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PubMed1987

Ridge augmentation using solid and porous hydroxylapatite particles with and without autogenous bone or plaster.

Edentulous areas of dog jaws were augmented with solid or porous particles of hydroxylapatite (HA) alone, or combined with either finely crushed autogenous bone or plaster of paris. At the end of the experiment (24 weeks), the augmented ridges were firm and stable and covered with healthy mucosa. The ridges augmented with only porous particles of HA demonstrated a greater amount of bone ingrowth compared with the solid, dense particles. The new bone formation occurred in those parts of the implants adjacent to the underlying alveolar bone. The addition of autogenous bone to the HA particles did not enhance bony deposition, and none of the autogenous bone chips survived for 24 weeks. The amount of new bone in the ridges augmented with plaster of paris and HA was similar to the other groups, and the plaster did not interfere with healing. There was evidence of resorption of the underlying cortical bone in many of the specimens.

Alveolar Process↗

PubMed2000

Coherent scattering and matrix correction in bone-lead measurements.

The technique of K shell x-ray fluorescence of lead in bone has been used in many studies of the health effects of lead. This paper addresses one aspect of the technique, namely the coherent conversion factor (CCF) which converts between the matrix of the calibration standards and those of human bone. The CCF is conventionally considered a constant but is a function of scattering angle. energy and the elemental composition of the matrices. The aims of this study were to quantify the effect on the CCF of several assumptions which may not have been tested adequately and to compare the CCFs for plaster of Paris (the present matrix of calibration standards) and a synthetic apatite matrix. The CCF was calculated, using relativistic form factors, for published compositions of bone, both assumed and assessed compositions of plaster, and the synthetic apatite. The main findings of the study were, first, that impurities in plaster, lead in the plaster or bone matrices, coherent scatter from non-bone tissues and the individual subject's measurement geometry are all minor or negligible effects; and, second, that the synthetic apatite matrix is more representative of bone mineral than is plaster of Paris.

Adult↗

PubMedDate not supplied

Haematoma block in reduction of distal radial fractures.

A total of 35 patients who presented in the Accident and Emergency Department of University College Hospital with displaced distal radial fracture between January 2000 and March 2001 had reduction of the fracture under haematoma block using 10ml of 2% lignocaine. There was significant reduction of the pain following infiltration of the fracture site with lignocaine and significant pain reduction during manipulation compared to pain score at presentation. All the patients had satisfactory reduction of the fracture. The fracture was mobilised in Plaster of Paris 6 weeks in patients with Collens' fracture and 3 weeks in patients with distal radial epiphyseal injury. All patients had good range of movement at 8 weeks after removal of Plaster of Paris and patients expressed satisfaction with this method. We recommend the use of Haematoma block for patients of 15 years and above with displaced distal radial fracture in the Accident and Emergency Department.

Accidental Falls↗

PubMed2005

An experimental study of pressure-volume dynamics of casting materials.

Casting materials are commonly used in a trauma and post-operative setting in orthopaedic practice. Swelling after trauma or surgery is universal, hence, the importance of understanding the pressure-volume dynamics of various materials commonly used for casting. This study attempts to define the pressure response of casts made from three commonly used materials to increasing volume, using a cylindrical model cast. Plaster of Paris (PoP), rigid fibreglass and semi-rigid non-fibreglass (Softcast) were chosen for comparison. Softcast had the best compliance and rate dependency characteristics, accommodating significantly more volume of fluid compared to plaster of Paris or Rigid fibreglass material. The latter two had similar compliance. All three materials demonstrated stress-relaxation which is of advantage in reducing peak pressures for a given volume change. This study shows that the casting materials behave in a viscoelastic manner, which allows them to accommodate more volume change than would otherwise be possible. The use of semi-rigid material may be safer than other materials as far as response to swelling (volume expansion) is concerned.

Calcium Sulfate↗

PubMed1995

Reduction of post-traumatic osteoporosis after external fixation of tibial fractures.

Disuse osteoporosis following tibial fractures is associated with pain and prolonged rehabilitation. In a prospective study, 22 patients with stable tibial fractures treated in plaster of Paris were compared with 15 patients in whom unstable tibial fractures were treated by external fixation. All patients were allowed to bear full weight from the day after the injury. The patients treated with plaster of Paris had the less severe fractures but still had a greater number of the higher grades of osteoporosis. We found a significantly lower degree of osteoporosis in the external fixator group. A comparison of the median percentage bearing weight in the two groups of patients showed greater percentage bearing weight in the external fixator group at four and eight weeks after the injury. We suggest that the reduction of post-traumatic osteoporosis is due to improved early function and weight bearing in patients treated by external fixation.

Adolescent↗

PubMed1994

The reproducibility of 109Cd-based X-ray fluorescence measurements of bone lead.

We assessed the reproducibility of X-ray fluorescence-based lead measurements from multiple measurements made on a low-concentration plaster of paris phantom and in five subjects measured five times on two occasions. Over a 6-month period, 220 measurements of the same phantom were obtained and showed a standard deviation of 1.29 micrograms Pb (g plaster of paris)-1. The two sets of in vivo measurements were made 10 months apart and revealed a mean standard deviation of 3.4 micrograms Pb (g bone mineral)-1 and 5.1 micrograms Pb (g bone mineral)-1 for males and females, respectively. Our measured standard deviation exceeded by 20-30% the calculated standard deviation associated with a single measurement both in the phantom and in subjects. This indicates that some variance is introduced during the measurement process. Operator learning and consistency significantly minimized this increased variability. Measured lead concentrations of the left and right tibia in 14 subjects showed no significant differences between legs. As a result, either tibia can be sampled and compared over time. The levels of reproducibility we report here mean that X-ray fluorescence-based determinations of bone lead concentrations are reliable both over the short and long term. Thus, reasonably sized confidence intervals can be placed on detected changes in concentration and should permit acquisition of longitudinal data within a reasonable length of time.

Bone and Bones↗

PubMed1999

Effect of matrix placement on furcation perforation repair.

Furcation perforations are a serious complication during endodontic treatment, and a matrix to aid placement of repair material has been recommended. This study tested the sealing ability of amalgam and Ketac silver placed with and without plaster of Paris as a matrix. A bacterial penetration technique was used to test the seal. Perforations created in the pulpal floor of extracted human mandibular molars were repaired as follows: group 1, amalgam; group 2, amalgam plus plaster as a matrix; group 3, Ketac silver; and group 4, Ketac silver plus plaster (17 teeth/group). Leakage was measured by placing bacteria (Streptococcus sobrinus) in the pulp chamber, and recording the time taken for bacterial growth in a medium bathing the root surface. A plaster of Paris matrix improved the seal with amalgam, but not with Ketac silver. Ketac silver provided the best seal, but all materials showed complete leakage within 22 days.

Calcium Sulfate↗

PubMed1982

Colles' fractures treated by plaster and polyurethane braces: a controlled clinical study.

In a prospective randomized controlled trial polyurethane casts and traditional plaster-of-Paris braces were compared in 46 cases of Colles' fractures of the forearm. Secondary fracture dislocation, subjective inconveniences, and the need for secondary adjustment of the cast were recorded. No significant difference was observed in the two groups. In comparison with plaster the synthetic bandage is lighter, water repellent, and hardens faster, and as far as circular bandages are concerned, they have zippers. It is concluded that polyurethane braces are a good supplement to plaster-of-Paris bandage in such fractures and recommended in selected cases.

Adolescent↗

PubMed1994

[Comparative studies of synthetic and nonsynthetic cast dressings].

Six different cast materials were evaluated and compared for radiolucency and mechanical properties. Synthetic casts, that do not contain fiberglass are more radiolucent than fiberglass cast materials or plaster of Paris. The fiberglass cast is particularly stable, and the advantage of the cotton cast is a low dead weight. The costs of synthetic casts made according to the producer manufacturers' recommendations do not differ significantly, but they are all much more expensive than plaster of Paris. Splitting a synthetic cast along its length and bending it open is not enough to prevent compartment syndrome, and wedging is recommended to keep it open.

Absorptiometry, Photon↗

PubMed1981

Treatment for partial tears of the lateral ligament of the ankle: a prospective trial.

There is debate about the most appropriate form of treatment for partial tears of the lateral ligament of the ankle, which are common after inversion injuries. A prospective trial of four forms of treatment was carried out. The forms of treatment used were: no treatment with only a minimal bandage, Tubigrip support, immobilisation in plaster-of-Paris, and physiotherapy. The end point was taken when the patient returned to work or had a low score on an objective clinical scale. Early mobilisation, with or without physiotherapy, was found to offer the most rapid return to functional activity. Patients who had had their ankle immobilised in plaster-of-Paris required more days off work and longer attendance at a follow-up clinic. Inversion injuries are common and cause absence from work and discomfort for the patient. These findings suggest that mobilisation with physiotherapy, although not practical for all patients, is the most satisfactory course of treatment.

Adolescent↗

PubMed2006

Finite element analysis of different bone substitutes in the bone defects around dental implants.

PURPOSE: To evaluate the distribution of stress and strain for the evaluation of implant and graft stability at each stage before stabilization of the graft is achieved after implantation was performed. MATERIALS AND METHODS: Dembone (Pacific Coast Tissue Bank, Los Angeles, CA), Bio-Oss (Geistlich Pharma, Wolhusen, Switzerland), particulate dentin, and plaster of Paris were used to fill bone defects. The distribution of stress was compared in the mandible and maxilla, between vertical load and load applied at 30 degrees angle, and according to time, with 3 different graft materials. RESULTS: Stress occurred more when it was applied at an angle, rather than applied vertically. Stress was relatively high immediately after implantation, and particulate dentin-plaster of Paris showed larger mechanical properties and lower stress distribution overall. The largest stress distribution was shown when stress was applied at an angle when demineralized freeze-dried bone was used. The pattern of stress distribution was different according to differences in the mechanical properties of implants. CONCLUSION: Caution is needed not to apply stress at an angle immediately after implantation. Differences of stress were reduced with time as the implant became stabilized.

Adult↗

PubMed2004

The effect of a range of disinfectants on the dimensional accuracy of some impression materials.

In this study the dimensional accuracy of two model materials; dental stone and plaster of Paris, reproduced from three commonly used impression materials; alginate, polyether and addition-cured silicone, retained by their adhesives in acrylic resin trays and exposed to four disinfectant solutions was evaluated. Ninety casts were used to investigate the effect of the four disinfectants on the dimensional accuracy of alginate, polyether and addition-cured silicone impression material. For each impression material 30 impressions were taken, half were poured in dental stone and half in plaster of Paris. The disinfectants used were Dimenol, Perform-ID, MD-520, and Haz-tabs. Measurements were carried out using a High Precision Reflex Microscope. For the alginate impressions only those disinfected by 5-minute immersion in Haz-tabs solution and in full-strength MD 520 were not adversely affected by the disinfection treatment. All polyether impressions subjected to immersion disinfection exhibited a clinically acceptable expansion. Disinfected addition-cured silicone impressions produced very accurate stone casts. Those disinfected by spraying with fill-strength Dimenol produced casts that were very similar to those left as controls, but those treated by immersion disinfection exhibited negligible and clinically acceptable expansion. The results of the studied demonstrated that the various disinfection treatments had different effects on the impression materials. It is important that an appropriate disinfectant is used for each type of impression material.

2-Propanol↗

PubMed2003

Management of open tibia fracture--Anderson and Hutchins technique re-visited.

Prior to September 1995, most open tibia fractures seen at the University College Hospital, Ibadan had hitherto been managed by the application of plaster-of-Paris after limited wound debridement. The outcome of this form of treatment was found, from the outpatient clinic follow-up records, to be associated with a high rate of complications including chronic osteomyelitis and joint stiffness. In most hospitals in the developed and developing countries, majority of these injuries are best managed by the use of various types of external fixators. However, these external fixator devices are by no means cheap and often times most patients in our environment are unable to afford them since the country operates a health care system where the patients are solely responsible for their health care needs. In this study, the Anderson and Hutchins technique (Steinmann's pins threaded through bone and incorporated in plaster-of-Paris) was used in the management of thirty-four open tibia fractures between September 1995 and August 1999. Seventy-nine percent of these were severe or Type III open fractures. The time to radiological union was 21 weeks and pin tract infection occurred in 15 percent of the patients, mainly in the proximal (tibia) pins. The use of a single stout proximal (tibia) transfixing Steinmann's pin was found to offer a stable fixation.

Adolescent↗

PubMed2003

Role of Joshi's external stabilisation system fixator in the management of idiopathic clubfoot.

PURPOSE: To explore the role of Joshi's external stabilisation system fixator in correcting cases of clubfoot peculiar to India, we studied cases of neglected clubfoot, dropout cases of plaster-of-paris cast treatment, or failed surgical procedures that had been followed for a minimum period of 2 years. METHODS: 26 children underwent 44 Joshi's external stabilisation system procedures at the Central Institute of Orthopaedics at the Safdarjung Hospital, New Delhi, between January 1998 and December 1999 for the conditions of interest. Three-dimensional correction was achieved by use of the distractor device. RESULTS: Excellent results were obtained in 77% of the cases, good results in 13%, and poor results in 9% of the cases. Complications in half of the cases were pintract infections, which eventually healed on an outpatient basis without any residual sequelae. CONCLUSION: The Joshi's external stabilisation system frame is ideally suited for the child in whom clubfoot deformities remain uncorrected by plaster-of-paris casts and manipulation, as well as for recurrent clubfoot. Casting after complete correction not only protects the osteopenic bones while the pin-tracts heal, but also maintains correction and allows gradual weightbearing.

Child↗

PubMed2000

Traumatic medial malleolar fracture of a fibula flap donor leg.

A 50-year-old male presented with a T4 N0 squamous cell carcinoma of the floor of the mouth and alveolus. Treatment included a partial mandibulectomy with a free osseocutaneous fibula flap reconstruction. He made a good postoperative recovery and was given adjuvant radiotherapy. No problems were reported with the donor site or ankle. Five months after harvesting the flap the patient sustained a fracture of the medial malleolus having jumped over a ditch playing golf. This was treated successfully with a below knee plaster of Paris cast. The interosseous membrane was not ruptured in the accident indicating that the distal fibula left in situ was adequate to maintain the integrity of the mortice. A degree of ankle instability may be present after fibula flap harvest which is only revealed by athletic activity. (c) 2000 Harcourt Publishers Ltd Copyright 2000 The British Association of Plastic Surgeons DOI: 10.1054/bjps.1999.3227.

Journal Article↗

PubMed2004

In vitro analysis of the elution of tobramycin from a calcium sulfate bone void filler.

The use of synthetic calcium-based bone replacements has a recent history in craniofacial surgery as a non- to minimally load-bearing graft substitute. Given its avascular nature at the time of placement, infection is an ever present risk. Antibiotics are often added to the material during surgery based on an empirical impression. Whether effective antibiotic release actually occurs and over what time are not known for many of the available calcium-based preparations. The purpose of this study was to investigate the release kinetics of tobramycin from molded cylinders of Calcigen S bone void filler (Biomet, Warsaw, IN) and to compare this with the release kinetics of tobramycin from plaster of Paris-based systems as reported in the literature. Calcigen S bone void filler is a form of calcium sulfate that is closely related to plaster of Paris yet remains distinct. In vitro studies as well as clinical series have demonstrated that plaster of Paris is an effective vehicle to deliver tobramycin in which therapeutic doses of the antibiotic are released after implantation. In vitro analysis of the elution of tobramycin from Calcigen S bone void filler substrate is similar to that of plaster of Paris.

Analysis of Variance↗

PubMed1995

Early mobilization in the treatment of Colles' fracture: a 3 year prospective study.

Ninety consecutive women with unilateral Colles' fractures were randomized into two different treatment groups. The control group was treated for 5 weeks in conventional short-arm, below the elbow plaster of Paris casts. The other group (N = 45) was treated similarly in plaster casts for 3 weeks and then had flexible casting applied for the remaining 2 weeks which allowed for early joint mobilization. Functional recovery was assessed by measuring grip strength and joint mobility at intervals over the 3 years. Radiographic and overall assessments were also made during 3 year course of study. Virtually all patients reported greater comfort after switching to the flexible casting. Mean grip scores and joint mobilities were higher at all time points with early mobilization, reaching levels of statistical significance at 6 months for grip score and at 3 months for joint mobility. By 3 years most differences between treatment groups had resolved. We found no evidence that early mobilization was detrimental to recovery. We conclude that early mobilization is a satisfactory treatment option for Colles' fracture, and may, in fact, hasten functional recovery.

Adult↗

PubMed1989

Osteopenia after ankle fractures. The influence of early weight bearing and muscle activity.

Fifty-seven patients surgically treated for ankle fractures were followed for two years with bone mineral content (BMC) estimations at various levels of both lower extremities. Maximum BMC reduction was seen four months after operation. Bone mineral was partly regenerated during the remainder of the first year. There was hardly any regeneration during the second year. The persisting bone mineral deficit was between 3.5% and 9% depending on the region measured. BMC changes were minor in the contralateral limb and mainly consisted of a slight gain. During the first six postoperative weeks, patients (1) performed active movements of the ankle and subtalar joints but did not bear weight; (2) wore a plaster of paris cast without bearing weight; or (3) bore full weight in a plaster cast. The bone mineral loss was similar in the three treatment groups.

Adult↗