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At least 1,603 records · Page 89Linked to original sources
PubMed2001

Intra-articular fracture of the knee with spondyloepiphyseal dysplasia congenita: successful result of open reduction and internal fixation.

In spondyloepiphyseal dysplasia congenita (SEDC), since the cartilage is congenitally abnormal, functional recovery of an intra-articular fracture is uncertain even with surgical treatment. We report a 29-year-old Japanese woman with SEDC whose left knee injury (intercondylar femur fracture and tibial plateau fracture) was surgically reduced and fixed. Although special care was required during the operation for associated atlantoaxial instability and cardiopulmonary suppression due to severe thoracolumbar kyphoscoliosis as well as osteopenia, she had neither restriction of knee motion nor pain at follow-up 2 years and 4 months after surgery. Therefore, although the situation involving fractures in a patient with SEDC is complicated, we believe the main problem to be solved is whether the risk-related kyphoscoliosis and atlantoaxial instability can be managed or not. Fractures themselves can be treated based on the principles used for patients without SEDC.

Adult↗
PubMed2000

The unreamed tibia nail. Multicenter study of the AO/ASIF. Osteosynthesefragen/Association for the Study of Internal Fixation.

In the last 10 years, traumatologists have become more aware of the importance of blood supply to fracture fragments for both the healing of fractures and prevention of infection. Due to our experience with fractures having severely disrupted periosteal blood supply, we are looking more critically at intramedullary reamed nailing as a treatment option. This research was a result of our increased knowledge of the interplay between periosteal and endosteal blood supply.

Adolescent↗
PubMed1988

Mobility of the mandible following advancement and maxillomandibular or rigid internal fixation: an experimental investigation in Macaca mulatta.

This study examined the postsurgical range of mandibular motion following sagittal advancement osteotomy in Macaca mulatta when either maxillomandibular or rigid osseous fixation were used. Seventeen adult female Macaca mulatta underwent sagittal advancement osteotomy of approximately 4 to 6 mm. Six had 6 weeks of maxillomandibular fixation and eleven had rigid osseous fixation with no maxillomandibular fixation. Mandibular range of motion was measured by the change in the angle of the posterior aspect of the mandibular ramus from a closed-mouth and an open-mouth cephalogram. Parametric tests were used to statistically analyze the results. The results of this investigation showed that the animals who did not undergo maxillomandibular fixation maintained a greater range of motion in the early postsurgical period and obtained preoperative mobility by 12 weeks postsurgery. The animals who underwent six weeks of maxillomandibular fixation showed statistically significant decreases in range of motion when compared to the rigid fixation group at each period of time postsurgery, with significant reductions from preoperative values at 12 weeks postsurgery.

Animals↗
PubMed2006

Biomechanical study of prophylactic internal fixation of the radial osteocutaneous donor site using the sheep tibia model.

This study investigated the strengthening effect of different types of plate and position after osteotomy of the sheep tibia, which is a model for the radial osteocutaneous donor site. Fifty matched pairs of adult sheep tibias were tested in torsion and four-point bending. Firstly, the weakening effect of an osteotomy was compared with the intact bone. Then pairs of bones with an osteotomy were compared with and without reinforcement with different types of 3.5mm plate. The plate was placed in either the anterior (over the defect) or posterior (on the intact cortex) position. In torsion the mean strength of the intact bone was 45% greater than after osteotomy (P=0.02). The reinforced bone was on average 61% stronger than the unreinforced bone (P<0.001). In bending the mean strength of the intact bone was 188% greater than after osteotomy (P=0.02). The reinforced bone was on average 184% stronger then the unreinforced bone (P<0.001). The tibia was able to withstand much greater loads in bending. The dynamic compression plate was the strongest reinforcement in both torsion and bending. The position of the plate did not alter the strengthening effect in torsion but the posterior position resisted greater bending loads (P=0.01). This may not be relevant in clinical practice as the radius is likely to fracture first as a result of lower torsional forces.

Analysis of Variance↗
PubMed2006

Masticatory function and neurosensory disturbance after mandibular correction by bilateral sagittal split ramus osteotomy: a comparison between miniplate and bicortical screw rigid internal fixation.

Bilateral sagittal split osteotomy is commonly used to treat mandibular prognathism. Several fixation methods for bony segments have been described. The present study compared masticatory function and neurosensory recovery patterns after mandibular correction between two methods of rigid fixation, bicortical screw (n = 38) and monocortical miniplate (n = 32). Patients who had undergone bilateral sagittal split osteotomy for Class III malocclusion were reviewed, and masticatory function and neurosensory recovery were studied with the appropriate indicators at 1, 3, 6 and 12 months postoperatively. Minimal differences were seen between groups at 1-year postoperatively, and although patients treated with miniplate fixation tended to recover faster, with regard to masticatory function and neurosensory disturbance, than those treated with screw fixation, no significant differences were identified. As the two methods seem to provide equal comfort and reliability, the choice should be made by the individual surgeon.

Adolescent↗
PubMed2005

Coronal fractures of the distal femoral condyle: a biomechanical evaluation of four internal fixation constructs.

This study evaluated different fixation methods in posterior femoral condyle coronal fractures. A standardised osteotomy was created in synthetic composite femurs and fixed with one of four methods (one 3.5 mm diameter screw, two 3.5 mm screws, one 6.5 mm screw, two 6.5 mm screws). The stiffness and mean loads to specified displacements were measured. The stiffness of two 6.5 mm screws was significantly greater than both single 3.5 mm screw (3567 versus 2584N/mm; p=0.0075) and double 3.5 mm screws (3567 versus 2080N/mm; p=0.003). There was no statistical difference in the stiffness of one 6.5 mm screw compared to either the single or double 3.5mm screws. Increasing the screw diameter and using two screws increased the load at 1, 2 and 3 mm of displacement. In the fixation of posterior femoral condyle fractures, two 6.5 mm screws are more rigid than either single or double 3.5 mm screws. The use of a second screw marginally increases the rigidity of fixation. If 3.5 mm screws are used in the fixation of posterior femoral condyle fractures, at least two screws should be used to approximate the biomechanical stability of a single 6.5 mm screw.

Biomechanical Phenomena↗
PubMed2005

The periauricular transparotid approach for open reduction and internal fixation of condylar fractures.

INTRODUCTION: Treatment of fractures of the mandibular condyle fractures varies among centres as there still is no general consensus. The aim of this paper was to determine the safety and efficiency of surgical treatment using a transparotid approach for direct plating. PATIENTS AND METHODS: A prospective clinical study was conducted on 34 patients with 36 fractures of the condyle. All 36 fractures were displaced, and 14 (39%) of them were fracture dislocations. The fractures were treated surgically with a transparotid facelift or retromandibular approach using miniplates and screws for fixation. Patients were carefully followed up and were asked to answer a survey paper 2-39 months postoperatively. RESULTS: Occlusion practically identical to the pretraumatic condition was achieved in 31 out of 33 dentate patients (94%). Postoperative interincisal distance was 30-61 mm (mean 44 mm), 4 patients (12%) had postoperative deflection to the side of injury during mouth opening. Facial symmetry was achieved in all of the patients. Eight out of 36 cases (22%) had a transient weakness of certain ipsilateral facial muscle groups, lasting for 4-8 weeks. In one of these patients, a mild weakness of the upper lip and lower eyelid persisted after 13 months. There were 5 cases of miniplate fractures (14%), all of them in patients in whom 1.7 or thinner miniplates were used. There were 5 cases of salivary fistulae (14%), all of them in patients where the parotid capsule was not closed in a watertight fashion. According to the postoperative survey completed by 32 patients, 30 of them (94%) were very satisfied with the outcome of treatment. CONCLUSION: If conducted properly, the transparotid facelift approach offers a safe and effective approach for direct fixation of condylar fractures.

Adolescent↗
PubMed2001

The results of internal fixation of three- and four-part proximal humeral fractures with the Polarus nail.

Twenty-three patients with acute displaced three- and four-part fractures of the proximal humerus, including seven patients with associated shaft involvement, were treated with the Polarus intramedullary interlocking nail using a closed technique. At the 1-year follow up, the median Neer scores were 89 and 60 for the three- and four-part fractures, respectively. Three patients (13%), all of whom were in the four-part group, continued to have significant pain at final review. We found the implant to be extremely satisfactory and particularly useful in the treatment of combined neck and shaft fractures of the humerus.

Adult↗