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Sample records for volar locking-plate fixation

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

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    Ozer Kagan

    2010-11-01

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

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

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    Jones, Christopher W; Lawson, Richard D

    2014-02-01

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

  3. 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.

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    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.

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

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    Brown Jaclyn

    2011-09-01

    Full Text Available Abstract Background Fractures of the distal radius are extremely common injuries in adults. However, the optimal management remains controversial. In general, fractures of the distal radius are treated non-operatively if the bone fragments can be held in anatomical alignment by a plaster cast or orthotic. However, if this is not possible, then operative fixation is required. There are several operative options but the two most common in the UK, are Kirschner-wire fixation (K-wires and volar plate fixation using fixed-angle screws (locking-plates. The primary aim of this trial is to determine if there is a difference in the Patient-Reported Wrist Evaluation one year following K-wire fixation versus locking-plate fixation for adult patients with a dorsally-displaced fracture of the distal radius. Methods/design All adult patients with an acute, dorsally-displaced fracture of the distal radius, requiring operative fixation are potentially eligible to take part in this study. A total of 390 consenting patients will be randomly allocated to either K-wire fixation or locking-plate fixation. The surgery will be performed in trauma units across the UK using the preferred technique of the treating surgeon. Data regarding wrist function, quality of life, complications and costs will be collected at six weeks and three, six and twelve months following the injury. The primary outcome measure will be wrist function with a parallel economic analysis. Discussion This pragmatic, multi-centre trial is due to deliver results in December 2013. Trial registration Current Controlled Trials ISRCTN31379280 UKCRN portfolio ID 8956

  5. Locking plate fixation for proximal humerus fractures.

    LENUS (Irish Health Repository)

    Burke, Neil G

    2012-02-01

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

  6. Biomechanical Properties of 3-Dimensional Printed Volar Locking Distal Radius Plate: Comparison With Conventional Volar Locking Plate.

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    Kim, Sung-Jae; Jo, Young-Hoon; Choi, Wan-Sun; Lee, Chang-Hun; Lee, Bong-Gun; Kim, Joo-Hak; Lee, Kwang-Hyun

    2017-09-01

    This study evaluated the biomechanical properties of a new volar locking plate made by 3-dimensional printing using titanium alloy powder and 2 conventional volar locking plates under static and dynamic loading conditions that were designed to replicate those seen during fracture healing and early postoperative rehabilitation. For all plate designs, 12 fourth-generation synthetic composite radii were fitted with volar locking plates according to the manufacturers' technique after segmental osteotomy. Each specimen was first preloaded 10 N and then was loaded to 100 N, 200 N, and 300 N in phases at a rate of 2 N/s. Each construct was then dynamically loaded for 2,000 cycles of fatigue loading in each phase for a total 10,000 cycles. Finally, the constructs were loaded to a failure at a rate of 5 mm/min. All 3 plates showed increasing stiffness at higher loads. The 3-dimensional printed volar locking plate showed significantly higher stiffness at all dynamic loading tests compared with the 2 conventional volar locking plates. The 3-dimensional printed volar locking plate had the highest yield strength, which was significantly higher than those of 2 conventional volar locking plates. A 3-dimensional printed volar locking plate has similar stiffness to conventional plates in an experimental model of a severely comminuted distal radius fracture in which the anterior and posterior metaphyseal cortex are involved. These results support the potential clinical utility of 3-dimensional printed volar locking plates in which design can be modified according the fracture configuration and the anatomy of the radius. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  7. Osteosynthesis with long volar locking plates for meta- physeal-diaphyseal fractures of the distal radius

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    Gogna Paritosh

    2013-12-01

    Full Text Available 【Abstract】Objective: Metaphyseal-diaphyseal fractures of the distal radius are a major treatment dilemma and orthopaedic surgeons have to pay due consideration to restoration of anatomy of distal radius together with ro- tation of the radial shaft and maintenance of radial bow and interosseous space. We performed this study to evaluate the clinic-radiological outcome of metaphyseal-diaphyseal fractures of the distal radius treated with long volar locking plates. Methods: This prospective study involved 27 pa- tients (22 males and 5 females with metaphyseal-diaphy- seal fracture of the distal radius. Their mean age was (30.12± 11.48 years (range 19-52 years and the follow-up was 26.8 months (range 22-34 months. All patients underwent open reduction and internal fixation with a long volar locking plate. According to AO/OTA classification, there were 7 type A3, 13 type C2 and 7 type C3 fractures. Subjective assessment was done based on the disabilities of the arm, shoulder and hand (DASH questionnaire. Functional evaluation was done by measuring grip strength and range of motion around the wrist and the radiological determinants included radial angle, radial length, volar angle and ulnar variance. The final as- sessment was done according to Gartland and Werley scor- ing system. Results: Postoperative radiological parameters were well maintained throughout the trial, and there was signifi- cant improvement in the functional parameters from 6 weeks to final follow-up. The average DASH scores improved from 37.5 at 6 weeks to 4.2 at final follow-up. Final assessment using Gartland and Werley scoring system revealed 66.67% (n=18 excellent and 33.33% (n=9 good results. There was one case of superficial infection which responded to antibi- otics and another carpel tunnel syndrome which was ma- naged conservatively. Conclusion: Volar locking plate fixation for metaphy- seal-diaphyseal fractures of distal radius is associated with excellent to good

  8. Osteosynthesis with long volar locking plates for metaphyseal-diaphyseal fractures of the distal radius

    Institute of Scientific and Technical Information of China (English)

    Paritosh Gogna; Harpal Singh Selhi; Rohit Singla; Mukul Mohindra; Amit Batra; Reetadyuti Mukhopadhyay; Rajesh Rohilla

    2013-01-01

    Objective:Metaphyseal-diaphyseal fractures of the distal radius are a major treatment dilemma and orthopaedic surgeons have to pay due consideration to restoration of anatomy of distal radius together with rotation of the radial shaft and maintenance of radial bow and interosseous space.We performed this study to evaluate the clinic-radiological outcome of metaphyseal-diaphyseal fractures of the distal radius treated with long volar locking plates.Methods:This prospective study involved 27 patients (22 males and 5 females) with metaphyseal-diaphyseal fracture of the distal radius.Their mean age was (30.12±11.48) years (range 19-52 years) and the follow-up was 26.8 months (range 22-34 months).All patients underwent open reduction and internal fixation with a long volar locking plate.According to AO/OTA classification,there were 7 type A3,13 type C2 and 7 type C3 fractures.Subjective assessment was done based on the disabilities of the arm,shoulder and hand (DASH) questionnaire.Functional evaluation was done by measuring grip strength and range of motion around the wrist and the radiological determinants included radial angle,radial length,volar angle and ulnar variance.The final assessment was done according to Gartland and Werley scoring system.Results:Postoperative radiological parameters were well maintained throughout the trial,and there was significant improvement in the functional parameters from 6 weeks to final follow-up.The average DASH scores improved from 37.5 at 6 weeks to 4.2 at final follow-up.Final assessment using Gartland and Werley scoring system revealed 66.67%(n=l8) excellent and 33.33% (n=9) good results.There was one case of superficial infection which responded to antibiotics and another carpel tunnel syndrome which was managed conservatively.Conclusion:Volar locking plate fixation for metaphyseal-diaphyseal fractures of distal radius is associated with excellent to good functional outcome,early rehabilitation and minimal complications.

  9. 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.

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

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    Pathak, Abhishek; Gaur, Sanjiv

    2016-01-01

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

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

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    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.

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

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    Allison K. Tetreault, BA

    2016-12-01

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

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

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

    2016-03-01

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

  14. Osteosíntesis percutánea con placas volares bloqueadas en fracturas metafisarias distales de radio Descripción de la técnica y resultados preliminares. [Percutaneous volar locked plate fixation in metaphyseal fractures of distal radius: technical description and preliminary results].

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    Natalia del Milagro Gutierrez Olivera

    2016-05-01

    Full Text Available Objetivo Evaluar resultados objetivos y subjetivos obtenidos luego de realizar osteosíntesis con placas en T bloqueadas volares, colocadas con técnica mínimamente invasiva, en fracturas del radio distal con extensión metafisaria. Material y Métodos Evaluación retrospectiva de seis pacientes adultos que presentaron fracturas inestables de radio distal, extra-articulares o articulares parciales, con extensión  metafisaria, tratadas quirúrgicamente con placas en T largas de compresión bloqueadas volares, mediante  técnica mínimamente invasiva, entre 2007 y  2012. Edad promedio 40,6 años. Todas las fracturas fueron cerradas, clasificadas como tipo 23A3 (n: 5 y 23B1 (n: 1 según el Sistema AO/ASIF. Se realizó reducción indirecta de la fractura, bajo visión radioscópica, a través de dos pequeñas incisiones se deslizó en forma percutánea una placa bloqueada volar en T. Se analizaron  parámetros radiológicos (angulación volar, inclinación radial y altura radial, el rango de movimiento y la fuerza. Los resultados subjetivos fueron evaluados usando la Escala de DASH y la Escala Visual Análoga. Resultados Tiempo de consolidaron promedio de 2,3 meses. Los resultados radiográficos no mostraron diferencias significativas entre el primer y el último control radiográfico al año de seguimiento. Flexión y extensión promedio 70° y 60°, pronación y supinación 79° y 80° respectivamente. Fuerza de prensión promedio 78,4%. El score de DASH 19,84 puntos y el EVA 1,5 puntos. Conclusión Las técnicas mínimamente invasivas reducen el daño quirúrgico y complicaciones. Son una opción en pacientes con daño severo de partes blandas, conminución metafisaria y trauma de alta energía. Pequeñas incisiones alejadas del sitio de fractura respetan los tejidos blandos y la biología ósea, contribuyendo a lograr la consolidación. La colocación de placas volares bloqueadas percutáneas es un procedimiento técnicamente demandante

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

    Institute of Scientific and Technical Information of China (English)

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

    2016-01-01

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

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

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    Wurm, Simone; Augat, Peter; Bühren, Volker

    2015-09-01

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

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

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

    2014-09-01

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

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

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    Fischer Florian

    2008-10-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2017-03-01

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

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

    Science.gov (United States)

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

    2012-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Takahiro Niikura

    2012-01-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    John Mukhopadhaya

    2017-01-01

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

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

    Science.gov (United States)

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

    2013-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Jaiswal Atin

    2013-12-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  12. 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.

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

    OpenAIRE

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

    2009-01-01

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

  14. Outcomes of pin and plaster versus locking plate in distal radius intraarticular fractures.

    Science.gov (United States)

    Bahari-Kashani, Mahmoud; Taraz-Jamshidy, Mohammad Hosein; Rahimi, Hassan; Ashraf, Hami; Mirkazemy, Masoud; Fatehi, Amirreza; Asadian, Mariam; Rezazade, Jafar

    2013-01-01

    Distal radius fractures are among the most prevalent fractures predictive of probable occurrence of other osteoporotic fractures. They are treated via a variety of methods, but the best treatment has not been defined yet. This study was performed to compare the results of open reduction and internal fixation with locking plates versus the pin and plaster method. In this prospective study, 114 patients aged 40 to 60 years with Fernandez type III fracture referring to Imam-Reza and Mehr hospitals of Mashhad from 2009 to 2011, were selected randomly; after obtaining informed consent, they were treated with pin and plaster fixation (n = 57) or internal fixation with the volar locking plate (n = 57). They were compared at the one year follow up. Demographic features and standard radiographic indices were recorded and MAYO, DASH and SF - 36 tests were performed. Data was analyzed by SPSS software version 13, with descriptive indices, Mann-Whitney and Chi-square tests. SF-36 test demonstrated a better general health (P plaster group. Also, in the LCP group mean MAYO score (P plaster group. Mean DASH score was not different between the groups (P = 0.218). The rate of acceptable results of radiographic indices (P plaster method. In treatment of intra-articular distal radius fractures in middle-aged patients internal fixation with locking plates may be prefered to pin and plaster as the treatment of choice.

  15. 解剖型桡骨掌侧锁定接骨板固定术治疗不稳定性桡骨远端骨折的疗效%Curative efficacy of unstable distal radius fracture treated by anatomic volar locking plate

    Institute of Scientific and Technical Information of China (English)

    纪斌; 曹成福; 成翔宇; 唐桐生; 樊海峰; 庞金辉

    2013-01-01

    目的 探讨解剖型桡骨掌侧锁定接骨板固定术治疗不稳定性桡骨远端骨折的疗效.方法 2010年7月-2012年6月,上海中医院大学附属普陀医院共收治67例不稳定性桡骨远端骨折患者,根据Müller AO分型,A3型11例、B2型4例、B3型2例、C1型15例、C2型23例、C3型12例.所有患者均采用切开复位后行解剖型桡骨掌侧锁定接骨板内固定术,术后定期随访.术后6个月采用Stewart改良的Sarmiento系统和Dienst标准对骨折复位情况和患腕关节功能进行评估.结果 所有患者均获随访,随访时间6~18个月,平均随访时间为(12.6±3.2)个月.X线片显示所有骨折均愈合,平均愈合时间为(8.7±2.4)周.术后6个月,经X线片测量桡骨茎突高度为(10.3±2.1) mm、掌倾角为(8.5±4.2)°、尺偏角为(21.1±4.9)°,均基本恢复正常;采用Stewart改良的Sarmiento系统评估显示复位优良率为95.5%(64/67),采用Dienst标准评估患侧腕关节功能的优良率为92.5%(62/67).结论 采用切开复位后行解剖型桡骨掌侧锁定接骨板内固定术治疗不稳定性桡骨远端骨折可获得较理想的疗效.%Objective To evaluate the radiologic and functional outcomes of internal fixation for unstable distal radius fractures with anatomic volar locking plate.Methods From July 2010 to June 2012,67 patients underwent open reduction and internal fixation with anatomic volar locking plate.These comminuted distal radius fractures included 11 type A3,4 type B2,2 type B3,15 type C1,23 type C2,and 12 type C3,according to the AO/ASIF classification.Fracture reduction and wrist joint function were assessed by Sarmiento criteria modified by Stewart and Dienst scale at 6 months after operation.Results All patients were followed up for (12.6 ±3.2) months (range,6-18 months).X-ray showed that all fractures were healed after (8.7 ± 2.4) weeks.The average height of radial malleolus was (10.3 ± 2.1) mm,the volar inclined angel was (8.5± 4.2)

  16. 计算机仿真技术在桡骨远端骨折掌侧锁定钢板放置定位的作用研究%The Computer Simulation Technology in the Research of Fracture of the Distal Radius Volar Locking Plates Positioned Side

    Institute of Scientific and Technical Information of China (English)

    詹祖锋; 刘晓霞; 胡军; 刘有余

    2015-01-01

    conventional X-ray and CT to calculate the radius and volar plate positioning. Results: compared with two groups of patients with operation of distal radius fractures, fluoroscopy times in observation group, operation time were lower than the control group, there was significant difference, with statistical significance (P<0.05). Conclusion:the technique of computer simulation in the fracture of the distal radius positioning of volar locking plates the effect significantly, compared with the conventional X examination to determine the best method for accurate calculation of the distance between the fracture of the distal radius articular surface and the edge of the hole center, improve the stability of fracture fixation and adaptability, reduce the number of inspection and treatment after dialysis. The clinical advantages of higher, no serious adverse reactions, it is worthy of popularization and application.

  17. Locking plate osteosynthesis of clavicle fractures

    DEFF Research Database (Denmark)

    Fridberg, Marie; Ban, Ilija; Issa, Zaid

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sven Mardian

    2015-01-01

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

  19. The concept of locking plates.

    Science.gov (United States)

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

    2010-05-01

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

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

    Institute of Scientific and Technical Information of China (English)

    叶文斌; 翟文亮; 丁真奇

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    杨志; 陈记明

    2015-01-01

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

  2. Adult periarticular locking plates for the treatment of pediatric and adolescent subtrochanteric hip fractures.

    Science.gov (United States)

    Sanders, Samuel; Egol, Kenneth A

    2009-01-01

    Two cases are presented in which adult, precontoured, lower-extremity periarticular locking plates were utilized for fixation of subtrochanteric femur fractures in pediatric patients. Recognition of the fact that a distal tibial locking plate in a small child and a proximal tibial locking plate in an adolescent anatomically ft the proximal femur in each case may provide a surgeon treating subtrochanteric hip fractures in this population increased options for operative stabilization.

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

    Directory of Open Access Journals (Sweden)

    Ketan Gupta

    2015-02-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Fabio Rodia; Emmanouil Theodorakis; Georgios Touloupakis; Angelo Ventura

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    金大地; 瞿东滨; 陈建庭; 江建明; 王吉兴; 朱青安

    2001-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Aggarwal Sameer

    2010-08-01

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

  7. Unstable Distal Radius Fractures Treated by Volar Locking Anatomical Plates

    Science.gov (United States)

    Jose, Anto; Deniese, Pascal Noel; Babu, Abey Thomas; Rengasamy, Kanagasabai; Najimudeen, Syed

    2017-01-01

    Introduction Fracture of the distal end of radius represents the most common fracture of the upper extremity accounting for 16-20% of all fractures. Plating is now emerging as the gold standard for management of distal radius fractures due to increased rate of complications such as malunion, subluxation/dislocation of distal radio-ulnar joint or late collapse of fracture. Procedures such as closed reduction and cast immobilization, ligamentotaxis with external fixator and percutaneous pin fixation are no longer acceptable. Aim The purpose of the study was to evaluate the functional and radiological outcome of unstable distal radius fractures treated with the volar locking plate. Materials and Methods We reviewed 53 patients from January 2011 to December 2015, treated for unstable distal radius fractures using a volar locking compression plate. Standard radiographic and clinical assessment after 12 months (range 12-16 months) were measured and final functional and radiological outcome were assessed using the Modified Mayo wrist scoring system and Sarmiento’s modification of Lindstorm criteria respectively. Results There were 42 males and 11 females with an average age of 39.12±31.78 years (18-71 years). At the end of 12 months, 36 patients had an excellent radiological outcome and 10 patients had good radiological outcome as per Sarmiento’s modification of Lindstorm criteria. Eleven patients had an excellent functional outcome and 26 patients had a good functional outcome as per modified Mayo wrist scoring system. There was one case of superficial wound infection which subsided with intravenous antibiotics. Conclusion The volar locking plate fixation helps in early mobilization of the wrist, restores anatomy, allows early return to function, prevents secondary loss of reduction and hence is an effective treatment for unstable fractures of the distal radius. PMID:28274009

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

    Directory of Open Access Journals (Sweden)

    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. 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.

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

    Institute of Scientific and Technical Information of China (English)

    熊鹰; 李群辉; 柳百炼; 赵烽; 王大兴; 张仲子

    2012-01-01

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

  11. 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.

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

    Institute of Scientific and Technical Information of China (English)

    齐新文; 王兆杰; 邝立鹏; 陈军平; 俞华威; 安荣泽

    2011-01-01

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

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

    Science.gov (United States)

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

    2010-06-01

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

  14. Reducing Postoperative Fracture Displacement After Locked Plating of Proximal Humerus Fractures: Current Concepts.

    Science.gov (United States)

    Newman, Jared; Kahn, Mani; Gruson, Konrad I

    2015-07-01

    The incidence of proximal humerus fractures in the elderly has been rising. Concomitantly, operative fixation with use of locking plates has been increasing. Postoperative complications of locking plate fixation, particularly in the setting of osteoporotic bone, include screw penetration of the articular surface, progressive fracture displacement, and avascular necrosis. Intraoperative techniques to enhance the fixation construct and reduce complications include use of rotator cuff sutures, bone void fillers (fibular strut allograft, cancellous allograft, autograft, bone cement), appropriate placement of divergent and shorter locking screws, and medial calcar reduction and support. More recent clinical and biomechanical studies suggest that use of these strategies may reduce complications after locked plating of osteoporotic proximal humerus fractures. Furthermore, a multidisciplinary approach to the evaluation and treatment of osteoporosis may be beneficial in these patients.

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

    Directory of Open Access Journals (Sweden)

    Yamashita Toshihiko

    2010-12-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张智长; 王韬; 陆男吉; 罗从风; 曾炳芳

    2011-01-01

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

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

    DEFF Research Database (Denmark)

    Froberg, Lonnie; Troelsen, Anders; Brix, Michael

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Latifi Mohammed

    2012-04-01

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

  19. Treatment of intra-articular distal radius fractures by the volar intrafocal Kapandji method: a case series.

    Science.gov (United States)

    Rubin, Guy; Chezar, Avi; Rinott, Micha; Bor, Noam; Rozen, Nimrod

    2013-06-01

    At present, the most common treatment for intra-articular fractures with a volar fragment is open reduction and internal fixation with a volar locking plate. This manuscript describes and evaluates the safety and efficacy of a modified Kapandji technique with insertion of a volar Kirschner wire for osteosynthesis of intra-articular distal radius fractures with a volar fragment. Four patients treated with the "volar Kapandji technique" completed follow-up of at least 12 (12 to 54) months. The mean age was 43 (23 to 53) years. The mean Disability of the Arm, Shoulder, and Hand score was 21.7 (0 to 41) and the mean Patient-Rated Wrist Evaluation score was 12.9 (0 to 25.8). The mean loss of flexion was 13.7 (0 to 30) degrees, the mean loss of extension was 10 (0 to 30) degrees, the mean loss of supination was 0 degrees, and the mean loss of pronation was 10 (0 to 20) degrees. There was no loss in dorsal angulation, radial inclination, or radial length compared with the other hand. No early or late complications were recorded.

  20. 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。

  1. Complications of the locking plate for displaced proximal humeral fractures

    Institute of Scientific and Technical Information of China (English)

    LU Yi; WANG Man-yi; ZHU Yi-ming; JIANG Chun-yan

    2010-01-01

    Background Although the locking plate has become popular for treating displaced proximal humeral fractures in recent years, the complications of this method are still underestimated. We tried to evaluate the factors that have an influence on the complications experienced after proximal humeral fractures fixed by locking plates and compare the results from patients having complications with those having no complications.Methods From September 2004 to September 2007, 92 out of 111 displaced proximal humeral fractures treated by open reduction and internal fixation with a locking plate were available for follow-up, with an average time of 15.2months (12-36 months). The range of motion, Visual Analog Score (VAS) for pain, American Shoulder and Elbow Surgeons' Form (ASES), Constant-Murley, University of California-Los Angles scoring system (UCLA) score, and Simple Shoulder Test (SST) for function evaluation was all recorded at the latest follow-up. The results from patients with complications were evaluated according to the indices listed above and compared with those patients without any complications.Results There were 17 patients with complications, an 18.5% complication rate. Among them, the forward flexion,external rotation and internal rotation were 139.1°±24.3°, 24.1°±19.6°, and up to T10 level on average. The mean VAS score was 1.0±1.1, the ASES score was 82.9±13.8, the Constant 82.1±11.8, the UCLA 28.5±4.1 and the mean SST 9.5on average. There was no significant difference of complication rate among different age, sex, and injured side, fresh or delayed fracture, combined with other injury or not groups. Compared with the group without complications, patients with complications showed significantly less external rotation and lower Constant-Murley and UCLA functional scores (P <0.05). A significant difference in results was seen between patients with complications and those without complications.Conclusion The indication control and appropriate

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

    Directory of Open Access Journals (Sweden)

    Gupta Rakesh Kumar

    2013-08-01

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

  3. Role of locking plates in treatment of difficult ununited fractures: a clinical study

    Institute of Scientific and Technical Information of China (English)

    Ashok Kumar; Himanshu Gupta; Chandra Shekhar Yadav; Shah Alam Khan; Shishir Rastogi

    2013-01-01

    Objective:To present our experience in treatment of difficult ununited long bone fractures with locking plate.Methods:Retrospective evaluation of locking plate fixation in 10 difficult nonunions of long bone fractures was done.Fixation was done with locking plate for femoral shaft fracture (3 patients),supracondylar fracture of femur (gap nonunion),fracture of clavicle,fracture of both forearm bones (radius and ulna) fracture of ulna,fracture of shaft of humerus,fracture of tibial diaphysis and supracondylar fracture of humerus (one patient each).Five fractures had more than one previous failed internal fixation.One patient had infected nonunion which was managed by debridement with cast immobilization followed by fixation with locking plate at six weeks.Seven fractures were atrophic,two were oligotrophic,and one was hypertrophic.Fibular autograft was used in 2 cases and iliac crest cancellous bone graft used in all the patients.Results:Minimum follow-up was 6 months (range,6 months to 2.5 years).Average rime for union was 3.4 months (range 2.5 to 6 months).None of the patients had platerelated complications or postoperative wound infections.Conclusion:Along with achieving stability with locking compression plate,meticulous soft tissue dissection,acceptable reduction,good fixation technique and bone grafting can help achieve union in difficult nonunion cases.Though locking plate does not by itself ensure bony union,we have found it to be another useful addition to our armamentarium for treating difficult fracture nonunions.

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

    Institute of Scientific and Technical Information of China (English)

    Rakesh Kumar Gupta; Vinay Gupta; Dickey Richard Marak

    2013-01-01

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

  5. 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

  6. OUTCOME OF LOCKING PLATES IN DISTAL TIBIA FRACTURES TREATMENT

    Directory of Open Access Journals (Sweden)

    Lokesh

    2016-05-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    孙强; 郑加法

    2009-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    董必成; 李朝军; 尹东武; 杨利; 白虎荣; 冯文顺; 李小健

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    周君琳; 赵会; 秦永超; 陆铁

    2016-01-01

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

  11. Influence of plate-bone contact on cyclically loaded conically coupled locking plate failure.

    Science.gov (United States)

    Rotne, Randi; Bertollo, Nicky; Walsh, William; Dhand, Navneet K; Voss, Katja; Johnson, Kenneth A

    2014-03-01

    The maintenance of friction between locking plates and bone is not essential, so that they can be applied with a gap between the plate and underlying bone. We hypothesised that the presence of a gap under a locking plate with a conical coupling mechanism would reduce fixation stability or allow uncoupling of the locking screws from the plate. Locking plates with two conically coupled locking screws were applied to 6 pairs of adult canine femora. One of each pair had plate to bone contact and the contralateral construct had a 2 mm plate to bone gap. Constructs were cyclically loaded in cantilever bending with 10 percent incremental increases every 1000 cycles at 2 Hz, starting at 250 N. The constructs were fatigued to failure. To evaluate fatigue life of the conical coupling, testing was repeated with aluminium tubing replacing the bone, to eliminate screw-bone cutout failure. The mean sustained loads and cycles to failure in the contact group (420.80, standard error [SE] 14.97 N; 7612.00, SE 574.70 cycles) were significantly greater than in the gap group (337.50, SE 14.97 N; 4252.00, SE 574.70 cycles), (pplate fatigue and breaking, with one construct having elevation of the plate over the screw head. Elevation of locking plates with a conical coupling system by 2 mm from the bone reduced construct fatigue life but did not result in screw head uncoupling from the plate. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

    Institute of Scientific and Technical Information of China (English)

    周建刚; 孟维春; 曹骏敏; 蒋臻欢

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    孟德强; 刘德昌; 张新潮

    2015-01-01

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

  14. 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...

  15. Surgical Management of 3 and 4-Part Proximal Humerus Fractures with Locking Plates in Elderly

    Directory of Open Access Journals (Sweden)

    Emrah Kovalak

    2017-05-01

    Full Text Available Aim: Proximal humeral fractures are approximately 5% of all fractures and, %15-20 is displaced and unstable. By the introduction of locking plates there used to be a substantial rise in the osteosynthesis of the 3 and 4-part proximal humeral fractures. But there is still a lack of consensus for the optimal treatment of these complex fractures. In this retrospective study, we aimed to evaluate the functional outcomes and prognostic factors of 3 and 4-part proximal humerus fractures treated with locking plate osteosynthesis in elderly. Material and Method: 53 patients with displaced 3 and 4-part proximal humeral fractures treated with locking plate osteosynthesis between 2010 and 2015 were included. The fractures were classified according to Neer classification system. Outcomes were assessed by Constant-Murley scoring system (CMS, visual analog pain scale and plain radiographs. In reference to range of motion, forward elevation and abduction of the arm were measured.Results: No statistically significant differences found between the 3- part and 4- part fractures in CMS, forward elevation and, abduction (p>0.05. Pain was significantly higher in 4-part fractures (p=0.035. CMS, forward elevation, and abduction were inversely correlated with age and delay in surgery. There was statistical significance between the patients had complications and those not in terms of CMS, forward elevation and, abduction (p=0.029, p=0.017 and p=0.024. Discussion: Functional outcomes of locking plate fixation of proximal humerus fractures are associated with patient related factors, fracture pattern, surgeon and, the implant. When indications are carefully selected, locking plate osteosynthesis yield good outcomes in surgical treatment of 3 or 4-part proximal humerus fractures.

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

    Institute of Scientific and Technical Information of China (English)

    郝廷; 王兴国; 李筱贺

    2016-01-01

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

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

    Science.gov (United States)

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

    2009-09-01

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

  18. Locking plates in proximal humerus fractures.

    Science.gov (United States)

    Strohm, P C; Helwig, P; Konrad, G; Südkamp, N P

    2007-12-01

    It is well known that proximal humerus fractures are among the three most frequent fracture types. Epidemiological invetsigations show that in people elder than 60 years the fracture of the proximal humerus is more frequent than fractures of the hip region (17). Over the last decades several techniques have been applied for treatment of proximal humerus fractures. Widely accepted is the initiation of a conservative treatment regimen for undisplaced fractures, however, the standard treatment for displaced fractures, especially three and four part fractures, is still the center of scientific debate. Many different implants have been tested and investigated, thus demonstrating lack of sufficient results. Over the last years the development of angle stable, locking implants started and clinical studies demonstrated encouraging results. In our clinic the locking proximal humerus plate and the PHILOS plate advanced to the implant of choice for treatment of displaced proximal humerus fractures. There are still cases of implant failure and humerus head necrosis, but most of these complications were caused by the fracture type and not an implant specific problem. However the overall results with these new implants are encouraging. Key words: locking plates, proximal humerus fracture, humerus, humerus fracture, PHILOS, PHP.

  19. Missed isolated volar dislocation of the scaphoid

    DEFF Research Database (Denmark)

    Kolby, Lise; Larsen, Søren; Jørring, Stig;

    2007-01-01

    A patient presented with volar dislocation of the scaphoid, the diagnosis of which had been missed for two weeks. He was treated with open reduction through a combined volar and dorsal approach with decompression of the median nerve, internal fixation, and a cast for eight weeks. One year postope...

  20. 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

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

    Institute of Scientific and Technical Information of China (English)

    纪泉; 文良元; 薛庆云; 赵立连; 黄公怡

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    宋建军; 赵春斌; 平少华

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    青祖宏; 刘明; 高巍; 何蔚; 刘杨; 李永焕

    2013-01-01

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

  4. Adult proximal humerus locking plate for the treatment of a pediatric subtrochanteric femoral nonunion: a case report.

    Science.gov (United States)

    Cortes, Luis E; Triana, Miguel; Vallejo, Francisco; Slongo, Theddy F; Streubel, Philipp N

    2011-07-01

    Nonunions of pediatric subtrochanteric femur fractures are exceedingly rare and have to date not been reported in the literature. We present the case of an 11-year-old boy who developed such a nonunion after open reduction internal fixation using a pediatric locked proximal femur plate. Using an adult proximal humerus locking plate, adequate proximal fixation of the nonunion was obtained. Furthermore, previously placed distal screw holes were safely bridged and the biomechanical environment around the nonunion site improved. Uneventful healing was possible with the use of adjuvant bone grafting. No short- or midterm complications occurred. Although other implants can certainly be adapted to a use different than that of its original design, the present case suggests that adult proximal humerus locking plates may be a safe option for revision surgery of the proximal pediatric femur.

  5. 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

  6. 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

  7. Proximal Humeral Fractures: A Biomechanical Comparison of Locking Plate Constructs in a Cadaveric 3-Part Fracture Model

    OpenAIRE

    2010-01-01

    The purpose of our study was to biomechanically compare, under cyclic loading conditions, fracture site motion, humeral head collapse, and intra-articular hardware penetration in simulated 3-part osteoporotic proximal humeral fractures stabilized with 1 of 2 locking-plate constructs. We performed fixation on simulated 3-part proximal humeral fractures in 10 pairs of cadaveric osteoporotic humeri with a Hand Innovations S3 Proximal Humerus Plate (S3 plate) or an LCP Proximal Humerus Plate (LCP...

  8. Development of site-specific locking plates for acetabular fractures.

    Science.gov (United States)

    Xu, Meng; Zhang, Li-Hai; Zhang, Ying-Ze; He, Chun-Qing; Zhang, Li-Cheng; Wang, Yan; Tang, Pei-Fu

    2013-05-01

    Site-specific locking plates have gained popularity for the treatment of fractures. However, the clinical use of a site-specific locking plate for acetabular fractures remains untested due to production limits. To design a universal site-specific locking plate for acetabular fractures, the 3-dimensional (3D) photographic records of 171 pelvises were retrospectively studied to generate a universal posterior innominate bone surface. Using 3D photographical processing software, the 3D coordinate system was reset according to bony landmarks and was scaled based on the acetabular diameter to allow a direct comparison between surfaces. The measured surface was separated into measurement units. At each measurement unit, the authors calculated the average z-axis values in all samples and obtained the 3D coordinate values of the point cloud that could be reconstructed into the universal surface. A plate was subsequently designed in 3D photographical processing software, and the orientation and distribution of locking screws was included. To manufacture a plate, the data were entered into Unigraphics NX version 6.0 software (Siemens PLM Software, Co, Ltd, Plano, Texas) and a CNC digital milling machine (FANUC Co, Ltd, Yamanashi, Japan). The resulting locking plate fit excellently with the reduced bone surface intraoperatively. Plate contouring was avoided intraoperatively. Universal 3.5-mm locking screws locked successfully into the plate, and their orientations were consistent with the design. No screw yielded to acetabular penetration. This method of designing a site-specific acetabular locking plate is practical, and the plates are suitable for clinical use. These site-specific locking plates may be an option for the treatment of acetabular fractures, particularly in elderly patients.

  9. 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

  10. 解剖型锁定加压钢板与人工肱骨头置换治疗肱骨近端骨折的效果比较%Effect comparison between anatomical locking plate fixation and humeral head replacement in the treatment of proximal humerus fractures

    Institute of Scientific and Technical Information of China (English)

    郑创义

    2015-01-01

    目的:比较解剖型锁定加压钢板与人工肱骨头置换治疗肱骨近端骨折的疗效。方法选取本院骨科2005年1月~2014年3月收治的肱骨近端骨折患者45例,根据手术方法将患者分为内固定术组(n=27)和肱骨头置换术组(n=18)。内固定术组给予骨折切开复位、解剖型锁定加压钢板固定,肱骨头置换术组给予人工肱骨头置换方法治疗。术后定期复查X线片,了解并发症发生情况。同时在末次复诊时按照Constant-Murley肩关节评分标准进行功能评分。结果术后随访8~36个月,平均18个月。内固定术组中的主要并发症是肱骨头坏死(6例)、骨折畸形愈合(7例)和骨性关节炎(2例);肱骨头置换术组的并发症是大结节、小结节(或两者均有之)骨质吸收(6例)、关节不稳定(1例)、异位骨化(1例)。内固定组的并发症发生率(55.6%)显著高于肱骨头置管术组(44.4%)(P<0.05),优良率(77.8%)显著高于肱骨头置换组(66.7%)(P<0.05),Constant-Murley评分显著高于肱骨头置换组(P<0.05)。结论解剖型锁定加压钢板治疗肱骨近端骨折的疗效优于人工肱骨头置换,值得临床推广。%Objective To compare the therapeutic effects of anatomical locking plate fixation (ALPF) and humeral head replacement (HHR) on proximal humerus fractures. Methods 45 patients with proximal humerus fractures at the ortho-pedics department in our hospital from January 2005 to March 2014 were selected and divided into ALPF group (n=27) and HHR group (n=18) based on operation methods.ALPF group were received anatomical proximal humeral locking plate fixation,while HHR group underwent humeral head replacement. X-rays was regularly reviewed after surgery to e-valuate complications,and Constant-Murley score system was used to assess the shoulder joint function at the last re-turn visit. Results All patients were followed up for 8

  11. Use of a Proximal Humeral Locking Plate for Complex Ankle and Hindfoot Fusion.

    Science.gov (United States)

    Shearman, Alexander D; Eleftheriou, Kyriacos Iordanis; Patel, Akash; Pradhan, Rajib; Rosenfeld, Peter Francis

    2016-01-01

    Arthrodesis of the ankle and hindfoot in the setting of major deformity is challenging and associated with substantial risks. Patients often have significant comorbidities that lead to unforgiving soft tissues, poor vascularity, and poor bone quality. This creates the high-risk scenario of poor wound healing and poor implant fixation. Complications can be devastating, leading to loss of the limb and sepsis. The use of locking plate technology might provide biomechanical and operative technique advantages in such patients. We retrospectively assessed the results of the modified use of the PHILOS(™) (Synthes(®), Zuchwil, Switzerland) proximal humeral locking plate in 21 patients (11 males, 10 females; mean age 56.1 years, range 25 to 74 years) who had undergone complex fusions, including tibiotalar (n = 4), tibiocalcaneal (n = 7), or tibiotalocalcaneal (n =10) fusions. The average follow-up period was 14.6 (median 10, range 6 to 49) months. Of the 21 fusions, 18 achieved union (85.7%) at an average period of 4.8 (median 4.3, range 3 to 12) months. The overall deep infection rate was 14.3%. Overall, 17 of the 21 patients (81%) were satisfied with the result (good to excellent), 1 reported the result was fair (4.8%), and 3 patients developed nonunion and were dissatisfied with the procedure (14.3%). The present study is the largest series to date of patients undergoing complex ankle and hindfoot arthrodesis with the use of a proximal humeral locking plate and confirms previous findings that the technique is reliable with union, satisfaction, and complication rates comparable to those of other techniques.

  12. OPERATIVE MANAGEMENT OF INTRA-ARTICULAR DISTAL HUMERAL FRACTURES WITH LOCKING PLATES

    Directory of Open Access Journals (Sweden)

    Abhilekh

    2015-11-01

    Full Text Available BACKGROUND: Intra-articular distal humeral fractures are common, but complex elbow injuries. To obtain good results, anatomical reduction with rigid fixation and early range of mobilization is required. Treatment of these fractures with conventional plates is associated with many complications such as non-anatomic reduction of articular surfaces, malunion, non-union, loosening of implant, residual stiffness of the elbow and post-traumatic osteoarthrosis. In this situation the application of locking plates having a fixed angle plate screw construct can minimise most of the above complications. OBJECTIVE: To evaluate radiological and functional outcome of locking plate application for the management of intra-articular distal humeral fractures. MATERIAL AND METHODS: This prospective study was conducted from January 2013 to December 2014. We operated 20 patients of AO type-C intra-articular distal humeral fractures. Fracture was exposed using modified Campbell’s posterior approach in less comminuted fractures and a V-shaped Olecranon osteotomy was done to get better exposure of the articular surface in cases with severe articular comminution. The fracture was stabilized using an intercondylar screw, pre-contoured locking compression plates and/or locking reconstruction plates as per preoperative planning. Patients were reviewed at monthly interval for clinical-radiological evaluation. Final outcome measures included radiological assessment, range of motion and Mayo elbow performance score (MEPS. RESULTS: All the fractures were united at an average 12 weeks. Two patients developed numbness in the distribution of ulnar nerve and one patient developed superficial infection in immediate postoperative period. None of the patients had malunion and loosening of implant. The average arc of flexion-extension was 105`, although no patient had loss of supination/pronation. Mayo Elbow Performance Score was excellent in 15 (75%, good in 3 (15%, fair in 1 (5

  13. Comparison between two angular stable locking plates for medial opening-wedge high tibial osteotomy: Decisive wedge locking plate versus TomoFix™.

    Science.gov (United States)

    Shin, Young-Soo; Kim, Keong-Ho; Sim, Hyun-Bo; Yoon, Jung-Ro

    2016-11-01

    An adequate stable fixation implant should be used for medial opening-wedge high tibial osteotomy (MOWHTO) to promote rapid bone healing without complications. This study compared the radiographic and clinical outcomes as well as plate-specific complications between two angular stable locking plates in patients following MOWHTO. This prospective study involved 97 patients (50 with DWL(®), group I; 47 with TomoFix™, group II) undergoing MOWHTO for primary medial compartment osteoarthritis between 2010 and 2013. Clinical and radiographic evaluations were performed by using the HSS and WOMAC scores, and calculating mechanical femorotibial angle (mFTA), medial proximal tibial angle (MPTA), joint line convergence angle (JLCA), and posterior tibial slope (PTS) on radiographs both preoperatively and after 3 years. A statistically significant difference was observed for the MPTA at the last follow-up between the two groups (P = 0.033). Additionally, the last follow-up MPTA of group I was associated with the osteotomy technique (P = 0.004) and preoperative JLCA (P = 0.034) whereas the last follow-up MPTA of group II was associated with gender (P = 0.001) and BMI (P = 0.008). Furthermore, the results showed that group I had a higher rate of non-union (4%) compared to that in group II (0%). Both locking plates are useful tools in the treatment of medial compartment knee osteoarthritis with varus deformity in young, active patients. However, under special consideration of the complication we found in present study, the TomoFix™ seems to be a better alternative in using the MOWHTO for highly demanding patients. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  14. Notch sensitivity jeopardizes titanium locking plate fatigue strength.

    Science.gov (United States)

    Tseng, Wo-Jan; Chao, Ching-Kong; Wang, Chun-Chin; Lin, Jinn

    2016-12-01

    Notch sensitivity may compromise titanium-alloy plate fatigue strength. However, no studies providing head-to-head comparisons of stainless-steel or titanium-alloy locking plates exist. Custom-designed identically structured locking plates were made from stainless steel (F138 and F1314) or titanium alloy. Three screw-hole designs were compared: threaded screw-holes with angle edges (type I); threaded screw-holes with chamfered edges (type II); and non-threaded screw-holes with chamfered edges (type III). The plates' bending stiffness, bending strength, and fatigue life, were investigated. The stress concentration at the screw threads was assessed using finite element analyses (FEA). The titanium plates had higher bending strength than the F1314 and F138 plates (2.95:1.56:1) in static loading tests. For all metals, the type-III plate fatigue life was highest, followed by type-II and type-I. The type-III titanium plates had longer fatigue lives than their F138 counterparts, but the type-I and type-II titanium plates had significantly shorter fatigue lives. All F1314 plate types had longer fatigue lives than the type-III titanium plates. The FEA showed minimal stress difference (0.4%) between types II and III, but the stress for types II and III was lower (11.9% and 12.4%) than that for type I. The screw threads did not cause stress concentration in the locking plates in FEA, but may have jeopardized the fatigue strength, especially in the notch-sensitive titanium plates. Improvement to the locking plate design is necessary. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Repositioning and stabilization of the radial styloid process in comminuted fractures of the distal radius using a single approach: the radio-volar double plating technique

    OpenAIRE

    Jacobi Matthias; Wahl Peter; Kohut Georges

    2010-01-01

    Abstract Background A possible difficulty in intra-articular fracture of the distal radius is the displacement tendency of the radial styloid process due to the tension of the brachioradialis tendon. Methods Ten patients treated within one year for complex distal radius fractures by double-plating technique with a radial buttress plate and volar locking plate, through a single volar approach, were followed prospectively during 24 months. Outcome measures included radiographic follow-up, range...

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

    Institute of Scientific and Technical Information of China (English)

    赖金平; 冯虹; 赵敏; 夏远军

    2015-01-01

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

  17. FINITE ELEMENT STRUCTURAL & THERMAL ANALYSIS OF LOCK PLATE

    OpenAIRE

    Mr. Ketan Patil; Mr. Roshan Marode; Prof. V. M. Chidri; Prof. A.J. Keche

    2012-01-01

    In Centrifugal Pipe Casting machine, hot molten metal is injected from one end and the other end remains closed by a covering plate having standard dimension. This covering plate is locked by a worker with the help of a spanner. This covering plate again needs to be opened after completion of casting process for the extraction of the pipe from the mould. This paper discuss mainly focused on the analysis of locking plate and its new design so that the humaninterference must be reduced to highe...

  18. Outcomes evaluation of locking plate osteosynthesis in displaced fractures of the proximal humerus

    Directory of Open Access Journals (Sweden)

    Mauro Emilio Conforto Gracitell

    2013-12-01

    Full Text Available Objective: To evaluate functional outcomes, radiographic findings and complications of proximal humeral fractures treated with locking plates and to determine prognostic factors for successful clinical outcomes. Methods: Forty patients undergoing internal fixation of fractures of the proximal humerus with the Philos(r plate were included in the study. The surgeries were performed between 2004 and 2011 and the patients underwent radiographic and clinical evaluation, by Constant -Murley and Dash score. Outcomes were analyzed by use of multivariate regression with several different variables. Results: Patients were on average of 61.8 ± 16.28 years, and most were female (70%. The Constant -Murley score was 72.03 ± 14.01 and Dash score was 24.96 ± 19.99. The postoperative radiographs showed a head-shaft angle of 135.43º± 11.82. Regression analysis showed that the patient's age and the Hertel classification influenced the Constant -Murley scale (p = 0.0049 and 0.012, respectively. Other prognostic criteria such as Neer and AO classification, head-shaft angle, the presence of metaphyseal comminution and extension of the humeral metaphyseal fragment showed no effect on prognosis. Complications occurred in four patients (10%. Conclusion: The fixation with the Philos(r plate provided good clinical and radiographic results in fractures of the proximal humerus, with a low complication rate. Patient's age and Hertel classification were defined as prognostic factors that led to worse functional outcomes.

  19. Biomechanical evaluation of Caspar and Cervical Spine Locking Plate systems in a cadaveric model.

    Science.gov (United States)

    Clausen, J D; Ryken, T C; Traynelis, V C; Sawin, P D; Dexter, F; Goel, V K

    1996-06-01

    There exist two markedly different instrumentation systems for the anterior cervical spine: the Cervical Spine Locking Plate (CSLP) system, which uses unicortical screws with a locking hub mechanism for attachment, and the Caspar Trapezial Plate System, which is secured with unlocked bicortical screws. The biomechanical stability of these two systems was evaluated in a cadaveric model of complete C5-6 instability. The immediate stability was determined in six loading modalities: flexion, extension, right and left lateral bending, and right and left axial rotation. Biomechanical stability was reassessed following fatigue with 5000 cycles of flexion-extension, and finally, the spines were loaded in flexion until the instrumentation failed. The Caspar system stabilized significantly in flexion before (p < 0.05) but not after fatigue, and it stabilized significantly in extension before (p < 0.01) and after fatigue (p < 0.01). The CSLP system stabilized significantly in flexion before (p < 0.01) but not after fatigue, and it did not stabilize in extension before or after fatigue. The moment needed to produce failure in flexion did not differ substantially between the two plating systems. The discrepancy in the biomechanical stability of these two systems may be due to differences in bone screw fixation.

  20. Congruency of scapula locking plates: implications for implant design.

    Science.gov (United States)

    Park, Andrew Y; DiStefano, James G; Nguyen, Thuc-Quyen; Buckley, Jenni M; Montgomery, William H; Grimsrud, Chris D

    2012-04-01

    We conducted a study to evaluate the congruency of fit of current scapular plate designs. Three-dimensional image-processing and -analysis software, and computed tomography scans of 12 cadaveric scapulae were used to generate 3 measurements: mean distance from plate to bone, maximum distance, and percentage of plate surface within 2 mm of bone. These measurements were used to quantify congruency. The scapular spine plate had the most congruent fit in all 3 measured variables. The lateral border and glenoid plates performed statistically as well as the scapular spine plate in at least 1 of the measured variables. The medial border plate had the least optimal measurements in all 3 variables. With locking-plate technology used in a wide variety of anatomical locations, the locking scapula plate system can allow for a fixed-angle construct in this region. Our study results showed that the scapular spine, glenoid, and lateral border plates are adequate in terms of congruency. However, design improvements may be necessary for the medial border plate. In addition, we describe a novel method for quantifying hardware congruency, a method that can be applied to any anatomical location.

  1. Locking plate osteosynthesis in displaced 4-part fractures of the proximal humerus

    DEFF Research Database (Denmark)

    Brorson, Stig; Frich, Lars H; Winther, Annika;

    2011-01-01

    There is considerable uncertainty about the optimal treatment of displaced 4-part fractures of the proximal humerus. Within the last decade, locking plate technology has been considered a breakthrough in the treatment of these complex injuries....

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

    Science.gov (United States)

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

    2017-05-01

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

  3. Analysis of amelioration of neurological function on cervical degeneration disease after treatment with cervical spine locking plate%颈椎带锁钢板内固定术对颈椎退变性疾病神经功能改善的分析

    Institute of Scientific and Technical Information of China (English)

    赖志军; 谢惠缄; 谢唏衷; 肖建如

    2002-01-01

    Objective To discuss the clinical effect of treatment with anterior decompression, bone graft and cervical locking plate fixation for cervical degeneration disease.Method 23 patients with cervical spondylotic myelopathy and cervical ossification of the posterior longitudinal ligament have undergone the treatment of anterior cervical spine locking plate fusion.Neurological signs and symptoms were evaluated before and after surgery, and mean follow up time was 11.3 months.Result In all cases,radiography demonstrated a solid bony fusion.Additional general complications include a large wound hematoma in one and hoarseness in one.All patients' neurological function were improved.Conclusion The clinical effect of treatment with anterior decompression, bone graft and cervical locking plate fixation for cervical degeneration disease is satisfactory.

  4. Additive fiber-cerclages in proximal humeral fractures stabilized by locking plates: no effect on fracture stabilization and rotator cuff function in human shoulder specimens.

    Science.gov (United States)

    Voigt, Christine; Hurschler, Christof; Rechi, Louise; Vosshenrich, Rolf; Lill, Helmut

    2009-08-01

    The effect of additive fiber-cerclages in proximal humeral fractures stabilized by locking plates on fracture stabilization and rotator cuff function is unclear. Here it was assessed in a human cadaver study. 24 paired human shoulder specimens were harvested from median 77-year-old (range 66-85) female donors. An unstable 3-part fracture model with an intact rotator cuff was developed. 1 specimen of each pair received an additive fiber-cerclage of the rotator cuff after plate fixation, and the other one received a plate fixation without an additive fiber-cerclage. Force-controlled hydraulic cylinders were used to simulate physiological rotator cuff tension, while a robot-assisted shoulder simulator performed 4 relevant cases of load: (1) axial loading at 0 degrees, (2) glenohumeral abduction at 60 degrees, (3) internal rotation at 0 degrees abduction, and (4) external rotation at 0 degrees abduction, and imitated hanging arm weight during loading without affecting joint kinematics. A 3-dimensional real-time interfragmentary motion analysis was done in fracture gaps between the greater tuberosity and the head, as well as subcapital. The capacity of the rotator cuff to strain was analyzed with an optical system. Interfragmentary motion was similar between the groups with and without fiber-cerclages, in both fracture gaps and in any of the cases of load. Cerclages did not impair the capacity of the rotator cuff to strain. INTERPRETATION; Provided that unstable 3-part fractures are reduced and stabilized anatomically by a locking plate, additive fiber-cerclages do not reduce interfragmentary motion. Additive fiber-cerclages may be necessary in locking plate osteosyntheses of multiple-fractured greater tuberosities or lesser tuberosity fractures that cannot be fixed sufficiently by the plate.

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  6. Proximal humeral fractures: a biomechanical comparison of locking plate constructs in a cadaveric 3-part fracture model.

    Science.gov (United States)

    Rose, David M; Sutter, Edward G; Mears, Simon C; Gupta, Rohit R; Belkoff, Stephen M

    2010-11-01

    The purpose of our study was to biomechanically compare, under cyclic loading conditions, fracture site motion, humeral head collapse, and intra-articular hardware penetration in simulated 3-part osteoporotic proximal humeral fractures stabilized with 1 of 2 locking-plate constructs. We performed fixation on simulated 3-part proximal humeral fractures in 10 pairs of cadaveric osteoporotic humeri with a Hand Innovations S3 Proximal Humerus Plate (S3 plate) or an LCP Proximal Humerus Plate (LCP plate; 1 each for each pair). The specimens were potted, mounted on a materials testing machine, and subjected to 5000 cycles of abduction in the scapular plane, loading through the supraspinatus tendon. Interfragmentary displacement at 2 virtual points (the most medial aspect of the calcar and the most superior aspect of the osteotomy line between the greater tuberosity and humeral head) was measured using an optical tracking system. Humeral head rotation was also measured. We used a generalized linear latent and mixed model to check for an effect of cyclic loading and treatment on the parameters of interest (significance, P fracture site motion, it is unknown whether the magnitude of the motion is clinically significant.

  7. 颈椎前路锁定钢板治疗颈椎疾病的疗效观察%Effectiveness of Anterior Cervical Locking Plate System in Cervical Surgery

    Institute of Scientific and Technical Information of China (English)

    任云峰; 熊鹰; 赵烽; 张仲子

    2011-01-01

    目的 观察颈椎前路减压、取髂骨植骨结合锁定型钢板系统内固定治疗颈椎疾病的临床疗效.方法 2001年3月至2008年3月采用该方法治疗颈椎疾病34例,并进行12 ~24个月后随访.结果 术前Frankel分级A-D级31例中,25例有1 ~2级的改善,6例无明显改善.植骨块融合良好,无严重并发症发生.结论 该方法具有固定牢靠、植骨融合率高、手术操作简单、手术并发症少等优点,是一种治疗颈椎疾病的良好方法.%Objective To evaluate the effectiveness of anterior decompression, bone grafting combined with locking plate system internal fixation for cervical spinal desease.Methods From March 2001 to March 2008 34 patients were operated with anterior decompression, bone grafting and locking plate system fixation, all the patients were followed up for 12 to 24 months.Results 25 patients of Frankel's A-D were improved by to 2 degree after operation,6 patients had no obvious improvement.There was no plate or screw breaking and loosening; no dislocation of graft bone, all the bones were fusion in 6 months.Conclusion Anterior decompression , bone grafting combined with locking plate system internal fixation can provide reliable stability for the fixation segments with higher bony fusion rate,less complications,and the operation was much simple and safe.It was a good choice for treatment of cervical spinal disease.

  8. 股骨近端外侧锁定钢板治疗Russell-Taylor Ⅱ型股骨转子下骨折%Femoral subtrochanteric fractures treated with proximal lateral femur locking Plate

    Institute of Scientific and Technical Information of China (English)

    胡孙君; 陈舰; 陈杰; 俞光荣; 张世民

    2012-01-01

    目的 探讨股骨近端外侧锁定钢板治疗股骨转子下骨折的治疗效果.方法 对28例Russell-Taylor Ⅱ型股骨转子下骨折患者采用股骨近端外侧锁定钢板固定.结果 28例均获得随访,时间10~24个月.根据髋关节Harris评分:优13例,良10例,中5例.结论 股骨近端外侧锁定钢板治疗股骨转子下骨折可以达到可靠的固定效果,骨折愈合较快,短期临床疗效良好.%Objective To study the outcome of subtrochanteric hip fractures treated by proximal lateral femur locking plate. Methods 28 elder patients with subtrochanteric hip fractures were treated with proximal lateral femur locking plate. Results All patients were followed up for 10 ~24 months. According to Hams index, there were 13 excellent cases, f 0 good and 5 fair. Conclusions The proximal lateral femur locking plate is the kind of stable and effective internal fixation of treating subtrochanteric hip fractures, and the clinical outcome is satisfied.

  9. 重建锁定接骨钢板治疗肩胛骨骨折的临床效果观察%Observation of clinical effect by reconstruction locking plate in the treatment of scapular fracture

    Institute of Scientific and Technical Information of China (English)

    魏树刚

    2015-01-01

    ObjectiveTo research and analyze clinical effect by reconstruction locking plate in the treatment of scapular fracture.MethodsA total of 68 scapular fracture patients were randomly divided into reconstruction fixation group and locking fixation group, with 34 cases in each group. The reconstruction fixation group received reconstruction locking plate for treatment, and the locking fixation group received T-type locking titanium plate internal fixation. Curative effects of the two groups were recorded and compared.ResultsThe reconstruction fixation group had total effective rate as 97.06%, and the locking fixation group had that as 70.59%. The reconstruction fixation group had obviously higher total effective rate than the locking fixation group, and their difference had statistical significance (P<0.05).ConclusionReconstruction locking plate provides precise effect in treating scapular fracture, and it is worthy of clinical promotion.%目的:研究分析采用重建锁定接骨钢板技术治疗肩胛骨骨折的临床效果。方法68例肩胛骨骨折患者随机分为重建固定组和锁定固定组,各34例。其中重建固定组给予重建锁定接骨钢板治疗,锁定固定组给予T型锁定钛板内固定治疗,分别记录两组患者的治疗效果,并比较。结果重建固定组总有效率为97.06%,锁定固定组总有效率为70.59%,重建固定组总有效率明显高于锁定固定组,差异具有统计学意义(P<0.05)。结论重建锁定接骨钢板技术治疗肩胛骨骨折效果明显,值得临床推广。

  10. Treatment of distal clavicle fracture with distal radius volar locking compression plate

    Institute of Scientific and Technical Information of China (English)

    YU Chao; SUN Yue-hua; ZHAO Chang-qing; SHI Ding-wei; WANG You

    2009-01-01

    Objective: To observe the early clinical outcomes of the internal fixation with distal radius volar locking compression plate (LCP) in treatment of distal clavicle fracture.Methods: Six patients with unilateral distal clavicle fractures, identified as type Ⅱ according to Neer classification system, including 4 males and 2 females, were treated with open reduction and internal fixation using a distal radius volar LCP. Bone union was evaluated by routine X-ray radiography, and shoulder joint function were assessed by Constant score system.Results: All fractures achieved bone union at 6 to 8 weeks postoperatively, and Constant scores ranged from 95 to 100 at the postoperative 10 to 12 weeks.Conclusion: Fixation of distal clavicle fracture with distal radius volar LCP demonstrates excellent effects of bone union with rarely early complications, thus providing a new technique to treat distal clavicle fracture.

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

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Tenor Junior

    2016-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Wen Zhang

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

  13. 应用锁定钢板治疗股骨转子间骨折%Treatment of intertrochanteric fracture with proximal femoral lock plate

    Institute of Scientific and Technical Information of China (English)

    李志洲; 徐衍斌; 王再欣; 于欣; 周凤吉; 季晓风

    2012-01-01

    Objective To evaluate retrospectively the effect for treatment of intertrochanteric comminuted fracture with lock plate. Methods A retrospective analysis was conduced to investigate 237 cases of intertrochanteric comminuted fracture which were treated with femoral lock plate from April 2007 to February 2010 , we evaluated the bone union time and hip function of the 210 patients whom were well followed up for average 12.5months (from 6 to 34months). Results This operation is easy to manage, with the advantage of stable fixation, the average union time was 21 weeks (range 12 to 32 weeks). Superficial vein thrombosis in 12 cases, decubitus ulcer in 3 cases, pneumonia in 4 cases, varus deformation in 2 cases were found, 10 patients were changed to hip arthroplasty surgery. The end results were 161 excellent, 18 good, based on Harris hip scale. Conclusion Excellent clinical effects can be achieved if the patients are treated correctly, femoral lock plate may be a better option for the treatment of intertrochanteric comminuted fracture.%目的 回顾分析锁定钢板治疗股骨转子间粉碎性骨折疗效.方法 2007 年4 月~ 2010年2月应用锁定钢板治疗237 例转子间粉碎性骨折患者,回顾分析其中210 例获得随访患者临床疗效,平均随访12.5 个月( 6~34月),观察骨折愈合时间,髋关节功能恢复情况.结果 平均骨折愈合时间21周(12~32 周),发生浅静脉血栓12例,褥疮3例,肺内感染4例,髋内翻2 例,改行人工关节置换10例.按照Harris 评分髋关节功能优161 例,良18 例,可19例,差12 例.结论 应用锁定钢板治疗转子间粉碎性骨折,手术操作简单,固定稳定,能够获得良好的临床疗效,是治疗转子间粉碎性骨折的较好选择.

  14. Interface contact profiles of a novel locking plate and its effect on fracture healing in goat

    Institute of Scientific and Technical Information of China (English)

    WEI Da-cheng; ZHAO Yu-feng; XING Shu-xing; WANG Ai-min

    2010-01-01

    Objective: To evaluate the interface characteristics of the new-designed locking plate (LP) and limited contact-dynamic compression plate (LC-DCP) and compare the fracture healing between LP and LC-DCP in a goat tibia fracture model.Methods: Eight-hole LP and LC-DCP were applied to fix flesh goat tibiae in a reproducible manner. The average pressure, force and interface contact area were calculated using Fuji prescale pressure sensitive film interposed among the plate and the bone and image analysis system. Eighthole LP and LC-DCP were applied to each tibia in a goat tibia fracture model. The fracture healing was evaluated by X-ray photography at postoperative 8 weeks. The goats were sacrificed at postoperative 12 weeks. Three-point bending test was conducted in the tibiae.Results: The interface contact of LP system was smaller than that ofLC-DCP (P<0.05), while interface contact force of LP system was higher than that of LC-DCP (P<0.05). Radiographs revealed that the fracture line disappeared in the LP group, while the fracture line was visible in DCP group at postoperative 8 weeks. At postoperative 12 weeks, the bending strength and bending load of fractured tibia were higher in LP group than in DCP group, respectively.Conclusion: The new-designed locking plate can significantly decrease the contact area on the bone interface,which further provides better fracture healing than conventional plates.

  15. Proximal femoral locking plate treatment of intertrochanteric fractures in older adults%股骨近端锁定板治疗老年人股骨粗隆间骨折

    Institute of Scientific and Technical Information of China (English)

    田学林; 朱冬承

    2014-01-01

    目的:探讨股骨近端锁定板治疗老年人股骨粗隆间骨折的疗效。方法选取我院老年人股骨粗隆间骨折患者88例为研究对象,对照组采取常规内固定,观察组采取股骨近端锁定板内固定,比较两组疗效。结果观察组治疗总有效率为95.45%;对照组治疗总有效率为68.18%。结论股骨近端锁定板治疗老年人股骨粗隆间骨折具有很好的临床效果,能有效促进患者恢复,提高其生活质量。%Objective To explore the proximal femoral locking plate curative effect for the treatment of intertrochanteric fractures in older adults. Methods Selected from 88 cases of patients with intertrochanteric fractures in older adults as the research object,control group,take regular internal fixation group take the proximal femoral locking plate internal fixation,compared two groups of therapeutic effect. Results Observation treatment group the total effective rate was 95.45%; The control group total effective rate was 68.18%. Conclusion Proximal femoral locking plate treatment of intertrochanteric fractures in older adults have very good clinical effect,can effectively promote the patient recover,improve the quality of life.

  16. A case of acute trans-scaphoid volar dislocation of the lunate into the distal forearm

    Institute of Scientific and Technical Information of China (English)

    Mohamed Al Khayarin; Mohamed Al Ateeq Al Dosari; Shibly Abdul Basith; Mohammed Waseemuddin

    2016-01-01

    Trans-scaphoid volar dislocation of the lunate with displacement into the distal forearm proximal to the radiocarpal joint is an extremely rare, high energy injury with extensive ligament disruption. They are unstable and require open reduction and internal fixation with repair of ligaments. They are associated with significant morbidity and loss of function. We report the case of a patient with this injury. Open reduction, internal fixation and ligament repair were done. The patient had a good functional outcome.

  17. Galeazzi fracture with volar dislocation of the distal radioulnar joint.

    Science.gov (United States)

    Kim, Suezie; Ward, James P; Rettig, Michael E

    2012-11-01

    Galeazzi fracture dislocations are fractures of the distal one-third of the radial diaphysis with traumatic disruption of the distal radioulnar joint (DRUJ). This injury results in subluxation or dislocation of the ulnar head. We present a case of a Galeazzi fracture with a volar dislocation of the DRUJ. Open reduction of the DRUJ with Kirschner wire fixation in pronation was necessary to reduce the joint and maintain anatomic alignment. Repair of the triangular fibrocartilage complex was also necessary to maintain stability of the DRUJ.

  18. Extraarticular proximal tibial fractures repaired with multifunctional locking intramedullary nail and locking plate Extraarticular proximal tibial fractures repaired with multifunctional locking intramedullary nail and locking plate%多功能带锁髓内钉和钢板置入内固定修复关节外胫骨创伤性骨折

    Institute of Scientific and Technical Information of China (English)

    陈德明; 徐晓阳; 王蔚; 张力; 常乐

    2016-01-01

    BACKGROUND: Many researchers at home and abroad think that interlocking intramedul ary nails may be more suitable for comminuted fractures of the tibia with severe soft tissue injury. Plate fixation is more advantageous for distal tibial fractures. OBJECTIVE: To compare the effects of multifunctional locking intramedul ary nail and locking plate in treatment of extraarticular proximal tibial fractures. METHODS: 156 patients with extraarticular proximal tibial fractures were included and divided into intramedul ary nail group (n=78) and the locking plate group (n=78) according to repair method. Curative effects and healing time were compared between the two groups. At 3 months after treatment, Johner-Wruh tibial fracture scores were used to assess the repair effect in both groups. In addition, operation time, blood loss, healing time and complications were compared between the two groups.RESULTS AND CONCLUSION: Mean healing time was 9.3 months in the locking plate group and 9.2 months in the intramedul ary nail group. At 3 months after treatment, the repair effect was significantly better in the intramedul ary nail group than in the locking plate group (P < 0.05). Blood loss and time were less in the intramedul ary nail group than in the locking plate group (P < 0.05), and surgical difficulty was high. At 3 months after treatment, the incidence rates of tibia eversion/inversion, neurovascular injury and nonunion/infection were significantly lower in the intramedul ary nail group than in the locking plate group (P < 0.05). These findings confirmed that the multifunctional locking intramedul ary nailing for extraarticular proximal tibial fractures obtained reliable efficacy, exact effect, reduced blood loss and low incidence of complications. Thus, it is better than locking plate.%背景:国内外多数学者认为带锁髓内钉可能更适合于粉碎性且软组织损伤严重的胫骨骨折,而钢板内固定则对于胫骨远端骨折更有优势。目的:

  19. Multiple volar dislocations of the carpometacarpal joints with an associated fracture of the first metacarpal base

    Institute of Scientific and Technical Information of China (English)

    Latif Zafar Jilani; Mazhar Abbas; Siddharth Goel; Mohammad Nasim Akhtar

    2014-01-01

    Multiple volar dislocations of carpometacarpal (CMC) joints are uncommon and have been reported rarely.A 25 years old male presented with injury to his left hand 6 days following a road traffic accident.Clinical examination revealed gross swelling of the hand and diffuse tenderness over the carpometacarpal area.His radiographs of the hand showed volar dislocation of the second,third and fourth CMC joints in association with an extra-articular fracture of the base of thumb metacarpal.He was treated by open reduction and percutaneous fixation using Kirschner wires.The functional results were excellent at one year follow-up.

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

    Directory of Open Access Journals (Sweden)

    Ahmed

    2013-05-01

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

  1. Open-wedge high tibial osteotomy: incidence of lateral cortex fractures and influence of fixation device on osteotomy healing.

    Science.gov (United States)

    Dexel, Julian; Fritzsche, Hagen; Beyer, Franziska; Harman, Melinda K; Lützner, Jörg

    2017-03-01

    Open-wedge high tibial osteotomy (HTO) is an established treatment for young and middle-aged patients with medial compartment knee osteoarthritis and varus malalignment. Although not intended, a lateral cortex fracture might occur during this procedure. Different fixation devices are available to repair such fractures. This study was performed to evaluate osteotomy healing after fixation with two different locking plates. Sixty-nine medial open-wedge HTO without bone grafting were followed until osteotomy healing. In patients with an intact lateral hinge, no problems were noted with either locking plate. A fracture of the lateral cortex occurred in 21 patients (30.4 %). In ten patients, the fracture was not recognized during surgery but was visible on the radiographs at the 6-week follow-up. Lateral cortex fracture resulted in non-union with the need for surgical treatment in three out of eight (37.5 %) patients using the newly introduced locking plate (Position HTO Maxi Plate), while this did not occur with a well-established locking plate (TomoFix) (0 out of 13, p = 0.023). With regard to other adverse events, no differences between both implants were observed. In cases of lateral cortex fracture, fixation with a smaller locking plate resulted in a relevant number of non-unions. Therefore, it is recommended that bone grafting, another fixation system, or an additional lateral fixation should be used in cases with lateral cortex fracture. III.

  2. 掌侧LCP结合Kapandji技术治疗背侧不稳定桡骨远端关节内骨折初步报道%Volar LCP fixation combined with Kapandji technique for dorsal unstable inter-articular distal radial fractures

    Institute of Scientific and Technical Information of China (English)

    邓迎生; 王秋根; 邓洪漪; 张秋林; 纪方; 李伟; 云雄

    2009-01-01

    Objective To explore the method and evaluate the effect of volar LCP fixation combined with Kapandji technique for dorsal unstable inter-articular distal radial fractures.nethods Forty-three patients(male 17 and female 26,aged 42 to 65 years with the mean of 57 years)with dorsal unstable inter-articular distal radial fractures were treated with volar LCP combined with Kapandij techniques.There were 26 cases for fype C1,16 cases for type C2 and 1 case for tvpe C3 according to AO/ASIF classification criteria of fractures.To modify again Sarmiento scale(modified by Stewart first),and the parameters of imageology of the fractures were estimated,while the wrist function through Gartland-Werley functional assessment system.The effects were evaluated through comparing the volar tilt.radial inclination,articular set-off,radial shortening and wrist funetion.Results All the patients were followed up from 16 to 47 months (average 27 months)postoperatively,and the volar tilt increased from -19.3°±11.2° to 8.1°±3.2°,radial inclination increased from -13.6°±4.1° to 18.0°±8.2°,the radial shortening decreased from(6.2±2.8)mm to(0.2±0.2)mm,and articular set-off decreased from(5.5±4.3)mm to(0.1±0.2)mm.Postoperatively,34 patients achieved excellent and 9 good according to the twice modified Sarmiento scale io the radiologieal manifestation and 18 patients displayed excellent and 22 good with 3 fair according to Gartland-Werley functional assessment system.Conclusion Volar LCP fixation comlfined with Kapandji technique is a safe and effective method for treating the unstable distal radial fractures of type C,which can prevent reduction lost,reduce need for hone grafting.provide for early Wrist motion and avoid tendon irritation.%目的 探讨掌侧锁定加压钢板(locking compression plate,LCP)结合Kapandji技术治疗背侧不稳定桡骨远端关节内骨折的方法 及疗效.方法 背侧不稳定桡骨远端关节内骨折患者43例,男17例,女26例;年龄42

  3. Benefits and harms of locking plate osteosynthesis in intraarticular (OTA Type C) fractures of the proximal humerus

    DEFF Research Database (Denmark)

    Brorson, Stig; Rasmussen, Jeppe Vejlgaard; Frich, Lars Henrik

    2012-01-01

    INTRODUCTION: Locking plate osteosynthesis of proximal humeral fractures are widely recommended and used, even in complex intraarticular fracture patterns such as AO/OTA Type C fractures. We systematically reviewed clinical studies assessing the benefits and harms of osteosynthesis with angle...... stable plates in AO/OTA Type C fractures of the proximal humerus. METHODS: We conducted an iterative search in PubMed, Embase, Cochrane Library, Web of Science, Cinahl, and PEDro in all languages from 1999 to November 2010. Eligible studies should study the outcome for Type C fractures after primary...... osteosynthesis with locking plate within two weeks of injury, and a follow-up period of six months or more. Patients should be evaluated with the Constant-Murley Score (CS). Two observers extracted data independently. RESULTS: Twelve studies and 282 Type C fractures were included. Results were categorised...

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

  5. Tangential View and Intraoperative Three-Dimensional Fluoroscopy for the Detection of Screw-Misplacements in Volar Plating of Distal Radius Fractures

    Directory of Open Access Journals (Sweden)

    Rausch

    2015-06-01

    Full Text Available Background Volar locking plate fixation has become the gold standard in the treatment of unstable distal radius fractures. Juxta-articular screws should be placed as close as possible to the subchondral zone, in an optimized length to buttress the articular surface and address the contralateral cortical bone. On the other hand, intra-articular screw misplacements will promote osteoarthritis, while the penetration of the contralateral bone surface may result in tendon irritations and ruptures. The intraoperative control of fracture reduction and implant positioning is limited in the common postero-anterior and true lateral two-dimensional (2D-fluoroscopic views. Therefore, additional 2D-fluoroscopic views in different projections and intraoperative three-dimensional (3D fluoroscopy were recently reported. Nevertheless, their utility has issued controversies. Objectives The following questions should be answered in this study; 1 Are the additional tangential view and the intraoperative 3D fluoroscopy useful in the clinical routine to detect persistent fracture dislocations and screw misplacements, to prevent revision surgery? 2 Which is the most dangerous plate hole for screw misplacement? Patients and Methods A total of 48 patients (36 females and 13 males with 49 unstable distal radius fractures (22 x 23 A; 2 x 23 B, and 25 x 23 C were treated with a 2.4 mm variable angle LCP Two-Column volar distal radius plate (Synthes GmbH, Oberdorf, Switzerland during a 10-month period. After final fixation, according to the manufactures' technique guide and control of implant placement in the two common perpendicular 2D-fluoroscopic images (postero-anterior and true lateral, an additional tangential view and intraoperative 3D fluoroscopic scan were performed to control the anatomic fracture reduction and screw placements. Intraoperative revision rates due to screw misplacements (intra-articular or overlength were evaluated. Additionally, the number of

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

    Science.gov (United States)

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

    2016-12-01

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

  7. Mechanical assessment of local bone quality to predict failure of locked plating in a proximal humerus fracture model.

    Science.gov (United States)

    Röderer, Götz; Brianza, Stefano; Schiuma, Damiano; Schwyn, Ronald; Scola, Alexander; Gueorguiev, Boyko; Gebhard, Florian; Tami, Andrea

    2013-09-01

    The importance of osteoporosis in proximal humerus fractures is well recognized. However, the local distribution of bone quality in the humeral head may also have a significant effect because it remains unclear in what quality of bone screws of standard implants purchase. The goal of this study was to investigate whether the failure of proximal humerus locked plating can be predicted by the DensiProbe (ARI, Davos, Switzerland). A 2-part fracture with metaphyseal impaction was simulated in 12 fresh-frozen human cadaveric humeri. Using the DensiProbe, local bone quality was determined in the humeral head in the course of 6 proximal screws of a standard locking plate (Philos; Synthes GmbH, Solothurn, Switzerland). Cyclic mechanical testing with increasing axial loading until failure was performed. Bone mineral density (BMD) significantly correlated with cycles until failure. Head migration significantly increased between 1000 and 2000 loading cycles and significantly correlated with BMD after 3000 cycles. DensiProbe peak torque in all screw positions and their respective mean torque correlated significantly with the BMD values. In 3 positions, the peak torque significantly correlated with cycles to failure; here BMD significantly influenced mechanical stability. The validity of the DensiProbe was proven by the correlation between its peak torque measurements and BMD. The correlation between the peak torque and cycles to failure revealed the potential of the DensiProbe to predict the failure of locked plating in vitro. This method provides information about local bone quality, potentially making it suitable for intraoperative use by allowing the surgeon to take measures to improve stability.

  8. Application of anterior decompression and reconstruction using titanium mesh with locking plates in the management of cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    Maolin He; Zengming Xiao; Shide Li; Qianfen Chen

    2008-01-01

    Objective:To observe the clinical effect of anterior decompression and reconstruction using titanium mesh with locking plates in the treatment of cervical spondylotic myelopathy.Methods:One hundred and twenty patients with cervical spondylotic myelopathy were treated by anterior decompression and reconstruction using titanium mesh with locking plates.There were 66 men and 54 women ranges in age from 37 to 72 Years(mean age, 58.3 years).The mean Japanese orthopedic surgery association(JOA) scale was 9.6 points before operation.Patients were followed up clinically and radiographically.Results:Having stood surgery well, the operation time ranged between 60-100 min and bleeding during operation ranged between 20-200 ml.There were no case of postoperative infection, recurrent laryngeal nerve palsy, or esophageal or tracheal laceration or rupture.The average follow-up period was 14.3 months(range, 12 to 24 months) in 96 who were followed up.At the last follow-up visit the mean JOA scale had improved to 14.4 points, reflecting an improve ment of 4.8 points.The results were considered to be excellent in 87 patients, good in 25, fair in 6, and poor in 2.No hardware-related complications or adjacent segment degenerative changes were encountered during the follow-up periods.Stable bone union was observed in all cases and the average time required for fusion was 5.7 months.Conclusion:Titanium mesh filled with autologous bone graft can avoid the complications associated with harvesting bone from the iliac crest donor site.When combined with cervical anterior locking plate, it can obtain satisfatory clinical results for the treatment of cervical spondylotic myelopathy.

  9. Orion锁定型颈椎前路钢板系统的临床应用%Clinical application of Orion anterior cervical locking plate system

    Institute of Scientific and Technical Information of China (English)

    郭澄水; 蒋学金; 陈新良; 韩国华; 孔祥飞

    2001-01-01

    Objective To evaluate the clinical application of Orion anterior cervical locking plate system in cervical injuries and cervical spondylous myelopathy. Methods 3 cervical spinal fractures and 2 cervical spondylous myelopathy were treated by anterior decompression, autografting and Orion plate fixation. Results 5 cases were followed up for 4~12 months. Bone graft was completely fused without complications of broken plate or loosening screw. Conclusion Orion plate can offer cervical stability after anterior decompression and bone grafting. It is easy to apply and suitable for the treatment of cervical fractures with spinal cord injuries.%目的探讨Orion锁定型颈椎前路钢板系统对颈椎骨折和脊髓型颈椎病手术固定的效果。方法对3例颈椎骨折合并高位截瘫和2例脊髓型颈椎病患者施行颈椎前路减压植骨融合及Orion钢板内固定。结果术后随访4~12个月,植骨已完全融合,无钢板断裂、螺钉松动等情况发生。结论 Orion锁定型颈椎前路钢板系统方法简单、容易掌握,内固定牢固,尤其适用于颈椎骨折伴高位截瘫患者的内固定治疗。

  10. 锁定解剖钢板内固定治疗股骨转子间骨折%Treatment of trochanteric fractures with proximal femoral locking plates

    Institute of Scientific and Technical Information of China (English)

    徐荣华; 霍维玲; 吴昊; 陈明

    2011-01-01

    目的 探讨锁定解剖钢板内固定治疗股骨转子间骨折的临床疗效.方法 应用有限切开锁定解剖钢板内固定治疗股骨转子间骨折56例.结果 56例均获随访,时间3~24个月.全部骨性愈合,愈合时间3~6个月.有2例发生髋内翻,无骨不连、内固定断裂等并发症发生.结论 锁定解剖钢板治疗股骨转子间骨折切口小,手术时间短,出血量少,术后可早期功能锻炼,并发症少,尤其适用于老年骨质疏松患者.%Objective To investigate the clinical and radiographic results of proximal femoral locking plates( PFLPs ) for a minimally invasive method of treating intertrochanteric hip fractures.Methods A total of 56 patients with inter-trochanteric hip fractures were treated by limited open reduction and fixation with PFLPs.Results All the cases were followed up for 3 ~ 24 months and they all got bony union in 3 ~ 6 months.Coxa vara was found in 2 cases.No infection , pseudoarthrosis or implant failure was recorded.Conclusions PFLPs for intertrochanteric fractures is benificial for earlier functional exercise, shortening operating times, diminishing operating wound, less blood loss and little postoperative complications.It is especially of benefit to the old man with severe osteoporosis.

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

    Science.gov (United States)

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

    2017-09-15

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

  12. 锁定钢板治疗肱骨近端骨折术后并发症的相关因素分析%Correlative factor analysis of complications in proximal humerus fractures treated with locking plates

    Institute of Scientific and Technical Information of China (English)

    韦盛旺; 赵友明; 杨杰; 郭晓山; 陈华; 杨翔; 陈林

    2012-01-01

    目的 探讨应用锁定钢板治疗肱骨近端骨折发生术后并发症的相关因素.方法 回顾性分析80例(并发症组29例,无并发症组51例)行锁定钢板(LPHP或PHILOS)治疗肱骨近端骨折患者资料,应用Logistic回归分析研究各因素与术后并发症的关系.结果 单因素分析示,并发症组在年龄、术后内侧皮质缺损、肱骨颈干角复位不佳等方面与无并发症组比较,差异有统计学意义(P <0.05);Logistic回归分析发现术后内侧皮质缺损和肱骨颈干角复位不佳是发生术后并发症的独立预测因素.结论 影响锁定钢板治疗肱骨近端骨折术后并发症的相关因素较多,其中术后内侧皮质缺损及肱骨颈干角复位不佳是主要因素.%Objective To explore the correlative factors affecting the complications in proximal humerus fractures treated with locking plates. Methods Eighty patients (29 cases with complications and 51 cases without) with proximal humerus fractures were treated by locking plates (LPHP or PHILOS) and were retrospectively analyzed. And logistic regression analysis was used to find main factors. Results The univariate analysis showed that age, the integrity of the medial humerus wall postoperatively and head-shaft angle had a significant association with complications encountered in proximal humerus fractures treated with locking plate fixation (P<0.05). The multiple stepwise logistic regression showed that the postoperative integrity of the medial humerus wall and head-shaft angle were key factors affecting the complications. Conclusion The integrity of the medial humerus wall and head-shaft angle are the main factors affecting the complications.

  13. 微创经皮钢板固定技术结合锁定钢板治疗胫骨粉碎性骨折%MIPPO Technology Combined with Locking Plate in the Treatment of Comminuted Fracture of Tibia

    Institute of Scientific and Technical Information of China (English)

    邵安泽; 岳洋; 潘长军; 顾飞; 吴瑞; 聂玮

    2015-01-01

    目的:观察微创经皮钢板固定(MIPPO)技术闭合复位结合锁定钢板治疗胫骨粉碎性骨折的临床效果.方法:采用MIPPO技术闭合复位结合锁定钢板治疗胫骨粉碎性骨折24例,男17例女7例,年龄23~65岁,平均42.4岁,胫骨中上段骨折15例,胫骨中下段9例.结果:24例患者均获得随访,时间6~14m,平均9.6m,术后采用Johner-Wruhs关节功能评定标准,24例患者优21例,良2例,中1例.结论:运用MIPPO技术闭合复位结合锁定钢板治疗胫骨粉碎性骨折能有效的降低软组织创伤,减少血运破坏,骨折愈合时间短等优点,是治疗胫骨粉碎性骨折的一种有效办法.%Objective: To investigate the use of closed reduction MIPPO technology combined with locking plate in the treatment of tibial comminuted fracture of the clinical effect. Methods:The use of closed reduction MIPPO technology combined locking plate in the treatment of comminuted fracture of the tibia in 24 cases, including 17 males and 7 females, aged 23~65 years, mean 42.4 years, the upper tibia 15 cases of fracture of tibia in nine cases the next segment.Results:24 patients were followed up for 6~14m, average 9.6m, after using Johner-Wruhs joint function evaluation standard, the results were excellent in 21 cases, good in 2 cases, 1 case.Conclusion:Closed reduction MIPPO technology combined with the locking plate in the treatment of comminuted fracture of the tibia with a soft tissue trauma, less blood supply destruction, reliable fixation, fracture healing time is short, etc., it is an effective way to treat comminuted fracture of the tibia.

  14. 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.

  15. Volar dislocation of the index carpometacarpal joint in association with a Bennett's fracture of the thumb: a rare injury pattern.

    LENUS (Irish Health Repository)

    Dillon, J P

    2012-02-03

    We describe a case of volar dislocation of the index carpometacarpal (CMC) joint in association with a Bennett\\'s fracture of the thumb following a motorcycle accident. Volar dislocation of the index carpometacarpal joint is an exceedingly rare but easily missed injury, with only a few reported cases in the literature. This report highlights the importance of a true lateral radiograph and close scrutiny of the film to detect this injury. Closed reduction supplemented with Kirschner wire fixation restored normal anatomical relations and achieved an excellent clinical result.

  16. Volar morphology of the distal radius in axial planes: a quantitative analysis.

    Science.gov (United States)

    Oura, Keiichiro; Oka, Kunihiro; Kawanishi, Yohei; Sugamoto, Kazuomi; Yoshikawa, Hideki; Murase, Tsuyoshi

    2015-04-01

    To investigate the cause of rupture of the flexor pollicis longus (FPL) after volar plate fixation of distal radius fractures, previous studies have examined the shape of the distal radius in the sagittal plane or in the lateral view. However, there are no reports on the anatomical shape of the volar surface concavity of the distal radius in the axial plane. We hypothesized that this concavity might contribute to the mismatch between the plate and the surface of the radius. To test this hypothesis, we constructed three-dimensional models of the radius and FPL based on computed tomography scans of 70 normal forearms. We analyzed axial cross-sectional views with 2 mm intervals. In all cases, the volar surface of the distal radius was concave in the axial plane. The concavity depth was maximum at 6 mm proximal to the palmar edge of the lunate fossa and progressively decreased toward the proximal radius. FPL was closest to the radius at 2 mm proximal to the palmar edge of the lunate fossa. The volar surface of the distal radius was externally rotated from proximal to distal. These results may help to develop new implants which fit better to the radius and decrease tendon irritation.

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

    Science.gov (United States)

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

    2017-08-01

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

  18. Treatment of proximal humeral fractures with interlocking intramedullary nail versus locking plate%锁定钢板与交锁髓内钉治疗肱骨近端骨折的疗效分析

    Institute of Scientific and Technical Information of China (English)

    徐小东; 张殿英; 付中国; 王天兵; 陈建海; 杨明; 芦浩

    2014-01-01

    Background Proximal humeral fracture is usually seen in elder citizens with osteoporosis,and such a fracture in younger patients mainly results from high-energy inj ury.Surgical procedure is often adopted for patients with unstable or obviously displaced fracture.Open reduction and locking plate fixation or closed reduction and interlocking intramedullary nail fixation are two common treatment methods for proximal humeral fracture.In this paper,retrospective analysis was conducted to compare the clinical curative effects between locking plate and intramedullary nail in the treatment of proximal humeral fracture.Methods General data:From January 2012 to May 2013,38 patients with full information in our department were randomly selected in the retrospective analysis, including 13 male and 25 female,aged from 20 to 86,and the mean age was 66.5 ± 16.9 years. According to the different treatment methods,the patients were divided into the locking plate group (24 cases)and the interlocking intramedullary nail group (14 cases).All patients had unilateral closed fractures treated with locking plate or interlocking intramedullary nail,including 22 cases on the left side and 17 cases on the right side.28 patients were injured from low energy falls and 10 cases were from high energy trauma like skiing,motor accidents,etc.According to Neer classification,7 cases of two-part fracture,1 1 cases of three-part fracture and 6 cases of four-part fracture were in the locking plate group,and 8 cases of two-part fracture,5 cases of three-part fracture and 1 case of four-part fracture were in the interlocking intramedullary nail group.In the meanwhile,on the basis of AO classification,4 type 11-A cases,14 type 11-B cases and 6 type 11-C cases were in the locking plate group,and 7 type 1 1-A cases,6 type 1 1-B cases and 1 type 1 1-C case were in the interlocking intramedullary group.PHILOS plate of Synthes,Inc.and TRIGEN intramedullary nail of Smith &Nephew,Inc.were used in the operation

  19. 多轴锁定钢板治疗复杂胫骨平台骨折的初步疗效分析%Multiaxial locking plates for treatment of complex tibiai plateau fractures

    Institute of Scientific and Technical Information of China (English)

    郭永飞; 刘岩; 苟三怀; 曹振羽; 陈爱民; 欧阳跃平; 张伟; 侯春林

    2009-01-01

    目的 报告多轴锁定钢板治疗复杂胫骨平台骨折的方法及初步疗效. 方法 2006年7月至2007年6月,采用开放复位、多轴锁定钢板内固定治疗复杂胫骨平台骨折25例,闭合性骨折21例,开放性骨折4例;骨折按Schatzker分型:Ⅳ型6例,Ⅴ型16例,Ⅵ型3例;根据影像学测量结果及HSS评分标准进行临床效果评定.结果 所有患者术后获得7~15个月(平均10.5个月)随访,骨折4~6个月后骨折均获骨性愈合,术后6个月膝关节HSS评分78~96分,平均88.4分.发生皮瓣坏死1例,切口局部感染1例,无一例发生内固定松动、断裂或骨折复位丢失现象.术后1周、3个月及6个月的内翻角和后倾角比较差异无统计学意义(P>0.05). 结论胫骨平台多轴锁定钢板操作简便,锁定螺钉置入角度选择性高,内固定稳定性好,避免了原始及继发复位的丢失,是手术治疗复杂胫骨平台骨折安全、有效的内固定方法.%Objective To report clinical effects of multiaxial locking plates in the treatment of the complex tibial plateau fractures. Methods From July 2006 to June 2007, 25 cases of complex tibial plateau fractures, 18 males and 7 females, were treated with surgical reduction and internal fixation using multiaxial locking plates. The mean age of the patients was 32.8(20 to 56) years. There were 21 closed fractures and 4 open ones. According to Schatzker classification, 6 cases were of type Ⅳ, 16 of type Ⅴ, and 3 of type Ⅵ. The follow-up period lasted 10.5(7 to 15) months on average. The knee functions in all the patients were assessed according to radiological manifestations and HSS scoring. Results All fractures united at 4 to 6 months postoperatively and the average HSS score after half a year was 88.4 (78 to 96). Skin flap necrosis was found in 1 case and incision infection in another. No loosening or rupture of the fixator, or reduction failure was observed. Conclusions The multiaxial locking plate is an

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

    Directory of Open Access Journals (Sweden)

    A. B. Scrimgeour

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sun-Jun Hu

    2012-12-01

    union or a revision surgery. Among the 45 patients, 43 patients obtained fracture union without further intervention. 38 fractures healed with no loss of position at the 1-year follow-up. There were no cases of hip screw cutting through the femoral head. The mean score of Harris social index was 86.5±9.8 (73~95. The mean Parker and Palmer mobility score was 7.4±2.1 (3~9. CONCLUSION: The proximal lateral femur locking plate is the kind of stable and effective internal fixation of treating subtrochanteric hip fractures which has the advantage of stable fixation especially for the lateral femoral wall fracture. Level of Evidence IV, Case Series.

  2. Volar lunate dislocation associated with a Salter-Harris Type III fracture of the distal radial epiphysis in an 8 year-old child.

    Science.gov (United States)

    Sharma, H; Azzopardi, T; Sibinski, M; Wilson, N

    2007-02-01

    Carpal fracture-dislocations in children are extremely rare injuries and are easily missed or misdiagnosed. An 8 year-old boy who presented with a volar lunate dislocation associated with a Salter Harris Type III injury of the distal radial epiphysis is reported. Open reduction without internal fixation followed by plaster immobilisation achieved good short-term results.

  3. Unilateral non-traumatic radiocarpal volar dislocation in a child: A long-term evolution Luxación radiocarpiana volar atraumática unilateral en una niña: Evolución a largo plazo

    OpenAIRE

    S. García-Mata; A.M. Hidalgo-Ovejero

    2009-01-01

    We report an eight year-old female with trisomy 21 referred to our clinic for limitation of wrist mobility. The patient had been diagnosed and treated by polyarticular juvenile chronic arthritis for six months. Clinical and radiological study revealed volar radiocarpal dislocation of the left wrist. She was treated surgically by open reduction, temporary K-w fixation with six weeks of immobilization. The dislocation relapsed but the joint remained painless. One year later she had 5º of dorsal...

  4. Adolescent Volar Barton Fracture with Open Physis treated with Volar Plating using Buttressing Principle

    Directory of Open Access Journals (Sweden)

    Shah H

    2015-07-01

    Full Text Available Objective: The objective of the study was to assess the outcome of Salter- Harris type III distal radius fracture fixed using the principle of buttressing and avoiding screw insertion through the physis. Materials and Method: Eight school going children in the age group of 11-16 years with volar Barton fractures were treated with a volar plate using the buttress principle without inserting screws in the distal fragment. Patients were evaluated over a period of 18 months. Clinical evaluation was done using the Green O’Brien criteria and radiological evaluation using the Sarmiento criteria. Results: The average union time was two months. All the patients had good to excellent functional outcome with full extension and flexion. Conclusion: Buttress plating of volar Barton fractures in the adolescent age group is an excellent technique to achieve satisfactory outcome without violation of the physis.

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

    Directory of Open Access Journals (Sweden)

    Prafulla Herode

    2013-01-01

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

  6. The use of locking plates in proximal humeral fractures: Comparison of outcome by patient age and fracture pattern

    Directory of Open Access Journals (Sweden)

    Leonard Michael

    2009-01-01

    Full Text Available Purpose: This study was undertaken to evaluate the efficacy of a proximal humeral locking plate, and to specifically study the effect of patient age and fracture type on the outcome. Materials and Methods: Thirty-one cases of proximal humeral fractures fixed by using the proximal humeral interlocking (PHILOS plate were reviewed. Results: Average functional scores (minimum 18 months post operation per AO / ASIF fracture type were 25.3 for type A, 21.4 for type B, and 22.7 for type C. There was no statistically significant difference between the groups. The functional scores for patients over 65 years of age were significantly inferior (P = 0.03. At a final radiological review (mean 12 months post operation, 30 (96% of the patients demonstrated fracture union. Seven patients (22.5% required a second surgical procedure. Conclusion: We obtained both good functional results and bone healing with the PHILOS plate, irrespective of fracture type; the older patients had a poorer outcome. We caution the surgeons on the high potential for reoperations with its use.

  7. ROLE OF LOW PROFILE PRECONTOURED DISTAL TIBIAL LOCKING PLATE USING MIPPO TECHNIQUE IN PILON FRACTURE

    Directory of Open Access Journals (Sweden)

    Isaac Sunder

    2015-10-01

    Full Text Available : Tibial pilon fracture – Spectrum of injury ranging from fractures caused by low energy rotational foces to fractures caused by high energy axial compression forces due to RTA/ fall from height with significant metaphyseal communition articular communition with diaphyseal extension. Almost 80% patients will have fibula fracture. The aim of the study is study the efficacy of LP PD DTP in the management of closed pilon fractures (OTA type A Type B and Type C 1 and open pilon fractures (Grade 1 Grade II Grade III A (Gustilo Anterson grading. 1. I have studied 21 patients of pilon fracture classified using AO/OTA classification Type A-metaphyseal; Type B–Partially articular; Type C Metaphyseal fracture with articular involvement. 2. Used LP/ PC/ Distal tibial plate using MIPPO technique in OTA–A, B and C 1 closed & grade I II Grade III A compound fractures. OBSERVATIONS: 1. In contrary to stages protocol (Ist external fixation with fibular plating after 2-3 Weeks ORIF/MIPPO with/Without bone grafting, it is done percutaneously or minimally invasive and it can be done on day 1 without any major soft tissue problem & post-operative infection. 2. Duration of stay in the hospital can be reduced. 3. Since it is done through calcaneal traction or femoral distractor – fibula length restored & plating may not be necessary all the time and fibula plating can be avoid if the soft tissue condition is not favorable for plating laterally. 4. Since it is done through calcaneal traction/femoral distractor inspite of ground glass communition–good reduction is almost always possible. 5. Since MIPPO–need for bone grafting in less. 6. As in staged protocol more time is spent in soft tissue healing and after 2–3 weeks, fractures reduction if difficult and almost impossible with indirect reduction and may warrant open reduction. I conclude that LP PC distal tibial plate using MIPPO technique offers several advantages over two staged protocol and improved

  8. 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.

  9. 锁定钢板治疗肱骨近端骨折30例临床分析%Clinical analysis of locking plate in treatment of proximal humerus fractures 30 cases

    Institute of Scientific and Technical Information of China (English)

    肖锦春

    2011-01-01

    Objective To investigate the effect of locking compression plate (LCP) in treatment of complex proximal humeral fractures. Methods The proximal humerus locking plate in treatment of proximal humerus fractures, 30 cases classified according to Neers, two - part fracture in 12 cases, three - part fractures in 16 cases, four - part fractures in 2 cases. Results The group of 30 cases of surgical patients were 6 to 13 months follow -up, average 11.5 months, all fractures healed within 12 months. According to Neer shoulder function assessment criteria; excellent in 18 cases, good in 8 cases, effective in 4 cases, the whole group of excellent and good rate was 86. 7%. Conclusions Treatment of proximal humeral locking plate fixation of proximal humeral fractures, reliable, fewer complications, and early functional exercises, results were satisfactory, especially for elderly patients with osteoporosis is particularly applicable.%目的 探讨应用锁定加压接骨板(LCP)治疗肱骨近端复杂骨折的疗效.方法 应用肱骨近端锁定钢板治疗肱骨近端骨折30例,根据Neers分类,二部分骨折12例,三部分骨折16例,四部分骨折2例.结果 本组30例手术患者均获得6~13个月的随访,平均11.5个月,骨折12个月内全部愈合.按Neer肩关节功能评分标准评定:优18例,良8例,可4例,全组优良率86.7%.结论 肱骨近端锁定钢板治疗肱骨近端骨折固定可靠,并发症少,可早期进行功能锻炼,疗效满意,特别是对于老年骨质疏松的患者尤为适用.

  10. Treatment of long unstable femoral intertrochanteric fractures with locking plate and cable rope%锁定钢板及缆绳联合治疗老年长段粗隆骨折

    Institute of Scientific and Technical Information of China (English)

    杨玉宝; 阚金庆; 高忠礼; 李林

    2012-01-01

    目的:探讨锁定钢板和缆绳治疗老年长段粗隆间骨折的临床疗效.方法:自2004年6月至2010年6月治疗26例老年长段粗隆间骨折,男16例,女10例;年龄50~65岁,平均(58.23±4.45)岁.车祸伤22例,其中10例合并其他复合伤;坠落伤4例.Evans分型:I型21(顺转子型),其中Ia型8例,Ib型10例,Ic型2例,Id型1例;Hrd型(逆转子型)5例.26例中均采用锁定钢板及缆绳固定治疗,髋关节功能根据Harris评分.结果:26例均获得随访,时间9~18个月,平均15个月.手术顺利,术后7~14d下地无负重功能锻炼,6周逐渐负重功能锻炼,12周后逐渐完全负重.髋关节功能Harris评分,疼痛(39.79±6.54)分,功能(31.08±9.45)分,畸形及活动(3.85±0.46)分,总分(77.31±13.97)分;结果优10例,良13例,可3例.结论:锁定钢板及缆绳适合治疗老年长段涉及粗隆Evans分型的各种类型骨折,尤其是骨质疏松患者取得较好临床效果.%Objective: To investigate clinical effect of long unstable femoral intertrochanteric fractures with locking plate and cable rope. Methods: From June 2004 to June 2010, twenty-six elderly patients with long unstable femoral intertrochanteric fractures were treated locking plate and cable rope fixation, included 16 males and 10 females with an average age of (58.23?4.45) years ranging from 50 to 65 years. There were 22 cases for traffic accident, 10 of them for traffic accident with other injury; 4 cases for falling injury. According to Evans classification, 21 cases were in type I, among them 8 in type la, 10 in type Ib, 2 in type Ic, 1 in type Id; the other 5 cases were type Hrd. Hip function scores were recorded to evaluate the treatment outcomes by Harris hip function score system. Results: Twenty-six cases were followed-up for 9 to 18 months (means 15 months). The operations were successful. All the patients received functional training for walking without weight loading from 7 to 14 days after operation , and walking

  11. 后外侧锁定接骨板治疗大块后踝骨折的疗效分析%Efficacy of Posterolateral Locking Plate in the Treatment of Large Posterior Malleolar Fracture

    Institute of Scientific and Technical Information of China (English)

    胥正锋; 尹望平; 倪妙忠; 吴荣博

    2014-01-01

    目的:探讨经后外侧入路应用锁定接骨板治疗大块后踝骨折的临床疗效。方法:2010年1月-2012年6月经后外侧入路应用锁定接骨板内固定治疗后踝大块骨折患者23例,其中男性15例,女性8例;年龄32~78岁,平均年龄43.7岁;受伤至手术时间5~12d,平均7.3d。术前以石膏或跟骨牵引术固定患肢,待患肢肿胀消退后,采用后外侧入路锁定接骨板治疗后踝骨折。根据美国足踝外科协会(American Orthopedic Foot and Ankle Society ,AOFAS )的踝与后足评分标准评价踝关节功能。结果:所有患者均获得随访,随访时间14~22个月,平均17.4个月。23例患者均获得骨性愈合,无内固定松动或断裂;X线片示骨折愈合时间为术后11~21周,平均14.7周;完全负重时间为15~25周,平均17.1周;术后12个月AOFAS评分为73~94分,平均83.4分。1例患者术后第7天出现伤口浅表感染,经换药及敏感抗生素治疗后愈合,其他患者伤口愈合良好。结论:采用后外侧入路锁定接骨板治疗能在直视下对后踝进行有效复位和妥当固定,用于治疗后踝大块骨折时疗效良好。%Objective:To investigate the clinical efficacy of posterolateral locking plate in the treatment of large posterior malle-olar fracture .Methods :From January 2010 to June 2012 ,23 patients with large posterior malleolar fractures were treated by posterolateral locking plate ,including 15 males and 8 females ,all of whom aged from 32 to 78 years with an average age of 43 .7 years .The average time from injury to operation was 7 .3 days ,which ranged from 5 to 12 days .Calcaneal traction fixa-tion or plaster was performed on the injured limb before operation .Once that swelling reduced ,all patients were treated by posterolateral locking plate and were assessed with the ankle hindfoot clinical rating system of the American Orthopaedic Foot and Ankle Society (AOFAS

  12. Anterior cervical locking plate combined with bone graft for cervical vertebral fractures%颈前路带锁钢板联合植骨手术治疗颈椎骨折

    Institute of Scientific and Technical Information of China (English)

    王家明

    2011-01-01

    目的探讨和评价颈前路带锁钢板联合钛网植骨治疗颈椎损伤的应用价值。方法自2003年6月至2009年5月经住院手术的13例颈椎骨折的患者行颈椎前路椎体次全切除术减压,同时带锁钢板内固定联合钛网植骨或自体髂骨植骨融合。结果全部病例得到随访,平均18个月,内固定牢靠无松脱,植骨融合,椎体高度无丢失。结论颈前路带锁钢板联合钛网植骨可即刻恢复节段高度,重建节段稳定性,手术操作简单,并发症少,解决了颈椎损伤重建的难题。%Objective To evaluate the efficacy of anterior cervical locking plate combined with bone graft for cervical vertebral fractures. Methods Totally 13 patients with cervical vertebral fracture hospitalized from June 2003 to May 2009 were treated with internal fixation of steel plate combined with fusion of titanium mesh or iliac bone autograft after the resection of anterior cervical vertebra. Results All cases were followed up for an average of 18 months. The internal fixation was stable, the bone graft fusion was well and the height of vertebra body was close to normal. Conclusion The operation can be used to recover the height and stability of vertebra body. It is an easy operation with few complications and it is conducive to the reconstruction of injured cervical vertebra.

  13. Comparative clinical study of locking screws versus smooth locking pegs in volar plating of distal radius fractures.

    Science.gov (United States)

    Boretto, J G; Pacher, N; Giunta, D; Gallucci, G L; Alfie, V; De Carli, P

    2014-09-01

    The present study was performed to test the null hypothesis on no difference in stability of fixation after volar plating of intra-articular distal radius fractures (AO C2-C3) with either locking smooth pegs or locking screws in a clinical setting. A retrospective evaluation included adult patients with C2-C3 AO fractures treated with a volar plate with locking smooth pegs or locking screws. Radiographic assessment was performed to evaluate extra- and intra-articular parameters in the early postoperative period and after bone union. Twenty-seven consecutive patients were included. Thirteen cases had fixation with locking screws and 14 had fixation with locking smooth pegs. Both groups had bone fragment displacement after fixation. However, there were no significant differences between the groups either in extra- or intra-articular parameters defined by Kreder et al. (1996). Our study shows that, in a clinical setting, there is no difference in stability fixation between locking screws or smooth locking pegs in C2-C3 distal radius fractures.

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

    LENUS (Irish Health Repository)

    Nassiri, M

    2013-03-01

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

  15. Advantages of using volar vein repair in finger replantations.

    Science.gov (United States)

    Mersa, Berkan; Kabakas, Fatih; Pürisa, Hüsrev; Özçelik, Ismail Bülent; Yeşiloğlu, Nebil; Sezer, Ilker; Tunçer, Serdar

    2014-01-01

    Providing adequate venous outflow is essential in finger replantation surgeries. For a successful result, the quality and quantity of venous repairs should be adequate to drain arterial inflow. The digital dorsal venous plexus is a reliable source of material for venous repairs. Classically, volar digital veins have been used only when no other alternative was available. However, repairing volar veins to augment venous outflow has a number of technical advantages and gives a greater chance of survival. Increasing the repaired vein:artery ratio also increases the success of replantation. The volar skin, covering the volar vein, is less likely to be avulsed during injury and is also less likely to turn necrotic, than dorsal skin, after the replantation surgery. Primary repair of dorsal veins can be difficult due to tightness ensuing from arthrodesis of the underlying joint in flexion. In multiple finger replantations, repairing the volar veins after arterial repair and continuing to do so for each finger in the same way without changing the position of the hand and surgeon save time. In amputations with tissue loss, the size discrepancy is less for volar veins than for dorsal veins. We present the results of 366 finger replantations after volar vein repairs.

  16. Effect observation on locking plate combining with autologous iliac bone graft in the treatment of aseptic nonunion after surgery of long bone fractures of extremities%锁定钢板联合自体髂骨植骨治疗四肢长骨干骨折术后无菌性骨不连的效果观察

    Institute of Scientific and Technical Information of China (English)

    刘志军

    2014-01-01

    Objective To research and evaluate the effect of locking plate combining with autologous iliac bone graft on treating aseptic nonunion after surgery of long bone fractures of extremities. Methods 43 cases of patients with aseptic nonunion on limb long bone caused by bone fixation failure were accepted in our hospital from January 2006 to June 2013.All of patients were treated with locking plate combining with autologous iliac bone graft. Results All patients were followed up.The follow-up time ranged from 7 to 24 months,with an average of 12.6 months.All of nonunion were healed in (5.9±1.0) months.Cut surface infection occurred in 3 cases (6.9%),which were cured after treatment.The slow-ly healed wound were 2 cases (4.7%) and limb about 2 cm shortened in 1 case (2.3%).None of cases suffered from malunion.At the final follow-up,joint activity improved more significantly compared with before surgery,including 35 cases (81.4%) with excellent effect,7 cases (16.3%) moderate,and 1 case (2.3%) poor. Conclusion In the treatment of patients with aseptic nonunion after surgery of long bone fractures of extremities,using locking plate for internal fixation is a curative therapy.Locking plate combining with autologous iliac bone graft can provide reliable fixation stability for fractura,and shows good functions on bone induction and conduction,so it obtains a favorable effect.%目的:研究评价锁定钢板联合自体髂骨植骨治疗四肢长骨干骨折术后无菌性骨不连的临床效果。方法选取2006年1月~2013年6月因内固定失败而造成四肢长骨干无菌性骨不连患者43例,均采用锁定钢板固定联合自体髂骨植骨进行治疗。结果患者均获得随访,随访时间7~24个月,平均12.6个月。骨不连均愈合,愈合时间为(5.9±1.0)个月。3例(6.9%)出现切口表面感染,经治疗后均痊愈;2例(4.7%)切口延迟愈合;1例(2.3%)出现肢体短缩<2 cm,无一例发生骨折畸形愈合。末次随访时关节活

  17. Effect of fixing distal radius fracture with volar locking palmar plates while preserving pronator quadratus

    Institute of Scientific and Technical Information of China (English)

    Fan Jian; Chen Kai; Zhu Hui; Jiang Bo; Yuan Feng; Zhu Xiaozhong; Mei Jiong

    2014-01-01

    Background L-shaped incision of pronator quadratus (PQ) muscle along its radial and distal borders was always taken for distal radius fractures reduction and internal fixation.Repair of the PQ muscle was always recommended at the end of operation for some instructive reasons.But repair of PQ is not satisfied because of poor quality of muscle and fascial tissues which may cause pain or impede forearm pronation and supination for post-operative scarring around PQ.Inserting the locking palmar plate to pass under the pronator quadratus muscle and the locking screws are inserted through miniincisions in pronator quadratus in some patients with distal radius fractures is a reasonable technique which can preserve the pronator quadratus.The purpose of this study was to evaluate and compare the clinical effects after volar plating of the distal radius fractures while preserving the pronator quadratus and pronator quadratus repair.Methods Between September 2010 and April 2012,65 patients (42 males and 23 females; aged 20-68 years and a mean age of 42.5 years) with distal radius fracture underwent open reduction and internal fixation using the volar locking palmar plates (Depuy or Smith companies).The patients were classified as 23A-2 through 23C-3 according to the Orthopaedic Trauma Association (OTA) classifications.All surgeries were completed by the same trained team.The volar locking palmar plates of distal radius performed with preserving pronator quadratus group involved 30 patients including 19 males and 11 females and performed with pronator quadratus repair group involved 35 patients including 23 males and 12 females.We compared the two groups for wrist pain,forearm range of motion,grip strength,pedoperative complications and wrist functional recovery score.Results The minimum follow-up for the whole cohort was one year.The differences between the two groups were significant with regard to wrist pain,forearm range of motion,grip strength and wrist function at 1,2,and

  18. Biomechanical and clinical researches of cervical spine locking plate for treatment of cervical bursting fracture%颈椎前路带锁钢板治疗颈椎爆裂骨折的试验及临床研究

    Institute of Scientific and Technical Information of China (English)

    陈福文; 周密; 贾连顺; 张树明; 王剑平; 宋迪煜; 朱方正; 朱泽兴

    2012-01-01

    Objective To evaluate the stability and clinical feasibility of cervical spine locking plate (CSLP)for the treatment of cervical fractures. Methods Six fresh cadaver cervical specimens (from C2-6) were used for test. The normal three -dimension motions of C3_5 segments were measured on a three-dimensional spinal motion test machine. Then C4 bursting fracture models were built to measure the range of motions (ROM). Iliac bony grafts were implanted and the ROM were tested once more. Finally the injured segments were fixed with AO cervical spine locking plate to measure the ROM. Thirty-two cases of lower cervical spine fractures were treated surgically with anterior decompression and fusion, and were internally fixed with CSLP. Results After bony implantation and CSLP fixation, the ROM of cervical spines in flexion/extension, left/right bending, and left/right axial rotation reduced significantly. Compared with normal ROM, flexion/extension and left/right bending were reduced significantly while left/right axial rotation didn't change significantly. After 6-48 months follow-up, all fracture were reduced completely and implanted bone was fused. Postoperative X-ray showed plates and screws were in their correct position, no loosening and breakage of both plates and screws was found. Conclusion CSLP is an ideal fixation apparatus for treatment of cervical fracture in cervical spine and can restore stability in three-dimensional ROM.%目的 评价颈椎前路带锁钢板固定系统(CSLP)治疗颈椎骨折的稳定性及临床有效性.方法 将6具新鲜成人颈椎标本(C2~6)置于脊柱三维测量仪上测定C3~5节段的ROM,制造C4爆裂骨折,测定其三维运动变化后分别进行植骨、植骨+CSLP固定,并重复测量其三维运动.对32例下颈椎骨折行前路减压融合,并以CSLP进行内固定治疗.结果 植骨+CSLP固定后在屈伸、侧弯、旋转方向较损伤后明显下降,与正常值相比,屈伸和侧弯运动均明显减少,但

  19. 肱骨近端解剖锁定钢板与解剖钢板治疗肱骨Neer三、四部分骨折的疗效比较%Comparison of proximal humerus locking plate and anatomical plate for Neer three-and four-part of proximal humeral fractures

    Institute of Scientific and Technical Information of China (English)

    朱豪东; 蔡新新; 郭云峰; 郑柏生; 周卓谦

    2015-01-01

    目的:探讨肱骨近端解剖钢板与肱骨近端解剖锁定钢板治疗老年肱骨近端 Neer三、四部分骨折的功能及疗效差异。方法收集有完整随访资料的151例老年Neer 三、四部分骨折患者,按手术方式分为肱骨近端解剖钢板组(A 组,65例)和肱骨近端解剖锁定钢板组(B 组,86例),在随访过程采用Constant 评分及Neer 评分评价并比较两组疗效。结果 B 组平均愈合时间显著短于A 组(P<0.05)。两组的术后1年和术后2年功能比较:B 组Neer 评分的疼痛、功能、活动度及总分均显著优于 A 组(P<0.05);B 组 Constant 评分的疼痛、日常生活活动、主动活动及总分显著优于 A 组(P<0.05)。结论肱骨近端解剖钢板与肱骨近端解剖锁定钢板均可用于老年Neer 三、四部分骨折,但解剖锁定钢板愈合更快,功能恢复更好,临床推荐优先使用。%Objective To investigate the effect of proximal humerus locking plate and proximal humerus anatomical plate on complex 3- and 4-part fractures of the proximal humerus (Neer classification) in the elders. Methods 151 cases of proximal humeral fractures were included in the study and divided into proximal humerus anatomical plate group (A group, n=65 cases) and proximal humerus locking plate group (B group, n=86 cases) according to different operation methods. The patients of A group underwent fracture fixation by anatomical plate and those in B group received fracture fixation by locking proximal humerus plate. The treatment effect was evaluated in two groups and compared between two groups by Neer score and Constant score. Results The mean humerus healing time of B group was significant superior to A group (P<0.05). Neer score, constant score, pain , function , activity and total score of shoulder in B group were significant superior to those in A group in 1 year and 2 years after operation (P<0.05). Conclusion Proximal humerus

  20. Locking intrameduilar nail and locking plate in treatment of proximal humerus fractures:a comparative study%锁定型髓内针和锁定型钢板治疗肱骨近端骨折的对比研究

    Institute of Scientific and Technical Information of China (English)

    朱以明; 鲁谊; 姜春岩

    2008-01-01

    目的 对比肱骨近端锁定型髓内针或肱骨近端锁定型钢板治疗肱骨近端骨折的疗效,并探究两种内固定物各自的特点. 方法 54例新鲜肱骨近端二部分外科颈骨折患者,分为髓内针同定组(26例)和锁定犁钢板同定组(28例),两组在平均年龄比例、性别比例、优势侧受累比例方面差异尤统计学意义.最终随访时进行洋细肩关节体检,拍摄肩关节X线片以评价愈合的情况,并应用疼痛的视觉评分(VAS),美国肩肘外科医师评分(ASES),Constant-Murley评分,以及简单肩关节功能问卷(SST)评估患者肩关节功能,对比两组的结果. 结果 所有骨折均在术后8周内初步愈合.随访过程中两组均未出现感染、肱骨头坏死.钢板组患者并发症率较髓内针组高.两组的肩关节功能恢复情况均比较令人满意.两组间在术后患肢平均主动前屈上举、主动体侧外旋、主动内旋体侧内旋活动度、Constant-Murley评分、SST评分方面差异无统计学意义.但钢板组在最终患者的肩关节ASES评分、VAS评分和平均冈上肌肌力等方而优于髓内针组. 结论 两种内固定物均可较满意地治疗肱骨近端二部分外科颈骨折.锁定型髓内针创伤较小,而锁定型钢板在术后功能恢复方面更具优势.%Objective To compare the results of locking intramedullar nail and Locking plate in treating proximal humerus fractures and discuss features of each instrument. Methods A total of 54 patients with fresh two-part surgical neck fracture of proximal humerus were divided into intramedullar nail fixation group(26 patients)and locking plate fixation group(128 patients).with no statistical difference upon age,gender and dominate hand involvement in two groups.At final follow-up,physical examination and X-ray films were used to evaluate fracture healing of shoulder ioint.In the meantime,VAS score,ASES score,Constant-Murley score,UCLA and SST questionnaire were used to

  1. Biomechanical performance of variable and fixed angle locked volar plates for the dorsally comminuted distal radius.

    Science.gov (United States)

    Martineau, D; Shorez, J; Beran, C; Dass, A G; Atkinson, P

    2014-01-01

    The ideal treatment strategy for the dorsally comminuted distal radius fracture continues to evolve. Newer plate designs allow for variable axis screw placement while maintaining the advantages of locked technology. The purpose of this study is to compare the biomechanical properties of one variable axis plate with two traditional locked constructs. Simulated fractures were created via a distal 1 cm dorsal wedge osteotomy in radius bone analogs. The analogs were of low stiffness and rigidity to create a worst-case strength condition for the subject radius plates. This fracture-gap model was fixated using one of three different locked volar distal radius plates: a variable axis plate (Stryker VariAx) or fixed axis (DePuy DVR, Smith & Nephew Peri-Loc) designs. The constructs were then tested at physiologic loading levels in axial compression and bending (dorsal and volar) modes. Construct stiffness was assessed by fracture gap motion during the different loading conditions. As a within-study control, intact bone analogs were similarly tested. All plated constructs were significantly less stiff than the intact control bone models in all loading modes (pbending (pbending.

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

    Science.gov (United States)

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

    2008-10-01

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

  3. 锁定钢板治疗老年肱骨外科颈骨折%Locking Plate in the Treatment of Surgical Neck Fractures of Humerus in Elderly Patients

    Institute of Scientific and Technical Information of China (English)

    胡北

    2015-01-01

    Objective To study the analysis of proximal humerus locking plate in the treatment of humerus surgical neck fracture healing. Methods This study selected 50 cases of elderly patients with humerus surgical neck fracture were from our hospital in October 2013~December 2014 during hospitalization in patients undergoing surgery, to select al of the old age patients with humerus surgical neck fracture treated by those who did the same personnel row locking plate, postoperative fol ow-up for 9 months. Statistical treatment ef ect. Results Al patients with postoperative wound infection, not fracture malunion or don't heal as wel as the internal fixation of fracture, loose;To recover the shoulder function evaluation standard reference Neer criteria for evaluation the curative ef ect of al of the patients;Its specific function recovery is:23 cases, 19 cases, 6 cases, 2 cases, fine rate was 84%. Conclusion Locking proximal humeral plate treatment has a good treatment and humerus surgical neck fracture fixed ef ects, and joint function recovered wel and fracture end good healing of fracture, fewer complications, early functional exercise can help patients and restore injured limb function, is a good surgical treatment method, is worthy of clinical promotion.%目的探讨分析肱骨近端锁定钢板治疗老年肱骨外科颈骨折的临床治疗效果。方法本次研究选取的50例老年肱骨外科颈骨折患者均来自我院2013年10月~2014年12月的住院接受手术治疗的患者,对选取的所有老年肱骨外科颈骨折患者均由同一手术组人员行锁定钢板手术治疗,术后进行随访9个月。统计治疗效果。结果术后所有患者都未发生伤口感染、骨折畸形愈合或不愈合以及内固定断裂、松动;对于肩关节功能的恢复评价标准参照Neer评分标准对所有患者的疗效进行评定;其具体功能恢复情况为:优23例,良19例,可6例,差2例,优良率为84%。结论肱骨近

  4. 微创胫骨远端L型锁定钢板治疗Pilon骨折16例临床分析%Clinical Analysis of 16 Cases of Pilon Fracture Treated with Distal Tibia L Locking Plate of Minimally Invasive

    Institute of Scientific and Technical Information of China (English)

    黄绪奎

    2015-01-01

    Objective:To disscuss the operation main points and clinical therapeutic effect of Pilon fracture treated with distal tibia L locking plate of minimally invasive.Method:The data of 16 cases of Pilon fracture patients treated with distal tibia minimally invasive limited open reduction of side L locking plate internal fixation were retrospectively analyzed in our hospital from January 2013 to June 2014.11 cases of fibula segment or external ankle fractures were performed after the lateral and longitudinal incision,the decision to choose reset 1/3 tubular or reconstruction plate fixation or fibula distal lateral plate fixation according to the fracture situation.Result:6-18 months follow-up after operation,all fracture patients were reached clinical healing. No internal fixation loosening or fracture,fracture displacement,skin flap necrosis,infection of incision,complications,etc.The Johner-wruhs grading system was used to evaluate surgical curative effect,10 cases were good,4 cases were well,2 cases were medium,0 case was poor,no incision infection.Conclusion:Distal tibia L minimally invasive locking plate for Pilon fractures is with a small surgical trauma,periosteal stripping significantly reduced,thus protect fracture blood supply effectively,improve the cure rate of fracture and reduce the fracture complications.At the same time,patients in clinic are able to take early ankle function exercises,it can obtain satisfactory clinical effect.%目的:探讨采用微创胫骨远端L型锁定钢板治疗Pilon骨折的手术要点与临床治疗效果。方法:回顾分析笔者所在医院2013年1月-2014年6月16例Pilon骨折患者的资料,采用胫骨远端前侧微创有限切开复位L型锁定钢板内固定。其中合并腓骨下段或外踝骨折则作后外侧纵切口11例,复位后根据骨折情况决定选用1/3管形或重建钢板固定或腓骨远端外侧钢板固定。结果:术后随访6~18个月,所有患者均达到临床愈合。无

  5. The biomechanical study of medial cortex defect on axial stability of proximal humeral fracture fixed with locking plate%内侧皮质缺损对肱骨近端骨折锁定钢板内固定轴向稳定性影响的生物力学研究

    Institute of Scientific and Technical Information of China (English)

    白露; 张文涛; 江长青; 张洪雷; 黄伟; 张新涛; 李伟

    2014-01-01

    Background Proximal humeral fracture is a common injury of shoulder girdle. Currently,locking plate was widely used in management of proximal humeral fractures.Known as“internal fixator”,locking plate can provide more purchase in osteoporosis humeral head,bearing more biomechanical advantages.However,some large series of clinical research showed varus deformity became one of the main complication of proximal humeral fractures treated with locking plate that caused by axial instability.Multi-center trail found that medial cortex defect of proximal metaphyseal of humerus was an independent risk factor of reduction loss and varus malunion.Furthermore,such pathophysiological biomechanic basis was still vague.Our research was planned to study the relationship between medial cortex defect and axial stability of locking plate fixed proximal humeral fracture,in order to find inner rule of how medial cortex defect affect locking plate fixation of proximal humeral fracture.Methods Eighteen adult humerus specimen(6 pairs male),average death age 63.4 years(49-73).All the specimen were excluded bone tumor and occult fracture.Fracture model were prepared at X-Y table.Specimen were cut to 200mm from proximal to shaft.Fracture line was cut at surgical neck perpendicular to humeral shaft.Five millimeter medial cortex defect were also created by T-Saw.All the specimen were fixed using Synthesis PHILOS (Proximal Humerus Internal Osteosythesis System)following AO fixation rules.Specimens were randomized into contrast group, medial cortex half defect group and medial cortex quarter defect group.Axial compression and shear test were done in RGM-40XX2100 machine (Load scale 10 kN,± 1% ).Mechanical Load:Preload:50N,Velocity:5 mm/min,Maximum displacement:5 mm.In axial compression and shear tests,the slope of the load de ection curve was used to compute baseline axial stiffness.Each test was repeated three times and average stiffness was calculated.Statistical analyses were performed

  6. Isolated volar surgical approach for the treatment of perilunate and lunate dislocations

    Directory of Open Access Journals (Sweden)

    Hakan Basar

    2014-01-01

    Conclusion: The clinical and radiological results of the isolated volar surgical approach were satisfactory. The dorsal approach was not needed for reduction of dislocations during operations. Our results showed that an isolated volar approach was adequate.

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

    Science.gov (United States)

    Galos, David; Taylor, Benjamin; McLaurin, Toni

    2017-01-01

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

  8. Development and clinical application of locking plate positioning connector%锁定钢板定位连接器的研制与临床应用

    Institute of Scientific and Technical Information of China (English)

    杨鹏; 翟睿; 史建民

    2012-01-01

    目的 设计一种锁定钢板的定位连接装置,探讨其在应用MIPPO技术治疗中的优越性.方法 将自制锁定钢板定位连接器应用于40例下肢骨折患者手术中,其中胫腓骨骨折18例,股骨近端骨折12例,股骨远端骨折10例.结果 40例手术均顺利完成,术中未发生定位偏差;切口长度7.3~16.5(12.2±2.24)cm,术中出血量80~310(110±25)ml,术后住院时间3~12(6±2.1)d.患者均获随访,时间6~26(12±2.4)个月.骨折均骨性愈合,时间5~7个月.1例术后出现腓浅神经麻痹.结论 锁定钢板定位连接器的应用能准确定位皮下钢板钉孔,减小手术切口和术中出血量,缩短患者住院时间,是锁定钢板微创手术中一个实用小工具.%Objective To design of a locking plate positioning and connecting device, and to discuss the application of MIPPO technology. Methods Self locking plate locating connector was used in 40 cases of lower limb fracture patients in operation, including 18 cases of tibia and fibula fractures, proximal femoral fracture in 12 cases, 10 cases of distal femoral fractures. Results 40 cases of laparoscopic operation were successful, with no positional deviation; operation incision length 7. 3 ~ 16. 5( 12. 2 ±2. 24 ) cm, intraoperative bleeding volume 80 ~310( 110 ±25 ) ml,postoperative hospital stay was 3~12(6±2. 1) days. All cases were followed up for 6 ~ 26( 12 ± 2. 4 ) months, the fractures were healed, 5 to 7 months; 1 case of postoperative superficial peroneal nerve palsy. Conclusions Application of locking plate locating connector can be accurately positioned subcutaneously steel nail hole, which can reduce the operation incision and bleeding in the operation, shorten the time of hospitalization. It is a locking plate of minimally invasive operation in a practical gadget.

  9. Si te sobreprotejo, no aprenderás a volar

    OpenAIRE

    Ortega Delgado, Juan Carlos; Enríquez Lara, Mónica Mercedes

    2013-01-01

    Tesis (Maestría en Educación desde la Diversidad). Universidad de Manizales. Facultad de Ciencias Sociales y Humanas, 2013 RESUMEN 1. Mónica Enríquez 2. Juan Carlos Ortega SI TE SOBREPROTEJO, NO APRENDERÁS A VOLAR El presente artículo se basa en la investigación denominada SI TE SOBREPROTEJO, NO APRENDERÁS A VOLAR, realizada acerca de la sobreprotección vista como otra forma de maltrato, la cual se ubica en el macroproyecto de Desarrollo Humano, Sujeto y diversidad, de...

  10. Si te sobreprotejo, no aprenderás a volar

    OpenAIRE

    Ortega Delgado, Juan Carlos; Enríquez Lara, Mónica Mercedes

    2013-01-01

    Tesis (Maestría en Educación desde la Diversidad). Universidad de Manizales. Facultad de Ciencias Sociales y Humanas, 2013 RESUMEN 1. Mónica Enríquez 2. Juan Carlos Ortega SI TE SOBREPROTEJO, NO APRENDERÁS A VOLAR El presente artículo se basa en la investigación denominada SI TE SOBREPROTEJO, NO APRENDERÁS A VOLAR, realizada acerca de la sobreprotección vista como otra forma de maltrato, la cual se ubica en el macroproyecto de Desarrollo Humano, Sujeto y diversidad, de...

  11. Treatment of comminuted proximal humeral fractures by locking plate%锁定钢板治疗肱骨近端粉碎性骨折

    Institute of Scientific and Technical Information of China (English)

    陈晓东; 王宇仁; 崔一民; 王栋梁; 王伟; 董海; 沈超; 何继业; 蒋雷声

    2008-01-01

    目的 了解锁定钢板治疗粉碎性肱骨近端骨折的疗效及相关手术技术.方法 2003年2月-2007年3月,采用锁定钢板治疗肱骨近端粉碎性骨折34例,其中21例采用肱骨近端锁定钢板(locking proximal humerus plate,LPHP),13例采用肱骨近端锁定系统(proximal humerus interlockingsystem,PHILOS).根据Neer分型,三部分骨折30例,四部分骨折4例.结果 术后32例获得12~36个月随访,平均18.6个月.2例失访.术后骨折均愈合,无内固定失效,骨折平均愈合时间为10周.根据Constant评分标准评定:优4例,良23例,可4例,差1例;优良率为84.4%.其中60岁以下Constant评分平均为83(77~90),60岁以上平均为72(30~86).三部分骨折评分平均为76(70~90),而四部分骨折平均为60(30~74).结论 锁定钢板是治疗肱骨近端粉碎性骨折的有效方法.肱骨近端内侧的有效支撑以及减少软组织剥离是手术成功的关键.%Objective To investigate the surgical techniques and evaluate the results of locking plate in treatment of comminuted proximal humeral fractures. Methods From February 2003 to March 2007, 34 cases of Comminuted proximal humeral fractures were treated using locking plate manufactured by Synthes (21 cases with locking proximal humerus plate, LPHP; 13 cases with proximal humerus interlocking system, PHILOS). There were 9 males and 25 females. The ages of this group ranged from 43 to 81 years, with an average of 64.7 years. According to Neer classification, there were 30 cases of three-part fractures, and 4 cases of four-part fractures. Results The follow-up period of 32 cases ranged from 12 months to 36 months, the average being 18.6 months. Two were lost for follow up. Bone union was achieved in all the cases, with the mean healing period of 10 weeks. According to Constant scoring, the excellent and good result rate was 84.4%. Conclusion Locking plate is an effective method for treating comminuted proximal humeral fractures. Mechanical

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

    Science.gov (United States)

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

    2016-01-01

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

  14. Comparison of the efficacy of double locking plate and Y plate in the treatment of type C inter-condylar humeral fracture%双锁定钢板与Y型钢板治疗C型肱骨髁间骨折的疗效对比

    Institute of Scientific and Technical Information of China (English)

    汪文录; 王春喜

    2016-01-01

    目的:比较双锁定钢板与 Y 型钢板内固定治疗 C 型肱骨髁间骨折的临床效果。方法选择2011年12月至2014年10月 C 型肱骨髁间骨折患者32例,随机分为观察组(双锁定钢板组)和对照组(Y 型钢板组),每组16例,观察组患者给予双锁定钢板内固定治疗,对照组患者给予 Y 型钢板内固定治疗,比较两组患者的手术时间、术中出血量、住院时间及肘关节功能。结果两组患者手术时间、术中出血量、住院时间比较差异均未见统计学意义(P ﹥0.05);观察组患者肘关节功能恢复优10例,良4例,可1例,差1例,优良率为87.50%;对照组患者肘关节功能恢复优7例,良4例,可3例,差2例,优良率为68.75%;观察组患者肘关节功能恢复优良率高于对照组(P ﹤0.05)。结论双锁定钢板治疗 C 型肱骨髁间骨折可提供坚强的内固定,有利于患者术后肘关节功能恢复,减少并发症。%Objective To compare the clinical effect of double locking plate and Y plate internal fixation in treatment of type C intercondylar humeral fractures. Methods From November 2011 to Octo-ber 2014,the 32 cases of type C intercondylar humeral fractures were randomly divided into two groups, the observation group(double locking plate group)and the control group(Y plate group),with 16 cases in each group. The observation group was treated by double locking plate internal fixation,and the control group was treated by Y plate internal fixation. The operation time,bleeding volume and hospitalization time and elbow joint function were compared between the two groups. Results By follow-up of 12 -24 months(mean,15. 6 months)for 32 cases,there was no significant difference in operation time, bleeding volume and hospitalization time between the two groups(P ﹥ 0. 05). In the observation group, the function of elbow joint was excellent in 10 cases,good in 4 cases,fair in 1 case,poor in 1 case

  15. S3肱骨近端锁定钢板治疗肱骨近端骨折短期疗效分析%Initial outcome and efficacy of S3 proximal humerus locking plate in the treatment of proximal humerus fractures

    Institute of Scientific and Technical Information of China (English)

    张志明; 朱雪松; 包肇华; 杨惠林

    2012-01-01

    目的 探讨S3肱骨近端锁定钢板治疗肱骨近端骨折的短期疗效.方法 应用S3肱骨近端锁定钢板治疗肱骨近端骨折22例,按Neer分型,其中二部分骨折4例,三部分骨折11例,四部分骨折7例.结果 随访时间3~15个月,平均6.2个月.术后肩关节功能参照Neer功能评分标准,优17例,良4例,可1例,优良率为95.5%.结论 新型的S3肱骨近端锁定钢板独特的设计理念给肱骨近端骨折复位后提供了牢固的软骨下支撑和内固定支架,应用该钢板治疗肱骨近端骨折可获得较好的固定效果.%Objective To explore the initial outcome and efficacy of S3 proximal humerus locking plate in the treatment of proximal humerus fractures. Methods Twenty-two patients with proximal humerus fracture were treated with the S3 proximal humerus locking plate. Most of the fractures were complex, two-part(n =4), three-part(n = 11) and four-part (ra =7) fractures according to the Neer classification of the proximal humerus fractures. Results All patients were followed up for 3 ~ 15 months. There were no complications related to the implant including loosening or breakage of the plate. Good and excellent results were documented in 17 patients and fair results in 4 patients according the Neer scores of shoulder. Conclusion New design concepts of S3 proximal humerus plate provide the subchondral support and the internal fixation support. With the addition of the proper exercise of the shoulder joint, the outcomes would be satisfied.

  16. Modified cup flap for volar oblique fingertip amputations

    Directory of Open Access Journals (Sweden)

    Ahmadli, A.

    2016-02-01

    Full Text Available We describe a modified volar “V-Y cup” flap for volar fingertip defects that do not exceed more than half of the distal phalanx for better aesthetic and functional outcome. In seven cases out of eight, the flap was elevated with a subdermal pedicle, whereas in one case, the flap was elevated as an island on the bilateral neurovascular bundle. The fingertips have been evaluated for sensibility using standard tests, hook nail deformity and patient satisfaction. Seven flaps have survived completely. The flap with skeletonized bilateral digital neurovascular bundle has shown signs of venous insufficiency on the 5 postoperative day with consecutive necrosis. Suturing the distal edges of the flap in a “cupping” fashion provided a normal pulp contour. The modified flap can be used for defects as mentioned above. Subdermally dissected pedicle-based flap is safe and easy to elevate. The aesthetic and functional outcomes have been reported to be satisfactory.

  17. Analysis of the Outcomes of Anatomical Lock Plate for C Type Distal Humerus Fracture%解剖锁定接骨板治疗C型肱骨远端骨折的疗效分析

    Institute of Scientific and Technical Information of China (English)

    朱前拯; 刘成刚; 段亚景; 杨雨润; 杨欢; 陈星佐; 王立强; 陈瀛; 杨连发; 林朋

    2015-01-01

    目的:观察解剖锁定接骨板治疗C型肱骨远端骨折以及术后规范化康复的疗效。方法2009年12月至2013年6月使用解剖锁定接骨板治疗17例C型肱骨远端骨折患者,其中男性6例,女性11例;年龄24~84岁,平均51.2岁。损伤原因:低能量损伤9例(低能量组);高能量损伤8例(高能量组)。受伤至手术时间为1~30d,平均8.4d。术后患者开始规范化肘关节功能康复治疗。末次随访时记录患侧肘关节活动范围并采用M ayo肘关节功能评分。结果所有患者术后获9~48个月(平均18.59个月)随访,所有骨折均愈合,1例合并尺骨鹰嘴截骨处延迟愈合。末次随访时,肘关节伸直15.0°±10.2°,屈曲103.2°±16.3°,活动范围88.2°±22.8°。M EPS评分(83.9±19.2)分,优良率76.5%(13/17)。高能量组与低能量组MEPS评分分别为(71.9±22.5)分和(94.6 ± 4.9)分,差异有统计学意义( P=0.025)。结论 A O解剖锁定接骨板治疗C型肱骨远端骨折的疗效肯定,高能量损伤患者的预后较差,初始损伤因素影响患者肘关节功能恢复,规范化的康复治疗有助于肘关节功能恢复。%Background Among AO types ,C type distal humerus fracture is a very complicated intra‐articular fracture .The distal humerus metaphysis and the articular surface are easy to get severe smash ,which add more difficulties to the treatment .C type distal humerus fracture is complicated with bone defects ,soft tissue injury ,nerve injury ,osteoporosis and other symptoms ,which add to the unsteady fixation and can lead to adverse impacts to prognosis .AO distal humerus lock plates are paralleled plates that vertically fix the internal fracture .It designs to be anatomical plastotype and the distal point is fixed with the 2 .7mm screws .It is more flexible and convenient to use in the operation , and can effectively prevent the

  18. Post-traumatic Raynaud's phenomenon following volar plate injury.

    Science.gov (United States)

    Chodakiewitz, Yosef G; Daniels, Alan H; Kamal, Robin N; Weiss, Arnold-Peter C

    2014-04-01

    Post-traumatic Raynaud's phenomenon following non-penetrating or non-repetitive injury is rare. We report a case of Raynaud's phenomenon occurring in a single digit 3 months following volar plate avulsion injury. Daily episodes of painless pallor of the digit occurred for 1 month upon any exposure to cold, resolving with warm water therapy. Symptoms resolved after the initiation of hand therapy, splinting, and range-of- motion exercises.

  19. Osteotomias do rádio distal com uso de placa volar de ângulo fixo Osteotomy of the distal radius using a fixed-angle volar plate

    Directory of Open Access Journals (Sweden)

    Ricardo Kaempf de Oliveira

    2012-04-01

    rigid fixation with a fixed-angle volar plate, we started to use the same method for osteotomy of the distal radius. METHODS: A retrospective review was conducted, and 20 patients treated between February 2002 and October 2009 were found. The mean length of follow-up was 43.9 months (range: 12 to 96 months. The surgical indications were persistent pain, deformity and functional limitation subsequent to a dorsally displaced fracture. RESULTS: The mean preoperative deformity was 27º of dorsal tilt of the distal radius, 87º of ulnar tilt, and 7.3 mm of shortening of the radius. All the osteotomies consolidated and the final mean volar tilt was 6.2º, with ulnar tilt of 69.3º and shortening of 1 mm. The mean mobility of the wrist increased by 19.9º (flexion and by 24º(extension. Mean forearm supination increased by 23.5º and pronation by 21.7º. Grip strength increased from 13.4 to 34.5 pounds. CONCLUSION: Use of a fixed-angle volar plate for a volar approach towards osteotomy of the distal radius enables satisfactory correction of the deformities and eliminates the need for removal of the synthesis material caused by tendon complications

  20. Comparison of Locking Plate and PFNA for Intertrochanteric Fractures%锁定钢板与PFNA治疗股骨粗隆间骨折的对比分析

    Institute of Scientific and Technical Information of China (English)

    刘国龙; 窦庆寅; 韩同坤; 阳闽军

    2011-01-01

    Objective To compare the clinical effects of locking plate and PFNA in the treatment of intertrochanteric fractures. Methods A total of 138 cases of intertrochanteric fractures were treated with anatomical proximal femoral locking plate (locking plate group, n = 63) and modified proximal femoral intramedullary nails (PFNA group,n= 75) according to age and modified Evans classification. Perioperative indicators and degree of functional recovery of hip after surgery were compared between the two groups. Results All patients were followed up for 7-36 months. There were significant differences in cut size, amount of bleeding, reduction of neck shaft angle,and average healing time between locking plate group and PFNA group (P<0.05), but the differences in operation time and postoperative hip function were not significant between the two groups (P>0. 05). Conclusion PFNA is a better choice than proximal femoral anatomical locking plate in the treatment of intertrochanteric fractures due to smaller incisions,less blood loss and shorter time in bed.%目的 比较锁定钢板与改良股骨近端加锁髓内钉(PFNA)2种内固定方式治疗股骨粗隆间骨折的临床疗效.方法 根据不同年龄段和骨折分型,对138例股骨粗隆间骨折患者分别采用股骨近端解剖型锁定钢板(解剖型锁定钢板组,n=63)及PFNA(PFNA组,n=75)进行内固定.对2组围术期指标和术后髋关节功能恢复程度进行比较.结果 2组患者均获随访7~36个月.2组切口大小、出血量、颈干角减少、平均愈合时间比较,差异有统计学意义(P<0.05).2组骨折手术时间、术后髋关节功能比较,差异无统计学意义(P>0.05).结论 2种内固定方法 临床效果相当,但与股骨近端解剖型锁定钢板比较,PFNA创伤小、出血量少、卧床时间短.

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

    Science.gov (United States)

    Vallier, Heather A

    2016-11-01

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

  2. Ulno-volar bayonet hand: Its differential diagnosis from Madelung's deformity

    Energy Technology Data Exchange (ETDEWEB)

    Christ, F.

    1981-04-01

    The ulno-volar bayonet hand related to the mostly hereditary multiple exostoses is compared to Madelung's forearm deformity under clinical and roentgenological view in differential diagnosis. The ulno-volar bayonet hand is considerably more seldom, basing upon dysplasia of the lower part of the ulna, less inconvenient in function, and hardly tending to the development of early arthrosis.

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

    Directory of Open Access Journals (Sweden)

    Manish Bairagi

    2016-07-01

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

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

    Science.gov (United States)

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

    2016-12-01

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

  5. 多轴锁定钢板内固定治疗复杂胫骨平台骨折临床观察%Clinical observation of multiaxis locking plate on treating complex tibial plateau fractures

    Institute of Scientific and Technical Information of China (English)

    周志华; 王修卓; 杨新

    2013-01-01

    Objective To explore multiaxis locking plate in the treatment of complex tibial plateau fractures fixed treatment effect. Methods 24 cases of complex fracture of tibial plateau were treated using multiaxis locking plate. Results 24 cases have been followed-up period was average of 12 months. (ranging from 6 months to 24 months), an According to Merchant score standard evaluation of knee joint function, excellent in 4 cases (16.6%), good in12 cases (50%),pretty good in 6 (25%) points, poor in 2 (8.4%). Conclusion Multiple spindle locking plate fixed in treatment of complex fracture of tibial plateau is widely used, the more stable after fixed, less postoperative complications, and is a good choice.%  目的探讨多轴锁定钢板内固定治疗复杂胫骨平台骨折的治疗效果。方法24例胫骨平台骨折患者采用多轴锁定钢板内固定治疗。结果24例均获随访,时间6个月~24个月,平均12个月。按Merchant评分标准评价膝关节功能,优4例(16.6%),良12例(50%),中6例(25%),差2例(8.4%)。结论多轴锁定钢板内固定治疗复杂胫骨平台骨折适用范围广,固定稳固,预后好,术后并发症少,可以作为复杂胫骨平台骨折的较佳治疗选择。

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

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2012-10-01

    92 years. All the cases had a mean postoperative follow-up period of 12 months. Thirteen fractures were classified as presenting in two parts, 28 as three, eight as four and seven as epiphyseal fractures. RESULTS: Among the patients operated, 26 were considered to have achieved excellent results, twelve good, ten fair and eight poor, according to the UCLA score. Thirty complications occurred in 20 patients (35.7%, among which the most frequent complication was inadequate reduction of the fracture, which occurred in eight cases. Subacromial impact, caused by the plate, occurred in seven cases, while inadequate fixation occurred in six cases. Other complications such as pseudarthrosis, adhesive capsulitis, avascular necrosis, loss of varus reduction and infection were also seen. CONCLUSION: The functional results from treating fractures of the proximal extremity of the humerus using a locking plate depended on correct anatomical reduction of the fracture and stable fixation of the implant. Complications still occur frequently, particularly because of intraoperative technical difficulty, fracture severity and possible inexperience of the surgeon.

  7. Comment to: Haque S, Khan A, Sharma A, Sundararajan S: Technical tip: tightrope fixation of neer type II distal clavicle fracture supported by a case series. Pol Orthop Traumatol, 2014; 79: 19-22.

    Science.gov (United States)

    Gökkuş, Kemal; Saylik, Murat; Aydin, Ahmet Turan

    2014-04-15

    Additional suture anchor fixation to coracoclaviculer area with precountered distal clavicle locking plate allows an anatomic reduction with bone-bone contact and gives additional neutralisation effect with coracoclavicular suture anchor fixation against the trapezius muscle pulling effect .Event though the effeciency of this technique reported by other authors,still there is a few articles and cases reported.In the terms of proving the efficiency of the combination technique we would like to stress to contribute the published article by Haque et al.

  8. Two kinds of locking plate for treatment of proximal humerus fractures in the elderly%两种锁定钢板置入内固定治疗老年肱骨近端骨折

    Institute of Scientific and Technical Information of China (English)

    陈立; 赵弟庆; 杨广忠; 陈刚

    2013-01-01

    were divided into PHILOS group (n=34) and LPHP group (n=27). According to the Neer system, there were two parts of fractures in seven cases, three parts of fractures in 11 cases, four parts of fractures in nine cases in LPHP group;there were two parts of fractures in nine cases, three parts of fractures in 14 cases, four parts of fractures in 11 cases in PHILOS group. The operation time, blood loss, and drainage volume were recorded. The time of fracture healing, functional recovery, and complications were observed. Statistical analysis was performed. RESULTS AND CONCLUSION:Al 61 patients were fol owed up for 12-36 months (mean 20.6 months). There was no statistical difference in operation time, blood loss, drainage volume, time of fracture healing, functional recovery and complications between the two groups (P>0.05). Both LPHP and PHILOS groups could obtain good effects in treatment of senile proximal humeral fractures. The excellent and good rate was respectively 81.5%and 82.4%in two groups. They have advantages of reliable fixation, few complications, and high satisfaction rate. Currently these locking plates have a high clinical value and can be considered as useful implants for ORIF of displaced and unstable proximal humeral fractures.

  9. Treatment of physeal fractures of the distal radius by volar intrafocal Kapandji method: surgical technique.

    Science.gov (United States)

    Rubin, Guy; Orbach, Hagay; Chezar, Avi; Rozen, Nimrod

    2017-01-01

    Distal radial physeal fractures with volar displacement are rare. Several methods of operative treatment include volar plate without inserting distal screws, percutaneous technique using two anterior skin incisions and reversed Kapandji technique with pins introduced through a posterior approach and locked at the anterior cortex of the fracture. We report three cases along with a literature review of the surgical techniques described in the past and a novel surgical technique for this uncommon fracture termed "Volar Kapandji". All patients had anatomic reduction at the last follow-up radiography, and all patients had a full range of motion and VAS 0 at the last follow-up. No complications were recorded. This case study presents the minimally invasive option for treating rare cases of physeal distal radius fractures with volar displacement. V.

  10. 解剖型锁定钢板固定治疗累及股骨干的转子间或转子下骨折%Treating femoral intertrochanteric and subtrochanteric fractures combined with femoral shaft fractures using anatomic locking plate

    Institute of Scientific and Technical Information of China (English)

    王少林; 谭祖键; 周明全; 吴钢; 张胜利; 龙祥明

    2012-01-01

    Objective To evaluate clinical efficacy of treating femoral intertrochanteric and subtrochanteric fractures combined with femoral shaft fractures using anatomic locking plate.Methods From January 2009 to June 2011,we treated 72 cases of femoral intertrochanteric and subtrochanteric fractures combined with femoral shaft fractures using anatomic locking plate.Sixty-four cases were followed up.There were 50 males and 14 female,with an average age of 42.8 years (range,21-79).All patients suffered from closed femoral unilateral fractures.The interval between injury and surgery was 2 h-16 d (average,4.6 d).All patients were followed up at regular interval.During the follow-up period,clinical and radiographic data were recorded.The clinical efficacy was evaluated with Harris hip function score.Results The mean operative time was 65 min (range,45-120 min); the mean blood loss was 210 ml (range,50-650 ml).All patients began to walk with crutches 3-35 d after surgery.During the follow-up period,no infection,deep vein thrombosis,screwed cut-out and implant failure occurred in all patients.Coxa vara with shortening deformity was noted in 2 cases,solid bone union was found in all the cases.The mean time of fracture healing was 5.2 months (range,3.6-10.5 months).According to Harris hip score,45 cases were classified as excellent,14 as good and 5 as fair,with excellent and good rate being 92.19% (59/64).Conclusion Anatomic locking plate fixation provides stable fixation,with a high union rate and a minimal complication rate in treatment of intertrochanteric and subtrochanteric fractures combined with femoral shaft fracture.%目的 评价采用解剖型锁定钢板固定治疗累及股骨干的转子间或转子下骨折的临床疗效.方法 2009年1月至2011年6月,采用解剖型锁定钢板固定治疗累及股骨干的转子间或转子下骨折者72例,64例患者获得随访.男50例,女14例;年龄21~79岁,平均42.8岁.所有患者均为股骨单侧闭

  11. Clinical outcomes of proximal humeral internal locking system self-locking plates in treatment of proximal humeral fractures%肱骨近端内固定系统自锁钢板治疗肱骨近端骨折疗效分析

    Institute of Scientific and Technical Information of China (English)

    唐康来; 许建中; 谭晓康; 吴雪晖; 徐格; 龚继承; 汪华清; 谢肇; 马树枝; 王序全

    2008-01-01

    目的 介绍肱骨近端内固定系统(proximal humeral internal locking system,PHILOS)白锁钢板治疗肱骨近端骨折的方法并分析其疗效. 方法 本组男19例,女16例;年龄29~92岁,平均53.5岁.所有骨折均按Neer分型标准进行分类,其中二部分骨折19例,三部分骨折15例,四部分骨折1例.手术采用胸人肌-三角肌间隙入路,均采用PHILOS自锁钢板进行固定.术后对所有患者进行平均18.9个月(6~46个月)的临床随访,主要包括X线片和Constant功能评分. 结果 X线片证实所有肱骨近端骨折均得到良好的复位并完全骨性愈合,愈合时间8~12周.最近一次Constant-Murley功能评分:平均89.5分(82~94分).随访期间未发生钢板松动、肱骨头缺血性坏死和需肱关节创伤性关节炎等并发症. 结论 PHILOS自锁钢板是治疗肱骨近端骨折的好方法,具有操作方便、固定可靠、疗效确切及并发症少的优势.%Objective To evaluate the clinical results of proximal humeral internal locking sys-tem(PHILOS)self-locking plates in treatment of proximal humeral fractures. Methods There were 35 patients including 19 males and 16 females(at mean age of 53.5 years,ranging from 29 to 92 years)with proximal humeral fractures treated with PHILOS plate.According to the Neer's classification sys-tem,there were two-part fractures in 19 patients,three-part fractures in 15 and four-part fractures in 1.Surgery was performed with PHILOS serf-locking plate via dehopectoral approach.All patients were fol-lowed up for mean 18.9 months(6-46 months)and evaluated by using Constant score and X-rays. Re-suits X-rays proved that all fractures got good reduction and complete healing during 8-12 weeks.The latest Constant scores was mean 89.5 points(82-94 points).There were no complications including plate loosing.humenral head necrosis or gleno-humeral ioint osteoarthritis. Conclusion PHILOS plate is a good choice for treatment of proximal humeral fractures

  12. Unilateral non-traumatic radiocarpal volar dislocation in a child: A long-term evolution Luxación radiocarpiana volar atraumática unilateral en una niña: Evolución a largo plazo

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    S. García-Mata

    2009-04-01

    Full Text Available We report an eight year-old female with trisomy 21 referred to our clinic for limitation of wrist mobility. The patient had been diagnosed and treated by polyarticular juvenile chronic arthritis for six months. Clinical and radiological study revealed volar radiocarpal dislocation of the left wrist. She was treated surgically by open reduction, temporary K-w fixation with six weeks of immobilization. The dislocation relapsed but the joint remained painless. One year later she had 5º of dorsal flexion and 25º of volar flexion and absence of pain. In spite of this situation the family said that the girl lived normal life without any limitation because of her condition, refusing further treatment. Eight years later the girl remains asymptomatic and does a normal life without limitation because of her condition. The patient and her family refused any treatment. Based in the failure of surgical treatment performed in our case we think that abstention could be the most reasonable option, mainly in the immature patients.Presentamos el caso de una niña de ocho años con trisomía 21 que fue remitida a nuestra consulta por limitación de la movilidad de la muñeca izquierda. La paciente había sido diagnosticada y tratada por artritis crónica juvenil poliarticular durante seis meses. El estudio clínico y radiológico mostraba una luxación radiocarpiana volar de la muñeca izquierda. Se le efectuó reducción abierta y fijación temporal mediante agujas de Kirschner, con seis semanas de inmovilización. La luxación recidivó, pero la articulación permanecía indolora. Un año más tarde presentaba 5º de flexión dorsal y 25º de flexión volar con ausencia de dolor. A pesar de esa situación, la familia manifestaba que la niña realizaba una vida normal, sin ninguna limitación para su condición, rehusando cualquier tratamiento posterior. Ocho años más tarde, la paciente permanecía asintomática, realizando una vida normal sin limitaciones

  13. 锁定钛板及半肩关节置换治疗肱骨近端骨折的疗效分析%Locking plates and semi-shoulder arthroplasty for complex proximal humeral fractures

    Institute of Scientific and Technical Information of China (English)

    吕扬; 李少柟; 周方; 田耘; 姬洪全; 张志山

    2011-01-01

    目的 探讨锁定钛板及半肩关节置换术治疗肱骨近端骨折的疗效与适应证。方法 2005年1月至2008年12月共收治51例肱骨近端骨折患者,其中39例获得随方,男12例,女27例;平均年龄65.1岁(17 ~ 80岁)。骨折按Neer分型:二部分骨折23例,三部分骨折10例,四部分骨折6例。受伤至手术时间平均为5.5d(1~9d)。手术方式选择:二部分骨折及年龄<60岁的患者使用锁定钛板内固定治疗,四部分骨折及年龄> 60岁的患者使用半肩关节置换术。本组使用肱骨近端内固定系统(PHILOS)钛板切开复位内固定32例(PHILOS钛板组),其中二部分骨折23例,三部分骨折9例;采用肱骨头置换术治疗7例(关节置换组),其中三部分骨折1例,四部分骨折6例。结果 PHILOS钛板组患者手术时间平均为84 min(60 ~ 140 min),失血量平均为155 mL( 100 ~400 mL);关节置换组患者手术时间平均为125 min( 100 ~ 170 min),失血量平均为220 mL(150~450) mL。39例患者术后获平均23个月(16~46个月)随访,无一例出现并发症。PHILOS钛板组28例术后3个月复查X线片示骨折愈合,另4例术后6个月骨折愈合,肩臂手功能丧失量表(DASH)评分平均为20.7分,患者对手术主观满意率为87.5%。关节置换组7例患者DASH评分平均为36.0分,患者对手术主观满意率为71.4%。结论 对于年龄<60岁的患者及大部分Neer 二、三部分骨折的老年患者,可以选择PHILOS钛板内固定治疗,而年龄>60岁的四部分骨折患者选择半肩关节置换术可以获得较满意的疗效。%ObjectiveTo explore the clinical effects and indications of locking plates and semi-shoulder arthroplasty for complex proximal humeral fractures. Methods Thirty-nine cases of proximal humeral fractures were treated from January 2005 to December 2008. They were 12 men and 27 women, with a mean age of 65.1 years. According to

  14. CAD-CAM plates versus conventional fixation plates for primary mandibular reconstruction: A biomechanical in vitro analysis.

    Science.gov (United States)

    Rendenbach, Carsten; Sellenschloh, Kay; Gerbig, Lucca; Morlock, Michael M; Beck-Broichsitter, Benedicta; Smeets, Ralf; Heiland, Max; Huber, Gerd; Hanken, Henning

    2017-09-01

    CAD/CAM reconstruction plates have become a viable option for mandible reconstruction. The aim of this study was to determine whether CAD/CAM plates provide higher fatigue strength compared with conventional fixation systems. 1.0 mm miniplates, 2.0 mm conventional locking plates (DePuy Synthes, Umkirch, Germany), and 2.0 mm CAD/CAM plates (Materialise, Leuven, Belgium/DePuy Synthes) were used to reconstruct a polyurethane mandible model (Synbone, Malans, CH) with cortical and cancellous bone equivalents. Mastication was simulated via cyclic dynamic testing using a universal testing machine (MTS, Bionix, Eden Prairie, MN, USA) until material failure reached a rate of 1 Hz with increasing loads on the left side. No significant difference was found between the groups until a load of 300 N. At higher loads, vertical displacement differed increasingly, with a poorer performance of miniplates (p = 0.04). Plate breakage occurred in miniplates and conventional locking plates. Screw breakage was recorded as the primary failure mechanism in CAD/CAM plates. Stiffness was significantly higher with the CAD/CAM plates (p = 0.04). CAD/CAM plates and reconstruction plates provide higher fatigue strength than miniplates, and stiffness is highest in CAD/CAM systems. All tested fixation methods seem sufficiently stable for mandible reconstruction. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  15. 解剖重建锁定钢板固定治疗肱骨近端三、四部分骨折脱位%Management of proximal humeral Neer 3-part and 4-part fracture dislocations with anatomic reconstruction locking plate

    Institute of Scientific and Technical Information of China (English)

    杨国勇; 向明; 胡晓川; 陈杭; 杨顺; 唐浩琛

    2012-01-01

    Objective To analyze the therapeutic effect of open reduction with internal fixation (ORIF) and anatomic reconstruction locking plate in treatment of Neer 3-part and 4-part fracture dislocations of proximal humerus. Methods The study involved 30 patients with Neer 3-part and 4-part fracture dislocations treated with anatomic reconstruction locking plate from September 2004 to December 2007.Twenty patients had complete follow-up data.The treatment methods included locking proximal humeral plate (LPHP) in seven patients and proximal humeral internal locking system (PHILOS) in 13.There were 15 males and five females,at age range of 29-84 years (average 52.5 years),including nine patients younger than 65 years and 11 older than 65 years.According to Neer classification,there were 15 patients with 3-part fracture dislocations including 12 anterior and three posterior dislocations and five patients with 4-part fracture dislocations including four anterior and one posterior dislocations. VAS and Constant scoring system were adopted to evaluate the shoulder joint function postoperatively. Results All 20 patients were followed up for 36-71 months ( average 51 months),which showed avascular necrosis of humeral head in six patients (30%),plating loosening in two,screw penetration in six,nonunion in two and infection in two.The mean visual analogue score (VAS) was 2.55 poiuts and the mean Constant score for the shoulder was 80.8.According to the Neer shoulder functional evaluation standard,eight patients were graded as excellent,six as good,three as fair and three as poor,with excellence rate of 70%.Conclusions Although the anatomic reconstruction locking plate and ORIF can cause a high incidence of avascular necrosis of humeral head in the treatment of Neer 3-part and 4-part fracture dislocations of proximal humerus,especially for the patients older than 65 years.However,there is no obvious correlation between necrosis of humeral head and shoulder function

  16. Second Toe Plantar Free Flap for Volar Tissue Defects of the Fingers

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    Yong Jin Cho

    2013-05-01

    Full Text Available BackgroundThe reconstruction of volar surface defects is difficult because of the special histologic nature of the tissue involved. The plantar surface is the most homologous in shape and function and could be considered the most ideal of reconstructive options in select cases of volar surface defects. In this paper, we evaluate a single institutional case series of volar tissue defects managed with second toe plantar free flaps.MethodsA single-institution retrospective review was performed on 12 cases of reconstruction using a second toe plantar free flap. The mean age was 33 years (range, 9 to 54 years with a male-to-female ratio of 5-to-1. The predominant mechanism was crush injury (8 cases followed by amputations (3 cases and a single case of burn injury. Half of the indications (6 cases were for soft-tissue defects with the other half for scar contracture.ResultsAll of the flaps survived through the follow-up period. Sensory recovery was related to the time interval between injury and reconstruction-with delayed operations portending worse outcomes. There were no postoperative complications in this series.ConclusionsFlexion contracture is the key functional deficit of volar tissue defects. The second toe plantar free flap is the singular flap whose histology most closely matches those of the original volar tissue. In our experience, this flap is the superior reconstructive option within the specific indications dictated by the defect size and location.

  17. Fractures and fracture-dislocations of the proximal humerus: A retrospective analysis of 82 cases treated with the Philos(®) locking plate.

    Science.gov (United States)

    Erasmo, Rocco; Guerra, Giovanni; Guerra, Luigi

    2014-12-01

    To present the experience in a single institution of the management of 82 consecutive fractures and fracture-dislocations of the proximal humerus treated with the Proximal Humeral Internal Locking System (Philos(®)) plate. A total of 81 patients with 82 proximal humerus fractures (one patient had bilateral fracture) were treated at our institution with open reduction and internal fixation with Philos(®) plate from January 2008 to December 2012 and the clinico-radiological outcome was analysed. Twelve of these patients also had a dislocation of the proximal humerus. According to the Neer classification, there were seven two-part fractures, 40 three-part fractures and 35 four-part fractures. All patients received a similar physical therapy programme following internal fixation. Mean final follow-up was 32 months. Functional outcome was evaluated for each patient using the Constant-Murley score; radiographic evaluation was also conducted and complications were recorded. At the end of the follow-up period, the mean Constant-Murley score for the injured side was 75 points (range 42-92); results were graded as excellent for eight patients, good for 52, moderate for 17 and poor for five. Twenty-three patients (28%) had complications during the follow-up period. Reoperation was required in 12 patients. Complications included avascular necrosis of the humeral head in 10 patients (12%), varus positioning of the head in four patients (4.8%), impingement syndrome in three patients (3.6%), secondary screw perforation in three patients (3.6%), non-union of the fracture in two patients (2.4%) and infection in one patient (1.2%). Open reduction and internal fixation of proximal humeral fractures with the Philos(®) plate was associated with good clinical outcomes provided the correct surgical technique was used. To better evaluate the real incidence of complications, it is important to follow patients for more than one year after surgery as some complications may arise after

  18. 两种方法治疗 Schatzker Ⅵ型胫骨平台骨折疗效比较%The efficacy comparison of two kinds of internal fixation methods to treat Schatzker Ⅵ-type tibial plateau fracture

    Institute of Scientific and Technical Information of China (English)

    王伟

    2015-01-01

    Objective To compare the efficacy of uniaxial and biaxial locking plate to treat Schatzker Ⅵ-type fracture of tibial plateau.Methods Surgical treatment of 64 cases Schatzker Ⅵ-type tibial plateau fractures were performed, 29 cases of which were treated with single locking plate which counted as the uniaxial plate group,the other 35 cases of biaxial locking plate treatment counted as the biaxial plate treatment group.The knee score of each patient was re-corded every 3,6,9,12 months (HSS score standard).Results The difference of HSS score between the two groups after 12 months was statistically significant (P <0.05),biaxial locking plate group showed more effective than uniax-ial locking plate group.Conclusions Internal fixation with two plates to treat Schatzker Ⅵ-type fracture of tibial plateau features has the advantages such as strong fixation,early performance of postoperative joint function exercise, and the clinical results are optimal.%目的:比较单锁定钢板和双锁定钢板治疗 Schatzker Ⅵ型胫骨平台骨折的疗效。方法手术治疗64例Schatzker Ⅵ型胫骨平台骨折,29例单锁定钢板治疗患者为单钢板组,35例双锁定钢板治疗者为双钢板治疗组,记录所有患者术后3、6、9、12个月术膝的膝关节功能 HSS 评分。结果两组在术后12个月 HSS 评分差异有统计学意义(P <0.05),双钢板组疗效优于单钢板组。结论双钢板内固定治疗 Schatzker Ⅵ型胫骨平台骨折固定坚强,术后可行早期关节功能锻炼,临床疗效满意。

  19. [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

  20. 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分.并发症发生率为41.3%(38/92):出血(1.1%)、肱骨头/大结节对合不良(3.3%);慢性疼痛(6.5%),肱骨头缺血性坏死(AVN)(0%);复位丢失和螺钉切出(4.3%);钢板断裂(3.3%);肩峰下撞击(11.9%);肩周炎(4.3%);肩袖撕裂(1.1%);感染(1.1%).24例患者因上述并发症而行2次手术.结论:锁定钢板治疗肱骨近端移位骨折的临床疗效可靠,虽然其并发症和再手术率较高,但二者的发生率仍稍低于现有的文献报道.

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

    Directory of Open Access Journals (Sweden)

    Latifi Mohammed

    2012-07-01

    Full Text Available Abstract The first publication of the work [1] did not present one of the authors' names. Kunalan Ganthel has now been added to the author list. In addition, Habib Sherkat has been added to the Acknowledgements, with thanks for providing help with the use of hyperelastic module of Abaqus Software.

  2. 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.

  3. The experience of humerus surgical neck fracture with proximal humeral locking plate%锁定钢板治疗肱骨外科颈骨折临床疗效研究

    Institute of Scientific and Technical Information of China (English)

    曾强

    2013-01-01

    目的探讨肱骨近端锁定钢板(LPHP)治疗肱骨外科颈骨折的临床疗效。方法将78例肱骨外科颈骨折患者随机分为两组,试验组采用LPHP治疗,对照组采用克氏针内固定治疗,对比两组的治疗效果。结果试验组骨折愈合时间为(6.20±0.95)个月,快于对照组的(7.44±0.98)个月(P<0.05)。试验组患者Neer评分的总优良率为87.50%,显著高于对照组的65.79%(P<0.05)。结论肱骨近端锁定钢板固定治疗肱骨外科颈骨折疗效肯定,值得进一步推广。%Objective To investigate the therapeutic effect of humerus surgical neck fracture with proximal humeral locking plate. Methods 78 patients of humerus surgical neck fracture were randomly divided into two groups. The experimental group was treated by LPHP treatment. The control group was treated by Kirschner. Then comparing to the therapeutic effect of the two groups. Results Fracture healing time of the experimental group was (6.20±0.95) months. It was faster than the control group (7.44±0.98) months (P < 0.05). Neer score excellent and good rate of the experimental group was 87.50%, significantly higher than 65.79% of the control group (P<0.05). Conclusion The efficiency that proximal humeral locking plate was used to treat humerus surgical neck fracture is certain. So it is worthy of future promotion.

  4. Radial ridge excision for symptomatic volar tendon subluxation following de Quervain's release.

    Science.gov (United States)

    Collins, Evan D

    2014-09-01

    Traditional surgical release to address de Quervain's stenosing tenosynovitis can lead to the rare complication of volar tendon subluxation. This study presents a surgical procedure, which entails excision of the radial ridge as an alternative treatment to relieve pain associated with symptomatic volar tendon subluxation following de Quervain's release. The procedure was performed on 6 patients complaining of painful volar tendon subluxation of abductor pollicis longus (APL) and extensor pollicis brevis (EPB), following a first dorsal compartment release and postoperative splinting. We opened the same incision sharply, with direct view of the tendons of the first dorsal compartment. The wrist was ranged through extension and flexion, and volar subluxation of the APL and EPB over the prominent radial ridge was confirmed. The bony portion of the radial ridge was excised and filed smooth. The periosteal flap is advanced over the ridge and sutured into place. The APL and EPB tendons were released from dorsal retractors. All patients reported relief upon follow-up. Excision of this ridge removes the obtrusive friction to the APL and EPB tendons, allowing them to glide painlessly over the radial styloid.

  5. Scaphoid dislocation associated with axial carpal dissociation during volar flexion of the wrist: a case report.

    Science.gov (United States)

    Kanaya, Kohei; Wada, Takuro; Yamashita, Toshihiko

    2010-01-01

    We present the first report of a patient with an isolated scaphoid dislocation with axial carpal dissociation sustained during volar flexion of the wrist. The scaphoid was dislocated to the radial side of the radial styloid process and was slightly shifted to the dorsal side. It was shown that the position of the wrist played an irrelevant role for occurring scaphoid dislocation.

  6. Second Toe Plantar Free Flap for Volar Tissue Defects of the Fingers

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    Yong Jin Cho

    2013-05-01

    Full Text Available Background  The reconstruction of volar surface defects is difficult because of the specialhistologic nature ofthe tissue involved. The plantarsurface isthe most homologousin shapeand function and could be considered the mostideal ofreconstructive optionsin select casesof volar surface defects. In this paper, we evaluate a single institutional case series of volartissue defectsmanagedwith second toe plantarfree flaps.Methods  Asingle-institution retrospective reviewwas performed on 12 cases ofreconstructionusing a second toe plantar free flap. The mean age was 33 years (range, 9 to 54 years witha male-to-female ratio of 5-to-1. The predominant mechanism was crush injury (8 casesfollowed by amputations (3 cases and a single case of burn injury. Half of the indications (6caseswere forsoft-tissue defectswith the other halfforscar contracture.Results  All ofthe flapssurvived through the follow-up period. Sensory recoverywasrelatedto the time interval between injury and reconstruction−with delayed operations portendingworse outcomes. Therewere no postoperative complicationsin thisseries.Conclusions  Flexion contracture is the key functional deficit of volar tissue defects. Thesecond toe plantar free flap is the singular flap whose histology most closely matches thoseof the original volar tissue. In our experience, this flap is the superior reconstructive optionwithin the specific indications dictated by the defectsize and location.

  7. Resultados clínico-radiológicos en pacientes jóvenes con fractura articular completa de radio distal tratados con placa palmar bloqueada. [Clinical and radiological results in young patients with complete articular distal radius fractures treated with volar locked plate.

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    Pablo De Carli

    2016-02-01

    Conclusión: El tratamiento de las fracturas de radio distal tipo C en pacientes jóvenes con placa palmar bloqueada muestra resultados clínicos y radiológicos favorables con corrección de la mayoría de los escalones articulares.

  8. Comparison of the efficacy of single volar subcutaneous digital block and the dorsal two injections block.

    Science.gov (United States)

    Afridi, Riaz Ahmed Khan; Masood, Tariq; Ahmed, Ehtisham; Obaidullah, Abdul Majeed Jaffar; Alvi, Hamid Fazeel

    2014-01-01

    Digital nerve blocks are commonly used as effective techniques of anaesthesia to allow a variety of surgical procedures performed on digits. This study was conducted to compare the efficacy of volar subcutaneous single injection block and the traditional dorsal two injections digital block. This randomized controlled trial was conducted at Plastic and Reconstructive Surgery Department, Hayatabad Medical Complex Peshawar from December. 2009-10. A total of 126 patients with pathology distal to the first palmer digital crease divided into two equal groups. Group A received volar subcutaneous digital block while group B dorsal two injections block. Efficacy of digital block was measured in terms of time of onset of anaesthesia, which was the total time duration after administering local anaesthetic to loss of pinprick sensation and total duration of anaesthesia, which was defined as the time period from onset of block (loss of pinprick sensation) till the appearance of pain which required additional local anaesthetic or postoperative analgesia. A total of 126 patients were studied, 63 in each group. Of the total patients, 102 (81%) were male and 24 (19%) female with a mean age of 27 ± 4.2 years (range 17-60 years). The mean time of onset of anaesthesia from injection till the loss of pin prick sensation was 3.32 ± 0.42 minutes for volar single injection group and 4.53 minutes ± 0.57 minutes for dorsal two injections group (p = 0.049). Similarly the mean total duration of anaesthesia for the volar subcutaneous group was 271.9 ± 29.34 minutes while for the dorsal two injections group, it was 229.52 ± 28.82 minutes (p = 0.415). Single injection volar subcutaneous digital block provides faster onset of anaesthesia, produces predictable, consistent dense anaesthesia of all of the fingers with the help of single injection prick.

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

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    Isaac Sunder Sen

    2016-10-01

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

  10. [Experience with Poly Ether Ether Ketone (PEEK) cages and locking plate for anterior cervical fusion in the treatment of spine trauma without cord injury].

    Science.gov (United States)

    Delépine, F; Jund, S; Schlatterer, B; de Peretti, F

    2007-12-01

    The purpose of this study was to determine whether spinal fusion using radiotransparent cages can be an appropriate treatment for traumatic injury of the cervical spine. This series included 30 patients aged 17-84 years (average 46 years) treated between October 1999 and June 2003 for traumatic injury of the cervical spine without neurological deficit or cord injury. There were two bifocal cases so that the study concerned 32 fusions. Injuries were: tear drop (n=1), serious flexion sprain (n=8), biarticular dislocation (n=4), serous hyperextension sprain (n=4), dislocation-fracture (n=1), uniarticular fracture (n=7), fracture-separation of the facet joints (n=4), post-traumatic herniation (n=3). For each injury, we measured pre and postoperatively and at last follow-up: the intersomatic angle, anterior displacement, and height of the intersomatic space at the center of the intervertebral disc. All x-rays were read twice, by two independent investigators. In the event of disagreement, the x-rays were read again by a senior surgeon and the main author of this article. Anterior fusion was achieved using a Poly Ether Ether Ketone (PEEK) (32%) and knitted carbon (68%) cage (cologne, Ostapek, Nexis) filled with cancellous bone harvested percutaneously from the iliac crest. The cage was associated with an anterior titanium plate fixation (Senegas, Euros and Orion, Medtronic). A posterior approach was associated if further stability was required (n=4 fusions). All patients were reviewed at minimum five months follow-up. Intersomatic fusion was verified on the standard x-rays (plus stress images and computed tomography at three months). Fusion was considered to be achieved if continuous bone lines crossed the graft and angle measurements remained stable, with the cage in the same position on successive examinations. One patient died from lung cancer five months after spinal fusion. All other patients survived with a mean follow-up of 24 months. Fusion was achieved in all

  11. Biomechanical comparison of dorsal versus volar plate osteosynthesis for the dorsally unstable distal radius fracture%桡骨远端骨折掌侧与背侧接骨板固定的生物力学比较

    Institute of Scientific and Technical Information of China (English)

    邓芒; 付中国; 张殿英; 陈建海; 张培训; 姜保国

    2008-01-01

    Objective To compare the biomechanical stability of dorsal and volar plate osteosynthesis in the treatment of dorsally displaced distal radius fracture. Methods Six pairs cadaveric radius specimens were osteotomized at the distal region to make the dorsally displaced models, then the specimens were fixed by dorsal plate ostoosynthesis in one specimen (dorsal group) and by volar plate osteosynthesis in the other specimen of the same pair (volar group). Then all the specimens were placed in the Skimazu material testing machine for axial loading till failure. The load-displacement curves were recorded, peak load and energy absorbed by the specimen at the destroying point were gathered to assess the 2 methods of fixation. Statistic analysis was run to compare results of the two groups. Results Five pairs of specimens were bended toward the volar side under axial load, 1 pair of specimens were axially compacted. The mean peak load was (1 326.77±384.86) N for the dorsal group and (1 520.05±579.56) N for the volar group, respectively. The energy absorbed by the specimen at the destroying point was ( 8.21±3.74 ) J for the dorsal group and ( 10.04±3.62 ) J for the volar group respectively. Paired-samples t-test suggested no significant difference between the 2 groups ( P > 0.05 ). Conclusion Volar plate ostoosynthesis is the ideal choice for treatment of distal radius fracture.%目的 比较背侧移位桡骨远端骨折掌、背侧接骨板内固定后的生物力学性能,为桡骨远端骨折的治疗策略提供实验依据.方法 取6对12块人体桡骨远端标本,制作背侧移位桡骨远端骨折模型,配对标本一侧采用接骨板掌侧内固定,另一侧采用接骨板背侧内固定,固定完成后置于材料测试机上进行轴向压缩实验,实验模式为载荷破坏实验,记录载荷一位移曲线,获得标本破坏时的载荷和骨吸收的能量,实验结果进行统计学配对处理.结果 5对标本在轴向载荷

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

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    Al. Șerban

    2014-02-01

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

  13. 前路经寰枕寰枢关节锁定钛板螺钉内固定系统的匹配性研究%Compatible study of anterior occiput to axis transarticular locking plate system

    Institute of Scientific and Technical Information of China (English)

    李明; 蔡贤华; 黄卫兵; 张中

    2015-01-01

    目的:观察新型前路经枕寰枢关节锁定钛板螺钉内固定系统与枕颈复合体的匹配性,探讨此内固定系统临床应用的可行性。方法对枕颈部CT扫描数据进行三维重建,并通过数字化模拟手术进行解剖学匹配实验。通过观察钛板枢椎椎体前表面的切合性及螺钉的走行,测量经关节螺钉的理想钉道参数,评估此内固定系统与枕颈复合体的匹配性。结果钛板与枢椎椎体前表面相匹配;经关节螺钉均穿过寰枕关节及寰枢关节进入枕骨髁,无穿出骨质者,螺钉均未损伤舌下神经管。椎体固定螺钉均位于枢椎椎体骨质内,未进入椎管及椎间隙。经关节螺钉钉道理想钉道参数与内固定系统实际钉道参数差异无统计学意义。结论前路经寰枕寰枢关节锁定钛板螺钉内固定系统与枕颈复合体解剖学匹配性较好,具有临床应用可行性。%Objective To investigate the feasibility of anterior occiput to axis transarticular locking plate system through analyzing its compatibility with the occipital cervical complex. Methods Thirty health cases were selected from the date of head-neck CT examination randomly. 3D models of occipital cervical complex were reconstructed on the date. The anatomical compatibility was assessed between the systems and the 30 cases through surgical simulation by computer via digital technology. The morphological compatibility between the titanium plate and the surface of the axis as well as the screw trajectory were observed. The ideal screw trajectory parameters of trans- articular screws were measured so that the compatibility could be assessed. Results There was a morphological match between the titanium plate and the surface of the axis. All the trans-articular screws passed through the atlanto-occipital articulation and the atlanto-axial articulation, without piercing the bones or going into the hypoglossal canal. The fixed screws were in the

  14. Y型锁定钢板置入治疗成人肱骨髁间骨折36例%Y-type locking plate for intercondylar fractures of the adult hunmerus in 36 cases

    Institute of Scientific and Technical Information of China (English)

    程煜方; 魏忠民; 黄方敏; 张克良; 李子熙

    2011-01-01

    背景:肱骨髁间骨折是一种复杂的关节内骨折,骨折端的显露及固定均比较困难.目的:观察经尺骨鹰嘴截骨入路Y型解剖型锁定钢板治疗肱骨髁间骨折的效果.方法:采用尺骨鹰嘴截骨入路,Y型解剖型锁定钢板治疗肱骨髁间骨折36例,男22例,女14例,年龄19-76岁,平均47岁,按AO/OTA分型:C1型8例,C2型15例,C3型13例.结果与结论:32例获得随访,随访时间为10~26个月.用改良的Cassebaum评分标准评分,优15例,良13例,中3例,差1例,优良率89.6%.尺骨鹰嘴截骨入路切口无一例感染,骨折愈合时间为2.5~4.5个月,平均3.5个月.固定后钢板未出现松动现象.结果显示用尺骨鹰嘴截骨入路Y型解削型锁定钢板治疗肱骨髁间骨折,显露范围广,固定牢靠,能有效防止骨折不愈合,可指导患者早期在CPM机上进行肘关节功能锻炼,肘关节功能恢复良好,是治疗肱骨髁间骨折的有效方法.%BACKGROUND: Jnlercondylar fracture of the humerus is a hind of complex intra-articular fractures. Fracture exposure andfixation are difficult.OBJECTIVE: To explore the surgical effect of Y-type locking plate through the approach of olecranon osterolomy onintercondylar fracture of Ihe adult humerus.METHODS: Thirty-six adult patients with intercondylar fractures of the hunmerus were treated with Y-type locking plale Ihroughthe approach of olecranon osterotomy. Including 22 mates and 14 females, aged 19-76 years. Averagely47year. According lothe AO/OTA dassificaiton. Type C1 fracture was found in 8 cases, type C2 in 15, and type C3 in 13.RESULTS AND CONCLUSION: Thirty-two cases received a follow-up of 10-26 months. According to Cassebaum scale, thefunction of the elbow showed excellent in 15 cases, good in 13 cases, fair in 3 cases and poor in 1 case, and the excellent-goodrate was 89.6%. No infection occurred. The mean time for fracture healing was 2.4 to 4.5 months, averagely 3.5 months. Thetechnique of Y-type locking plate for

  15. Comparison of visual effects of immersion fluids for dermoscopic examination of acral volar melanocytic lesions

    Directory of Open Access Journals (Sweden)

    Tzu-Hsiu Chen

    2014-06-01

    Conclusion: The use of either mineral oil or ultrasound jelly as interface provides acceptable visual effects for the dermoscopic examination of acral volar melanocytic lesions. The use of the polarized light mode reduced the reflection and scattering of light, resulting in better visual effect than that achieved using the nonpolarized light mode. In the early diagnosis of acral melanoma, choosing the appropriate application of immersion fluid and observation mode yields the optimal visual effect.

  16. Multiple Volar Carpometacarpal Dislocations with Associated Carpal Tunnel Syndrome: A Case Report

    Directory of Open Access Journals (Sweden)

    C Fletcher

    2015-09-01

    Full Text Available We report a rare injury involving volar fracture dislocations of the second to fifth carpometacarpal dislocations. Carpometacarpal dislocations are usually dorsally displaced and most commonly only involve the fourth and fifth joints. An associated carpal tunnel syndrome adds another dimension to the complexity and rarity of the injury in this index case. A high index of clinical suspicion and subsequent emergent management is of utmost importance to treat this unusual combination of injuries in order to avoid significant morbidity.

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

    Institute of Scientific and Technical Information of China (English)

    叶鹏

    2014-01-01

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

  18. Comparison of the Efficacy of Sustaining Plate vs.Locking Plate for the Treatment of Tibial Plateau Fracture%支持钢板、锁定钢板治疗胫骨平台骨折的疗效比较

    Institute of Scientific and Technical Information of China (English)

    谭海涛; 张朝跃; 曾跃林; 陈铖

    2014-01-01

    【目的】对比分析锁定钢板(LP)和支持钢板(SP)内固定治疗胫骨平台骨折的疗效。【方法】收集胫骨平台骨折患者44例,其中 SP内固定19例(SP组),LP内固定25例(LP组),对比分析两组患者的手术时间、术中出血量、术后伤口引流量、住院时间、骨折愈合时间及膝关节功能评定结果。【结果】两组患者住院时间、术后引流量比较无统计学差异(P>0.05);与 LP组比较,SP组术中出血量较多,手术时间、骨折愈合时间较长;LP组优良率92.00%,显著高于 SP组(78.94%),其差异有统计学意义(P<0.05)。【结论】LP治疗胫骨平台骨折疗效优于 SP,主要表现在术中出血量、手术时间、骨折愈合时间和膝关节功能评分等指标。%[Objective]To compared and analyze the efficacy of sustaining plate(SP)vs.locking plate(LP) for the treatment of tibial plateau fracture.[Methods]A total of 44 patients tibial plateau fracture were col-lected.Among them,19 patients underwent SP internal fixation(SP group),while 25 patients underwent LP internal infixation(LP group).The age,gender,inj ury status,type,operation time,blood loss,postoperative wound drainage volume,length of hospital stay,healing time of fracture and the rating results of knee joint function in 2 groups were compared and analyzed.[Results]There was no significant difference in gender con-stitution,average age,the combined inj ury,fracture type,hospitalization time and postoperative drainage vol-ume between two groups(P>0.05).Compared with LP group,intraoperative blood loss was more,and op-eration time and healing time were longer in SP group.The good and excellent rate in LP group was markedly higher than that in SP group(92.00% vs.78.94%),and there was significant difference(P<0.05).[Con-clusion]LP for the treatment of tibial plateau fracture is better than SP.The main indexes are intraoperative blood loss

  19. Difference in cortical activation during use of volar and dorsal hand splints:a functional magnetic resonance imaging study

    Institute of Scientific and Technical Information of China (English)

    Sung Ho Jang; Woo Hyuk Jang

    2016-01-01

    There have been no studies reported on the difference in cortical activation during use of volar and dorsal hand splints. We attempted to investigate the difference in cortical activation in the somatosensory cortical area during use of volar and dorsal hand splints by functional magnetic resonance imaging (fMRI). We recruited eight healthy volunteers. fMRI was performed while subjects who were iftted with volar or dorsal hand splints performed grasp-release movements. Regions of interest were placed on the primary motor cortex (M1), primary somatosensory cortex (S1), posterior parietal cortex (PPC), and secondary somato-sensory cortex (S2). Results of group analysis of fMRI data showed that the total numbers of activated voxels in all ROIs were significantly higher during use of volar hand splint (3,376) compared with that (1,416) during use of dorsal hand splint. In each ROI, use of volar hand splint induced greater activation in all ROIs (M1:1,748, S1:1,455, PPC:23, and S2:150) compared with use of dorsal hand splint (M1:783, S1:625, PPC:0, and S2:8). The peak activated value was also higher during use of volar hand splint (t-value:17.29) compared with that during use of dorsal hand splint (t-value:13.11). Taken together, use of volar hand splint induced greater cortical activation relevant to somatosensory function than use of dorsal hand splint. This result would be important for the physiatrist and therapist to apply appropriate somatosensory input in patients with brain injury.

  20. The proximal humerus pressure locking plate clinical efficacy for treatment of proximal humeral fractures with traditional steel%肱骨近端加压锁定钢板与传统钢板治疗肱骨近端骨折的临床疗效比较

    Institute of Scientific and Technical Information of China (English)

    唐拥军

    2013-01-01

      目的对肱骨近端加压锁定钢板和传统钢板应用于肱骨近端骨折的效果加以对比分析。方法随机选择我院2009年5月~2011年5月肱骨近端骨折患者56名,分成A、B组,A组治疗组33名患者,B组对照组23名患者,分别给予加压锁定钢板和传统钢板方法加以医治。结果经医治,A组患者Neer功能分数高于B组,有效率高于B组,并发症概率低于B组患者。结论肱骨近端加压锁定钢板应用于肱骨近端骨折,效果较好。%Objective Pressurized locking plates and traditional steel to contrast analysis applied to the effect of proximal humerus fractures of the proximal humerus. Methods Random selection in our hospital from May 2009 to May 2011 proximal humeral fractures in 56 patients, divided into A, group B, group A treatment group of 33 patients, 23 patients of the B group, the control group were given pressurized locking plate andconventional plate method to be healed. Results A group of patients after healing the Neer function scores higher than group B, there are more efficient than group B, the complication probability lower than that in group B patients. Conclusion Pressurize the proximal humeral locking plate is applied to the proximal humerus fractures, better.

  1. Clinical Analysis on Locking Plate Combining Bone Grafting in Treating with Fracture of Surgical Neck of Humerus%锁定钢板联合植骨治疗老年性肱骨外科颈骨折临床分析

    Institute of Scientific and Technical Information of China (English)

    张坤和; 黄黎; 王理德

    2014-01-01

    Objective To explore clinical efficacy of locking plate combining bone grafting in treating the senile with fracture of surgical neck of humerus and to provide references for future clinical treatment. Methods 180 patients with fracture of surgical neck of humerus admitted by this Hospital were selected as research subjects, who were divided into the research group and the control group on different treatment methods with 90 cases in each group. The patients in the research group underwent locking plate combining bone grafting treatment, and patients in the control group underwent locking plate treatment. Results The comparison and difference between intra-operative duration and postoperative healing time of patients in two groups were statistically significant (P <0.05).Conclusions The locking plate combining bone grafting in treating the senile with fracture of surgical neck of humerus delivers remarkable clinical efficacy, and patients are greatly recovered.%目的:探究钢板联合植骨治疗老年肱骨外科颈骨折的临床效果,为后期临床治疗提供参考。方法选取我院收入的肱骨骨折患者180例为研究对象,根据治疗方式的不同分为研究组与对照组各90例。研究组行锁定钢板联合植骨治疗,对照组行锁定钢板治疗。结果两组患者在手术及术后愈合时间比较,差异具有统计学意义(P<0.05)。结论锁定钢板联合植骨治疗老年性肱骨外科颈骨折的临床效果显著,患者恢复好。

  2. Latarjet Fixation

    Science.gov (United States)

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

    2016-01-01

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

  3. Randomized clinical trial on percutaneous minimally invasive osteosynthesis of fractures of the distal extremity of the radius,

    Directory of Open Access Journals (Sweden)

    Marcio Aurélio Aita

    2014-06-01

    Full Text Available OBJECTIVES: the purpose of this study was to compare the postoperative radiological and clinical outcomes with minimally invasive percutaneous osteosynthesis using three implants: volar locking plate, intramedullary nail system and nonbridging external fixator for distal radius fractures.METHODS: forty-eight patients (A group, 16; B group 16; C group 16 underwent minimally invasive percutaneous osteosynthesis of reductible and unstable displaced (Type IIB by Rayhack Classification distal radius fractures. In B group intramedullary nail system was used, in A group the patients were treated with volar locking plate and in C group the patients were treated by nonbridging external fixator from January 2011 to December 2012. The mean follow-up period was 12 months. Radiologic parameters, range of motion, grip strength, and disability of the arm, shoulder, and hand score were evaluated at each examination (3rd and 6th week, and 12th months. The visual analog scale of wrist pain and complications were assessed at the final follow-up.RESULTS: the groups did not differ significantly in radiological outcomes after 12 months, but the clinical results, VAS scale and dash score in group A (volar locking plate and B (nail intramedullary were statistically significantly better than that of C group (nonbridging external fixator. One patient underwent an osteosynthesis with nail intramedullary and another with external fixator (C group developed persistent pain near the site of the superficial radial nerve because of the distal's screw and pins, respectively.CONCLUSION: in clinical parameters, significant differences in outcomes were found between groups A and B after six weeks versus C group.

  4. Clinical effectiveness analysis of PHILOS locking plates and humeral head replacement for treatment of complex fractures of proximal humerus in elderly%PHILOS锁定钢板与人工肱骨头置换治疗老年复杂肱骨近端骨折的效果对比

    Institute of Scientific and Technical Information of China (English)

    张敏; 白鹏程; 张媺; 江建平; 王辉; 金绍林; 冯孝志; 周明

    2015-01-01

    Objective To analyze the effect of PHILOS locking plate fixation and the artificial humerus head replacement on proxi-mal complex humerus fracture. Methods The clinical data of 43 patients aged over 60 with three or four parts fractures in proximal humerus were retrospectively studied,including 32 cases of PHILOS group and 11 cases of artificial humerus head replacement group. Two groups were compared in operation time,surgical blood loss and NEER score and the incidence of postoperative complications. Results All patients obtained similar outpatient follow-up for 6~20 months with an average of 11. 63 months. There was no difference in operation time and blood loss of the two groups(P>0. 05). After treatment,according to NEER grading evaluation of curative effect,no obvious statistical significance difference existed between the two groups (P>0. 05). However,the postoperative complication rate of PHILOS group was higher than that of artificial humerus head replacement group;postoperative plate and acromion impingement occurred in 2 cases,screw through the shoulder joint in 2 cases,but there was no functional impact,and there was 1 case of displacement of the greater tuberosity postoperatively,1 case of humerus head necrosis,while there were no complications in artificial femoral head replacement group. Conclusion PHILOS or steel plate internal fixation and the artificial humerus head replacement can be used in the treatment of senile complex humeral proximal fractures. There are no obvious differences in the quality of life and shoulder joint function recovery,but the incidence of postoperative complications in artifi-cial humerus head replacement group is lower than that of PHILOS group.%目的:对比分析PHILOS锁定钢板内固定术与人工肱骨头置换术治疗老年复杂肱骨近端骨折的临床疗效。方法回顾性分析60岁以上老年肱骨近端三、四部分骨折患者43例临床资料,其中PHILOS组32例,人工肱骨头置换组11

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

    Science.gov (United States)

    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.

  6. Clinical Analysis of the Treatment of Proximal Humeral Locking Plate of Proximal Humerus Fractures in Elderly%肱骨近端锁定钢板治疗老年肱骨近端骨折的临床分析

    Institute of Scientific and Technical Information of China (English)

    施云东

    2015-01-01

    Objective To evaluate and observe functional outcome of locking proximal humeralplate(LPHP)used for fixationof the proximal humerus fractures in elderly.Methods In 108 cases of proximal humerus in elderly hospital in April 2011 to April 2014 received fractures were targeted,according to neer classification of fractures were classified in some patients,including 48 cases of fracture type Ⅱ,Ⅲ fracture 50 cases,ⅳ fractures in 10 cases. Al patients underwent treatment of proximal humeral locking plate by neer scores were assessed for treatment effect.Results After treatment,al patients 4 to 10 months of folow-up,results showed that al patients have received bone fractures healed and no deformity occurs in good overal healing rate of 98.1 percent, fracture healing time of 9 to 11 weeks,in al cases no complications of infection,nerve injury.Conclusion Locking proximal humeral plateosteosynthes is leads to satisfactory functional outcomes in proximal humerus fractures,which is aless complications,early functional exercise,effective therapeutic method.%目的:对肱骨近端锁定钢板治疗老年肱骨近端骨折的临床分析效果进行分析。方法以我院2011年4月~2014年4月接收的108例老年肱骨近端骨折患者为对象,根据Neer分型对患者骨折部分进行分型,其中Ⅱ型骨折48例,Ⅲ型骨折50例,Ⅳ型骨折10例。所有患者均行肱骨近端锁定钢板治疗,通过Neer评分对患者治疗效果进行评定。结果治疗后对所有患者进行4~10个月的随访,结果显示所有患者骨折情况均得到愈合,且无畸形发生,在总体愈合优良率方面达98.1%;骨折愈合时间9~11周;所有病例均未产生感染、神经损伤等并发症。结论肱骨近端锁定钢板治疗老年肱骨近端骨折不仅愈合率高,且康复时间短,较少发生术后并发症,对复位丢失情况能够有效防止,使板下血运和骨折愈合得到保护。

  7. 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.

  8. Clinical Effect of Different Internal Fixation Materials in the Treatment of Elderly Patients With Proximal Humeral Fractures%观察不同内固定材料治疗老年肱骨近端骨折的临床效果

    Institute of Scientific and Technical Information of China (English)

    潘琦

    2015-01-01

    目的:观察不同的内固定材料治疗老年肱骨近端骨折的临床效果。方法选取2014年1~12月在我院接受治疗的老年肱骨近端骨折患者80例,将患者随机分为观察组与对照组,每组各40例。其中观察组患者以肱骨近端固定锁定钢板系统(PHILOS)为内固定材料对患者进行治疗,对照组患者以肱骨近端锁定接骨板(LPHP)为内固定材料进行治疗,对两组患者的治疗效果进行比较。结果两组患者在手术时间与术中出血量比较差异无统计学意义(P>0.05),但观察组患者骨折愈合时间短于对照组,术后疼痛率低于对照组,组间比较差异具有统计学意义(P<0.05)。结论肱骨近端固定锁定钢板系统为内固定材料治疗老年肱骨近端骨折具有疗效。%ObjectiveTo investigate clinical results of the treatment of senile material fixation of proximal humerus fractures clinical results. MethodsFrom January to December 2014,in our hospital treated 80 patients with fractures,the patients were randomly divided into two groups,40 cases in each group. Observation group of patients with proximal humeral locking plate fixation system(PHILOS)as internal fixation in treatment of patients,and control group of patients with proximal humeral locking plate(LPHP)for internal fixation materials. The treatment effects were compared.Results The patients in observation group with healing time was shorter than the control group,the rate of post-operative pain was litter than the control group,the difference between two groups was statisticaly significant(P<0.05).Conclusion proximal humeral locking plate fixation system for the fractures in elderly was with good effect.

  9. Locking Plate Combined with Traditional Chinese Medicine Seven Scattered Modiifed Treatment of Senile Comminuted Subtrochanteric Fractures of the Femur in 26 Cases%锁定钢板配合中药七厘散加味治疗老年股骨粗隆下粉碎性骨折26例

    Institute of Scientific and Technical Information of China (English)

    王力群

    2014-01-01

    Objective:To observe the anatomical locking plate combined with oral seven scattered by traditional Chinese medicine in the treatment of intertrochanteric fractures in the elderly comminuted fractures of the clinical efficacy. Methods:The intertrochanteric femoral anatomic locking plate combined with oral traditional Chinese medicine in the treatment of elderly patients with scattered seven subtrochanteric comminuted fractures in 26 cases, clinical observation. Results:In these patients, 11 cases were excellent, 42.31%, good in 13 cases, accounting for 50%, 2 cases, accounting for 7.69%, the excellent and good rate was 92.31%. Conclusion:Anatomical locking plate system used for the treatment of senile comminuted subtrochanteric fractures of the femur of good curative effect, can reduce the fracture hematoma and interference on fracture healing. With the oral administration of seven scattered with Chinese medicine is conducive to fracture healing.%目的:观察解剖型锁定钢板配合内服七厘散加味中药治疗老年股骨粗隆下粉碎性骨折的临床疗效。方法:回顾性分析我院2009年7月~2012年5月期间收治的老年股骨粗隆下粉碎性骨折患者26例的临床资料,对全部患者采用股骨粗隆解剖型锁定钢板配合内服七厘散加味中药进行治疗,观察临床疗效。结果:本组患者优11例,占42.31%,良13例,占50%,可2例,占7.69%,优良率92.31%。结论:解剖锁定钢板系统用于治疗老年股骨粗隆下粉碎性骨折疗效好,能减少骨折部位的血肿及对骨折愈合的干扰。配合内服七厘散加味中药有利于骨折愈合。

  10. No benefit to surgical fixation of flail chest injuries compared with modern comprehensive management: results of a retrospective cohort study

    Science.gov (United States)

    Farquhar, Jaclyn; Almahrabi, Yahya; Slobogean, Gerard; Slobogean, Bronwyn; Garraway, Naisan; Simons, Richard K.; Hameed, S. Morad

    2016-01-01

    Background Chest wall trauma is a common cause of morbidity and mortality. Recent technological advances and scientific publications have created a renewed interest in surgical fixation of flail chest. However, definitive data supporting surgical fixation are lacking, and its virtues have not been evaluated against modern, comprehensive management protocols. Methods Consecutive patients undergoing rib fracture fixation with rib-specific locking plates at 2 regional trauma centres between July 2010 and August 2012 were matched to historical controls with similar injury patterns and severity who were managed nonoperatively with modern, multidisciplinary protocols. We compared short- and long-term outcomes between these cohorts. Results Our patient cohorts were well matched for age, sex, injury severity scores and abbreviated injury scores. The nonoperatively managed group had significantly better outcomes than the surgical group in terms of ventilator days (3.1 v. 6.1, p = 0.012), length of stay in the intensive care unit (3.7 v. 7.4 d, p = 0.009), total hospital length of stay (16.0 v. 21.9 d, p = 0.044) and rates of pneumonia (22% v. 63%, p = 0.004). There were no significant differences in long-term outcomes, such as chest pain or dyspnea. Conclusion Although considerable enthusiasm surrounds surgical fixation of flail chest injuries, our analysis does not immediately validate its universal implementation, but rather encourages the use of modern, multidisciplinary, nonoperative strategies. The role of rib fracture fixation in the modern era of chest wall trauma management should ultimately be defined by prospective, randomized trials. PMID:27438051

  11. 锁定接骨板与解剖接骨板治疗老年肱骨近端骨折的比较%Comparison of Locking Plate and Anatomical Plate in Treatment of Elderly Patients with Proximal Humerus Fractures

    Institute of Scientific and Technical Information of China (English)

    潘捷; 黄吉利; 龙德生

    2011-01-01

    Objective:To compare the effects of locking plate and anatomical plate on elderly patients with proximal humerus fractures.Methods:The proximal humerus locking plate and ana-tomical plate were used to treat 56 cases of proximal humeral fractures.Operative time(min),blood loss(mL),postoperative pain score(score),postoperative joint function score(score) were compared of two treatment methods.Results:56 patients were followed up for 6 months to 18 months,average of 12 months.Locking plate group blood loss(134.55±30.67)mL were less than the anatomical plate group(178.69±50.73)mL;operation time(79.65±20.37)min were less than anatomical plate group(96.87±30.63)min;postoperative pain VAS score(1.35±0.22)points were less than anatomical plate group(2.27±1.23)points;postoperative shoulder function Neer score(94.53±8.54)points and Constant score(90.26±10.37)points were higher than anatomical plate group.Differences were statistically significant(P0.05).Conclusion:The treatment to proximal humerus fractures in aged patients with locking plate has more advantage than anatomical plate.%目的:对比锁定接骨板与解剖接骨板治疗老年肱骨近端骨折的效果.方法:应用肱骨近端锁定接骨板及解剖接骨板治疗肱骨近端骨折56例.比较两种治疗方法在手术时间、术中出血量、术后疼痛评分、术后关节功能评分(score)等方面的差异.结果:56例均获随诊,随诊时间6~18个月,平均12个月.锁定接骨板组术中出血量(134.55±30.67)mL少于解剖接骨板组(178.69±50.73)mL;手术时间(79.65±20.37)min短于解剖接骨板组(96.87±30.63)min;术后疼痛VAS评分(1.35±0.22)分低于解剖接骨板组(2.27±1.23)分;术后肩关节功能Neer评分(94.53±8.54)分及Constant评分(90.26±10.37)分均高于解剖接骨板组.差异均有统计学意义(P〈0.05).结论:锁定接骨板治疗老年

  12. Photographic fixative poisoning

    Science.gov (United States)

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

  13. Introduction of an alternative standardized radiographic measurement method to evaluate volar angulation in subcapital fractures of the 5th metacarpal

    Energy Technology Data Exchange (ETDEWEB)

    Hoffelner, Thomas; Resch, Herbert; Moroder, Philipp; Korn, Gundobert; Steinhauer, Felix [University of Salzburg, Department of Traumatology and Sports Injuries, Salzburg (Austria); Atzwanger, Joerg [University of Salzburg, Department of Radiology, Salzburg (Austria); Minnich, Bernd [University of Salzburg, Department of Organismic Biology, Salzburg (Austria); Tauber, Mark [Shoulder and Elbow Surgery ATOS Clinic Munich, Munich (Germany)

    2012-10-15

    The purpose of the present study was to compare the intra- and interobserver reliability of two different measurement methods for volar angulation of the 5th metacarpal (MC) in an attempt to establish a new standard measurement method to reduce interobserver discrepancies for therapeutic decisions. Twenty patients with subcapital fractures of the 5th MC were radiologically investigated. Imaging consisted of a radiographs in antero-posterior and precise lateral view in addition to a CT scan of the 5th MC. Measurement of volar angulation was accomplished using the conventional and the shaft articular surface (SAS) method. The measurements of five investigators were exported to a spreadsheet for statistical analysis to evaluate the intra-and interobserver reliability. The conventional technique showed large differences among the investigators and poor interobserver reliability (W = 0.328 and 0.307) both at injury (p = 0.001) and at follow-up (p = 0.189). The intraobserver concordance of all investigators showed better results with the SAS than with the conventional technique. With the SAS technique, no statistically significant difference among the investigators could be detected at either the time of injury (p = 0.418) or at follow-up (p = 0.526) with excellent interobserver reliability (W = 0.051 and W = 0.041). Evaluation of volar angulation at follow-up using CT scans did not show any statistically significant difference between the techniques with better correlation among the observers with the SAS technique (p = 0.838). The interobserver correlation of volar angulation with lateral radiographs using the conventional technique was insufficient. Therefore, we recommend the use of the novel SAS technique as standardized measurement method which showed higher accuracy and interobserver reliability in order to facilitate the choice of adequate treatment option. (orig.)

  14. Volar locking compression plate combined with artificial bone grafting for treatment of comminuted distal radial fracture%掌侧锁定加压接骨板结合人工骨植骨治疗桡骨远端骨折

    Institute of Scientific and Technical Information of China (English)

    周凯龙; 王培吉

    2014-01-01

    目的 探讨应用掌侧锁定加压接骨板(LCP)结合人工骨植骨治疗桡骨远端粉碎性骨折的临床疗效.方法 2011年1月至2013年8月期间在我院行掌侧LCP结合人工骨植骨,治疗A3、C2、C3型桡骨远端粉碎性骨折45例.术前及术后测量掌倾角、尺偏角、桡骨轴向短缩及关节面台阶程度.结果 所有患者均获得6~18个月的随访,平均12个月,骨折均获得骨性愈合,人工骨无不良反应;各影像学数据较术前均有明显改善;按Gartland-Werley评分标准评定,A3型优良率为94.4%、C2型优良率为87.5%、C3型优良率为81.8%.结论 应用掌侧LCP结合人工骨植骨治疗A3、C2、C3型桡骨远端粉碎性骨折,能够恢复桡骨长度,获得坚强内固定.%Objective To investigate the clinical results of the application of volar locking compression plate combined with artificial bone grafting in the treatment of comminuted distal radial fractures.Methods From January 2011 to August 2013,45 cases of type A3,type C2 and type C3 comminuted distal radial fractures were treated with volar locking compression plate combined with artificial bone grafting.All the cases were closed fractures with radial shortening or articular surface collapse.Volar tilt angle,radial inclination angle,axial shortening of the radius and extent of joint surface step deformity were measured both pre and post operatively.Results All the patients were follow-up for 6 to 18 months,with an average of 12 months.Bone union was noted in all the cases.There was no adverse reaction to the artificial bone grafts.Radiographic parameters were significantly improved.The clinical results were evaluated using the Gartland-Werley wrist score and rated as excellent and good in 94.4% of type A3 fractures,87.5% of type C2 fractures,and 81.8% of type C3 fractures.Conclusion Applying volar locking compression plate combined with artificial bone grafting can achieve rigid fixation and restore radial length in

  15. Dermoscopic findings and histological correlation of the acral volar pigmented maculae in Laugier-Hunziker syndrome.

    Science.gov (United States)

    Sendagorta, Elena; Feito, Marta; Ramírez, Paloma; Gonzalez-Beato, María; Saida, Toshiaki; Pizarro, Angel

    2010-11-01

    Laugier-Hunziker syndrome (LHS) is an acquired, benign, macular hyperpigmentation of the lips and oral mucosa, often associated with pigmentation of the nails. Volar acral maculae on the palms and fingertips of patients affected by LHS are a typical feature of this rare entity. Dermoscopic examination of these maculae has been described in a previous report, in which authors found a parallel-furrow pattern. We describe two cases in which a parallel-ridge pattern (PRP) was found on the dermoscopic examination of the pigmented acral lesions. Histological examination showed increased melanin in basal keratinocytes, which was most prominent in those located at the crista intermedia profunda, that is, in the epidermal rete ridges underlying the surface ridges. In our study, dermoscopic features of the pigmented maculae found on LHS differed from those previously described. In addition, by means of this case report, the histological features of these lesions are described for the first time, showing an excellent correlation with dermoscopy. The reported cases prove that although the PRP is very specific of melanoma, it is also possible to find it in benign lesions. Therefore, we must be familiar with the differential diagnosis of PRP, and take into consideration the clinical context in which we find it. Further studies are needed to increase our knowledge on the histological and dermoscopic features of acral pigmented maculae of LHS.

  16. Computer-based classification of dermoscopy images of melanocytic lesions on acral volar skin.

    Science.gov (United States)

    Iyatomi, Hitoshi; Oka, Hiroshi; Celebi, M Emre; Ogawa, Koichi; Argenziano, Giuseppe; Soyer, H Peter; Koga, Hiroshi; Saida, Toshiaki; Ohara, Kuniaki; Tanaka, Masaru

    2008-08-01

    We describe a fully automated system for the classification of acral volar melanomas. We used a total of 213 acral dermoscopy images (176 nevi and 37 melanomas). Our automatic tumor area extraction algorithm successfully extracted the tumor in 199 cases (169 nevi and 30 melanomas), and we developed a diagnostic classifier using these images. Our linear classifier achieved a sensitivity (SE) of 100%, a specificity (SP) of 95.9%, and an area under the receiver operating characteristic curve (AUC) of 0.993 using a leave-one-out cross-validation strategy (81.1% SE, 92.1% SP; considering 14 unsuccessful extraction cases as false classification). In addition, we developed three pattern detectors for typical dermoscopic structures such as parallel ridge, parallel furrow, and fibrillar patterns. These also achieved good detection accuracy as indicated by their AUC values: 0.985, 0.931, and 0.890, respectively. The features used in the melanoma-nevus classifier and the parallel ridge detector have significant overlap.

  17. Free toe pulp flap for finger pulp and volar defect reconstruction

    Directory of Open Access Journals (Sweden)

    Jyoshid R Balan

    2016-01-01

    Full Text Available Background: Fingertip injury requiring flap cover is very common in the modern era. The ideal cover should fulfill both functional and aesthetic improvement. Materials and Methods: From June 2015 to April 2016, we performed seven free toe pulp flaps for finger defect reconstruction. All patients were males. Five flaps were done in emergency post-traumatic cases, and two were done in elective set up. The cases included reconstruction of three thumbs, one index and one ring finger in an emergency set up and two ring fingers in the elective. Thumb reconstruction was done with great toe lateral pulp and the other digits reconstructed with second toe pulp flap. Follow-up evaluation included both functional and aesthetic assessment. Results: Five flaps survived completely, one suffered partial loss, and one flap failed completely. The median follow-up period was 9 months. The median duration of surgery was 255 min (range 210 to 300 min. The median two-point discrimination was 6.5 mm (range 4–8 mm. There was the return of temperature sensation in all patients; two had cold intolerance. The Semmes-Weinstein monofilament score varied from 3.61 to 5.07 (median filament index value 4.31/pressure value of 2 g/mm2. Three patients had delayed donor site wound healing. Conclusions: The free toe pulp flap is an efficient choice for fingertip and volar finger defects reconstruction with an excellent tissue match.

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

    Directory of Open Access Journals (Sweden)

    Panigrahi

    2016-08-01

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

  19. Double-dorsal versus single-volar digital subcutaneous anaesthetic injection for finger injuries in the emergency department: A randomised controlled trial.

    Science.gov (United States)

    Martin, Shane P; Chu, Kevin H; Mahmoud, Ibrahim; Greenslade, Jaimi H; Brown, Anthony F T

    2016-04-01

    The objective of this present study is to compare pain associated with the double-dorsal versus a single-volar subcutaneous injection in the provision of digital anaesthesia for finger injuries presenting to the ED. A randomised controlled trial from November 2012 to January 2014 at a single adult tertiary-referral hospital. ED patients with finger injuries requiring digital anaesthesia was randomised to either the double-dorsal or a single-volar subcutaneous injection technique. The primary outcome was patient reported injection pain measured on a 100 mm visual analogue scale with the assessor blinded to the injection technique. The secondary outcome was success of anaesthesia defined as ability to perform the assessment and treatment without further anaesthetic supplementation after 5 min. Eighty-six patients were enrolled. Median (IQR) age was 34 (24-47) years and 79% were men. The majority (66.3%) had distal phalanx injuries. Forty patients were randomised to the double-dorsal and 46 to a single-volar subcutaneous injection technique. The mean (standard deviation) pain score of the double-dorsal injection was 39.1 (24.2) and a single-volar injection was 37.3 (24.5) with a difference of 1.8 (95% CI -8.8 to 12.3). Digital anaesthesia was successful in 64.9% of the double-dorsal and 71.7% of the single-volar subcutaneous injections, a difference of 6.8% (95% CI -12.7 to 26.3). In ED patients with finger injuries requiring digital anaesthesia, both the double-dorsal or single-volar subcutaneous injection techniques have similar pain of injection and success rates of anaesthesia. Single-volar injection appears suitable alternative to the commonly performed double-dorsal injection in the ED. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  20. 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.

  1. 应用肱骨近端锁定型钢板治疗肱骨近端骨折的回顾性研究%A retrospective study after treatment of proximal humeral fractures with locking plates

    Institute of Scientific and Technical Information of China (English)

    董军政; 申海波; 李延明; 王利民; 朱以明; 姜春岩

    2010-01-01

    目的 探讨AO Philos钢板治疗肱骨近端骨折手术体会.方法 回顾性分析2006年7月-2009年5月应用AO Philos钢板治疗肱骨近端骨折29例,按Neer分型2部分骨折11例,3部分骨折16例,4部分骨折2例.结果 29例患者均获得随访,时间9~16个月,平均11.3个月,功能评定采用肩关节Neer功能评分标准:优13例,良12例,可4例,优良率86.2%.结论 AO Philos钢板治疗肱骨近端骨折具有手术创伤小,固定有效可靠,允许早期功能锻炼,疗效确切.%Objective The purpose of our study was to evaluate the treatment of proximal humeral fractures with AO Philos plate. Methods From June 2007 to May 2009, 29 cases of proximal humeral fractures were fixed with AO Philos plate. According to Neer classification, 11 cases were two-part fractures, 16 cases three-part fractures and 2 cases four-part fractures. Results Twenty-nine cases were followed 9-16 months (averaging 11.3 months). The results were evaluated with Neer's evaluation system: 13 patients were graded as excellent,12 as good, 4 as fair. Conclusion AO Philos plate is less invasive comparing with traditional method. It can provide solid fixation, permit early functional rehabilitation and lead to a compromising clinical result.

  2. [Three cases of chronic volar dislocation of the distal radioulnar joint that were treated with the Sauvé-Kapandji procedure].

    Science.gov (United States)

    Saito, Jun; Sakai, Akinori; Okimoto, Nobukazu; Ohshige, Toshihisa; Murakami, Taizou; Nakamura, Toshitaka

    2003-06-01

    Three cases of chronic volar dislocation of the distal radioulnar joint were treated with the Sauvé-Kapandji procedure. All patients were in their twenties. They visited our clinic complaining limitation of forearm wrist rotation and pain around the wrist for more than 6 weeks after an injury. Radiograph and CT scan revealed chronic volar dislocation of the distal radioulnar joint. Closed reduction failed. The Sauvé-Kapandji procedure was required to prevent the distal radioulnar joint from becoming unstable after open reduction. Range of motion of the injured wrist improved greatly, pain disappeared and they were able to return to sports after the operation and rehabilitation. Therefore, the Sauvé-Kapandji procedure is effective in curing chronic volar dislocation of the distal radioulnar joint.

  3. Follow-up of volar plate interposition arthroplasty (Tupper) of the metacarpophalangeal joints in rheumatoid hands: preliminary findings

    DEFF Research Database (Denmark)

    Gøtze, J P; Jensen, Claus Hjorth

    2000-01-01

    We present the results of a three-year follow-up study of 59 interposition volar plate arthroplasties (Tupper) on metacarpophalangeal joints in 13 patients with erosive rheumatoid arthritis. The median age at the time of operation was 60 years (range 45-77). All patients reported lasting pain...... relief at rest. Improvement of hand function was, however, less satisfactory as both grip and pinch strength were compromised in all patients. Seven patients were satisfied with the outcome whereas six complained of stiffness in the operated joints. All but one patient concluded that they would have...

  4. [Postoperative morbidity in surgically treated extension fractures of the distal radius. A comparative study of dorsal and volar approach].

    Science.gov (United States)

    Zettl, R P; Ruchholtz, S; Taeger, G; Obertacke, U; Nast-Kolb, D

    2001-08-01

    The aim of this study was to investigate perioperative morbidity in operative interventions in distal radiusfractures, comparing the operative approach from volar and dorsal. Only problems, resulting from the operative approach towards the distal aspect of the radius, were examined. In a Case-Control-Study, we investigated patients with operative by plate-osteosynthesis treated distal radius-extensions-fractures. During 3 years we investigated 92 patients. 49 were operated with a volar approach, and after changing the operative management, consecutive 43 patients with a dorsal approach to the distal radius. Indications for operative treatment were not changed. The approach to the distal aspect of the radius corresponded to the recent guidelines. Further perioperative procedures were identical, including procedures in anesthesiology. Datas of patients have been investigated for epidemiology, kind of operations, point of time in treatment, duration of operation, X-Ray, immobilisation and time of inhospital stay as well as all documented complications. It has been shown, that in respect of all criterias, concerning length of operation (106 vs. 83 min), intraoperative X-Ray (3.0 vs. 1.65 min) as well as postoperative immobilisation (33 vs. 25 days), and documented incidences of complications like secondary wound-healing (19/49 vs. 0/43) or nerval irritations (13/49 vs. 1/43), the dorsal osteosynthesis is definitively to be favored.

  5. 肱骨近端锁定加压钢板治疗肱骨近端骨折的疗效%The effect of proximal humeral locking plate in treating proximal humeral fractures

    Institute of Scientific and Technical Information of China (English)

    曾勉东; 谢景开; 杨波; 张志; 尹飚

    2013-01-01

    [ Objective ] To evaluate and observe functional outcome of locking proximal humeral plate ( LPHP) used for fixation of the proximal humerus fractures in elderly. [ Method] Retrospective analysis from December 2009 to December 2011,41 patients with an acute proximal humerus fracture were managed with locking proximal humeral plate osteosynthesis after open reduction,15cases were males, 28case were females, with age of 49 to 82(mean 67. 5). According to Neer classification, 12 cases were two-part fracture,22 cases were three-part fracture,7 cases were four-part fracture. [Result] All of them were with the mean follow-up of ranged 8-28 months (mean 14 months),healing at the last review. Functional score standard of Neer was used for evaluating the shoulder function, 13 cases were excellent,21 cases were good,4 cases were morderate,3 cases were poor,the excellent and good results rate was 82.9%. [ Conclusion] Locking proximal humeral plate osteosynthesis leads to satisfactory functional outcomes in proximal humerus fractures, which is a less complications, early functional exercise, effective therapeutic method.%[目的]观察、评价肱骨近端锁定加压钢板(locking proximal humeral plate,LPHP)治疗复杂性老年肱骨近端骨折的疗效.[方法]回顾性分析2009年12月~2011年12月41例老年肱骨近端二部分以上骨折采用骨折切开复位结合锁定钢板内固定治疗的疗效,其中男13例,女28例,年龄49 ~ 82岁(平均67.5岁).按Neer分类法:2部分骨折12例,3部分骨折22例,4部分骨折7例.[结果]41例均获随访,随访时间8~ 28个月(平均14个月),骨折均得到了愈合,随访肩关节功能按Neer功能评分标准,优13例,良21例,可4例,差3例,优良率达82.9%.有1例发生肱骨头缺血坏死,2例发生肩峰撞击综合征.[结论]锁定钢板针治疗老年性肱骨近端骨折固定可靠,并发症少,骨折愈合良好,便于早期功能锻炼,是一种有效的治疗方法.

  6. 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

  7. Different implant fixation repairs femoral neck combined with ipsilateral subtrochanteric fractures:comparisons of biomechanical properties%不同植入物内固定修复股骨颈合并同侧转子下骨折:生物力学性能比较

    Institute of Scientific and Technical Information of China (English)

    王延军; 侯军; 万博; 刘刚; 牛刚; 张扬; 党晓谦

    2016-01-01

    背景:选择强度和刚度良好的内固定器植入物是修复股骨颈合并同侧转子下骨折的关键。目的:比较不同植入物内固定修复股骨颈不和同侧转子下骨折的生物力学性能。方法:将24根成年防腐尸体标本制作成为股骨颈骨折合并同侧转子下内侧皮质缺损5 cm的骨折模型,并按照随机数字表法将其均分为股骨近端锁定板组、加长型股骨近端防旋髓内钉组和加长型股骨近端髓内钉组,比较3组轴向压缩实验、扭转实验以及轴向压缩破坏实验结果。结果与结论:加长型股骨近端防旋髓内钉组轴向抗压刚度、破坏载荷大于股骨近端锁定板组和加长型股骨近端髓内钉组,加长型股骨近端髓内钉组大于股骨近端锁定板组,差异有显著性意义(P 0.05)。一定程度上讲,加长型股骨近端防旋髓内钉内固定股骨颈合并同侧转子下骨折相对股骨近端锁定板和加长型股骨近端髓内钉而言,更具有生物力学方面的优势。%BACKGROUND:Choosing internal fixator implants with good strength and stiffness is the key to repair femoral neck combined with ipsilateral subtrochanteric fractures. OBJECTIVE:To compare the biomechanical properties of different implant fixation for femoral neck combined with ipsilateral subtrochanteric fractures. METHODS:Totaly 24 adult antiseptic cadaver specimens were used to produce fracture models with femoral neck fracture combined with 5 cm of ipsilateral subtrochanteri medical cortical defect, and were divided into femoral proximal locking plate group, lengthening proximal femur anti-rotation intramedulary nail group and lengthening proximal femoral nail group according to the random number table method. The results of axial compression test, torsion test and axial compression failure rest in three groups were compared. RESULTS AND CONCLUSION: The axial compressive stiffness and failure load in lengthening proximal femur anti

  8. 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。

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

    Directory of Open Access Journals (Sweden)

    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

  10. 微创内固定系统与锁定加压接骨板治疗胫骨近端骨折的对比研究%Comparison of internal fixation and locking plate in treatment of fracture of proximal tibia

    Institute of Scientific and Technical Information of China (English)

    王琨; 刘宏泽; 杨文国; 王志强; 胡瑞峰; 王伟; 张广申; 解云晶

    2010-01-01

    目的 对比研究生物学固定技术(biological osteosynthesis,BO)微创内固定系统(1ess invasive stabilization systems,LISS)与锁定加压接骨板治疗胫骨近端骨折患者的临床疗效.方法 回顾分析2005年5月至2009年3月收治的胫骨近端骨折患者32例,男23例,女9例;年龄28~57岁,平均46岁;左侧17例,右侧15例;交通伤18例,高处坠落伤6例,跌伤8例;闭合性骨折27例,开放性骨折5例;新鲜骨折31例,陈旧骨折1例.骨折按AO/OTA分类:A型关节外骨折24例,C型关节内骨折8例.随机分为2组,各16例,分别进行LJSS治疗和锁定加压接骨板治疗,术前X线片示均为胫骨平台粉碎性骨折,胫骨近端骨折.将术中对骨缺损较大患者进行一期植骨,术后观察对伤口愈合情况、术后x线检查结果及关节功能恢复情况.结果 全部获得随访,随访时间为3~23个月,平均13个月.术后12个月行X线检查示骨折对位对线佳,骨折均愈合,愈合时间为5~8个月,平均6.4个月.按照Kolmert和Wulff的评价标准:锁定加压接骨板治疗组,优10例,良4例,可2例,优良率为86.5%;LISS 治疗组,优12例、良3例、可1例,优良率为93.8%.结论 LISS具有微创、安全、简便、快速的特点,治疗胫骨近端骨折的切口愈合时间、长度、骨折愈合时间、膝关节功能恢复等方面均优于锁定加压接骨板.

  11. Clinical analysis of 52 cases of proximal humeral locking plate fixation of proximal humeral fractures%肱骨近端锁定钢板内固定治疗肱骨近端骨折52例临床分析

    Institute of Scientific and Technical Information of China (English)

    冯晨; 王闯; 周洋; 郑科文; 王涛

    2015-01-01

    目的:分析与探讨肱骨近端锁定钢板内固定治疗肱骨近端骨折的临床疗效.方法:选取2009年4月~2014年4月期间收治的肱骨近端骨折患者共52例,对其采用切开复位加肱骨近端锁定钢板内固定治疗,对患者的临床疗效、愈合时间等进行分析,并对术后发生的并发症情况进行记录.结果:采用肱骨近端锁定钢板内固定治疗后,52例患者均手术成功,术后愈合时间平均为12.0±3.0周,对其术后情况进行随访,其中恢复优秀共46例,良好共4例,一般1例,较差1例,总优良率为96.1%.术后恢复较差的1例患者其主要原因为术后发生肱骨头坏死.结论:采用肱骨近端锁定钢板内固定治疗肱骨近端骨折具有较好的临床疗效,建议在骨折发生后尽量采取解剖复位的方法,建立起肱骨颈内侧重支撑,降低并发症的发生率.

  12. 锁定钢板治疗肱骨近端三部分和四部分骨折的疗效及并发症——5年随访分析%Functional outcome and complications following locking plate fixation for 3-and 4-part proximal humerus fractures: a 5-year follow-up

    Institute of Scientific and Technical Information of China (English)

    吴渊; 叶庭均; 王亚梓; 王蕾

    2014-01-01

    目的 评估锁定钢板内固定治疗Neer三部分和四部分肱骨近端骨折的疗效及并发症.方法 回顾性分析接受锁定钢板内固定治疗的122例三部分或四部分肱骨近端骨折患者,其中肱骨近端内锁定系统(PHILOS)钢板84例,围关节锁定钢板38例,平均随访时间为61.7个月(60~80个月).采用Constant -Murley肩关节功能评分评价患肢术后功能,同时对各种并发症进行分析.结果 末次随访时患者术后平均Constant-Murley肩关节功能评分为77.8分,PHILOS组平均76.3分,围关节锁定钢板组平均78.1分,两者差异无统计学意义(P=0.098).18例(14.8%)患者术后出现肱骨头坏死、骨折不愈合、浅表感染、螺钉切出及肩部撞击征等并发症.结论 锁定钢板内固定治疗复杂肱骨近端骨折可取得较满意的疗效.采用不同设计锁定钢板手术引起并发症的危险性无明显差异.

  13. 锁定钢板内固定与人工肱骨头置换治疗老年复杂肱骨近端骨折的比较研究%Comparison of locking plate internal fixation versus hemiarthroplasty for treatment of the elderly complex proximal humeral fractures

    Institute of Scientific and Technical Information of China (English)

    陈豪杰; 陈云丰; 王磊; 李琦

    2015-01-01

    目的 比较锁定钢板(PHILOS)切开复位内固定和人工肱骨头置换(HA)治疗复杂肱骨近端骨折的疗效差异.方法 回顾性分析2010年6月-2013年6月行手术治疗的肱骨近端3部分和4部分骨折(或伴脱位)47例,其中PHILOS组29例和HA组18例.观察记录患术后3m、6m及12m的Constant-Murley评分和DASH评分,术后12m的SF-36量表评分以及术后并发症和二次手术情况.结果 两组术后3m的Constant-Murley评分总分、DASH评分、术后12 m的SF-36量表评分、两组术后并发症的差异无统计学意义,而术后6m、术后12m的Constant-Murley评分总分、DASH评分PHILOS组优于HA组,PHILOS组2例行二次手术,HA组无二次手术.结论 与人工肱骨头置换相比,锁定钢板治疗复杂肱骨近端骨折具有更好的功能结果,相近的并发症,生活质量相似.

  14. 抗生素骨水泥被覆锁定钢板在膜诱导技术治疗胫骨创伤后骨感染中的运用%Application of antibiotic cement-coated locking plates in induced membrane technique for treating post-traumatic tibial osteomyelitis

    Institute of Scientific and Technical Information of China (English)

    余鑫; 贾硕; 吴宏日; 喻胜鹏; 谢肇

    2017-01-01

    Objective To investigate the clinical outcome of post-traumatic tibial osteomyelitis treated by induced membrane technique combined with the antibiotic cement-coated locking plate.Methods A restrospective case series analysis was made on 71 cases of post-traumatic tibial osteomyelitis treated by induced membrane technique from September 2014 to September 2014.There were 55 males and 16 females, aged 18-60 years(mean, 37.4 years).Mean length of bone defect following debridement was 4.5 cm(range, 4-11 cm).Antibiotic cement-coated locking plates were used to provide the stability of the bone defects after one-stage debridement.Bone grafting and exchanging the plates with ntramedullary nails were done during the second-stage surgery.Parameters were monitored dynamically after operation to evaluate infection recurrence and bone healing, including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), clinical features(sinus formation, redness and swelling, warmth and pain) and X-ray films of the involved limbs.Results All patients were followed up for 13-25 months (mean, 19.5 months).There was no sign of recurring infection and CRP and ESR were normal in all cases after the first stage surgery.However, four cases (6%) had recurrent infection with sinus exudates and their CRP and ESR were abnormal after the second stage surgery, and further treatments were carried out on these patients.Follow-up showed bony union in all patients within mean 5.5 months (range, 4-6 months).Conclusion Induced membrane technique with antibiotic cement-coated locking plates for treatment of post-traumatic tibial osteomyelitis can shorten bone healing time and decrease infection recurrent rate without obvious impact on osteogenic activity.%目的 探讨在膜诱导技术治疗胫骨创伤后骨感染中使用抗生素骨水泥被覆锁定钢板的临床疗效. 方法 采用回顾性病例系列研究分析2014年9月-2015年9月运用膜诱导技术治疗的

  15. The clinical benefits of reconstructing the medial column support in locked plating of proximal humerus fractures%内侧柱支撑重建在锁定钢板治疗成人肱骨近端骨折中的临床意义

    Institute of Scientific and Technical Information of China (English)

    曾浪清; 陈云丰; 刘燕洁; 陈强; 王赤宇; 王磊; 张闻

    2012-01-01

    目的 探讨锁定钢板固定肱骨近端骨折术中肱骨近端内侧柱支撑重建的临床意义.方法 回顾性分析2005年6月至2010年12月采用锁定钢板治疗且获得随访的125例肱骨近端骨折患者临床资料,男54例,女71例;年龄18~88岁,平均54.6岁.骨折根据Neer分型:二部分骨折57例,三部分骨折62例,四部分骨折6例.根据术后X线片所示肱骨近端内侧柱支撑重建情况分为2组:内侧柱支撑重建组(重建组,84例)和内侧柱支撑未重建组(未重建组,41例).随访记录并比较两组患者的肩关节功能Constant评分、肱骨头内翻角度、视觉模拟评分(VAS)及并发症发生情况.结果 所有患者术后获6~30个月(平均13.6个月)随访.重建组与未重建组平均Constant评分分别为(77.9±13.0)、(67.3±11.3)分,优良率分别为72.6%、43.9%,平均VAS评分分别为(1.6±2.0)、(3.2±2.4)分,以上项目两组比较差异均有统计学意义(P<0.05);重建组术后肱骨头内翻角度(1.2°±3.3°)小于未重建组(4.4°±4.0°),术后并发症发生率(16.6%)、二次手术率(4.8%)均较未重建组(34.1%、17.0%)低,差异均有统计学意义(P<0.05).结论 锁定钢板固定肱骨近端骨折术中重建肱骨近端内侧柱支撑、骨折端良好复位不仅能使肱骨头得到有效的支撑、预防术后肱骨头内翻及内固定失败,而且术后能取得更满意的疗效.%Objective To evaluate the clinical benefits of reconstructing the medial column support in locked plating of proximal humerus fractures.Methods A retrospective analysis was conducted of the eligible 125 patients who had undergone locked plating of proximal humerus fracture in our institution between June 2005 and December 2010.They were 54 men and 71 women,18 to 88 years of age (average,54.6 years).By the Neer classification,there were 57 cases of two-part fracture,62 cases of three-part fracture and 6 cases of four-part fracture.One independent examiner

  16. CARBON DIOXIDE FIXATION.

    Energy Technology Data Exchange (ETDEWEB)

    FUJITA,E.

    2000-01-12

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

  17. Improving Carbon Fixation Pathways

    OpenAIRE

    Ducat, Daniel C.; Silver, Pamela A

    2012-01-01

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

  18. Evaluation of performance and personal satisfaction of the patient with spastic hand after using a volar dorsal orthosis.

    Science.gov (United States)

    Garros, Danielle dos Santos Cutrim; Gagliardi, Rubens José; Guzzo, Regina Aparecida Rossetto

    2010-06-01

    The performance and the satisfaction of the patient were quantitatively compared with the use of the volar dorsal orthosis in order to position the spastic hand. Thirty patients wearing the orthosis for eight hours daily were evaluated by the Canadian Occupational Performance Measure and the box and blocks test, for a three-month period. Five activities were selected (among daily life activities, productive activities, and leisure activities) by the patients, which were impaired by spasticity. There was an improvement related to performance after use of orthosis, with an average of 1.4 + or - 0.5 to 6.3 + or - 0.8 (pPatient satisfaction average after wearing the orthosis was of 1.7 + or - 0.4 to 6.3 + or - 0.6 (ppatient satisfaction.

  19. Arthroscopic-Assisted Combined Dorsal and Volar Scapholunate Ligament Reconstruction with Tendon Graft for Chronic SL Instability.

    Science.gov (United States)

    Ho, Pak-Cheong; Wong, Clara Wing-Yee; Tse, Wing-Lim

    2015-11-01

    Background Both the dorsal and the volar portion of the scapholunate interosseous ligament (SLIL) are major stabilizers of the scapholunate (SL) joint. Most reconstruction methods to restore SL stability do not address the volar constraints and frequently fail to reduce the SL gapping. Wrist arthroscopy allows a complete evaluation of the SL interval, accompanying ligament status, and associated SL advanced collapse (SLAC) wrist changes. It enables simultaneous reconstruction of the dorsal and palmar SL ligaments anatomically with the use tendon graft in a boxlike structure. Materials and Methods From October 2002 to June 2012, the treatment method was applied in 17 patients of chronic SL instability of average duration of 9.5 months (range 1.5-18 months). There were three Geissler grade 3 and 14 grade 4 instability cases. The average preoperative SL interval was 4.9 mm (range 3-9 mm). Dorsal intercalated segment instability (DISI) deformity was present in 13 patients. Six patients had stage 1 SLAC wrist change radiologically. Concomitant procedures were performed in four patients. Description of Technique With the assistance of arthroscopy and intraoperative imaging as a guide, a combined limited dorsal and volar incision exposed the dorsal and palmar SL interval without violating the wrist joint capsule. Bone tunnels of 2.4 mm were made on the proximal scaphoid and lunate. A palmaris longus tendon graft was delivered through the wrist capsule and the bone tunnels to reduce and connect the two bones in a boxlike fashion. Once the joint diastasis is reduced and any DISI malrotation corrected, the tendon graft was knotted and sutured on the dorsal surface of the SL joint extra-capsularly in a shoe-lacing manner. The scaphocapitate joint was transfixed with Kirschner wires (K-wires) to protect the reconstruction for 6-8 weeks. Results The average follow-up was 48.3 months (range 11-132 months). Thirteen returned to their preinjury job level. Eleven

  20. 髓外固定与髓内固定系统应用于临床分组治疗股骨粗隆间骨折对比分析与评价%Comparative Analysis and Evaluation on Medullary External Fixation and Intramedullary Fixation System Applied in Treating Intertrochanteric Fracture by Clinical Grouping

    Institute of Scientific and Technical Information of China (English)

    蒙向铖; 覃小武; 韦东; 李林峰

    2015-01-01

    Objective To compare and analyze and evaluate the clinical efficacy of external fixation and intramedullary fixation in the treatment of patients with femoral intertrochanteric fracture. Methods Seventy two patients with femoral intertrochanteric fracture were divided into two groups with 36 cases in each group according to different methods of operation. Patients in Group A underwent external system internal fixation of open reduction locking plate medullary (proximal femoral locking plate) treatment, while those in Group B underwent closed reduction or intramedullary system internal fixation treatment of open reduction proximal femoral nail anti-rotation (PFNA).Clinical efficacies on patients in two groups were compared, and the analysis and evaluation were made. Results The comparisons in the operation duration, bleeding amount and hip joint function before and after treatment were not significantly different (P > 0.05).But the complication rate of patients in Group B (8.33%) was lower than that of patients in Group A (19.44%), and the inter-group via statistical analysis satisfied P < 0.05, and the differences were significant. Conclusion External medullary fixation and intramedullary fixation system on patients with femoral intertrochanteric fracture deliver better efficacies, but the incidence of postoperative complications of intramedullary fixation system was significantly lower, suitable operation method should be chosen in clinical treatment according to conditions of patient to get best efficacies.%目的:研究股骨粗隆间骨折患者行髓外固定与髓内固定的临床疗效并进行对比分析与评价。方法将72例股骨粗隆间骨折患者按手术方式的不同分为两组,各36例,A组患者行切开复位锁定钢板髓外系统内固定(股骨近端锁定板)治疗, B组患者行闭合复位或切开复位股骨近端防旋髓内钉(PFNA)髓内系统内固定治疗,对比两组患者临床疗效并进行分析与

  1. Minimally invasive percutaneous plate fixation of distal tibia fractures.

    LENUS (Irish Health Repository)

    Bahari, Syah

    2007-10-01

    We report a series of 42 patients reviewed at a mean of 19.6 months after treatment of distal tibial and pilon fractures using the AO distal tibia locking plate with a minimally invasive percutaneous plate osteosynthesis (MIPPO) technique. Mean time to union was 22.4 weeks. All fractures united with acceptable alignment and angulation. Two cases of superficial infection were noted, with one case of deep infection. Mean SF36 score was 85 and mean AOFAS score was 90 at a mean of 19 months follow-up. We report satisfactory outcomes with the use of the AO distal tibia locking plate in treatment of unstable distal tibial fractures. Eighty-nine percent of the patients felt that they were back to their pre injury status and 95% back to their previous employment.

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

    Directory of Open Access Journals (Sweden)

    Vannemreddy Prasad

    2009-01-01

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

  3. TIBIOTARSAL COMPRESSION ARTHRODESIS USING A LATERAL LOCKING PLATE.

    Science.gov (United States)

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

    2012-01-01

    Objetivos: A artrodese tibiotársica (TT) continua sendo uma importante opção no tratamento da artrose primária ou pós-traumática do tornozelo mas persiste ainda a controvérsia sobre o melhor método de fixação do foco de artrodese. Independentemente do tipo de material utilizado, o objetivo maior é a obtenção da fusão articular sólida, saudável e indolor. O propósito do presente estudo é apresentar os resultados preliminares de um novo sistema de placa bloqueada lateral compressiva para a artrodese do tornozelo. Método: Treze pacientes consecutivos portadores de artrose tibiotársica foram submetidos à artrodese do tornozelo nove pacientes eram homens e quatro mulheres. Com o auxílio de um guia, as superfícies articulares do talo e da tíbia foram decorticadas. Um sistema de compressão foi aplicado para evitar o alinhamento indesejável dos segmentos e uma placa bloqueada pré-moldada lateral foi utilizada para obter a fusão articular. Resultados: Tanto o escore AOFAS quanto o VAS melhoraram com a cirurgia. Todos os tornozelos operados consolidaram dentro do prazo de seis meses. Em todos os pacientes, foi obtido um ótimo alinhamento nos planos sagital, coronal e transverso. Conclusão: Acreditamos que a combinação de compressão bilateral, cortes ósseos com contornos pré-demarcados e placa lateral bloqueada, constitui uma técnica moderna, segura e útil para a artrodese do tornozelo.

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

    Directory of Open Access Journals (Sweden)

    Ashutosh Kumar Singh

    2013-01-01

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

  5. External fixators in haemophilia.

    Science.gov (United States)

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

    2004-01-01

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

  6. Flexible fixation and fracture healing

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  7. Treatment of the distal fracture in radioulna based on the volar wrist dual channel approach and postoperative X-ray diagnosis.

    Science.gov (United States)

    Li, Zheng; Zhang, Zhenwei; Yu, Shaoxiao; Bai, Yinwei; Lin, Huixin; Zeng, Jinhao; Ye, Xuelang; Xu, Dachuan

    2015-12-01

    The fracture of the distal ulna and radius is a kind of fracture that results in high morbidity and occurrence rate and contributes to about one-sixth of the entire body's fracture. In this study, we implemented the improved palmar wrist surgery by a volar wrist dual channel approach. Between 2011 and 2014, we have treated 67 distal radius fracture patients. We divided them into two parts randomly, and treat them by the Carpometacarpal direct approach solution and dual wrist palmar surgical approach solution respectively. After the surgery, the differences in the incidence of median nerve irritation are significant (P dual wrist palmar surgical approach solution are much less than that as compared to the Carpometacarpal direct approach solution (P dual wrist palmar surgical approach can lead to a successful treatment of the distal radius fractures volar distal radial ulnar by reducing the blind exposure problem. As such, the surgeon can complete treatment of fractures of the region under direct vision during operation. Furthermore, reducing the median nerve in the carpal tunnel and the structure of the stretch can decrease the incidence of postoperative complications. Postoperative X-ray diagnosis is then performed to examine the patients' recovery and assist in clinical follow-up. Our study proves that the volar wrist dual channel approach can be successfully achieved by a surface incision surgical implementation of the dual channel, and gives rise to a minimally invasive operation.

  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. Estilo de afrontamiento y resultados del tratamiento de exposición en sujetos con fobia a volar

    Directory of Open Access Journals (Sweden)

    Jordi Miró

    2003-01-01

    Full Text Available El objetivo de este trabajo cuasi-experimental es doble. Por una parte, se trata de estudiar si el estilo de afrontamiento de los pacientes (buscadores y evitadores de información; monitoring y blunting está relacionado con los efectos de la terapia de exposición; por otra, examinar si este estilo está relacionado con sesgos de atención. Aplicamos el CAFFT (Computer Assisted Fear of Flying Treatment, esto es, un programa de exposición asistido por ordenador, a una muestra de 17 personas con miedo a volar en avión. Para la evaluación del estilo de afrontamiento empleamos la versión española de la Miller Behavioural Style Scale, mientras que los sesgos de atención fueron valorados mediante el test Stroop . Los resultados muestran que el tratamiento fue efectivo, y si bien no detectan relación con el estilo de afrontamiento, se observa que el estilo de búsqueda de información (por ejemplo, monitoring está asociado con mayores trastornos antes del tratamiento, aunque éstos desaparecen tras el mismo. Nuestros datos también muestran una relación estadísticamente significativa entre sesgo de atención y estilo de afrontamiento.

  10. ¿Caos en el electrocardiograma de estudiantes con miedo a volar? Un análisis de no linealidad

    Directory of Open Access Journals (Sweden)

    Jordi Llabrés

    2005-01-01

    Full Text Available La Teoría del Caos proporciona una nueva forma de analizar las respuestas psicofisiológicas asociadas a los trastornos de ansiedad. Pero para poder aplicar los métodos de análisis no lineal de esta relativamente reciente teoría, primero es necesario comprobar la existencia de algún tipo de no linealidad que justifique su uso. En este estudio experimental se analiza, mediante el procedimiento de los datos vicarios, la no linealidad de las señales generadas por el sistema cardiovascular (ECG de estudiantes con y sin miedo a volar, en diferentes condiciones de estimulación. Los errores de predicción de las series vicarias fueron siempre mayores que los de las correspondientes series empíricas (p < 0,05, demostrándose así que las señales ECG, en todos los sujetos y en todas las condiciones, presentan propiedades no lineales y que por tanto resulta adecuado analizarlas desde planteamientos no lineales para obtener conocimiento acerca de su complejidad, entropía, regularidad, etc.

  11. Molecular Biology of Nitrogen Fixation

    Science.gov (United States)

    Shanmugam, K. T.; Valentine, Raymond C.

    1975-01-01

    Reports that as a result of our increasing knowledge of the molecular biology of nitrogen fixation it might eventually be possible to increase the biological production of nitrogenous fertilizer from atmospheric nitrogen. (GS)

  12. 髋动力锁定钢板、重建钉与动力髋钢板治疗高龄股骨转子间骨折患者的疗效分析%Effect of anatomical dynamic hip lock plate, proximal femoral nail, and dynamic hip screws in the treatment of subtrochanteric femoral fractures in elderly patients: a comparative study

    Institute of Scientific and Technical Information of China (English)

    许思亮; 朱智奇; 候明

    2012-01-01

    Objective To investigate the effect of anatomical dynamic hip lock plate (ADHLP), proximal femoral nail (PFN), and dynamic hip screws (DHS) in the treatment of subtrochanteric femoral fractures in elderly patients. Methods One hundred and four patients with subtrochanteric femoral fracture in our hospital were divided into three groups: the ADHLP group, the PFN group and the DHS group. The operation time, intraoperative bleeding, Harris score one month and 6, 12 months after surgery, the healing time and the complications were compared between the three groups. Results The operation time, intraoperative bleeding and fracture healing time in PFN group were significantly less than those in DHS and ADHLP group, P<0.05. In the threee groups, Harris scores 12 months after surgery showed statistically significant difference with the scores 1 month and 6 months after surgery, P<0.05. The incidence of complications in PFN group was significantly lower than that in the other two groups, P<0.05. Conclusion PFN is preferred for treating elderly patients with subtrochanteric femoral fracture than DHS and ADHLP, with shorter operation time, less intraoperative bleeding, faster fracture healing and lower complications.%目的 探讨髋动力锁定钢板、重建钉与动力髋钢板在高龄股骨转子间骨折患者中的疗效差别.方法 回顾性研究我院收治的股骨转子间骨折患者共104例,根据治疗方式不同分为髋动力锁定钢板(ADHLP)组、重建钉(PFN)组以及动力髋钢板(DHS)组.对比三组患者手术时间、术中出血术后1个月、6个月、12个月Harris评分、骨折愈合时间以及并发症发生情况.结果 PFN组患者手术时间、术中出血及骨折愈合时间显著低于DHS组及ADHLP组,结果比较差异有统计学意义(P<0.05).三组患者术后12个月Harris评分与术后1个月、6个月评分比较差异有统计学意义(P<0.05).PFN组患者术后并发症发生率显著低于另外两

  13. Fuel economy and exhaust emissions characteristics of diesel vehicles: Test results of a prototype Chrysler Volare, 225 CID (3.7-liter) automobile

    Science.gov (United States)

    Walter, R. A.

    1982-01-01

    The results obtained from fuel economy and emission tests conducted on a prototype Chrysler Volare diesel vehicle are documented. The vehicle was tested on a chassis dynamometer over selected drive cycles and steady-state conditions. The fuel used, was a DOE/BETC referee fuel. Particulate emission rates were calculated from dilution tunnel measurements and large volume particulate samples were collected for biological and chemical analysis. The vehicle obtained 32.7 mpg for the FTP urban cycle and 48.8 mpg for the highway cycle. The emissions rates were 0.42/1.58/1.17/0.28 g/mile of HC, CO, NOx and particulates respectively.

  14. Femoral Reconstruction Using External Fixation

    Directory of Open Access Journals (Sweden)

    Yevgeniy Palatnik

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    王春鹏

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

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

  17. First metatarsophalangeal joint arthrodesis: current fixation options.

    Science.gov (United States)

    Moon, Jared L; McGlamry, Michael C

    2011-04-01

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

  18. 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.

  19. 肱骨近端角度变化对锁定钢板内固定治疗肱骨近端骨折预后的影响%Influence of the changes of proximal humeral angle on the prognosis of the proximal humeral fractures treated with locking plate

    Institute of Scientific and Technical Information of China (English)

    张云龙; 陈云丰; 陈圣宝; 芮碧宇; 张明; 薛培璘

    2015-01-01

    目的:探讨肱骨后倾角、颈干角变化对锁定钢板内固定治疗肱骨近端骨折预后的影响。方法2012年9月至2013年10月,采用肱骨近端锁定内固定系统(PHILOS)治疗52例肱骨近端骨折患者,其中38例获得12个月以上的随访,记录患者术后并发症并评估患者疼痛视觉模拟评分(VAS)及Constant‐Murley肩关节评分。所有患者术后3 d内行双侧肱骨全长CT检查,在三维CT 重建图像上测量双侧肱骨后倾角及颈干角。比较患侧与健侧肱骨后倾角和颈干角并将肱骨近端骨折患者分为后倾角增加组、后倾角减小组及颈干角增大组、颈干角减小组。结果患侧与健侧肱骨后倾角差异无统计学意义,但患侧肱骨颈干角显著大于健侧。末次随访时,肱骨颈干角增加组与减小组VAS评分、并发症发生率及Constant‐M urley肩关节评分均无统计学差异;肱骨后倾角减小组并发症发生率明显低于后倾角增大组,而Constant‐M urley肩关节评分显著高于后倾角增大组。结论与健侧相比,患侧肱骨颈干角改变对锁定钢板内固定患者预后影响不大,但肱骨后倾角较健侧增大是患者预后的危险因素之一。%Objective To explore the influence of the changes of humeral retroversion angle (HRA) and neck‐shaft angle (NSA ) on the prognosis of proximal humeral fractures treated with locking plate . Methods From September 2012 to October 2013 ,52 patients of proximal humeral fracture were treated with the proximal humeral internal locking system (PHILOS) ,and 38 patients received the follow‐up more than 12 months .During the follow‐up ,the Constant‐Murley shoulder score ,visual analogue scale (VAS) and complication rate were evaluated .All patients received the CT scanning on the bilateral whole humerus in 3 days after operation ,three‐dimensional CT reconstruction were applied for measuring HRA and NSA .The patients were divided

  20. Understanding Nitrogen Fixation

    Energy Technology Data Exchange (ETDEWEB)

    Paul J. Chirik

    2012-05-25

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

  1. Options for acetabular fixation surfaces.

    Science.gov (United States)

    Klika, Alison K; Murray, Trevor G; Darwiche, Hussein; Barsoum, Wael K

    2007-01-01

    Aseptic loosening is the most common cause for revision total hip arthroplasty (THA). Due to poor long-term results with cemented acetabular components, cementless implants that rely on biologic fixation became popular in the United States for both primary and revision procedures in the early 1980s. Cementless acetabular components used in THA have been reported to have superior radiographic performance compared with cemented fixation, although the optimal method of acetabular fixation remains controversial. Cementless acetabular components require initial implant stability to allow for bone ingrowth and remodeling into the acetabular shell, providing long-term durability of the prosthesis. Many improved implant materials are available to facilitate bone growth and remodeling, including the 3 most common surface treatments; fibermesh, sintered beads, and plasma spray coatings. Recently added to these are porous metal surfaces, which have increased porosity and optimal pore sizes when compared with titanium fibermesh. The most studied of these materials is the titanium fibermesh fixation surface, which has demonstrated a mechanical failure rate of 1% at 10 to 15 years. This technology utilizes the diffusion bonding process to attach fiber metal pads to a titanium substrate using heat and pressure. The sintered bead fixation surface offers a porous coating of various sizes of spherical beads, achieved by the sintering process, and has been shown to provide long-term fixation. While there are less long-term published data regarding the titanium plasma spray surface, its early results have provided evidence of its durability, even in the face of significant osteolysis. The most recently added alternative fixation surface is porous tantalum metal, which offers potentially greater bone ingrowth and bone graft incorporation due to its high porosity (80%) and low modulus of elasticity (3 MPa). Porous tantalum implants have shown early favorable clinical results and have

  2. Finite element analysis of femoral neck fracture with different fixation ways%三种内固定方式修复股骨颈骨折的有限元分析

    Institute of Scientific and Technical Information of China (English)

    夏志锋; 梁明; 李亚峰; 曾冠楠

    2016-01-01

    BACKGROUND:Finite element method is widely used in the femoral neck fracture, but the study concerning different fixation methods of femoral neck fracture is not much. OBJECTIVE:To analyze biomechanical properties of different fixation methods for femoral neck fracture using finite element analysis. METHODS:The femur of voluntters was scanned with CT, at thickness 0.6 mm, from the site above the greater trochanter of the femur. Scanning data were saved in .DICOM format. Data of right proximal femur were imported into Mimics software. Osteotomy was performed according to Pauwels I type fracture. Models of two tensile force screws, ful y threaded hol ow screw and proximal femoral locking plate were established. Three-dimensional finite element method was used to analyze stress distribution, stress concentration position, displacement distribution and maximum displacement in different models of femoral neck fracture with different internal fixation methods. RESULTS AND CONCLUSION:(1) The maximum stress value of two lag screws model was biggest. The maximum stress value of ful y threaded hol ow screw model was minimized. The maximum stresses of two lag screws model, ful y threaded hol ow screw model and proximal femoral locking plate model al were concentrated in the fixed end of fractures. (2) The femoral maximum stress of two lag screws model was biggest. The femoral maximum stress value of proximal femoral locking plate model was minimized. The femoral maximum stresses of two lag screws model, ful y threaded hol ow screw model and proximal femoral locking plate model al were concentrated in the medial femoral smal rotor near and medial femoral and fixation contact points. (3) The maximum displacement of two lag screws model was biggest. The maximum displacement of ful y threaded hol ow screw model was minimized. The maximum displacement of two lag screws model, ful y threaded hol ow screw model and proximal femoral locking plate model al was in the femoral head. (4

  3. Libertad para volar

    OpenAIRE

    Loureiro, Olalla

    2008-01-01

    La formación, el empleo y la arquitectura sin barreras son aspectos esenciales para la integración del colectivo de personas con discapacidad. Sin embargo, la independencia y la normalización son un grado más en la lucha por la igualdad de trato y es ahí donde entran en juego factores como el ocio y el tiempo libre.

  4. Libertad para volar

    OpenAIRE

    Loureiro, Olalla

    2008-01-01

    La formación, el empleo y la arquitectura sin barreras son aspectos esenciales para la integración del colectivo de personas con discapacidad. Sin embargo, la independencia y la normalización son un grado más en la lucha por la igualdad de trato y es ahí donde entran en juego factores como el ocio y el tiempo libre.

  5. Effect of induced aniseikonia on fixation performance.

    Science.gov (United States)

    Remole, A

    1988-01-01

    The purpose of the study was to determine to what extent induced aniseikonia affects fixation performance. Aniseikonia was induced in the vertical meridian only, whereas fixation alignment was monitored in the horizontal meridian. A previously developed technique based on the dependency of border enhancement bandwidth on fixation eccentricity was used to monitor deviations from central fixation during fusion. Stress on the fusion mechanism was supplied by controlled increments of forced horizontal vergence. It was found that deviation from central fixation in the horizontal meridian generally increases with increasing amounts of vertical aniseikonia. The effect is particularly pronounced for small amounts of aniseikonia.

  6. Nitrogen fixation by marine cyanobacteria.

    Science.gov (United States)

    Zehr, Jonathan P

    2011-04-01

    Discrepancies between estimates of oceanic N(2) fixation and nitrogen (N) losses through denitrification have focused research on identifying N(2)-fixing cyanobacteria and quantifying cyanobacterial N(2) fixation. Previously unrecognized cultivated and uncultivated unicellular cyanobacteria have been discovered that are widely distributed, and some have very unusual properties. Uncultivated unicellular N(2)-fixing cyanobacteria (UCYN-A) lack major metabolic pathways including the tricarboxylic acid cycle and oxygen-evolving photosystem II. Genomes of the oceanic N(2)-fixing cyanobacteria are highly conserved at the DNA level, and genetic diversity is maintained by genome rearrangements. The major cyanobacterial groups have different physiological and ecological constraints that result in highly variable geographic distributions, with implications for the marine N-cycle budget.

  7. Implant fixation by bone ingrowth.

    Science.gov (United States)

    Kienapfel, H; Sprey, C; Wilke, A; Griss, P

    1999-04-01

    The term osseointegration referred originally to an intimate contact of bone tissue with the surface of a titanium implant; the term bone ingrowth refers to bone formation within an irregular (beads, wire mesh, casting voids, cut grooves) surface of an implant. The section dealing with the historical background describes the development of macroporous, microporous, and textured surfaces with an emphasis on the evolution of porous and textured metal surfaces. The principal requirements for osseointegration and bone ingrowth are systematically reviewed as follows: i) the physiology of osseointegration and bone ingrowth, including biomaterial biocompatibility with respect to cellular and matrix response at the interface; ii) the implant surface geometry characteristics; iii) implant micromotion and fixation modes; and iv) the implant-bone interface distances. Based on current methods of bone ingrowth assessment, this article comparatively reviews and discusses the results of experimental studies with the objective of determining local and systemic factors that enhance bone ingrowth fixation.

  8. Abnormal Fixational Eye Movements in Amblyopia.

    Science.gov (United States)

    Shaikh, Aasef G; Otero-Millan, Jorge; Kumar, Priyanka; Ghasia, Fatema F

    2016-01-01

    Fixational saccades shift the foveal image to counteract visual fading related to neural adaptation. Drifts are slow eye movements between two adjacent fixational saccades. We quantified fixational saccades and asked whether their changes could be attributed to pathologic drifts seen in amblyopia, one of the most common causes of blindness in childhood. Thirty-six pediatric subjects with varying severity of amblyopia and eleven healthy age-matched controls held their gaze on a visual target. Eye movements were measured with high-resolution video-oculography during fellow eye-viewing and amblyopic eye-viewing conditions. Fixational saccades and drifts were analyzed in the amblyopic and fellow eye and compared with controls. We found an increase in the amplitude with decreased frequency of fixational saccades in children with amblyopia. These alterations in fixational eye movements correlated with the severity of their amblyopia. There was also an increase in eye position variance during drifts in amblyopes. There was no correlation between the eye position variance or the eye velocity during ocular drifts and the amplitude of subsequent fixational saccade. Our findings suggest that abnormalities in fixational saccades in amblyopia are independent of the ocular drift. This investigation of amblyopia in pediatric age group quantitatively characterizes the fixation instability. Impaired properties of fixational saccades could be the consequence of abnormal processing and reorganization of the visual system in amblyopia. Paucity in the visual feedback during amblyopic eye-viewing condition can attribute to the increased eye position variance and drift velocity.

  9. Intramedullary foot fixation for midfoot Charcot neuroarthropathy.

    Science.gov (United States)

    Lamm, Bradley M; Siddiqui, Noman A; Nair, Ajitha K; LaPorta, Guido

    2012-01-01

    Midfoot Charcot collapse commonly occurs through the tarsometatarsal and/or midtarsal joints, which creates the characteristic "rocker bottom" deformity. Intramedullary metatarsal fixation spanning the tarsus into the talus and/or calcaneus is a recently developed method for addressing unstable midfoot Charcot deformity. The intramedullary foot fixation technique has various advantages when addressing midfoot Charcot deformity in the neuropathic patient. These advantages include anatomical realignment, minimally invasive fixation technique, formal multiple joint fusion, adjacent joint fixation beyond the level of Charcot collapse, rigid interosseus fixation, and preservation of foot length. The goals of the intramedullary foot fixation procedure are to create a stable, plantigrade, and ulcer-free foot, which allows the patient to ambulate with custom-molded orthotics and shoes.

  10. Comparison of fixation disparity curve parameters obtained with the Wesson and Saladin fixation disparity cards

    National Research Council Canada - National Science Library

    Ngan, Janice; Goss, David A; Despirito, Joseph

    2005-01-01

    This study compared fixation curve parameters with two commercially available fixation disparity cards, one that has been available for several years, the Wesson card, and a new one, the Saladin card...

  11. Modeling fixation locations using spatial point processes.

    Science.gov (United States)

    Barthelmé, Simon; Trukenbrod, Hans; Engbert, Ralf; Wichmann, Felix

    2013-10-01

    Whenever eye movements are measured, a central part of the analysis has to do with where subjects fixate and why they fixated where they fixated. To a first approximation, a set of fixations can be viewed as a set of points in space; this implies that fixations are spatial data and that the analysis of fixation locations can be beneficially thought of as a spatial statistics problem. We argue that thinking of fixation locations as arising from point processes is a very fruitful framework for eye-movement data, helping turn qualitative questions into quantitative ones. We provide a tutorial introduction to some of the main ideas of the field of spatial statistics, focusing especially on spatial Poisson processes. We show how point processes help relate image properties to fixation locations. In particular we show how point processes naturally express the idea that image features' predictability for fixations may vary from one image to another. We review other methods of analysis used in the literature, show how they relate to point process theory, and argue that thinking in terms of point processes substantially extends the range of analyses that can be performed and clarify their interpretation.

  12. 肱骨头内翻畸形导致肱骨近端骨折内固定失败的生物力学研究%Biomechanical study of failed internal fixation for proximal humerus fractures caused by varus deformity of humeral head

    Institute of Scientific and Technical Information of China (English)

    白露; 张洪雷; 陈鹏; 李伟; 江长青; 张文涛

    2015-01-01

    Background Proximal humerus fracture (PHF ) is a common disease in the traumatic orthopedics due to decreased density of bone in the proximal humerus with age .It occurs more often in the medium‐and old‐age people ,accounting for 5% of fractures .With the process of aging population ,the incidence of PHF tends to increase .In recent 20 years ,the surgery methods of unstable PHF change greatly from the percutaneous fixation and common plate for fractures to locking plate fixation with "internal fixator" as mainstay .As the locking plate is widely used for PHF ,some medium‐and long‐term clinical follow‐up data indicated loss of reduction of fracture ,varus deformity of humeral head ,and secondary internal fixation failure were found in PHF cases with two or three sites of defective medial cortex .These complications are characterized by defective medial cortex and varus deformity of humeral head .Over time ,it causes varus and prolapsed of humeral head ,breakage of screws or plate .From biomechanics ,the loss of support for proximal humerus by the medial cortex is an unstable factor .But not all cases with defective medial cortex develop internal fixation failure .The types of internal fixation failure vary in patients .Is the varus deformity of humerus head another risk factor for internal fixation failure? This study investigated the relationship between the varus deformity of humeral head and the internal fixation failures after locking plate treatment for PHF from the biomechanics .Methods Sample treatment and establishment of fracture model:6 pairs of adult humeral samples with antiseptic treatment were obtained from the anatomy department of the Shenzhen University‐affiliated Medical School .The pathological symptoms such as bone disease and chronic fracture were excluded by radiograph .The samples were stored at -20 ℃ before biomechanical study and thawed at room temperature (18 ℃) for 8 h when the biomechanical study was about to start

  13. Outcome of rail fixator system in reconstructing bone gap

    Directory of Open Access Journals (Sweden)

    Amit Lakhani

    2014-01-01

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

  14. Comparison of fixation disparity curve parameters obtained with the Wesson and Saladin fixation disparity cards.

    Science.gov (United States)

    Ngan, Janice; Goss, David A; Despirito, Joseph

    2005-01-01

    This study compared fixation curve parameters with two commercially available fixation disparity cards, one that has been available for several years, the Wesson card, and a new one, the Saladin card. Fixation disparity curves were measured on 50 subjects with the Wesson fixation disparity card and the Saladin fixation disparity card. The x intercepts were on average more in the base-in direction with the Wesson card than with the Saladin card. The y intercepts were shifted in the exo direction with the Wesson card compared with the Saladin card. The slope with the Wesson card was steeper than the slope obtained with the Saladin card. The distribution of curve types was also different with the two different instruments. Fixation disparity curves measured with these two instruments are different, and separate norms should be used for each fixation disparity measurement method.

  15. Effect of Additive on Sulfur-fixation Process of Sulfur-fixation Agent

    Institute of Scientific and Technical Information of China (English)

    XIE Jun-lin; QIU Jian-rong; ZHAO Gai-ju; LOU Jin-ping; HAN Chun-hua

    2003-01-01

    The crystallization behavior of desulfurization product is directly related to its high-temperatureresistant ability. Effects of the additive on the sulfur-fixation efficiency of the Ba-sulfur-fixation agent and also on the crystallization behavior of the sulfur-fixation product were studied when CaCO3 and BaCO3 were used as the desulfurization agent and MgO and SrCO3 used as the assistant sulfur-fixation agent. The result shows that increase of sulfur-fixation capability for the additive is not owe to their directly react to form sulfate or interact with CaCO3 and BaCO3 to form composite mineral heat-resistant in high temperature, but owe to their activation to sulfur-fixation reaction of the sulfur-fixation agent.

  16. 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.

  17. 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. .

  18. Dinitrogen fixation in aphotic oxygenated marine environments

    Directory of Open Access Journals (Sweden)

    Eyal eRahav

    2013-08-01

    Full Text Available We measured N2 fixation rates from oceanic zones that have traditionally been ignored as sources of biological N2 fixation; the aphotic, fully oxygenated, nitrate (NO3--rich, waters of the oligotrophic Levantine Basin (LB and the Gulf of Aqaba (GA. N2 fixation rates measured from pelagic aphotic waters to depths up to 720 m, during the mixed and stratified periods, ranged from 0.01 nmol N L-1 d-1 to 0.38 nmol N L-1 d-1. N2 fixation rates correlated significantly with bacterial productivity and heterotrophic diazotrophs were identified from aphotic as well as photic depths. Dissolved free amino acid amendments to whole water from the GA enhanced bacterial productivity by 2to 3.5 and N2 fixation rates by ~ 2 fold in samples collected from aphotic depths while in amendments to water from photic depths bacterial productivity increased 2 to 6 fold while N2 fixation rates increased by a factor of 2 to 4 illustrating that both BP an heterotrophic N2 fixation are carbon limited. Experimental manipulations of aphotic waters from the LB demonstrated a significant positive correlation between transparent exopolymeric particles (TEP concentration and N2 fixation rates. This suggests that sinking organic material and high carbon (C: nitrogen (N micro-environments (such as TEP-based aggregates or marine snow could support high heterotrophic N2 fixation rates in oxygenated surface waters and in the aphotic zones. Indeed, our calculations show that aphotic N2 fixation accounted for 37 to 75 % of the total daily integrated N2 fixation rates at both locations in the Mediterranean and Red Seas with rates equal or greater to those measured from the photic layers. Moreover, our results indicate that that while N2 fixation may be limited in the surface waters, aphotic, pelagic N2 fixation may contribute significantly to new N inputs in other oligotrophic basins, yet it is currently not included in regional or global N budgets.

  19. Immaturity of Visual Fixations in Dyslexic Children.

    Science.gov (United States)

    Tiadi, Aimé; Gérard, Christophe-Loïc; Peyre, Hugo; Bui-Quoc, Emmanuel; Bucci, Maria Pia

    2016-01-01

    To our knowledge, behavioral studies recording visual fixations abilities in dyslexic children are scarce. The object of this article is to explore further the visual fixation ability in dyslexics compared to chronological age-matched and reading age-matched non-dyslexic children. Fifty-five dyslexic children from 7 to 14 years old, 55 chronological age-matched non-dyslexic children and 55 reading age-matched non-dyslexic children participated to this study. Eye movements from both eyes were recorded horizontally and vertically by a video-oculography system (EyeBrain(®) T2). The fixation task consisted in fixating a white-filled circle appearing in the center of the screen for 30 s. Results showed that dyslexic children produced a significantly higher number of unwanted saccades than both groups of non-dyslexic children. Moreover, the number of unwanted saccades significantly decreased with age in both groups of non-dyslexic children, but not in dyslexics. Furthermore, dyslexics made more saccades during the last 15 s of fixation period with respect to both groups of non-dyslexic children. Such poor visual fixation capability in dyslexic children could be due to impaired attention abilities, as well as to an immaturity of the cortical areas controlling the fixation system.

  20. Immaturity of Visual Fixations in Dyslexic Children.

    Directory of Open Access Journals (Sweden)

    TIADI eBi Kuyami Guy Aimé

    2016-02-01

    Full Text Available To our knowledge, behavioral studies recording visual fixations abilities in dyslexic children are scarce. The object of this paper is to explore further the visual fixation ability in dyslexics compared to chronological age-matched and reading age-matched non-dyslexic children. Fifty-five dyslexic children from 7 to 14 years old, fifty-five chronological age-matched non-dyslexic children and fifty-five reading age-matched non-dyslexic children participated to this study. Eye movements from both eyes were recorded horizontally and vertically by a video-oculography system (EyeBrain® T2. The fixation task consisted in fixating a white-filled circle appearing in the centre of the screen for 30 seconds. Results showed that dyslexic children produced a significantly higher number of unwanted saccades than both groups of non-dyslexic children. Moreover, the number of unwanted saccades significantly decreased with age in both groups of non-dyslexic children, but not in dyslexics. Furthermore, dyslexics made more saccades during the last 15 sec of fixation period with respect to both groups of non-dyslexic children. Such poor visual fixation capability in dyslexic children could be due to impaired attention abilities, as well as to an immaturity of the cortical areas controlling the fixation system.

  1. Biomechanical Analysis of Latarjet Screw Fixation: Comparison of Screw Types and Fixation Methods.

    Science.gov (United States)

    Shin, Jason J; Hamamoto, Jason T; Leroux, Timothy S; Saccomanno, Maristella F; Jain, Akshay; Khair, Mahmoud M; Mellano, Christen R; Shewman, Elizabeth F; Nicholson, Gregory P; Romeo, Anthony A; Cole, Brian J; Verma, Nikhil N

    2017-09-01

    To compare the initial fixation stability, failure strength, and mode of failure of 5 different screw types and fixation methods commonly used for the classic Latarjet procedure. Thirty-five fresh-frozen cadaveric shoulder specimens were allocated into 5 groups. A 25% anteroinferior glenoid defect was created, and a classic Latarjet coracoid transfer procedure was performed. All grafts were fixed with 2 screws, differing by screw type and/or fixation method. The groups included partially threaded solid 4.0-mm cancellous screws with bicortical fixation, partially threaded solid 4.0-mm cancellous screws with unicortical fixation, fully threaded solid 3.5-mm cortical screws with bicortical fixation, partially threaded cannulated 4.0-mm cancellous screws with bicortical fixation, and partially threaded cannulated 4.0-mm captured screws with bicortical fixation. All screws were stainless steel. Outcomes included cyclic creep and secant stiffness during cyclic loading, as well as load and work to failure during the failure test. Intergroup comparisons were made by a 1-way analysis of variance. There were no significant differences among different screw types or fixation methods in cyclic creep or secant stiffness after cyclic loading or in load to failure or work to failure during the failure test. Post-failure radiographs showed evidence of screw bending in only 1 specimen that underwent the Latarjet procedure with partially threaded solid cancellous screws with bicortical fixation. The mode of failure for all specimens analyzed was screw cutout. In this biomechanical study, screw type and fixation method did not significantly influence biomechanical performance in a classic Latarjet procedure. When performing this procedure, surgeons may continue to select the screw type and method of fixation (unicortical or bicortical) based on preference; however, further studies are required to determine the optimal method of treatment. Surgeons may choose the screw type and

  2. Evaluation of performance and personal satisfaction of the patient with spastic hand after using a volar dorsal orthosis Avaliação do desempenho e da satisfação pessoal do paciente com mão espástica após o uso da órtese dorsal volar

    Directory of Open Access Journals (Sweden)

    Danielle dos Santos Cutrim Garros

    2010-06-01

    Full Text Available The performance and the satisfaction of the patient were quantitatively compared with the use of the volar dorsal orthosis in order to position the spastic hand. Thirty patients wearing the orthosis for eight hours daily were evaluated by the Canadian Occupational Performance Measure and the box and blocks test, for a three-month period. Five activities were selected (among daily life activities, productive activities, and leisure activities by the patients, which were impaired by spasticity. There was an improvement related to performance after use of orthosis, with an average of 1.4±0.5 to 6.3±0.8 (pComparou-se quantitativamente o desempenho e a satisfação do paciente com o uso da órtese dorsal volar para posicionamento da mão espástica. Foram analisados 30 pacientes que fizeram uso da órtese por 8 horas diárias, avaliados por meio da Medida Canadense de Desempenho Ocupacional e teste caixa e blocos, no intervalo de 3 meses. Foram selecionadas 5 atividades (entre as atividades de vida diária, produtivas e de lazer pelos pacientes que estavam comprometidas pela espasticidade. Obteve-se melhora em relação ao desempenho após o uso da órtese, com média de 1,4±0,5 para 6,3±0,8 (p<0,01. Quanto à média da satisfação foi de 1,7±0,4 para 6,3±0,6 (p<0,01 com o uso da órtese. Nesta casuística, o uso da órtese de punho e dedos para espasticidade apresentou melhora no desempenho funcional e satisfação do paciente.

  3. Carbon dioxide fixation in isolated Kalanchoe chloroplasts

    Energy Technology Data Exchange (ETDEWEB)

    Levi, C.; Gibbs, M.

    1975-07-01

    Chloroplasts isolated from Kalanchoe diagremontiana leaves were capable of photosynthesizing at a rate of 5.4 ..mu..moles of CO/sub 2/ per milligram of chlorophyll per hour. The dark rate of fixation was about 1 percent of the light rate. A high photosynthetic rate was associated with low starch content of the leaves. Ribose 5-phosphate, fructose 1, 6-diphosphate, and dithiothreitol stimulated fixation, whereas phosphoenolpyruvate and azide were inhibitors. The products of CO/sub 2/ fixation were primarily those of the photosynthetic carbon reduction cycle. (auth)

  4. Methanotrophy Induces Nitrogen Fixation in Boreal Mosses

    Science.gov (United States)

    Tiirola, M. A.

    2014-12-01

    Many methanotrophic bacterial groups fix nitrogen in laboratory conditions. Furthermore, nitrogen (N) is a limiting nutrient in many environments where methane concentrations are highest. Despite these facts, methane-induced N fixation has previously been overlooked, possibly due to methodological problems. To study the possible link between methanotrophy and diazotrophy in terrestrial and aquatic habitats, we measured the co-occurrence of these two processes in boreal forest, peatland and stream mosses using a stable isotope labeling approach (15 N2 and 13 CH4 double labeling) and sequencing of the nifH gene marker. N fixation associated with forest mosses was dependent on the annual N deposition, whereas methane stimulate N fixation neither in high (>3 kg N ha -1 yr -1) nor low deposition areas, which was in accordance with the nifH gene sequencing showing that forest mosses (Pleurozium schreberi and Hylocomium splendens ) carried mainly cyanobacterial N fixers. On the other extreme, in stream mosses (Fontinalis sp.) methane was actively oxidized throughout the year, whereas N fixation showed seasonal fluctuation. The co-occurrence of the two processes in single cell level was proven by co-localizing both N and methane-carbon fixation with the secondary ion mass spectrometry (SIMS) approach. Methanotrophy and diazotrophy was also studied in peatlands of different primary successional stages in the land-uplift coast of Bothnian Bay, in the Siikajoki chronosequence, where N accumulation rates in peat profiles indicate significant N fixation. Based on experimental evidence it was counted that methane-induced N fixation explained over one-third of the new N input in the younger peatland successional stages, where the highest N fixation rates and highest methane oxidation activities co-occurred in the water-submerged Sphagnum moss vegetation. The linkage between methanotrophic carbon cycling and N fixation may therefore constitute an important mechanism in the rapid

  5. Nitrogen Fixation in Denitrified Marine Waters

    OpenAIRE

    Camila Fernandez; Laura Farías; Osvaldo Ulloa

    2011-01-01

    Nitrogen fixation is an essential process that biologically transforms atmospheric dinitrogen gas to ammonia, therefore compensating for nitrogen losses occurring via denitrification and anammox. Currently, inputs and losses of nitrogen to the ocean resulting from these processes are thought to be spatially separated: nitrogen fixation takes place primarily in open ocean environments (mainly through diazotrophic cyanobacteria), whereas nitrogen losses occur in oxygen-depleted intermediate wat...

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

    Directory of Open Access Journals (Sweden)

    Mrázek M.

    2010-07-01

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

  7. Maxwellian Eye Fixation during Natural Scene Perception

    Directory of Open Access Journals (Sweden)

    Jean Duchesne

    2012-01-01

    Full Text Available When we explore a visual scene, our eyes make saccades to jump rapidly from one area to another and fixate regions of interest to extract useful information. While the role of fixation eye movements in vision has been widely studied, their random nature has been a hitherto neglected issue. Here we conducted two experiments to examine the Maxwellian nature of eye movements during fixation. In Experiment 1, eight participants were asked to perform free viewing of natural scenes displayed on a computer screen while their eye movements were recorded. For each participant, the probability density function (PDF of eye movement amplitude during fixation obeyed the law established by Maxwell for describing molecule velocity in gas. Only the mean amplitude of eye movements varied with expertise, which was lower in experts than novice participants. In Experiment 2, two participants underwent fixed time, free viewing of natural scenes and of their scrambled version while their eye movements were recorded. Again, the PDF of eye movement amplitude during fixation obeyed Maxwell’s law for each participant and for each scene condition (normal or scrambled. The results suggest that eye fixation during natural scene perception describes a random motion regardless of top-down or of bottom-up processes.

  8. Fixational eye movements predict visual sensitivity.

    Science.gov (United States)

    Scholes, Chris; McGraw, Paul V; Nyström, Marcus; Roach, Neil W

    2015-10-22

    During steady fixation, observers make small fixational saccades at a rate of around 1-2 per second. Presentation of a visual stimulus triggers a biphasic modulation in fixational saccade rate-an initial inhibition followed by a period of elevated rate and a subsequent return to baseline. Here we show that, during passive viewing, this rate signature is highly sensitive to small changes in stimulus contrast. By training a linear support vector machine to classify trials in which a stimulus is either present or absent, we directly compared the contrast sensitivity of fixational eye movements with individuals' psychophysical judgements. Classification accuracy closely matched psychophysical performance, and predicted individuals' threshold estimates with less bias and overall error than those obtained using specific features of the signature. Performance of the classifier was robust to changes in the training set (novel subjects and/or contrasts) and good prediction accuracy was obtained with a practicable number of trials. Our results indicate a tight coupling between the sensitivity of visual perceptual judgements and fixational eye control mechanisms. This raises the possibility that fixational saccades could provide a novel and objective means of estimating visual contrast sensitivity without the need for observers to make any explicit judgement.

  9. Variable Nitrogen Fixation in Wild Populus.

    Directory of Open Access Journals (Sweden)

    Sharon L Doty

    Full Text Available The microbiome of plants is diverse, and like that of animals, is important for overall health and nutrient acquisition. In legumes and actinorhizal plants, a portion of essential nitrogen (N is obtained through symbiosis with nodule-inhabiting, N2-fixing microorganisms. However, a variety of non-nodulating plant species can also thrive in natural, low-N settings. Some of these species may rely on endophytes, microorganisms that live within plants, to fix N2 gas into usable forms. Here we report the first direct evidence of N2 fixation in the early successional wild tree, Populus trichocarpa, a non-leguminous tree, from its native riparian habitat. In order to measure N2 fixation, surface-sterilized cuttings of wild poplar were assayed using both 15N2 incorporation and the commonly used acetylene reduction assay. The 15N label was incorporated at high levels in a subset of cuttings, suggesting a high level of N-fixation. Similarly, acetylene was reduced to ethylene in some samples. The microbiota of the cuttings was highly variable, both in numbers of cultured bacteria and in genetic diversity. Our results indicated that associative N2-fixation occurred within wild poplar and that a non-uniformity in the distribution of endophytic bacteria may explain the variability in N-fixation activity. These results point to the need for molecular studies to decipher the required microbial consortia and conditions for effective endophytic N2-fixation in trees.

  10. Comparison of clinical efficacy of proximal femoral nail anti-rotatio and locking plate for proximal femoral fractures%髓内钉与近端锁定钢板治疗股骨近端骨折的对比研究

    Institute of Scientific and Technical Information of China (English)

    叶庆林; 邹华章; 罗春强; 梁桂泉; 卢志文

    2016-01-01

    目的探讨股骨近端螺旋刀片抗旋髓内钉( PFNA)和股骨近端锁定钢板( PFLCP)治疗股骨近端骨折患者的临床疗效并进行对比分析。方法笔者回顾性分析2010年3月~2014年3月采用PFNA和PFLCP法治疗股骨近端骨折70例的病例资料,PFNA内固定治疗40例,PFLCP内固定治疗30例。观察比较两组患者手术时间、术中透视时间、术中失血量、术后引流量以及Parker-Palmer评分的差异。结果所有患者随访6~9个月,平均8.9个月。末次随访时两种方法的Parker-Palmer评分差异无统计学意义( P>0.05)。两种方法的手术时间、术中透视时间、术中失血量、术后引流量以及Parker-Palmer评分的差异均无统计学意义(P>0.05),但PFNA组的术中透视时间明显短于PFLCP组。结论 PFNA和PFLCP均是治疗股骨近端骨折较好的内固定材料。%Objective To compare and analyze the clinical efficacy of proximal femoral nail anti-rotation (PFNA) and proximal femoral locking compression plate (PFLCP) in the treatment of proximal femoral fracture . Methods From Mar.2010 to Mar.2014,70 patients with proximal femoral fracture treated with PFNA and PFLCP were collected.All of these patients were randomly divided into PFNA group (40 cases) and PFLCP group (30 ca-ses).The operation time,intraoperative fluoroscopy time,intraoperative blood loss,postoperative drainage volume and Parker-Palmer score between these two groups were compared .Results All patients were followed up for 6-9 months,averaging 8.9 months.There was no significant difference in the intraoperative blood loss ,operative time, postoperative drainage volume and Parker-Palmer score between the two groups .But intraoperative fluoroscopy time of the PFNA group was shorter than that of the PFLCP group .Conclusion PFNA and PFLCP were both good in-ternal fixation materials for the treatment of proximal femoral fractures .

  11. Nitrogen fixation in trees - 1

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-01-01

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

  12. Finite element analysis of posterior cervical fixation.

    Science.gov (United States)

    Duan, Y; Wang, H H; Jin, A M; Zhang, L; Min, S X; Liu, C L; Qiu, S J; Shu, X Q

    2015-02-01

    Despite largely, used in the past, biomechanical test, to investigate the fixation techniques of subaxial cervical spine, information is lacking about the internal structural response to external loading. It is not yet clear which technique represents the best choice and whether stabilization devices can be efficient and beneficial for three-column injuries (TCI). The different posterior cervical fixation techniques (pedicle screw PS, lateral mass screw LS, and transarticular screw TS) have respective indications. A detailed, geometrically accurate, nonlinear C3-C7 finite element model (FEM) had been successfully developed and validated. Then three FEMs were reconstructed from different fixation techniques after C4-C6 TCI. A compressive preload of 74N combined with a pure moment of 1.8 Nm in flexion, extension, left-right lateral bending, and left-right axial rotation was applied to the FEMs. The ROM results showed that there were obvious significant differences when comparing the different fixation techniques. PS and TS techniques can provide better immediate stabilization, compared to LS technique. The stress results showed that the variability of von Mises stress in the TS fixation device was minimum and LS fixation device was maximum. Furthermore, the screws inserted by TS technique had high stress concentration at the middle part of the screws. Screw inserted by PS and LS techniques had higher stress concentration at the actual cap-rod-screw interface. The research considers that spinal surgeon should first consider using the TS technique to treat cervical TCI. If PS technique is used, we should eventually prolong the need for external bracing in order to reduce the higher risk of fracture on fixation devices. If LS technique is used, we should add anterior cervical operation for acquire a better immediate stabilization. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  13. The fixation and saccade P3.

    Science.gov (United States)

    Dandekar, Sangita; Ding, Jian; Privitera, Claudio; Carney, Thom; Klein, Stanley A

    2012-01-01

    Although most instances of object recognition during natural viewing occur in the presence of saccades, the neural correlates of objection recognition have almost exclusively been examined during fixation. Recent studies have indicated that there are post-saccadic modulations of neural activity immediately following eye movement landing; however, whether post-saccadic modulations affect relatively late occurring cognitive components such as the P3 has not been explored. The P3 as conventionally measured at fixation is commonly used in brain computer interfaces, hence characterizing the post-saccadic P3 could aid in the development of improved brain computer interfaces that allow for eye movements. In this study, the P3 observed after saccadic landing was compared to the P3 measured at fixation. No significant differences in P3 start time, temporal persistence, or amplitude were found between fixation and saccade trials. Importantly, sensory neural responses canceled in the target minus distracter comparisons used to identify the P3. Our results indicate that relatively late occurring cognitive neural components such as the P3 are likely less sensitive to post saccadic modulations than sensory neural components and other neural activity occurring shortly after eye movement landing. Furthermore, due to the similarity of the fixation and saccade P3, we conclude that the P3 following saccadic landing could possibly be used as a viable signal in brain computer interfaces allowing for eye movements.

  14. Chemical and physical basics of routine formaldehyde fixation

    Directory of Open Access Journals (Sweden)

    Rooban Thavarajah

    2012-01-01

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

  15. Control and Functions of Fixational Eye Movements

    Science.gov (United States)

    Rucci, Michele; Poletti, Martina

    2016-01-01

    Humans and other species explore a visual scene by rapidly shifting their gaze 2-3 times every second. Although the eyes may appear immobile in the brief intervals in between saccades, microscopic (fixational) eye movements are always present, even when attending to a single point. These movements occur during the very periods in which visual information is acquired and processed and their functions have long been debated. Recent technical advances in controlling retinal stimulation during normal oculomotor activity have shed new light on the visual contributions of fixational eye movements and their degree of control. The emerging body of evidence, reviewed in this article, indicates that fixational eye movements are important components of the strategy by which the visual system processes fine spatial details, enabling both precise positioning of the stimulus on the retina and encoding of spatial information into the joint space-time domain.

  16. Breast specimen shrinkage following formalin fixation

    Directory of Open Access Journals (Sweden)

    Horn CL

    2014-02-01

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

  17. Biometric recognition via fixation density maps

    Science.gov (United States)

    Rigas, Ioannis; Komogortsev, Oleg V.

    2014-05-01

    This work introduces and evaluates a novel eye movement-driven biometric approach that employs eye fixation density maps for person identification. The proposed feature offers a dynamic representation of the biometric identity, storing rich information regarding the behavioral and physical eye movement characteristics of the individuals. The innate ability of fixation density maps to capture the spatial layout of the eye movements in conjunction with their probabilistic nature makes them a particularly suitable option as an eye movement biometrical trait in cases when free-viewing stimuli is presented. In order to demonstrate the effectiveness of the proposed approach, the method is evaluated on three different datasets containing a wide gamut of stimuli types, such as static images, video and text segments. The obtained results indicate a minimum EER (Equal Error Rate) of 18.3 %, revealing the perspectives on the utilization of fixation density maps as an enhancing biometrical cue during identification scenarios in dynamic visual environments.

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

    African Journals Online (AJOL)

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

  19. Cosmetic arm lengthening with monorail fixator

    Institute of Scientific and Technical Information of China (English)

    Hemendra Kumar Agrawal; Balvinder Singh; Mohit Garg; Vipin Khatkar; Sumit Batra; Vinod Kumar Sharma

    2015-01-01

    Upper limb length discrepancy is a rare occurrence.Humerus shortening may need specialized treatment to restore the functional and cosmetic status of upper limb.We report a case of humerus lengthening of 9 cm with a monorail external fixator and the result was observed during a 2-year follow-up.Humerus lengthening needs specialized focus as it is not only a cosmetic issue but also a functional demand.The monorail unilateral fixator is more functional and cosmetically acceptable,and thus becomes an effective treatment option.

  20. Ab externo scleral fixation of intraocular lens.

    Science.gov (United States)

    Slade, D Snow; Hater, Michael A; Cionni, Robert J; Crandall, Alan S

    2012-08-01

    We describe an ab externo technique that facilitates IOL scleral fixation and reduces the risk associated with previous ab externo scleral fixation techniques. This technique uses a microvitreoretinal blade and an internal limiting membrane forceps to create sclerotomies and retrieve the suture, respectively. Dr. Cionni is a consultant to Morcher GmbH, Stuttgart, Germany. Dr. Crandall is a consultant to Alcon Laboratories, Inc., Ft. Worth, Texas, USA. No other author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  1. Skeletal Fixation in a Mutilated Hand.

    Science.gov (United States)

    Bhardwaj, Praveen; Sankaran, Ajeesh; Sabapathy, S Raja

    2016-11-01

    Hand fracture fixation in mutilating injuries is characterized by multiple challenges due to possible skeletal disorganization and concomitant severe injury of soft tissue structures. The effects of skeletal disruption are best analyzed as divided into specific locales in the hand: radial, ulnar, proximal, and distal. Functional consequences of injuries in each of these regions are discussed. Although a variety of implants are now in vogue, K-wire fixation has stood the test of time and is especially useful in multiple fracture situations. Segmental bone loss is quite common in such injuries, which can be safely reconstructed in a staged manner. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Fixation Property of Copper Triazole Wood Preservatives

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    According to AWPA E11-2006 standard,copper fixation rates of several copper-based formulations,such as ammoniacal copper,amine copper,and ammoniacal-ethanolamine copper,as well as alkaline copper quaternary(ACQ),were tested and compared in this paper.And the fixation rates of tebuconazole(TEB) and propiconazole(PPZ) in several formulations,such as copper azole,emulsified type and solvent type,were also compared.The determination of copper content in the leachate was analyzed by atomic absorption spectrom...

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

    Science.gov (United States)

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

    2017-01-01

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

  4. Posterior fixation suture and convergence excess esotropia.

    Science.gov (United States)

    Steffen; Auffarth; Kolling

    1998-09-01

    The present study investigates the results of Cuppers' 'Fadenoperation' in patients with non-accommodative convergence excess esotropia. Particular attention is given to postoperative eye alignment at distance fixation. Group 1 (n=96) included patients with a 'normal' convergence excess. The manifest near angles (mean ET 16.73 degrees +/- 6.33 degrees, range 4 degrees -33 degrees ) were roughly twice the size of the distance angles (mean ET 6.50 degrees +/- 3.62 degrees, range 0 degrees -14 degrees ). These patients were treated with a bilateral fadenoperation of the medial recti without additional eye muscle surgery. Three months after surgery, the mean postoperative angles were XT 0.5 degrees +/- 3.3 degrees (range XT 11 degrees -ET 5 degrees ) for distance fixation, and ET 2.7 degrees +/- 3.6 degrees (range XT 5 degrees -ET 14 degrees ) for near fixation, respectively. Postoperative convergent angles at near fixation >ET 10 degrees were present in two patients (1.9%). Group 2 (n=21) included patients with a mean preoperative distance angle of ET 9.2 degrees +/- 3.7 degrees (range 6 degrees -16 degrees ) and a mean preoperative near angle of ET 23.4 degrees +/- 3.1 degrees (range 16 degrees -31 degrees ). These patients were operated on with a bilateral fadenoperation of the medial recti and a simultaneous recession of one or both medial rectus muscles. Mean postoperative angles were XT 0.5 degrees +/- 4.6 degrees (range XT 12 degrees -ET 7 degrees ) for distance fixation and ET 1.4 degrees +/- 4.5 degrees (range XT 8 degrees -ET 13 degrees ) for near fixation, respectively. In this group, 2 patients (10.6%) had a postoperative exotropia >XT 5 degrees at distance fixation, and two patients had residual esotropia>ET 10 degrees at near fixation. Group 3 (n=17) included patients with a pronounced non-accommodative convergence excess. Near angle values (mean of 17.8 degrees +/- 5.3 degrees, range ET 7 degrees -26 degrees ) were several times higher than the distance

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Barabash Yu.A.

    2010-09-01

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

  7. Acuity, crowding, reading and fixation stability.

    Science.gov (United States)

    Falkenberg, Helle K; Rubin, Gary S; Bex, Peter J

    2007-01-01

    People with age-related macular disease frequently experience reading difficulty that could be attributed to poor acuity, elevated crowding or unstable fixation associated with peripheral visual field dependence. We examine how the size, location, spacing and instability of retinal images affect the visibility of letters and words at different eccentricities. Fixation instability was simulated in normally sighted observers by randomly jittering single or crowded letters or words along a circular arc of fixed eccentricity. Visual performance was assessed at different levels of instability with forced choice measurements of acuity, crowding and reading speed in a rapid serial visual presentation paradigm. In the periphery: (1) acuity declined; (2) crowding increased for acuity- and eccentricity-corrected targets; and (3), the rate of reading fell with acuity-, crowding- and eccentricity-corrected targets. Acuity and crowding were unaffected by even high levels of image instability. However, reading speed decreased with image instability, even though the visibility of the component letters was unaffected. The results show that reading performance cannot be standardised across the visual field by correcting the size, spacing and eccentricity of letters or words. The results suggest that unstable fixation may contribute to reading difficulties in people with low vision and therefore that rehabilitation may benefit from fixation training.

  8. Osteomyelitis in burn patients requiring skeletal fixation

    NARCIS (Netherlands)

    Barret, JP; Desai, MH; Herndon, DN

    2000-01-01

    Deep and severe burns often present with the exposure of musculoskeletal structures and severe deformities. Skeletal fixation, suspension and/or traction are part of their comprehensive treatment. Several factors put burn patients at risk for osteomyelitis, osteosynthesis material being one of them.

  9. Nitrogen fixation in the phyllosphere of Gramineae

    NARCIS (Netherlands)

    Bessems, E.P.M.

    1973-01-01

    The investigation was carried out with Zea mays , grown under temperate conditions, and with Tripsacum laxum Nash, grown in the tropics. The conditions for nitrogen fixation were found to be unfavourable in the leachate, obtained by spray irrigation of the aerial plant

  10. Synthetic biology for CO2 fixation.

    Science.gov (United States)

    Gong, Fuyu; Cai, Zhen; Li, Yin

    2016-11-01

    Recycling of carbon dioxide (CO2) into fuels and chemicals is a potential approach to reduce CO2 emission and fossil-fuel consumption. Autotrophic microbes can utilize energy from light, hydrogen, or sulfur to assimilate atmospheric CO2 into organic compounds at ambient temperature and pressure. This provides a feasible way for biological production of fuels and chemicals from CO2 under normal conditions. Recently great progress has been made in this research area, and dozens of CO2-derived fuels and chemicals have been reported to be synthesized by autotrophic microbes. This is accompanied by investigations into natural CO2-fixation pathways and the rapid development of new technologies in synthetic biology. This review first summarizes the six natural CO2-fixation pathways reported to date, followed by an overview of recent progress in the design and engineering of CO2-fixation pathways as well as energy supply patterns using the concept and tools of synthetic biology. Finally, we will discuss future prospects in biological fixation of CO2.

  11. Behind the discovery of "Nissenbaum's fixative".

    Science.gov (United States)

    Nissenbaum, G

    2001-01-01

    The author describes the serendipitous discovery, conception, development, and history of Nissenbaum's Fixative while an undergraduate biology major in the early 1950s. The subsequent uses, applications, and modifications over the past forty-seven years are also described. Some of the modifications omitted from his short original paper are mentioned. Highlights of his subsequent career in the field of medicine are noted.

  12. Treating Somatic Fixation: A Biopsychosocial Approach

    Science.gov (United States)

    McDaniel, Susan H.; Campbell, Thomas; Seaburn, David

    1991-01-01

    Somatic fixation occurs when the patient or physician focuses exclusively on the biomedical aspects of a complex illness. Individual, family, and cultural factors promote the expression of emotional experience through physical symptoms. The physician or treatment team establishes a collaborative relationship with the patient and family, integrating biomedical and psychosocial evaluations and respecting the patient's defenses. PMID:21228995

  13. Headspace analysis of foams and fixatives

    Energy Technology Data Exchange (ETDEWEB)

    Harper, Kyle [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Truong, Thanh-Tam [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Magwood, Leroy [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Peters, Brent [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Nicholson, James [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Washington, II, Aaron L. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2017-07-27

    In the process of decontaminating and decommissioning (D&D) older nuclear facilities, special precautions must be taken with removable or airborne contamination. One possible strategy utilizes foams and fixatives to affix these loose contaminants. Many foams and fixatives are already commercially available, either generically or sold specifically for D&D. However, due to a lack of revelant testing in a radioactive environment, additional verification is needed to confirm that these products not only affix contamination to their surfaces, but also will function in a D&D environment. Several significant safety factors, including flammability and worker safety, can be analyzed through the process of headspace analysis, a technique that analyzes the off gas formed before or during the curing process of the foam/fixative, usually using gas chromatography-mass spectrometry (GC-MS). This process focuses on the volatile components of a chemical, which move freely between the solid/liquid form within the sample and the gaseous form in the area above the sample (the headspace). Between possibly hot conditions in a D&D situation and heat created in a foaming reaction, the volatility of many chemicals can change, and thus different gasses can be released at different times throughout the reaction. This project focused on analysis of volatile chemicals involved in the process of using foams and fixatives to identify any potential hazardous or flammable compounds.

  14. External fixation for phalangeal and metacarpal fractures

    NARCIS (Netherlands)

    Drenth, DJ; Klasen, HJ

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

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

    Science.gov (United States)

    2010-04-01

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

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

    NARCIS (Netherlands)

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

    1994-01-01

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

  17. Characterization for Soil Fixation by Polyelectrolyte Complex

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-05-15

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

  18. 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.

  19. 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

  20. Southwick Osteotomy Stabilised with External Fixator

    Science.gov (United States)

    Grubor, Predrag; Mitkovic, Milorad; Grubor, Milan

    2014-01-01

    ABSTRACT Introduction: Epiphysiolysis of the femoral head is the most common accident occurring towards the end of pre-puberty and puberty growth. Case report: The author describes the experience in the treatment of chronic epiphysiolysis in two patients treated by Southwick osteotomy. The site is accessed by way of a 15-cm long lateral skin incision and the trochanteric region is reached through the layers. The osteotomy angles prepared beforehand on a thin aluminium model are used to mark the Southwick osteotomy site on the anterior and lateral sides at the level of the lesser trochanter. Before performing the trochanteric osteotomy, two Mitković convergent pins type M20 are applied distally and proximally, above the planned osteotomy site. A tenotomy of the iliopsas muscle is performed, and then the previously marked bone triangle is redissected up to three quarters of the width of the femur. The distal part of the femur is rotated inwards, so that the patella is turned towards the ceiling. The osteotomised fragments of the femur are adapted, repositioned and fixated by installing an external fixator on the previously placed pins. Two more pins are placed, one proximally and one distally, with a view to adequately stabilising the femur. The patient was mobile from day two after the surgery. If, after the surgery, the lead surgeon realises that there is a requirement to make a correction of 5, 10 and 15 degrees of the valgus, varus, anteversion or retroversion deformity, the correction shall be performed without surgically opening the patient, using the fixator pins. Conclusion: After performing a Southwick osteotomy it is easier to adapt, reposition and fixate the osteotomised fragments of the femur using a fixator type M20. Adequate stability allows regaining mobility quickly, which in turn is the best prevention of chondrolysis of the hip. It is possible to make post-operative valgus, varus, anteversion and retroversion corrections of 5, 10 and 15 degrees

  1. 股骨近端抗旋髓内钉内固定术对股骨转子下骨折的治疗效果观察%Observation on Anti-spin Proximal Femoral Intramedullary Nail Fixation for the Treatment of Intertrochanteric Fracture

    Institute of Scientific and Technical Information of China (English)

    朱延兵; 牛海峰; 赵巍

    2016-01-01

    Objective To observe the anti-spin proximal femoral intramedullary nail fixation for treatment of subtrochanteric fractures. Methods58 cases of subtrochanteric fractures were randomly divided into observation group (anti-spin proximal femoral intramedullary nail ifxation) and control group (proximal femoral locking plate ifxation).Results The operative time, less blood loss in observation group were less than the control group, the difference was signiifcant (P0.05).ConclusionThe proximal femoral nail anti-rotation ifxation in the treatment of intertrochanteric fractures has good effect.%目的:观察股骨近端抗旋髓内钉内固定术对股骨转子下骨折的治疗效果。方法收集股骨转子下骨折患者58例,随机分为观察组(股骨近端抗旋髓内钉内固定术)与对照组(股骨近端锁定钢板固定术)。结果观察组手术时间、术中出血量少于对照组,差异有统计学意义(P<0.05);但两组骨折愈合时间、髋关节功能恢复优良率对比,无统计学差异(P>0.05)。结论股骨近端抗旋髓内钉内固定术在股骨转子下骨折治疗中效果理想。

  2. Short-term follow-up of pertrochanteric fractures treated using the proximal femoral locking plate.

    Science.gov (United States)

    Johnson, Benjamin; Stevenson, Jonathan; Chamma, Ramsey; Patel, Amit; Rhee, Shin-Jae; Lever, Caroline; Starks, Ian; Roberts, Phillip J

    2014-05-01

    The proximal femoral locking compression plate is a fixed angled anatomically contoured stainless steel plate used to treat pertrochanteric fractures of the proximal femur. Recent reports quote a high failure rate associated with this implant. We aimed to identify the common methods of failure and determine the elements of surgical techniques that could be altered to potentially improve outcomes should this implant be used for the treatment of unstable pertrochanteric fractures. Retrospective chart analysis. Three separate centers. Twenty-nine patients with 29 fractures. All patients were treated for pertrochanteric fractures using the proximal femoral locking compression plate. The patient demographics, fracture classification, implant details, and complications. Twelve of 29 fractures (41.4%) suffered a complication associated with the implant, and 83% of these occurred in elderly women. Complications included bending, backing-out, fracture, or cut-out of the proximal screws and plate fracture. Common technical errors included the following: (1) leaving the plate proud proximally, (2) malposition of the proximal screws within the femoral neck/head, (3) inappropriate use of the hook plate, (4) creating too ridged a construct when used as a bridging plate. Our experience with the use of this implant suggests an unacceptably high failure rate (41.4%). A knowledge of the common pitfalls encountered when using this device is critical in an effort to reduce failure rates. Based on our data, we would urge caution when considering this device for unstable pertrochanteric fractures, especially in the elderly female. Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

  3. Fixation-coexistence transition in spatial populations

    Science.gov (United States)

    Dall'Asta, Luca; Caccioli, Fabio; Beghè, Deborah

    2013-01-01

    Balancing selection is a special case of frequency-dependent selection that is known to be the major force for the maintenance of biodiversity and polymorphism in natural populations. In finite populations, genetic drift eventually drives the population to fixation to the detriment of biodiversity. The interplay between selection and genetic drift is much richer in spatially extended populations, where the local density of individuals can be low even in the limit of infinitely large systems. We consider the limit of low local density of individuals (strong genetic drift) that is well represented by a modified voter model. We show analytically the existence of a non-equilibrium phase transition between a region in which fixation always occurs and a coexistence phase for a one-dimensional system. We also provide a characterization of the dynamical properties of the system, in particular for what concerns the coarsening behavior and the speed of propagation of heterozygosity above the threshold.

  4. Fixation of tritium gas by rats

    Energy Technology Data Exchange (ETDEWEB)

    Ichimasa, Y.; Ichimasa, M.; Shiba, T.; Oda, M.; Akita, Y.

    1986-01-01

    The oxidation rate of tritium gas (HT) in the rat was determined using a one-way circuit inhalation apparatus. To eliminate tritiated water (HTO) produced by the apparatus, three traps (a -60/sup 0/C cold trap, a silica gel column and molecular sieves) were used. The oxidation rate was found to be 15.2 Bq per kg of blood per hour for each Bq or HT per ml of inhaled air. This rate was approximately one-third that obtained previously by other workers using a closed circuit inhalation system. No significant differences in tritium concentration were detected between blood and tissues. The fixation of HT by rat faecal suspension under aerobic and anaerobic conditions was determined. Fixation under anaerobic conditions was greater than under aerobic conditions.

  5. Translaminar facetal screw (magerl′s fixation

    Directory of Open Access Journals (Sweden)

    Rajasekaran S

    2005-01-01

    Full Text Available Translaminar facet screw fixation (TLFS achieves stabilization of the vertebral motion segment by screws inserted at the base of the spinous process, through the opposite lamina, traversing the facet joint, and ending in the base of the transverse process. It is simple, does not require any specialized equipment, and has the advantages of being a procedure of lesser magnitude, lesser operative time, less cost and few complication rate. Recently there is growing interest in this technique to augment the anterior lumbar fusions to achieve global fusion less invasively. In this review article, we discuss the clinical and biomechanical considerations, surgical technique, indications, contraindications and recent developments of TLFS fixation in lumbar spine fusion.

  6. 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.

  7. 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。

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

    Science.gov (United States)

    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.

  9. Nitrogen fixation in Red Sea seagrass meadows

    KAUST Repository

    Abdallah, Malak

    2017-05-01

    Seagrasses are key coastal ecosystems, providing many ecosystem services. Seagrasses increase biodiversity as they provide habitat for a large set of organisms. In addition, their structure provides hiding places to avoid predation. Seagrasses can grow in shallow marine coastal areas, but several factors regulate their growth and distribution. Seagrasses can uptake different kinds of organic and inorganic nutrients through their leaves and roots. Nitrogen and phosphorous are the most important nutrients for seagrass growth. Biological nitrogen fixation is the conversion of atmospheric nitrogen into ammonia by diazotrophic bacteria. This process provides a significant source of nitrogen for seagrass growth. The nitrogen fixation is controlled by the nif genes which are found in diazotrophs. The main goal of the project is to measure nitrogen fixation rates on seagrass sediments, in order to compare among various seagrass species from the Red Sea. Moreover, we will compare the fixing rates of the Vegetated areas with the bare sediments. This project will help to ascertain the role of nitrogen fixing bacteria in the development of seagrass meadows.

  10. 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.

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

    Science.gov (United States)

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

    1988-03-01

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

  12. The clinical observation of three different internal fixations in treating elderly stable femoral intertrochanteric fracture%3种不同方式内固定治疗老年稳定型股骨粗隆间骨折的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    文皓; 丁雪勇; 徐希彦

    2015-01-01

    Objective To compare the clinical efficacy of locking plate (LCP),dynamic hip screw (DHS)and proximal femo-ral nail (PFNA)internal fixation in the treatment of elderly stable femoral intertrochanteric fracture.Methods A total of 60 pa-tients with stable stable intertrochanteric fractures in elderly patients were randomly divided randomly into proximal femoral LCP fixation group (group A),the DHS fixation group (group B)and PFNA fixation group (group C).The operative time,blood loss, postoperative complications and postoperative weight-bearing time were analyzed among three different groups.Results There were significant difference in blood loss,postoperative weight-bearing time,operative time among three different groups (P < 0.05 ). Group C was significantly better than the group A(P <0.05).Two cases of hip varus deformity,one case of crew loosening and su-perficial infection were appeared among group A.One case of hip varus deformity occurred in group B.One case of suffered refrac-ture occurred in group C.Conclusion LCD fixation,fixation with DHS and PFNA fixation are effective treatment for stable femoral intertrochanteric fracture in the elderly patients.%目的:探讨锁定钢板(LCP)固定、动力髋螺钉(DHS)内固定和股骨近端髓内钉(PFNA)内固定治疗老年股骨粗隆间骨折的疗效。方法选择老年稳定型股骨粗隆间骨折患者60例,随机分至股骨近端 LCP 固定组(A 组)、DHS 内固定组(B 组)和 PFNA 固定组(C 组),对3组患者手术时间、出血量、术后负重时间及并发症发生情况进行分析和比较。结果A 组、B 组、C组与在术中出血量、术后负重时间及手术时间的比较具有统计学意义(P <0.05)。C 组优良率显著优于 A 组(P <0.05)。A 组出现2例髋内翻,1例断钉、退钉,1例浅表感染;B 组出现1例髋内翻;C 组出现1例股骨转子间再骨折。结论LCP 固定、DHS 内固定和 PFNA 均为老年稳定型股骨粗隆间骨折的有效治疗方式。

  13. Weigners fixative-an alternative to formalin fixation for histology with improved preservation of nucleic acids.

    Science.gov (United States)

    Klopfleisch, R; von Deetzen, M; Weiss, A Th; Weigner, J; Weigner, F; Plendl, J; Gruber, A D

    2013-01-01

    Formalin fixation and paraffin embedding (FFPE) is the standard method for tissue storage in histopathology. However, FFPE has disadvantages in terms of user health, environment, and nucleic acid integrity. Weigners fixative has been suggested as an alternative for embalming cadavers in human and veterinary anatomy. The present study tested the applicability of Weigners for histology and immunohistochemistry and the preservation of nucleic acids. To this end, a set of organs was fixed for 2 days and up to 6 months in Weigners (WFPE) or formalin. WFPE tissues from the skin, brain, lymphatic tissues, liver, and muscle had good morphologic preservation, comparable to formalin fixation. The quality of kidney and lung samples was inferior to FFPE material due to less accentuated nuclear staining and retention of proteinaceous interstitial fluids. Azan, Turnbull blue, toluidin, and immunohistochemical stainings for CD79a, cytokeratin, vimentin, and von Willebrand factor led to comparable results with both fixates. Of note, immunohistochemical detection of CD3 was possible after 6 months in WFPE but not in FFPE tissues. mRNA, miRNA, and DNA from WFPE tissues had superior quality and allowed for amplification of miRNA, 400-bp-long mRNA, and 1000-bp-long DNA fragments after 6 months of fixation in WFPE. In summary, Weigners fixative is a nonhazardous alternative to formalin, which provides a good morphologic preservation of most organs, a similar sensitivity for protein detection, and a superior preservation of nucleic acids. Weigners may therefore be a promising alternative to cryopreservation and may be embraced by people affected by formalin allergies.

  14. Results of application of external fixation with different types of fixators

    Directory of Open Access Journals (Sweden)

    Grubor Predrag

    2012-01-01

    Full Text Available Introduction. Extra-focal or external fixation is the method of fracture fixation through the healthy part of the bone using pins or wires. Objective. The aim was to determine which external splints (Ortofix, Mitković, Charnley and Ilizarov had the best biomechanical properties in primary stabilization of spiral, transverse and commutative bone fractures. Methods. To determine the investigation methodology of biomechanical characteristics of the external fixator we used mathematical and computer simulator (software, juvidur physical model and clinical examination. Results. Values of advancing fragments in millimetres obtained by the study of mathematical and computer simulator (software: Charnley - 0.080 mm, Mitković M 20 - 0.785 mm, Ilizarov - 2.245 mm and Ortofix - 1.400 mm. In testing the juvidur model the following values were obtained: the external fixator Mitković M20 - 1.380 mm, Ortofix - 1.470 mm, Ilizarov - 2.410 mm, and Charnley - 2.510 mm. Clinical research of biomechanical characteristics of the effect of vertical force yielded the following results: Mitković M20 - 0.89 mm, Ortofix - 0.14 mm, Charnley - 0.80 mm and Ilizarov - 1.23 mm. Conclusion. When determining the total number of the stability test splints under the effect of vertical force (compression and force effect in antero-posterior, later-lateral plane of cross, spiral and comminuted long bone fractures, the best unified biomechanical stability was shown by the following external fixators: firstly, Mitković M20 (0.93mm, secondly, Charnley fixator (1.14 mm, thirdly, Ortofix (1.22 mm, and fourthly, Ilizarov (1.60 mm.

  15. 掌侧入路与背侧入路对腕舟骨骨折愈合率的影响%Effect of volar approach versus dorsal approach on the healing rate of scaphoid bone fractures

    Institute of Scientific and Technical Information of China (English)

    喻永新; 尚如国

    2014-01-01

    目的:探讨掌侧入路与背侧入路对腕舟骨骨折愈合率的影响。方法:中文数据库以“腕舟骨骨折”与“掌侧入路”和“背侧入路”的布尔逻辑搭配结果作为检索词,英文数据库以“scaphoid fractures”与“dorsal”、“volar”及“palmar”的布尔逻辑搭配结果作为检索词。用计算机检索中国知网、万方学术期刊数据库、维普中文期刊数据库、中国生物医学文献服务系统、中国生物医学期刊网引文数据库、Pubmed及Sciencedirect数据库建库至2013年11月收录的所有相关文献。利用Revman5.2统计软件进行统计分析。结果:共纳入9篇文献,涉及435例患者,其中随机对照实验2篇,非随机对照实验7篇;中文文献4篇,外文文献5篇。漏斗图显示文献不存在发表偏倚。掌侧入路组与背侧入路组总的骨折愈合率比较,差异无统计学意义[Z=149,P=0.140;OR=0.420,95%CI(0.140,1.310)];掌侧入路组术后6~8个月的骨折愈合率优于背侧入路组[Z=2.840,P=0.004;OR=6.930,95%CI(1.820,26.320)]。掌侧入路组与背侧入路组术后并发症发生率比较,差异无统计学意义[Z=0.590,P=0.560;OR=0.760,95%CI(0.310,1.890)]。掌侧入路组与背侧入路组术后腕部活动功能比较,差异无统计学意义[Z=0.990,P=0.320;OR=1.900,95%CI(-1.840,5.840)]。结论:掌侧入路与背侧入路治疗腕舟骨骨折对骨折愈合率的影响没有差异,但经掌侧入路固定的患者骨折愈合更快。%Objective:To explore the effect of volar approach versus dorsal approach on the healing rate of scaphoid bone fractures. Methods:The Boolean logical combination of Scaphoid fractures,Dorsal,Volar and Palmar were used as index terms.All the literatures of controlled trial included from database establishing to November 2013 were retrieved from

  16. Improving Saliency Models by Predicting Human Fixation Patches

    KAUST Repository

    Dubey, Rachit

    2015-04-16

    There is growing interest in studying the Human Visual System (HVS) to supplement and improve the performance of computer vision tasks. A major challenge for current visual saliency models is predicting saliency in cluttered scenes (i.e. high false positive rate). In this paper, we propose a fixation patch detector that predicts image patches that contain human fixations with high probability. Our proposed model detects sparse fixation patches with an accuracy of 84 % and eliminates non-fixation patches with an accuracy of 84 % demonstrating that low-level image features can indeed be used to short-list and identify human fixation patches. We then show how these detected fixation patches can be used as saliency priors for popular saliency models, thus, reducing false positives while maintaining true positives. Extensive experimental results show that our proposed approach allows state-of-the-art saliency methods to achieve better prediction performance on benchmark datasets.

  17. Overcoming Design Fixation Through Education and Creativity Methods

    DEFF Research Database (Denmark)

    Howard, Thomas J.; Maier, Anja; Onarheim, Balder

    2013-01-01

    This paper reports an experiment on the topic design fixation using 12 teams of masters students working on three design problems from (Jansson and Smith 1991). The objective of the experiment is to determine the effectiveness of two interventions to help overcome fixation on example solutions....... The first intervention consisted of educating each team on the phenomena and effects of design fixation. The results showed that this intervention reduced the number of fixation elements in comparison to the control group (p=0.025). The second intervention involved using Dix et als' (2006) 'Bad Ideas...... of ideas produced per group and the groups' fixation ratios, adding to the quantity breads novelty debate. Finally, the study also provided further evidence of the hypothesis by Agogué et al (2011) that example solutions constructed from restrictive partitions have a greater fixation affect....

  18. Transient cortical excitation at the onset of visual fixation.

    Science.gov (United States)

    Rajkai, Csaba; Lakatos, Peter; Chen, Chi-Ming; Pincze, Zsuzsa; Karmos, Gyorgy; Schroeder, Charles E

    2008-01-01

    Primates actively examine the visual world by rapidly shifting gaze (fixation) over the elements in a scene. Despite this fact, we typically study vision by presenting stimuli with gaze held constant. To better understand the dynamics of natural vision, we examined how the onset of visual fixation affects ongoing neuronal activity in the absence of visual stimulation. We used multiunit activity and current source density measurements to index neuronal firing patterns and underlying synaptic processes in macaque V1. Initial averaging of neural activity synchronized to the onset of fixation suggested that a brief period of cortical excitation follows each fixation. Subsequent single-trial analyses revealed that 1) neuronal oscillation phase transits from random to a highly organized state just after the fixation onset, 2) this phase concentration is accompanied by increased spectral power in several frequency bands, and 3) visual response amplitude is enhanced at the specific oscillatory phase associated with fixation. We hypothesize that nonvisual inputs are used by the brain to increase cortical excitability at fixation onset, thus "priming" the system for new visual inputs generated at fixation. Despite remaining mechanistic questions, it appears that analysis of fixation-related responses may be useful in studying natural vision.

  19. Complications of halo fixation of the cervical spine.

    Science.gov (United States)

    Hayes, Victor M; Silber, Jeff S; Siddiqi, Farhan N; Kondrachov, Dmitriy; Lipetz, Jason S; Lonner, Baron

    2005-06-01

    Halo fixators play an integral role in stabilizing the cervical spine. They are most widely used after upper cervical to midcervical spine fractures and dislocations and as a supplement to various surgical fixation techniques. Compared with supine cervical traction techniques, halo fixators allow early patient mobilization and shorten hospital stays. The incidence of halo-fixator complications remains high. Minor complications include pin loosening, localized infection, periorbital edema, superficial pressure sores, and unsightly scars. Major complications include pin penetration, osteomyelitis, subdural abscess, nerve palsies, fracture overdistraction, and persistent instability. Many of these potential complications can be avoided with proper pin placement and meticulous pin care.

  20. Principles of intramedullary pin and wire fixation.

    Science.gov (United States)

    Howard, P E

    1991-02-01

    Knowledge and experience in the proper use of IM pins, K-wires, and orthopedic wire is a valuable asset to the veterinarian's ability to successfully repair a variety of long bone fractures. Most long bone fractures are amenable to repair with this form of fixation. When the principles of application are violated or the implants are used when contraindicated, complications often occur. Proper use of these implants results in the successful management of complex fractures to the satisfaction of both the animal owner and the veterinarian (Fig 10).

  1. Rib Fracture Fixation: Indications and Outcomes.

    Science.gov (United States)

    Senekjian, Lara; Nirula, Raminder

    2017-01-01

    Rib fractures are a frequently identified injury in the trauma population. Not only are multiple rib fractures painful, but they are associated with an increased risk of adverse outcomes. Pneumonia in particular can be devastating, especially to an elderly patient, but other complications such as prolonged ventilation and increased intensive care and hospital durations of stay have a negative impact on the patient. Computed tomography scan is the best modality to diagnosis rib fractures but the treatment of fractures is still evolving. Currently patient care involves a multidisciplinary approach that includes pain control, aggressive pulmonary therapy, and possibly surgical fixation. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Symposium on nitrogen fixation in tropical trees

    Energy Technology Data Exchange (ETDEWEB)

    Dobereiner, J.

    1984-01-01

    A special issue containing the proceedings of an international symposium held on 19-24 September 1983 at Rio de Janeiro. Some 35 papers were presented in six sessions: Importance of leguminous trees (2 papers); Occurrence of leguminous trees (5); Nitrogen fixation in trees (12); Utilization of nitrogen fixing trees (7); Nutrition of leguminous trees (5); and Agroforestry systems (4). Recommendations of the symposium are presented on p. 341-344 (Pt, En), and a List of nitrogen fixing trees which should receive immediate attention in Brazil (26 species) is given on p. 345.

  3. Biological fixation in anterior cruciate ligament surgery

    Directory of Open Access Journals (Sweden)

    Chih-Hwa Chen

    2014-04-01

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

  4. [The experimental investigations upon the influence of ocular fixation on habituation of postural reflexes in pigeon].

    Science.gov (United States)

    Kaźmierczak, H

    1994-01-01

    The subject of investigation was the influence of ocular fixation on acquisition of habituation in experimental rotatory test in pigeons. The habituation training was performed in the three difference conditions: with full ocular fixation, fixation partly reduced and fixation excluded. Author confirmed that habituation with fixation excluded gave the best results of habituation of postural reflexes and head nystagmus in pigeons in rotatory training.

  5. 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.

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

    Directory of Open Access Journals (Sweden)

    El-Anwar, Mohammad Waheed

    2015-03-01

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

  7. A COMPARATIVE STUDY IN LAPAROSCOPIC INGUINAL HERNIA REPAIR BETWEEN FIXATION VS NON-FIXATION OF MESH

    Directory of Open Access Journals (Sweden)

    Ayush

    2016-02-01

    Full Text Available INTRODUCTION An inguinal hernia is a weakness in the wall of the abdominal cavity that is large enough to allow escape of soft body tissue or internal organ, especially a part of the intestine. It usually appears as a lump and for some peoples can cause pain and discomfort, limit daily activities and the ability to work. If the bowel strangulates or becomes obstructed it can be life-threatening. A hernia is repaired generally using a synthetic mesh either with open surgery or increasingly using less invasive laparoscopic procedures. AIMS AND OBJECTIVES To compare and evaluate Laparoscopic hernia repair (trans-abdominal pre-peritoneal and total extra peritoneal repair (TAPP & TEP using Prolene mesh with or without fixation. MATERIAL AND METHODS Our study was conducted in dept. of surgery, Government Medical College and associated Dr. Susheela Tiwari Hospital. A total sample of 100 patients who underwent inguinal hernia repair as an elective surgery. 50 of whom underwent fixation of mesh (fixation will be done either by tacker or suture. Rest 5o underwent non fixation of mesh. RESULTS In our study Statistically there was non-significant heterogeneity in operating time (p = 0.15, post-operative pain (p = 0.45, post-operative complications (p = 0.55 and length of hospital stay (p = 0.11 were statistically comparable between two techniques of mesh fixation in LIHR. The risk of developing chronic groin pain (p = 0.67 and risk of hernia recurrence (p = 0.77 was also similar. CONCLUSION NMF in LIHR does not increase the risk of hernia recurrence. It is comparable with TMF in terms of operation time, post-operative pain, post-operative complications, length of hospital stay and chronic groin pain. Therefore, based upon the results of our study NMF approach may be adopted routinely and safely in LIHR.

  8. External fixator vs.volar locking compression plate fixation combined with Kapandji technique for unstable distal radial fractures of type C: a clinic study%掌侧锁定加压钢板与外固定支架治疗不稳定桡骨远端C型骨折的比较研究

    Institute of Scientific and Technical Information of China (English)

    邓迎生; 谢杨; 官正茂; 杨长伟; 王谦; 张秋林; 王秋根; 纪方; 蔡晓冰; 唐昊; 吴剑宏; 汪方; 汤旭日

    2007-01-01

    目的 比较研究掌侧锁定加压钢板(LCP)与外固定支架固定治疗不稳定桡骨远端C型骨折的疗效及适应证.方法 2000年1月~2006年6月分别采用外固定支架和掌侧LCP结合克氏针撬拨、植骨等技术治疗不稳定桡骨远端C型骨折61例(85侧),骨折按AO/ASIF分型:C1型28侧,C2型33侧,C3型24侧.其中掌侧LCP治疗组34侧,外固定支架固定组51侧.比较两组手术前后掌倾角、尺偏角、桡骨短缩及关节活动范围等,初步评价其临床疗效.结果 所有患者经6~27个月(平均16个月)随访.掌倾角、尺偏角、桡骨短缩及关节面均获明显改善.腕关节功能按Gartland-Werley标准评定,C1、C2型骨折LCP组优于外固定支架组,差异有统计学意义(P<0.05);C3型骨折两组差异无统计学意义(P>0.05).结论 对于掌侧或背侧不稳定的C1、C2型桡骨远端骨折,掌侧LCP可提供有效固定及早期活动;背侧不稳定的C型桡骨远端骨折是外固定支架的最佳适应证;严重粉碎的C3型骨折(尤其掌侧不稳定者)应联合运用LCP和外固定支架等技术.

  9. Perspectives in Biological Nitrogen Fixation Research

    Institute of Scientific and Technical Information of China (English)

    Qi Cheng

    2008-01-01

    Nitrogen fixation, along with photosynthesis is the basis of all life on earth. Current understanding suggests that no plant fixes its own nitrogen. Some plants (mainly legumes) fix nitrogen via symbiotic anaerobic microorganisms (mainly rhizobia). The nature of biological nitrogen fixation is that the dinitrogenase catalyzes the reaction-splitting triple-bond inert atmospheric nitrogen (N2) into organic ammonia molecule (NH3). All known nitrogenases are found to be prokaryotic,multi.complex and normally oxygen liable. Not surprisingly, the engineering of autonomous nitrogen-fixing plants would be a long-term effort because it requires the assembly of a complex enzyme and provision of anaerobic conditions. However,in the light of evolving protein catalysts, the anaerobic enzyme has almost certainly been replaced in many reactions by the more efficient and irreversible aerobic version that uses O2. On the other hand, nature has shown numerous examples of evolutionary convergence where an enzyme catalyzing a highly specific, O2-requiring reaction has an oxygen-independent counterpart, able to carry out the same reaction under anoxic conditions. In this review, I attempt to take the reader on a simplified journey from conventional nitrogenase complex to a possible simplified version of a yet to be discovered Ilght-utilizing nitrogenase.

  10. Biological Nitrogen Fixation: Perspective and Limitation

    Directory of Open Access Journals (Sweden)

    N D Purwantari

    2008-03-01

    Full Text Available The demand of chemical fertilizer, N in particular will be increasing until 2020. In Indonesia, the demand of fertilizer from 1999 – 2002 increased 37.5 and 12.4% for urea and ammonium sulphate, respectively. At the same time, the price of this fertilizer is also increasing and it can not be afforded by the farmer. Other problem in using chemical fertilizer is damaging to the soil and environment. One of the problem solvings for this condition is to maximize biological nitrogen fixation (BNF. BNF is the fixation of N atmosphere by association between soil bacteria rhizobia and leguminous plant. BNF is sustainable and environmentally friendly in providing nitrogen fertilizer. Therefore, it would reduce the requirement of chemical nitrogen fertilizer for the plant. Gliricidia sepium fixes 170 kg N/ha/12 months, equivalent with 377 kg urea, Sesbania sesban 179 kg N/ha/10 months, equivalent 397 kg with urea, soybean 26 – 57 kg/2 months equivalent with 57 – 126 kg urea. The amount of N2- fixed varies, affected by species, environmental and biological factors. There are some limitations in applying this technology. The effect of N contribution is very slow at the beginning but in the long term, it would be beneficial for plant production and at the same time, maintain condition of physical and chemical of soil, soil microbes and therefore soil fertility.

  11. Nitrogen Fixation and Hydrogen Metabolism in Cyanobacteria

    Science.gov (United States)

    Bothe, Hermann; Schmitz, Oliver; Yates, M. Geoffrey; Newton, William E.

    2010-01-01

    Summary: This review summarizes recent aspects of (di)nitrogen fixation and (di)hydrogen metabolism, with emphasis on cyanobacteria. These organisms possess several types of the enzyme complexes catalyzing N2 fixation and/or H2 formation or oxidation, namely, two Mo nitrogenases, a V nitrogenase, and two hydrogenases. The two cyanobacterial Ni hydrogenases are differentiated as either uptake or bidirectional hydrogenases. The different forms of both the nitrogenases and hydrogenases are encoded by different sets of genes, and their organization on the chromosome can vary from one cyanobacterium to another. Factors regulating the expression of these genes are emerging from recent studies. New ideas on the potential physiological and ecological roles of nitrogenases and hydrogenases are presented. There is a renewed interest in exploiting cyanobacteria in solar energy conversion programs to generate H2 as a source of combustible energy. To enhance the rates of H2 production, the emphasis perhaps needs not to be on more efficient hydrogenases and nitrogenases or on the transfer of foreign enzymes into cyanobacteria. A likely better strategy is to exploit the use of radiant solar energy by the photosynthetic electron transport system to enhance the rates of H2 formation and so improve the chances of utilizing cyanobacteria as a source for the generation of clean energy. PMID:21119016

  12. Analysis of Bone Fixation Methods in Digital Replantation

    Science.gov (United States)

    Lee, Seung Woo; Kim, Jin Soo; Roh, Si Young; Lee, Kyung Jin

    2017-01-01

    Background Adequate fixation of replanted digits is essential not only for short-term healing but for long-term function. Various bony fixation methods using Kirschner (K-) and intraosseous wire are available in replantation. We examined clinical and radiographic outcomes of fixation methods on bone union after digital replantation. Methods A single institutional retrospective review identified 992 patients who had undergone 1,247 successful replantations between July 2009 and September 2015. Exclusion criteria included amputations of the distal phalanx, comminuted fractures, and intra-articular fractures. Patients were classified according to 5 categories of fixation methods: single K-wire, double longitudinal K-wires, cross K-wires, wire with, and wire without K-wire support. Bone union was evaluated by 5-month postoperative X-ray and fixation outcomes were compared across the 5 groups. Results The exclusion criteria were applied, and 88 patients with 103 replanted digits remained for analysis. Single K-wire fixation was used in 40 digits, double longitudinal K-wires in 30, and cross fixation in 14. Wire with and without K-wire support was required in 15 and 4 digits. Nonunion was observed in 32 digits (31.1%), of which 13 required additional operations such as bone graft or corrective osteotomy. The highest percent of nonunion was observed after cross fixation (35.7%) and the lowest after wire alone (25.0%). Conclusions In this study, contrary to general knowledge, we found that single K-wire fixation was not associated with poorer outcomes. Successful bone union outcomes may be achieved by careful selection of bone fixation methods. This study provides useful information for planning bone fixation in digital replantation. PMID:28194348

  13. 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

  14. Nitrogen fixation in boreal peatlands: the effects of increased N deposition on N2-fixation

    Science.gov (United States)

    Popma, J. M.; Wieder, R.; Lamers, L.; Vile, M. A.

    2013-12-01

    Boreal peatlands are of great importance to global carbon and nitrogen cycling. While covering only 3-4 % of the terrestrial surface, they account for 25-30 % of the world's soil C and 9-15 % of the world's soil N. In Western Canada atmospheric dry deposition rates are extremely low: approximately 1 kg N ha-1 yr-1. Though these systems have been functioning as net sinks over the past 11,000 years, natural and anthropogenic disturbances might compromise the historical balance of C and N. Biological N2-fixation has recently been shown to represent a very significant input of N into these systems, contributing to 62% of total N in Western Canada. Interactions between N deposition and biological N2-fixation are as yet, unknown, but the impact of elevated deposition of N-compounds from increased industrial expansion of oil sands mining to peatlands, is concerning. Given that nitrogenase, the enzyme responsible for catalyzing N2-fixation, is energetically costly when active, enhanced inputs of atmospheric N deposition could be a major determinant for enzyme activity and rates of biological N input to these bogs. Understanding interactions between N deposition and N2 fixation in boreal peatlands can aid in predicting the consequences of increased N deposition and setting critical loads. We conducted a field-fertilization experiment in a poor fen in Alberta, Canada, to determine the effects of enhanced N deposition on a dominant fen species Sphagnum angustifolium. The experiment consisted of seven N treatments: Control, 0, 5, 10, 15, 20 and 25 kg N ha-1 y1, n=3. N2-fixation was measured during summer 2012 and 2013 using the acetylene reduction assay (ARA). ARA rates were converted to rates of N2-fixation by calibrating ARA with paired 15N2-incubations. In both 2012 and 2013, with increasing N deposition from 0 kg N ha-1 yr-1 to 25 kg N ha-1 yr-1, rates of N2 fixation decreased, with highest rates in the 0 kg N ha-1 yr-1 treatment mosses (54.2 × 1.40; 48.58 × 7.12 kg N ha

  15. 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).

  16. Comparative study of the results of compound tibial shaft fractures treated by Ilizarov ring fixators and limb reconstruction system fixators

    Institute of Scientific and Technical Information of China (English)

    Chandra Prakash Pal; Harish Kumar; Deepak Kumar; K.S.Dinkar; Vivek Mittal; Naveen Kumar Singh

    2015-01-01

    Purpose: Ilizarov ring fixator and limb reconstruction system (LRS) fixators have been used in the management of complex tibial fractures with severe soft tissue injuries, compound tibial fractures, and infected tibial nonunion for which conventional internal fixation cannot be contemplated.Fracture union and distraction osteogenesis can be done simultaneously with these external fixators, allowing early weight bearing.Several previous studies have shown almost equal results of rail and ring fixators for the compound tibial shaft fractures.Thus we performed a prospective study to evaluate the union rate, functional outcome and amount of limb lengthening after the treatment of compound tibial shaft fractures with or without infected nonunion by ring or LRS fixators.Methods: This prospective study was done at Sarojini Naidu Medical College and Hospital, Agra, India and included 32 patients of compound tibial shaft fractures with or without infected nonunion.There were 26 males and 6 females and the average age was 40 years.Patients were randomly divided into two groups (n =16 for each): one underwent Ilizarov fixation and the other received LRS fixation.Cases were followed up for 3-24 months, 6 months on average from September 2012 to October 2014.Functional and radiological outcomes were assessed using the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria for both rail and ring fixators.Results: Union was achieved in all cases.Radiological outcome was found excellent in 68.75%, good in 18.75% and fair in 12.50% of cases treated by rail fixators whereas it was excellent in 56.25%, good in 18.75%, fair in 12.50% and poor in 12.50% of cases treated by ring fixators.Functional result was satisfactory in 75.00% of cases treated by rail fixator and 68.75% of cases treated by ring fixators whereas the corresponding rate of unsatisfactory was 25.00% vs.31.25%.Conclusion: In our short-term assessment, LRS fixators show a

  17. Modeling evolution using the probability of fixation: history and implications.

    Science.gov (United States)

    McCandlish, David M; Stoltzfus, Arlin

    2014-09-01

    Many models of evolution calculate the rate of evolution by multiplying the rate at which new mutations originate within a population by a probability of fixation. Here we review the historical origins, contemporary applications, and evolutionary implications of these "origin-fixation" models, which are widely used in evolutionary genetics, molecular evolution, and phylogenetics. Origin-fixation models were first introduced in 1969, in association with an emerging view of "molecular" evolution. Early origin-fixation models were used to calculate an instantaneous rate of evolution across a large number of independently evolving loci; in the 1980s and 1990s, a second wave of origin-fixation models emerged to address a sequence of fixation events at a single locus. Although origin fixation models have been applied to a broad array of problems in contemporary evolutionary research, their rise in popularity has not been accompanied by an increased appreciation of their restrictive assumptions or their distinctive implications. We argue that origin-fixation models constitute a coherent theory of mutation-limited evolution that contrasts sharply with theories of evolution that rely on the presence of standing genetic variation. A major unsolved question in evolutionary biology is the degree to which these models provide an accurate approximation of evolution in natural populations.

  18. Sacroiliac screw fixation: A mini review of surgical technique

    Directory of Open Access Journals (Sweden)

    Hernando Raphael Alvis-Miranda

    2014-01-01

    Full Text Available The sacral percutaneous fixation has many advantages but can be associated with a significant exposure to X-ray radiation. Currently, sacroiliac screw fixation represents the only minimally invasive technique to stabilize the posterior pelvic ring. It is a technique that should be used by experienced surgeons. We present a practical review of important aspects of this technique.

  19. Sacroiliac screw fixation: A mini review of surgical technique

    Science.gov (United States)

    Alvis-Miranda, Hernando Raphael; Farid-Escorcia, Hector; Alcalá-Cerra, Gabriel; Castellar-Leones, Sandra Milena; Moscote-Salazar, Luis Rafael

    2014-01-01

    The sacral percutaneous fixation has many advantages but can be associated with a significant exposure to X-ray radiation. Currently, sacroiliac screw fixation represents the only minimally invasive technique to stabilize the posterior pelvic ring. It is a technique that should be used by experienced surgeons. We present a practical review of important aspects of this technique. PMID:25336831

  20. Overcoming Organizational Fixation: Creating and Sustaining an Innovation Culture

    Science.gov (United States)

    Stempfle, Joachim

    2011-01-01

    Fixation on established paradigms and practices can severely limit the capability of organizations to change, thereby jeopardizing the ability of organizations to keep up with changes in their environment and new technological developments. Overcoming organizational fixation is therefore a requirement for any organization that strives to achieve…

  1. Narcotisation, fixation and preservation experiments with marine zooplankton

    NARCIS (Netherlands)

    Heyman, R.P.

    1981-01-01

    In this report narcotisation, fixation and preservation experiments with marine zooplankton are described. Narcotisation turns out to be useless for mixed plankton samples. M.S. 222 works well as narcotisation medium for organisms to be photographed. Fixation with 4% formalin proved to be a necessar

  2. Improving the fixation of an artificial intervertebral disc

    NARCIS (Netherlands)

    Eijkelkamp, MF; Hayen, J; Veldhuizen, AG; Van Horn, [No Value; Verkerke, GJ

    2002-01-01

    The fixation of an artificial intervertebral disc has been studied especially with respect to the dimensions, the convexity of the endplates and the size of the fixation elements. From literature and cadaveric vertebrae, the dimensions and shape of the lumbar vertebral endplates were determined and

  3. Overcoming Organizational Fixation: Creating and Sustaining an Innovation Culture

    Science.gov (United States)

    Stempfle, Joachim

    2011-01-01

    Fixation on established paradigms and practices can severely limit the capability of organizations to change, thereby jeopardizing the ability of organizations to keep up with changes in their environment and new technological developments. Overcoming organizational fixation is therefore a requirement for any organization that strives to achieve…

  4. Microbial community shifts influence patterns in tropical forest nitrogen fixation.

    Science.gov (United States)

    Reed, Sasha C; Townsend, Alan R; Cleveland, Cory C; Nemergut, Diana R

    2010-10-01

    The role of biodiversity in ecosystem function receives substantial attention, yet despite the diversity and functional relevance of microorganisms, relationships between microbial community structure and ecosystem processes remain largely unknown. We used tropical rain forest fertilization plots to directly compare the relative abundance, composition and diversity of free-living nitrogen (N)-fixer communities to in situ leaf litter N fixation rates. N fixation rates varied greatly within the landscape, and 'hotspots' of high N fixation activity were observed in both control and phosphorus (P)-fertilized plots. Compared with zones of average activity, the N fixation 'hotspots' in unfertilized plots were characterized by marked differences in N-fixer community composition and had substantially higher overall diversity. P additions increased the efficiency of N-fixer communities, resulting in elevated rates of fixation per nifH gene. Furthermore, P fertilization increased N fixation rates and N-fixer abundance, eliminated a highly novel group of N-fixers, and increased N-fixer diversity. Yet the relationships between diversity and function were not simple, and coupling rate measurements to indicators of community structure revealed a biological dynamism not apparent from process measurements alone. Taken together, these data suggest that the rain forest litter layer maintains high N fixation rates and unique N-fixing organisms and that, as observed in plant community ecology, structural shifts in N-fixing communities may partially explain significant differences in system-scale N fixation rates.

  5. Low Carbon Costs of Nitrogen Fixation in Tropical Dry Forests

    Science.gov (United States)

    Gei, M. G.; Powers, J. S.

    2015-12-01

    Legume tree species with the ability to fix nitrogen (N) are highly diverse and widespread across tropical forests but in particular in the dry tropics. Their ecological success in lower latitudes has been called a "paradox": soil N in the tropics is thought to be high, while acquiring N through fixation incurs high energetic costs. However, the long held assumptions that N fixation is limited by photosynthate and that N fixation penalizes plant productivity have rarely been tested, particularly in legume tree species. We show results from three different experiments where we grew eleven species of tropical dry forest legumes. We quantified plant biomass and N fixation using nodulation and the 15N natural isotope abundance (Ndfa or nitrogen derived from fixation). These data show little evidence for costs of N fixation in seedlings grown under different soil fertility, light regimes, and with different microbial communities. Seedling productivity did not incur major costs because of N fixation: indeed, the average slope between Ndfa and biomass was positive (range in slopes: -0.03 to 0.3). Moreover, foliar N, which varied among species, was tightly constrained and not correlated with Ndfa. This finding implies that legume species have a target N that does not change depending on N acquisition strategies. The process of N fixation in tropical legumes may be more carbon efficient than previously thought. This view is more consistent with the hyperabundance of members of this family in tropical ecosystems.

  6. A systematic review on dynamic versus static distal tibiofibular fixation.

    Science.gov (United States)

    Inge, S Y; Pull Ter Gunne, A F; Aarts, C A M; Bemelman, M

    2016-12-01

    In the last couple of years dynamic fixation for syndesmosis injuries, using a suture-button technique, raised more interest due to its advantages over the static fixation. In the current systematic review suture-button fixation is compared to the traditionally applied static fixation in unstable ankle fractures accompanied with distal tibiofibular syndesmosis injury, including the functional outcome, post-operative complications, reoperation rate, recurrent diastasis and financial aspects. A computerized literature search using PubMed/MEDLINE and EMBASE was conducted in search of suitable articles between January 2006 and February 2016. A total of 4 suture-button studies, 5 suture-button vs. static fixation studies and 1 study discussing the financial aspects were identified. The AOFAS of 104 patients treated with the suture-button device was 91.08 points with an average study-follow up of 24.85 months. The AOFAS of 106 patients treated with a static fixation device was 87.95 with an average follow-up of 24.78 months. Removal of the suture-button device was reported in 10.5% of 229 patients and removal of the screws in 38.5%. Dynamic fixation demonstrated to be a viable alternative to the static fixation device, with lower reoperation rates and less complications. They can accurately stabilize the ruptured syndesmosis without device breakage or loss of reduction. 1A economic/decision. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. 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.

  8. STUDY ON SPANNING EXTERNAL FIXATORS FOR PERIARTICULAR OPEN FRACTURES

    Directory of Open Access Journals (Sweden)

    Prasanth Maddila

    2017-04-01

    Full Text Available BACKGROUND Open fractures which occur close to any fracture need immobilisation for the soft tissues to heal. Some open fractures are even fixed with provisional fixations to maintain the alignment of the fractures. The provisional fixation needs to be augmented with external support, which can be given by spanning external fixators across a joint. MATERIALS AND METHODS Our study consists of 38 open fractures of the lower limbs, which are of Gustilo-Anderson’s type IIIB, an MT4 of AO-ASIF soft tissue injury classification essentially requiring open wound management as well as fracture fixation. Wound lavage and debridements are carried out till the soft tissues show granulations. The position in which joint is immobilised is functional and with access to open wound for dressings and inspection without any displacement of the fracture as well as creeping granulation tissue. RESULTS All the cases in our study are maintained with functional position till soft tissue cover is achieved and provisional fixation is done with definitive fixation after soft tissue cover with skin grafting. CONCLUSION Spanning external fixators are useful in maintaining functional positions as well as augmenting the provisional fixation of the compound fractures.

  9. Femoral fractures : indications an[d] biomechanics of external fixation

    NARCIS (Netherlands)

    A.H. Broekhuizen (Tom); B. van Linge

    1988-01-01

    textabstractInternal fixation can be carried out in various ways. For femoral shaft fractures, an (interlocking) nail is becoming increasingly popular, instead of open realignment of the fracture. External fixation, which has become a generally accepted method of treating fractures of the lower

  10. Overcoming design fixation through education and creativity methods

    DEFF Research Database (Denmark)

    Howard, Thomas J.; Maier, Anja; Onarheim, Balder;

    2013-01-01

    This paper reports an experiment on the topic design fixation using 12 teams of masters students working on three design problems from (Jansson and Smith 1991). The objective of the experiment is to determine the effectiveness of two interventions to help overcome fixation on example solutions....... The first intervention consisted of educating each team on the phenomena and effects of design fixation. The results showed that this intervention reduced the number of fixation elements in comparison to the control group (p=0.025). The second intervention involved using Dix et als' (2006) 'Bad Ideas......' method during a final design task. The results showed that the method did not help the teams as it caused the fixation ratio to increase and the number of ideas per team to decrease. In addition to the above mentioned interventions, the experiment also revealed a negative correlation between the number...

  11. Stiffness analysis of the sarafix external fixator of composite materials

    Directory of Open Access Journals (Sweden)

    Nedim Pervan

    2016-01-01

    Full Text Available This paper describes a structural analysis of the CAD model three versions fixators Sarafix which to explore the possibility of introducing composite materials in the construction of the connecting rod fixators comparing values of displacement and stiffness at characteristic points structure. Namely, we investigated constructional performance of fixators Sarafix with a connecting rod formed from three different composite materials, the same matrix (epoxy resin with three different types of fibers (E glass, kevlar 49 and carbon M55J. Results of structural analysis fixators Sarafix with a connecting rod made of composite materials are compared with the results of tubular connecting rod fixators made of stainless steel. After comparing the results, from the aspect of stiffness, we gave the final considerations about composite material which provides an adequate substitution for the existing material.

  12. Surgical Revision after Sacroiliac Joint Fixation or Fusion

    Science.gov (United States)

    Holt, Timothy

    2017-01-01

    Background Minimally invasive sacroiliac joint (SIJ) fusion has been shown to be safe and effective for the treatment of SIJ dysfunction. Multiple devices are available to perform SIJ fixation or fusion. Surgical revision rates after these procedures have not been directly compared. Methods We retrospectively identified all patients in our practice who underwent SIJ fixation or fusion between 2003 and 2015. Using both chart review and focused contact with individual patients, we determined the likelihood of surgical revision. Revision rates were compared using Kaplan-Meier survival analysis. Results Thirty-eight patients underwent SIJ fixation with screws and 274 patients underwent SIJ fusion using triangular titanium implants. Four-year cumulative revision rates were 30.8% for fixation and 5.7% for fusion. Conclusions In our study, SIJ fixation with screws had a much higher revision rate compared to SIJ fusion with triangular titanium implants designed for bone adherence.

  13. Callus patterns in femur lengthening using a monolateral external fixator

    Energy Technology Data Exchange (ETDEWEB)

    Isaac, Dileep; Fernandez, Harry; Song, Hae-Ryong; Kim, Tae-Young; Kumar Shyam, Ashok [Korea University Medical Centre, Guro Hospital, Department of Orthopaedic Surgery, Rare Diseases Institute, Seoul (Korea); Lee, Seok-Hyun [Dongguk University International Hospital, Department of Orthopaedic Surgery, Ilsan (Korea); Lee, Jong-Chan [Korea University, Department of Statistics, Seoul (Korea)

    2008-04-15

    We studied the callus pattern seen in femoral lengthening using monolateral external fixator to determine whether callus types and shapes can predict the final outcome of the procedure. The radiographs of 41 cases of femoral lengthening (33 unilateral and 8 bilateral) in 33 patients with a mean age 11.9 years (range 4-22 years) were retrospectively analysed by four observers and classified into different shapes and types in concordance with the Ru Li classification. The classification was tested for concurrence and reproducibility by inter-observer studies. An average of 6.2 cm of lengthening (range 3-10.8) was achieved with an external fixator index of 36.5 (range 20.9-55.3). The fusiform type of callus (fixator index 32.04, maturation index 21.6) showed the best result followed by the cylinder type of callus (fixator index 35.7, maturation index 22.3) and the lateral type of callus (fixator index 33.2, maturation index 21.5). However, the concave type of callus showed poor results with a fixator index of 49.4 and a maturation index of 37.1. The homogeneous path showed the best results (fixator index 30.4, maturation index 18.6). The heterogeneous path also showed good results (fixator index 36.4, maturation index 23.9). The mixed path (fixator index 42.5, maturation index 30.8) and the lucent path (fixator index 45.1, maturation index 32.8) showed poor results. Analysis of the callus pattern helps the surgeon to predict the outcome of the procedure and guide him in planning any additional interventions if necessary. (orig.)

  14. Do you like what you see? : The role of first fixation and total fixation duration in consumer choice

    NARCIS (Netherlands)

    van der Laan, Laura N.; Hooge, Ignace T C; De Ridder, Denise T D; Viergever, Max A.; Smeets, Paul A M

    2015-01-01

    Although there has been recent growing interest in the associations between measures of visual attention and consumer choice, there is still uncertainty about the role of the first fixation in consumer choice and the factors that drive total fixation duration. The study aimed (1) to investigate the

  15. 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...

  16. Do you like what you see? The role of first fixation and total fixation duration in consumer choice

    NARCIS (Netherlands)

    Laan, van der L.N.; Hooge, I.T.C.; Ridder, de D.T.D.; Viergever, M.A.; Smeets, P.A.M.

    2015-01-01

    Although there has been recent growing interest in the associations between measures of visual attention and consumer choice, there is still uncertainty about the role of the first fixation in consumer choice and the factors that drive total fixation duration. The study aimed (1) to investigate the

  17. Do you like what you see? The role of first fixation and total fixation duration in consumer choice

    NARCIS (Netherlands)

    van der Laan, Laura N.; Hooge, Ignace T C; De Ridder, Denise T D; Viergever, Max A.; Smeets, Paul A M

    2015-01-01

    Although there has been recent growing interest in the associations between measures of visual attention and consumer choice, there is still uncertainty about the role of the first fixation in consumer choice and the factors that drive total fixation duration. The study aimed (1) to investigate the

  18. Sand Dunes Fixation in Baiji District, Iraq

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    This study was carried out at Sand Dunes Stabilization Researches Station in Baiji district (230 ln north of Baghdad, Iraq) to evaluate the effects of local soil conditioners manufactured from oil derivatives and plant residuals on sand dunes fixation as the first step for sand dunes stabilization. The results indicate that the fuel oil has the first place in improving wind erosion parameters in the study area, such as increasing mean weight diameter, dry aggregates percentage, the needed time for complete disaggregation by dry sieving, and decreasing the disaggregation rates. Bitumen emulsion occupies the second place, while the plant residuals occupies the third place and has slight effects on the studied parameters. Effects of conditioners on natural vegetation cover are negative in oil derivatives treatments,while positive in plants residuals treatments.

  19. Acute bony bankart lesion and surgical fixation.

    Science.gov (United States)

    Rosenthal, Michael D; Provencher, Matthew T

    2009-10-01

    The patient was a 25-year-old man who sustained a traumatic left anterior shoulder dislocation. After self-reducing the first time, as well as in subsequent repeated dislocations over the following 2-day period, the patient reported his injury to the medical staff, who sent him to the physical therapist for evaluation. Anterior-posterior, scapular outlet, and axillary radiographic views demonstrated a bony glenoid lesion consistent with a bony Bankart lesion, which was best seen on the scapular outlet view. A 3-dimensional computed tomography scan was performed to assess the size and displacement of the bony Bankart lesion. Six days following injury, the patient underwent operative fixation of the bony Bankart lesion. Following surgery, the patient completed 5 months of physical therapy and subsequently returned to high-demand upper body activities. At 3 years following surgery, the patient reported full functional ability without shoulder instability or pain.

  20. Les aciers inoxydables dans les fixations

    CERN Document Server

    CETIM

    2010-01-01

    Cet ouvrage, qui fait la synthèse de plusieurs travaux menés par le Cetim, propose une vue d'ensemble sur les aciers inoxydables utilisés pour les fixations. Au sommaire : les normes EN, ISO et ATSM qui s'y rapportent , les désignations symboliques , les nuances et caractéristiques mécaniques , les différentes formes de corrosion, les méthodes pour les détecter , les règles du métier , les mises en oeuvre. L'ouvrage comprend plusieurs fiches matériaux et des tableaux qui présentent les équivalences entre les désignations.

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

    Science.gov (United States)

    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.

  2. The Stability of Double Jaw Surgery: A Comparison of Rigid Fixation versus Skeletal Wire Fixation

    Science.gov (United States)

    1988-08-01

    Further studies regarding the effect of rigid versus wire fixation on the temporomandibular joint would be valuable to correlate morphological changes and...13 7 22 mandibular procedures such as a body osteotomy could have been performed. 4. No temperomandibular joint surgery could have been performed...Cephalometric Points Recorded ----- .... 27 164 24 - -~~2 - -% 3w.~ 1 28 TABLE 3.-- Cephalometric Measurements DESCRIPTION PTS. USED 1. SNA Angle 1-2-3 deg 2

  3. 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

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

    Directory of Open Access Journals (Sweden)

    D-Y Kim

    2015-05-01

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

  5. Visual Fixation for 3D Video Stabilization

    Directory of Open Access Journals (Sweden)

    Hans-Peter Seidel

    2011-03-01

    Full Text Available Visual fixation is employed by humans and some animals to keep a specific 3D location at the center of the visual gaze. Inspired by this phenomenon in nature, this paper explores the idea to transfer this mechanism to the context of video stabilization for a hand-held video camera. A novel approach is presented that stabilizes a video by fixating on automatically extracted 3D target points. This approach is different from existing automatic solutions that stabilize the video by smoothing. To determine the 3D target points, the recorded scene is analyzed with a state-of-the-art structure-from-motion algorithm, which estimates camera motion and reconstructs a 3D point cloud of the static scene objects. Special algorithms are presented that search either virtual or real 3D target points, which back-project close to the center of the image for as long a period of time as possible. The stabilization algorithm then transforms the original images of the sequence so that these 3D target points are kept exactly in the center of the image, which, in case of real 3D target points, produces a perfectly stable result at the image center. Furthermore, different methods of additional user interaction are investigated. It is shown that the stabilization process can easily be controlled and that it can be combined with state-of-the-art tracking techniques in order to obtain a powerful image stabilization tool. The approach is evaluated on a variety of videos taken with a hand-held camera in natural scenes.

  6. "Cold" Fixation: Reconciliation of Nitrogen Fixation Rates and Diazotroph Assemblages in the Arctic Ocean

    Science.gov (United States)

    Fong, A. A.; Waite, A.; Rost, B.; Richter, K. U.

    2016-02-01

    Measurements of biological nitrogen fixation are typically conducted in oligotrophic subtropical and tropical marine environments where concentrations of fixed inorganic nitrogen are low. To date, only a handful of nitrogen fixation studies have been conducted in high latitude marine environments, but further investigation is needed to resolve the distribution of cold ocean diazotrophic assemblages. Nitrogen fixation rates and nifH gene distributions were measured at seven stations from 5°E to 20°E, north of 81°N in the Arctic Ocean at the onset of summer 2015. Discrete water samples in ice-covered regions were collected from the sea surface to 200 m for 15N2-tracer additions and targeted nifH gene and transcript analyses. Previous work suggests that heterotrophic bacteria dominate diazotrophic communities in the Arctic Ocean. Therefore, additional nifH gene surveys of sinking particles were conducted to test for enrichment on organic matter-rich microenvironments. Together, these measurements aim to reconcile diazotrophic activity with microbial community composition, further elucidating how nitrogen fixers could impact current concepts in polar carbon and nutrient cycling.

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

    Science.gov (United States)

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

    2000-01-01

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

  8. 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.

  9. Insufficiency fracture at the distal diaphysis of the radius after synovectomy combined with the Sauvé-Kapandji procedure in a patient with rheumatoid arthritis.

    Science.gov (United States)

    Nagira, Keita; Hagino, Hiroshi; Yamashita, Yasutsugu; Kishimoto, Yuji; Teshima, Ryota

    2010-10-01

    We report here a rare case of insufficiency fracture at the distal diaphysis of the radius in a patient with rheumatoid arthritis (RA) after synovectomy combined with the Sauvé-Kapandji procedure. A 71-year-old woman who had been diagnosed with RA had been consecutively treated with several disease-modifying antirheumatic drugs. She had undergone synovectomy of the right wrist combined with the Sauvé-Kapandji procedure, due to a tendon rupture, 2 years before the current presentation (first visit). Although she had not experienced any recent trauma, the wrist pain had increased after she had lifted up the bedding at the funeral of her friend about 1 month prior to her first visit. Radiographs of her right wrist taken at the second visit showed a fracture at the distal diaphysis of the radius at the level of the excision osteotomy of the distal ulna; however, no displacement of the distal fragment was observed. We immobilized her forearm in a long-arm cast. However, after 3 weeks of cast immobilization, a displacement of the distal fragment was observed. A manual reduction of the displacement was performed and the arm was again immobilized in a long-arm cast. However, 1 week later, a displaced distal fragment was again observed. Subsequently, she received an open reduction and internal fixation using a volar locking plate and screws with an autologous iliac crest bone graft. Bone union was completed by 8 months following the operation.

  10. The mechanical stability of extra-articular distal radius fractures with respect to the number of screws securing the distal fragment.

    Science.gov (United States)

    Crosby, Samuel N; Fletcher, Nicholas D; Yap, Erwin R; Lee, Donald H

    2013-06-01

    The treatment of distal radius fractures with volar locked plating (VLP) has gained popularity. Many different designs and sizes of plates afford a wide variety of configurations of locking screws that can be placed into the distal fracture fragment. The purpose of this study was to determine whether using half of the distal locking screws decreased stability when compared with using all possible distal locking screws with 4 different VLP systems. Twenty-four identical synthetic distal radius sawbone models were instrumented with 1 of 4 designs of VLP devices over a standardized dorsal wedge osteotomy to simulate a dorsally comminuted, extra-articular distal radius fracture. Distal locking screws were placed in varying configurations. Six radii per plate model with different screw configurations then underwent axial loading, volar bending, and dorsal bending using a servohydraulic machine. Distal fragment displacement was recorded using a differential variable reluctance transducer. There was no significant difference in fracture fragment displacement when using half of the distal locking screw set compared with using the full screw set. Mean differences in displacement between half and full screws were less than 0.1 mm. All configurations had the greatest magnitude of displacement during axial loading. Mean displacement was less in plates containing 2 rows of distal locking screws (-0.4 mm) compared with plates containing 1 row (-0.6 mm). Using half of the distal locking screws in VLP in an extra-articular, nonosteoporotic distal radial fracture model with noncyclical, nondestructive loading does not decrease construct stability compared with using all of the screws. Not filling all holes in VLP is more cost effective and does not sacrifice plate stiffness or construct stability. Plates with 2 rows of distal locking screws create more stable fixation than plates with 1 row of distal locking screws. Copyright © 2013 American Society for Surgery of the Hand

  11. An effective fixative for glucocorticoid receptors in fetal tissues

    Energy Technology Data Exchange (ETDEWEB)

    Koga, T.; Kurisu, K.

    1982-01-01

    As a preliminary study in an autoradiographic study of glucocorticoid (GC) receptor localization in orofacial tissues of mouse fetuses, a search was made to determine the most effective fixative for preservation of the GC-receptor complex. Twelve-day-old mouse fetuses were administered tritiated triamcinolone acetonide (/sup 3/H-TAC) intraamniotically and subsequently processed by one of the following three procedures: freeze-drying, prefixation with Karnovsky's fixative, or the catechin fixative (Karnovsky's fixative containing 1% D-catechin) and postfixation with osmium tetroxide. Light microscopic autoradiography and liquid scintillation counting of the specimens revealed that the catechin fixative gave the best results for fixation of the steroid-receptor complex and preservation of tissue structure. Light and electron microscopic autoradiographic studies of the time course of the localization of /sup 3/H-TAC in palatal shelves supported the catechin fixative as being the most effective in preservation of GC-receptor or ligand complexes.

  12. Fixation Release and the Bone Bandaid: A New Bone Fixation Device Paradigm

    Directory of Open Access Journals (Sweden)

    Narges Shayesteh Moghaddam

    2017-01-01

    Full Text Available The current gold standard of care for mandibular segmental defeat reconstruction is the use of Ti-6Al-4V immobilization hardware and fibular double barrel graft. This method is often successful immediately at restoring mandible function, however the highly stiff fixation hardware causes stress shielding of the grafted bone and stress concentration in the fixation device over time which can lead to fixation device failure and revision surgery. The purpose of reconstructive surgery could be to create normal stress trajectories in the mandible following engraftment. We investigate the use of a two stage mechanism which separates the immobilization/healing and regenerative phases of mandibular segmental defect treatment. The device includes the use of a very stiff, Ti-6Al-4V, releasable mechanism which assures bone healing. Therefore it could be released once the reconstructed boney tissue and any of its ligamentous attachments have completely healed. Underneath the released Ti-6Al-4V plate would be a pre-loaded nitinol (NiTi wire-frame apparatus that facilitates the normal stress-strain trajectory through the engrafted bone after the graft is healed in place and the Ti-6Al-4V fixation device has been released. Due to the use of NiTi wires forming a netting that connects vascularized bone and possibly bone chips, bone grafts are also more likely to be incorporate rather than to resorb. We first evaluated a healthy adult mandible during normal mastication to obtain the normal stress-strain distribution. Then, we developed the finite element (FE model of the mandibular reconstruction (in the M1-3 region with the proposed fixation device during the healing (locked state and post-healing (released state periods. To recreate normal stress trajectory in the reconstructed mandible, we applied the Response Surface Methodology (RMS to optimize the Bone Bandaid geometry (i.e., wire diameters and location. The results demonstrate that the proposed mechanism

  13. 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

  14. Biological Nitrogen Fixation In Tropical Dry Forests Of Costa Rica

    Science.gov (United States)

    Gei, M. G.; Powers, J. S.

    2012-12-01

    Evidence suggests that tropical dry forests (TDF) are not nitrogen (N) deficient. This evidence includes: high losses of gaseous nitrogen during the rainy season, high ecosystem soil N stocks and high N concentrations in leaves and litterfall. Its been commonly hypothesized that biological nitrogen fixation is responsible for the high availability of N in tropical soils. However, the magnitude of this flux has rarely if ever been measured in tropical dry forests. Because of the high cost of fixing N and the ubiquity of N fixing legume trees in the TDF, at the individual tree level symbiotic fixation should be a strategy down-regulated by the plant. Our main goal was to determine the rates of and controls over symbiotic N fixation. We hypothesized that legume tree species employ a facultative strategy of nitrogen fixation and that this process responds to changes in light availability, soil moisture and nutrient supply. We tested this hypothesis both on naturally established trees in a forest and under controlled conditions in a shade house by estimating the quantities of N fixed annually using the 15N natural abundance method, counting nodules, and quantifying (field) or manipulating (shade house) the variation in important environmental variables (soil nutrients, soil moisture, and light). We found that in both in our shade house experiment and in the forest, nodulation varied among different legume species. For both settings, the 15N natural abundance approach successfully detected differences in nitrogen fixation among species. The legume species that we studied were able to regulate fixation depending on the environmental conditions. They showed to have different strategies of nitrogen fixation that follow a gradient of facultative to obligate fixation. Our data suggest that there exists a continuum of nitrogen fixation strategies among species. Any efforts to define tropical legume trees as a functional group need to incorporate this variation.

  15. Results of fixation of dorsally displaced intra-articular distal radius fractures with non angular stable implants%非角度稳定性钢板固定治疗桡骨远端关节内背侧移位骨折的结果

    Institute of Scientific and Technical Information of China (English)

    Wong Merng Koon

    2006-01-01

    Objective Intra-articular fractures of the distal radius in young adults comprise a distinct fracture pattern that is difficult to manage and associated with a high frequency of post-traumatic arthritis. Restoration of articular congruency and alignment should improve the outcome. Methods In this study we prospectively reviewed the results of 21 consecutive cases of dorsally displaced intra-articular distal radius fractures which were treated with internal fixation after failing to achieve articular congruency with closed reduction. Results 3 patients were lost to follow-up. For the rest of 18 patients, follow-up time ranges from 18 to 75 weeks the fractures had healed with highly satisfactory radiographic and functional results. The final volar tilt averaged 4.9°; radial inclination 23.9°; radial length 14mm; and articular incongruity, 0. 1 mm. Wrist motion at final follow-up examination averaged flexion 62°, extension 60°, radial deviation 16°, ulnar deviation 27°, pronation 77°and supination 74°. Grip strength averaged 83% of the uninjured side. The overall outcome of 18 patients (94.4%) had a good or excellent result according to the system of Gartland and Werley and 18 patients (72. 2% ) had a good result according to the modified system of Green and O'Brien at the most recent evaluation. The only complication in this series was a superficial pin tract infection, which was rapidly resolved with removal of pins at 5th week of external fixation.Conclusion Thus restoration of articular congruency and alignment is possible with minimal complication using modern non-angular stable methods of internal fixation.

  16. Nitrogen fixation during an unusual summer Baltic Sea

    DEFF Research Database (Denmark)

    Voss, Maren; Dalsgaard, Tage; Fabian, Jenny

    Nitrogen fixation is a major nitrogen source for the open ocean. Also the land-locked, partly anoxic Baltic Sea receives almost as much nitrogen from nitrogen fixation as it receives from eutrophied rivers. Growth conditions for cyanobacteria are usually very favorable with low N/P ratios after...... variety in nitrogen fixing species than usual was observed. Under these conditions nitrogen fixation rates were studied over a three weeks period throughout the upper water column. Moreover, a methods comparison was performed to test the dissolved dinitrogen gas additions against the bubble addition...

  17. A STUDY ON FRACTURE FIXATION OF DISTAL END OF RADIUS BY PERCUTANEOUS PINNING

    Directory of Open Access Journals (Sweden)

    Kiran Kumar L

    2016-07-01

    s tubercle. The correct starting point confirmed with fluoroscopy and the wire is driven in a proximal and volar direction across the fracture site to engage the volar cortex of the radius proximal to the fracture. Additional wires were passed as necessary to secure additional fracture fragments. The wires were bent and cut leaving them superficial to the skin. The radial styloid incision was closed with interrupted absorbable sutures. A below elbow POP slab was applied. The pins were removed between 4 to 6 weeks. Postoperative pain and inflammation were managed using anti-inflammatory drugs, diclofenac sodium 50 mg twice daily, and serratiopeptidase. All patients were given oral ceftriaxone 200 mg twice a day for 5 days. Patients were asked to perform active finger movements from day one. Immediate postoperative check x-rays were taken in both PA and lateral views. The reduction of the fracture was confirmed and any displacements were noted. Patients were discharged after the 5th postoperative day and advised active exercises. On followup at 2 nd , 4 th , 6 th weeks and, 6 th , 12 th , 18 th months, the fracture union was assessed clinically by absence of tenderness and radiologically by bridging callus formation. Below elbow slab was removed by 4 wks. and patient is advised for active movement of wrist (Fig. 5 and 6. Then, K wires were removed without anaesthesia on an outpatient basis by 4-6 wks. The patients were advised to defer lifting heavy weights for further 4 to 6 weeks. After discharge, all patients were reviewed weekly for the first 6 weeks. Patients were assessed subjectively for pain at the fracture site clinically for tenderness, loosening of the pins, and any signs of infection. Pronation and supination of the forearm and active movement of the elbow and shoulder were advised throughout the period of healing. After the 6th week, physiotherapy was initiated. The range of wrist movements was recorded and any deformity was assessed. RADIOGRAPHIC ASSESSMENT Check

  18. 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.

  19. Use of the radial groove view intra-operatively to prevent damage to the extensor pollicis longus tendon by protruding screws during volar plating of a distal radial fracture.

    Science.gov (United States)

    Lee, S K; Bae, K W; Choy, W S

    2013-10-01

    The aims of this study were to assess the efficacy of a newly designed radiological technique (the radial groove view) for the detection of protrusion of screws in the groove for the extensor pollicis longus tendon (EPL) during plating of distal radial fractures. We also aimed to determine the optimum position of the forearm to obtain this view. We initially analysed the anatomy of the EPL groove by performing three-dimensional CT on 51 normal forearms. The mean horizontal angle of the groove was 17.8° (14° to 23°). We found that the ideal position of the fluoroscopic beam to obtain this view was 20° in the horizontal plane and 5° in the sagittal plane. We then intra-operatively assessed the use of the radial groove view for detecting protrusion of screws in the EPL groove in 93 fractures that were treated by volar plating. A total of 13 protruding screws were detected. They were changed to shorter screws and these patients underwent CT scans of the wrist immediately post-operatively. There remained one screw that was protruding. These findings suggest that the use of the radial groove view intra-operatively is a good method of assessing the possible protrusion of screws into the groove of EPL when plating a fracture of the distal radius.

  20. The Role of Personality and Team-Based Product Dissection on Fixation Effects

    Science.gov (United States)

    Toh, Christine; Miller, Scarlett; Kremer, Gül E. Okudan

    2013-01-01

    Design fixation has been found to be complex in its definition and expression, but it plays an important role in design idea generation. Identifying the factors that influence fixation is crucial in understanding how to enhance the design process and reduce the negative effects of fixation. One way to potentially mitigate fixation is through…

  1. 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.

  2. Potential for nitrogen fixation in fungus-growing termite symbioses

    Directory of Open Access Journals (Sweden)

    Panagiotis Sapountzis

    2016-12-01

    Full Text Available Termites host a gut microbiota of diverse and essential symbionts that enable specialization on dead plant material; an abundant, but nutritionally imbalanced food source. To supplement the severe shortage of dietary nitrogen (N, some termite species make use of diazotrophic bacteria to fix atmospheric nitrogen (N2. Fungus-growing termites (subfamily Macrotermitinae host a fungal exosymbiont (genus Termitomyces that provides digestive services and the main food source for the termites. This has been thought to obviate the need for N2-fixation by bacterial symbionts. Here we challenge this notion by performing acetylene reduction assays of live colony material to show that N2 fixation is present in two major genera (Macrotermes and Odontotermes of fungus-growing termites. We compare and discuss fixation rates in relation to those obtained from other termites, and suggest avenues of research that may lead to a better understanding of N2 fixation in fungus-growing and other termites.

  3. 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.

  4. Compression capability of cerclage fixation systems. A biomechanical study.

    Science.gov (United States)

    Shaw, J A; Daubert, H B

    1988-08-01

    Cerclage wire or tension band techniques are frequently complicated by broken wires or inadequate bony stabilization. The fixation capabilities of various cerclage systems were defined in this study by measuring the maximum compression forces generated by the different methods as well as their ultimate strengths. Parham bands and swage-lock titanium cables were found to exhibit the greatest fixation potential and highest ultimate strengths. Cerclage fixation using stainless steel wire was found to be enhanced by using a modified square knot. Mersilene tape was found to have fixation capabilities of similar magnitude to 20 guage stainless wire secured with a twist knot. The polypropylene and nylon cable ties tested showed no advantage when compared to the other systems.

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

    African Journals Online (AJOL)

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

  6. Application of Op-amp Fixators in Analog Circuits

    Directory of Open Access Journals (Sweden)

    R. Rohith Krishnan

    2016-10-01

    Full Text Available Nullor elements have applications not only in analog behaviour modeling but also in analog circuit design and analysis. Fixator- orator pair, the emerging tool in analog design is a combination of a nullor and sources. A method for the realization of fixator- orator pair is discussed in this paper. Application of fixator-norator pair into a circuit makes it possible to perform the AC and DC designs in a linear like way. Fixator fixes a critical biasing spec at the design, whereas the pairing norator finds the value of power conducting components or DC sources that meets the design. A scaling amplifier design, an active load design and a CMOS differential amplifier design are provided as examples to demonstrate the procedure and the methodology.

  7. Outcome of complex tibial plateau fractures treated with external fixator

    Directory of Open Access Journals (Sweden)

    Sushil H Mankar

    2012-01-01

    Conclusion: We believe that minimally invasive treatment by percutaneous techniques and external fixation is a fairly reasonable treatment alternative, if near anatomical reduction of joint surface can be confirmed on fluoroscopy.

  8. Condylar resorption in orthognathic surgery. The role of intermaxillary fixation.

    Science.gov (United States)

    Bouwman, J P; Kerstens, H C; Tuinzing, D B

    1994-08-01

    Condylar resorption that occurs after orthognathic surgery was investigated in a large sample of patients treated in the Department of Oral and Maxillofacial Surgery of the Free University in Amsterdam, the Netherlands. The findings correspond with previous publications on this subject. In a 1-year follow-up study the role of intermaxillary fixation was investigated radiologically. In a group of 158 patients prone to show occurrence of condylar resorption, 24 (26.4%) of the 91 patients treated with intermaxillary fixation showed signs of condylar resorption. In the group of 67 patients treated without intermaxillary fixation only eight (11.9%) of the patients showed signs of reduced volume of the condyle. Avoidance of intermaxillary fixation seems to reduce the incidence of condylar resorption after orthognathic surgery in patients with a mandibular deficiency with high mandibular plane angle.

  9. Effects of size, fixation location, and inversion on face identification

    National Research Council Canada - National Science Library

    Sekuler, Allison; Pachai, Matthew; Hashemi, Ali; Bennett, Patrick

    2015-01-01

    One possible explanation for the face inversion effect (FIE) is that inversion swaps the eye and mouth locations relative to fixation, and attention typically is directed to the top of a stimulus for faces...

  10. Percutaneous K-wire fixation in paediatric Supracondylar fractures ...

    African Journals Online (AJOL)

    Percutaneous K-wire fixation in paediatric Supracondylar fractures of humerus: A retrospective study. ... Nigerian Medical Journal ... conducted in the Department of Orthopaedic surgery in M. M. Medical College from July 2005 to July 2010.

  11. Effect of Phosphorus Fertilizer on Nitrogen Fixation by Some Grain ...

    African Journals Online (AJOL)

    acer

    ABSTRACT: Nitrogen fixation by grain legumes contributes N to tropical soils. But in Sudano –. Sahelian .... at 650C, weighed and analyzed for the N concentrations (Marr ... The increase of whole plant growth and plant nitrogen concentration ...

  12. Lateral atlantoaxial joint arthrography in atlantoaxial rotatory fixation.

    Science.gov (United States)

    Hosono, Noboru; Yonenobu, Kazuo; Tada, Koichi; Yoshikawa, Hideki

    2003-04-01

    There has been much debate about the pathogenesis of atlantoaxial rotatory fixation. Intraarticular abnormality has not been well documented thus far. This is the first case of chronic atlantoaxial rotatory fixation in which atlantoaxial joints were examined by consecutive arthrography. A 7-year-old girl was diagnosed with atlantoaxial rotatory fixation on a three-dimensional CT scan. Arthrography of the lateral atlantoaxial joints indicated a rupture of the joint capsule on the dislocated side at first, followed by a successful repair after 5 weeks' immobilization with a halo apparatus. Because torticollis recurred after taking off the halo vest, we performed surgery in which severe adhesion of the cartilage surface of facet joint was noted on the undislocated side and release of the adhesion was needed to mobilize the atlas. Atlantoaxial arthrodesis by screw fixation facilitated a solid fusion of the segment.

  13. VAC® for external fixation of flail chest

    Directory of Open Access Journals (Sweden)

    Rikke Winge

    2012-06-01

    Full Text Available A large anterior chest wall defect following tumor resection was reconstructed with a Gore- Tex® membrane and a combined musculocutaneous rectus femoris and tensor fasciae latae free flap. Subsequent paradoxical respiration impeded weaning from the ventilator. Appliance of Vacuum Assisted Closure® (VAC® resulted in immediate chest wall stability and a decrease in the patient’s need for respiratory support. Shortly thereafter, the VAC® was discontinued and the patient was discharged from the intensive care unit (ICU. This case report is the first to describe the successful use of VAC® as an adjuvant to a one-stage procedure for large thoracic wall reconstruction, allowing sufficient temporary external fixation to eliminate paradoxical respiration and plausibly shorten the stay in the ICU. No adverse effects on flap healing or haemodynamics were recorded. It is likely that external VAC® can improve thoracic stability and pulmonary function in a patient with flail chest and decrease the need for mechanical ventilation.

  14. Three-dimensional finite element analysis of unstable intertrochanteric fracture in different fixation ways%不稳定股骨转子间骨折不同内固定方式的三维有限元分析

    Institute of Scientific and Technical Information of China (English)

    陈少明; 邱玉金; 卢斌; 杨志强; 王宝九; 冯振东

    2016-01-01

    优缺点,可以根据需要选择合适的内固定装置。%BACKGROUND:The morphological and mechanical transfers of unstable intertrochanteric fractures were complicated, so it is difficult to analyze the biomechanical characteristicsof the common experimental methods in a comprehensive way. Moreover, the high cost, long cycle and poor repeatability of common tests limit its application in biomechanics. OBJECTIVE:To analyze the biomechanical characteristics of unstable intertrochanteric fracture in different fixation ways by three-dimensional finite element analysis. METHODS:Intertrochanteric fracture locking dynamic hip fixation model (C1), Gamma nail fixation model (C2) and proximal femoral anatomical locking plate model (C3) were established. The distal end of the femur was fixed, and subjected to the hip reaction force of 2800 N and abduction muscle strength of 1 200 N. Three-dimensional finite element analysis was used to analyze the stress distribution, stress concentration and maximum displacement of unstable intertrochanteric fracture in three different fixation ways. RESULTS AND CONCLUSION:(1) Stress: the anterolateral stress and anteromedial stress of C3 were the maximum. Posterolateral stress and posteromedial stress ofC3 were the minimum. There were significant differences among the three groups (alP< 0.05). (2) Stress of fracture space: significant differences in anterolateral stress, anteromedial stress, posterolateral stress and posteromedial stress were determined in C1, C2 and C3 (P< 0.05). Anterolateral stress of C3 was significantly less than anterolateral stresses of C1 and C2 (P< 0.05). Anteromedial stress of C3 was significantly less than that of C1 and C2 (P< 0.05). Posterolateral stress of C1 was significantly larger than that of C2 and C3 (P<0.05). Posteromedial stress of C1 was significantly larger than that of C2 (P< 0.05). Posteromedial stress of C3 was significantly less than that of C1 and C2 (P< 0.05). (3) Significant differences

  15. Experimental fixation of femoral osteotomies by cerclage with nylon straps.

    Science.gov (United States)

    Rhinelander, F W; Stewart, C L

    1983-10-01

    Following the successful experience of Partridge in the fixation of human femoral fractures by nylon-strap cerclage, this research in 23 mature dogs was performed to compare nylon-strap with wire-loop cerclage for healing periods of up to 12 weeks. Supplemented by intramedullary fixation with Steinmann pins, long oblique femoral osteotomies were fixed in one femur of each dog by nylon straps and in the other femur by wire loops, at separate operations. The nylon straps were all secured at the same tension by a special "gun." The wire loops were all secured at the same tension by the Rhinelander tightener-twister. Half of the nylon straps had "bumps" along the inner surface, which were added by Partridge in an effort to circumvent the microvascular disturbance reported with Parham bands. On examination by microangiography and correlated histology, all of the osteotomies, regardless of the type of fixation, showed good progress toward osseous union. After fixation by wire cerclage no loss of position or disturbance of blood supply was noted. After fixation by nylon straps slight (clinically insignificant) longitudinal displacement, attributed to slight lengthening of the straps, with consequent loosening was noted in all cases. This loosening was considered advantageous because it appeared to be responsible for the unexpected lack of impairment of the vascularization of the underlying cortical bone by any of the straps. The bumps on the undersurface of some of the straps were, thus, of no vascular advantage, and their presence made accurate fixation of the ostectomy fragments more difficult on the small bones. These studies support the value of fixation by plain nylon straps and show their advantage over straps with bumps for fixation of long oblique single osteotomies of bones the size of the canine femur.

  16. 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.

  17. 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

  18. Postinflammatory ossicular fixation: CT analysis with surgical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Swartz, J.D.; Wolfson, R.J.; Marlowe, F.I.; Popky, G.L.

    1985-03-01

    Postinflammatory ossicular fixation is a common problem encountered by the otologic surgeon upon exploration because of conductive hearing loss in patients with chronic otitis media. These nonotosclerotic noncongenital lesions take three pathologic forms: fibrous tissue fixation (chronic adhesive otitis media), hyalinization of collagen (tympanosclerosis), and new bone formation (fibro-osseous sclerosis). More than 300 patients with the clinical diagnosis of chronic otitis media have been examined. This study encompasses 23 proved cases.

  19. Minimal Invasive Percutaneous Fixation of Thoracic and Lumbar Spine Fractures

    Directory of Open Access Journals (Sweden)

    Federico De Iure

    2012-01-01

    Full Text Available We studied 122 patients with 163 fractures of the thoracic and lumbar spine undergoing the surgical treatment by percutaneous transpedicular fixation and stabilization with minimally invasive technique. Patient followup ranged from 6 to 72 months (mean 38 months, and the patients were assessed by clinical and radiographic evaluation. The results show that percutaneous transpedicular fixation and stabilization with minimally invasive technique is an adequate and satisfactory procedure to be used in specific type of the thoracolumbar and lumbar spine fractures.

  20. 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.

  1. Learning to Predict Sequences of Human Visual Fixations.

    Science.gov (United States)

    Jiang, Ming; Boix, Xavier; Roig, Gemma; Xu, Juan; Van Gool, Luc; Zhao, Qi

    2016-06-01

    Most state-of-the-art visual attention models estimate the probability distribution of fixating the eyes in a location of the image, the so-called saliency maps. Yet, these models do not predict the temporal sequence of eye fixations, which may be valuable for better predicting the human eye fixations, as well as for understanding the role of the different cues during visual exploration. In this paper, we present a method for predicting the sequence of human eye fixations, which is learned from the recorded human eye-tracking data. We use least-squares policy iteration (LSPI) to learn a visual exploration policy that mimics the recorded eye-fixation examples. The model uses a different set of parameters for the different stages of visual exploration that capture the importance of the cues during the scanpath. In a series of experiments, we demonstrate the effectiveness of using LSPI for combining multiple cues at different stages of the scanpath. The learned parameters suggest that the low-level and high-level cues (semantics) are similarly important at the first eye fixation of the scanpath, and the contribution of high-level cues keeps increasing during the visual exploration. Results show that our approach obtains the state-of-the-art performances on two challenging data sets: 1) OSIE data set and 2) MIT data set.

  2. 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.

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

    Science.gov (United States)

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

    2016-09-01

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

  4. Molybdenum limitation of asymbiotic nitrogen fixation in tropical forest soils

    Science.gov (United States)

    Barron, Alexander R.; Wurzburger, Nina; Bellenger, Jean Phillipe; Wright, S. Joseph; Kraepiel, Anne M. L.; Hedin, Lars O.

    2009-01-01

    Nitrogen fixation, the biological conversion of di-nitrogen to plant-available ammonium, is the primary natural input of nitrogen to ecosystems, and influences plant growth and carbon exchange at local to global scales. The role of this process in tropical forests is of particular concern, as these ecosystems harbour abundant nitrogen-fixing organisms and represent one third of terrestrial primary production. Here we show that the micronutrient molybdenum, a cofactor in the nitrogen-fixing enzyme nitrogenase, limits nitrogen fixation by free-living heterotrophic bacteria in soils of lowland Panamanian forests. We measured the fixation response to long-term nutrient manipulations in intact forests, and to short-term manipulations in soil microcosms. Nitrogen fixation increased sharply in treatments of molybdenum alone, in micronutrient treatments that included molybdenum by design and in treatments with commercial phosphorus fertilizer, in which molybdenum was a `hidden' contaminant. Fixation did not respond to additions of phosphorus that were not contaminated by molybdenum. Our findings show that molybdenum alone can limit asymbiotic nitrogen fixation in tropical forests and raise new questions about the role of molybdenum and phosphorus in the tropical nitrogen cycle. We suggest that molybdenum limitation may be common in highly weathered acidic soils, and may constrain the ability of some forests to acquire new nitrogen in response to CO2 fertilization.

  5. 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

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

    Science.gov (United States)

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

    2017-07-01

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

  7. Fixating on metals: New insights into the role of metals in nodulation and symbiotic nitrogen fixation

    Directory of Open Access Journals (Sweden)

    Manuel eGonzález-Guerrero

    2014-02-01

    Full Text Available Symbiotic nitrogen fixation is one of the most promising and immediate alternatives to the overuse of polluting nitrogen fertilizers for improving plant nutrition. At the core of this process are a number of metalloproteins that catalyze and provide energy for the conversion of atmospheric nitrogen to ammonia, eliminate free radicals produced by this process, and create the microaerobic conditions required by these reactions. In legumes, metal cofactors are provided to endosymbiotic rhizobia within root nodule cortical cells. However, low metal bioavailability is prevalent in most soils types, resulting in widespread plant metal deficiency and decreased nitrogen fixation capabilities. As a result, renewed efforts have been undertaken to identify the mechanisms governing metal delivery from soil to the rhizobia, and to determine how metals are used in the nodule and how they are recycled once the nodule is no longer functional. This effort is being aided by improved legume molecular biology tools (genome projects, mutant collections, and transformation methods, in addition to state-of-the-art metal visualization systems.

  8. The importance of regulation of nitrogen fixation

    Science.gov (United States)

    Menge, D. N.

    2012-12-01

    I am not a proponent of including more detail in models simply because it makes them more realistic. More complexity increases the difficulty of model interpretation, so it only makes sense to include complexity if its benefit exceeds its costs. Biological nitrogen (N) fixation (BNF) is one process for which I feel the benefits of including greater complexity far outweigh the costs. I don't think that just because I work on BNF; I work on BNF because I think that. BNF, a microbial process carried out by free-living and symbiotic microbes, is the dominant N input to many ecosystems, the primary mechanism by which N deficiency can feed back to N inputs, and a main mechanism by which N surplus can develop. The dynamics of BNF, therefore, have huge implications for the rate of carbon uptake and the extent of CO2 fertilization, as well as N export to waterways and N2O emissions to the atmosphere. Unfortunately, there are serious deficiencies in our understanding of BNF. One main deficiency in our understanding is the extent to which various symbiotic N fixing organisms respond to imbalanced nutrition. Theory suggests that these responses, which I will call "strategies," have fundamental consequences for N fixer niches and ecosystem-level N and C cycling. Organisms that fix N regardless of whether they need it, a strategy that I will call "obligate," occupy post-disturbance niches and rapidly lead to N surplus. On the contrary, organisms that only fix as much N as they need, a "facultative" strategy, can occupy a wider range of successional niches, do not produce surplus N, and respond more rapidly to increased atmospheric CO2. In this talk I will show new results showing that consideration of these strategies could on its own explain the latitudinal distribution of symbiotic N fixing trees in North America. Specifically, the transition in N-fixing tree abundance from ~10% of basal area south of 35° latitude to ~1% of basal area north of 35° latitude that we observe

  9. Nitrogen fixation on early Mars and other terrestrial planets: experimental demonstration of abiotic fixation reactions to nitrite and nitrate.

    Science.gov (United States)

    Summers, David P; Khare, Bishun

    2007-04-01

    Understanding the abiotic fixation of nitrogen is critical to understanding planetary evolution and the potential origin of life on terrestrial planets. Nitrogen, an essential biochemical element, is certainly necessary for life as we know it to arise. The loss of atmospheric nitrogen can result in an incapacity to sustain liquid water and impact planetary habitability and hydrological processes that shape the surface. However, our current understanding of how such fixation may occur is almost entirely theoretical. This work experimentally examines the chemistry, in both gas and aqueous phases, that would occur from the formation of NO and CO by the shock heating of a model carbon dioxide/nitrogen atmosphere such as is currently thought to exist on early terrestrial planets. The results show that two pathways exist for the abiotic fixation of nitrogen from the atmosphere into the crust: one via HNO and another via NO(2). Fixation via HNO, which requires liquid water, could represent fixation on a planet with liquid water (and hence would also be a source of nitrogen for the origin of life). The pathway via NO(2) does not require liquid water and shows that fixation could occur even when liquid water has been lost from a planet's surface (for example, continuing to remove nitrogen through NO(2) reaction with ice, adsorbed water, etc.).

  10. 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.

  11. Hydroxyapatite-enhanced tibial prosthetic fixation.

    Science.gov (United States)

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

    2000-01-01

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

  12. [A special instrument: the halo fixator].

    Science.gov (United States)

    Schmolke, Stephan; Gossé, Frank

    2008-03-01

    Installation of an external fixator in combination with a body cast for temporary or definitive immobilization and retention of unstable fractures of the craniocervical junction and upper part of the cervical spine. Further established applications include presurgical extension treatment of paralytic scoliosis and temporary retention within complex spine deformity operations after ventral release or mobilized osteotomies. Closed reposition and temporary retention of unstable injuries of the cervical spine up to operation. Extension treatment for careful reposition of fresh or dated malpositions of the cervical spine. Conservative treatment of injuries of the craniocervical junction and the upper part of the cervical spine. Presurgical extension of paralytic scoliosis. Temporary extension after ventral release. Cranial fractures and intracranial injuries. Soft-tissue infections of the skull. Children traction is applied in two stages; first, the head ring is attached to the skull, then, the body cast and suspension assembly are added. Local anesthesia, depending on circumstances. Sizing of the components; the optimal size of the ring is about 1.5" larger than the circumference of the patient's head. Patient in sitting or supine position. The halo ring is held in proper position by stabilizer plates; the lower margin of the ring should be just above the ears and about 0.4" above the eyebrows. The anterior pins are placed in shallow groove on the forehead between supraorbital ridges and frontal protuberances. Threaded skull pins are screwed with defined torque (4-8"/pounds) in the lamina externa of the cranial calotte without perforating the lamina interna. To avoid side-to-side drifting, the diagonally opposite pins should be tightened simultaneously. Finally, connection of the halo ring with a body cast or putting on an extension device. Secure external stabilization of unstable injuries of upper cervical spine. Improvement of correction results of patients with

  13. Use of tightrope fixation in ankle syndesmotic injuries

    Institute of Scientific and Technical Information of China (English)

    Julian Maempel; Anthony Ward; Tim Chesser; Michael Kelly

    2014-01-01

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

  14. Denitrification and N2 fixation in the Pacific Ocean

    Science.gov (United States)

    Deutsch, Curtis; Gruber, Nicolas; Key, Robert M.; Sarmiento, Jorge L.; Ganachaud, Alexandre

    2001-06-01

    We establish the fixed nitrogen budget of the Pacific Ocean based on nutrient fields from the recently completed World Ocean Circulation Experiment (WOCE). The budget includes denitrification in the water column and sediments, nitrogen fixation, atmospheric and riverine inputs, and nitrogen divergence due to the large-scale circulation. A water column denitrification rate of 48±5 Tg N yr -1 is calculated for the Eastern Tropical Pacific using N* [Gruber and Sarmiento, 1997] and water mass age tracers. On the basis of rates in the literature, we estimate sedimentary denitrification to remove an additional 15±3 Tg N yr-1. We then calculate the total nitrogen divergence due to the large scale circulation through the basin, composed of flows through a zonal transect at 32°S, and through the Indonesian and Bering straits. Adding atmospheric deposition and riverine fluxes results in a net divergence of nitrogen from the basin of -4±12 Tg N yr-1. Pacific nitrogen fixation can be extracted as a residual component of the total budget, assuming steady state. We find that nitrogen fixation would have to contribute 59±14 Tg N yr-1 in order to balance the Pacific nitrogen budget. This result is consistent with the tentative global extrapolations of Gruber and Sarmiento [1997], based on nitrogen fixation rates estimated for the North Atlantic. Our estimated mean areal fixation rate is within the range of direct and geochemical rate estimates from a single location near Hawaii [Karl et al., 1997]. Pacific nitrogen fixation occurs primarily in the western part of the subtropical gyres where elevated N* signals are found. These regions are also supplied with significant amounts of iron via atmospheric dust deposition, lending qualitative support to the hypothesis that nitrogen fixation is regulated in part by iron suppy.

  15. Malate Synthesis by Dark Carbon Dioxide Fixation in Leaves 1

    Science.gov (United States)

    Levi, Carolyn; Perchorowicz, John T.; Gibbs, Martin

    1978-01-01

    The rates of dark CO2 fixation and the label distribution in malate following dark 14CO2 fixation in a C-4 plant (maize), a C-3 plant (sunflower), and two Crassulacean acid metabolism plants (Bryophyllum calycinum and Kalanchoë diagremontianum leaves and plantlets) are compared. Within the first 30 minutes of dark 14CO2 fixation, leaves of maize, B. calycinum, and sunflower, and K. diagremontianum plantlets fix CO2 at rates of 1.4, 3.4, 0.23, and 1.0 μmoles of CO2/mg of chlorophyll· hour, respectively. Net CO2 fixation stops within 3 hours in maize and sunflower, but Crassulaceans continue fixing CO2 for the duration of the 23-hour experiment. A bacterial procedure using Lactobacillus plantarum ATCC No. 8014 and one using malic enzyme to remove the β-carboxyl (C4) from malate are compared. It is reported that highly purified malic enzyme and the bacterial method provide equivalent results. Less purified malic enzyme may overestimate the label in C4 as much as 15 to 20%. The contribution of carbon atom 1 of malate is between 18 and 21% of the total carboxyl label after 1 minute of dark CO2 fixation. Isotopic labeling in the two carboxyls approached unity with time. The rate of increase is greatest in sunflower leaves and Kalanchoë plantlets. In addition, Kalanchoë leaves fix 14CO2 more rapidly than Kalanchoë plantlets and the equilibration of the malate carboxyls occurs more slowly. The rates of fixation and the randomization are tissue-specific. The rate of fixation does not correlate with the rate of randomization of isotope in the malate carboxyls. PMID:16660319

  16. Malate synthesis by dark carbon dioxide fixation in leaves.

    Science.gov (United States)

    Levi, C; Perchorowicz, J T; Gibbs, M

    1978-04-01

    The rates of dark CO(2) fixation and the label distribution in malate following dark (14)CO(2) fixation in a C-4 plant (maize), a C-3 plant (sunflower), and two Crassulacean acid metabolism plants (Bryophyllum calycinum and Kalanchoë diagremontianum leaves and plantlets) are compared. Within the first 30 minutes of dark (14)CO(2) fixation, leaves of maize, B. calycinum, and sunflower, and K. diagremontianum plantlets fix CO(2) at rates of 1.4, 3.4, 0.23, and 1.0 mumoles of CO(2)/mg of chlorophyll. hour, respectively. Net CO(2) fixation stops within 3 hours in maize and sunflower, but Crassulaceans continue fixing CO(2) for the duration of the 23-hour experiment.A bacterial procedure using Lactobacillus plantarum ATCC No. 8014 and one using malic enzyme to remove the beta-carboxyl (C(4)) from malate are compared. It is reported that highly purified malic enzyme and the bacterial method provide equivalent results. Less purified malic enzyme may overestimate the label in C(4) as much as 15 to 20%.The contribution of carbon atom 1 of malate is between 18 and 21% of the total carboxyl label after 1 minute of dark CO(2) fixation. Isotopic labeling in the two carboxyls approached unity with time. The rate of increase is greatest in sunflower leaves and Kalanchoë plantlets. In addition, Kalanchoë leaves fix (14)CO(2) more rapidly than Kalanchoë plantlets and the equilibration of the malate carboxyls occurs more slowly. The rates of fixation and the randomization are tissue-specific. The rate of fixation does not correlate with the rate of randomization of isotope in the malate carboxyls.

  17. The emergence and early evolution of biological carbon-fixation.

    Directory of Open Access Journals (Sweden)

    Rogier Braakman

    Full Text Available The fixation of CO₂ into living matter sustains all life on Earth, and embeds the biosphere within geochemistry. The six known chemical pathways used by extant organisms for this function are recognized to have overlaps, but their evolution is incompletely understood. Here we reconstruct the complete early evolutionary history of biological carbon-fixation, relating all modern pathways to a single ancestral form. We find that innovations in carbon-fixation were the foundation for most major early divergences in the tree of life. These findings are based on a novel method that fully integrates metabolic and phylogenetic constraints. Comparing gene-profiles across the metabolic cores of deep-branching organisms and requiring that they are capable of synthesizing all their biomass components leads to the surprising conclusion that the most common form for deep-branching autotrophic carbon-fixation combines two disconnected sub-networks, each supplying carbon to distinct biomass components. One of these is a linear folate-based pathway of CO₂ reduction previously only recognized as a fixation route in the complete Wood-Ljungdahl pathway, but which more generally may exclude the final step of synthesizing acetyl-CoA. Using metabolic constraints we then reconstruct a "phylometabolic" tree with a high degree of parsimony that traces the evolution of complete carbon-fixation pathways, and has a clear structure down to the root. This tree requires few instances of lateral gene transfer or convergence, and instead suggests a simple evolutionary dynamic in which all divergences have primary environmental causes. Energy optimization and oxygen toxicity are the two strongest forces of selection. The root of this tree combines the reductive citric acid cycle and the Wood-Ljungdahl pathway into a single connected network. This linked network lacks the selective optimization of modern fixation pathways but its redundancy leads to a more robust topology

  18. Treatment of obsolete volar dislocation of the distal radioulnar joint by Sauvé-Kapandji procedure%Sauvé-Kapandji术治疗陈旧性下尺桡关节掌侧脱位