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[The experimental study of PDLLA/rhBMP-2 compound screws for internal fixation of mandibular fracture].

OBJECTIVE: To study the effect of poly D,L-lactic acid (PDLLA) screws with PDLLA-rhBMP compound on bone regeneration in the screw holes and fracture ends of dog mandibles. METHODS: A self-control study was carried out in 4 dogs. PDLLA/rhBMP-2 compound screws were implanted to fix the mental fractures and PDLLA screws were used as control. The samples from mandibles were collected at 4, 8, 12, 16 weeks after implantation and observed by radiography and histology. RESULTS: All dogs showed a greater degree of bone regeneration around PDLLA/rhBMP-2 screws than PDLLA ones and all fractures were fixed and healed well. CONCLUSION: The PDLLA-rhBMP screw has a better effect of inducing osteogenesis than PDLLA screw, and is able to exert a good fixation to fracture.

Animals↗

Unstable pelvic ring injuries. Outcome and timing of surgical treatment by internal fixation.

OBJECTIVE: To evaluate the radiological and functional results of surgical treatment of unstable pelvic injuries and to study the factors affecting the final outcome. METHODS: Thirty-eight patients with unstable type C pelvic injuries from King Khalid University Hospital, Riyadh and North West Armed Forces Hospital, Tabuk, Kingdom of Saudi Arabia during the period January 1996 through to January 2001 were reviewed. There were 31 males and 7 females. The mean age was 37-years. Thirty-two patients had 76 associated skeletal fractures. A percutaneous iliosacral screw was carried out for all patients in the study. Anterior stabilization was needed for 23 patients. RESULTS: There were 2 complications of fixation, an iatrogenic S1 root injury and dismantled symphyseal plate. The average hospital stay was 29 days and the average time to start mobilization was 15 days. The radiological result was satisfactory in 32 patients (84%) while functional result was satisfactory in 27 patients (71%). CONCLUSION: Unstable pelvic ring injuries should be managed surgically and must be carried out as soon as the general condition of the patient allows, even up to 4-weeks.

Adolescent↗

[Predictive criterions of unrecognized articular effraction after internal fixation of femoral neck fractures].

On the basis of a retrospective study comprising 91 cases of femoral neck fracture treated by DHS, unrecognized screw articular penetration was observed in 9 cases (9.9%). The coxa valga (Garden I) fractures are the most interested by this complication (7 cases out of 9). With a practical purpose and to avoid remarking each time complex measurements again we found that the distance "d" separating the end of the implant from subchondral bone calculated on antero posterior and lateral views and so the angle measured on the lateral view were two criteria significantly predictive of this technical error with respectively P: 0.005 and P: 0.0005. Thus during the surgical procedure taking these two measurements after the installation of the pin guide would allow attention on the risk incurred. In case of doubt, we have changed the way of this pin before resorting to drilling and tapping.

Bone Nails↗