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PubMed2001

[Analysis and experimental study of reasons for breakage in the bone fracture plate during internal fixation].

Bone fracture plate has been in clinical use for internal fixation of fracture, however, during healing, the steel plate breaks occasionally. This paper applied the static strength theory to imitate the pressed down combination out of shape that was borne by single limb of human body standing. Fracture was made on low limbs of the fresh dead body, fixed with a bone fracture plate. Strain measure was made on a bone fracture plate. Additionally, fatigue experiment and four-point bending experiment were carried out on a bone fracture plate. The reason for a breakage in the bone fracture plate was analyzed with static strength theory and low period fatigue theory.

Bone Plates↗
PubMed1986

The dorsal approach for internal fixation of fractures of the lateral malleolus.

Anatomic reduction and internal fixation of the lateral malleolus are the key to management of ankle fractures. The usual application of one-third tubular plates to the lateral surface of the distal fibula has certain disadvantages. In selected cases we prefer a dorsal approach to the lateral malleolus. Indications, technique and experience are discussed.

Adolescent↗
PubMed1995

The acetabular T-type fracture. A biomechanical evaluation of internal fixation.

The purpose of this study was to evaluate the stability of different types of internal fixation requiring anterior, posterior, or combined surgical approaches for the T-type acetabular fracture. Eight specimens were loaded 25 times in a cyclic manner to 150 N for each type of fixation construct evaluated. The model attempted to range the hip through an arc of motion anticipated in the limited activities expected after surgery. Strain gauges were placed on the 3 fracture planes of the T-type fracture. These gauges measured displacements. Internal fixation consisted of a single anterior column plate, compared with a single posterior column plate, compared with simultaneous placement of both anterior column and posterior column plates. The differences in displacements measured between the 3 types of fixation at each of the 3 fracture sites were not statistically significant. In evaluating motion at the anterior fracture line, the anterior plate made the largest contribution to stability, although this result was not statistically significant. The posterior plate similarly contributed most to posterior fracture stability, although again not statistically significant. Each of the 3 fixations controlled the inferior fracture line motions in a comparable manner.

Acetabulum↗
PubMed1993

Internal fixation of supracondylar fractures after condylar total knee arthroplasty.

Condylar buttress plates were applied in six patients with total knee arthroplasties and supracondylar fractures. According to the criteria of Cain, 50% of the patients had a satisfactory result with an average follow-up period of 17 months. Time to union (full weight bearing) averaged 14 weeks. The final coronal femorotibial alignment averaged 5 degrees of valgus, whereas preoperative valgus had averaged 8 degrees. Four patients were pain free and the two others had minimal pain that did not interfere with daily activity. Knee motion averaged 97 degrees. All patients were ambulating; five of six patients needed two crutches outdoors for reasons unrelated to the index fracture. Four patients had rheumatoid arthritis (RA) with multiple joint involvement, and the fifth was debilitated secondary to old age. No nonunion, loss of fixation, or infection occurred. Open reduction and internal fixation (ORIF) using the condylar buttress plate provides stable fixation, allowing early knee motion and ambulation. If extreme osteoporosis is present, the addition of bone cement enhances screw fixation.

Aged↗
PubMedDate not supplied

A newer plate system for internal fixation of un-stable pelvic fractures.

To fit for internal fixation of unstable fractures of various parts of the curved pelvis, plates of different shapes and sizes were devised. The plates were used in 18 clinical cases. The late complications such as leg length inequality, pelvic obliquity and low back pain were effectively avoided.

Adolescent↗
PubMed2000

Internal fixation versus hemiarthroplasty versus total hip arthroplasty for displaced subcapital fractures of femur--13 year results of a prospective randomised study.

In this prospective randomised trial we compare the mortality, morbidity and functional results of patients following each of the three principal methods of treatment for displaced subcapital fractures of the femur. Two hundred and ninety patients over the age of 65 years were included and randomly allocated to undergo closed reduction and internal fixation with a sliding compression screw plate or uncemented Austin Moore hemiarthroplasty or cemented Howse II total hip arthroplasty (THA). Nineteen patients were subsequently excluded. The 13 year results show that there was no statistical difference in the mortality between the three groups (81, 85 and 91% respectively). Internal fixation and hemiarthroplasty groups fared poorly with a revision rate of 33 and 24%, respectively, compared with 6.75% in the THA group. The dislocation rate was 13% following hemiarthroplasty and 20% following THA. Average Harris hip scores were 62, 55 and 80, respectively, for the internal fixation, hemiarthroplasty and THA groups. In the long term, both internal fixation and hemiarthroplasty resulted in a poor outcome with respect to pain and mobility. Despite high early complications, THA resulted in least pain and most mobility both in the short and long-term and was encouraging with a revision rate of only 6.25%. THA should be seriously considered in physiologically active patients with a displaced subcapital fracture of the femur.

Aged↗
PubMed2002

[Clinical study on two internal fixation methods Kaneda and Z-plate in the operation of anterior surgical approach after thoracolumbar fractures].

OBJECTIVE: To study the difference between two internal fixation methods Kaneda and Z-plate in the operation of anterior surgical approach and decompression after thoracolumbar fractures. METHODS: The bio-mechanical structure of the internal fixture, install when operating, complications and time of the operation were compared in the cases by Kaneda and Z-plate. RESULTS: Z-plate method had the following characteristics: reasonable of the bio-mechanical structure; stability after internal fixture being installed; capability of completely propping up the injured centrum and keeping the height of middle-column; simple operation when installing internal fixture and shorter time of operation (1.1 hours, P < 0.05); fewer complications. CONCLUSION: Z-plate is an ideal internal fixation method in the operation of anterior surgical approach after thoracolumbar fractures.

Adolescent↗
PubMedDate not supplied

Open reduction and internal fixation of comminuted radial head fractures.

Between November 1981 and November 1984, eight patients with comminuted radial head fractures were treated with open reduction and internal fixation. The recommended treatment for these fractures has been early motion, with or without radial head excision. According to the AO classification all were B3-1 or B3-2 fractures. All fractures were fixed through Kocher incisions using Kirschner wires and AO small fragment screws. All patients began motion 7 to 10 days following surgery. In a retrospective study, clinical results were reviewed in six patients with an average followup of 12 months (range, 4 to 40 months). Three patients had associated elbow dislocations, one requiring internal fixation of the coronoid process. Loss of range of motion averaged 3 degrees of flexion, 10 degrees of extension, 3 degrees of pronation, and 20 degrees of supination. Cybex testing demonstrated no significant difference in strength between injured and uninjured extremities. The only complication was a transient posterior interosseous nerve palsy. No patient had evidence of any radial shortening. Our findings suggest that open reduction and internal fixation gives satisfactory elbow function and avoids complications of radial shortening, loss of motion, and wrist symptoms that may subsequently occur following radial head excision.

Adult↗
PubMed1987

Internal fixation of fractures and dislocations in the cervical spine.

The treatment of fractures of the cervical spine, like that of fractures of the extremities, has been considerably improved in the last decade. The aim of these changes has been to prevent and correct deformities and to achieve such a high degree of primary stability with the use of different internal fixation techniques that traditional external fixation can be avoided. Non-stable internal fixation and laminectomies, which invariably result in further loss of stability, have thus been completely eliminated from the therapeutic arsenal. The new system implies a considerably milder course of treatment for the patient. Confinement to bed is limited to a few days, even for tetraplegic patients. The duration of stay in the hospital is short and any necessary rehabilitation can be started at an extremely early stage. This article describes some of the new techniques and provides examples of indications for and methods of performing stable internal fixation.

Adolescent↗
PubMed2006

[Anterior decompression and reconstruction with internal fixation for severe thoracolumbar burst fracture].

OBJECTIVE: To explore the injury mechanism of the severe thoracolumbar burst fracture and the necessity of anterior decompression and reconstruction with internal fixation. METHODS: From January 1999 to January 2004, 21 patients were treated with anterior decompression and reconstruction. The fractures were located at T12 in 6 patients, L1 in 12, L2 in 4, L3 in 3,and L4 in 1. Four patients were treated with the "anterior approach" and "posterior approach" surgeries for severe column fractures. RESULTS: All the patients were restored to the normal physiological radian, and the spinal canal was decompressed completely. They were followed up for 1-6 years, and the bony fusion was observed radiologically. The spinal cord function was improved to the 1-3 Frankel grade in all the patients except 2. There were no such complications as leakage of the cerebrospinal fluid, plate-screw loosening or breaking, or segment instability. The clinical effects were satisfactory. CONCLUSION: The operation of the anterior decompression and reconstruction with internal fixation for severe thoracolumbar burst fracture has advantages of complete decompression, full bone-grafting, and firm internal fixation. It can restore the spinal height and improve the spinal cord function.

Adult↗
PubMed1984

Internal fixation technique in pathological fractures of the extremities.

More often than not, the standard methods of internal fixation are insufficient to meet the demands of treatment of pathological fractures. In malignant diseases with improved survival rates, durability of the osteosynthesis is needed. The seemingly convenient prosthetic replacement therefore has to be regarded with caution. Good results without complications cannot be expected unless the fixation of the components is in healthy bone. In the younger patient with a curable disease, late complications have to be considered. We describe methods of internal fixation that satisfy these particular requirements, and pertinent clinical examples elucidate the techniques.

Adult↗
PubMed1998

The reconstruction twisted wire-screws for internal fixation of two- and three-part fractures of the proximal humerus.

Using the implants for internal fixation of the proximal humeral fractures has several problems which lead to complications and poor results of the fracture treatment. Because there is no suitable implant for internal fixation of the fracture. Therefore, the reconstruction twisted wire was developed in 1990 to improve the results of the fracture treatment. Between 1990 and 1994, the reconstruction twisted wire was used in 31 patients whose ages ranged from 18 to 90 years. Sixteen patients had displaced two-part surgical neck fractures. Fifteen patients had displaced three-part fractures. Postoperative follow-up ranged from two and a half years to five years and one month. All fractures healed. No avascular necrosis of the humeral head was observed at the follow-up. There was temporary subluxation of the shoulder joint in three patients and loosening of the screws in two patients with marked osteoporosis. One had a rupture of wire between the greater tuberosity and the shaft and loosening of the screw at the greater tuberosity and united with 10 degrees varus deformity. According to the functional scale proposed by Hawkins, 28 of the 31 patients achieved a "good" result and 3 patients had a "fair" result.

Adolescent↗
PubMed1989

Significance of urgent (within 6h) internal fixation in the management of fractures of the neck of the femur.

The value of internal fixation of fractures of the neck of the femur within 6 h was assessed in a review of a 3-year series. Three groups were compared, in which the operation was performed within 6 h, between 6 and 24 h and after 24 h respectively. The time and quality of union and the incidence of collapse of the head of the femur were significantly better in the first group. The difference in the results between the other two groups was not significant. In view of these data the authors recommend the internal fixation of fractures of the neck of the femur within 6 h.

Adolescent↗