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At least 253 records · Page 14Linked to original sources
PubMed1992

Immediate internal fixation of open fractures of the diaphysis of the forearm.

Immediate (within 24 h) open reduction and internal fixation of 103 open fractures of one or both bones of the forearm was accomplished in 69 patients between 1980 and 1989. Fifty-four of the 103 patients were reevaluated 1 to 7 years postinjury (average 2.5 years) to determine the efficacy of this treatment. Forty-five (90%) of the 50 patients with Grade I, II, or IIIA injuries had satisfactory results. The four patients with Grade IIIB or IIIC injuries had unacceptable results. This study demonstrates, as have previous investigations, that immediate open reduction and internal fixation of open forearm fractures provide acceptable results in Grades I, II, and selected Grade III injuries. The subdivision of Grade III fractures into A, B, and C types provides a previously unreported statistically significant difference in the results obtained in management of these injuries. The difference in results in Grade I, II, and IIIA injuries as compared to the Grade IIIB and C injuries was statistically significant (p = 0.0004). The difference in Grade IIIA injuries as compared to Grade IIIB and C injuries was also significant (p = 0.014). Immediate open reduction and internal fixation can be recommended in Grade I, II, and IIIA open forearm fractures. Although it is unclear from this report whether the results in Grade IIIB and C fractures were due to the management protocol, the severity of the initial injury, or combined factors, immediate open reduction and plate fixation yielded poor results in these injuries.

Academic Medical Centers↗
PubMed1998

Internal fixation of maxillofacial fractures: indications and current implant technologies and materials.

Rigid fixation techniques are frequently utilized for the repair of maxillofacial skeletal injuries. This paper reviews the commonly available implants and materials along with their typical indications. The focus is primarily on the most recent trends and developments. Latticework plates and meshes provide greater fixation strength with smaller amounts of metal; modern reconstruction plates allow for fixation of the screws directly to the plates; self-drilling screws make application faster and easier. Resorbable implants made of various polyester polymers are now available, though their indications remain limited thus far. Future developments are discussed as well, including the advent of endoscopic plate placement and image-guided skeletal repositioning.

Absorbable Implants↗
PubMed1998

Open reduction and internal fixation of acute mandibular fractures in adults.

The mandible is often fractured during maxillofacial trauma because of its prominence within the facial skeleton and the fact that it is a favorite target in interpersonal violence. Treatment of mandibular fractures has made significant advances over the years due to the study of biomechanical principles, advancements in biomaterials and instrumentation and scientifically based research of treatment outcomes. This article will review the principles and philosophy of AO/ASIF techniques as applied to treatment of mandible fractures. Representative cases of different mandible fractures and their treatment will reinforce the clinical application of rigid fixation techniques.

Adult↗
PubMed1998

Internal fixation in pediatric maxillofacial fractures.

Pediatric facial trauma presents unique problems in diagnosis and management. The following review highlights relevant points of craniofacial growth and applied anatomy. The epidemiology of pediatric facial fractures is presented followed by pertinent features of clinical presentation and diagnosis. Management of midfacial injuries is discussed individually for each specific type of fracture with emphasis on the role of rigid fixation. Finally, the relationships between childhood fractures, rigid fixation and craniofacial growth are reviewed.

Child↗
PubMed1999

Occlusal outcome in patients undergoing orthognathic surgery with internal fixation.

Fifty consecutive patients undergoing orthognathic surgery with internal fixation (IF) were studied retrospectively with a weighted Peer Assessment Rating (PAR) Index to assess occlusal outcome at the end of all active treatment, and compared with 50 patients who had undergone treatment for malocclusion by orthodontic means alone. In the surgically treated patients, the mean percentage reduction in the weighted PAR Index was 83% and 31 out of 38 patients (82%) were 'greatly improved'. This implies a high standard of treatment in terms of the occlusal outcome. There was no difference in the proportion of patients having a final weighted PAR Index of less than 10 and no significant difference in the final weighted PAR Index between the two groups. This suggests that the occlusal outcome is no different whether patients undergo orthognathic surgery or orthodontic treatment alone, and that excellent occlusal results can be achieved in patients undergoing orthognathic surgery with internal fixation.

Humans↗
PubMed2004

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

Early reports of open reduction and internal fixation of fractures of the radial head were positive, perhaps because of the prevalence of isolated partial head fractures for which good results would be expected. Subsequent reports have found that complex fractures of the radial head are prone to early failure, nonunion, and poor forearm rotation after operative fixation. Combined with increased availability and use of metal radial head prosthesis for complex fractures of the radial head, the role of open reduction and inter-nal fixation is being redefined.

Epiphyses↗
PubMed1991

Operative treatment of spinal fractures with the AO internal fixator.

A multicentered prospective trial to investigate the usefulness of the AO spinal internal fixator for the treatment of thoracolumbar fractures and fracture-dislocations was undertaken. This pedicle screw-rod system was effective in stabilizing a variety of unstable fracture patterns. It was effective in decompressing the canal of retropulsed bony fragments associated with burst fractures. By the use of this implant, sagittal plane deformity was easily corrected.

Adult↗
PubMed1989

Bio-absorbable plates and screws for internal fixation of mandibular fractures. A study in six dogs.

Bio-absorbable plates and screws were used for internal fixation of artificially created mandibular fractures in 6 dogs. The plates and screws were fabricated from a block of poly(L-lactide) (PLLA), with a high molecular weight. The material is microporous and has excellent mechanical properties. Plates and screws were inserted in accordance with Champy's principles on internal fixation. Clinical and radiographical follow-up and examination of the fracture site under general anesthesia showed that all fractures healed without callus and without complications. The plates or screws did not fail, despite the tensile strength of the PLLA used is less than stainless steel or any other metal. An explanation for their successful application may be the high impact resilience of this material. The proprioceptive mechanisms, however, that keep the dogs from maximal loading of their broken mandibles, may also play a role. Plates and screws of this bio-absorbable PLLA appear to be an attractive alternative for internal fixation of mandibular fractures and certainly for less loaded fractures of the human skeleton. The necessity to remove metallic osteosynthesis can be avoided.

Absorption↗
PubMed2001

Use of a craniofacial miniplate for internal fixation in a young child with cervical instability. Case report.

Commercially available anterior cervical internal fixation devices are designed for placement in adults and older children. Use of these systems in preschool-aged children is precluded due to the small size of their cervical vertebral bodies (VBs). The authors describe a 2-year-old boy who suffered a C3-4 injury, resulting in complete ligamentous disruption. Because of the gross cervical instability, they elected to perform surgery via posterior and anterior approaches, supplemented with internal fixation, during the same operation. The purpose of the anterior internal fixation device is to deliver compressive forces onto the interbody graft and keep it in place, thus optimizing the potential for a successful fusion. Because of the discrepancy in size between the VBs and the plate and screws, however, the authors were unable to use any of the standard anterior cervical fixation devices. Instead, they implanted a craniofacial miniplate, and the patient was required to wear an external halo brace. The miniplate provided enough stability to allow for a solid fusion. The authors believe that this technique is a reasonable option in young children who require anterior cervical fixation.

Adult↗
PubMed1990

Early screw removal for correction of occlusal discrepancies following rigid internal fixation in orthognathic surgery.

Occlusal discrepancies that occur after orthognathic surgery in which rigid internal fixation was used are technically difficult to correct. These discrepancies often lead to prolonged postoperative orthodontics and possibly to compromised results. The effectiveness of the removal of rigid internal fixation in correcting these changes was studied retrospectively. Of 169 patients who underwent bilateral sagittal osteotomies of the mandible, 13 developed postoperative malocclusions, and their rigid internal fixation was removed (an average of 21 days postoperatively). Occlusion was improved in 11 of the patients. In the two patients who showed no improvement in occlusion, fixation had been removed at 5 weeks in one and at 6 weeks in the other. One patient had a slight relapse 6 months postoperatively. All other patients had stable occlusions and experienced no complications. Recommendations for use of the technique and potential complications are discussed.

Bone Screws↗