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At least 1,531 records · Page 85Linked to original sources
PubMed1992

[Spinal internal fixator--analysis of problems in 28 cases].

Problems encountered in the management of thoracolumbar and lumbar spinal fractures with the "fixateur interne" are reviewed. 28 patients were treated between 1986 and 1988. Retrospective analysis identified the following problems: a. Loosening of nuts at the longitudinal rod and/or clamp ends--b. Major corrosion defects of Schanz screws and clamps--c. Large implant volume--d. Non-availability of intermediate rod lengths. Earlier problems, i.e. the absence of an effective press-fit (transverse stabilizer) between the 2 longitudinal rods and the non-availability of a cutter for trimming the Schanz screws, have meanwhile been resolved. Loosening of the nuts at the clamp end may cause substantial loss of reduction and jeopardize the outcome of treatment. The problem of how to identify loosening, which is usually recognizable within 27 days, is discussed at length. Since loosening occurs irrespective of fracture type and site, instrumentation length, ancillary surgical procedures, type of postoperative care, preoperative neurological status and operating surgeon, it appears to be inherent in the system. Alterations in neighbouring vertebral segments attributable to rebundant rod lengths cannot altogether be excluded. The potential occurrence of corrosion defects should prompt implant removal after radiologically confirmed fracture healing.

Adult↗
PubMed1977

A comparison of the treatment of trochanteric fractures of the femur by internal fixation with a nail plate and the Ender technique.

In our experience, trochanteric fractures fixed with Ender nails achieved a degree of success similar to those treated by nail plating, but the risk of wound infection was much less with the former method. The results of 78 trochanteric fractures of the femur internally fixed with Ender nails have been analysed and compared with the results in 100 similar patients treated by nail plate fixation. The Ender method has advantages over existing operative methods, in that in our series the infection rate was zero and we found that the operation produced less shock. We consider that this method, although technically more difficult, can be used for most intertrochanteric fractures and merits further trial.

Adult↗
PubMed1994

Skeletal stability after mandibular advancement: a comparison of two rigid internal fixation techniques.

OBJECTIVE: To compare two different methods of rigid fixation for any difference in postoperative stability after mandibular advancement. MATERIAL AND METHODS: Thirty-eight patients with Class II malocclusion treated by bilateral sagittal split osteotomy (BSSO) and mandibular advancement were selected for this retrospective study. Group A (n = 16) had noncompressive bicortical screws inserted in the gonial area through a transcutaneous approach and Group B (n = 22) had the bone segments fixed with unicortical screws and miniplates on the lateral surface of the mandibular body. Cephalograms were taken preoperatively, 2 days postoperatively, and 6 months after the operation, and a computer program was used to superimpose the three cephalograms and register the advancement and postoperative instability. RESULTS: There was a minimal difference in advancement of the mandible in the two groups. Statistical analysis showed no significant difference in postsurgical stability. However, positive correlation between the amount of advancement and the amount of postsurgical instability was demonstrated using a linear multiple regression test (P = .0002). CONCLUSION: This study indicates that the two different methods of internal rigid fixation of the segments after surgical advancement of the mandible give equal stability postoperatively and their use is a matter of surgical choice.

Adult↗
PubMed1990

Intertrochanteric femoral fractures. Mechanical failure after internal fixation.

In a prospective study we assessed the causes of mechanical failure in a series of 230 intertrochanteric femoral fractures which had been internally fixed with either a sliding hip screw or a Küntscher Y-nail. The overall rate of mechanical failure was 16.5%; cutting-out of the implant from the femoral head was the cause in three-quarters of the instances. Implants placed posteriorly in the femoral head cut out more often (27%) than those placed centrally (7%). The cut-out rate was also determined by the quality of the fracture reduction, but age, walking ability and bone density (assessed by the Singh grade and metacarpal indices) had no significant influence. We conclude that these fractures should be reduced as accurately as possible and it is imperative that the implant is placed centrally within the femoral head.

Aged↗
PubMed1980

Carbon fibre reinforced epoxy as a high strength, low modulus material for internal fixation plates.

A multi-axial carbon fibre/epoxy composite fracture plate has been developed. This type of plate appears to allow early consolidation of internally fixed fractures whilst avoiding the ensuing disadvantage of 'plate induced osteopoenia' which are observed with metal devices. The mechanical properties of these plates (determined 'in vitro') are reported, along with early results of implantation in sheep.

Animals↗
PubMed1994

Internal fixation of volar-displaced distal radial fractures.

We reviewed a series of 79 distal radial fractures with volar displacement which had been fixed internally using a buttress plate. The fractures were classified using the Frykman and AO systems; 59% were intraarticular. Complications occurred in 40.5% of cases; malunion was most frequent (28%). Functional recovery in patients with malunion was significantly worse than in those with good anatomical restoration (p < 0.001). The AO and Frykman classifications and the degree of restoration of volar tilt were predictive of outcome.

Activities of Daily Living↗
PubMed1979

Internal fixation versus nontreatment of hip fractures in senile patients.

Institutionalized senile patients with hip fractures have a high mortality regardless of whether treatment consists of internal stabilization or is non-operative. In an effort to select the best therapeutic approach in this type of patient, 150 patients were examined in 3 comparable groups. In the first group of 50 patients treatment consisted of surgical stabilization of the fracture. In the second group of 45 patients treatment was non-operative; mortality in these 2 groups was over 50% at the end of 16 weeks. In an effort to improve this degree of risk we transferred 53 patients from the psychiatric hospital to a general hospital for prompt internal stabilization of the hip fractures. There was a striking decrease in mortality to 28% in the third group. We have concluded that under optimal conditions, prompt surgical stabilization of hip fractures in elderly senile individuals offers them the best opportunity of surviving the injury and is preferable to nontreatment.

Aged↗
PubMed2003

Internal fixation after intra-articular fracture of the distal ulna.

We describe a patient who sustained a displaced isolated intra-articular fracture of the distal ulna, causing limitation of rotation of the forearm. The extent of displacement of the fracture which was not evident on plain radiographs was revealed by CT. The fracture was reduced and internally fixed using a standard technique applicable to the fixation of fractures of the radial head. Full movement was restored. An isolated injury to the distal ulna is rare and requires careful clinical and radiological assessment.

Fracture Fixation, Internal↗
PubMed1986

Immediate internal fixation of open fractures of the diaphysis of the forearm.

Between 1975 and 1983, fifty-seven patients were treated at Sunnybrook and Harborview Medical Centers with immediate internal plate fixation of an open diaphyseal fracture of the forearm. Fifty patients were available for follow-up, which ranged from one to nine years and averaged three years. The injuries were classified on the basis of the extent of soft-tissue injury as defined by Gustilo and Anderson, and consisted of twenty Type-I injuries, nineteen Type-II injuries, and eleven Type-III injuries. The complications included deep infection in two patients and non-union in six. The functional results were excellent or good in 85 per cent of the series. This study demonstrates that immediate stable plate fixation is a beneficial method of treatment of open fractures of the forearm. The results are related to the severity of the initial soft-tissue injury and the surgical technique. Autogenous cancellous bone-grafting at the time of closure of the wound in comminuted fractures in which interfragmental compression cannot be obtained is recommended.

Adolescent↗
PubMed1985

Arthroscopic assisted internal fixation of certain fractures about the knee.

A technique is presented by which single-fragment, major intra-articular fractures about the knee can be reduced anatomically under arthroscopic control and internally fixed with percutaneously placed cancellous screws. A displaced intra-articular fracture of the femoral condyle and a tibial plateau fracture were treated utilizing this technique. Both patients obtained excellent results with rapid return of function of the injured limb.

Adolescent↗
PubMedDate not supplied

Perioperative care of patients undergoing spinal stabilization with internal fixation (continuing education credit).

1. Low back pain affects approximately 80% of the adult population. There are between 200,000 and 500,000 spinal surgeries performed every year. 2. New spinal implant systems offer hope for persons with failed spinal surgery--as well as for those with spinal fractures, metastatic disease, and severe degenerative disorders. 3. Although complications can develop, the benefits of new spinal fixation systems far outweigh the problems.

Humans↗
PubMed1984

[Osteosynthesis of severe injuries of the thoracic and lumbar spine with internal fixation].

From a posterior approach long Schanz screws are inserted through the pedicles into the bodies of the two vertebrae just adjacent to the lesion and connected by the threaded Fixateur-interne-rods. By tightening the nuts the Schanz screws are fixed in all directions. The advantages of the F.I.-system are: excellent reposition by the long lever-arm of the Schanz screws, immobilization of only two segments avoiding the iatrogenic loss of mobility and lumbar lordosis, stability against flexion forces better than with Harrington distraction rods, additional rotational stability.

Fracture Fixation, Internal↗