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Results for “FRACTURE FIXATION”

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PubMed1997

Reliability of PMMA bone cement fixation: fracture and fatigue crack-growth behaviour.

Fracture mechanics tests were performed to characterize the fracture toughness and fatigue crack-growth behaviour of polymethylmethacrylate (PMMA) bone cement, commonly used in joint replacement surgery. Compact tension specimens of various thicknesses were prepared and tested in both air and Ringer's solution. Contrary to previous reports citing toughness as a single valued parameter, the PMMA was found to exhibit resistance-curve behaviour with a plateau toughness of approximately 0.6 MPa m1/2 in air, and approximately 2.0 MPa m1/2 in Ringer's solution. The increased toughness in Ringer's solution is thought to arise from the plasticizing effect of the environment. Under cyclic loads, the material displayed true mechanical fatigue failure in both environments; fatigue crack-growth rates, da/dN, were measured over the range approximately 10(-10) to 10(-6) m/cycle and found to display a power-law dependence on the stress intensity range, DeltaK. The cement was found to be more resistant to fatigue-crack propagation in Ringer's solution than in air. Wear debris was observed on the fatigue fracture surfaces, particularly those produced in air. These findings and the validity of using a linear-elastic fracture mechanics approach for viscoelastic materials are discussed in the context of providing more reliable and fracture-resistant cemented joints.

Journal Article↗
PubMed1990

Holding power impaired in rheumatoid femoral heads. Cadaveric study of fracture fixation devices.

A measurement was made of the holding strength and the energy needed to extract a NoLok hip screw, a von Bahr screw, and a Hansson hookpin from cadaveric femoral heads. The specimens were obtained from female subjects aged 65 years or more, with 36 specimens each from rheumatoid (RA) and nonrheumatoid (non-RA) donors. Retraction of the implants was made by a continuous uniaxial pullout at 10 mm/min. For each type of device, the holding strength in rheumatoid femoral heads was less than in non-RA specimens. In rheumatoid specimens the maximum holding strength for the NoLok screw (1,622 N) was higher than that of the other two devices, whereas the von Bahr screw (1,177 N) had a higher maximum holding strength than the Hansson hook-pin (603 N). In non-RA, there was no difference in maximum holding power between the NoLok screw (2,549 N) and the von Bahr screw (2,282 N); however, both had a higher holding strength than the Hansson hook-pin (851 N). A rapid fall off was experienced in the force required to continue extraction of both types of screws, whereas for the Hansson hook-pin the strength decreased slowly. For each type of device, the energy needed for extraction of the implant was less in the RA group femoral heads, while there were no differences in total extraction energy between devices.

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PubMed1998

[Absorbable self-reinforced biomaterials used for fracture fixation implants].

A series of absorbable polymers used for osteosynthesis implants are introduced in this review. To reduce the degradation rate and increase the strength of them, some methods, such as self-reinforced or coating with other polymers, have been presented. Some clinical and animal's experiments have been discussed.

Absorbable Implants↗
PubMed1996

Early, full weightbearing with flexible fixation delays fracture healing.

Secondary fracture healing is known to be accelerated by the process of periosteal callus formation that can be induced by flexible fracture fixation in connection with loading of the injured extremity. The purpose of this study was to compare the healing of experimental fractures of long bones in sheep under early weightbearing with that of fractures under delayed, steadily increasing weightbearing. Differences in the quality of fracture healing were described by biomechanical (rigidity of fracture, indentation stiffness of callus) and histologic methods. Prevention from early, full weightbearing resulted in a higher flexural rigidity of the fracture, an increased mechanical stiffness of the callus tissue, and an enhanced bone formation at the healing front. Although early loading of a fresh fracture initiated an enormous amount of periosteal callus, the healing of the osteotomy was significantly delayed, and the quality of the newly formed tissue was reduced as compared with fractures with a reduced loading situation. A reduction of load transfer by delaying full weightbearing is advantageous for the healing of fractures stabilized with flexible fixation systems.

Animals↗
PubMed1978

The strength of metal reinforced methylmethacrylate fixation of pathologic fractures.

Fixation of the pathological fracture in terminal patients has in the past added the trauma of an extensive surgical procedure to an already weakened patient. Intramedullary fixation with single and double rods in conjuction with polymethylmethacrylate have been compared to ascertain the effect of different loading conditions using torque and analysis under compression measurements of the strength of repair bone. Extensive intramedullary reaming can be avoided with polymethylmethacrylate. The cement effectively transmits the load from the proximal to the distal fragment. The single large rod method would be more desirable for stiffer bones while the double thin rod technique may be applicable to more flexible bones.

Animals↗
PubMed1995

A biomechanical comparison of two methods of fixation of fractures of the forearm.

In this study two different types of forearm internal fracture fixations were compared: limited-contact dynamic compression (DC) plates and fluted intramedullary (IM) rods. Eight matched pairs of intact forearms, consisting of the distal part of the humerus, elbow joint, radius, ulna, interosseus membrane, wrist joint, and metacarpals, were randomly separated into two groups. Each was placed into a custom-designed apparatus and subjected to medial bending, supination, pronation, axial compression, and distraction loading. Loads were applied by a materials testing system, and angular displacements were measured by inclinometers. The procedure consisted of first testing specimens intact, then retesting after osteotomizing and fixing the radius with either a plate or rod in half of the group and retesting after osteotomizing and fixing the ulna in the other half. Testing was continued by osteotomizing and remaining intact bone to create a two-bone fracture, fixing them, and retesting after creating a 5-mm gap at the osteotomy sites. These tests showed that the intact ulna contributes more to forearm stability in bending and torsion than does the radius. Therefore, if the radius is fractured but the ulna remains intact, IM rodding will produce constructs with greater stiffnesses, particularly in torsion, than if the ulna is fractured and the radius is intact. In the case of a two-bone fracture, implantation of rods will result in a construct with significantly less stiffness in torsion, as well as distraction and compression (in the case of a fracture gap), than if the fractures were plated.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomechanical Phenomena↗
PubMed1996

Absorbable devices in the fixation of fractures.

Totally absorbable internal fracture fixation devices were introduced clinically in the treatment of fractures and osteotomies of the extremities at our department in 1984. A total of 2,500 patients were managed using bone or ligament fixation devices made of self-reinforced (matrix and fibers of same polymer) absorbable alpha-hydroxy polyesters between November 5, 1984, and January 12, 1994. The devices used included cylindrical rods or pins, screws, tacks, plugs, and wires. The most common indication for the use of absorbable implants was displaced malleolar fracture of the ankle. Transphyseal fixation with small-diameter polyglycolide pins was used in children. The postoperative clinical course was uneventful in over 90% of the patients. The complications included bacterial wound infection in 3.6% and failure of fixation in 3.7%. In one-fifth of these cases, however, reoperation was not necessary. The occurrence of noninfectious foreign-body reactions 2 to 3 months postoperatively has been observed in 2.3% of the patients operated in the last years with polyglcolide implants but in none of the patients with polylactide implants. This inflammatory tissue response often required aspiration with a needle or small incision but did not influence the ultimate functional or radiologic result of treatment. Owing to the biodegradability of these internal fixation devices, over 1,000 implant removal procedures were avoided during the 9-year period under review, allowing medical personnel at these facilities to focus on other procedures. Avoidance of removal procedures results in financial benefits and psychological advantages. The benefits of absorbable implants for war surgery are the same as for civilian life. Absorbable implants can also be used in open fractures and infection operations.

Absorption↗
PubMed1988

[Fixation of fractures of the femoral neck using screws or hook-pins. Radionuclide study and short-term results].

In a prospective randomized investigation, AO screws (53 cases) and hook-pins (57 cases) were used for femoral neck fracture fixation in 110 cases. The results of the one-week postoperative scintimetry and a four-month radiographic follow-up were analysed. The femoral head vitality according to scintimetry was similar in the two groups, whether undisplaced or displaced fractures. Within four months from the operation, six cases with screw fixation had been subjected to total hip arthroplasty while only one with hook-pins, all because of fracture redisplacement. However, at the four-month control, another more fracture operated on with screws and five more operated on with hook-pins were scheduled for hip arthroplasty. Thus, no difference between the two methods regarding postoperative femoral head vitality or complications in short term follow-up, was noted.

Adult↗
PubMed2004

Nancy nailing of diaphyseal forearm fractures. Single bone fixation for fractures of both bones.

We identified 25 children (10 girls and 15 boys) who had been treated with single bone intramedullary fixation for diaphyseal fractures of both forearm bones. Their mean age was 10.75 years (4.6 to 15.9). All had a good functional outcome. We conclude that in selected children, single bone intramedullary nailing is a suitable method of treatment for diaphyseal fractures of both bones of the forearm.

Adolescent↗
PubMed2002

The role of biofilm formation in percutaneous Kirschner-wire fixation of radial fractures.

This study examines the formation of bacterial biofilms on percutaneous wires used for fracture fixation. Twelve control (clinically uninfected) wires and ten infected wires were collected and examined using broth culture and scanning electron microscopy. Three of the 12 control wires grew Staphylococcus spp. with very low bacterial counts in their percutaneous portions. In the clinically infected wires, six wires in four subjects had positive cultures in their percutaneous portions and four of these also had positive cultures in their deep portions with much higher bacterial counts than the controls. In two patients (four wires) treated with antibiotics, cultures were negative except for the percutaneous portion of one wire. Scanning electron microscopy did not reveal bacterial biofilm formation, but biological deposit without bacteria was noted on most wires. During the 6 weeks of fracture fixation, some bacterial colonization of wires occurred, but bacteria did not form biofilms which may increase bacterial resistance to systemic antibiotics, cause implant loosening and act as a source of late infection.

Biofilms↗
PubMed1996

Postoperative radiographs or thermal prints after internal fixation of fractures? A study of DHS fixation of hip fractures.

Immediate postoperative radiographs confirm the quality of reduction and fixation of fractures. This information is already available from the image intensifier and can be saved as hard copy thermal prints. If thermal prints give the surgeon the necessary patient and clinical information them immediate postoperative radiography should not be required. In this retrospective study of 20 hip fractures treated by dynamic hip screw (DHS) fixation, plain radiographs and thermal prints were compared for the patient and clinical information they contained. Thermal prints were found to be deficient in some areas but, nevertheless, can potentially replace postoperative radiographs in many orthopaedic procedures saving time, money and radiation exposure.

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