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At least 685 records · Page 38Linked to original sources
PubMed1999

Use of the fork plate for internal fixation of periprosthetic fractures and osteotomies in connection with total knee replacement.

Six cases of periprosthetic fractures of the distal femur following total knee arthroplasty were treated with a newly developed fork plate. Instead of the blade of the condylar plate, this implant features two prongs that are adaptable in length. Because of the space between the prongs, the distal femoral fragment surrounds the anchorage pegs of the prosthesis and can be gripped near the joint line. The average patient age was 74 years. Follow-up ranged between 2 and 54 months. All patients were mobilized immediately postoperatively. Full weight bearing and bone consolidation was achieved by 9 weeks postoperatively.

Aged↗
PubMed1999

Extensor mechanism sparing approach to the elbow for reduction and internal fixation of intercondylar fracture of the humerus.

OBJECTIVE: To evaluate the short term results of extensor mechanism sparing approach to the elbow for fixation of intercondylar fractures of the distal end of humerus and compare it with existing Surgical approaches. DESIGN: This is a prospective study conducted from June, 1992 to June, 1997. SETTING: Department of Orthopaedic Surgery, Jinnah Postgraduate Medical Centre and Mehran Clinic (Pvt.), Karachi. PRINCIPLE OF SURGICAL APPROACH: This approach is based upon the principle that by sparing the extensor mechanism, we reduce the amount of surgical trauma and help in early rehabilitation which can contribute in improving the results of this difficult fracture. RESULTS: There were nine type 2 fractures, eight type 3 fractures and four type 4 fractures according to Rise borough and Radin classification. Based upon the same authors criteria, there were over all 57.14% good 23.81% fair and 19.04% poor results. Adequate exposure was achieved in all of type 2 and seven (87.5%) out of eight type 3 fractures. We failed in type 4 fractures. Mean operating time was 107.38 (+/- 24.67) minutes. CONCLUSION: The results in this series are comparable to other studies. They can however be improved with proper selection of cases, experience with the technique along with better fixation and rehabilitations.

Elbow↗
PubMed2000

Osteocutaneous radial forearm free flaps. The necessity of internal fixation of the donor-site defect to prevent pathological fracture.

BACKGROUND: Osteocutaneous radial forearm free flaps have fallen from favor due to pathological fractures of the radius. The purposes of this study were to propose a means to decrease the rate of pathological fracture by prophylactic fixation of the donor-site defect and to evaluate this technique biomechanically. METHODS: Two groups of ten matched pairs of fresh-frozen cadaveric radii were harvested. In Group 1, an eight-centimeter length of radius comprising 50 percent of the cross-sectional area of the bone was removed to simulate an osteocutaneous radial forearm donor-site defect. This defect was created in one member of each pair, with the other bone in the pair left intact. In Group 2, both members of the ten matched pairs of radii had identical defects created as previously described. However, one radius in each pair had a twelve-hole, 3.5-millimeter dynamic compression plate placed across the segmental defect. In each group, five matched pairs were tested to failure in torsion and five matched pairs were tested to failure in four-point bending. RESULTS: In Group 1, the intact radius was a mean of 5.7 times stronger in torsion and 4.2 times stronger in four-point bending than the radius with the segmental resection. In Group 2, the radius that was ostectomized and fixed with a plate was a mean of 4.0 times stronger in torsion and 2.7 times stronger in four-point bending than the ostectomized radius. CONCLUSIONS: Removal of an eight-centimeter segment from the radius dramatically decreased both torsion and bending strength. Application of a plate over the defect in the radius significantly restored the strength of the radius (p = 0.01).

Biomechanical Phenomena↗
PubMedDate not supplied

Heterotopic ossification in rehabilitation patients who have had internal fixation of an acetabular fracture.

High-energy trauma patients often have multiple injuries and are frequently seen by a physiatrist following their acute care. Acetabular fractures are common in this patient population. Following surgical treatment of acetabular fractures, a very high incidence of heterotopic ossification can occur. We describe 94 patients who underwent posterior surgical fixation of an acetabular fracture. Of these, 87 received heterotopic ossification prophylaxis in the form of irradiation or indomethacin; 5 did not receive prophylaxis. Seven of the 45 patients who were initially started on indomethacin had their medication discontinued for various reasons. Of the 12 patients who did not receive adequate prophylaxis, 5 developed disabling heterotopic ossification. We present our experience with this patient population, and we discuss the importance of adequate prophylaxis for heterotopic ossification.

Acetabulum↗
PubMedDate not supplied

Immediate passive mobilization of the hip after internal fixation of acetabular fractures.

The authors report the results obtained in 16 patients affected with displaced fracture of the acetabulum treated surgically and mobilized passively immediately after surgery by means of a continuous passive mobilization apparatus for the hip. The age of the patients at the time of trauma ranged from 21 to 54 years. The posterior wall was involved in 12 cases, while the anterior column was also involved in 4. Excellent or good reduction of the fracture was obtained in all of the cases. Immediately after surgery, a continuous passive motion apparatus for the hip was applied to be used for approximately 3 weeks. At final follow-up, which was obtained after a mean time of 5 years, all of the patients except 2 had obtained good results. Moderate joint deficit was present in 1 case, while sciatic nerve palsy that had already been observed prior to surgery persisted in another. Evident radiographic signs of coxarthrosis were not present in any of the cases. Based on the opinion of Salter et al. (1980), who in an experimental study had observed better healing of the cartilaginous lesions in the joints submitted to movement, immediately after surgery we applied a continuous passive motion apparatus for the hip in a group of patients affected with fracture of the acetabulum. As none of the patient followed-up by us presented evident signs of hip arthrosis, the authors hypothesize that continuous passive movement, immediately carried out after osteosynthesis, plays a significant role in preventing post-traumatic arthrosis of the hip. In truth, small irregularities of the acetabular cavity, possibly present after an apparently anatomical reduction, could be minimized by the plasmating effect of the head of the femur in movement.

Acetabulum↗