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At least 721 records · Page 40Linked to original sources
PubMed1985

Monitoring the healing of a tibial osteotomy in the rabbit treated with external fixation.

Fracture site axial rigidity was monitored non-destructively at weekly intervals during healing of tibial osteotomies in adult rabbits. Two groups of 20 rabbits each were treated with external fixators of two different rigidities. Four animals from each group were killed at 3, 5, 6, 7, and 8 weeks to determine the bending moments at failure of the healing fractures. Normal fracture healing was accompanied by characteristic phases in the development of fracture site axial rigidity. From 0 to 3 weeks there was a period of low and approximately constant rigidity, followed by a linear increase during 3 to 5 weeks to an approximately three to four times greater rigidity. The maximum average normalized axial rigidities were reached at 6 weeks and were 57% (high rigidity group) and 77% (low rigidity group) of the untreated contralateral controls. The maximum average normalized failure moments occurred at 8 weeks and were 48% (high rigidity) and 44% (low rigidity) of controls. The differences due to fixator rigidity were not statistically significant except for a large increase in failure moments at 3 weeks for the low rigidity group. Axial rigidities were correlated (r2 = 0.74 and 0.53, respectively) with failure moments, but only during the first 6 weeks. The monitoring technique provides a nondestructive means for following the biomechanical progress of fracture healing in an animal model. The occurrence of the characteristic increase in fracture site axial rigidity at 3 to 5 weeks can also be used to distinguish between normal and abnormal healing.

Animals↗
PubMed2005

Arthroscopically assisted retrodrade intramedullary fixation for fractures of the distal femur: technique, indications and results.

The purpose of this study is to present our experience with the technique, the problems and the potential pitfalls of arthroscopically assisted retrograde femoral nailing for supracondylar femoral fractures. In a 2-year period, nine patients (seven women, two men, average age 72 years) with supracondylar femoral fractures were treated in our department with a retrograde nailing under arthroscopic control. The mean operative time was 63.8 min (42-84 min) and the mean follow up period was 34.5 months (ranged 12-52). Solid union of the fracture was achieved in all patients without additional intervention, in 14 weeks (range 12-18). There was no malalignment (more than 5 degrees in any plane) or implant failure. In conclusion we believe that the arthroscopically assisted technique is a very good method to treat supracondylar fractures of the femur. It has very low morbidity since the knee is not opened through the operation, and the surgeon has the ability to inspect the joint for any additional damage. It is very helpful in multitrauma patients and in young patients, where the precision of the entry point is critical. However, we do not recommend the technique in intraarticular fractures because the reduction is difficult and the fixation is performed with safety only under direct vision.

Adult↗
PubMed2002

Open reduction and internal fixation of fractured mandibular condyles by a retromandibular approach: surgical morbidity and informed consent.

Treatment of fractured mandibular condyles remains controversial. In this paper we present data collected prospectively on 42 fractured condyles treated by open reduction and internal fixation. The central issue, which is sometimes forgotten, is the informed consent of our patients. To this end we have looked at the surgical morbidity related to the retromandibular approach.

Adult↗
PubMed2000

The use of minimally invasive fixation in fractures of the hand--the minifixator concept.

The minimally-invasive treatment of metacarpal and phalangeal fractures with a low profile external fixator is described. In most sites fixator pins are inserted percutaneously and closed reduction of the fracture is performed. Due to the special design bridging of adjacent joints in shaft, distal or proximal fractures is not necessary unless the fracture is intraarticular. The results of treatment are described. Advantages and disadvantages of a small external fixator in relation to conservative management and open reduction and internal fixation are discussed.

Bone Nails↗
PubMed1999

Open reduction and internal fixation of fracture of the posterior process of the talus: a case report and review of the literature.

A fracture of the posterior process of the talus is rare. In this report, we present a case of isolated displaced fracture of the posterior process of the talus, which was treated by early open reduction and internal fixation through a posteromedial approach. The fracture healed without evidence of avascular necrosis of either the posterior fragment or the talar body. The purpose of this article is to highlight the importance of early postoperative management of this uncommon type of fracture.

Adult↗
PubMed1992

Complications of smooth pin fixation of fractures and dislocations in the hand and wrist.

A retrospective review of patients treated with internal fixation of fractures or dislocations of the hand or wrist over a four-year period was undertaken to determine the complication rates of pin fixation for stabilization of these injuries. One hundred thirty-seven patients who received 422 pins were studied. All pins were unthreaded, measured 0.035-0.069 inches (0.9-1.8 mm) in diameter, were placed with a power drill, and were left protruding through the skin. The mean time that pins were left in place was 6.5 weeks, (range, two days to 24 weeks). Minimum follow-up time was 43 days after pin removal. Thirty-four complications occurred in 24 patients, and the overall complication rate was 18%. Forty-five of the 422 pins were involved (11%). Complications included infections in ten patients (7%), pin loosening without infection in six (4%), loss of reduction in six (4%), symptomatic nonunion in six (4%), impaled flexor tendon in two (2%), asymptomatic pseudarthrosis in one (1%), pin migration in one (1%), median nerve injury in one (1%), and radial artery injury in one (1%). Osteomyelitis developed in two of the patients with infections. Pin tract infection occurred at a mean time of ten weeks and aseptic loosening at a mean time of eight weeks. The frequent complication rates emphasize the need for meticulous pin placement, adequate intraoperative evaluation of pin position, and satisfactory patient compliance. Despite the frequency of these complications, serious permanent sequelae did not occur in most patients.

Bone Nails↗
PubMed1998

Drill-hole guide for internal fixation of fractures of the mandibular condyle.

We have developed a drill-hole guide valuable in accurately positioning the fracture of the mandibular ramus. It operates by introducing a Kirschner wire through the fracture stump from the mandibular angle to the condyle. A 2.0- to 2.4-mm-diameter Kirschner wire is drilled into the ramus from below and proceeds up to the condylar fragment through the stump of the fracture. With this guide, 15 patients with 23 subcondylar fractures underwent open reduction with Kirschner wire fixation. In each case, wire, by means of a pinning technique, was inserted accurately from the mandibular angle to the repositioned condyle.

Adult↗
PubMed1980

Internal and external fixation of fractures in children.

We have illustrated instances in which open reduction with internal or external fixation should be used in the care of fractures in children. These methods should be used when closed reduction fails or in other circumstances in which they are the initial treatment of choice. At no time should the surgeon hesitate to utilize these operative options if they represent the best method of achieving the most functional end result in a pediatric fracture.

Child↗
PubMed1979

[An experimental study on various internal fixations in fracture of a long bone (author's transl)].

In the operative treatment of a long bone fracture, the most important point is to secure the bone healing and to strengthen the bone after removal of internal fixation materials. In this regards, the author has analyzed the mechanical strength of various internal fixation methods (a plate, a medullary nail, screws and encircling wires) on the bone by using acrylics models. Experimental studies of their influences on the bone have also been performed especially investigating the decrease in the bone strength in rabbits. All of internal fixation materials are made of 316L stainless steel. Recently, there has been a tendency to use larger materials for internal fixations such as an AO compression plate or a Küntscher type medullary nail. However, it was found that the rigid plate fixation greatly affects the bone strength. A medullary nail produced less impairment to the bone. But this method is restricted in its application because of the weak fixability of the torsional load. On the other hand, the internal fixations with screws or encircling wires are weaker than the other methods especially against the bending load. Therefore the commencement of postoperative treatment will be delayed. But, these two methods have little influence on the bone during fixation.

Animals↗
PubMed1975

Instramedullary supramid pin and plate-screw fixation for fracture of the humerus.

A method of fixing the humerus is presented. A supramid pin is introduced into the medullary cavity and a plate with screws is attached to the bone surface. The screws are driven through the fracture fragments into the supramid pin. The resulting fixation is firm and suitable for certain complicated cases in which the usual fixation methods have their limitations.

Adult↗
PubMed1978

Internal fixation of fractures.

In recent years close consideration of the biomechanical principles of treatment of mandibular fractures has led to the use of operative as well as conservative methods. Since this combined method of treatment appeared cumbersome, a new kind of osteosynthesis plate was developed for functionally stable internal fixation of mandibular fractures, without the necessity of additional fixation elements. After consideration of the biomechanics of the mandible, an even greater indication for the use of the lag-screw osteosynthesis is found. Use of both the tension band plate and the lag screw makes it possible to perform the operation intraorally. This is a further indication for the use of the operative internal fixation of fractures in the treatment of mandibular fractures, since it has many advantages for the patient.

Bone Plates↗
PubMed1994

Open reduction and internal fixation of fractures of the acetabulum. Results in 163 fractures.

Management of displaced fractures of the acetabulum represents one of the greatest challenges in fracture surgery. This study reports intermediate term results for a single surgeon of 163 fractures in 161 patients treated by open reduction and internal fixation. The mean length of followup was 3.7 years. The most common fracture patterns treated were both column (67), transverse/posterior wall (32), posterior wall (14), and T shaped (12). The surgical approaches chosen were ilioinguinal (86), Kocher-Langenbeck (58), and extended iliofemoral (26) with 7 patients having sequential or simultaneous dual approaches. Reductions were rated by plain radiography and considered anatomic in 93 (56%) and near anatomic (< 2 mm displacement) in 40 (25%). There were 7 (4%) infections, 2 (1%) vascular injuries, 3 (2%) sciatic injuries, and 1 (1%) obturator nerve injury. Overall outcome was rated as excellent in 23 (14%), good in 101 (61%), fair in 25 (16%), and poor in 14 (9%). Nine patients have undergone hip salvage procedures. These results add to the growing body of clinical data which validates open reduction as the treatment of choice in most displaced fractures of the acetabulum.

Acetabulum↗
PubMed1991

Degradation of and tissue reaction to biodegradable poly(L-lactide) for use as internal fixation of fractures: a study in rats.

Samples of high-molecular-weight poly(L-lactide) (PLLA) (Mv = 9.0 x 10(5), a biomaterial developed for plates and screws used in internal fixation of jaw fractures, were implanted subcutaneously in the backs of rats to study tissue reaction to PLLA and to follow the degradation process. The PLLA seemed to follow the degradation pattern typical of biodegradable polyesters. After pure hydrolysis up to about 104 wk, phagocytic activity of macrophages was found at about 143 wk. Full resorption of PLLA was not demonstrated in this study. Except for the early and final parts of the implant period, no acute or chronic inflammatory reaction was observed. No implant was rejected. It is estimated that more than 3 yr will be required for total resorption of PLLA. For bone-healing this long period is of no practical importance. There is no need for removal of PLLA after fracture healing as is the case with metal fixation devices. Thus, PLLA has potential application in internal fixation of fractures and osteotomies in the maxillofacial region and other fractures that are not too heavily loaded in the human body.

Animals↗
PubMed2005

The effect of low intensity ultrasound and bioabsorbable self-reinforced poly-L-lactide screw fixation on bone in lateral malleolar fractures.

INTRODUCTION: There are no previous reports of low intensity pulsed ultrasound therapy in connection with bioabsorbable fracture fixation. In this randomised, prospective, double-blind and placebo-controlled study, the effects of ultrasound on bone mineral density and bone healing were examined in lateral malleolar fractures fixed with a bioabsorbable self-reinforced poly-L-lactide screw (SR-PLLA). MATERIALS AND METHODS: Thirty adult patients with SR-PLLA screw-fixed lateral malleolar fracture underwent ultrasound therapy 20 min daily for 6 weeks. Half of the patients were provided randomly with a sham ultrasound device. Bone mineral density and bone healing were assessed by dual-energy X-ray absorptiometry (DXA) and by radiographs. RESULTS: Bone mineral density of the fractured lateral malleolus tended to increase slightly during 12 weeks of follow-up. The increase was symmetrical and statistically non-significant between the ultrasound and non-ultrasound group. All the fractures healed uneventfully. The biocompatibility of the bioabsorbable SR-PLLA fixation device and low intensity pulsed ultrasound was good. Despite the slight tendency for more frequent callus formation in the ultrasound group, no statistically significant effect of low intensity pulsed ultrasound on lateral malleolar fracture healing could be observed. CONCLUSION: It was not possible to observe any statistically significant effect of low intensity pulsed ultrasound on lateral malleolar fracture healing in this study. Further studies are needed to examine the role of ultrasound therapy in the healing of fractures treated with bioabsorbable fixation devices.

Absorbable Implants↗
PubMed2007

Safe zone for the placement of medial malleolar screws.

BACKGROUND: Hardware placement for fracture fixation can put soft-tissue structures at risk for injury or abutment. The prominence of the hardware is a frequent cause of pain after the fixation of ankle fractures. This study was designed to assess the risk of injury or abutment of the posterior tibial tendon with the placement of medial malleolar screws. METHODS: Ten unmatched cadaveric limbs that had been disarticulated at the knee were used, and the medial malleolus was exposed by dissection of the skin. With use of fluoroscopy and direct visualization of the deep fascia, three Kirschner wires were placed through the tip of the medial malleolus and directed parallel to the medial articular surface. The first wire was placed in the center of the anterior colliculus. Two additional wires were placed parallel and posterior to the initial wire at 5-mm intervals. The wires were overdrilled, and 4.0-mm screws were inserted over the Kirschner wires. The specimens were dissected to inspect for trauma and the proximity of the screws to the posterior tibial tendon. The medial malleolus was divided into three zones on the basis of anatomic landmarks. Zone 1 is the anterior colliculus; Zone 2, the intercollicular groove; and Zone 3, the posterior colliculus. RESULTS: Screws placed in Zone 1 (the anterior colliculus) did not contact the posterior tibial tendon in any specimens. Screws placed in Zone 2 (the intercollicular groove) were, on the average, 2 mm from the posterior tibial tendon. Screws placed in Zone 3 (the posterior colliculus) resulted in tendon abutment in all ten specimens and in tendon injury in five of the ten specimens. CONCLUSIONS: Screws inserted posterior to the anterior colliculus place the posterior tibial tendon at significant risk for injury or abutment.

Adult↗