Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Internal Fixators”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 937 records · Page 52Linked to original sources
PubMedDate not supplied

[Displaced femoral neck fractures: internal fixation or arthroplasty?].

Femoral neck fractures are a challenge for orthopedic surgeon due to the high rate of complication for such fractures. The aim of this study was to propose a treatment algorithm based on author's current concept in management of femoral neck fractures. Fractures were classified according Garden in four types but, for practical reasons, fractures were considered undisplaced (Garden I and II) and displaced (Garden III and IV). Treatment method was chosen based on next criteria: patient's age, associated pathology, patient's mental status and expectations, quality of the bone (osteoporosis), type and age of fracture, quality of reduction. Based on this criteria, the proposal algorithm may led to close reduction and internal fixation, open reduction and internal fixation or arthroplasty.

Aged↗
PubMed1999

Complications of internal fixation of maxillofacial fractures with microplates.

PURPOSE: The aim of this retrospective study was to evaluate the complications of open reduction and internal fixation of maxillofacial fractures with microplates. PATIENTS AND METHODS: In 44 patients with maxillofacial trauma, fractures of the maxillofacial skeleton were treated by open reduction and internal fixation using a 1.0-mm and 1.5-mm microsystem. Simultaneously occurring fractures of the mandible or frontozygomatic suture were treated with a 2.0-mm miniplate system. Perioperative and postoperative complications were traced using patient charts, operation reports, and radiographs. The average follow-up was 46.8 months (range, 31 to 54 months). RESULTS: A total of 124 1.0-mm microplates and 546 1.0-mm microscrews, and 17 1.5-mm microplates and 75 1.5-mm microscrews, was used. The perioperative complication rate was 1.2% for the 1.0-mm screws (use of four emergency screws, breakage of one screw in the dense frontozygomatic suture area, and an insertion of a screw in a premolar root). The postoperative complication rate was 0.8% for the 1.0-mm screws (screw dislocation without clinical implication). No complications were observed with the 1.5-mm system. Plate-related infection did not occur. All fractures healed well. Three patients asked for plate removal because of a vague, persisting pain in the treated area. After removal, only one patient was free of pain. A loose 1.5-mm screw was found in this patient. CONCLUSION: The overall complication rate for microsystems was 2.0%. Both microsystems proved to be a reliable modality to fix fractures of the maxillofacial skeleton. Complications can be considered incidental and of neglectable clinical significance.

Adolescent↗
PubMed2002

Open reduction and internal fixation of three and four-part fractures of the proximal part of the humerus.

BACKGROUND: Controversy persists concerning the preferred treatment of displaced fractures of the proximal part of the humerus. The present study was undertaken to evaluate the results of open reduction and internal fixation of three and four-part fractures of the proximal part of the humerus and the functional limitations of patients in whom avascular necrosis of the humeral head develops as a complication of this fracture. METHODS: We assessed the intermediate and long-term results for sixty patients with a three or four-part fracture of the proximal part of the humerus who had undergone open reduction and internal fixation with cerclage wires or a T-plate. The Constant score and a visual analog score for pain were calculated, and radiographs of the proximal part of the humerus were evaluated. RESULTS: After an average of ten years of follow-up, fifty-two patients (87%) had a good or excellent result on the basis of the Constant score whereas eight patients (13%) had a poor result. Fifty-one patients (85%) were satisfied with the result at the time of the most recent examination. Twenty-two patients (37%) had development of avascular necrosis of the humeral head, and seventeen (77%) of these twenty-two patients had a good or excellent Constant score. CONCLUSIONS: Open reduction and internal fixation with cerclage wires or a T-plate yields good functional results in most patients. This option should be considered even for patients with fracture-dislocation patterns that are associated with a high risk for avascular necrosis of the humeral head, as this complication did not preclude a good result.

Adult↗
PubMed2003

Avulsion fractures of the tibial tuberosity in adolescent athletes treated by internal fixation and tension band wiring.

Avulsion of the tibial tuberosity is a rarely reported fracture. It is mainly considered as an athletic injury accounting for less than 3% of all epiphyseal lesions. In this study, we hypothesized that the use of tension band wiring as a supplement of the internal fixation for the avulsion fractures of the tibial tuberosity would lead the adolescent athletes to a more effective rehabilitation program and an earlier resumption of their previous activity level. Ten patients were treated in our department over a period of 11 years (1985-1995). Operative treatment was thought necessary for all our cases due to tibial tuberosity displacement. Open reduction and internal fixation in combination with tension band wiring was used. The result in all cases was that the reduction was maintained intact and the fracture united. The functional results were excellent, and all patients returned to their previous athletic activities. Our conclusion is that the combination of internal fixation and tension band wiring for avulsion fractures of the tibial tuberosity seems to be more effective and advantageous than conservative or other surgical methods. Avoiding the need of external support and allowing early joint motion, the method described prevents serious quadriceps atrophy, allowing the young athletes to return earlier to their previous sport activities.

Adolescent↗
PubMed2004

[Comparison of internal fixation treatment of tibia intercondylar eminence fracture between absorbable screw and metallic screw].

OBJECTIVE: To compare advantage and disadvantage of internal fixation method for tibia intercondylar eminence fracture between absorbable screw and metallic screw. METHODS: From 1996 to 2002, 200 patients with fracture of tibia intercondylar eminence were divided into group A (with absorbable screw, n = 120) and group B (with metallic screw, n = 80). And the biological compatibility, biomechanics, bone union and complications were compared between two groups. RESULTS: There were no obvious differences in operating time and circumstance of recovery position between two groups. Group A was obviously better than group B in biological compatibility, biomechanics, bone union, joint function recovery. The average healing time of group A was three months, that of group B was three and half months. The good rates of joint function in two groups were 98.0% and 95.0% respectively. The occurrence rates of wound arthritis were 1.7% and 3.7%. There was significant difference between them (P < 0.01). CONCLUSION: Absorbable screw is a more ideal material of internal fixation to treat tibia intercondylar eminence fracture.

Absorbable Implants↗
PubMed1996

The effects of internal fixation on calcium carbonate. Ceramic anterior spinal fusion in dogs.

STUDY DESIGN: An anterior interbody fusion was performed in the canine thoracic spine. Either calcium carbonate or autologous iliac crest bone graft was used to fill a surgically created spinal defect between T7 and T8. Some of the spines were stabilized intraoperatively with anterior instrumentation. Four experimental arthrodesis groups were studied: iliac crest bone graft with or without instrumentation and ceramic with or without instrumentation. OBJECTIVE: To evaluate the effects of internal fixation on an anterior interbody fusion using calcium carbonate ceramic, and to compare this with autologous iliac crest bone grafting. SUMMARY OF BACKGROUND DATA: Bone grafting can be associated with significant morbidity, and an acceptable substitute material is sought. In vivo analysis of ceramic as a substitute has revealed fracture and failure of the implant. Creating a stable environment with internal fixation may improve the performance of ceramic as a bone graft substitute. METHODS: Fusions were evaluated in 20 adult beagles 8 weeks after surgery. Structural properties of the fusion segment were evaluated with biomechanical testing. Histologic analysis was performed to determine junction healing, new bone formation, and revascularization. RESULTS: Fusion segments with iliac crest bone graft and instrumentation were significantly stiffer than the other three groups in all tested modes of angular deformation. Greater junction healing was seen when instrumentation was used with iliac crest bone graft. Greater junction healing, new bone formation, and revascularization were observed when instrumentation was used with calcium carbonate ceramic. Most of the ceramic implants without fixation demonstrated near complete isolation with no revascularization. CONCLUSIONS: Internal fixation resulted in histologically and biomechanically superior healing of autologous iliac crest bone graft in this canine model of anterior interbody fusion. Although fixation did not statistically improve the biomechanical properties of ceramic fusion segments, it had a profound effect on the ability of the ceramic to be revascularized and remodeled. Porous ceramic bone graft substitutes appear to depend on a stable environment for incorporation.

Animals↗
PubMed1983

Internal fixation of malleolar fractures using the A.O. tension band wiring techniques.

The principle of tension band wiring in open reduction and internal fixation of malleolar fractures is presented in three case reports. A brief history of the classification of ankle fractures is given so that the mechanism of injury can be understood. This must be known when attempts at closed or open reduction and immobilization are done. If closed reduction fails to bring about good anatomical reduction and alignment, the fracture must be openly reduced and internally fixated. The chief indications for tension band wiring are given, and their application in treating ankle fractures.

Adult↗
PubMed2005

Biomechanical stability of high tibial opening wedge osteotomy: internal fixation versus external fixation.

PURPOSE: The goal of our study was to evaluate stability of internal fixation with a plate compared to external fixation in an opening wedge high tibial osteotomy model. Significance. To our knowledge, this is the only study to compare internal plate to external fixation in an opening wedge osteotomy model. The design of this cadaver study limits its direct application to clinical practice. MATERIAL AND METHOD: In each of the six pairs of fresh-frozen human cadaver knees one specimen was randomly assigned to internal plate fixation while the other was stabilized with an external fixation. The osteosynthesis plate incorporated a 12.5mm block that distracted the medial tibial cortices. Each knee was loaded on a mechanical testing machine to 700 N for 10,000 cycles to simulate immediate full weight bearing in a walking individual. SUMMARY OF RESULTS: The internal plate osteosynthesis provided significantly greater stiffness and smaller loss of correction (1.60mm) than the external fixation (3.22 mm) under cyclic loading condition (P<0.05). For static loading, the mean value of stiffness resulting in failure for the internal plate and external fixation, were respectively, 938 N/mm and 459 N/mm. Load to failure also showed two times greater stiffness in the plate osteosynthesis group. No hardware failure was observed in either construct. DISCUSSION AND CONCLUSION: Plate fixation was superior to external fixation in maintaining correction. However, progressive adjustment of the distraction with the external fixator allows precise "fine-tuning" during the healing process that is not possible with internal fixation.

Adult↗
PubMed1989

The mechanical and morphological properties of bone beneath internal fixation plates of differing rigidity.

The internal fixation of diaphyseal fractures by bone plates is a well recognized treatment. The normal physiological stress of bone is reduced by plates that cause a negative balance of bone-remodeling processes. Many investigators have shown that the degree of stress protection is dependent on the rigidity of the plates. It was the aim of this study to quantify mechanical and morphological changes at different locations in a plated diaphyseal bone as a function of differing plate rigidity. Two types of plates with the same size but different materials were used. The stainless steel plates had a modulus of elasticity and bending stiffness 3.2 times higher than the carbon fiber reinforced carbon plates. Both types of plates were applied to the intact right and left femora of six foxhounds for 6 months. The stiffer stainless steel plates led to a significantly higher bone loss and correspondingly greater loss of mechanical properties. These effects were greatest directly beneath the plate and less with increasing distance from the plate.

Animals↗
PubMed1991

Internal fixation of forearm fractures in the 1980s: lessons to be learnt.

A series of 156 diaphyseal forearm fractures in 108 patients were treated by internal fixation between 1980 and 1985. These cases have been critically reviewed in the light of the present knowledge and expertise of internal fixation. A total of 122 fractures were fixed with ASIF compression plates. An analysis of results shows that 17 patients (15.7 per cent) had a poor clinical symptom result, 29 patients (26.9 per cent) had a poor functional score, 14 (13 per cent) had a poor subjective and employment score, and 40 fractures (32 per cent) united after 18 weeks. Non-union rate was 10.3 per cent, the infection rate was 5.5 per cent and there were three cases (2.7 per cent) of synostosis. Only six patients had primary cancellous bone grafting. A statistical analysis of the variables which may affect the result shows that the most important factors are accurate reduction of the fracture, correct use of interfragmentary screw fixation and rigid fixation. Failure to observe these rules will produce a poor result. Fracture complexity and comminution, especially if combined with a butterfly fragment, predispose to a poor result.

Adolescent↗
PubMed1984

Extraarticular subtalar arthrodesis with internal fixation.

Forty extraarticular subtalar arthrodeses with internal fixation were performed in 26 patients with cerebral palsy who had a mobile, paralytic planovalgus deformity. We assessed the correction achieved and maintained by evaluating the clinical status, improvement in gait, correction of deformity, and foot stability. Union was achieved in a mean interval of 10 weeks with no instance of mechanical failure of the fixation screw. At a mean follow-up of 30 months, 38 feet (95%) were rated excellent or good and two were rated fair. The advantages of this technique of extraarticular subtalar arthrodesis warrant continued use of this procedure.

Adolescent↗
PubMed2006

[Open reduction and internal fixation of distal radius extension fractures in women over 60 years of age with the dorsal radius plate (pi-plate)].

PURPOSE: The goal of this study was to review the clinical and radiological results and to correlate them with the functional outcome score DASH in women over 60 years who underwent open reduction and internal fixation with a pi-plate for displaced distal radius fractures. METHOD AND CLINICAL MATERIAL: In this retrospective study, forty-nine women over 60 years old with mainly intra-articular distal radius fractures underwent open reduction and internal fixation with a pi-plate. The dorsal approach was used permitting an anatomical reduction of the articular surface under direct vision of the radio-carpal joint. Patient follow-up was for a minimum of twelve months with a mean of 32 months. RESULTS: For 71 % of patients, there were no limitations in their daily activities and only one patient complained of a major disability. Overall, the flexion of the wrist was reduced by 15 degrees compared to the opposite side (mean 50 degrees). The DASH score (14.4) was not higher than that of a comparable age controlled group without radius fracture. The pi-plate was demonstrated to be a stable implant in osteoporotic bone and there was only one secondary dislocation. Most patients were painfree with two patients describing tolerable pain, one because of a progressing radio-carpal osteoarthritis and the second due to a neuroma of the superficial branch of the radial nerve. The other major complication was a late rupture of the extensor tendon of the index finger in one of the twelve patients where the pi-plate had not been removed. CONCLUSION: We recommend anatomical reduction and internal fixation for displaced intra-articular distal radius fractures using a dorsal approach to achieve a good wrist function including painless load bearing with the implant removed four months after surgery.

Aged↗
PubMed1990

The treatment of nonunion of proximal tibial osteotomy with internal fixation.

Nonunion of proximal tibial osteotomy is a rare occurrence. Treatment goals should emphasize preservation of proximal tibial bone stock in view of possible subsequent total knee arthroplasty (TKA). Previous reports, in mostly smaller series, have emphasized the use of external fixation in the management of this problem. There have been no previous reports regarding the use of internal fixation in the treatment of nonunion occurring after tibial osteotomy performed proximal to the tibial tubercle. In this report, the results of internal fixation in the treatment of six cases of nonunion after proximal tibial osteotomy are analyzed with regard to functional and roentgenographic results. Healing of the nonunion was obtained in all six patients. Realignment of angulatory deformities was uniformly achieved. Achievement of union and correction of axial malalignment, in addition to creating an improved substrate for later TKA, provided other objectives as well. Elimination of pain and instability at the nonunion site allowed these patients to derive some of the intended benefits from the original osteotomy.

Female↗
PubMed1987

Role of internal fixation in infection of open fractures: studies with Staphylococcus aureus and Proteus mirabilis.

Studies of infections in open fractures are described. The hamster was chosen as the experimental model. Osteotomies of the femur were created with an osteotomy saw. Some osteotomies were left to heal and others were fixed with an 0.9 mm K-wire. The infection rates in fixed and unfixed fractures were compared. The first group of hamsters with fixed and unfixed osteotomies was returned to cages with open wounds. There was no difference in the infection rate at 2 weeks. The second group was deliberately contaminated with Staphylococcus aureus and then returned to cages with open wounds. In this group, the infection rate at 2 weeks was lower in the internally-fixed fractures than in the unfixed fractures. The third group was deliberately contaminated with the gram negative organism Proteus mirabilis. In these animals, the infection rate was increased in the presence of the internal fixation device. The fourth group was deliberately contaminated with both Staphylococcus aureus and Proteus mirabilis. The infection rate in these animals was very high; Proteus was recovered from those animals with internal fixation and Staphylococcus was recovered from those animals without internal fixation. These studies in the hamster document the usefulness of this animal as an inexpensive and reproducible model for studying infection of open fractures. The hamsters tolerated the procedure well, and wound and fracture healing progressed satisfactorily.

Animals↗
PubMed1985

Principles and application of internal fixation in cattle.

The principles of bone healing and vascular and periosteal responses are considered in relation to different methods of fracture fixation and complications. Advantages and disadvantages of the available internal fixation devices are reviewed for the fractures that most commonly occur in the different age groups.

Animals↗
PubMed2001

Preliminary investigation of the biomechanics of internal fixation of sagittal split osteotomies with miniplates using a newly designed in vitro testing model.

PURPOSE: This article reports a preliminary study undertaken to investigate the biomechanics of internal fixation systems for sagittal split ramus osteotomy of the mandible with advancement, using a newly designed 3-point bovine rib testing model. MATERIALS AND METHODS: After 1 of 5 different miniplates internal fixation systems was placed, a vertical load was applied just below the superior border of sagittal split osteotomy gaps in bovine ribs positioned in a custom-made cradle using a compound cantilered bar device. Load/displacement data were gathered, and the mean elastic limits of the 5 miniplate designs were compared by using a 1-way analysis of variance (ANOVA) with Tukey multiple comparisons. RESULTS: The elastic limit of the rigid fixation system was higher when using a curved plate design than with a straight plate design. CONCLUSION: The 3-point bovine rib model used in this study is an inexpensive, discriminating, and reproducible method for testing internal fixation systems on sagittal ramus osteotomies under conditions that more accurately represent the human mandible in function.

Analysis of Variance↗
PubMed1997

Pneumoretroperitoneum secondary to an open reduction and internal fixation of a femoral fracture: case report.

We present a case of pneumoretroperitoneum detected on computed tomography that resulted from open reduction and internal fixation of a femoral fracture. Retroperitoneal air has many etiologies. These range from the clinically insignificant to the potentially catastrophic, if not recognized promptly. We present a case of retroperitoneal air secondary to open reduction and internal fixation of a femoral fracture. To our knowledge, this association has not previously been described.

Adult↗
PubMed2004

Hip arthroplasty for failed internal fixation of intertrochanteric fractures.

Nineteen patients who had hip arthroplasties for complications of internal fixation of intertrochanteric fractures were reviewed. There were 6 males and 13 females. The mean age was 64.1 years (range, 21-87 years) at the time of the fracture. The average interval from fracture to arthroplasty was 40.3 months (range, 2-288 months). The prosthesis types included 16 total hip arthroplasties and 3 bipolar hip arthroplasties. A standard femoral stem was used in every patient, and although the stem length did not extend well beyond the most distal screw holes, there was no stress fracture. Complications such as intraoperative fracture of the greater trochanter and postoperative dislocation were common. The Harris Hip Score significantly improved from 38.4 points before the conversion to 79.8 points after an average follow-up of 7.4 years (range, 2-18 years). There was no revision for mechanical failure.

Arthroplasty, Replacement, Hip↗