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At least 1,117 records · Page 62Linked to original sources
PubMed1981

Malleolar fractures treated with rigid internal fixation and immediate mobilization.

Twenty=eight consecutive patients with displaced malleolar fractures were treated with anatomically exact open reduction, rigid internal fixation and immediate postoperative exercises, following the principles of the Swiss ASIF group. There were no operative or postoperative complications. One patient had a minor abscess over a loosened screw, while 1 patient developed pes equinus that required treatment. AT follow-up 2 to 12 months after the operation, 25 patients were walking normally. The movements of the ankle joint were excellent or good in 25 patients. The method is recommended.

Adolescent↗
PubMed1994

The use of rigid internal fixation in mandibular fractures complicated by osteomyelitis.

PURPOSE: Reports on treatment of "infected" mandibular fractures with open reduction and rigid internal fixation (RIF) consist of either isolated cases or mixed series of patients with soft tissue infections or inadequately documented osteomyelitis. The definition of "infected fracture" is often vague and may include both soft tissue or bone sepsis. MATERIALS AND METHODS: In this retrospective study, seven patients with mandibular fractures and documented osteomyelitis were treated by a protocol that included open reduction and RIF. Technetium-99m methylene diphosphonate (99mTc) and Indium 111 (111In) radionuclide scans, bone cultures, and microscopic examination were used to document the diagnosis of osteomyelitis. The infections were treated with antibiotics, incision and drainage, and surgical debridement. Reconstruction plates that were large enough to provide four holes in each bone segment were used for RIF of the fractures and simultaneous reconstruction of the osseous defects. RESULTS: After an average follow-up of 26 months, all patients remained infection free, and the fracture sites were stable. Five of the seven patients had inferior alveolar nerve dysfunction after treatment; no other significant complications were noted. CONCLUSION: The results of this study indicate that the protocol of simultaneous debridement, reduction, and RIF is a satisfactory method for treatment of mandibular fractures complicated by osteomyelitis. Prospective studies and longitudinal follow-up of larger numbers of patients would be desirable to confirm these findings.

Adult↗
PubMed2006

Mallet fractures: a novel approach to internal fixation using a hook plate.

A new treatment of mallet fractures of the distal phalanx is presented. Open reduction and internal fixation was performed using a "hook" plate fabricated from a 1.3 mm AO hand modular system straight plate. This technique avoids the need to place implants or wires through the small avulsion fragment while still being able to achieve a stable "tension-plate" type of fixation construct strong enough to allow protected early active motion of the distal interphalangeal joint. In minimising the need for prolonged splinting, patient comfort is also improved. In a consecutive series of nine fractures, union was achieved in all cases. At an average follow-up period of 17 months, four had excellent and five had good results using the Crawford rating scale. Using the Warren and Norris scale, all patients had a successful result. The final average active range of flexion of the distal interphalangeal joint was 64 degrees and there was no extensor lag.

Adult↗
PubMed1998

[Internal fixation with mini-titanium plate for midface fractures].

Thirty four patients with midface bone fractures were fixed by rigid internal fixation (RIF) with min-titanium plate. An optimum exposure is provided for the fracture sites of zygomatic, zygomatic arch, orbital floor and maxilla with the coronal incision and adjuvant incisions. The approach was of benefit to accurate anatomic reduction and fixation of the fracture segments. RIF with min-titanium plate provided three-dimensional stability. The fixation of zygomatic-frontal crevice and zygomatic maxillary crevice were the key for obtaining sufficient stability, and at least two fixation screws were required above zygomatic-frontal crevice.

Adult↗
PubMed1990

Continuous passive motion after internal fixation of distal humerus fractures.

Two patients with severe intra-articular fractures of the distal humerus were treated with internal fixation and postoperative continuous passive motion (CPM) of the elbow. The CPM machine's range of motion was initially set at 30 degrees to 70 degrees of flexion for one patient and 45 degrees to 90 degrees of flexion for the other. The arc of motion was gradually increased daily without discomfort. There was no occurrence of wound complications, nonunion, loss of reduction, heterotopic ossification, or failure of fixation. At last evaluation, both patients had full pronation and supination. One patient had 0 degrees to 135 degrees of elbow flexion, and the other had 30 degrees to 110 degrees. Both patients had pain-free elbows. CPM was found to be a valuable therapeutic modality in the postoperative management of intra-articular fractures of the elbow.

Adolescent↗
PubMed1988

Posterior malleolar fractures of the ankle associated with external rotation-abduction injuries. Results with and without internal fixation.

Thirty-eight patients in whom a fracture of the posterior malleolus was shown to comprise 25 per cent or more of the articular surface on the lateral radiograph were followed for an average of forty-four months (range, twenty-four to ninety-nine months). All injuries were judged to be a result of external rotation or abduction of the talus. Fifteen patients had fixation of the posterior malleolus, and twenty-three did not. Open reduction and internal fixation was carried out on all associated fractures of the medial and lateral malleoli. Satisfactory reduction of the posterior malleolus was often achieved when the fibula was reduced, and frequently this was maintained despite the absence of fixation. No posterior subluxation of the talus occurred in either group. No statistically significant difference was noted between the clinical results with and without fixation.

Adult↗
PubMed1987

Analysis of a Lane-plate internal fixation device after 64 years in vivo.

A patient presented for an above-knee amputation 64 years after successful internal fixation of a femoral fracture with a Lane plate. Chemical analyses of the plate and corrosion products were done using atomic absorption spectrophotometry, x-ray energy spectroscopy and x-ray diffraction. Mechanical properties of the fixation devices were measured using Rockwell-type instruments and metallographic analyses were also performed. In addition, pathologic and radiologic investigations of the underlying bone were carried out. Results disclosed that extensive corrosion had weakened the plate by 50%. The metallosis of the surrounding soft tissues and abnormal morphologic features of underlying bone were analysed. No appreciable cellular inflammatory or dysplastic reaction of adjacent tissues was identified. The underlying bone showed a persistent lack of mature compact bone and no evidence of remodelling. The products of corrosion were mainly ferrous carbonate and some ferrous chloride. The mechanism of the corrosion was the formation of a galvanic cell between the iron carbide and surrounding iron, with dissolution of the iron and formation of the corrosion products.

Aged↗
PubMed1987

Extrinsic femoral artery occlusion following internal fixation of an acetabular fracture. A case report.

Vascular injury is one of the drastic complications that can arise from internal fixation of acetabular fractures. A 29-year-old, obese man sustained multiple trauma, including a displaced transverse acetabular fracture. Extreme obesity made adequate exposure to the posterior acetabular area difficult, causing placement of a large lag screw in malposition, such that it penetrated the superior pubic ramus at a point adjacent to the superficial femoral artery. Angiography, immediately after operation, revealed extrinsic compression of this vessel. The lag screw was successfully repositioned, with immediate return of vessel patency and no sequelae. The surgical approach and anatomic landmarks for placement of posterior to anterior lag screws are reviewed in an effort to prevent this complication.

Accidents, Traffic↗
PubMed1994

Effect of internal fixation plates on microcirculation in under-plate cortical bones. Microangiography and scanning electronmicroscopy.

To elucidate the effect of the internal fixation plates on the local bone blood supply, we used microangiography and scanning electron microscopy to observe the morphological changes of microcirculation in the cortical bones obtained from intact rabbit tibiae on which plates of two different stiffness had been fixed for comparison. The results indicated that both rigid stainless steel plate and less rigid methyl methacrylate plate could induce the bone microcirculation under the plate to undergo a process from early depression to late reactive recruitment. The features of the microcirculation recruitment such as vascular number, arrangement and dilatation varied with plates of different stiffness and were more obvious in the cortex fixed by rigid stainless steel plate.

Animals↗
PubMed1987

Fractures of the phalanges: results of internal fixation using 1.5mm and 2mm A. O. screws.

Thirty-six patients were treated for 38 phalangeal fractures using 1.5 mm and 2 mm A. O. screws. Plates were not used in the fingers. Oblique fractures of the condyles, shafts or bases of the proximal or middle phalanges were treated by internal fixation because of instability, displacement or rotation. 40% of fractures had associated skin wounds, were comminuted or had damage to the extensor mechanism. The mean duration of post-operative immobilization was 9 days and the mean time off work was 6 weeks. Total active movement in the involved ray was 220 degrees or greater in 24 cases, 180 degrees to 215 degrees in eight cases, and less than 180 degrees in two patients at follow up. The patients were reviewed between three and 54 months after treatment and the mean duration of follow up was 24 months. The most frequent complication was 10 degrees to 30 degrees of flexion deformity of the proximal interphalangeal joint after internal fixation of condylar fractures. Results were satisfactory in 90% of cases.

Adult↗
PubMed1990

'Buttonholed' femoral shaft fracture in adolescents: an indication for internal fixation?

Four patients aged 11 to 14 years sustained femoral shaft fractures. The fractures proved to be irreducible by conventional closed methods. At operation; either the proximal or distal end of the fracture was found to have 'buttonholed' through the lateral intermuscular septum, preventing reduction. The case histories and clinical results are presented. To our knowledge this complication has not been described previously, and we believe that it is an indication for open reduction and internal fixation, for reasons that will be discussed. In the patients described here there was no important leg length inequality as a result of the internal fixation.

Adolescent↗
PubMed1999

[Surgical reduction and rigid internal fixation of midface fractures].

OBJECTIVE: To determine the cause, clinical characteristics and treatment of midface fractures. METHODS: A retrospective review of 98 patient records was conducted. Data regarding age, cause of fracture, anatomic site, treatment modalities and clinical results were reviewed. RESULTS: Of the 98 patients, 78.6% were male, with the peak incidence occurring in the age group from 21 to 40 years old. Of the fractures, 32.6% were due to traffic accidents, 24.5% to assaults, and 17.3% to accidental falls. Most patients (87.8%) were treated by open reduction surgery and rigid internal fixation. Only 12.2% of patients were treated by closed reduction fixation. Almost all of the patients regained normal face appearance and functional occlusion. CONCLUSION: Surgical reduction and rigid internal fixation of midface fractures is a satisfactory method of treatment.

Adolescent↗
PubMedDate not supplied

Internal fixation for coronal shear fracture of the distal end of the humerus by the anterolateral approach.

Six patients with a displaced coronal shear fracture of the distal end of the humerus were treated surgically with the anterolateral approach to the elbow, in which the capitulum and trochlea could be exposed widely. All underwent open reduction and internal fixation to reduce anatomically and mobilize the joint at an early stage. The mean duration of follow-up was 40 months (range, 24-54 months). All fractures healed with an acceptable functional result. In no case did we observe collapse of the capitulum or trochlea. We recommend open reduction by the anterolateral approach, which provides good exposure of the fracture sites and allows internal fixation to be accomplished with the use of Herbert screws, resulting in good fixation and compression of the bone fragments.

Accidental Falls↗
PubMed2003

[External or internal fixation for arthrodesis of the ankle -- a comparative study of perioperative and long-term results].

SUBJECT: This study evaluates the results of external and internal fixation techniques for arthrodesis of the ankle. METHODS: Perioperative and subjective, clinical, and radiological long-term results (average follow-up: 9 years) in 55 patients following arthrodesis of the ankle due to posttraumatic arthritis were compared in two groups with different fixation techniques--compression arthrodesis with external fixator (AO) or internal screw fixation. RESULTS: Patients with external fixation revealed a significantly higher deep infection rate, which was treated conservatively, while the rates of nounion, revision surgery due to infection, and total revision surgery did not show any difference in the two groups. CONCLUSION: Both surgical techniques applied mostly guarantee a safe and stabile fixation in arthrodesis of the ankle and provide convincing long-term results without showing a difference in comparing the outcome.

Ankle Injuries↗
PubMed1989

Supracondylar-intercondylar fractures of the femur. Treatment by internal fixation.

The records on fifty-two supracondylar-intercondylar fractures of the femur were reviewed twenty to 120 months after injury. More than one-third of the fractures had been open. All of the fractures were treated in a single trauma center, using: (1) a single lateral incision, (2) internal fixation with ASIF interfragmentary screws and plates, (3) bone-grafting of comminuted metaphyseal segments, (4) impaction of comminuted metaphyseal segments in osteoporotic elderly patients, and (5) repair of any associated torn ligaments and patellar fractures. Postoperatively, early active motion of the knee was encouraged, and for selected patients a brace was used only to protect the repair of associated disruptions of ligaments or of the extensor mechanism. The fractures were classified by the ASIF system, with C1 being a simple Y pattern, C2 having additional supracondylar comminution, and C3 having intra-articular comminution. The final results were rated using the system that was described by Neer et al. for fractures of the distal end of the femur. The average time between the operation and full weight-bearing (healing) was 13.6 weeks and ranged from 12.3 weeks for C1 fractures (as graded using the ASIF classification) to 15.4 weeks for C3 fractures. The average final arc of motion of the knee was 107 degrees, ranging from 113 degrees for C1 fractures to 99 degrees for C3 fractures. C1 fractures had a better outcome (92 per cent excellent and good results) than did C2 and C3 fractures (77 per cent excellent and good results). Two amputations and one arthrodesis were done to treat infection, and infection accounted for three of the four poor results. Age did not influence the final results, although elderly patients had a longer period of hospitalization. Supracondylar-intercondylar fractures of the femur should be analyzed separately from other fractures of the distal end of the femur because of their intra-articular involvement and associated ligamentous injuries and patellar fractures. Rigid internal fixation permits early functional rehabilitation of the patient and decreases the incidence of malunion, non-union, and loss of fixation.

Adult↗
PubMed2005

Tourniquets may increase postoperative swelling and pain after internal fixation of ankle fractures.

UNLABELLED: Tourniquets frequently are used in orthopaedic surgery to provide a bloodless field. There is still controversy among authors regarding the benefits and potential risks of using a tourniquet. The objective of this prospective randomized study was to quantify the effect of tourniquet use on postoperative swelling, pain, and range of motion after open reduction and internal fixation of ankle fractures. Fifty-four patients with closed ankle fractures were treated surgically; 26 patients were operated on using a thigh tourniquet (Group A), and 28 patients had surgery without the use of a tourniquet (Group B). The groups of patients were similar for age, gender, fracture types, and operative procedures. There was no difference in operation time. Using a tourniquet during open reduction and internal fixation of ankle fractures did increase postoperative swelling and postoperative pain at Day 5 and at Week 6 after surgery. We found a trend for a better range of motion in the ankle until the 6-week followup in the nontourniquet group compared with the group in which the tourniquet was inflated. According to these results we do not recommend using a tourniquet for osteosynthesis of ankle fractures. LEVEL OF EVIDENCE: Therapeutic study, Level I-1 (randomized controlled trial). See the Guidelines for Authors for a complete description of levels of evidence.

Adolescent↗