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At least 1,297 records · Page 72Linked to original sources
PubMed1990

Supracondylar fractures of the femur: long-term follow-up of closed versus nonrigid internal fixation.

Twenty-nine patients were evaluated a minimum of ten years (average: 16 years) after femoral supracondylar fracture. Fracture type, mechanism of injury, and age of 14 patients initially treated nonoperatively were similar to those of 15 patients treated with nonrigid internal fixation. Complications were more common and more severe in the surgically-treated group. Knee range of motion remained permanently decreased in both groups, averaging 3 degrees lack of extension to 63 degrees of flexion. In both groups, 60% had symptoms of knee pain, instability, and gait abnormalities. Long-term poor results were caused by degenerative arthritis or loss of knee motion (or both). Degenerative arthritis developed in patients whose fracture healed with articular incongruity, greater that 15 degrees of valgus, any amount of varus, or a loss of normal mechanical axis. Results were satisfactory in seven of 15 patients in the surgical group and eight of 14 in the nonoperative group.

Adult↗
PubMed1997

Direct complications of trochanteric osteotomy in open reduction and internal fixation of acetabular fractures.

Osteotomy of the greater trochanter has been used to enhance exposure, especially the dome, in posterior and lateral exposures of the acetabulum. In 55 patients, osteotomy of the greater trochanter was performed in connection with open reduction and internal fixation of a displaced acetabular fracture. The trochanter was reattached by screw fixation. One osteotomy resulted in nonunion, and 2 cases showed partial avulsion or migration of the trochanter. Eleven of the 55 patients (20%) required screw removal from the trochanter. Five patients developed complete ankylosis from heterotopic ossification despite indomethacin prophylaxis; 1 young man underwent excision. Since this procedure increases the complications of fracture management, the inherent risk-to-benefit ratio should be evaluated in each patient.

Acetabulum↗
PubMed1985

Internal fixation for stress fractures of the ankylosed spine.

Three cases of stress fractures affecting the rigid spine of ankylosing spondylitis are reported. Even without the typical destructive features of the Romanus lesion, symptoms may be very prolonged and disabling and the diagnosis difficult. Internal fixation produces immediate pain relief and rapid fracture union.

Adult↗
PubMed1993

Open reduction and internal fixation of ipsilateral fractures of the scapular neck and clavicle.

Ipsilateral fractures of the scapular neck and clavicle disrupt the suspensory mechanism of the shoulder, resulting in functional loss and deformity. Fifteen patients who had such fractures were managed with open reduction and internal fixation and were followed for an average of twenty-five months (range, fourteen to forty-seven months). All but one patient had a good or excellent functional result according to the scoring system of Rowe. All fractures healed at an average of eight weeks postoperatively. Complications from concomitant fractures of the ribs were treated uneventfully. We concluded that operative treatment of these complex fractures is safe and yields predictably good results.

Adolescent↗
PubMed1995

Open reduction and internal fixation for displaced intra-articular fractures of the os calcis.

Thirty-one patients with displaced intra-articular fracture of the os calcis who were admitted to Queen Mary Hospital, Hong Kong from 1989 to 1991 and who underwent open reduction and internal fixation and bone grafting of the os calcis, were followed up for at least 30 months. Pre- and postoperative X-rays were taken. Functional results were assessed clinically in terms of pain, deformities, activities and motion loss. The majority of the patients had acceptable functional outcome. The results were analysed in an attempt to correlate with the fracture pattern.

Accidents, Occupational↗
PubMed1992

Computer-aided optimization of choice and positioning of bone plates and screws used for internal fixation of mandibular fractures.

The present study describes a biomechanical integrated model of the mandibular system in which the maxilla and mandible, the masticatory muscles, and the temporomandibular joints are regarded as one system. In this model, strains in plate-osteosynthesis devices for internal fixation of mandibular fractures can be minimized by optimizing their positions. The model evaluates maximal bite force strategies on all possible dental elements; it uses a linear programming technique and a muscle architecture model, resulting in muscle recruitment patterns. The shape of a "standard" lower jaw is digitized by means of a three-dimensional (3-D) coordinate retrieval device and drawn on a computer screen after its dimensions have been changed according to the clinical case at hand. The 3-D location of the fracture as well as the anatomic restrictions for screw placement can be indicated on the screen. Osteosynthesis devices can be indicated in terms of dimensions, number, and material properties.

Biomechanical Phenomena↗
PubMed1989

Open reduction and internal fixation of displaced, comminuted intra-articular fractures of the distal end of the radius.

The results in sixteen patients who had a displaced, comminuted intra-articular fracture of the distal end of the radius and who were treated by open reduction and internal fixation were retrospectively reviewed. At a mean follow-up of 4.8 years, 81 per cent of the patients had a rating of good or excellent by the scoring system of Gartland and Werley, but only 56 per cent had such a rating when the modified scoring system of Green and O'Brien was used. All of the fractures healed at an average of nine weeks. A step-off of two millimeters or more in the distal radial articular surface at the time of healing was important, because the four patients in whom the fracture healed with this amount of incongruity all had post-traumatic arthritis at follow-up, compared with only three of twelve in whom the incongruity was less than two millimeters.

Adult↗
PubMedDate not supplied

Chevron ankle arthrodesis with bone grafting and internal fixation.

A new technique for ankle arthrodesis was described in 1983 by Marcus et al. in the Journal of Bone and Joint Surgery. It is a chevron ankle arthrodesis with bone grafting and internal fixation. The operation has many features distinguishing it from previously described methods of ankle arthrodesis. The advantages of the technique over other methods of arthrodesis include: bimalleolar approach to the ankle providing excellent exposure; minimal bone resection of the tibiotalar joint, thereby preserving height of the joint and length of the extremity; inherent mechanical stability at the osteotomy sites afforded by the Chevron cuts; several features designed to enhance rapid fusion, including the congruity and stability of the cuts made, onlay bone grafting and rigid internal compression fixation; a normal-looking ankle contour postoperatively, resulting in a superior cosmetic result. The operation has been utilized at St. Anne's Hospitals and can be augmented for use in pantalar arthrodesis.

Ankle Joint↗
PubMed1984

Less rigid internal fixation plates: historical perspectives and new concepts.

In the application of "rigid" plates for diaphyseal fractures, lack of callus healing and overprotection of the underlying bone are viewed by many investigators as undesirable consequences. Potential solutions offered to overcome these deficiencies include modification of the timing of plate removal, use of biologically degradable materials for plates so that stress-shielding can be minimized, and use of less rigid plate fixation systems. This study emphasizes the selection of appropriate design criteria for less rigid plate-fixation systems. To accomplish this goal, the axial, bending, and torsional stiffness parameters are considered in place of the oversimplified terms such as "flexible plate" or "elastic fixation." With the aid of finite element modeling and simplified bench experiments, we performed parametric studies and singled out the plate axial stiffness as the dominant factor in altering the bone stresses. As a result, we designed two experimental plates, one a thin Ti-6Al-4V (titanium with 6% aluminum and 4% vanadium) alloy plate with low stiffness in axial and bending directions, and the other a tubular stainless steel plate with low stiffness in the axial direction but moderate stiffness in bending and torsional directions. The low-stiffness Ti-6Al-4V alloy plate was first tested in a demanding bilateral canine midshaft osteotomy, and proved to be inadequate. Both experimental plates were successful in the unilateral osteotomies, with the tubular plate yielding the best results. After 6 months of plating, the bones beneath the tubular plate had superior mechanical and structural properties as compared to those of the control "rigid" stainless steel and the Ti-6Al-4V alloy plates. Application of this plate prolonged for 9 months did not cause reduction in bone properties and strength. The success of the tubular plate is due to its moderate bending and torsional stiffnesses, which provide adequate fixation to achieve callus union, while its low axial stiffness permits the underlying bone to share the physiological stresses needed for bone remodeling. These drastic changes in mechanical demands on the internal fixation plate during the early healing phase and the postunion remodeling phase are discussed.

Alloys↗
PubMed1994

Open reduction and internal fixation method for fractures at the proximal interphalangeal joint.

When fragment size and mineralization permit, unstable and displaced proximal interphalangeal joint fractures can be secured in an anatomic position by any one of a number of direct (through the fragments) or indirect (buttress) pinning or screw fixation techniques. Transcutaneous or limited open reduction and fixation techniques are preferred in an effort to minimize additional soft tissue trauma and scarring. Plating is reserved for fractures otherwise difficult, if not impossible, to retain. The objectives of these internal fixation techniques are pain control and early active functional restoration.

Finger Injuries↗
PubMed1989

Ninety-ninety intraosseous wiring for internal fixation of the digital skeleton.

Ninety-ninety intraosseous wiring has been used in more than 150 cases over the last 4 years to obtain skeletal stability. This technique has been effective for the internal fixation of replanted parts, arthrodeses, transverse fractures, and elective free-tissue transfers. All osteotomies and fractures healed promptly, usually within 6 weeks. There have been no instances of nonunion, malunion, or implant failure. Only one wire had to be removed due to its prominence. Ninety-ninety intraosseous wiring is an expeditious, straightforward, and very stable method to secure rigid internal fixation and allow early active motion of the digital skeleton.

Amputation, Traumatic↗
PubMed2006

Arthroscopic assisted reduction and internal fixation of lateral femoral epiphyseal injury in adolescent soccer player: a report of one case.

Ligament injuries are more common than fractures in adolescents. We operated on an adolescent soccer player, who had a lateral femoral epiphyseal injury using arthroscopic-assisted reduction and percutaneous internal fixation. During second-look arthroscopy 2 years after the first operation, there was articular cartilage congruity, without any visible step-off. The axial alignment did not reveal any residual valgus deformity.

Adolescent↗
PubMed2003

Percutaneous internal fixation of selected scaphoid nonunions with an arthroscopically assisted dorsal approach.

BACKGROUND: Preliminary reports have indicated that selected scaphoid nonunions-i.e., those that are well aligned and without extensive sclerosis or bone resorption at the nonunion site-can be treated effectively with internal fixation alone. We examined the feasibility of percutaneous fixation in a series of such nonunions. METHODS: A consecutive series of fifteen patients with fibrous union or nonunion of a carpal scaphoid fracture with minimal sclerosis or resorption at the nonunion site were treated with rigid fixation alone (without bone graft) with a headless compression screw inserted with a dorsal percutaneous technique. RESULTS: Clinical examination, standard radiographs, and computed tomography scans confirmed union in all patients at an average of fourteen weeks. Nonunions treated less than six months after the injury healed faster than those treated later (p < 0.02). According to the Mayo modified wrist score, there were twelve excellent and three good results. CONCLUSIONS: The results in our series were due to careful examination and grading of the scaphoid nonunions preoperatively. The findings in this small series support the observation in earlier reports that percutaneous repair of selected scaphoid nonunions requires only rigid fixation to achieve healing.

Adolescent↗
PubMed1987

Osteotomy of the trochanter in open reduction and internal fixation of acetabular fractures.

Osteotomy of the trochanter can enhance lateral and posterior exposures of the acetabulum and the retro-acetabular space. Over a two-year period, an osteotomy of the trochanter was done in ten patients in connection with open reduction and internal fixation of a displaced acetabular fracture. The trochanter was reattached by two 6.5-millimeter cancellous screws. All of the osteotomies healed uneventfully, with no evidence of migration of the trochanter. Since these fractures tend to occur in younger patients who have healthy bone, non-union of the trochanter is unlikely to be a problem.

Acetabulum↗
PubMed1982

Internal fixation of a tibial fracture in an adult horse.

A 3-year-old Thoroughbred mare was examined because of hindlimb lameness from incomplete fracture of the tibia, which became a complete diaphyseal fracture during the examination. The fracture was repaired by open reduction and internal fixation with lag screws and 2 neutralization plates. A cranial approach was used and the plates were placed craniolateral and medial on the tibia. At 18 months after surgery, there was no evidence of complications resulting from the fracture or its repair. It was concluded that a cranial approach with craniolateral and medial plate placement allows easier insertion and gives increased stability over previously described methods.

Animals↗
PubMed2001

Simultaneous management of ipsilateral gonarthritis and ununited tibial stress fracture: combined total knee arthroplasty and internal fixation.

Nonunion of a proximal tibial stress fracture is rare and can be difficult to manage, especially if associated with ipsilateral gonarthritis. Three patients with nonunion of a proximal tibial stress fracture adjacent to an arthritic knee joint were managed by performing simultaneous total knee arthroplasty and internal fixation of the fracture site. The technique involved performing a total knee arthroplasty with angular correction at the site of the extra-articular and intra-articular deformity, bone grafting of the nonunion site, and stabilization of the fracture with a long uncemented intramedullary stemmed tibial component and a unicortical plate. Fibular ostectomy was required during the index surgery in 2 cases to achieve the desired angular correction. In all 3 patients, healing of the nonunion site and limb realignment was achieved. There were no complications or infections associated with the surgery. All patients progressed to full weight bearing at 3 months and had clinical and radiographic union of the nonunion site at 6 months.

Aged↗
PubMed1995

Arthroscopic reduction and internal fixation of distal radius fractures.

Despite recent advances in the treatment of complex distal radius fractures, problems of stiffness, carpal instability, and posttraumatic arthritis remain in a significant number of cases. Associated soft-tissue and ligamentous injuries are being recognized with increasing frequency. Arthroscopic reduction and internal fixation not only allow for anatomic reduction of the distal radius fracture with minimal surgical trauma, but provides a valid diagnostic and treatment alternative for the often missed associated injuries.

Adult↗
PubMed1994

Open reduction and internal fixation of fractures of the acetabulum. Results in 163 fractures.

Management of displaced fractures of the acetabulum represents one of the greatest challenges in fracture surgery. This study reports intermediate term results for a single surgeon of 163 fractures in 161 patients treated by open reduction and internal fixation. The mean length of followup was 3.7 years. The most common fracture patterns treated were both column (67), transverse/posterior wall (32), posterior wall (14), and T shaped (12). The surgical approaches chosen were ilioinguinal (86), Kocher-Langenbeck (58), and extended iliofemoral (26) with 7 patients having sequential or simultaneous dual approaches. Reductions were rated by plain radiography and considered anatomic in 93 (56%) and near anatomic (< 2 mm displacement) in 40 (25%). There were 7 (4%) infections, 2 (1%) vascular injuries, 3 (2%) sciatic injuries, and 1 (1%) obturator nerve injury. Overall outcome was rated as excellent in 23 (14%), good in 101 (61%), fair in 25 (16%), and poor in 14 (9%). Nine patients have undergone hip salvage procedures. These results add to the growing body of clinical data which validates open reduction as the treatment of choice in most displaced fractures of the acetabulum.

Acetabulum↗