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Results for “FRACTURE FIXATION”

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PubMed1992

Internal fixation of ulnar fractures by locking nail.

Fractures and dislocations of the forearm are commonly observed in trauma clinics. With time, there will probably be significant increases in fractures of the forearm associated with traffic and sports. The efficacy of the treatment of ulnar fractures by a new locking nail, developed by Lefevre in Strasbourg, was tested in 20 patients. The fractures were severely displaced ulnae or both bones of the forearm. The minimum follow-up period was six months. The average age of the patients was 33.5 years (range, 14-77 years). The nail is placed into the ulna proximally. Locking is achieved by two screws placed at the proximal and distal end of the nail. The healing time for the fractures of both bones of the forearm ranged from 75 days to 20 weeks, with an average of 15 weeks. Healing time for the ulnar fractures ranged from eight to 20 weeks, with an average of ten weeks. The advantages of this nail were easy closed technique, compression effects at the fracture site, and enough stability so that an external support and tourniquet, in isolated ulnar fractures, were not necessary.

Adolescent↗
PubMed2005

Transoral 2.0-mm locking miniplate fixation of mandibular fractures plus 1 week of maxillomandibular fixation: a prospective study.

PURPOSE: In this study, a 2.0-mm locking miniplate (LMP)/screw system was assessed in the treatment of mandibular fractures with a 1-week period of maxillomandibular fixation (MMF). PATIENTS AND METHODS: Fifty mandibular fractures in 34 patients with a mean of 6.97 days of MMF were included in the study. The 2.0-mm LMPs were adapted along Champy's line of ideal osteosynthesis and secured with four 8.0-mm locking monocortical screws. All patients were followed for a minimum of 6 weeks. The incidence of soft tissue infections, nonunion, malunion, malocclusion, osteomyelitis, nerve injury, and tooth damage was prospectively assessed. RESULTS: Primary bone healing was achieved in 98% of cases. Three complications (6%) were observed. Two minor complications of intraoral wound dehiscence and malocclusion were noted. A fibrous nonunion requiring 3 additional weeks of MMF was noted. No evidence of malunion, osteomyelitis, plate fracture, iatrogenic nerve injuries, or dental injuries was noted. CONCLUSIONS: A single 2.0-mm LMP placed along Champy's line of ideal osteosynthesis with four 8-mm monocortical locking screws plus 1 week of MMF fixation is a reliable and effective treatment modality for mandibular fractures.

Adolescent↗
PubMed1990

[Post-traumatic osteitis. The acute infection].

The acute infection is defined as bacterial growth within the surgical wound, that may occur within days to weeks after initial surgery but before bone union. The chances of complete recovery after an acute soft tissue inflammation are closely related to the interval between initial surgery and first signs of infection, the early recognition of the complication, the type of bacteria involved and the therapeutic measures. The first symptoms of an impending infection are the classical clinical ones of any inflammation: tenderness, swelling and reddening. All imaging procedures are of little or no value. The therapy consists of very aggressive and, if required, repeated wound revisions with debridement of all necrotic tissue, removal of loose bone fragments or loose implant material, wash-outs with antiseptic solutions (e.g. Taurolin) or even deposition of gentamycin beads. Systemic antibiotics may be added temporarily. The in- or external fixation devices must provide stable fracture fixation and the bone as well as the soft tissue envelope must be well vascularized.

Acute Disease↗
PubMed1999

Pin-tract complications in external fixation of fractures of the distal radius.

We analyzed retrospectively the rate and outcome of pin-tract complications in 314 unstable fractures of the distal radius, treated with the Hoffmann small-frame external fixator. The overall rate of complications was 27%. The commonest complication (21%) was pin-tract infection, which was treated with oral antibiotics. There were no cases of osteitis. Complications led to premature removal of the fixator in 17 of the cases. Women over the age of 75 years had a significantly higher rate of pin loosening (17%), but not a higher rate of premature removal of the fixator due to complications. 4% of the cases had a pin-site fracture, all women. The rate of pin-tract complications was high, but severe complications were rare, even in old women.

Adolescent↗
PubMed1999

Combining transforming growth factor-beta(1) to a bioabsorbable self-reinforced polylactide pin for osteotomy healing: an experimental study on rats.

The effect of a bioabsorbable pin containing transforming growth factor-beta(1) on fracture healing was studied in a rat model. The growth factor was mixed into a bioabsorbable polymer paste (a blend of an l-lactic acid oligomer and a copolymer of epsilon-caprolactone and dl-lactide) that was used to fill the grooves of a self-reinforced fracture fixation pin made of a poly-ld-lactic acid copolymer. In an in vitro assay, sustained release of the growth factor from the pins over a 7-day period was demonstrated. A distal femoral osteotomy was made in 60 rats and stabilized with the fracture fixation pin in 48 of them; In the remaining 12 rats, no fixation was performed. The pin used in the study group contained either 5 microg (15 rats) or 50 microg (15 rats) of the growth factor, while in a control group of 18 rats an identical pin without the growth factor was used. After a follow-up of 1, 3, or 6 weeks, the femurs were examined radiographically, histologically, histomorphometrically, and microradiographically, and also used in tetracycline labeling studies. Faster callus formation was evident in the growth factor-treated rats but no acceleration in the healing of the osteotomy was detected.

Absorbable Implants↗
PubMed1993

Pediatric mandibular fractures treated by rigid internal fixation.

Mandibular fractures in the pediatric patient population are relatively uncommon. These patients present with their own unique treatment requirements. Most fractures have been treated conservatively by dental splints. Closed reduction techniques with maxillomandibular fixation (MMF) in very young children can pose several concerns, including cooperation, compliance and adequate nutritional intake. Rigid internal fixation of unstable mandibular fractures using miniplates and screws circumvents the need for MMF and allows immediate jaw mobilization. At major pediatric trauma institutions, there has been an increasing trend toward the use of this treatment when open reduction is necessary. This article presents a report of a five-year-old child who presented with bilateral mandibular fractures and was treated by rigid internal fixation and immediate mandibular mobilization.

Bone Plates↗
PubMed1994

The incidence, pathogenesis, diagnosis, and treatment of fat embolism.

Fat embolism syndrome is a potentially serious and life threatening complication of long bone trauma, blunt trauma, and intramedullary manipulation. In long bone fractures, fat embolism is encountered in 0.9% to 2.2% of cases. During intramedullary manipulations, such as prosthetic stem insertion or reaming, the incidence is typically lower (range, 0.5% to 0.8%). Diagnosis is dependent upon the clinical recognition of dyspnea, petechiae, and cognitive dysfunction in the first several days following fracture, trauma, or intramedullary surgery. Treatment consists of pulmonary support and aggressive resuscitation. Studies support early fracture fixation, but the role of systemic steroids, heparin, and other modalities remains speculative.

Brain Diseases↗
PubMed1993

Analysis of the external fixator pin-bone interface.

External fixator pins were inserted into tibiae of dogs under four in vivo loading conditions to examine the mechanism of pin loosening. Pins were quantitatively measured for pin torque resistance, and the pin tracts were studied radiographically and histologically. The pins holding an unstable fracture had more gross pin loosening. Pins also may become loose under static loads. Radiographic lucency of 1 mm or more in the cortical bone around a pin was evidence of gross pin loosening. Histologic examination showed that tight pin tracts were characterized by a lack of bone remodeling. Loose pin tracts were characterized by extensive bone resorption and inflammatory infiltrates. Pin loosening can be detected radiographically. Pin insertion technique is important to improve the initial pin torque resistance to minimize pin loosening. Sixty-nine percent of pins with an initial torque resistance of less than 68 Ncm became grossly loose compared with only 9% of pins with an initial torque resistance greater than 68 Ncm, regardless of the experimental group. Unstable external fracture fixation is another important factor in producing pin loosening. Pins loaded under unstable fracture fixation had the highest incidence of gross loosening. When applying an external fixator, the fracture rigidity should be critically evaluated and, if necessary, protected weight bearing must be introduced initially to minimize pin loosening.

Animals↗
PubMed1996

The vibrational mode of the tibia and assessment of bone union in experimental fracture healing using the impulse response method.

This study attempts to clarify the use of the impulse response method in the assessment of fracture healing. The vibrational mode as well as the effect of simulated callus consolidation on the vibrational parameters of excised human tibia were studied. Two separate vibrations were found, one vibrating strongly in the lateral direction and the other vibrating weakly in the antero-posterior direction. The ability to identify the primary vibrational mode in the lateral direction would make the impulse response method suitable for use in clinical practice. The callus consolidation process was simulated by the sequential consolidation of an adhesive material in an experimentally produced fracture gap. The change in hardness of the epoxy was found to correlate well with the change of resonant frequency of the bone. The resonant frequency demonstrated a steady increase during the initial phase of consolidation of the adhesive, up to about 40% of its final hardness. With the addition of various constructs for fracture fixation to the in vitro model such as a plate, Ender's pins, a Russell-Taylor intramedullary nail, or an Orthofix external fixator, the relationship between the consolidation of the 'callus' and the change in resonant frequency of the bone was not disturbed.

Bony Callus↗