients treated by means of an arthroscopy-assisted CC fixation or by means of a hook plate were included. The inclusion period was between 2008 and 2012. The QoL was evaluated at the last follow-up visit by means of the SF36, the visual analog scale (VAS), the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the Constant score and the global satisfaction (scale from 0 to 10). The presence of scapular dyskinesis and remaining vertical instability were evaluated. Comparison between groups was performed. Thirty-one patients were included: 20 arthroscopy-group (ARTH group: 3 Rockwood III, 3 IV and 14 V) and 11 hook plate-group (HOOK group: 5 Rockwood III and 6 V). The mean age was 36 [25-52] year-old for the ARTH group and 41 [19-55] for the HOOK group (P=0.185). The mean results of the questionnaires were: (1) physical SF36 score (ARTH group 58.24±2.16 and HOOK group 53.70±4.33, P<0.001); (2) mental SF36 score (ARTH group 56.15±2.21 and HOOK group 53.06±6.10, P=0.049); (3) VAS (ARTH group 0.40±0.50 and HOOK group 1.45±1.51, P=0.007); (4) DASH (ARTH group 2.98±2.03 and

  20. Treatment of plastic Titanium plate on fixation of calcaneal fractures%可塑钛板内固定治疗跟骨骨折

    Institute of Scientific and Technical Information of China (English)

    崔庆元

    2011-01-01

    Objective To investigate the plastic plate fixation of calcaneal fractures. Methods Totally 22 patients, 18 males, 10 cases of left foot, right foot 7 cases in which both feet 1 female 4 cases , 3 cases of left foot right foot in 1 case. The average age of 22 -44 years old 33 years old. Are fall injuries. Are blunt trauma, the use of L - shaped lateral calcaneal incision subperiosteal dissection to expose the subtalar and calcaneocuboid joints, so Bohler recovery to 30° angle or so, with a plastic titanium plate. Results After 2 feet skin flap with partial necrosis of subcutaneous infection in which a foot, some exposed steel, dressing healed. Patients were followed up using Maryland foot score excellent joint function rate of 88%. Conclusions Plastic plate fixation of calcaneal fractures, if done correctly, results are quite satisfactory.%目的 探讨可塑钛板内固定治疗跟骨骨折.方法 本组22例,男性18例,左足10例,右足7例,其中双足1例,女性4例,左足3例,右足1例.年龄22 ~44岁,平均33岁.均为坠落伤.均为闭合性损伤,采用跟骨外侧L型切口骨膜下剥离,显露距下关节及跟骰关节,使B(o)hler角恢复至30°左右,用可塑钛合金钢板固定.结果 术后两足切口皮缘有部分坏死其中1足出现皮下感染,钢板部分外露,换药愈合.术后随访采用Maryland足部评分法关节功能优良率达88%.结论 可塑钛板内固定治疗跟骨骨折,只要方法得当,效果十分理想.

  1. Comparison of percutaneous cannulated screw fixation and calcium sulfate cement grafting versus minimally invasive sinus tarsi approach and plate fixation for displaced intra-articular calcaneal fractures: a prospective randomized controlled trial.

    Science.gov (United States)

    Feng, Yongzeng; Shui, Xiaolong; Wang, Jianshun; Cai, Leyi; Yu, Yang; Ying, Xiaozhou; Kong, Jianzhong; Hong, Jianjun

    2016-07-15

    The management of displaced intra-articular calcaneal fractures (DIACFs) remains challenging and controversial. A prospective randomized controlled trial was conducted to compare percutaneous reduction, cannulated screw fixation and calcium sulfate cement (PR+CSC) grafting with minimally invasive sinus tarsi approach and plate fixation (MISTA) for treatment of DIACFs. Ultimately, 80 patients with a DIACFs were randomly allocated to receive either PR+CSC (N = 42) or MISTA (N = 38). Functional outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scores. Radiological results were assessed using plain radiographs and computed tomography (CT) scans, and postoperative wound-related complications were also recorded. The average time from initial injury to operation and the average operation time in the PR+CSC group were both significantly shorter than those in the MISTA group (p < 0.05). There were significantly fewer complications in the PR+CSC group than those in the MISTA group (7.1 % vs 28.9 %, p < 0.001). The calcaneal width immediate postoperatively and at the final follow-up in the MISTA group were obviously improved compared to those in the PR+CSC group (p < 0.001). The variables of sagittal motion and hindfoot motion of the AOFAS scoring system in the PR+CSC group were significantly higher than those in the MISTA group (p < 0.05). The good and excellent results in the two groups were comparable for Sanders Type-II calcaneal fractures, but the good to excellent rate in the MISTA group was significantly higher for Sanders Type-III fractures (p < 0.05). The clinical outcomes are comparable between the two minimally invasive techniques in the treatment of Sanders Type-II DIACFs. The PR+CSC grafting is superior to the MISTA in terms of the average time between initial injury and operation, operation time, wound-related complications and subtalar joint activity. However, the MISTA has its own

  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......Copenhagen Business School (CBS) finds itself needing to address the issue of English-medium instruction for its increasing number of foreign exchange and full degree students. With internationalisation as a main pillar of the institution’s agenda, there are concerns whether the teaching faculty...... 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...

  3. PLATE

    DEFF Research Database (Denmark)

    Kling, Joyce; Hjulmand, Lise-Lotte

    2008-01-01

    Copenhagen Business School (CBS) finds itself needing to address the issue of English-medium instruction for its increasing number of foreign exchange and full degree students. With internationalisation as a main pillar of the institution’s agenda, there are concerns whether the teaching faculty......’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...

  4. Application of C2 Transpedicular Screw Fixation Combined with C3 Lateral Mass Screw Plate Fixation in Posterior Treatment of Old Hangman's Fracture%经后路C2椎弓根C3侧块短节段固定治疗陈旧性枢椎椎弓骨折

    Institute of Scientific and Technical Information of China (English)

    曹成刚; 梁益建; 何睿; 石化洋; 曾勇; 陈伶

    2012-01-01

    Objective To approach the therapeutic effect of C2 transpedicular screw fixation combined with C3 lateral mass screw plate fixation on old Hangman' s fracture. Methods Nine patients with old Hangman' s fracture were treated with C2 transpedicular screw fixation combined with C3 lateral mass screw plate fixation as well as bone gr'aft fusion in our hospital from 2002. Results A mean follow-up time was 8 months(6 to 15 months). All cases got bony union. No infection, neurological deficits, or other complications were found. Conclusion It can be an effective and simple way to treat old Hangman' s fracture with C2 transpedicular screw fixation combined with C3 lateral mass screw plate fixation, which can ultimately preserve the cervical function.%目的 探讨经后路C2椎弓根C3侧块短节段内固定治疗陈旧性枢椎椎弓骨折(Hangman骨折)的疗效.方法 2002年以来9例陈旧性Hangman骨折采用经后路C2椎弓根C3侧块短节段固定,植骨融合治疗.结果 所有患者随访6~15个月,平均8个月.所有患者均骨性愈合,未出现感染、神经损伤等并发症.结论 经后路C2椎弓根C3侧块短节段内固定治疗陈旧性Hangman骨折是一种安全有效并能最大程度保留患者颈部功能的方法.

  5. 钢板内固定与经皮克氏针固定治疗桡骨远端骨折疗效比较%Treatment of distal radius fractures:a comparison between plate internal fixation and percutaneous K-wires fixation

    Institute of Scientific and Technical Information of China (English)

    顾昕; 楼列名; 李少华

    2009-01-01

    目的 比较切开复位钢板内固定和经皮克氏针固定治疗桡骨远端骨折的临床疗效.方法选取2002年1月-2007年6月收治的110例行切开复位内固定的桡骨远端骨折患者,选取同期107例行经皮克氏针固定的患者,随访比较两组临床疗效. 结果 所有患者随访5-12个月,按Gartland和Werley评分标准,钢板内固定组的优良率为86.4%,经皮克氏针固定组优良率为74.8%(P0.05). 结论 切开复位内固定治疗桡骨远端骨折总体临床疗效优于经皮克氏针组,但治疗C3型骨折疗效欠佳.%Objective To compare the clinical results of open reduction and plate internal fixation and percutaneous kirschner-wire fixation in the management of distal radius fractures. Methods A retrospective comparison was done on clinical data of 110 patients with distal radius fractures who were treated by plate internal fixation and that of 107 by pereutaneous kirschner-wire fixation from January 2002 to June 2007. Results All patients were followed up for 5-12 months. According to Gartland and Werley scoring system, the excellent rate was 86.4% in plate internal fixation group, which was significantly higher than 74.8% in percutaneous kirschner-wire fixation group (P 0.05). Conclusions Compared with percutaneous kirschner-wire fixation, plate internal fixation is better in treatment of distal radius fractures, but has poor results in management of type C3 fractures.

  6. Outcomes and financial implications of intra-articular distal radius fractures: a comparative study of open reduction internal fixation (ORIF) with volar locking plates versus nonoperative management.

    Science.gov (United States)

    Toon, Dong Hao; Premchand, Rex Antony Xavier; Sim, Jane; Vaikunthan, Rajaratnam

    2017-02-02

    To evaluate the functional and radiographic outcomes, as well as the treatment costs, of closed displaced intra-articular distal radius fractures treated with either open reduction internal fixation (ORIF) with volar locking plates or nonoperative treatment with plaster cast immobilisation. A total of 60 patients (32 receiving ORIF, 28 receiving nonoperative treatment) with closed intra-articular distal radius fractures were included. The mean age was 52.1 and 57.4, respectively. Functional and radiographic assessments were carried out at 12 months post-injury. Patients' treatment costs, median salaries and lengths of medical leave were obtained. DASH and MAYO wrist score in the ORIF group did not differ significantly from those in the nonoperative group. Apart from superior ulnar deviation in the ORIF group (p = 0.0096), differences in the range of motion of the injured wrists were not significant. Similarly, there were no significant differences in grip strength and visual analog scale for pain. Volar tilt (p = 0.0399), radial height (p = 0.0087), radial inclination (p = 0.0051) and articular step-off (p = 0.0002) were all significantly superior in the ORIF group. There was a 37-fold difference in mean treatment costs between ORIF (SGD 7951.23) and nonoperative treatment (SGD 230.52). Our study shows no difference in overall functional outcomes at 12 months for closed displaced intra-articular distal radius fractures treated with either ORIF with volar locking plates or plaster cast immobilisation, and this is independent of radiographic outcome. A longer follow-up, nevertheless, is needed to determine whether the development of post-traumatic arthritis will have an effect on function. The vast difference in treatment costs should be taken into consideration when deciding on the treatment option. Level 3.

  7. Ipsilateral Femoral Fracture Non-Union and Delayed Union Treated By Hybrid Plate Nail Fixation and Vascularized Fibula Bone Grafting: A Case Report

    Directory of Open Access Journals (Sweden)

    CK Chan

    2013-07-01

    Full Text Available Non-union is a well recognized complication of femoral neck fractures. The decision whether to attempt fracture fixation or to resort to hip replacement is particularly difficult in patients in the borderline age group in whom complex attempts at gaining union may fail and later present a difficult revision. On the other hand the patient may be young enough that arthroplasty best be avoided . Besides, presence of ipsilateral femoral shaft fracture with delayed union in addition to the femoral neck non-union will pose major problems at operation. We share our experience in treating a femoral neck fracture non-union with ipsilateral femoral shaft delayed union in the shaft and in the distal femur in a fifty years old patient. The fracture was treated with an angle blade plate and supracondylar nail supplemented with a free vascularised fibular bone grafting and autologous cancellous graft. There was radiological union at fourth month. At sixth months, the patient was free of pain and able to walk without support. Thus, we would like to suggest that vascularised fibula bone grafting with supracondylar nailing is a viable option for this pattern of fracture.

  8. 颈椎前路蝶形钢板内固定系统的研制及临床应用%Design and preliminary clinical application of anterior cervical butterfly-like locking plate fixation system

    Institute of Scientific and Technical Information of China (English)

    金大地; 瞿东滨; 陈建庭; 江建明; 王吉兴; 朱青安

    2001-01-01

    Objective To evaluate the biomechanical stability and the preliminary clinical efficacy of self-designed anterior cervical butterfly-like locking plate fixation system. Methods The anterior cervical fixation system is composed of one butterfly-like plate and three types of screw made of titanium alloy(TC4,Ti6Al4V) on the basis of unicortical screw fixation and point contact plate fixation principle. Biomechanical stability analyses of the system and Orion locking plate system (Sofamor - Danek Corp) were performed in fresh cervical spine specimens from fourteen young male cadavers. 61 patients with cervical disorders were stabilized with the fixation system. The mean age of the patients during surgery was 48.2 years (range 18 to 68 years). The diagnosis included spondylosis in 26 cases, cervical intervertebral disk protrusion 14, fracture and/or dislocation 18 and tuberculosis 3. Results This anterior butterfly-like cervical plate fixation system holds similar biomechanical stability effects as Orion system. Of 61 cases received the plate fixation system after anterior decompression and autologous interbody fusion, 48 were followed-up for six to ten months, and showed solid interbody fusion in three to four months. No early complications such as implant loosening or failure related to the fixation system were noted. Conclusion The anterior cervical plate fixation system can provide sufficient biomechanical stability to cervical spine after anterior decompression surgery.%目的研制颈椎前路蝶形钢板内固定系统,评价其生物力学稳定性,并进行临床初步应用观察.方法该系统包括蝶形钢板及三种不同用途的螺钉,采用单皮质螺钉固定及点接触原理,由医用钛合金材料(TC4)制成.采用14具青年男性尸体的新鲜颈椎标本,利用脊柱三维运动分析系统,比较蝶形钢板固定与Orion钢板固定对失稳颈椎的稳定作用.临床上应用于颈椎患者的治疗61例,其中颈椎病26例,颈椎间

  9. Intramedullary nail versus dynamic compression plate fixation in treating humeral shaft fractures: grading the evidence through a meta-analysis.

    Directory of Open Access Journals (Sweden)

    JianXiong Ma

    Full Text Available There is a debate regarding the choice of operative intervention in humeral shaft fractures that require surgical intervention. The choices for operative interventions include intramedullary nailing (IMN and dynamic compression plate (DCP. This meta-analysis was performed to compare fracture union, functional outcomes, and complication rates in patients treated with IMN or DCP for humeral shaft fractures and to develop GRADE (Grading of Recommendations, Assessment, Development, and Evaluation-based recommendations for using the procedures to treat humeral shaft fractures. A systematic search of all the studies published through December 2012 was conducted using the Medline, Embase, Sciencedirect, OVID and Cochrane Central databases. The randomized controlled trials (RCTs and quasi-RCTs that compared IMN with DCP in treating adult patients with humeral shaft fractures and provided data regarding the safety and clinical effects were identified. The demographic characteristics, adverse events and clinical outcomes were manually extracted from all of the selected studies. Ten studies that included a total of 448 patients met the inclusion criteria. The results of a meta-analysis indicated that both IMN and DCP can achieve similar fracture union with a similar incidence of radial nerve injury and infection. IMN was associated with an increased risk of shoulder impingement, more restriction of shoulder movement, an increased risk of intraoperative fracture comminution, a higher incidence of implant failure, and an increased risk of re-operation. The overall GRADE system evidence quality was very low, which reduces our confidence in the recommendations of this system. DCP may be superior to IMN in the treatment of humeral shaft fractures. Because of the low quality evidence currently available, high-quality RCTs are required.

  10. Clinical efficacy of locking compression plate fixation in treatment of femoral intertrochanteric fracture%锁定加压钢板治疗股骨转子间骨折21例临床分析

    Institute of Scientific and Technical Information of China (English)

    杨岭; 聂磊; 孙湖山

    2012-01-01

    Objective: To investigate the effects of locking compression plate fixation in treatment of intertrochanteric fracture. Methods: Twenty-one cases with femoral intertrochanteric fracture were treated with locking compression plate fixation. Results: The fractures of all cases were recovered after 3-6 months. The complications of nails breakage and internal fixation loosening were not found. The function recovery of hip joint were good and no clear lower limb shortening deformity. Excellent and good effects in 13 and 8 cases were confirmed according to Harris standard. Conclusions: Treatmment of femoral intertrochanteric fracture with locking compression plate fixation is easy to install and fix, which is an effective method of operation with shorter operative time, less bleeding and goog hip joint function recovery.%目的:观察锁定加压钢板治疗股骨转子间骨折的疗效.方法:应用锁定加压钢板治疗股骨转子间骨折21例.结果:21例患者3~ 6个月骨折均愈合,未出现断钉、内固定松动等并发症,无明显髋内翻和下肢短缩畸形;Harris评分为优11例,良8例,可2例.结论:锁定加压钢板治疗股骨转子间骨折具有容易安装、固定可靠、手术时间短、出血量少、髋关节功能恢复优良率高等特点,是一种有效的手术方法.

  11. External fixation followed by locking plate internal fixation to treat tibia and fibula open fractures\\%外固定架一期固定后二期锁定钢板内固定治疗胫腓骨开放性骨折

    Institute of Scientific and Technical Information of China (English)

    李生平; 黄辉; 彭维波

    2012-01-01

    目的 评价应用外固定架固定后二期锁定钢板内固定治疗胫腓骨开放性骨折的疗效.方法 对118例胫腓骨开放骨折患者行外固定架固定后二期锁定钢板内固定治疗.结果 118例均获随访,时间12~24个月.除1例因钢板移位影响骨折愈合外,其余患者骨折均愈合,时间3.1~5.2个月,骨折愈合率为99.2%;并发症发生率4.2%.按照Enneking评分系统评估疗效:优96例,良11例,可7例,优良率为90.7%.膝关节活动度:伸0°,屈135°,踝关节活动度:背伸30°,跖屈40°.结论 外固定架固定后二期锁定钢板内固定治疗胫腓骨开放骨折操作简便,固定牢靠,骨折愈合快,并发症少,临床疗效满意.%Objective To study the curative effect of treatment of tibia and fibula open fractures with external fixation bllowed by locking plate internal fixation in Phase II. Methods 118 patients with tibia and fibula open fractures vere treated with external fixation followed by locking plate internal fixation. The healing of fracture was observed. Results All 118 cases were followed up for 12 ~24 months. The time of fracture healing was 3. 1 ~5. 2 months. The ;omplication rate was 4. 2% , fracture healing rate was 99. 2% . According to Enneking function assessment system, he curative effect was excellent in 96 patients, good in 11, fair in 7 and poor in 4, and the excellent and good rate was )0. 7% . The joint range of knee motion was 0 degrees for extension and 135 degrees for flexion. Moreover, joint range )f extend motion was 30 degrees for extension and 40 degrees for flexion. Conclusions It is an effective way to treat ibia and fibula open fractures with external fixation combined with locking plate internal fixation in Phase II , which las advantages of simple operation, reliable fixation,low infection rate, fast fracture healing,and less complications.

  12. 股骨髁上骨折应用L形加压钢板内固定后的早期康复治疗%The early rehabilitation intervention after internal fixation English Column with L-shaped compression armor plate for supracondylar fracture of femur

    Institute of Scientific and Technical Information of China (English)

    岳红卫; 李国顺

    2002-01-01

    Background: The thickness and width of L shaped armor plate can antagonize muscle traction with the ability of anti inflecting, anti torsion and anti shearing force, which overcomes the weakness of common armor plate and osseous pin that have weaker fixation force and need external fixation. The fixation can satisfy the request of early functional training. And the functional training can be performed on the continuous passive movement (CPM) instrument 1 week after operation to prevent adhesion of knee joint, elasticity losing in soft tissue around joint, ankylosis, osteoporosis and osteoarthritis.

  13. Biomechanical Stability of Four Fixation Constructs for Distal Radius Fractures

    OpenAIRE

    Capo, John T.; Kinchelow, Tosca; Brooks, Kenneth; Tan, Virak; Manigrasso, Michaele; Francisco, Kristin

    2009-01-01

    Implants available for distal radius fracture fixation include dorsal nonlocked plating (DNLP), volar locked plating (VLP), radial–ulnar dual-column locked plating (DCPs), and locked intramedullary fixation (IMN). This study examines the biomechanical properties of these four different fixation constructs. In 28 fresh-frozen radii, a wedge osteotomy was performed, creating an unstable fracture model and the four fixation constructs employed (DNLP, VLP, DCPs, and IMN). Dorsal bending loads wer...

  14. Displaced midshaft fractures of the clavicle: non-operative treatment versus plate fixation (Sleutel-TRIAL. A multicentre randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Vos Dagmar I

    2011-08-01

    Full Text Available Abstract Background The traditional view that the vast majority of midshaft clavicular fractures heal with good functional outcomes following non-operative treatment may be no longer valid for all midshaft clavicular fractures. Recent studies have presented a relatively high incidence of non-union and identified speciic limitations of the shoulder function in subgroups of patients with these injuries. Aim A prospective, multicentre randomised controlled trial (RCT will be conducted in 21 hospitals in the Netherlands, comparing fracture consolidation and shoulder function after either non-operative treatment with a sling or a plate fixation. Methods/design A total of 350 patients will be included, between 18 and 60 years of age, with a dislocated midshaft clavicular fracture. The primary outcome is the incidence of non-union, which will be determined with standardised X-rays (Antero-Posterior and 30 degrees caudocephalad view. Secondary outcome will be the functional outcome, measured using the Constant Score. Strength of the shoulder muscles will be measured with a handheld dynamometer (MicroFET2. Furthermore, the health-related Quality of Life score (ShortForm-36 and the Disabilities of Arm, Shoulder and Hand (DASH Outcome Measure will be monitored as subjective parameters. Data on complications, bone union, cosmetic aspects and use of painkillers will be collected with follow-up questionnaires. The follow-up time will be two years. All patients will be monitored at regular intervals over the subsequent twelve months (two and six weeks, three months and one year. After two years an interview by telephone and a written survey will be performed to evaluate the two-year functional and mechanical outcomes. All data will be analysed on an intention-to-treat basis, using univariate and multivariate analyses. Discussion This trial will provide level-1 evidence for the comparison of consolidation and functional outcome between two standardised

  15. 解剖型锁定钢板外固定治疗锁骨骨髓炎%Usage of anatomic locking plate as an external fixator for the treatment of clavicular osteomyelitis

    Institute of Scientific and Technical Information of China (English)

    叶文斌; 翟文亮; 丁真奇

    2011-01-01

    目的 探讨解剖型锁定钢板治疗锁骨骨髓炎的效果.方法 对14例锁骨骨髓炎患者进行病灶清除、灌洗,解剖型锁定钢板外固定治疗.根据ASES系统对肩关节功能进行综合评价.结果 14例均获随访,时间6~23(10±2.5)个月.均获得良好的愈合.肩关节功能评分平均为91.3分±3.2分.结论 解剖型锁定钢板可提供良好的外固定,用于锁骨骨髓炎病灶清除后固定确实、可行.%Objective To evaluate the effects of anatomic locking plate as an external fixator for the treatment of clavicular osteomyelitis.Methods 14 patients who had clavicular osteomyelitis and partially bone defect were treated by focus clearance and locking plate external fixation.At the last follow up, the shoulder function was evaluated according to the ASES system.Results Each of 14 patients ohtained healing, and was followed up for 6 ~ 23 months on average of( 10 ±2.5 ) months.and the average ASES score was ( 91.3 ±3.2 ).Conclusions It proves an excellent way hy using of anatomic locking plate as external fixation for clavicle osteomyelitis.

  16. 微创锁定板内固定和切开复位内固定治疗跟骨关节内骨折效果分析%Analysis Efficacy of Minimally Invasive Locking Plate Fixation and Open Reduction Internal Fixation in the Treatment of Intra-articular Calcaneal Fractures

    Institute of Scientific and Technical Information of China (English)

    张番; 郑淑媛

    2014-01-01

    Objective:To investigate the clinical treatment efficacy of minimally invasive locking plate fixation and open reduction internal fixation in the treatment of intra-articular calcaneal fractures.Method:76 patients with calcaneal fracture in orthopedic department for elective surgery in our hospital from June 2012 to July 2013 were selected.All cases were randomly divided into the minimally invasive fixation group and the open reduction internal fixation group according to the admission number parity,38 cases in each group.The surgical time,intraoperative and postoperative bleeding, hospitalization time,healing time of the two groups were compared.The postoperative treatment efficacies of the two groups were evaluated by AOFAS ankle and hindfoot scoring system,visual analog scale(VAS method)and condensed Health Status Scale(SF-36).Postoperative complications of the two groups were recorded.Result:The surgical time and intraoperative and postoperative bleeding volume of the minimally invasive fixation group were significantly less than the open reduction internal fixation group,the differences were statistically significant(P0.05).The total complication rate of the minimally invasive fixation group was 7.9%,it was significantly lower than 36.8% of the open reduction internal fixation group,the difference was statistically significant(P0.05);微创内固定组总并发症发生率7.9%明显低于切口内固定组的36.8%,差异有统计学意义(P<0.05)。结论:微创锁定板内固定治疗跟骨关节内骨折临床效果优于切开复位内固定,有助于减少术后并发症的发生,促进跟骨术后功能恢复,提高患者生活质量,值得在临床推广使用。

  17. 肱骨远端C型骨折三种双钢板固定方法疗效比较%Comparative study on curative effect of internal fixations with three dual plates for type C fractures of distal humerus

    Institute of Scientific and Technical Information of China (English)

    陶然; 徐华; 王友华; 曹毅; 周振宇; 陆跃; 刘璠

    2013-01-01

    目的 比较肱骨远端C型骨折的三种双钢板固定方法. 方法 选择2004年1月-2008年12月收治的59例肱骨远端C型骨折患者,均采用双钢板固定.其中垂直双钢板固定34例(A组),背侧双钢板固定14例(B组),平行双钢板固定11例(C组).采用Mayo的肘关节评分系统(MEPS)对患侧肘关节进行功能评分.三组围术期的变量用方差分析、x2检验及Fish-er确切概率法进行比较. 结果 平均随访时间28个月(12 ~55个月).所有骨折均顺利愈合,各组疗效均较满意.三组功能结果差异无统计学意义,C组中固定有难度的患者比例明显高于其他两组.A组和B组中常需要1枚额外的髁间螺钉,但在C组中很少需要. 结论 三种双钢板固定均为治疗肱骨远端C型骨折的有效方法,钢板位置的放置常取决于临床骨科医师的经验及骨折的具体形态.%Objective To compare three different internal fixations using dual plates in treatment of type C distal humerus fractures.Methods A total of 59 patients with type C distal humerus fractures fixed with dual plates between January 2004 and December 2008 were enrolled in the study,including 34 patients managed by perpendicular dual plate internal fixation (Group A),14 patients by dorsal dual plate internal fixation (Group B),and 11 patients by parallel dual plate internal fixation (Group C).Functional outcomes of injured elbow joints were assessed using Mayo elbow performance score (MEPS).Fisher' s exact probability,chi-square test and variance analysis were used to compare the perioperative variables among groups.Results The patients were followed up for average 28 months (range,12-55 months),which showed that all fractures were smoothly healed with satisfactory curative effects in each group.There were no significant differences with respect to functional outcomes among three groups.The patients with surgery difficulty in Group C were more than those in other two groups.Besides,an additional

  18. Stability of unicortical locked fixation versus bicortical non-locked fixation for forearm fractures

    Institute of Scientific and Technical Information of China (English)

    Timothy J.Pater; Steve I Grindel; Gregory J.Schmeling; Mei Wang

    2014-01-01

    Locking plate fixation is being widely applied for fixation of forearm fractures and has many potential advantages, such as fixed angle fixation and improved construct stability, especially in osteoporotic bone. Biomechanical data comparing locking devices to commonly used Low Contact Dynamic Compression (LCDCP) plates for the fixation of forearm fractures has been lacking. The purpose of this study was to compare the fixation stability of a 3.5-mm unicortical locked plate with bicortical non-locked LCDCP plates. Six matched pairs of fresh frozen cadaveric forearms were randomly assigned to unicortical locked and bicortical unlocked groups. Non-destructive four-point bending and torsional test was performed on the ulna and radius separately, using a servohydraulic testing system to obtain construct stiffness of the intact specimens and specimens after osteotomy and plating. The specimens were then loaded to failure to test the fixation strength. The locked unicortical fixation showed significantly higher bending stiffness than the unlocked bicortical fixation, but with significantly lower stiffness and strength in torsion. Fixation strength was comparable between the two groups under bending, but significantly greater in the bicortical non-locked group under torsion. Findings from this study suggest that postoperative rehabilitation protocols may need modification to limit torsional loading in the early stage when using locked unicortical fixation. The study also points out the potential advantage of a hybrid fixation that combines locked unicortical and unlocked bicortical screws.

  19. 肱骨近端解剖锁定钢板治疗肱骨外科颈骨折的效果观察%Observation on effect of surgical neck fractures of humerus by locking proximal humerus plate fixation

    Institute of Scientific and Technical Information of China (English)

    陈兆平

    2014-01-01

    目的:探究肱骨近端解剖锁定钢板治疗肱骨外科颈骨折的临床效果。方法选取近3年到我院就诊的肱骨外科颈骨折患者120例,给予患者肱骨近端解剖锁定钢板治疗,观察其临床效果并定期随访,评价其肩关节功能。结果所有患者均顺利完成手术,术中未出现神经、血管损伤,住院期间和随访期间均未发生感染等并发症,术后切口都是Ⅰ期愈合,按照 neer 评定标准,优良率达92.5%。结论肱骨近端解剖锁定钢板治疗肱骨外科颈骨折,具有固定可靠、效果良好、并发症少、操作简单等优点,适合临床推广应用。%objective To explore the effect of surgical neck fractures of humerus by locking proximal humerus plate fixation. Methods choced 120 patients with surgical neck fractures of humerus which was cheated in our hospital in the last three years, treated the patients with locking proximal humerus plate fixation, then observed the clinical effect and evaluated the function of shoulders after regular follow-up. Results all patients completed the surgery smoothly, no case of blood vessels and nerve damage, and no infection occurred during hospitalization and the follow up period, all the patients got recovered in Ⅰ period and the excellent and good rate was 92.5%. Conclusions surgical neck fractures of humerus by locking proximal humerus plate fixation, has the advantages of reliable fixation, good effect, less complications and simple operation, it is suitable for clinical application.

  20. 15例 Hangman 骨折前路融合钛板固定分析%Anterior Cervical Fusion with Titanium Plate Fixation for Hangman’s Fracture:An Analysis of 15 Cases

    Institute of Scientific and Technical Information of China (English)

    江海亮; 潘剑成; 张宗明; 林阳; 杨文超; 贺立新

    2014-01-01

    ABSTRACT:Objective To investigate the efficacy and value of anterior cervical fusion with tita-nium plate fixation for the treatment of hangman’s fracture.Methods Fifteen patients with hangman’s fracture underwent anterior cervical fusion with titanium plate fixation from March 2003 to March 2011.Patients were followed up for an average of 12 months (range,10 to 18 months).Results Clinical symptoms were relieved and cervical lordosis was maintained with blurry C2 vertebral arch fracture line in all patients after operation.Bone graft fusion rate reached 100% 6 months after operation.No loosening and fracture of fixation system were found in all patients.Conclusion Anterior cervical fusion with titanium plate fixation can result in immediate stability,prevent graft dislodgement,avoid plaster immobilization,maintain cervical lordosis,pro-mot fracture healing and increase bone graft fusion rate in the treatment of hangman’s fracture.%目的:探讨前路融合钛板内固定术治疗 Hangman 骨折的疗效和应用价值。方法2003年3月至2011年3月,对15例 Hangman 骨折患者行颈椎前路融合钛板内固定术。术后进行10~18个月随访,平均随访12个月。结果术后症状明显恢复。全部病例颈椎生理前凸维持良好,C2椎弓骨的线模糊。术后6个月植骨融合率达到100%。无内固定系统松动及断裂现象存在。结论应用颈前路植骨融合内固定术治疗不稳定性 Hangman 骨折,具有术后上颈椎即时稳定,防止植骨块移位,无须石膏固定,维持生理前凸,促进骨折愈合和植骨融合率高等优点。

  1. Complications of rigid internal fixation.

    Science.gov (United States)

    Campbell, Chris A; Lin, Kant Y

    2009-03-01

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

  2. Open reduction and internal fixation of OTA type C2-C4 fractures of the calcaneus with a triple-plate technique.

    Science.gov (United States)

    Brunner, Alexander; Müller, Jochen; Regazzoni, Pietro; Babst, Reto

    2012-01-01

    The purpose of this study was to present a surgical technique of open reduction and internal fixation of displaced intra-articular calcaneal fractures with 3 AO mini-fragment plates and to evaluate the clinical and radiological outcome of a consecutive group of patients after a mean follow-up of 41.7 months. A series of 54 patients (16 women and 38 men) with 62 calcaneal fractures were treated over a period of 6.5 years. Forty-five patients with 50 calcaneal fractures were completely clinically and radiologically followed up. Clinical follow-up included assessment of range of motion, pain according to a visual analogue scale, the American Orthopaedic Foot and Ankle Society hindfoot score, and the short-form 36 health survey. Radiological follow-up included plain axial and lateral radiographs and measurement of the Böhler's angle and Gissane's angle. Independent Student's t test and paired Student's t test were used alongside the chi-square test to compare clinical and radiological data and score values between different groups of patients. Eleven patients showed breakage of the osteosynthesis material during the healing process and 2 patients sustained deep wound infection requiring revision surgery. At the final follow-up all fractures had healed. The average range of motion was supination 26.4° (range 0° to 50°; SD 11.6°), pronation 15.4° (range 0° to 30°; SD 6.4°), dorsal extension 14.3° (range -10° to 30°; SD 8.0°), and plantarflexion 39.6° (range 20° to 65°; SD 11.7°). Patients with OTA type C4 fractures achieved significantly lower supination (p fracture types. The mean visual analog scale pain score was 3.6 (range 0 to 8; SD 2.3) points, average American Orthopaedic Foot and Ankle Society hindfoot score was 70.8 (range 33 to 100; SD 17.1) points, and the mean short-form 36 score was 60.98 (range 22.9 to 93.0; SD 18.4) points. The mean postoperative Böhler's angle was 28.9° (range 8° to 38°; SD 7.1°), which decreased to 23.6° (range 4

  3. Proximal humerus comminuted fracture of the plate fixation in the treatment of locking application%肱骨近端粉碎性骨折应用锁定钢板内固定治疗的临床分析

    Institute of Scientific and Technical Information of China (English)

    叶鹏

    2014-01-01

    Objective:To study the comminuted fractures of the proximal humerus locking plate internal fixation treatment.Methods:A retrospective analysis of 22 cases of proximal humerus fractures in our hospital patient data.Results:Patients with fractures healed,the average healing time of 22W frac-ture,the excellent and good rate was 81.8%.Conclusion:the use of locking plate fixation for comminuted fractures of the proximal humerus,effect.%目的:研究分析肱骨近端粉碎性骨折应用锁定钢板内固定治疗效果。方法:回顾性分析我院收治的22例肱骨近端粉碎性骨折患者的资料。结果:患者骨折愈合良好,骨折平均愈合时间为22w,优良率为81.8%。结论:采用锁定钢板内固定治疗肱骨近端粉碎性骨折,效果显著。

  4. 前路钛板结合方形区螺钉内固定治疗涉及方形区的髋臼骨折%Quadrilateral plate fractures of the acetabulum treated by internal fixation with reconstruction titanium plate combined with trans-plate quadrilateral screws via the ilioinguinal approach

    Institute of Scientific and Technical Information of China (English)

    蔡贤华; 刘曦明; 汪国栋; 徐峰; 王华松; 李世梁; 黄大伟; 徐洲发

    2013-01-01

    目的 探讨前路钛板结合方形区螺钉内固定治疗涉及方形区的髋臼骨折的疗效. 方法 2005年1月至2011年5月共收治52例涉及方形区的髋臼骨折患者,其中36例获得随访,男21例,女15例;年龄21~59岁,平均43.5岁.骨折按Letournel分型:双柱骨折15例,横形骨折4例,前柱伴后半横形骨折8例,T形骨折9例.所有患者均采用髂腹股沟入路,复位后行重建钛板及经钛板3 ~5枚皮质骨螺钉(方形区螺钉)部分经骨表面内固定.术后应用Matta放射学标准评估骨折复位质量,末次随访时采用改良Merle d'Aubigné和Postel评分标准评定髋关节功能. 结果 36例患者术后获12 ~ 72个月(平均41.7个月)随访.术后骨折复位质量按Matta放射学标准评定:解剖复位19例,良好复位12例,不满意复位5例,复位优良率为86.1%.所有患者骨折均获临床愈合,愈合时间为2~4个月,平均3个月.末次随访时采用改良Merle d'Aubigné和Postel评分标准评定髋关节功能:优16例,良13例,可5例,差2例,优良率为80.6%.本组患者功能优良率与骨折复位质量呈明显正相关(r=0.513,P=0.001).无一例患者发生方形区螺钉松脱、断裂.结论 前路钛板结合方形区螺钉内固定可靠,无进入髋关节腔之虞,是治疗以前柱损伤为主的双柱骨折、向前移位的横形骨折、部分前柱合并后半横形骨折及部分T形骨折的有效方法之一.%Objective To explore the clinical efficacy of internal fixation using reconstruction titanium plate combined with trans-plate quadrilateral screws in treatment of quadrilateral plate fractures of the acetabulum via the ilioinguinal approach.Methods Of the 52 quadrilateral plate fractures of the acetabulum which had been treated between January 2005 and May 2011,36 cases were followed up.They were 21 males and 15 females,with an average age of 43.5 years (from 21 to 59 years).By Letournel's classification,there were 15 double

  5. Three-dimensional stereophotogrammetrical analysis of peristomal fixation of adhesive base plates during hands-free speech among laryngectomised patients related to tracheostoma volumes.

    NARCIS (Netherlands)

    Dirven, R.; Wouters, Y.; Vreeken, R.; Maal, T.J.J.; Marres, H.A.M.

    2012-01-01

    OBJECTIVES: This study evaluates the relation between stoma volumes by means of objective three-dimensional measurements of laryngectomised individuals and peristomal fixation of adhesive baseplates during hands-free speech. DESIGN: A three-dimensional stereophotogrammetrical image was captured of t

  6. 锁定钢板内固定联合抗骨质疏松药物治疗老年肱骨近端骨折的临床效果观察%Efficacy of locking plate fixation with anti-osteoporosis drug treatment of older patients with proximal humeral fractures

    Institute of Scientific and Technical Information of China (English)

    宋建军; 赵春斌; 平少华

    2015-01-01

    Objective To investigate the effect of the locking plate fixation with anti-osteoporosis drug in the treatment of older patients with proximal humeral fractures. Methods Sixty-two patients with proximal humeral fractures who were treated in Yuzhou Mining Company Hospital of Kailuan Group of Hebei Province from Feb. 2011 to Oct. 2013 were divided into observation group(n=30)and control group(n=32). Patients in both groups were given locking plate fixation,and patients in the observer group were also received anti-osteoporosis treatment. The information including hospitalization periods,efficacy and bone mineral density of the two groups was recorded. Results The hospitalization periods of the observation group and control group were (6. 9 ± 1. 0)d,(9. 5 ± 1. 1)d,and the difference was statistically significant(t=8. 426,P﹤0. 05). The efficacy in observer group was excellent in 17 cases,good in 10 cases,fair in 2 cases and poor in 1 case,and the efficacy of the control group was excellent in 14 cases,good in 10 cases,fair in 5 cases and poor in 3 cases. The difference was statistically significant(χ2 =4. 617,P ﹤0. 05 ). After the anti-osteoporosis treatment,the bone mineral density of the observer group and control group were( 0. 79 ± 0. 13)g/cm2 and(0. 66 ± 0. 05)g/cm, the difference was statistically significant( t =10. 251,P ﹤0. 05 ). Conclusion The effect of locking plate fixation with anti-osteoporosis drug is better with shorter hospital stay,safe and reliable,and it is worthy of clinical application.%目的:探讨锁定钢板内固定联合抗骨质疏松药物治疗老年肱骨近端骨折的效果。方法将我院2011年2月至2013年10月收治的62例老年肱骨近端骨折患者随机分为观察组30例和对照组32例。两组均给予锁定钢板内固定治疗,观察组术后给予抗骨质疏松治疗。观察并比较两组患者的住院时间、治疗效果及骨密度。结果观察组和对照组住院时间分别为(6.9±1

  7. 钢板内固定与外固定架治疗桡骨远端不稳定骨折的Meta分析%Plate internal fixation versus external fixator for the treatment of unstable distal radius fractures:A Meta-analysis

    Institute of Scientific and Technical Information of China (English)

    陈柯屹; 杨广忠; 马创; 赵弟庆; 王国旗; 余凯; 袁春晓; 李京; 杨新明

    2013-01-01

    BACKGROUND:The surgical method for the treatment of unstable distal radius fracture mainly includes plate internal fixation and external fixator, but both of these two methods have the advantages and disadvantages. Which treatment is more conducive to the rehabilitation of patients, there is stil controversy. OBJECTIVE:To evaluate the clinical effectiveness of internal fixation and external fixator for the treatment of unstable distal radius fractures. METHODS:The relative databases and literatures were searched with the computer and hand to col ect the randomized control ed trials of internal fixation versus external fixator for the treatment of unstable distal radius fractures. After extraction literature data and quality evaluation, RevMan 5.2 software was used for system evaluation. The grip strength, disabilities of arm, shoulder&hand score, complications rates, infection rates, deformity rates and ulnar variance rates were compared between two groups. RESULTS AND CONCLUSION:A total of 9 literatures, involving total y 524 patients were included, 286 patients in the internal fixation group and 238 patients in the external fixator group. There was no significant difference in grip strength between internal fixation group and the external fixator group. The results of Meta-analysis showed that the internal fixation group was better than the external fixator group in the aspects of disabilities of arm, shoulder&hand score, complications rate, infection rate, deformity rate and ulnar variance rate at 3 months and 1 year after treatment. The results indicate that the plate internal fixation is better than external fixator in the treatment of unstable distal radius fractures, but the large sample, double-blind, and high quality randomized control ed trials are stil needed to identify the results.%背景:桡骨远端不稳定骨折的手术治疗方式主要包括钢板内固定和外固定架,但2种治疗方法各有优缺点,哪种治疗更有利于患者

  8. Biomechanical evaluation of screw and plate fixation in pelvic fractures%螺钉与钢板在骨盆骨折置入内固定应用中的生物力学评价

    Institute of Scientific and Technical Information of China (English)

    赵艳

    2011-01-01

    背景:骨盆骨折在临床中较为常见,植入内固定物方法多、难度大,如治疗不当,会引起骨盆周围软组织损伤、皮肤坏死、感染,是导致临床内固定治疗失败的重要原因之一.目的:从生物力学角度探讨骨盆骨折内固定治疗的最佳方法并评价其效果.方法:应用计算机检索2004-01/2011维普数据库中与骨盆骨折有关的文献.检索关键词为骨盆骨折;内固定;效果评价.纳入与螺钉、钢板内固定置入治疗骨盆骨折相关的文献进行分析.结果与结论:骨盆骨折是一种高能量的损伤,作为临床发生率逐年升高、致残率高和病死率高的一种疾病,进行相关生物力学研究有助于解释骨盆骨折的发生机制、骨折分型并对最终的治疗方式的选择有着非常重要的作用.骨折的解剖复位和牢靠的固定,以及螺钉、钢板的内固定技术都很重要,开发研制创伤小、感染率低、固定牢靠、相容性良好的内固定置入体,是目前治疗不稳定型骨盆骨折的重要方向.%BACKGROUND: Pelvic fractures are more common in clinic. There are various internal fixation methods for implantation that arediffi cult. If not treated properly, it can cause pelvic soft tissue injury, skin necrosis, infection, leading to clinical failure of internalfixation as one important reason.OBJECTIVE: To investigate the optimal internal fixation therapy for pelvic fractures and to evaluate its effect.METHODS: A computer-based online search of VIP database (2004-01/2011) was conducted to retrieve articles regarding screwand plate internal fixation of treatment of pelvic fractures using the keywords of “pelvic fracture, internal fixation, effect evaluation”.RESULTS AND CONCLUSION: Pelvic fracture is a high-energy injury with high morbidity and high mortality, and the incidence isincreased year by year in clinic. Relevant biomechanical studies are useful to explain the action mechanism and fracture type

  9. [Case-control study on Zero-profile implant for anterior cervical discectomy and fusion and conventional cage plate internal fixation for the treatment of single segmental cervical intervertebral disc herniation].

    Science.gov (United States)

    Shao, Hai-yu; Zhang, Jun; Yang, Di; Chen, Jin-ping; Huang, Ya-zeng

    2016-06-01

    To compare clinical efficacy of Zero-profile implant for anterior cervical discectomy and fusion and conventional titanium plate with cage internal fixation for the treatment of single segmental cervical intervertebral disc herniation. From August 2011 to March 2014, clinical data of 139 patients with single cervical disc herniation treated with anterior cervical discectomy and interbody fusion with internal fixation were retrospectively analyzed. The patients were divided into two groups according to its operation method. There were 63 patients in group A which performed anterior discectomy and interbody fusion with Zero-profile;76 patients in group B which performed anterior cervical discectomy and cage plate internal fixation. JOA score and Odom functional rating between two groups were compared before and after operation. Videofluorographic swallowing study (VFSS) were used to evaluate thickness of prevertebral soft tissue. Bazaz dysphagia score were used to assess incidence of dysphagia. Postoperative AP X-ray and CT of cervical vertebra at 12 months were applied for evaluating bone graft fusion. Postoperative MRI was applied for evaluating the incidence of adjacent segment degeneration. Blood loss,operative time, preoperative and postoperative JOA score, Odom functional rating and VFSS score, Bazaz score, fusion rate between vertebral bodies and incidence of adjacent segment degeneration were compared between two groups. There were no statistical meaning between two groups in JOA score, Odom functional rating before and after operation (P > 0.05); and no significant meaning in VFSS score between two groups before operation (P > 0.05); There were no significant difference in operative time and blood loss. There was statistical meaning in VFSS, Bazaz dysphagia score at 2 days, and 6 months after operation (P 0.05). Eight patients (12.7%) in group A occurred adjacent segment degeneration and 19 patients (25%) in group B occurred adjacent segment degeneration

  10. Stainless Steel 2.0-mm Locking Compression Plate Osteosynthesis System for the Fixation of Comminuted Hand Fractures in Asian Adults

    Directory of Open Access Journals (Sweden)

    Hing-Cheong Wong

    2011-12-01

    Conclusions: The stainless steel 2.0-mm LCP is useful for the fixation of unstable comminuted hand fractures, especially in metacarpal bones, because of its advantage of better stability, which allows more aggressive rehabilitation. However, its design is not very versatile and, therefore, limits its use in the finger region. Its bulkiness frequently causes implant impingement. The patients must be informed about the chance of implant removal later.

  11. Arthroscopic button plate fixation therapy for instable distal clavicular fracture%关节镜下纽扣钢板固定术治疗不稳定锁骨远端骨折

    Institute of Scientific and Technical Information of China (English)

    陈建海; 党育; 付中国; 姜保国

    2015-01-01

    Background The cases of distal clavicular fracture account for 12%-1 5% of all clavicular fracture cases.Distal clavicular fracture combined with coracoclavicular ligament rupture frequently behave as unstable fracture,with the opportunity for fracture non-union in conservative therapy being as high as 21%.Although partial patients with fracture nonunion show mild clinical symptoms,the symptomatic nonunion may affect the functions of shoulder joint.Therefore,most of physicians suggest operative treatment for unstable distal clavicular fracture.The operative treatment can achieve fracture union rate up to 98%.The distal clavicular fracture is characterized by fracture combined with ligament injury, and there are also diversified clinical therapies. The frequently reported internal fixation methods include kirschner wire,tension band,coraco-clavicular screw, anchor,clavicular hook plate,anatomical locking plate as well as suture fixation,etc.After fracture union,the metallic internal implants are frequently required to be taken out through operation. Different therapies have both their advantages and disadvantages.At present,there has been no unified therapy for unstable distal clavicular fracture.Arthroscopic button plate fixation therapy for unstable distal clavicular fracture is a relatively new minimally invasive treatment method,and its technology is originated from arthroscopic button plate fixation for the treatment of dislocation of acromioclavicular joint.We made retrospective analysis on the clinical effects of arthroscopic button plate fixation on distal clavicular fracture and discussed the potential advantages and disadvantages of this therapy.Method Ⅰ.General materials:Twenty-one patients with unstable distal clavicular fracture who received operative treatment in our department during the period from September 2010 to December 2012 are collected,seventeen cases of these meet inclusion criteria,namely 10 male cases and 7 female cases,with an average

  12. 肱骨近端锁定接骨板治疗老年肱骨近端骨折%Proximal humerus locking plate fixation in the treatment of proximal humeral fracture

    Institute of Scientific and Technical Information of China (English)

    杨志; 陈记明

    2015-01-01

    目的:探讨应用肱骨近端锁定接骨板内固定治疗老年肱骨近端骨折的手术疗效。方法:回顾分析应用肱骨近端锁定接骨板内固定治疗21例老年肱骨近端骨折患者的临床资料,Neer分型,三部分骨折17例,四部分骨折4例。结果:通过术后(13.5±1.2)个月随访。骨折愈合时间3~8个月;根据Neer肩关节功能评分标准进行评定,优12例,良6例,可2例,差1例,优良率85.7%。结论:肱骨近端锁定接骨板治疗老年肱骨近端骨折内固定牢靠,局部创伤小,骨折愈合时间短,关节功能恢复满意,是老年肱骨近端骨折理想的治疗方法。%Objective:To explore the operation effect of the proximal humerus locking plate fixation in the treat-ment of proximal humeral fracture. Methods:a retrospective analysis of the proximal humerus locking plate fixation in the treatment of 21 cases of senile proximal humeral fractures in patients with clinical data, The Neer type, the three part fractures in 17 cases, 4 cases of four part fractures. Results:the patients were followed up for 10~18 months, av-erage 13.2 months. Fracture healing time of 3~8 months; shoulder joint function were evaluated according to Neer score standard, excellent in 12 cases, good in 6 cases, 2 cases, poor in 1 cases, the excellent and good rate was 85.7%. Conclusion:the proximal humerus locking plate in the treatment of senile proximal humeral fracture internal fixation is the ideal treatment of senile proximal humeral fracture , with few local trauma, short fracture healing time, and satis-factory joint function recovery.

  13. Clinical comparative analysis on percutaneous sacroiliac screws internal fixation and sacroiliac joint anterior plate fixation in the treatment of unstable pelvic fractures%经皮骶髂螺钉与骶髂关节前方钢板固定治疗不稳定性骨盆骨折的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    杨雷; 王洪飞; 王中海

    2012-01-01

    目的 探讨经皮骶髂螺钉与骶髂关节前方钢板固定治疗不稳定性骨盆骨折的临床疗效.方法 选取本院2008年1月至2011年6月收治的不稳定性骨盆骨折患者64例,随机分为两组,采用骶髂关节前方钢板固定治疗的患者32例为对照组,采用经皮骶髂螺钉内固定治疗的患者32例为观察组,比较两组患者围术期临床指标、术后Matta评分、术后Majeed功能评分.结果 观察组手术时间、术中出血量、伤口总长度、术后发热时间、住院时间均明显少于对照组,观察组并发症发生率(3.1%)明显低于对照组(21.9%),观察组术后Matta评分总优良率(96.9%)明显高于对照组(81.2%),观察组术后Majeed功能评分总优良率(93.8%)明显高于对照组(75.0%),差异均有统计学意义(P<0.05).结论 经皮骶髂螺钉内固定治疗不稳定性骨盆骨折具有损伤小、出血少、疼痛轻、恢复快等优点,是一种安全有效的微创手术方法,临床疗效明显好于骶髂关节前方钢板固定,术前充分准备及患者积极配合可以大幅降低并发症的发生率,值得临床推广使用.%Objective To investigate clinical efficacy of percutaneous sacroiliac screws internal fixation and sacroiliac joint anterior plate fixation in the treatment of unstable pelvic fractures. Methods Sixty-four patients with unstable pelvic fractures were selected in the hospital from January 2008 to June 2011, which were randomly divided into two groups. The control group (n=32) used sacroiliac joint anterior plate fixation, while the study group (n=32) used percutaneous sacroiliac screw internal fixation for treatment. The perioperative clinical indicators, postoperative Matta score, postoperative Majeed function score of all patients were compared. Results The operation time, intraop-erative blood loss, wound total length, postoperative fever time, duration of hospitalization in the study group were significantly less than those

  14. 齿状突螺钉钢板内固定系统的生物力学研究%A biomechanical evaluation of odontoid screw plate fixation system

    Institute of Scientific and Technical Information of China (English)

    胡勇; 董伟鑫; 孙肖阳; 袁振山; 张蛟; 谢辉; 邬春晖

    2016-01-01

    目的 评价自行设计的齿状突螺钉钢板内固定系统在治疗Ⅰ型Hangman骨折伴Ⅱ型齿状突骨折联合C2~C3椎间盘损伤时的生物力学性能.方法 选取8具新鲜尸体颈椎标本(包括C1~C3颈椎节段),在生物力学试验机上依次测试以下各组C1~C2及C2~C3节段的三维运动范围(ROM)值及中性区值:完整标本状态(A组);失稳状态:Hangman Ⅰ型骨折+Ⅱ型齿状突骨折+C2~C3椎间盘切除(B组);颈椎前路钢板+齿状突螺钉+ cage固定组(C组);齿状突螺钉钢板固定组(D组);后路C2~C3椎弓根侧块螺钉+齿状突螺钉固定组(E组)和后路C1~C3椎弓根侧块螺钉固定组(F组),并对结果进行统计学分析.结果 在C1~C2节段,D组和F组的ROMC1~c2值在各个方向上差异均有统计学意义(P<0.05).在C2~C3节段,D组与C组相比,ROMC2~c3值在各个方向上均较小,且差异有统计学意义(P<0.05);D组与E、F组相比,ROMC2~C3值在前屈、后伸方向上较小,且差异有统计学意义(P<0.05).结论 齿状突螺钉钢板内固定系统在治疗Hangman Ⅰ型骨折伴Ⅱ型齿状突骨折联合C2~ C3椎间盘损伤时具有良好的生物力学性能,可以作为治疗此类合并伤的一种补充方法.%Objective To evaluate the biomechanical stability of anterior odontoid screw plate (AOSP).Methods Eight fresh-frozen cadaveric cervical spine specimens were subjected to stepwise destabilization of the C1-Ca complex,simulating a type Ⅰ Hangman fracture,type Ⅱ odontoid fracture,and the C2-3 disc injury.Intact specimens,fractured specimens,and fractured specimens with posterior,anterior fixation techniques were divided into six groups:control group (intact),injury group of type Ⅱ odontoid fracture and type Ⅰ Hangman fracture combined with C2-3 disk injury,after anterior cervical plate + odontoid screw + cage (ACP + OS + cage) group,after anterior odontoid screw plate (AOSP) fixation system group,after affixing rods from

  15. Comparison between External Fixator Combined with Kirschner Wire and Internal Fixation with Locking Compression Plate in the Treatment of Type C Fractures of Distal Radius%外固定架结合克氏针与锁定钢板内固定治疗桡骨远端C型骨折的疗效对比

    Institute of Scientific and Technical Information of China (English)

    郑创义; 黄钟炼; 陈舜亮

    2015-01-01

    Objective:To compare the clinical efficacy between external fixator combined with kirschner wire technique and internal fixation with locking compression plate in the treatment of type C fractures of distal radius.Method:Thirty-eight patients with type C distal radial fractures from February 2007 to January 2014 were selected as the study objects.Twenty-one patients who underwent external fixator combined with kirschner wire were classified into group A.Seventeen patients who underwent open reduction and internal fixation with locking compression plate through volar were classified into group B.According to the AO classification,there were 5 cases of type C1,8 cases of type C2 and 8 cases of type C3 in group A.5 cases of type C1, 5 cases of type C2 and 7 cases of type C3 in group B.After the operation all patients were followed up with the use of radiographs and the wrist joints function was assessed by Dienst Scores.Result:All patients were followed up for 4 to 13 months(average 8.6 months).All fractures united in 3 to 8 months(average 5.3 months).There were 2 cases of pin tract infection and 2 cases of pin loosening and withdrawal in group A.There were 2 cases occurred loss of reduction and screws penetrated into the joint cavity in group B.The differences in the excellent and good rates of the wrist joint function of type C1 fractures and type C2 fractures between group A and group B were not significant(P>0.05).The excellent and good rates of wrist joint function of type C3 fractures were significantly higher in group A than in group B(P0.05),C3型骨折A组优于B组(P<0.05)。结论:对于闭合性桡骨远端C1、C2型骨折,可选择外固定架结合克氏针固定或锁定钢板内固定术,而对于C3型骨折,选择外固定架结合克氏针固定术疗效相对较佳。

  16. A prospective study of biological fixation with either plate or interlocking nail on the mean duration of union in diaphyseal fractures of tibia

    Directory of Open Access Journals (Sweden)

    Rajendra B Uppin

    2013-01-01

    Full Text Available Objective: To study the results of Biological plating or Interlocking nail for the closed diaphyseal fracture of the tibia in Department of Orthopedics, KLE University′s, Dr. Prabhakar Kore Hospital and Medical Research Center, Belgaum. The aim of this study was the evaluation of the results of biological plating or interlocking nail for closed diaphyseal fractures of the tibia. Materials and Methods: The study included 30 patients. All the patients underwent a comprehensive orthopedic examination and work-up was done to diagnose and classify tibial fractures. The treatment modalities were suggested accordingly. Results: Intramedullary nailing should be the method of choice for treating the closed type of tibial shaft fractures. Biological plating should be considered as an alternative in intramedullary interlocking nail in specific indications. Conclusion: Comprehensive orthopedic examination with detailed study of fracture pattern and type of fracture help to evaluate the different modalities of treatment.

  17. Biologic fixation through bridge plating for comminuted shaft fracture of the clavicle: technical aspects and prospective clinical experience with a minimum of 12-month follow-up.

    Science.gov (United States)

    Jung, Gu Hee; Park, Chang-Min; Kim, Jae-Do

    2013-12-01

    For comminuted shaft fracture of clavicle, the operative goal, aside from sound bone healing without complications of direct reduction, is maintenance of the original length in order to maintain the normal biomechanics of adjacent joint. Our bridge plating technique utilizing distraction through a lumbar spreader was expected to be effective for restoring clavicular length with soft tissue preservation. However, there are two disadvantages. First, there is more exposure to radiation compared to conventional plating; and second, it is difficult to control the rotational alignment. Despite these disadvantages, our technique has important benefits, in particular, the ability to preserve clavicular length without soft tissue injury around the fracture site.

  18. 髋臼横断骨折后柱长/短钢板内固定的有限元建模及分析%FEM Modeling and Analysis of Transverse Fractured Acetabulum with Fixations of Posterior Column Long Plate and Short Plate

    Institute of Scientific and Technical Information of China (English)

    吴淑琴; 潘宏侠; 裴葆青

    2011-01-01

    目的 建立有效的髋臼横断骨折有限元模型,完成两种内固定方式的比较.方法 利用Mimics 10.0中建立髋臼骨骨折的三维模型,在逆向工程Geomagic中进行相应处理后,在ANSYS Workbench中生成短/长钢板固定模型,并进行加载分析.结果 相同加载方式下,短钢板模型的最大位移、模型整体及髋臼窝处的最大应力和最大应变,均大于长钢板模型.另外,短钢板模型更容易错位失效.结论 本文有限元模型能有效地反映骨盆应力分布,分析结果表明后壁钢板固定时,将钢板长度延伸至坐骨结节处能提供更大的稳定性.%Objective To establish a valid finite element model of the transverse fractured acetabulum and finish the analysis of inner fixation ways. Methods The three-dimensional image of the pelvis was reconstructed with the software Mimics 10. 0 and was modified with the software Geomagic. Then the 3D model of fractured pelvis was imported into ansys workbench and was established after some operations. After that the integrated 3D finite element models of transverse fractured acetabulums were established, which were fixed with posterior column long and short plates respectively. Finally the vertical load pressure was exerted on the upper terminal plate of the pelvis with some constrainer, and the distribution of stress was analyzed. Results With same loads , the maximum total deformation , von-mises stress and von-mises strain of short plate were bigger than them of long plate. In addition, the model with short plate was easier to lapse. Conclusion It was indicated that the proposed model was stable and valid to contribute the stress of pelvis. For the fixation of transverse fractured acetabulum with a posterior plate, extending the plate to hucklebone tuber was considered more stable.

  19. 颈椎前路减压植骨钛板内固定治疗颈脊髓损伤%Treatment of Cervical Spinal Cord Injury by Anterior Decompression, Bone Graft and Titanium Plate Internal Fixation

    Institute of Scientific and Technical Information of China (English)

    沈宁江; 王先安; 林庆彪; 林明侠; 陈建

    2013-01-01

    Objective To evaluate the clinical efficacy of anterior decompression, bone graft and internal fixation for cervical spine fracture with cervical spinal cord injury. Methods 215 cases of cervical spine fracture with cervical spinal cord injury had been treated by the method of anterior decompression,iliac bone graft and cervical locking titanium plate fixation. X-rays were taken regularly after surgery and recovery of spinal cord function were recorded. Results 184 cases were followed for an average time of 3. 5 years. Bone graft union was achieved 3 months after surgery. The cervical intervertebral height and the physiological curvature maintained satisfactory without implant complications. Nerve function of 172 patients improved 1 to 2 degree. Only 12 cases with stage A nerve function obtained no recovery. Conclusion Patients of cervical fracture with cervical spinal cord injury should undergo surgery of anterior decompression,bone graft and plate fixation as soon as possible. It is good to spinal cord function recovery. The injured segments can obtain instant and firm stability, which makes care and functional exercises easier.%目的 评价颈椎前路减压植骨内固定治疗颈椎骨折合并颈脊髓损伤的临床疗效.方法 对215例颈椎骨折合并颈脊髓损伤的患者施行颈椎前路减压、自体髂骨植骨和颈椎带锁钛板内固定术.术后定期复查X线片,判定脊髓功能恢复情况.结果 随访184例患者,平均随访时间3.5年.术后3个月植骨块获得骨性愈合,颈椎椎间高度和生理曲度维持满意,无内置物并发症,172例患者神经功能提高1~2级,仅12例A级患者神经功能无恢复.结论 颈椎骨折合并颈脊髓损伤应尽早行前路减压、植骨、钛板内固定术,有利于脊髓功能恢复,能使损伤节段获得即刻、坚强的稳定,方便护理和功能锻炼.

  20. Comparative study of bridge plate associated to the intramedullary pin and the dynamic compression plate on the experimental osteotomy fixation of femoral in rabbits (Oryctolagus cuniculus). Clinical, radiographic, histological and scintigraphy analyses; Estudo comparativo da placa em ponte associada ao pino intramedular e da placa de compressao dinamica na fixacao de osteotomia experimental em femur de coelhos (Oryctolagus cuniculus). Analises clinica, radiografica, histologica e cintilografica

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Natalie Ferreira

    2011-07-01

    The objectives were to benchmark and monitor the fracture healing of femoral osteotomy in rabbits after fixation with dynamic compression plate and bridge plate associated with intramedullary pin. Were used 14 New Zealand rabbits, four months old with mean weight of 3.5 pounds, from the Experimental Farm Professor Helio Barbosa of the Veterinary School of Minas Gerais Federal Univ. (UFMG). The animals were randomly divided into two groups (I and II). All rabbits underwent osteotomy across the middle third of right femur. In the group I was made to fix the osteotomy with the bridge plate (BP) associated with intramedullary pin, introduced the technique of minimal invasion. In group II, we used dynamic compression plate (DCP) via the conventional approach. Both groups were evaluated clinical, radiographic, histologic and scintigraphic findings. Clinical assessments were performed weekly until the 12{sup th} postoperative week and radiographic examinations were performed before, immediately after, at 15, 30, 45, 60 and 90 days. The bone scintigraphy were performed before and at 20, 50 and 90 days after surgery to monitor the bone metabolism qualitatively and quantitatively. Observed perfusion and bone healing process. After 90 days of study, there was histopathologic evaluation of the osteotomized area and the insertion of screws. In the region of the osteotomy was observed predominance of trabecular bone in group I and group II, the predominance of bone osteons, compatible with the original bone. On insertion of the screws did not differ between groups and there was cortical discontinuity, little necrosis and local hemorrhage. The two types of fixation have led to consolidation within the scheduled period, maturing in early fixation with DCP fixation compared with BP. Scintigraphy demonstrated by the indices of activity and image characteristics, the process of bone healing was significantly greater in animals undergoing early fixation with DCP. (author)

  1. Analysis of the Effect of Locking Compression Plate Internal Fixation for Aged Fractures of Humerus%老年肱骨远端骨折锁定加压钢板内固定手术疗效分析

    Institute of Scientific and Technical Information of China (English)

    冯波

    2015-01-01

    Objective To study the analysis of the distal humerus fractures in elderly patients with locking compression plate fixation for the treatment of clinical effect.Methods 34 cases of elderly patients with distal humerus fractures were selected in May 2014 to May 2012 in our hospital, all patients were treated with locking compression plate fixation surgery, all patients were observed fracture healing effect. ResultsAll patients were followed, including fracture healing excellent in 19 cases, good in 13 cases, good in 13 cases, medium in 1 cases, and poor in 1 cases, the treatment rate of 94.1% excellent, and all the patients were not there wound infection, delayed union and nonunion and other complications.Conclusion Locking compression plate ifxation distal humeral fractures in elderly patients can promote fracture healing, the effect is signiifcant.%目的:研究分析老年肱骨远端骨折患者采用锁定加压钢板内固定术治疗的临床效果。方法选择我院2012年5月~2014年5月收治的34例老年肱骨远端骨折患者,所有患者均采用锁定加压钢板内固定手术治疗,观察所有患者的骨折愈合效果。结果对所有患者进行随访,其中骨折愈合优19例、良13例、可1例、差1例,其治疗优良率达94.1%;且所有患者均未出现伤口感染、骨折延迟愈合和骨不连等并发症。结论锁定加压钢板内固定术治疗老年肱骨远端骨折能够促进患者骨折愈合,效果显著。

  2. Secondary clavicle fracture after hook plate fixation for acromial clavicular joint dislocation%锁骨钩钢板治疗肩锁关节脱位并发骨折的探讨

    Institute of Scientific and Technical Information of China (English)

    许永康; 舒占坤; 张羽

    2015-01-01

    Background Dislocation of the acromio-clavicle (AC)joint is a common injury, accounting for 12% of shoulder girdle injuries.According to Rockwood classification,type Ⅰ and ⅡAC injuries prefer to conservative treatment;type Ⅳ-Ⅵ injuries are good indications for surgical treatment.Operative treatment for type Ⅲ injury is still controversial.Hook plate has been used by many surgeons as an internal fixation device to maintain the reduced AC joint in place.There are some complications that may occur in some cases,such as implant failure,loss of reduction and secondary clavicle fracture.This study is designed to evaluate the clinical outcome of patients treated by hook plate and explore the cause of secondary clavicle fracture.Methods From January 2008 to January 2014,73 patients who sustained clavicle fracture was operated and fixed by hook plate.The operation was performed under general anesthesia or regional cervical plexus nerve block.The incision was from distal third of clavicle down to corocoid.The acromial clavicular joint,distal third of clavicle,corocoid and corococlavicular ligament were exposed.Debridement of AC joint was performed and cartilage debris was removed.Corococlavicle ligament was explored and sutures were preload in the ligament. Acromial clavicular joint dislocation was reduced and proper hook plate was chosen.The plate was fixed by screws and sutures were tied.The acromial clavicular capsule was repaired.The wound was closed layer by layer.Post-operative care:the shoulder was protected in a sling for 3 weeks.Pendulum exercise began immediately after operation.Passive motion could be started as pain be tolerated. Results Seventy-three patients were included in this study.There were 47 males and 26 females.The patients suffered from fall in 37 cases,traffic accident in 1 7 cases and hit on the shoulder in 1 9 cases. According to Rockwood classification,type Ⅲ in 61 cases,type Ⅳ in 12 cases.The follow up time was from 1 to 34 months

  3. 经皮骶髂螺钉和骶髂关节前路钢板内固定治疗不稳定骨盆骨折的临床疗效比较%Clinical curative effect comparison on percutaneous sacroiliac screws internal fixation and sacroiliac joint anterior plate fixation in the treatment of unstable pelvic fractures

    Institute of Scientific and Technical Information of China (English)

    蔺广生

    2016-01-01

    目的:探讨经皮骶髂螺钉和骶髂关节前路钢板内固定治疗不稳定骨盆骨折的临床疗效。方法选取2012年1月~2014年1月收治的149例不稳定骨盆骨折患者,根据治疗方法将其分成骶髂钢板组和骶髂螺钉组。其中骶髂钢板组74例,给予骶髂关节前路钢板内固定治疗;骶髂螺钉组75例,给予经皮骶髂螺钉治疗。比较两组患者临床资料、手术相关指标、临床疗效以及术后并发症。结果两组患者性别、年龄、致伤原因、合并伤以及Tile分类等资料数据比较差异无统计学意义( P>0.05);骶髂螺钉组患者手术时间、出血量、切口长度以及住院时间[(86.1±11.2)min,(16.7±8.5)mL,(1.7±0.6)cm和(8.7±2.7)d]均显著低于骶髂钢板组患者[(122.3±20.5)min,(516.3±118.7)mL,(15.7±1.5)cm和(17.7±4.8)d,P<0.05];骶髂螺钉组患者骨折复位优良率和功能恢复优良率(97.3%和96.0%)均显著高于骶髂钢板组患者(79.7%和73.0%,P<0.05);骶髂螺钉组患者术后并发症发生率(4.0%)显著低于骶髂钢板组患者(24.3%,P<0.05)。结论经皮骶髂螺钉治疗不稳定骨盆骨折临床疗效显著,且具有出血量小、创伤小、恢复快、术后并发症少等优点,值得临床推广应用。%Objective To investigate clinical efficacy of percutaneous sacroiliac screws internal fixation and sacroiliac joint anterior plate fixation in the treatment of unstable pelvic fractures.Methods From Jan.2012 to Jan.2014,149 cases of unstable pelvic fracture were selected to study.According to the treatment method,all the patients were divided into sacroiliac plate group and sacroiliac screw group.There were 74 patients in the sacroiliac plate group treated with the sacroiliac joint anterior plate internal fixation and 75 patients in the sacroiliac screw group treated with percutaneous sacroiliac screw fixation

  4. H 形钢板固定骶髂关节分离的生物力学评价%Biomechanical assessment on internal fixation with H-shaped reconstruc-tion plate for sacroiliac joint dislocation

    Institute of Scientific and Technical Information of China (English)

    廖文胜; 丁强; 王利民

    2013-01-01

    目的:设计针对骶髂关节脱位内固定治疗的H形钢板,并行生物力学评价。方法:根据解剖特点,设计并制作适用于骶髂关节脱位的H形钢板。收集12个成年防腐骨盆标本,切断骶髂前韧带、骶髂后韧带和骶髂骨间韧带,制作成12对骶髂关节分离模型并随机分为两组,分别使用H形钢板固定和传统的双钢板固定。应用万能生物力学试验机,分别测量侧方和垂直方向上骶髂关节间位移1、2和3 mm时所需要的载荷。结果:在侧方位移1、2和3 mm和垂直位移1 mm时,H形钢板固定组所需载荷均大于传统双钢板固定组(t=4.774,4.202,5.561和2.793,P<0.05)。垂直位移2和3 mm时,两组间所需载荷差异无统计学意义(t=1.362,0.775,P>0.05)。结论:H形钢板应用于骶髂关节分离的固定时,对抗旋转和垂直方向上的初始移位的能力更强,具有更好的力学稳定性。%Aim:To design H-shaped reconstruction plate for the fixation of sacroiliac joint dislocation and to observe its biomechanical characteristics .Methods:H-shaped reconstruction plate was designed based on anatomical features of sacroiliac joint .A total of 12 pelvises of cadaver were achieved ,and dissected sagittally through the midline of the sacrum and the pubic symphysis .All ligaments surrounding the sacroiliac joints were removed .12 pairs of sacroiliac joint disloca-tion model were obtained and divided into two groups randomly .Six samples(Group A)were fixed with H-shaped plates and 4 screws,another 6 samples(Group B)were fixed with two traditional reconstruction plates and 4 screws.Then biomechani-cal tests were performed to measure the loading force at the different displacement (1, 2, and 3 mm) in the lateral and ver-tical direction, respectively.Results:The loading force of Group A was larger than that of Group B at 1,2 and 3 mm dis-placement in lateral direction and 1 mm

  5. Analysis of residual stress and hardness in regions of pre-manufactured and manual bends in fixation plates for maxillary advancement.

    Science.gov (United States)

    Araújo, Marcelo Marotta; Lauria, Andrezza; Mendes, Marcelo Breno Meneses; Claro, Ana Paula Rosifini Alves; Claro, Cristiane Aparecida de Assis; Moreira, Roger William Fernandes

    2015-12-01

    The aim of this study was to analyze, through Vickers hardness test and photoelasticity analysis, pre-bent areas, manually bent areas, and areas without bends of 10-mm advancement pre-bent titanium plates (Leibinger system). The work was divided into three groups: group I-region without bend, group II-region of 90° manual bend, and group III-region of 90° pre-fabricated bends. All the materials were evaluated through hardness analysis by the Vickers hardness test, stress analysis by residual images obtained in a polariscope, and photoelastic analysis by reflection during the manual bending. The data obtained from the hardness tests were statistically analyzed using ANOVA and Tukey's tests at a significance level of 5 %. The pre-bent plate (group III) showed hardness means statistically significantly higher (P < 0.05) than those of the other groups (I-region without bends, II-90° manually bent region). Through the study of photoelastic reflection, it was possible to identify that the stress gradually increased, reaching a pink color (1.81 δ / λ), as the bending was performed. A general analysis of the results showed that the bent plate region of pre-bent titanium presented the best results.

  6. Fixation of complex proximal humeral fractures in elderly patients with a locking plate: A retrospective analysis of radiographic and clinical outcome and complications

    Institute of Scientific and Technical Information of China (English)

    Fabio Rodia; Emmanouil Theodorakis; Georgios Touloupakis; Angelo Ventura

    2016-01-01

    Purpose:The optimal surgical treatment of displaced type B and C fractures of the proximal humerus in the elderly remains controversial.Good clinical results have been reported by plating these fractures as well as a high rate of complications.Our retrospective study aims to evaluate clinical recovery and complications using the S3 locking plate in elderly patients.Methods:Fifty-one patients older than 65 years of age,with a complex proximal humeral fracture type B or C (AO classification system),were included.Patients have been followed up for a minimum of 12 months.We assessed callus formation,radiological results,clinical outcome (according to the Constant Shoulder Score System) and complications.Any difference in the clinical recovery among the 2 types of fracture pattern (B and C) was investigated.Results:The mean time of fracture healing was 12.4 weeks.The mean Constant score at 3,6 and 12 months was 68,73 and 75 respectively.No statistically significant difference in the clinical outcome was observed between the B and C fracture patterns (p > 0.05).We noticed an overall of 5 complications (9.8%).There was no need to revision any of the implants.Conclusion:Anatomic reduction and proper plate positioning are essential for minimizing implantrelated complications.In our experience the S3 angular stability system offers a proper osteosyntesis and a good clinical recovery with a low rate of complications.

  7. 微型钛板与锚定法颈椎单开门治疗颈椎病效果的对比研究%Mini titanium plate fixation versus anchor fixation in unilateral open-door laminoplasty for treatment of multilevel cervical myelopathy

    Institute of Scientific and Technical Information of China (English)

    温世锋; 郭东明; 徐中和; 肖文德; 李菊根; 尹庆水

    2013-01-01

    Objective To evaluate clinical efficacy of mini titanium plate fixation versus anchor fixation in unilateral open-door laminoplasty for treatment of multilevel cervical myelopathy (MCM).Methods A retrospective study of fifty-five patients with MCM who had undergone unilateral open-door laminoplasty was performed.Twenty-six patients underwent surgery with mini titanium plate fixation (A group)and twenty-nine patients with anchor fixation (B group) respectively.Clinical results were assessed by comparing the following parameters between patients who were in the two groups:Japanese Orthopaedic Association (JOA) score and JOA recovery rate,and image results were measured by Ishihara's curvature index,and area of the narrowest spinal canal and spinal cord in MRI.Results Fifty patients were followed up from 6 to forty-two months with an average of (27.1 ±9.9) months.No statistically significant differences were identified in follow-up JOA score and JOA recovery rate (P>0.05).A group had larger difference between the pre-and postoperative Ishihara's curvature index,area of the narrowest spinal canal and spinal cord (P<0.05).Conclusions Satisfactory recovery of neurological function can be achieved and maintained by the two fixations,however,A group had better image results than B group.%目的 比较颈椎单开门应用两种固定技术治疗多节段脊髓型颈椎病的的临床及影像学结果.方法 55例多节段脊髓型颈椎病患者,均进行颈椎单开门椎管扩大成形术,根据内固定技术分为微型钛板固定技术(A组)26例和锚定法固定技术(B组)29例.通过比较JOA评分及改善率评价临床疗效,而影像学结果则通过比较X线颈椎曲度变化值和MRI椎管与脊髓最狭窄处面积进行评估.结果 其中50例获得随访6~42个月,平均(27.1±9.9)个月.两组患者随访时JOA评分及改善率比较差异均无统计学意义(P>0.05);而在颈椎曲度变化值、椎管与脊髓最狭窄处面积变化

  8. Clinical Effect of Percutaneous Sacroiliac Screws Fixation and Plate Fixation in Front of Sacroiliac Joints in Treating ;Unstable Pelvic Fractures%经皮骶髂螺钉与骶髂关节前方钢板固定治疗不稳定性骨盆骨折的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    刘洪; 唐长友; 贺健军

    2015-01-01

    Objective To investigate the clinical effect of plate fixation in front of sacroiliac joints and percutaneous sacroiliac screws fixation in treating unstable pelvic fractures. Methods 82 patients with unstable pelvic fractures treated in our hospital from March 2011 to March 2014 were selected and randomly divided into two groups. The control group (41 cases) was treated with plate fixation in front of sacroiliac joints, the observation group (41 cases) was treated with percutaneous sacroiliac screws fixation. The operation time, length of incision, bleeding volume during operation, hospitalization time, the treatment effects and complications were compared between two groups. Results The length of incision, operation time and hospitalization time of observation group were significantly shorter than those of control group, the bleeding volume during operation was significantly less than that of control group;the excellent and good rate of fracture reduction in observation group was 95.12%, significantly higher than 75.61%of control group;the incidence of complications of observation group was 4.88%, significantly lower than 19.51%of control group;all the difference was statistical (P<0.05). Conclusions In the treatment of unstable pelvic fractures, percutaneous sacroiliac screws fixation has the advantages of small trauma, quick recovery, better clinical effect and higher safety, which is worthy of promotion.%目的:探讨不稳定性骨盆骨折分别采用骶髂关节前方钢板固定与经皮骶髂螺钉固定治疗的临床效果。方法选取2011年3月至2014年3月我院收治的不稳定性骨盆骨折患者82例,随机分为两组各41例。对照组采用骶髂关节前方钢板固定治疗,观察组采用经皮骶髂螺钉固定治疗。比较两组的手术时间、切口长度、术中出血量、住院时间、治疗效果及并发症发生情况。结果观察组切口长度、手术时间及住院时间均明显短于对照组,术中出

  9. 弹性髓内钉治疗儿童股骨干骨折钢板固定失效病例%Elastic intramedullary nail for the treatment of femoral shaft fracture in children with failed plate fixation

    Institute of Scientific and Technical Information of China (English)

    王华明; 陈志龙; 李卫平; 裴生太; 陈世海

    2013-01-01

      BACKGROUND: Elastic intramedul ary nail fixed technology supported by three principle of elastic fixation fracture is suitable for children’s short transverse and oblique shape limbs long tubular bone fracture. This paper wil investigate the advantages of elastic intramedul ary nail in the treatment of femoral shaft fracture with failed plate fixation in children. OBJECTIVE: To observe the clinical effect and prognosis of elastic intramedul ary nail technology in the treatment of femoral shaft fracture with failed plate fixation in children. METHODS: Retrospective analysis was performed in 21 cases of femoral shaft fracture patients with plate fracture and failure after fixation in the Department of Pediatric Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine from March 2008 to August 2012. During the surgery, the plates were removed from the primary incision; after cleaned the fracture end, the medial and lateral retrograde percutaneous penetration of elastic nail was performed to fix the fracture on 1.0-2.0 cm from the femoral distal patel ar. At 3-6 months after surgery, the healing of the fracture was evaluated based on the imaging data, and then the screw was removed. The efficacy was analyzed in accordance with the Flynn fracture healing criteria in 2001. RESULTS AND CONCLUSION: Al the 21 patients were fol owed-up for 10 months in average. According to the Flynn fracture healing criteria, there were 19 cases of excel ent, two cases of good, no poor, and the excel ent and good rate was 100%. After fol owed-up for 10 months, two cases had overgrowth of affected limbs with the unequal length 30°, there was no elastic nail breakage or nonunion. Compared with open reduction technology, elastic intramedul ary nail for fracture fixation has fast recovery and healing and has fewer complications, so it is the effective method for the treatment of femoral shaft fracture fixation in children.%  背景:弹性髓内钉固定通过三点

  10. 钢板固定治疗胫骨平台骨折231例临床疗效观察%Observation on Clinical Effect of Plate Fixation for Tibial Plateau Fracture in 231 Cases

    Institute of Scientific and Technical Information of China (English)

    王春鹏

    2015-01-01

    Objective To discuss the clinical effect of different plate ifxation methods for tibial plateau fracture. Methods 231 patients with tibial plateau fracture were given plate ifxation in our hospital from 2012 to 2014. The clinical effects were made a retrospective analysis. 112 cases with unilateral locking plate ifxation was A group, 119 cases with bilateral anatomic plate ifxation was B group. The healing time of patients with fracture ifxation and their function of knee joint were compared between the two groups. Results The healing time and knee function in group A were signiifcantly better than the control group, P<0.05, there were differences. Conclusion Unilateral locking plate fixation for tibial plateau fracture can shorten the fracture healing time, make knee joint rehabilitation early and the knee functions are better.%目的:探讨不同钢板固定方式治疗胫骨平台骨折的效果。方法回顾性分析2012~2014年在我院进行胫骨平台骨折内固定治疗的患者231例,其中112例采用单侧锁定钢板内固定为A组,119例采用双侧解剖钢板内固定为B组,对比两组不同内固定方式患者的骨折愈合时间,膝关节功能。结果 A组患者的骨折愈合时间,以及膝关节功能优于对照组,P<0.05,差异有统计学意义。结论单侧锁定钢板内固定治疗胫骨平台骨折,骨折能够较早的愈合,膝关节得到较早的康复锻炼,膝关节功能较好。

  11. Comparison of clinical effects between external fixator combined with limited internal fixation and plates for treatment of intraarticular calcaneal fractures%外固定架结合有限内固定与钢板内固定治疗跟骨关节内骨折比较

    Institute of Scientific and Technical Information of China (English)

    柴雷子; 薛锋; 丁亮; 沈玉春; 赵勇

    2013-01-01

    Objective To investigate the clinical effects of the external fixator combined with the limited internal fixation for the treatment of intrarticular calcaneal fractures.Methods According to different ways of treatment of intraarticular calcaneal fractures,78 patients(86 feet) were divided into two groups:42 patients(48 feet) were treated with the external fixator combined with the limited internal fixation as group A; 36 patients (38 feet) were treated with plates as group B.Fracture healing time,recovery of the calcaneal,clinical outcomes and the rate of incision complications were compared.Results A total of 78 cases were followed up for 8~34 months (average 16.8 months).Both group A and B all had acceptable reduction in calcaneal length,height,width,Bohler angle,and Gissane angle,there was significant difference between preoperative and postoperative results(P <0.05),and there was no signicant difference in postoperative results between group A and group B(P >0.05).Based on the Maryland grading system,excellent rate was 89.6% in the group A,excellent rate was 86.8% in the group B,there were no significant difference between them(P >0.05).The rate of incision complications in the group A was lower than in the group B,there was significant difference between them (4.2% vs 21.1%,P <0.05).Conclusion External fixator combined with limited internal fixation for intraarticular calcaneal fractures is satisfactory and minimally invasive.%目的 探讨外固定架结合有限内固定治疗跟骨关节内骨折的临床疗效.方法 78例(86足)跟骨关节内骨折分为2组:A组42例(48足)采用外固定架结合有限内固定治疗;B组36例(38足)采用钢板内固定治疗.对两组骨折愈合时间、跟骨恢复情况、临床疗效、切口并发症发生率等指标进行比较.结果 78例均获得平均16.8(8~34)个月随访.两组术后跟骨的长度、宽度、高度、Bohler角及Gissane角均得到了良好的恢复,与术前比较

  12. 外侧锁定板与内侧支持接骨板联合治疗C2及C3型股骨髁间骨折%Internal Fixation of Femoral Intercondylar Fracture with Lateral Locking Plate and Medial Buttress Plate

    Institute of Scientific and Technical Information of China (English)

    周建刚; 孟维春; 曹骏敏; 蒋臻欢

    2011-01-01

    Objective:To investigate the clinical effects of the treatment of type C2 and C3 femoral intercondylar fractures using locking plate and buttress plate. MethodS:From 2007 to 2010,18 cases of femoral intercondylar fractures were treated with lateral locking plates and medial buttress plates. According to Osteosynthe stfragen (AO) fracture classification, the fractures were classified as type C2 in 12 cases and type C3 in 6 cases. Medial and lateral approaches were used in the operation. After reduction,buttress plates were placed medially and locking plates were inserted laterally. There was no additional external fixation device postoperatively. Results: All the cases were followed up for an average of 8. 3 months and they all got bony union in 12-22 weeks. According to the criteria of Lysholm Knee Score, the result was as follows: 8 excellent, 8 good and 2 fair. The excellent and good rate was 89%. Conclusions: Open reduction and internal fixation with locking and buttress plates in the treatment of type C2 and C3 femoral intercondylar fracture has the advantage of a low rate complication, stable fixation and rapid bone union,and presents good clinical outcome.%目的:探讨外侧锁定板结合内侧支持接骨板治疗股骨髁间C2及C3型骨折的可行性.方法:采用外侧锁定板结合内侧支持接骨板治疗股骨髁间骨折患者18例.按AO分型:C2型12例,C3型6例,手术均采用内、外侧联合入路,骨折解剖复位后分别在外侧放置髁支持钢板,内侧放置普通钢板固定,术后不予外固定.结果:所有患者获得随访,平均随访时间为8.3个月,骨折均愈合,愈合时间12~22周.膝关节功能Lysholm评分:优8例,良8例,可2例,优良率为89%.结论:切开复位外侧锁定板结合内侧支持接骨板内固定治疗C2及C3股骨髁间型骨折并发症少、固定牢固、骨折愈合快,能获得良好的临床效果.

  13. Case-control study on therapeutic effects between Kirschner wire fixation after early bebridement and staged plate fixation in the treatment of open calcaneal fractures%早期清创复位克氏针内固定与Ⅱ期钢板内固定治疗开放性跟骨骨折的病例对照研究

    Institute of Scientific and Technical Information of China (English)

    朱永展; 李逸群; 吴峰; 张宏宁; 温建强; 包杭生

    2012-01-01

    Objective:To compare therapeutic effects between Kirschner wire fixation after early debridement(Kirschner wire group) and staged plate fixation (plate group) in the treatment of open calcaneal fractures. Methods: From January 2001 to May 2008,55 patients (58 feel) with open calcaneal fractures were reviewed,the mean age was 36.8 years(ranged, 19 to 65 years) and the average visit time was 3 hours (ranged,30 min to 7 h). All the patients were divided into two groups:Kirschner wire group and plate group. There were 20 males(20 feet) and 9 females(9 feet) in Kirschner wire group,in which 15 feet were type 1,13 feet were type Ⅱ , 1 foot was type Ⅲ A according to Gustilo classification and 9 feet were type Ⅱ ,18 feet were type Ⅲ ,2 feet were type Ⅳ according to Sanders classification. The patients in Kirschner wire group were treated with early de-bridement,fracture reduction and Kirschner wire fixation,and the soft tissue defects were covered with VSD temporarily,and then were enveloped by skin or flap grafts at the second stage. There were 18 males (19 feet) and 8 females (10 feet) in the plate group, in which 13 feet were type 1,14 feet were type Ⅱ , 2 feet were type Ⅲ A according to Gustilo classification and 11 feet were type Ⅱ , 15 feet were type Ⅲ , 3 feet were type Ⅳ according to Sanders classification. The patients in the plate group were treated with early debridement, and plate internal fixation with were performed when the wound became stabilization. Results : Twenty-three feet (15 patients) in the Kirschner wire group and 22 feet (13 patients) in the plate group were followed, the duration ranged from 10 to 36 months,with an average of 24 months. Compared with preoperative ones,the heel height, width, Bohler angle and Gissane angle of calcaneal got improvements. According to AOFAS ankle- foot evaluation system, 11 feet got an excellent result,8 good in the Kirschner wire group;2 feet had wound local skin necrosis and cured by dressing

  14. 桥接钢板技术治疗不稳定性髋臼骨折临床效果分析%Clinical effect analysis of bridging plate fixation in treatment of unstable acetabulum fractures

    Institute of Scientific and Technical Information of China (English)

    沈影超; 王强; 顾云峰; 蒋晓伟

    2016-01-01

    Objective To observe the clinical effect of bridging plate fixation for the treatment of unstable acetabulum fractures. Methods The data of 12 patients with unstable acetabulum fracture who were treated by bridging plate fixation in our hospital from March 2014 to March 2015 were retrospectively analyzed.According to the OTA/AO type,8 cases were type B fracture,4 cases were type C fracture. Five patients were treated by ilioinguinal approach,4 patients recieved Stoppa approach.Through follow-up,the acetabulum fracture was eval-uated according to Matta evaluation standards,and the results was observed.Results All of 12 cases were followed up from 12 months to 16 months,with the average time of (14.1 ±2.2)months.The imaging showed that the postoperative femoral head-acetabulum matching was good,and there was no reset lost in a year.According to Matta evaluation standards,10 cases was excellent,1 case was good,1 case was in general.Conclusion The clinical curative effect of bridging plate fixation for instability of acetabulum fracture is excellent.Different approa-ches can not influence the way of functional recovery,but the time of the operation through Stoppa approach is shorter.%目的:观察桥接钢板技术治疗不稳定性髋臼骨折的临床疗效。方法回顾性分析2014年3月至2015年3月应用桥接钢板技术治疗的12例不稳定性髋臼骨折患者的临床资料,根据OTA/AO分型B型骨折8例,C型骨折4例;手术方式采用髂腹股沟入路5例,Stoppa入路4例。通过随访,Matta按髋臼骨折四级评定标准评分,并对上述结果进行评价。结果12例患者均获得随访,随访时间12~16个月,平均(14.1±2.2)个月。影像学显示术后股骨头-髋臼匹配良好,至术后1年无复位丢失。Matta髋臼骨折四级评定标准疗效,优10例,良1例,可1例。结论桥接钢板技术治疗不稳定性髋臼骨折的临床疗效优异;不同手术入路对功能恢复无影

  15. 小夹板外固定与钢板内固定材料置入对骨折断端成骨活性的影响%Influence of external fixation by small splint versus Internal fixation by steel plate on osteogenetlc activity of fracture bones☆

    Institute of Scientific and Technical Information of China (English)

    李瑛; 邹季; 熊勇

    2008-01-01

    influence of external fixation of small splint on healing of long bone fracture of rabbit, and compare to the internal fixation of steel plate.DESIGN: Randomized and controlled animal trial. SETTING: Research Institute of Orthopedics, Hubei College of Traditional Chinese Medicine.MATERIALS: The experiment was performed at the Laboratory of Orthopedics, Hubei College of Traditional Chinese Medicine from April 2006 to April 2007. Thirty rabbits were randomly divided into small splint fixation group and steel plate fixation group with 15 rabbits in each group. Small splint was self-made of fir-barks with good elasticity, and composed of exterior, interior, front and back splints. The upper part of the splint was wide and the lower part was narrow. We sting an eyelet in the small splint that is used in front and behind part. A hole was drilled in the front and back splints close to the tubercle of tibia. Steel plate was provided by Jiangsu Golden Deer Group (Type HA2.0). METHODS: The standard models of transverse fracture of 3 mm in the meta-infer 1/3 of left tibia were established. In small splint fixation group (SSF group), the fracture was fixed by plaster stone, and 5 days later, replaced by external fixation of small splint. The steel fixation group (SF group) was fixed by steel plate with 4 holes. Animals were executed 14, 24, and 34 days after surgery, respectively. The growth condition of bony callus in fracture sites was observed, and the histomorphology of bony callus and bone cell production during fracture healing was observed. MAIN OUTCOME MEASURES: Macroscopic observation of rabbit tibial bony callus, and histomorphology of bony callus and bone cell formation. RESULTS: In SSF group, the bony callus formed early, and there were plentiful and active osteoblast. Thirty-four days after surgery, bony union was observed in fracture sites. In SF group, there was little fibrous bony callus in the fracture ends 14 days after surgery, accompanied by granulation tissue

  16. 颈椎后路单开门结合钛板内固定治疗脊髓型颈椎病%Clinical observation of posterior cervical single door joint titanium plate fixation treatment for cervical myelopathy

    Institute of Scientific and Technical Information of China (English)

    李水胜; 黄黎

    2014-01-01

    目的:探讨分析颈椎后路单开门结合钛板内固定治疗脊髓型颈椎病的临床疗效。方法回顾性分析2009年5月至2012年6月间在我院进行治疗的46例脊髓型颈椎病患者的临床记录资料。结果治疗后,治疗组的优良率为82.61%,高于对照组的52.17%,具有显著性差异(P ﹤0.05);治疗组的 JOA 评分高于对照组,ROM、颈椎屈曲、后伸角度均低于对照组,均具有显著性差异(P ﹤0.05)。结论颈椎后路单开门结合钛板内固定治疗脊髓型颈椎病的临床疗效显著,值得临床推广应用。%Objective:To investigate clinical effect of posterior cervical single door joint titanium plate fixation in treat-ment for cervical myelopathy. Methods:The clinical records of 46 patients with cervical myelopathy in our hospital from May 2009 to June 2012 were reviewed. Results:After treatment,the excellent rate of treatment group( 82. 61% )were sig-nificantly higher than that of the control group(52. 17% )(P ﹤ 0. 05). The JOA score of the treatment group was signifi-cantly higher than that of the control group and ROM,cervical flexion ,extension angles of the treatment group were lower than that of the control group( P ﹤ 0. 05 ). Conclusion:Clinical efficacy of posterior cervical single door joint titanium plate fixation in treatment for cervical myelopathy is remarkable and worthy of clinical application.

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

    Directory of Open Access Journals (Sweden)

    Barabash Yu.A.

    2010-09-01

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

  18. Finite element analysis of bridge combined fixation system and the locking plate-screw system on the application for femoral fractures%桥接组合式内固定系统与锁定接骨板钉系统在股骨骨折应用中的有限元分析

    Institute of Scientific and Technical Information of China (English)

    熊鹰; 李群辉; 柳百炼; 赵烽; 王大兴; 张仲子

    2012-01-01

    背景:桥接组合式内固定系统在人体骨折固定上,与锁定钢板相比效果如何,有待实验证实.目的:比较桥接组合式内固定系统与金属锁定接骨板钉系统固定股骨干骨折的生物力学特性.方法:对两种固定方式的有限元模型进行模拟加载,了解各模型中骨与内固定的应力分布和应变特点,并对结果加以分析.结果与结论:爬楼梯时接骨板锁定螺钉上的应力比步态时增48.6%,达到480 MPa,最大应力出现在中间锁定螺钉上.桥接系统中间联接棒上的最大应力比步态时大34.1%,最大值为373.9 MPa,出现在联接棒中间略远端附近;骨折区域上的应力桥接组合式内固定系统小于金属锁定接骨板钉系统.提示桥接组合式内固定系统较金属锁定接骨板钉系统具有更好的生物力学性能,固定更牢靠、利于骨折生长,是骨折内固定的一种更好选择.%BACKGROUND: The effect of the bridge combined fixation system for the fixation of bone fracture compared with locking plate system needs to be confirmed by experiment. OBJECTIVE: To compare the biomechanical properties of bridge combined fixation system and locking plate-screw system for the fixation of femoral fractures. METHODS: We used the finite element analysis method to analyze biomechanical characters of the femoral fractures fixed with the locking plate-screw system and bridge combined fixation system, such as the stress distribution and the strain characteristics of bone and fixation. RESULTS AND CONCLUSION: The stress on the locking plate screw when climbing stairs was increased for 48.6% compared with walking, the stress was 480 MPa and the maximum stress was on the middle of the locking plate-screw screws. The maximum stress on the middle of the bridge system when climbing was 34.1% larger than that when walking, the maximum stress was 373.9 MPa and occurred near the distal connection rod. The stress on the fracture area of bridge combined

  19. Comparison of the effects on percutaneous sacroiliac joint screw fixation and anterior sacroiliac joint plate fixation in the treatment of unstable pelvic fractures%经皮骶髂关节螺钉与骶髂关节前方钢板固定治疗不稳定型骨盆骨折的效果比较

    Institute of Scientific and Technical Information of China (English)

    丁涛

    2016-01-01

    Objective To investigate the efficacy of percutaneous sacroiliac joint screw fixation and anterior sacroiliac joint plate fixation in the treatment of unstable pelvic fractures. Methods Forty cases of patients with unstable pelvic fractures were divided into two groups according to odd and even numbers. The control group (odd numbers, 20 cases) was given anterior sacroiliac joint plated fixation, while the observation group (20 cases) was given percutaneous sacroiliac joint screw. The efficacy of the two groups were evaluated with perioperative indexes, Majeed scores and complications during 6 months follow-up. Results The operative time, blood loss and hospitalization time of the observation group were significantly superior to those of the control group (P<0.05); the excellent rate of the observation group was significantly higher than that of the control group (P<0.05); during follow-up, the complication rate of the observation group was lower than that of the control group (P<0.05). Conclusion Percutaneous sacroiliac joint screw fixation has a good therapeutic effect on unstable pelvic fracture, with less operation time and fewer complications, so as to promote the recovery of patients, which is worthy of clinical application.%目的:探讨经皮骶髂关节螺钉与骶髂关节前方钢板固定治疗不稳定型骨盆骨折的疗效。方法选取40例不稳定型骨盆骨折患者,按住院单双号分为两组。对照组(20例)给予骶髂关节前方钢板固定治疗,观察组(20例)给予经皮骶髂关节螺钉治疗,观察并记录两组围手术期指标、Majeed评分及随访6个月期间并发症发生情况。结果观察组手术时间、术中出血量、住院时间均明显优于对照组( P<0.05);观察组患者手术治疗的优良率明显高于对照组( P<0.05),随访期间,观察组患者并发症发生率明显低于对照组( P<0.05)。结论经皮骶髂关节螺钉手术对不稳定型骨盆骨折

  20. Comparison of therapeutic effects between open reduction and internal fixation with conventional plate via L-shaped lateral approach and internal fixation with percutaneous plate using a sinus tarsi approach in treatment of calcaneal fractures%经跗骨窦切口插入钢板与经外侧L形切口钢板内固定治疗跟骨骨折临床疗效的比较

    Institute of Scientific and Technical Information of China (English)

    夏胜利; 王秀会; 陆耀刚; 王惠中; 王子平

    2012-01-01

    Objective To compare therapeutic effects between open reduction and internal fixation with conventional plate via L-shaped lateral approach and internal fixation with percutaneous plate using a sinus tarsi approach in the treatment of calcaneal fractures. Methods All of 108 patients (117 feet) of displaced intra—articular calcaneal fractures were randomly divided into two groups: minimally invasive treatment group with 59 cases (64 feet) and conventional treatment group with 49 cases (53 feet).Results All patients were followed up for 8 to 28 months (mean 19 months).Lateral roentgenograms showed satisfactory restoration of the calcaneal height,width,length,Bohlers angle and Gissanes angle after operation in all patients.Early wound complications occurred postoperatively in 8 feet in conventional treatment group, while no feet developed wound complication in invasive treatment group. Maryland foot score demonstrated excellent results achieved in 49 feet, good in 11, fair in 4 in minimally invasive treatment group with the excellent and good rates of 93.8%, and excellent results in 31 feet, good in 15 feet, fair in 7 feet in conventional treatment group with the excellent and good rates of 86.8%, with significant difference found between two groups (P <0.01). Conclusion Compared with conventional surgical methods of treatment of displaced intra—articular calcaneal fractures, sinus tarsi approach for the reduction and internal fixation with percutaneous plate not only significantly reduces operative time and achieves satisfactory clinical therapeutic effects, but also effectively avoids postoperative complications.%目的 比较经跗骨窦切口插入钢板内固定与经外侧L形切口复位钢板内固定治疗跟骨骨折的临床疗效.方法 108例(117足)跟骨关节内骨折被随机分为微创及常规治疗组,微创治疗组59例(64足)采用经跗骨窦切口插入钢板内固定,常规治疗组49例(53足)采用外侧L

  1. A modified unilateral open-door miniscrew-plate fixation:a biomechanical study%新型改良单开门微型钛钉-钛板内固定的生物力学研究

    Institute of Scientific and Technical Information of China (English)

    刘帅; 雷伟; 吴子祥; 樊勇; 严亚波; 石磊; 刘达; 张扬

    2011-01-01

    Objective To evaluate the biomechanical performance of a modified miniscrew-plate fixation in the unilateral open-door cervical laminoplasty.Methods Eight specimens of cervical spine (C3-C7) were made from intact adult cadavers.After randomization into 2 groups, with 4 specimens and 20 vertebral segments in each group, the unilateral open-door cervical laminoplasty was performed in each cervical vertebra in both groups.In group A the modified miniscrew-plates were used while in group B the traditional miniscrew-plates were implanted.A MTS880 machine was used to test the maximal load of the reclosed open-door miniscrew-plate at each cervical vertebra, and the maximal load and energy of the completely closed open-door miniscrew-plate.Results In the reclosing process, the mean maximal load was 873.61 ±154.40 N in group A and 297.17 ± 133.41 N in group B.In the complete closing state, the mean maximal load was 812.98 ± 141.79 N in group A and 145.77 ±59.21 N in group B; the mean energy was 5.95 ±0.83 J in group A and 1.65 ± 0.70 J in group B.There were significant differences between the 2 groups ( P < 0.05 ) .Conclusion The modified miniscrew-plate can have better biomechanical performance than the traditional miniscrew-plate in simulated unilateral open-door cervical laminoplasty.%目的 探讨改良单开门微型钛钉-钛板内固定的生物力学特性.方法 选取8具无损伤的新鲜人尸体颈椎标本(C3-7),经分次处理后随机分为两组,每组4具标本20个节段:A组:于每个节段颈椎标本模拟单开门颈椎管扩大成形术,术中使用改良单开门微型钛钉-钛板固定;B组:每节段颈椎标本模拟同样手术操作,使用传统单开门钛钉-钛板(Centerpiece钉板)固定.应用MTS880生物材料实验机测试每个颈椎节段标本开门后再关门的最大负荷、完全关门时的负荷及功耗,并对两组结果进行比较.结果 再关门过程中A组和B组的最大负荷平均分别为(873.61±154.40)

  2. 锁定加压钢板在治疗桡骨远端不稳定骨折中的应用%Locking Compression Plate Fixation for Intraarticular and Unstable Distal Radial Fractures

    Institute of Scientific and Technical Information of China (English)

    张珂; 刘其明; 赵庆华; 李峰; 王予治; 孙羽

    2012-01-01

      目的:探讨锁定加压钢板(locking compression plate,LCP)治疗不稳定型桡骨远端骨折(distal radial fractures,DRF)的效果.方法:分析自2006年1月~2012年5月我院采用锁定加压钢板治疗桡骨远端不稳定骨折20例患者临床资料,其中男12例,女8例;年龄18~66岁,平均年龄44.6岁.按AO桡尺骨远端骨折分型,B2、3型(部分关节面骨折,掌背侧骨块)6例;Cl型(完全关节内骨折,干骺端骨折)7例;C2型(完全关节内骨折,干骺端粉碎骨折)5例;C3型2例.部分患者初期手法复位固定治疗失败.掌侧入路切开复位,LCP内固定治疗.结果:术后门诊随访2~36个月.桡骨远端骨折均完全愈合,按改良的Mcbirde评分和纽约骨科医院腕关节功能评估标准,优良率为85℅(17/20).结论:对桡骨远端不稳定性骨折,掌侧LCP是一种安全有效的治疗方法.%  Objective:To investigate the locking compression plate (locking compression plate,LCP) the effect of the treatment of unstable distal radial fracture (distal radial fractures,DRF). Methods: Analysis from January 2006 to May 2012 using locking compression plate for treatment of distal radius unstable fracture of the clinical data of 20 patients,including 12 males and 8 females; age 18-66 years,mean age 44.6 years old. Radius and ulna in remote according to the AO fracture classification,B2,3 (partial articular fractures,palm dorsal bone) six cases: Cl (complete articular fractures of the metaphyseal fracture) 7 cases; C2,type (full intra-articular fracture,metaphyseal comminuted fracture) 5 cases; C3 type 2 patients. Fixed treatment failure in some patients early manipulative reduction. Volar open reduction and internal fixation in the LCP.Results: Folowed-up from 2 to 36 months,Distal radius fractures are completely healed,the improved Mcbirde score and the New York Orthopaedic Hospital,wrist function evaluation criteria, excellent rate of 85 ℅ (17/20). Conclusion:Volar LCP

  3. 经口咽入路寰椎前路钢板固定治疗不稳定性寰椎骨折%Unstable atlas fractures treated by anterior plate fixation through transoral approach

    Institute of Scientific and Technical Information of China (English)

    马维虎; 许楠健; 徐荣明; 胡勇; 孙韶华; 刘观燚; 赵刘军; 蒋伟宇; 顾勇杰

    2012-01-01

    Objective To explore the clinical outcomes of anterior plate fixation through transoral approach in the treatment of unstable atlas fractures.Methods From March 2004 to May 2010,20 patients with unstable atlas fractures were treated by anterior plate fixation through transoral approach,including 12 males and 8 females,aged from 23 to 68 years (average,47.7±13.9 years).Of the 20 cases of unstable atlas fractures,4 cases were classified as anterior 1/2 Jefferson fracture,8 cases as 1/2 ring Jefferson fracture,and 8 cases as anterior 3/4 ring Jefferson fracture.The preoperative average VAS scores were 6.0±1.3 points,ranged from 4 to 8 points.Clinical and imaging examinations were performed during follow-up period to evaluate the outcomes.Results All patients were followed up for 12 to 81 months,with an average of 48.5±20.0 months.There were no screw loosing and breakage,no plate displacement,and no spinal cord and vertebral artery injury during operation.A total of 20 plates were placed and all 40 screws were inserted into atlas lateral mass.Computed tomography scans demonstrated 2 screws were placed too close to the vertebral artery canal,but without clinical consequences.The postoperative VAS scores were from 0 to 3 points with an average of 1.3±1.0 points.Static and dynamic films 6 months after surgery demonstrated that fusion was achieved in all cases.Atlantoaxial rotational function was restored satisfactorily.No plate-related complication was observed in all patients in the whole follow-up period.Conclusion Anterior plate fixation through transoral approach is an effective method for management of unstable atlas fractures,which has advantages such as solid bony fusion and low incidence of complication.%目的 探讨经口咽入路寰椎前路钢板内固定治疗不稳定性寰椎骨折的临床疗效.方法 2004年3月至2010年5月,采用经口咽入路寰椎前路钢板内固定治疗不稳定性寰椎骨折患者20例,男12例,女8例;年龄23~68

  4. Using closed reduction and minimally invastive locking plate fixation to treat distal radius fractures%闭合复位微创锁定钢板内固定治疗桡骨远端骨折

    Institute of Scientific and Technical Information of China (English)

    明立功; 明朝戈; 王自方; 王新德; 孟维娜; 王慧

    2016-01-01

    目的:探讨采用闭合复位微创接骨板固定术(minimally invasive plate osteosynthesis, MIPO )置入锁定加压接骨板(locking compression plate, LCP)内固定治疗桡骨远端骨折的手术技巧及疗效。方法自2010年以来,在桡骨远端解剖学基础上,采用远端腕关节横弧形切口、近端纵行小切口MIPO技术置入LCP内固定治疗桡骨远端骨折12例。结果12例患者术后获12~25个月(平均15个月)随访。骨折愈合时间6~12周,平均8周。采用AO组织建议的Garland and Werley评分方法,对本组的疗效进行评估。优10例,良1例,可1例,优良率91.7%。12例平均手术时间为(55±15) min,术中平均失血量为(35±10) mL,术后平均住院时间为(7±2) d。无一例发生医源性正中神经损伤,所有患者伤口均Ⅰ期愈合。结论采用小切口MIPO技术置入LCP内固定治疗桡骨远端骨折,具有骨折愈合快、并发症少、功能恢复快的优点,临床效果良好。%Objective To describe the surgical skill and the effect of using closed reduction MIPO technology into LCP internal fixation for the treatment of distal radius fractures. Methods Since from 2010, based on the anatomy of distal radius, 12 cases with distal radius fractures were treated by using MIPO technology into LCP internal fixation, by which applying horizontal arc incision of distal wrist joint and longitudinal small incision of proximal of wrist joint. Results 12 cases were followed-up from 12 to 24 months (average 15 months), bone union time from 6 to 12 weeks (average 8 weeks). The scoring methods used Garland and Werley, the results showed excellent in 10 cases, good in 1 case, fair in 1 case, with an excellent and good rate of 91.7%. The mean operative time was (55 ±15) min in 12 cases, mean intraoperative blood lose was (35 ±10) mL, the average hospitallization time was (7 ±2) d. None of the iatrogenic injury of the median nerve, all

  5. Fixation of displaced proximal humeral fractures with proximal humeral internal locking plate in the elderly%肱骨近端锁定型钉板治疗老年人移位的肱骨近端骨折

    Institute of Scientific and Technical Information of China (English)

    纪泉; 文良元; 薛庆云; 赵立连; 黄公怡

    2011-01-01

    Objective To investigate the treatment effect of the proximal humeral internal locking system (PHIL()S) on the elderly patients with displaced proximal humeral fractures.Methods From Feb 2004 to Mar 2007, 36 patients (mean age: 72.2 years) with proximal humeral fractures were treated with PHILOS plate fixation which included 14 cases with 2-part, 17 cases with three-part and 5 cases with four-part fractures according to Neer classification. Operation time,intraoperative blood loss, blood transfusion, perioperative complications and function evaluation of the operated shoulder joint were calculated with 14.5 months follow-up at average.Results The average operation time and blood loss were (61.5± 11.6) min and ( 165.2±91.2) ml, respectively. 1 case with accidents of blood vessel and 1 case with pneumonia were found without neurovascular injuries. All fractures were radiographically healed in an average of 3-5 months. No necrosis of humeral head appeared and 30 (83.3%) cases were excellent or good according to Neer scoring system. Two part fracture and early operation ( within 3 days after operation) might improve the postoperative function of shoulder joint, but the patient's age, gender and ASA score were not statistically with Neer score.Conclusions PHILOS plate fixation is a suitable procedure for displaced proximal humeral fractures via stable fixation and early rehabilitation, especially for elderly patients combined with osteoporosis.%目的 探讨肱骨近端锁定型钉(PHILOS)板治疗老年人移位的肱骨近端骨折的疗效。方法 回顾性分析2004年2月至2007年3月用PHILOS板治疗的36例肱骨近端骨折患者,Neer分型二部分骨折14例,三部分骨折17例,四部分骨折5例。统计手术时间、输血量和手术并发症,评价肩关节功能。 结果 患者平均年龄72.2岁,平均随访14.5个月。术中平均输血165.2 ml,术后X线显示骨折复位满意,无神经、血管损

  6. 重建钢板上置和前置治疗老年锁骨中段骨折的疗效分析%Superior versus anterior reconstruction plate internal fixation for middle clavicular fractures in old patients: a comparative study

    Institute of Scientific and Technical Information of China (English)

    卢旻鹏; 王群波; 赵波; 何超; 焦春艳; 饶小华; 张铭华

    2011-01-01

    Objective To compare the effect of anterior and superior reconstruction plate internal fixation in treatment of middle clavicular fractures in the old patients.Methods Thirty-nine old patients with middle clavicular fractures received anterior and superior reconstruction plate internal fixation treatment,respectively.There were 19 males and 20 females at average age of 66.7 years.The operation time,intraoperative blood loss and healing time were observed and compared in two groups.According to the Constant scoring system,shoulder functional evaluation was made at half a year after operation and the latest follow-up.Results All the patients were followed up for 10-32 months (average 18.7 months).Of the two groups,there was no statistical significance in aspects of healing time and Constant score at half a year after operation and the latest follow-up ( P >0.05 ).The complication of superior reconstruction plate internal fixation group was significant higher than that of anterior reconstruction plate internal fixation group,while the anterior reconstruction plate internal fixation group had shorter operation time and less intraoperative blood loss in comparison with the superior reconstruction plate internal fixation group ( P < 0.05).Conclusion As for the middle clavicular fractures in the old patients,both anterior and superior reconstruction plate internal fixation can obtain satisfactory curative effect.With shorter operation time,less intraoperative bleeding and less complications,anterior reconstruction plate internal fixation is a much reliable treatment for middle clavicle fractures in the old patients and deserves wider application.%目的 比较重建钢板上置和前置治疗老年锁骨中段骨折的疗效.方法 分别用重建钢板上置法、重建钢板前置法治疗锁骨中段骨折39例,其中男19例,女20例;平均年龄66.7岁.记录并比较两组手术时间、术中出血量、骨折愈合时间;术后半年

  7. 应用小切口PHILOS钢板治疗肱骨近端骨折效果评价%Small incision PHILOS plate fixation in treatment of proximal fracture:a recent outcome analysis

    Institute of Scientific and Technical Information of China (English)

    巴雪峰; 孙改生; 凯瑟尔; 廖炎炎; 汪少波; 周燕

    2012-01-01

    [目的]探讨PHILOS钢板有限切开治疗肱骨近端骨折的方法与疗效.[方法]应用PHILOS肱骨近端解剖型钢板有限切开(肱骨近端前外侧入路)治疗肱骨近端骨折54例.其中男31例,女23例,年龄48~79岁,平均62岁.根据Neer分型二部分骨折19例(解剖颈骨折9例,外科颈骨折8例,大结节骨折2例);三部分骨折25例;四部分骨折10例(骨折伴肩关节脱位2例).[结果]54例患者经18个月的随访,54例均愈合,影像学提示骨愈合发生在10周左右,有1例发生轻度肩峰撞击,1例四部分骨折的患者发生部分肱骨头坏死.根据术后肩关节Neer评分法,优27例,良23例,可4例,优良率达92.6%.[结论]肱骨近端骨折应用PHILOS钢板固定,重视内侧皮质复位内侧柱的重建,手术创伤小,复位简便,骨折愈合顺利,肩关节功能恢复好,未发现术后明显复位丢失、钉板松动和断裂病例,为目前治疗肱骨近端骨折的较理想的方法.%[Objective ] To investigate the clinical efficacy of small incision PHILOS plate fixation in treatment of proximal fracture. [Method]Proximal humerus anatomic plate PHILOS limited incision (anterolateral proximal humerus) procedure was carried ou in 54 cases of proximal humeral fractures, with 31 males and 23 females, aged 48 - 79 years (mean 62 years). According to Neer classification, there were two-part fractures in 19 patients ( anatomical neck fracture in 9 cases, surgical neck fractures in 8 cases,greater tubercle fracture in 2 cases),three-part fracture in 25 cases,four-part fracture in 10 cases (fracture with dislocation in 2 cases). [ Result] All patients received follow up for 18 months. Fracture healed in all patients. Bone healing happened at 10 weeks after operation according to radiology analysis. Mild impingement was found in I case. Partial humeral head necrosis was found in 1 four-part fracture case. According to Neer classification,there were excellent result in 27 cases, good in 23

  8. 前正中纵行切口双钢板固定治疗C3型股骨远端骨折%Treatment of type C3 distal femoral fractures with double-plating fixation via anteriormiddle approach

    Institute of Scientific and Technical Information of China (English)

    张志敏; 刘建; 黄春霞; 赵占富; 王钢; 秦聪聪

    2012-01-01

    Objective:To investigate clinical efficacy and feasibility of double-plating fixation via anteriormiddle approach in treating type C3 distal femoral fractures. Methods: From August 2008 to August 2011,12 cases with type C3 distal femoral fractures were treated,including 5 open fractures and 7 closed fractures. Among them,there were 8 males,4 females with an average of 40 years (ranged,25 to 55 years). There were 7 in left side, 5 in right side. Nine cases were caused by car accident,3 cases by falling down. The duration from injury to hospital was form 20 minutes to 5 days (mean 135 min). After tibia bone traction for 5 to 8 days, the operation were performed by double-plating fixation via anteriormiddle approach, and autograft of iliac bone or allograft bone grafting were given to bone defect. Knee joint function was evaluated according to Merchanetal criteria. ResultS:The operation time was from 110 to 160 min,with an average of 135 min,the blood loss was from 300 ml to 500 ml,with an average of 400 ml. Post-operative wound were stage I healing. All patients were followed up from 16 to 36 months ( mean 24 months). No infection,reduc tion loss,nonunion,deep vein thrombosis occurred. Bone healing time was for 18 to 24 weeks with an average of 21 weeks. According to the Merchanetal criteria,4 cases got excellent results,6 good,l fair and 1 poor. Conclusion: Double-plating fixation via anteriormiddle approach for type C3 distal femoral fractures is an effective way, which has advantages of obvious exposure, simple manipulation, anatomical reduction, stable fixation. However, operation indications and operating instructions should be strictly followed.%目的:探讨前正中纵行切口双钢板固定治疗C3型股骨远端骨折的临床疗效和可行性.方法:自2008年8月至2011年8月,收治C3型股骨远端骨折12例,男8例,女4例;年龄25~55岁,平均40岁;车祸伤9例,高处坠落伤3例;左侧7例,右侧5例;开放性骨折5

  9. 儿童前臂双骨折选择髓内钉固定还是切开复位钢板内固定?%Both-bone forearm fractures in children Intramedullary nailing or open reduction with plate fixation?

    Institute of Scientific and Technical Information of China (English)

    Joseph R Dettori; 王簕; 杨云峰

    2011-01-01

    Six small retrospective cohort studies shed little light on whether intramedullary nailing (IMN) or open reduction internal fixation (ORIF) with plate fixation is more effective in treating both-bone forearm fractures in children. No statistically significant difference between treatment groups was found with regard to functional outcomes or the average magnitude of radial bowing.Small sample sizes may have precluded detection of statistically significant differences. In one study, a statistically significant difference was found in the average radial bow location in the IMN group as compared with both the ORIF group and normative values. Cosmetically,IMN provided significantly better results (ie, smaller incision/scar length) than ORIF as assessed by two studies. For both nonunion/delayed healing and complications, rates varied widely between studies and did not consistently favor one treatment method over the other. Randomized controlled studies with larger sample sizes and longer follow-up periods are needed to determine which treatment option is optimal. Use of validated outcomes measures is recommended.%@@ 根据6项小样本回顾性队列研究的结果,在评价髓内钉固定(IMN)和切开复位钢板内固定(ORIF)治疗儿童前臂双骨折的疗效时证据较弱.研究结果显示,在患肢功能和桡骨弓的恢复方面,两种治疗方法差异无统计学意义.由于样本量较小,本身就排除了产生统计学差异的可能性.一项研究显示,IMN组桡骨弓的顶点位置与ORIF组相比差异均有统计学意义.2项研究认为,与ORIF组相比,IMN组术后结果更好(如手术切口、瘢痕更小).在骨折不愈合或延迟愈合和并发症发生率方面,各研究结论不一,无法说明哪种方法更优.综上所述,仍需大样本的随机对照研究并进行长期随访,采用有效的评价方法,以便更好地评价哪种治疗方法更好.

  10. PHILOS 接骨板治疗复杂肱骨干中上段骨折的初步报告%Fixation of complex middle-proximal humeral shaft fractures using the PHILOS plate: early experience

    Institute of Scientific and Technical Information of China (English)

    陈雁西; 梅炯; 李山珠; 王树青; 张世民; 程黎明; 王先辉; 刘新成; 俞光荣

    2008-01-01

    Objective To evaluate the clinical outcomes of the proximal humeral internal locking system (PHILOS) plate treating the complex middle-proximal humeral shaft fractures.Methods From April 2007 to January 2008,a total of 16 patients with acutely complex middle-proximal humeral shaft fractures were treated by open reduction and internal fixation using the PHILOS plate.There were 6 males and 10 females with an average age of 71.5 years (range,54-88 years),the left side was involved in 11 cases,and the right side was involved in 5 cases.According to AO/OTA classification,4 cases belonged to CI,3 to C2,and 9 to C3.The operative time,PHILOS plate insertion time and operative blood loss were recorded.Functional assessment was done using the Constant-Murley shoulder score and percentage Constant-Murley score,>80% was excellent or good,60%-80% was satisfactory,and < 60% was poor.Results The mean operative time was 115 min(range,75-160 min),PHILOS plate insertion time was 35 min(range,25-45 min),operative blood loss was 350 ml (range,150-525 ml) and hospitalization time was 18.5 d (range,17-22 d).In 14 patients,the mean follow-up time was 9.6 months (range,5-12 months).The mean fractures healing time was 12.1 weeks (range,7-16 weeks).No complications were found,such as delayed union and nonunion,displaced,avascular necrosis,cutout or backout of the screws and plates.The mean ROM of the shoulders was 150°(range,120°-170°).The Constant-Murley score of the injury side was mean 78.5 (range,62-92) at the final follow-up,which was 87.6% (range,75.6%-97.6%) of the Constant-Murley score of normal side.The clinical outcomes were excellent or good in 12 cases(85.7%),satisfactory in 2 eases.Conclusion According to our experience,the PHILOS plate design provides stable fixation with a good functional outcome for the complex middle-proximal humeral shaft fractures and eliminates most hardware problems and complications.%目的 评价肱骨近端内固定锁定系统(PHILOS)接骨

  11. Screw and plate fixation for fractures of tibial shaft: three-dimensional finite element analysis%胫骨中段骨折钢板螺钉固定的有限元分析

    Institute of Scientific and Technical Information of China (English)

    胡新佳; 林博文; 王华; 张美超; 杨述华; 肖德明

    2011-01-01

    Objectives To determine biomechanical performances of limited contact-dynamic compression plate (LC-DCP) fixation with screws in different number and position for treatment of fractures of tibial shaft. Methods CT scan was performed for a fresh sample of adult tibia to construct a 3D finite element model of normal tibia using Mimics 10. 01 and Ansys 10. 0. Finite element models of oblique fractures of middle tibia were made on the basis of the normal model to be all fixed with LC-DCP of 14 holes but with screws in 5 different patterns. Model A was fixed with screws in the 1st, 2nd, 3rd, 12th, 13th and 14th holes; model B with screws in the 1st, 4th, 7th, 8th, 11th and 14th holes; model C with screws in the 1st,3rd, 6th, 9th, 12th and 14th holes; model D with screws in the 1st, 2nd, 7th, 8th, 13th and 14th holes;and model E with screws in all 14 holes. Finite element software Ansys 10. 0 was used to establish 3-D finite element models of 5 fixation models for tibial shaft fracture. Five kinds of digital loadings were simulated in computer, with 1000 N compressive load and 5 N · m torque moment for all models. Results In model A, the highest stresses were on the 3rd and 12th holes. In model B, the highest compressive stress was on the 1st hole, next by the 4th hole; the highest torsion stresses were on the 7th and 8th holes. In model C, the highest compressive stress was on the 1st hole, next by the 3rd hole; the highest torsion stresses were on the 6th and 9th holes. In models D and E, the highest compressive stress was on the 1st hole, next by the 2nd hole; the highest torsion stresses were on the 7th and 8th holes. Conclusions In treatment of tibia shaft fractures with minimally invasive percutaneous plate osteosynthesis, fixation with a 14-hole LC-DCP and 6 screws is appropriate. The appropriate fixation holes are the 1st, 2nd, 7th, 8th, 13 th and 14th holes.%目的 通过有限元分析探讨有限接触型动力加压钢板(LC-DCP)不同螺钉固定数目及

  12. Clinical Effect of Fixation of the Older Osteoporosis Fractures of Humeral Surgical Neck Using the Locking Plate-Philos%Philos系统治疗老年骨质疏松性肱骨外科颈骨折

    Institute of Scientific and Technical Information of China (English)

    齐新文; 王兆杰; 邝立鹏; 陈军平; 俞华威; 安荣泽

    2011-01-01

    Objective To investigate the clinical effect of inter fixation of the older osteoporosis fractures of humeral surgical neck using the locking plate-Philos (Proximal humeral internal locking system) via the deltopctoral-groove approach. Methods Reduction and locking plate-Philos fixation were done via deltopctoral-groove approach on 23 cases with the older osteoporosis humeral surgical neck fractures from March 2008 to December 2010. Bone graft was applicated on 19 of 23 cases and the rotator cuff was repaired simultaneously if damaged. The medicine of anti-osteoporosis and promoting fractures healing were applied after be in hospital. Shoulder joint passive exercises was performed at 2 days after Operation.actived exercises were done gradually 2 weeks after operation. According to Neer classification.there were 4 cases of two parts fracture. 13 cases of three parts fractures and 6 cases of four parts fractures. Results The postoperative radiographs verified good position of plate and screws,with satisfactory fracture reduction and no neurovascular injury (such as axillery nerve and humeral artery) happened. Fat liquefaction happened on 4 cases. Follow-up for 6~24 months (average 9. 8 months) showed no necrosis of humeral head.no delayed-union and un-union happen, 2 cases heterotopic ossification. According to Constant Score: the rate of excellent good was 82. 6%. After 6 months,the bone mineral density SD value of patients were higher than the first BMD SD value, but this was not statistically significant (P>0. 05). Conclusion Locking plate-Philos can firmly fixe the fractures of humeral surgical neck and possessed such advantages as assistance of reduction,early exercises and less disturbance of the blood supply. This plate showed good results for fractures of humeral surgical neck.especially communited fractures and older osteoporosis patients.%目的 探讨经肌间隙入路应用Philos系统治疗老年骨质疏松性肱骨外科颈骨折的疗效.方法

  13. Transoral plate internal fixation for treatment of instability atlas fracture%经口咽入路钢板内固定治疗不稳定性寰椎骨折

    Institute of Scientific and Technical Information of China (English)

    孙韶华; 方剑利; 马维虎; 刘观燚

    2013-01-01

    Objective:To evaluate the efficacy and safety of transoral plate internal fixation for instability atlas fracture. Methods: A retrospective study was performed in eight patients with instability atlas fractures, who were treated by a transoral plate internal fixation from July 2007 to June 2011. There were 6 males and 2 females, with an average age of 39.5 years old ranging from 23 to 48 years. Among them, 5 case were falling injury, 3 cases were traffic accident injury. Three patients had bilateral fractures of the anterior arch (prehalf Jefferson fractures, Landells type Ⅰ), 5 had anterior arc fracture associated posterior arc fracture (Half-ring Jefferson fractures,Landells type Ⅱ ) ,and 2 had anterior and posterior arc fracture associated with single lateral mass fractures ( Landells type Ⅲ ). Results: All patients were followed up for 6 to 24 months after operation (av- eraged 13 months), and all the patients had the clinical symptoms improved to some extent. Operation time ranged from 80 to 140 min (averaged 98 min) ; the intra-operative blood loss was 120 to 300 ml (averaged 180 ml) ;and the average fluoroscopic time was 55 s. No patients happened neurological and vertebral artery injuries-related complications or other complications after operation. The followed-up X-ray and CT manifested osseous fusion in all the 8 patients,no loosening or breakage of the screws. Conclusion: Transoral plate internal fixation for instability atlas fracture is a reliable and safety technique that allows maintenance of rotatory mobility in the C1.2 joint and restoration of congruency in the atlanto-occipital and atlanto-axial joints.%目的:分析应用经口咽入路钢板内固定治疗不稳定性寰椎骨折的临床疗效及安全性.方法:2007年7月至2011年6月,应用经口咽入路钢板内固定治疗不稳定性寰椎骨折8例,男6例,女2例;年龄23~48岁,平均39.5岁;高处坠落伤5例,交通伤3例.双侧寰椎前弓骨折(前1/2 Jefferson

  14. 颈椎管成形微钛板固定与椎板切除内固定后C5神经根麻痹的比较%Comparison of C5 nerve root palsy after laminoplasty with mini-titanium plate fixation and laminectomy with internal fixation

    Institute of Scientific and Technical Information of China (English)

    冯大鹏; 许卫兵; 赵智; 袁亮; 李光灿; 南丰; 李正维

    2015-01-01

    BACKGROUND:Laminoplasty and laminectomy are the most commonly used treatment methods for multilevel cervical spondylotic myelopathy, which is more common in elderly patients. C5 nerve root palsy is the common postoprative complication after posterior cervical repair. OBJECTIVE:To compare the incidence of C5 nerve root palsy after laminoplasty with mini-titanium plate fixation and laminectomy with internal fixation in repair of multilevel cervical spondylotic myelopathy. METHODS:Total y 134 patients with multilevel cervical spondylotic myelopathy from August 2010 to December 2014 were enrol ed, and then divided into laminoplasty group (n=45) and laminectomy group (n=89) owing to different ways of repair. Patients in the laminoplasty group were treated with laminoplasty with mini-titanium plate fixation, and patients in the laminectomy group were treated with laminectomy with internal fixation. C5 nerve root palsy condition after repair was recorded and evaluated. The cervical lordosis angle (Cobb angle) and cervical curvature index were compared. The Japanese Orthopaedic Association score was used for neurological assessment. RESULTS AND CONCLUSION:Al patients in both groups were fol owed up for more than 6 months. There were no significant differences in cervical lordotic angle and cervical curvature index at the first week before and after the treatment between these two groups (P>0.05). The Japanese Orthopaedic Association scores of patients after 6 months of treatment were significantly improved compared with that before treatment in these two groups (P  目的:比较颈椎管成形微钛板固定与椎板切除内固定修复多节段脊髓型颈椎病后C5神经根麻痹的发生率。方法:2010年8月至2014年12月纳入多节段脊髓型颈椎病患者134例,因修复方式不同分为两组,椎管成形组45例接受颈椎管成形微钛板固定,颈板切除组89例接受椎板切除内固定。记录并评估修复后C5神经根麻痹情

  15. A feasibility study of upper thoracic vertebral plate screw fixation through posterior approach%上胸椎后路椎板螺钉固定的可行性研究

    Institute of Scientific and Technical Information of China (English)

    钟熙强; 何少奇; 董伊隆; 刘良乐; 黄益奖; 戴鸣海; 汤呈宣

    2016-01-01

    Objective:To study the anatomical parameters of upper thoracic vertebral plate of Chinese adults and explore the feasibility of upper thoracic vertebral plate screw fixation through posterior approach in Chinese adults.Methods:The cadaveric T1 -4 specimens of 40 Chinese adults were selected and the anatomical parameters that related to the upper thoracic vertebral plate screw fixation technique were measured by using vernier caliper and conimeter.The anatomical parameters included the thickness of upper,middle and lower part of vertebral plate,the height of vertebral plate,the screw path length and the included angle between vertebral plate axis and sagittal plane. Results:There was no statistical difference in the thickness of the middle part of T4 vertebral plate and the included angle between T1 -4 vertebral plate axis and sagittal plane axis between 20 females and 20 males(5.94 +/-0.1 3 vs 6.00 +/-0.22 mm,t =1 .609,P =0.1 1 2;46.00 +/-1 .1 0 vs 46.50 +/-1 .1 0 degrees,t =1 .955,P =0.054;46.30 +/-0.80 vs 46.60 +/-1 .1 0 degrees,t =1 .383,P =0.1 71 ;45.40 +/-1 .40 vs 45.30 +/-1 .40 degrees,t =0.404,P =0.688;45.20 +/-1 .40 vs 45.30 +/-1 .40 degrees,t =0.41 0,P =0.683).The thickness of the middle part of T1 -3 vertebral plate were less in adult female cadavers compared to adult male cadavers(5.86 +/-0.1 0 vs 5.93 +/-0.1 8 mm,t =2.083,P =0.040;5.88 +/-0.1 1 vs 5.97 +/-0.20 mm,t =2.581 ,P =0.01 2;5.90 +/-0.09 vs 6.00 +/-0.1 9 mm,t =2.885,P =0.006).Such parameters of T1 -4 were less in adult female cadavers compared to adult female cadavers as thick-ness of upper part of vertebral plate(5.39 +/-0.1 2 vs 5.51 +/-0.1 3 mm,t =4.202,P =0.000;5.43 +/-0.09 vs 5.52 +/-0.1 1 mm,t =4.1 84,P =0.000;5.43 +/-0.1 0 vs 5.53 +/-0.1 0 mm,t =4.279,P =0.000;5.41 +/-0.08 vs 5.53 +/-0.07 mm,t =7.557,P =0.000),thickness of lower part of vertebral plate(5.43 +/-0.1 2 vs 5.55 +/-0.1 2 mm,t =4.51 3,P =0.000;5.43 +/-0.07 vs 5.57 +/-0.1 0 mm,t =7.068,P =0.000;5.44 +/-0.08 vs 5.57 +/-0.1 1 mm

  16. Prospects of implant with locking plate in fixation of subtrochanteric fracture: experimental demonstration of its potential benefits on synthetic femur model with supportive hierarchical nonlinear hyperelastic finite element analysis

    Directory of Open Access Journals (Sweden)

    Latifi Mohammed

    2012-04-01

    Full Text Available Abstract Background Effective fixation of fracture requires careful selection of a suitable implant to provide stability and durability. Implant with a feature of locking plate (LP has been used widely for treating distal fractures in femur because of its favourable clinical outcome, but its potential in fixing proximal fractures in the subtrochancteric region has yet to be explored. Therefore, this comparative study was undertaken to demonstrate the merits of the LP implant in treating the subtrochancteric fracture by comparing its performance limits against those obtained with the more traditional implants; angle blade plate (ABP and dynamic condylar screw plate (DCSP. Materials and Methods Nine standard composite femurs were acquired, divided into three groups and fixed with LP (n = 3, ABP (n = 3 and DCSP (n = 3. The fracture was modeled by a 20 mm gap created at the subtrochanteric region to experimentally study the biomechanical response of each implant under both static and dynamic axial loading paradigms. To confirm the experimental findings and to understand the critical interactions at the boundaries, the synthetic femur/implant systems were numerically analyzed by constructing hierarchical finite element models with nonlinear hyperelastic properties. The predictions from the analyses were then compared against the experimental measurements to demonstrate the validity of each numeric model, and to characterize the internal load distribution in the femur and load bearing properties of each implant. Results The average measurements indicated that the constructs with ABP, DCPS and LP respectively had overall stiffness values of 70.9, 110.2 and 131.4 N/mm, and exhibited reversible deformations of 12.4, 4.9 and 4.1 mm when the applied dynamic load was 400 N and plastic deformations of 11.3, 2.4 and 1.4 mm when the load was 1000 N. The corresponding peak cyclic loads to failure were 1100, 1167 and 1600 N. The errors

  17. Adult diaphyseal both-bone forearm fractures: A clinical and biomechanical comparison of four different fixations.

    Science.gov (United States)

    Zhang, X F; Huang, J W; Mao, H X; Chen, W B; Luo, Y

    2016-05-01

    Although there have been a small number of studies reporting single bone fixation of either radius or ulna as well as hybrid fixation, the paucity of data for the hybrid fixation method still remains. Hybrid fixation with plate and IM nailing would achieve good fixation and functional outcome, minimal damage to soft tissues and lower re-fracture risk. Forty cadavers (20 males, 20 females; mean age 68.06, SD 1.58years) were selected in biomechanical study under axial loading, bending loading, and torsional loading. Eighty-seven patients (47 males, 40 females; mean age 38.03±0.88years) were enrolled in the clinical study and randomly received different fixation: both-bone plate fixation or both-bone intramedullary nailing, plate fixation of ulna and intramedullary nailing of radius and intramedullary nailing of ulna and plate fixation of radius. In the biomechanical study, intramedullary nailing of ulna and plate fixation of radius had similar results with that using both-bone plate method under axial, bending and torsional loading (All P>0.05), suggesting the more stable fixation compared with the other two groups (All Pradius showed the lowest incidence of postoperative complications and the best functional recovery outcome comparing with other three groups of patients (Both Pradius showed good stability in biomechanics, fewer complications and better functional clinical outcomes. Level II, prospective randomised study. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  18. Treatment of condylar fractures by anatomic reduction and rigid fixation with mini-plates%髁突骨折解剖复位及小型接骨板 坚强内固定

    Institute of Scientific and Technical Information of China (English)

    张益; 张兴文

    2001-01-01

    Objective To evaluate open reduction and miniplate rigid fixation for condylar fractures. Methods Ninty-seven condylar fractures (unilateral 47, bilateral 25) in 72 consecutive patients were studied. In them, 12 were old fractures, 81 were condylar neck and subcondylar fractures, 90 displaced or dislocated. Eighty-nine fractures were treated by operation, including removal of 7 broken condyles, reduction for 6 condyles with the aid of ramus osteotomy and directe anatomical reduction for 76 condyles. Fifty-nine fractures were fixed with a single miniplate, 21 with a double miniplates and 2 only with screws. Sixty-eight fractures were approached by retromandibular incision and 21 by periarticular incision. Postoperative follow-up period was 1 to 3 months in 9 cases, 3 to 6 months in 36 cases and 27 cases over 6 months, all cases were radiologically and clinically examinated to confirm the post-operative position of reduced fragment and complications secondary to operation. Results There were 2 wound infection, 2 malocclusion, 2 nonunion, 3 plate fracture, 2 plate deformity, 7 inaccurate reduction, 6 fractured bone absorption, 7 mouth open, 5 TMJ chronic pain, 9 facial nerve damages, all above accounted 33% morbidity; however 91% (70/77) severely displaced or dislocated condylar neck and subcondylar fractures got accurate reduction and satisfactory final outcomes. Conclusions miniplate rigid fixation based on anatomical reduction is an effective procedure in limitation of treating severely displaced or dislocated condylar neck and subcondylar fractures, biomechanical placement of plate is very important in successful application of this technique.%目的探讨髁突骨折解剖复位和小型接骨板坚强内固定的技术要点和并发症的发生因素。方法髁突骨折72例97侧(单侧47例,双侧25例)。陈旧性骨折12侧,髁颈和髁颈下骨折81侧,移位和脱位骨折90侧。8侧未手术,7侧髁突摘除,6侧升

  19. Latarjet Fixation

    Science.gov (United States)

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

    2016-01-01

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

  20. 外固定架辅助复位结合微创钢板置入内固定修复复杂性胫腓骨粉碎性骨折%External fixation combined with minimally invasive plate fixation for complex tibial and fibular fracture

    Institute of Scientific and Technical Information of China (English)

    康国锋; 张光明; 王建炜; 梁英杰; 毕艳楠

    2011-01-01

    背景:高能量的胫腓骨粉碎性骨折常合并软组织损伤,若在内固定过程中复位方法不当可造成软组织的二次损伤;寻找一种既能达到稳定的内固定,又尽量避免加重软组织损伤的方法是骨科医生研究的目标.目的:观察应用临时外固定支架辅助复位结合微创钢板置入修复复杂性胫腓骨粉碎性骨折的临床疗效.方法:广州医学院附属广州市第一人民医院自2008-02/2010-03收治的复杂胫腓骨粉碎性骨折患者39例,在行微创内固定的同时采用临时外固定支架术中辅助复位,内固定安放牢固后拆除临时外固定.结果与结论:39例均获得随访,随访时间6~18个月.手术平均时间75 min,其中36例患者内固定后患肢肿胀程度轻,手术切口一期甲级愈合,2例患者伤口边缘水肿,结痂后瘢痕愈合,1例内固定后3个月出现急性骨髓炎,经保守抗炎治疗后恢复.未出现钉道感染、螺钉松动及切口感染、皮肤坏死、露骨露腱病例,依据AOFAS踝关节评分法,钢板置入半年后踝关节恢复情况:优29例,良8例,一般2例.踝关节屈伸活动范围≥30° 29例,20°~30° 8例,20°以下2例.%BACKGROUND:High-energy comminuted fracture of tibis and fibula is often associated with soft tissus injury, the improper reduction method during the operative process of internal fixation can cause secondary soft tissue damage, resulting in serious both to achieve stable internal fixation, and avoid aggravated soft tissue damage is the object of study for orthopaedic surgeon OBJECTIVE: To investigate the clinical therapeutic effect of external fixation combined with MIPO technology used in complex tibial and fibularfracture METHODS: Retrospective analysis was used in 39 cases of complex comminuted fracture of tibia and fibula selected from the temporary external fixation assisted reduction technology combined with MIPO technology used in all cases, and be removed after internal fixed

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

    Science.gov (United States)

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

    2008-06-01

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

  2. 经口寰枢椎前路钢板固定有限元分析及临床意义%The finite element analysis and clinical significance of through the mouth atlanto-axial vertebral anterior plate fixation

    Institute of Scientific and Technical Information of China (English)

    王海燕; 张琪; 李筱贺; 李志军; 高尚; 张少杰; 王星; 蔡永强; 王志强; 马界荣

    2015-01-01

    Objective To analyze through the mouth atlanto-axial vertebral anterior plate fixation in finite element for the development of the segmental anterior fixation surgery and to provide the reference of inner plant improvement. Methods One case, male, 36 years old, 64 kg weight was randomly selected in January 2014 in our hospital, whom was excluded of the skull-atlanto-axial vertebral disease. The patient received scanning with a thickness of 0.625 mm;Image data were rebuilt in the Mimics16.01 software and Pro/ENGINEER4.0 software was used to rebuild the atlanto-axial vertebral anterior plate. After reconstruction of steel screw 3D model according to the classic through the mouth,the model was imported into Mimics16.01 and the model surface was meshed and material assigned. The model was then imported into Ansys14.0, and was forced 80 N vertical loading. The surface was applied 15 Nm torque to simulate three-motion state example, forward bends, stretch, side-bending. The stress and deformation of screw and rod were measured. Results Atlanto-axial vertebral three-dimensional reconstruction model were divided into 39842 individual grid and the model was loaded. The stress of upper screw root in bend was biggest (62.34 ± 5.52) Mpa (F=73.23, P<0.05, the difference was statistically significant).A screw of the root and the top, lateral stress was the largest, respectively were (78.42 ± 5.5.14) Mpa (F=112.32, P<0.05);(95.48 ± 7.12)Mpa (F=62.32, P<0.05), the difference had statistical significance; Under three different motion state and a screw root stress, Upper screw root stress in bending forward was greater than the lower (forward bends, stretch and lateral bending state , t value were 12.2, 9.23, 22.98, P<0.05, differences were statistically significant), and in the lateral current screw root stress was greater than the upper;In the same movement state, the top was greater than the root, the differences were statistically significant (forward bends, stretch and

  3. outcome of plate osteosynthesis in the management of proximal ...

    African Journals Online (AJOL)

    Rush pins with blade plates, locking plates and IM nails. (8-10). IM fixation ... Three patients who had pathological fractures from tumour and infection were excluded from the study. Results: ... being implant failure, nonunion, osteonecrosis of.

  4. 肱骨近端交锁髓内钉和锁定接骨板治疗肱骨近端骨折的生物力学研究%Biomechanical investigation on current fixation options for proximal humerus fractures:locked intramedullary nail and locked plate

    Institute of Scientific and Technical Information of China (English)

    周君琳; 赵会; 秦永超; 陆铁

    2016-01-01

    Background Proximal humeral fracture is a common fracture in elderly patients with osteoporosis,locking plate and intramedullary nail fixation are the most popular methods for its surgical treatment at present.There are advantages and disadvantages for both methods of internal fixation treatment.Currently,the choice of internal fixation method is a problem faced by traumatic orthopedic doctors. In this study we used proximal humeral locking plate or interlocking intramedullary nail for fracture fixation in vitro human samples with anticorrosive treatment tosimulate theload condition of shoulder joint after internal fixation,measured and calculated the axial load and stiffness of the fracture model,and discussed the fixed strength of the two internal fixation devices.We also analyzed the characteristics of these two kinds of internal fixation methods from the perspective of biomechanics.Methods (1)Selection of humeralsamples.A total of 36 humeralsamples with antiseptic treatment wereselected from 18 specimens of 60-85 years old,including 14 male samplesand 22 female samples.The X-ray films of the samples were taken to exclude congenital deformity,fracture and tumor.We appliedUnigamma X-ray Plus bone mineral density instrument to measure bone mineral density (humeral head area were unified delimited),results in each group were recorded for variance analysis.(2)Construction of fracture model with internal fixation.According to Neerclassification and the method introduced by Kwon,we produced three-partproximal humeral fracture model.We cut the humeral head with a oscillating saw at the surgical neck plane,the thickness of saw blade was 1 mm,confirmed the position of intertubercular sulcus on the osteotomy plane,then saw the bone along intertubercular sulcus to the distal humerus, thedirection is perpendicular to the osteotomy plane,until to the base of the lesser tubercle level,cut the greater tuberosity from proximal humerusat the base of lesser tuberosity

  5. FIXATION OF ADULT EXRTA –ARTICULAR DISTAL THIRD DIA PHYSEAL FRACTURE OF HUMERUS-A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Ahmed

    2013-05-01

    Full Text Available ABSTRACT : Distal humerus fracture in adult is very difficul t to treat. It is very difficult to achieve alignment, anatomical reduction, rigid fixation, im mediate mobilization and fracture union in such patient MATERIAL AND METHOD-We operate 41 patient o f close extra articular fracture of distal third of humerus, using posterior approach. 10 case s were fixed with single locking plate,6 cases by single distal multiple hole plate,12 cases by two r econstruction plate,6 cases by simple T plate,7case s by oblique metaphyseal locking plate. RESULT- Doubl e plating with reconstruction plates provide a more rigid fixation than a single-locked plate. CON CLUSION- Fixation of extra articular distal humerus, diaphyseal fracture in adult are better w ith double plating than single plating, which provide more rigid fixation with early mobilization and higher mayo elbow score

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

    Science.gov (United States)

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

    2014-12-01

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

  7. Minimally Invasive Plate Osteosynthesis with Conventional Compression Plate for Diaphyseal Tibia Fracture

    Directory of Open Access Journals (Sweden)

    IM Anuar-Ramdhan

    2014-11-01

    Full Text Available The diaphyseal tibia fracture is best treated with intramedullary nail but in some cases where the nail is not applicable, plate fixation will be the next option of fixation. The extensile anterior approach is normally used for conventional compression plate fixation in tibia shaft fractures. The extensive surgical dissection may devitalizes the bony fragments and interfere with the fracture union as well as soft tissue healing. Minimally Invasive Plate Osteosynthesis (MIPO provides good preservation of blood supply and fracture hematoma at the fracture site thus promotes biological bone healing. The use of indirect reduction techniques and small skin incisions to introduce the plate is technically demanding and requires fluoroscopy exposures throughout the surgery, being some of its drawbacks. We recommend MIPO for conventional compression plate fixation in tibial shaft fractures in view of the reduced surgical trauma to the surrounding soft tissue and good functional outcome.

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

    Institute of Scientific and Technical Information of China (English)

    张星华

    2014-01-01

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

  9. 普通接骨板与锁定接骨板治疗成人闭合性跟骨关节内骨折疗效对比%Clinical analysis of open reduction and internal fixation with unlocking plate or locking plate for treatment of adult in-tra-articular calcaneal fractures

    Institute of Scientific and Technical Information of China (English)

    曲绍东; 杨占辉; 史宏伟; 石明国; 张立军; 贾文杰; 苏庆军

    2015-01-01

    Objective To analyze the effect of open reduction and internal fixation (ORIF) with unlocking plate or locking plate for treatment of adult intra-articular calcaneal fracture. Methods 68 cases of calcaneal fracture,including 72 feet in 56 males (4 males were bilateral) and 12 females,with the average age of 35 years (ranging from 18 to 71), were en-rolled. According to Sanders' classification,15 feet were classified as type Ⅱ,46 feet were classified as type Ⅲ, and 11 feet were classified as type Ⅳ. 44 feet were treated with unlocking plate for calcaneal fracture in group A , 28 feet were treated with locking plate for calcaneal fracture in group B. The cases of existing ipsilateral lower limb fracture, ipsilateral vascular injury, and ipsilateral lower limb open injury were excluded. Results The wounds of 64 feet healed piemarily,5 feet were delayed healing. The soft tissue coloboma of 3 feet delayed until pedicle flap transfered. The B(o)hler angle of two groups were significantly different between preoperation and postoperation, but there were no significant differences in B(o)hler angle between two groups. 64 feet in 63 cases were followed up for 12~26 months. According to the AOFAS Ankle-Hindfoot Scale ,49 feet scored 90~100 points,13 feet scored 75~89 points and 2 feet scored 50~74 points. The excellent and good rate was 96.9%. Conclusion ORIF with unlocking plate or locking plate are all effective methods to treat the calcaneal fracture , there are no significant dif-ferences in curative effect between the two methods.%目的 分析普通接骨板与锁定接骨板治疗成人闭合性跟骨骨折的临床疗效. 方法 本组跟骨骨折68例(72足),男56例,女12例,4例男性为双侧. 年龄18~71岁,平均35岁. 应用Sanders分型,其中Ⅱ型15足,Ⅲ型46足,Ⅳ型11足.其中应用非锁定跟骨接骨板治疗44足(A组),应用锁定跟骨接骨板治疗28足(B组).排除术前合并同侧下肢骨折、同侧血管损伤及同

  10. Plate fixation and small splint for intraarticular fracture of distal radius:comparison of curative effects%钢板内固定与小夹板治疗桡骨远端关节内骨折的效果比较

    Institute of Scientific and Technical Information of China (English)

    黄海晶; 温建民

    2014-01-01

    背景:目前,国内外有不少有关钢板内固定与小夹板治疗桡骨远端骨折的临床试验,但尚缺乏相关的系统评价。  目的:评价钢板内固定与小夹板治疗桡骨远端关节内骨折疗效。  方法:电子检索中国生物医学文献数据库(1979年至2008年)、中国知网(1979年至2008年)、维普数据库(1989年至2008年)和万方数字化期刊群(1998年至2008年),其中中国知网包括中国期刊文献数据库、重要会议全文数据库、硕博学位论文数据库;国外数据库PubMed(1966年至2008年)、EMbase(1980年至2008年)和Cochrane Library(2008年第4期)。不能获取的全文,则辅以手工检索天津中医药大学图书馆过刊资料库。收集钢板内固定与小夹板治疗桡骨远端关节内骨折的临床随机对照试验,由两名评价者独立提取资料并进行方法学质量评估。按检索策略和资料收集方法,查到英文文献363篇,中文文献488篇,其中期刊文献401篇,会议论文集79篇,学位论文8篇。经阅读标题、、全文后,最终12项研究符合纳入标准。统计学采用Cochrane 协作网提供的RevMan 5.0.20软件进行Meta分析。  结果与结论:文章系统评价涉及锁定加压钢板、普通钢板内固定、小夹板及石膏外固定等方法。Meta分析结果显示,锁定加压钢板治疗桡骨远端关节内骨折的疗效优于普通钢板、小夹板或石膏外固定,且并发症少。而普通钢板内固定治疗桡骨远端关节内骨折的疗效与石膏外固定或小夹板比较疗效差异尚无显著性意义。%BACKGROUND:At present, there are many clinical trials concerning plate fixation and smal splint for distal radius fracture, but there is lack of systemic evaluation. OBJECTIVE:To evaluate the curative effect of the plate fixation and smal splint in the treatment of intraarticular fractures of the distal radius. METHODS:We retrieved the Chinese

  11. Fixation of displaced subcapital femoral fractures. Compression screw fixation versus double divergent pins.

    Science.gov (United States)

    Christie, J; Howie, C R; Armour, P C

    1988-03-01

    One hundred and twenty-seven consecutive patients with displaced subcapital fractures of the femoral neck (Garden Grade III or IV) all under 80 years of age and independently mobile, were randomly allocated to fixation with either double divergent pins or a single sliding screw-plate device. The incidence of non-union and infection in the sliding screw-plate group was significantly higher, and we believe that when internal fixation is considered appropriate multiple pinning should be used. Mobility after treatment was disappointing in about half of the patients, and we feel that internal fixation can only be justified in patients who are physiologically well preserved and who maintain a high level of activity.

  12. Treatment of intertrochanteric and subtrochanteric femur fractures with indirect reduction and submuscular reversed polyaxial locking plate fixation%间接复位、经皮股骨髁万向锁定板倒置治疗股骨转子间及转子下骨折

    Institute of Scientific and Technical Information of China (English)

    张智长; 王韬; 陆男吉; 罗从风; 曾炳芳

    2011-01-01

    目的 探讨间接复位、经皮股骨髁万向锁定板倒置治疗股骨转子间及转子下骨折治疗效果.方法 对28例股骨转子间及转子下骨折患者,均采用牵引床间接复位、穿皮股骨髁万向锁定板倒置固定.结果 28例均获得随访,时间5~11个月.骨折愈合时间为3~6个月.无肢体短缩、髋内翻等并发症.结论 对外侧壁粉碎或反斜行骨折、髓腔过细不适合髓内固定、假体周围骨折等股骨转子间及转子下骨折,采用间接复位、股骨髁万向锁定板倒置固定效果良好.%Objective To evaluate the clinical effects of treating intertrochanteric and subtrochanteric femur fractures with indirect reduction and submuscular reversed polyaxial locking plate fixation.Methods 28 patients of intertrochanteric and subtrochanteric femur fractures were treated by indirect reduction and submuscular reversed polyaxial locking plate fixation.Results All 28 patients were followed up for 5 ~ 11 months.Fractures healed at 3 ~ 6 months.No complications as limb shortening, or varus deformity was found.Conclusions For patients with fractures with trochanteric extension,reverse obliquity fractures , subtrochanteric fractures associated with indwelling intramedullary hardware, patients with intramedullary canals too small for intramedullary nailing, indirect reduction and submuscular reversed polyaxial locking plate is effective.

  13. 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.

  14. Treatment of C3 Type Fracture of Distal Humerus through the Double-plate Internal Fixation of the Olecranon Osteotomy%经鹰嘴截骨双钢板内固定治疗C3型肱骨远端骨折

    Institute of Scientific and Technical Information of China (English)

    周建全; 张海林; 邹锐; 殷剑伟; 龚建华

    2012-01-01

    目的 探讨肱骨远端C3型骨折的入路选择及内固定钢板的放置方法.方法 选择2004年1月至2010年11月我院收治的肱骨远端骨折患者56例,其中C3型骨折32例,全部采用经鹰嘴截骨显露肱骨远端,肱骨内外侧解剖钢板90°放置内固定的手术治疗.所有病例均随访9 ~15个月,平均11.3个月.结果 32例患者切口均一期愈合,所有骨折骨性愈合,无内固定松动及退针出现;未出现骨化性肌炎;按改良Broberg和Morrey评分系统,优18例,良9例,可4例,差1例,优良率为84.4%.结论 经鹰嘴截骨、90°双钢板内固定治疗C3型骨折,具有暴露充分、直视下良好整复关节面、内固定坚强可靠的优点,能满足早期功能锻炼的要求,符合国际内固定研究协会关节内骨折的治疗原则,是一种治疗复杂性肱骨远端骨折的可靠方法.%Objective To explore the approaching choice of C3 type fracture of distal humerus and the placement method of internal fixation plate. Methods 56 patients admitted to our hospital from January 2004 to November2010,for the distal humerus fractures including 32 cases of C3 fractures,all received the o-lecranon osteotomy,lateral and medial anatomy of the humerus plate 90°fixation surgical treatment; all cases were followed up for 9 to 15 months with an average of 11. 3 months. Results Incision of 32 patients healed in the first stage,all fractures healed and no internal fixation pin loosening and back,no myositis ossificans. According to the modified Broberg and Morrey scoring system,excellent in 18 cases,good in 9 cases,fair in 4 cases and poor in 1 case. Excellent and good rate was 84.4%. Conclusion The olecranon osteotomy,which can effectively heal C3 type fracture of distal humerus through the 90° internal fixation, is featured with the advantages of full exposion and good vision of the entire articular surface under direct sight, and strong and reliable fixation, which could meet the requirements of

  15. The curative effect analysis of acetabulum fracture treated with bridge combined fixation sys-tem or reconstruction plate%桥接组合式内固定系统与重建钢板治疗髋臼骨折的疗效比较

    Institute of Scientific and Technical Information of China (English)

    关翔; 宋香全; 王洪炳; 周朝波

    2015-01-01

    Objective To investigate the clinical efficacy of reconstruction plate or bridge combined fixation system in the treatment of acetabulum fractures. Methods Fifty-five patients of acetabulum fractures treated by surgery were selected for a case-control study. Twenty-eight patients was treated by reconstruction plate, while twenty-seven pa-tients was treated by bridge combined fixation system. Operation time, intraoperative blood loss and hospital stay of two groups were observed and compared. Results The time of hospital stay, operative time, amount of bleeding of the group treated by bridge combined fixation system was better than the group treated by reconstruction plate. There are statistically significant difference between the two groups (P<0. 05). For the postoperative hip joint function of the reconstruction plate group,14 cases were excellent,9 good,4 fair, and 1 poor, and the rate of excellence and good results was 23/28. For the bridge combined fixation system group,13 cases were excellent,11 good,2 fair, and 1 poor, and the rate of excellence and good results was 24/27. There are statistically significant difference between the two groups of curative effect ( P<0. 05 ) . Conclusions The bridge combined fixation system has the advantages of less trauma, better functional recovery and less postoperative complications, which can be used as the preferred way for the surgical treatment of acetabulum fracture.%目的:探讨重建钢板与桥接组合式内固定系统治疗髋臼骨折临床疗效。方法手术治疗55例髋臼骨折的患者,分别行重建钢板(28例)和桥接组合式内固定系统(27例)内固定,观察两组的手术时间、术中出血量、住院时间,比较两组疗效。结果桥接组合式内固定系统组的手术时间、术中出血量、住院时间均优于重建钢板组,差异有统计学意义(P<0.05)。术后髋关节功能:重建钢板组优14例,良9例,可4例,差1例,优良率23/28;桥接

  16. 前路钢板置入固定治疗骶髂关节脱位的三维有限元分析%Three-dimensional finite element analysis of anterior plate fixation for the treatment of sacroiliac joint dislocation☆

    Institute of Scientific and Technical Information of China (English)

    肖进; 尹庆水; 张美超; 赵卫东; 李鉴轶

    2011-01-01

    BACKGROUND: Most reported biomechanical studies on sacroiliac joint injury and fixation use cadavers or artificial bone models to simulate the sacroiliac joint injury.OBJECTIVE: To analyze the vertical stability of anterior plate fixation for sacroiliac joint dislocation using three-dimensional finite element method. METHODS: The anterior plate fixation model of unilateral sacroiliac joint dislocation was constructed on the basis of the three-dimensional finite element model of a complete pelvis. An axial load of 500 N was applied on the model; the cloud pictures of stress, strain and displacement were obtained after calculation and compared with that of the complete pelvis under the same conditions.RESULTS AND CONCLUSION: Stress concentration occurred at the internal fixation system; the maximum stress was found at the screws near the injured sacroiliac joint, far greater than the maximum stress of the complete pelvis under the same condition. The maximum strain was found in the healthy sacroiliac joint; the fixed sacroiliac joint had no strain. The maximum displacement was found in the injured sacroiliac joint; it was about twice longer than the complete pelvis. These findings indicate that the vertical stability of pelvis is poor using anterior plate internal fixation treatment for sacroiliac joint dislocation; and stress concentration occurs at the screws and plates.%背景:已有文献报道骶髂关节损伤及固定的生物力学研究,但多是在尸体标本或人工骨模型上模拟骶髂关节损伤.目的:利用三维有限元方法对骶髂关节脱位前路钢板内固定的垂直稳定性进行分析.方法:在完整骨盆三维有限元模型的基础上,建立一侧骶髂关节脱位后前路钢板内固定模型.对模型施加500 N轴向载荷,经计算得到应力、应变及位移云图,并与完整骨盆的同一工况进行比较分析.结果与结论:在内固定系统处出现了应力集中现象,尤其以靠近骶髂关节的螺钉周

  17. The treatment of sternal wound infection by internal fixation of sternum with titanium plate after cardiac surgery%钛板固定在心脏术后胸骨正中切口感染治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    亓发芝; 冯自豪; 张勇; 顾建英

    2013-01-01

    目的 探讨应用钛板内固定,增强胸骨稳定性,提高心脏手术后胸骨正中切口感染的临床治疗效果.方法 采用回顾性调查的方法,对26例应用钛板内固定,治疗胸骨切口感染的病例进行分析.结果 2009年1月至2011年12月应用钛板内固定治疗26例,均为慢性感染患者,感染持续时间均超过3个月.3例深部感染患者采用伤口持续负压吸引(VAC)的方法辅助创面准备.26例患者均行胸大肌肌瓣转移,无一例发生钛板感染需再次手术取出,且无一例因胸骨再次感染而需二次手术.结论 应用钛板内固定可以加强胸骨稳定性,减少局部组织渗出,提高心脏手术后胸骨正中切口感染的临床治疗效果.%Objective To investigate the internal fixation of sternum with titanium plate for the treatment of sternal wound infection after cardiac surgery.Methods A retrospective study of 26 patients from Jan 2009 to Dec 2011 was carried out.All the 26 cases with sternal wounds infection after cardiac surgery,were treated by internal fixation with titanium plates.Results All the patients had choronic infection,lasting for more than 3 months.3 patients received vacuum-assisted closure treatment after complete debridment.All the wounds were covered with pectoral major muscle flap.All the wounds healed completely with no recurrence of infection..Conclusions Internal fixation of sternum with titanium plate can increase the stability.It helps to improve the treatment efficacy of sternal wound infection after cardiac surgery.

  18. 改良前外侧入路胫骨近端锁定加压钢板固定治疗胫骨平台后外侧骨折%CLINICAL EFFECT OF IMPROVED ANTEROLATERAL PROXIMAL TIBIA AFTER LOCKING COM- PRESSION PLATE FIXATION IN THE TREATMENT OF LATERAL TIBIA PLATEAU FRACTURE

    Institute of Scientific and Technical Information of China (English)

    何建华

    2015-01-01

    Objective To analyze the clinical effect of modified anterolateral proximal tibia locking compres‐sion plate fixation in patients with lateral tibia plateau fracture .Methods Totally 80 cases of tibia plateau lateral fracture patients were treated in author's hospital from March 2011 to March 2013 were randomly di‐vided into observation group and control group .The control group received conventional treatment methods anterolateral approach ,while the observation group received an improved anterolateral approach proximal tibia compression plate fixation ,and then the clinical effect were compared between the two groups .Results There were significant difference (P The modified anterolateral proximal tibia locking compression plate fixation is worthy of clinical use for patients of the poster lateral tibia plateau fractures with a significant effect ,simple and safe operation .%目的:分析改良前外侧入路胫骨近端锁定加压钢板固定治疗胫骨平台后外侧骨折的临床效果。方法将收治的80例胫骨平台后外侧骨折患者随机分为观察组和对照组,对照组给予传统前外侧入路的治疗方法,观察组给予改良前外侧入路胫骨近端加压钢板固定治疗,分析和比较二组患者的治疗效果。结果二组患者平均手术时间、手术出血量、并发症发生率等各手术参数、随访结果及膝关节功能评分的比较差异有统计学意义(P<0.05)。结论改良前外侧入路胫骨近端锁定加压钢板固定治疗胫骨平台后外侧骨折疗效显著、操作简便、安全性高,值得临床推广使用。

  19. Plating versus intramedullary nail fixation for the treatment of humeral shaft fractures in adults:A systematic review update%钢板和髓内针固定治疗成人肱骨干骨折的系统评价

    Institute of Scientific and Technical Information of China (English)

    李连华; 王浩; 张妍; 蔡艳红; 张浩; 刘智; 孙天胜

    2013-01-01

    BACKGROUND:There is controversial on which method is preferred for the treatment of humeral shaft fractures, plate or intramedul ary nail fixation? Some studies have compared the effect of those two methods, but the results are different. While the results of the systematic research and the Meta-analysis on the comparative studies is also different due to the differences in the number and the extraction of the researches. OBJECTIVE:To systematical y evaluate the efficacy of plating versus intramedul ary nail fixation in the treatment of adult humeral shaft fracture. METHODS:A computer-based retrieve was conducted in PubMed database, MEDLINE database, Cumulative Index to Nursing&Al ied Health Literature, Evidence-Based Medicine database, CBM database, Wanfang database and CNKI database for the randomized or quasi-randomized control ed trials on the comparison of plating and intramedul ary nail fixation in the treatment of adult humeral shaft fracture. The quality of these trials was critical y assessed according to Jadad. The effective data were extracted for Meta-analysis by Stata 12.0 software. RESULTS AND CONCLUSION:Total y, 15 randomized or quasi-randomized control ed trials were col ected including four quasi-randomized control ed trials and 11 randomized control ed trials. The results showed that intramedul ary nail fixation may increase the risk of complications (odds ratio=0.37(0.19, 0.59), P=0.00). Bias Egger’s test of P=0.91 showed there was no significant publication bias. The risk of re-operation of intramedul ary nail fixation was increased (odds ratio=0.28(0.14, 0.57), P=0.00) with the Egger’s test of P=0.69. The incidence of shoulder impingement of intramedul ary nail fixation was significantly higher than that of pate fixation (odds ratio=0.13(0.05, 0.35), P=0.00), and there were no significant differences in postoperative infection, nonunion, implant failure, iatrogenic nerve palsy, operation time and bone union time between two methods. The

  20. 术前数字化设计在成人股骨远端C1型骨折钢板内固定中的应用研究%Computer-assisted preoperative planning for plate fixation of adult C1-type fracture of distal femur: a cadaveric study

    Institute of Scientific and Technical Information of China (English)

    郑晓晖; 张国栋; 牛素生; 黄文华; 肖建坤; 陈贞庚; 涂致远

    2014-01-01

    Objective To evaluate the effectiveness of preoperative computer-assisted planning for plate fixation of adult C 1-type fracture of distal femur.Methods Ten pairs of cadaveric specimen of adult femur were used to create models of Cl-type fracture of distal femur.All models were subjected to spiral three-dimensional (3D) CT scan.The CT images were stored in DICOM format and transferred to a personal computer running MIMICS 14.0 software.In the experimental group (all 10 right sides),3D images reconstruction,3D editing,virtual plate and screws introduction,and measurement on virtual implants were performed to carry out a preoperative digital planning.The actual operations were then conducted strictly according to the parameters from virtual preoperative planning.In the control group (all 10 left sides),the fracture fixation was performed according to orthopaedic conventions.The evaluation system included:① similarity between virtual and actual implant fixation (10 points for perfection),② assessment of internal fixation quality in both groups (40 points for perfection),③ biomechanical compression test,and ④ time for internal fixation in both groups.Results The average score of the similarity between virtual and actual implant fixation was 9.7 points.The experimental group significantly surpassed the control group in fracture reduction,plate choice,implant fitness,screw insertion,maximum load and breaking load (P < 0.05).The experimental group consumed significantly less time for internal fixation than the control group (32.5 ± 3.2 min versus 39.1 ± 2.3 min),but used significantly more time for the whole procedure (preoperative planning plus internal fixation) (81.9 ± 10.0 minversus 39.1 ± 2.3 min) (P <0.05).Conclusion Since computer-assisted digital preoperative planning can lead to more appropriate choice of implant,better fitness between plate and bone outline,and more accurate insertion of screws,it enhances the biomechanical performance of

  1. Anatomic security of applying different numbers of screws at the sacrum sides in the anterior double plate fixation of the sacroiliac joint%骶髂关节前路双钢板固定骶骨侧不同螺钉数量的解剖安全性研究

    Institute of Scientific and Technical Information of China (English)

    刘佳; 高仕长; 倪卫东; 蒋电明; 周程鹏

    2012-01-01

    0bjective: To compare the anatomic security of applying different numbers of screws at the sacrum sides in the anterior double plates fixation of the sacruiliac joint and to clarify which is safer when the stability of the fixation is considered. Methods: (1) Totally 15 normal cadavers pelvis were scanned by CT. Thin-section CT scan data were saved and analyzed by the software Materi-alise's interactive medical image control system (MIMICS 10.0). The virtual operations of the anterior double plates approach for fixation of the sacroiliac joint were performed in the same software. (2)The left sides of the sacroiliac joint were named as group A,in which two screws were placed into the sacrum sides. The right sides of the sacroiliac joint were named as group B,in which one screw was placed into the sacrum sides. The distances from the medial edge of the plates to the lateral sides of the anterior branches of lumbar nerves 4,5 were measured. The relationship of the screws and the sacroiliac joint was checked by radiograph. Results: (1 )In the virtual operations,the sacrum sides can accommodate two screws safely- (2)In group A,the distances from the medial edge of the upper and lower plates to the lateral sides of the anterior branches of lumbar nerve 5 were (3.0 ± 1.4) mm and (1.5 ± 1.0) mm respectively. The upper and lower plates can be placed below the anterior branches of lumbar nerve 4 safely. In group B,the distances from the medial edge of the upper plates to the lateral sides of the anterior branches of lumbar nerves 4,5 were (5.0 ± 1.1) mm and (10.3 ±1.3) mm respectively and those from the medial edge of the lower plates were (2.7 ± 0.5) mm and (5.1 ±0.9) nun respectively. (3)ln X-ray examination,no screw of the left upper plates was found in the sacroiliac joint in group A and 4 screws of the left lower plates were observed. On the other hand, no screw of the right plates (lower and upper) in the group B was found in the sacroiliac joint. Conclusions

  2. Photographic fixative poisoning

    Science.gov (United States)

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

  3. Effects of a sliding plate on morphology of the epiphyseal plate in goat distal femur.

    Science.gov (United States)

    Lin, Da-sheng; Lian, Ke-jian; Hong, Jia-yuan; Ding, Zhen-qi; Zhai, Wen-liang

    2012-01-01

    The aim of this study was to observe the effects of a sliding plate on the morphology of the epiphyseal plate in goat distal femur. Eighteen premature female goats were divided randomly into sliding plate, regular plate and control groups. Radiographic analysis and histological staining were performed to evaluate the development of epiphyseal plate at 4 and 8 weeks after surgery. In the sliding plate group, the plate extended accordingly as the epiphyseal plate grows, and the epiphyseal morphology was kept essential normal. However, the phenomenon of the epiphyseal growth retardation and premature closure were very common in the regular plate group. In addition, the sliding plate group exhibited more normal histologic features and Safranin O staining compared to the regular plate group. Our results suggest that the sliding plate can provide reliable internal fixation of epiphyseal fracture without inhibiting epiphyseal growth.

  4. Effects of a Sliding Plate on Morphology of the Epiphyseal Plate in Goat Distal Femur

    Directory of Open Access Journals (Sweden)

    Da-sheng LIN, Ke-jian LIAN, Jia-yuan HONG, Zhen-qi DING, Wen-liang ZHAI

    2012-01-01

    Full Text Available The aim of this study was to observe the effects of a sliding plate on the morphology of the epiphyseal plate in goat distal femur. Eighteen premature female goats were divided randomly into sliding plate, regular plate and control groups. Radiographic analysis and histological staining were performed to evaluate the development of epiphyseal plate at 4 and 8 weeks after surgery. In the sliding plate group, the plate extended accordingly as the epiphyseal plate grows, and the epiphyseal morphology was kept essential normal. However, the phenomenon of the epiphyseal growth retardation and premature closure were very common in the regular plate group. In addition, the sliding plate group exhibited more normal histologic features and Safranin O staining compared to the regular plate group. Our results suggest that the sliding plate can provide reliable internal fixation of epiphyseal fracture without inhibiting epiphyseal growth.

  5. Internal fixation of mandibular angle fractures: a meta-analysis.

    Science.gov (United States)

    Regev, Eran; Shiff, Jacob S; Kiss, Alex; Fialkov, Jeffrey A

    2010-06-01

    The degree of rigidity of internal fixation required for the treatment of mandibular angle fractures has long been at the center of debate in the literature. A statistical comparison between rigid fixation and monocortical fixation has been difficult because of multiple terms, definitions, and technical variations. The purpose of this study was to use the meta-analysis tool to combine information from multiple studies and to compare complication rates for different fixation methods. An English language literature search was conducted for articles on mandibular angle fractures. Information was collected on four variables of interest: compression/noncompression technique, monocortical/bicortical screws, number of plates, and location of plates. Five outcome rates were analyzed: infection, reoperation, hardware removal, malunion, and nonunion. Meta-analyses were run using Comprehensive Meta Analysis, version 2.2.03. Twenty-four studies with relevant data on the variables and outcomes of interest met the inclusion criteria. Significantly higher rates of infection, reoperation, and hardware removal were found for compression compared with noncompression, two plates compared with one plate, and for plates located on both the inferior and superior borders as compared with superior or inferior only. There were also significantly higher infection rates for bicortical screws compared with monocortical screws and higher malunion rates for compression compared with noncompression plating techniques. The results of this meta-analysis found lower complication rates with the use of noncompression, monocortical, and single-plate fixation, supporting the trend toward a single, superiorly placed, monocortical miniplate for fixation of mandibular angle fractures.

  6. 微型钛板塑形内固定整复术治疗眼眶骨折患者的临床疗效%Analysis of clinical efficacy and complications of titanium mini plate internal fixation and reconstructive surgery for patients with orbital fracture

    Institute of Scientific and Technical Information of China (English)

    刘洋; 王彦荣; 胡文静

    2016-01-01

    AIM: To analyze the clinical efficacy and complications of titanium mini plate internal fixation and reconstructive surgery for patients with orbital fracture. METHODS: Fifty - seven cases (60 eyes) with orbital fracture from March 2013 to April 2014 in our hospital were researched. According to the random number table method, the patients were divided into observation group (29 cases with 30 eyes) and control group (28 cases with 30 eyes ). The control group was treated with hydroxyapatite artificial bone plate for internal fixation, and the observation group with titanium mini plate internal fixation and reconstructive surgery. The diplopia grading, grading of ocular movement disorder before and at 1, 3mo after treatment and postoperative complications ( prolapse, dislocation, infection ) were compared between the two groups. RESULTS: In both group, all the 60 eyes were healed without scar formation. The rate of diplopia grading as grade 0 1mo postoperatively of observation group and the control groups were 63% and 40% ( P CONCLUSION: The clinical curative effect of titanium mini plate internal fixation and reconstructive surgery has a good effect for orbital fractures, which can improve the therapeutic effect and reduce the incidence of adverse reactions.%目的:微型钛板塑形内固定整复术治疗眼眶骨折患者的临床疗效及并发症的分析。  方法:选择2013-03/2014-04我院收治的眼眶骨折患者57例60眼,按照随机数表法将患者分为观察组29例30眼和对照组28例30眼。观察组给予微型钛板塑形内固定整复术治疗;对照组患者给予羟基磷灰石复合人工骨板的内固定治疗。在治疗前、治疗后1、3mo 比较两组患者的复视分级、眼球运动障碍分级情况以及治疗后的并发症情况(脱出、移位、感染)。  结果:两组患眼均为Ⅰ期愈合,均无瘢痕形成。观察组与对照组患者术后1mo 的复视分级为0级的比例分别为63%与40%,

  7. Indications and surgical techniques of fixation of rib fractures with memory alloy osteosynthesis plates%记忆合金环抱器固定肋骨骨折的适应证及手术技巧

    Institute of Scientific and Technical Information of China (English)

    徐恩五; 乔贵宾; 彭秀凡; 蒋仁超; 张卓华; 曾伟生

    2012-01-01

    Objective To evaluate the clinical effects of memory alloy embracing fixators in fixation of the rib fractures and investigate the related surgical indications and surgical techniques.Methods Retrospectively review was conducted on the clinical data of 30 patients with rib fractures treated with memory alloy embracing fixators from October 2010 to April 2011 at General Hospital of Guangzhou Military Command.The number of memory alloy embracing fixators used in operation,the number of fixed positions,and operation time were recorded.The pain scores before and after operation were comparatively studied.Operation efficacy and complications were analyzed.Results Of the 30 patients,the total operation time,number of fixators,and number of fixed ribs were (111.9±48.0) minutes,4.3±2.1 and 3.5±1.3,respectively.Meanwhile,the difference between pre-operative and post-operative pain scores was significant (6.93±0.88) points vs (4.04±0.62) points,P<0.05).The ambulation perlod was (4.6±1.9) days and length of hospital stay was (27.2±10.8) days.Incisional and thoracic wall hematoma was detected in three patients and pulmonary infection in six post-operatively but none presented intractable chest pain,foreign body rejection or wound infection.Conclusion Memory alloy embracing fixators for rib fractures is reliable,easy,and effective in alleviating pain,improving lung function,reducing the frequency of ventilator use and preventing complications like lung infection.%目的 评价记忆合金环抱器固定肋骨骨折的临床效果,探讨该术式的手术适应证及手术技巧.方法 回顾性总结2010年10月-2011年4月应用记忆合金环抱器治疗的肋骨骨折患者30例的临床资料.统计记忆合金环抱式固定器的使用数量、固定部位、手术时间,对比患者术前、术后的疼痛评分,分析手术疗效及并发症情况.结果 30例患者手术时间(111.9±48.0)min,使用固定器(4.3±2.1)个,固定肋骨(3.5±1.3)

  8. Sixty-Two Aid Projects in Full Swing

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    Sixty-TwoAidProjectsinFullSwingbyBengyiInlateJuly1994,theCPCCentralCommitteeandtheStateCouncilheldtheThirdWorkingfromthelong-...

  9. 带锁髓内钉与加压钢板内固定治疗胫腓骨骨折的临床疗效及安全性分析%Clinical Effect and Safety Analysis of Interlocking Intramedullary Nail and Compression Plate Internal Fixation in Treatment of Tibial and Fibula Fractures

    Institute of Scientific and Technical Information of China (English)

    单志军

    2015-01-01

    目的:比较带锁髓内钉与加压钢板内固定治疗胫腓骨骨折的临床疗效及安全性。方法选择我院收治的58例胫腓骨骨折患者分别行带锁髓内钉与加压钢板内固定治疗。结果观察组患者出现骨痂时间、负重时间及愈合时间均小于对照组,且观察组并发症发生率13.79%低于对照组并发症发生率27.59%,差异有统计学意义(P<0.05)。结论带锁髓内钉治疗胫腓骨骨折疗效好,安全有效且并发症少。%ObjectiveTo compare the clinical efficacy and safety of interlocking intramedulary nailing and compression plate internal fixation.Methods Chose 58 cases of tibia and fibula fractures for treatment with interlocking intramedulary nailing and compression plate internal fixation in our hospital.Results The incidence of bone calus,time and healing time of observation group were significantly lower than that of control group,and the incidence of complications was significantly lower than that in control group(P<0.05).Conclusion The treatment of tibial and fibula fractures with interlocking intramedulary nailing are safe and effective.

  10. Mechanical design optimization of bioabsorbable fixation devices for bone fractures.

    Science.gov (United States)

    Lovald, Scott T; Khraishi, Tariq; Wagner, Jon; Baack, Bret

    2009-03-01

    Bioabsorbable bone plates can eliminate the necessity for a permanent implant when used to fixate fractures of the human mandible. They are currently not in widespread use because of the low strength of the materials and the requisite large volume of the resulting bone plate. The aim of the current study was to discover a minimally invasive bioabsorbable bone plate design that can provide the same mechanical stability as a standard titanium bone plate. A finite element model of a mandible with a fracture in the body region is subjected to bite loads that are common to patients postsurgery. The model is used first to determine benchmark stress and strain values for a titanium plate. These values are then set as the limits within which the bioabsorbable bone plate must comply. The model is then modified to consider a bone plate made of the polymer poly-L/DL-lactide 70/30. An optimization routine is run to determine the smallest volume of bioabsorbable bone plate that can perform and a titanium bone plate when fixating fractures of this considered type. Two design parameters are varied for the bone plate design during the optimization analysis. The analysis determined that a strut style poly-L-lactide-co-DL-lactide plate of 690 mm2 can provide as much mechanical stability as a similar titanium design structure of 172 mm2. The model has determined a bioabsorbable bone plate design that is as strong as a titanium plate when fixating fractures of the load-bearing mandible. This is an intriguing outcome, considering that the polymer material has only 6% of the stiffness of titanium.

  11. Biomechanical comparison of reconstruction plate versus pedicle screw-rod system in fixation of the models of Tile B1 pelvic injury%钢板与钉棒系统固定骨盆Tile B1型损伤模型的生物力学比较

    Institute of Scientific and Technical Information of China (English)

    李尚政; 苏伟; 庄小强; 白宇; 陆生林

    2014-01-01

    Objective To compare the biomechanical properties of reconstruction plate and pedicle screw-rod system in fixation of the models of Tile B1 pelvic injury.Methods We used 7 cadaveric specimens of normal adult pelvis from 2 males and 5 females with an average death age of 42.1 years.The cadaveric pelvis preserved an intact spine from the fifth lumbar vertebra to 20 centimeters above the proximal ends of both femurs,intact pubic symphysis,bilateral hip joints,bilateral sacroiliac joints,and major pelvic ligaments.After the pelvic specimens were put in an AGS-X biomechanical testing machine at a simulated standing neutral posture,they were subjected to a vertical load of up to 500 N downward from the L5 vertebral body.The displacements of the symphysis pubis were recorded sequentially in the following 4 conditions:1.intact pelvis (the intact group); 2.models of Tile B1 pelvic injury simulating rotatory unstable injury of the pelvis in which the symphysis pubis was cut apart in combination with ruptures of ipsilateral sacrospinous and sacrotuberous ligaments (the injury group); 3.Tile B1 pelvic injury fixated with a reconstruction plate (the plate group).4.Tile B1 pelvic injury fixated with the pedicle screw-rod system (the screw-rod group).Results Under the vertical load of 500 N,the displacements of the symphysis pubis in the intact,injury,plate and screw-rod groups were respectively 0.121 ±0.025 mm,4.512 ±0.391 mm,0.358 ±0.051 mm,and 0.656 ±0.103 mm.There were significant differences between the 4 groups (F =725.707,P =0.000).The displacement increased from the intact group,the plate group,the screw-rod group to the injury group.The differences between any 2 groups were significant (P < 0.05).Conclusions In fixation of the models of Tile B1 pelvic injury,the reconstruction plate and the pedicle screw-rod system can both effectively restore the biomechanical stability of the injured pelvis.However,internal fixation with the reconstruction plate may yield better

  12. The use of rigid internal fixation in the surgical management of cervical spondylosis.

    Science.gov (United States)

    Kwon, Brian K; Vaccaro, Alexander R; Grauer, Jonathan N; Beiner, John M

    2007-01-01

    In the surgical management of cervical spondylosis, the application of rigid internal fixation can enhance the immediate stability of the cervical spine. The sophistication of such internal fixation systems and the indications for their use are continuously evolving. A sound understanding of regional anatomy, biomechanics, and kinematics within the cervical spine is essential for the safe and effective application of internal fixation. Numerous options currently exist for anterior cervical plating systems; some lock the screws to the plate rigidly (constrained), whereas others allow for some rotational or translational motion between the screw and plate (semiconstrained). The role of anterior fixation in single and multilevel fusions is still the subject of some controversy. Long anterior cervical reconstructions may require additional posterior fixation to reliably promote fusion. Rigid fixation in the posterior cervical spine can be achieved with lateral mass screws or pedicle screws. Although lateral mass screws provide excellent fixation within the subaxial cervical spine, the regional anatomy of C2 and C7 often make it difficult to place such screws, and pedicle screws at these levels are advocated. Pedicle screws achieve fixation into both the anterior and posterior column and are arguably the most stable form of rigid internal fixation within the cervical spine. Familiarity with these internal fixation techniques can be an extremely valuable tool for the spine surgeon managing these degenerative disorders of the cervical spine.

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

    Directory of Open Access Journals (Sweden)

    Parashar Atul

    2007-01-01

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

  14. Combined application of vascularized pedicled pectoralis major clavicular periosteal flap and locking plate fixation plus bone morphogenetic protein implantation in the treatment of clavicular defect and nonunion after operation%带血管胸大肌蒂锁骨膜联合锁定钛板固定BMP植入治疗锁骨术后骨不愈合及骨缺损

    Institute of Scientific and Technical Information of China (English)

    孙强; 郑加法

    2009-01-01

    目的 探讨锁骨骨折术后骨缺损、骨折不愈合的临床特点,评价锁定钛板固定骨形态发生蛋白(bone morphogenetic protein,BMP)植入联合带血管胸大肌蒂锁骨膜转位的治疗效果.方法 2004年1月-2008年4月,锁骨骨折不愈合12例,平均年龄42.8岁,均行内固定物取出,清除骨折端纤维瘢痕及硬化骨,锁定钛板同定BMP植入,带血管胸大肌蒂锁骨膜转位覆盖,术后进行功能康复锻炼. 结果 12例患者术后均获得随访,时间8~24个月,平均1.2年,应用Constant-Murley肩关节评分系统进行评价,所有患者均在4~7个月达到临床愈合,部分患者已将内固定物取出. 结论 锁定钛板固定BMP植入联合带血管胸大肌蒂锁骨膜转位治疗锁骨骨缺损、骨不连,可取得良好的临床效果.%Objective To investigate the clinical characteristics of clavicular defect and nonunion after operation and evaluate the clinical effects of vascularized pedicled pectoralis major clavicular periosteal flap and locking plate fixation plus bone morphogenetic protein (BMP) implantation. Methods From January 2004 to April 2008, 12 patients (mean age, 42.8 years old) with clavicular defect and nonunion were treated in Zhongshan Hospital. The internal fixators were removed, and then fibrous scars and sclerotic bones were cleared. The clavicular detects were fixed with locking plate, with implantation of the BMP. The wound was covered with vascularized pedicled pectoralis major clavicular periosteal flap. Postoperative functional rehabilitation exercises were performed. Results All patients were followed up for 8-24 months (mean 1.2 years). The clinical results were evaluated by Constant-Murley scoring system. The clavicular defects were healed in all patients within 4-7 months, and the internal fixators were successfully removed from some of the patients. Conclusions Vascularized pedicled pectoralis major clavicular periosteal flap combined with locking plate fixation

  15. 改良股骨近端锁定板内固定治疗股骨粗隆间合并粗隆下骨折的疗效观察%Curative Effect Observation of the Modified Proximal Femoral Locking Plate Internal Fixation in the Treatment of Intertrochanteric Combined Subtrochanteric Fracture

    Institute of Scientific and Technical Information of China (English)

    董必成; 李朝军; 尹东武; 杨利; 白虎荣; 冯文顺; 李小健

    2015-01-01

    Objective:To investigate the curative effect observation of the modified proximal femoral locking plate internal fixation in the treatment of intertrochanteric combined subtrochanteric fracture.Method:The clinical data of 18 patients with intertrochanteric combined subtrochanteric fracture in our hospital from January 2009 to May 2015 were retrospectively analyzed.They were treated with the modified proximal femoral locking plate internal fixation,and the treatment effect was observed.Result:The operation time of the group was 80-120 min,the intraoperative bleeding was 400-800 mL,the average was 510 mL.All patients were healed by first intention,during a mean 14(6 to 18 months) months following-up,the fracture were healed.The postoperative functional recovery of hip joint in the follow-up according to Harris score standard,excellent in 10 cases,good in 4 cases,fair in 4 cases,the excellent and good rate was 77.8%.Conclusion:The clinical effect of the modified proximal femoral locking plate internal fixation in the treatment of intertrochanteric combined subtrochanteric fracture is reliable,fracture anatomical reduction,stable internal fixation, high fracture healing rate and less complications,is worthy of clinical popularization and application.%目的:探讨改良股骨近端锁定板内固定治疗股骨粗隆间合并粗隆下骨折的疗效观察。方法:回顾性分析本院2009年1月-2015年5月治疗的18例股骨粗隆间合并粗隆下骨折患者的临床资料,所有患者均采用改良股骨近端锁定板内固定进行治疗,观察其治疗效果。结果:本组手术时间80~120 min,术中出血400~800 mL,平均510 mL。所有患者切口Ⅰ期愈合,随访6~18个月,平均14个月骨折愈合。本次随访髋关节术后功能恢复根据Harris评分标准,评定优10例,良4例,可4例,优良率为77.8%。结论:改良股骨近端锁定板内固定治疗股骨粗隆间合并粗隆下骨折临床效果可靠,骨

  16. Finite element analysis of distal femoral locking plate and minimally invasive internal fixation system in different motion states%股骨远端锁定微创内固定系统不同运动状态下的有限元分析

    Institute of Scientific and Technical Information of China (English)

    郝廷; 王兴国; 李筱贺

    2016-01-01

    BACKGROUND:Traditional distal femoral fixation plate screw breakage is relatively common. Designing good anatomical and attached fixation system is the key for clinical application. OBJECTIVE:To perform finite element analysis in two states of motion of the minimal y invasive distal femoral fixation system, compare stress distribution of different parts in the same fixed way, different fixed methods and the same fixed parts of different motion states. METHODS:Imaging data of a 34-year-old male patient weighing 68 kg with 33-C1 type fracture of distal femur were selected. CT data were input into Mimics 16.0 for reconstruction. PRO-E software was used to establish minimal y invasive internal fixation system with distal femoral locking plate. Data were introduced into reconstructed models of distal femur fracture in Mimics for grid division. Data were introduced into Ansys products 11.0 to construct finite element model, fix the surface of distal femur, and loaded 340 N on greater trochanter of femur. Stress distribution of each plate, screw hole and screw tail was analyzed in each group. Stress at the same region was compared in flexion and extension movement states. RESULTS AND CONCLUSION:(1) Finite element models of anatomic locking plate for distal femur fracture fixation were successful y established, total y 43 536 units, 41 256 nodes. (2) With the steel segment gradual y down (S1-S5), the stress gradual y increased. A1-A5 with the increase in the number of screws, the stress gradual y increased, but A6 suddenly decreased. (3) According to the cloud atlas of stress, these were wel distributed except A1. From distal end to extremity of screw, the stress of screws increased. Among corresponding segments, significant differences in stress around the nail holes and steel segment stress were detected. Moreover, the steel stress was greater than the stress of corresponding segment of screw hole. (4) Results suggest that using anatomical locking plate and minimal y

  17. 不同类型肱骨骨折钢板内固定后稳定性分析%Stability of different types of humeral fractures after internal fixation with plate

    Institute of Scientific and Technical Information of China (English)

    宋景仑; 张奉琪; 王鹏程

    2012-01-01

    目的 用生物力学实验方法分析横断骨折、短斜骨折和粉碎骨折三种情况下肱骨骨折钢板内固定术后稳定性.方法 选取骨密度值相近的肱骨干标本30个,分三组分别制作成横断骨折、短斜骨折和粉碎骨折.将标本水平位放置于生物力学机,于骨折处垂直向下载荷,记录肱骨力-外翻位移.将标本竖直固定于生物力学机,肱骨头侧向上,给肱骨外旋负荷,记录肱骨扭矩-外旋转角.结果 肱骨横断骨折、短斜骨折和粉碎骨折三组的外翻位移及外旋角依次增大,经统计学比较各组间有统计学差异(1-a=95%,P<0.05)结论 肱骨骨折钢板固定时,横断骨折、短斜骨折和粉碎骨折的稳定性依次降低,粉碎骨折术后功能锻炼要适度,必要时辅以适当外固定.%Objective To analyze the stability after internal fixation for transverse fracture,short oblique fracture and comminuted fractures by biomechanical experiment. Methods Thirty specimens of humerus shaft with similar bone density were selected to make the models of transverse fracture, short oblique fracture and comminuted fracture. The humerus force-eversion displacement was recorded while the specimen was imposed vertically by the machine. The humeral torque-external rotation angle was recorded while the humerus was externally rotated on the machine. Results The eversion displacement and external rotation angle increased gradually for the transverse fractures, short oblique fractures comminuted fractures in turn, and there was statistically different among three groups ( P < 0.05 ). Conclusion The internal fixation stability for transverse fracture, short oblique fractures and comminuted fracture decreases gradually. The postoperative functional exercise should be proper for comminuted fractures,and can be supplemented by the appropriate external fixation if necessary.

  18. Avaliação biomecânica da fixação da fratura supracondiliana do fêmur comparando placa-lâmina 95º com DCS Fixation of supracondylar femoral fractures: a biomechanical analysis comparingthe 95º blade plate and the dynamic condylar screw (DCS

    Directory of Open Access Journals (Sweden)

    Marco Antônio Percope Andrade

    2010-01-01

    Full Text Available OBJETIVO: Demonstrar por meio de ensaios biomecânicos comparativos entre a placa-lâmina de 95º e o parafuso condilar dinâmico (Dynamic Condylar Screw - DCS, qual apresenta maior resistência às cargas compressivas e de flexão, bem como tentar correlacionar o tipo de falha apresentada durante os testes com cada um dos tipos de placa. MÉTODOS: Sessenta e cinco fêmures suínos foram submetidos a osteotomia em cunha de subtração medial de um centímetro (cm, na região metafisária distal do fêmur, com o objetivo de simular fratura supracondiliana instável. Foi realizada osteossíntese dessas peças, sendo 35 fixadas com placa-lâmina 95º e 30 com placas com DCS, submetendo-as a cargas em compressão axial e flexão. Outra variável estudada foi o tipo de falha apresentada em cada grupo com a tentativa de correlacioná-la com o tipo de placa. RESULTADOS: Os resultados não mostraram diferença estatisticamente significante na resistência biomecânica entre os dois tipos de placas ou entre o tipo de falha e a placa utilizada na osteossíntese. CONCLUSÃO: Os dois tipos de placas se comportam de maneira semelhante, embora haja um indicativo de que a placa-lâmina seja, no ensaio de flexão, superior à placa DCS. Não foi observada diferença entre o tipo de falha e o tipo de placa utilizada.OBJECTIVE: to determine, by means of comparative biomechanical tests between the 95o angled blade plate and the dynamic condylar screw (DCS, the one that presents greater compressive load resistance and flexion, and to correlate the failure type presented during the tests with each type of plate. METHODS: Sixty-five porcine femurs were submitted to a 1 cm medial wedge osteotomy, in the metaphysic, to simulate an unstable supracondylar femoral fracture. Osteosynthesis of these pieces was performed: 35 were fixated with a 90o lateral blade plate, and 30 with DCS plates. Another variable studied was the failure type presented in each group, attempting

  19. Biomechanical Study of Acetabunlum Transverse and Posterior Wall Fractures Treated by Internal Fixation with Locking Reconstruction Plate%锁定重建接骨板治疗髋臼横行伴后壁骨折的生物力学研究

    Institute of Scientific and Technical Information of China (English)

    付久洋; 吴啸波

    2015-01-01

    Objective To evaluate the stability of 3 different internal fixation methods for transverse and posterior wall fractures of the acetabulum. Methods Seighteen acetabula of 9 whole pelvises were divided into 3 groups randomly. Models of transverse and posterior wall fracturesof acetabulum were established and then fixed with one of following three internal fixation methods:(Group A)posterior column locking reconstruction plate group,(Group B)posterior column common reconstruction plate withposterior wall 2 lag screwsgroup ,(Group C)anterior column lag screw and posterior column common reconstruction plate with posterior wall2 lag screws group. biomechanical tests are conducted in a single leg stance tomeasurethe maximal loads in the three groups and the displacements of the posterior wall fractures when the stress were loaded to 2 200 N on the three groups. Results The maximal loads in Groups A,B,C were as follows:(2243. 74 ± 116. 36)N,(2769. 05 ± 131. 42) N,(2832. 87 ± 137. 93)N. When the stress was loaded to 2 200 N on the three groups,the displacements of the posterior wall fractures were as follows:(2. 15 ± 0. 26)mm,(0. 45 ± 0. 05)mm,(0. 53 ± 0. 07)mm. We found there was no significant difference between the Group B and the Group C(P > 0. 05). There was significant difference between Groups B,C and Groups A,(P 0.05)。B、C 两组数据与 A 组比较,差异均有统计学意义(P <0.05,P <0.01)。结论锁定重建接骨板固定髋臼横行伴后壁骨折固定可靠,能够满足患者早期功能锻炼的要求,具有较大临床应用价值。

  20. Three-dimensional finite element analysis of calcaneus fracture treated with plate fixation%三维有限元分析钢板内固定治疗跟骨骨折*

    Institute of Scientific and Technical Information of China (English)

    黄诸侯; 李俊; 杜景文; 陈日齐; 张建新

    2013-01-01

      背景:有多种钢板治疗跟骨骨折,但究竟哪种效果更好,目前尚无定论。  目的:在跟骨骨折三维有限元模型上模拟加载3种类型的钢板,观察比较应力、应变及移位等生物力学性能。  方法:在踝关节中立位和背伸20°位建立跟骨骨折三维有限元模型,分别模拟使用跟骨Ⅰ型、Ⅱ型、Ⅲ型3种形状钢板对骨折进行固定,加载后计算内固定物自身的应力分布、骨骼的应力分布及骨折块间的移位程度。  结果与结论:①两种体位骨折模型3种固定方式下的钢板应力分布都不均匀,钢板前部应力水平均高于后部,Ⅰ型钢板的应力分布相对比较均匀。②两种体位骨折模型3种固定方式下跟骨的应力最大值均在跟骨前部,而正常跟骨最大应力值在跟结节处,Ⅰ型钢板固定跟骨骨折后骨骼的最大应力值均小于Ⅱ型、Ⅲ型钢板。③两种体位骨折模型3种固定方式下均发生了骨折块间的位移,其位移趋势是一致的。结果显示,与Ⅱ型、Ⅲ型钢板固定相比较,跟骨Ⅰ型钢板固定后所承受应力更小,且应力分布更均匀,较符合生物力学原理。%BACKGROUND:There are many types of plate can be used for the treatment of calcaneus fracture, but it is not clear which type has the best effect. OBJECTIVE:To observe and compare the biomechanical properties, such as stress, strain and displacement of three types of plate through loading them on the three-dimensional finite element model of calcaneus fracture. METHODS:The three-dimensional finite element model of calcaneus fracture was established when the ankle joint was in neutral position and back stretches 20° position, then the type Ⅰ, type Ⅱ and type Ⅲ plates were used to fix the fracture model. Through loading force on the model, the stress distribution of plates and calcaneus, and displacement between fracture gaps were calculated

  1. 自固化磷酸钙人工骨植骨联合可塑形钛板内固定治疗 Sanders Ⅲ,Ⅳ型跟骨骨折%Autosetting Calcium Phosphate Cement Bone-Grafting and Internal Fixation with Shaping Titanium Plate for Treatment of SandersⅢ,ⅣCalcaneal Fractures

    Institute of Scientific and Technical Information of China (English)

    韩振学; 李志仙

    2014-01-01

    [ ABSTRACT] Objective To investigate the curative effect of Sanders Ⅲ,Ⅳ calcaneal fractures by autosetting calcium phosphate cement bone-grafting and internal fixation with shaping titanium plate.Methods Twenty-eight cases(28 feet) SandersⅢ,Ⅳcalcaneal frac-tures adopted open reduction with shaping titanium plate internal fixation combined with autosetting calcium phosphate cement bone-grafting, the shaping titanium plate were placed at the outward of calcaneus,reset evaluation of calcaneal fractures by measuring Bohler's Angle,Gis-sane's Angle in postoperation.Results All patients were followed up,postoperative skin necrosis in 2 cases and sural nerve injury in 1 case. After 6 months,Bohler's Angle in 20 foot≥35°,in 8 foot≥30°,Gissane Angle fully recovered to normal range and calcaneal varus deformity on axial were not seen.Fracture healing time was 2~3 months,according to Maryland foot scoring system,treatment effects of all patients were as follows:excellent in 15 feet,good in 5 feet,normal in 3 feet and poor in 2 feet,the total excellent and good rate was 83.7%,the excel-lent and good rate ofⅣtype was 56.2%.Conclusion The treatment of SandersⅢ,Ⅳcalcaneal fractures by autosetting calcium phosphate cement bone-grafting and internal fixation with shaping titanium plate is simple and its curative effect is satisfied.%目的:探讨自固化磷酸钙人工骨植骨联合可塑形钛板内固定治疗Sanders Ⅲ,Ⅳ型跟骨骨折的疗效。方法对28例(28足) SandersⅢ,Ⅳ型跟骨骨折均采用切开复位可塑形钛板固定联合自固化磷酸钙人工骨治疗,跟骨外侧放置可塑形钛板,术后测量Bohler's 角、Gissane's角,评价跟骨骨折的复位情况。结果所有患者均得到随访,术后皮缘坏死2例,腓肠神经损伤1例。术后6个月Bohler's 角20足≥35°,8足≥30°,Gissane角全部恢复至正常范围,轴位片上未见跟骨内翻畸形。骨折愈合时间2~3个月,

  2. Effect of anti slide plate internal fixation by posterolateral approach through fibula in the treatment of patients with supination-eversion fractures of ankle%经腓骨后外侧入路抗滑钢板内固定对旋后外旋型踝关节骨折的效果

    Institute of Scientific and Technical Information of China (English)

    何加海; 陈连锁; 刘西斌; 辛海松

    2016-01-01

    Objective:To explore the clinical effect of anti slide plate internal fixation by posterolateral approach through fibula in the treatment of patients with supination-eversion fractures of ankle.Methods:80 patients with supination-eversion fractures of ankle were selected.They were randomly divided into the two groups on average.The lateral locking plate treatment was given to the control group,while patents were treated with anti slide plate internal fixation by posterolateral approach through fibula in the study group.The clinical curative effect,fracture healing time and adverse reaction of the two groups were analyzed statistically. Results:The excellent rate of ankle joint function in the study group was 87.5%,which was significantly higher than that in the control group of 62.5%;fracture healing time was significantly shorter than that of the control group;the adverse reaction rate of 12.5% was significantly lower than that in the control group of 27.5% ;the differences were statistically significant(P<0.05). Conclusion:The effect of anti slide plate internal fixation by posterolateral approach through fibula in the treatment of patients with supination-eversion fractures of ankle was significant.%目的:探讨经腓骨后外侧入路抗滑钢板内固定对旋后外旋型踝关节骨折的效果。方法:收治旋后外旋型踝关节骨折患者80例,随机平分为两组。对照组给予外侧锁定钢板治疗,研究组给予经腓骨后外侧入路抗滑钢板内固定治疗,对两组临床疗效、骨折愈合时间及不良反应发生情况进行统计分析。结果:研究组的踝关节功能优良率87.5%,高于对照组的62.5%;骨折愈合时间短于对照组;不良反应发生率12.5%,低于对照组27.5%;差异均有统计学意义(P<0.05)。结论:经腓骨后外侧入路抗滑钢板内固定对旋后外旋型踝关节骨折的效果显著。

  3. Effect analysis of anterior transposition of the ulnar nerve for double locking plate fixation in the treatment of patients with humeral intercondylar fracture%肱骨髁间骨折双锁定钢板内固定尺神经前置的临床效果分析

    Institute of Scientific and Technical Information of China (English)

    孟德强; 刘德昌; 张新潮

    2015-01-01

    目的:探讨尺神经前置对双锁定钢板内固定治疗肱骨髁间骨折患者临床疗效的影响。方法将我院骨科2008年2月~2013年2月收治的113例肱骨髁间骨折患者随机分为两组,两组均行双锁定钢板内固定,观察组在此基础上行尺神经前置手术,比较两组的临床疗效。结果观察组手术时间大于对照组,差异有统计学意义(P<0.01),住院时间、骨折愈合时间小于对照组,差异有统计学意义(P<0.01),两组手术出血量差异无统计学意义(P>0.05);观察组肘关节功能恢复情况优于对照组,差异有统计学意义(Z=-2.177,P=0.029);术后两组并发症有切口红肿、皮下血肿、钢板断裂、神经损伤,差异无统计学意义( P>0.05),经对症治疗及综合护理,两组的并发症基本缓解。结论尺神经前置术在双锁定钢板内固定肱骨髁间骨折患者中具有促进临床疗效、改善肘关节功能和减少不良反应等特点。%Objective To investigate the clinical efficacy of anterior transposition of the ulnar nerve for double locking plate fixation in the treatment of patients with humeral intercondylar fracture. Methods A total of 113 cases of humeral intercondylar fractures treated in our hospital from Feb. 2008 to Feb.2013 were randomly di-vided into two groups. Both groups underwent double locking plate fixation and the observation group was also per -formed ulnar nerve transposition. The clinical efficacy of the two groups was compared. Results Operation time of the observation group was more than that of the control group, the difference was statistically significant (P0.05);The function recovery of elbow joint of the observation group was better than that of the control group, the difference was statistically significant ( Z=-2.177,P=0.029);complications of the two groups after operation in-cluded incision swelling, subcutaneous hematoma, plate fracture

  4. The clinical application of unilateral open-door cervical expansive laminoplasty plus centerpiece titanium plate fixation for multilevel cervical spondylotic myelopathy%单开门椎管扩大成形Centerpiece钛板固定术治疗多节段脊髓型颈椎病的临床应用

    Institute of Scientific and Technical Information of China (English)

    曾云; 熊敏; 余化龙; 何宁; 王志勇; 刘志刚; 韩珩; 陈森; 郭乐运

    2012-01-01

    Objective To evaluate the efficacy of unilateral open -door cervical expansive laminoplasty plus centerpiece titanium plate fixation for multilevel cervical spondylotic myelopathy. Methods 39 patients with multilevel cervical spondylotic myelopathy were randomly divided into "centerpiece titanium plate" group and "tradition" group. Before and after operation, the JOA score were performed. The improving rate of nerve function,the rate of spinal canal expansion and the rates of complication were compared after operation. Results Before operation,both of the two groups were the same in age and JOA score (P>0.05). Two groups of operative time were respec-tively( 109±25) min and (lll±23) min,there were no significant differences between them(P>0.05). The rate of spinal canal expansion of "centerpiece titanium plate" group (61 %±21%)was obviously higher than"tradition"group(40%±17%)(P0.05),but"centerpiece titanium plate" group had a significant increase at 12 months after operation (P<0.05). CT scan at 3-6 months after operation displayed that door spindle already reach osseous fusion. There were no occurrence of "re-close of door" in two groups. Conclusion The rate9 of complication of "centerpiece titanium plate" group were lower than "tradition" group (P<0.05). Conclusion Unilateral open-door cervical expansive laminoplasty plus centerpiece titanium plate fixation is a new operation which is safe,simple,effective with few complication.%目的 评价单开门颈椎管扩大成形Centerpiece钛板固定术治疗多节段脊髓型颈椎病的临床应用价值.方法 39例多节段脊髓型颈椎病患者随机分为Centerpiece钛板组(18例)及传统组(21例),治疗前后行JOA评分,比较治疗后神经功能改善率、椎管扩大率、并发症发生率.结果 前两组年龄、JOA评分均无显著性差异;两组手术时间分别为(109±25) min和(111±23) min,无显著性差异( P>0.05);Centerpiece钛板组椎管扩大率(61%±21

  5. Anterior cervical Cage-assisted fusion combined with locking titanium plate internal fixation for the treatment of extension-type cervical fracture%颈前路Cage融合锁定钛板置入内固定治疗伸直型颈椎骨折

    Institute of Scientific and Technical Information of China (English)

    吴剑; 刘艳西; 秦星星; 郑勇; 石振; 鲍同柱

    2013-01-01

    BACKGROUND:There is no literature about the treatment according to the mechanism of cervical spine injury classification, especial y for the treatment of extension type cervical fracture/dislocation with merger cases of posterior composite structure damage, whether simple anterior approach can meet the needs of the treatment has no detailed elaboration. This article may analyze from the aspect of cervical spine injury mechanism. OBJECTIVE:To observe the short-term effect of anterior cervical Cage-assisted fusion combined with locking titanium plate internal fixation for the treatment of extension type cervical fracture. METHODS:A retrospective analysis was performed in 15 extension type cervical spine fracture dislocation patients treated with decompression anterior cervical intervertebral disc resection plus bone graft with cage-fusion locking titanium plate internal fixation from June 2006 to March 2011 in the Department of Orthopedics, Xianning Central Hospital, including 10 cases of single segment injury and treatment, and five cases of multiple segment injury and treatment. Japanese Orthopaedic Association score and the neck disability index were compared before and after treatment;the cervical flexion and height were measured according to the antersposterior X-ray film taken before fixation, 1 week after fixation and final fol ow-up.RESULTS AND CONCLUSION:The patients were fol owed-up for 8-37 months. One case had Cage mild sinking and shift, and there was no internal fixation breakage or loosening in al the patients. Transient pharyngeal discomfort was observed in 11 patients. Compared with the preoperation, the Japanese Orthopaedic Association score, neck dysfunction index, fusion segment cervical flexion and fusion segment intervertebral disc height were significantly improved at 1 week after fixation and final fol ow-up (P0.05). The short-term effect of decompression anterior cervical intervertebral disc resection plus bone graft with cage-fusion locking

  6. Locking proximal humerus plate/proximal humeral internal locking system versus other internal fixations for the treatment of proximal humeral fractures in adults: a Meta analysis%肱骨近端锁定钢板或肱骨近端内锁定系统与其他内固定治疗肱骨近端骨折的Meta分析

    Institute of Scientific and Technical Information of China (English)

    胡稷杰; 金丹; 魏宽海; 任高宏; 余斌; 王钢

    2012-01-01

    目的 对采用肱骨近端锁定钢板(LPHP)或肱骨近端内锁定系统(PHILOS)与其他内固定治疗肱骨近端骨折(PHFs)的疗效进行Meta分析,为临床治疗提供参考依据. 方法 通过计算机检索MEDLINE(1966年至2011年12月)、EMbase(1966年至2011年12月)、Cochrane图书馆(2011年第4期)和中国生物医学文献数据库(2001至2011年)等,搜集有关LPHP/PHILOS和其他内固定治疗PHFs的各种对照研究,对纳入的文献选择Neer评分、Constant-Murley功能评分、肩关节疼痛和功能障碍指数(SPADI)量表和美国肩肘外科医师(ASES)评分、异位骨化发生率、感染率、肱骨头缺血坏死率、骨折延迟愈合率、螺钉松动率、钢板断裂率、肩峰下撞击征发生率、肱骨头半脱位发生率、肩关节活动受限发生率、肩关节疼痛发生率、二次手术率作为Meta分析的评价指标,采用RevMan 5.0进行分析. 结果 共纳入18项研究1133例患者.LPHP/PHILOS与其他内固定治疗PHFs相比,螺钉松动率更低,差异均有统计学意义[OR=0.23,95% CI(O.07,0.74),P=O.01].LPHP/PHILOS与其他内固定治疗PHFs的Neer评分优良率、异位骨化发生率、感染率、肱骨头缺血坏死率、骨折延迟愈合率、钢板断裂率、肩峰撞击征发生率、肱骨头半脱位发生率、肩关节活动受限发生率比较,差异均无统计学意义(P>0.05). 结论 LPHP/PHILOS与其他内固定在特定条件下各有利弊,不能盲目扩大LPHP/PHILOS的临床适应证,治疗方案要结合患者的病情甚至经济情况综合考虑.%Objective To evaluate and compare locking proximal humerus plate/proximal humeral internal locking system (LPHP/PHILOS) versus other internal fixations in the treatment of proximal humeral fractures (PHFs) in adults.Methods According to Cochrane Reviews,Cochrane library (Issue 4,2011),Ovid MEDLINE (from January 1966 to December 2011),EMbase (from January 1966 to December 2011),Chinese National Knowledge

  7. Limited open reduction and internal fixation with anterolateral L-shape locking compression plate for treatment of distal metaphyseal tibial fractures%有限切开复位结合前外侧 L 形锁定加压接骨板内固定治疗胫骨远端干骺端骨折

    Institute of Scientific and Technical Information of China (English)

    周炎; 杨越; 刘世清; 余铃; 廖琦; 赵奇; 张春; 黄涛; 张锐; 夏韶强

    2015-01-01

    目的:探讨胫骨远端干骺端骨折应用有限切开复位结合前外侧L形锁定加压接骨板( locking compression plate, LCP)内固定治疗的临床疗效。方法2011年6月~2013年1月共收治15例胫骨远端干骺端骨折患者。骨折按照国际内固定研究协会( AO/ASIF)分型:43A2型3例,43A3型10例,43B1型2例,均合并腓骨下端骨折;胫骨远端干骺端骨折线距踝关节面1.6~4.5cm,平均2.8cm;闭合性骨折8例,开放性骨折7例( GustiloⅠ型2例,Ⅱ型3例,ⅢA型2例)。 GustiloⅢA型2例急诊行清创、腓骨内固定及外固定支架固定,余患者术前行跟骨骨牵引。运用有限切开复位结合前外侧L形LCP内固定治疗,术中酌情植骨,术后早期功能锻炼。结果所有患者术后获12~18个月(平均16个月)随访,术后2例切口表皮坏死,经换药处理后愈合,余切口均一期愈合。骨折于术后16~24周(平均20周)获骨性愈合。末次随访时根据美国骨科协会足踝外科分会( American Orthopedic Foot Ankle Society,AOFAS)评分标准:评分为73~95分,平均89.5分,其中优10例,良3例,可2例,优良率86.7%。随访期间无感染、骨不连及内固定松动断裂等并发症发生。结论采用有限切开复位结合前外侧L形LCP内固定治疗胫骨远端干骺端骨折,术中利用微创置板技术,并酌情植骨,术后早期功能锻炼,可获得良好疗效。%Objective To investigate the clinical effects of limited open reduction and internal fixation with anterolateral L-shape locking compression plate for treatment of distal metaphyseal tibial fractures.Methods Fifteen patients with distal metaphyseal tibial fractures were treated in our department between Jun.2011 and Jan.2013.According to AO/ASIF classification,3 patients were with Type 43A2 fracture,10 patients with Type 43A3 fracture, 2 patients with Type 43B1 fracture and all were combined

  8. A randomized-controlled trial of restoration of femoral defect in rabbits by hydroxyapatite-coated titanium plate fixation%羟基磷灰石涂层钛板固定修复兔股骨缺损的随机对照实验

    Institute of Scientific and Technical Information of China (English)

    余学东; 安洪

    2004-01-01

    perspective study was conducted.SETTING and PARTICIPANTS: The study was conducted in the Center for Experimental Animals, Chongqing University of Medical Sciences, from which the 15 adult New Zealand rabbits of either gender with a body mass of 2.52 kg were obtained.INTERVENTIONS: Right femoral stem was exposed under aseptic operation for the establishment of osseous defect model with a 10 mm defect. HA mass artificial osseous graft + HA-coated titanium plate fixation were used in study group; HA mass artificial osseous graft(with or without) + common titanium plate or stainless steel plate were used in control group. Specimens were taken respectively at 2, 4, 8, 12 and 16 weeks after operation for the observation of general morphology and histology.MAIN OUTCOME MEASURES: The new osteogenesis was observed in both study and control groupRESULTS: At 4 weeks after surgery, there were osteogenesis and adhesion on the surface of the removed HA-coated titanium plate; at 12 weeks after surgery, the HA-coated titanium plate was completely wrapped by new bones and the connection between plate and surrounding tissue was substance. However, there were no osteogenesis and adhesion found on the surface of bone plate in control group. The observation of histology at 2, 4, 8, 12and 16 weeks after surgery indicated the speed, quality and quantity of osteogenesis at each time point in study group were significantly better than that of control group.CONCLUSION: HA-coated titanium plate has guiding reaction in osteogenesis, which can be substantially connected with surrounding osseous tissues fixation that is reliable and helpful to the restoration of osseous defect.

  9. Surgery Locking Compression Plate Fixation for the Treatment of Long Bone Comminuted Fracture of the Limbs%锁定加压钢板内固定手术对四肢长骨粉碎性骨折的治疗价值

    Institute of Scientific and Technical Information of China (English)

    封小东

    2016-01-01

    Objective Application in patients with limb long bone comminuted fracture internal fixation with locking compression plate (LCP) analysis, this paper discusses the clinical effect of surgical treatment. Methods In our hospital in 2014-2015 were a total of 60 patients with limbs long bone comminuted fracture as a clinical research data, the patients were randomly divided into two groups: treatment group and control group, 30 cases of patients in each group. The control group used the traditional plaster external fixation + manual reduction treatment, treatment group application of LCP internal fixation surgery reset, compare two methods of surgical treatment effect. Results After treatment, the treatment group was significantly higher than the control group, after statistics, a significant statistical significance (P<0.05). Follow-up survey was performed after the surgery, two groups of anatomical repositioning effect is good, none of the patients with complications. Treatment group patients average healing time was significantly shorter than the control group the average healing time of, the statistics, a significant statistical significance (P<0.05). Conclusion Limbs long bone comminuted fracture surgery treatment, application of locking compression plate fixation can achieve significant treatment effect, worthy of popularization and application in clinic.%目的:对四肢长骨粉碎性骨折患者应用锁定加压钢板(LCP)内固定手术治疗的临床效果进行分析探讨。方法将本院在2014-2015年收治的四肢长骨粉碎性骨折患者共计60例作为临床研究资料,将患者随机分为两组:治疗组与对照组,每组患者有30例。对照组应用传统的石膏外固定+手法复位治疗,治疗组应用 LCP 内固定手术复位,比较两种手术方法的治疗效果。结果经过治疗后,治疗组的优良率显著高于对照组,经统计,有显著的统计学意义(P<0.05)。手术后对患者进行

  10. 双钢板内固定治疗肱骨远端粉碎性骨折%Treatment of distal humerus extremity comminuted fracture by internal fixation with double plates

    Institute of Scientific and Technical Information of China (English)

    游逸丰; 潘建成; 王慧; 周佩敏

    2009-01-01

    Objective To evaluate the effect of the distal humerus extremity comminuted fracture treated by double plates through oleeranon osteotomy. Method Twenty-eight patients with humerus extremity comminuted fractures were fixed by double plates through olecranon osteotomy followed by early functional exercise. Results All the cases were followed up 9-31 months. The curative effect was assessed by the method of modified Cassebaum rating system. The operation was excellent in 10 cases, good in 12 cases, fair in 5 cases, bad in 1 case. The excellent and good rate was 78.57%(22/28). Conclusion Treatment of humerus extremity comminuted fractures by double plates through olecranon osteotomy followed by early functional exercise are excellent with satisfactory functional recovery.%目的 评价经鹰嘴截骨双钢板内固定治疗肱骨远端粉碎性骨折的疗效.方法 对28例肱骨远端粉碎性骨折采取后路经鹰嘴截骨切口,开放解剖复位,双钢板内固定,术后早期功能锻炼.结果 28例患者获得9~31个月的随访,用改良Cansebaum评分系统评价术后疗效,优10例,良12例,可5例,差1例,优良率78.57%(22/28).结论 经鹰嘴截骨双钢板内固定和早期的功能锻炼,不失为治疗肱骨远端粉碎性骨折的一种有效手段.

  11. Treatment of thoraco-lumbar spinal tuberculosis with kyphotic deformity with surgical techniques of Z-plate-ⅡTM internal fixation apparatus system%胸腰椎结核的手术内固定治疗

    Institute of Scientific and Technical Information of China (English)

    胡朝晖; 李康华; 刘文和; 李兵; 李龙

    2006-01-01

    [目的]探讨Z-plate-ⅡTM前路内固定技术治疗胸腰椎结核合并后凸畸形的疗效.[方法]总结行Z-plate-ⅡTM前路内固定技术治疗胸腰椎结核合并后凸畸形患者68例,随访时间2.2~6.3 a,平均3.3 a.内容包括植骨融合率、截瘫恢复情况和后凸畸形矫正状况.[结果]所有患者均显示骨性融合;45例合并截瘫的患者中,症状完全改善25例,部分改善15例;治愈率55.56%,好转率33.33%,合计恢复率为88.89%.术后后凸畸形平均矫正28.9°,随访2.2~6.3 a,平均3.3 a,后凸角度平均丢失2.7°.[结论]Z-plate-ⅡTM前路内固定技术可恢复脊柱的即刻稳定性,有利于骨融合,促进截瘫恢复和防止截瘫复发,矫正及预防后凸畸形.

  12. Plating of patella fractures: techniques and outcomes.

    Science.gov (United States)

    Taylor, Benjamin C; Mehta, Sanjay; Castaneda, Joaquin; French, Bruce G; Blanchard, Chris

    2014-09-01

    Operative treatment of displaced patella fractures with tension band fixation remains the gold standard, but is associated with a significant rate of complications and symptomatic implants. Despite the evolution of tension band fixation to include cannulated screws, surprisingly little other development has been made to improve overall patient outcomes. In this article, we present the techniques and outcomes of patella plating for displaced patella fractures and patella nonunions.

  13. Comparison of Internal Fixations for Distal Clavicular Fractures Based on Loading Tests and Finite Element Analyses

    Directory of Open Access Journals (Sweden)

    Rina Sakai

    2014-01-01

    Full Text Available It is difficult to apply strong and stable internal fixation to a fracture of the distal end of the clavicle because it is unstable, the distal clavicle fragment is small, and the fractured region is near the acromioclavicular joint. In this study, to identify a superior internal fixation method for unstable distal clavicular fracture, we compared three types of internal fixation (tension band wiring, scorpion, and LCP clavicle hook plate. Firstly, loading tests were performed, in which fixations were evaluated using bending stiffness and torsional stiffness as indices, followed by finite element analysis to evaluate fixability using the stress and strain as indices. The bending and torsional stiffness were significantly higher in the artificial clavicles fixed with the two types of plate than in that fixed by tension band wiring (P<0.05. No marked stress concentration on the clavicle was noted in the scorpion because the arm plate did not interfere with the acromioclavicular joint, suggesting that favorable shoulder joint function can be achieved. The stability of fixation with the LCP clavicle hook plate and the scorpion was similar, and plate fixations were stronger than fixation by tension band wiring.

  14. Biomechanical stability of four fixation constructs for distal radius fractures.

    Science.gov (United States)

    Capo, John T; Kinchelow, Tosca; Brooks, Kenneth; Tan, Virak; Manigrasso, Michaele; Francisco, Kristin

    2009-09-01

    Implants available for distal radius fracture fixation include dorsal nonlocked plating (DNLP), volar locked plating (VLP), radial-ulnar dual-column locked plating (DCPs), and locked intramedullary fixation (IMN). This study examines the biomechanical properties of these four different fixation constructs. In 28 fresh-frozen radii, a wedge osteotomy was performed, creating an unstable fracture model and the four fixation constructs employed (DNLP, VLP, DCPs, and IMN). Dorsal bending loads were applied and bending stiffness, load to yield 5 mm displacement, and ultimate failure were measured. Bending stiffness for VLP (16.7 N/mm) was significantly higher than for DNLP (6.8 N/mm), while IMN (12.6 N/mm) and DCPs (11.8 N/mm) were similar. Ultimate load to failure occurred at 278.2 N for the VLP, 245.7 N for the IMN, and 52.0 N for the DNLP. The VLP was significantly stronger than the DNLP and DCPs, and the IMN and DCPs were stronger than the DNLP. The VLP has higher average bending stiffness, ultimate bending strength, and resistance to 5 mm displacement than the other constructs and significantly higher ultimate bending strength than the DCPs and DNLP. There was no statistically significant difference between the VLP and IMN. VLP and IMN fixation of distal radius fractures can achieve comparable stability.

  15. 颈前钢板置入内固定并植骨融合修复成人颈椎结核:生物相容性良好%Anterior cervical plate fixation and graft fusion in the repair of adult cervical tuberculosis:good biocompatibility

    Institute of Scientific and Technical Information of China (English)

    梁亮; 甫拉提•买买提; 朱松青; 徐韬; 盛伟斌

    2015-01-01

    背景:脊柱结核累及颈椎的较少。抗结核药物的应用对于伴有神经功能障碍及椎体破坏较重出现椎间不稳的患者收效甚微。目的:评价一期前路病灶清除植骨融合内固定修复成人颈椎结核后技术植入物与宿主的生物相容性。方法:收集于2010年5月至2012年6月在新疆医科大学第一附属医院脊柱外科进行治疗的颈椎结核患者14例,均采用Zephir 颈椎前路钢板进行一期前路病灶清除植骨融合内固定治疗。结果与结论:与内固定前相比,末次随访患者血沉、C-反应蛋白、目测类比评分下降(P <0.05),日本骨科协会评分增加(P <0.05)。除1例Frankel 脊髓损伤分级C 级患者恢复到D 级外,其余患者Frankel 脊髓损伤分级没有明显变化。与内固定前相比,7例伴后凸畸形患者的Cobb 角明显缩小。且内固定后椎体与植骨区域可见骨小梁通过,融合节段无移位及骨吸收、骨不连、假关节形成等现象出现。内固定后颈部疼痛及功能受限均得到不同程度的缓解或消失。说明此方法能有效治疗颈椎结核,且钢板与宿主的生物相容性良好。%BACKGROUND:Spinal tuberculosis seldom involves cervical vertebra. The application of anti-tuberculosis drug has slight effects on patients combined with nerve dysfunction and severe vertebral destruction, which results in unstable cervical vertebra. OBJECTIVE: To evaluate biocompatibility of graft and host after one-stage anterior debridement graft fusion and internal fixation in the repair of adult cervical tuberculosis. METHODS: A total of 14 patients who suffered from cervical tuberculosis were admitted into Department of Spinal Surgery, First Affiliated Hospital, Xinjiang Medical University between May 2010 and June 2012. They underwent Zephir anterior cervical plate for one-stage anterior debridement graft fusion and internal fixation. RESULTS AND CONCLUSION:Compared with pre-fixation

  16. Research of half circular external fixation stand and anatomical plate in the treatment of distal tibia open comminuted fracture complicated with distal fibula fracture%半环形外固定支架加解剖钢板治疗胫骨远端开放性粉碎性骨折合并腓骨骨折的研究

    Institute of Scientific and Technical Information of China (English)

    匡家寿

    2015-01-01

    目的:探讨半环形外固定支架加解剖钢板治疗胫骨远端开放性粉碎性骨折(DTOCF)合并腓骨骨折的应用价值。方法38例确诊治疗的DTOCF合并腓骨远端骨折患者,依据随机分配原则分为解剖组和对照组,各19例。对照组给予常规胫骨远端骨折单臂外固定支架腓骨远端重建钢板内固定手术治疗,解剖组给予胫骨远端半环形外固定支架及腓骨解剖钢板治疗,采用Baird-Jackson踝关节评分(BJAS)评估疗效并随访1年,统计分析所有患者骨折愈合时间、手术时间、出血量、疗效和并发症。结果解剖组骨折愈合时间、手术时间、出血量明显低于对照组,差异有统计学意义(P<0.05);解剖组患者治疗优良率为94.74%,对照组患者治疗优良率为78.95%,前者明显高于后者,差异有统计学意义(P<0.05);解剖组患者并发症发生率为10.53%,对照组患者并发症发生率为26.32%,前者明显低于后者,差异有统计学意义(P<0.05)。结论胫骨远端骨折半环形外固定支架及腓骨远端骨折解剖钢板治疗,可有效提高DTOCF合并腓骨远端骨折的疗效,降低并发症发生,值得临床作进一步推广。%Objective To investigate the application value of half circular external fixation stand and anatomical plate in the treatment of distal tibia open comminuted fracture (DTOCF) complicated with distal fibula fracture.Methods A total of 38 patients of diagnosed DTOCF complicated with distal fibula fracture were randomly divided into anatomy group and control group, with 19 cases in each group. The control group received conventional surgery by one-arm fixation support for distal tibia fracture and reconstruction plate fixation for distal fibula fracture. The anatomy group received half circular external fixation stand for distal tibia fracture and anatomical plate for distal fibula fracture. Baird-Jackson ankle score (BJAS) was applied for evaluation

  17. Outcome of locking compression plates in humeral shaft nonunions

    Directory of Open Access Journals (Sweden)

    Malhar N Kumar

    2013-01-01

    Conclusions: Locking compression plating and cancellous bone grafting is a reliable option for achieving union in humeral diaphyseal nonunion with failed previous internal fixation and results in good functional outcome in patients with higher physiological demands.

  18. Effectiveness of plate augmentation for femoral shaft nonunion after nailing

    Directory of Open Access Journals (Sweden)

    Chin-Jung Lin

    2012-08-01

    Conclusion: Plate augmentation with retention of the nail with autologous bone grafting may be an effective and reliable alternative in treating nonunion of the femoral shaft fracture after open reduction and internal fixation with intramedullary nail.

  19. Biomechanical Comparison of Fixation Devices for First Metatarsocuneiform Joint Arthrodesis.

    Science.gov (United States)

    Knutsen, Ashleen R; Fleming, John F; Ebramzadeh, Edward; Ho, Nathan C; Warganich, Tibor; Harris, Thomas G; Sangiorgio, Sophia N

    2017-08-01

    Common surgical treatment of first tarsal-metatarsal arthritis is by first metatarsocuneiform joint arthrodesis. While crossed-screw and locking plate fixation are the most widely used methods, a novel construct was designed to alleviate soft tissue irritation while still providing stable fixation. Using anatomic first metatarsal and medial cuneiform composites, we compared 3 arthrodesis implants (crossed-screw, dorsal locking plate, and IO Fix) under 2 cyclic bending loading scenarios (cantilever and 4-point bending). Additionally, the optimal orientation (plantar-dorsal or dorsal-plantar) of the IO Fix construct was determined. Failure load, diastasis, joint space angle, and axial and angular stiffness were determined. Both crossed-screw fixation and the IO Fix constructs experienced significantly higher failure loads than the dorsal locking plate during both loading scenarios. Additionally, they had lower plantar diastasis and joint space angle at failure than the plate. Moreover, the plantar-dorsal IO Fix construct was significantly stiffer than the crossed-screw during cantilever bending. Finally, the plantar-dorsal orientation of the IO Fix device had higher failure load and lower diastasis and angle at failure than in the dorsal-plantar orientation. The results suggest that the IO Fix system can reduce motion at the interfragmentary site and ensure compression for healing comparable to that of the crossed-screw fixation. Level V: Bench testing.

  20. The concept of locking plates.

    Science.gov (United States)

    Cronier, P; Pietu, G; Dujardin, C; Bigorre, N; Ducellier, F; Gerard, R

    2010-05-01

    After a short historical review of locking bone plates since their inception more than a century ago to the success of the concept less than 15 years ago with today's plates, the authors present the main locking mechanisms in use. In the two broad categories - plates with fixed angulation and those with variable angulation - the screw head is locked in the plate with a locknut by screwing in a threaded chamber on the plate or by screwing through an adapted ring. The authors then provide a concrete explanation, based on simple mechanical models, of the fundamental differences between conventional bone plates and locking plates and why a locking screw system presents greater resistance at disassembly, detailing the role played by the position and number of screws. The advantages of epiphyseal fixation are then discussed, including in cases of mediocre-quality bone. For teaching purposes, the authors also present assembly with an apple fixed with five locking screws withstanding a 47-kg axial load with no resulting disassembly. The principles of plate placement are detailed for both the epiphysis and diaphysis, including the number and position of screws and respect of the soft tissues, with the greatest success assured by the minimally invasive and even percutaneous techniques. The authors then present the advantages of locking plates in fixation of periprosthetic fractures where conventional osteosynthesis often encounters limited success. Based on simplified theoretical cases, the economic impact in France of this type of implant is discussed, showing that on average it accounts for less than 10% of the overall cost of this pathology to society. Finally, the possible problems of material ablation are discussed as well as the means to remediate these problems.

  1. Internal fixation of proximal humeral fractures with the proximal humeral internal locking system plate in the elderly%肱骨近端内固定锁定系统接骨板治疗老年性肱骨近端骨折

    Institute of Scientific and Technical Information of China (English)

    王英; 申海波; 崔岩

    2012-01-01

    目的 探讨锁定接骨板在治疗老年肱骨近端骨折的临床作用.方法 2008年6月至2011年6月,应用AO PHILOS接骨板治疗老年肱骨近端骨折32例.经三角肌胸大肌肌间沟入路,术中C臂透视下复位骨折端,接骨板置于结节间沟外侧0.5cm、大结节顶点下方0.8~1.0cm.术后医生指导下早期康复锻炼.结果 32例患者中28例术后获得随访,随访时间6-12个月,平均7.2个月.术后无腋神经血管损伤,无感染和伤口开裂.X线片显示骨折复位满意,钢板螺钉位置良好,无内固定松动断裂,无复位丢失,无骨折不愈合及肱骨头坏死病例.7例患者出现短时假性肩关节脱位,功能锻炼后自动复位;骨折端轻度复位不佳3例.骨折愈合时间13-32周,平均16.5周.所有患者均遗留有不同程度的肩关节活动受限,主要是上举受限.NEER评分:优9例,良11例,可8例,优良率71.4%.结论 肱骨近端锁定接骨板是治疗老年人肱骨近端骨折的理想内固定材料具有固定可靠、对肱骨头血供影响小、并发症少等优点,利于术后早期功能锻炼.%Objective To investigate the clinical effects of internal fixation of proximal humeral fractures with the proximal humeral internal locking system (PHILOS) plate in the elderly. Methods 32 elderly patients with proximal humeral fractures were treated with the PHILOS plate from June 2008 to June 2011. With C-arm X-rays during surgery, reduction and fixation were performed through pectoro-deltoid approach. The plate was placed 0.5cm to the lateral edge of the intertubercular groove and 0.8-1.0cm under the top of the greater tubercle. Early functional exercises were done under the doctor's direction. Results Among them, 28 patients were followed up postoperatively for an average period of 7.2 months (range; 6-12 months). No neurovascular injury of the axilla, infection or wound dehiscence occurred after surgery. The postoperative radiographs showed satisfactory fracture

  2. Hydroxyapatite-enhanced tibial prosthetic fixation.

    Science.gov (United States)

    Toksvig-Larsen, S; Jorn, L P; Ryd, L; Lindstrand, A

    2000-01-01

    Sixty-two knees (60 patients) were randomized to four noncemented groups. In Groups 1, 3, and 4, the bone cuts were made with a cooled saw blade. In Group 1, 15 patients were operated on with the porous coated Osteonic 7000 tibial component. In Group 2, 15 patients were operated on with the same tibial component as in Group 1 but with the use of a standard saw blade. In Group 3, 16 patients were operated on with the hydroxyapatite-coated Osteonic tibial component, and in Group 4, 16 patients were operated on with the hydroxyapatite Duracon tibial component. All patients were followed up clinically and with roentgenstereometric analysis. There were no differences among the groups regarding clinical outcome. One knee was revised (Group 2) after 1 year because of loosening of the tibial component. The maximum migration at 1 year was 1.7 mm in Group 1, 1.9 mm in Group 2, 1.3 mm in Group 3, and 1 mm in Group 4. At the 2-year followup, the migrations were 1.8 mm, 1.5 mm, 1.4 mm, and 1 mm in Groups 1, 2, 3, and 4, respectively. The inducible displacement that occurred at 1 year was 0.6 mm in Group 1, 0.5 mm in Group 2, 0.4 mm in Group 3, and 0.4 mm in Group 4. The hydroxyapatite coating had a strong positive effect on the tibial component fixation. No prosthesis in the hydroxyapatite groups showed continuous migration.

  3. Biomechanical Study of Acetabular Tridimensional Memoryalloy Fixation System

    Science.gov (United States)

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

    2011-07-01

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

  4. Limited open reduction and internal fixation with anatomical locking compression plate for treatment of tibial Pilon fractures%有限切开复位结合锁定加压接骨板内固定治疗胫骨Pilon骨折

    Institute of Scientific and Technical Information of China (English)

    魏世隽; 蔡贤华; 刘曦明; 江新; 付强; 钱胜龙

    2013-01-01

    目的 探讨踝关节面有限切开复位结合微创接骨术(minimally invasive plate osteosynthesis,MIPO)置入锁定加压接骨板(locking compression plate,LCP)内固定治疗胫骨Pilon骨折的方法及临床疗效. 方法 选择2009年8月-2011年8月收治的21例胫骨Pilon骨折患者,其中男16例,女5例;年龄21 ~68岁,平均42.3岁.骨折根据AO/OTA分型:43B型12例,43C型9例;开放性骨折2例(均为Gustilo-AndersonⅠ型).采用有限切开复位踝关节面,结合MIPO技术置入LCP内固定的方法进行治疗,术后非负重早期功能锻炼. 结果 21例手术患者中19例术后获得12 ~24个月随访,平均14个月.应用Burwell-Chamley影像学评价标准判定骨折复位质量,关节面获得解剖复位17例,复位一般2例,以上患者骨折均获得骨性愈合.根据Mazur等制定的踝关节评分系统进行术后功能评价:优7例,良10例,可2例,差0例,优良率达89%. 结论 有限切开复位结合LCP内固定治疗Pilon骨折能有效重建关节解剖关系,减少软组织剥离,固定牢靠,配合早期功能锻炼,有利于患肢功能恢复.%Objective To investigate methods and clinical effects of limited open reduction of ankle articular surface and locking compression plate (LCP) placement using minimally invasive plate osteosynthesis (MIPO) in managing tibial Pilon fractures.Methods Twenty-one patients with tibial Pilon fractures treated between August 2009 and August 2011 were involved in the study,including 16 males and 5 females,at age of 21-68 years (average 42.3 years).According to AO/OTA classification,12 patients were with type 43B fractures and nine with type 43C fractures.There were two patients with open fractures (both Gustilo-Anderson type Ⅰ fractures).Limited open reduction of ankle articular surface plus LCP placement using MIPO were performed.Early functional training without weight-bearing was carried out postoperatively.Results Nineteen patients were followed up for 12

  5. Anterior cervical plating plus axial screw fixation for treating cervical flexion-distraction injury: anatomic study%颈椎前路钢板并轴向螺钉固定治疗屈曲牵张型损伤的解剖学研究

    Institute of Scientific and Technical Information of China (English)

    瞿东滨; 邹琳; 杨勇; 徐准; 程勇泉

    2012-01-01

    Objective To study the anatomical flexibility of anterior cervical plating plus axial screw fixation for treating cervical flexion-distraction. Methods Fifty cases of digital lateral X-ray films from adult healthy volunteers aged 24-48 years, with mean 28 years, were measured directly in the JW-PACS picture system. Measuring parameters included vertebral body height, intervertebral disc height and disc depth. The line started from anteroinferior point of the inferior vertebrae to posterosuperior point of the superior vertebrae was drawn to mimic the axial screw fixation in the lateral film. The maximal screw length, screw cephalic inclination angle and the distance between screw and anterior vertebral margin at disc level was recorded. Simulated anterior cervical plating and axial screw fixation was carried out in one preserved human specimen under the guidance of C-arm X-ray fluoroscope. Results The maximal length of anterior cervical axial screw was (41.18+3.92 )mm, and the axial screw inclination angle (25.21±3.58)°. The suitable depth of interbody graft was more than (11.69±1.63)mm, but less than (17.09±1.50)mm of disc depth. Simulated procedure in the preserved specimen demonstrated that axial screw fixation could be successfully completed at C2/3, C3/4, C4/5, and C5/6 levels, but difficult be performed at C6/7 due to obstacle of sternum. Conclusions The flexibility of axial screw fixation plus anterior cervical plating is confirmed from this study for managing of cervical flexion-distraction injuries.%目的 提出一种联合颈椎前路钢板固定治疗屈曲牵张型颈椎损伤的新术式—颈椎轴向螺钉固定术,进行解剖学可行性研究.方法 随机调取50例正常成年志愿者的颈椎侧位片.年龄22~48岁,平均28岁.通过JW-PACS图像系统,测量C2~6椎体高度;C2/3~C5/6椎间盘高度以及椎间盘矢径;并模拟轴向螺钉固定,即下位椎体前下缘至上位椎体后上缘的连线,测量轴向螺钉最大

  6. 咬合导板及颌间牵引钉技术在游离腓骨瓣修复下颌骨缺损中的应用%APPLICATION OF OCCLUSAL GUIDE PLATE COMBINED WITH INTERMAXILLARY FIXATION SCREW IN MANDIBULAR DEFECT REPAIR WITH FREE FIBULAR FLAP

    Institute of Scientific and Technical Information of China (English)

    杨志诚; 向旭; 严颖彬; 史平; 王超

    2013-01-01

    Objective To investigate the clinical value of occlusal guide plate combined with intermaxillary fixation screw in mandibular defect repair with free fibular flap. Methods Between August and December 2011, 7 patients with mandibular tumor were treated, including 5 cases of ameloblastoma and 2 cases of gingival cancer. Of 7 patients, 4 were males and 3 were females, aged 32-65 years (median, 50 years). Occlusal guide plate was prepared and the implanted position of intermaxillary fixation screws was determined preoperatively. Hemimandibulectomy was performed in 5 cases, half mandibular segmental resection with condyle reservation in the other 2 cases. The free fibular flaps of 11-13 cm in length were harvested for repairing mandibular defects. When the free fibular flaps were fixed, the occlusal guide plate and intermaxillary fixation screws were utilized to restorate the occlusal relation. The donor site was sutured directly. Results The average operation time was 9.5 hours (range, 7-12 hours). All free fibular flaps survived completely. All incisions at the donor site and recipient site healed by first intention. All patients were followed up 10-14 months with an average of 12.3 months. All patients had symmetrical face, good occlusal relation, normal mouth opening, and normal mandibular lateral movement, and no pain of bilateral temporomandibular joints occurred. Panoramic tomography showed good mandibular contour and the suitable emplacement of fibular flaps postoperatively. No tumor recurrence occurred during follow-up period. Conclusion When repairing the mandibular defect with free fibular flap, occlusal guide plate with intermaxillary fixation screw contributes to simplifying operation, accurate recovery of the appearance and occlusal relation, and improving the oral comfort level postoperatively.%目的 探讨咬合导板及颌间牵引钉技术在游离腓骨瓣修复下颌骨缺损中的应用价值.方法 2011年8月-12月,收治7

  7. 颈后路多节段椎弓根螺钉内固定术与颈前路钢板内固定术治疗Hangman骨折疗效对比分析%The Efficacy Comparison of Internal Fixation by Multilevel Pedicle Screw in Posterior and Internal Fixation by Steel Plate in Anterior on Treating ;Hangman Fracture

    Institute of Scientific and Technical Information of China (English)

    李军

    2014-01-01

    目的:观察比较Hangman骨折采用颈后路多节段椎弓根螺钉内固定术与颈前路钢板内固定术的疗效。方法:选取笔者所在医院2010年6月-2013年6月收治的Hangman骨折患者45例,按照随机数字表法分成颈后路组23例和颈前路组22例。比较两组患者手术时间及术中出血量,手术治疗产生的并发症,术后骨折的痊愈程度及恢复脊髓功能的情况。结果:两组患者手术时间、术中出血量、术后骨折痊愈的程度及恢复脊髓功能的情况比较差异均无统计学意义(P>0.05)。颈后路组的并发症总发生率(4.35%)明显低于颈前路组的并发症总发生率(31.82%),两组比较差异有统计学意义(P0.05).The overall incidence of complications in posterior group(4.35%) was significantly lower than anterior group(31.82%),and the difference between the two groups was statistically significant(P<0.05).Conclusion:The ideal method for treating Hangman fracture is internal fixation by multilevel pedicle screw in posterior.

  8. Plating of proximal humeral fractures.

    Science.gov (United States)

    Martetschläger, Frank; Siebenlist, Sebastian; Weier, Michael; Sandmann, Gunther; Ahrens, Philipp; Braun, Karl; Elser, Florian; Stöckle, Ulrich; Freude, Thomas

    2012-11-01

    The optimal treatment for proximal humeral fractures is controversial. Few data exist concerning the influence of the surgical approach on the outcome. The purpose of this study was to evaluate the clinical and radiological outcomes of proximal humeral fractures treated with locking plate fixation through a deltopectoral vs an anterolateral deltoid-splitting approach. Of 86 patients who met the inclusion criteria, 70 were available for follow-up examination. Thirty-three patients were treated through a deltopectoral approach and 37 through an anterolateral deltoid-splitting approach. In all cases, open reduction and internal fixation with a PHILOS locking plate (Synthes, Umkirch, Germany) was performed. Clinical follow-up included evaluation of pain, shoulder mobility, and strength. Constant score and Disabilities of the Arm, Shoulder and Hand (DASH) score were assessed. A clinical neurological examination of the axillary nerve was also performed. Consolidation, reduction, and appearance of head necrosis were evaluated radiographically. After a mean follow-up of 33 months, Constant scores, DASH scores, and American Shoulder and Elbow Surgeons scores showed no significant differences between the groups. Clinical neurologic examination of the axillary nerve revealed no obvious damage to the nerve in either group. Deltopectoral and anterolateral detoid-splitting approaches for plate fixation of proximal humeral fractures are safe and provide similar clinical outcomes. The results of this study suggest that the approach can be chosen according to surgeon preference.

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

    Directory of Open Access Journals (Sweden)

    Celso Hermínio Ferraz Picado

    2007-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kadir Kotil

    2011-01-01

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

  11. The Minimally Invasive Plate Osteosynthesis (MIPO Technique with a Locking Compression Plate for Femoral Lengthening

    Directory of Open Access Journals (Sweden)

    Tetsunaga,Tomonori

    2008-10-01

    Full Text Available A minimally invasive plate osteosynthesis technique using a locking compression plate (LCP has been used widely in trauma cases. Its advantages are that the MIPO technique does not interfere with the fracture site and thus provides improved biological healing, and that the LCP has excellent angular stability. Its use in bone lengthening, however, has not been established. In such cases, it is desirable to shorten the external skeletal fixation period as much as possible. Here, the MIPO technique using an LCP was applied to femoral distraction osteogenesis in an attempt to shorten the external skeletal fixation period. For femoral lengthening, the MIPO technique was performed in 2 stages. Orthofix external fixators (Orthofix, England were used to insert screws from the anterolateral side rather than from the lateral side of the femur for bone lengthening. When sufficient callus formation was detected postoperatively at the site of bone lengthening, and the absence of infection was ensured, limb draping was performed, including a whole external fixator, and then the MIPO technique was applied with an LCP. In 3 cases (5 limbs, the average duration of external skeletal fixation was 134days, the average external-fixation index was 24days/cm, and the average consolidation index was 22days/cm. The MIPO technique using an LCP made it possible to shorten the external skeletal fixation-wearing period in femoral lengthening.

  12. 切开复位锁定钢板内固定治疗肱骨近端骨折111例%Proximal Humerus Fracture treated with Open Reduction and Internal Fixation with Locking Plate

    Institute of Scientific and Technical Information of China (English)

    刘立源; 陈灼; 刘锦召; 马震; 张保红

    2012-01-01

    Objective:To explore the clinical efficacy of open reduction and locking proximal humerus plate (LPHP) in treating proximal humerus fracture. Methods:From January 2008 to June 2010, 111 patients with proximal humerus fracture of Neer type II , IE and IV , who were treated with open reduction and LPHP, were followed up for the record of OSS, VAS scales as well as the complications. Results:A total of 92 cases finished a half-year to one-year follow-up, with an average of 68 years (20 to 97 years), 18 males and 74 females. The mean Oxford Shoulder Score (OSS) was 16. 37 and Visual Analogue Scale (VAS) was 3. 1. The complication rate was 41. 3% :1. 1% hemorrhage rate, 3. 3% poor connection of humerus head and greater tubercle, 6. 5% chronic pain, 0% avascular necrosis of humerus head, 4. 3% loss of reduction and cutting-out of the screw, 3. 3% plate fracture, 11. 9% collision injury of subacromion, 4. 3% periarthritis of shoulder, 1. 1% rotator cuff tears, and 1. 1% infection. Twenty-four patients underwent secondary surgery due to the above complications. Conclusion:LPHP is an effective therapy for proximal humerus fracture. Although it has high complications and rate of reoperation, the incidences are lower than those reported in current literature.%目的:探讨切开复位、锁定钢板内固定治疗肱骨近端移位骨折的临床疗效,评价并发症发病率和患肩功能的恢复程度,并对PHILOS或LPHP板进行比较.方法:选取2008年1月-2010年6月间因肱骨近端骨折而手术治疗的根据Neer分型划分为2、3或4级的111例患者,通过电话及门诊复查随访1年并进行牛津肩关节评分(OSS)、疼痛程度VAS评分评估及记录相关的并发症及相关处理.结果:92例患者完成术后0.5~1年的随访(83%,92/111),平均年龄为68岁(20~97岁),其中男女比例1∶5(18∶74),平均的牛津大学肩评分为16.37分(范围:11~54分),0~10的VAS评分测定的疼痛程度平均得分为3.1

  13. Distal fibula fracture fixation: Biomechanical evaluation of three different fixation implants.

    Science.gov (United States)

    Knutsen, Ashleen R; Sangiorgio, Sophia N; Liu, Chang; Zhou, Steve; Warganich, Tibor; Fleming, John; Harris, Thomas G; Ebramzadeh, Edward

    2016-12-01

    The goal of this study was to evaluate the biomechanical performance of three distal fibula fracture fixation implants in a matched pair cadaveric fibula model: (1) a 5-hole compression plate with lag screw, (2) a 5-hole locking plate with lag screw, and (3) the 6-hole tabbed-plate with locking screws. Three-dimensional motions between the proximal and distal fibular segments were measured under cyclic valgus bending, cyclic compressive axial loading, and cyclic torsional external-rotation loading. During loading, strains were measured on the surfaces of each fibula near the simulated fracture site, and on the plate, to assess load transfer. Bone quality was quantified globally for each donor using bone mineral density (BMD) measured using Dual X-ray absorptiometry (DEXA) and locally at the fracture site using bone mineral content (BMC) measured using peripheral quantitative computed tomography (pQCT). Mean failure loads were below 0.2Nm of valgus bending and below 4Nm of external-rotational torque. Mean failure angulation was below 1degree for valgus bending, and failure rotation was below 7degrees for external-rotation. In the compression plate group, significant correlations were observed between bone quality (global BMD and local BMC) and strain in every one of the five locations (Pearson correlation coefficients >0.95, p<0.05). In contrast, in the locking and tabbed-plate groups, BMD and BMC correlated with far fewer strain locations. Overall, the tabbed-plate had similar construct stability and strength to the compression and locking plates. However, the distribution of load with the locking and tabbed-plates was not as heavily dependent on bone quality. Copyright © 2016 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  14. A cadaveric analysis of cervical fixation: the effect of intermediate fixation points and dynamization in multilevel cervical fusions.

    Science.gov (United States)

    Lubelski, Daniel; McCormick, William E; Ferrara, Lisa; Benzel, Edward C; Kayanja, Mark

    2014-11-01

    The authors conducted a study to compare biomechanical effects on the cervical spine of bridging fixation and intermediate fixation techniques, in both fixed and dynamic modes. A biaxial, servohydraulic machine biomechanically tested 23 human cervical spines for stiffness and strain in compression, extension, flexion, and lateral bending through 3 specimen states: 1) intact, 2) defect (corpectomy and discectomy), and 3) grafting with plate application in 1 of 4 constructs: C3-7 dynamized long strut (DLS), C3-7 fixed long strut (FLS), C3-5-7 dynamized multisegment (DMS), and C3-5-7 fixed multisegment (FMS). Compared with FMS, FLS had significantly greater strain in extension (at C-3 and at the rostral and caudal parts of the graft) and in lateral bending (at C-3 and at the caudal part of the graft). Fixed (FLS and FMS) constructs had greater flexion stiffness than did dynamized (DLS and DMS) constructs and showed a trend toward greater lateral bending stiffness. Instrumentation revealed greater extension strain with the long fixed (FLS and DLS) constructs than with the multifixed (FMS and FMS) constructs at the rostral and caudal parts of the graft but no significant differences between the dynamized (DLS and DMS) and fixed (FLS and FMS) constructs. Multisegmental fixation provided greater stabilizing forces than did bridging constructs for both dynamized and fixed plates. Use of multisegmental fixation can potentially decrease strain at the screw-plate interface and reduce the rate of hardware failure.

  15. 经前路椎体次全切钛笼置入锁定钢板螺丝钉内固定治疗相邻两节段脊髓型颈椎病%Adjacent Two Segments Anterior Subtotal Titanium Cage into the ;Locking Plate Screw Fixation for the Treatment of Cervical Spondylotic Myelopathy

    Institute of Scientific and Technical Information of China (English)

    青祖宏; 刘明; 高巍; 何蔚; 刘杨; 李永焕

    2013-01-01

    Objective To summarize the clinical efficacy of the anterior corpectomy cut with titanium cage and locking plate screw fixation for the treatment of two adjacent cervical spondylotic myelopathy.Method August 2010~December 2012,Anterior corpectomy cut with titanium cage and locking plate screw fixation for the treatment of adjacent two segments cervical spondylotic myelopathy 25 cases,including 18 men and 7 women patients,aged 33~75 years,mean 56.5 years.In 25 patients with varying degrees of symptoms of spinal cord compression. There are 9 cases(C4/C5). There are 15 cases(C5/C6).There are 1 case(C6/C7).Observed lateral cervical spine,cervical hyperextension flexion X-rays and cervical MR, before and after surg ery and follow-up phase,so as to learn spinal cord compression,cervical stability and postoperative cervical height,curvature,titanium cage plate screw position and cervical fusion. Compared preoperative to postoperative and follow-up,pain visual analog scale (VAS) and the Japan Orthopaedics Association (JOA) pain score.Results Operative time (120±30) min,blood loss (150±50)ml.The surgery does not appear related complications.The followed up time are 2~24 months (mean 12.5 months). Nerve function significantly improved.JOA score increased from preoperative 6.2±1.1 to the last follow-up 14.3±1.5,with an average improvement rate was (82.3±11.4)%.VAS average score is 2.1 points.The follow-up period is not found that the titanium cage shift,loose screws and lesion spinal cord compression phenomenon.Conclusion Anterior corpectomy cut with titanium cage and locking plate screw fixation for the treatment of two adjacent segments of cervical spondylotic myelopathy,effectively relieve nerve compression of the spinal cord,quickly restored cervical curvature and height,reconstruction of spinal stability,shorter operative time,less bleeding, and less damage.It has created favorable conditions for the rehabilitation of neurological function in patients,which is an

  16. Effect analysis of Philos plate in the treatment of proximal humeral fracture%Philos 钢板治疗肱骨近端骨折疗效分析

    Institute of Scientific and Technical Information of China (English)

    焦庆丰; 白鹏程; 张媺; 王辉; 路友群; 吴健; 周明

    2016-01-01

    Objective To investigate the clinical efficacy of Philos plate in the treatment of proximal humeral frac-tures.Methods Sixty-two patients of proximal humeral fractures were treated with Philos plate .Results All pa-tients were followed up for 12~17 months,the fractures were all healed in the last follow-up.According to Constant score criterion,the results were excellent in 22 patients, good in 36, fair in 4.The excellent-good rate was 93.55%. Conclusions Philos plate is good in the treatment of proximal humeral fractures , has the advantages of minimal damage and stable fixation .But that′s not best for Neer four part fracture .%目的:探讨使用Philos钢板治疗肱骨近端骨折的临床效果。方法采用Philos钢板治疗62例肱骨近端骨折患者。结果患者均获得随访,时间12~17个月,骨折均愈合。根据Constant 评分标准评价:优22例,良36例,一般4例,优良率93.55%。结论 Philos钢板治疗肱骨近端骨折,具有固定牢固、损伤小的优点,但不是Neer四部分骨折的最佳适应证。

  17. CARBON DIOXIDE FIXATION.

    Energy Technology Data Exchange (ETDEWEB)

    FUJITA,E.

    2000-01-12

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

  18. Improving Carbon Fixation Pathways

    OpenAIRE

    Ducat, Daniel C.; Silver, Pamela A

    2012-01-01

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

  19. A Study on the Power Generation Capacity of Piezoelectric Energy Harvesters with Different Fixation Modes and Adjustment Methods

    OpenAIRE

    Zhixiang Li; Gongbo Zhou; Zhencai Zhu; Wei Li

    2016-01-01

    The power generation capacity of piezoelectric energy harvesters (PEHs) is not only related to the properties of the piezoelectric material, the vibration magnitude and the subsequent conditioning circuit, but also to the fixation modes and adjustment methods. In this paper, a commercial piezoelectric ceramic plate (PCP) in simply supported beam fixation mode and cantilever beam fixation mode were analyzed through finite element simulations and experiments, and furthermore, two ways of adjust...

  20. Clinical study of treatment of intercondylar fractures of the distal humerus by double plate fixation viacombined medial and lateral triceps approach%经肱三头肌内外侧联合入路双钢板内固定治疗肱骨髁间骨折的临床研究

    Institute of Scientific and Technical Information of China (English)

    朱俊锟; 应锦河; 柳育健

    2009-01-01

    Objective To evaluate the treatmene results of double plating of type C1,C2(AO/ASIF) intercondylar fractures of the distal humerus through combinod mediolateral tricepe-sparing approach (TSA).Methods A retrospective analysis of 7 cases of intercondylar comminuted fractures of the distal humerus was conducted. There were 3 cases of type C1 and 4 cases of type C2. All the patients were treated with open reduction and double plate and cannulated screw fixation through combined mediolateral triceps-sparing approach. Results Postoperative follow up period was 15 montks (range, 8 to 18 months). Results were evaluated using the Mayo Elbow Performance Score (MEPS). Five cases were graded as excellent, while 2 cases good. Average elbow flexion was (118.6±11.4)°. Average extension lag was (22.9±12.1)°. Carrying angle was (20±5)°. No implant loosening or breakage was noted. Conclusion Combined mediolateral TSA is an ideal approach for fixation of type C1, C2 intercondylar fractures of the distal humerus in that it provides adequate exposure to the fracture site, facilitates fracture reduction and allows early rehabilitation.%目的 探讨经肱三头肌内外侧联合人路(triceps-sparing approach,TSA)双钢板内固定治疗C1、C2型(AO/ASIF)肱骨髁间骨折的疗效.方法 对7例肱骨髁间粉碎性骨折(C1型3例,C2型4例)的患者,采用经肱三头肌内外侧联合入路,双钢板及髁间空心钉固定.结果 术后随访时间为8~18个月,平均15个月.根据Mayo评分系统(MEPS)评定:优5例,良2例.肘关节平均屈曲角度为(118.6±11.4)°,平均伸直角度丢失(22.9±12.1)°,肘关节携带角(20±5)°.无一例出现内固定松动、断裂.结论 经肱三头肌内外侧联合入路治疗C4、C2型肱骨髁间骨折是较理想的手术入路,具有暴露充分、骨折达到良好复位固定及术后早期康复等优点.

  1. 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. 

  2. Estudo químico, macroscópico e da resistência à flexão de placas e parafusos de titânio usados na fixação interna rígida Chemical, macroscopical and bending resistance study of titanium plates and screws used in internal rigid fixation

    Directory of Open Access Journals (Sweden)

    Alexandre Elias TRIVELLATO

    2000-12-01

    Full Text Available O objetivo deste estudo foi comparar quatro sistemas de placas e parafusos de titânio de 2,0 mm de diâmetro utilizados em fixação interna rígida, sendo duas marcas nacionais (Engimplan e Bucomax e duas importadas (Synthes e W. Lorenz. Foram realizadas as seguintes análises: composição química, através de espectrometria por dispersão de energia (EDS e espectrometria de emissão atômica (AES, macroscópica, por meio de medidas padronizadas e de resistência à flexão. Os resultados obtidos permitem concluir que as marcas nacionais apresentaram um comportamento inferior, em relação a padronização das dimensões das placas e parafusos avaliados, influenciando nos resultados dos testes de flexão, para os quais estas se comportaram da mesma maneira. Entretanto, a marca comercial W. Lorenz utiliza liga de titânio-6alumínio-4vanádio para a confecção dos parafusos, fato responsável pelo melhor resultado no teste de flexão que qualquer outra marca. Os demais parafusos e placas apresentaram-se constituídos de titânio comercialmente puro, de acordo com a EDS e posteriormente confirmados pela AES.The aim of this study was to compare four systems of titanium plates and screws (diameter of 2.0 mm used for internal rigid fixation. From them, two were made in Brazil (Engimplan and Bucomax, one in Switzerland (Synthes, and the other, in Germany (W. Lorenz. The following analyses were done: chemical analysis using Energy Dispersive Spectroscopy (EDS and Atomic Emission Spectroscopy (AES, measurement of dimensions and bending resistance test. The obtained results allow to conclude that both Brazilian systems showed inferior behavior regarding dimensional standards. The bending assay showed that the Brazilian systems are similar to each other. However, the W. Lorenz screws are made of titanium-6aluminum-4vanadium alloy, which can be the reason for their better performance in the bending assay, when compared with that of the other three

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

    Institute of Scientific and Technical Information of China (English)

    孙继飞; 何强; 刘振利; 陈庆胜

    2012-01-01

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

  4. TO COMPARE FUNCTIONAL OUTCOME, COMPLICATIONS & RESULTS OF OPEN REDUCTION & INTERNAL FIXATION WITH CLOSED REDUCTION & EXTERNAL FIXATION IN VOLAR DISPLACED DISTAL RADIAL FRACTURE

    Directory of Open Access Journals (Sweden)

    Ketan Gupta

    2015-02-01

    Full Text Available Distal radius fractures account for 17% of all fractures in adults. The fracture of the lower end of radius crush the mechanical foundation of man‟s most elegant tool, the hand. No other fracture has a greater potential to devastate hand function. Today, o pen reduction of the fracture with internal fixation and closed reduction of the fracture with external fixation, forms the mainstay of the treatment of an uncomplicated distal end radius fracture in a patient unless specifically contraindicated. AIMS AND OBJECTIVES: To compare functional outcome, complications & results of two commonly used surgical methods; Open reduction & internal fixation with volar placed buttress plate and Closed reduction & external fixation with „Jess fixator‟ and internal fixation with „k - wire‟ in volar displaced distal radial fractures. MATERIALS AND METHODS : Total 30 cases were included in the study. 15 patients were treated with Open reduction & internal fixation with volar placed buttress plate and 15 were treated with Closed r eduction & external fixation with „Jess fixator‟ and internal fixation with „k - wire‟ in volar displaced distal radial fractures. Patients were followed up at regular intervals and Anatomical and functional outcomes were evaluated in all the patients. RESUL TS: Patients treated with Open reduction & internal fixation, 8 showed excellent results, 5 good and 2 fair results. Patients treated with closed reduction and external fixation 4 showed excellent results, 5 good, 4 fair and 2 showed poor results. CONCLUSI ON: O.R.I.F is generally preferred modality gives better results in terms of functional recovery and decrease morbidity to patient

  5. Open Reduction and Internal Fixation of Mandibular Fracture without Rigid Maxillomandibular Fixation

    Directory of Open Access Journals (Sweden)

    El-Anwar, Mohammad Waheed

    2015-03-01

    Full Text Available Introduction The ability to treat fracture with open reduction and internal fixation (OR/IF has dramatically revolutionized the approach to mandible fracture. With OR/IF, the postoperative role of rigid maxillomandibular fixation (MMF has declined, but it is used to maintain proper occlusion until internal fixation of the fracture is achieved. Objective To assess intraoperative manual MMF during OR/IF of selected cases of mandibular fractures. Methods This prospective study was conducted on 80 patients with isolated mandibular fractures managed by OR/IF using two titanium miniplates. The patients were classified into two groups: a control group (40 patients treated by OR/IF after intraoperative rigid MMF followed by immediate MMF removal, and a study group (40 patients treated by rigid MMF, which was replaced by temporary intraoperative manual MMF (3MF until plate fixation. Results There were no significant differences of the postoperative complication and dental occlusion, although a highly significant reduction of operative time was achieved in the 3MF group. Patient who received the 3MF technique had statistically significantly better average intrinsic vertical mouth opening in the early postoperative period (1 week after surgery, and normal mouth opening could be achieved in all cases in both groups 8 weeks after surgery. Conclusions Intraoperative rigid MMF is not mandatory and can be replaced in selected cases of fracture mandible by manual maintenance of proper dental occlusion until hardware fixation, gaining the advantages of shorter operative time and less risk of blood-transmitted diseases to the surgical team and the patient in addition to the benefits of immediate postoperative mandible mobilization.

  6. 锁定加压接骨板结合克氏针治疗中青年C型桡骨远端骨折%Locking compression plate combined with Kirschner wire fixation for treatment of high-energy type C distal radius fractures in young patients

    Institute of Scientific and Technical Information of China (English)

    王健; 张怀保; 卓高豹; 邱海胜; 劳杰

    2014-01-01

    Objective To investigate the long-term efficacy of locking compression plate (LCP) combined with Kirschner wire fixation in treating high-energy type C distal radius fractures in young adults.Methods From June 2008 to November 2012,26 young adults (14 males and 12 females) with high-energy type C distal radius fractures were treated.The age of the patients averaged 28 years.According to AO classification,there were 14,6 and 6 cases of type C1,type C2 and C3 fractures,respectively.Twenty,4 and 2 cases were treated by fixation using LCP combined with Kirschner wire through volar,dorsal and radial approach,respectively.Postoperative evaluations included visual analogue score of wrist pain,active range of motion of the wrist,Gartland-Werley score,Batra radiological score and complications.Results In 26 patients,the follow-up duration was 18 to 48 months,the average being 26 months.Fracture healing time was 12 to 24 weeks,with an average of 18 weeks.The time of Kirschner wire removal was 3 to 5 weeks postoperatively (mean,4 weeks),and that of plate removal was 12 to 18 months (average 14 months).Reflex sympathetic dystrophy occurred in 1 case 3 months after the surgery.Postoperative traumatic arthritis occurred in 3 cases.The Gartland-Werley scores at the final follow-up were excellent in 18 cases,good in 5 cases and fair in 3 cases.Conclusion There is usually significant displacement of irregular fracture fragments on the articular surface in young adults with high-energy type C distal radius fractures.LCP combined with Kirschner wire fixation through volar,dorsal and radial approach can obtain personalized anatomic reduction of the fracture.It is one of the effective methods for treatment of unstable distal radius fractures.%目的 探讨锁定加压接骨板(locking compression plates,LCP)结合克氏针治疗中青年高能量损伤C型桡骨远端骨折的疗效.方法 自2008年6月至2012年11月收治中青年C型桡骨远端骨折26例,平均年龄28

  7. The clinical effects of expansive unilateral open-door laminoplasty of the cervical spine with OsteoMed M3 plate and screws fixation%颈椎单开门椎管扩大成形术OsteoMed M3钉板固定的疗效

    Institute of Scientific and Technical Information of China (English)

    席新华; 吴强; 胡孔和; 包拥政; 李文俊; 何小龙; 朱文刚; 冯宗玉; 钟学仁

    2012-01-01

      目的总结颈椎单开门椎管扩大成形术中OsteoMed M3钉板内固定的效果.方法回顾性分析2007年10月至2011年2月汕头大学医学院附属粤北人民医院收治的20例颈椎病患者的临床资料,患者行颈椎单开门椎管扩大成形术并应用OsteoMed M3钉板固定;术后1周、12个月测量椎板开门角度和纤维性椎管矢状径(FSD),计算开门角度增加率和丢失率;术后3、12个月进行JOA评分并计算改善率;观察术后12个月轴性症状分级并计算其发生率.结果20例患者均顺利完成手术,未出现神经损伤、伤口感染等并发症.术后平均随访时间17.3个月.术后1周开门角度及FSD均明显较术前增加(P<0.05);术后12个月开门角度及FSD较术后1周有所降低,但仍明显高于术前(P<0.05).术后3、12个月JOA评分分别为(8.4±1.8)分、(11.0±2.4)分,与术前的(5.5±2.0)分比较,差异有统计学意义(P<0.05);术后3、12个月JOA改善率分别为(25±16)%、(48±22)%.术后12个月,5例(25%)患者出现轴性症状,其中可3例、差2例,经治疗后4例缓解、1例缓解不明显.结论OsteoMed M3钉板系统操作安全简单,可保证脊柱的稳定性.%  Objective To evaluate the clinical effects of OsteoMed M3 titanium plate and screws fixation in expansive unilateral open-door laminoplasty of the cervical spine. Methods From October 2007 to February 2011, 20 patients with cervical spondylosis were treated by expansive unilateral open-door laminoplasty using OsteoMed M3 plate and screws fixation at Yuebei People's Hospital Affiliated to Shantou University Medical College. The lamina open angle and fibrous sagittal diameter (FSD) were measured at 1 week and 12 months after operation, and the increase rate and loss rate of open angle were calculated. The Japanese Orthopaedic Association (JOA) scoring was applied to evaluate at 3, 12 months after operation, and JOA recovery rate was calculated. Axial symptom (AS) was

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

    Institute of Scientific and Technical Information of China (English)

    夏曦; 唐绍锋; 曹志武; 王辉; 姚女兆; 王文军

    2016-01-01

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

  9. Percutanous Fixation on Metadiaphyseal Fractures of the Proximal Humerus by Precontoured Long PHILOS Plate:the Preliminary Study%长型PHILOS接骨板扭转塑形经皮治疗肱骨中上段骨折的初步报告

    Institute of Scientific and Technical Information of China (English)

    王磊; 陈云丰; 魏海峰; 张长青; 曾炳芳

    2011-01-01

    Objective To evaluate the surgical treatment and clinic outcome ofpercutanous fixation with precontoured long PHILOS plate on metadiaphyseal fractures of the proximal humerus. Methods 13 patients of acute metadiaphyseal fractures of the proximal humerus were surgical treated by percutanous fixation with precontoured PHILOS plate from Febmary 2009 to February 2010. There were 4 males and 9 females with an average age of 72.9 years (range, 54~87 years). All the fractures on humeral shaft were classified by AO/OTA as type-B (n=6),type-C (n=7) and all the fractures extended to proximal humerus, which could be classified by Neet as type-I (n=9), type-ll (n=2)and type-III (n=2). The deltopectoral approach or lateral deltoid-splitting approach were used in proximal incision, and the operation time and blood loss were recorded in every case, including all the complications postoperatively. Functional assessment was done by Constant-MurIcy score and percentage to oormal side on shoulder, and MEPI score on elbow. Results The dcltopectoral approach was used in 8 patients while the lateral deltoid-splitting approach was used in 5 patients, the operation time was 96.5 minutes in average (range, 60~180 minutes), the blood loss was 238.5ml in average (range, 100~400mi). All the patients were followed-up in 16.9 months in average (range, 11 ~23 months), the fracture was healed in 11.6 weeks in average (range, 7~17 weeks). There was no iatrogenic radial nerve injuried postoperatively, instead of cutaneous antebrachii lateralis nerve injuried in 1 case and scapulohumeral pcriarthritis in another case temporarily. At the final follow-up, the Constant-Murley shoulder score on fracture side was 79 in average (range, 65~91), which was 87.6%in average (range, 75.8%~95.6%) to normal side, the clinical outcomes on shoulder were excellent or good in 12 cases (92.3%), satisfied in 1 cases.The MEPI was 96.9 in average (range, 90~100). Conclusions Percutanous fixation

  10. Operative Fixation of Rib Fractures Indications, Techniques, and Outcomes.

    Science.gov (United States)

    Galos, David; Taylor, Benjamin; McLaurin, Toni

    2017-01-01

    Rib fractures are extremely common injuries and vary in there severity from single nondisplaced fractures to multiple segmental fractures resulting in flail chest and respiratory compromise. Historically, rib fractures have been treated conservatively with pain control and respiratory therapy. However this method may not be the best treatment modality in all situations. Operative fixation of select rib fractures has been increasing in popularity especially in patients with flail chest and respiratory compromise. Newer techniques use muscle sparing approaches and precontoured locking plate technology to obtain stable fixation and allow improved respiration. Current reports shows that rib fracture fixation offers the benefits of improved respiratory mechanics and improved pain control in the severe chest wall injury with resultant improvement in patient outcomes by decreasing time on the ventilator, time in the intensive care unit, and overall hospital length of stay.

  11. Comparisons of external fixator combined with limited internal fixation and open reduction and internal fixation for Sanders type 2 calcaneal fractures: Finite element analysis and clinical outcome.

    Science.gov (United States)

    Pan, M; Chai, L; Xue, F; Ding, L; Tang, G; Lv, B

    2017-07-01

    The aim of this study was to compare the biomechanical stability and clinical outcome of external fixator combined with limited internal fixation (EFLIF) and open reduction and internal fixation (ORIF) in treating Sanders type 2 calcaneal fractures. Two types of fixation systems were selected for finite element analysis and a dual cohort study. Two fixation systems were simulated to fix the fracture in a finite element model. The relative displacement and stress distribution were analysed and compared. A total of 71 consecutive patients with closed Sanders type 2 calcaneal fractures were enrolled and divided into two groups according to the treatment to which they chose: the EFLIF group and the ORIF group. The radiological and clinical outcomes were evaluated and compared. The relative displacement of the EFLIF was less than that of the plate (0.1363 mm to 0.1808 mm). The highest von Mises stress value on the plate was 33% higher than that on the EFLIF. A normal restoration of the Böhler angle was achieved in both groups. No significant difference was found in the clinical outcome on the American Orthopedic Foot and Ankle Society Ankle Hindfoot Scale, or on the Visual Analogue Scale between the two groups (p > 0.05). Wound complications were more common in those who were treated with ORIF (p = 0.028). Both EFLIF and ORIF systems were tested to 160 N without failure, showing the new construct to be mechanically safe to use. Both EFLIF and ORIF could be effective in treating Sanders type 2 calcaneal fractures. The EFLIF may be superior to ORIF in achieving biomechanical stability and less blood loss, shorter surgical time and hospital stay, and fewer wound complications.Cite this article: M. Pan, L. Chai, F. Xue, L. Ding, G. Tang, B. Lv. Comparisons of external fixator combined with limited internal fixation and open reduction and internal fixation for Sanders type 2 calcaneal fractures: Finite element analysis and clinical outcome. Bone Joint Res 2017

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

  13. 切开复位锁定钢板内固定和人工肱骨头置换治疗高龄肱骨近端粉碎性骨折的对比研究%A retrospective trial of open reduction and locking plate internal fixation versus hemiarthroplasty for comminuted proximal humeral fractures in old patients

    Institute of Scientific and Technical Information of China (English)

    何帮剑; 金红婷; 吕一; 季四青; 周国庆; 童培建

    2013-01-01

    性骨折,尤其是合并重度骨质疏松者,建议采用人工肱骨头置换术治疗.%Objective;To compare open reduction and locking plate internal fixation with hemiarthroplasty in the clinical curative effects and safety for comminuted proximal humeral fractures in old patients. Methods:The medical records of 50 old patients who underwent operative treatment for comminuted proximal humeral fractures were analyzed retrospectively. Twenty-three patients(group A) were administrated with open reduction and locking plate internal fixation, while the others (group B)were administrated with hemiarthroplasty. The two groups were compared with each other in such parameters as operative time, blood loss, postoperative drainage, hospital stay, Constant- Murley shoulder scores at last follow-up,and complications during postoperative period and follow - up period. ResultS;The operative time( (70. 74 ±10.16) min) ,blood loss( ( 192. 96 ±50. 29) ml) , postoperative drainage( (52. 78 ± 10. 59) ml) and hospital stay( (9. 78 ± 2. 14) d) of group B were all lower than those of group A( (92. 17 ± 11.66) min, (242. 61 ±63. 48) ml, (74. 35 ±20. 91) ml, ( 14. 22 ±4. 30) d) respectively, and there were statistical differences between the 2 groups (t =6. 946 ,P = 0. 000;t =3. 085, P=0. 003 ;t =4. 705, P = 0. 000; t =4. 733, P = 0.000). There were no statistical differences in ihe following scores of shoulder pain( (12.65 ±1.92) ,(13. 19 ± 1.59)) activities of daily living( ( 15. 73 ± 2. 20) , ( 15. 93 ± 2. 25 ) ) , range of motion of shoulder( ( 28. 70 ± 7. 71 ) , ( 30. 59 ± 7. 72 ) ) , muscle power of upper limb((13.48 ±3. 37) ,( 13. 30 ±3. 18 )) and Constant-Murley total scores( (70. 57 ± 9. 31 ) , (73. 00 ± 7. 61 ) ) between the 2 groups respectively(t = - 1. 072 ,P =0. 289;t = - 0. 295 ,P = 0. 769;t = - 0. 866,P = 0. 391 ;t = 0. 196 ,P = 0. 845;t = - 1.018,P = 0. 314). The patients in the 2 groups were all followed up for 24 - 72 months with a median of 51. 5

  14. COMBINATION OF FIXATION TECHNIQUES IN THE MANAGEMENT OF COMPLEX DISTAL RADIUS FRACTURE- OUR EXPERIENCES

    Directory of Open Access Journals (Sweden)

    Isaac Sunder Sen

    2016-10-01

    Full Text Available BACKGROUND The aim of the study is to categorically suggest the apt method of surgical technique for a particular type of distal radius fracture (Frykman’s type III-VI. Distal radius fracture are among the most common fractures of the upper extremity inspite of increased focus on regular prevention of osteoporosis, early identification and its prompt management. Most distal radius fractures are the result of low energy mechanisms that can be successfully treated either nonoperatively or with a variety of operative techniques if indicated. Complex distal radius fractures occur most commonly in high-energy injuries with extensive comminution or bone loss and associated soft tissue or vascular injuries. These high-energy fractures can present challenges in reconstructing the distal radius. Effective restoration of the bony architecture requires a thorough knowledge of distal radius anatomy, understanding of the goals of treatment, versatility in surgical approaches and familiarity with multiple fixation options. Although, majority of the extra-articular fracture without signs of instability can be successfully managed with POP immobilisation for a period of 4-5 weeks followed by active physiotherapy, other types (Frykman’s III-VI need surgical management that too with combination of surgical techniques namely augmented spanning external fixator with supplemented K-wire fixation or external fixation followed by fragment specific volar locking compression plate osteosynthesis. MATERIALS AND METHODS I have studied 50 cases of distal radius fractures classified using Frykman’s classification using combination of techniques namely augmented spanning external fixator application with K-wire supplementation and spanning external fixator application followed by volar LCP fixation in which external fixator had been used as a reduction tool in majority of the cases and external fixator had been removed after plate osteosynthesis. In some cases retained

  15. Biological Plating in Comminuted Subtrochanteric Fractures

    Directory of Open Access Journals (Sweden)

    MR Aghamirsalim

    2012-05-01

    Full Text Available Background: Comminuted subtrochanteric fractures have been a challenge for orthopedic surgeons in terms of appropriate reduction and stable fixation. Numerous methods have been used for the fixation of comminuted subtrochanteric fractures among which some are accompanied with technical difficulties and complications of their own. Regarding the results of previous studies, we decided to evaluate the biological fixation method in comminuted subtrochanteric fractures. Methods: In this prospective study, we evaluated 20 men with comminuted subtrochanteric femoral fractures. The patients underwent indirect reduction with dynamic hip screw (DHS or dynamic condylar screw (DCS fixation within one week of injury. The patients were evaluated clinically for pain, hip and knee range of motion, leg-length discrepancy and angular and rotational deformities, in addition the radiographic assessment of the union. Results: According to Seinsheimer's classification of subtrochanteric fractures, four patients had type III, nine had type IV and seven had type V fractures. Fracture fixation was performed by DCS in eight and by DHS in 12 cases. The average time of the operations was 79.4 (ranging from 60-125 minutes. Mean blood loss was 634 (ranging from 340-1160 milliliters. Uneventfully, union occurred in all patients with no clinical pain or dysfunction. Conclusion: Submuscular plating with either DCS or DHS is a viable option to treat comminuted subtrochanteric fractures. The results of this study highly suggest use of submuscular plating in the treatment of comminuted subtrochanteric fractures, especially in the third world countries.

  16. External fixators in haemophilia.

    Science.gov (United States)

    Lee, V; Srivastava, A; PalaniKumar, C; Daniel, A J; Mathews, V; Babu, N; Chandy, M; Sundararaj, G D

    2004-01-01

    External fixators (EF) are not commonly used for patients with haemophilia. We describe the use of EF (Ilizarov, AO- uni- and bi-planar fixators and Charnley clamp) in nine patients (mean age: 19.2 years; range: 9-37) with haemophilia for the following indications - arthrodesis of infected joints, treatment of open fractures and osteoclasis. EF required an average of nine skin punctures [range: 4-17 were maintained for a period of 15 weeks (range: 8-29.5), without regular factor replacement, till bone healing was adequate and were removed with a single dose of factor infusion]. The mean preoperative factor level achieved was 85% (range: 64-102%). Much lower levels were subsequently maintained till wound healing. The average total factor consumption was 430 IU kg(-1) (range: 240-870), administered over a period of 17 days (range: 9-44). There were no major complications related to EF except in a patient who developed inhibitors. In conclusion, EF can be used safely in haemophilic patients who do not have inhibitors and does not require prolonged factor replacement.

  17. Curative effect of anatomical Ti-plate fixation combining with bone graft in the treatment of intra-articular calcaneal fractures%解剖型跟骨钛板并植骨治疗跟骨关节内骨折的临床疗效

    Institute of Scientific and Technical Information of China (English)

    王怀斌; 袁志; 裴国献; 刘建; 毕龙; 王连军; 孙克理; 隋天棋

    2014-01-01

    Objective To investigate the curative effect of anatomical Ti-plate combined with bone graft in treatment of intra-articular calcaneal fractures .Methods Retrospective analysis was conducted in 25 patients with 33 feet from Mar.2009 to May 2012,who were diagnosed as Sanders typeⅡ-Ⅳintra-articular calcaneal fractures .There were 20 males(26 feet) and 5 females (7 feet) with average age of (36.16 ±14.63)years(ranged from 15 to 65 years old) .There were 17 cases of single foot injury and 8 cases of double feet injury .All the patients were treated with Ti-plate fixation combined with bone graft and their calcaneal anatomic forms were recovered during operation .Mary-land foot score was used to evaluate the postoperative function .Results All the 25 cases (33 feet) were followed up for 12-36 months,with a mean time of 19.3 months.According to Maryland foot score ,17 feet were rated as excellent , 12 feet as good,4 feet as moderate.The excellent and good rate was 87.88 %.Conclusion Anatomical Ti-plate combined with bone graft for treatment of intra-articular calcaneal fractures can restore the smoothness of subtalar joint surface,help patients take earlier functional exercise and obtain a reliable curative effect .%目的:探讨解剖型跟骨钛板并植骨治疗跟骨关节内骨折的临床疗效。方法选择2009年3月~2012年5月期间收治的25例(33足)SanderslⅡ~Ⅳ型跟骨关节内骨折患者,男性20例(26足),女性5例(7足);年龄15~65岁,平均(36.16±14.63)岁。单足17例,双足8例,采用切开复位解剖型跟骨钛板内固定并植骨进行治疗,术中恢复跟骨解剖形态,按Maryland足部评分系统进行术后功能评分,评价手术效果,进行系统的回顾性总结分析。结果本组25例(33足)术后均获12~36个月随访(平均19.3个月),按Maryland足部评分标准:优17足、良12足、可4足,差0足;优良率为87.88%。

  18. Double Plating of Distal Fibula Fractures.

    Science.gov (United States)

    Vance, Danica D; Vosseller, J Turner

    2017-02-01

    Distal fibula fractures are common orthopaedic injuries that often require open reduction internal fixation (ORIF) to anatomically reduce the fracture and minimize the risk of posttraumatic arthritis. In certain clinical situations, stouter fixation may be advantageous to decrease the risk of fixation failure. In this study, the authors report on 12 patients who underwent distal fibula ORIF with 2 one-third tubular plates. Twelve consecutive patients who underwent distal fibula ORIF with 2 one-third tubular plates were retrospectively reviewed. Clinical and radiographic outcomes were reviewed, and functional outcomes were obtained using the Foot and Ankle Outcome Score (FAOS). Institutional review board approval was obtained. All 12 fractures healed clinically and radiographically. One patient was lost to follow-up after healing of the fracture. One patient had removal of fibular hardware at 15 months after surgery. Ten patients had no hardware related pain and good ankle function. FAOS scores were obtained at a mean of 25.6 months after surgery and were as follows: pain (87.6, SD = 9.5), activities of daily living (90.4, SD = 14.5), symptoms (93.3, SD = 9.5), sports (89.5, SD = 18.1), and quality of life (57.4, SD = 21.3). Double plating of distal fibula fractures is a viable technique for problem fractures that potentially provides a readily accessible, low-cost alternative to other means of enhancing fixation. Level IV.

  19. Early clinical efficacy of unilateral open-door cervical expansive laminoplasty plus centerpiece titanium plate fixation for cervical spinal stenosis%单开门颈椎管扩大成形Centerpiece钛板内固定术治疗颈椎管狭窄症的早期临床疗效

    Institute of Scientific and Technical Information of China (English)

    汪雷; 李涛; 宋跃明; 刘浩; 裴福兴; 刘立岷; 龚全; 孔清泉; 曾建成

    2011-01-01

    目的:探讨单开门颈椎管扩大成形Centerpiece钛板内固定术治疗颈椎管狭窄症的早期临床疗效.方法:2009年8月~2010年6月采用后路C3~C7单开门椎管扩大成形Centerpiece钛板内固定术治疗颈椎管狭窄症患者30例,其中男性23例,女性7例,年龄42~81岁,平均65.2岁.MRI显示3个节段狭窄9例,4个节段狭窄15例,5个节段狭窄6例.以JOA评分(17分法)及其改善率评价术后神经功能改善情况;术后复查颈椎X线、CT及MRI,在术前及术后3d、6个月的颈椎侧位X线片上测量C5节段椎管矢状径,计算椎管扩大率[(术后椎管矢状径-术前椎管矢状径)/(术前椎管矢状径)x 100%],评价椎管扩大和维持情况及门轴侧骨融合情况结果:手术时间为145±20min,术中出血量为215±75ml,术中未出现相关并发症.1例术后第2天出现C5神经根症状,经2周保守治疗疼痛明显缓解,术后2个月时症状完全消失.随访9~20个月,平均14.6个月,术前JOA评分为8.7±0.8分,术后6个月为15.2±1.1分,改善率为(75±18) %.影像学复查示术后3d、6个月时颈椎管扩大满意,脊髓受压完全解除,C5节段椎管矢状径术前为9.2±0.8mm,术后3d,6个月均为15.9±1.2mm,椎管扩大率为(71.8±11.0)%.术后6个月时门轴侧均达骨性愈合,无1例出现关门及神经损害症状加重的情况结论:单开门颈椎管扩大成形Centerpiece钛板内固定术是治疗颈椎管狭窄症的一种简便、安全的方法,早期疗效较满意.%Objective:To evaluate the early clinical efficacy of unilateral open-door cervical expansive laminoplasty plus centerpiece titanium plate fixation for cervical spinal stenosis. Method : From August 2009 to June 2010,30 cases suffering from cervical spinal stenosis underwent unilateral open-door expansive laminoplasty plus centerpiece fixation,of these,there were 23 males and 7 females,with a mean age of 65.2 years (range, 42-81 years ) .Preoperative MRI showed stenosis at three

  20. 股骨近端解剖型锁定钢板治疗老年骨质疏松性EvanⅢ、Ⅳ型股骨粗隆间骨折疗效分析%The therapeutic effect of locking plate internal fixation on senile patients with osteoporotic and EvanⅢ,Ⅳ proximal femoral intertrochanteric fractures

    Institute of Scientific and Technical Information of China (English)

    赖金平; 冯虹; 赵敏; 夏远军

    2015-01-01

    目的:探讨股骨近端解剖型锁定刚板治疗老年骨质疏松性EvanⅢ、Ⅳ型股骨粗隆间骨折的临床效果。方法:回顾性分析66例老年EvanⅢ、Ⅳ型股骨粗隆间骨折伴骨质疏松患者,随机分为对照组和观察组,每组各33例。观察组采用切开复位股骨近端解剖型锁定钢板内固定治疗,对照组采用股骨近端髓内钉治疗。观察手术时间、术中出血量、术后下地时间、住院费用及并发症发生情况,并行Sander评分,术后1、3、6、12月分别复查X片观察骨折愈合情况和内固定位置。结果:观察组手术时间和住院费用明显低于对照组[(67.2±5.8)min比(78.7±7.3)分);(1.2±0.5)万比(1.9±0.8)万],而术中出血量和术后下地时间高于对照组[(262.4±10.1)mL比(174.2±8.8) mL;(3.1±0.6)月比(2.4±0.7)月],差异有统计学意义。12月末次随访,两组Sander评分未见统计学差异,均未发生髋内翻、内固定松动、深静脉血栓等并发症。骨折愈合时间观察组(4.6±0.3)个月,高于对照组(3.8±0.4)月。结论:股骨近端解剖型锁定刚板治疗老年骨质疏松性EvanⅢ、Ⅳ型股骨粗隆间骨折手术时间短、术中出血量高、住院费用低,术后髋关节功能佳;但术后下地时间及骨折愈合时间延长,须谨慎选择患者。%ObjectiveTo investigate the anatomical proximal femur in the treatment of osteoporotic EvanⅢ,Ⅳ intertro-chanteric fractures of the clinical effects of locking rigid board.Methods66 casesge (>65y) with osteoporosis and EvanⅢ,Ⅳ intertrochanteric fractures in our hospital were retrospective analyzed. They were randomly divided into control group and observation group, each group of33 cases. The observation group was treated with open reduction and proximal femoral locking plate fixation ,and the control group with the proximal femur intramedullary nail fixation. The operation

  1. EXTERNAL FIXATOR IN THE MANAGEMENT OF UNSTABLE PELVIC FRACTURES

    Directory of Open Access Journals (Sweden)

    Devi prasad

    2014-08-01

    Full Text Available Universally, high- energy trauma is the major cause of mortality and morbidity in the younger age group. Usually pelvic fractures are caused by high energy trauma. Hence it affects not only the musculoskeletal system, but also the soft tissues and viscera contained in the pelvis leading to increased mortality and morbidity. Management of such patients remains a challenge to the trauma surgeon, even in the most sophisticated trauma centers. The aim of our study is to evaluate the role of external fixation in the management of pelvic fractures, both as a resuscitative measure and definitive treatment of unstable pelvic fractures (Type B & Type C. In our study, all patients underwent stabilization with external fixator and the mortality rate was zero with additional internal fixation with reconstruction plating being done in three patients. The primary advantage of external fixation in pelvic injury is to maintain the reduction by which it produces a tamponade effect and results in reduction in haemorrhage, and helps transportation of the patient. External stabilization for unstable pelvic fractures with external fixator is an established treatment procedure and we in our study confirm the usefulness of the procedure in an emergency situation and can be continued effectively as a definitive management for type B & C Pelvic injuries

  2. Flexible fixation and fracture healing

    DEFF Research Database (Denmark)

    Schmal, Hagen; Strohm, Peter C; Jaeger, Martin

    2011-01-01

    to the bone surface than external fixator bars. External fixators have the advantage of being less expensive, highly flexible, and technically less demanding. They remain an integral part of orthopaedic surgery for emergent stabilization, for pediatric fractures, for definitive osteosynthesis in certain...

  3. Biomechanical analysis of titanium fixation plates and screws in ...

    African Journals Online (AJOL)

    2015-08-10

    Aug 10, 2015 ... complex because the major stress‑bearing of the mandible are disrupted in this ... elastic as were the other materials used in this analysis. The .... the computational model is developed based on the modular principle and is ...

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

    OpenAIRE

    2007-01-01

    Background: Displaced fractures of the zygomatic bone can result in significant functional and aesthetic sequelae. Therefore the treatment must achieve adequate and stable reduction at fracture sites so as to restore the complex multidimensional relationship of the zygoma to the surrounding craniofacial skeleton. Many experimental biophysical studies have compared stability of zygoma after one, two and three-point fixation with mini plates. We conducted a prospective clinical study comparing...

  5. The treatment of AO type C fractures of the distal radius with dynamic external fixation combined with minimally invasive reset and bone gratting and locking compression plate%动力型外固定支架结合微创复位植骨与锁定钢板内固定治疗桡骨远端骨折的比较研究

    Institute of Scientific and Technical Information of China (English)

    付炳金; 朱晓东

    2014-01-01

    reset and bone grafting and open reduction combined with locking compression plate internal fixation .To evaluate the merit and demerit of the two methods .Methods From September 2010 to March 2014 , we choose 62 cases with AO type C2 and C3 fractures of the distal radius ,and make a retrospective study of these patients'fol-low -up data .32 cases were treated with dynamic external fixation combined with minimally invasive reset and bone grafting , 30 cases were treated with open reduction combined with locking compression plate internal fixation .Collected and sorted out the patients'X-ray measurement data ,the common surgery complications ,as well as the wrists'Gartland-Werley function scores ,for statistical analysis .Results 62 cases of distal radius fractures have received bone healing .After surgeries ,the com-mon surgery complications showed that ,in the external fixation group ,nail track infection 2 ,wrist joint pain 1 ,wrist joint stiffness 1;whilein the LCP group ,wound infection 2 ,wrist joint pain 2 .At 24 months after the treatments ,the wrists'Gart-land-Werley function scores showed that ,in the external fixation group ,excellent /good 28;whilein the LCP group ,excel-lent /good 28 .After statistical analysis ,The external fixation group and the LCP group was pointless to cast (P>0.05) .Con-clusions The treatment of AO type C2 and C3 fractures of the distal radius with dynamic external fixation combined with mini-mally invasive reset and bone grafting is an effective method .This method is simple ,less invasive .It can effectively correct the shortening deformity and angular deformity of the distal radius ,making an anatomical reduction of the distal radius fractures , and increasing the stability of the fractures .The treatment of AO type C2 and C3 fractures of the distal radius with locking com-pression plate is an effective method ,too .This surgery has a good reset effect ,and a high fixation strength .It can effectively avoid reset losing of the

  6. Eighth international congress on nitrogen fixation

    Energy Technology Data Exchange (ETDEWEB)

    1990-01-01

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

  7. Modeling and minimizing interference from corneal birefringence in retinal birefringence scanning for foveal fixation detection.

    Science.gov (United States)

    Irsch, Kristina; Gramatikov, Boris; Wu, Yi-Kai; Guyton, David

    2011-07-01

    Utilizing the measured corneal birefringence from a data set of 150 eyes of 75 human subjects, an algorithm and related computer program, based on Müller-Stokes matrix calculus, were developed in MATLAB for assessing the influence of corneal birefringence on retinal birefringence scanning (RBS) and for converging upon an optical/mechanical design using wave plates ("wave-plate-enhanced RBS") that allows foveal fixation detection essentially independently of corneal birefringence. The RBS computer model, and in particular the optimization algorithm, were verified with experimental human data using an available monocular RBS-based eye fixation monitor. Fixation detection using wave-plate-enhanced RBS is adaptable to less cooperative subjects, including young children at risk for developing amblyopia.

  8. Extracapsular hip fractures: fixation with a twin hook or a lag screw?

    Science.gov (United States)

    Olsson, O; Ceder, L; Lunsjö, K; Hauggaard, A

    2000-01-01

    The twin hook, which has 2 oppositely directed apical hooks, is an alternative to the lag screw for use with a 'dynamic plate' in the fixation of trochanteric hip fractures. In this prospective study lasting 1 year, 102 consecutive patients with trochanteric hip fractures were treated by 19 surgeons with either a twin hook or a lag screw combined with a conventional sliding hip screw plate or a Medoff sliding plate. Seven intraoperative errors were made with the twin hook but postoperative migration did not differ significantly between the 2 groups. Postoperative fixation failures were equally distributed between the 2 groups. The twin hook provides adequate fixation, which is comparable to that produced by a lag screw.

  9. Modeling and minimizing interference from corneal birefringence in retinal birefringence scanning for foveal fixation detection

    Science.gov (United States)

    Irsch, Kristina; Gramatikov, Boris; Wu, Yi-Kai; Guyton, David

    2011-01-01

    Utilizing the measured corneal birefringence from a data set of 150 eyes of 75 human subjects, an algorithm and related computer program, based on Müller-Stokes matrix calculus, were developed in MATLAB for assessing the influence of corneal birefringence on retinal birefringence scanning (RBS) and for converging upon an optical/mechanical design using wave plates (“wave-plate-enhanced RBS”) that allows foveal fixation detection essentially independently of corneal birefringence. The RBS computer model, and in particular the optimization algorithm, were verified with experimental human data using an available monocular RBS-based eye fixation monitor. Fixation detection using wave-plate-enhanced RBS is adaptable to less cooperative subjects, including young children at risk for developing amblyopia. PMID:21750772

  10. 腓骨重建及小钛板固定下颌骨体部缺损的三维有限元分析%Fibula reconstruction and small titanium plate fixation for repair of mandibular body defects:a three-dimensional finite element analysis

    Institute of Scientific and Technical Information of China (English)

    陈彪; 屈鹏飞; 刘耀强; 范戌辉; 刘吉伦; 杨威

    2015-01-01

    的应力比较大,应重视其稳定性和固位性;前牙咬合时的应力大于后牙咬合时的应力,修复后应避免前牙咬合。%BACKGROUND: In clinic,the mechanical study about fibula reconstruction for the repair of mandibular bone defect is unrealistic; the finite element analysis, however, provides a new approach for the biomechanical study of mandibular reconstruction. OBJECTIVE: To establish the three-dimensional finite element model of mandibular body defect under fibula reconstruction and smal titanium plate fixation, and to analyze the biomechanical features. METHODS:The three-dimensional model of mandibular body defect under fibula reconstruction and internal fixation was established. 100 N bite force was loaded on the anterior teeth, contralateral first molar and contralateral second molar, respectively. The maximum stress and maximum displacement before and after model reconstruction, the stress of bone tissues around the titanium plate and titanium screw holes under anterior and posterior loading, and the maximum displacement of the front and rear ends of the fibula under anterior and posterior loading were observed. RESULTS AND CONCLUSION:The maximum stress of the normal mandible concentrated in the condylar neck. In the reconstructed models, the maximum stress concentrated in the contralateral condylar neck. Under the same bite force, the maximum stress value of the reconstructed mandibular model was greater than that of the normal mandible. The maximum stress value of the anterior teeth was greater than that of the posterior teeth. The stress value was maximal between two screw holes inside each titanium plate and almost concentrated in the mandibular angle. The maximum stress of the residual titanium screw of the mandible concentrated in the first titanium screw over the mandibular defect under loading, while the maximum stress of the titanium screw of the fibular end concentrated in the titanium screw below the mesial segment of

  11. 骶髂关节前路钢板螺钉固定手术安全区的应用解剖学研究%The surgical safe zone of the anterior plate and screw fixation on sacroiliac joint: applied anatomy

    Institute of Scientific and Technical Information of China (English)

    刘佳; 孙善全; 倪卫东; 蒋电明; 高仕长

    2012-01-01

    Objective To explore the surgical safe zone of the anterior plate and screw fixation for treating sacroiliac joint fracture and dislocation. Methods 15 normal pelvic specimens were used. The horizontal distances from L4, L5 anterior roots to the sacroiliac joint, the vertical distances from U4, L5 roots to sacral wing, the distances from the intervertebral foreman of L4, Ls to the rim of true pelvis, and the diameter of the L4, L5 roots were measured respectively. On two dimensional pelvic coronal reconstruction images, the angle between sacroiliac joint and sagittal-plane, the width of the sacrum were tested. Results The horizontal distance from the lateral side of the L4, L5 roots to the sacroiliac joint gradually diminished from the top to the bottom, with the widest of (2.1±0.2)and (2.7±0.2 )cm respectively, and the narrowest of (1.2±0.2)cm and (1.5±0.2 )cm respectively. The vertical distances between the L, root and the sacrum also diminished gradually from the intervertebral foramen to the rim of the pelvis. The length of the L4 and L5 roots were( 7.4+0.8 )cm and 3.9±0.5 )cm, and the diameters (2.7±0.8 )mm and (7.3±1.4 )mm respectively. On CT reconstruction images, the angle between sacroiliac joint and sagittal plane was about 30°, and the distance from the sacroiliac joint to the lateral side of the spinal canal changed from 3.3cm to 2.3cm, the horizontal distance from the sacroiliac joint to the lateral side of the intervertebral foramen was about 2cm. Conclusions The surgical safe zone of the anterior plate and screw fixation for treating sacroiliac joint fracture and/or dislocation can be defined as the follows: the upper and lower plates places on the upper third of the sacroiliac joint, with the limited exposure range of 2.5cm, or the middle third of the sacroiliac joint, with the limited exposure range of 1.5cm. The screw should be inserted with introversional angle of 300.%目的 通过对骶髂关节周围解剖和CT重建进行研究,明

  12. Treatment of Multi - segmental Cervical Spondylotic Myelopathy Treated Posterior Unilateral Open-door Laminoplasty Combined with Centerpiece Ttitanium Plate Internal Fixation%后路单开门 Centerpiece 内固定治疗多节段脊髓型颈椎病

    Institute of Scientific and Technical Information of China (English)

    胡勇; 董伟鑫; 赵红勇; 袁振山; 孙肖阳; 马维虎; 徐荣明

    2014-01-01

    Objective To explore the clinical effect and safty of posterior unilateral open-door laminoplasty combined with Centerpiece titanium plate internal fixation for multi-segmental cervical spondylotic myelopathy. Methods From May 2010 to May 2012,32 patients with multi-segmental cervical spondylotic myelopathy were treated by posterior unilateral open door laminoplasty combined with Centerpiece titanium plate internal fixation. There were 20 males and 12 females,with a mean age of(60. 4 ± 7. 6)years(ranged 49 to 77 years). The neurofunction was evaluated by Japan Orthopaedic Association(JOA) score. The cervical curvature angle(α)was demonstrated by the cross angle between posterior vertebral body margins of C2 and C7 on cervical radiographs. Calculated cervical range of motion according to the difference of the angle of α between hyperex-tension and hyperflexion cervical radiographs. Calculated shoulder and pain VAS scores assess the range of axial symptoms. Re-sults The operative time and intraoperative blood loss were respectively 140 min(100 ~ 160 min)and 460 mL(250 ~ 800) mL. All patients were followed up from 12 to 38 months with an median of 22 months. The JOA scores was(9. 26 ± 3. 16)be-fore surgery and(12. 95 ± 2. 35)at 1 week after surgery,which showed significant differences(P ﹤ 0. 05). The improve rate of Japanese Orthopaedic Association(JOA)scores was(56. 4 ± 9. 3)% . The JOA scores was(13. 30 ± 2. 46)3 months after surgery and(13. 16 ± 1. 39)1 year after surgery,there were no significant differences when compared with the JOA scores at 1 week after surgery(P ﹥ 0. 05). The cervical curvature angle were(18. 1 ± 3. 8)° before surgery an(16. 7 ± 5. 4)° 3 months after surgery. There were no significient differences(P ﹥ 0. 05). The cervical range of motion was(35. 46 ± 11. 54)° before surgery and(30. 65 ± 8. 95)° 3 months after surgery. There were no significient differences(P ﹥ 0. 05). The VAS scores were ((3. 8 ± 1. 8)before surgery

  13. 颌间牵引钉联合小型或微型钛板内固定修复颌骨骨折%Internal fixation with intermaxillary traction nail combined with small/mini-titanium plate in the treatment of mandibular fractures

    Institute of Scientific and Technical Information of China (English)

    胡超; 肖金刚; 胡文健; 王雯; 潘庆; 曾昕

    2016-01-01

    BACKGROUND:Mandibular fractures often harm patient’s work and life. Intermaxilary traction nail with smal/mini-titanium plate, relative to traditional dental arch splint combined with smal/mini titanium plate treatment alone, is characterized by short treatment time and good fixation effect, which can improve the maxilofacial dysfunction and promote the early completion of the treatment. OBJECTIVE:To explore the curative effect of intermaxilary traction nail with mini-titanium plateversus dental arch splint combined with smal/mini-titanium plate on mandibular fractures METHODS:Ninety cases of mandibular fractures hospitalized at the Department of Oral and Maxilofacial Surgery, Stomatological Hospital of Southwest Medical University in China from July 2011 to May 2015 were enroled in this study. These patients were equivalently randomized into control group subjected to dental arch splint combined with smal/mini-titanium plate and observation group subjected to intermaxilary traction nail with mini-titanium plate. Al the patients were folowed up for 4-6 months. Curative effects, including excelent and good rate and total efficiency, were compared between the two groups. Maxilofacial function and incidence of adverse reactions were observed and recorded, respectively, to analyze the experimental data and assess their clinical values. RESULTS AND CONCLUSION:The total efficiency and the maxilofacial function were significantly better in the observation group than the control group (P   目的:通过试验颌间牵引钉联合微型钛板内固定相对牙弓夹板联合小型或微型钛板治疗的优势,探究其对于颌骨骨折的疗效及其应用效果。  方法:选取2011年7月至2015年5月在西南医科大学附属口腔医院颌面外科住院治疗的颌骨骨折患者90例,随机分为对照组和观察组,每组各45例。对照组使用牙弓夹板联合小型或微型钛板内固定治疗,观察组采用颌间牵引钉

  14. PHILOS humerus plate for a distal tibial fracture.

    Science.gov (United States)

    Twaij, Haider; Damany, Dev

    2013-01-04

    This report discusses the use of an alternative implant in the emergency fixation of a distal tibial fracture. We planned to fix the shear-type medial malleolar fracture in a closed, tri-malleolar fracture with a locking distal tibial plate. Intra-operatively, it was noted that the required plate was unavailable. A PHILOS humeral plate seemed to fit the contours of the distal tibia. The broad end of the PHILOS, when placed distally, gave options to place locking screws in the medial malleolar fragment. The fracture was stable after fixation. The patient made a full post-operative recovery and follow-up at 4 months was satisfactory. Despite adequate planning, there will be instances where one has to improvise. An understanding of the principles of fracture management can aid in finding solutions. PHILOS humeral plate may be used to stabilize a distal tibial fracture if an appropriate distal tibial locking plate is not available.

  15. Multi-incision with multiple low-profile plates for fixation of Rüedi-Allg(o)wer type Ⅱ and Ⅲ pilon fracture%多切口多枚小钢板治疗Rüedi-Allg(o)werⅡ~Ⅲ型pilon骨折

    Institute of Scientific and Technical Information of China (English)

    唐三元; 杨辉; 李远辉; 孙鸿涛; 詹鹏; 唐天华

    2014-01-01

    目的 探讨多切口多枚小钢板(multiple low-profile plate,MLPP)内固定治疗Rüedi-Allg(o)werⅡ~Ⅲ型pilon骨折的疗效. 方法 回顾性分析2007年7月-2012年3月采用多切口MLPP固定治疗且获得随访的21例pilon骨折患者资料.其中Rüedi-Allg(o)werⅡ型7例,Ⅲ型14例.根据X线片及CT显示的骨折折线累及范围选择多个切口,采用MLPP固定骨折.采用Burwell-Charnley影像学评价标准评价复位质量,美国足踝外科协会(American Orthopedic Foot&Ankle Society,AOFAS)踝与后足功能评分评价踝关节及后足功能.统计骨折类型、骨折愈合率、切口并发症发生率. 结果 骨折均愈合,骨折复位优良率为95%(20/21);AOFAS评分优11例,良6例,可4例,优良率达81%.无切口感染患者,1例切口开裂,5例发生创伤性关节炎. 结论 多切口MLPP固定治疗pilon骨折可减少切口并发症,有利于骨折复位、稳定,以达到早活动、晚负重的要求.%Objective To assess the outcome of fixation of Rüedi-Allg(o)wer type Ⅱ and Ⅲ pilon fracture using multiple low-profile plates (MLPP) via multiple incisions.Methods A retrospective study was made on 21 cases of pilon fracture immobilized using MLPP via multiple incisions between July 2007 and March 2012.There were 7 cases of Rüedi-Allgower type Ⅱ and 14 type Ⅲ.Fractures were reduced and fixed based on X-ray films and CT scans for fracture line and effect area.Quality of reduction was evaluated by Burwell-Charnley radiological score.Ankle and hindfoot functions were evaluated by American Orthopedic Foot & Ankle Society ankle-hindfoot scale.Fracture types,healing rate,and wound complication incidence were recorded.Results All fractures were healed,with the excellence rate of 95% (20/21).According to AOFAS score,the results were rated as excellent in 11 cases,good in 6,fair in 4,with the excellence rate of 81%.None suffered from wound infection,except for wound dehiscence in 1 case and traumatic

  16. Functional results of osteosynthesis with mini-plate and screws in metacarpal fractures

    Directory of Open Access Journals (Sweden)

    Hakan Başar

    2014-01-01

    Conclusions: Mini-plate and screws fixation of unstable metacarpal fractures produces anatomical reduction of fractures with stabilization that is rigid enough to allow early mobilization, thereby preventing stiffness and hence good functional results.

  17. Open-wedge high tibial osteotomy: incidence of lateral cortex fractures and influence of fixation device on osteotomy healing.

    Science.gov (United States)

    Dexel, Julian; Fritzsche, Hagen; Beyer, Franziska; Harman, Melinda K; Lützner, Jörg

    2017-03-01

    Open-wedge high tibial osteotomy (HTO) is an established treatment for young and middle-aged patients with medial compartment knee osteoarthritis and varus malalignment. Although not intended, a lateral cortex fracture might occur during this procedure. Different fixation devices are available to repair such fractures. This study was performed to evaluate osteotomy healing after fixation with two different locking plates. Sixty-nine medial open-wedge HTO without bone grafting were followed until osteotomy healing. In patients with an intact lateral hinge, no problems were noted with either locking plate. A fracture of the lateral cortex occurred in 21 patients (30.4 %). In ten patients, the fracture was not recognized during surgery but was visible on the radiographs at the 6-week follow-up. Lateral cortex fracture resulted in non-union with the need for surgical treatment in three out of eight (37.5 %) patients using the newly introduced locking plate (Position HTO Maxi Plate), while this did not occur with a well-established locking plate (TomoFix) (0 out of 13, p = 0.023). With regard to other adverse events, no differences between both implants were observed. In cases of lateral cortex fracture, fixation with a smaller locking plate resulted in a relevant number of non-unions. Therefore, it is recommended that bone grafting, another fixation system, or an additional lateral fixation should be used in cases with lateral cortex fracture. III.

  18. 肱骨近端锁定加压钢板置入内固定治疗复杂肱骨近端骨折的并发症%Postoperative complications of complex proximal humeral fractures after treated with proximal humeral internal locking system plate fixation

    Institute of Scientific and Technical Information of China (English)

    马福元; 杨铁毅; 姜锐; 张岩; 刘粤; 邵进

    2013-01-01

    BACKGROUND:Proximal humeral internal locking system fixation for complex humeral fractures via deltoid splitting approach provides good clinical results, but certain complications stil existed. OBJECTIVE:To explore the postoperative complications and the related risk factors for displaced three-part and four-part fractures of proximal humerus treated with proximal humeral internal locking system fixation via deltoid-splitting approach, and to propose the corresponding countermeasures. METHODS:106 cases with displaced three-part and four-part fractures of proximal humerus were retrospectively analyzed. The relationship between postoperative complications and the related risk factors was analyzed with Logistic regression analysis. RESULTS AND CONCLUSION:A total of 81 patients were fol owed-up for 12 to 30 months. The mean Constant score at 12 months after operation was (76.57±4.70) points. The postoperative complications occurred in 31 patients (38.3%) of which impingement syndrome involved in 16 cases (19.8%), head-shaft angle loss in six cases (7.4%), head-shaft angle loss combined with screws cut-out in two cases (2.5%), pure screws cut-out in two cases (2.5%), humeral head necrosis in two cases (2.5%), fat liquefaction in five cases (6.2%). Single factor analysis showed that there were significant differences in the superiorly located greater tuberosity, superiorly located plate and Neer classification between impingement group and un-impinged group (P<0.05). There were statistical y significant differences in age, postoperative medial cortical defects and Neer classification between head-shaft angle loss group and un-loss group (P<0.05). By means of logistic regression analysis, the superiorly located greater tuberosity, superiorly located plate and Neer classification were the individual predictors for postoperative impingement syndrome;postoperative medial cortical defect and Neer classification were the individual predictors for postoperative head

  19. 解剖型锁定加压钢板与人工肱骨头置换治疗肱骨近端骨折的效果比较%Effect comparison between anatomical locking plate fixation and humeral head replacement in the treatment of proximal humerus fractures

    Institute of Scientific and Technical Information of China (English)

    郑创义

    2015-01-01

    目的:比较解剖型锁定加压钢板与人工肱骨头置换治疗肱骨近端骨折的疗效。方法选取本院骨科2005年1月~2014年3月收治的肱骨近端骨折患者45例,根据手术方法将患者分为内固定术组(n=27)和肱骨头置换术组(n=18)。内固定术组给予骨折切开复位、解剖型锁定加压钢板固定,肱骨头置换术组给予人工肱骨头置换方法治疗。术后定期复查X线片,了解并发症发生情况。同时在末次复诊时按照Constant-Murley肩关节评分标准进行功能评分。结果术后随访8~36个月,平均18个月。内固定术组中的主要并发症是肱骨头坏死(6例)、骨折畸形愈合(7例)和骨性关节炎(2例);肱骨头置换术组的并发症是大结节、小结节(或两者均有之)骨质吸收(6例)、关节不稳定(1例)、异位骨化(1例)。内固定组的并发症发生率(55.6%)显著高于肱骨头置管术组(44.4%)(P<0.05),优良率(77.8%)显著高于肱骨头置换组(66.7%)(P<0.05),Constant-Murley评分显著高于肱骨头置换组(P<0.05)。结论解剖型锁定加压钢板治疗肱骨近端骨折的疗效优于人工肱骨头置换,值得临床推广。%Objective To compare the therapeutic effects of anatomical locking plate fixation (ALPF) and humeral head replacement (HHR) on proximal humerus fractures. Methods 45 patients with proximal humerus fractures at the ortho-pedics department in our hospital from January 2005 to March 2014 were selected and divided into ALPF group (n=27) and HHR group (n=18) based on operation methods.ALPF group were received anatomical proximal humeral locking plate fixation,while HHR group underwent humeral head replacement. X-rays was regularly reviewed after surgery to e-valuate complications,and Constant-Murley score system was used to assess the shoulder joint function at the last re-turn visit. Results All patients were followed up for 8

  20. [ANATOMICAL PLATE COMBINED WITH CORTICAL BONE PLATE ALLOGRAFTS FOR TREATMENT OF COMMINUTED FRACTURES OF FEMORAL CONDYLES].

    Science.gov (United States)

    Guo, Zhimin; Gong, Xingxing; Li, Yanwei; Qiu, Xiaochun; Zhang, Meng; Shangguan, Tiancheng; Ao, Qingfang; Liu, Qiang

    2015-01-01

    To summarize the effectiveness of anatomical plate combined with cortical bone plate allografts in the treatment of comminuted fractures of the femoral condyles. Between January 2008 and December 2012, 18 patients with comminuted fractures of the femoral condyles were treated, including 13 males and 5 females with an average age of 45 years (range, 23-65 years). Fractures were caused by traffic accident in 11 cases, by falling from height in 4 cases, and by the other in 3 cases. The locations were the left side in 7 cases and the right side in 11 cases. Of 18 fractures, 12 were open fractures and 6 were closed fractures. The mean time from injury to operation was 6 days (range, 4-15 days). The fixation was performed by anatomical plate combined with cortical bone plate allografts, and autograft bone or allogeneic bone grafting were used. Superficial local skin necrosis occurred in 1 case, and was cured after skin graft, and other incisions achieved primary healing. All patients were followed up 12-36 months (mean, 23 months). X-ray films showed that bone union was achieved within 3-12 months (5.6 months on average). No related complication occurred, such as fixation loosening, refracture, infection, or immunological rejection. According to Merchan et al. criteria for knee joint function evaluation, the results were excellent in 7 cases, good in 9 cases, fair in 1 case, and poor in 1 case at last follow-up; the excellent and good rate was 88.9%. Anatomical plate combined with cortical bone plate allograft fixation is a good method to treat comminuted fractures of the femoral condyles. This method can effectively achieve complete cortical bone on the inside of the femur as well as provide rigid fixation.

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

    Directory of Open Access Journals (Sweden)

    Sherin Kamal Elhalawany

    2015-01-01

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

  2. Interdigitated craniotomy: a simple technique to fix a bone flap with only a single plate.

    Science.gov (United States)

    Takahashi, Noboru; Fujiwara, Kazunori; Saito, Keiichi; Tominaga, Teiji

    2015-10-01

    In pterional craniotomy, fixation plates cause artifacts on postoperative radiological images; furthermore, they often disfigure the scalp in hairless areas. The authors describe a simple technique to fix a cranial bone flap with only a single plate underneath the temporalis muscle in an area with hair, rather than using a plate in a hairless area. The key to this technique is to cut the anterior site of the bone flap at alternate angles on the cut surface. Interdigitation between the bone flap and skull enables single-plate fixation in the area with hair, which reduces artifacts on postoperative radiological images and provides excellent postoperative cosmetic results.

  3. Molecular Biology of Nitrogen Fixation

    Science.gov (United States)

    Shanmugam, K. T.; Valentine, Raymond C.

    1975-01-01

    Reports that as a result of our increasing knowledge of the molecular biology of nitrogen fixation it might eventually be possible to increase the biological production of nitrogenous fertilizer from atmospheric nitrogen. (GS)

  4. Meniscal allograft transplantation. Part 1: systematic review of graft biology, graft shrinkage, graft extrusion, graft sizing, and graft fixation.

    Science.gov (United States)

    Samitier, Gonzalo; Alentorn-Geli, Eduard; Taylor, Dean C; Rill, Brian; Lock, Terrence; Moutzouros, Vasilius; Kolowich, Patricia

    2015-01-01

    To provide a systematic review of the literature regarding five topics in meniscal allograft transplantation: graft biology, shrinkage, extrusion, sizing, and fixation. A systematic literature search was conducted using the PubMed (MEDLINE), ScienceDirect, and EBSCO-CINAHL databases. Articles were classified only in one topic, but information contained could be reported into other topics. Information was classified according to type of study (animal, in vitro human, and in vivo human) and level of evidence (for in vivo human studies). Sixty-two studies were finally included: 30 biology, 3 graft shrinkage, 11 graft extrusion, 17 graft size, and 6 graft fixation (some studies were categorized in more than one topic). These studies corresponded to 22 animal studies, 22 in vitro human studies, and 23 in vivo human studies (7 level II, 10 level III, and 6 level IV). The principal conclusions were as follows: (a) Donor cells decrease after MAT and grafts are repopulated with host cells form synovium; (b) graft preservation alters collagen network (deep freezing) and causes cell apoptosis with loss of viable cells (cryopreservation); (c) graft shrinkage occurs mainly in lyophilized and gamma-irradiated grafts (less with cryopreservation); (d) graft extrusion is common but has no clinical/functional implications; (e) overall, MRI is not superior to plain radiograph for graft sizing; (f) graft width size matching is more important than length size matching; (g) height appears to be the most important factor influencing meniscal size; (h) bone fixation better restores contact mechanics than suture fixation, but there are no differences for pullout strength or functional results; and (i) suture fixation has more risk of graft extrusion compared to bone fixation. Systematic review of level II-IV studies, Level IV.

  5. Mechanical properties of Indonesian-made narrow dynamic compression plate.

    Science.gov (United States)

    Dewo, P; van der Houwen, E B; Sharma, P K; Magetsari, R; Bor, T C; Vargas-Llona, L D; van Horn, J R; Busscher, H J; Verkerke, G J

    2012-09-01

    Osteosynthesis plates are clinically used to fixate and position a fractured bone. They should have the ability to withstand cyclic loads produced by muscle contractions and total body weight. The very high demand for osteosynthesis plates in developing countries in general and in Indonesia in particular necessitates the utilisation of local products. In this paper, we investigated the mechanical properties, i.e. proportional limit and fatigue strength of Indonesian-made Narrow Dynamic Compression Plates (Narrow DCP) as one of the most frequently used osteosynthesis plates, in comparison to the European AO standard plate, and its relationship to geometry, micro structural features and surface defects of the plates. All Indonesian-made plates appeared to be weaker than the standard Narrow DCP because they consistently failed at lower stresses. Surface defects did not play a major role in this, although the polishing of the Indonesian Narrow DCP was found to be poor. The standard plate showed indications of cold deformation from the production process in contrast to the Indonesian plates, which might be the first reason for the differences in strength. This is confirmed by hardness measurements. A second reason could be the use of an inferior version of stainless steel. The Indonesian plates showed lower mechanical behaviour compared to the AO-plates. These findings could initiate the development of improved Indonesian manufactured DCP-plates with properties comparable to commonly used plates, such as the standard European AO-plates.

  6. Effect of Intraoperative Three-Dimensional Imaging During the Reduction and Fixation of Displaced Calcaneal Fractures on Articular Congruence and Implant Fixation

    DEFF Research Database (Denmark)

    Eckardt, Henrik; Lind, Marianne

    2015-01-01

    articular displacement was 0 mm in 69% of the Sanders type 2 fractures and 57% of the Sanders type 3 fractures. Operation duration averaged 118 minutes, and there were no reoperations due to misplaced screws or plates. The average absorbed radiation dose per patient was 288 mGy·cm. CONCLUSION......BACKGROUND: Operative treatment of displaced calcaneal fractures should restore joint congruence, but conventional fluoroscopy is unable to fully visualize the subtalar joint. We questioned whether intraoperative 3-dimensional (3D) imaging would aid in the reduction of calcaneal fractures......, resulting in improved articular congruence and implant positioning. METHOD: Sixty-two displaced calcaneal fractures were operated on using standard fluoroscopic views. When the surgeon had achieved a satisfactory reduction, an intraoperative 3D scan was conducted, malreductions or implant imperfections were...

  7. Influence of plate-bone contact on cyclically loaded conically coupled locking plate failure.

    Science.gov (United States)

    Rotne, Randi; Bertollo, Nicky; Walsh, William; Dhand, Navneet K; Voss, Katja; Johnson, Kenneth A

    2014-03-01

    The maintenance of friction between locking plates and bone is not essential, so that they can be applied with a gap between the plate and underlying bone. We hypothesised that the presence of a gap under a locking plate with a conical coupling mechanism would reduce fixation stability or allow uncoupling of the locking screws from the plate. Locking plates with two conically coupled locking screws were applied to 6 pairs of adult canine femora. One of each pair had plate to bone contact and the contralateral construct had a 2 mm plate to bone gap. Constructs were cyclically loaded in cantilever bending with 10 percent incremental increases every 1000 cycles at 2 Hz, starting at 250 N. The constructs were fatigued to failure. To evaluate fatigue life of the conical coupling, testing was repeated with aluminium tubing replacing the bone, to eliminate screw-bone cutout failure. The mean sustained loads and cycles to failure in the contact group (420.80, standard error [SE] 14.97 N; 7612.00, SE 574.70 cycles) were significantly greater than in the gap group (337.50, SE 14.97 N; 4252.00, SE 574.70 cycles), (pplate fatigue and breaking, with one construct having elevation of the plate over the screw head. Elevation of locking plates with a conical coupling system by 2 mm from the bone reduced construct fatigue life but did not result in screw head uncoupling from the plate. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Stuck, B A; Heller, T

    2011-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Yaniel Truffin Rodriguez

    2015-12-01

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

  10. Biomechanical stability of different fixation constructs for ORIF of radial neck fractures.

    Science.gov (United States)

    Capo, John T; Svach, David; Ahsgar, John; Orillaza, Nathaniel S; Sabatino, Christopher T

    2008-10-01

    Radial head and neck fractures are common and at times require operative fixation. There is no consensus on the ideal fixation construct for unstable radial neck fractures. Using 7 fresh frozen cadaveric radii, fractures of the radial neck were created 2 cm from the articular surface. The fractures were stabilized with 5 different commonly used constructs: crossed K-wires; a 2.4-mm T-plate using screws in the head (T-plate and nonlocked screw construct); a T-plate using a screw and locked buttress pin in the head (T-plate and locked buttress pin construct); a T-plate with an interfragmentary screw from the shaft retrograde, through the plate into the head (retrograde interfragmentary screw construct); and a T-plate with an interfragmentary screw from a nonarticular portion of the head antegrade into the shaft (antegrade interfragmentary screw construct). All constructs were tested for bending and torsional rigidity using an Instron mechanical testing machine (Model 306; MTS Systems, Eden Prairie, Minnesota). The highest rigidity in both bending and torsion was the antegrade interfragmentary screw construct. During bending, the antegrade interfragmentary screw construct was significantly stronger than a T-plate and nonlocked screw construct. In torsion, the retrograde interfragmentary screw construct was significantly stiffer than K-wires and approached significance over a T-plate and locked buttress pin construct. Locking bolts vs screws into the head did not significantly increase rigidity in torsion or bending. In this model, plating showed an increase in stiffness in torsional loading as compared to K-wires. The addition of a lag screw across the neck fracture consistently showed an increase in torsional and bending stiffness of the constructs. These data may assist orthopedic surgeons in determining the best fixation for radial neck fractures.

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

    Directory of Open Access Journals (Sweden)

    Riediger Dieter

    2008-05-01

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

  12. Stabilization of mobile mandibular segments in mandibular reconstruction: use of spanning reconstruction plate.

    Science.gov (United States)

    Yap, Yan Lin; Lim, Jane; Ong, Wei Chen; Yeo, Matthew; Lee, Hanjing; Lim, Thiam Chye

    2012-09-01

    The fibular free flap is the gold standard for mandibular reconstruction. Accurate 3-dimensional contouring and precise alignment of the fibula is critical for reestablishing native occlusion and facial symmetry. Following segmental mandibulectomy, the remaining mandibular fragments become freely mobile. Various stabilization methods including external fixation, intermaxillary fixation, and preplating with reconstruction plate have been used. We describe a modification to the preplating technique. After wide resection of buccal squamous cell carcinoma, our patient had an 11-cm mandibular defect from the angle of the left mandible to the right midparasymphyseal region. A single 2.0-mm Unilock® (Synthes, Singapore) plate was used to span the defect. This was placed on the vestibular aspect of the superior border of the mandibular remnants before resection. Segmental mandibulectomy was then performed with the plate removed. The spanning plate was then reattached to provide rigid fixation. The fibular bone was contoured with a single osteotomy and reattached. The conventional technique involves molding of the plate at the inferior border of the mandible. This is time-consuming and not possible in patients with distorted mandibular contour. It is also difficult to fit the osteotomized fibula to the contoured plate. In comparison, the superiorly positioned spanning plate achieve rigid fixation of the mandible while leaving the defect completely free and unhampered by hardware, allowing space for planning osteotomies and easier fixation of the neomandible. Using this modified technique, we are able to recreate the original mandibular profile with ease.

  13. Surgical technique for minimally invasive fibula fracture fixation.

    Science.gov (United States)

    Carlile, G S; Giles, N C L

    2011-09-01

    This paper describes a minimally invasive percutaneous technique for reduction and fixation of distal fibula fractures using plate osteosynthesis. We believe this technique benefits patients with poor quality soft tissue envelopes. So far a total of 25 patients have undergone percutaneous fixation, 22 females and 3 males. At no stage yet has a minimally invasive procedure been abandoned intra-operatively in favour of conversion to an open procedure. The mean age was 61.6 years (range 25-80 years). The mean time to surgery was 2.00 days (range 0-5) and mean time to discharge was 4.20 days (range 1-9). At a minimum of over 1 year's follow-up all fractures have healed, with no delayed unions or complications so far experienced.

  14. Femoral Reconstruction Using External Fixation

    Directory of Open Access Journals (Sweden)

    Yevgeniy Palatnik

    2011-01-01

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

  15. Create Your Plate

    Medline Plus

    Full Text Available ... A A A Listen En Español Create Your Plate Create Your Plate is a simple and effective ... and that your options are endless. Create Your Plate! Click on the plate sections below to add ...

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

    Directory of Open Access Journals (Sweden)

    Nishant Gaonkar

    2015-02-01

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

  17. Progressive slip after removal of screw fixation in slipped capital femoral epiphysis: two case reports

    Directory of Open Access Journals (Sweden)

    Engelsma Yde

    2012-11-01

    Full Text Available Abstract Introduction In slipped capital femoral epiphysis the femoral neck displaces relative to the head due to weakening of the epiphysis. Early recognition and adequate surgical fixation is essential for a good functional outcome. The fixation should be secured until the closure of the epiphysis to prevent further slippage. A slipped capital femoral epiphysis should not be confused with a femoral neck fracture. Case presentation Case 1 concerns a 15-year-old boy with an adequate initial screw fixation of his slipped capital femoral epiphysis. Unfortunately, it was thought that the epiphysis had healed and the screw was removed after 11 weeks. This caused new instability with a progressive slip of the femoral epiphysis and subsequently re-fixation and a subtrochanteric correction osteotomy was obligatory. Case 2 concerns a 13-year-old girl with persistent hip pain after screw fixation for slipped capital femoral epiphysis. The screw was removed as lysis was seen around the screw on the hip X-ray. This operation created a new unstable situation and the slip progressed resulting in poor hip function. A correction osteotomy with re-screw fixation was performed with a good functional result. Conclusion A slipped epiphysis of the hip is not considered ‘healed’ after a few months. Given the risk of progression of the slip the fixation material cannot be removed before closure of the growth plate.

  18. Biomechanical analysis of acromioclavicular joint dislocation treated with clavicle hook plates in different lengths.

    Science.gov (United States)

    Shih, Cheng-Min; Huang, Kui-Chou; Pan, Chien-Chou; Lee, Cheng-Hung; Su, Kuo-Chih

    2015-11-01

    Clavicle hook plates are frequently used in clinical orthopaedics to treat acromioclavicular joint dislocation. However, patients often exhibit acromion osteolysis and per-implant fracture after undergoing hook plate fixation. With the intent of avoiding future complications or fixation failure after clavicle hook plate fixation, we used finite element analysis (FEA) to investigate the biomechanics of clavicle hook plates of different materials and sizes when used in treating acromioclavicular joint dislocation. Using finite element analysis, this study constructed a model comprising four parts: clavicle, acromion, clavicle hook plate and screws, and used the model to simulate implanting different types of clavicle hook plates in patients with acromioclavicular joint dislocation. Then, the biomechanics of stainless steel and titanium alloy clavicle hook plates containing either six or eight screw holes were investigated. The results indicated that using a longer clavicle hook plate decreased the stress value in the clavicle, and mitigated the force that clavicle hook plates exert on the acromion. Using a clavicle hook plate material characterized by a smaller Young's modulus caused a slight increase in the stress on the clavicle. However, the external force the material imposed on the acromion was less than the force exerted on the clavicle. The findings of this study can serve as a reference to help orthopaedic surgeons select clavicle hook plates.

  19. Fixation Release and the Bone Bandaid: A New Bone Fixation Device Paradigm

    Directory of Open Access Journals (Sweden)

    Narges Shayesteh Moghaddam

    2017-01-01

    Full Text Available The current gold standard of care for mandibular segmental defeat reconstruction is the use of Ti-6Al-4V immobilization hardware and fibular double barrel graft. This method is often successful immediately at restoring mandible function, however the highly stiff fixation hardware causes stress shielding of the grafted bone and stress concentration in the fixation device over time which can lead to fixation device failure and revision surgery. The purpose of reconstructive surgery could be to create normal stress trajectories in the mandible following engraftment. We investigate the use of a two stage mechanism which separates the immobilization/healing and regenerative phases of mandibular segmental defect treatment. The device includes the use of a very stiff, Ti-6Al-4V, releasable mechanism which assures bone healing. Therefore it could be released once the reconstructed boney tissue and any of its ligamentous attachments have completely healed. Underneath the released Ti-6Al-4V plate would be a pre-loaded nitinol (NiTi wire-frame apparatus that facilitates the normal stress-strain trajectory through the engrafted bone after the graft is healed in place and the Ti-6Al-4V fixation device has been released. Due to the use of NiTi wires forming a netting that connects vascularized bone and possibly bone chips, bone grafts are also more likely to be incorporate rather than to resorb. We first evaluated a healthy adult mandible during normal mastication to obtain the normal stress-strain distribution. Then, we developed the finite element (FE model of the mandibular reconstruction (in the M1-3 region with the proposed fixation device during the healing (locked state and post-healing (released state periods. To recreate normal stress trajectory in the reconstructed mandible, we applied the Response Surface Methodology (RMS to optimize the Bone Bandaid geometry (i.e., wire diameters and location. The results demonstrate that the proposed mechanism

  20. Method of osteotomy fixation and need for removal following bimaxillary orthognathic, osseous genioplasty, and intranasal surgery: a retrospective cohort study.

    Science.gov (United States)

    Posnick, J C; Choi, E; Chavda, A

    2017-10-01

    The purpose of this study was to determine the incidence and causes of fixation hardware removal after bimaxillary orthognathic, osseous genioplasty, and intranasal surgery. A retrospective study was performed, involving subjects with a bimaxillary developmental dentofacial deformity (DFD) and symptomatic chronic obstructive nasal breathing. At a minimum, subjects underwent Le Fort I osteotomy, bilateral sagittal ramus osteotomies (SROs), septoplasty, inferior turbinate reduction, and osseous genioplasty. The primary outcome variable studied was fixation hardware removal. Demographic, anatomical, and surgical predictor variables were assessed. Two hundred sixty-two subjects met the inclusion criteria. Their mean age at operation was 25 years (range 13-63 years); 134 were female (51.1%). Simultaneous removal of a third molar was performed in 39.9% of SROs. Three of 262 Le Fort I procedures (1.1%) and two of 524 SROs (0.4%) required hardware removal. There were four cases of ramus wound dehiscence, four of ramus surgical site infection (SSI), one of chin SSI, two of maxillary sinusitis, and one of lingual nerve injury; none of these subjects underwent hardware removal. A limited need for fixation hardware removal after orthognathic procedures was confirmed. There was no statistical correlation between hardware removal and patient sex, age, pattern of DFD, simultaneous removal of a third molar, or occurrence of wound dehiscence, SSI, or lingual nerve injury. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

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

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

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

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

    Science.gov (United States)

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

    2008-10-01

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

  3. First metatarsophalangeal joint arthrodesis: current fixation options.

    Science.gov (United States)

    Moon, Jared L; McGlamry, Michael C

    2011-04-01

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

  4. Comparison of hybrid fixation versus dual intramedullary nailing fixation for forearm fractures in older children: Case-control study.

    Science.gov (United States)

    Feng, Yongzeng; Shui, Xiaolong; Wang, Jianshun; Cai, Leyi; Wang, Gang; Hong, Jianjun

    2016-06-01

    The aim of the present study was to compare the clinical outcomes of hybrid fixation using elastic stable intramedullary nailing (ESIN) for the radius and plate screw fixation for the ulna (Hybrid group) with dual ESIN fixation (D-ESIN group) for both-bone forearm fractures in children between 10 and 16 years of age. Fifty patients with both-bone forearm fractures (28 patients in the Hybrid group and 22 patients in the D-ESIN group) were reviewed. Functional outcomes were evaluated according to the criteria of Price et al. Radiological results were assessed by fracture union at three and six months and bone union time. Postoperative complications were also recorded. The times of fluoroscopy intraoperatively and duration of immobilization postoperatively were significantly lower in the Hybrid group (P < 0.05). The union rate of the ulna at three months postoperatively in the hybrid group was significantly higher than that in the D-ESIN group (P < 0.05). The average time of bone union was significantly shorter in the hybrid group than that in the D-ESIN group (P < 0.05). There were no differences according to the satisfactory rate and degree, the major and minor complications between the groups. Hybrid fixation is superior in terms of the times of fluoroscopy intraoperatively, duration of immobilization postoperatively, delayed union rate of the ulna and the average time of bone union. Therefore, hybrid fixation is an alternative treatment for both-bone forearm fractures in children between 10 and 16 years of age. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Dalibor Milojko Đenadić

    2013-06-01

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

  6. Surgical approaches for minimally invasive plate osteosynthesis in dogs.

    Science.gov (United States)

    Pozzi, A; Lewis, D

    2009-01-01

    Fracture stabilisation techniques continue to evolve and to provide approaches which minimise the iatrogenic trauma associated with surgery. Minimally invasive plate osteosynthesis (MIPO) is a recently described method of biological internal fixation performed by introducing a bone plate via small insertional incisions that are made remote to the fracture site. The plate is slid adjacent to the bone in an epiperiosteal tunnel connecting the two insertional incisions. Screws are placed in the plate through the insertional incisions or via additional stab incisions made over the holes in the plate. In this paper we describe the surgical approaches used to perform MIPO in humeral, radial, femoral and tibial fractures in dogs. We found that these approaches allowed safe insertion of the plate without grossly damaging neuro-vascular structures. Further studies are needed to evaluate the clinical outcome of MIPO in dogs.

  7. Understanding Nitrogen Fixation

    Energy Technology Data Exchange (ETDEWEB)

    Paul J. Chirik

    2012-05-25

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

  8. Options for acetabular fixation surfaces.

    Science.gov (United States)

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

    2007-01-01

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

  9. 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

    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.......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...

  10. 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...

  11. AXIS侧板钢板螺钉内固定系统对下颈椎骨折脱位后颈髓功能恢复作用%Effect of AXIS lateral mass screw- plate internal fixation system on functional recovery of spinal cord in fracture of lower cervical vertebrae

    Institute of Scientific and Technical Information of China (English)

    昌耘冰; 尹庆水; 夏虹; 吴增晖; 徐国洲; 张余; 权日; 章凯

    2003-01-01

    AIM:To evaluate the methods and results of the AXIS lateral mass screw- plate system in the treating of lower cervical spine injury.METHODS:29 cases of lower cervical vertebrae injury were fixed with AXIS system.All of them were followed- up for more than 1 year.RESULTS:All cases had a good bone union without malformation.We found no complication of the injury to the vertebral arteries or nerves.There was no loosening of the plate and screw. CONCLUSION:AXIS lateral mass screw- plate system has the characteristic of stable,simple and safe and is suitable for the treatment of lower cervical spine injury.

  12. The design of a cervical vertebra titanium plate-interbody fusion cage

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To study the biomechanical feature of a newly designed cervical vertebra internal fixation device and its clinical applications Methods: Some functional spinal units were fixed respectively with titanium plate, fusion cage and new device designed by ourselves, then a controlled biomechanical study including flexion, extension, torsion and lateral bending was performed and the results were analyzed. Results: As to the mechanical performance, fusion cage showed poor performance in extension test and so did the titanium plate in the distortion test. However, the new device showed good performance in every test. Conclusion: Both simple titanium plate fixation and simple fusion cage fixation have biomechanical defaults, but they are complementary. The titanium plate-interbody fusion cage avoids the defaults and has specific advantages.

  13. The Clavicular Hook Plate: Consequences in Three Cases.

    Science.gov (United States)

    Chandrasenan, Jeevan; Badhe, Sachin; Cresswell, Timothy; De Beer, Joe

    2007-10-01

    The small fragment AO clavicular hook plate is indicated for certain fractures of the lateral end of clavicle and for symptomatic acromio-clavicular joint dislocations where there is rupture of the stabilizing ligaments. The complex anatomy and biomechanics of the acromio-clavicular joint can lead to complications that result in damage to the joint itself or acromial erosion. In addition, the rotator cuff complex is at risk of injury when inserting the plate. We report three cases where patients who underwent hook plate fixation subsequently required removal of the implant due to complications previously unreported in current literature.

  14. A failure study of a locking compression plate implant

    Directory of Open Access Journals (Sweden)

    Nirajan Thapa

    2015-04-01

    Full Text Available In this case study a failed locking compression plate was investigated. Such plating systems are used to provide the stability to fractured bone and fixation. The locking compression plate had been separated in two pieces. One of the fracture surfaces from the failed component was investigated for surface topographical features. The visual, optical and scanning electron microscopy results indicated the presence of beach marks, intermetallic inclusions, corrosion pits and striations indicating fatigue crack propagation and overload failure. Some corrosion damage also was documented on the fractography. This case study shows that corrosion may have initiated fatigue crack which grew by the activities of daily living causing the failure.

  15. REVERSE ENGINEERING OF THE MITKOVIC TYPE INTERNAL FIXATOR FOR LATERAL TIBIAL PLATEAU

    Directory of Open Access Journals (Sweden)

    Nikola Vitković

    2015-12-01

    Full Text Available In orthopaedic surgery it is very important to use proper fixation techniques in the treatment of various medical conditions, i.e. bone fractures or other traumas. If an internal fixation method, such as plating, is required, it is possible to use Dynamic Compression Plates (DCP or Locking Compression Plates (LCP and their variants. For DCP implants it is important to match the patient's bone shape with the most possible accuracy, so that the most frequent implant bending is applied in the surgery. For LCP implants it is not so important to match the patient’s bone shape, but additional locking screw holes are required. To improve the geometrical accuracy and anatomical correctness of the shape of DCP and to improve the LCP geometric definition, new geometrical modelling methods for the Mitkovic type internal fixator for Lateral Tibia Plateau are developed and presented in this research. The presented results are quite promising; it can be concluded that these methods can be applied to the creation of geometrical models of internal fixator customized for the given patient or optimized for a group of patients with required geometrical accuracy and morphological correctness.

  16. Effect of induced aniseikonia on fixation performance.

    Science.gov (United States)

    Remole, A

    1988-01-01

    The purpose of the study was to determine to what extent induced aniseikonia affects fixation performance. Aniseikonia was induced in the vertical meridian only, whereas fixation alignment was monitored in the horizontal meridian. A previously developed technique based on the dependency of border enhancement bandwidth on fixation eccentricity was used to monitor deviations from central fixation during fusion. Stress on the fusion mechanism was supplied by controlled increments of forced horizontal vergence. It was found that deviation from central fixation in the horizontal meridian generally increases with increasing amounts of vertical aniseikonia. The effect is particularly pronounced for small amounts of aniseikonia.

  17. Proximal Humeral Fractures: A Biomechanical Comparison of Locking Plate Constructs in a Cadaveric 3-Part Fracture Model

    OpenAIRE

    2010-01-01

    The purpose of our study was to biomechanically compare, under cyclic loading conditions, fracture site motion, humeral head collapse, and intra-articular hardware penetration in simulated 3-part osteoporotic proximal humeral fractures stabilized with 1 of 2 locking-plate constructs. We performed fixation on simulated 3-part proximal humeral fractures in 10 pairs of cadaveric osteoporotic humeri with a Hand Innovations S3 Proximal Humerus Plate (S3 plate) or an LCP Proximal Humerus Plate (LCP...

  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. Observations concerning different patterns of bone healing using the Point Contact Fixator (PC-Fix) as a new technique for fracture fixation.

    Science.gov (United States)

    Hofer, H P; Wildburger, R; Szyszkowitz, R

    2001-09-01

    The recent trend in all surgical disciplines has been the development of techniques in minimally invasive surgery and the optimal maintenance of the blood supply to the bone fragments during osteosynthesis. Currently, the Point Contact Fixator (PC-Fix) has been introduced as a new implant for the stabilization of forearm bones. This plate-like splint and screw fixation system, which actually acts as an internal fixator, is characterized by minimized isolated contacts to the bone and proven angular stability of the monocortically locked screws. By using the PC-Fix, a further reduction of damage to the blood supply to the bone is achieved. Since 1994, 38 patients have been treated with this new device; we have reviewed the radiographs of 52 consolidated forearm fractures/osteotomies in accordance with the patterns of bone healing associated with the different methods of implant application according to the fracture type. In the groups in which traditionally precise reduction, interfragmentary compression and stable fixation was achieved (N=31), we found in 71% an absence of periosteal callus (direct bone healing). In the groups in which compression and adaptation were combined, or even main fragments adapted without compression, with wedges remaining unreduced in soft tissue connection (N=21), we found a visible external callus in 81% (indirect healing) (P = 0.002). Indirect healing after internal fixation is no longer regarded as a disturbance to healing, but is a goal in itself. The appearance of callus is a welcome sign indicating a prompt and positive reaction in the course of bone union which will lead to progressive fracture immobilization. When using the PC-Fix in a "biological way", callus formation and solid union take place earlier than in conventional plating. The new internal fixator offers substantial technical and mechanical advantages in fracture treatment. Therefore, it is an ideal implant to satisfy the requirements of modern biological

  20. COMPARATIVE STUDY OF FOREARM FRACTURES TREATED WITH LOCKING COMPRESSION PLATE LIMITED CONTACT DYNAMIC COMPRESSION PLATE

    Directory of Open Access Journals (Sweden)

    Jayachandra Reddy

    2015-02-01

    Full Text Available OBJECTIVES: This study has been carried out to compare the functional outcome of fracture fixation in diaphyseal forearm fractures by using Locking Compression Plate versus Limited contact dynamic compression Plate. To study the difference in the duration of union & complications with LCP & LC - DCP. METHODOLOGY: It is a prospective randomised comparative study which was carried out from December 2012 to December 2014 in our In stitution. In Group I, 20 patients were subjected to open reduction and internal fixation with 3.5 mm stainless steel LCP and locking head/nonlocking screws. In Group II, 20 patients were managed by 3.5mm LCDCP and non - locking screws. Clinical assessments regarding pain and function, radiological assessments were undertaken at the final follow - up. RESULTS - The time required for LCP fixation (mean 93.5 min, range 75 - 120 min was found to be more than that required for LC - DCP (mean 81.94 min, range 60 - 110 mi n. But