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At least 343 records · Page 19Linked to original sources
PubMed1976

[High tibial osteotomy--fixation by means of external fixation--indication, technique, complications (author's transl)].

High tibial osteotomy has proved its value in the treatment of gonarthrosis with or without axis deformity. The thrust of weight-bearing and other stresses is lessened on the degenerated tibial condyle and transferred to the more normal condyle. The stable fixation by means of external fixation allows early movement of the knee joint.-R-ferences to operative technique, indication, complications and after-treatment.

Arthrodesis↗
PubMed1989

Complications of orthognathic surgery: a comparison between wire fixation and rigid internal fixation.

This retrospective review compares the results of using rigid internal fixation (RIF) and wire fixation for orthognathic surgery patients. The records of two groups of demographically similar patients who underwent comparable surgery, performed by the same four attending surgeons at the same institutions during the same time period (1983 to 1986), were evaluated for complications and unanticipated treatment results. The most striking finding of this study is the general similarity between the two groups. However, differences in frequency of excessive weight loss and persistent restriction of mandibular opening suggest a benefit from early mobility of the mandible that comes with RIF. Because there was no concomitant increase in complications or unexpected results of treatment, the introduction of RIF for orthognathic surgery may offer patients some potential advantages.

Humans↗
PubMed1987

Chemical implant fixation using hydroxyl-apatite coatings. The development of a human total hip prosthesis for chemical fixation to bone using hydroxyl-apatite coatings on titanium substrates.

Sintered hydroxyl-apatite implants form very tight bonds with living bone but are susceptible to fatigue failure. Plasma-sprayed apatite coatings on titanium substrates overcome the fatigue problem. The static tensile substrate bond strength of the apatite coating is in excess of 85 megapascals (MPa) (12,000 psi). In a plug implant study designed to discount mechanical retention, a bone bonding shear strength of 64 MPa (9280 psi) was achieved, comparable to the strength of cortical bone. Histologic sections confirm the close bonding between apatite coating and living bone. In a canine total hip arthroplasty study, the apatite-coated implants proved far superior to the uncoated controls. Uncoated prostheses were surrounded by fibrous tissue and were easily extracted from the femur at any postoperative time. The apatite-coated implants were rigidly fixed within three weeks with demonstrable bone formation up to the implant surface. Bony defects up to 2 mm in depth were filled with bone within six weeks. The hypothetical mechanism of bone bonding is chemical. Hydroxyl-apatite coatings permit an implant fixation far superior to current methods using either cemented or cementless techniques. The plan is to study a human total hip prosthesis with hydroxyl-apatite coating for chemical fixation to bone.

Animals↗
PubMed1987

Vertical fixation disparity correction: effect on the horizontal forced-vergence fixation disparity curve.

Following a suggestion made by Percival in regard to dissociated phorias, we corrected vertical associated phoria in several patients who had disparities in both vertical and horizontal fixation. The principal objective result of this correction was a flattening of the slope of the type I horizontal forced-vergence curve. This result may be significant particularly because the slope has been identified as being a good prognosticator of patients likely to be symptomatic. Attention to a concurrent vertical component may offer a convenient way to normalize a steep slope on horizontal fixation disparity curves.

Adult↗
PubMed1995

Internal fixation (pedicle screw fixation) for fusions of the lumbar spine.

STUDY DESIGN: Literature review. OBJECTIVES: To illustrate the indications and potential complications of pedicle screw application in the lumbar spine. SUMMARY OF BACKGROUND DATA: Except for the treatment of severe spondylolisthesis (grades 3 and 4) at L5-S1, using autogenous bone graft and with device removal often fusion is obtained. Pedicle screw devices labeled for stabilizing the lumbar spine or correcting deformities in fusion procedures are currently considered Class III medical devices by the Food and Drug Administration, that is, investigational or experimental forms of spinal fixation. Recent clinical studies have attested to their usefulness and safety by qualified surgeons for selected surgical indications. METHODS: Literature synthesis. RESULTS: Segmental fixation increases the fusion rate and clinical success of indicated patients undergoing the procedure in lumbar spine operations, as it does in the treatment of fusion of long bone injuries, scoliosis, and other comparable surgeries. CONCLUSION: With this technology, surgeons can effectively reduce the pseudarthrosis rate, improve patient satisfaction and results of functional studies, and ultimately reduce the long-term cost to society as a result of effective initial posterior lumbar spine surgery.

Bone Screws↗
PubMed1987

Intraosseous wire fixation versus rigid osseous fixation of mandibular fractures: a preliminary report.

While wire osteosynthesis has been the accepted modality to use with open reduction of mandibular fractures, several authors have suggested the use of more rigid techniques to achieve the same result while also eliminating adverse effects associated with prolonged maxillomandibular fixation. Few studies have directly compared the two techniques in a prospective manner. The purpose of this paper was to evaluate complications seen with wire osteosynthesis versus a small bone plating system in management of mandibular fractures. The results suggest that small bone plating systems similar to the one used in this study may serve as a suitable alternative to wire osteosynthesis for the management of mandibular parasymphysis, body, and angle fractures. The length of the procedure, the length of hospital stay, and patient comfort were comparable with the two techniques. Factors that may contribute to failure are: location of the fracture, poor patient compliance, length of time from the trauma to the repair, antibiotic choice, and most importantly, operator skill and experience.

Adolescent↗
PubMed2002

Transoral 2.0-mm miniplate fixation of mandibular fractures plus 2 weeks' maxillomandibular fixation: a prospective study.

PURPOSE: We conducted a study to assess the efficacy of intraoral treatment of mandibular fractures using a 2.0-mm miniplate and 2 weeks of maxillomandibular fixation (MMF). PATIENTS AND METHODS: Forty-four mandible fractures in 31 patients with a mean of 15 days of MMF were included in this study. A 2.0-mm miniplate was adapted along Champy's lines of ideal osteosynthesis and secured with four 8.0-mm monocortical screws. All patients were followed for at least 8 weeks after surgery. The incidences of bone or soft tissue infections, wound dehiscence, nonunion, malunion, malocclusion, plate fractures, and iatrogenic neurosensory deficits were prospectively evaluated. RESULTS: Primary bone healing was achieved in 100% of cases. No soft or hard tissue infection, malocclusion, malunion, nonunion, dental injuries, plate fracture, or iatrogenic nerve injuries were observed. Two (4.52%) minor complications-intraoral wound dehiscences-were noted. CONCLUSIONS: The use of a single 2.0-mm miniplate adapted along Champy's line of ideal osteosynthesis and stabilized with 4 monocortical screws plus 2 weeks of MMF was a viable treatment modality for mandibular fractures.

Adolescent↗
PubMed1990

[Method of fracture fixation using external fixation devices].

An improvement of the results of treatment can be reached, beside respecting the indication of external fixateurs, with correct tactics of the treatment. Because of the disadvantages of the fixateur externe, we strive to restrict their use, to the time by all means necessary, and if possible to use other methods of fixation. This is motivated especially by the effect on fracture healing and the hindering of the movements and activity of the patient.

Biomechanical Phenomena↗
PubMed1979

[Fixation of the osteotomised greater trochanter by total hip prosthesis in 181 cases. Advantages of the fixation with intramedullary Kirschner wire and the figure-of-eight wire loop (author's transl)].

It is mostly possible to implant a total hip prosthesis without an osteotomy of the greater trochanter. It is however necessary to do it in some cases such as an ankylosed hip, a reimplantation and a severe form of the coxarthrosis. 181 patients have been followed up. The fixation by intramedullary Kirschner wire and figure-of-eight wire loop has been of success. It is a simple method. No fracture of the greater trochanter has been observed.

Aged↗
PubMed1996

Dynamic glutaraldehyde fixation of a porcine aortic valve xenograft. I. Effect of fixation conditions on the final tissue viscoelastic properties.

Sixty porcine aortic valves were fixed under dynamic conditions at specific durations, pressures and vibration rates in a 0.5% glutaraldehyde phosphate buffer (pH 7.4, 0.2 M). Tensile relaxation tests were performed at low through high extension rates (0.3, 3 and 30 mm s-1) and tissue denaturation temperatures were determined by the hydrothermal isometric tension method. Conventional statically fixed valves and fresh valves were used as controls. No differences between dynamic and static treatment were observed at pulsation rates above those expected in the physiological range (i.e. above 1.2 Hz) or at higher pressures such as 30 mmHg. However, differences in both stress relaxation rates and denaturation temperatures were delineated in milder fixation conditions, i.e. at low pressures (< 4 mmHg) and low vibration rates similar to that of the normal heart beat (approximately 1.2 Hz). In these conditions the relaxation rate of the dynamically fixed tissue (-7.4 +/- 0.7% of stress remaining per log(s)) was similar to that of the fresh tissue (-6.7 +/- 1.2% log(s-1)) and significantly higher than the statically treated tissue (-3.9 +/- 1.7% log(s-1)). The rates of stress relaxation appeared to be strain rate dependent in both radial and circumferential directions when the tissues were strained at physiological rates during testing (> approximately 15000% min-1). Dynamically treated valves showed higher denaturation temperatures (mean +/- SD) (89.4 +/- 0.5 degree C) compared with the statically fixed (82.7 +/- 1.4 degrees C) or untreated (fresh) valves (65.5 +/- 0.8 degree C). The results suggest a higher degree of internal cross-linking owing possibly to enhanced penetration of the glutaraldehyde reagent and a greater accessability of reactive cross-linking sites on the collagen molecules. Better stress relaxation rates are likely associated with an increase in potential shearing between adjacent collagen fibres thus preserving the natural stress-reducing mechanism of the fresh, untreated valves. The dynamically treated valves therefore possess characteristics that may enable them to better resist long-term mechanical fatigue and in vivo degradation.

Animals↗
PubMed1996

Biological fixation of subtrochanteric fractures by external fixation.

Fifty-one subtrochanteric fractures have been stabilized by external fixation over the last 9 years. Union occurred in all types of fractures, usually within 6 months. Soft tissue interposition led to non-union in three patients. Refracture in one patient and significant limb-length discrepancy in two patients was seen. The technique is versatile, easily reproducible and 'biological'. Protected weight-bearing is not necessary after removal.

Adult↗
PubMed2003

Closed reduction transarticular Kirschner wire fixation versus open reduction internal fixation in the treatment of Bennett's fracture dislocation.

Thirty two patients with fracture dislocations of the base of the thumb metacarpal with a single large fracture fragment (Bennett's fracture) were either treated by open reduction and internal fixation or closed reduction and percutaneous transarticular Kirschner wiring. All were assessed at a mean follow up of 7 (range 3-18) years. Patients with an articular step off more than 1mm were excluded. The type of treatment did not influence the clinical outcome or the prevalence of radiological post-traumatic arthritis. The percutaneous group had a significantly higher incidence of adduction deformity of the first metacarpal. This was attributed to Kirschner wire placement near the fracture line or in the compression zone of the fracture, resulting in loss of reduction. This however did not result in an inferior outcome.

Adult↗
PubMedDate not supplied

Biomechanical comparison of conventional open reduction and internal fixation versus calcium phosphate cement fixation of a central depressed tibial plateau fracture.

OBJECTIVE: To evaluate the effect of calcium phosphate bone cement on stability and strength of the fracture repair in a central depressed tibial plateau fracture cadaveric model. DESIGN: Paired human cadaveric tibial specimens. SETTING: Biomechanics laboratory. PATIENTS: Uniform pure depression fractures of lateral tibial plateau were created in twenty human cadaveric tibial specimens. INTERVENTION: The first part of the study used thirteen pairs of tibiae in two groups: a control group receiving the conventional treatment of morselized bone graft and two cancellous screws and an experimental group receiving calcium phosphate bone cement only. The second part of the study used seven pairs of tibiae in two experimental groups: one receiving calcium phosphate bone cement with a more extensive void preparation and the other group receiving calcium phosphate bone cement with a more extensive void preparation and two screws. MAIN OUTCOME MEASUREMENTS: Each tibia was loaded on a Material Testing Systems machine from twenty newtons to 250 newtons for 10,000 cycles to simulate immediate postoperative load transmission to the tibial plateau. Specimens were then loaded to failure to determine the ultimate strength of the reconstruction. Displacement of the articular fragment and stiffness at each cycle were measured during dynamic loading. Peak load, deformation at peak load, and resistance to depression were measured during the load to failure. RESULTS: The treatment of depressed tibia plateau fractures with a calcium phosphate cement provides equivalent or better stability than conventional open reduction and internal fixation in pure depression tibial plateau fractures. If the fracture void is prepared by eliminating the cancellous bone under the subchondral plate, the results are further improved. CONCLUSIONS: This study suggests that the non-weight-bearing postoperative period may be significantly reduced without clinically significant articular collapse.

Absorptiometry, Photon↗
PubMedDate not supplied

A comparison of nonthreaded, enhanced threaded, and Ellis fixation pins used in type I external skeletal fixators in dogs.

Three different pin types (Ellis, enhanced threaded, and nonthreaded) were used in type 1 external skeletal fixation after transverse osteotomy of the radius and ulna in 12 skeletally mature dogs. Dogs were placed into three groups of four dogs based on the pin type used. Axial extraction forces were determined for each of the pin types after 8 weeks of weight bearing (chronic study). Nine contralateral radii were used to determine axial extraction forces for nine of each pin type not subjected to weight bearing forces (acute study). The force required for extraction of the enhanced threaded and Ellis pins in the chronic and acute studies was not significantly different. The force required to extract the nonthreaded pins was significantly less than that required for the other two pin types. Ground reaction forces had returned to levels measured before surgery by 2 weeks after surgery in the enhanced threaded and Ellis pin groups, however, dogs in the nonthreaded pin group required 4 weeks until normal ground reaction forces were measured. Radiographic evaluations 1, 2, 4, 6, and 8 weeks after surgery showed no difference among groups in the number of pin tract radiolucencies, however, the enhanced threaded pins had caused more trans-cortical chip fractures than the other two pin types. None of the pins broke during the eight-week chronic study.

Animals↗
PubMed1978

Fixation of pelvic fractures and dislocations. An experimental study on the loading of pelvic fractures and sacro-iliac dislocations after external compression fixation.

A trapezoid external compression fixation frame, assembled with the Hoffman instruments, was used for stabilizing experimental injuries to the pelvic skeleton of ten cadaver specimens. The resistance to loading in a position corresponding to upright standing was tested in 17 experiments and related to the calculated load in vivo. The results indicated that ipsilateral injuries, either presenting as dislocations of the sacro-iliac joint and symphysis or as unilateral fractures of the sacrum or ilium in combination with fractures of the pubic rami could be stabilized by the external compression frame well enough to permit weight-bearing in the upright standing position. Bilateral injuries to the pelvic skeleton, vertical or oblique, could not, however, be stabilized enough to resist more than a fraction of the normal load in the upright standing position.

Aged↗