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At least 37 records · Page 2Linked to original sources
PubMed2003

Treatment of nonunions following anterior cervical discectomy and fusion with interspinous wiring and bone grafting.

Between 1979 and 2000, 25 posterior arthrodeses were performed for repair of symptomatic nonunions following anterior discectomy and fusion. The surgical technique in all cases was an interspinous wiring with an autogenous bone graft in 20 and morselized allograft bone in five. The average follow-up was 5 years (range, 1-14 years). In all patients, the anterior pseudarthrosis progressed to a solid union as judged by an independent musculoskeletal radiologist. In 17 patients, their preoperative pain was relieved; however, of these, six developed recurrent pain caused by degeneration at an adjacent level on an average of 5 years (range, 1-14 years) after their posterior surgery. The authors propose that posterior interspinous wiring with a bone graft is a safe and efficacious method of repair of an anterior pseudarthrosis. However, patients must be cautioned that even though the pseudarthrosis can be predictably repaired by a posterior procedure, preoperative pain may not be relieved.

Bone Transplantation↗
PubMed1995

Influence of intraoperative femoral fractures and cerclage wiring on bone ingrowth into canine porous-coated femoral components.

Intraoperative femoral fractures occur more frequently with cementless than with cemented components. In this study, the influence of controlled femoral fractures fixed with cerclage wires on rotational stability and bone ingrowth into porous-coated canine femoral components was evaluated. These data were compared with results of previous studies on unrecognized femoral fractures (not stabilized) and on the intact canine femur. Micromotion analysis revealed a significant increase in rotational instability in fractures not stabilized with cerclage wires (P < .05) compared with the intact femur. Experimentally created femoral fractures had a significantly deleterious effect on bone ingrowth even after cerclage wiring. This appears to be caused by a lack of bone ingrowth deep to the fracture and an increase in femoral component micromotion. In clinical practice, femoral fractures occurring during cementless total hip arthroplasty are a serious problem, and use of a cemented prosthesis is recommended if rotational stability of the stem cannot be ensured.

Animals↗
PubMed1976

Atlanto-axial fusion in rheumatoid arthritis. A new method of fixation with wire and bone cement.

Twenty-eight occipito-cervical fusions performed over the past 4 years in patients with rheumatoid arthritis are discussed. All of the patients with one exception had signs of neurological involvement preoperatively due to pressure on occipital nerve roots, spinal cord and/or vertebral arteries. A surgical technique using wire, pin and bone cement and permitting early mobilization without external fixation was used and is described in detail. The clinical results were excellent in 21 cases with an additional five patients showing improvement. One patient did not benefit from surgery and one had no symptoms preoperatively. The results are encouraging and the possibility of early mobilization (the day after surgery) is of the utmost importance for this group of patients.

Adult↗
PubMed1979

Bending properties of wire-reinforced bone cement for applications in spinal fixation.

PMMA beam specimens were tested in four-point bending to determine if the bending strength of acrylic bone cement, as used in posterior spinal fusion, could be improved by metal-wire reinforcement. The result showed that the load-carrying capacities of 1- and 0.5-mm diam stainless-steel-wire-reinforced PMMA specimens in bending were significantly higher than similar unreinforced normal PMMA samples. On an average, steel reinforcement comprising approximately 1% of the cross-sectional area of the PMMA specimens caused a 15% increase in bending strength. Even after the cement fractured, the reinforcing wires still sustained an appreciable amount of bending moment, thus preventing catastrophic failure of cement alone.

Bone Cements↗
PubMed2006

Tensioning technique and fixator stability of a circular external fixator with threaded fine wires.

Hybrid external fixators have become more popular over recent years, and although biomechanical tests show varying results from paper to paper, a consistent finding is shear motion occurring at the fracture/osteotomy site during loading. This can be reduced to some extent by frame configuration, and with the use of olive stop wires, but both of these have limitations. We have investigated the use of threaded fine wires in a circular hybrid fixator. A reliable tensioning method is described which minimises movement at the wire-bone interface during tensioning, and threaded wires are seen to offer a significant improvement in fracture site shear stiffness when compared to smooth fine wires.

Animals↗
PubMed1993

Mechanical performance of external fixators with wires for the treatment of bone fractures--Part II: Wire tension and slippage.

The work shows correct procedures needed in order to gather reliable data from measurement of displacements versus axial load in a laboratory mounting of the Ilizarov external fixator. The mechanism of settling after load cycling is investigated. Detension under load is a major problem of wires. By means of vibration frequency measurements, tests on single wire allow determination of reduction in wire tension due to transverse loading: it is found that, almost independently from the amount of clamp tightening, the tension reaches a lower limit related only to the transverse load and not related to pretension. It is shown that, for higher clamp tightening torques, wire detension must be attributed to permanent plastic deformation of the wires; moreover, it is shown that the unavoidable errors in the spacing of the tensioned wires lead to marked decrease of their stiffness under transverse load.

Biomechanical Phenomena↗
PubMed1993

Atlanto-axial stabilization with posterior transarticular screw fixation: technical description and report of 22 cases.

Magerl's technique of combining C1-C2 posterior screw fixation with a supplemental bone-wire fusion has been advocated for the management of atlanto-axial instability. Between October 1990 and August 1992, a modification of this technique was used in the treatment of 22 patients with this disorder. In the absence of spinal deformity or neoplastic disease, screw fixation and bony fusion were used alone without associated wiring, thus avoiding the risk of neural injury resulting from the sublaminar passage of wire and the retrodisplacement of ventral structures. Patient ages ranged from 30 months to 80 years; follow-up ranged from 5 to 27 months, with a mean of 14.9 months. The causes of the instabilities were as follows: eight cases of nonunion of Type II odontoid fracture, four cases of rheumatoid arthritis, three cases of tumor, two cases of ligamentous instability, two cases of pseudoarthrosis after bone-wire fusion, two cases of halo noncompliance, and one case of Os odontoideum. All 20 patients who underwent fusion were placed in a Philadelphia collar for 12 weeks. Nineteen of 20 (95%) patients achieved solid fusion. Twenty-one of 22 (95%) had significant reduction in preoperative pain. No patient developed myelopathy or bulbar findings. The one intraoperative complication was an inability to achieve secure screw purchase on one side that required unilateral screw placement with a Gallie fusion-using cable. Postoperative complications included one patient with a superficial wound infection that resolved after local debridement and antibiotics and suboccipital numbness in two patients. Progression of spinal deformity, screw pullout or breakage, and neurological or vascular complications did not occur.(ABSTRACT TRUNCATED AT 250 WORDS)

Atlanto-Axial Joint↗
PubMed1998

Brown-Sequard syndrome caused by a Kirschner wire as a complication of clavicular osteosynthesis.

A case of spinal cord injury caused by delayed migration of a Kirschner wire is reported. Some cases of distant injuries caused by bone wires, and acupuncture needles have been published, but this is the first reported case of delayed thoracic spinal cord damage caused by the migration of a clavicular wire. A 22-year-old male patient was admitted with a clinical picture of spinal shock after performing physiotherapeutic exercises. Two months prior to this, the patient had undergone surgical treatment for a clavicular fracture in a different clinical center. Imaging showed a clavicular wire had migrated into the spinal canal. An early prescription of a spinal cord methyl-prednisolone protective treatment (NASCIS II), the surgical extraction of the foreign body and the rehabilitation exercises were the keys to a quick recovery.

Adult↗
PubMedDate not supplied

Effect of cerclage wires on periosteal bone in growing dogs.

Three diameters of wire were placed circumferentially around the femora of six 22 week old puppies. The wires were placed over the periosteum on one limb and under the periosteum on the other limb. The effect of the wires on actively growing bone was evaluated 3 and 8 weeks after placement. Diffuse growth of periosteal new bone occurred in immature dog femora in which cerclage were placed under the periosteum. This reaction corresponded with dramatically increased medullary and periosteal microvascularity coupled with histologic active trabecular bone formation. In femora in which wires were placed over the periosteum, even though the placement of the wires should supposedly have been the most detrimental, there were active vessels within the cortex directly under all wires. In both preparations, cerclage wires were becoming encased in the growing cortical bone 8 weeks after placement. Cerclage wires did not devitalize immature bone nor did it restrict adjacent appositional bone growth.

Angiography↗
PubMed1985

Microvascular and histologic effect of circumferential wire on appositional bone growth in immature dogs.

Circumferential wires were placed around both midshaft femora of six immature dogs. On one side the wires were placed under the periosteum and on the other side the wires were placed over the periosteum. All wires were tightened to an equivalent tension. A diffuse growth of periosteal new bone occurred in those femora in which wires were placed under the periosteum but not in those over the periosteum. Corresponding microangiographs at 3 weeks in those femora in which wires were placed under the periosteum revealed dramatically increased medullary and periosteal vascularity coupled with histologic active trabecular bone formation. In those femora in which the wires were placed over the periosteum, even though the placement of the wires should supposedly have been the most detrimental, vascularity was not restricted. There were perfused vessels within the cortex directly under the wires. At 8 weeks the wires in both preparations were becoming encased in the growing cortical bone. Cerclage did not devitalize immature bone nor did it restrict adjacent appositional bone growth.

Angiography↗
PubMed2002

Posterior atlantoaxial fixation: biomechanical in vitro comparison of six different techniques.

STUDY DESIGN: Six different techniques for atlantoaxial fixation were biomechanically compared in vitro by nondestructive testing. OBJECTIVE: To evaluate the immediate three-dimensional stability of a new atlas claw combined with transarticular screws and alternative techniques for transarticular screw fixation in comparison with established techniques. SUMMARY OF BACKGROUND DATA: Posterior transarticular screw fixation in combination with wire-bone graft constructs is frequently used for C1-C2 fixation. Sublaminar wire passage carries the potential risk of neurologic complication. Transarticular screw fixation is technically demanding and, for anatomic reasons, not always feasible. METHODS: Six human cervical specimens were loaded nondestructively with pure moments, and unconstrained motion at C1-C2 was measured. The six specimens were instrumented with each of the following fixation techniques: Gallie fixation, transarticular screws and Gallie fixation, transarticular screws, transarticular screws and a new atlas claw, isthmic screws in the axis and the atlas claw, and lateral mass screws in the atlas and isthmic screws in the axis connected with rods. RESULTS: The transarticular screws restricted lateral bending and axial rotation best. The three-point fixations (transarticular + Gallie and transarticular + claw) additionally restricted flexion-extension, with lowest values for transarticular screws and the atlas claw. The alternative techniques were not as stable as the three-point fixations, but more stable than the Gallie fixation. CONCLUSIONS: Biomechanically, the three-point fixation with transarticular screws and the atlas claw provides a rigid internal fixation that is not dependent on bone graft and sublaminar wiring. In cases wherein transarticular screws are not feasible, the isthmic screws and claw or the lateral mass screws and isthmic screws are biomechanical alternatives with less immediate stability.

Aged↗
PubMedDate not supplied

The role of bone marrow in bone morphogenetic protein-induced repair of femoral massive diaphyseal defects.

The midshaft of the femur of one-year-old rats was resected and the reparative process completely blocked by distraction of the bone ends with an omega-shaped wire. Bone repair extended retrograde instead of across the diaphyseal defect and invariably culminated in nonunion. New bone was induced to grow across the defect by implantation of BMP, and regeneration was similarly enhanced by transplantation of autologous marrow, but union was produced only by composite transplants of marrow and implants of BMP. Union occurred more rapidly from the transplant-implant composite than from autologous cortical bone. These observations suggest that bone marrow stroma cell include both pre-existing osteogenic precursor cells and mesenchymal cells that respond to BMP by differentiating into osteoblast for the repair of large femoral bone defects.

Animals↗
PubMedDate not supplied

A more reliable method for incudostapedial rebridging ossiculoplasty: bone cement and wire.

Polymaleinate glass ionomer cement is a commercially available bone cement (Ketac Cem Radiopaque, ESPE, Germany) that can be used to reconstruct a discontinuity between the incus and the stapes. The popularity of bone cement in otologic surgery is increasing. If the missing part of the incus is too long, the results in the long term could be unsatisfying. Under such circumstances, a new method of incudostapediopexy that uses wire and involves remodeling of the long process of the incus with bone cement is introduced. A retrospective analysis of the outcomes of incudostapedial rebridging ossiculoplasty (ISRO) procedures carried out in 21 patients between June 1999 and September 2003 was performed. A total of 17 patients were treated with bone cement only; in 4 of these patients, hearing loss reoccurred within 6 months. The procedure was repeated in 2 of these patients using both bone cement and wire with satisfactory hearing results (air-bone gaps, 7.5 and 8.8 decibels hearing level [dB HL]) after 1 year. Four patients underwent ISRO wire and bone cement initially. The long-term results of these 6 "wire-and-cement" cases, which were followed for a mean of 21 months, were satisfactory (air-bone gap, 9.8 dB HL). The postoperative air-bone gap in the 15 patients who were treated by ISRO with bone cement only excluding the 2 reoperation cases was 12.1 dB HL. ISRO with bone cement is a cost-effective and safe procedure that yields good hearing results in selected cases. If the distance between eroded incus and stapes is too long to be reconstructed with bone cement alone, the surgeon should consider using wire with bone cement.

Adolescent↗