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At least 1,459 records · Page 81Linked to original sources
PubMed1988

Skeletal stability following sagittal split osteotomy using monocortical miniplate internal fixation.

Skeletal stability was evaluated in 20 patients with mandibular hypoplasia, treated with bilateral sagittal split osteotomies to advance the mandible. Stable internal fixation was obtained using osseous miniplates and monocortical screws. Intermaxillary fixation was released after 5.15 days (range 1 to 11 days). The average B-point advancement was 6.07 mm (range 2.25 to 17.5 mm) and the average Pogonion-point advancement was 5.39 mm (range 1.75 to 14 mm). Mandibular range of motion, TMJ dysfunction and neurosensory deficits were also evaluated. The follow-up period averaged 8.85 months (range 6 to 14 months) and final evaluations were made after completion of orthodontics. Relapse measured at B-point was 10.7% and at Pogonion was 18.7%. Maximal opening decreased an average of 0.47 mm. Symptoms in 8 patients with TMJ dysfunction resolved, while 3 others developed TMJ dysfunction following surgery. Neurosensory deficits were subjectively identified in 9 patients (10 sides) and were objectively measured in 5 patients (5 sides).

Bone Plates↗
PubMed1989

Subcapital fractures after open reduction and internal fixation of intertrochanteric fractures of the hip. Report of three cases.

Three cases of subcapital fractures were discovered after open reduction and internal fixation of intertrochanteric fractures of the hip. These fractures: (1) illustrate devices and methods that contribute to this complication; (2) occur typically in elderly patients with an osteoporotic type of bone; and (3) indicate measures necessary to avoid this complication.

Aged↗
PubMed1999

Internal fixation of the sternum in median sternotomy dehiscence.

Sternal dehiscence may be defined as separation of the bony sternum and manubrium following median sternotomy. It may occur at any time postoperatively and has various etiologies. Restoration of sternal integrity in sternal dehiscence is a challenging problem, particularly when associated with deep-seated infection. This report reviews a single-stage technique that virtually eliminates the infected sternotomy wound and provides anatomic reduction and stabilization of the sternum. Complete debridement of infected and/or nonviable soft tissue, bone, and cartilage is followed by pulse irrigation. Parallel stainless steel mandibular reconstruction plates are then placed on each side of the remaining sternum and wired together. One or more transmanubrial compression plates may be added. Bilateral pectoralis major musculocutaneous flap advancement and primary skin closure is performed over two to three closed suction drains. From January of 1994 to July of 1996, this technique was used by the same surgeon in 26 male and 4 female patients aged 43 to 78 years (mean = 61). Indications for the operation were sternal dehiscence with infection (osteomyelitis and/or mediastinitis) in 14 patients and sternal dehiscence without infection in 16 patients. All patients survived to discharge with mean time on the ventilator, intensive care unit length of stay, and postoperative length of stay of 0.7, 2, and 8 days, respectively. Choice and duration of antibiotics were based on culture results and operative findings. Subsequent hardware removal was necessary in one patient for hardware loosening and three patients for late periplate infection. A closed wound was eventually achieved in all 30 patients, and sternal stability was restored in 29 patients. In the management of sternal dehiscence, the described technique of internal fixation can provide anatomic sternal reduction and stabilization, elimination of infection, and wound closure in a single-stage operation. Successful outcomes were achieved despite the presence of severe infection.

Adult↗
PubMed1997

Strength recovery in fractured sheep tibia treated with a plate or an internal fixator: an experimental study with a two-year follow-up.

OBJECTIVES: Comparison of fracture healing with two different implants: a conventional Dynamic Compression Plate (DCP) and a new internal Point Contact Fixator (PC-Fix). DESIGN: Randomized, prospective study in experimental animals. Observation times: 12, 24, 48 and 96 weeks, with six sheep per group. SETTING: Following surgery, animals were kept with unrestricted weight-bearing in individual stalls for 12 weeks, thereafter in groups. ANIMALS: 56 adult Swiss mountain sheep. INTERVENTION: A standardized oblique fracture of the sheep tibia was reduced and compressed by a lag screw and "neutralized" with one of the implants. MAIN OUTCOME MEASUREMENTS: Standard radiographs were used for callus size measurements. After sacrifice the implant was removed and both the treated bone and the contralateral bone were tested for static strength in bending with the plate side under tension. Broken bones were processed for histological evaluation. RESULTS: In the DCP group all six bones failed through the original fracture at 12 weeks. At 24 and 48 weeks two out of six, at 96 weeks one out of six bones failed through the original fracture, others through one of the screw holes. In the PC-Fix group there were no failures through the original fracture with a single exception at 96 weeks. The strength values in the PC-Fix groups of 12 and 96 weeks were significantly higher then in the corresponding DCP groups. CONCLUSIONS: Healing of simple diaphysial fractures treated by PC-Fix was superior to that achieved by conventional plating. The histological evaluation suggested that the observed differences can be accounted for by the absence of implant-related cortical necrosis and by the circumferentially uninterrupted (if smaller) callus in the PC-Fix group.

Animals↗
PubMed1998

In vitro short-term response of human erythrocytes to implant materials used in maxillo-facial rigid internal fixation.

A short-term in vitro experimental study was performed to analyze the effects of metallic miniplates used in maxillo-facial rigid internal fixation on some functional features of human erythrocytes that represent a pivotal rheological component for correct blood flow in the tissular area surrounding metallic implants. In our working conditions, no interference on osmotic fragility, intracellular ATP content and spontaneous hemolysis was observed. Conversely, a statistically significant increase of rigidity in the deeper lipid region of erythrocyte membrane was verified. On the basis of our results, the in vitro erythrocyte modifications after 18 h of whole blood/metallic device contact are relatively small and negligible.

Biocompatible Materials↗
PubMed1988

Anatomic reconstruction and functional rehabilitation of oromandibular defects with rigid internal fixation.

Fifteen consecutive patients undergoing extensive surgery for head and neck cancer involving the oral cavity and oropharynx were reconstructed using the technique of rigid internal fixation combined with various vascularized flaps. The follow-up ranged from 6 to 18 months. Modifications in various myocutaneous or vascularized free flaps combined with an analysis of the radiation physics necessary to make this procedure a viable alternative for immediate and delayed mandibular reconstruction will be discussed. Consistently satisfactory functional and cosmetic results have been achieved.

Adult↗
PubMed1985

Lateral acetabular bone graft in total hip arthroplasty. A three- to eight-year follow-up study without internal fixation.

A series of 20 total hip arthroplasties were performed on 17 patients with significant acetabular deficiencies. Autogeneic femoral head bone grafting was performed without internal fixation. There was one failure caused by inadequate support of the graft, and this operation was revised. All grafts united within six months of surgery. Long-term follow-up evaluation revealed no evidence of progressive radiolucency or graft resorption.

Acetabulum↗
PubMed1975

Improved healing of experimental long bone fractures in rabbits by delayed internal fixation.

Experiments in rabbits were conducted to test the clinical propositions that a) the risk of nonunion in certain long bone fractures can be sharply reduced by open reduction and internal fixation, and b) that there is an optimum critical period following trauma in which this procedure should be carried out to facilitate healing. Bilateral standard open fractures of rabbit radii were internally fixed by intramedullary K-wires immediately or at 5, 10, and 17 days after trauma. These bones were subjected to stress and histometric analyses at 4-56 days after the initial fractures. The observations suggested that the pace of fracture healing could be optimized by time-delay surgery. The most exuberant and strongest calluses developed when the bones were fixed 10 days after fracture, and the rate of healing was improved. Delay times of 5 or 17 days did not provide better healing than that achieved by an immediate operation. Callus quality, in terms of the proportion of fiber bone, lamellar bone, and cartilage, was similar in all groups. The tensile strengths of the bones during callus formation were highly correlated with the ratio of callus/cortical bone areas (p less than 0.01).

Animals↗
PubMed1992

Severe aseptic synovitis of the knee after biodegradable internal fixation. A case report.

Biodegradable rods made of polyglycolide (Dexon, Biofix) or lactide-glycolide copolymer (Vicryl) have been used for the past 5 years for internal fixation of a variety of fractures and osteotomies (Böstman et al. 1989, 1990b). Experience from using such rods for fixation of intraarticular osteochondral lesions seems to be less extensive. We report a case of severe synovial reaction to biodegradable rods used for fixation of osteochondritis dissecans of the knee and discuss possible reasons for the increased risk of foreign-body reactions when these rods are used intraarticularly.

Adult↗
PubMed2000

A biomechanical evaluation of internal fixation for ankle arthrodesis comparing two methods of joint surface preparation.

This study compared the biomechanics of two methods of joint preparation for ankle fusion with internal fixation. In the first method, the articular cartilage of the ankle joint was removed leaving the joint contour intact. In the second method, parallel flat saw cuts were used to prepare the joint surface for fusion. The specimens were loaded submaximally in a cyclic repetitive fashion before they were loaded to failure. Increasing joint motion occurred as the number of cycles increased. The difference between the two specimen types was not statistically significant during the repetitive tests or when loaded to failure. These results demonstrate both techniques of joint preparation studied are useful and biomechanically sound.

Adult↗
PubMed1987

A new material (single crystal sapphire screw) for internal fixation of the mandibular ramus.

A new single crystal sapphire bone screw which has favourable properties such as chemical stability, mechanical strength and biocompatibility, was applied for rigid internal fixation of the sagittal split osteotomies in 86 cases since 1982. Radiographic findings supported the excellent biocompatibility of the material; there was no noticeable bone loss around the screw and the excellent bone adaptation to the threaded portion was observed. The screws can mechanically support the split mandibular rami until bone union occurs. Complications due to the screw were not encountered in follow-up periods of 0.5-3.5 years.

Aluminum↗
PubMedDate not supplied

Internal fixation of distal fibula fractures: a case presentation demonstrating a unique technique for a severely comminuted fibula.

The laterally comminuted fracture-dislocation of the ankle can be associated with devastating consequences. Previously described surgical as well as nonsurgical-treatment results have been disappointing. Accurate anatomical reduction and rigid fracture stabilization of a comminuted fibula can be extremely difficult. This manuscript presents some of the more common methods of comminuted fibular fracture fixation described in the literature. A case report demonstrates successful anatomical stabilization of a comminuted fibula, utilizing a method for internal fibular fixation which has been previously employed, but has not been advocated, in the literature. Clinical and radiographic results at 12 and 20 months post-injury are promising.

Adult↗
PubMed2001

Effect of an internal fixator and a bone graft on intersegmental spinal motion and intradiscal pressure in the adjacent regions.

Stabilizing a lumbar spine with an implant alters the mechanical properties of the bridged region. In order to determine whether this procedure is associated with higher loads in the adjacent segments, seven lumbar cadaver spines were mounted in a spine tester and loaded with pure moments of flexion/extension, left and right lateral bending, and left and right axial rotation. The material studied comprised intact lumbar spines, intact spines with bisegmental internal spinal fixators, and postcorpectomy spines both with a graft and fixators and with fixators alone. Intradiscal pressures and intersegmental motion were measured at all levels. In the bridged region, these parameters were strongly affected by an internal fixator. In most cases, the effect was small in the regions above and below the fixators. Highly significant differences in these regions (P<0.01) were far below the interspecimen range. We did not find any case where both intradiscal pressure changes and intersegmental motion showed highly significantly differences in the regions adjacent to the bridged one. Our results suggest that disc degeneration, which is sometimes found at the level directly above and below the fixators, is not caused by mechanical factors.

Adult↗
PubMed1984

Arthrodesis of the wrist by internal fixation in rheumatoid arthritis: a follow-up study of forty-five consecutive cases.

Between 1972 and 1981, 59 wrists of 44 patients destroyed by rheumatoid arthritis were arthrodesed by internal fixation with a Rush pin. This study comprises 45 wrists of 38 surviving patients--nine men and 29 women, aged 20 to 72 years. The follow-up time ranged from 1 to 11 years with a mean of 3.9 years. The surgical technique used in this study is simple and safe, and a good position of the wrist in both frontal and lateral projections can easily be achieved. The Rush pin is passed down the third metacarpal and into the radius. It stabilizes the wrist adequately. All the wrists operated on obtained a strong bony fusion of the radiocarpal joint. The complication rate was low. Five of 45 Rush pins were removed because the subcutaneously located distal tip between the metacarpals irritated tendons and skin. In one male patient a thin Rush pin broke and a pseudoarthrosis of the intercarpal joints developed; there was, however, no need to remove the pin.

Adult↗
PubMed1990

The surgical treatment of skeletal anterior open-bite deformities with rigid internal fixation in the mandible.

The rationale for the surgical correction of skeletal anterior open-bite deformities by bilateral mandibular rotation osteotomy is presented. Results of this procedure in which rigid internal fixation is used are reported and show a very high degree of long-term stability. The procedure offers a useful alternative to the more common approach of posterior maxillary intrusion, which does not always address the cosmetic defect.

Bone Plates↗
PubMed2006

Internal fixation of distal radius fractures with novel intramedullary implants.

UNLABELLED: Fracture of the distal radius is a common injury and treatment varies depending on the fracture, patient factors, and surgeon preference. Internal fixation has grown in popularity because it affords increased stability and early motion of the extremity. The desire to provide stable fracture support while minimizing soft tissue dissection and complications has led to the development of new intramedullary implants. These implants use distal screw divergence for subchondral support, fixed-angle screws locked to the implant, and minimally invasive technique to allow early patient rehabilitation. Early results of these intramedullary devices are promising but require longer followup. LEVEL OF EVIDENCE: Level IV (expert opinion).

Bone Plates↗
PubMed1980

Mortality patterns following internal fixation for acute femoral neck fractures in the elderly with special emphasis on potential excess mortality following reoperations.

Mortality patterns and excess mortality have been studied and quantified in 103 patients treated with internal fixation for acute, displaced femoral neck fractures with special emphasis on the potential excess mortality which may follow later operations for capital necrosis, failure of the osteosynthesis, etc. Of 103 patients studied 31 needed one or more reoperations. We have confirmed previously published reports that excess mortality is limited to the first six months after the primary operation. Quantification of the excess mortality which may follow reoperations shows that later operations are not followed by an increased death rate compared with the standard population.

Aged↗