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Sample records for reduction internal fixation

  1. [Complications of open reduction and internal fixation versus external fixation for unstable distal radius fractures: a meta-analysis].

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    Yang, Z; Yuan, Z Z; Ma, J X; Ma, X L

    2016-12-20

    Objective: To make a systematic assessment of the complications of open reduction and internal fixation versus external fixation for unstable distal radius fractures. Method: A computer-based online search of PubMed, ScienceDirect, EMBASE, BIOSIS, Springer and Cochrane Library were performed.The randomized and controlled trials of open reduction and internal fixation versus external fixation for unstable distal radius fractures were collected.The included trials were screened out strictly based on the criterion of inclusion and exclusion.The quality of included trials was evaluated.RevMan 5.0 was used for data analysis. Result: A total of 17 studies involving 1 402 patients were included.There were 687 patients with open reduction and internal fixation and 715 with external fixation.The results of Meta-analysis indicated that there were statistically significant differences with regard to the postoperatively total complications, infection, malunion, tendon rupture (I(2)=8%, RR=0.77(95%CI 0.65-0.91, Z=3.10, P0.05). Conclusion: Postoperative complications are present in both open reduction and internal fixation and external fixation.Compared with external fixation, open reduction and internal fixation is lower in total complications postoperatively, infection and malunion, but external fixation has lower tendon rupture incidence.

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

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    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.

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

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    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

  4. A Meta-Analysis for Postoperative Complications in Tibial Plafond Fracture: Open Reduction and Internal Fixation Versus Limited Internal Fixation Combined With External Fixator.

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    Wang, Dong; Xiang, Jian-Ping; Chen, Xiao-Hu; Zhu, Qing-Tang

    2015-01-01

    The treatment of tibial plafond fractures is challenging to foot and ankle surgeons. Open reduction and internal fixation and limited internal fixation combined with an external fixator are 2 of the most commonly used methods of tibial plafond fracture repair. However, conclusions regarding the superior choice remain controversial. The present meta-analysis aimed to quantitatively compare the postoperative complications between open reduction and internal fixation and limited internal fixation combined with an external fixator for tibial plafond fractures. Nine studies with 498 fractures in 494 patients were included in the present study. The meta-analysis found no significant differences in bone healing complications (risk ratio [RR] 1.17, 95% confidence interval [CI] 0.68 to 2.01, p = .58], nonunion (RR 1.09, 95% CI 0.51 to 2.36, p = .82), malunion or delayed union (RR 1.24, 95% CI 0.57 to 2.69, p = .59), superficial (RR 1.56, 95% CI 0.43 to 5.61, p = .50) and deep (RR 1.89, 95% CI 0.62 to 5.80) infections, arthritis symptoms (RR 1.20, 95% CI 0.92 to 1.58, p = .18), or chronic osteomyelitis (RR 0.31, 95% CI 0.05 to 1.84, p = .20) between the 2 groups. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

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

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

    2008-10-01

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

  6. Open reduction and internal fixation: Screw injury - Retrospective study

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    Preetha Balaji

    2017-01-01

    Full Text Available Background/Aims: Open reduction and internal fixation (ORIF is a standard surgical procedure in jaw trauma and in orthognathic surgery. Insertion of screws is a significant risk for accidental tooth root injury with varying outcomes. Contrary evidences are found in literature due to a variety of study designs. This study was undertaken to address the lacunae and possibly estimate the difference in occurrence of tooth damage during or after ORIF between trauma and planned osteotomies. Materials and Methods: In this retrospective study, the data of ORIF in either trauma or orthognathic surgery fulfilling inclusion and exclusion criteria were collected and analyzed. Results: There were 1632 patients fulfilling the inclusion and exclusion criteria and formed the study group, of which 663 were in orthognathic surgery, of whom 210 had bimaxillary orthognathic surgery. In the trauma group, 358 patients had fractures involving both jaws whereas 272 had maxilla alone and 339 had mandibular fractures alone. On comparing the outcome, of the 9073 screws studied, 93.40% were not involved in any contact with the teeth, 6.3% were in category of potential hits (near apices or the root surfaces, and only 0.28% had evidence of root damage with the screws. It is observed that molar and premolar had a significant difference in terms of the type of surgery (P ≤ 0.05 whereas canine (P = 0.75 and incisor (P = 0.67 showed no statistical difference. Conclusion: ORIF when used as mentioned is a safe way for the management of fractures. The incidence of root injury is not uncommon but can be avoided with careful planning and execution.

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

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    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

  8. 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.

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    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

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

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    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

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

    DEFF Research Database (Denmark)

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

    Internal Fixation (ORIF) or External Fixation (EF). Method : A search was conducted using PUBMED, Embase, Cochrane Central, Open Grey, Orthopaedic Proceedings and WHO International Clinical Trials Registry Platform. Studies with level of evidence I-IV comparing EF with two-stage ORIF of DIATF in patients...

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

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    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.

  12. Open reduction and closed reduction internal fixation in treatment of femoral neck fractures: a meta-analysis.

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    Wang, Weiguo; Wei, Junjie; Xu, Zhanwang; Zhuo, Wenkun; Zhang, Yuan; Rong, Hui; Cao, Xuecheng; Wang, Pingshan

    2014-05-22

    A meta-analysis was performed to assess the association between healing rate, avascular necrosis (AVN) of femoral head and two reductions-open reduction internal fixation (ORIF) and closed reduction internal fixation (CRIF) for femoral neck fracture. A literature-based search was conducted to identify all relevant studies published before September 10, 2013. The odd ratio (OR) and 95% confidence interval (CI) were used for estimating the effects of the two reduction methods. Data were independently extracted by two investigators who reached a consensus on all of the items. The heterogeneity between studies was examined by χ2-based Q statistic. Egger's regression analysis was used to evaluate publication bias. Statistical analysis was performed by Stata 10.0 software. We examined 14 publications. The results of the present meta-analysis showed that AVN of femoral head were significant associated with the two reductions (CRIF vs. ORIF, OR=1.746, 95% CI 1.159-2.628, p=0.008), while the healing rate were not (CRIF vs. ORIF, OR=0.853, 95% CI 0.573-1.270, p=0.433). The present meta-analysis indicated the risk of AVN of femoral head was significant higher after CRIF fixation compared with ORIF, but no association between the healing rate and the two reductions for femoral neck fracture.

  13. External fixation versus open reduction and internal fixation for tibial pilon fractures: A meta-analysis based on observational studies

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    Yi-Chen Meng; Xu-Hui Zhou

    2016-01-01

    Purpose:Tibial pilon fractures remain challenging for an orthopaedic surgeon to repair.External fixation (ExFix) and open reduction and internal fixation (ORIF) are two widely used methods for repairing tibial pilon fractures.However,conclusions of comparative studies regarding which method is superior are controversial.Our aim is to compare ORIF and ExFix and clarify which method is better in terms of reduction and union results and major complications.Methods:A computerized research of MEDLINE,EMBASE,Springer,and Cochrane Library (before December 2014) for studies of any design comparing ORIF and ExFix was conducted.Weighted mean difference (WMD),risk ratio (RR) and corresponding 95% confidence intervals (CI) were used for estimating the effects of the two methods.Statistical analyses were done using Review Manager Version 5.2.Results:Ten cohort studies and one randomized clinical trial were included in our ultimate analysis.And the analysis found no significant difference between the two methods in deep infection (p =0.13),reduction (p =0.11),clinical evaluation (p =0.82),post-traumatic arthrosis (p =0.87),and union time (p =0.35).Besides,ExFix group was found to have a higher rate of superficial infection (p =0.001),malunion (p =0.01) and nonunion (p =0.02),but have a lower risk of unplanned hardware removal (p =0.0002).Conclusions:We suggest that ORIF has a relatively lower incidence rate of superficial infection,malunion and nonunion,but a higher rate of unplanned hardware removal.No difference was found in deep infection,reduction,clinical evaluation,post-traumatic arthrosis and union time.

  14. External fixation versus open reduction and internal fixation for tibial pilon fractures: A meta-analysis based on observational studies.

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    Meng, Yi-Chen; Zhou, Xu-Hui

    2016-10-01

    Tibial pilon fractures remain challenging for an orthopaedic surgeon to repair. External fixation (ExFix) and open reduction and internal fixation (ORIF) are two widely used methods for repairing tibial pilon fractures. However, conclusions of comparative studies regarding which method is superior are controversial. Our aim is to compare ORIF and ExFix and clarify which method is better in terms of reduction and union results and major complications. A computerized research of MEDLINE, EMBASE, Springer, and Cochrane Library (before December 2014) for studies of any design comparing ORIF and ExFix was conducted. Weighted mean difference (WMD), risk ratio (RR) and corresponding 95% confidence intervals (CI) were used for esti- mating the effects of the two methods. Statistical analyses were done using Review Manager Version 5.2. Ten cohort studies and one randomized clinical trial were included in our ultimate analysis. And the analysis found no significant difference between the two methods in deep infection (p = 0.13), reduction (p = 0.11), clinical evaluation (p = 0.82), post-traumatic arthrosis (p = 0.87), and union time (p = 0.35). Besides, ExFix group was found to have a higher rate of superficial infection (p =0.001), malunion (p = 0.01) and nonunion (p = 0.02), but have a lower risk of unplanned hardware removal (p = 0.0002). We suggest that ORIF has a relatively lower incidence rate of superficial infection, malunion and nonunion, but a higher rate of unplanned hardware removal. No difference was found in deep infection, reduction, clinical evaluation, post-traumatic arthrosis and union time.

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

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    Eckardt, Henrik; Lind, Dennis; Toendevold, Erik

    2015-01-01

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

  16. 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

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

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    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

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

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

    2013-01-01

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

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

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

    2013-01-01

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

  20. A meta-analysis of external fixation versus open reduction and internal fixation for complex tibial plateau fractures.

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    Zhao, Xing-Wen; Ma, Jian-Xiong; Ma, Xin-Long; Jiang, Xuan; Wang, Yin; Li, Fei; Lu, Bin

    2017-03-01

    Both external fixation (ExFx) and open reduction and internal fixation(ORIF) were used to treat complex tibial plateau fractures, but it was not sure which one was better. So we did this meta-analysis to evaluate the outcomes of ExFx and ORIF in managing complex tibial plateau fractures. Articles published before August 5, 2016 were selected from PubMed, Cochrane library, and some other electronic database. Relevant journals were also searched manually with no language limited. Two independent reviewers searched and assessed the literature. A fixed effect model was initially used for meta-analyses with RevMan 5.3. When compared with ORIF, cases undergoing ExFx were more likely to return to the preinjury state at the early stage, but no difference in the later period of follow-up. However, ExFx group had higher infection rate (OR 1.98, 95% CI 1.08-3.63, P = 0.03), higher venous thromboembolism rate (OR 1.56, 95% CI 0.49-4.96, P = 0.45), higher re-operation rate (OR 0.87, 95% CI 0.47-1.62, P = 0.66) and lower compartment syndrome rate (OR 0.61, 95% CI 0.12-3.22, P = 0.56), lower TKA rate (OR 0.51, 95% CI 0.20-1.34, P = 0.17). There were no statistically significant differences in the rate of deep infection, venous thromboembolism, compartment syndrome and VTE between the two groups. Although external fixation may offer some advantages, both were acceptable strategies in managing complex tibial plateau fractures. According to our analysis results, we strongly recommend that selection of definitive fixators should base on the fracture patterns, soft-tissue condition as well as the injury stages in clinical practice. More important, further multicentered, randomized controlled studies should be implemented to get a more reliable and clear result. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  1. The functional outcome of surgically treated unstable pelvic ring fractures by open reduction, internal fixation

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    Kaykhosro Mardanpour

    2011-07-01

    Full Text Available Background:Unstable Pelvic fracture,a result of high energy antero-posterior compression injury, has been managed based on internal fixation and open reduction. The mode of fixation in Unstable Pelvic fracture has, however, been a subject of controversy and some authors have proposed a need to address the issue of partial breach of the pelvic ring elements in these injuries. This study was performed to evaluate the functional and radiological results of treatment of pelvic ring fractures by open reduction, internal fixation. Methods: Thirty eight patients with unstable pelvic fractures, treated from 2002 to2008 were retrospectively reviewed. The mean age of patients’ was 37 years old (range 20 to 67. Twenty six patients were men and 12 women. The most common cause was a road traffic accident (N=37, 97%. There were 11 type-C and 27 type-B fractures according to Tile’s classification. Thirty six patients sustained additional injuries. The most prevalent additional injuries were lower extremity fractures. Open reduction, internal fixation as a definite management was applied for all patients. Quality of reduction was graded according to the grades proposed by Matta and Majeed’s score was used to assess the clinical outcome. The mean period of follow-up was 25 months (ranged from 6 to 109 months. About 81.6% of patients had either good or excellent radiological reduction. Results: The functional outcome was excellent in 66%, good in 15%, fair in 11% and poor in 7% of the patients. There were 4 postoperative infections. No sexual function problem was reported. Nerve deficits recovered completely in 2 and partially in 3 of 11 patients with preoperative neurologic deficiency. There was no significant relation between functional outcome and the site of fracture Conclusion: Unstable pelvic ring fracture injuries should be managed surgically by rigid stabilization that must be carried out as soon as the general ndition of the patient permits, and

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

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    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

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

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    Pendse Aniruddha

    2006-01-01

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

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

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    Fakoor

    2015-08-01

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

  5. 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

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

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    Keykhosro Mardanpour

    2013-07-01

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

  7. Hardware Removal Due to Infection after Open Reduction and Internal Fixation: Trends and Predictors

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    Mohammad Rasouli

    2015-07-01

    Full Text Available Background:  Little is known about trends and predictors of hardware related infection following open reduction and internal fixation (ORIF of extremity fractures, one of the major causes of failure following ORIF. The present study was designed and conducted to determine trends and predictors of infection-related hardware removal following ORIF of extremities using a nationally representative database. Methods:  We used Nationwide Inpatient Sample data from 2002 to 2011 to identify cases of ORIF following upper and lower extremity fractures, as well as cases that underwent infection-related hardware removal following ORIF. Multivariate analysis was performed to identify independent predictors of infection-related hardware removal, controlling for patient demographics and comorbidities, hospital characteristics, site of fracture, and year.  Results:   For all ORIF procedures, the highest rate of hardware removal related to infection was observed in tarsal fractures (5.56%, followed by tibial (3.65% and carpal (3.37% fractures. Hardware removal rates due to infection increased in all fractures except radial/ulnar fractures. Tarsal fractures(odds ratio (OR=1.06, 95% confidence interval (CI: 1.04-1.09, P

  8. 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.

  9. Ununited fracture neck of femur treated with closed reduction and internal fixation with cancellous screw and fibular strut graft

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    Singh Daria

    2006-01-01

    Full Text Available Background: Ununited fracture neck of femur in young adults has been tackled in various ways. Methods: Twenty five patients of ununited fracture neck of femur in age group 21-55 years were treated by closed reduction, cancellous screw fixation and fibular strut graft and followed up for 2-6 years. Time gap between injury and operation was 6 weeks to 58 weeks. Five cases were previously fixed with various fixation devices. Results: Osseous union was achieved in 24 cases with average time of 18.16 weeks. Main complication encountered in follow-up was avascular necrosis of femoral head, others were joint stiffness and shortening. Functional end results were good to excellent in 24 cases. Conclusion: Closed reduction with internal fixation by cancellous screw and fibular strut grafting is easy and useful procedure.

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

    Science.gov (United States)

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

    2016-01-01

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

  11. The Relationship of the Facial Nerve to the Condylar Process: A Cadaveric Study with Implications for Open Reduction Internal Fixation

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    Barham, H. P.; Collister, P.; V. D. Eusterman; Terella, A. M.

    2015-01-01

    Introduction. The mandibular condyle is the most common site of mandibular fracture. Surgical treatment of condylar fractures by open reduction and internal fixation (ORIF) demands direct visualization of the fracture. This project aimed to investigate the anatomic relationship of the tragus to the facial nerve and condylar process. Materials and Methods. Twelve fresh hemicadavers heads were used. An extended retromandibular/preauricular approach was utilized, with the incision being based pa...

  12. 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.

  13. Hardware Removal Due to Infection after Open Reduction and Internal Fixation: Trends and Predictors

    Science.gov (United States)

    Rasouli, Mohammad R.; Viola, Jessica; Maltenfort, Mitchell G.; Shahi, Alisina; Parvizi, Javad; Krieg, James C.

    2015-01-01

    Background: Little is known about trends and predictors of hardware related infection following open reduction and internal fixation (ORIF) of extremity fractures, one of the major causes of failure following ORIF. The present study was designed and conducted to determine trends and predictors of infection-related hardware removal following ORIF of extremities using a nationally representative database. Methods: We used Nationwide Inpatient Sample data from 2002 to 2011 to identify cases of ORIF following upper and lower extremity fractures, as well as cases that underwent infection-related hardware removal following ORIF. Multivariate analysis was performed to identify independent predictors of infection-related hardware removal, controlling for patient demographics and comorbidities, hospital characteristics, site of fracture, and year. Results: For all ORIF procedures, the highest rate of hardware removal related to infection was observed in tarsal fractures (5.56%), followed by tibial (3.65%) and carpal (3.37%) fractures. Hardware removal rates due to infection increased in all fractures except radial/ulnar fractures. Tarsal fractures(odds ratio (OR)=1.06, 95% confidence interval (CI): 1.04-1.09, P<0.001), tibial fractures (OR=1.04, 95% CI: 1.03-1.06, P<0.001) and those patients with diabetes mellitus (OR=2.64, 95% CI: 2.46-2.84, P<0.001), liver disease (OR=2.04, 95% CI: 1.84- 2.26, P<0.001), and rheumatoid arthritis (OR=2.06, 95% CI: 1.88-2.25 P<0.001) were the main predictors of infection-related removals; females were less likely to undergo removal due to infection (OR= 0.61, 95% CI: 0.59-0.63 P<0.001). Conclusions: Hardware removal rates due to infection increased in all fractures except radial/ulnar fractures. Diabetes, liver disease, and rheumatoid arthritis were important predictors of infection-related hardware removal. The study identified some risk factors for hardwarerelated infection following ORIF, such as diabetes, liver disease, and rheumatoid

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

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

    2015-10-01

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

  15. The retromandibular transparotid approach for reduction and rigid internal fixation using two locking miniplates in mandibular condylar neck fractures.

    Science.gov (United States)

    Kanno, T; Sukegawa, S; Tatsumi, H; Nariai, Y; Ishibashi, H; Furuki, Y; Sekine, J

    2014-02-01

    We evaluated the safety, efficacy, and morbidity associated with the treatment of displaced mandibular condylar neck fractures using a retromandibular transparotid approach to reduce and rigidly fix using two 2.0-mm locking miniplates. Our surgical inclusion criteria were: patient selection of open reduction and fixation, displaced unilateral condylar fractures with derangement of occlusion, and bilateral condylar fractures with an anterior open bite. The study group consisted of 19 patients who underwent surgery for 19 mandibular condylar neck fractures; patients were analyzed prospectively, with more than 6 months of follow-up, and were evaluated in terms of functional results, scar formation, postoperative complications, and stability of fixation. The results showed that functional occlusion identical to the preoperative condition and correct anatomical reduction of the condylar segments in centric occlusion, followed by immediate functional recovery, was achieved in all patients. No patient suffered from any major or permanent complication postoperatively, although there were two cases (11%) of temporary facial nerve palsy, which resolved completely within 3 months. Surgical scars were barely visible. The retromandibular transparotid approach with open reduction and rigid internal fixation for displaced condylar neck fractures of the mandible is a feasible and safe, minimally invasive surgical technique that provides reliable clinical results.

  16. 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.

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

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    Zacharia Facaros

    2010-10-01

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

  18. Efficacy of open reduction and internal fixation with a miniplate and hollow screw in the treatment of Lisfranc injury

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    Li Baoliang

    2015-07-01

    Full Text Available Purpose: To investigate efficacy of open reduction and internal fixation with the miniplate and hollow screw in the treatment of Lisfranc injury. Methods: Ten cases of Lisfranc injury treated by open reduction, miniplate and hollow screw in our hospital were retrospectively analyzed. There were 6 males and 4 females with age ranging from 25 to 45 years (mean 32 years. Among them, one case was classified as Type A, six Type B and three Type C. Injury mechanism included road traffic accidents (3 cases, fall from height (5 cases and hit by heavy object (2 cases. All injuries were closed without cerebral trauma or other complicated injuries. The time interval between injury and operation was 6e10 days (average 6.6 days. Postoperatively, the foot function was assessed using Visual Analogue Scales (VAS and American Orthopaedic Foot and Ankle Society (AOFAS Scales. Healing time and complications were observed. Results: All patients were followed up for 18e24 months (average 20 months. Anatomic reduction was achieved in all patients on images. There was statistical significance between preoperative score (7.89 ± 0.34 and score at postoperative 8 weeks (0.67 ± 0.13. According to the AOFAS score, 5 cases were defined as excellent, 3 cases as good and 2 cases as fair. During follow-up, there was no wound infection or complications except for osteoarthritis in 2 cases. Healing time ranged from 3 to 6 months with an average of 3.6 months. Conclusion: Anatomical reduction of Lisfranc injury can be achieved by open reduction and internal fixation with the miniplate and hollow screw. Normal structure of Lisfranc joint is regained to a great extent; injured ligaments were also repaired. Therefore, this method offers excellent curative effect and can avoid postoperative complications and improve the patients' quality of life.

  19. Efficacy of open reduction and internal fixation with a miniplate and hollow screw in the treatment of Lisfranc injury

    Institute of Scientific and Technical Information of China (English)

    Baoliang Li; Wenbo Zhao; Lei Liu; Fuguo Huang; Guanglin Wang; Yue Fang

    2015-01-01

    Purpose:To investigate efficacy of open reduction and internal fixation with the miniplate and hollow screw in the treatment of Lisfranc injury.Methods:Ten cases of Lisfranc injury treated by open reduction,miniplate and hollow screw in our hospital were retrospectively analyzed.There were 6 males and 4 females with age ranging from 25 to 45 years (mean 32 years).Among them,one case was classified as Type A,six Type B and three Type C.Injury mechanism included road traffic accidents (3 cases),fall from height (5 cases) and hit by heavy object (2 cases).All injuries were closed without cerebral trauma or other complicated injuries.The time interval between injury and operation was 6-10 days (average 6.6 days).Postoperatively,the foot function was assessed using Visual Analogue Scales (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) Scales.Healing time and complications were observed.Results:All patients were followed up for 18-24 months (average 20 months).Anatomic reduction was achieved in all patients on images.There was statistical significance between preoperative score (7.89 ± 0.34) and score at postoperative 8 weeks (0.67 ± 0.13).According to the AOFAS score,5 cases were defined as excellent,3 cases as good and 2 cases as fair.During follow-up,there was no wound infection or complications except for osteoarthritis in 2 cases.Healing time ranged from 3 to 6 months with an average of 3.6 months.Conclusion:Anatomical reduction of Lisfranc injury can be achieved by open reduction and internal fixation with the miniplate and hollow screw.Normal structure of Lisfranc joint is regained to a great extent;injured ligaments were also repaired.Therefore,this method offers excellent curative effect and can avoid postoperative complications and improve the patients' quality of life.

  20. Transmasseteric antero-parotid facelift approach for open reduction and internal fixation of condylar fractures

    OpenAIRE

    Choi, Moon-Gi

    2015-01-01

    Surgical approaches to the condylar fracture include intraoral, preauricular, submandibular, and retromandibular approaches. Each approach has its own advantages and disadvantages. When a patient needs esthetic results and an intraoral approach is not feasible, the transmasseteric antero-parotid facelift approach is considered. This approach permits direct exposure and allow the surgeon to fixate the fractured unit tangentially. Tangential fixation is critical to osteosynthesis. Disadvantages...

  1. Posterior Cruciate Ligament Tibial Avulsion treated with Open Reduction and Internal Fixation through the Burks and Schaffer Approach

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    Khatri K

    2015-07-01

    Full Text Available Objective: To report functional outcome in Posterior Cruciate Ligament (PCL tibial avulsion fractures treated with open reduction and internal fixation through Burks and Schaffer approach. The patient specific functional outcome measures like IKDC grading together with objective grading with stress radiographs have rarely been used to assess PCL tibial avulsion fractures. Material and Methods: Twenty seven patients (21 males and 6 females were included in the study. The mean follow up duration was 22.30±6.82 months. They were assessed using international knee documentation committee (IKDC grades, Lysholm scoring and stress radiography. The injury severity scores (ISS of the patients were also recorded. Results: The mean Lysholm scores at the time of last follow up was 90.85±5.58. The IKDC grades achieved were normal in 20 patients, near normal in five and abnormal in two. The PCL laxity determined on active hamstring contraction stress radiography was grade I in 20 cases and grade II in seven cases. All patients had achieved bony union of tibial avulsion fractures at the time of last follow up. Statistically significant association was found between higher ISS and lower Lysholm scores. (t=3.455, p=0.0019. Good IKDC grades were associated with higher Lysholm scores (analysis of variance, F=32.51, p<.0001.There was no correlation between PCL laxity and functional outcome (t=.857, p =0.399. Conclusion: PCL tibial avulsion fractures treated through Burk and Schaffer approach with open reduction and internal fixation produces good results. The early rehabilitation without cast immobilisation prevents arthrofibrosis.

  2. Incidence and risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture: A systematic review and meta-analysis.

    Science.gov (United States)

    Shao, Jiashen; Chang, Hengrui; Zhu, Yanbin; Chen, Wei; Zheng, Zhanle; Zhang, Huixin; Zhang, Yingze

    2017-05-01

    This study aimed to quantitatively summarize the risk factors associated with surgical site infection after open reduction and internal fixation of tibial plateau fracture. Medline, Embase, CNKI, Wanfang database and Cochrane central database were searched for relevant original studies from database inception to October 2016. Eligible studies had to meet quality assessment criteria according to the Newcastle-Ottawa Scale, and had to evaluate the risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture. Stata 11.0 software was used for this meta-analysis. Eight studies involving 2214 cases of tibial plateau fracture treated by open reduction and internal fixation and 219 cases of surgical site infection were included in this meta-analysis. The following parameters were identified as significant risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture (p internal fixation of tibial plateau fracture. Surgeons should be cognizant of these risks and give relevant preoperative advice. Copyright © 2017. Published by Elsevier Ltd.

  3. 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.

  4. 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

  5. Occult internal iliac arterial injury identified during open reduction internal fixation of an acetabular fracture: a report of two cases.

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    Chaus, George W; Heng, Marilyn; Smith, Raymond M

    2015-07-01

    We present two cases of occult internal iliac arterial injury identified during operative reduction of a widely displaced posterior column posterior wall acetabular fracture. This complication was not recognised until reduction of the column fracture. There were no preoperative signs or symptoms indicative of a vascular injury. These cases emphasise the heightened awareness one must have when treating widely displaced posterior column fractures of the acetabulum, especially those fractures with extension into the greater sciatic notch, as previously formed clot can become dislodged and hemostasis lost. We also present management options when this complication occurs. We believe any surgeon treating acetabular fractures should be aware of this serious and potentially fatal complication.

  6. Posteromedial approach of gastrocnemius for reduction and internal fixation of avulsed tibial attachment of posterior cruciate ligament

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chun-li; XU Hu; LI Ming-quan

    2006-01-01

    Objective:To introduce a posteromedial approach through the medial border of the medial head of gastrocnemius for reduction and reattachment of bony avulsion of the posterior cruciate ligament (PCL) from the tibia.Methods: Eleven patients with avulsed tibial attachment of the PCL underwent an operative reduction and internal fixation through the posteromedial approach of the gastrocnemius in our department from February 1998 to March 2000. The skin incision was reversed L-shaped along the medial border of the medial head of the gastrocnemius and the posterior capsule was exposed by dissecting the medial border and lateral retraction, avoiding the damage of the popliteal neurovascular structures. After that, the posterior capsule was vertically dissected a little medially to the posterior intercondylar sulcus and just on the posterior medial tibial eminence positioned by finger palpation. Then the PCL and its tibial attachment were easily accessible. In the delayed cases, PCL peripheral releasing was necessary to overcome the ligament retraction and to refresh the fracture bed for optimal reduction and bony healing. At last, one or two biodegradable screws were used to fix the avulsed bone segment and 30° flexion knee plaster cast immobilization was regularly applied after the wound was closed. The evaluation included X-ray, posterior sag sign and posterior drawer test compared with the contralateral side. The functional assessment of the low limbs was not available because of concomitant injuries.Results: The posteromedial approach of the gastrocnemius used in repair of tibial attachment avulsed injury of the PCL could provide benefit of clear anatomical exposure, few blood loss (20 ml on average), no need for detachment or reattachment of any structure. The patients were followed up for 11 months on an average (ranging from 6 months to 2 years ). It demonstrated that bony healing was achieved within 4-6 weeks in cases of fresh injury and 7-9 weeks in cases of

  7. Involvement of Residents Does Not Increase Postoperative Complications After Open Reduction Internal Fixation of Ankle Fractures: An Analysis of 3251 Cases.

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    Louie, Philip K; Schairer, William W; Haughom, Bryan D; Bell, Joshua A; Campbell, Kevin J; Levine, Brett R

    Ankle fractures are common injuries frequently treated by foot and ankle surgeons. Therefore, it has become a core competency for orthopedic residency training. Surgical educators must balance the task of training residents with optimizing patient outcomes and minimizing morbidity and mortality. The present study aimed to determine the effect of resident involvement on the 30-day postoperative complication rates after open reduction and internal fixation of ankle fractures. A second objective of the present study was to determine the independent risk factors for complications after this procedure. We identified patients in the American College of Surgeons National Surgical Quality Improvement Program database who had undergone open reduction internal fixation for ankle fractures from 2005 to 2012. Propensity score matching was used to help account for a potential selection bias. We performed univariate and multivariate analyses to identify the independent risk factors associated with short-term postoperative complications. A total of 3251 open reduction internal fixation procedures for ankle fractures were identified, of which 959 (29.4%) had resident involvement. Univariate (2.82% versus 4.54%; p = .024) and multivariate (odds ratio 0.71; p = .75) analyses demonstrated that resident involvement did not increase short-term complication rates. The independent risk factors for complications after open reduction internal fixation of ankle fractures included insulin-dependent diabetes, increasing age, higher American Society of Anesthesiologists score, and longer operative times. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  8. TREATMENT OF CLOSED TIBIAL PILON FRACTURES WITH OPEN REDUCTION, INTERNAL FIXATION AND BONE GRAFTING. A STUDY OF 22 CASES COMPARING THE OBJE CTIVE AND SUBJECTIVE EVALUATION

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    Athmaram

    2015-02-01

    Full Text Available The cases of twenty two fractures of the ankle joint that involved the tibial plafond were reviewed. The fractures were classified in to five types according to the severity of the injury. Open reduction and internal fixation was performed using one third tubular plate for fibula and recon plate for the tibia. Bone grafting was don e to augment the fixation and maintain the reduction . For each fracture treated Objective and Subjective evaluation is done. The objective and subjective scores are compared. With this method we noticed that the Type III & IV fractures also had a good or e xcellent result .

  9. LATE OPEN REDUCTION AND INTERNAL FIXATION FOR FRACTURES OF LATERAL CONDYLE OF HUMERUS IN CHILDREN: A CLINICAL STUDY

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    Ajay

    2013-10-01

    Full Text Available ABSTRACT: BACKGROUND : Neglected fracture of the lateral condyle of distal humerus in children is very common. Patients with non union of the lateral condylar fracture have pain, instability or a progressive cubitus valgus deformity, condylar prominence. A neglected displaced lateral humeral condyle fracture remains a difficult problem to treat. The bone ends become indistinct and soft tissue becomes contracted; making anatomic reduction difficult. Moreover a n attempt to mobilize the fragment by stripping the soft tissues may lead to avascular necrosis. Several authors have recommended operative treatment for such patients, while others do not recommend operative intervention because stiff elbow and AVN are th e usual outcomes. The present study was undertaken to assess the results of open reduction and internal fixation in neglected lateral humeral condyle fracture in children. MATERIAL AND METHODS : This is a prospective study carried out between November 2008 and July 2011 in the department of orthopedics at Teerthanker Mahaveer Medical College and research centre, Moradabad. Eighteen patients (14M:4F with an average age of 7.3years (range 5.5 to 14 years who had lateral humeral condyle fracture and reporte d 3 or more weeks after sustaining injury, were included in the study. The fractures were classified according to the Jacobs system. All patients were operated using the lateral approach and fixation was done using K wire or screw with or without bone graf ting. The results were graded as excellent, good, fair or poor according to the modified criteria of Agarwal et al. RESULTS : There were 14 males and 4 females with a mean age of 7 years and 3 months (range 4 - 14 years. Among the nine (50% patients who pr esented between 5 to 8 weeks after injury, the results were excellent in 3, good in 4, fair in 1 and poor in 1 patient. Excellent to good results were seen in all the five (27% patients presenting between 3 - 5 weeks of injury. Among

  10. Pitfalls associated with open reduction and internal fixation of fractured ribs.

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    Sarani, Babak; Schulte, Leah; Diaz, Jose J

    2015-12-01

    Rib fracture is exceedingly common and remains a leading cause of death in patients with chest injury. Probability of death increases by 19% with each broken rib, and the probability of death increases further with age. Treatment is centered on pain control and early mobilization to provide adequate pulmonary hygiene. Multimodality interventions, such as incentive spirometry, postural changes, and coughing, are pivotal in minimizing the risk of pneumonia and death. Recently, many studies have found mortality benefit to operation fixation (ORIF) of ribs in select patients. However, this procedure remains underutilized partly due to lack of familiarity with its technique and pitfalls by trauma surgeons, in particular. Whereas there are publications on operative technique, there are no studies describing pitfalls associated with this procedure. The purpose of this paper is to describe pitfalls on the technical aspects of ORIF of the ribs based on the medical literature where possible and based on our experience in instances where peer reviewed evidence is lacking. The paper is not meant to serve as a protocol for managing rib fractures. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

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    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.

  12. Quality of life following total hip arthroplasty in patients with acetabular fractures, previously managed by open reduction and internal fixation

    Institute of Scientific and Technical Information of China (English)

    Prasoon Kumar; Ramesh Kumar Sen; Vishal Kumar; Ankit Dadra

    2016-01-01

    Purpose:Total hip replacement (THR) is one of the most successful and cost-effective surgical procedures and remains the treatment of choice for long-term pain relief and restoration of function for patients with diseased or damaged hips.Acetabular fractures managed either conservatively or operatively by fixation tend to present later with secondary joint changes that require THR.In this study we evaluated the functional outcome and quality of life achieved by such patients.Methods:Our study was carried out as a retrospective trial by recruiting patients who underwent THR from June 2006 to May 2012.A total of 32 patients were included with a mean age of 46.08 years ranging from (25-65) years.We evaluated the quality of life in the patients using scoring techniques of Short Musculoskeletal Functional Assessment (SMFA) and the 12-Item Short Form Health Survey (SF-12).Functional outcome was assessed using Harris Hip Score (HHS).Results:The mean HHS of the patients was 84.3 with a range from 56 to 100.The SMFA averaged 13.3.The SF-12 score averaged 49.1.The correlation of the HHS with SF-12 was positive (p =0.001) while with SMFA there was a negative correlation (p =0.001).Conclusion:From this study it is inferred that the functional outcome of THR and quality of life in patients who had acetabular fractures and were initially managed by open reduction and internal fixation is good.

  13. Performance and Return to Sport After Clavicle Open Reduction and Internal Fixation in National Football League Players.

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    Jack, Robert A; Sochacki, Kyle R; Navarro, Sergio M; McCulloch, Patrick C; Lintner, David M; Harris, Joshua D

    2017-08-01

    Clavicle fractures are common injuries in professional football. Surgical fixation of these injuries may lead to decreased nonunion rates, improved shoulder strength, and decreased residual functional impairment. To determine (1) return-to-sport (RTS) rate in National Football League (NFL) players after clavicle fracture open reduction and internal fixation (ORIF), (2) postoperative career length and games per season, (3) pre- and postoperative performance, and (4) postoperative performance compared with control players matched by position, age, years of experience, and performance. Cohort study; Level of evidence, 3. Publicly available records were used to identify players who underwent surgical treatment of a clavicle fracture while playing in the NFL. Demographic and performance data were collected for each player, and matched controls were identified. Control and case performance scores were calculated using a standardized scoring system. RTS was defined as playing in 1 NFL game after surgery. Comparisons between case and control groups at preoperative and postoperative time points were made using paired-samples Student t tests. Seventeen surgeries (16 players) were analyzed. Fifteen players (94.1%) were able to RTS in the NFL at a mean 211.3 ± 144.7 days postsurgery; 7 (44%) returned within the same season as their injury and subsequent fixation. The overall rate of a player's remaining in the NFL 1 year after surgery was 88.2%. Players who underwent surgery played in a similar number of games per season and had similar career lengths in the NFL as controls (P > .05). There were no significant (P > .05) differences between cases and matched controls presurgery and preindex. There was no difference (P > .05) in postoperative performance scores or games per season compared with preoperative scores or games per season for any position. Quarterbacks (n = 3, P = .049) and running backs (n = 5, P = .039) had significantly worse postoperative performance scores when

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

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

    2013-07-01

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

  15. The Relationship of the Facial Nerve to the Condylar Process: A Cadaveric Study with Implications for Open Reduction Internal Fixation.

    Science.gov (United States)

    Barham, H P; Collister, P; Eusterman, V D; Terella, A M

    2015-01-01

    Introduction. The mandibular condyle is the most common site of mandibular fracture. Surgical treatment of condylar fractures by open reduction and internal fixation (ORIF) demands direct visualization of the fracture. This project aimed to investigate the anatomic relationship of the tragus to the facial nerve and condylar process. Materials and Methods. Twelve fresh hemicadavers heads were used. An extended retromandibular/preauricular approach was utilized, with the incision being based parallel to the posterior edge of the ramus. Measurements were obtained from the tragus to the facial nerve and condylar process. Results. The temporozygomatic division of the facial nerve was encountered during each approach, crossing the mandible at the condylar neck. The mean tissue depth separating the facial nerve from the condylar neck was 5.5 mm (range: 3.5 mm-7 mm, SD 1.2 mm). The upper division of the facial nerve crossed the posterior border of the condylar process on average 2.31 cm (SD 0.10 cm) anterior to the tragus. Conclusions. This study suggests that the temporozygomatic division of the facial nerve will be encountered in most approaches to the condylar process. As visualization of the relationship of the facial nerve to condyle is often limited, recognition that, on average, 5.5 mm of tissue separates condylar process from nerve should help reduce the incidence of facial nerve injury during this procedure.

  16. The Relationship of the Facial Nerve to the Condylar Process: A Cadaveric Study with Implications for Open Reduction Internal Fixation

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    H. P. Barham

    2015-01-01

    Full Text Available Introduction. The mandibular condyle is the most common site of mandibular fracture. Surgical treatment of condylar fractures by open reduction and internal fixation (ORIF demands direct visualization of the fracture. This project aimed to investigate the anatomic relationship of the tragus to the facial nerve and condylar process. Materials and Methods. Twelve fresh hemicadavers heads were used. An extended retromandibular/preauricular approach was utilized, with the incision being based parallel to the posterior edge of the ramus. Measurements were obtained from the tragus to the facial nerve and condylar process. Results. The temporozygomatic division of the facial nerve was encountered during each approach, crossing the mandible at the condylar neck. The mean tissue depth separating the facial nerve from the condylar neck was 5.5 mm (range: 3.5 mm–7 mm, SD 1.2 mm. The upper division of the facial nerve crossed the posterior border of the condylar process on average 2.31 cm (SD 0.10 cm anterior to the tragus. Conclusions. This study suggests that the temporozygomatic division of the facial nerve will be encountered in most approaches to the condylar process. As visualization of the relationship of the facial nerve to condyle is often limited, recognition that, on average, 5.5 mm of tissue separates condylar process from nerve should help reduce the incidence of facial nerve injury during this procedure.

  17. Bladder incarceration following anterior pelvic infix of a traumatic pubic symphysis diastasis treated with immediate open reduction and internal fixation.

    Science.gov (United States)

    Jain, Mantu; Nanda, Saurav Narayan; Mohapatra, Soumya Shrikanta; Samal, Barada Prasanna

    2017-08-01

    Stabilization after a pelvic fracture can be accomplished using multiple techniques. The anterior external fixator has been traditionally used in variety of unstable pelvis either singly or in combination of posterior screws. These devices are cumbersome and restrict side turning and sitting particularly in obese patients. An alternative, anterior subcutaneous pelvic internal fixation technique (ASPIF) was developed which is well tolerated by patients for mobility and comfort and biomechanically more stable construct Complications of this construct included irritation of the lateral femoral cutaneous nerve, femoral nerve palsy &heterotypic ossification with reduced rates of infections and aseptic loosening as compared to external fixator. Bladder incarceration following treatment has never been reported and we encountered such a problem during management which we want to highlight.

  18. 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.

  19. 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

  20. A Comparative Assessment of Postoperative Analgesic Efficacy of Lornoxicam versus Tramadol after Open Reduction and Internal Fixation of Mandibular Fractures.

    Science.gov (United States)

    Jain, Ankesh Dilip; Vsm, Ravisankar; Ksn, Siva Bharani; Km, Sudheesh; Tewathia, Nisha

    2017-09-01

    Pain after any surgical procedure is inevitable but can be controlled by administration of analgesics in most cases. Postoperative pain after surgical treatment of mandibular fractures can be treated by nonsteroidal anti-inflammatory drugs (NSAIDs) and opioid analgesics. The purpose of this study is to critically compare the postoperative analgesic efficacy of small doses of intravenous TRAMADOL (opioid analgesic) versus LORNOXICAM (NSAID) in patients with mandibular trauma undergoing open reduction and internal fixation (ORIF) and to assess the presence of any adverse effects due to NSAID or opioid use. Forty adult ASA grade I-II patients with mandibular trauma, scheduled for ORIF under general anesthesia in the Department of Oral and Maxillofacial Surgery, College of Dental Sciences, Davangere, were selected for the study. The patients were randomly assigned into a tramadol group (Group T) and a lornoxicam group (Group L) and were administered intravenous tramadol 50 mg and intravenous lornoxicam 8 mg, respectively, at specific postoperative intervals. Pain intensity was quantitatively assessed at the 2nd, 4th, 6th, 12th, and 24th postoperative hours using a visual analog scale of 10 cm. Adverse effects of the analgesics were also recorded and compared. Both the drugs resulted in a significant decrease in pain intensity from 2nd to 24th postoperative hours, but better pain control was observed in Group L at 24th postoperative hour. Only two patients experienced nausea and vomiting in Group T and one patient experienced gastric acidity in Group L. The comparative results clearly demonstrate that pain control by intravenous lornoxicam is significantly better than by intravenous tramadol at 24th postoperative hour after ORIF of mandibular trauma. Side effects produced by both the drugs were minor and had no apparent effect on the study results.

  1. High Prevalence of Chronic Pain With Neuropathic Characteristics After Open Reduction and Internal Fixation of Ankle Fractures.

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    Rbia, Nadia; van der Vlies, Cornelis H; Cleffken, Berry I; Selles, Ruud W; Hovius, Steven E R; Nijhuis, Tim H J

    2017-09-01

    Unstable ankle fractures require treatment with open reduction and internal fixation (ORIF). Long-term functional outcome is satisfying in most patients; however, a number of patients have persistent complaints. Superficial nerve complications following ankle surgery may be the cause of chronic pain and disability. In this observational retrospective survey, a cohort of 527 women and men, who underwent ORIF in the period from January 2007 to January 2014, were invited to an online questionnaire. Pain symptoms were assessed using the McGill Pain Questionnaire (MPQ) and the Douleur Neuropathic en 4 Questions (DN4) Questionnaire. Descriptive statistics were used to present patient characteristics; a logistic regression model was used to analyze prognostic factors of neuropathic pain. A total of 271 patients completed the questionnaire. Mean follow-up period was 5.8 years (±1.9). Persistent neuropathic pain symptoms were present in 61 of all patients, and 51 of these patients reported an impaired quality of life caused by their symptoms. In univariate analysis, the following parameters were associated with neuropathic pain: age, hypertension, a thyroid disorder, lower back pain, fracture dislocations, and late complications such as nonunion, posttraumatic arthritis, or osteochondral injury. In multivariate analysis, an age between 40 and 60 years was found to be a significant predictor of neuropathic pain. Hypertension, dislocation, and late complications were significant predictors of persistent pain without neuropathic characteristics. The present study demonstrated a prevalence of persistent neuropathic pain symptoms after ORIF for ankle fractures in 23% of the respondents, which caused an impaired health-related quality of life. We identified 4 significant predictors of chronic and neuropathic pain after ORIF. This knowledge may aid the treating surgeon to identify patients who are at increased risk of persistent postoperative neuropathic pain and may affect the

  2. Does Extraction or Retention of the Wisdom Tooth at the Time of Surgery for Open Reduction and Internal Fixation of the Mandible Alter the Patient Outcome?

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    Hammond, Douglas; Parmar, Sat; Whitty, Justin; Pigadas, Nick

    2015-01-01

    Whether to extract or retain wisdom teeth present in a fracture line is a controversial topic. This study reviewed the records of all patients who had mandibular wisdom teeth at the time of the injury, and had an open reduction and internal fixation procedure between January 2009 and January 2012. The cohort of patients who concomitantly had their wisdom tooth extracted at the time of fixation had a greater complication rate (24.3%) compared with patients who did not (14.9%). This suggests that if third molars in the line of a fracture have caries, are fractured, show signs of pericoronitis, are periodontally involved, or are interfering with the occlusion are extracted at the time of fixation, this will increase the incidence of complications. PMID:26576231

  3. The "bony Bankart bridge" procedure: a new arthroscopic technique for reduction and internal fixation of a bony Bankart lesion.

    Science.gov (United States)

    Millett, Peter J; Braun, Sepp

    2009-01-01

    Arthroscopic treatment of bony Bankart lesions can be challenging. We present a new easy and reproducible technique for arthroscopic reduction and suture anchor fixation of bony Bankart fragments. A suture anchor is placed medially to the fracture on the glenoid neck, and its sutures are passed around the bony fragment through the soft tissue including the inferior glenohumeral ligament complex. The sutures of this anchor are loaded in a second anchor that is placed on the glenoid face. This creates a nontilting 2-point fixation that compresses the fragment into its bed. By use of the standard technique, additional suture anchors are used superiorly and inferiorly to the bony Bankart piece to repair the labrum and shift the joint capsule. We call this the "bony Bankart bridge" procedure.

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

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    Hussain Shahid

    2014-06-01

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

  5. 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

  6. External fixation combined with limited internal fixation in the treatment of pilon tibia fractures

    Directory of Open Access Journals (Sweden)

    Golubović Zoran

    2007-01-01

    Full Text Available Background/Aim. Intraarticular fractures of the tibial plafond (pilon fractures belong to the group of most severe fractures. They are usually caused by high-energy trauma and frequently associated with a marked soft-tissue damage. Surgical treatment has replaced the traditional nonoperative treatment. The aim of this study was to present the results of the treatment of distal tibial intraarticular fracture by the use of internal fixation, as well as the combination of minimal internal fixation and external fixation. Methods. The study included 47 patients with pilon tibia fractures who went through at the Clinic for Orthopedics and Traumatology, School of Medicine, Niš (1995-2004. Within the analyzed group there were 33 (70.2% males and 14 (29.8% females. The patients mean age was 45.8 years. In the first group, which consisted of 22 patients, open reduction and internal fixation of both the tibia and the fibula was performed in the two separate incisions. The second group consisted of 25 patients managed with external fixation by external fixator "Mitković" with limited internal fixation. Besides external fixation, a minimal internal fixation was performed by the use of Kirschner wires and screws. The patients were followed-up inside a 24-months-period. Results. The obtained was a substantially high number of complications after open reduction and internal fixation in the group of patients. There was no difference in a long-term clinical outcome. Postoperative osteitis, as the most severe complication in the management of closed pilon tibia fractures, was not registered in the second group. Conclusion. Considering the results obtained in this study, it can be concluded that external fixation by the "Mitković" external fixator with the minimal internal fixation is a satisfactory method for the treatment of fractures of the tibial plafond causing less complications than internal fixation. .

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

    Institute of Scientific and Technical Information of China (English)

    朴成哲; 李培; 阿良; 王敏

    2003-01-01

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

  8. 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.

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

    Institute of Scientific and Technical Information of China (English)

    Shahid Hussain; Manzoor Ahmad; Tufail Muzaffar

    2014-01-01

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

  10. Effects of three-dimensional navigation on intraoperative management and early postoperative outcome after open reduction and internal fixation of displaced acetabular fractures

    DEFF Research Database (Denmark)

    Oberst, Michael; Hauschild, Oliver; Konstantinidis, Lukas;

    2012-01-01

    BACKGROUND: This study was conducted to evaluate whether intraoperative procedure and/or early postoperative results after open reduction and internal fixation (ORIF) of displaced acetabulum fractures are influenced by the use of a three-dimensional (3D) image intensifier in combination with a na....... In addition, the complication rate in the navigated group was significantly lower. CONCLUSION: We support the use of navigation systems and a 3D image intensifier as helpful tools during ORIF of displaced acetabular fractures. LEVEL OF EVIDENCE: Therapeutic study, level III....... acetabular fractures led to a significant increase in skin-to-skin time. Postoperative radiolographic analysis revealed an improvement in the quality of fracture reduction in the 3D navigation group. Navigation in combination with the 3D images of the ISO-C 3D limited the need for extended approaches...

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    Dominik Seybold

    2011-01-01

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

  13. Posterior reduction and internal fixation with posterior cranial fossa cranioectomy decompression for Chiari malformation type Ⅰ with basilar invagination, atlantoaxial subluxation, and syringomyelia

    Directory of Open Access Journals (Sweden)

    HU Peng

    2012-08-01

    Full Text Available Background Chiari malformation type Ⅰ(CM-Ⅰ is one of the soft tissue anomalies in craniovertebral junction (CVJ. This kind of soft tissue anomaly usually develops with bone anomaly, such as atlantoaxial subluxation, basilar invagination, platybasia, C1 assimilation, etc. For these complex combined anomalies, the treatment remains unaddressed. This study was performed to evaluate the effect of posterior reduction and internal fixation with posterior cranial fossa cranioectomy decompression for Chiari malformation type Ⅰ with basilar invagination, atlantoaxial subluxation, and syringomyelia. Methods Patients with basilar invagination and atlantoaxial subluxation treated from July 2004 to September 2011 were reviewed. Including criterions were made to screen matching patients. Including patients were retrospectively analyzed on both clinical outcomes and radiographical results. Japanese Orthopaedic Association (JOA score was used to evaluate the clinical outcomes, while the syrinx maximum size was measured on transverse view of MRI T2 image. The results were analyzed by SPSS 17.0 using t -text. Significant difference was considered when P ≤ 0.05. Results Fourteen patients met the including criterions, including 4 male patients and 10 female patients, with a mean age of 31.86 ± 11.36 (standard deviation, range: 17-51 years. Mean JOA score preoperatively of 14 patients was 13.07 ± 1.59 (standard deviation, while that was 15.57 ± 1.02 (standard deviation postoperatively (t = 9.946, P = 0.000. The mean syrinx size was (7.05 ± 1.98 mm (standard deviation, while that was (2.21 ± 1.91 mm (standard deviation postoperatively (t = 7.271, P = 0.000. There were no procedure-related morbidity or mortality happened. Conclusion Direct posterior reduction and internal fixation with posterior cranial fossa cranioectomy decompression can obviously improve the clinical outcomes and shrink syrinx for patients suffered from Chiari malformation typeⅠ with

  14. Comparison between radial head arthroplasty and open reduction and internal fixation in patients with radial head fractures (modified Mason type III and IV): a meta-analysis.

    Science.gov (United States)

    Sun, Hao; Duan, Jun; Li, Fengsheng

    2016-04-01

    Open reduction and internal fixation (ORIF) and radial head arthroplasty (RHA) are the most common operative treatments in patients with radial head fractures. The purpose of this study was to determine the efficacy of RHA and ORIF treatments in patients with radial head fractures (modified Mason type III and IV). We conducted a computerized search of five electronic databases from their inception to July 2015. All clinical trials comparing ORIF versus RHA treatment in patients with radial head fractures were included. We evaluated the primary outcomes included elbow functional evaluation criteria by Broberg and Morrey, elbow score (Broberg and Morrey), Mayo Elbow Performance Score (MEPS) and QuickDASH score. Secondary outcomes included Visual Analog Scale (VAS), range of motion, operation time and complications. The "assessing risk of bias" table was applied to assess the risk of bias of the included studies. Eight studies were included in this meta-analysis, which consisted of 138 cases of ORIF and 181 RHA. Methodological quality of the studies was moderate to low. RHA afforded significantly higher satisfaction rate, better elbow score (Broberg and Morrey) and MEPS, shorter operation time, lower incidence of bone nonunion or absorption and internal fixation failure when compared to ORIF. There were no significantly differences in QuickDASH score and other complications. RHA has better outcome in patients with radial head fractures (modified Mason type III and IV) than ORIF with medium-short-term follow-up period, but longer-term studies will be required to ascertain whether the apparent benefits of RHA were offset by late complications. Therapeutic decision analysis; a meta-analysis, Level III.

  15. Open reduction and internal fixation of Ideberg IV and V glenoid intra-articular fractures through a Judet approach: a retrospective analysis of 11 cases.

    Science.gov (United States)

    Hu, Chuanzhen; Zhang, Weibin; Qin, Hui; Shen, Yuhui; Xue, Zichao; Ding, Haoliang; An, Zhiquan

    2015-02-01

    To evaluate the methods and the outcomes of complex intra-articular glenoid fractures, treated by open reduction and internal fixations. The outcomes of 11 cases of complex intra-articular glenoid scapular fractures were retrospectively analyzed. The fractures were classified as type IV in five cases, type Va in two and Vb in four cases, according to Ideberg classification system. The mean step or gap between the main articular fragments was 6.3 ± 6.2 (4-25) mm. The fractures were openly reduced through a Judet approach and fixed with reconstructive plates or bands placed on the lateral and medial side of affected scapula, respectively. The main articular fragments were strengthened with a 4.0-mm cannulated screw in five cases. The bone union, the anterior flexion, the external and internal rotation of the shoulders were checked and recorded. The functional outcomes were evaluated using DASH questionnaire, Constant and UCLA shoulder score systems, respectively. 11 patients were followed up with an average of 28.2 ± 12.6 (12-50) months. All the fractures were united smoothly without second intervention. At the latest visiting, the mean anterior flexion of affected shoulder was 157.3 ± 7.37° (range 150°-170°), the mean external rotation of the affected shoulder was 58.2 ± 7.5° (range 50°-70°). When the shoulder in the internal rotation, the extended thumb reached to L4 or L1 or T10 or T7 in one case, to T12 in two cases and to T8 in four cases, respectively, the mean Constant score was 91.7 ± 2.8 (86-96) points. The mean UCLA score was 32.7 ± 1.7 (30-35) points, leading to four cases of excellent and seven cases of good results. The mean DASH score was 7.4 ± 3.3 (3.4-13) points. Good outcomes could be obtained when Ideberg IV and V glenoid fractures were treated by open reduction and internal fixation through a Judet approach.

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

    Directory of Open Access Journals (Sweden)

    Bhavani Prasad

    2015-06-01

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

  17. 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.

  18. Long-term results of Galeazzi-equivalent injuries in adolescents--open reduction and internal fixation of the ulna.

    Science.gov (United States)

    Cha, Soo Min; Shin, Hyun Dae; Jeon, Je Hyung

    2016-03-01

    We diagnosed 10 Galeazzi-equivalent injuries. We report the radiological and clinical results at the end of growth in adolescents, including the results of ulnar lengthening. This study included 10 Galeazzi-equivalent injuries (seven patients requiring open reduction and three requiring closed reduction for ulnar lesions) seen since 2004. The periosteum was entrapped around the fractured physis in five patients and the extensor carpi ulnaris to the periosteum was interposed in two patients. Among the seven patients, ulnar lengthening was performed in only three patients. Ulnar variances at the time of the lengthening were -6, -6, and -5 mm. Gradual lengthening was performed. Radiologic abnormalities, including the ulnar variances, were investigated at the end of growth. In addition, pain scores, the range of wrist motion, and grip strength were evaluated and compared with nonlengthened ulnas. The mean age of the patients at the final follow-up was 19.7 years, and the mean total follow-up period was 6 years. The final ulnar variances were -5, -5, -3, and 0 mm in four patients with nonlengthened ulnas among the seven patients. Three patients with lengthened ulnas showed final neutral variances. In four nonlengthened ulnas, three ulnas bowed to the radial side and two ulnar heads had an inclined and deformed shape. Joint mismatch of the distal radioulnar joint surface was found in one patient with lengthened and one with nonlengthened ulnas. Three patients with nonlengthened ulnas showed decreased range of wrist motions. Comparison of contralateral grip strength indicated a significant difference between patients with or without lengthened ulnas. Long-term follow-up after Galeazzi-equivalent injuries may be essential to check for premature epiphyseal closure, length discrepancies, or joint incongruency. A procedure for a shortened ulna could be needed; however, the appropriate time and degree of lengthening remain to be investigated.

  19. 两种手术方法治疗儿童不可复性肱骨髁上骨折的疗效比较%Limited open reduction with internal fixation versus closed reduction with external fixation in the treatment of irreducible supracondylar humerus fractures in children: an outcome comparison

    Institute of Scientific and Technical Information of China (English)

    李凡; 李明静; 刘郁东; 徐剑; 胡涛

    2016-01-01

    目的 比较有限切开复位克氏针经皮内固定与闭合复位外固定支架外固定治疗儿童不可复性肱骨髁上骨折的疗效.方法 自2012年1月至2014年1月,我们共收治34例儿童不可复性Gartland Ⅲ型肱骨髁上骨折患儿,其中18例行有限切开复位克氏针经皮内固定(内固定组),16例行闭合复位外固定支架外固定(外固定组).比较两组患儿的手术时间、术中透视次数、骨折愈合时间、术后3d与2个月时Baumann角的变化及肘关节功能.结果 术后所有患儿均获得随访,时间为12~24个月,平均16.5个月.内固定组手术时间(49.1±6.6)min较外固定组(72.3±12.6)min短,术中透视次数(3.6±0.9)次较外固定组(10.1±2.0)次少,差异均有统计学意义(P<0.05).两组患儿均在术后4周获骨折临床愈合,术后2个月获骨性愈合.内固定组术后3d与2个月时Baumann角变化(2.4±1.3)°与外固定组(6.1±2.1)°比较,差异有统计学意义(P< 0.0001).按照Flynn肘关节评分标准评定疗效:术后3个月内固定组优良率为27.8%(5/18),外固定组为25.0%(4/16);术后1年内固定组优良率为99.4%(17/18)、外固定组为81.3%(13/16).两组患儿均无骨折延迟愈合、骨筋膜室综合征及医源性血管神经损伤等并发症.结论 有限切开复位克氏针经皮内固定与闭合复位外固定支架外固定治疗儿童不可复性Gartland Ⅲ型肱骨髁上骨折,骨折愈合时间相同,但前者可获得更满意的复位、更稳定的固定、更好的肘关节功能,而且手术时间短,术中透视次数少.%Objective To compare the clinical results of treating irreducible supracondylar humerus fractures (Gartland type Ⅲ) in children with limited open reduction and internal fixation versus closed reduction with external fixator.Methods The clinical data of 34 pediatric patients who had been treated for supracondylar humerus fractures (Gartland type Ⅲ) from January 2012 to January 2014 were

  20. Functional Outcome of Internal Fixation of Radial and Ulna Fracture

    Directory of Open Access Journals (Sweden)

    mehrdad Mansouri

    2006-02-01

    Conclusion: Anatomic reduction and internal fixation is the standard method for treatment of fractures by displacing radios and ulna in adults. According to results, it seems more intension to motions specially pronation and muscle strengthening foream after surgery will have affect on improving patients’ function specially pronation and Grip strength.

  1. 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.

  2. The application of closed reduction internal fixation and iliac bone block grafting in the treatment of acute displaced femoral neck fractures.

    Directory of Open Access Journals (Sweden)

    Zhiyong Li

    Full Text Available OBJECTIVE: This study aimed to evaluate the preliminary clinical and radiographic outcomes of acute displaced femoral neck fracture treated by closed reduction and internal fixation (CRIF with free iliac bone block grafting with comparison to a routine protocol of CRIF without bone grafting. METHODS: From December 2008 to February 2010, 220 adult patients with acute displaced femoral neck fractures were enrolled in this study. In study group, there were 124 patients (57 males, 67 females with a mean age of 44.8 years (range, 20-64 years. There were 70 transcervical fractures and 54 subcapital fractures. The patients were treated by CRIF and free iliac bone block grafting. The control group consisted of 96 adult patients (46 males, 50 females with a mean age of 46.3 years (range, 23-64 years. There were 61 transcervical fractures and 35 subcapital fractures. The patients in control group were treated by CRIF without bone grafting. RESULTS: In study group, 112 patients were followed up for an average of 27.4 months (range, 24-34 months. All fractures healed within 5 months. However, 10 patients presented AVN of the femoral heads. The mean Harris score was 88.6 (range, 41-100. In control group, 68 patients were followed up for an average of 31.2 months (range, 24-42 months. The rates of AVN of the femoral head and fracture nonunion in control group were 26.5% (18/68 and 16.2% (11/68, respectively, significantly higher than those in study group (both P<0.05. The mean Harris score in control group was 83.8 (41-100, significantly lower than that in study group (P<0.05. CONCLUSION: Acute displaced femoral neck fractures can be treated by CRIF and free iliac bone block grafting in a minimally invasive manner. This technique can guarantee uneventful fracture healing and significantly reduce the rate of femoral head osteonecrosis.

  3. Does Open Reduction and Internal Fixation versus Primary Arthrodesis Improve Patient Outcomes for Lisfranc Trauma? A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Smith, Nicholas; Stone, Craig; Furey, Andrew

    2016-06-01

    Although Lisfranc injuries are uncommon, representing approximately 0.2% of all fractures, they are complex and can result in persistent pain, degenerative arthritis, and loss of function. Both open reduction and internal fixation (ORIF) and primary fusion have been proposed as treatment options for these injuries, but debate remains as to which approach is better. We asked whether ORIF or primary fusion led to (1) fewer reoperations for hardware removal; (2) less frequent revision surgery; (3) higher patient outcome scores; and (4) more frequent anatomic reduction. A systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Three trials met the criteria for inclusion within the meta-analysis. Qualifying articles for the meta-analysis had data extracted independently by two authors (NS, AF). The quality of each study was assessed using the Center for Evidence Based Medicine's evaluation strategy; data were extracted from articles rated as good and fair: two and one article, respectively. The risk ratio for hardware removal was 0.23 (95% confidence interval [CI], 0.11-0.45; p < 0.001) indicating more hardware removal for ORIF than fusion. For other revision surgery, the risk ratio for ORIF was 0.36 (95% CI, 0.08-1.59; p = 0.18) favoring neither. Similarly, neither was favored using patient-reported outcomes; the standard mean difference was calculated to be 0.50 (95% CI, -2.13 to 3.12; p = 0.71). When considering the risk of nonanatomic alignment, neither was favored (risk ratio, 1.48; 95% CI, 0.34-6.38; p = 0.60). The surgeon should consider the increased risk of hardware removal along with its associated morbidity and discuss this with the patient preoperatively when considering ORIF of Lisfranc injuries. Because no new trials have been performed since 2012, further randomized controlled trials will be needed improve our understanding of these interventions. Level I, therapeutic study.

  4. THE DISTRACTION REDUCTION FIXATION SYSTEM AND ITS APPLICATION IN SPONDYLOLISTHESIS

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective. An internal fixation apparatus— — distraction reduction fixation system(DRFS) was designed to satisfy the clinical needs for spondylolisthesis. Methods. Since 1996, 53 patients were treated with DRFS. Among them, 35 had spondylolisthesis, 12 had lumbar canal stenosis accompanied with instability, 2 had vertebral tumors and 4 suffered from spinal fracture. The average age was 53.6 years old (ranged 24~ 72yrs). The mean time for follow-up was 30.6 months (16 ~ 44 months). Results. The slip rate was 0.15± 0.10 before operation, and decreased to 0.09± 0.07 after operation. Entire slip reposition was achieved in 19 cases (54.3% ). The change in height of the intervertebral space within the fixation segments was 0.7± 0.17. Conclusion. DRFS achieved better results for spondylolisthesis less II degree and no other adverse effects were found. Compared with other foreign and domestic techniques, it had advantages in less implants, less operation gears required and ease to utilize in operation. It was proved to be an ideal internal fixation apparatus.

  5. 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。

  6. 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.

  7. Eighth international congress on nitrogen fixation. Final program

    Energy Technology Data Exchange (ETDEWEB)

    1990-12-31

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

  8. 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.

  9. 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

  10. Influencing factors of prognosis of open reduction and internal fixation for Pilon frecture%切开复位内固定治疗Pilon骨折预后影响因素分析

    Institute of Scientific and Technical Information of China (English)

    郑吉高

    2014-01-01

    目的:探讨切开复位内固定治疗 Pilon 骨折临床疗效影响因素。方法对60例切开复位内固定治疗Pilon 骨折患者的临床资料进行回顾性分析,并对影响手术疗效的相关因素进行分析。结果合并深部感染和创伤性关节炎的患者骨折分型越高、骨折复位情况越差,预后越差(P <0.01)。结论影响切开复位内固定治疗 Pilon 骨折预后的影响因素包括骨折分型、骨折复位、合并深部感染和创伤性关节炎。%Objective To discuss influencing factors of prognosis clinical efficacy of open reduction and internal fixation for Pilon frecture. Methods Clinical data of 60 cases with open reduction and internal fixation for Pilon frecture were retrospectively analyzed. Influencing factors of clinical efficacy were analyzed. Results Cases with higher frecture classification, worse reduction of fracture, complicated with deep fungal infection and traumatic arthritis showed worse clinical efficacy(P < 0.01). Conclusion Frecture classification,reduction of fracture, complicated with deep fungal infection and traumatic arthritis are influencing factors of clinical efficacy of open reduction and internal fixation for Pilon frecture.

  11. Closed Reduction and Percutaneous Fixation of Calcaneal Fractures in Children.

    Science.gov (United States)

    Feng, Yongzeng; Yu, Yang; Shui, Xiaolong; Ying, Xiaozhou; Cai, Leyi; Hong, Jianjun

    2016-07-01

    Open reduction and internal fixation has been widely used to treat displaced intra-articular calcaneus fractures in children. However, the complications of surgical trauma and the wound created through the extended lateral approach cannot be ignored. This study analyzed the outcomes of displaced intra-articular calcaneal fractures in children treated with closed reduction and percutaneous fixation. Medical records of pediatric patients who had displaced intra-articular calcaneus fractures and underwent closed reduction and percutaneous fixation at the study institution between January 2008 and January 2013 were reviewed. Preoperative radiographs and computed tomography scans were used to evaluate and classify the fractures. Clinical outcomes and radiographic findings were assessed at postoperative follow-up. The study included 14 displaced intra-articular calcaneal fractures in 11 patients (7 boys and 4 girls). Mean patient age was 11.18 years (range, 6-16 years), and average follow-up time was 42.8 months postoperatively (range, 12-72 months). There were 6 tongue-type fractures and 8 joint depression-type fractures, based on the Essex-Lopresti classification, and there were 11 type II and 3 type III fractures, based on the Sanders classification. Average Böhler angle was 8.00° (range, -5° to 18°) preoperatively and 30.79° (range, 26° to 40°) postoperatively (P<.001). Average subjective American Orthopaedic Foot and Ankle Society hindfoot score was 65.7 (range, 52-68). No patients had wound breakdown or infection. In the treatment of displaced intra-articular calcaneal fractures in pediatric patients, closed reduction and percutaneous fixation achieved good outcomes, with few complications. [Orthopedics. 2016; 39(4):e744-e748.]. Copyright 2016, SLACK Incorporated.

  12. Endoscopically assisted reduction and fixation of condylar neck/base fractures--The learning curve.

    Science.gov (United States)

    Loukota, R A

    2006-12-01

    Following the introduction of a new technique for fixation of fractures of the condylar neck and base in our department, the operative times were compared with those for the traditional and frequently used method of open reduction and internal fixation. A distinct learning curve was seen.

  13. 胫腓骨骨折切开复位内固定与单臂外固定架治疗骨折疗效对比分析%The comparative analysis of the treatment of fractures tibia and fibula fractures with open reduction and internal fixation with a single-arm external fixator

    Institute of Scientific and Technical Information of China (English)

    尹怀林

    2013-01-01

      目的研究分析胫腓骨骨折切开复位内固定与单臂外固定架治疗骨折的疗效.方法以82例胫腓骨骨折患者为研究对象,随机分为两组,内固定组给予切开复位内固定治疗,外固定组给予单臂外固定架治疗,对比观察两组治疗效果.结果外固定组患者成骨性愈合率较高,功能完全正常率高,患者术后并发症少,与对照组比较,P <0.05,差异有统计学意义.结论对胫腓骨骨折患者给予单臂外固定架治疗具有较好的效果.%Objective To study analysis of the tibia and fibula fracture ORIF arm external fixator fractures. Methods 82 cases of tibia and fibula fracture patients for the study were randomly divided into two groups,internal fixation group were treated with open reduction and internal fixation of the external fixation group was given a single arm external fixator,comparing the effect of treatment were observed. Results Patients with external fixation group into a higher rate of bone healing,the function is completely normal rate, fewer postoperative complications,compared with the control group(P < 0.05),the difference was statistically significant. Conclusion The tibia and fibula fracture patients given arm external fixator with good results.

  14. THE DISTRACTION REDUCTION FIXATION SYSTEM AND ITS APPLICATION IN SPONDYLOLISTHESIS

    Institute of Scientific and Technical Information of China (English)

    王以朋; 叶启彬; 邱贵兴; 林进; 张嘉

    2001-01-01

    Objective. An internal fiLxation apparatus ——distraction reduction fixation system (DRFS) was designed to satisfy the clinical needs for spondylolisthesis. Methods. Since 1996, 53 patients were treated with DRFS. Among them, 35 had spondylolisthesis, 12 had lumbar canal stenesis accompanied with instability, 2 had vertebral tumors and 4 suffered from spinal fracture.The average age was 53.6 years old (ranged 24 -72yrs). The mean time for follow-up was 30. 6 months (16 -44 months). Results. The slip rate was 0. 15 ±0. 10 before operation, and decreased to 0. 09 ± 0. 07 after operation. Entireslip reposition was achieved in 19 cases (54. 3% ). The change in height of the intervertebral space within the fixation segments was 0. 7 ± 0. 17. Conclusion. DRFS achieved better results for spondylolisthesis less Ⅱ degree and no other adverse effects werefound. Compared with other foreign and domestic techniques, it had advantages in less implants, less operationgears required and ease to utilize in operation. It was proved to be an ideal internal fixation apparatus.

  15. Open reduction and internal fixation of tibia and fibula fractures in 60 patients%切开复位内固定术治疗胫腓骨骨折60例临床观察

    Institute of Scientific and Technical Information of China (English)

    任宇宏

    2012-01-01

      目的:探讨切开复位内固定术治疗胫腓骨骨折的临床疗效。方法:对60例胫腓骨骨折患者进行切开复位内固定术治疗,观察治疗效果,并进行术后随访6~18个月。结果:术后复查X线示所有病例均复位良好,无切口感染,骨折愈合情况为:优42例,良12例,可6例,优良率为90%。结论:胫腓骨骨折通过切开复位内固定疗法有较好的临床效果,值得临床进一步推广应用。%  Objiective Explore open reduction and internal fixation for pertrochanteric fractures of the clinical curative effect.Methods Sixty cases of patients with fracture of tibial fibula line open reduction and internal fixation for treatment,Curative effect,and patients were followed up for 6 to 10 months.Results Postoperative X line and review all the cases reset good,no incision infection,Fracture healing for:optimal 42 cases good in 12 cases,can be in 6,was 90%.Conclusion Tibial fibula through the internal fixation,Worth clinical further popularized.

  16. 寰枢椎脱位术中复位技术及内固定的研究进展%Intraoperative reduction and internal fixation for atlanto-axial dislocation

    Institute of Scientific and Technical Information of China (English)

    武乐成; 倪斌

    2016-01-01

    寰枢椎复合体是颈椎中最重要的功能单位.寰枢关节失稳或脱位,是脊柱外科的急重症之一.临床上多通过后路寰枢椎融合术重建寰椎复合体的稳定性.寰枢椎后路融合技术的发展经历了钢丝或钛缆捆扎固定、椎板夹固定、经寰枢关节螺钉固定、以及后来的钉板固定和钉棒固定等过程.对于术前牵引未能复位者,需进行术中复位.本文主要就以上术中复位技术和内固定方法进行综述.%Atlanto-axial complex is the most important functional unit of the cervical spine.Atlanto-axial instability or dislocation,one of the most serious pathologies in spinal surgery,is often managed by posterior atlantoaxial fixation and fusion.Several posterior fixation techniques have been used to stabilize the atlanto-axial complex,including wire/cable-bone fixation,Halifax clamps,transarticular screw fixation,screw-plate fixation and screw-rod fixation.For atlanto-axial dislocation that cannot be reduced with skull traction before operation,intraoperative reduction is often needed.Current intraoperative reduction techniques can be classified into transoropharyngeal surgical release followed by posterior reduction and fixation,transoropharyngeal reduction and fixation,and posterior reduction and fixation using screw-rod system according to approaches.Furthermore,posterior reduction can be performed using elevating-pull,leverages,and cantilever techniques.This study reviews the intraoperative reduction and fixation techniques mentioned above.

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

    Directory of Open Access Journals (Sweden)

    Yaniel Truffin Rodríguez

    2014-10-01

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

  18. POST TRAUMATIC INSTABILITY OF SUB - AXIAL CERVICAL SPINE - REDUCTION AND INTERNAL FIXATION BY LATERAL MASS SCREWS : A LONG TERM FOLLOW - UP STUDY

    Directory of Open Access Journals (Sweden)

    Godagu

    2015-10-01

    Full Text Available AIM: We present here the clinical results of 24 patients who were operated for cervical instability following trauma by lateral mass fixation at our institution between July 2010 and Dec 2013 and to assess the stability of the construct at 2yr follow - up study. MATERIALS AND METHODS: Between July 2010 and Dec 2013 a total of 24 pts. Were operated by lateral mass fixation for cervical spine instability following trauma to subaxial cervical spine between C3 - C6. Presenting with posterior element injury like facet locking and subluxation injuries were included in the study. Al l these patients were evaluated postoperatively for neurologic improvement , complications and Results were analyzed. RESULTS: A total of 104 screws were placed in to the lateral masses during the study. There were 8(33.3% deaths in this series not related to the surgical procedure. There were no immediate complications related to the procedure. There was no evidence of neurovascular injury either during the procedure or immediately following the surgery. There was CSF leak in one case of badly traumatized cord injury during the procedure. Neurological improvement was seen in 13(81.2% out of surviving 16 cases of trauma at the end of 3m to the extent of self - ambulation and the rest three did not show any improvement and remained quadriplegic. CONCLUSION: In this study we report good long term stability achieved by the lateral mass fixation with rods and screws with least morbidity and the safety of the procedure compared to other methods of posterier elements fixations. Both Roy Camille and Magerl technique can be followed for screw placement, where in Magerl technique has slight advantage of avoiding the nerve root injury and a longer screw can be placed to achieve a good bony purchase. Over all it is very safe and efficacious procedure in the hands of an ex perienced surgeon

  19. 分阶段切开复位内固定治疗严重Pilon骨折临床观察%Phased Reduction and Internal Fixation Treatment for Severe Pilon Fractures

    Institute of Scientific and Technical Information of China (English)

    冷华平

    2015-01-01

    目的:对严重Pilon骨折采取分阶段切开复位内固定治疗的效果进行研究。方法选取我院在2012年2月1日~9月30日所接受治疗的68例严重Pilon骨折患者,采用常规的外固定治疗患者35例,其他33例患者采取分阶段切开复位内固定,对两组患者的治疗效果进行分析。结果所有患者的手术均顺利进行,但是观察组的术后愈合时间较短,低于对照组,P<0.05,差异具有统计学意义;观察组的并发症的出现率低于对照组,差异具有统计学意义。结论采用分阶段切开复位内固定的手术方式治疗Pilon骨折效果较优。%Objective Research the phased reduction and fixation in the treatment of severe Pilon fractures. Methods Chose 68 cases of severe Pilon fractures in our hospital from 1st February 2012 to 30th September 2012,35 cases were treated with conventional external fixation,33 patients were taking other fixed within a phased approach open reduction,analysed two groups of patients for treatment effect. Results Al patients were operated smoothly,but the healing time in the observation group was significantly lower than the control group,P<0.05,there was significant difference,occurrence rate of complications was much lower than the control group,there was a significant difference. Conclusion Phased reduction and internal fixation treatment for severe Pilon fractures has good effect.

  20. Maintenance of reduction with suture button fixation devices for ankle syndesmosis repair.

    Science.gov (United States)

    Peterson, Kyle S; Chapman, W Drew; Hyer, Christopher F; Berlet, Gregory C

    2015-06-01

    Malreduction of the syndesmosis can lead to increased peak pressures and subsequent arthritis. The purpose of this study was to evaluate the initial syndesmotic reduction and radiographic maintenance when using a knotless suture button fixation device for treatment of syndesmotic injury. A retrospective chart and radiographic review was performed to identify patients who underwent open reduction internal fixation of ankle syndesmosis ruptures treated with a knotless, suture button fixation system. Radiographic measurements included medial clear space, tibiofibular overlap, tibiofibular clear space, and the distance between buttons. Fifty-six patients underwent repair of an ankle fracture with syndesmotic rupture over a 3-year period, with a mean follow-up of 160.9 days. The tibiofibular clear space and tibiofibular overlap significantly improved from pre- to first postoperative, but also demonstrated some loss of fixation at final follow-up (P buttons increased on average 1.1 mm from immediate postoperative to final follow-up, demonstrating some postoperative creep and loss of fixation in the system. A low complication rate and need for a revision operation was found in our patient cohort. Some loss of reduction did occur postoperatively, although this did not correlate to adverse patient outcomes. Syndesmotic stabilization, using a knotless suture button fixation device demonstrated adequate initial syndesmotic reduction, but also exhibited an increase in the tibiofibular clear space and tibiofibular overlap, relative to initial postfixation position, at short-term follow-up. Level IV, retrospective case series. © The Author(s) 2015.

  1. Effect of sustentaculum tali screw placement after open reduction and internal fixation of intraarticular calcaneal fractures%切开复位内固定跟骨关节内骨折后载距突固定效果

    Institute of Scientific and Technical Information of China (English)

    强敏菲; 陈雁西; 张坤; 李浩博; 戴号

    2014-01-01

    Objective To investigate the effect of sustentaculum tali screw placement on outcomes following open reduction and internal fixation (ORIF) of intraarticular calcaneal fractures.Methods A retrospective analysis was made on 139 patients with intraarticular calcaneal fractures treated by ORIF from April 2008 to January 2012.According to Sanders classification,there were 9 patients with type Ⅱ fractures,87 with type Ⅲ fractures and 43 with type Ⅳ fractures.Fracture reduction followed by placement of calcaneal anatomic plate or anatomic locking plate was performed via calcaneal lateral L-shape incision.All the patients received X-rays and CT scans within postoperative 2 weeks.Placement of screws in sustentaculum tail was detected by CT volume rendering to visualize implants combined with multiplanar reconstruction imaging (MPR).Patients were divided into accurate fixation group (Group A,n =28),marginal fixation group (Group B,n =58),and non-fixation group (Group C,n =53) based on radiological results.Intra-and peri-operative parameters,time to partial weight-bearing,time to full weight-bearing,fracture healing time,and clinical outcome were compared among groups.Functional outcome was assessed using American Orthopedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Scale.Results Postoperative X-rays indicated accurate fixation of sustentaculum tail in 64 patients,marginal fixation in 22,and non-fixation in 53,but CT images manifested accurate fixation in 28 patients,marginal fixation in 58,and non-fixation in 53.Group A had operation duration of (93 ±11) min and intraoperative blood loss of (252 ± 27) ml,longer or higher than those in Group B [(85 ±8) min,(194±16) ml] and Group C [(57±6) min,(136 ±13) ml] (P<O.05).There was no significant difference in mean hospital stay among the three groups (P > 0.05).Ninety-two patients were followed-up for 12-38 months (mean 18.5 months) and 85 patients completed foot and ankle exercise as planned

  2. Outcomes of Internal Fixation in a Combat Environment

    Science.gov (United States)

    2010-01-01

    postoperative infection, had missed injuries. One was a closed bimalleolar ankle fracture that had the fibula fracture and syndesmosis inter- nally fixed...is to describe the outcomes of fractures that were internally fixed in the combat environment. The records of patients who had internal fixation...analyzed. Forty-seven patients had internal fixation performed on 50 fractures in a combat theater hospital. Hip, forearm, and ankle fractures made up the

  3. 切开内固定联合外固定架治疗桡骨远端关节内骨折疗效观察%Observation of curative effect of open reduction internal fixation combined with external fixation of intra-articular fractures of the distal radius

    Institute of Scientific and Technical Information of China (English)

    王传文; 黄久勤; 王红旗

    2014-01-01

    Objective To investigate the clinical effect internal fixation combined with external fixator incision in the treatment of intra-articular fractures of the distal radius.Methods 80 cases of intra-articular distal radius fracture patients underwent cut internal fixation combined with external fixator in the treatment of orthopedic were chosen,postoperative rehabilitation exercises,fracture healing after the removal of the external fixator.All patients were followed up for 8 months to 12 months,an average of 9.2 months.Results 80 patients were intraarticular fractures healed,the time required was 4 to 10 months,an average of 6.3 months.In accordance with the assessment of functional systems Dienst wrist,51 cases wrist function were excellent,21 cases were good,the good rate was 90% (72/80).There were no clinical fractures common complication after surgery.Conclusion Open internal fixation combined with external fixator treatment of intra-articular fractures of the distal radius fractures not only makes reduction of fracture and immobilization satisfaction,but also conducive to the wrist of early postoperative functional rehabilitation exercise.%目的 观察采用切开内固定联合外固定架法治疗桡骨远端关节内骨折的临床效果.方法 80例采用切开内固定联合外固定架法治疗的桡骨远端关节内骨折患者,术后进行康复锻炼,骨折愈合后拆除外固定架.对所有患者进行随访,时间为8~12个月,平均9.2个月,按照Dienst腕关节功能系统评定治疗效果.结果 80例患者关节内骨折全部愈合,所需时间为4 ~ 10个月,平均6.3个月.腕关节功能优51例,良21例,可8例,优良率为90%(72/80).临床上骨折手术后常见的并发症均未出现.结论 切开内固定联合外固定架法治疗桡骨远端关节内骨折既能使骨折复位、固定满意,又有利于术后早期手腕部的功能康复锻炼.

  4. Percutaneous reduction and fixation of intraarticular calcaneal fractures

    NARCIS (Netherlands)

    T. Schepers (Tim); L.M.M. Vogels (Lucas); I.B. Schipper (Inger); P. Patka (Peter)

    2008-01-01

    textabstractObjective: Percutaneous reduction by distraction and subsequent percutaneous screw fixation to restore calcaneal and posterior talocalcaneal facet anatomy. The aim of this technique is to improve functional outcome and to diminish the rate of secondary posttraumatic arthrosis compared to

  5. Efficacy of three methods of internal fixation on femoralneck fracture

    Institute of Scientific and Technical Information of China (English)

    闫洪印; 陈扬; 肖建德; 李振宇; 龚敏; 马若凡; 刘尚礼

    2002-01-01

    @@ From 1990 to 2000, we used Hansson pin, AOhollow-pulling screw, and bendable screw to treat150 cases of fresh femoral neck fracture and theresult was analysed to compare the efficacy of the threemethods of internal fixation.

  6. Causes and strategies of skin necrosis after open reduction and internal fixation of calcaneal fracture%跟骨骨折内固定术后皮肤坏死原因及对策

    Institute of Scientific and Technical Information of China (English)

    邓志成; 朱小华; 王小平; 许国泰; 郭胜

    2013-01-01

    目的 探讨跟骨骨折行外侧L型切口钢板内固定术后伤口皮肤延迟愈合、皮肤坏死的原因及对策.方法 回顾分析我院骨科2006-2010年行外侧L型切口钢板内固定术的72例跟骨骨折患者术后伤口情况.结果 本组72例均获平均4.5个月的随访,术后发生创口边缘皮肤坏死、创口感染导致创口不愈合7例,5例经换药后愈合.2例行腓肠神经营养皮瓣转移修复创面治疗痊愈.结论 采取跟骨外侧L型切口行切开复位钢板内固定治疗跟骨关节内骨折时,熟练掌握跟骨周围解剖结构,把握手术时机、规范操作、充分引流、按皮瓣技术操作是避免后皮肤坏死的关键.%Objective To explore the causes and strategies of skin necrosis and incision delayed union after open reduction and internal fixation (ORIF) by lateral L-shaped incision. Methods Seventy two patients of calcaneal fractures in our department from 2006 to 2010 with lateral incision were observed and discussed after open reduction and internal fixation (ORIF). Results The patients were followed up for an average of 4.5 months. Skin incision edge partially necrosis or faulty union postoperation occurred in seven patients, of which five were cured by dressing and two were cured by skin island flap supplied by the nervus suralis. Conclusion For treating calcaneal intraarticu-lar fractures with ORIF through lateral L-shaped incision, the surgeons should know the regional anatomy around the calcaneos very well, choose the best operation timing, drain the wound properly and perform according to skin flap technique. These are the key points to avoid the skin flap necrosis.

  7. Internal fixation at ECWA Hospital, Egbe, Kogi State, Nigeria.

    Science.gov (United States)

    Agaja, S B

    2002-01-01

    Forty two (42) cases of fractures treated by internal fixation at Egbe Hospital ECWA, Kogi State, Nigeria were analysed retrospectively. Most of the patients requiring internal fixation were young male patients in their reproductive years 26 patients were under 50 years of age out of which 22 patients were males (84.6%) whilst only 4 patients (15.4%) were females. Internal fixation was found to be commoner in males: 31 patients (73.8%) than in females: 11 patients (26.2%). Fractures requiring internal fixation are commoner in the lower limbs than in the upper limbs (Ratio 6:1). The femur is the commonest site of internal fixation, 22 cases (54.2%) followed by the tibia, 6 cases (14.3%). Majority of the patients, 28 cases (67%) left the hospital under 50 days whereas when treated conservatively most will be in the hospital for up to 100 days. Only about 60% of the cases require blood transfusion and even a more cautious approach could reduce this percentage. 13 (31%) of the cases had fever post-operatively which was not necessarily due to infection. Based on its advantages, internal fixation is therefore encouraged and should only be performed by a surgeon who has adequate experience, equipment, instruments and a good operating theatre setting.

  8. Satellite Doppler Fixation and International Boundaries

    Science.gov (United States)

    Leppard, N. A. G.

    1980-01-01

    International boundaries have seldom been completely defined in geodetic terms. The existence of natural resources, which ignore the arbitrary boundaries of man, assume considerable importance when division of those resources becomes a point of issue between potential owners. This is particularly so when the boundary is illdefined in a geodetic sense. World-wide satellite reference systems, like natural resources, also have little regard for the internally less precise national or international systems. When the one is used to define the location of the other, great care must be taken to ensure equitable division, for financial gain and loss can be considerable. The definition of position is complicated by the existence of the two ephemerides for the N.N.S.S. satellites and the number of alternative reduction procedures available. The definition of the position of the Frigg Gas Field in the North Sea is an example of how the United Kingdom and Norway resolved the geodetic problem of reconciling geodetic and Doppler data.

  9. 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.

  10. Platelet-rich plasma combined with closed reduction and hollow screw internal fixation for femoral neck fracture%PRP联合闭合复位空心螺钉内固定治疗股骨颈骨折

    Institute of Scientific and Technical Information of China (English)

    陈志军; 杨彪; 张大华

    2016-01-01

    目的:分析自体富血小板血浆( PRP)联合闭合复位空心螺钉内固定治疗股骨颈骨折的临床效果。方法回顾性分析2010年5月至2014年8月在我院治疗的200例股骨颈骨折患者的临床资料,分为PRP组和对照组,各100例。 PRP组采用PRP联合闭合复位空心螺钉内固定治疗,对照组单纯采用闭合复位空心螺钉内固定治疗,记录2组患者住院时间、骨折愈合时间、切口愈合情况、术后并发症、Harris评分及髋关节功能恢复情况。结果 PRP组住院时间、骨折愈合时间明显短于对照组,切口甲级愈合率高于对照组,术后合并股骨头坏死及骨折不愈合率明显低于对照组,差异均具有统计学意义(P<0.05)。 PRP组患者术后6个月、12个月Harris评分分别为87.35、90.82分,均高于对照组的81.37、84.32分,术后6个月、12个月髋关节功能优良率分别为86%、90%,高于对照组的67%和76%,差异均具有统计学意义(P<0.05)。结论 PRP联合闭合复位空心螺钉内固定治疗股骨颈骨折能明显缩短骨折愈合时间,减少术后并发症,提高患者髋关节功能及术后生活质量,安全性和有效性较高。%Objective To explore the clinical effect of autologous platelet-rich plasma ( PRP) combined with closed reduction and hol-low screw internal fixation for femoral neck fracture .Methods Totally 200 cases of femoral neck fracture were collected from May 2010 to August 2014 in our hospital .Randomly divided them into two groups , namely the PRP group and the control group , with 100 patients in each group.The PRP group were given autologous platelet-rich plasma ( PRP) combined with closed reduction and hollow screw internal fixation , while the control group were given closed reduction and hollow screw internal fixation merely .The length of stay , time of fracture healing , wound healing state , postoperative complications rate

  11. 切开复位内固定治疗SandersⅢ型及Ⅳ型跟骨骨折%Treatment of Sanders type Ⅲ and Ⅳ calcaneal fractures with open reduction and internal fixation

    Institute of Scientific and Technical Information of China (English)

    陈志伟; 杨乐忠; 吴文特; 刘春磊

    2011-01-01

    目的:探讨切开复位内固定治疗Sanders Ⅲ、Ⅳ型跟骨骨折的手术方法和治疗效果.方法:2004年1月至2010年1月,采用切开复位内固定术治疗51例58足SandersⅢ、Ⅳ型跟骨骨折,男29例,女22例;年龄17~58岁,平均29.5岁;伤后至手术时间7~14d,平均10d.术前均行CT扫描及三维重建,按Sanders分类:Ⅲ型26足,Ⅳ型32足.均经可延长的外侧"L"形入路切开复位钢板内固定治疗.术后通过X线测量Bohler角、Gissane角并与术前进行比较,按照Maryland足部评分系统从疼痛、功能方面对疗效评定.结果:51例58足全部获随访,时间6~24个月,平均13个月.术后皮缘表皮坏死2足,慢性疼痛4足,晚期发生距下关节炎2足,并发症发生率13.8%(8/58).按照Maryland足部评分系统:优23足,良27足,可5足,差3足.结论:切开复位钢板内固定治疗SandersⅢ、Ⅳ型跟骨骨折,能够获得较满意的解剖复位,且固定可靠,是治疗SandersⅢ、Ⅳ型跟骨骨折的有效方法.%Objective:To investigate the surgical techniques and results of open reduction and internal fixation for the treatment of Sanders type Ⅲ, Ⅳ calcaneal fractures. Methods:From January 2004 to January 2010,58 feet of Sanders type Ⅲ, Ⅳ in 51 patients were treated with open reduction and plate fixation through L incision. There were 29 males and 22 females,the age ranged from 17 to 58 years with an average of 29.5 years old. The time between injury and operation ranged from 7 to 14 days(mean, 10 days). All the patients underwent systematic CT scan with coronal and horizontal images and sagittal reconstruction. The classification of the fractures by the Sanders scale showed that there were 26 feet of type Ⅲ, 32 feet of type Ⅳ. The B(o)hler angle and Gissane angle were compared before and after operation. The clinical results were evaluated with the Maryland foot score: pain ( 45 scores), function (55 scores: distance walked 10 scores, stability 4, support 4, limp 4

  12. Nitrogen fixation (acetylene reduction) by epiphytes of freshwater macrophytes.

    Science.gov (United States)

    Finke, L R; Seeley, H W

    1978-07-01

    The involvement of epiphytic microorganisms in nitrogen fixation was investigated in a shallow freshwater pond near Ithaca, N.Y. The acetylene reduction technique was used to follow diel and seasonal cycles of nitrogen fixation by epiphytes of Myriophyllum spicatum. Acetylene-reducing activity was maximal between noon and 6 p.m., but substantial levels of activity relative to daytime rates continued through the night. Experiments with the seasonal course of activity showed a gradual decline during the autumn months and no activity in January or February. Activity commenced in May, with an abrupt increase to levels between 0.45 and 0.95 nmol of ethylene formed per mg (dry weight) of plant per h. Through most of the summer months, mean rates of acetylene reduction remained between 0.15 and 0.60 nmol/mg (dry weight) per h. It was calculated from diel and seasonal cycles that, in the pond areas studied, epiphytes were capable of adding from 7.5 to 12.5 mug of N per mg of plant per year to the pond. This amount is significant relative to the total amount of nitrogen incorporated into the plant. Blue-green algae (cyanobacteria), particularly Gloeotrichia, appeared to bear prime responsibility for nitrogen fixation, but photosynthetic bacteria of the genus Rhodopseudomonas were isolated from M. spicatum and shown to support high rates of acetylene reduction.

  13. 切开复位内固定治疗移位的跟骨关节内骨折的疗效分析%Open reduction and internal fixation for displaced intra-articular calcaneal fractures

    Institute of Scientific and Technical Information of China (English)

    李喜功; 孙俊英; 殷浩; 宋兵华; 朱若夫; 唐祖林

    2008-01-01

    Objective To evaluate open reduction and internal fixation for displaced intra-articular calcaneal fractures and analyze factors affecting its clinical results. Methods From March 2004 to July 2006,46 displaced intra-arficular calcaneal fractures in 40 patients were surgically treated by open reduction and internal fixation.According to Sanders classification,there were 16 cases of type Ⅱ,19 cases of type Ⅲ and 11 cases of type Ⅳ. Results All the patients were followed up for anaverage of 18(13 to 28)months.The effects of treatment were evaluated according to Maryland Foot Score:excellent in 21 feet,good in 16 feet,fair in 6 feet,poor in 3 feet. The total good to excellent ratewas 82.6%.The respective good to excellent rates were 93.8%for type Ⅱ fractures,84.2%for type Ⅲ,and 54.5%for type Ⅳ;87.2%for the group with time interval from injury to surgery ≤14d,and 42.9%for the group with time interval>14d;37.5%for thegroup with B(o)hler angle<15°,and 89.5% for the group with B(o)hler angle≥15 °.91.2%for the group with reduction of intra-articular calcaneal fractures ≤2 mm,and 45.5% for the group with the reduction>2mm.The differences within each factor group were statistically significant(P<0.05). Conclusions Open reduction and internal fixation fordisplaced intra-articularcalcaneal fractures is a good method.Fracture type,time interval from injury to surgery,B(o)hler angle reduction,reduction of intra-articular calcaneal fractures are important factors affecting outcome of operation.%目的 评定切开复位内固定治疗移位的跟骨关节内骨折的疗效,并分析其影响因素.方法 回顾性分析2004年3月至2006年7月收治的采用切开复位内固定治疗的移位跟骨关节内骨折40例(46足).按照Sanders分型:Ⅱ型16足,Ⅲ型19足,Ⅳ型11足,总结评定其临床疗效并分析影响疗效的相关因素. 结果 所有患者均得到随访,平均随访18个月(13~28个月).根据Maryland足部评

  14. Design and Optimization of Resorbable Silk Internal Fixation Devices

    Science.gov (United States)

    Haas, Dylan S.

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

  15. 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.

  16. External versus internal fixation for bicondylar tibial plateau fractures: systematic review and meta-analysis.

    Science.gov (United States)

    Metcalfe, David; Hickson, Craig J; McKee, Lesley; Griffin, Xavier L

    2015-12-01

    It is uncertain whether external fixation or open reduction internal fixation (ORIF) is optimal for patients with bicondylar tibial plateau fractures. A systematic review using Ovid MEDLINE, Embase Classic, Embase, AMED, the Cochrane Library, Open Grey, Orthopaedic Proceedings, WHO International Clinical Trials Registry Platform, Current Controlled Trials, US National Institute for Health Trials Registry, and the Cochrane Central Register of Controlled Trials. The search was conducted on 3rd October 2014 and no language limits were applied. Inclusion criteria were all clinical study designs comparing external fixation with open reduction internal fixation of bicondylar tibial plateau fractures. Studies of only one treatment modality were excluded, as were those that included unicondylar tibial plateau fractures. Treatment effects from studies reporting dichotomous outcomes were summarised using odds ratios. Continuous outcomes were converted to standardized mean differences to assess the treatment effect, and inverse variance methods used to combine data. A fixed effect model was used for meta-analyses. Patients undergoing external fixation were more likely to have returned to preinjury activities by six and twelve months (P = 0.030) but not at 24 months follow-up. However, external fixation was complicated by a greater number of infections (OR 2.59, 95 % CI 1.25-5.36, P = 0.01). There were no statistically significant differences in the rates of deep infection, venous thromboembolism, compartment syndrome, or need for re-operation between the two groups. Although external fixation and ORIF are associated with different complication profiles, both are acceptable strategies for managing bicondylar tibial plateau fractures.

  17. 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.

  18. Talar neck fractures treated with closed reduction and percutaneous screw fixation:a case series.

    Science.gov (United States)

    Fernandez, Michael L; Wade, Allison M; Dabbah, Michael; Juliano, Paul J

    2011-02-01

    Talus fractures are relatively rare injuries, accounting for approximately 3% of all foot fractures. Fractures of the talar neck account for almost 50% of all talus fractures. Diagnosis and treatment of these fractures play an important role in patients' outcomes. Treatment of talar neck fractures has slowly evolved from closed treatment to open reduction and internal fixation. Treatment of type I and type II talar neck fractures is debated in the orthopedic community. Choosing which treatment to perform depends on injury severity, associated injuries, and surgeon experience and preference. In this article, we report on our retrospective review of all talar neck fractures treated with closed reduction and percutaneous fixation between 1996 and 2001 at the Pennsylvania State University Milton S. Hershey Medical Center.

  19. 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.

  20. Fixation of Radiological Contamination; International Collaborative Development

    Energy Technology Data Exchange (ETDEWEB)

    Rick Demmer

    2013-03-01

    A cooperative international project was conducted by the Idaho National Laboratory (INL) and the United Kingdom’s National Nuclear Laboratory (NNL) to integrate a capture coating with a high performance atomizing process. The initial results were promising, and lead to further trials. The somewhat longer testing and optimization process has resulted in a product that could be demonstrated in the field to reduce airborne radiological dust and contamination.

  1. 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.

  2. 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.

  3. A Prospective Randomized Trial to Assess Fixation Strategies for Severe Open Tibia Fractures: Modern Ring External Fixators Versus Internal Fixation (FIXIT Study).

    Science.gov (United States)

    OʼToole, Robert V; Gary, Joshua L; Reider, Lisa; Bosse, Michael J; Gordon, Wade T; Hutson, James; Quinnan, Stephen M; Castillo, Renan C; Scharfstein, Daniel O; MacKenzie, Ellen J

    2017-04-01

    The treatment of high-energy open tibia fractures is challenging in both the military and civilian environments. Treatment with modern ring external fixation may reduce complications common in these patients. However, no study has rigorously compared outcomes of modern ring external fixation with commonly used internal fixation approaches. The FIXIT study is a prospective, multicenter randomized trial comparing 1-year outcomes after treatment of severe open tibial shaft fractures with modern external ring fixation versus internal fixation among men and women of ages 18-64. The primary outcome is rehospitalization for major limb complications. Secondary outcomes include infection, fracture healing, limb function, and patient-reported outcomes including physical function and pain. One-year treatment costs and patient satisfaction will be compared between the 2 groups, and the percentage of Gustilo IIIB fractures that can be salvaged without soft tissue flap among patients receiving external fixation will be estimated.

  4. Internal Fixation of Unstable Pelvic Ring Injuries via the Modified Stoppa Approach

    Directory of Open Access Journals (Sweden)

    TK Ong

    2011-03-01

    Full Text Available BACKGROUND: The modified Stoppa approach was first described in 1993 by Hirvensalo as an alternative to the ilioinguinal approach for treatment of pelvic ring fracture. METHODS: This is a retrospective study of 5 patients with unstable pelvic fracture treated with internal fixation using the modified Stoppa approach. Residual displacement of the pelvic ring was measured and graded using the methods described by Matta and Lindahl. Functional outcomes were assessed using the modified Merle D’ Aubigne and Postel Hip scoring system. RESULTS: Of all patients with Type C pelvic injury, three had concomitant acetabular fracture. The mean Injury Severity Score (ISS score was 39. Anatomic reduction of the pelvic ring was achieved in 3 patients and good reduction in 2 patients. Three patients had good functional outcomes. One patient had superficial wound infection. Three patients had erectile dysfunction. CONCLUSION: The modified Stoppa approach is appropriate for internal fixation of unstable pelvic ring injury.

  5. Open reduction and internal fixation via a posterior approach for posterior fractures of tibial plateau%后方入路治疗胫骨平台后方骨折

    Institute of Scientific and Technical Information of China (English)

    陈成帷; 陈雷; 番哲尔; 杨胜武

    2012-01-01

    目的:探讨后方入路治疗胫骨平台后方骨折的骨折类型、手术方法和临床疗效.方法:回顾性分析自2008年6月至2011年2月采用后方入路治疗且随访完整的8例胫骨平台后方骨折,男5例,女3例;年龄23~55岁,平均41.1岁.致伤原因:车祸伤5例,高处坠落伤3例.2例胫骨平台后方冠状面骨折伴后交叉韧带撕脱和1例后外侧平台劈裂伴塌陷骨折采用正后方“S”形入路,2例后内侧平台骨折采用后内侧倒“L”型入路,3例同时累及胫骨平台前后侧及胫骨干骺端骨折者采用后内侧倒“L”形入路联合前外侧入路行钢板螺钉内固定.关节面塌陷者采用同种异体骨或自体髂骨植骨术.结果:所有患者获得随访,时间8~39个月,平均20个月.全部病例获得影像学上的骨性愈合,愈合时间11~21周,平均14.5周.术中未出现血管、神经损伤,术后无一例出现切口感染、内固定松动及断裂.所有患者术后即刻与术后6个月胫骨平台内翻角(TPA)、内外侧平台后倾角(PA)度数均无统计学差异.术后末次随访Rasmussen 膝关节功能评分为19~29分,平均25.60分,其中优4例,良3例,可1例.术后末次随访Rasmussen放射学评分14~18分,平均17.25分,其中优6例,良2例.结论:胫骨平台骨折以后侧为主时,后方入路能得到很好的骨折端暴露,有利于直视下复位固定,术后近期疗效满意.%Objective: To discuss the fracture patterns, operative procedures and clinical results of open reduction and internal fixation via a posterior approach to treat posterior fractures of tibial plateau. Methods: From June 2008 to February 2011,8 patients with posterior tibial plateau fractures treated with posterior approach,were reviewed retrospectively. There were 5 males and 3 females,with an average of 41.1 years ranging from 23 to 55. Of the 8 cases,5 cases were caused by traffic accidents, 3 caused by fall. Two cases of posterior coronal fractures

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2003-10-01

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

  8. Anterior internal fixation to treat vertical unstable pelvic fracture

    Institute of Scientific and Technical Information of China (English)

    王世松; 张鹏程; 杜敦进; 杨泗华

    2002-01-01

    With the Chinese development of industry, agriculture and communication, various traffic and work related accidents are increasing, leading to an increase in pelvic fractures. Among the different kinds of fractures, pelvic fracture is the third largest cause of death.1 The treatment of pelvic fractures is a “hot spot” and a difficult point in orthopedic surgery. Since 1998 we have treated 20 patients with vertical unstable pelvic fracture using anterior internal fixation. Satisfactory results have been obtained.

  9. The Ankle Injury Management (AIM) trial: a pragmatic, multicentre, equivalence randomised controlled trial and economic evaluation comparing close contact casting with open surgical reduction and internal fixation in the treatment of unstable ankle fractures in patients aged over 60 years.

    Science.gov (United States)

    Keene, David J; Mistry, Dipesh; Nam, Julian; Tutton, Elizabeth; Handley, Robert; Morgan, Lesley; Roberts, Emma; Gray, Bridget; Briggs, Andrew; Lall, Ranjit; Chesser, Tim Js; Pallister, Ian; Lamb, Sarah E; Willett, Keith

    2016-01-01

    BACKGROUND Close contact casting (CCC) may offer an alternative to open reduction and internal fixation (ORIF) surgery for unstable ankle fractures in older adults. OBJECTIVES We aimed to (1) determine if CCC for unstable ankle fractures in adults aged over 60 years resulted in equivalent clinical outcome compared with ORIF, (2) estimate cost-effectiveness to the NHS and society and (3) explore participant experiences. DESIGN A pragmatic, multicentre, equivalence randomised controlled trial incorporating health economic evaluation and qualitative study. SETTING Trauma and orthopaedic departments of 24 NHS hospitals. PARTICIPANTS Adults aged over 60 years with unstable ankle fracture. Those with serious limb or concomitant disease or substantial cognitive impairment were excluded. INTERVENTIONS CCC was conducted under anaesthetic in theatre by surgeons who attended training. ORIF was as per local practice. Participants were randomised in 1 : 1 allocation via remote telephone randomisation. Sequence generation was by random block size, with stratification by centre and fracture pattern. MAIN OUTCOME MEASURES Follow-up was conducted at 6 weeks and, by blinded outcome assessors, at 6 months after randomisation. The primary outcome was the Olerud-Molander Ankle Score (OMAS), a patient-reported assessment of ankle function, at 6 months. Secondary outcomes were quality of life (as measured by the European Quality of Life 5-Dimensions, Short Form questionnaire-12 items), pain, ankle range of motion and mobility (as measured by the timed up and go test), patient satisfaction and radiological measures. In accordance with equivalence trial US Food and Drug Administration guidance, primary analysis was per protocol. RESULTS We recruited 620 participants, 95 from the pilot and 525 from the multicentre phase, between June 2010 and November 2013. The majority of participants, 579 out of 620 (93%), received the allocated treatment; 52 out of 275 (19%) who received CCC later

  10. Displaced avulsion of the ischial apophysis: a hamstring injury requiring internal fixation.

    Science.gov (United States)

    Servant, C T; Jones, C B

    1998-09-01

    A case is reported of an adolescent sprinter who was chronically disabled by pain after non-operative management for an acute hamstring injury. He had sustained an avulsion fracture of the ischial apophysis with displacement of 2.5 cm. Avulsion fractures of the ischial apophysis with displacement of 2 cm or more are unusual, but they frequently result in a symptomatic non-union, and early diagnosis, open reduction, and internal fixation is to be encouraged.

  11. Toxic shock syndrome post open reduction and Kirschner wire fixation of a humeral lateral condyle fracture.

    Science.gov (United States)

    Chan, Yuen; Selvaratnam, Veenesh; Garg, Neeraj

    2015-08-11

    Use of Kirschner wires (K-wires) is the most common method of fracture stabilisation in lateral condyle fracture fixation in children. We report a case of toxic shock syndrome (TSS) following an open reduction and internal fixation using K-wires for a humeral lateral condyle fracture in a 5-year-old girl. TSS is a toxin-mediated multisystem illness. It typically presents with shock and it is most often attributed to toxin-producing strains of Staphylococcus aureus and Streptococcus pyogenes. It can lead to multiorgan failure and, ultimately, death. It is important to be aware of TSS, as it can present within any setting. Patients often have non-specific symptoms and their condition can worsen rapidly. TSS postorthopaedic surgery is rare; however, due to the serious nature of this disease, it is important to promptly recognise and diagnose TSS, and to ensure appropriate treatment is started without delay.

  12. The analysis of therapeutic effect of Halo-vest reduction combined with anterior decompression and internal fixation on lower cervical spine fracture-dislocation%Halo-vest复位单纯前路减压内固定治疗下颈椎骨折脱位的疗效分析

    Institute of Scientific and Technical Information of China (English)

    姚关锋; 王新家; 罗滨; 王伟东; 曾机灿

    2013-01-01

    Objective:To investigate the efficacy of lower cervical spine fracture-dislocation treated by Halo-vest reduction combined with anterior decompression and internal fixation. Methods:A total of 17 patients with lower cervical spine fracture-dislocation were treated by operation from January 2009 to December 2011.The Halo-vest external fixation was performed under 1oca1 anesthesia in the first step, and then under reduction anterior decompression and internal fixation were carried out in the second step.Results: After surgery, al patients were fol owed up for more than 12 months.According to the X-ray films and CT scan,the fracture-dislocation was made in a complete reset,the natural arrangement of the cervical spine and physiological circular measure regained and the implanted bone was completely fused,without internal fixation breaking or loosening.According to the Frankel grading,the grade of 5 cases were remarkably reduced(2 levels),10 cases effectively reduced(1 leve1),and 2 cases were invalid.Conclusions: The treatment of lower cervical spine fracture-dislocation with Halo-vest reduction combined with anterior decompression and internal fixation is effective.%  目的探讨Halo-vest复位单纯前路减压内固定治疗下颈椎骨折脱位的疗效。方法对2009年l月至2011年12月17例下颈椎骨折脱位患者,首先在局麻下行Halo-vest固定术,然后逐步撑开,在复位情况下,行前路减压内固定术。结果术后随访12~24个月,平均15.4个月。常规X光正侧位片显示骨折脱位均复位,恢复颈椎的正常序列及生理弧度,CT显示植骨融合,未发现内固定断裂及松动。按Frankel分级,显效(降低2级)5例,有效(降低1级)10例,无效2例。结论在Halo-vest复位的基础上行前路减压植骨融合内固定是治疗下颈椎骨折脱位的安全有效方法。

  13. Time Savings and Surgery Task Load Reduction in Open Intraperitoneal Onlay Mesh Fixation Procedure

    Directory of Open Access Journals (Sweden)

    Sanjoy Roy

    2015-01-01

    Full Text Available Background. This study assessed the reduction in surgeon stress associated with savings in procedure time for mechanical fixation of an intraperitoneal onlay mesh (IPOM compared to a traditional suture fixation in open ventral hernia repair. Study Design. Nine general surgeons performed 36 open IPOM fixation procedures in porcine model. Each surgeon conducted two mechanical (using ETHICON SECURESTRAPTM Open and two suture fixation procedures. Fixation time was measured using a stopwatch, and related surgeon stress was assessed using the validated SURG-TLX questionnaire. T-tests were used to compare between-group differences, and a two-sided 95% confidence interval for the difference in stress levels was established using nonparametric methodology. Results. The mechanical fixation group demonstrated an 89.1% mean reduction in fixation time, as compared to the suture group (p<0.00001. Surgeon stress scores measured using SURG-TLX were 55.5% lower in the mechanical compared to the suture fixation group (p<0.001. Scores in five of the six sources of stress were significantly lower for mechanical fixation. Conclusions. Mechanical fixation with ETHICON SECURESTRAPTM Open demonstrated a significant reduction in fixation time and surgeon stress, which may translate into improved operating efficiency, improved performance, improved surgeon quality of life, and reduced overall costs of the procedure.

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

    Directory of Open Access Journals (Sweden)

    Sagar

    2015-06-01

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

  15. 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

  16. 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

  17. [Clinical results after all arthroscopic reduction and fixation of bony Bankart lesion].

    Science.gov (United States)

    Zhu, Yi-Ming; Jiang, Chun-Yan; Lu, Yi; Xue, Qing-Yun

    2011-07-01

    To investigate the shoulder function after arthroscopic reduction and internal fixation in patients with bony Bankart lesion. Between May 2004 and May 2008, 45 patients with bony Bankart lesion who were treated with all arthroscopic reduction and internal fixation with metal anchors were included in this study. Among them 40 patients were male and 5 patients were female. The average age at the surgery was 27.6 years (16.5 - 50.1 years). The average duration of follow-up was 29.7 months (24.8 - 49.0 months). A history of recurrent dislocation of affected shoulder was found in all patients. Metal anchors were used to fix the bony Bankart lesion during the surgery. Hill-Sachs remplissage technique was used to treat the Engaging Hill-Sachs lesion. The preoperative American Shoulder and Elbow Society (ASES) score, Constant-Murley score, Rowe score and the VAS score for instability were 84 ± 14, 95.1 ± 4.6, 39.4 ± 2.9 and 5 ± 3 respectively. No significant change was found regarding active forward elevation, external rotation and internal rotation after the surgery. The ASES score, Constant-Murley score, Rowe score and the VAS score of stability were 95 ± 7, 98.3 ± 2.2, 84.5 ± 22.0 and 1 ± 2, improved significantly higher after the surgery (P Bankart lesion can achieve a good result.

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

    Institute of Scientific and Technical Information of China (English)

    JIANG Zan-li; Gary Chen

    2011-01-01

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

  19. Subciliary incision and lateral cantholysis in rigid internal fixation of zygomatic complex fractures

    Institute of Scientific and Technical Information of China (English)

    钟来平; 陈关福

    2004-01-01

    Objective: To introduce the technique of subciliary incision and lateral cantholysis with tri-dimension reduction and rigid internal fixation to treat zygomatic complex fractures.Methods: The subciliary incision and lateral cantholysis combined with tri-dimension reduction and rigid internal fixation of zygomatic complex fractures with titanium microplates were applied in 56 patients with zygomatic complex fractures. Another lateral eyebrow incision or sublabial incision was used to simplify the operation.Results: The postoperative follow-up period ranged from 6 months to 5 years. During the follow-up period, all the patients had satisfying postoperative results. All clinical symptoms disappeared except the numbness in the infraorbital region in 2 patients. In 94.6% patients no complications such as obvious scar, ectropion, entropion or blepharoedema were found, only 5.4% of the patients had slight ectropion 6 months after operation.Conclusions: The subciliary incision and lateral cantholysis have many advantages such as invisible scar,sufficient exposure, minimal injury, and few complications and combined with rigid internal fixation with titanium microplates this technique could be used as one of the routine operation methods to treat zygomatic complex fractures.

  20. [Results after internal fixation of humerus distal fractures in patients over than 65 years old].

    Science.gov (United States)

    Serrano-Mateo, L; Lopiz, Y; León-Serrano, C; García-Fernández, C; López-Durán-Stern, L; Marco, F

    2014-01-01

    Distal humerus fractures in the elderly frequently associated with poor bone quality and comminution, making it harder to achieve proper osteosynthesis. Our aim is to evaluate the radiological and functional results of open reduction and internal fixation of these fractures. Retrospective study of 26 patients treated by open reduction and internal fixation between the years 2005-2010. Mean follow-up was 42 months. At final follow-up, a radiography evaluation (Knirk and Jupiter score) and clinical examination using Mayo Elbow Performance Score and Quick-Disabilities of the Arm, Shoulder and Hand Score was performed. Mean age of the group was 76.8 years (65-89), with 83% of the patients being female. Sixteen patients suffered type C fractures and 8 type A by AO classification. All underwent posterior surgical approach. Mean elbow flexion reached 118.86°, with a mean extension deficit of 25°. More than 3-quarters (79.1%) of the patients showed 0-1 grade degenerative changes on the X-ray films at final follow-up. Functional results reached an average 19.87 points on Quick-Disabilities of the Arm, Shoulder and Hand Score, and 85 points on Mayo Elbow Performance Score scores. Non-union occurred in 2 cases: distal humerus in one patient and olecranon osteotomy in another. Ulnar nerve neuropraxia was recorded in 2 cases, and radial nerve in one. All 3 recovered uneventfully. Revision surgery was required, with 2 patients needing hardware removal and one a new fixation. Treatment by open reduction and internal fixation with plating in elderly people for type A and C distal humerus fractures gives good functional results regarding this population, and thus scarcely disturbs their quality of life. Copyright © 2012 SECOT. Published by Elsevier Espana. All rights reserved.

  1. RESORBABLE HIGH-STRENGTH ROD FOR FRACTURE INTERNAL FIXATION

    Institute of Scientific and Technical Information of China (English)

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

    2004-01-01

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

  2. 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.

  3. Meta analysis of the clinical outcomes between Minimally invasive internal fixation and open reduction in treatment of calcaneus fracture%微创内固定与切开复位治疗跟骨骨折疗效比较Meta分析

    Institute of Scientific and Technical Information of China (English)

    王东; 王起奎; 周君琳

    2015-01-01

    Objective To compare the safety and clinical outcome between minimally invasive internal fixation and open reduction in treatment of calcaneus fracture based on Meta analysis.Methods A computer-based online search of the Cochrane library,Medline database,CNKI,Wan Fang database,the Chinese biomedical literature database,PubMed,Ovid database and all was performed for clinical trials regarding minimally invasive internal fixation and open reduction in treatment of calcaneus fracture.Meta analysis was used to analyze the postoperative local soft tissue,calcaneal last follow-up Bohler angle and Gissane angle.Results A total of 17 studies were included(used Jadad quality grading,one is 7 points,two is 4 points,four is 3 points,ten is 2 points),involving 1138 patients,including 569 patients used minimally invasive internal fixation and 569 used open reduction.Meta analysis showed that the incidence of postoperative local soft tissue poor healing used minimally invasive internal fixation is lower than used open reduction about,the difference was statistically significant [OR =0.26,95% CI:(0.14,0.47),P < 0.01].Meta analysis showed that the calcaneal last follow-up Bohler angle of minimally invasive internal fixation was lower than open reduction,the difference was statistically significant [WMD =-1.29,95% CI:(-2.39,-0.19),P =0.02].There were no statistically significant differences in the calcaneal last follow-up Bohler angle between minimally invasive internal fixation and open reduction[WMD =1.01,95%CI:(-3.02,5.04),P =0.62].Conclusions Regardless of the calcaneal fracture type,minimally invasive internal fixation or open reduction,the postoperative Bohler angle and Gissane angle at the calcaneus mechanical recovery characteristics are the same.However,the postoperative soft tissue healing of minimally invasivc internal fixation is less better than open reduction.%目的 系统评价微创内固定与切开复位治疗跟骨骨折的安全性与疗效.方法 计

  4. Closed reduction with CT-guided screw fixation for unstable sacroiliac joint fracture-dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Baskin, Kevin M.; Cahill, Ann Marie; Kaye, Robin D. [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Born, Christopher T. [Temple University Hospital/Temple Children' s Hospital, Temple Sports Medicine, Marlton, NJ (United States); Grudziak, Jan S. [Children' s Hospital of Pittsburgh, Department of Orthopedic Surgery, Pittsburgh, PA (United States); Towbin, Richard B.

    2004-12-01

    Unstable posterior pelvic ring fractures and dislocations are uncommon but potentially life-threatening injuries in children. Early definitive management reduces risk of immediate complications as well as chronic pain and gait dysfunction. Conventional operative therapy carries substantial risk of extensive blood loss and iatrogenic neurological and vascular injury. Minimally invasive image-guided intervention may further reduce immediate risk and improve long-term outcome. To describe CT-guided closed reduction and internal fixation (CRIF) and review outcomes of unstable fracture-dislocation of the sacroiliac (SI) joint in children. Between 2000 and 2003, three children (two girls, one boy) age 8-14 years were referred to interventional radiology for treatment of unstable SI joint fracture-dislocation not adequately treated with anterior external fixation alone. The three affected SI joints (two left, one right) were treated in a combined approach by pediatric interventional radiologists and orthopedic surgeons, using a percutaneous approach under CT guidance. Over a threaded guiding pin, 7.3 mm cannulated screws were used to achieve stable reduction of the affected SI joints. One screw was removed after slight (2 mm) migration. No neurovascular or other complications occurred. All patients had satisfactory healing with near-anatomic reduction, although recovery of the youngest was delayed by associated spinal injury. Compared to open surgical alternatives, CRIF under CT guidance reduces operating time, decreases blood loss, and allows early definitive fixation and immediate non-weight-bearing mobilization with a low rate of complication for unstable posterior pelvic ring fractures. In addition, CT-guided placement of the guide pin may allow safer screw positioning and may minimize the total number of screws needed to achieve pelvic stability. (orig.)

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  6. Research on Open Reduction and Philos Internal Fixation in Treating Elder Patients with Proximal Humeral Fracture%切开复位肱骨近端内固定锁定系统治疗老年肱骨近端骨折

    Institute of Scientific and Technical Information of China (English)

    朱红; 黄富国; 陈玉龙; 唐付林; 蒲超

    2011-01-01

    目的 探讨切开复位肱骨近端内固定锁定系统(proximal humeral internal locking system,PHILOS)治疗老年肱骨近端骨折的疗效.方法 2008年5月-2009年5月,对22例60岁以上肱骨近端新鲜移位骨折按Neer分型,二部分2例,三部分16例,四部分4例;采用肩前方入路切开复位PHILOS治疗.结果 22例患者获12~18个月随访,平均14.6个月,采用Constant-Murley评分,优8例,良10例,可3例,差1例.优良率81.4%.结论 切开复位PHILOS治疗老年肱骨近端骨折疗效肯定.%Objective To discuss the clinical effect of open reduction and internal fixation with the proximal humeral internal locking system (PHILOS) plate in treating elder patients with proximal humeral fracture. Methods From May 2008 to May 2009, we classified 22 cases of fresh displaced proximal humeral fracture according to the Neer classification. All patients were older than 60 years. There were two cases of two-part fracture, 16 cases of three-part fracture and four cases of four-part fracture. The open reduction and internal fixation with PHILOS plate was performed with the anterior deltopectoral approach. Results The 22 patients were followed up for 12 to 18 months with a mean period of 14. 6 months. According to Constant-Murley Shoulder Score measurement, eight cases were graded as excellent, 10 good, three fair, and one poor with a excellent and good rate of 81.4%. Conclusion The open reduction and internal fixation with Philos plate is effective in treating elder patients with proximal humeral fracture.

  7. Removal of internal fixation--the effect on patients' complaints: a study of 66 cases of removal of internal fixation after malleolar fractures

    DEFF Research Database (Denmark)

    Jacobsen, S; Honnens de Lichtenberg, M; Jensen, C M

    1994-01-01

    To estimate the effect of removal of internal fixation after treatment of malleolar fractures on postoperatively presented complaints, we retrospectively evaluated 66 patients by their records and by personal questionnaires. Of all the patients, 89.4% had one or more complaints. These were typica...... period. We conclude that removal of internal fixation after malleolar fractures is indicated when common types of complaints are presented.......To estimate the effect of removal of internal fixation after treatment of malleolar fractures on postoperatively presented complaints, we retrospectively evaluated 66 patients by their records and by personal questionnaires. Of all the patients, 89.4% had one or more complaints. These were...

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

    Science.gov (United States)

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

    2015-07-08

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

  9. 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

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    Gupta A

    2008-01-01

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

  13. 耳前长角形切口在复杂颧骨复合体骨折复位内固定术中的应用%Long-corniform Preauricular Approach to Open Reduction and Internal Fixation of Complicated Zygomatic Complex Fractures

    Institute of Scientific and Technical Information of China (English)

    周剑虹; 许振华; 任常群; 王文峰; 黄欣

    2011-01-01

    Objective: To evaluate the clinical results of open reduction and internal fixation of complicated zygo-matic complex fractures using a long-corniform preauricular access. Methods: 106 cases with complicated zygo-matic complex fracture were underwent open reduction and internal fixation through a long-corniform preauricular access. The subcutaneous tissue flap was dissected and elevated after the surgical field was infiltrated with tumes-cent solution, then the superficial temporal fascia was incised on 2cm above the zygomatic arch and dissection was performed under the superficial temporal fascia downward to the zygomatic arch. When the fracture stumps were separated and appeared, straightforward reduction and internal fixation were performed. Results: Through clinical and radiologic postoperative examinations, satisfactory results were obtained with few complications. Conclusion: Combined with subcutaneous tumescent solution infiltration technique, not only the long-corniform preauricular access can provide an excellent view of the surgical field, facilitating handling of the fracture, but also it can reduce injury and hemorrhage dramatically compared with scalp coronal incision.%目的:探讨应用耳前长角形切口在复杂颧骨复合体骨折切开复位内固定术中的应用效果.方法:在106例复杂颧骨复合体骨折切开复位内固定术中采用耳前长角形切口,术区皮下肿胀分离后沿皮下翻瓣,在颧弓上方2cm切开颞深筋膜浅层并沿此层深面剥离到颧弓,分离显露骨折部位,直视下行骨折复位内固定术.结果:术后通过临床及影像学检查随访,效果满意,无严重并发症.结论:耳前长角形切口结合皮下肿胀分离技术不但为复杂颧骨复合体骨折复位内固定术提供良好的视野,方便骨折复位固定,而且与头皮冠状切口相比大大减少了损伤和出血,值得临床推广.

  14. 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.

  15. Intraocular pressure variations during zygomatic fracture reduction and fixation: a clinical study.

    LENUS (Irish Health Repository)

    Murray, Dylan J

    2012-02-03

    BACKGROUND: The reduction of midface fractures has been associated with the rare but devastating complication of blindness. An increase in intraocular pressure is important in the mechanism of blindness in this setting. In this study, the authors assessed the intraocular pressure in patients who underwent zygomatic fracture reduction (with or without fixation). METHODS: Using applanation tonometry, 29 patients underwent intraocular pressure measurements before, during, and after fracture fixation. The contralateral pressures were measured and used as the control. RESULTS: There were 29 patients with a mean age of 35 years, and the mean time to surgery was 5 days. Preoperatively, all patients had normal intraocular pressures and normal visual acuity. All patients underwent a Gillies lift and 18 patients required open reduction and fixation of the frontozygomatic suture (n = 4) or the infraorbital margin (n = 2), and the remainder (n = 12) required fixation of both points. There was no statistically significant increase in the intraocular pressures following the reduction of uncomplicated zygomatic fractures. Statistically significant pressure reductions were noted immediately after reduction and fixation. CONCLUSIONS: The surgical reduction of uncomplicated zygomatic fractures has no adverse effect on the intraocular pressure. It is the authors\\' opinion that adjunctive measures to reduce the pressures are unnecessary.

  16. A STUDY ON INTERNAL FIXATION OF COMPOUND FRACTURES OF TIBIA USING INTERLOCKING NAIL WITHOUT REAMING

    Directory of Open Access Journals (Sweden)

    Pradeep Chandra

    2016-06-01

    Full Text Available As one-third of the tibial surface is subcutaneous throughout its length, open fractures are commonly encountered in this bone. The factors which determine the outcome of these fractures are severity of the injury, indicated by the degree of initial displacement, comminution and soft tissue injury and the damage to the tibial blood supply. In open fractures not only is the endosteal circulation disrupted but also the periosteal circulation, because of periosteal stripping. The various available options of treatment such as conservative short leg or long leg casting, open reduction and internal fixation with plates and screws, intramedullary fixation (Including Ender pins, Intramedullary nails and Interlocking Intramedullary nails with reaming or without reaming and external fixation techniques have their own advantages and disadvantages. The present study was conducted in the Department of Orthopaedics, Gandhi Hospital, during the period from October 2013 to November 2015, to evaluate the results of internal fixation with interlocking intramedullary nailing without reaming in the treatment of the open fractures of tibia. In our study, we got 91% good-to-excellent results evaluated by Johner and Wruh criteria. We opine that closed unreamed interlocking intramedullary nailing yields good-to-excellent results in compound diaphyseal fractures of the tibia, as this technique allows a good control over the rotations with axial stability of the fracture, thus maintaining the length of the limb and enabling early joint motion. The endosteal blood supply is also well preserved. These factors help in lowering the rates of infection, malunions and non-unions.

  17. Comparison of Complications for Internal and External Fixation for Charcot Reconstruction: A Systematic Review.

    Science.gov (United States)

    Dayton, Paul; Feilmeier, Mindi; Thompson, Mitchell; Whitehouse, Paul; Reimer, Rachel A

    2015-01-01

    The surgical reconstruction of Charcot deformity can be a challenge for foot and ankle surgeons. Consensus is lacking among surgeons regarding the best method of surgical fixation to be used in reconstruction, and clear strong evidence is also lacking in published studies. We undertook a systematic review of electronic databases and other relevant sources in an attempt to better understand the complications and outcomes associated with internal and external fixation for Charcot foot and ankle reconstruction. A total of 23 level 4 studies with 616 procedures were identified. Of these, 12 studies with 275 procedures used internal fixation, and 11 studies with 341 procedures used external fixation. The odds of a successful outcome with internal fixation was 6.86. The odds of a successful outcome with external fixation was 13.20 (odds ratio 0.52, 95% confidence interval 0.30 to 0.90). The odds of success for internal fixation was 0.52 times as likely as the odds of success with external fixation. Because the odds ratio did not include 1, this difference was statistically significant at the p foot and ankle surgeons when making decisions regarding fixation for Charcot reconstruction.

  18. Application of IMF screws to assist internal rigid fixation of jaw fractures: our experiences of 168 cases.

    Science.gov (United States)

    Bai, Zhenxi; Gao, Zhibiao; Xiao, Xia; Zhang, Wenjuan; Fan, Xing; Wang, Zhaoling

    2015-01-01

    Intermaxillary fixation (IMF) screws were first introduced to achieve IMF as a kind of bone borne appliance for jaw fractures in 1989. Because this method can overcome many disadvantages associated with tooth borne appliance, IMF screws have been popularly used for jaw fractures since then. From March 2011 to February 2014, we treated 168 cases with single or multiple jaw fractures by open reduction and a total of 705 IMF screws were intraoperatively applied in all the cases to achieve IMF and maintain dental occlusion as an adjuvant to open reduction. The numbers, implantation sites and complications of IMF screws were retrospectively analyzed. In our experience, we found that IMF screws were important to assist open reduction of jaw fractures but their roles should be objectively assessed and the reliability of open reduction and internal rigid fixation must be emphasized. Much attention should be paid when implanting.

  19. Open Versus Arthroscopic Reduction for Tibial Eminence Fracture Fixation in Children.

    Science.gov (United States)

    Watts, Chad D; Larson, A Noelle; Milbrandt, Todd A

    2016-01-01

    Stiffness is a common complication following surgically treated tibial eminence fractures. Fractures can be addressed with either open reduction and internal fixation (ORIF) or arthroscopic reduction and internal fixation (ARIF). We sought to evaluate the effects of surgical approach and other modifiable perioperative factors on postoperative arthrofibrosis. We hypothesized that ARIF would result in a lower risk of arthrofibrosis. We retrospectively reviewed the records of all patients aged 18 years and below treated for tibial eminence fractures at our institution from 1998 to 2014. All patients were treated by either pediatric or sports fellowship-trained orthopaedic surgeons and followed until radiographic union and return of range of motion or treatment for arthrofibrosis (minimum 3 mo). Thirty-one patients were included in our analysis, 13 in the ORIF group and 18 in the ARIF group. The groups were similar in regards to sex, age, fracture type, fixation method, and length of postoperative immobilization. However, when compared with the ORIF group, patients in the ARIF group had significantly longer time from injury to surgery (4.2 vs. 6.3 d, P=0.03), operative time (98 vs. 141 min, P=0.02), and tourniquet time (76 vs. 100 min, P=0.006). In the ARIF group, 6 (33.3%) patients acquired arthrofibrosis compared with only 1 (7.7%) patient in the ORIF group. Delaying surgery ≥7 days from injury [hazard ratio (HR)=4.7, P=0.04] and operative time ≥120 minutes (HR=9.1, P=0.03) were risk factors for arthrofibrosis. ARIF was a risk factor in univariate (HR=4.0, P=0.04), but not in multivariate (1.4, P=0.77) analysis. Delayed surgery (≥7 d from injury) and prolonged operative times (≥120 min) were significant risk factors for arthrofibrosis. Although ARIF was not an independent risk factor, these patients were exposed to markedly longer wait times before surgery and operative times when compared with ORIF patients. ORIF is a reasonable option for treatment of

  20. Distal radioulnar joint instability (Galeazzi type injury) after internal fixation in relation to the radius fracture pattern.

    Science.gov (United States)

    Korompilias, Anastasios V; Lykissas, Marios G; Kostas-Agnantis, Ioannis P; Beris, Alexandros E; Soucacos, Panayiotis N

    2011-05-01

    The purpose of this study was to classify Galeazzi type injuries and determine the association of residual instability after rigid fixation with the fracture pattern of the shaft of the radius, using a system that is based on anatomic landmarks of the radial shaft. The clinical records of 95 patients (72 men and 23 women) with Galeazzi type injuries requiring open reduction and internal fixation of the fractures were retrospectively reviewed. The mean follow-up was 6.8 years (range, 18 mo to 11 y) after injury. Sixty-nine fractures occurred in the distal third of the radial shaft (type I), 17 fractures were in the middle third (type II), and 9 fractures were in the proximal third of the shaft of the radius (type III). Gross instability of the distal radioulnar joint (DRUJ) was determined intraoperatively by manipulation after radial fixation as compared to the uninjured side. Forty patients had DRUJ instability after internal fixation and were treated with temporary pinning with a K-wire placed transversely proximal to the sigmoid notch. Distal radioulnar joint instability after internal fixation was recorded in 37 type I fractures, 2 type II fractures, and 1 type III fracture. Distal radioulnar joint instability following radial shaft fracture fixation is significantly higher in patients with type I fractures than in patients with type II or type III fractures. The location of the radius fracture can be sufficiently used for preoperative estimation of percentage chance of potential DRUJ instability after fracture fixation. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  1. 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.

  2. CLOSED REDUCTION AND PERCUTANEOUS K-WIRES FIXATION OF DISPLACED SUPRACONDYLAR HUMERUS FRACTURES IN CHILDREN

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective. To observe the effects of closed reduction and pereutaneous K-wires fixation of displacd supracondylar humnerus fracture in children. Methods. Retrospective review of fourteen patients who sustained displaced supmcondylar fracture of distal humerus treated by closed reduction and percutaneous K-wires fixation. Results. All patients' K-wires were removed at 4 weeks post-operation. Their elbow function regained at 8weeks. The average period of followed up was 10 month (varies from 6 to 18 month), all fractmes healed very well without any permanent complications. Two transient nerves palsy, ulnar and radial nerve each, recovered completely at12 weeks and 16 weeks post-operation respectively. Conclusion. Closed reduction and percutaneous K-wires fixation is a safe and efficient treatment for displaced humerus surpracondylar fracture in children.

  3. Evaluation of Reduction Accuracy of Suture-Button and Screw Fixation Techniques for Syndesmotic Injuries.

    Science.gov (United States)

    Kocadal, Onur; Yucel, Mehmet; Pepe, Murad; Aksahin, Ertugrul; Aktekin, Cem Nuri

    2016-12-01

    Among the most important predictors of functional results of treatment of syndesmotic injuries is the accurate restoration of the syndesmotic space. The purpose of this study was to investigate the reduction performance of screw fixation and suture-button techniques using images obtained from computed tomography (CT) scans. Patients at or below 65 years who were treated with screw or suture-button fixation for syndesmotic injuries accompanying ankle fractures between January 2012 and March 2015 were retrospectively reviewed in our regional trauma unit. A total of 52 patients were included in the present study. Fixation was performed with syndesmotic screws in 26 patients and suture-button fixation in 26 patients. The patients were divided into 2 groups according to the fixation methods. Postoperative CT scans were used for radiologic evaluation. Four parameters (anteroposterior reduction, rotational reduction, the cross-sectional syndesmotic area, and the distal tibiofibular volumes) were taken into consideration for the radiologic assessment. Functional evaluation of patients was done using the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale at the final follow-up. The mean follow-up period was 16.7 ± 11.0 months, and the mean age was 44.1 ± 13.2. There was a statistically significant decrease in the degree of fibular rotation (P = .03) and an increase in the upper syndesmotic area (P = .006) compared with the contralateral limb in the screw fixation group. In the suture-button fixation group, there was a statistically significant increase in the lower syndesmotic area (P = .02) and distal tibiofibular volumes (P = .04) compared with the contralateral limbs. The mean AOFAS scores were 88.4 ± 9.2 and 86.1 ± 14.0 in the suture-button fixation and screw fixation group, respectively. There was no statistically significant difference in the functional ankle joint scores between the groups. Although the functional outcomes were similar, the

  4. The mid - and long - term clinical outcomes of open reduction and internal fixation for dislocation of hip joint combined with posterior wall or/and column fractures of acetabulum%髋关节后脱位并髋臼后壁(柱)骨折手术治疗结果分析

    Institute of Scientific and Technical Information of China (English)

    何长街; 刘志礼; 舒勇; 黄山虎

    2011-01-01

    目的 探讨髋臼后壁(柱)骨折伴髋关节脱位手术治疗的中远期疗效.方法 回顾性分析21例髋关节脱位伴髋臼骨折患者临床资料,其中20例髋臼脱位行闭合复位,1例行急诊切开复位内固定;所有合并的髋臼骨折均采用开放复位内固定术治疗.结果 完整随访19例,失访 2例,随访时间29~86个月.按髋关节功能恢复情况评分:优13例,良3例,可2例,差1例,优良率84.2%.结论 髋关节脱位伴髋臼骨折应尽早诊断,应尽快行髋关节复位,骨折应尽早开放复位内固定,早期功能锻炼,避免过早负重.%Objectives To investigate the mid - and long - term clinical outcomes of open reduction and internal fixation(ORIF) for treating the dislocation of hip joint with posterior wall or/and column fractures of acetabulum. Methods The clinic data of 21 patients with dislocation of hip joint and posterior wall fracture of acetabulum who were given close reduction( n = 20)or open reduction and internal fixation(ORIF) ( n = 1 ) for disclocation of hip joint and then were treated with ORIF for the fracture of acetabulum were retrospectively analyzed. Results A total of 19 patients were followed up for 29 to 86 mon. According to Letournel E's hip joint functional scoring system, clinical outcome was excellent in 13 patients,good in 3 patients,fair in 2 patients,and poor in one patient. The ratio of fineness of the midand long - term clinical outcomes was 84. 2%. Conclusion The dislocation of hip joint combined with posterior wall fracture of acetabulum should be diagnosed early, and reduction of the hip joint and ORIF should be performed as soon as possible. The positive functional exercise is necessary and the premature weight bearing on the hip joint should be avoided at early time.

  5. Delayed Open Reduction and K-Wire Fixation of Widely Displaced Supracondylar Fractures of Humerus in Children using Medial Approach

    Science.gov (United States)

    Waikhom, Sanjib; Ibomcha, Irom; Digendra, Akoijam; Sohkhlet, Handboy R

    2016-01-01

    Introduction Supracondylar fractures of humerus in children are usually treated with percutaneous pinning on emergency basis. When the operating time is delayed, percutaneous pinning is difficult due to massive swelling. Late presentation is common in developing countries. Aim To assess the outcome of open reduction and internal fixation with K-wire of widely displaced supracondylar fracture when operated later than 2 days after the injury. Materials and Methods A total of 52 children (aged 3-12 years) with widely displaced supracondylar fracture of humerus (Gartland type-III) who presented later than 2 days after injury were treated with open reduction through medial approach and fixation with cross K-wires. Results were assessed with Flynn’s criteria. Result: A total of 40 patients completed follow-up. Mean age of all (n=52) patients was 4.8 years (range 3-12 years). Mean delay of presentation was 7.5 days (range 2-14 days). Hundred percent patients had satisfactory results according to Flynn’s criteria. Two patients had pin infections. Conclusion Open reduction through medial approach and fixation with two cross K-wires is a reliable method of treatment for supracondylar fractures of humerus in children when the operation is delayed. PMID:27656516

  6. Arthroscopy-Assisted Reduction and Fixation of a Transversal Glenoid Fracture: About a Case

    Directory of Open Access Journals (Sweden)

    David Zbili

    2017-01-01

    Full Text Available An articular glenoid fracture is an uncommon injury. Usually significantly displaced intra-articular glenoid fractures are treated with open reduction surgery. Conventional open surgery techniques involve high morbidity. Here we describe an arthroscopy-assisted reduction and fixation method of an Ideberg type III glenoid fracture. This method provides good articular reduction without extensive exposure or soft tissue dissection and without nerve and/or vascular lesion.

  7. 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...

  8. A novel internal fixator device for peripheral nerve regeneration.

    Science.gov (United States)

    Chuang, Ting-Hsien; Wilson, Robin E; Love, James M; Fisher, John P; Shah, Sameer B

    2013-06-01

    Recovery from peripheral nerve damage, especially for a transected nerve, is rarely complete, resulting in impaired motor function, sensory loss, and chronic pain with inappropriate autonomic responses that seriously impair quality of life. In consequence, strategies for enhancing peripheral nerve repair are of high clinical importance. Tension is a key determinant of neuronal growth and function. In vitro and in vivo experiments have shown that moderate levels of imposed tension (strain) can encourage axonal outgrowth; however, few strategies of peripheral nerve repair emphasize the mechanical environment of the injured nerve. Toward the development of more effective nerve regeneration strategies, we demonstrate the design, fabrication, and implementation of a novel, modular nerve-lengthening device, which allows the imposition of moderate tensile loads in parallel with existing scaffold-based tissue engineering strategies for nerve repair. This concept would enable nerve regeneration in two superposed regimes of nerve extension--traditional extension through axonal outgrowth into a scaffold and extension in intact regions of the proximal nerve, such as that occurring during growth or limb-lengthening. Self-sizing silicone nerve cuffs were fabricated to grip nerve stumps without slippage, and nerves were deformed by actuating a telescoping internal fixator. Poly(lactic co-glycolic) acid (PLGA) constructs mounted on the telescoping rods were apposed to the nerve stumps to guide axonal outgrowth. Neuronal cells were exposed to PLGA using direct contact and extract methods, and they exhibited no signs of cytotoxic effects in terms of cell morphology and viability. We confirmed the feasibility of implanting and actuating our device within a sciatic nerve gap and observed axonal outgrowth following device implantation. The successful fabrication and implementation of our device provides a novel method for examining mechanical influences on nerve regeneration.

  9. Role of joystick-assisted nail insertion in close reduction and internal fixation of subtrochanteric fractures%撬拨辅助钉道控制在闭合治疗股骨转子下骨折中的意义

    Institute of Scientific and Technical Information of China (English)

    王建东; 王秋根; 桑伟林; 王传舜; 赵奇; 李凡

    2009-01-01

    Objective To evaluate the effect of joystick-assisted natl insertion in close reduction and internal fixation of subtrochanteric fractures. Methods The study involved 23 patients with subtruchanteric fractures treated in our hospital. Schanz pins were placed into the posterior part of the femoral trochanter to assist the reduction of the displaced fragment before fixation with proximal femoral natl (PFN) and proximal femoral natl anti-rotation (PFNa). Results The operation lasted for mean 39 minutes (30-55 minutes), with mean blood loss of 78 ml (50-120 ml). Roentgenography showed good alignment on follow-up and fracture healing, with no serious complication observed. Conclusions Schanz pin inserted in femoral trechanter can help reduce the displaced proximal fragment in patients with subtrochanteric fractures, with advantages of short operation time, minor trauma and stable fixation.%目的 评估术中使用斯氏针撬拨辅助钉道控制闭合复位的效果. 方法 23例股骨转子下骨折,术中用斯氏针置入股骨大转子后部协助复位,闭合复位后股骨近端髓内钉(PFN)或抗旋股骨近端髓内钉(PFNa)固定. 结果 23例患者手术时间30~55 min,平均39 min,出血量50~120 ml,平均76 ml.术中透视、术后X线复查骨折对位对线优良,骨折全部获得愈合,无严重并发症. 结论在髓内钉治疗股骨转子下骨折时,股骨近侧置入斯氏针撬拨辅助钉道控制能较好纠正和控制股骨转子下骨折近端骨折块的移位,手术时间短,创伤小,固定可靠.

  10. Halo-vest reduction combined with anterior decompression and internal fixation for lower cervical spine fracture and dislocation%Halo-vest支架复位联合前路减压内固定治疗下颈椎骨折脱位

    Institute of Scientific and Technical Information of China (English)

    姚关锋; 王新家; 王伟东; 郑瑞武; 陈灵梓

    2015-01-01

    Objective To investigate the efficacy of lower cervical spine fracture and dislocation treated by Halo-vest reduction combined with anterior decompression and internal fixation.Methods From January 2009 to December 2012,26 cases of lower cervical spine fracture and dislocation underwent Halovest reduction combined with anterior decompression and internal fixation.There were 18 males and 8 females,aged 19-64 years (mean,42.1 years).Injury resulted from traffic crashes in 11 cases,high falls in 9,and hit by heavy objects in 6.Segment of injury was C5/6in 10 cases,C6/7in 9,C3/4in 4,and C4/5in 3.Prior to anterior decompression/internal fixation and fusion,the Halo-vest external fixation was performed.Neurological performance was evaluated after operation.Results All the patients were followed up for 24-36 months (mean,27.4 months).According to the X-ray films and CT scan at the final follow-up,the alignment of the cervical spine was maintained and the implanted bone was completely fused without internal fixation breaking or loosening.Preoperative neurological status according to the Frankel grading was grade A in 6 cases,grade B in 8,grade C in 7,and grade E in 2.After operation,there were 5 cases in grade A,3 in grade B,4 in grade C,5 in grade D,and 9 in grade E.All together,6 cases presented two-grade improvement in neurological status,13 one-grade improvement,and 5 no changes (P < 0.05).Conclusion Halo-vest reduction combined with anterior decompression and internal fixation is safe and effective in treatment of lower cervical spine fracture and dislocation.%目的 探讨Halo-vest支架复位联合前路减压内固定治疗下颈椎骨折脱位的临床疗效. 方法 2009年1月-2012年12月采用Halo-vest支架复位联合前路减压融合内固定治疗下颈椎骨折脱位患者26例,其中男18例,女8例;年龄19~64岁,平均42.1岁.致伤原因:交通伤11例,高处坠落伤9例,重物压砸伤6例.骨折脱位部位:C5/610例,C6/79例,C3/44例,C4/53

  11. 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

  12. Microscope-assisted transoral-transpharyngeal reduction and fixation of basilar invagination and atlantoaxial dislocation

    Directory of Open Access Journals (Sweden)

    ZHU Wei-jie

    2012-08-01

    Full Text Available Objective To study the outcome of the transoral reduction and fixation of basilar invagination and atlantoaxial dislocation, to evaluate this novel technique involving a microscope-assisted anterior release and reduction and fixation through a transoral-transpharyngeal approach and describe the safety and efficacy of a new minimal invasive technique for the irreducible atlantoaxial dislocation (IADD. Methods A prospective clinical study was performed. Three consecutive irreducible atlantoaxial dislocation patients underwent a microscope-assisted anterior release and reduction and fixation through transoral-transpharyngeal approach. Transoral atlantoaxial reduction plate (TARP for anterior fixation and autologous morselized bone grafting were used during the operation. The Japanese Orthopaedic Association (JOA scoring system was used to evaluate each patient's neurological status pre- and post-operatively, and serial MRI and radiographs were used to evaluate the status of the reduction including the atlantoaxial interval and cervicomedullary angle were also measured. The clinical features, imaging data, special preoperative preparation, surgical approach, skills and postoperative complications of the 3 cases were analyzed. Results The average operation time was 130 min (110 min, 130 min, 150 min, respectively and the mean estimated blood loss was 150 ml (100 ml, 200 ml, 150 ml, respectively. According to the postoperative CT all the 3 plates and 12 screws were appropriately placed and fixed. All cases of basilar invagination and atlantoaxial dislocation were corrected differentially in terms of anatomic reduction and neurological disturbances were reversed remarkably. The improvement rate of spinal cord function was 75.00%, 40.00%, 56.25%, respectively according to JOA score, average improvement rate was 57.08%, and average recovery rating was "good". Postoperative nosocomial intracranial infection occurred in one case and was cured finally

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

    Directory of Open Access Journals (Sweden)

    Venkatesh Kumar

    2014-05-01

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

  14. 经皮撬拨复位轴向结合横向多枚中空钉内固定治疗SandersⅡ、Ⅲ型跟骨骨折的临床疗效%An analysis of the clinical effects of percutaneous fracture reduction followed by internal fixation with multiple axial and horizontal cannulated screws in the treatment of Sanders type II and III calcaneal fracture

    Institute of Scientific and Technical Information of China (English)

    林文琛; 许耀明; 颜峻; 李超颖; 郑烽礼

    2014-01-01

    ObjectiveTo explore and compare the curative effects of percutaneous fracture reduction followed by internal fixation with cannulated screws and open reduction followed by internal fixation with titanium plate in the treatment of Sanders typeⅡ andⅢ calcaneal fracture at early stage.Methods 60 patients with calcaneal fracture from February 2010 to September 2013 were selected. They all belonged to Sanders typeⅡ andⅢ fracture, in which 34 patients were typeⅡ and 26 typeⅢ. All patients were randomly assigned to two groups and received surgeries of percutaneous fracture reduction followed by internal fixation with cannulated screws and open reduction followed by internal fixation with titanium plate. They were observed in the follow-ups, and functional evaluation was carried out via Marryland evaluation system. Excellent and good rate of the two methods was calculated, and differences between the two groups were analyzed through statistics. Results Follow-ups were carried out for 60 patients, and the follow-up time was 4-38 months (average 18 months). Clinical effects: among 31 patients who received percutaneous fracture reduction followed by internal fixation with cannulated screws, 18 patients showed excellent foot functions, 6 good, 3 average and 2 unsatisfactory. The excellent and good rate was 83.8%; among 29 patients who received open reduction followed by internal fixation with titanium plate, 18 patients showed excellent foot functions, 6 good, 3 average and 2 unsatisfactory. The excellent and good rate was 82.8%. The differences of the excellent and good rate between the two methods were not statistically significant (x2=0.617,P =0.971>0.05).Conclusion Percutaneous fracture reduction followed by internal fixation with cannulated screws and open reduction followed by internal fixation with titanium plate in the treatment of calcaneal fracture can both achieve favorable effects. Percutaneous fracture reduction followed by internal fixation with

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

    Science.gov (United States)

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

    2013-01-01

    A 24-year-old woman with pain in the right elbow after a fall demonstrated a coronal shear fracture on radiographic studies. Perioperative a coronal shear fracture was seen and treated successfully with a polylactide Rigid fix resorbable pin. The operative correction resulted in normal function at 6 months follow-up. We state that a capitellum shear fracture can be fixated with a single resorbable pin, leading to successful fusion. PMID:23378544

  16. Treatment of linguiform calcaneus fracture by close nail-pry reduction and internal fixation with hollow screws%闭合撬拨复位经皮空心螺钉内固定治疗跟骨舌形骨折

    Institute of Scientific and Technical Information of China (English)

    涂淑强; 黄科棣; 帅永明; 徐南云; 袁秋文; 郭剑

    2012-01-01

    Objective: To study the curative effects of close nail-pry reduction and internal fixation with hollow screws for treatment of linguiform calcaneus fracture. Methods: From May 2006 to October 2009,32 patients (35 feel) with linguiform calcaneus fracture were treated by close nail-pry reduction and internal fixation with hollow screws, including 23 males and 9 females ranging in age from 25 to 46 years, with a mean of 37.6 years. According to Paley classification, 3 cases were Paley II a, and 29 cases were Paley II b. All cases were close fractures. The time from injury to operation was 3 to 10 days after most swelling subsided. BBhler angle and Gissane angle were measured by X-ray before and after operation. The therapeutic effect was assessed according to ZHANG Tie-liang's foot score. Results:All the patients were followed-up for 6 to 18 months,with a mean of 12 months. All fractures gained bone healing. The time of fracture healing averaged 12 months. The fractures healed completely and no infection occurred. According to ZHANG Tie-liang's foot scale,the postoperative function was excellent in 18 feet,good in 10 feet, moderate in 5 feet and poor in 2 feet. The Bohler angle and Gissane angle were significant improved after treatment (P<0.01 ). Conclusion: The surgical method of close nail-pry reduction and internal fixation with hollow screws for treatment of linguiform calcaneus fracture can regain the foot function, with minimal injury, fewer complications, earlier recovery and lower costs.%目的:探讨闭合撬拨复位经皮空心螺钉内固定治疗跟骨舌形骨折的手术疗效.方法:自2006年5月至2009年10月共收治32例(35足)跟骨舌形骨折,男23例,女9例;年龄25~46岁,平均37.6岁.根据Paley分类法:PaleyⅡa型3例,PaleyⅡb型29例,均为闭合性骨折.手术时间为伤后3~10d,均等局部肿胀消退至中、轻度后手术.通过X线片测量手术前后B(o)hler角及Gissane角,并按张铁良足部综

  17. Open Reduction and Internal Fixation with DHS Combined with Anti-rotation Screw to Treat Pauwels Type Ⅲ Femoral Neck Fracture in Young Adults%切开复位DHS联合抗旋螺钉固定治疗青壮年股骨颈PauwelsⅢ型骨折

    Institute of Scientific and Technical Information of China (English)

    曲国胜; 刘建华; 马英; 杨国良; 冯世斌

    2011-01-01

    目的:评价切开复位DHS 联合抗旋螺钉固定治疗青壮年股骨颈Pauwels Ⅲ型骨折的临床效果.方法:采用回顾性分析的方法,总结2005 年2月~2009 年4月,我院手术治疗的Pauwels Ⅲ型骨折患者26 例.其中,男22 例,女4例,年龄19~47 岁,平均38.4 岁.骨折按Pauwels 型均为Ⅲ型,采用切开复位DHS 联合空心钉固定.结果:本组患者随访时间20~70 个月,平均31.2 个月.除3例发生股骨头缺血性坏死外,其余23名患者骨折均得到愈合.根据Harris 髋关节功能评分系统评估疗效,优18 例,良5例,差3例.结论:切开复位DHS 联合抗旋螺钉固定治疗青壮年股骨颈Pauwels Ⅲ型骨折的疗效肯定,解剖复位、坚强固定是获得满意疗效的关键.%Objective:To evaluate the result of Pauwels type Ⅲ femoral neck fracture in young adults treated with open reduction and internal fixation with DHS combined with anti-rotation screw.Methods:A retrospective analysis was done on the clinical date of 16 cases of young Pauwels type Ⅲ fracture,which were surgically treated in our hospital from February 2005 to April 2009.There were 15 males and 1 females,with an average of 38.4 years old (ranged from l9 to 47 years old).All were Pauwels type Ⅲ fracture and treated with the method of open reduction and fixed with DHS combined with anti-ration screw.Results: The average period of follow-up of these 16 cases was 20~70 months.l4 patients got fracture union,and 2 cases suffered from osteonecrosis of femoral neck.According to Harris criterion,the results of the treatment was evaluated as excellent in 11 cases,good in 3 cases,bad in 2 cases.Conclusion:Effect of the open reduction and internal fixation with DHS combine with anti-rotation screw to treat young Pauwels type Ⅲ fracture is definite,anatomic reduction and rigid fixation of operation can lower the rate of complications effectively.

  18. Complications and functional outcome after internal fixation of dorsally displaced distal radial fractures

    DEFF Research Database (Denmark)

    Bove, Jeppe; Viberg, Bjarke; Greisen, Pernille

    -ray images showed 14 cases of too radi- al plate placement and 1 one forgotten tower. Conclusion: The literature describes an overall complication frequency between 0 and 27%, with a lower frequency of secondary procedures compared to this study. There is still a need for further studies......Background: Recently there has been an increasing interest in open reduction and internal fixation of distal radius fractures. Even so further studies are still needed. Purpose: To document the functional outcome and identify complica- tions among patients treated with a volar locking plate (DVR......-locking plate, DePuy Orthopaedics) newly introduced in our department. Methods: The study was designed as a historical cohort study. 37 females and 6 males with a mean (CI) age of 72,6 (69,5-75,6) were included. 35 received 6 months follow up (median 6,4) and 30 received 1 year follow up (median 14,0). Outcome...

  19. HIGH DEGREE SPONDYLOLISTHESIS IN ADULTS: MONOSEGMENTAL REDUCTION AND FIXATION

    Directory of Open Access Journals (Sweden)

    Eduardo Henrique Chiovato Abdala

    2015-09-01

    Full Text Available Objective:To evaluate a method to reduce high degree spondylolisthesis in adults with monosegmental fixing preserving the adjacent level and the improvement of sagittal balance.Methods:A prospective study, with 12 adult patients with high degree spondylolisthesis (III and IV in adults who underwent surgery by the same team. We included 7 women and 5 men with a mean age of 37 years and lombosciatalgy that had no improvement with conservative treatment. The surgical technique used was total or partial reduction by Spondylolisthesis Reduction Instrument (SRI system, with instrumentation only in the affected level, thus sparing the adjacent level, associated with 360ofusion.Results:The L5-S1 level was involved in nine patients, L4-L5 in two, and VT-S1 in one patient. The isthmic type predominated in nine patients, followed by dysplastic type in two, and one iatrogenic spondylolisthesis. These patients were assessed by the Oswestry scale, which showed a preoperative average of 59% and postoperative average of 12.4% (P<0.05. A significant improvement in the average slip angle from 54.66% to 9.5% (35% to 0% was found. No major complications such as infection, neurological damage or material breaks were observed.Conclusion:The reduction of high degree listhesis instrumenting only the affected level produces good results, with good control of pain and functional improvement of patients. However, a larger follow-up is required to better evaluation.

  20. 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.

  1. [Bone substitutes augmentation combined with internal fixation versus internal fixation alone in treating proximal femoral fractures in the elderly: a meta-analysis].

    Science.gov (United States)

    Wu, Jian-bin; Yang, Lei; Zhou, Fei-ya; Feng, Yong-zeng

    2016-06-01

    To systematically review the effectiveness of bone substitute augmentation combined with internal fixation versus internal fixation alone in treating proximal femoral fractures in the elderly. Subject term and keywords were searched from Pubmed, Cochrane databases and CNKI from database foundation to August 2015. Randomized controlled studies and qusi-randomized controlled studies on bone substitutes augmentation combined with internal fixation versus internal fixation alone for the treatment of proximal femoral fractures in the elderly were chosen. Postoperative re-displacement, re-operation rate, complications (infection and bone ununion), functional outcome, quality of life scores and muscle strength were seen as outcome indicators. Enumeration data were statistical analyzed by risk difference and 95% confidence interval. Measurement data were analyzed by standardized mean difference and 95% confidence interval. If the same measurement data were evaluated by different standards in different studies, standardized mean differences and 95% confidence interval were used. The methods of statistical analysis were used by Cochrane databases. Eleven RCTs (677 patients) were included. Meta-analysis results indicated that bone substitutes augmentation combined with internal fixation occurred fewer re-displacement [SMD = -0.75, 95% CI (-1.03, -0.47)] and obtained better function [SMD = 0.40, 95% CI (0.20, 0.59)]. While there were no significant differences in reoperation rate [RD = 0.02, 95% CI (-0.05, -0.09)], pain at 1 week after operation [MD = -1.79, 95% CI (-13.55, -9.96)], pain ranged from 6 to 8 weeks [MD = -7.24, 95% CI (-20.07, -5.59)], postoperative pain at 12 weeks [MD = -0.32, 95% CI (-4.9, -3.55)], muscle strength [MD = 1.25, 95% CI (-6.98, -9.48)], bone ununion [RD = 0.02, 95% CI (-0.01, -0.05)] and postoperative complications [MD = 0.01, 95% CI (-0.03, -0.04)]. Compared with single internal fixation, bone substitutes augmentation combined with internal

  2. Evaluation the treatment outcomes of intracapsular femoral neck fractures with closed or open reduction and internal fixation by screw in 18-50-year-old patients in Isfahan from Nov 2010 to Nov 2011

    Directory of Open Access Journals (Sweden)

    Mohammad Javdan

    2013-01-01

    Conclusion: This study showed that femoral neck fracture is associated with several complications, especially if open reduction was necessary. So, the surgical method and necessary equipments such as radiolucent bed, C-ARM machine, and implant cannulated screw set should be considered.

  3. Arthroscopic Reduction and Internal Fixation of Avulsion Fracture of Anterior Cruciate Ligament from Tibial Eminence with Stainless Steel Wire%关节镜下钢丝固定治疗前交叉韧带胫骨止点撕脱骨折

    Institute of Scientific and Technical Information of China (English)

    卢华定; 史德海; 董云旭; 王昆; 曾春

    2011-01-01

    Objective To investigate the therapeutic efficacy of arthroscopic internal fixation of avulsion fracture of the anterior cruciate ligament (ACL) from the tibial eminence with stainless steel wire. Methods Thirteen cases of displaced avulsion fracture of the ACL from the tibial eminence were treated by arthroscopic reduction and internal fixation with stainless steel wire from January 2003 to June 2006.Adjustable brace was used for protection after surgery, and active rehabilitation training was conducted. The Lysholm scoring scale system was used to evaluate knee functions before and after surgery. Regular X-ray plain films at AP and lateral views were conducted to detect the bony healing of avulsed fragments postoperatively. Results Thirteen cases were followed up for 6 to 32 months and the average time was 14 months. No complications of intraarticular infection, iatrogenic injury, anchylosis, loss of knee extension, or nonunion of fracture were found. X-ray films revealed good bone union in all the 13 cases three months after surgery. No knee instability was detected, and knee flexion and extension function was normal in all patients. The Lysholm scores were improved from 39.4±9.98 preoperatively to 95.2±2.94 postoperatively, with significant statistical difference by the student-t test (t = 24.001,P <0.01). Conclusion Arthroscopic reduction and internal fixation with stainless steel wire in the treatment of avulsion fracture of the anterior crnciate ligament from the tibial eminence has advantages of simplicity, broad indications,minimal invasion, and rapid postoperative recovery. It is believed as an ideal choice for such avulsion fracture of the anterior cruciate ligament from the tibial eminence.%目的 探讨关节镜下钢丝内固定治疗前交叉韧带(ACL)胫骨止点撕脱骨折的临床疗效.方法 自2003年1月~2009年6月采用关节镜下复位钢丝内固定治疗13例移位的ACL胫骨止点撕脱骨折,术后可调式支具保护,积

  4. Clamping stiffness and its influence on load distribution between paired internal spinal fixation devices.

    Science.gov (United States)

    Rohlmann, A; Calisse, J; Bergmann, G; Radvan, J; Mayer, H M

    1996-06-01

    The load distribution between two internal spinal fixation devices depends, besides other factors, on their stiffness. The stiffness ranges were determined experimentally for the clamps of the AO internal fixator with lateral nut and with posterior nut as well as for the clamps of the SOCON fixator. The stiffness of eight devices each differed by a factor of 3.1 for the clamp with lateral nut, by a factor of 1.5 for the clamp with posterior nut, and by a factor of 1.4 for the clamp of the SOCON fixator. For the AO clamp with lateral nut, the influence of the nut-tightening torque on the stiffness was determined. Using instrumented internal spinal fixation devices mounted to plastic vertebrae and simulating a corpectomy, the load distribution between the implants was measured for different tightening torques. It could be shown that, for the AO internal fixator whose clamps have a lateral nut, a nut-tightening torque > 5 Nm has only a negligible influence on load-sharing between the implants. Tooth damage occurs when the teeth of the clamp body and clamping jaw of the clamp with lateral nut do not gear together exactly, which leads to changes in the clamping stiffness and load-sharing between the two implants.

  5. IMF Screw: An Ideal Intermaxillary Fixation Device During Open Reduction of Mandibular Fracture.

    Science.gov (United States)

    Sahoo, N K; Mohan, Ritu

    2010-06-01

    Intermaxillary fixation (IMF) is conventionally used for treatment of fractures involving maxillomandibular complex both for closed reduction and as an adjuvant to open reduction. To overcome the cumbersome procedure of tooth borne appliances cortical bone screws were introduced in the year of 1989 to achieve IMF which is essentially a bone borne appliance. In our institution we treated 45 cases of mandibular fracture both single and multiple fractures by open reduction over a period of 24 months. IMF screws were used to achieve dental occlusion in all the cases. Various advantages, disadvantages and complications are discussed. In our institutional experience we found that the IMF screws are an ideal device for temporary intermaxillary fixation for the cases having only mandibular fracture.

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

    Directory of Open Access Journals (Sweden)

    Milenković Saša

    2013-01-01

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

  7. The reverse abdominal reduction and the 'waistcoating' procedure for the correction of the fixated Pfannenstiel incision.

    Science.gov (United States)

    Harrison, Douglas H

    2016-05-01

    The principles of a standard abdominal reduction are well understood; this technique has been used for many years. However, a reverse abdominal reduction may be considered in some cases, for example, continued weight loss, and thus skin redundancy on the upper abdomen in patients who have already undergone abdominal reduction and upper abdomen improvement in patients requiring a mastopexy or breast reduction simultaneously. Reverse abdominal reduction is rarely mentioned in the medical literature, but it can prove successful; although the scar across the lower sternum has often been considered to be unsatisfactory, often it does not prove to be so. Thus, this procedure can be proven to be successful in suitable cases. Secondly, the Pfannenstiel incision, if not satisfactorily repaired in the first instance, can become fixated to the abdominal wall; this fixation along with the inevitable migration of skin and fat at its cephalic edge causes a rather displeasing contour defect when wearing tight-fitting swimwear. The principle of the waistcoating procedure is essentially to chamfer the fat cephalically; this procedure is employed for removing the Pfannenstiel scar from the abdominal wall. The principle is simple and effective and can be applied in cases with fixated scars. These two aforementioned principles are not commonly used, but they can prove particularly effective in suitable cases. We illustrate the principles.

  8. Treatment of multiple base unstable fractures of metatarsal bone combined with tarsometatarsal joint injury by open reduction and internal fixation%切开复位内固定治疗多发跖骨基底部不稳定骨折合并跖跗关节损伤

    Institute of Scientific and Technical Information of China (English)

    张海波; 李勇; 蔡友芳

    2013-01-01

    [Objective] To explore the therapy and the clinical effectiveness of open reduction and internal fixation in the treatment of multiple base unstable fractures of metatarsal bone combined with tarsometatarsal joint injury. [ Method] From January 2003 to July 2001,35 patients with multiple base unstable fractures of metatarsal bone combined with tarsometatarsal joint injuries underwent open reduction and internal fixation. There were 22 males and 13 females with an average age of 37.4 years (range,20 -58 years) ,with total of 89 base fractures. There were 9 cases in the second to third metatarsal bone,7 in the third to fourth metatarsal bone and 19 in the second to fourth metatarsal bone. The classification of tarsometatarsal joint injury showed that there were 2 case of simple middle column ,7 cases of inner and middle columns, 10 cases of lateral and middle colums ,16 cases of three columns. The second and third base fractures of metatarsal bone were treated with transarticular fixation by miniplate. [Result]All the patients were followed up,the duration ranged from 12 to 30 months (averaged 22. 5 months). No complications such as wound infection, skin necrosis and fixture breakage were found postoperatively. The clinical fracture healing time was 8 to 17 weeks (mean ,13.9 weeks). The results were excellent in 11 cases, good in 18 cases, fair in 4 cases, and poor in 2 cases according to American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score system,with excellent and good result rate of 82. 9%. [ Conclusion ] The anatomical reduction and stable fixation of tarsometatarsal joint and metatarsal base are also important to rebuild the function of foot, can reduce incidence rate of osteoarthritis at midfoot and obtain very good clinical effect. Reasonable internal fixation should be selected according to injury type.%[目的]探讨切开复位内固定治疗多发跖骨基底部不稳定骨折合并跖跗关节损伤的方法及临床疗效.[方法]2003年1

  9. [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.

  10. Clinical efficacy and safety of limited internal fixation combined with external fixation for Pilon fracture: A systematic review and meta-analysis.

    Science.gov (United States)

    Zhang, Shao-Bo; Zhang, Yi-Bao; Wang, Sheng-Hong; Zhang, Hua; Liu, Peng; Zhang, Wei; Ma, Jing-Lin; Wang, Jing

    2017-04-01

    To compare the clinical efficacy and complications of limited internal fixation combined with external fixation (LIFEF) and open reduction and internal fixation (ORIF) in the treatment of Pilon fracture. We searched databases including Pubmed, Embase, Web of science, Cochrane Library and China Biology Medicine disc for the studies comparing clinical efficacy and complications of LIFEF and ORIF in the treatment of Pilon fracture. The clinical efficacy was evaluated by the rate of nonunion, malunion/delayed union and the excellent/good rate assessed by Mazur ankle score. The complications including infections and arthritis symptoms after surgery were also investigated. Nine trials including 498 pilon fractures of 494 patients were identified. The meta-analysis found no significant differences in nonunion rate (RR = 1.60, 95% CI: 0.66 to 3.86, p = 0.30), and the excellent/good rate (RR = 0.95, 95% CI: 0.86 to 1.04, p = 0.28) between LIFEF group and ORIF group. For assessment of infections, there were significant differences in the rate of deep infection (RR = 2.18, 95% CI: 1.34 to 3.55, p = 0.002), and the rate of arthritis (RR = 1.26, 95% CI: 1.03 to 1.53, p = 0.02) between LIFEF group and ORIF group. LIFEF has similar effect as ORIF in the treatment of pilon fractures, however, LIFEF group has significantly higher risk of complications than ORIF group does. So LIFEF is not recommended in the treatment of pilon fracture. Copyright © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.

  11. A new device for internal fixation of thoracolumbar and lumbar spine fractures: the 'fixateur interne'.

    Science.gov (United States)

    Dick, W; Kluger, P; Magerl, F; Woersdörfer, O; Zäch, G

    1985-08-01

    A new system of operative fixation of thoracolumbar and lumbar spine fractures is presented: the 'fixateur interne' (F.I.). From a posterior approach long Schanz screws are inserted through the pedicles into the body of the two vertebrae just adjacent to the lesion and connected by th threaded F.I. rods. By tightening the nuts the Schanz screws are fixed in all directions. The advantages of the F.I. system are: excellent reposition by the long lever-arm of the Schanz screws, immobilization of only two segments and therefore good mobility of the residual spine, stability against flexion forces better than is obtained with Harrington distraction rods, additional rotational stability, and fixation in lordosis or kyphosis as is desired. The F.I. does not act as a four point bending system like all other dorsal spine instrumentation systems, but provides stability in flexion by itself. Therefore it can be Used independently of the condition of all ligaments (including the anterior longitudinal ligament) and of the posterior wall of the fractured vertebrae, and there is no need to fix more than the two immediately adjacent vertebrae, thus avoiding the often painful and cumbersome iatrogenic loss of lumbar lordosis and of mobility and permitting early mobilization of the patient. Experience with the first 45 patients is very promising.

  12. 手术与手法复位治疗踝关节骨折的临床有效性与安全性综合评价%Comprehensive Evaluation of efficacy and Safety of Open Reduction and Internal Fixation and Closed Manipulative Reduction on Ankle Fractures

    Institute of Scientific and Technical Information of China (English)

    成晓波

    2014-01-01

    Objective To comprehensive evaluate the efficacy and safety of Open Reduction and Internal Fixation(ORIF)and Closed Manipulative Reduction(CMR)on ankle fractures (AF). Methods 98 cases with AF in the hospital from October 2011 to October 2012 were selected, as for Lange-Hansen Typing ,30 cases were type I , 36 cases were type II, 32 cases were type IV. Of which 49 patients treated by ORIF,as the ORIF group; another 49 patients were treated by CMR,as the CMR group. Ankle X-rays Leeds score, 4,6,12 weeks finger fracture call us growth and hospitalization time and costs in two groups were recorded and compared after surgery. Results The excel ent rate of patients with I degree injury in ORIF group was 100.0% (16/16), and 92.9% (13/14) in CMR group, excel ent rate of patients with II degree injury in ORIF group 82.4% (14/17), and 57.9% (11/19) in CMR group, excel ent rate of patients with IV degree injury in ORIF group was 75.0% (12/16), and 43.8% (7/16) in CMR group, the difference of efficacy in patients with I degree injury in two groups was not statistically significant, and efficacy in patients with II-IV degree injury was higher in ORIF group than in CMR group, and the difference was statistical y significant (P<0.05); bone call us growth rates at 4,6,12 week significantly lower in ORIF group than in CMR group, the difference was statistically significant (P<0.05); hospitalization time and treatment costs in CMR group was (11.2±2.4) d and (5346.5±439.3) million, while (17.4±4.1) d and (16352.4±1252.3) million in the ORIF group, significantly less in CMR group than in ORIF group, and the difference was statistically significant (P<0.05). Conclusion Call us growth is better, and hospitalization time and costs are less when choose CMR to treat AF, but ORIF has a significantly better functional recovery of ankle, thus need to select the appropriate treatment of patients according to the degree of damage.%目的:对切开复位内固定术(ORIF)与手法复

  13. 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

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

    Objective: To assess the outcome of immediate plate osteosynthesis via application of antibiotic impregnated collagen fleeces (gentamicin-collagen and antibiotic sponge) which gradually release antibiotic locally in the surgical treatment of open fractures presented to us 6 hours after injury. Methods: All cases were treated in our tertiary level trauma center and teaching hospital including 35 patients with open fractures who were treated by immediate open reduction and plate fixation from January 2008 to August 2010. Among them, 31 patients were available for adequate follow-up and assessment. All fractures were treated by irrigation and debridement, immediate open reduction and plate fixation along with placement of antibiotic-releasing collagen fleeces around the plate just before closure of wound. Patients were assessed to determine postoperative infection, delayed union or nonunion and development of other postoperative complications. It was hypothesized that immediate plate osteosynthesis after thorough debridement and local antibiotics would give safe and acceptable clinical results in treatment of open fractures. Results: The 31 patients with adequate final follow-up were assessed at a mean time of 40 weeks (15-160 weeks). Most fractures united primarily in an acceptable time period according to area of involvement. Local wound complications (superficial infection and skin loss) were found in 3 patients (9.67%). Deep infection was noted in 2 patients (6.45%). None of these patients needed implant removal and both fractures united in due time. Delayed union was noted in 5 patients (16.13%). No patient progressed to nonunion or implant failure in long term follow-up. Excessive scarring was developed in 2 patients (6.45%). Conclusions: Immediate plate osteosynthesis after adequate debridement and placement of collagen film eluting antibiotics locally produces excellent results regarding bone union and absence of deep infections and is a safe technique in the

  15. 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

    -24 months (average 14 months).According to Burwell-Chamley' s radiological evaluation system,17 patients obtained anatomical reduction of articular surface and two patients obtained moderate reduction,but they all had bony healing.Ankle function evaluated by Mazur' s criterion were excellent in seven patients,good in 10 and fair in two,with excellence rate of 89%.Conclusion Limited open reduction combined with LCP internal fixation can successfully construct articular anatomic relationship,decrease soft tissue dissection and attain solid fixation in treatment of Pilon fractures and further facilitate functional recovery of the affected extremity in coordination with early functional exercise.

  16. Clinical effects of internal fixation for ulnar styloid fractures associated with distal radius fractures: A matched case-control study.

    Science.gov (United States)

    Sawada, Hideyoshi; Shinohara, Takaaki; Natsume, Tadahiro; Hirata, Hitoshi

    2016-11-01

    Ulnar styloid fractures are often associated with distal radius fractures. However, controversy exists regarding whether to treat ulnar styloid fractures. This study aimed to evaluate clinical effects of internal fixation for ulnar styloid fractures after distal radius fractures were treated with the volar locking plate system. We used prospectively collected data of distal radius fractures. 111 patients were enrolled in this study. A matched case-control study design was used. We selected patients who underwent fixation for ulnar styloid fractures (case group). Three control patients for each patient of the case group were matched on the basis of age, sex, and fracture type of distal radius fractures from among patients who did not undergo fixation for ulnar styloid fractures (control group). The case group included 16 patients (7 men, 9 women; mean age: 52.6 years; classification of ulnar styloid fractures: center, 3; base, 11; and proximal, 2). The control group included 48 patients (15 men, 33 women; mean age: 61.1 years; classification of ulnar styloid fractures: center, 10; base, 31; and proximal, 7). For radiographic examination, the volar tilt angle, radial inclination angle, and ulnar variance length were measured, and the union of ulnar styloid fractures was judged. For clinical examination, the range of motions, grip strength, Hand20 score, and Numeric Rating Scale score were evaluated. There was little correction loss for each radiological parameter of fracture reduction, and these parameters were not significantly different between the groups. The bone-healing rate of ulnar styloid fractures was significantly higher in the case group than in the control group, but the clinical results were not significantly different. We revealed that there was no need to fix ulnar styloid fractures when distal radius fractures were treated via open reduction and internal fixation with a volar locking plate system. Copyright © 2016 The Japanese Orthopaedic Association

  17. An Overview of Internal Fixation Implant Metallurgy and Galvanic Corrosion Effects.

    Science.gov (United States)

    Koh, Justin; Berger, Aaron; Benhaim, Prosper

    2015-08-01

    Orthopedic and hand surgery implants for internal fixation of fractures have evolved substantially over the past 50 years. Newer metal compositions have been used, and new standards have been applied to older alloys, resulting in modern implants with unique physical properties and better clinical performances. Conventional wisdom has long dictated that implanting different metals should be avoided, but few guidelines exist regarding the safety of using in proximity implant systems of dissimilar metals. To better characterize the landscape of internal fixation implant metallurgy, we have compiled the recommendations and conclusions of the currently available and pertinent literature.

  18. Internal fixation of displaced inferior pole of the patella fractures using vertical wiring augmented with Krachow suturing.

    Science.gov (United States)

    Oh, Hyoung-Keun; Choo, Suk-Kyu; Kim, Ji-Wan; Lee, Mark

    2015-12-01

    We present the surgical technique of separate vertical wiring for displaced inferior pole fractures of the patella combined with Krachow suture and report the surgical outcomes. Between September 2007 to May 2012, 11 consecutive patients (mean age, 54.6 years) with inferior pole fractures of the patella (AO/OTA 34-A1) were retrospectively enrolled in this study. Through longitudinal incision, all patients underwent open reduction and internal fixation by separate vertical wiring combined with Krackow suture. The range of motion, loss of fixation, and Bostman score were primary outcome measures. The union time was 10 weeks after surgery on average (range: 8-12). No patient had nonunion, loss of reduction and wire breakage. There was no case of wound problem and irritation from the implant. At final follow-up, the average range of motion arc was 129.4° (range: 120-140). The mean Bostman score at last follow-up was 29.6 points (range: 28-30) and graded excellent in all cases. Separate vertical wiring combined with Krackow suture for inferior pole fractures of the patella is a useful technique that is easy to perform and can provide stable fixation with excellent results in knee function. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Primary subtalar joint arthrodesis with internal and external fixation for the repair of a diabetic comminuted calcaneal fracture.

    Science.gov (United States)

    Facaros, Zacharia; Ramanujam, Crystal L; Zgonis, Thomas

    2011-01-01

    Comminuted, intra-articular calcaneal fractures can cause severe lower extremity impairment and have devastating effects on a patient's well being. Diabetes is a multisystem process that may cause neuropathy and loss of protective sensation further complicating the prognosis. Not all calcaneal fractures are created equal and when considering the patient's overall presentation and extent of injury, the combined approach of internal and external fixation for fracture reduction may be beneficial for restoration of anatomic alignment and function. Copyright © 2011 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Iacobellis, C; Visentin, A; Aldegheri, R

    2012-05-01

    This study examines 32 patients operated for radial head fractures, mean age 48.7 years (range 26-76 years), Mason type II in 25 cases and Mason type III with 3 main fragments in 7 cases. Fractures were surgically reduced and fixed with Herbert's (12 cases) or Osteomed (20 cases) cannulated screws. The latter have a head that is prono-supination. In addition, suturing of the annular ligament and the joint capsule is made easier by the reduced invasiveness of screws. Screw treatment is effective in non-comminuted fractures of the radial head.

  1. 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.

  2. MIPPO and open reduction and internal fixation for the treatment of distal tibial fractures of patients in China:a systematic review%我国胫骨远端骨折经MIPPO与切开复位内固定治疗的系统评价

    Institute of Scientific and Technical Information of China (English)

    王国胜; 高健; 续斌; 尕蓉莉; 沈志敏

    2014-01-01

    Objective Systematicly reviewing of MIPPO with open reduction and internal fixation of distal tibial fracture efficacy and safety.Methods We searched for all randomized controlled and quasi-random-ized controlled trials of MIPPO and open reduction and internal fixation for the treatment of distal tibial fractures of patients by electronically searching CNKI (2003.9-2013.5),WANFANG (2003.9-201 3.5), VIP(2003.9-2013.5),CBM,CHAOXING.We handsearched domestic literature published in orthopedic journals and related magazines in the past five years:China Journal of Orthopaedics Series,Orthopaedic Journal of China,Journal of Clinical Orthopaedics,etc.The Revman5.0 provided by the Cochrane Collabo-ration was used for management and analysis.Results 1 2 randomized controlled and quasi-Randomized controlled were included.733 patients,Evaluation results for the quality of included studiesshow 12 B grade,2 C grade.System evaluation results show that less blood loss in the MIPPO group compared with the open reduction and internal fixation group[SMD=-4.46,95%CI (-5.87,-3.05),P <0.05];frac-ture healing time is short [SMD=-1.54,95%CI (-2.02,-1.06),P <0.05];postoperative excellent rate [RR = 1.22,95%CI(1.13,1.32),P < 0.05 ], but no significant difference in ope-rative time. Conclusion Using MIPPO treatment of distal tibial fractures has obvious advantages,worthy of promo-tion.However,due to the systematic review are still some limitations,it requires a lot of rigorous,large sample volume,multi-center,and with the right randomized,blinded,allocation concealment and right and exit of patients lost to follow correct ITT analysis,literature studies further demonstrated.%目的:系统评价我国小切口复位内固定术(MIPPO)与切开复位内固定治疗胫骨远端骨折的疗效与安全性。方法计算机检索中国知网(CNKI:2003年9月-2013年5月)、万方数据库(2003年9月-2013年5月)、维普数据库(2003年9月-2013年5月),中国生物医学

  3. Timing of internal fixation of femoral neck fractures. A systematic review and meta-analysis of the final outcome.

    Science.gov (United States)

    Papakostidis, Costas; Panagiotopoulos, Andreas; Piccioli, Andrea; Giannoudis, Peter V

    2015-03-01

    The aim of the present study was to evaluate the effect of timing of internal fixation of intracapsular fractures of the neck of femur on the development of late complications, particularly osteonecrosis of femoral head (ONFH) and non-union. We undertook a systematic review of the literature adhering to the PRISMA guidelines. There were 7 eligible reports for the final analysis. The methodological quality of component studies was assessed with the Coleman Methodology Score (CMS). Each included study was assigned a score independently by the two reviewers. The final score of each individual study constituted the average value of the scores given by the two reviewers. The agreement between the two assessors was tested with intraclass correlation coefficient (ICC). The CMS ranged from 37 to 64 within component studies (mean: 46.5, SD: 10.8, median: 41). The ICC was 0.94 (95% CI: 0.69-0.99), implying a nearly perfect agreement between the two assessors. Based on the available data regarding the timing of operative fixation of the femoral neck fractures, 4 discreet pairs of comparison groups could be created: (1) fractures fixed within 6h from injury versus fractures fixed after 6h from injury; (2) fractures fixed within 12h versus after 12h; (3) fractures fixed within 24h versus after 24h; and (4) fractures fixed within 6h versus after 24h. Outcome measures were analyzed within each one of the above pairs of treatment groups. The following subgroups analyses were a priori decided: (1) initial fracture displacement (displaced vs. undisplaced fractures); (2) fixation method (cannulated screws vs. sliding hip screw); (3) quality of reduction (anatomic vs non-anatomic reduction). This study failed to prove any essential association between timing of NOF fracture internal fixation and incidence of AVN. With respect to non-union though, it indicated that delay of internal fixation of more than 24h could increase substantially the odds of non-union. Copyright © 2015 Elsevier

  4. The societal costs of femoral neck fracture patients treated with internal fixation

    NARCIS (Netherlands)

    Zielinski, S.M.; Bouwmans, C.A.; Heetveld, M.J.; Bhandari, M.; Patka, P.; Lieshout, E.M. van; Kampen, A. van

    2014-01-01

    SUMMARY: The study rationale was to provide a detailed overview of the costs for femoral neck fracture treatment with internal fixation in the Netherlands. Mean total costs per patient at 2-years follow-up were 19,425. Costs were higher for older, less healthy patients. Results are compa

  5. The societal costs of femoral neck fracture patients treated with internal fixation

    NARCIS (Netherlands)

    Zielinski, S.M.; Bouwmans, C.A.; Heetveld, M.J.; Bhandari, M.; Patka, P.; Lieshout, E.M. van; Kampen, A. van

    2014-01-01

    SUMMARY: The study rationale was to provide a detailed overview of the costs for femoral neck fracture treatment with internal fixation in the Netherlands. Mean total costs per patient at 2-years follow-up were 19,425. Costs were higher for older, less healthy patients. Results are

  6. Internal fixation treatments for intertrochanteric fracture: a systematic review and meta-analysis of randomized evidence.

    Science.gov (United States)

    Yu, Jiajie; Zhang, Chao; Li, Ling; Kwong, Joey S W; Xue, Li; Zeng, Xiantao; Tang, Li; Li, Youping; Sun, Xin

    2015-12-11

    The relative effects of internal fixation strategies for intertrochanteric fracture after operation remain uncertain. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to address this important issue. We searched PubMed, EMBASE and CENTRAL for RCTs that compared different internal fixation implants in patients with intertrochanteric fracture at 6-month follow-up or longer. We ultimately included 43 trials enrolling 6911 patients; most trials were small in sample sizes and events. Their risk of bias was generally unclear due to insufficient reporting. Because of these, no statistically significant differences were present from most of the comparisons across all the outcomes, and no definitive conclusions can be made. However, a number of trials compared two commonly used internal fixation strategies, gamma nail (GN) and sliding hip screw (SHS). There is good evidence suggesting that, compared to SHS, GN may increase the risk of cut out (OR = 1.87, 95% CI, 1.08 to 3.21), re-operation (OR = 1.61, 95% CI, 1.02 to 2.53), intra-operative (OR = 3.14, 95% CI, 1.34 to 7.35) and later fractures (OR = 3.67, 95% CI, 1.37 to 9.83). Future randomized trials or observational studies that are carefully designed and conducted are warranted to establish the effects of alternative internal fixation strategies for intertrochanteric fracture.

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

    DEFF Research Database (Denmark)

    Bech, Rune Dueholm

    2008-01-01

     Promising Effect Of Intraarticular Ropivacaine In Femoral Neck Fractures Treated With Internal Fixation Rune Bech*, Jens Lauritsen*+,Tine Dimon*, Ole Ovesen*, Claus Emmeluth, Søren Overgaard*. *:Dept. Ortopaedic Surgery, Odense University Hospital, +:Institute of Public Health-dept. biostatistic...

  8. Limited internal fixation combined external fixation in the treatment of distal radius comminuted fractures%有限内固定加外固定支架治疗桡骨远端粉碎性骨折

    Institute of Scientific and Technical Information of China (English)

    向乾彬; 范海泉; 黄海讯; 俞阳; 江洋; 刘江川; 陈铭

    2012-01-01

    目的 探讨有限内固定加外固定支架治疗桡骨远端粉碎性骨折的临床疗效.方法 采用有限内固定加外固定支架治疗桡骨远端粉碎性骨折45例.结果 42例患者获得随访,时间3~36个月.按Lidstrom评分系统行影像学评价:优30例,良7例,中5例,优良率为88.09%;依据Dienst标准评价腕关节功能:优30例,良8 例,中4 例,优良率为90.47%.无严重并发症发生.结论 有限内固定结合外固定支架治疗桡骨远端粉碎性骨折,复位满意,操作简单,固定牢固,疗效满意.%Objective To study the effect of limited internal fixation and external fixation for the treatment of comminuted fracture of distal radius. Methods Limited internal fixation combined with external fixation were used in the treatment of 45 cases of comminuted fracture of distal radius. Results 42 cases were followed up for 3 ~ 36 months. With Lidstrom scoring system image evaluation, excellent 30 cases,7 good,5 fair,and the excellent and good rate was 88. 09% ; According to Dienst functional evaluation standard, the wrist joint function evaluation was excellent in 30 cases, good in 8, and fair in 4 cases, and the excellent and good rate was 90. 47%. No serious complications were found. Conclusions Limited internal fixation combined external fixation for distal radius comminuted fractures provide good reduction and satisfactory effect.

  9. 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

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

    Institute of Scientific and Technical Information of China (English)

    周淮; 徐晓军

    2011-01-01

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

  11. Improvement of photosynthetic CO2 fixation at high light intensity through reduction of chlorophyll antenna size.

    Science.gov (United States)

    Lee, James W; Mets, Laurens; Greenbau, Elias

    2002-01-01

    At elevated light intensities (greater than approximately 200 microE/[m2 x s]), the kinetic imbalance between the rate of photon excitation and thermally activated electron transport results in saturation of the rate of photosynthesis. Since maximum terrestrial solar radiation can reach 200 microE/(m2 x s), a significant opportunity exists to improve photosynthetic efficiency at elevated light intensities by achieving a kinetic balance between photon excitation and electron transport, especially in designed large-scale photosynthetic reactors in which a low-cost and efficient biomass production system is desired. One such strategy is a reduction in chlorophyll (chl) antenna size in relation to the reaction center that it serves. In this article, we report recent progress in this area of research. Light-saturation studies for CO2 fixation were performed on an antenna-deficient mutant of Chlamydomonas (DS521) and the wild type (DES15) with 700 ppm of CO2 in air. The light-saturated rate for CO2 assimilation in the mutant DS521 was about two times higher (187 micromol/[h x mg of chl]) than that of the wild type, DES15 (95 micromol/[h x mg of chl]). Significantly, a partial linearization of the light-saturation curve was also observed. These results confirmed that DS521 has a smaller relative chl antenna size and demonstrated that reduction of relative antenna size can improve the overall efficiency of photon utilization at higher light intensities. The antenna-deficient mutant DS521 can provide significant resistance to photoinhibition, in addition to improvement in the overall efficiency of CO2 fixation at high light. The experimental data reported herein support the idea that reduction in chl antenna size could have significant implications for both fundamental understanding of photosynthesis and potential application to improve photosynthetic CO2 fixation efficiency.

  12. Using biomechanics to improve the surgical technique for internal fixation of intracapsular femoral neck fractures.

    Science.gov (United States)

    Wu, Chi-Chuan

    2010-01-01

    Despite advances in science and technology, the success rate for the treatment of displaced intracapsular femoral neck fractures in high-energy injuries remains disappointing. The blood supply system in the femoral head of humans does not favor recovery from these fractures. Once these fractures occur, osteonecrosis and nonunion rates may be as high as 30%, even if the newest technique is used. There are some surgical techniques used to supplement internal fixation to reestablish the blood supply in the femoral head, but none have been evidently successful. After analysis of related studies, the author concludes that immediate surgical treatment using improved techniques incorporating the principles of biomechanics can improve the success rate of treatment of these fractures. Using these principles, the fracture site can achieve sufficient stability. Consequently, the blood supply in the femoral head and neck can be reestablished earlier and loss of reduction of fragments during treatment can be minimized. Thus, the chance of full recovery from these complicated fractures can be maximized. In this study, the biomechanical characteristics of these fractures and the principles associated with the surgical techniques used for treating them are reviewed and clarified. Finally, a surgical technique which is ideal from the author's viewpoint is presented. The author believes that the recommended surgical technique may become the best method for treating these complicated fractures.

  13. Displaced Anterior Column Acetabular Fracture: Closed Reduction and Percutaneous CT-Navigated Fixation

    Energy Technology Data Exchange (ETDEWEB)

    Huegli, R.W.; Staedele, H.; Messmer, P.; Regazzoni, P.; Steinbrich, W.; Gross, T. [Univ. Hospital of Basel (Switzerland). Dept. of Radiology

    2004-10-01

    The purpose of this study is to demonstrate the feasibility of computer-tomography-navigated closed reduction and percutaneous fixation (CRPF) in a patient with an externally rotated left acetabular fracture. After a follow-up of 18 months the patient was pain-free and had a normal range of motion in both hip joints. Radiologically, the fracture was fully consolidated, remodelled, and there were no signs of osteoarthritis. To our knowledge, CT-navigated CRPF of a rotated acetabular fracture has not been reported before. Further studies regarding the feasibility of the method are warranted(CRPF)

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

    Science.gov (United States)

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

    2005-03-01

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

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

    Directory of Open Access Journals (Sweden)

    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.    

  16. 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.

  17. [Meta-analysis of internal fixation versus hip replacement in the treatment of trochanteric fractures].

    Science.gov (United States)

    Dong, Jian-Bin; Wang, Zhi-Yong; Lu, Hao; Tian, Yuan; Wang, Xin-Rui; Zhang, Zhi-Qiang

    2015-03-01

    To compare the efficacy of internal fixation (including PFNA and PFN) versus hip replacement (including FHR or THA) in the treatment of trochanteric fractures in adults. Reports of studies using randomized controlled trials (RCT) to compare internal fixationg with hip replacement in the management of intertrochanteric fractures were retrieved (up to January 1, 2013) from the Cochrane Library, PUBMED Data, CNKI (China National Knowledge infrastructure), Elsevier, the Chinese Biomedical Database, Wanfang Data, and manually. Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software RevMan 5.0 was used for data-analysis. Seven articles were included in the meta-analysis. The results showed that,compared internal fixation with hip replacement,there were statistical significance in the duration of surgery time [WMD = -2.66, 95% CI (-5.25,-0.06), P = 0.05], intra-operative blood loss [WMD = -24.20, 95% CI (-30.38, -18.02), P 0.05]. CON- CLUSION: Hip replacement (containing FHR or THA) for the treatment of intertrochanteric fractures is superior to internal fixa- tion in regards to the duration of surgery time, the mean duration of hosipital stays, mean post-operative down time, intra-opera- tive blood loss, the rate of post-operative good Harris scores. But there is not enough evidence to show any difference between hip replacement (containing THA or FHR) and internal fixation in regards to the rate of deep venous thrombosis. However, internal fixation for the treatment of intertrochanteric fractures is superior to hip replacement (containing FHR or THA) in regards to total complications rate.

  18. Clinical outcome of internal fixation of unstable juvenile osteochondritis dissecans lesions of the knee.

    Science.gov (United States)

    Webb, Jonathan E; Lewallen, Laura W; Christophersen, Christy; Krych, Aaron J; McIntosh, Amy L

    2013-11-01

    Juvenile osteochondritis dissecans (OCD) lesions of the knee are a common cause of knee pain in skeletally immature patients.The authors sought to determine lesion healing rates, the risk factors associated with failure to heal, and the clinical outcomes for patients who underwent internal fixation for unstable OCD lesions. A retrospective review was conducted of all patients who underwent internal fixation of OCD lesions from 1999 to 2009. Using validated scoring systems, clinical outcome and functional activity were evaluated at the follow-up. The study group comprised 19 patients (20 knees). Mean patient age was 14.5 years (range, 12-17 years). Mean clinical follow-up was 7 years (range, 2-13 years). Mean radiographic follow-up was 2.5 years (range, 0.5-9 years). Fourteen (70%) lesions were grade 3 and 6 (30%) were grade 4. Eleven knees had lateral condyle lesions and 9 had medial lesions. Bioabsorbable fixation was used in 13 knees, metal fixation was used in 5 knees, and 2 knees were fixed with a combination of methods. Osseous integration was evident in 15 (75%) of 20 knees at final follow-up. The 5 unhealed lesions were lateral condylar lesions. Mean Tegner activity scores improved from 3.3 preoperatively to 5.6 at final follow-up. Mean Lysholm and International Knee Documentation Committee scores were 86.8 and 88.7, respectively, at final follow-up. Further operative intervention was required in 11 knees, with 50% of patients undergoing removal of hardware and 15% requiring subsequent osteochondral allograft transplantation. The authors recommend bioabsorbable fixation for symptomatic stable lesions and metal compression screws with staged removal for unstable lesions.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    Background and purpose - Internal fixation (IF) in femoral neck fractures has high reoperation rates and some predictors of failure are known, such as age, quality of reduction, and implant positioning. Finding new predictors of failure is an ongoing process, and in this study we evaluated...... the importance of low bone mineral density (BMD). Patients and methods - 140 consecutive patients (105 females, median age 80) treated with IF had a dual-energy X-ray absorptiometry (DXA) scan of the hip performed median 80 days after treatment. The patients' radiographs were evaluated for fracture displacement......, or new hip fracture). A stratified Cox regression model on fracture displacement was applied and adjusted for age, sex, quality of reduction, implant positioning, comorbidity, and walking disability. Results - 49 patients had a T-score below -2.5 (standard deviation from the young normal reference mean...

  20. 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.

  1. The application of absorbable internal fixation materials in maxillofacial surgery%可吸收内固定材料在颌面外科的应用

    Institute of Scientific and Technical Information of China (English)

    林华维; 刘强; 潘虹海

    2015-01-01

    目的:手术切开复位内固定术是目前颌面部骨折最常用的手术治疗方法,近年来随着高分子材料科学的发展,可吸收内固定材料的机械强度、生物相容性等均得到了很大提高,并显示出其优点,开始逐渐在临床广泛应用。该文就应用于颌面外科的可吸收内固定材料的分类、降解吸收、临床应用以及优缺点等方面进行综述。%Open reduction and rigid internal fixation surgery is one of the most commonly used methods of surgical treatment for max -illofacial fractures .With the development of polymer material science in recent years ,absorbable internal fixation materials have greatly improved in term of mechanical strength , biocompatibility , etc.Showing advantages , absorbable internal fixation materials have been gradually applied in clinic .This paper reviews absorbable internal fixation materials applied in the maxillofacial surgery regarding their cranial classification ,degradation of absorption ,clinical applications as well as advantages and disadvantages .

  2. Enhancement of Apoptosis by Titanium Alloy Internal Fixations during Microwave Treatments for Fractures: An Animal Study.

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    Gang Wang

    Full Text Available Microwaves are used in one method of physical therapy and can increase muscle tissue temperature which is useful for improving muscle, tendon and bone injuries. In the study, we sought to determine whether titanium alloy internal fixations influence apoptosis in tissues subjected to microwave treatments at 2,450 MHz and 40 W during the healing of fractures because this issue is not yet fully understood.In this study, titanium alloy internal fixations were used to treat 3.0-mm transverse osteotomies in the middle of New Zealand rabbits' femurs. After the operation, 30-day microwave treatments were applied to the 3.0 mm transverse osteotomies 3 days after the operation. The changes in the temperatures of the muscle tissues in front of the implants or the 3.0 mm transverse osteotomies were measured during the microwave treatments. To characterize the effects of titanium alloy internal fixations on apoptosis in the muscles after microwave treatment, we performed TUNEL assays, fluorescent real-time (quantitative PCR, western blotting analyses, reactive oxygen species (ROS detection and transmission electron microscopy examinations.The temperatures were markedly increased in the animals with the titanium alloy implants. Apoptosis in the muscle cells of the implanted group was significantly more extensive than that in the non-implanted control group at different time points. Transmission electron microscopy examinations of the skeletal muscles of the implanted groups revealed muscular mitochondrial swelling, vacuolization. ROS, Bax and Hsp70 were up-regulated, and Bcl-2 was down-regulated in the implanted group.Our results suggest that titanium alloy internal fixations caused greater muscular tissue cell apoptosis following 2,450 MHz, 40 W microwave treatments in this rabbit femur fracture models.

  3. Treatment of Early Post-op Wound Infection after Internal Fixation

    Science.gov (United States)

    2015-10-01

    Jefferson Davis Highway, Suite 1204, Arlington, VA 22202- 4302. Respondents should be aware that notwithstanding any other provision of law, no person shall...DISTRIBUTION / AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Severe fractures are...common in modern warfare with fractures being fixed via internal fixation of plates and screws to hold the fracture stable while the bone heals

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

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    Kostić Igor M.

    2015-01-01

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

  5. 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.

  6. Bone radiofrequency ablation combined with prophylactic internal fixation for metastatic bone tumor of the femur from hepatocellular carcinoma.

    Science.gov (United States)

    Ogura, Koichi; Miyake, Ryoko; Shiina, Shuichiro; Shinoda, Yusuke; Okuma, Tomotake; Kobayashi, Hiroshi; Goto, Takahiro; Nakamura, Kozo; Kawano, Hirotaka

    2012-08-01

    A 64-year-old man with 6-year history of hepatocellular carcinoma (HCC) was referred to us regarding bone metastasis to the right proximal femur. Although he underwent radiotherapy for pain palliation and local tumor control, the pain persisted and the tumor relapsed 3 months after the radiotherapy and he was thought to be at high risk of pathologic fracture. Given hypervascularity and large tumor size, a prophylactic internal fixation combined with adjuvant radiofrequency ablation (RFA) was proposed to reduce blood loss and prevent viable tumor cells being disseminated. His postoperative course was uneventful without requiring blood transfusion and preoperative symptoms immediately disappeared after surgery. He became capable of weight-bearing walk with a single cane and was almost asymptomatic without local progression on the plain radiographs when he died 14 months after surgery. Combination therapy of RFA and internal fixation using intramedullary nailing for metastases of the long bones from HCC seems to be a very promising technique both for sufficient pain relief and for local control of the tumor. Adjuvant RFA may become a potential option for patients with metastases of the long bones for the purpose of prevention of tumor dissemination and reduction of intraoperative blood loss.

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  8. Abiotic nitrogen fixation on terrestrial planets: reduction of NO to ammonia by FeS.

    Science.gov (United States)

    Summers, David P; Basa, Ranor C B; Khare, Bishun; Rodoni, David

    2012-02-01

    Understanding the abiotic fixation of nitrogen and how such fixation can be a supply of prebiotic nitrogen is critical for understanding both the planetary evolution of, and the potential origin of life on, terrestrial planets. As nitrogen is a biochemically essential element, sources of biochemically accessible nitrogen, especially reduced nitrogen, are critical to prebiotic chemistry and the origin of life. Loss of atmospheric nitrogen can result in loss of the ability to sustain liquid water on a planetary surface, which would impact planetary habitability and hydrological processes that shape the surface. It is known that NO can be photochemically converted through a chain of reactions to form nitrate and nitrite, which can be subsequently reduced to ammonia. Here, we show that NO can also be directly reduced, by FeS, to ammonia. In addition to removing nitrogen from the atmosphere, this reaction is particularly important as a source of reduced nitrogen on an early terrestrial planet. By converting NO directly to ammonia in a single step, ammonia is formed with a higher product yield (~50%) than would be possible through the formation of nitrate/nitrite and subsequent conversion to ammonia. In conjunction with the reduction of NO, there is also a catalytic disproportionation at the mineral surface that converts NO to NO₂ and N₂O. The NO₂ is then converted to ammonia, while the N₂O is released back in the gas phase, which provides an abiotic source of nitrous oxide.

  9. Internal Fixation of Transverse Patella Fractures Using Cannulated Cancellous Screws with Anterior Tension Band Wiring

    Directory of Open Access Journals (Sweden)

    Khan I

    2016-07-01

    Full Text Available Aims: To evaluate the effectiveness and safety of anterior tension band wiring technique using two cannulated cancellous screws in patients with transverse (AO34-C1 or transverse with mildly comminuted (AO34-C2 patellar fractures. Materials and Methods: This is a prospective study of 25 patients with transverse fracture or transverse fracture with mildly comminuted patella fractures. All the patients were treated with open reduction and internal fixation using two parallel cannulated screws and 18G stainless steel wire as per the tension band principle. Results: There were eighteen males (72% and seven females (28%. The age group ranged from 24 to 58 years, with mean age of 38 years. The most common mode of injury was fall (72% followed by road traffic accident (20% and violent quadriceps contraction (8%. Transverse fracture was present in 60% and transverse fracture with mild comminution in 40% of patients. Mean time to achieve union was 10.7 weeks (range 8-12 weeks. Mean ROM at three months was 113.8 degree (90-130 and at final follow up this improved to 125.4 degrees (range 100-140. There was one case of knee stiffness and no case of implant failure was observed. Patients were evaluated using Bostman scoring, the mean score at three months being 26.04 which improved to 27.36 at the end of final follow up at one year. Conclusion: Cannulated cancellous screws with anterior tension band wiring is a safe, reliable and reproducible method in management of transverse patellar fractures, with less chances of implant failure and soft tissue irritation.

  10. [Utility of nickel-titanium shape memory alloys of vertebral body reduction fixator with assisted distraction bar].

    Science.gov (United States)

    Man, Yi; Zheng, Yue-huan; Cao, Peng; Chen, Bo; Zheng, Tao; Sun, Chang-hui; Lu, Jiong

    2011-06-07

    To test the nickel-titanium (Ni-Ti) shape memory alloys of vertebral body reduction fixator with assisted distraction bar for the treatment of traumatic and osteoporotic vertebral body fracture. A Ni-Ti shape memory alloys of vertebral body reduction fixator with assisted distraction bar was implanted into the compressed fracture specimens through vertebral pedicle with the radiographic monitoring to reduce the collapsed endplate as well as distract the compressed vertebral fracture. Radiographic film and computed tomographic reconstruction technique were employed to evaluate the effects of reduction and distraction. A biomechanic test machine was used to measure the fatigue and the stability of deformation of fixation segments. Relying on the effect of temperature shape memory, such an assembly could basically reduce the collapsed endplate as well as distract the compressed vertebral fracture. And when unsatisfied results of reduction and distraction occurred, its super flexibility could provide additional distraction strength. A Ni-Ti shape memory alloys of vertebral body reduction fixator with assisted distraction bar may provide effective endplate reduction, restore the vertebral height and the immediate biomechanic spinal stability. So the above assembly is indicated for the treatment of traumatic and osteoporotic vertebral body fracture.

  11. Biomechanical analysis of four types of internal fixation in subtrochanteric fracture models.

    Science.gov (United States)

    Wang, Jie; Ma, Xin-long; Ma, Jian-xiong; Xing, Dan; Yang, Yang; Zhu, Shao-wen; Ma, Bao-yi; Chen, Yang; Feng, Rui; Jia, Hao-bo; Yu, Jing-tao

    2014-05-01

    To compare the biomechanical properties of four types of internal fixation (proximal femoral nail [PFN], dynamic hip screw [DHS], dynamic condylar screw [DCS], and proximal femoral locking plate [PFLP]) for different types of subtrochanteric fractures. Thirty-two antiseptic femurs were randomly divided into four groups. After internal fixation had been implanted, different types of subtrochanteric fracture models were produced and each tested under vertical, torsional and vertical damage loads. The stiffness ratio of PFN in each fracture model and failure load were the highest in the four groups; however, the torsional stiffness ratio was the lowest. Tension strain ratios of DHS and DCS on the lateral side became compression strain ratios with restoration of the medial fragment. The stiffness ratio of DHS was lower than PFLP in each fracture model, torsional stiffness ratio was the highest in fracture models II to V and the failure load was lower only than PFN. The stiffness ratio and failure load of DCS were both the lowest, torsional stiffness ratio was similar to PFLP's in fracture models II to V. The stiffness ratio of PFLP was only lower than PFN's in each fracture model, but the failure load was lower than DHS's. Four types of internal fixation achieve better stabilities for type I subtrochanteric fractures. PFN and PFLP produce reliable stability in type IIIA subtrochanteric fractures. If the medial buttress is restored, DCS can be considered. For type IV subtrochanteric fractures, only PFN provides stable fixation. PFLP is suitable for comminuted fractures with large fragments. © 2014 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

  12. Atlanto-axial dislocation complicating a type II odontoid fracture. Reduction and final fixation.

    Science.gov (United States)

    Riouallon, G; Pascal-Moussellard, H

    2014-05-01

    A case of traumatic posterolateral C1-C2 dislocation associated with odontoid fracture is reported. This is a rare case of traumatic posterolateral C1-C2 dislocation associated with odontoid fracture. Its management is discussed. A traumatic dislocation of atlanto-axial joint associated with an odontoid fracture remains a rare injury. No case of posterior dislocation has been reported so far in the literature with this type of management. The case is of a 25 year-old-man with a primary atlanto-axial posterolateral dislocation associated with a type II displaced odontoid fracture without any neurological complication. The patient underwent gentle traction during 24 hours with a halo frame. An incomplete reduction was achieved. Two days later, a complete reduction was obtained thanks to a preoperative manual traction maintained by a Mayfield (R) modified skull clamp. Anterior C1-C2 fixation was performed according to Vaccaro's technique. The patient wore a cervical collar and underwent physiotherapy during three months. To our best knowledge, this case represents the first traumatic atlanto-axial dislocation associated with an odontoid fracture which was treated through retropaharyngeal approach. This had been rendered possible thanks to the final reduction maneuver in extension.

  13. [Analysis of reason and strategy for the failure of posterior pedicle screw short-segment internal fixation on thoracolumbar fractures].

    Science.gov (United States)

    Xing, Jin-Ming; Peng, Wen-Ming; Shi, Chu-Yun; Xu, Lei; Pan, Qi-Huao

    2013-03-01

    To analyze the reason and strategy for failure of posterior pedicle screw short-segment internal fixation on thoracolumbar fractures. From March 2008 to December 2010,the clinical data of 18 patients with thoracolumbar fracture failed in posterior pedicle screw short-segment internal fixation were retrospectively analyzed. There were 11 males and 7 females with an average age of 37.2 years (ranged, 19 to 63). The time from the first operation to complication occurrence was from 6 to 44 months with an average of 14.3 months. Of them,fusion failure was in 7 cases (combined with screw breakage in 4 cases), the progressive neuro-dysfunction was in 5 cases,the progressive lumbodorsal pain was in 6 cases. All 18 patients with kyphosis were treated with anterior internal fixation remaining posterior fixation (9 cases) and anterior internal fixation after posterior fixation removal (9 cases). All the patients were followed up from 18 to 50 months with an average of 30.5 months. No intetnal fixation loosening and breakage were found, moreover, X-ray and lamellar CT showed bone healing well. Preoperative, postoperative at 3 months and at final follow-up, ODI score was respectively 31.6+/-5.1, 8.6+/-5.7, 8.3+/-3.2; VAS score was respectively 7.2+/-2.3, 2.3+/-0.7, 2.1+/-1.1; kyphosis angle was respectively (-21.2/-+7.8 degreeso, (-5.3+/-6.8 degrees ), (-5.8+/-7.8 )degrees. Compared with preoperative data ,above-listed items had obviously ameliorated(Pinternal fixation may result in the complications such as bone nonunion ,internal fixation breakage and progressive kyphosis. Anterior reconstruction may be a good strategy for the failure of posterior operation.

  14. [Case-control study on T-shaped locking internal fixation and external fixation for the treatment of dorsal Barton's fracture].

    Science.gov (United States)

    Chen, Huan-qing; Wen, Xi-le; Li, Yang-ming; Wen, Cong-you

    2015-06-01

    To compare clinical effect of T-shaped locking internal fixation and external fixation in treating dorsal Barton's fracture,and investigate selective strategy of internal fixation. From January 2008 to January 2013, 100 patients with dorsal Barton's fracture were randomly divided into two groups. In treatment group, there were 30 males and 20 females with an average age of (33.8±3.6) years old;30 cases were type B, 20 cases were type C;and treated with T-shaped locking internal fixation. In control group, there were 32 male and 18 females with an average age of (32.9±3.4) years old; 29 cases were type B, 21 cases were type C; and treated with external fixation. Volar tilt, ulnar deviation and radial height at 3 months after operation were detected and compared between two groups. Mechara functional evaluation were used to evaluate postoperative clinical effects. Clinical cure time, postoperative complications,joint mobility and function score were recorded and compared between two groups. In treatment group,volar tilt was (11.9±2.7)°, ulnar deviation was (20.8+ 2.9)°,and radial height was (10.9±1.8) mm; while volar tilt was (9.1±1.6)°, ulnar deviation was (17.1±2.9)°, and radial height was (8.1±1.5) mm in control group. Treatment group was better than control group in volar tilt, ulnar deviation and radial height. Clinical cure time in treatment group was(12.0±2.3) weeks, shorter than control group (18.0±4.1) weeks. The incidence of complications in treatment group was lower than control group. According to Mehara functional evaluation,20 cases got excellent results, 25 good, 3 moderate and 2 poor in treatment group; 16 cases got excellent results, 14 good, 10 moderate and 10 poor in control group. Treatment group was better than control group in clinical effects. T-shaped locking internal fixation with postoperative functional exercise for the treatment of dorsal Barton's fracture fits for biomechanics demands,and has advantages of stable fixation

  15. Effectiveness of Hindfoot Arthrodesis by Stable Internal Fixation in Various Eichenholtz Stages of Neuropathic Ankle Arthropathy.

    Science.gov (United States)

    Sundararajan, Silvampatty R; Srikanth, Kanchana P; Nagaraja, Handenahally S; Rajasekaran, Shanmuganathan

    The optimal time to treat neuropathic (Charcot) arthropathy of the ankle and peritalar joint is controversial because of the various treatment options available and the variable results reported in published studies. We sought to determine the outcome of hind foot arthrodesis with stable internal fixation in patients with different Eichenholtz stages of arthropathy. We prospectively studied patients with substantial disabilities caused by neuropathic arthropathy in deformed, unstable ankle and peritalar joints, with or without ulcerations, who had undergone treatment from July 2007 to December 2012. All patients underwent ankle arthrodesis, autologous iliac crest bone grafting, and subtalar joint arthrodesis, with or without talonavicular joint arthrodesis, fixed internally with an intramedullary hindfoot nail, with or without an additional plate or cancellous screws. Of the 33 enrolled patients, 9 (27.3%) had stage I, 13 (39.4%) had stage II, and 11 (33.3%) had stage III Charcot arthropathy. The cause of arthropathy was diabetes mellitus in 25 (75.8%) patients. The duration of symptoms ranged from 1 to 120 (median 7) months. The mean follow-up period was 40 (range 12 to 76) months and did not differ markedly among the groups. The hindfoot scores, rate of salvage or amputation, or complication rates did not differ significantly across Eichenholtz stage. For the patients with stage I, II, and III, the preoperative hindfoot score was 50, 49, and 48, respectively (p = .9). The corresponding postoperative scores were 68, 68, and 70 (p = .5). We found no evidence that the effectiveness of hindfoot arthrodesis by stable fixation varied across the Eichenholtz stage of Charcot arthropathy involving ankle and peritalar joint. Furthermore, we found that stable internal fixation and bone grafting using a hindfoot nail results in an 84.84% union rate and salvages the unstable and disabled foot in 90.9% of patients with ankle and peritalar Charcot arthropathy.

  16. Application of internal fixation of steel-wire limited loop in early Achilles tendon rupture

    Institute of Scientific and Technical Information of China (English)

    Zhe Chen; Jia-Sen Wei; Zhao-Yang Hou; Jiong Hu; Yan-Guang Cao; Qi-Xin Chen

    2013-01-01

    Objective:To explore the clinical effect and safety of internal fixation of steel-wire limited loop in earlyAchilles tendon rupture.Methods:Seventy-six patients respectively with early transected and avulsed types ofAchilles tendon rupture were selected and treated with internal fixation of steel-wire limited loop.The patients began to take exercise for their lower limbs through continous passive motion as early as possible after surgical repair, and the loops were removed after3-5 months.Six months later, the condition of complications includingAchilles tendon re-rupture, wound fistula, wound infection and skin necrosis, cutaneous sensation in sural nerve dominance region, time back to preinjury work or learning as well as time to physical activities were observed.One year later, the therapeutic effect was evaluated, and the maximum circumferences of bilateral legs and ruptured plane circumferences ofAchilles tendon were measured.Results:The wound of all patients healed well, no complications likeAchilles tendon re-rupture, wound fistula, wound infection and skin necrosis occured, and the cutaneous sensation in sural nerve dominance region was normal.The mean time back to preinjury workor learning as well as to pysical activities of all patients were respectively10 and22 weeks.Seventy out of76 patients(92.1%) achieved an excellent effect, and6(7.9%) good effect.The excellent and good rate came up to100%.The maximum circumference in the affected leg decreased to 2 mm averagely compared with the offside, while the ruptured plane circumferences ofAchilles tendon in the affected side increased to2.2 mm compared with the offside.Conclusions:For earlyAchilles tendon rupture, internal fixation of steel-wire limited loop can recover the ankle function better, return to the preinjury state in the shortest time, and has few complications.

  17. Application of internal fixation of steel-wire limited loop in early Achilles tendon rupture.

    Science.gov (United States)

    Chen, Zhe; Wei, Jia-Sen; Hou, Zhao-Yang; Hu, Jiong; Cao, Yan-Guang; Chen, Qi-Xin

    2013-11-01

    To explore the clinical effect and safety of internal fixation of steel-wire limited loop in early Achilles tendon rupture. Seventy-six patients respectively with early transected and avulsed types of Achilles tendon rupture were selected and treated with internal fixation of steel-wire limited loop. The patients began to take exercise for their lower limbs through continous passive motion as early as possible after surgical repair, and the loops were removed after 3-5 months. Six months later, the condition of complications including Achilles tendon re-rupture, wound fistula, wound infection and skin necrosis, cutaneous sensation in sural nerve dominance region, time back to preinjury work or learning as well as time to physical activities were observed. One year later, the therapeutic effect was evaluated, and the maximum circumferences of bilateral legs and ruptured plane circumferences of Achilles tendon were measured. The wound of all patients healed well, no complications like Achilles tendon re-rupture, wound fistula, wound infection and skin necrosis occured, and the cutaneous sensation in sural nerve dominance region was normal. The mean time back to preinjury work or learning as well as to pysical activities of all patients were respectively 10 and 22 weeks. Seventy out of 76 patients (92.1%) achieved an excellent effect, and 6 (7.9%) good effect. The excellent and good rate came up to 100%. The maximum circumference in the affected leg decreased to 2 mm averagely compared with the offside, while the ruptured plane circumferences of Achilles tendon in the affected side increased to 2.2 mm compared with the offside. For early Achilles tendon rupture, internal fixation of steel-wire limited loop can recover the ankle function better, return to the preinjury state in the shortest time, and has few complications. Copyright © 2013 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

  18. End-stage hindfoot arthrosis: outcomes of tibiocalcaneal fusion using internal and Ilizarov fixation.

    Science.gov (United States)

    Crawford, Brooke; Watson, J Tracy; Jackman, James; Fissel, Brian; Karges, David E

    2014-01-01

    End-stage post-traumatic pantalar arthrosis from ankle, pilon, and talus fractures has often been complicated by infection, bone loss, and a soft tissue deficit. Patients can present with neuropathy, diabetes, tobacco use, and previously failed arthrodesis. Fusion in this population has been challenging, with nonunion rates up to 30%, often leading to amputation. We reviewed the results of a standardized protocol that combined simultaneous internal fixation with the Ilizarov technique to achieve fusion in high-risk patients. With institutional review board approval, a retrospective review of the patients treated with simultaneous internal fixation and an Ilizarov frame was undertaken. The records and radiographs allowed identification of the comorbidities and the presence or absence of successful fusion. Complications were acknowledged and treated. Fifteen patients had undergone the procedure. The mean follow-up period was 27.9 (range 9 to 67) months. Thirteen patients (86.67%) had had previous fusion failure. Twelve patients (80%) had developed post-traumatic arthrosis, 5 (33.33%) of whom had open injuries. All patients had 1 comorbidity, and 10 (66.67%) had multiple, including rheumatoid arthritis, diabetes (types 1 and 2), and smoking. Four patients (26.67%) presented with deep infection and bone loss. Union was achieved in 11 (73.33%), with 12 (80%) patients experiencing profound pain relief. Seven patients (46.67%) required symptomatic hardware removal. Three patients (20%) eventually underwent below-the-knee amputation for recalcitrant nonunion. Statistically significant correlations were found between smoking and wound infection and revision and between nonunion and amputation. Our results have indicated that combined internal fixation with Ilizarov application can provide a strong surgical option for the management of end-stage, pantalar arthritis. More studies are needed to compare the cohort outcomes and gait analysis in these patients with those who have

  19. Feasibility of vertebral internal fixation using deer and sheep as animal models

    Institute of Scientific and Technical Information of China (English)

    LIU Guo-min; LI You-qiong; XU Chuan-jie; ZHU Xiao-min; LIU Yi

    2010-01-01

    Backgroud Studies on new vertebral internal fixations of animals are very important prior to clinical application. This study aimed to determine the feasibility of vertebral internal fixation on morphologic and biomechanical properties using deer and sheep as animal models and comparing to human data.Methods Thirty sets of fresh Sika deer lumbar, 30 sets of fresh sheep lumbar, and 20 sets of fresh lumbar from male cadavers were used. We examined the morphology of the centra and pedicles of the three groups, and determined the cancellous bone density and biomechanical properties in all groups.Results There were marked differences in all parameters measured between the different species. The sizes of the upper, middle, and lower transverse diameter were largest in the human, followed by the deer, then the sheep. The index of centrum transverse diameters and sagittal diameters were less than 0.8 (a triangle), and the deer was more similar to the human. The heights of the right vertebral pedicles and the anterior disc heights (IDH) were largest in the human, followed by the deer, then the sheep. The apparent density, elastic modulus, and ultimate load were largest in the sheep, followed by the deer, then the human. The range of motion (ROM) of functional lumbar units (FLUs) with a combined flexion-extension moment was largest in the human, followed by the deer then the sheep. Conclusions The deer lumbar is more similar to that of human in anatomical form and biomechanics than the sheep lumbar. As such, deer is more appropriate as an animal model for use in vertebral internal fixation studies.

  20. Charcot foot reconstruction with combined internal and external fixation: case report

    Directory of Open Access Journals (Sweden)

    Zgonis Thomas

    2010-02-01

    Full Text Available Abstract Charcot neuroarthropathy is a destructive and often-limb threatening process that can affect patients with peripheral neuropathy of any etiology. Early recognition and appropriate management is crucial to prevention of catastrophic outcomes. Delayed diagnosis and subsequent pedal collapse often preclude successful conservative management of these deformities and necessitate surgical intervention for limb salvage. We review the current literature on surgical reconstruction of Charcot neuroarthropathy and present a case report of foot reconstruction with combined internal and external fixation methods.

  1. Titanium internal fixation system used for sternum reconstruction after resection of chondrosarcoma

    Institute of Scientific and Technical Information of China (English)

    LIU Zheng-cheng; ZHAO Heng

    2010-01-01

    @@ Chondrosarcoma is the most common malignant primary ches t wall tumor, only 20% of these cases involve sternum.1 Current therapy for chondrosarcoma requires adequate surgical excision and radiation therapy,2chemotherapy have not been yet proved to be effective.However, reconstruction of the defect is difficult, the problems of providing soft tissue coverage additionally complicating the surgery and even potentially limit the ability to achieve clear margin. Titanium internal fixation system can provide proper chest stability, ensure wide surgical margin and reduce hurts.

  2. The quality of life after a femoral neck fracture in elderly patients: a comparative study between internal fixation and arthroplasties

    Directory of Open Access Journals (Sweden)

    Dennis Sansanovicz

    2017-01-01

    Full Text Available Introduction: The femoral neck fracture is a frequent pathology in the elderly population, with about of 100,000 cases per year in Brazil. The surgical treatment by internal fixation or arthroplastic hip replacement is advocated today. The non-surgical treatment is reserved for cases of exception. Objective: To compare the quality of patient postoperative life treated for femoral neck fracture by two different techniques: hip arthroplasty and internal fixation. Methods: Through the SF-36 questionnaire, we study the quality of life of 60 patients with more than 65 years, treated between 2004 and 2012 in our service. Half of the patients was submitted to internal fixation and the other half to the arthroplastic replacement. Results: Higher averages in the large majority of the parameters of the questionnaire were obtained by the group which was carried out by internal fixation, but without statistical significance in most of these differences. Some international reports indicate that patients who have suffered a fracture of the femoral neck and were treated with internal fixation may recover the quality of life they had before the fracture. Paradoxically, there is a growing trend among orthopedic surgeons to perform a hip replacement surgery in these cases. Conclusion: Further studies are needed to define which is the best surgical treatment option.

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

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    Rubenbauer Bianka

    2009-12-01

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

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

    Science.gov (United States)

    Pieske, Oliver; Wittmann, Alexandra; Zaspel, Johannes; Löffler, Thomas; Rubenbauer, Bianka; Trentzsch, Heiko; Piltz, Stefan

    2009-12-15

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

  5. Combined Internal and External Fixation for Diabetic Charcot Reconstruction: A Retrospective Case Series.

    Science.gov (United States)

    Hegewald, Kenneth W; Wilder, Megan L; Chappell, Todd M; Hutchinson, Byron L

    2016-01-01

    Diabetic Charcot neuroarthropathy is a complex, limb-threatening disease process with major lifestyle-altering repercussions for patients. When Charcot neuroarthropathy leads to unstable deformity, ulceration, and potential infection despite conservative therapies, foot and ankle surgeons often consider reconstructive limb salvage procedures to restore function. The purpose of the present study was to evaluate the clinical and radiographic outcomes of diabetic Charcot reconstruction using combined internal and external fixation. A total of 22 patients were reviewed; 16 (72.73%) midfoot and 6 (27.27%) tibiotalocalcaneal arthrodesis procedures were consecutively performed from March 2009 to May 2013. All surgical procedures were performed in nonacute phases of the Charcot process in patients with diagnosed diabetes mellitus and documented peripheral neuropathy. Patients were excluded from the study if they were not diabetic despite having undergone Charcot reconstruction, regardless of the fixation method, or if they did not complete radiographic imaging. During a mean follow-up period of 58.60 ± 42.37 (range 16 to 164) weeks, limb salvage was achieved in 20 patients (90.91%), and 2 (9.09%) required below-the-knee amputation at a mean of 42 ± 14.14 weeks. Wound dehiscence occurred in 8 (36.36%), pin tract infection in 10 (45.45%), and superficial wound infection in 9 (40.91%) and peaked in bimodal fashion at 4 and 8 weeks postoperatively. Radiographic analysis of the pre- versus postoperative alignment showed statistically significant changes in the lateral talo-first metatarsal angle (p = .02) and lateral talar declination angle (p = .01). The limb salvage rates with diabetic Charcot reconstruction are improving in part because of the continued development of increasingly superior modalities for both internal and external fixation.

  6. Residual intersegmental spinal mobility following limited pedicle fixation of thoracolumbar spine fractures with the fixateur interne.

    Science.gov (United States)

    Lindsey, R W; Dick, W; Nunchuck, S; Zach, G

    1993-03-15

    The Fixateur Interne has been proposed for limited pedicle fixation of thoracolumbar spine fractures with the assumption that motion in the nontraumatized spinal segments could be maintained. To date, no data exist that both localize and quantitate spinal mobility about the fractured vertebra. Voluntary maximum lateral flexion and extension radiographs were obtained on patients with unstable thoracolumbar spine fractures at a minimum of 2 years after Fixateur Interne instrumentation (implant was removed after 1 year). Residual intersegmental motion was measured at levels adjacent to both the vertebra fracture and the fixation. Fifty-nine patients were reviewed, and the posterior vertebral body angle demonstrated a mean total sagittal motion of 2.98 degrees. Cephalad and caudal to the fractured vertebra, a mean of 1.34 degrees and 3.08 degrees, respectively, of residual motion was noted; cephalad and caudal to the previously instrumented segment a mean of 3.22 degrees and 6.88 degrees, respectively, was measured. The authors conclude that residual mobility is most evident at the caudal end of the instrumented segment, removed from the fractured vertebra. The level with end plate disruption becomes essentially ankylosed, with or without a fusion.

  7. 不同内固定方法治疗成人桡骨颈骨折的疗效分析%Comparative study of internal fixation of adult radial neck fracture with different fixation methods

    Institute of Scientific and Technical Information of China (English)

    刘杰; 郭士方; 王栓科; 张辉

    2010-01-01

    Objective To evaluate the clinical outcomes of different internal fixation methods to treat adult radial neck fractures. Methods Twenty-one cases of Mason Ⅱ and Ⅲ radial neck fractures were treated with open reduction and internal fixation. Mini-plate and Kirschner-wire fixation was used in 16 cases and 5 cases, respectively. Elbow functions were evaluated and compared between the two groups. Results All patients were follow-up for 16 to 42 months (average 33 months). Nonunion occurred in one case with K-wire fixation, which was treated with mini-plate fixation 8 months after the first surgery. All other 20 cases achieved bone union. According to Broberg and Morrey score system, the mini-plate group had excellent results in 11 cases, good results in 4 cases and fair results in 1 case, with an overall excellent and good rate of 93.8%. The K-wire group had excellent results in 1 case, good results in 2 cases, fair results in 1 case and poor results in 1 case, with an overall excellent and good rate of 60.0%. Conclusion Open reduction and internal fixation is the most appropriate way to treat adult Mason Ⅱ and Ⅲ radial neck fractures. Mini-plate fixation is significantly better than K-wire fixation.%目的 探讨应用不同内固定方法治疗成人桡骨颈骨折的疗效.方法 对21例Mason Ⅱ、Ⅲ桡骨颈骨折患者,采用切开复位微型钢板内固定(16例)和克氏针内固定(5例),术后对两组肘关节功能进行比较分析.结果 21例患者均获得随访,随访时间为16~42个月,平均33个月.1例克氏针固定患者骨折不愈合,术后8个月再次行微型钢板内固定.余20例患者均骨性愈合.按照Broberg和Money肘关节功能评分标准进行评估:微型钢板组优11例、良4例、可1例,优良率为93.8%;克氏针固定组优1例、良2例、可1例、差1例,优良率为60.0%.结论 在治疗成人MasonⅡ、Ⅲ型桡骨颈骨折时,采用切开复位内固定是获得良好肘关节功能的首要选择.

  8. 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

  9. Finite element analysis of three patterns of internal fixation of fractures of the mandibular condyle.

    Science.gov (United States)

    Aquilina, Peter; Chamoli, Uphar; Parr, William C H; Clausen, Philip D; Wroe, Stephen

    2013-06-01

    The most stable pattern of internal fixation for fractures of the mandibular condyle is a matter for ongoing discussion. In this study we investigated the stability of three commonly used patterns of plate fixation, and constructed finite element models of a simulated mandibular condylar fracture. The completed models were heterogeneous in the distribution of bony material properties, contained about 1.2 million elements, and incorporated simulated jaw-adducting musculature. Models were run assuming linear elasticity and isotropic material properties for bone. This model was considerably larger and more complex than previous finite element models that have been used to analyse the biomechanical behaviour of differing plating techniques. The use of two parallel 2.0 titanium miniplates gave a more stable configuration with lower mean element stresses and displacements over the use of a single miniplate. In addition, a parallel orientation of two miniplates resulted in lower stresses and displacements than did the use of two miniplates in an offset pattern. The use of two parallel titanium plates resulted in a superior biomechanical result as defined by mean element stresses and relative movement between the fractured fragments in these finite element models.

  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. Osteosynthesis of ununited femoral neck fracture by internal fixation combined with iliac crest bone chips and muscle pedicle bone grafting

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    D D Baksi

    2016-01-01

    Full Text Available Background: Ununited femoral neck fracture is seen commonly in developing countries due to delayed presentation or failure of primary internal fixation. Such fractures, commonly present with partial or total absorption of femoral neck, osteonecrosis of femoral head in 8-30% cases with upward migration of trochanter posing problem for osteosynthesis, especially in younger individuals. Several techniques for treatment of such conditions are described like osteotomies or nonvascularied cortical or cancellous bone grafting provided varying degrees of success in terms of fracture union but unsatisfactory long term results occurred due to varying incidence of avascular necrosis (AVN of femoral head. Moreover, in presence of AVN of femoral head neither free fibular graft nor cancellous bone graft is satisfactory. The vascularied bone grafting by deep circumflex iliac artery based on iliac crest bone grafting, free vascularied fibular grafting and muscle pedicle periosteal grafting showed high incidence of success rate. Osteosynthesis is the preferred treatment of choice in ununited femoral neck fracture in younger individuals. Materials and Methods: Of the 293 patients operated during the period from June 1977 to June 2009, 42 were lost to followup. Seven patients with gluteus medius muscle pedicle bone grafting (MPBG were excluded. Thus, out of 244 patients, 208 (85.3% untreated nonunion and 36 (14.7% following failure of primary internal fixation were available for studies. Time interval between the date of injury and operation in untreated nonunion cases was mean 6.5 months and in failed internal fixation cases was mean 11.2 months. Ages of the patients varied from 16 to 55 years. Seventy patients had partial and 174 had subtotal absorption of the femoral neck. Evidence of avascular necrosis (AVN femoral head was found histologically in 135 (54.3% and radiologically in 48 (19.7% patients. The patients were operated by open reduction of fracture

  12. Current management options for displaced intra-articular calcaneal fractures: Non-operative, ORIF, minimally invasive reduction and fixation or primary ORIF and subtalar arthrodesis. A contemporary review.

    Science.gov (United States)

    Sharr, P J; Mangupli, M M; Winson, I G; Buckley, R E

    2016-03-01

    Management of Displaced Intra-articular Calcaneal Fractures (DIACFs) continues to be technically demanding. The literature has not been definitive in its guidance for surgeons dealing with these injuries. Recent publications have further added to the lack of clarity. This review is intended to summarise the present state of knowledge, and provide some genuine guidance for clinicians. To review previous research, focussing on articles published within the last fifteen years, and summarise the findings to aid surgeons in managing DIACFs with choosing best management for patients. We reviewed the best evidence and literature, focussing on articles published within the last fifteen years, and summarised findings into workable recommendations. Variables of (1) patient, (2) the associated soft tissue injury and (3) the fracture characteristics were used to aid surgeons in choosing the best of the available options for each patient that presents with a DIACF. Management of DIACFs can best be divided into four broad categories: (i) non-operative management, (ii) open reduction and internal fixation, (iii) minimally invasive reduction and fixation, and (iv) primary subtalar arthrodesis. The evolution of the literature would suggest orthopaedic surgeons managing calcaneus fractures should have an expert's knowledge, surgical expertise and the latest techniques to cover these four options, to tailor the treatment of DIACFs to the individual patient. Copyright © 2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  13. Application of CITYgreen model in benefit assessment of Nanjing urban green space in carbon fixation and runoff reduction

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Based on the analytical framework and calculation principles of the CITY green model to assess the benefits of urban green spaces in terms of carbon fixation and runoff reduction,an approach was made to obtain appropriate parameters for this model to calculate the ecological benefits of different urban land use types in the main city of Nanjing.The results indicate that carbon fixation benefits received by the main city of Nanjing is 5%-60% of that by natural forests on a per unit area basis.The ecological value of carbon fixation and runoff reduction of the Nanjing urban green space was about 177 million RMB in total.The ecological benefits of different land use types were in the order of green area > public facilities > residential areas > roads and squares > industrial areas > municipal utilities.This research can provide references for city planning and urban green space establishment and facilitate the popularization of quantitative assessment of ecological benefits of green spaces in Chinese cities.

  14. Motion-preserving reduction and fixation of C1 Jefferson fracture using a C1 lateral mass screw construct.

    Science.gov (United States)

    Jo, Kwang-Wook; Park, Ik-Seong; Hong, Jae Taek

    2011-05-01

    The treatment of C1 Jefferson fractures is controversial. Non-surgical treatment with halo fixation always bears the risk of insufficient healing with further instability and increasing neck pain. However, a C1-2 fusion can markedly decrease the rotatory motion of the neck. The aim of this report is to describe a new treatment for C1 Jefferson fractures. We used open reduction and C1 fixation using a bilateral C1 lateral mass screw construct. The screws were connected with a rod and nuts to reduce lateral spread of the lateral masses. This method is an alternative surgical option for C1 Jefferson fractures in select patients and can maintain important C1-2 joint motion.

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

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    Qian Xu

    2015-01-01

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

  16. Nitrogen fixation (acetylene reduction) by annual winter legumes on a coal surface mine

    Energy Technology Data Exchange (ETDEWEB)

    Gabrielson, F.C.

    1982-01-01

    The winter annuals, crimson clover, rose clover, subterranean clover and hairy vetch, were evaluated for their ability to fix nitrogen on coal surface mine substrates by measuring their ability to reduce acetylene to ethylene. The effects of fertilizer, Abruzzi ryegrass, Kentucky 31 fescue grass and a phytotoxic plant Chenopodium album on nitrogen fixation was also assessed. Crimson clover was recommended as the best legume to use on topsoil and shale in the South. Hairy vetch gave good results on shale and subterranean clover did well on topsoil. The use of these species for revegetation is discussed. Overall, no correlation between substrate pH and ethylene levels was found and effects of substrate depended upon the legume species. Super phosphate fertilizer supported less nitrogen fixation than 13-13-13. Abruzzi ryegrass in some unknown way inhibited plant density and nitrogen fixation by legumes but not by free living substrate micro-organisms. Shale from under dead Chenopodium plants in both field and greenhouse experiments did not inhibit nitrogen fixation. 11 references, 7 tables.

  17. Nitrogen fixation (Acetylene Reduction) by annual winter legumes on a coal surface mine

    Energy Technology Data Exchange (ETDEWEB)

    Gabrielson, F.C.

    1982-01-01

    The winter annuals, crimson clover, rose clover, subterranean clover and hairy vetch, were evaluated for nitrogen fixing capacity on coal surface mine substrates by measuring their ability to reduce acetylene to ethylene. The effects of fertilizer, Abruzzi rye, Kentucky 31 fescue grass and a phytotoxic plant Chenopodium album on nitrogen fixation were also assessed. Crimson clover was recommended as the best legume to use on topsoil and shale in the south. Hairy vetch gave good results on shale and subterranean clover did well on topsoil. The use of these species for revegetation is discussed. Overall, no correlation between substrate pH and ethylene levels was found and effects of substrate depended upon the legume species. Super phosphate fertilizer supported less nitrogen fixation than 13-13-13. Abruzzi rye in some unknown way inhibited plant density and nitrogen fixation by legumes but not by free living substrate micro-organisms. Shale from under dead Chenopodium plants in both field and greehouse experiments did not inhibit nitrogen fixation. 7 tables.

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

    Directory of Open Access Journals (Sweden)

    Venkateswara Rao

    2015-09-01

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

  19. Development of a fixation device for robot assisted fracture reduction of femoral shaft fractures: a biomechanical study.

    Science.gov (United States)

    Weber-Spickschen, T S; Oszwald, M; Westphal, R; Krettek, C; Wahl, F; Gosling, T

    2010-01-01

    Robot assisted fracture reduction of femoral shaft fractures provides precise alignment while reducing the amount of intraoperative imaging. The connection between the robot and the fracture fragment should allow conventional intramedullary nailing, be minimally invasive and provide interim fracture stability. In our study we tested three different reduction tools: a conventional External Fixator, a Reposition-Plate and a Three-Point-Device with two variations (a 40 degrees and a 90 degrees version). We measured relative movements between the tools and the bone fragments in all translation and rotation planes. The Three-Point-Device 90 degrees showed the smallest average relative displacement and was the only device able to withstand the maximum applied load of 70 Nm without failure of any bone fragment. The Three-Point-Device 90 degrees complies with all the stipulated requirements and is a suitable interface for robot assisted fracture reduction of femoral shaft fractures.

  20. Limited Internal Fixation Combined External Fixator in the Treatment of Open Fractures of Tibia and Fibula%有限内固定结合组合式外固定架治疗胫腓骨开放性骨折

    Institute of Scientific and Technical Information of China (English)

    许明友; 江深河

    2014-01-01

    Objective To summarize the experience of limited internal fixation combined external fixation in open fractures of tibia and fibula in the treatment of clinical ef icacy. Methods I Division in 2009 September~2013 year in December the use of limited internal fixation combined external fixation for the treatment of open fractures of tibia and fibula in 53 cases. Results 53 cases of fracture healing. Conclusion The fixation is reliable, simple operation, less injury, wound infection risk reduction advantages, has high clinical application value.%目的:总结有限内固定结合组合式外固定在胫腓骨开放性骨折治疗过程中的临床疗效。方法我科于2009年9月~2013年12月使用有限内固定结合组合式外固定治疗胫腓骨开放性骨折53例。结果53例骨折均愈合。结论固定可靠,操作简单、手术损伤较小,伤口感染风险降低等优点,具有较高的临床运用价值。

  1. 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.

  2. External Fixation Combined with Limited Internal Fixation for the Treatment of Tile C Type Pelvic Fracture%外固定联合有限内固定治疗Tile C型骨盆骨折

    Institute of Scientific and Technical Information of China (English)

    李琳

    2014-01-01

    Objective To explore the clinical effects of the external fixation combined with limited internal fixation in the treatment of Tile C type pelvic fracture. Methods 27 patients of Tile C type pelvic fracture were administrated with external fixation combined with limited internal fixation. 25 of the 27 patients were followed up. There were 17 patients of Tile C1pelvic fracture;8 patients of Tile C2 pelvic fracture. Results 25 patient were followed up for 6 months to 2 year( average,1. 5 years). According to Tornetta standard evaluation score after reduction of fracture,the results were excellent in 12 cases,good in 9 cases,fair in 3 cases and bad in 1 cases. The total excellent and good rate was 84%. According to Majeed score system af-ter the postoperative functional recovery,the results were excellent in 11 cases,good in 11 cases,fair in 2 cases and bad in 1 cases,the total excellent and good rate was 88%. Conclusion External fixation combined with limited internal fixation can not only restore pelvic ring continuity and overall stability of structure but also have mang advantages,such as practical,effective operation,small trauma,less bleeding,convenient adjustment and disassemble. The methods is worthy of wide application.%目的:探究外固定联合有限内固定治疗Tile C型骨盆骨折的临床疗效。方法对27例Tile C型骨盆骨折采用外固定支架联合有限内固定进行治疗,本组27例,25例获得随访,根据Tile分型,C1型17例,C2型8例。结果本组随访时间为6个月~2年,平均1.5年。骨盆骨折复位后根据Tornetta评分标准评价,优12例,良9例,可3例,差1例,总体优良率为84%;术后功能恢复情况采用MaJeed评分系统评价,优11例,良11例,中2例,差1例,总体优良率为88%。结论对于Tile C型骨盆骨折,采用外固定联合有限内固定双重固定不仅可以恢复骨盆环解剖序列的连续性和整体结构的稳定性,而且该方法具有实

  3. Arthroscopic disc fixation to the condylar head. Use of resorbable pins for internal derangement of the temporomandibular joint (stage II-IV). Preliminary report of 34 joints.

    Science.gov (United States)

    Goizueta-Adame, Carlos C; Pastor-Zuazaga, Daniel; Orts Bañón, Juan E

    2014-06-01

    The study describes the arthoscopic use of resorbable pins for the internal derangement of the temporomandibular joint with McCain's technique. Clinical and image features are reported retrospectively. Twenty-seven consecutive patients (34 joints) were included. Symptomatic internal derangement and anterior-medial disc displacement with or without reduction in magnetic resonance images (MRI) were diagnosed in all cases. Two resorbable pins (SmartNail) were placed in each joint employing arthroscopic surgery with a third portal for disc recapture and fixation to condylar head. Clinical data 24 months after surgery are reported (movements, pain score, clicking, laterodeviation, occlusal changes). In eight joints a MRI control was required between 1 and 2 years after surgery. Visual analogue scale values (0-100) decreased from 70.8 to 11.9 (p < 0.001) in the first control (week) and kept down after 24 months of follow-up (VAS: 4.8). Movements began to recover in 3 months and mouth opening increased from 34 mm to 43.2 mm 1 year after surgery (p < 0.001). Clicking, laterodeviation and contralateral excursions improvement were statistically significant (p < 0.001). MRI showed disc fixation to condyle head in closed and opened mouth. Disc fixation to condylar head with resorbable pins is a safe and satisfactory procedure. Pain becomes drastically reduced and mandibular function recovers normal parameters in patients with internal derangement. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  4. 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.

  5. Bio-Environment-Induced Degradation and Failure of Internal Fixation Implants

    Directory of Open Access Journals (Sweden)

    Yan Zhou

    2015-10-01

    Full Text Available Internal fixations provide fast healing but their failure remains problematic to patients. Here, we report an experimental study in failure of three typical cases of metals: a bent intramedullary stainless steel nail, a broken exterior pure Ti plate, and a broken intramedullary stainless steel nail. Characterization of the bent nail indicates that those metals are vulnerable to corrosion with the evidence of increased surface roughness and embrittlement. Depredated surface of the Ti plate resulted debris particles in the surrounding tissue of 15.2 ± 6.5 μm in size. Nanoparticles were observed in transmission electron microscope. The electron diffraction pattern of the debris indicates a combination of nanocrystalline and amorphous phases. The failure mode of the broken nail made of stainless steel was found to be fatigue initiated from the surface. This study clearly shows the biological-attack induced surface degradation resulting in debris and fatigue. Future design and selection of implant materials should consider such factors for improvement.

  6. Midterm results following medial closed wedge distal femoral osteotomy stabilized with a locking internal fixation device.

    Science.gov (United States)

    Forkel, Philipp; Achtnich, Andrea; Metzlaff, Sebastian; Zantop, Thore; Petersen, Wolf

    2015-07-01

    Aim of this study was to evaluate the subjective and radiological outcome and to evaluate the complications of a medial closing wedge osteotomy at the femur for lateral osteoarthritis with genu valgum. Twenty-three patients with grade III to IV cartilage damage and valgus knee alignment were treated with medial closing wedge osteotomy at the distal femur. The osteotomy was stabilized with an internal plate fixator. Age varied between 25 and 55 years (mean 47 years). One patient was lost to final follow-up. After 3.5 years, all Knee Osteoarthritis Outcome Score (KOOS) subitems increased significantly. There was no significant difference in the subgroup analysis of KOOS subitems for patients with and without microfracture or age (>50 vs. <50 years). There were no perioperative complications. One patient had an overcorrection. All, but one osteotomy, showed stable bone healing. There was a loss of correction due to delayed bone healing in one case. Possible explanations for this complication were injury of the lateral cortex or smoking. This case required revision with bone graft and an additional lateral plate. In no case, a conversion to an endoprosthesis was necessary. The femoral medial closing wedge osteotomy is a surgical method for improving symptoms of lateral osteoarthritis in the valgus knee. IV.

  7. 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.

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

    Science.gov (United States)

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

    2011-04-11

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

  9. A COMPARATIVE STU DY BETWEEN “CLOSED REDUCTION, CAST IMMOBILISATION “AND “CLOSED REDUCTION, PERCUTANEOUS K - WIRE FIXATION, CAST IMMOBILISATION” IN DISTAL RADIUS FRACTURES

    Directory of Open Access Journals (Sweden)

    Subramaniam

    2015-08-01

    Full Text Available BACKGROUND DATA: D istal radius fracture is a common fracture encountered by an orthopaedic surgeon. V arious treatment modalities exist for the same. K - wire fixation being one among them. T he traditional closed reduction and cast immobilization also provides fair results. H e nce the need to know which among the two provides cost effective treatment for the patient. MATERIALS AND METHODS: prospective study done between the periods J uly 2005 to J une 2007. D orsally displaced distal radius fractures with or without intra articular involvement were included in the study. 42 patients were involved in the study. T hey were randomly divided into two groups of 21 each. C losed reduction and below elbow immobilization were done in 21 patients, and closed reduction, percutaneous k - wire fixa tion were done in another 21 patients. 6 patients were lost to follow up in both the groups. Parameters assessed at the end of one year are - clinical: pain, any evidence for pin tract infection, evidence for nerve lesion, evidence of reflex sympathetic dystrophy, evidence of tendon rupture, mobility of wrist joint – palmar flexion, dorsiflexion, pronation, supination, grip strength assessment using jamar dynamometer. RADIOLOGICAL: dorsal angle of radius and radial shortening were assessed. RESULTS: statistical analysis was computed using mean and standard deviation, between the two groups. ‘t’ test was used to compare the mean values. p<0.05 was considered statistically significant. C losed reduction, percutaneous k - wire fixation showed statistically significant value p<0.05 with postoperative grip strength. I ntra articular fractures showed significantly higher mean pain scale score compared to extra articular freactues. E xtra articular fractures showed significantly higher mean values in range of motion – palmar flexion, dorsiflexion, rotations and in grip strength. CONCLUSION: C losed reduction and percu tnaeus k - wire fix ation showed superior

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

    Directory of Open Access Journals (Sweden)

    Fujioka Hiroyuki

    2012-12-01

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

  11. Does Arthroplasty Provide Better Outcomes Than Internal Fixation At Mid- and Long-term Followup? A Meta-analysis.

    Science.gov (United States)

    Jiang, Jin; Yang, Chen-hui; Lin, Qiao; Yun, Xiang-dong; Xia, Ya-yi

    2015-08-01

    Arthroplasty has been shown to be superior regarding low risk of reoperation and better function score to internal fixation for treatment of displaced femoral neck fractures at short-term followup. However, there are unanswered questions regarding the efficacy of arthroplasty in the longer term compared with internal fixation. We performed a meta-analysis comparing arthroplasty (hemiarthroplasty or THA) with internal fixation in patients with displaced femoral neck fractures with respect to (1) mortality, (2) reoperation, (3) functional recovery, and (4) complications, including only randomized trials with a minimum of 4 years followup. Computerized databases, including PubMed (MEDLINE), EMBASE, Cochrane Register of Controlled Trials databases, and Web of Science™ were searched for studies published from the inception date for each database to March 2014. Eleven randomized controlled trials that compared arthroplasty (either hemiarthroplasty or THA) with internal fixation for treatment of patients with a femoral neck fracture were included in our analysis. The quality of the trials was assessed according to the Cochrane Handbook and meta-analyses were conducted using RevMan 5.2 software from the Cochrane Collaboration. The heterogeneity among studies was evaluated by the I-squared index (I2) and publication bias was assessed using forest plots. There were no differences between the internal fixation and arthroplasty groups for patient mortality at mid-term (48.4% vs 46.8%) or long-term followup (83.2% vs 81.5%). Arthroplasty was associated with a lower risk of reoperation at mid-term (7.2% vs 39.8%; relative risk [RR]=0.10; 95% CI, 0.06-0.07) and at long-term followup (14.3% vs 43.8%; RR=0.10; 95% CI, 0.06-0.07). Arthroplasty was associated with better functional recovery at mid-term followup (standard mean difference [SMD]=0.55; 95% CI, 0.02-1.09), whereas function at long-term followup (SMD=0.14; 95% CI, -0.35 to 0.62) was not different between the arthroplasty

  12. Review of techniques for monitoring the healing fracture of bones for implementation in an internally fixated pelvis.

    Science.gov (United States)

    Wong, Lydia Chwang Yuh; Chiu, Wing Kong; Russ, Matthias; Liew, Susan

    2012-03-01

    Sacral fractures from high-impact trauma often cause instability in the pelvic ring structure. Treatment is by internal fixation which clamps the fractured edges together to promote healing. Healing could take up to 12 weeks whereby patients are bedridden to avoid hindrances to the fracture from movement or weight bearing activities. Immobility can lead to muscle degradation and longer periods of rehabilitation. The ability to determine the time at which the fracture is stable enough to allow partial weight-bearing is important to reduce hospitalisation time. This review looks into different techniques used for monitoring the fracture healing of bones which could lead to possible methods for in situ and non-invasive assessment of healing fracture in a fixated pelvis. Traditional techniques being used include radiology and CT scans but were found to be unreliable at times and very subjective in addition to being non in situ. Strain gauges have proven to be very effective for accurate assessment of fracture healing as well as stability for long bones with external fixators but may not be suitable for an internally fixated pelvis. Ultrasound provides in situ monitoring of stiffness recovery but only assesses local fracture sites close to the skin surface and has only been tested on long bones. Vibration analysis can detect non-uniform healing due to its assessment of the overall structure but may suffer from low signal-to-noise ratio due to damping. Impedance techniques have been used to assess properties of non-long bones but recent studies have only been conducted on non-biological materials and more research needs to be done before it can be applicable for monitoring healing in the fixated pelvis.

  13. sign hip construct: achieving hip fracture fixation without using an ...

    African Journals Online (AJOL)

    Objective: The aim of this study was to assess outcomes of using the SIGN Hip Construct (SHC) to achieve ... The majority (76%) of patients were ambulatory within. 3 days after the surgery. ... Conclusion: Using the SIGN Hip Construct, hip fracture fixation can be ... elderly has made stable reduction and internal fixation.

  14. International decade for natural disaster reduction

    Science.gov (United States)

    Hays, W. W.

    1990-01-01

    Throughout history, humanity has found itself in conflict with naturally occurring events of geologic, hydrologic, and atmospheric origin. this conflict has been demonstrated repeatedly when people build urban centers at the water's edge, in or near active fault systems capable of generating earthquakes, on steep slopes, near active volcanoes, or at the urban-wilderness interface prone to wildfires. Naturally occurring, recurrent events such as floods, windstorms, tsunamis, earthquakes, landslides, volcanic eruptions, and wildfires have tested human-engineered works many times and have often found them unable to withstand the forces generated by the event. In the past 20 years, for example, events like these throughout the world have claimed more than 2.8 million lives and adversely affected 820 million people; single disasters have caused economic losses of billions of dollars. Industrialized countries like the United States and Japan have been able to absorb the socioeconomic losses of past natural disasters, but the economics of many developing countries have been devastated by losses equal to a large percentage of their gross national product. Furthermore, the magnitude of the losses is increasing at a rapid rate as the building wealth of nations is expanded to meet the needs of rapidly increasing population, often without adequate consideration of the potential threat posed by the recurrent natural hazards and without implementing effective loss-reduction measures because of lack of knowledge or lack of technical capability. 

  15. Arthroscopically Assisted Coracoclavicular Fixation Using a Single Flip Button Device Technique: What Are the Main Factors Affecting the Maintenance of Reduction?

    Directory of Open Access Journals (Sweden)

    Yong-Beom Lee

    2017-01-01

    Full Text Available Background. Among coracoclavicular (CC fixation techniques, the use of flip button device was demonstrated to have successful outcomes with the advantage of being able to accommodate an arthroscopic procedure. Purpose. This study was conducted to investigate the factors associated with loss of fixation after arthroscopically assisted CC fixation using a single flip button device for acromioclavicular (AC joint dislocations. Materials and Methods. We enrolled a total of 47 patients (35 men and 12 women. Plain radiography was performed at a mean of 24 months postoperatively to evaluate the final radiological outcome. The primary outcome measure was a long-term reduction of the AC joint for at least 24 months. Results. We found that 29 patients had a high quality reduction (61.7% and 18 patients had a low quality reduction (38.3% in initial postoperative CT findings. Our study showed that the duration (5 days from injury to treatment and the quality of initial postoperative reduction were significantly associated with the maintenance of reduction at final follow-up. Conclusion. Our study showed that maintaining stable reduction after arthroscopically assisted CC fixation using a single flip button device technique is difficult especially in patients who received delayed treatment or whose initial reduction quality was poor.

  16. [Digital panoramic radiography in patients with rigid internal fixations devices after maxillofacial surgery].

    Science.gov (United States)

    Nessi, R; Ottolina, P; Lazzerini, F; Giannì, A B

    1998-01-01

    Digital techniques have found promising applications in dental radiology in the recent past, namely with radiovisiography and digital panoramic radiography. These images present some features making them particularly interesting for alveolar bone studies. Digital panoramic radiography with light-emitting phosphors was performed on 16 patients during postoperative follow-up. The patients were previously submitted to multiple maxillofacial osteosynthesis with rigid internal fixation devices (32 miniplates, 12 microplates, 14 screws). Digital images were always observed and printed with analogic-like and Xeroradiographic-like post-processing. Digital panoramic radiographs yielded clear and effective images of the maxillary and mandibular arches and of surgical osteosynthesis, as demonstrated by a retrospective evaluation performed by three independent observers on a blind basis (score 3: 60.42%), with no major interobserver differences (p = .7286). Xeroradiographic-like images were the most effective in depicting bone structures and osteosynthesis materials, thanks to their better detailing and typically lower overall contrast. Among the drawbacks of the digital technique, reduced cassette size may prevent the full view of the mandibular arch from the symphysis to both condylar regions. The edge effect, which is typical of Xeroradiographic images, may mask useful details within the trabecular bone close to metal implants. This effect was present in some of our cases, but it was seldom disturbing according to our retrospective evaluation (score 3: 53.40%), with good interobserver agreement (p = .1117). Digital panoramic radiography proves to be a useful tool to study metal implants after maxillofacial surgery as well as alveolar bone structure. The digital technique markedly reduces the radiation dose to the patient, which is very important for an X-ray examination that must be repeated several times, often in young subjects.

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

    Science.gov (United States)

    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.

  18. 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.

  19. Speech at the Meeting on the International Disaster Reduction Day

    Institute of Scientific and Technical Information of China (English)

    Simayi Aimaiti

    2001-01-01

    @@ Comrades,The theme of this year's international disaster reduction day is "Disaster Prevention, Education and Youth". The purpose of this meeting is to review the activities we have taken for the International Decade for Natural Disaster Reduction (IDNDR), to summarize our achievements and experience with disaster reduction, to predict the disaster reduction situation and mission that China is to face in the 21st century, and to identify the appropriate approaches to work in the future. This is very important to disaster reduction in our country in the new century.Mr. Duojicairan has just given an overall summary of the activities taken by China for IDNDR.Leaders from the Ministry of Education (MOE) and the Forestry Administration (FA) have also introduced their endeavors and experience in education on disaster reduction and in forest fire disaster reduction respectively. Besides, members of CCIDNDR and experts from the Disaster Reduction Panel have presented their ideas and suggestions on how to promote disaster reduction in China in the new century, which are very constructive. In the following passage, I'd like to make a few points on how to further carry out disaster reduction in our country.

  20. Internal fixation of the spine in the surgical treatment of scoliosis.

    Science.gov (United States)

    Skwarcz, A; Majcher, P; Fatyga, M

    2000-09-30

    Progressive idiopathic scoliosis, despite the good effects of treatment by kinesitherapy and corrective corsets, continues to pose a complicated problem in planning surgical procedure. On the one hand, the steady growth and improvement of systems for three-plane correction and fixation of scoliosis improves the radiological and clinical outcome; on the other hand, three arises the necessity to choose the surgical procedure and system of implants appropriate for the given type, localization, and angular dimensions of the curvature. The problems faced by the operating surgeon include not only making the right choice of implants, but also arranging the transpedicular screws and hooks at the proper strategic points along the curvature of the spine. On the basis of clinical material from 200 patients surgically treated for idiopathic scoliosis, the authors present surgical solutions and analyze various implant systems (CD-HORIZON, DERO, STRYKER), made of steel or titanium, for three-plane correction and fixation of the spine. Attention is called to the application in the lumbar spine of transpedicular screws, which improve the correction and fixation of the spine and reduce the amount of instrumentation needed, while assuring the essential horizontal arrangement of the lower lumbar vertebrae. The authors' own experience shows that modern systems for three-plane correction and fixation of the spine in scoliosis exceeding 750, despite spondylodesis, do not assure the proper correction and biomechanical value, in comparison to the Wisconsin method, which combines BW distraction with Luque intersegmentary fixation.

  1. 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

  2. Pilon骨折一期闭合复位外固定支架固定术后骨折复位良好患者后续治疗方法的选择%Consequent treatment after one-stage close reduction with external fixation in Pilon fracture patients with good fracture reduction

    Institute of Scientific and Technical Information of China (English)

    付文芹; 刘佐庆; 潘福根; 高如峰

    2016-01-01

    目的 探讨Pilon骨折一期闭合复位外固定支架固定术后骨折复位良好患者后续治疗方法的选择.方法 选择复旦大学附属中山医院青浦分院2006年1月至2012年6月行一期闭合复位外固定支架固定术后骨折复位良好的Pilon骨折患者36例,根据后续治疗方案将患者完全随机分为未更换内固定组和更换内固定组,各18例.未更换内固定组未行二期更换内固定手术治疗,更换内固定组在术后2周左右行拆除外固定支架更换内固定手术.术后随访,观察2组患者并发症发生情况并于末次随访时评价患者踝关节功能.结果 术后随访13 ~35个月,未更换内固定组发生钉道感染1例,无皮肤坏死、神经血管损伤并发症;更换内固定组出现皮肤部分坏死3例.未更换内固定组末次随访时踝关节功能评分与更换内固定组比较[(91.6±2.3)分比(92.3±2.7)分],差异无统计学意义(P>0.05).结论 对于闭合复位外固定支架固定治疗的Pilon骨折患者,如果骨折复位满意,可以选择不更换内固定,将外固定支架固定作为确定性治疗.%Objective To investigate the choice of consequent treatment after one-stage close reduction with external fixation in Pilon fracture patients with good fracture reduction.Methods Totally 36 patients with Pilon fracture who obtained good postoperative fracture reduction after one-stage close reduction with external fixation from January.2006 to June 2012 were enrolled and divided into non-internal fixation group and internal fixation group according to the follow-up treatment (18 cases in each group).In non-internal fixation group,two-stage internal fixation was not performed;in internal fixation group,the external fixation was remove and two-stage internal fixation was performed 2 weeks after external fixation.The complications were observed and the ankle joint function at the last follow-up was assessed.Results The patients were followed up for 13

  3. Formation of internal cracks in steel billets during soft reduction

    Institute of Scientific and Technical Information of China (English)

    Wenjun Wang; Linxin Ning; Raimund Biilte; Wolfgang Bleck

    2008-01-01

    To investigate the formation of internal cracks in steel billets during soft reduction, fully coupled thermo-mechanical finite element models were developed using the commercial software ABAQUS, also casting and soft reduction tests were carried out in a laboratory strand casting machine. With the finite element models, the temperature distribution, the stress and strain states in the bil- let were calculated. The relation between internal cracks and equivalent plastic strain, as well as maximal principal stress was ana- lyzed. The results indicate that tensile stresses can develop in the mushy zone during soft reduction and the equivalent strain nearby the zero ductility temperature (ZDT) increases with decreasing sofid fraction. Internal cracks can be initiated when the accumulated strain exceeds the critical strain or the applied tensile stress exceeds the critical fracture stress during solidification.

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

    LENUS (Irish Health Repository)

    McGreal, G

    2012-02-03

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

  5. 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.

  6. Reduction of internal noise in auditory perceptual learning.

    Science.gov (United States)

    Jones, Pete R; Moore, David R; Amitay, Sygal; Shub, Daniel E

    2013-02-01

    This paper examines what mechanisms underlie auditory perceptual learning. Fifteen normal hearing adults performed two-alternative, forced choice, pure tone frequency discrimination for four sessions. External variability was introduced by adding a zero-mean Gaussian random variable to the frequency of each tone. Measures of internal noise, encoding efficiency, bias, and inattentiveness were derived using four methods (model fit, classification boundary, psychometric function, and double-pass consistency). The four methods gave convergent estimates of internal noise, which was found to decrease from 4.52 to 2.93 Hz with practice. No group-mean changes in encoding efficiency, bias, or inattentiveness were observed. It is concluded that learned improvements in frequency discrimination primarily reflect a reduction in internal noise. Data from highly experienced listeners and neural networks performing the same task are also reported. These results also indicated that auditory learning represents internal noise reduction, potentially through the re-weighting of frequency-specific channels.

  7. Limited internal fixation combined with external fixation for comminuted humerus shaft fractures%有限内固定结合外固定支架治疗肱骨干粉碎性骨折

    Institute of Scientific and Technical Information of China (English)

    黄俊武; 周玉龙; 周一飞; 李振兴; 石成弟; 郭晓山

    2016-01-01

    Objective To evaluate the clinical outcome in the treatment of humerus shaft comminuted fractures using limited open reduction and internal fixation combined with an external fixator.Methods Data of 80 patients with comminuted humerus shaft fractures treated from January 2005 to January 2013 were analysed retrospectively.All the patients underwent limited open reduction and internal fixation combined with an external fixator (treatment group) and open reduction and plate fixation (control group) according to the random number table.In the treatment group,there were 40 patients (28 males,12 females),at mean age of 33.5 years (range,21-54 years),with causes of injury including traffic accidents in five patients,falls in nine,crashes in seven and others in six.There were seven patients with open fractures and 33 with closed fractures.In the control group,there were 40 patients (25 males,15 females),at mean age of 32.9 years (range,19-55 years),with causes of injury including traffic accidents in 16 patients,tumbling in seven,crush in seven and others in ten.There were eight patients with open fractures and 32 with closed fractures.The operation time,intraoperative blood loss,bone union time and complications in both groups were recorded.Clinical efficacy was evaluated using the Stewart and Hundley standard.Results Mean follow-up was 19 months (range,15-24 months).Treatment and control groups showed significant differences in operation time [(55.5 ± 10.3) minutes vs.(120.5 ± 15.3) minutes],intraoperative blood loss [(120.4 ± 20.7) ml vs.(245.4 ± 26.7) ml] and bone union time [(11.6 ± 1.3) weeks vs.(14.9 ± 2.3) weeks] (P < 0.05).Rate of incision infection was 8% (3/40) in treatment group and 10% (4/40) in control group (P > 0.05).In treatment group the results were excellent in 31 patients and good in nine.In control group the results were excellent in 27 patients,good in nine,fair in one and poor in three.One patient with radial nerve injury after a

  8. How to evaluate the quality of fracture reduction and fixation of the wrist and ankle in clinical practice: a Delphi consensus

    NARCIS (Netherlands)

    Beerekamp, M.S.; Haverlag, R.; Ubbink, D.T.; Luitse, J.S.; Ponsen, K.J.; Goslings, J.C.

    2011-01-01

    METHOD: A Delphi study was conducted to obtain consensus on the most important criteria for the radiological evaluation of the reduction and fixation of the wrist and ankle. The Delphi study consisted of a bipartite online questionnaire, focusing on the interpretation of radiographs and CT scans of

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

    Institute of Scientific and Technical Information of China (English)

    Ming-Chao Zhang

    2016-01-01

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  11. 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...

  12. The Clinical Effect of the Length of the Rod under Direct Vision Combined with Posterior Reduction and Internal Fixation with Pulling Nerve Injury with Severe Traumatic Lumbar Fracture and Dislocation%后路直视下长短棒结合提拉复位内固定治疗伴神经损伤的重度创伤性腰椎骨折脱位的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    孙中政; 孙海燕; 楚超; 孙树发; 丁超; 王英胜; 郝其全

    2015-01-01

    目的:观察直视下长短棒结合提拉复位内固定治疗伴神经损伤的重度创伤性腰椎骨折脱位在临床上的应用价值。方法回顾分析2010年~2013年解放军第89医院收治的35例伴神经损伤的重度腰椎骨折脱位采用后路直视下长短棒结合提拉复位内固定术,术后采用Suk标准判断植骨融合情况。结果平均手术时间约170min,出血量约600ml,术后随访脊柱植骨融合且稳定,术中未发现神经根及硬膜囊等医源性损伤。术后行脊柱正侧位X线检查,椎体脱位及旋转、成角移位均完全纠正,椎体前缘高度由术前的45%恢复到术后的95%.Cobb角从术前的32.5°±2.9°恢复至术后平均4.5°±2.2°。脊髓神经功能恢复按照Frankel截瘫分级,其中25例分别提高1~3级,10例A级无明显变化,术后3个月下地或坐轮椅,无迟发性脊髓损伤,未见断钉。结论重度骨折脱位伴神经损伤采用后路直视下长短棒结合提拉复位内固定术,可有效去除对神经的骨性压迫并重建脊柱的稳定性,融合率较高,安全有效。%[ ABSTRACT] Objective To observe the clinical application value of direct vision combined with the length of the rod pulling fixa -tion on lumbar fracture and dislocation with severe traumatic nerve injury .Methods Retrospective analysis of 35 cases of severe lumbar frac-ture and dislocation complicated with nerve injury in PLA 89th hospitals during 2010~2013 treated by pulling open reduction and internal fixation with posterior length under rod was made ,the treatment effect was evaluated by Suk standards .Results The average operation time ws about 170 minutes,blood loss was about 600ml,intraoperative nerve root and dural sac such as iatrogenic injury was not found and postop -erative follow-up showed stable spinal bone graft fusion .Postoperative lateral X -ray examination of the spine ,vertebrae dislocation and rota

  13. 空心螺钉内固定术治疗Jones骨折32例分析%The analyses of 32 Jones fracture by using hollow screw internal fixation

    Institute of Scientific and Technical Information of China (English)

    唐兵; 秦定扬

    2010-01-01

    目的 观察空心螺钉内固定术治疗Jones骨折的临床疗效.方法 回顾性分析采用切开复位空心螺钉内固定术治疗Jones骨折32例患者的临床资料.结果 32例患者均治愈出院,平均随访18个月,根据Maryland足部评分系统评分:优25例,良6例,差1例,优良率96.9%.结论 空心螺钉内固定术治疗Jones骨折,操作简单,术后不用外固定,功能恢复快,并发症少,疗效满意.%Objective To analyze the therapy method and the therapeutic effect of Jones fracture by using hollow screw internal fixation.Methods All the Jones fractures were treated by open reduction hollow screw internal fixation and the plaster external fixation were not used after operation.Results The 32 cases with Jones fractures got excellent 25 cases,good 6cases and poor 1 case which used by Maryland foot score system to appraisal.All the cases were followed up for 6 months to 30 months and the average follow-up time is 18 months.Conclusion The treatment of hollow screw internal fixation was a satisfactory method to cure Jones fracture,which had get advantages of simple operation,small wound,short operation time,not external fixation,quick recovery and few complications.

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

    Institute of Scientific and Technical Information of China (English)

    卡依沙尔•买买提明; 赵岩

    2015-01-01

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

  15. Prebiotic Nitrogen Fixation by FeS Reduction of Nitrite Under Acidic Conditions

    Science.gov (United States)

    Summers, David P.; Mead, Susan C. (Technical Monitor)

    1999-01-01

    Theories for the origin of life require the availability of reduced nitrogen for the formation of such species as amino acid and nucleic acids. In a strongly reducing atmosphere, compounds essential to the chemical evolution of life, such as amino acids, can form by reactions between HCN, NH3, and carbonyl compounds produced in spark discharges. However, under non-reducing atmospheres, electric discharges produced NO rather than HCN or NH3. This raises the questions of; how ammonia can be formed under a neutral atmosphere, and what conditions are needed such formation to occur? On possibility is the conversion of NO into nitric and nitrous acids (through HNO) and rained into the oceans. The reduction of nitrite by aqueous Fe(II) (6 Fe(+2) + 7 H(+) + NO2(-) yields 6 Fe(III) + 2 H2O + NH3) such as was present on the early Earth could then have produced ammonia. However, this reaction does not proceed at pHs less than 7.3. An alternative is reduction by other forms of Fe(II), such as FeS. We will present results that show that FeS can reduce nitrite to ammonia at pHs as low as pH 5 under a variety of conditions.

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  17. Interactions between Lugol's fixative and ethylene in the acetylene-reduction assay for nitrogenase activity in lake water.

    Science.gov (United States)

    Leonardson, L

    1980-05-01

    Lugol's solution is a practical and efficient fixative for the acetylene-reduction assay of nitrogenase activity in aquatic organisms. Correction must be made, however, for the solubility of ethylene in the liquid phase and reactions between Lugol's solution and ethylene. With a vapor phase-liquid phase volume ratio of 1.9:1, the mean solubility of ethylene in mixtures of lake water and Lugol's solution was 7.2%. No correlation was found between ethylene solubility and the concentration of Lugol's solution. Storage of fixed samples for more than 1 day before gas chromatographic analysis resulted in increased loss of ethylene from the vapor phase; the loss amounted to ca. 18% after 3 days. Higher losses were noted at higher concentrations of Lugol's solution. Most probably these effects were caused by iodine addition to ethylene, as indicated by the consumption of ethylene by iodine-potassium iodide solutions. The reaction was catalyzed by the rubber septa of the incubaton vessels when the septa were in contact with the liquid phase. Loss of ethylene decreased with increased concentration of phytoplankton because the organisms absorbed iodine. By using a standardized technique and determining ethylene solubility and reaction patterns between ethylene and the mixture of water and Lugol's solution, it is possible to correct for the loss of ethylene.

  18. The impact of international greenhouse gas emissions reduction on Indonesia

    OpenAIRE

    Susandi, A.

    2004-01-01

    This dissertation represents a summary of three papers addressing impacts of climate policy on Indonesia. The extended version of MERGE (Model for Evaluating the Regional and Global Effects of Greenhouse Gas Reduction Policies) has been used to project Indonesian’s energy production, consumption and export to the year 2100, for a reference scenario and mitigation scenarios. In addition to the international trade of energy, coal has been included in this version. The study also analyzes the in...

  19. The impact of international greenhouse gas emissions reduction on Indonesia

    OpenAIRE

    Susandi, Armi

    2004-01-01

    This dissertation represents a summary of three papers addressing impacts of climate policy on Indonesia. The extended version of MERGE (Model for Evaluating the Regional and Global Effects of Greenhouse Gas Reduction Policies) has been used to project Indonesian’s energy production, consumption and export to the year 2100, for a reference scenario and mitigation scenarios. In addition to the international trade of energy, coal has been included in this version. The study al...

  20. 肘关节镜下复位经皮内固定治疗桡骨小头骨折%Elbow arthroscope assisted reduction and percutaneous fixation for treatment of radial head fractures

    Institute of Scientific and Technical Information of China (English)

    马苟平; 张春; 郭峭峰; 俞华军; 张晓文

    2015-01-01

    目的 观察肘关节镜下复位经皮内固定治疗桡骨小头骨折的临床疗效.方法 2010年1月至2014年1月对15例桡骨小头骨折患者,其中MasonⅡ型13例,MasonⅢ型2例,均采用肘关节镜下复位经皮内固定技术治疗.肘关节镜监视下行肘关节血肿清理、损伤软骨修整、碎片摘除、骨折复位及内固定.结果 所有患者术后均获得6~ 14个月的随访.末次随访时,肘关节屈伸活动度为(130±8)°,旋转活动度为(135±9)°.通过肘关节活动度及Mayo肘关节功能评分进行疗效评定:优10例,良4例,可l例.结论 肘关节镜下复位经皮内固定治疗桡骨小头骨折临床疗效满意,手术创伤小,有利于肘关节的功能恢复.%Objective To evaluate the clinical outcomes of treating radial head fractures with reduction and percutaneous fixation under elbow arthroscopy.Methods Fifteen cases of radial head fractures treated between January 2010 and January 2014 were involved in the study.There were 13 cases of Mason Ⅱ fractures and 2 cases of Mason Ⅲ fractures.All the fractures were treated with arthroscope assisted reduction and percutaneous internal fixation.Under elbow arthroscopy monitoring,intra-articular hematoma removal,cartilage repair,bone chip removal,and fracture reduction and fixation were done.Results All the patients were follow-up for 6 to 14 months postoperatively.The last follow-up and evaluation revealed (130 ± 8)° of elbow flexion/extension and (135± 9)° of forearm rotation.Judged by the elbow joint range of motion and the Mayo elbow function scores,the results were excellent in 10 cases,good in 4 cases and fair in 1 case.Conclusion Arthroscopic-assisted reduction and internal fixation of radial head fractures can lead to satisfactory clinical outcomes,is minimally invasive and is ideal for elbow function recovery.

  1. International Strategy of Disaster Reduction (ISDR) and Integrated Disaster Reduction in China

    Institute of Scientific and Technical Information of China (English)

    WANG Angsheng

    2001-01-01

    The article summarizes the achievements of the International Decade for Natural Disaster Reduction (IDNDR) and briefs the International Strategy of Disaster Reduction (ISDR) which is being carried out on a global scale in the 21st Century. It also presents the developments, components and workings of the China Disaster Reduction Center (CDRC), emphasizing its role in the integrated disaster reduction in contemporary China.The frequently seen natural and artificial disasters in China's urban areas are summed up with proposals on the overall planning, organization, programming, system, engineering, counterplans and preventive experiments of integrated urban disaster reduction.The article finally defines the relationship between CDRC and integrated urban disaster reduction, and proposes measures for promoting the development of CDRC. It stresses that all efforts of disaster prevention and mitigation in China will serve its long-range strategic goals. It is expected that the direct economic loss from disasters in China will decrease from the current 3. 8% to 0. 5% of China's GNP in 100 years, thus catching up with the developed countries in this field and making an important contribution to the sustained social-economic development of the country.

  2. 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.

  3. Internal fixation vs conservative treatment for displaced distal radius fractures: a meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Yu, Guang Shu; Lin, Yan Bin; Le, Li Sheng; Zhan, Mei Feng; Jiang, Xiao Xiang

    2016-05-01

    The aim of the present study was to compare clinical outcomes of internal fixation and conservative approach in the treatment of displaced distal radius fractures. Reports of studies were retrieved from the PubMed, Cochrane Library, EMBASE, BIOSIS, Ovid, CNKI, and Wanfang Data databases, as well as other sources. Methodological quality of the trials was critically assessed, and relevant data were extracted. Review Manager (RevMan) meta-analysis software (version 5.0; Cochrane Collaboration, London, UK) was used for data analysis. A total of 10 randomized controlled trials, which included 653 patients, were eligible for inclusion in the present meta-analysis, 7 of which were in English, and 3 of which were in Chinese. The trials had medium risk of bias. Results of meta-analysis showed that patients undergoing conservative treatment for distal radius fractures had better restoration of pronation (MD=1.80, 95% confidence interval [CI]=0.18-3.42, p=0.03; heterogeneity p=0.17, I2=43%), but shorter restoration of radial length (MD=2.62, 95% CI=1.47-3.76, pinternal fixation and conservative treatment for displaced distal radius fractures. Best course of of treatment must be determined based on concrete conditions.

  4. Clinical effect of internal fixation of screw intramedullary nail in the treatment of midshaft tibia fracture: report of 13 cases.%旋入式髓内针内固定治疗胫骨中段骨折13例

    Institute of Scientific and Technical Information of China (English)

    郭岁利

    2012-01-01

    目的 观察开放复位旋入式髓内针内固定治疗胫骨中段骨折的疗效.方法 选择2009年5月至2011年5月胫骨中段骨折患者13例,采用开放复位旋入式髓内针内固定对其进行治疗,并随访6~9个月,观察临床疗效.结果 13例均达骨性愈合,膝踝关节活动范围正常;优11例,良2例,优良率100%.无髓内针断裂、松动、变形等并发症.结论 采用开放复位旋入式髓内针内固定治疗胫骨中段骨折是一种简便易行的手术方法.%Objective To observe the clinical effect of open reduction and internal fixation of screw intramedullary nail in the treatment of midshaft tibia fracture. Methods Thirteen cases of midshaft tibia fracture were treated with open reduction and internal fixation of intramedullary nail surgery. The patients were followed up for 6 to 9 months after surgery. Results All of the 13 cases reached osseous healing. The range of knee joint motion and the range of ankle joint motion were all normal. The rate of excellent and good was 100% ( excellent in 11 cases and good in 2 cases ). Conclusion Open reduction and internal fixation of intramedullary nail is a simple and feasible operation for the treatment of midshaft tibia fracture.

  5. Reconstruction of multiplanar deformity of the hindfoot and midfoot with internal fixation techniques.

    Science.gov (United States)

    Dreher, Thomas; Hagmann, Sebastién; Wenz, Wolfram

    2009-09-01

    Reconstruction surgery of the midand hindfoot is a demanding challenge for foot surgeons. Satisfactory results depend not only on surgical technique and skills but also on the knowledge of underlying disorders, pathomechanics, and indication criteria. The cavovarus foot, the planovalgus foot, and Charcot's foot are some of the most challenging foot deformities, requiring different surgical strategies for their correction. Most of the osteotomies and fusions in children and adults can be fixed with transcutaneous Kirschner wires, which are inexpensive and easy to use and remove. The use of alternative fixation systems such as cannulated screws, compression screws, or angle-stable locking plates depends on patient age, vascular situation, risk for nonunion, and underlying pathology.

  6. Biomechanical Evaluation of Four Methods for Internal Fixation of Comminuted Subtrochanteric Fractures.

    Science.gov (United States)

    Wang, Jie; Ma, Jian-Xiong; Jia, Hao-Bo; Chen, Yang; Yang, Yang; Ma, Xin-Long

    2016-05-01

    Subtrochanteric fractures are common and result in significant morbidity and mortality. Various kinds of implants have been used to fix it. The aim of this study was to compare the biomechanical performance of PFN, DHS, DCS, and the PFLP in the treatment of subtrochanteric comminuted fractures.A total of 32 antiseptic human femurs from 16 donors were randomly allocated to 4 groups for fixation with PFN, DHS, DCS, and PFLP. A 2-cm cylindrical bone fragment was removed 1 cm below the lesser trochanter to simulate OTA/AO 32-C3.2 post instrumentation fracture. All specimens in single-leg stance situation were preloaded 5 times at 100 N in the axial direction to eliminate the time effect of relaxation and settling, followed by cyclic testing at a rate of 1 Hz with stepwise increasing load. Keeping the valley load at a constant level of 100 N during the entire cyclic test, the peak load, starting at 200 N, was increased by 100 N at 300-cycle steps until a maximum of 1500 cycles or until failure of the bone-implant construct occurred. Each specimen was kept unloaded under 100 N compression for 30 minutes between the 300-cycle steps.Femoral head displacement after 1500 cycles was 1.09 mm ± 0.13 for PFN, 1.78 mm ± 0.25 for DHS, 2.63 mm ± 0.46 for DCS, and 2.26 mm ± 0.16 for PFLP, with significant difference between any 2 implants (P subtrochanteric fractures OTA/AO 32-C3.2 revealed in the current test setup highest fixation strength with PFN, followed by DHS, PFLP, and DCS.

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

    Science.gov (United States)

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

    2015-11-09

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

  8. 胸腔镜下记忆合金环抱器内固定治疗多发肋骨骨折%Internal fixation of memory alloy embracing fixator by VATS for treatment of multiple fractured ribs

    Institute of Scientific and Technical Information of China (English)

    王鸿; 随志辉; 高涛涛; 刘磊

    2015-01-01

    目的:观察胸腔镜下记忆合金环抱器内固定术治疗多发肋骨骨折的效果。方法回顾性分析2006年9月至2014年12月采用胸腔镜下记忆合金环抱器内固定治疗多发肋骨骨折患者34例临床资料,与同期采用传统方法(非手术治疗)治疗患者24例进行比较,观察两组胸痛缓解时间、胸引管引流量、呼吸机支持时间、住院时间及并发症发生率的情况。结果胸腔镜组的胸痛时间、胸引管引流量、呼吸机支持时间、住院时间及并发症发生率均较优于传统方法组,差异均有统计学意义( P<0.05)。结论胸腔镜下记忆合金环抱器内固定治疗多发肋骨骨折创伤小,患者恢复快,能明显改善患者生活质量。%Objective To observe and assess the therapy efficacy of internal fixation of memory alloy embracing fixator by VATS for the treatment of multiple fractured ribs. Methods Retrospective study was conducted from September 2006 to December 2014 on 34 patients with the therapy of internal fixation of memory alloy embracing fixator by VATS for the treatment of multiple fractured ribs, versus 24 patients with the traditional non-operative therapy in the same period of time. The associated indexes of the two groups were recorded respectively, including time of chest-pain onset, volume of chest tube drainage, run-time of ventilator, length of stay and complication occurrence rate, etc. Results The recorded indexes of the VATS group were eminently shorter or less than those of the control group (P<0. 05). Conclu-sion Therapy of internal fixation of memory alloy embracing fixator by VATS for the treatment of multiple fractured ribs is superior with less surgical trauma, simpler operation, faster recovery and further improvement of patient's life quality.

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

    Directory of Open Access Journals (Sweden)

    Singh Ajay Pal

    2012-02-01

    Full Text Available 【Abstract】 Objective: Monteggia fracture dislocation equivalent, though already described by Bado, is still an unclassified entity. We aimed to retrospectively analyze 18 cases of Monteggia variants and discuss the injury mechanisms, management, and outcome along with a review of the literature. Methods: A retrospective record of Monteggia fracture dislocation (2003-2008 was reviewed from medical record department of our institute. Classic Monteggia fracture dislocation, children below 12 years or adults over 50 years, as well as open grade II & III cases were excluded from this study. Monteggia variant inclusion criteria included fracture of the proximal ulna together with a fracture of the radial head or neck and skeletal maturity. Totally 26 patients were identified with Monteggia variants and 18 were available for follow-up, including 11 males and 7 females with the mean age of 35 years. The ulna fracture was treated by compression plating along with tension band wiring. Radial head/neck was reconstructed in 12 patients while excised in 6 patients. Results: Follow-up ranged from 1-4 years, mean 2.6 years. Patients were assessed clinicoradiologically. Mayo Elbow Performance Score was employed to assess the outcomes. At final follow-up, the results were excellent in 10 patients, good in 4, fair in 2 and poor in 2. Mean range of motion of the elbow was 20°, 116°, 50° and 55° for extension, flexion, pronation and supination, respectively. Two patients had complications in the form of heterotopic ossification and stiffness of the elbow. One nonunion ulna, primarily treated by tension band wiring, was managed by refixation with locking reconstruction plate and bone grafting. Bone grafting was only required in this patient for nonunion. Another patient had implants removed on his request. The results in our series closely correlated with extent of intraarticular damage, coronoid fracture and comminuted fractures. Conclusions: Monteggia fracture dislocation equivalents are rare injuries and pre-surgery recognition by radiographs and 3-D CT helps make optimal plan. The poor results usually relate to intraarticular damage, coronoid fractures and comminution of the ulna and radial head fractures. Key words: Monteggia’s fracture; Radius fracture; Ulna

  10. The Effect of NaCl on growth, N2 fixation (acetylene reduction), and percentage total nitrogen in Leucaena leucocephala (Leguminosae) var. K-8.

    Science.gov (United States)

    Anthraper, Annie; Dubois, John D

    2003-05-01

    Leucaena leucocephala var. K-8 is a fast-growing, tropical leguminous tree that has multiple economic uses. This study was conducted to evaluate the effect(s) of varying NaCl concentrations on growth, N(2) fixation, and percentage of total tissue nitrogen in different organs in L. leucocephala. Seeds were germinated and grown for 10 wk with a nitrogen-free fertilizer applied every 2 wk. At 10 wk, plants were treated for either 0, 7, 14, 21, or 28 wk with either deionized water (control), 0.00625 mol/L, 0.0125 mol/L, 0.025 mol/L, 0.05 mol/L, or 0.1 mol/L NaCl in addition to the fertilizer every 2 wk. Growth was measured as plant height, nodule number and mass, and dry tissue mass. N(2) fixation was measured by the acetylene reduction assay. Percentage of tissue nitrogen was determined using Kjeldahl analysis. In younger plants (7-wk treatment), major fluctuations in NaCl tolerance were observed in the different plant organs. As plants matured (14- and 21-wk treatment) NaCl concentrations of 0.025 mol/L and higher caused the greatest reduction in growth and tissue nitrogen. We conclude that NaCl concentrations of 0.025 mol/L and greater caused a major decrease in growth, N(2) fixation, and percentage of tissue nitrogen in L. leucocephala plants that were less than 1 yr old.

  11. Burnei's "double X" internal fixation technique for supracondylar humerus fractures in children: indications, technique, advantages and alternative interventions : Study and Research Group in Pediatric Orthopaedics-2012.

    Science.gov (United States)

    Georgescu, I; Gavriliu, S; Pârvan, A; Martiniuc, A; Japie, E; Ghiță, R; Drăghici, I; Hamei, Ş; Ţiripa, I; El Nayef, T; Dan, D

    2013-06-15

    The Study and Research Group in Pediatric Orthopedics-2012 initated this retrospective study due to the fact that in Romania and in other countries, the numerous procedures do not ensure the physicians a definite point of view related to the therapeutic criteria in the treatment of supracondylar fractures. That is why the number of complications and their severity brought into notice these existent deficiencies. In order to correct some of these complications, cubitus varus or valgus, Prof. Al. Pesamosca communicated a paper called "Personal procedure in the treatment of posttraumatic cubitus varus" at the County Conference from Bacău, in June 24, 1978. This procedure has next been made popular by Prof. Gh. Burnei and his coworkers by operating patients with cubitus varus or valgus due to supracondylar humeral fractures and by presenting papers related to the subject at the national and international congresses. The latest paper regarding this problem has been presented at the 29th Annual Meeting of the European Pediatric Orthopedic Society in Zagreb, Croatia, April 7-10, 2010, being titled "Distal humeral Z-osteotomy for posttraumatic cubitus varus or valgus", having as authors Gh. Burnei, Ileana Georgescu, Ştefan Gavriliu, Costel Vlad and Daniela Dan. As members of this group, based on the performed studies, we wish to make popular this type of osteosynthesis, which ensures a tight fixation, avoids complications and allows a rapid postoperative activity. The acknowledged treatment for these types of fractures is the orthopedic one and it must be accomplished as soon as possible, in the first 6 hours, by reduction and cast immobilization or by closed or open reduction and fixation, using one of the several methods (Judet, Boehler, Kapandji, San Antonio, San Diego, Burnei's double X technique). The exposed treatment is indicated in irreducible supracondylar humeral fractures, in reducible, but unstable type, in polytraumatized patients with supracondylar

  12. Burnei’s “double X" internal fixation technique for supracondylar humerus fractures in children: indications, technique, advantages and alternative interventions

    Science.gov (United States)

    Georgescu, I; Gavriliu, S; Pârvan, A; Martiniuc, A; Japie, E; Ghiță, R; Drăghici, I; Hamei, S; Ţiripa, I; El Nayef, T; Dan, D

    2013-01-01

    Background. The Study and Research Group in Pediatric Orthopedics-2012 initated this retrospective study due to the fact that in Romania and in other countries, the numerous procedures do not ensure the physicians a definite point of view related to the therapeutic criteria in the treatment of supracondylar fractures. That is why the number of complications and their severity brought into notice these existent deficiencies. In order to correct some of these complications, cubitus varus or valgus, Prof. Al. Pesamosca communicated a paper called "Personal procedure in the treatment of posttraumatic cubitus varus" at the County Conference from Bacău, in June 24, 1978. This procedure has next been made popular by Prof. Gh. Burnei and his coworkers by operating patients with cubitus varus or valgus due to supracondylar humeral fractures and by presenting papers related to the subject at the national and international congresses. The latest paper regarding this problem has been presented at the 29th Annual Meeting of the European Pediatric Orthopedic Society in Zagreb, Croatia, April 7-10, 2010, being titled “Distal humeral Z-osteotomy for posttraumatic cubitus varus or valgus", having as authors Gh. Burnei, Ileana Georgescu, Ştefan Gavriliu, Costel Vlad and Daniela Dan. As members of this group, based on the performed studies, we wish to make popular this type of osteosynthesis, which ensures a tight fixation, avoids complications and allows a rapid postoperative activity. Introduction. The acknowledged treatment for these types of fractures is the orthopedic one and it must be accomplished as soon as possible, in the first 6 hours, by reduction and cast immobilization or by closed or open reduction and fixation, using one of the several methods (Judet, Boehler, Kapandji, San Antonio, San Diego, Burnei’s double X technique). The exposed treatment is indicated in irreducible supracondylar humeral fractures, in reducible, but unstable type, in polytraumatized

  13. Investigation into Operative Reduction and Fixation of Zygomatic Fracture%颧骨骨折手术复位和固定方法探讨

    Institute of Scientific and Technical Information of China (English)

    何杰儒; 杨卫东; 汪湛

    2012-01-01

    Objective: To investigate the operative reduction route and fixation method of zygomatic fracture. Methods: According to at least three points (fracture line) of zygomaticomaxillary buttress, zygomaticofrontal suture, infraorbital margin, zygomaticotemporal suture and sutura zygomaticosphenoidalis, 40 cases of zygomatic fracture were repositioned and fixed by bioabsorbable plate and domestic miniature titanium plate. The effects of reduction and fixation were analyzed and evaluated. Rusults: All patients reached satisfactory outcome with ideal facial figure and occlusal functions. Conclusion: Operative reduction and fixation of zygomatic fracture should accord to at least three anatomic points (fracture line) as an ideal reference standard, reset effects could not be evaluate by the reposition of one fracture line alone. Zygomatic fracture fixation, unless in the condition of little displacement or unlikely displace again after reduction, three points fixation should be complied.%目的:探讨颧骨骨折的手术复位和固定方法。方法:对40例颧骨骨折病例依据颧牙槽嵴、颧额缝、眶下缘、颧颞缝及颧蝶缝中至少三点(骨折缝)参考进行手术复位,并用可吸收板或国产微型钛板加以固定,分析评价复位和固定的效果。结果:所有患者术后均一期愈合,其面形、咬合功能均获得满意效果。结论:颧骨骨折复位时应至少有三个点(骨折缝)的解剖复位作为理想复位的参考标准,单凭某一骨折线的复位标准不能完全指导或评价复位效果。颧骨骨折的固定,除非骨折移位不大或复位后颧骨再次移位可能性不大的患者外,最好行三点固位。

  14. High rate of N2 fixation by East Siberian cryophilic soil bacteria as determined by measuring acetylene reduction in nitrogen-poor medium solidified with gellan gum.

    Science.gov (United States)

    Hara, Shintaro; Hashidoko, Yasuyuki; Desyatkin, Roman V; Hatano, Ryusuke; Tahara, Satoshi

    2009-05-01

    For evaluating N(2) fixation of diazotrophic bacteria, nitrogen-poor liquid media supplemented with at least 0.5% sugar and 0.2% agar are widely used for acetylene reduction assays. In such a soft gel medium, however, many N(2)-fixing soil bacteria generally show only trace acetylene reduction activity. Here, we report that use of a N(2) fixation medium solidified with gellan gum instead of agar promoted growth of some gellan-preferring soil bacteria. In a soft gel medium solidified with 0.3% gellan gum under appropriate culture conditions, bacterial microbiota from boreal forest bed soils and some free-living N(2)-fixing soil bacteria isolated from the microbiota exhibited 10- to 200-fold-higher acetylene reduction than those cultured in 0.2% agar medium. To determine the N(2) fixation-activating mechanism of gellan gum medium, qualitative differences in the colony-forming bacterial components from tested soil microbiota were investigated in plate cultures solidified with either agar or gellan gum for use with modified Winogradsky's medium. On 1.5% agar plates, apparently cryophilic bacterial microbiota showed strictly distinguishable microbiota according to the depth of soil in samples from an eastern Siberian Taiga forest bed. Some pure cultures of proteobacteria, such as Pseudomonas fluorescens and Burkholderia xenovorans, showed remarkable acetylene reduction. On plates solidified with 1.0% gellan gum, some soil bacteria, including Luteibacter sp., Janthinobacterium sp., Paenibacillus sp., and Arthrobacter sp., uniquely grew that had not grown in the presence of the same inoculants on agar plates. In contrast, Pseudomonas spp. and Burkholderia spp. were apparent only as minor colonies on the gellan gum plates. Moreover, only gellan gum plates allowed some bacteria, particularly those isolated from the shallow organic soil layer, to actively swarm. In consequence, gellan gum is a useful gel matrix to bring out growth potential capabilities of many soil

  15. 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...

  16. Anterior subcutaneous fixation with screw-rod internal fixator for the treatment of unstable anterior pelvic ring fractures%经皮钉-棒内支架治疗不稳定骨盆前环骨折

    Institute of Scientific and Technical Information of China (English)

    王朝晖; 何波涌; 曾敏川; 郭建辉; 唐艳平; 赵快平; 刘建伟

    2016-01-01

    目的探讨经皮钉-棒内支架治疗不稳定骨盆前环骨折临床应用。方法回顾性分析经皮钉-棒内支架治疗的12例不稳定骨盆前环骨折患者的临床资料,男性8例,女性4例;年龄23~63岁,平均43.8岁。骨盆骨折按照Tile分类:B34例,C14例,C23例,C31例。后环损伤采用经皮骶髂螺钉固定2例,髂腰固定1例,钢板固定6例,其中M张力带钢板固定4例。结果前环固定平均出血70mL(50~90mL),平均手术时间65min(50~85min)。单侧股外侧皮神经损伤5例,均恢复正常;随访4~15个月,无切口感染、内固定失效等,骨折均获骨性愈合,疗效满意。结论经皮钉-棒内支架是治疗不稳定骨盆前环骨折微创舒适、简便、安全的方法,疗效好,但术中应警惕股外侧皮神经损伤。%Objective To study percutaneous internal fixation with screw-rod system for the treatment of unstable anterior pelvic ring fractures .Methods The clinical data of 12 cases of unstable anterior pelvic ring frac-tures treated with anterior subcutaneous fixation with screw-rod system was retrospectively analyzed . According to the Tile’s classification,4 cases were B3,4 cases were C1,3 cases were C2,and 1 case was C3.In all these poste-rior ring fractures,2 cases were treated with percutaneous iliosacral screw fixation ,1 case with ilio-lumbar fixation,and 6 cases with plate fixation (including M-shaped tension plate fixation in 4 cases).Results The average blood loss and operation time of anterior pelvic ring fixation were 70 mL ( ranged from 50 to 90 mL) and 65 min( ranged from 50 to 85min)respectively.Unilateral lateral femoral cutaneous nerves were inpaired in 5 cases and the symptoms resolved after 2 weeks.All cases were followed up for 4 to 15 months,indicating bone healing and satisfactory clinical results , without wound infection or fixation failure .Conclusion The percutaneous internal fixation with screw-rod system

  17. Clinical experience of the treatment of comminuted fracture of tibia and fibula with limited internal fixation and external fixation%克氏针有限内固定加外固定支架治疗胫腓骨远端粉碎性骨折的临床体会

    Institute of Scientific and Technical Information of China (English)

    严海兵

    2015-01-01

    Objective:To investigate the therapeutic effect of Ke pin limited fixed and external fixation bracket in the treatment of comminuted fracture of distal tibia and fibula.Methods:140 patients with comminuted fracture of distal tibia and fibula were divided into the observation group and the control group.They used the Ke pin limited fixed+external fixation bracket treatment and the open reduction and locking plate internal fixation treatment respectively.Results:The two groups had no differents in operation time,hospitalization time and complications (P<0.05).Conclusion:Ke pin limited fixed and external fixation bracket in the treatment of comminuted fracture of distal tibia and fibula has small trauma,good recovery,less cost,easy to operate,safe and effective.%目的:探讨采用克氏针有限固定加外固定支架治疗胫腓骨远端粉碎性骨折的疗效。方法:将140例胫腓骨远端粉碎性骨折患者分为观察组和对照组,分别采用克氏针有限固定加外固定支架和切开复位锁定钢板内固定。结果:两组在手术时间、住院时间和并发症方面比较,差异有统计学意义(P<0.05)。结论:采用克氏针有限固定加+外固定支架治疗胫腓骨远端粉碎性骨折,创伤小、恢复好、花费少,操作简便,安全,有效。

  18. Nitrogen fixation (Acetylene reduction) in the sediments of the pluss-see : with special attention to the role of sedimentation

    NARCIS (Netherlands)

    Blauw, T.S.

    1987-01-01

    Sediments of productive lakes are usually rich in organic matter and, except for a thin surficial layer, anaerobic. These conditions seem to be favourable for heterotrophic nitrogen fixation. However, these sediments also contain relatively high ammonium concentrations. Ammonium represses

  19. Treatment of distal radius fractures with external fixation, limited open reduction and dorsal autologous cancellous onlay bone grafting

    Directory of Open Access Journals (Sweden)

    Mordechai Vigler

    2012-04-01

    Conclusion: Compared to current published results of distal radial fractures treated with external fixation supplemented with packed intramedullary autologous cancellous iliac crest graft, our dorsal on- lay technique is as effective a treatment modality. Additionally, there are several advantages including less bone graft to be harvested and associated morbidity. [Hand Microsurg 2012; 1(1.000: 10-16

  20. 股骨颈骨折内固定手术简史%A brief history of internal fixation of femoral neck fracture

    Institute of Scientific and Technical Information of China (English)

    梅炯

    2014-01-01

    1858年,德国外科医师VonLangenbeck采用镀银螺钉完成了世界第1例股骨颈骨折内固定手术.1875年,德国医生Franz K(o)nig在消毒后,成功利用金属螺钉实施股骨颈内固定术.1883年,美国外科医生Nicholass Senn提出了股骨颈骨折都应手术治疗的观点,但未能得到广泛认可.1931年,美国医生Smith-Petersen和他的同事发表了股骨颈骨折切开复位三翼钉内固定的治疗结果.随后,瑞典医生Sven Johansson、美国医生H.Heyward Wescott分别于1932年和1934年为闭合三翼钉内固定手术设计了相应的手术辅助器械.1941年,AAOS建议对股骨颈骨折使用三翼钉内固定.1976年,The British Medical Research Council指出,三翼钉不适用于有移位的股骨颈骨折.1980年,Asnis空心螺钉开始使用,并沿用至今.20世纪40年代,孟继懋和叶衍庆相继开展三翼钉内固定术治疗股骨颈骨折.1989年,危杰首先在中国就用AO空心钉治疗股骨颈骨折.此后,空心加压螺钉治疗股骨颈骨折在全国范围内得到了广泛的推广.%In 1858,a German surgeon named Von Langenbeck did the first internal fixation of femoral neck fracture (FNF) with metal silver screw.In 1875,a German doctor Franz K? nig did the same operation successfully with metal screws under antiseptic condition.In 1883,an American surgeon,Nicholass Senn suggested that all of the FNF should be treated by operation,but the proposition was not accepted extensively.In 1931,Smith-Petersen from the USA and his colleagues first published the report on the result of open reduction and internal fixation of FNF by the use of trifin nail.Due to the help of auxiliary appliance designed separately by the Swedish Sven Johansson (1932) and American H.Heyward Wescott (1934).In 1941,the American Academy of Orthopaedic Surgeons (AAOS) advocated the technique of trifin nail for its internal fixation.However,in 1976,the British Medical Research Council pointed out that the trifin nail was not

  1. 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.

  2. 闭合复位与切开复位交锁髓内钉内固定治疗胫腓骨干骨折疗效比较%Effect comparision of closed reduction and open reduction with intramedullary nail fixation for tibia and fibula fractures

    Institute of Scientific and Technical Information of China (English)

    张兵辰

    2012-01-01

    目的 比较切开复位与闭合复位治疗交锁髓内钉内固定治疗骨折的疗效.方法 选择胫腓骨骨折患者100例,随机分为观察组和对照组各50例,观察组接受闭合复位交锁髓内钉内固定治疗,对照组接受切开复位交锁髓内钉内固定术治疗,比较两组的治疗效果、并发症发生率.结果 观察组总有效率优于对照组,差异有统计学意义(χ2 = 5.32,P < 0.05).两组术后常见并发症发生率比较,观察组低于对照组(χ2 = 7.12,P < 0.05).观察组骨痂出现时间、骨折愈合时间、住院时间、手术时间、术中、术后出血量均优于对照组.结论 在应用交锁髓内钉内固定法治疗胫腓骨骨折时,闭合复位比切开复位更具优势,应该作为胫腓骨骨折治疗的首选方法.%Objective To compare of effect of closed reduction and open reduction with intramedullary nail fixation for tibia and fibula fractures. Methods 100 cases were selected of fracture of tibia and fibula, randomly divided into observation and control groups 50 patients each, observation group acceptted closed reduction and interlocking intramedullary nail fixation for the treatment, control group acceptted open reduction and interlocking intramedullary nail fixation for the treatment, compared treatment effects of two groups. Results Total efficiency of observation group was better than control groups (Χ2 = 5.32,P < 0.05). Common postoperative and complication rate of observation group was lower than the control group (Χ2 = 7.12,P < 0.05). Callus occurrence, fracture healing time, length of stay, time of surgery, intraoperative, and postoperative blood loss of observation group were better than the control group. Conclusion On application of interlocking intramedullary nail for internal fixation in treatment of tibia and fibula fracture time, closed reduction has more advantages than open reduction, it can be the preferred method for fracture of tibia and fibula.

  3. [Case-control study on close reduction and plaster slab fixation combined with plaster external traction for the treatment of pediatric Gartland type III supracondylar humerus fractures].

    Science.gov (United States)

    Kang, Yu-Xiang; Wei, Xiao-Chun; Li, Hai-Ming

    2014-07-01

    To compare the therapeutic effects between close reduction and plaster slab fixation combined with plaster external traction and operation for the treatment of pediatric closed Gartland type III supracondylar humerus fractures without neurovascular injury complications. From June 2009 to June 2012, 151 children with closed Gartland III supracondylar humerus fractures were retrospectively studied and divided into two groups, including 87 boys and 64 girls, ranging in age from 1 to 12 years old with an average of 5.3 years old. Among them, 76 children (conservative group) were treated with close reduction and plaster slab fixation combined with plaster external traction; 75 children (operation group) underwent surgical operation. The time of elbow joint function exercise, the healing time of fracture, the function recovery of elbow joint and carrying angle was recorded and analyzed. The therapeutic effects were evaluated by the Flynn criteria system. All patients were followed up from 6 to 36 months (18.3 months on average). The average time of fracture healing and elbow joint functional exercise of the conservative group was shorter than those of operation group (P 0.05). According to Flynn criteria system, in conservative group, the result was excellent in 31 cases, good in 35, fair in 7, and poor in 3; in operation group, 27 in excellent, 30 in good, 17 in fair and 1 in poor; there was no significant difference between two groups in therapeutic effects (P > 0.05). Close reduction and plaster slab fixation combined with plaster external traction in treatment of pediatric closed Gartland type III supracondylar humerus fractures without neurovascular injury complications,which has similar effect to surgical treatment, and the time of fracture healing and elbow joint function exercise are significantly shorter.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-01-15

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

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

    Science.gov (United States)

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

    2010-06-09

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

  6. Wedgeless 'V' shaped distal femoral osteotomy with internal fixation for genu valgum in adolescents and young adults.

    Science.gov (United States)

    Gupta, Vikas; Kamra, Gaurav; Singh, Davinder; Pandey, Ketan; Arora, Sumit

    2014-06-01

    The treatment of angular malalignment includes restoration of normal mechanical axis alignment and joint orientation.The supracondylar wedgeless distal femoral 'V' osteotomy, as a treatment modality, is sparsely explored in the literature. This study was conducted at a tertiary level teaching referral hospital from October 2010 to September 2012. Forty six lower limbs (in 30 patients) were operated with a wedgeless 'V' osteotomy that was fixed with a buttress 'L' plate. The pre-operative deformity, post-operative correction and knee range of movement were noted. Mobilisation was started at 3 weeks after surgery and full weight-bearing was allowed at 3 months. The knee score by Bostman et al. was used for functional outcome. The mean age of the patients in our study was 16.9 years (range: 15 years to 23 years). The patients were followed up for a mean period of 19.8 months (range, 15 months to 29 months). The mean radiological tibiofemoral angle was 22.2 degrees (range, 16 degrees to 29 degrees) before surgery, that improved to a mean postoperative value of 5.1 degrees (range, 0 degrees to 10 degrees) (p genu valgum in individuals nearing skeletal maturity and is easy to perform. It has the advantage of being wedgeless as it does not cause limb length discrepancy. Internal fixation helps in early rehabilitation after surgery.

  7. Surgical treatment of zygomatic bone fracture using two points fixation versus three point fixation-a randomised prospective clinical trial

    Directory of Open Access Journals (Sweden)

    Rana Majeed

    2012-04-01

    Full Text Available Abstract Background The zygoma plays an important role in the facial contour for both cosmetic and functional reasons; therefore zygomatic bone injuries should be properly diagnosed and adequately treated. Comparison of various surgical approaches and their complications can only be done objectively using outcome measurements which in turn require protocol management and long-term follow up. The preference for open reduction and internal fixation of zygomatic fractures at three points has continued to grow in response to observations of inadequate results from two point and one point fixation techniques. The objectives of this study were to compare the efficacy of zygomatic bone after treatment with ORIF using 2 point fixation and ORIF using 3 point fixation and compare the outcome of two procedures. Methods 100 patients were randomly divided equally into two groups. In group A, 50 patients were treated by ORIF using two point fixation by miniplates and in group B, 50 patients were treated by ORIF using three point fixation by miniplates. They were evaluated for their complications during and after surgery with their advantages and disadvantages and the difference between the two groups was observed. Results A total of 100 fractures were sustained. We found that postoperative complication like decreased malar height and vertical dystopia was more common in those patients who were treated by two point fixation than those who were treated with three point fixation. Conclusions Based on this study open reduction and internal fixation using three point fixation by miniplates is the best available method for the treatment zygomatic bone fractures.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. A study on the optimal surgical timing for rib internal fixation%肋骨内固定最佳手术时机的探讨

    Institute of Scientific and Technical Information of China (English)

    黄云; 赵夏

    2014-01-01

    Objective To investigate the optimal surgical timing for rib internal fixation.Methods The clinical data of 143 patients with rib fracture were retrospectively analyzed.The patients were divided into early phase fixation group (62 cases) and late phase fixation group (81 cases) according to the time from trauma to internal fixation.The ratio blood lose and body surface area,pulmonary complications and the changes of C reactive protein level before and 5 days after operation were recorded and compared.Results All the patients were healing.The median C reactive protein before operation in late phase fixation group was 45 mg/L,in early phase fixation group was 23 mg/L,there was statistical difference (P < 0.01).The ratio blood lose and body surface area in early phase fixation group was (334.19 ± 37.53) ml/m2,the rate of pulmonary complications was 22.6%(14/61),in late phase fixation group was (438.99 ± 55.24) ml/m2 and 38.3% (31/81),there were statistical differences (P < 0.01 or < 0.05).The median C reactive protein 5 days after operation in early phase fixation group was 189 mg/L,in late phase fixation group was 258 mg/L,there was statistical difference (P < 0.05).Conclusion Early phase (72 hours) rib internal fixation is expected to reduce patient trauma of systemic reactions,reduce the incidence of bleeding and pulmonary complications.%目的 探讨肋骨骨折内固定的最佳手术时机.方法 回顾性分析143例肋骨骨折患者的临床资料,根据受伤至手术内固定时间是否超过72 h分为早期固定组62例和晚期固定组81例,记录并比较两组失血量与体表面积比、肺部并发症情况及术前、术后第5天C反应蛋白水平变化.结果 两组患者均痊愈出院.晚期固定组术前C反应蛋白中位数为45 mg/L,早期固定组为23 mg/L,差异有统计学意义(P<0.01).早期固定组失血量与体表面积比为(334.19±37.53) ml/m2,肺部并发症发生率为22.6%(14/61),

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  11. Biomechanical in vitro evaluation of three stable internal fixation techniques used in sagittal osteotomy of the mandibular ramus: a study in sheep mandibles

    Science.gov (United States)

    de OLIVERA, Leandro Benetti; SANT'ANA, Eduardo; MANZATO, Antonio José; GUERRA, Fábio Luis Bunemer; ARNETT, G. William

    2012-01-01

    Among the osteotomies performed in orthognathic surgery, the sagittal osteotomy of the mandibular ramus (SOMR) is the most common, allowing a great range of movements and stable internal fixation (SIF), therefore eliminating the need of maxillomandibular block in the postoperative period. Objectives: The purpose of this study was to evaluate the biomechanical resistance of three national systems used for SIF in SOMR in sheep mandibles. Material and methods: The study was performed in 30 sheep hemi-mandibles randomly divided into 3 experimental groups, each containing 10 hemi-mandibles. The samples were measured to avoid discrepancies and then subjected to SOMR with 5-mm advancement. In group I, 2.0x12 mm screws were used for fixation, inserted in an inverted "L" pattern (inverted "L" group). In group II, fixation was performed with two 2.0x12 mm screws, positioned in a linear pattern and a 4-hole straight miniplate and four 2.0x6.0 mm monocortical screws (hybrid group). In group III, fixation was performed with two 4-hole straight miniplates and eight 2.0x6.0 mm monocortical screws (mini plate group). All materials used for SIF were supplied by Osteosin - SIN. The hemimandibles were subjected to vertical linear load test by Kratos K2000MP mechanical testing unit for loading registration and displacement. Results: All groups showed similar resistance during mechanical test for loading and displacement, with no statistically significant differences between groups according to analysis of variance. Conclusion: These results indicate that the three techniques of fixation are equally effective for clinical fixation of SOMR. PMID:23032203

  12. Biomechanical in vitro evaluation of three stable internal fixation techniques used in sagittal osteotomy of the mandibular ramus: a study in sheep mandibles

    Directory of Open Access Journals (Sweden)

    Leandro Benetti de Olivera

    2012-08-01

    Full Text Available Among the osteotomies performed in orthognathic surgery, the sagittal osteotomy of the mandibular ramus (SOMR is the most common, allowing a great range of movements and stable internal fixation (SIF, therefore eliminating the need of maxillomandibular block in the postoperative period. OBJECTIVES: The purpose of this study was to evaluate the biomechanical resistance of three national systems used for SIF in SOMR in sheep mandibles. MATERIAL AND METHODS: The study was performed in 30 sheep hemi-mandibles randomly divided into 3 experimental groups, each containing 10 hemi-mandibles. The samples were measured to avoid discrepancies and then subjected to SOMR with 5-mm advancement. In group I, 2.0x12 mm screws were used for fixation, inserted in an inverted "L" pattern (inverted "L" group. In group II, fixation was performed with two 2.0x12 mm screws, positioned in a linear pattern and a 4-hole straight miniplate and four 2.0x6.0 mm monocortical screws (hybrid group. In group III, fixation was performed with two 4-hole straight miniplates and eight 2.0x6.0 mm monocortical screws (mini plate group. All materials used for SIF were supplied by Osteosin - SIN. The hemimandibles were subjected to vertical linear load test by Kratos K2000MP mechanical testing unit for loading registration and displacement. RESULTS: All groups showed similar resistance during mechanical test for loading and displacement, with no statistically significant differences between groups according to analysis of variance. CONCLUSION: These results indicate that the three techniques of fixation are equally effective for clinical fixation of SOMR.

  13. Primary development and biomechanics of single vertebrae internal fixation system for thoracolumbar compression fracture%胸腰椎压缩性骨折单椎体内植入器的初步研制及其生物力学

    Institute of Scientific and Technical Information of China (English)

    李际才; 刘平均; 贺用礼; 赵卫东; 梁栋柱; 毛炳焱

    2014-01-01

    背景:对于压缩程度大于1/3的严重胸腰椎压缩性骨折,理想的治疗方法是微创内固定,其具有良好的生物力学性能,且植骨可靠,在达到伤椎复位、植骨与稳定目的的同时,尽可能地保留了脊柱运动单位和正常生理功能,从而减轻临近节段退变。  目的:研制一种内镜下经椎体侧方入路复位单椎体内植入器,评价其应用于胸腰椎压缩性骨折中的生物力学性能。  方法:根据成人胸腰椎椎体的解剖学测量数据研制各型号的单椎体内植入器。选取6具成人新鲜胸腰椎尸体标本,制作L1压缩性骨折模型,分为对照组、骨折损伤组、单椎体内植入器组、AF复位内固定组及前路钢板内固定组,分别进行三维运动范围实验。  结果与结论:生物力学测试表明,单椎体内植入器组在胸腰椎前屈及左右侧屈方向上与AF内固定组及前路钢板组运动范围差异无显著性意义(P >0.05),但在后伸及左右旋转方向上运动范围增大,差异有显著性意义(P 1/3 compression), ideal therapeutic method is minimal y invasive internal fixation, which has good biomechanical functions. Moreover, bone graft is reliable. Injured vertebra reduction and bone graft stability achieved. Motor unit of spinal column and normal physiological function were retained, resulting in lessening nearby segmental degeneration. OBJECTIVE:To discuss the design of single vertebrae internal fixation system and evaluate its biomechanical performance which apply to treat thoracolumbar compression fracture by endoscope. METHODS:A brand-new single vertebrae internal fixation system was designed in accordance with data of anatomic measurement of adult thoracolumbar vertebra. Six fresh adult corpse specimens were prepared to produce models of L 1 compression fracture, and assigned to control group, fracture injury group, single vertebrae internal fixation system group, AF

  14. 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。

  15. In vitro biomechanical evaluation of internal fixation techniques on the canine lumbosacral junction.

    Science.gov (United States)

    Early, Peter; Mente, Peter; Dillard, Stacy; Roe, Simon

    2015-01-01

    Few biomechanical studies have evaluated the effect of internal stabilization techniques after decompressive surgery on the stability of the canine lumbosacral junction. The purpose of this canine cadaver study is to evaluate the stability of the canine lumbosacral (LS) spine in flexion and extension following laminectomy and discectomy and then stabilization with each of the three techniques: pins and polymethylmethacrylate (P/PMMA), two dorsal locking plates (SOP) or bilateral transarticular facet screws (FACET).Using a cantilever biomechanical system, bending moments were applied to the LS and range of motion (ROM) was recorded via a rotational potentiometer. With 3 Nm, the ROM (n = 4 in each group) for P/PMMA, SOP and FACET were 1.92 ± 0.96°, 2.56 ± 0.55°and 3.18 ± 1.14°, respectively. With moments up to 35 Nm, the P/PMMA specimens appeared stable. Sacroiliac motion in the SOP and FACET groups invalidated further comparisons. Each of the stabilization techniques (P/PMMA, SOP, and FACET) significantly decreased the range of motion in flexion and extension for low bending moments.

  16. 肘关节镜辅助下复位固定治疗尺骨冠状突骨折%Elbow arthroscope assisted reduction and fixation treatment for coronoid fracture

    Institute of Scientific and Technical Information of China (English)

    杨顺; 向明; 杨国勇; 陈杭; 胡小川; 唐浩琛

    2014-01-01

    of supination.the total good and excellent rate was 100%(14/14).Discussion Discuss Elbow joint is is composed of trochlea of humerus and half-month notch of ulna,composed of coronary and olecranon.Ulna coronary is the most important humeral blocking structure in front of elbow,which is an important part preventing elbow dislocation and posteriormedial rotation unstability.There are many important soft tissue attachment points important structures in front of the elbow including the joint capsule,the medial collateral ligament,brachialis,and so on,.It is the main stable structure of elbow,resisting biceps,brachialis and triceps pulling ulna to elbow.Coronary processes is an important part of the anterior column and the medial column,forming a stable ring in front of the elbow.When it damages,elbow medial and front instability may occurs.Improper handling may lead to habitual dislocation.Therefore,in the treatment of ulna coronary fracture,restore or rebuild the height and shape of the coronary and repair or reconstruction the anterior beam of medial collateral ligament is very important.With development of further research of elbow joint,the important role of elbow has been recognized,the fractures usually lead to complex traumatic elbow instability,so the treatment of ulna coronary fracture also attract more and more attention of surgons. When the fracture fragment is large(Regan-Morrey Ⅱ,Ⅲ),because of the flexor pull leading fracture displacement,elbow instability easily occurs and it is difficult.to manually reduce and maintain the position of fracture.And because the fracture is hard to expose,and fix,especially for small pieces or comminuted fracture of the coronary.Improper treatment may easily causes joint instability,myositis ossificans,traumatic arthritis,stiff joints,etc.Coronary fracture belongs to intra-articular fracture, anatomical reduction and strong internal fixation is the basis of the joint function recovery in the treatment of intra-articular fractures

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

    Directory of Open Access Journals (Sweden)

    Mounasamy Varatharaj

    2012-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Dongmei Ye

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

  19. 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.

  20. Nitrogen Fixation (C(2)H(2) Reduction) by Broad Bean (Vicia faba L.) Nodules and Bacteroids under Water-Restricted Conditions.

    Science.gov (United States)

    Guerin, V; Trinchant, J C; Rigaud, J

    1990-03-01

    Water potentials of leaves and nodules of broad bean (Vicia faba L.) cultivated on a sandy mixture were linearly and highly (r(2) = 0.99) correlated throughout a water deprivation of plants. A decrease of 0.2 megapascal of the nodule water potential (Psi(nod)) induced an immediate 25% inhibition of the highest level of acetylene reduction of broad bean nodules attached to roots. This activity continued to be depressed when water stress increased, but the effect was less pronounced. Partial recovery of optimal C(2)H(2) reduction capacity of mildly water stressed nodules (Psi(nod) = -1.2 megapascals) was possible by increasing the external O(2) partial pressure up to 60 kilopascals. The dense packing of the cortical cells of nodules may be responsible for the limitation of O(2) diffusion to the central tissue. Bacteroids isolated from broad bean nodules exhibited higher N(2) fixation activity with glucose than with succinate as an energy-yielding substrate. Bacteroids from stressed nodules appeared more sensitive to O(2), and their optimal activity declined with increasing nodule water deprivation. This effect could be partly due to decreased bacteroid respiration capacity with water stress. Water stress was also responsible for a decrease of the cytosolic protein content of the nodule and more specifically of leghemoglobin. The alteration of the bacteroid environment appears to contribute to the decline in N(2) fixation under water restricted conditions.

  1. A case control study on the treatment of unstable distal radius fractures with internal and external fixation%内外固定治疗桡骨远端不稳定骨折的临床对照研究

    Institute of Scientific and Technical Information of China (English)

    赵勇; 崔秀仁; 关继超; 张兴平; 闫安; 张宽; 桑志成; 何冀川; 谢澄诚

    2011-01-01

    reduction and steel plate internal fixation (internal fixation group) or closed reduction and external fixation (external fixation group) .including 8 males and 52 females,with an average age of 60.27 years ranging from 34 to 85 years. Left side was in 33 cases and right side was in 27 cases. All fractures were closed and caused by hand supporting when falling down. According to AO classification,type A3 was in 22 cases,type B2 was in 4 cases,type B3 was in 2 cases,type Cl was in 20 cases,type C2 was in 8 cases,type C3 was in 4 cases. Palmar flexion,dorsiflexion,radial deviation,ulnar deviation, prona-tion,supination,grip strength, radial angle, radial length, volar tilt were observed before and after operation. Results-.All the patients were followed up from 12 to 18 months with an average of 15.4 months. The radial length was (4.85±2.75) mm,volar tilt (14.66±10.77)°,radial angle (7.90±4.70)° in the external fixation group,while those were (4.29±1.53) mm, (14.39± 5.01)°, (6.19±3.15)° in the internal fixation group, but with no statistical significance(P>0.05). Function comparison of internal and external fixation group, P-value of every function is more than 0.05 or equal to 0.05, with no statistical significance except for supination and radial deviation. The functions of wrist joints were evaluated according to Batra scoring system at 1 year after operation. The average radiological scores of external fixation group was 86.27, in which 15 cases were excellent, 11 good, 1 fair,3 poor,while the average functional scores was 94.93,and all the cases were excellent. The average radiological scores of internal fixation group was 91.27,16 cases were excellent, 12 good,2 fair,while the average functional scores was 94.23,in which all the cases were excellent. Conclusion;Compared with the open reduction and steel plate fixation,the unstable fractures of distal radius treating by diaplastic external fixator can be achieved a similar result, with no statistical

  2. 内固定术治疗移位的髋臼骨折疗效分析%Internal fixation treatment of shifting the acetabulum fracture curative effect analysis

    Institute of Scientific and Technical Information of China (English)

    吴海龙

    2014-01-01

    大多数移位的髋臼骨折患者需手术治疗,复位与固定效果明显,同时也降低创伤后关节炎的发生,更有利于早期功能恢复锻炼。治疗上,可根据骨折类型选择合适的手术入路,一般来说应争取通过一个入路达到完全的复位和固定,采用的入路中,Kocher-Langenbeck 入路适于进入后柱,髂腹股沟入路则适于进入前柱和内侧部分,延伸的髂股入路适于同时进入前,后柱,使用可塑形接骨板,螺钉或钢丝做内固定,便于骨折复位,固定稳定,并发症少临床效果好。%Most of the shift of the acetabulum fracturepatients require surgery treatment,reduction and fixation ef ect is obvious,but also reduce the incidence ofpost-traumatic arthritis,more conduG cive to the early function exercise.Treatment,can choose appropriate surgical approach,depending on the type of fracture ingeneral should be reached toget through a complete reduction and fixation,into the road,after Kocher - Langenbeck approach is suitable for entering the column,iliac inguinal approach is suitable for entering the anterior column and the inside of thepart,extend the iliac femoral apG proach is suitable for the top at the same time,the column,use the moldable boneplate,screw or steel wire internal fixation.

  3. Scaphoid Waist Internal Fixation for Fractures Trial (SWIFFT) protocol: a pragmatic multi-centre randomised controlled trial of cast treatment versus surgical fixation for the treatment of bi-cortical, minimally displaced fractures of the scaphoid waist in adults.

    Science.gov (United States)

    Dias, Joseph; Brealey, Stephen; Choudhary, Surabhi; Cook, Liz; Costa, Matthew; Fairhurst, Caroline; Hewitt, Catherine; Hodgson, Stephen; Jefferson, Laura; Jeyapalan, Kanagaratnam; Keding, Ada; Leighton, Paul; Rangan, Amar; Richardson, Gerry; Rothery, Claire; Taub, Nicholas; Thompson, John; Torgerson, David

    2016-06-04

    A scaphoid fracture is the most common type of carpal fracture affecting young active people. The optimal management of this fracture is uncertain. When treated with a cast, 88 to 90 % of these fractures unite; however, for the remaining 10-12 % the non-union almost invariably leads to arthritis. The alternative is surgery to fix the scaphoid with a screw at the outset. We will conduct a randomised controlled trial (RCT) of 438 adult patients with a "clear" and "bicortical" scaphoid waist fracture on plain radiographs to evaluate the clinical effectiveness and cost-effectiveness of plaster cast treatment (with fixation of those that fail to unite) versus early surgical fixation. The plaster cast treatment will be immobilisation in a below elbow cast for 6 to 10 weeks followed by mobilisation. If non-union is confirmed on plain radiographs and/or Computerised Tomogram at 6 to 12 weeks, then urgent surgical fixation will be performed. This is being compared with immediate surgical fixation with surgeons using their preferred technique and implant. These treatments will be undertaken in trauma units across the United Kingdom. The primary outcome and end-point will be the Patient Rated Wrist Evaluation (a patient self-reported assessment of wrist pain and function) at 52 weeks and also measured at 6, 12, 26 weeks and 5 years. Secondary outcomes include an assessment of radiological union of the fracture; quality of life; recovery of wrist range and strength; and complications. We will also qualitatively investigate patient experiences of their treatment. Scaphoid fractures are an important public health problem as they predominantly affect young active individuals in the more productive working years of their lives. Non-union, if untreated, can lead to arthritis which can disable patients at a very young age. There is a rapidly increasing trend for immediate surgical fixation of these fractures but there is insufficient evidence from existing RCTs to support

  4. Relationship between C2H2 reduction, H2 evolution and 15N2 fixation in root nodules of pea (Pisum sativum)

    DEFF Research Database (Denmark)

    Skøt, Leif

    1983-01-01

    The quantitative relationship between C2H2 reduction, H2 evolution and 15N2 fixation was investigated in excised root nodules from pea plants (Pisum sativum L. cv. Bodil) grown under controlled conditions. The C2H2/N2 conversion factor varied from 3.31 to 5.12 between the 32nd and the 67th day...... after planting. After correction for H2 evolution in air, the factor (C2H2-H2)/N2 decreased to values near the theoretical value 3, or in one case to a value significantly (P H2 production but used...... for N2 reduction, is often stated as the relative efficiency (1-H2/C2H2). This factor varied significantly (P H2 and N2, expressed as the H2/N2 ratio, was independent of plant age, however. This discrepancy and the observation...

  5. 应用改良AF脊柱内固定系统经皮微创内固定治疗胸腰椎压缩骨折%The Application of Improved AF Spinal Internal Fixation System With Percutaneous Minimally Invasive Internal Fixation for the Treatment of Thoracic and Lumbar Vertebral Compression Fracture

    Institute of Scientific and Technical Information of China (English)

    李晓龙; 王志军

    2015-01-01

    Objective To explore the efficacy of the AF spinal internal fixation system with percutaneous minimally invasive internal fixation for the treatment of thoracic and lumbar vertebral compression fracture. Methods Collected in our hospital 48 cases of thoracolumbar compression fractures, application of improved percutaneous minimally invasive internal fixation of AF spinal internal fixation system in the treatment of thoracolumbar compression fractures, postoperative review X-ray for curative effect analysis. Results 48 cases of compression injury vertebral height of vertebral body than preoperative obviously restoration, 90%of the average recovery to normal height of vertebral body Conclusion Application of improved percutaneous minimally invasive internal ifxation of AF spinal internal fixation system in the treatment of thoracolumbar compression fractures curative effect is distinct.%目的:探讨应用AF脊柱内固定系统经皮微创内固定治疗胸腰椎压缩骨折的疗效。方法收集本院48例胸腰椎压缩骨折,应用改良AF脊柱内固定系统经皮微创内固定治疗胸腰椎压缩骨折,术后复查X片进行疗效分析。结果48例压缩的伤椎椎体高度比术前明显得到恢复,平均恢复至正常椎体高度的90%。结论应用改良AF脊柱内固定系统经皮微创内固定治疗胸腰椎压缩骨折疗效显著。

  6. Cobra枕颈内固定系统结合Halo-vest治疗颅颈交界区畸形效果%Effect of cobra internal fixation system combined with halo-vest on treatment of the craniocervical malformation

    Institute of Scientific and Technical Information of China (English)

    郭亮兵; 廖文胜; 王利民; 王卫东; 谭鸿宇; 鲍恒; 刘屹林; 董小通

    2011-01-01

    BACKGROUND: Craniocervical posterior fusion can decompress the spinal cord and obtain the early stability for the instability occipitocervical fusion. The anatomic design of Cobra system can provid strongly internal fixation for this instability fusion and it is beneficial for fixation, reduction and bone graft fusion with the Halo-vest external fixation.OBJECTIVE: To evaluate the clinical application of Cobra internal fixation system with Halo-vest in craniocervical fusion surgery for craniocervical region malformation patients.METHODS: Thirty-four cases of craniocervical region malformation underwent craniocervical fusion using Cobra internal fixation system and with a specific therapy used Halo-vest according to the actual situation. The JOA17 spinal cord function evaluation standard was used for evaluation of the treatment effect. The neurologic recovery rate was calculated by the method established by Yin Qing-shui. At 3, 6, 12, and 24 months after the internal fixation, two-plane roentgenograms, CT and 3D reconstruction could be made to judge the internal fixation and bone grafting fusion situation, some patient also did MRI to clarify the spinal cord decompression.RESULT AND CONCLUSION: All of the patients were followed up for 7-29 months. There were no aggravations of the symptoms of spinal cord compression. The preoperative average spinal function was 8.2 and postoperative average was 14.8,respectively. The overall mean improvement was 75%. One patient died of cerebral infarction postoperatively. At the sixth month of follow-up, there were two cases with bone graft nonunions and absorption, two cases with the loosed occiput plate bolt, one case with the pulled out screws, one case with a nonhealing incision. The Halo-vest was used in ten cases for 3 to 4 months postoperatively. Other cases wore a cervical collar until the bone grafts were fused completely. It is suggested that Cobra internal fixation system offers a good biomechanical stability for

  7. Application of internal fixation and external fixator for unstable pelvic fracture%内固定加外固定架在不稳定型骨盆骨折治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    张军; 郭克斌; 熊元波; 魏君虎; 张炼; 翟剑亭

    2011-01-01

    目的 探讨内固定加外固定支架手术在不稳定型骨盆骨折治疗中的临床应用及疗效.方法 对我院自2001年3月至2009年6月收治的137例不稳定型骨盆骨折患者的临床资料进行回顾性分析,本组患者均采用内固定加外固定支架手术治疗.其中车祸交通伤81例,高处坠落伤34例,塌方挤压伤22例.根据Tile's分型,本组中B型89例,C型48例.所有患者术后均获随访,随访时间1~6年.结果 本组中125例术后关节功能明显改善,疼痛缓解,各种并发症发生率低.采用Matta评定标准进行评估,术后优良率达91.3%.结论 内固定加外固定支架手术治疗不稳定型骨盆骨折的临床疗效良好,能够重建骨盆稳定性,是治疗此类骨折的有效方法.%Objective To evaluate the clinical application and effect of internal fixation and external fixator for treatment of unstable pelvic fracture.Methods From March 2001 to June 2009,137 patients with unstable pelvic fractures were treated by internal fixation and external fixator,a retrospective study was conducted. The injuries were caused by the traffic accident in 81 patients,following falling from high places in 34 patients,crush injury by collapse in 22 patients. According to Tile classification, 89 cases were Tile B,48 cases were Tile C. All the patients were followed up for 1 to 6 years. Results Among the 137 patients,excellent results were achieved in 125 cases with the improvement in joint function and easement of pain,with lower complications. All the patients were reviewed using the Matta evaluation system,the result showed that the clinical effective rate exceeded 91.3%.Conclusions Internal fixation combined with external fixator is a very good method,which was effective for the treatment of unstable pelvic fracture,it may be the most effective way to rebuild the stability of pelvic.

  8. Reduction and fixation by high anterior cervical approach for treatment of type II and type IIA Hangman's fractures%高位颈前入路复位固定治疗Ⅱ型及ⅡA型Hangman骨折

    Institute of Scientific and Technical Information of China (English)

    谢学义; 彭新生

    2014-01-01

    目的:评价高位颈前入路复位固定治疗Ⅱ型及ⅡA型Hangman骨折的临床疗效。方法对2005年1月至2013年5月中山大学第一附属医院收治的21例Ⅱ型及ⅡA型Hangman骨折患者行高位颈前入路C2~C3椎间盘切除、复位及融合固定手术。记录手术时间、术中出血量,测量术后1周及末次随访时C2~C3前凸角;观察复位及并发症发生情况。结果手术时间50~90 min(平均75 min);术中出血量20~100 mL(平均55 mL)。术中无神经血管损伤并发症,所有患者成功获得固定。19例C2前脱位患者中,16例获得完全复位;3例基本复位。术后1周C2~C3平均前凸角为(3.1±0.8)°,优于术前的(-9±2.5)°(P<0.05);19例患者获得平均3年3个月(6个月至7年)的有效随访,末次随访时C2~C3平均前凸角为(2.6±0.5)°,未有明显丢失。所有患者获得椎间融合,未出现内固定松动、脱出、断裂等并发症。结论高位颈前入路C2~C3椎间盘切除、复位及融合固定治疗Ⅱ型及ⅡA型Hangman骨折,复位理想,内固定牢靠,能有效纠正和维持患者的颈椎前凸,融合率高,疗效满意。%Objective To evaluate the clinical effects of reduction and fixation by high anterior cervical approach for treatment of type II and type IIA Hangman's fractures. Methods From January 2005 to May 2013, 21 patients with type II and type IIA hangman's fractures underwent C2-C3 discectomy, reduction and intervertebral fusion with internal fixation by high anterior cervical approach. The operative time and intraoperative estimate blood loss were recorded, C2-C3 lordosis angles at one week postoperatively and the final follow-up were determined respectively, and the reduction and complications were observed. Results The average operative time was 75 min (50-90 min), the intraoperative estimate blood loss was 20-100 mL, with the average of 55 mL. No intraoperative

  9. 闭和复位空心钉内固定治疗股骨颈骨折40例疗效分析%Effect analysis of simple internal fixation combined with vertebral plasty in treatment of vertebral fracture

    Institute of Scientific and Technical Information of China (English)

    罗兵

    2013-01-01

    目的 对比探讨闭和复位空心钉内固定与全髋关节置换术治疗股骨颈骨折的方法及临床疗效.方法 选取普洱市人民医院近期确诊收治的70名股骨颈骨折患者分为两组,其中对照组32例行全髋关节置换术,治疗组38例行闭和复位空心钉内固定,随访期间对比两组患者的临床指标、临床疗效(优良率)及Frankel分级变化.结果 治疗后所有患者的Frankel分级均优于治疗前(P<0.05),而两组间相比,治疗组的Frankel分级、临床疗效及临床指标均优于对照组(P<0.05).结论 采用闭和复位空心钉内固定治疗股骨颈骨折,符合生物力学特征,可有效改善患者的临床症状及体征,且安全性高,值得推广.%Objective To investigate and contrast the method and clinical effect of closed reduction and internal fixation with cannulated screws versus total hip arthroplasty for the treatment of femoral neck fracture.Methods Selected recent diagnosed in our hospital from 70 patients with femoral neck fracture were divided into two groups,the control group 32 cases total hip arthroplasty,the treatment group 38 cases with closed reduction and internal fixation with cannulated screws,during follow-up were compared between the two groups the clinical indices of the patients,clinical outcome (good rate)and Frankel classification change.Results After treatment,all patients with Frankel grade are better than before treatment (P < 0.05),and between the two groups,treatment group Frankel grading,clinical efficacy and clinical indicators were better than those the control group (P < 0.05).Conclusions The closed reduction and internal fixation with cannulated screws for treatment of femoral neck fracture,meets the biomechanical features,can effectively improve the clinical symptoms and signs,and the security is high,is worth popularizing.

  10. [Case-control study on measurement of coracoclavicular and acromioclavicular ligament injuries during internal fixation operation for the treatment of fresh acromioclavicular joint dislocation of Tossy type III].

    Science.gov (United States)

    Guan, Ting-Jin; Sun, Peng; Zheng, Liang-Guo; Qi, Xiang-Yang

    2014-01-01

    To study measurement methods of acromioclavicular and coracoclavicular ligament injuries,its therapeutic effects and complications during internal fixation operation for the treatment of fresh acromioclavicular joint dislocations of Tossy type III. From July 2003 to May 2012,127 patients with acromioclavicular joint dislocations of Tossy type III were treated with wire fixation from coracoid process to clavicle or hook-plate fixation. The patients were divided into group A (63 cases) and group B (64 cases) according to whether acromioclavicular ligament and coracoclavicular ligament were repaired or not. In group A (ligaments repaired), there were 39 males and 24 females with an average age of (33.25 +/- 8.46) years old (ranged from 17 to 59 years). And in group B (no ligaments repaired), there were 41 males and 23 females with an average age of (34.10 +/- 7.19) years (ranged from 19 to 57 years). The operation times, intraoperative blood loss, postoperative infections, internal fixation failure, recurrence and other complications, together with therapeutic effects were compared between two groups. The outcome was analyzed according to Karlsson standard. In group A, 54 patients got an excellent result and 9 good according to Karlsson standard;the average operative time was (55.90 +/- 26.56) min; the average intraoperative bleeding amount was (99.80 +/- 50.30) ml; 1 patient had wire broken without re-dislocation at 16 weeks after operation, 3 patients got wound fat liquefaction and recovered after treatment, 1 patient had pain after shoulder joint motion and pain disappeared after implants were taken out. In group B, 52 patients got an excellent result and 12 good according to Karlsson standard; the average operative time was (49.50 +/- 23.14) min; the average intraoperative bleeding amount was (87.30 +/- 46.41) ml; 2 patients got wound fat liquefaction, and 2 patients had pain after shoulder joint motion. All the patients were followed up, and the duration ranged

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

    Institute of Scientific and Technical Information of China (English)

    张小东; 钟桂午; 王晓红; 杜小龙; 王贻幸

    2011-01-01

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

  12. 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

  13. 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.

  14. 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

  15. Biomechanics of Internal Fixation for Acromioclavicular Joint Dislocation and Scapula Neck Fracture%肩锁关节脱位并肩胛颈骨折内固定治疗的生物力学研究

    Institute of Scientific and Technical Information of China (English)

    段连鸿; 黄继锋; 梁栋柱; 赵卫东; 夏平光

    2011-01-01

    Objective To evaluate the biomechanical stability of internal fixation for acromioclavicular joint dislocation and scapula neck fracture. Methods The superior shoulder suspensory complex (SSSC) was anatomized from 7 cases of right upper limb antisepsis specimens including collarbone and scapula. The damage models were established. The stability of the SSSC was compared among the normal group, injury group and fixation group. Results The mean ranges of motion (ROMs) and neutral zones (ZNs) in different directions of the fixation group were lower than those of the injury group (P<0.05), but higher than those of the normal group (P<0.05). Conclusion Open reduction and rigid internal fixation should be applied for the patients with acromioclavicular joint dislocation and scapula neck fracture to avoid the shoulder instability.%目的 从生物力学方面评价肩锁关节脱位并肩胛颈骨折采取手术内固定治疗后的稳定性.方法 取7例包含锁骨及肩胛骨的右侧上肢防腐标本,解剖出肩胛上悬吊复合体(superior shoulder suspensory complex,SSSC),制作损伤模型,并对正常组、损伤组、固定组3种状态标本的活动度进行检测并前后比较.结果 浮肩损伤固定状态在不同方向上的中性区(neutral zone,NZ)及活动范围(range of motion,ROM)均值都明显小于损伤状态(P<0.05),但仍大于正常状态(P<0.05).结论 对肩锁关节脱位并肩胛颈骨折的患者,需要进行切开复位坚强内固定,以避免造成肩关节不稳定.

  16. The functional results of treatment of perilunate dislocations with volar approach and K-wires fixation

    Directory of Open Access Journals (Sweden)

    Hakan Basar

    2012-04-01

    Conclusion: Perilunate dislocations are rare and severe wrist injuries. Acute perilunate dislocations are usually relatively easy to reduce however carpal collaps and post-travmatic arthritis are seen usually during late period.Because of this open reduction and internal fixation technique is used to prevent carpal collaps and post-travmatic arthritis and to facilitate anatomic reduction.Our results show that open reduction and internal fixation with K-wire can restore affectively normal carpal relationship, providing acceptable grip strength and functional motion,also carpal collaps and post-travmatic arthritis were prevented. [Hand Microsurg 2012; 1(1.000: 17-21

  17. 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

  18. Occurrence of benthic microbial nitrogen fixation coupled to sulfate reduction in the seasonally hypoxic Eckernförde Bay, Baltic Sea

    Directory of Open Access Journals (Sweden)

    V. J. Bertics

    2012-06-01

    Full Text Available Despite the worldwide occurrence of marine hypoxic regions, benthic nitrogen (N cycling within these areas is poorly understood and it is generally assumed that these areas represent zones of intense fixed N loss from the marine system. Sulfate reduction can be an important process for organic matter degradation in sediments beneath hypoxic waters and many sulfate-reducing bacteria (SRB have the genetic potential to fix molecular N (N2. Therefore, SRB may supply fixed N to these systems, countering some of the N lost via microbial processes such as denitrification and anaerobic ammonium oxidation. The objective of this study was to evaluate if N2-fixation, possibly by SRB, plays a role in N cycling within the seasonally hypoxic sediments from Eckernförde Bay, Baltic Sea. Monthly samplings were performed over the course of one year to measure N2-fixation and sulfate reduction rates, to determine the seasonal variations in bioturbation (bioirrigation activity and important benthic geochemical profiles, such as sulfur and N compounds, and to monitor changes in water column temperature and oxygen concentrations. Additionally, at several time points, rates of benthic denitrification were also measured and the active N-fixing community was examined via molecular tools. Integrated rates of N2-fixation and sulfate reduction showed a similar seasonality pattern, with highest rates occurring in August (approx. 22 and 880 nmol cm−3 d−1 of N and SO42−, respectively and October (approx. 22 and 1300 nmol cm−3 d−1 of N and SO42−, respectively, and lowest rates occurring in February (approx. 8 and 32 nmol cm−3 d−1 of N and SO42−, respectively. These rate changes were positively correlated with bottom water temperatures and previous reported plankton bloom activities

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

    Institute of Scientific and Technical Information of China (English)

    张志静

    2016-01-01

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

  20. Risk stratification for avascular necrosis of the femoral head after internal fixation of femoral neck fractures by post-operative SPECT/CT

    Energy Technology Data Exchange (ETDEWEB)

    Han, Sang Won; Oh, Min Young; Yoon, Seok Ho; Kim, Jin Soo; Chang, Jae Suk; Ryu, Jin Sook [Asan Medical CenterUniversity of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Ji Wan [Dept. of Orthopedic Surgery, Haeundae Paik Hospital, Inje University, Busan (Korea, Republic of)

    2017-03-15

    Avascular necrosis (AVN) of the femoral head is a major complication after internal fixation of a femoral neck fracture and determines the functional prognosis. We investigated postoperative bone single-photon emission computed tomography/computed tomography (SPECT/CT) for assessing the risk of femoral head AVN. We retrospectively reviewed 53 consecutive patients who underwent bone SPECT/CT within 2 weeks of internal fixation of a femoral neck fracture and follow-up serial hip radiographs over at least 12 months. Nine patients developed femoral head AVN. In 15 patients who showed normal uptake on immediate postoperative SPECT/CT, no AVN occurred, whereas 9 of 38 patients who showed cold defects of the femoral head later developed AVN. The negative predictive value of immediate postoperative SPECT/CT for AVN was 100 %, whereas the positive predictive value was 24 %. Among 38 patients with cold defects, 1 developed AVN 3 months postoperatively. A follow-up bone SPECT/CT was performed in the other 37 patients at 2–10 months postoperatively. The follow-up bone SPECT/CT revealed completely normalized femoral head uptake in 27, partially normalized uptake in 8, and persistent cold defects in 2 patients. AVN developed in 3.7 % (1/27), 62.5 % (5/8), and 100 % (2/2) of each group, respectively. According to the time point of imaging, radiotracer uptake patterns of the femoral head on postoperative bone SPECT/CT indicate the risk of AVN after internal fixation of femoral neck fractures differently. Postoperative bone SPECT/CT may help orthopedic surgeons determine the appropriate follow-up of these patients.

  1. [A feasibility research of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) using hybrid internal fixation for recurrent lumbar disc herniation].

    Science.gov (United States)

    Mao, Ke-ya; Wang, Yan; Xiao, Song-hua; Zhang, Yong-gang; Liu, Bao-wei; Wang, Zheng; Zhang, Xi-Feng; Cui, Geng; Zhang, Xue-song; Li, Peng; Mao, Ke-zheng

    2013-08-01

    To investigate the feasibility of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) using hybrid internal fixation of pedicle screws and a translaminar facet screw for recurrent lumbar disc herniation. From January 2010 to December 2011, 16 recurrent lumbar disc herniation patients, 10 male and 6 female patients with an average age of 45 years (35-68 years) were treated with unilateral incision MIS-TLIF through working channel. After decompression, interbody fusion and fixation using unilateral pedicle screws, a translaminar facet screw was inserted from the same incision through spinous process and laminar to the other side facet joint. The results of perioperative parameters, radiographic images and clinical outcomes were assessed. The repeated measure analysis of variance was applied in the scores of visual analogue scale (VAS) and Oswestry disablity index (ODI). All patients MIS-TLIF were accomplished under working channel including decompression, interbody fusion and hybrid fixation without any neural complication. The average operative time was (148 ± 75) minutes, the average operative blood loss was (186 ± 226) ml, the average postoperative ambulation time was (32 ± 15) hours, and the average hospitalization time was (6 ± 4) days. The average length of incision was (29 ± 4) mm, and the average length of translaminar facets screw was (52 ± 6) mm. The mean follow-up was 16.5 months with a range of 12-24 months. The postoperative X-ray and CT images showed good position of the hybrid internal fixation, and all facets screws penetrate through facets joint. The significant improvement could be found in back pain VAS, leg pain VAS and ODI scores between preoperative 1 day and postoperative follow-up at all time-points (back pain VAS:F = 52.845, P = 0.000;leg pain VAS:F = 113.480, P = 0.000;ODI:F = 36.665, P = 0.000). Recurrent lumbar disc herniation could be treated with MIS-TLIF using hybrid fixation through unilateral incision, and the

  2. Allocating Internal Audit Resources for Fraud Risk Reduction

    OpenAIRE

    Jans, Mieke; Lybaert, Nadine; Vanhoof, Koen

    2008-01-01

    Corporate fraud these days represents a huge cost to our economy. To counter this cost, organizations allocate lots of resources in terms of internal audit. Mostly, these audits are performed at a random sample of observations. This paper provides a methodology to help allocating efforts of internal audit more efficiently. Academic literature concerning fraud detection already concentrated on how data mining techniques can be of value in the fight against fraud. In this paper w...

  3. Comprehensive comparing percutaneous endoscopic lumbar discectomy with posterior lumbar internal fixation for treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis: A retrospective case-control study.

    Science.gov (United States)

    Sun, Yapeng; Zhang, Wei; Qie, Suhui; Zhang, Nan; Ding, Wenyuan; Shen, Yong

    2017-07-01

    The study was to comprehensively compare the postoperative outcome and imaging parameter characters in a short/middle period between the percutaneous endoscopic lumbar discectomy (PELD) and the internal fixation of bone graft fusion (the most common form is posterior lumbar interbody fusion [PLIF]) for the treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis after a previous lumbar internal fixation surgery.In this retrospective case-control study, we collected the medical records from 11 patients who received PELD operation (defined as PELD group) for and from 13 patients who received the internal fixation of bone graft fusion of lumbar posterior vertebral lamina decompression (defined as control group) for the treatment of the lumbar disc prolapse combined with stable retrolisthesis at Department of Spine Surgery, the Third Hospital of Hebei Medical University (Shijiazhuang, China) from May 2010 to December 2015. The operation time, the bleeding volume of perioperation, and the rehabilitation days of postoperation were compared between 2 groups. Before and after surgery at different time points, ODI, VAS index, and imaging parameters (including Taillard index, inter-vertebral height, sagittal dislocation, and forward bending angle of lumbar vertebrae) were compared.The average operation time, the blooding volume, and the rehabilitation days of postoperation were significantly less in PELD than in control group. The ODI and VAS index in PELD group showed a significantly immediate improving on the same day after the surgery. However, Taillard index, intervertebral height, sagittal dislocation in control group showed an immediate improving after surgery, but no changes in PELD group till 12-month after surgery. The forward bending angle of lumbar vertebrae was significantly increased and decreased in PELD and in control group, respectively.PELD operation was superior in terms of operation time, bleeding volume, recovery period, and financial

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

    Science.gov (United States)

    Porter, Mark D.; Shadbolt, Bruce

    2016-01-01

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

  5. Risk evaluation of failed internal fixation for intertrochanteric fracture%股骨转子间骨折内固定失败的风险评估

    Institute of Scientific and Technical Information of China (English)

    童培建; 吴寒松; 赵鹏; 杜文喜; 吴连国; 胡柏松; 王健; 储小兵

    2012-01-01

    目的 总结分析股骨转子间骨折内固定治疗失败的原因,初步提出股骨转子间骨折的内固定手术失败风险评估表.方法 回顾性分析2008年4月至2011年4月,四家医院收治的267例接受内固定治疗的股骨转子间骨折患者,分析患者的年龄、性别、高血压、糖尿病、烟酒史、激素史、骨质疏松程度及骨折分型等因素与内固定失败的相关性.通过手术风险评估表评分,将患者分为手术失败低危风险组、中危风险组和高危风险组,比较各组内固定术后失败率差异是否自统计学意义.结果 接受内固定手术治疗的267例患者中42例患者治疗失败.患者高龄、糖尿病、严重骨质疏松、骨折不稳定等危险因素与内固定失败相关,而患者的性别、高血压、烟酒史、激素应用史等因素与内固定失败无关.糖尿病史、骨质疏松程度、骨折稳定性是患者内固定失败的危险因素(OR分别为3.76,2.37和2.74,P<0.05).股骨转子间骨折内固定失败患者主要集中在中、高危风险组.结论 严重骨质疏松、不稳定性骨折以及糖尿病均为致股骨转子间骨折手术失败的重要因素.对低危风险组的股骨转子间骨折患者可以首选内固定治疗,而对中危风险组和高危风险组患者建议谨慎选择内固定治疗,对高龄、高危风险组患者必要时可行人工关节置换术.%Objective To analyze and summarize the risk factors of failed internal fixation for intertrochanteric fracture.Methods From April 2008 to April 2011,267 patients with intertrochanteric fractures in 4 hospitals were treated with internal fixation.The relationship between the failure of internal failure and possible factors as age,gender,hypertension,diabetes,the abuse of alcohol and tobacco,use of glucocorticoid,the degree of osteoporosis and fractures type were studied.According to the surgical risk assessment table,the patients were divided into low

  6. Combined use of Ilizarov external fixation and Papineau technique for septic pseudoarthrosis of the distal tibia in a patient with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Stefanos D. Koutsostathis

    2014-02-01

    Full Text Available The surgical treatment of open pilon fractures has a high complication rate especially in diabetic patients. In this article, we present a case of an infected tibial non-union after an open reduction and internal fixation in a diabetic patient, treated with Ilizarov external fixation combined with Papineau technique. Combined use of external fixation and Papineau technique can provide an alternative option for the treatment of septic pseudoarthrosis of the distal tibia.

  7. 植入物与Halo-vest内外固定联合治疗下颈椎骨折脱位**☆%Combined therapy of implants internal fixation and Halo-vest external fixation for the treatment of subaxial cervical fracture-dislocation

    Institute of Scientific and Technical Information of China (English)

    姚关锋; 王新家; 罗滨; 王伟东; 曾机灿

    2013-01-01

    BACKGROUND:There is controversial in choosing the treatment method for the treatment of traumatic subaxial cervical fracture-dislocation and spinal cord injury. OBJECTIVE:To evaluate the clinical effect of implant internal fixation and Halo-vest external fixation on the stability after treatment of subaxial cervical fracture-dislocation. METHODS:A retrospective analysis was conducted on 17 patients with subaxial cervical fracture-dislocation in the Department of Orthopedics, the Second Affiliated Hospital of Shantou University Medical Col ege between January 2009 to December 2011, including 13 male patients and 4 female patients, the age was ranged from 21-65 years, average 41.6 years. There were six cases of high fal ing injury, three cases of crush injury and eight cases of traffic accident injury. The hospitalization time after injury was 2 hours to 5 days, average 2.5 days. Al the patients received Halo-vest external fixation under local anesthesia, then distraction gradual y, and received anterior decompression graft and titanium screw fixation under reduction. The treatment effect was evaluated through Frankel classification and imaging examination. RESULTS AND CONCLUSION:Al the patients were fol owed-up for 12-24 months, average 15.4 months. Normal anteraposterior X-ray film showed fracture reduction, the cervical vertebra restored to the normal sequence and physiological curvature;CT showed graft fusion without internal fixation fracture and loosing; according to Frankel classification, marked effect (decreased for 2 grade) in five cases, effective (decreased for 1 grade) in 10 cases, and ineffective in two cases. Implant internal fixation combined with Halo-vest external fixation is safe and reliable in the instability fixation of subaxial cervical fracture-dislocation, and can better restore the spinal sagittal alignment.%  背景:对于外伤性下颈椎骨折脱位及脊髓损伤,选择何种治疗方式目前尚存争议。  目的:评

  8. Occurrence of benthic microbial nitrogen fixation coupled to sulfate reduction in the seasonally hypoxic Eckernförde Bay, Baltic Sea

    Directory of Open Access Journals (Sweden)

    V. J. Bertics

    2013-03-01

    Full Text Available Despite the worldwide occurrence of marine hypoxic regions, benthic nitrogen (N cycling within these areas is poorly understood and it is generally assumed that these areas represent zones of intense fixed N loss from the marine system. Sulfate reduction can be an important process for organic matter degradation in sediments beneath hypoxic waters and many sulfate-reducing bacteria (SRB have the genetic potential to fix molecular N (N2. Therefore, SRB may supply fixed N to these systems, countering some of the N lost via microbial processes, such as denitrification and anaerobic ammonium oxidation. The objective of this study was to evaluate if N2 fixation, possibly by SRB, plays a role in N cycling within the seasonally hypoxic sediments from the Eckernförde Bay, Baltic Sea. Monthly samplings were performed over the course of one year to measure nitrogenase activity (NA and sulfate reduction rates, to determine the seasonal variations in bioturbation (bioirrigation activity and important benthic geochemical profiles, such as sulfur and N compounds, and to monitor changes in water column temperature and oxygen concentrations. Additionally, at several time points, the active N-fixing community was examined via molecular tools. Integrated rates of N2 fixation (approximated from NA and sulfate reduction showed a similar seasonality pattern, with highest rates occurring in August (approx. 22 and 880 nmol cm−3 d−1 of N and SO42−, respectively and October (approx. 22 and 1300 nmol cm−3 d−1 of N and SO42− respectively, and lowest rates occurring in February (approx. 8 and 32 nmol cm−3 d−1 of N and SO42−, respectively. These rate changes were positively correlated with bottom water temperatures and previous reported plankton bloom activities, and negatively correlated with bottom water oxygen concentrations. Other variables that also appeared to play a role in rate determination were bioturbation, bubble irrigation and winter storm

  9. Arthroscopy-Assisted Closed Reduction and Percutaneous Nail Fixation of Unstable Ankle Fractures: Description of a Minimally Invasive Procedure

    OpenAIRE

    Kong, Christopher; Kolla, Lee; Wing, Kevin; Younger, Alastair S.E.

    2014-01-01

    When one is surgically managing an unstable ankle fracture, anatomic reduction of the syndesmosis is typically accomplished using an open surgical approach. We propose an arthroscopically assisted technique that restores normal anatomy while using a percutaneously placed intramedullary nail to fix the fibula. The patient is positioned supine, and the ankle is placed under traction by use of a tensor bandage. Standard anteromedial and anterolateral arthroscopy portals are used. The joint is ex...

  10. 经皮克氏针内固定结合术后康复训练治疗Bennett骨折对关节功能恢复的观察%Internal fixation with Kirschner pins in combination of postoperative trainig recovering joint function following Bennett fracture

    Institute of Scientific and Technical Information of China (English)

    查天文; 聂梅

    2002-01-01

    Background:Bennett fracture belongs to intraarticular injury.Conventionally,external fixation with splint or plaster failures to maintain postrepair position,leading to fracture and translocation.On the other hand,longer term outer fixation will result in joint stiffness.Internal fixation with Kirschner pins in combination of postoperative training was characterized by stable fixation,less injury,allow early functional exercise and is beneficial to recovery of joint function.

  11. Sextant percutaneous pedicle screw fixation for correcting single-segment thoracolumbar fractures

    Institute of Scientific and Technical Information of China (English)

    Ming Jiang-hua; Zheng Hui-feng; Zhao Qi; Chen Qing; Wang Gang

    2014-01-01

    BACKGROUND:Though the effects of conservative or traditional open reduction and internal fixation in the treatment of thoracolumbar fractures are reliable and satisfactory for most cases, two methods also have shortages. Minimal-invasive percutaneous pedicle screw system provides a new available method. OBJECTIVE:To investigate the clinical effect of Sextant percutaneous pedicle screw system in the treatment of thoracolumbar fractures. METHODS:A total of 55 patients, who had undergone percutaneous pedicle screw fixation using Sextant system (25 patients) or traditional open internal fixation (30 patients) for single-level vertebral body compression fractures in Department of Orthopedics of Renmin Hospital of Wuhan University from February 2011 to January 2013, were enrol ed in this study. RESULTS AND CONCLUSION:Except two patients in traditional open internal fixation group were lost after discharge, al other patients were fol owed up for 8-14 months. Operative time, intraoperative blood loss, postoperative drainage amount and hospital day were better in percutaneous pedicle screw fixation group than in the traditional open internal fixation group (P0.05). The results show that percutaneous pedicle screw fixation using Sextant system has a satisfactory outcome in the treatment of thoracolumbar fractures. However, obeying indication strictly is very important for clinical application.

  12. Biomechanical evaluations of three anterior thoracolumbar internal fixation devices%三种胸腰椎前路内固定器的生物力学评价

    Institute of Scientific and Technical Information of China (English)

    朱建炜; 董启榕; 朱建泉; 成红兵; 王以进

    2005-01-01

    背景:胸腰椎前路内固定器械可分为两类:一类为以Kaneda代表的钉棍系统,一类为以Z-plate等代表的钉板系统.它们均具有良好的生物力学性能,但这类器械均为国外进口,价格昂贵,国内普通患者难以承受.作者在各种胸腰椎前路钢板系统和国人脊柱解剖特点的基础上,研制出一套适合国人胸腰椎形态学特点的前路新型钛合金钢板(NTP).目的:对DunnⅢ,NTP,Z-plate等3种前路内固定器生物力学进行比较,为临床应用提供科学的理论依据.设计:抽样调查.单位:苏州大学附属第二医院骨科和南通市虹桥医院放射科.对象:实验于2003-05/08在上海大学生物力学工程研究所完成.选择15具健康成年人体新鲜脊柱标本.方法:采用新鲜成人胸腰椎标本(T12~S1)15具,制成前、中柱损伤模型,分别以DunnⅢ、NTP、Z-plate固定,进行强度、刚度和稳定性的研究.主要观察指标:测量3组标本在轴向压缩、前屈、后伸、侧屈等4种工况下的载荷-应变变化,载荷-位移变化.结果:15具成年人体新鲜脊柱标本,均进入结果分析.在最大载荷500N下,Z-plate平均应变最小为410 uε,NTP平均应变其次为430 uε,而Dunn平均应变最大477 uε;脊柱的平均纵向位移,Z-plate组最小为2.23 mm,NTP组为2.38 mm,而Dunn组的平均纵向位移为2.85mm.胸腰椎骨折采用三种前路内固定器固定后,在脊柱的强度、刚度和稳定性方面,NTP、Z-plate均优于DunnⅢ(P<0.05),而NTP和Z-plate差异无显著性意义(P>0.05).结论:NTP和Z-plate系统符合脊柱的生物力学,能有效恢复失稳脊柱的稳定性,是较为理想的前路内固定器.%BACKGROUND: The anterior thoracolumbar internal fixation devices can be divided into two main categories: the stick system such as kaneda,and the plate system such as Z-plate. Both categories have satisfactory biomechanical properties, but the devices of these types are all imported and so

  13. One-off surgery of posterior reduction and fixation for the treatment of basilar invagination with atlantoaxial dislocation

    Directory of Open Access Journals (Sweden)

    LIU Jia-gang

    2012-08-01

    Full Text Available Objective To investigate the surgical treatment and clinical results for the primary basilar invagination (BI with atlantoaxial dislocation (AAD. Methods A retrospective study was performed. The study included 89 patients who had primary BI and AAD were surgically treated in our hospital from January 2008 to December 2011. There were 28 males and 61 females, aged between 10 and 69 years (mean 45.42 years. All patients were treated by the same 3-step surgical method. The first step, reduction of the AAD was performed by homemade odontoid repositor intraoperatively through posterior approach; the second step, AO stainless steel plates were fixed between the occiput and C2, 3 lateral mass screws; and the third step, occipitocervical fusion were completed by autologous iliac crest graft. Operation effect was recorded during follow-up period. Results Follow-up period was 6 to 48 months. Clinical symptoms were improved in 82.93% patients after the surgery. Japanse Orthopaedic Association (JOA score increased from preoperative (8.80 ± 1.36 points to postoperative (15.35 ± 1.47 points (t = 17.225, P = 0.001. In general, satisfactory decompression and bony fusion were shown on postoperative radiological examinations for all patients. Compared with pretreatment data, the postoperative imaging measurement showed that the mean data of atlanto-dental interval (ADI, 9.22 mm vs 3.72 mm and vertical dimension from the top of odontoid process to Chamberlain line (10.41 mm vs 3.23 mm were all reduced, and the cervicomedullary angle (130° vs 150° and space available of spinal cord (SAC, 11.13 mm vs 15.54 mm were all improved. Conclusion The one-off surgery of posterior reduction technique and fixing between occiput and C2, 3 lateral mass screws is a safe, easy, and effective treatment for patients with p

  14. One-stage posterior C2 and C3 pedicle screw fixation or combined anterior C2-C3 fusion for the treatment of unstable hangman's fracture.

    Science.gov (United States)

    Liu, Jingchen; Li, Ye; Wu, Yuntao

    2013-03-01

    The present study aimed to evaluate the effect of using one-stage posterior C2 and C3 pedicle screw fixation or combined anterior C2-C3 fusion in the treatment of unstable hangman's fracture. A total of 13 patients with unstable hangman's fractures underwent C2 and C3 pedicle screw fixation, lamina interbody fusion or combined anterior C2-C3 fusion and imaging examinations to evaluate the fracture fixation and healing condition at three days and three months following surgery. Postoperative X-ray and computed tomography (CT) results showed high fracture reduction, good internal fixation position and reliable fracture fixation. The three-month postoperative CT showed good vertebral fracture healing. C2 and C3 pedicle screw fixation has a good curative effect in the treatment of unstable hangman's fracture. The direct fixation of the fracture enables early ambulation by the patients.

  15. Subtrochanteric femur fracture treated by intramedullary fixation

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  16. Treatment of sacroiliac joint dislocation with percutaneous sacroiliac screw internal fixation%经皮骶髂螺钉内固定治疗骶髂关节脱位

    Institute of Scientific and Technical Information of China (English)

    陈红卫; 赵品益; 楼舒畅; 赵胜春; 陈欣; 赵钢生; 叶招明; 潘骏

    2008-01-01

    Objective To analyze the clinical effect of percutaneous sacroiliac screw internal fixation in treatment of sacroiliac joint dislocation. Methods From June 2002 to August 2006,16 patients with sacroiliac joint dislocation were treated with percutaneous sacroiliac screw internal fixation under C-arm X-ray tomography.There were 10 males and 6 females at age range of 10-58 years(mean 34.3 years).Results The operation lasted for 30-90 minutes(average 50.5 minutes).All patients were followed up for 12-36 months(average 18.3 months).The results of postoperative normotopia,lateral,ingate and egress Xray and CT scanning showed that all the screws were located within S1 and S2 of all,14 patients obtained satisfactory result of reduction,with no infection,nerve injuries,loosening or breakage of the screw fixation.The function and the sensation of the sacroiliac ioint and low extremities recovered to normal. Conclusions Percutaneous sacroiliac screw intemal fixation is an ideally safe and effective way to treat sacroiliac joint dislocation,for it has many advantages such as minimal invasion,reliable fixation,less complication and quick recovery.It is also very necessary to take caudad and cephalad view under an image intensifier during the operation to assure the accuracy of implantation.%目的 分析经皮骶髂螺钉内固定治疗骶髂关节脱位的临床疗效.方法 对2002年6月-2006年8月16例骶髂关节脱位患者的临床资料进行回顾性分析,其中男10例,女6例;年龄10~58岁,平均34.3岁.所有患者均在C形臂X线机监测下经皮骶髂螺钉内固定.结果 手术时间为30~90 min,平均50.5 min.术后行骨盆正位、侧位、人口位、出口位X线片和CT扫描,螺钉均位于S1、S2椎体内.16例均获得12~36个月(平均18.3个月)随访.14例骨折复位良好,无切口感染,无术中血管神经损伤,无内固定松动及断裂,腰骶及下肢活动、感觉均正常.结论 经皮骶髂螺钉内固定治疗骶髂关节脱

  17. 肺挫伤对连枷胸手术内固定疗效的影响%Internal fixation for traumatic flail chest with concomitant pulmonary contusion

    Institute of Scientific and Technical Information of China (English)

    吴国栋; 彭学锋; 罗伟彬

    2013-01-01

    目的:探讨手术内固定治疗连枷胸合并肺损伤的疗效以及肺挫伤对疗效的影响.方法:回顾性分析2002年1月至201 1年12月深圳市第二人民医院收治的62例连枷胸合并肺损伤患者的临床资料,其中内固定组24例、保守治疗组38例,肺挫伤简易评分法0~6分37例(A组,其中保守治疗22例、内固定15例)、7 ~18分25例(B组,其中保守治疗16例、内固定9例),比较呼吸机支持例数、呼吸机支持时间、住院时间及死亡例数等指标的差异.结果:(1)保守治疗组和内固定组呼吸机支持例数、呼吸机支持时间、住院时间、死亡例数比较,差异无统计学意义(P>0.05).(2)A组中保守治疗和内固定治疗患者呼吸机支持例数、呼吸机支持时间、住院时间比较,差异有统计学意义(P<0.05).(3)B组中保守治疗和内固定治疗患者患者呼吸机支持例数、呼吸机支持时间、住院时间分、死亡例数比较,差异无统计学意义(P>0.05).结论:连枷胸合并轻度肺挫伤经内固定治疗,可迅速改善患者呼吸功能;而合并严重肺挫伤的连枷胸患者内固定术后呼吸功能改善不够理想.%Objective:To study the effects of internal fixation for the treatment of traumatic flail chest with concomitant lung injury and pulmonary contusion.Methods:We did a retrospective analysis on the clinical profiles of 62 patients with traumatic flail chest and concomitant lung injury admitted to Shenzhen Second People's Hospital between January 2002 and December 2011,of whom 38 received conservative treatment and 24 internal fixation.37 patients rated the score of 0 to 6 for simple pulmonary contusion scale (group A,in whom 22 received conservative treatment and 15 internal fixation),and 25 patients rated the score of 7 to 18 for simple pulmonary contusion scale (group B,in whom 16 received conservative treatment and 9 internal fixation).The difference in the number of cases requiring and the duration

  18. 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

  19. Hemiarthroplasty compared to internal fixation with percutaneous cannulated screws as treatment of displaced femoral neck fractures in the elderly: cost-utility analysis performed alongside a randomized, controlled trial.

    Science.gov (United States)

    Waaler Bjørnelv, G M; Frihagen, F; Madsen, J E; Nordsletten, L; Aas, E

    2012-06-01

    We estimated the cost-effectiveness of hemiarthroplasty compared to internal fixation for elderly patients with displaced femoral neck fractures. Over 2 years, patients treated with hemiarthroplasty gained more quality-adjusted life years than patients treated with internal fixation. In addition, costs for hemiarthroplasty were lower. Hemiarthroplasty was thus cost effective. Estimating the cost utility of hemiarthroplasty compared to internal fixation in the treatment of displaced femoral neck fractures in the elderly. A cost-utility analysis (CUA) was conducted alongside a clinical randomized controlled trial at a university hospital in Norway; 166 patients, 124 (75%) women with a mean age of 82 years were randomized to either internal fixation (n = 86) or hemiarthroplasty (n = 80). Patients were followed up at 4, 12, and 24 months. Health-related quality of life was assessed with the EQ-5D, and in combination with time used to calculate patients' quality-adjusted life years (QALYs). Resource use was identified, quantified, and valued for direct and indirect hospital costs and for societal costs. Results were expressed in incremental cost-effectiveness ratios. Over the 2-year period, patients treated with hemiarthroplasty gained 0.15-0.20 more QALYs than patients treated with internal fixation. For the hemiarthroplasty group, the direct hospital costs, total hospital costs, and total costs were non-significantly less costly compared with the internal fixation group, with an incremental cost of €2,731 (p = 0.81), €2,474 (p = 0.80), and €14,160 (p = 0.07), respectively. Thus, hemiarthroplasty was the dominant treatment. Sensitivity analyses by bootstrapping supported these findings. Hemiarthroplasty was a cost-effective treatment. Trial registration, NCT00464230.

  20. Comparative analysis of international standards for the fatigue testing of posterior spinal fixation systems: the importance of preload in ISO 12189.

    Science.gov (United States)

    La Barbera, Luigi; Ottardi, Claudia; Villa, Tomaso

    2015-10-01

    Preclinical evaluation of the mechanical reliability of fixation devices is a mandatory activity before their introduction into market. There are two standardized protocols for preclinical testing of spinal implants. The American Society for Testing Materials (ASTM) recommends the F1717 standard, which describes a vertebrectomy condition that is relatively simple to implement, whereas the International Organization for Standardization (ISO) suggests the 12189 standard, which describes a more complex physiological anterior support-based setup. Moreover, ASTM F1717 is nowadays well established, whereas ISO 12189 has received little attention: A few studies tried to accurately describe the ISO experimental procedure through numeric models, but these studies totally neglect the recommended precompression step. This study aimed to build up a reliable, validated numeric model capable of describing the stress on the rods of a spinal fixator assembled according to ISO 12189 standard procedure. Such a model would more adequately represent the in vitro testing condition. This study used finite element (FE) simulations and experimental validation testing. An FE model of the ISO setup was built to calculate the stress on the rods. Simulation was validated by comparison with experimental strain gauges measurements. The same fixator has been previously virtually mounted in an L2-L4 FE model of the lumbar spine, and stresses in the rods were calculated when the spine was subjected to physiological forces and moments. The comparison between the FE predictions and experimental measurements is in good agreement, thus confirming the suitability of the FE method to evaluate the stresses in the device. The initial precompression induces a significant extension of the assembled construct. As the applied load increases, the initial extension is gradually compensated, so that at peak load the rods are bent in flexion: The final stress value predicted is thus reduced to about 50%, if

  1. One Case of Patient had an Allergy to Internal Fixation with Metal of Pedicle Screw System%椎弓根系统内固定金属过敏一例报道

    Institute of Scientific and Technical Information of China (English)

    王勇; 陈久毅

    2013-01-01

    Internal fixation with metal in the Department of orthopedics is a common treatment method. Metal implants allergy have been reported, but relatively rare. This paper reported a case of patient in our hospital had an allergy to internal fixation with metal of pedicle screw system.%  金属内固定在骨科为常见的治疗方法,金属内植物过敏曾有报道,但较为少见,现将我院椎弓根系统内固定过敏一例报道如下。

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Different Internal Fixation for Intertrochanteric Fractures in Elderly Patients%老年患者股骨粗隆间骨折内固定治疗

    Institute of Scientific and Technical Information of China (English)

    杨灵; 龙成; 徐巍; 刘跃洪; 汪红; 雷达

    2012-01-01

    of operation duration, blood loss, postoperative complications, fracture healing time and postoperative hip function score were used to evaluate the clinical outcome. Results Incisions of patients in all groups were healed without any wound infection. All patients were followed up for 18 to 108 months with an average time of 56.4 months. Group B, C and D had the advantages of shorter operation time, less blood loss, and shorter fracture healing time compared with group A (P 0.05). The rates of postoperative complications were higher in group A than other groups (P 0.05). Conclusions PPCP, Gamma nail and PFN are suitable for elderly patients with intertrochanteric fractures with slight trauma and fewer complications. The fracture reduction and the position of the internal fixation are important

  4. Evaluation of colon cancer histomorphology: a comparison between formalin and PAXgene tissue fixation by an international ring trial.

    Science.gov (United States)

    Gündisch, Sibylle; Slotta-Huspenina, Julia; Verderio, Paolo; Ciniselli, Chiara Maura; Pizzamiglio, Sara; Schott, Christina; Drecoll, Enken; Viertler, Christian; Zatloukal, Kurt; Kap, Marcel; Riegman, Peter; Esposito, Irene; Specht, Katja; Babaryka, Gregor; Asslaber, Martin; Bodó, Koppany; den Bakker, Michael; den Hollander, Jan; Fend, Falko; Neumann, Jens; Reu, Simone; Perren, Aurel; Langer, Rupert; Lugli, Alessandro; Becker, Ingrid; Richter, Thomas; Kayser, Gian; May, Annette M; Carneiro, Fatima; Lopes, José Manuel; Sobin, Leslie; Höfler, Heinz; Becker, Karl-Friedrich

    2014-11-01

    The aim of our study was to evaluate the quality of histo- and cytomorphological features of PAXgene-fixed specimens and their suitability for histomorphological classification in comparison to standard formalin fixation. Fifteen colon cancer tissues were collected, divided into two mirrored samples and either formalin fixed (FFPE) or PAXgene fixed (PFPE) before paraffin embedding. HE- and PAS-stained sections were scanned and evaluated in a blinded, randomised ring trial by 20 pathologists from Europe and the USA using virtual microscopy. The pathologists evaluated histological grading, histological subtype, presence of adenoma, presence of lymphovascular invasion, quality of histomorphology and quality of nuclear features. Statistical analysis revealed that the reproducibility with regard to grading between both fixation methods was rather satisfactory (weighted kappa statistic (k w) = 0.73 (95 % confidence interval (CI), 0.41-0.94)), with a higher agreement between the reference evaluation and the PFPE samples (k w = 0.86 (95 % CI, 0.67-1.00)). Independent from preservation method, inter-observer reproducibility was not completely satisfactory (k w = 0.60). Histomorphological quality parameters were scored equal or better for PFPE than for FFPE samples. For example, overall quality and nuclear features, especially the detection of mitosis, were judged significantly better for PFPE cases. By contrast, significant retraction artefacts were observed more frequently in PFPE samples. In conclusion, our findings suggest that the PAXgene Tissue System leads to excellent preservation of histomorphology and nuclear features of colon cancer tissue and allows routine morphological diagnosis.

  5. 探讨单螺钉内固定治疗下颌骨髁突矢状骨折的临床效果%To investigate the clinical effect of single screw internal fixation in the treatment of mandibular condyle sagittal fracture

    Institute of Scientific and Technical Information of China (English)

    张文兵

    2016-01-01

    目的:分析单螺钉内固定在下颌骨髁突矢状骨折的治疗中的临床效果.方法:收治髁突矢状骨折患者 100例,分两组,各50例.观察组实施单螺钉内固定治疗,对照组实施颌间牵引复位固定治疗.结果:观察组颞下颌关节功能障碍评分和并发症的发生率显著优于对照组(P<0.05).结论:在下颌骨髁突矢状骨折的治疗中,单螺钉内固定可以有效地缓解患者的颞下颌关节功能障碍,减少并发症.%Objective:To analyse the clinical effect of single screw internal fixation in the treatment of mandibular condyle sagittal fracture.Methods:100 patients with sagittal condylar fracture were selected,they were divided into two groups,each in 50 cases.The observation group was treated with single screw internal fixation,and the control group was treated with traction reduction and fixation.Results:The score of the temporomandibular joint dysfunction score and the incidence of complications in the observation group were significantly higher than those in the control group(P<0.05).Conclusion:In the treatment of mandibular condyle sagittal fracture,single screw internal fixation can effectively relieve patients of temporomandibular joint dysfunction, reduce complications.

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

    Institute of Scientific and Technical Information of China (English)

    Varatharaj Mounasamy; Pingal Desai; Satya Mallu; Senthil Sambandam

    2012-01-01

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

  7. 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

  8. 浮肩损伤内固定方式选择的生物力学研究%Biomechanics of internal fixation for treating floating shoulder injury

    Institute of Scientific and Technical Information of China (English)

    段连鸿; 黄继锋; 赵卫东; 梁栋柱; 夏平光; 刘新园

    2011-01-01

    目的 对浮肩损伤临床常用的3种内固定术式进行生物力学评价,为手术选择内固定方式提供生物力学依据.方法 7例包含锁骨及肩胛骨的左侧上肢防腐尸体标本,解剖出肩胛上悬吊复合体(SSSC),人为制造浮肩损伤模型,对4种状态进行试验:正常标本、单纯锁骨固定、锁骨加肩胛颈单钢板固定、锁骨加肩胛颈双钢板固定.利用脊柱三维运动分析系统测定不同状态下肩胛颈的运动范围(ROM),比较不同内固定方式对失稳SSSC的稳定作用.结果 生物力学测试表明,单纯锁骨固定的ROM值分别是:前屈(12.60±0.95)°、后伸(8.53±0.60)°、左侧弯(12.47±0.73)°、右侧弯(12.32±0.69)°、左旋(10.17±0.59)°、右旋(11.42±0.62)°,与其他各组相比明显增大(P<0.05);锁骨加肩胛颈双钢板固定的ROM值分别是:前屈(5.50±0.96)°、后伸(2.77±0.67)°、左侧弯(3.61±0.70)°、右侧弯(5.06±0.71)°、左旋(3.28±0.58)°、右旋(3.58±0.92)°,与其他固定组相比明显减小(P<0.05).结论 治疗浮肩损伤的最佳内固定方式为同时固定锁骨及肩胛颈骨折,肩胛颈骨折采取双钢板坚强内固定,以避免肩胛骨畸形愈合而造成肩关节不稳定.%Objective To evaluate biomechanic effects of commonly used internal fixation methods on the treatment of floating shoulder injury. Methods The superior suspensory shoulder complex (SSSC) were dissected for simulating floating shoulder injury in 7 antiseptic upper limb specimens including collarbone and scapula. The testing included the normal specimens, simple clavicle fixation, single plate fixation of clavicle and scapula neck, and double plate fixation of clavicle and scapula neck. The ROMs of scapula neck under different states were measured by spinal motion analysis system, as well, the stability of different fixation methods for instable SSSC was compared. Results The biomechanical testing showed that, the ROMs of simple clavicle

  9. Percutaneous Screw Fixation of Crescent Fracture-Dislocation of the Sacroiliac Joint.

    Science.gov (United States)

    Shui, Xiaolong; Ying, Xiaozhou; Mao, Chuanwan; Feng, Yongzeng; Chen, Linwei; Kong, Jianzhong; Guo, Xiaoshan; Wang, Gang

    2015-11-01

    Crescent fracture-dislocation of the sacroiliac joint (CFDSIJ) is a type of lateral compression pelvic injury associated with instability. Open reduction and internal fixation is a traditional treatment of CFDSIJ. However, a minimally invasive method has never been reported. The purpose of this study was to assess the outcome of closed reduction and percutaneous fixation for different types of CFDSIJ and present their clinical outcome. The authors reviewed 117 patients diagnosed with CFDSIJ between July 2003 and July 2013. Closed reduction and percutaneous fixation was performed in 73 patients. Treatment selection was based on Day's fracture classification. For type I fractures, fixation perpendicular to the fracture line were performed. For type II fractures, crossed fixation was performed. For type III fractures, fixation was performed with iliosacral screws. Forty-four patients were treated by open reduction and plate fixation. Demographics, fracture pattern distribution, blood loss, incision lengths, revision surgeries, radiological results, and functional scores were compared. All 117 patients were followed for more than 6 months (mean, 14 months [range, 6-24 months]). Blood loss, extensive exposure, duration of posterior ring surgery, duration of hospital stay, and infection rates were lower in the closed group (P<.01). Patients in the closed group achieved better functional performance (P<.01). There were no significant differences in reduction quality (P=.32), revision surgery rates (P=.27), and iatrogenic neurologic injuries (P=.2) between the 2 groups. The authors' results indicate that closed reduction and percutaneous fixation is a safe and effective surgical method for CFDSIJ. Copyright 2015, SLACK Incorporated.

  10. 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.

  11. Comparison of N(2) Fixation and Yields in Cajanus cajan between Hydrogenase-Positive and Hydrogenase-Negative Rhizobia by In Situ Acetylene Reduction Assays and Direct N Partitioning.

    Science.gov (United States)

    La Favre, J S; Focht, D D

    1983-08-01

    Pigeon peas [Cajanus cajan (L.) Millsp.] were grown in soil columns containing (15)N-enriched organic matter. Seasonal N(2) fixation activity was determined by periodically assaying plants for reduction of C(2)H(2). N(2) fixation rose sharply from the first assay period at 51 days after planting to a peak of activity between floral initiation and fruit set. N(2) fixation (acetylene reduction) activity dropped concomitantly with pod maturation but recovered after pod harvests. Analysis of (15)N content of plant shoots revealed that approximately 91 to 94% of plant N was derived from N(2) fixation. The effect of inoculation with hydrogenase-positive and hydrogenase-negative rhizobia was examined. Pigeon peas inoculated with strain P132 (hydrogenase-positive) yielded significantly more total shoot N than other inoculated or uninoculated treatments. However, two other hydrogenase-positive strains did not yield significantly more total shoot N than a hydrogenase-negative strain. The extent of nodulation by inoculum strains compared to indigenous rhizobia was determined by typing nodules according to intrinsic antibiotic resistance of the inoculum strains. The inoculum strains were detected in almost all typed nodules of inoculated plants.Gas samples were taken from soil columns several times during the growth cycle of the plants. H(2) was never detected, even in columns containing pigeon peas inoculated with hydrogenase-negative rhizobia. This was attributed to H(2) consumption by soil bacteria. Estimation of N(2) fixation by acetylene reduction activity was closest to the direct (15)N method when ethylene concentrations in the gas headspace (between the column lid and soil surface) were extrapolated to include the soil pore space as opposed solely to measurement in the headspace. There was an 8-fold difference between the two acetylene reduction assay methods of estimation. Based on a planting density of 15,000 plants per hectare, the direct (15)N fixation rates ranged

  12. On tiny-incision open reduction keshi needle fixation in treating 30 cases of supracondylar fracture of humerus%小切口复位治疗小儿肱骨髁上骨折30例

    Institute of Scientific and Technical Information of China (English)

    阮传江; 周平辉

    2011-01-01

    目的:探讨小切口切开复位后克氏针固定治疗小儿肱骨髁上骨折的疗效.方法:对30例肱骨髁上骨折的患儿,采用小切口切开复位后克氏针固定.结果:术后摄X片达到解剖复位28例,轻度尺偏2例,切口均一期愈合.结论:小切口切开复位后克氏针固定治疗小儿肱骨髁上骨折简单方便,术后并发症少,效果满意.%Objective :To explore the curative effects of tiny-incision open reduction keshi needle fixation in treating supracondylar fracture of humerus. Methods: Retrospective analysis the clinical data of 30 cases of supracondylar fracture of humerus, using on tinyincision open reduction keshi needle fixation. Results:Among 30 cases,28 were recovered and 2 was slightly biased. No complications after surgery. Conclusions:It is effective to treat supracondylar fracture of humerus by tiny-incision open reduction keshi needle fixation.

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

    Institute of Scientific and Technical Information of China (English)

    张晋亭

    2003-01-01

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

  14. 胸腰椎骨折内固定方法应用的比较分析%The Comparison of Application about Internal Fixation Method Applied to Thoracolumbar Fracture

    Institute of Scientific and Technical Information of China (English)

    王兴水

    2013-01-01

    Objective:To compare and analysis the application effect of internal fixation method applied to thoracolumbar fracture.Method:The 82 patients were surgical treatment respectively with internal fixation of posterior(internal fixation of decompression from the posterior called Harrington and internal fixation from the posterior through the pedicle of vertebral arch called AF system)and internal fixation from the front path called Kaneda,then compare the the improvement about cobb’s angle of injured spinal cord and the height of front and rear edge、the changes of Frankel classification and the adverse reaction case after treatment.Result:The effect of AF was better than Harrington and Kaneda on cobb’s angle and the height of front and rear edge;The adverse reaction case of Harrington and AF was less than Kaneda.Conclusion:Medical clinical should choose the right way of internal fixation when treatment with thoracolumbar fracture,internal fixation of decompression from the posterior can be considered first in the feasible premise.%  目的:比较分析胸腰椎骨折内固定方法的应用效果。方法:对82例患者分别采用后路内固定(后路减压式内固定方式Harrington和后路经椎弓根内固定AF系统)及前路内固定Kaneda方式进行手术治疗,比较治疗后伤椎Cobb’s角和前、后缘高度改善情况,以及Frankel分级变化情况、并发症发生情况。结果:Cobb’s角和前、后缘高度改善情况及Frankel分级上,AF较之Harrington与Kaneda效果更佳;另外,Harrington与AF较之Kaneda,并发症发生率相对更少。结论:治疗胸腰椎骨折时,应根据患者的具体情况选择合适的内固定方式,后路方式可行的前提下可优先考虑采用。

  15. 有限内固定结合外固定架治疗Rüedi-Allg(o)wer Ⅲ型Pilon骨折%Limited internal fixation combining with external fixation for the treatment of Rüedi-Allg wer Ⅲ Pilon fractures

    Institute of Scientific and Technical Information of China (English)

    廖伟; 王玉龙; 姬彦辉; 滕宇; 郑启新; 兰生辉

    2012-01-01

    目的 探讨有限内固定结合外固定支架治疗Rüedi-Allg werⅢ型Pilon 骨折的临床疗效.方法 2006 年3月~2010 年7月采用克氏针或螺钉内固定结合外固定支架固定治疗Rüedi-Allg werⅢ型pi1on 骨折18 例,术后2~3 个月拆除外固定支架.结果 术后18 例均获得随访.随访时间4~26 个月,平均15 个月,临床疗效满意,无切口、伤口感染,无皮肤坏死等严重并发症.参照Mazur 踝关节评分分级系统来评价,结果显示优6例,良9例,可3 例,总体优良率达约83.3%.结论 有限内固定结合外固定支架能有效固定骨折端,避免软组织感染和骨不连,是治疗严重粉碎Pilon骨折理想的方法之一.%Objective To investigate the clinical effect of treatment of Riiedi-Allgo2er IllPilon' s fractures with limited internal fixations and external fixators. Methods 18 cases of Riiedi-AllgowerlllPilon' s fractures with limited internal fixations and external fixators were treated during 2006 to 2010. They were all treated by Kirss-chnerwires or screws together with external fixations. External fixator were removed at 2 to 3 monks after operation. Results All cases were followed up after operation. The following observation time was 4 to 26 months, average 15 months. No infections of wound and incision, no skin necrosis complication was found. According to Mazur ankle joint scoring system, The results demonstrated 6 excellent, 9 good, 3 fair, the excellent and good rate was 83.3%. Conclusion Limited internal fixation and external fixator is one of the effective way of treatment of Pilon III fracture because it can immobilize the sections of fracture and avoid infection of soft tissue and nonunion of fracture.

  16. Surgical treatment of zygomatic bone fracture using two points fixation versus three point fixation-a randomised prospective clinical trial

    OpenAIRE

    2012-01-01

    Abstract Background The zygoma plays an important role in the facial contour for both cosmetic and functional reasons; therefore zygomatic bone injuries should be properly diagnosed and adequately treated. Comparison of various surgical approaches and their complications can only be done objectively using outcome measurements which in turn require protocol management and long-term follow up. The preference for open reduction and internal fixation of zygomatic fractures at three points has con...

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

    Objective: Monteggia fracture dislocation equivalent, though already described by Bado, is still an unclassified entity. We aimed to retrospectively analyze 18 cases of Monteggia variants and discuss the injury mechanisms, management, and outcome along with a re view of the literature. Methods: A retrospective record of Monteggia fracture dislocation (2003-2008) was reviewed from medical record department of our institute. Classic Monteggia fracture dislocation, children below 12 years or adults over 50 years, as well as open grade Ⅱ & Ⅲ cases were excluded from this study. Monteggia variant inclusion criteria included fracture of the proximal ulna together with a fracture of the radial head or neck and skeletal maturity. Totally 26 patients were identified with Monteggia variants and 18 were available for follow-up, including 11 males and 7 females with the mean age of 35 years. The ulna fracture was treated by compression plating along with tension band wiring. Radial head/neck was reconstructed in 12 patients while excised in 6 patients. Results: Follow-up ranged from 1 -4 years, mean 2.6 years. Patients were assessed clinicoradiologically. Mayo Elbow Performance Score was employed to assess the outcomes. At final follow-up, the results were excellent in 10 patients, good in 4, fair in 2 and poor in 2. Mean range of motion of the elbow was 20°, 116°, 50° and 55° for extension, flexion, pronation and supination, respectively. Two patients had complications in the form of heterotopic ossification and stiffness of the elbow. One nonunion ulna, primarily treated by tension band wiring, was managed by refixation with locking reconstruction plate and bone grafting. Bone grafting was only required in this patient for nonunion. Another patient had implants removed on his request. The results in our series closely correlated with extent of intraarticular damage, coronoid fracture and comminuted fractures. Conclusions: Monteggia fracture dislocation equivalents are rare injuries and pre-surgery recognition by radiographs and 3-D CT helps make optimal plan. The poor results usually relate to intraarticular damage, coronoid fractures and comminution of the ulna and radial head fractures.

  18. Tightrope fixation of ankle syndesmosis injuries: clinical outcome, complications and technique modification.

    LENUS (Irish Health Repository)

    Naqvi, Gohar A

    2012-06-01

    Ankle syndesmotic injuries are complex and require anatomic reduction and fixation. Tightrope fixation is a relatively new technique and we present the largest series of syndesmosis fixation using Arthrex Tightrope™ (Naples, FL, USA).

  19. Clostridium perfringens infection complicating periprosthetic fracture fixation about the hip: successful treatment with early aggressive debridement.

    LENUS (Irish Health Repository)

    Baker, Joseph F

    2012-07-13

    Periprosthetic fracture and infection are both challenges following hip arthroplasty. We report the case of an 87 year old female who underwent open reduction and internal fixation of a periprosthetic femoral fracture. Her post-operative course was complicated by infection with Clostridium perfringens. Early aggressive antibiotic treatment and surgical debridement were successful, and allowed retention of the original components.

  20. ECO LOGIC INTERNATIONAL GAS-PHASE CHEMICAL REDUCTION PROCESS - THE THERMAL DESORPTION UNIT - APPLICATIONS ANALYSIS REPORT

    Science.gov (United States)

    ELI ECO Logic International, Inc.'s Thermal Desorption Unit (TDU) is specifically designed for use with Eco Logic's Gas Phase Chemical Reduction Process. The technology uses an externally heated bath of molten tin in a hydrogen atmosphere to desorb hazardous organic compounds fro...

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

    Directory of Open Access Journals (Sweden)

    Jia-ming LIU

    2015-11-01

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

  2. 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.

  3. 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.

  4. Arthroplasty versus Internal Fixation for Displaced Intracapsular Femoral Neck Fracture in the Elderly: Systematic Review and Meta-analysis of Short- and Long-term Effectiveness

    Institute of Scientific and Technical Information of China (English)

    Chen-Yi Ye; An Liu; Ming-Yuan Xu; Nwofor Samuel Nonso; Rong-Xin He

    2016-01-01

    Background:There is conflicting evidence as to whether the femoral head should be preserved or replaced in elderly patients with displaced intracapsular femoral neck fractures.In this article,we performed a systematic review and meta-analysis to compare the short-and long-term effectiveness of arthroplasty (AR) and internal fixation (IF).Methods:PubMed,Embase,and the Cochrane Library were searched systematically up to January 2016.All randomized controlled trials directly comparing the effectiveness of AR and IF for displaced intracapsular fracture were retrieved with no limitation on language or publication year.Results:In total,eight prospective randomized studies involving 2206 patients were included.The results of our study showed that patients in the AR group reported significantly lower complication (risk ratio:0.56,95% confidence interval [CI] =0.38-0.80),re-operation (risk ratio:0.17,95% CI =0.13-0.22),revision rates (risk ratio:0.11,95% CI:0.08-0.16),and better function compared with their IF counterparts,and they were less likely to suffer postoperative pain.No statistically significant differences for the rates of mortality,infection,and/or deep vein thrombosis between AR and IF were found.Conclusions:Based on our analysis,we recommend that AR should be used as the primary treatment for displaced intracapsular femoral neck fractures in the elderly.However,IF may be appropriate for those who are very frail.

  5. Comparative analysis of supracondylar femur fracture treated with internal fixation%股骨髁上骨折内固定治疗的比较分析

    Institute of Scientific and Technical Information of China (English)

    刘明建; 陈岳峰

    2009-01-01

    Objective: To discuss the clinical effects of supracondylar femur fracture treated with two kinds of internal fixation methods. Methods: 80 cases of supracondylar femor fractures were divided into retrograde interlocking intramedullary nail (GSH) group and femur dynamic condylar screw (DCS) group, 40 cases treated with GSH,another 40 eases treated with DCS, then compared the clinical effects of two groups. Results: Fracture healing rate of two groups had no significant difference (P>0.05). HSS score of DCS group was better than GSH group, the difference was significant (P0.05).2种固定方式的HSS评分显示,DCS优于GSH组,有显著性差异(P<0.05).结论:内固定治疗股骨髁上骨折可获得良好的效果.股骨动力髁螺钉(DCS)可有效治疗股骨远端骨折,具有操作简便、直观、固定牢固等优点.

  6. External fixation in early treatment of unstable pelvic fractures

    Institute of Scientific and Technical Information of China (English)

    HU San-bao; XU Hong; GUO Heng-bing; SUN Tong; WANG Chang-jun

    2012-01-01

    Background Patients with pelvic fractures are often treated in hospitals without the capacity to implement an open reduction internal fixation (ORIF).This often leads to pelvic malunion in patients with unstable pelvic fracture,shock or even death due to uncontrollable pelvic hemorrhage and unstable hemodynamics.This study explored the role of early external fixation (within 7 days) for patients with unstable pelvic fractures.Methods A retrospective analysis was conducted on 32 patients with unstable pelvic fractures treated with early external fixation from January 2005 to January 2010 (file type B:18 cases; C:14 cases).The study comprised 28 males and 4 females,with a mean age of (32±8) years (range,21-56 years).Of these patients,22 were treated with emergency pelvic external fixation and 10 were treated with external fixation within 1-7 days.Fifteen cases suffered traumatic hemorrhagic shock.A statistical analysis was conducted to compare fluid infusion and blood transfusion volumes within the first 24 hours of these shock patients with another cohort of patients treated without early external fixation from January 1993 to January 1998.Results The average follow-up was (34.7±14.6) months (range,6-66 months).Six to eight weeks after external fixation,patients could walk with crutches; by 12 weeks,external fixation was removed and all fractures had healed.Seven patients presented with sequelae,including 3 patients with long-term lumbosacral pain,3 patients with erectile dysfunction and 1 patient with Morel-Lavallee lesion and other complications.The 15 shock patients in this study (2005-2010 group) required significantly lower volumes of fluid infusion and blood transfusion (Pfluid=0.000;Ptransfusion=0.000) as compared to the 1993-1998 cohort.Conclusions The early application of external fixation in unstable pelvic fracture patients positively affects hemodynamic stability,with outstanding efficacy as a final fixation option for unstable pelvic fractures.

  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. 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

  10. Report on survey of international cooperation possibility on chemical CO2 fixation and utilization technology in FY 1997; 1997 nendo chosa hokokusho (kagakuteki CO2 koteika yuko riyo gijutsu ni kakawaru kokusai kyoryoku kanosei chosa)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-03-01

    This survey focused on the end of the more promising companion and promoting the international cooperation on chemical CO2 fixation and utilization technology. As a result, the way of the carrying-forward of the international cooperation with more than one companion could be arranged beforehand. It led to getting an arrangement about a secrecy agreement respectively with Lurgi company and ABB company in Europe, and to providing a catalyst sample developed by RITE to implement an examination by the other party and to show related technical information. In addition, it concluded a cooperation agreement about a total system of the chemical CO2 fixation and utilization technology and methanol synthesis with ZSW. In Australia, negotiation about international cooperation with CSIRO which is a federal research organization and CRC (Cooperative Research Centre) for renewable energy has been started. The ideal circumstances are being ready for the chemical CO2 fixation project for which the international cooperation with the country where the natural energy is rich like Australia is essential when coming to practical use. To do alternating current with further high density in the following year it is desired to build a concrete study cooperation system. 1 fig., 4 tabs.

  11. Feasibility study of international cooperation on the chemical CO2 fixation and effective utilization technology in FY 1996; 1996 nendo kagakuteki CO2 koteika yuko riyo gijutsu ni kakawaru kokusai kyoryoku kanosei chosa

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-03-01

    In this survey, candidate organizations to cooperate internationally in the development of chemical CO2 fixation technologies have been selected, and possible forms of the cooperation each organization would participate in have been examined. The chemical CO2 fixation technology project of RITE (Research Institute of Innovation Technology for the Earth) involves the essential themes of CO2 separation membrane technology, catalytic hydrogenation reaction technology, and hydrogen production/supply technology, as well as the overall system. Through the arrangement, 19 international research institutes were selected as the potential candidates for international research cooperation. Either direct visit or questionnaire by mail was conducted to these institutes. The purposes of international cooperation in each of essential study theme are to review the possibility of improving technologies in each theme by introducing new technologies, and to review the possibilities of promoting practical implementation of chemical CO2 fixation system. The research institutes to be reviewed as partners for joint research are summarized. 10 figs., 16 tabs.

  12. 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

  13. Clinical value of percutaneous needle internal fixation technology in the treatment of limb fractures%经皮穿针内固定技术治疗四肢骨折的临床价值研究

    Institute of Scientific and Technical Information of China (English)

    胡鲲; 李溥; 覃家永; 陆耀宇; 胡建山

    2013-01-01

    Objective To explore the clinical value of percutaneous needle internal fixation technology in the treatment of limb fractures.Methods 498 patients with limb fractures were treated by percutaneous needle internal fixation,and the healing time was observed and the function was evaluated.Results all 498 patients were followed and the average follow-up time was (11±2.1)months (6~20 months).X-ray film showed that,the fractures were healed completely in phase-I,and all patients had no infection,non-union or other complications.The average time of healing was (6.9±1.8)months,the good rate of prognosis was 95.58%.Conclusion The treatment by percutaneous needle internal fixation technology for four limbs fractures met biomechanics fixation principle, the internal fixation was stable and conducive to healing of fractures and recovery of soft tissue.Especially for the treatment of children fractures and adult simple fractures,it had obvious advantages compared with other internal fixation methods.%目的探讨经皮穿针内固定技术在治疗四肢骨折中的临床价值。方法498例四肢骨折患者均行经皮穿针内固定治疗,观察骨折临床愈合时间并进行功能评定。结果498例均获得随访,平均随访时间(11±2.1)个月(6个月~20个月)。X线片显示,骨折全部Ⅰ期愈合,所有病例均无感染、骨不连等并发症发生。骨折愈合平均时间(6.9±1.8)个月,预后优良率为95.58%。结论经皮穿针内固定技术治疗四肢骨折符合生物力学固定(BO)原则,内固定牢靠,有利于骨折的愈合及软组织修复。特别对于儿童骨折、成人简单骨折的治疗与其他内固定方法相比较具有明显优势。

  14. 髌骨骨折聚髌器内固定术后早期功能锻炼疗效观察%Effect of the early function exercise after the operation of internal fixation with patella gatherer on fracture of patella

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@ Backgrand: After incision,correction and internal fixation with Kirschner pins and steel pins, many patients has been observed to have joints dysfunction even rigidity after the elimination of more than 4 weeks knee's extention movement under outer fixation protection which is necessary. Unit: Red Cross Hospital of Jingjiang City.

  15. 脊柱腰骶段生物力学特性及内固定材料的应用%Biomechanical properties of the lumbosacral spine and application of internal fixation materials

    Institute of Scientific and Technical Information of China (English)

    孙弘昊; 郭庆升; 朱志勇

    2016-01-01

    背景:近年来,建立在脊柱生物力学和材料科学基础上的脊柱内固定技术取得了迅猛发展。  目的:综述脊柱腰骶段生物力学特点,以及不同内固定材料在腰骶段脊柱结核稳定性重建中的作用。  方法:应用计算机检索Medline、中国期刊全文数据库中的相关文献,检索关键词为“腰骶段脊柱结核,生物材料,内固定,lumbo-sacral spinal tuberculosis, Biomaterials,fixation”。  结果与结论:坚强内固定是腰骶段结核的常规固定手段,内固定材料的应用提高了腰骶段脊柱结核治疗时重建脊柱序列和稳定性的疗效。金属材料如不锈钢、钛及钛合金因坚强内固定而被广泛应用,金属内固定材料最大的缺点是内固定后沉降、不透光性、应力遮挡效应和骨质疏松,影响了融合效果及内固定后影像学观察;可吸收材料具有良好的生物相容性和可降解性,是近年来用于骨科内固定的新兴材料。应根据椎体破坏程度和腰骶稳定性改变,研究其固定的生物力学结果,选择合适的内固定材料。%BACKGROUND:In recent years, the spinal internal fixation technology has made rapid development based on biomechanics and material sciences. OBJECTIVE: To review the biomechanical characteristics of the lumbosacral spine and the application of various internal fixation materials in the reconstruction of spinal stability after lumbosacral spinal tuberculosis. METHODS:A computer-based search of Medline and Chinese Journal Ful-Text Database was performed for relevant articles using the keyword of “lumbosacral spinal tuberculosis, biomaterials materials, fixation” in English and Chinese, respectively. RESULTS AND CONCLUSION: Rigid internal fixation is a conventional treatment for lumbosacral tuberculosis, which improves the spinal alignment and stability during the spinal reconstruction. Metalic materials such as stainless

  16. 有限内固定结合铰链式超关节外固定架治疗肱骨远端复杂骨折%Limited internal fixation combined with super-articular external fixator for complex distal humeral fractures

    Institute of Scientific and Technical Information of China (English)

    郭亚洲; 徐辉; 郑均华; 万昌涛; 钱苏林; 曾舸

    2012-01-01

    Objective To evaluate the application of limited internal fixation combined with hinged super - articular external fixator for complex distal humeral fractures( CDHF ). Methods Twelve cases of CDHF were treated with limited internal fixation combined with hinged super - articular externnal fixator, and the results were analyzed. Results All 12 patients were followed up for a mean duration of 7 months( range 4 ~ 15 months ). According to the Morrey scoring system,results were excellent in 7 cases, good in 3 , fair in 2, and the effective rate was 83. 3% . All cases of fracture healed without severe complication such as infection,limited flection or extension of elbow joint,cubitus varus and nerve injury. Conclusion Limited internal fixation combined with hinged super - articular external fixator in treatment of complex distal humeral fractures can promote early rehabilitation and improve the recovery of elbow function, which is an effective treatment for CDHF.%目的 总结有限内固定结合铰链式超关节外固定架治疗肱骨远端复杂骨折的效果.方法 对12例肱骨远端复杂骨折采用有限内固定结合铰链式超关节外固定架固定进行治疗.结果 12 例全部获得随访,随访时间平均7个月(4~15个月),根据Morrey指定评估指数评价,优7例,良3例,可2例.优良率83.3%.无感染、关节僵硬、肘内翻畸形、神经损伤等严重并发症发生.结论 有限内固定结合铰链式超关节外固定架治疗能早期进行关节活动,可明显恢复关节功能,是一种良好的治疗肱骨远端复杂骨折的方法.

  17. The Plato statistical analysis and countermeasures of internal fixation demolition mishandling%内固定拆除物处置不当的柏拉图统计分析与对策

    Institute of Scientific and Technical Information of China (English)

    马慧仙; 章霞红; 汪怡翠; 郑剑英

    2014-01-01

    目的:通过质量管理提高内固定拆除物的处理质量,防止纠纷的发生。方法:用柏拉图方法对不良数据进行收集,用鱼骨图进行原因分析,根据原因提出对策,制定措施,进行PDCA。结果:通过柏拉图分析,使得内固定拆除物处理的进步率达到了78%,合格率达到了93%。结论:用柏拉图分析等QC手法对内固定拆除物处理质量进行改进,是一种行之有效的方法。%To improve the quality of internal fixation demolition processing by the quality management methods , thus to prevent the occurrence of disputes .[Method] The data of internal fixation demolition mishandling was collected and an-alyzed by fishbone diagram .According to the reasons ,we put forward countermeasures ,set out measures and carried out plan-do-check action cycle (PDCA) .[Result] The progress rate of internal fixation demolition handling was 78% and the qual-ified rate was 93% with Plato analysis . [Conclusion ] The Plato analysis is one of the effective methods to improve the quality of internal fixation demolition processing by the quality management methods.

  18. 分体式髌骨爪内固定治疗髌骨骨折效果探讨%Effect Analysis of the Treatment of Patellar Fracture by Internal Fixation with Split Type of Patella

    Institute of Scientific and Technical Information of China (English)

    孙勇

    2015-01-01

    Objective To explore patel a claws separate the ef ect of internal fixation treatment of patel a fracture.Methods From January 2013~June 2015 for the treatment of 50 cases of patel ar fracture patients,the implementation of internal fixation for treatment of patel a claw of separate patients with retrospective analysis of clinical therapeutic ef ect.Results 50 cases of patel ar fracture patients with patel ar claw internal fixation for treatment of separate treatment of fine rate was 98%.Conclusion Internal fixation treatment of patel a fracture of patel a claw separate,not only the simple operation,good rigidity,and shorter operation time,do not need special auxiliary equipment,reduce the occur ence of complications.%目的:探析分体式髌骨爪内固定治疗髌骨骨折的效果。方法选取我院2013年1月~2015年6月治疗的50例髌骨骨折患者,实施分体式髌骨爪内固定进行治疗,回顾分析患者的临床治疗效果。结果50例髌骨骨折患者使用分体式髌骨爪内固定进行治疗,治疗优良率是98%。结论分体式髌骨爪内固定治疗髌骨骨折,不仅操作简单,固定性好,而且手术时间较短,不需要特殊器械的辅助,减少并发症的发生。

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

    Institute of Scientific and Technical Information of China (English)

    危杰; 吴晓亮; 王满宜

    2009-01-01

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

  20. Barriers for progress in salt reduction in the general population. An international study.

    Science.gov (United States)

    Newson, R S; Elmadfa, I; Biro, Gy; Cheng, Y; Prakash, V; Rust, P; Barna, M; Lion, R; Meijer, G W; Neufingerl, N; Szabolcs, I; van Zweden, R; Yang, Y; Feunekes, G I J

    2013-12-01

    Salt reduction is important for reducing hypertension and the risk of cardiovascular events, nevertheless worldwide salt intakes are above recommendations. Consequently strategies to reduce intake are required, however these require an understanding of salt intake behaviours to be effective. As limited information is available on this, an international study was conducted to derive knowledge on salt intake and associated behaviours in the general population. An online cohort was recruited consisting of a representative sample from Germany, Austria, United States of America, Hungary, India, China, South Africa, and Brazil (n=6987; aged 18-65 years; age and gender stratified). Participants completed a comprehensive web-based questionnaire on salt intake and associated behaviours. While salt reduction was seen to be healthy and important, over one third of participants were not interested in salt reduction and the majority were unaware of recommendations. Salt intake was largely underestimated and people were unaware of the main dietary sources of salt. Participants saw themselves as mainly responsible for their salt intake, but also acknowledged the roles of others. Additionally, they wanted to learn more about why salt was bad for health and what the main sources in the diet were. As such, strategies to reduce salt intake must raise interest in engaging in salt reduction through improving understanding of intake levels and dietary sources of salt. Moreover, while some aspects of salt reduction can be globally implemented, local tailoring is required to match level of interest in salt reduction. These findings provide unique insights into issues surrounding salt reduction and should be used to develop effective salt reduction strategies and/or policies. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. 单侧椎弓根螺钉内固定治疗腰椎退行性疾病的研究进展%Progress of unilateral pedicle screw internal fixation for the treatment of lumbar degenerative diseases

    Institute of Scientific and Technical Information of China (English)

    谷金(综述); 梁斌(审校)

    2015-01-01

    Unilateral pedicle screw internal fixation is one of the important means of treatment of lumbar de-generative diseases.It plays an important role on solving the postoperative immediate stability of the lumbar spine, and provide enough rigid internal fixation for intervertebral fusion.This paper expounds the research present situation, advantages, limitations and future research direction of unilateral pedicle screw internal fixation.%单侧椎弓根螺钉内固定是治疗腰椎退行性疾病的重要手段之一,其在解决腰椎术后的即刻稳定性方面起着重要作用,为椎间融合术提供足够刚性内固定。该文对单侧椎弓根螺钉内固定的研究现状、优势、局限性与未来的研究方向进行综述。

  2. Clinical observation of posterior internal fixation with vertebral pedicle screw and rod system on thoracolumbar spine fractures%椎弓根钉棒系统在胸腰椎骨折的疗效分析

    Institute of Scientific and Technical Information of China (English)

    黎华茂; 李敬中; 向峥; 林晓岗

    2012-01-01

    Objective To observe the clinical efficacy of posterior internal fixation of vertebral pedicle screw and rod system for thoracolumbar spine fractures. Methods Totally 59 patients with thoracic or lumbar vertebral fractures were treated with internal fixation of vertebral pedicle screw and rod system. The Frankel scale combined with X ray and CT images was used for the judgment of efficacy. Results Radiographic parameters were significantly improved after the experiment, the Frankel degree of cases with nerve injury symptoms was improved 2-4 degrees after surgery. Conclusions Internal fixation of vertebral pedicle screw and rod system is efficient for thoraco lumbar spine fractures.%目的 观察椎弓根钉棒系统内固定治疗胸腰椎骨折的临床疗效.方法 应用椎弓根钉棒系统内固定治疗胸腰椎骨折59例,采用Frankel分级结合X线片、CT影像表现判断疗效.结果 术后各项影像学指标均有明显改善,患者术后神经功能Frankel分级大多数都有2~4级提高.结论 椎弓根钉棒系统内固定是治疗胸腰椎骨折的一种有效方法,值得临床推广应用.

  3. Reduction gear for a turbo compound drive of a supercharged internal combustion engine. Reduktionsgetriebe fuer einen Turbocompoundantrieb einer aufgeladenen Brennkraftmaschine

    Energy Technology Data Exchange (ETDEWEB)

    Bergmann, H.; Fischer, G.; Bueschel, W.

    1991-01-24

    The invention concerns a