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At least 1,297 records · Page 72Linked to original sources
PubMed1984

[Surgical indications and choice of procedure in distal radius fractures--wire, plates, external fixation].

The treatment of the typical fracture of the radius is predominantly conservative. Unstable fractures, bending fractures and open fractures will receive operative treatment. Hereby Kirschner wires, blade plates and screws are applied for osteosynthesis. Heavy comminuted fractures were stabilized, besides by minimal osteosynthesis, by a mini-external fixation unit. The results of operative treatment in the Unfallchirurgische Klinik Giessen were in 50% excellent and good, in 38% satisfactory and in 12% bad. The main complications were disturbances of sensibility in the area of the superficial branch of the radial nerve.

Adult↗
PubMed1987

Late reduction of the dislocated lunate. A method using distraction by an external fixator.

The management of carpal dislocation after a late diagnosis is difficult. Open reduction is the usual treatment but collapse of the carpus may be hard to overcome without extensive dissection and consequent damage to the blood supply, ligaments and articular cartilage. A technique of distraction by an external fixator followed by semi-closed reduction is described and its successful use is reported in two cases.

Accidental Falls↗
PubMed1978

External fixation of double vertical pelvic fractures with a trapezoid compression frame.

Seventeen patients with double vertical fractures of the pelvic girdle were treated by early reduction and subsequent fixation of the pelvic ring with a trapezoid frame. This provided firm fixation of the fractured pelvis. With the frame attached, patients without associated injuries were allowed out of bed within 3 weeks and in every case the frame was removed 6 weeks after its application. External fixation of the pelvic fracture afforded relief from pain and greatly facilitated nursing. At follow-up, all the fractures had united in the position secured initially by the frame and no patient complained of pain in the sacro-iliac joints.

Adolescent↗
PubMed1984

Treatment of infected tibial pseudarthrosis by external fixation with the Wagner device.

We analyzed our experience with infected tibial pseudoarthrosis which resulted in a therapeutic plan for a radical operation or a step-by-step method, depending on the type of pseudarthrosis (PS), the severity of the infection, and the skin damage. We think that external fixation with the Wagner device is the procedure of choice. Owing to its simplicity and good stability, it is possible to treat the PS and the infection and to obtain good final results.

Adult↗
PubMed1982

[External fixator in the prevention and treatment of infections (author's transl)].

Although postoperative infection constitutes a serious complication after osteosyntheses of closed fractures and in the course of open fractures, application of the known principles permits the adaption of an optimistic attitude towards treatment. Stability of osteosynthesis preferably with external fixation, open-wound treatment with regular control of the wound, in special cases suction-irrigation drainage, local application of PMMA beat chains and short-term, high-dosed systemic antibiotic therapy after antibiogram are amongst the most important points to be taken into consideration.

Adult↗
PubMed1985

Management of infected fractures of the tibia with associated soft tissue loss: experience with external fixation, bone grafting and soft tissue reconstruction using pedicle muscle flaps or microvascular composite tissue grafts.

The aim of this study was to assess the results of treatment given by a team of orthopaedic and plastic surgeons in a series of infected unhealed fractures of the tibia associated with loss of adjacent soft tissues. Twenty-five lower leg fractures, treated during a 10 year period, entered the study and were grouped according to the principles of treatment followed. In the earlier Group A (nine patients), the osteosynthesis implants were retained or changed to more stable internal fixation devices, the soft tissue defects were closed by conventional muscle or musculocutaneous flaps and bone grafting procedures were performed late in the treatment scheme. In the later Group B (16 patients) the implants were removed and the fracture stabilised by external fixation; the defects were covered with pedicle muscle flaps or with microvascular composite tissue grafts and cancellous bone grafting was performed at the same operation. Twenty-three fractures healed. One fracture developed non-union and in one patient infection necessitated below-knee amputation. The time of union after surgical reconstruction was significantly shorter in Group B (24 +/- 3 weeks) than in Group A (47 +/- 11 weeks). The results suggested that: in severe infected fractures of the tibia surgical implants used previously for fracture treatment should be removed and replaced with an external frame using firm axial compression, microvascular composite grafts seem to improve greatly the rate of healing, early bone grafting should be included in the reconstruction and late infections can be largely avoided even after extensive one-stage reconstructive procedures.

Adolescent↗
PubMed1994

Early exchange intramedullary nailing of distal femoral fractures with vascular injury initially stabilized with external fixation.

Fracture of the femur with accompanying arterial injury represents approximately 1% of all femoral fractures. Controversy exists regarding the choice of fixation and the sequence of fixation and vascular repair. We report on the treatment of six patients with seven distal femoral fractures and angiographically documented arterial injuries treated over a 20-month period. The treatment protocol consisted of angiography followed by provisional external fixation and early primary exchange to an intramedullary nail. Five of the seven fractures were open. Three fractures were caused by blunt trauma, and four were secondary to shotgun blasts. Average follow-up was 12 months (range, 6-25 months). All fractures healed with an average time to union of 25 weeks. There were no complications related to the vascular repair. One case of an acute deep infection resolved after debridement and placement of polymethylmethacrylate cement beads impregnated with antibiotics and a course of intravenous antibiotics. All patients returned to their previous levels of activity. Based on the results of our experience with a small group of patients, we feel that this treatment protocol will prove to be a safe and efficient method of management of these difficult injuries.

Angiography↗
PubMed1994

External fixation of subglottic tracheal stents.

Bronchoscopically placed silicone stents are used increasingly for treating patients with tracheal stenosis due to benign or malignant airway disease. When stenosis occurs in the immediate subglottic region, however, complications of stent insertion, especially migration, are troublesome. The purpose of this report is to describe a technique of external fixation of subglottic stents that may be used when tracheotomy, Montgomery T-tubes, or other therapeutic measures are undesirable or have failed. This technique may also be considered in carefully selected patients with severe malacia and subglottic stenosis who have failed indwelling stent placement because of stent migration.

Aged↗
PubMed1996

The Ilizarov external fixator for treatment of deformities in Paget's disease.

Paget's disease of bone may cause progressive bowing of affected femurs and tibiae. Fractures or osteotomies in these patients technically are difficult to treat and may lead to delayed union or nonunion. The authors report their early results with the use of the Ilizarov external fixator to affix 3 corrective closing wedge osteotomies, 1 fracture, and 1 delayed union. Deformities were corrected fully during the surgery, with an option to correct remaining deformation progressively during the rest of treatment. Compression of the healing bone was applied to enhance osseous healing, when necessary. Three-dimensional control is possible, and the stability of the fixation is excellent in this structurally weak bone. Bony union was achieved without complications in all patients within 4 months.

Aged↗
PubMed2005

Evaluation of criteria for temporary external fixation in risk-adapted damage control orthopedic surgery of femur shaft fractures in multiple trauma patients: "evidence-based medicine" versus "reality" in the trauma registry of the German Trauma Society.

BACKGROUND: Femur-shaft fracture treatment (FSFT) follows controversial management concepts after multiple trauma: primary-definitive osteosynthesis, secondary-definitive osteosynthesis after temporary external fixation (EF) in all patients, or individualized primary- or secondary-definitive osteosynthesis ("risk-adapted damage control orthopedics"). This study compares the concepts by analyzing literature evidence and a prospective multicenter database. METHODS: A systematic literature analysis was performed. The German Trauma Society trauma registry was used to assess variables predictive of treatment concept. RESULTS: Contradictory results in 63 controlled trials failed to support a "generalized management strategy." In all, 1,465 FSFTs in 8,057 trauma registry patients (age 39 +/- 19.5 years; Injury Severity Score [ISS] 23.5 +/- 14.9; 17.3% mortality) were treated initially (<24 hour) by EF, nail, or plate in 47.0%, 41.1%, and 11.9%, respectively. Despite large interhospital variability, EF was more likely with increasing severity of ISS, Glasgow Coma Score, thorax trauma, base excess, coagulation abnormalities, and initial probability of death. CONCLUSIONS: Clinical "reality" reflects the controversies of "scientific evidence" for FSFT after multiple trauma in Germany. Although decision making is currently based on unvalidated criteria, anatomic and physiologic injury severity appears to influence the choice of management concept.

Adolescent↗
PubMed1996

[Unstable fractures of the distal radius. External fixation or percutaneous pinning?].

The results of treatment for distal radial fractures of types Older 3 with more than 5 mm shortening and Older 4 were studied in a prospective randomized series of 41 patients with regular follow-up to six months after operation. The patients were treated with closed reduction under anaesthesia and either external fixation ad modum Hoffman or percutanous pinning and a plaster cast for six weeks. Both treatment groups achieved a clinically and radiologically good result without any significant difference. There were no infections, and except for one patient with persistent signs of mild reflex dystrophy we experienced no serious complications. Owing to simplicity and treatment costs we generally prefer treatment by pinning and plaster cast.

Adult↗
PubMed2005

Evaluation of effectiveness of 10% polyvinylpyrrolidone-iodine solution against infections in wire and pin holes for Ilizarov external fixators.

CONTEXT AND OBJECTIVE: Superficial infection at wire and pin insertions in the skin is a frequent disorder among patients utilizing the Ilizarov method. The objective of this study was to evaluate the effectiveness of daily topical application of 10% polyvinylpyrrolidone-iodine solution against infections of the holes for Kirschner wires and Schanz pins among patients using Ilizarov external fixators, in comparison with cleaning these holes only with 0.9% sterile physiological saline solution. DESIGN AND SETTING: Controlled randomized clinical trial, in the Orthopedics and Traumatology Outpatient Clinic, Hospital São Paulo, and Orthopedics and Traumatology Center of Jundiaí. METHODS: 30 patients were treated using the Ilizarov technique: 15 were instructed to apply 0.9% physiological saline dressing on the wire and pin insertions and 15 to apply 0.9% physiological saline plus 10% polyvinylpyrrolidone-iodine. Patients were evaluated at outpatient return visits for identification of signs and symptoms of superficial infection at wire and pin insertion sites. Samples were collected from cases of purulent exudate secretion, for culturing and clinical tests. RESULTS: The chi-squared and Fischer exact tests were applied, but no statistically significant association between the intervention of topical polyvinylpyrrolidone-iodine solution and the prevention of infections at wire and pin insertions could be found. CONCLUSIONS: Topical 10% polyvinylpyrrolidone-iodine solution applied daily to Kirschner wire and Schanz pin insertions did not reduce the incidence of superficial infection at these holes, in comparison with mechanical removal of dirt using 0.9% physiological saline solution.

Adolescent↗
PubMed1998

Bladder incarceration in a traumatic symphysis pubis diastasis treated with external fixation: a case report and review of the literature.

Fractures of the pelvis constitute a small but significant proportion of skeletal injuries. However, they are associated with significant morbidity and mortality, including damage to the urogenital system, especially the urethra and urinary bladder. We report the rare finding of bladder herniation and entrapment after reduction of a traumatic symphyseal diastasis by external fixation and the diagnosis of these injuries with computed tomography. A comprehensive review of the literature is also performed, to improve understanding and provide guidelines for evaluation and treatment of pelvic injuries with suspected bladder involvement.

Adult↗
PubMed2000

Use of a hinged external fixator for elbow instability after severe distal humeral fracture.

The authors report the case of a forty-year-old man who developed acute elbow instability after fixation of an open, comminuted distal humeral fracture. Treatment with a hinged, external elbow fixator was successful in reestablishing elbow stability and a functional range of elbow motion. To the best of the authors' knowledge, the use of this device for acute elbow instability after distal humeral fracture fixation has not been previously reported.

Acute Disease↗
PubMed1995

Antebrachial deformities in the dog: treatment with external fixation.

The results of 12 dogs with antebrachial deformity treated by ulnar ostectomy, radial osteotomy and external skeletal fixation are presented. Postoperative complications were seen in only one dog; a delayed union requiring placement of autogenous cancellous bone graft at a second surgery to achieve healing. Postoperatively, owners reported limb function was good in almost all cases, although they were less pleased with the cosmetic appearance.

Animals↗
PubMedDate not supplied

[The use of Wagner's external fixator in the treatment of septic fractures of the femoral shaft (author's transl)].

The authors have treated 10 cases of septic fracture of the femoral shaft by the following technique. In the first stage, necrotic and infected tissues were excised at the fracture site including soft tissue and bone. The importance of a large excision is emphasised. The fracture was then immobilised by an external fixator. In the second stage, the shaft was reconstructed by grafting using bone chips and sometimes massive cancellous bone autografts. The fixators were left until solid bone union had been achieved. 9 excellent results were observed. In one case, the bone refractured with recurrence of sepsis.

Bacterial Infections↗
PubMed2001

Changes of blood circulation of the extremity after external fixation for tibia shaft defect: an experimental study.

OBJECTIVE: To assess and compare two approaches, end to end compression with lengthening (EECL) and segmental bone transport by lengthening (STBL), for long tubular bone defect and nonunion. METHODS: Ten goats were used to establish the bone defect model of the mid-tibia. The bone defect ends were shortened step by step with a sulcated half-ring external fixator. Changes of the blood flow of the distal extremity were measured with pulse-Doppler monitor and angiography. RESULTS: The blood flow in the distal extremity was not affected when bone defect was less than 15% of the original length. Blood circulatory disorder would appear in the distal extremity when bone defect ranged 15%-20% of the original length. The necrosis would appear in the extremity because of the blood circulatory obstacle when bone defect was more than 20% of the original length. CONCLUSIONS: EECL is an appropriate alternative of treatments if bone defect is less than 15%; while SBTL may be feasible if bone defect is over 20% of the original length. When bone defect ranges between 15% and 20%, EECL should be applied with great care on condition of keeping watch on the extremity circulation with pulse-Doppler monitor.

Angiography↗
PubMed1987

External fixation pin: an in vitro general investigation.

Surgical drilling and pin insertion can lead to mechanical and thermic damage of the bone. A methodology giving reproducible in vitro records of insertion and holding parameters of threaded implants is presented. Both drilling and tapping are related to the cutting technology. To understand the basic principles of the cutting technology some important parameters of drilling and tapping of an external fixation pin are defined. A bone model was selected based on specific mechanical and thermal properties of the bone tissue. In addition, a specific instrumentation was designed in order to compare the insertion characteristics and the anchorage of different pins. Electronic scanning microscopy of the samples was systematically performed to evaluate the quality of the bone thread. The in vitro measurements of the shearing torque and the pull-out force are representative of the immediate holding power of a pin. The different holding parameters were then correlated. Temperature measurements were performed during drilling, smooth part penetration (transfixing pins), tapping, and screwing. The final objective of the study was to develop new threaded implants with better biomechanical characteristics.

Biomechanical Phenomena↗