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At least 919 records · Page 51Linked to original sources
PubMed2002

[Using unstable fractures of the distal end of the radius: open reduction and internal fixation with T - type plate].

OBJECTIVE: To treat unstable fractures of the distal end of the radius with open reduction and internal fixation with T-type plate. METHODS: 45 patients were treated with T-type plate. Bone graft was used in fifteen patients with severe bone defect. Clinical findings of 45 patients with fractures of the distal end of the radius (one is bilateral fractures) showed fairly good results. RESULTS: The patients were followed up for an average period of 25.36 months. 41 patients showed excellent or good results with a rate of 91.11%. CONCLUSION: It is difficult to reduce unstable fracture of the distal end of the radius in the way of close reduction. Re-displacement is frequent for external fixation and is not reliable in maintaining reduction. These fractures should be treated with early open reduction and internal fixation, and reasonable exercise should be taken after the operation. Good results can be predicted. The most important factors affecting final outcome include radial shortening and reduction of articular surface.

Adolescent↗
PubMed1985

Avoidance of avascular necrosis of the femoral head, following fractures of the femoral neck, by early reduction and internal fixation.

Clinical, experimental and post-mortem studies suggest that avascular necrosis of the femoral head following fractures of the neck of the femur, is due to compression, torsion, stretching or rupture of the blood vessels by displacement of the fragments. If this is true then urgent reduction and internal fixation are important in the prevention of this complication. This study shows that those cases which were submitted to early reduction and internal fixation had a reduced incidence in severity of avascular necrosis compared with those in whom operation was delayed. Therefore it is proposed that fractures of the femoral neck should be treated by early reduction and internal fixation.

Aged↗
PubMed2004

Subciliary incision and lateral cantholysis in rigid internal fixation of zygomatic complex fractures.

OBJECTIVE: To introduce the technique of subciliary incision and lateral cantholysis with tri-dimension reduction and rigid internal fixation to treat zygomatic complex fractures. METHODS: The subciliary incision and lateral cantholysis combined with tri-dimension reduction and rigid internal fixation of zygomatic complex fractures with titanium microplates were applied in 56 patients with zygomatic complex fractures. Another lateral eyebrow incision or sublabial incision was used to simplify the operation. RESULTS: The postoperative follow-up period ranged from 6 months to 5 years. During the follow-up period, all the patients had satisfying postoperative results. All clinical symptoms disappeared except the numbness in the infraorbital region in 2 patients. In 94.6% patients no complications such as obvious scar, ectropion, entropion or blepharoedema were found, only 5.4% of the patients had slight ectropion 6 months after operation. CONCLUSIONS: The subciliary incision and lateral cantholysis have many advantages such as invisible scar, sufficient exposure, minimal injury, and few complications and combined with rigid internal fixation with titanium microplates this technique could be used as one of the routine operation methods to treat zygomatic complex fractures.

Adolescent↗
PubMed2003

Open reduction and internal fixation of fractures of the acetabulum--local experience.

INTRODUCTION: It is now widely accepted that open reduction and internal fixation of displaced acetabular fractures should be the standard of care. This paper reports a case series of acetabular fracture fixation performed at the Changi General Hospital by a single trauma surgeon. PATIENTS AND METHODS: A retrospective study was conducted of 15 consecutive cases of displaced acetabular fracture fixation between February 1996 and September 1999. Outcome was assessed radiologically and functionally with the use of a hip scoring system used by Matta. RESULTS: The patients' age had a mean of 34.9 years. All fractures were a result of high energy trauma. The median duration to operation upon admission was eight days. The mean hospital stay was 24.9 days and the mean medical hospitalisation leave was 159 days. Bony union was achieved in all patients. Two patients (13.3%) had a residual displacement of 1 mm. Four patients (26.6%) had a residual displacement of 2 mm. Of these four patients with 2 mm displacement, two eventually developed osteoarthritis. Subsequently, one of the two with OA required revision to a total hip arthroplasty two years post fracture. Other complications include 1 (6%) wound infection and 2 (13%) deep vein thrombosis. There were no complications of heterotopic ossification or sciatic nerve injury. Functional scores with a minimum follow up of one year and a mean of 22.6 months follow-up were excellent in 13.3%, good in 66.7%, fair in 13.3% and poor in 6.7%. CONCLUSION: The number of cases in this paper is insufficient to produce any statisticallly significant outcome predictors but accuracy of reduction is an important factor. A good to excellent result was attained in 80% of the patients which confirms that open reduction and internal fixation is the treatment of choice for displaced and acetabular fractures.

Acetabulum↗
PubMed1988

Open reduction and internal fixation of volar lip fractures of the distal radius.

Fractures of the volar lip of the distal radius are relatively uncommon injuries. However, controversy exists concerning the treatment of these fractures. We reviewed our experience with open reduction and internal fixation through a volar approach using buttress plates. Sixteen patients with 17 fractures were treated by this method. Their ages ranged from 16 to 65 years (average 38 years). Eight fractures occurred secondary to motor vehicle accidents, while the remaining patients sustained falls. Mean follow-up time was 19.5 months. All fractures healed with no infections. Sixteen of the fractures were treated primarily with open reduction and internal fixation, while one patient was treated 6 weeks after injury for a malunion. Ranges of motion averaged 71 degrees dorsiflexion, 60 degrees palmar flexion, 79 degrees pronation, 78 degrees supination, 22 degrees radial deviation, and 32 degrees ulnar deviation. Analysis of results demonstrated 12 excellent, 2 good, and 3 fair results. Two patients with fair results had nonanatomic restoration of the joint surface at surgery, while the other patient with a fair result was treated late. We recommend early open reduction and internal fixation of displaced or unstable volar lip fractures of the distal radius. Accurate anatomic alignment and stable fixation are achieved with the volar buttress plate. Motion can begin 2-3 days after surgery to aid in obtaining excellent functional results.

Adult↗
PubMed1977

[Minimal internal fixation of fractures in elder children (author's transl)].

The fractures in elder children (9--17 years) need a special treatment. Regarding the exact reposition they have to be handled like the fractures of adults. Regarding localisation, morphology of the bone and the way of internal fixation they have to be treated like those of smaller children. The "Minimal-Osteosynthesis" primarily means adaptation, refixation and continuous retention. The procedure is less traumatizing, however the indication should be as strictly as in other cases. The minimal osteosynthesis is giving more respect to the growing bone. The material of internal fixation may be removed much earlier than in adults. Stability for early physical exercises is rarely necessary in children. Even different types of minimal internal fixation are possible. A number of cases are demonstrated.

Accidents, Home↗
PubMed2003

Functional outcome of open reduction and internal fixation for completely unstable pelvic ring fractures (type C): a report of 40 cases.

OBJECTIVES: To evaluate functional outcomes, morbidity and mortality rates, and psychological and psychosomatic status in patients treated for completely unstable pelvic injuries (Tile class C). DESIGN: Prospective clinical study. SETTING: University hospital. PATIENTS/PARTICIPANTS: Forty patients treated with anterior and posterior internal fixation for unstable pelvic ring fractures between January 1992 and August 1999. INTERVENTION: Open reduction and anterior and posterior internal fixation of the pelvic ring. MAIN OUTCOME MEASUREMENTS: The data were analyzed as follows: pelvic fracture classification, Tile classification; severity of trauma, Injury Severity Score (ISS); functional outcomes, the Majeed Outcome Scale; psychological and psychosomatic status, Hamilton Depression and Anxiety Rating Score (HDARS). RESULTS: Preoperatively the average ISS was 29.4 (range 12-66). There was a statistically significant positive correlation between anxiety and ISS (r = 0.536, P < 0.01). Two patients died during the early postoperative period. Two additional patients were lost to follow-up, leaving 36 patients followed for an average of 45 months (range 21-116 months). Deep infections developed in three patients with a posterior pelvic ring injury who had been treated with percutaneous fixation techniques. These were treated successfully with débridement. Nine patients complained of pain of pelvic origin. Nerve deficits recovered completely in four of the seven patients with preoperative neurologic deficiency. Moderate or major depression was diagnosed in sexually dysfunctional patients in the 12th postoperative month according to HDARS (r = -0.559, P < 0.001). At the last visit, there was an inverse correlation between ability to work and depression and anxiety (r = -0.551, r = -0.391). An inverse correlation was found between pain and ability to work (r = 0.597, P < 0.001). Of the 36 patients, 26 returned to their original jobs at the last follow-up visit. CONCLUSIONS: Morbidity and mortality rates are higher in patients with a completely unstable pelvic ring injury. Emergency department stabilization and reconstruction of the pelvic ring with optimal operative techniques in these patients can reduce morbidity and mortality rates. Anterior and posterior internal fixation results in satisfactory clinical and radiologic outcomes. The affective status of patients is an important aspect that should be considered during the entire care of the patient.

Adolescent↗
PubMed1980

Primary open reduction and internal fixation of open fractures.

Our experience with primary open reduction with rigid internal fixation of 50 open fractures is presented. Twenty-seven patients had associated major multiple trauma. Twenty fractures were articular and 26 involved 3rd-degree wounds. The infection rate of 4%. A system of staged sequential debridement and wound management is presented. The authors believe this system has contributed to the low infection rate. No secondary amputations occurred. Eighty-two per cent of the patients had good functional results using Charnley's criteria. Fatal post-traumatic cardiopulmonary failure did not occur. The authors feel that early definitive fracture care employing rigid fixation which avoids casts, and allows improved wound management and early mobilization of the multiple-trauma patient, has decreased the cardiopulmonary and metabolic consequences commonly associated with polytrauma patient care.

Adolescent↗
PubMedDate not supplied

Primary internal fixation of carpal navicular fractures in the athlete.

Primary open reduction and internal fixation is an established procedure for treatment of carpal navicular fractures. With the use of an alignment device, the surgery can be performed on outpatients, under local anesthesia, in 30 to 45 min. The wrist is splinted in a protective device for approximately 6 weeks but no cast is necessary. Four of 13 patients in this series have been athletes. The procedure has allowed them to participate in sports during the healing period and to return to contact sports 6 to 8 weeks postoperatively without joint protection. These athletes have regained full range of motion in the wrist joint. Although the procedure is not recommended for hairline fractures which usually heal quickly or comminuted fractures of the navicular, it appears to be the treatment of choice for fractures of the carpal navicular bone at the level of the middle and proximal third of the bone or any displaced fragment with malposition in the axial or rotary plane.

Athletic Injuries↗
PubMed1991

[Internal fixation of fractured ribs with Kirschner wires for serious traumatic chest instability].

Internal fixation of fractured ribs with kirschner wires was done in 14 patients with serious traumatic chest wall instability. Four of these patients had fracture of prothorax ribs, and 10 fracture of lateral thorax ribs. This method can not only stabilize the chest wall but also reduce the fractured ribs. It is an ideal treatment for serious traumatic chest wall instability. In this paper, operative opportunity, indication and the main technical points of surgery are discussed.

Adult↗
PubMed1978

[The management of mandibular fractures by internal fixation (author's transl)].

The results of treating mandibular fractures with rigid internal fixation are discussed. This method was used in 55 patients through the application of dynamic compression plates. The technique was then assessed critically and the followup treatment evaluated. Indications and contraindications for the procedure are discussed, as are possible errors or complications. In addition, selected cases illustrating the advantages of the procedure for reconstruction and functional rehabilitation of mandibular defects following ablative surgery or trauma are described.

Bone Plates↗
PubMed2006

Prophylactic internal fixation of the radial osteocutaneous donor site.

The technique of prophylactic internal fixation (PIF) of the radial osteocutaneous donor site is described and reviewed. Twenty-two donor sites were reinforced with a 3.5mm dynamic compression plate across the anterior defect. The incidence of fracture was 4.5% (1 out of 22). The single fracture was due to a technical error and was managed conservatively. Fracture at a donor site that has not been plated is more frequent and often becomes displaced, requiring secondary surgery. In contrast, the incidence of fracture, displacement and secondary surgery following prophylactic internal fixation (PIF) is relatively low. There have been no significant long-term complications with PIF. It is now the method of choice for managing the radial osteocutaneous donor site.

Bone Plates↗
PubMed2000

The posterolateral approach to the distal humerus for open reduction and internal fixation of fractures of the lateral condyle in children.

Our study describes a posterolateral approach to the distal humerus for open reduction and internal fixation of displaced fractures of the lateral condyle. A total of 20 patients had open reduction and internal fixation over a four-year period using this approach, and at a mean follow-up of 12 months had full union, range of movement and no complications, either clinical or radiological. This approach is well suited to the exact visualisation and accurate reduction of this difficult fracture with minimal dissection of tissues.

Adolescent↗
PubMedDate not supplied

Internal fixation of a displaced tibial sesamoid fracture.

The authors present a surgical technique for the preservation and repair of an acutely fractured sesamoid using internal fixation of the sesamoid. A case report demonstrating the technique for the open reduction and internal fixation of a fractured tibial sesamoid is presented. The authors recommend this procedure as a viable alternative to surgical excision of the tibial sesamoid. The use of the procedure as an adjunct for the surgical treatment of recalcitrant traumatic sesamoiditis is also discussed.

Accidents, Traffic↗
PubMed1980

Internal fixation versus endoprosthesis in the treatment of femoral neck fractures in the elderly. A prospective analysis of the comparative costs and the consumption of hospital resources.

The consumption of hospital resources and the costs involved in treating femoral neck fractures in the elderly were studied and a comparison was made between internal fixation (von Bahr screws) and primary prosthetic replacement (Christiansen's endoprosthesis). The 1-year results of screw fixation were excellent or good in 55% of the patients, fair in 17% and poor in 28%, compared with 79% excellent or good results, 13% fair and 8% poor results in the prosthetic group. As regards the initial stay in hospital, prosthetic replacement was found to be associated with 2.4 times higher costs. This difference was reduced, however, by a more expensive follow-up and more frequent readmissions and reoperations in the internal fixation group. Considering the total costs, prosthetic replacement was found to be 1.6 times more expensive than internal fixation.

Aged↗
PubMed1991

Clinical application of sapphire pins as an internal fixation device for the upper extremity.

Since June 1980, sapphire pins (monocrystalline alumina ceramic pins) have been used in 22 patients as an internal fixation device for hand and elbow problems. In our follow-up studies, good bone healing was observed in all cases except for one delayed union in a fracture of the diaphysis of the proximal phalanx. Radiographs showed no pin migration or osteolytic reaction around the pins. We therefore conclude that our device and its insertion technique can be successfully applied to intraarticular fractures and fractures in the vicinity of the joint.

Adolescent↗
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↗
PubMed1986

Techniques of internal fixation for degenerative conditions of the lumbar spine.

The indications and techniques for internal fixation of the lumbar spine in degenerative conditions have changed drastically since internal fixation was first applied to the spine almost 100 years ago. Anterior instrumentation and fusion may be used for repair of pseudarthrosis after posterolateral fusion; symptomatic lumbar scoliosis associated with degenerative disc disease; late pain secondary to posttraumatic kyphosis; postlaminectomy instability; and lumbar pain secondary to thoracolumbar kyphosis. Posterior instrumentation and fusion has been performed with Luque instrumentation over 3-4 levels in cases of multilevel instability. Combined anterior and posterior instrumentation and fusion are required for lumbosacral fusion in lumbar scoliosis with degenerative disease, and surgical correction of postsurgical lumbar kyphosis (flat-back syndrome). The techniques are demanding but with attention to detail can be performed with acceptably low-complication rates.

Fractures, Bone↗