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At least 163 records · Page 9Linked to original sources
PubMed1988

Evaluation of the 3M staplizer: a new internal fixation system.

Clinical evaluation of a new method for internal fixation with power-driven staples is presented. We have used the 3M staplizer for 2 years in 100 cases and the result of the fixation obtained with the titanium staples in metaphyseal bone has been very good. Ninety-six cases healed without any problems, and in 4 there was displacement. The only case with infection was successfully treated with antibiotics. We conclude that the 3M staplizer is a reliable method for internal fixation of metaphyseal bone. The staples are easily driven into the bone, reasonable stability is obtained and the method is fast and safe.

Adolescent↗
PubMed1996

Open reduction and internal fixation of type II intra-articular calcaneus fractures.

Open reduction and internal fixation of 23 type II calcaneus fractures in 21 patients was performed using a standard extended lateral approach. Average follow-up was 26 months (range, 12-47 months). The Creighton-Nebraska Health Foundation Assessment Score for Fractures of the Calcaneus was used to evaluate fractures. The average score was 91.4 (range, 80-100), which represented an excellent result. A series of 10 type II fractures treated with closed methods was also evaluated using the same evaluation methods. The average score was 70 (range, 60-84), which represented a fair result. There was a clear statistically significant superiority with type II calcaneus fractures treated with open reduction and internal fixation (P < 0.0001). We recommend type I calcaneus fractures (nondisplaced) be treated with closed methods, and type II calcaneus fractures (displaced) be treated with open reduction and internal fixation.

Adolescent↗
PubMed2000

The treatment of pseudoarthrosis of the scaphoid by bone grafting and three methods of internal fixation.

OBJECTIVES: To measure the rate of union in patients with pseudoarthosis of the scaphoid, treated with trapezoidal bone grafting as outlined by Fernandez and 1 of 3 methods of internal fixation and to compare unions versus nonunions and potential predictors of union to determine if associations exist. DESIGN: A retrospective radiologic study of scaphoid pseudoarthroses. SETTING: Division of Orthopedic Surgery, Ottawa Hospital, General Site, a tertiary care facility. PATIENTS: Thirty-four patients with nonunion of scaphoid fractures, treated between 1990 and 1997, with an average follow-up of 19.8 months. INTERVENTIONS: Trapezoidal bone grafting and internal fixation with Kirschner (K) wires, an AO cannulated screw or a Herbert screw. OUTCOME MEASURES: The time to union of scaphoid pseudoarthroses and predictors of union, including the classification, location of pseudoarthrosis, type of internal fixation and length of bone graft. RESULTS: The results showed a correlation between the classification and location of the fracture as determined radiologically, and the outcome. There was no correlation between the type of internal fixation used and the outcome, or between the length of the bone graft and the outcome. Twenty-three patients had radiologically demonstrated union after a mean time of 8.2 months; 16 of 24 patients achieved successful union when treated with K-wire implants, after a mean time of 7.2 months. CONCLUSIONS: Trapezoidal bone grafting and internal fixation with K wires is a practical technique, classification and location of the fracture notwithstanding. Time to union is long, and the results may be unpredictable. Use of K wires for internal fixation presents the clinician with an alternative to fixation with either the AO cannulated screw or the Herbert screw, and has the advantages of cost, ease of insertion and accessibility. This method may therefore be the treatment of choice in developing countries. Resection of the area of pseudoarthrosis must include all fibrous tissue and sclerotic bone. The length of graft, within the parameters of this study, did not affect the outcome.

Accidental Falls↗
PubMed2005

Stability of the Le Fort I osteotomy with anterior internal fixation alone: a case series.

PURPOSE: The purpose of this case series was to evaluate the late postsurgical stability of the Le Fort I osteotomy with anterior internal fixation alone and no posterior zygomaticomaxillary buttress internal fixation. PATIENTS AND METHODS: Sixty patients with maxillary vertical hyperplasia and mandibular retrognathia underwent a 1-piece Le Fort I osteotomy of the maxilla with superior repositioning and advancement or setback. A bilateral sagittal split ramus osteotomy for mandibular advancement was also performed in 22 patients. Stabilization of each maxillary osteotomy was achieved using transosseous stainless steel wires and/or 3-hole titanium miniplates in the piriform aperture region bilaterally, with no zygomaticomaxillary buttress internal fixation. (Twelve of the 60 identified patients were available for a late postoperative radiographic evaluation.) Lateral cephalometric radiographs were taken preoperatively (T1), early postoperatively (T2), and late postoperatively (T3) to analyze skeletal movement. RESULTS: These 12 patients (5 male, 7 female) had a mean age of 24.5 years at surgery. Mean time from surgery to T2 was 41.2 days; mean time from surgery to T3 was 14.8 months. One patient received anterior wire osteosynthesis fixation, while 11 patients received both anterior titanium miniplate internal skeletal fixation and anterior wire osteosynthesis fixation. Six patients underwent Le Fort I osteotomy with genioplasty, 1 patient underwent Le Fort I osteotomy with bilateral sagittal split ramus osteotomy, and 5 patients underwent Le Fort I osteotomy with bilateral sagittal split ramus osteotomy and genioplasty. These 12 patients all underwent maxillary superior repositioning with either advancement (11 patients) or setback (1 patient). Statistically significant surgical (T2-T1) changes were found in all variables measured. In late postsurgical measurements (T3-T2), all landmarks in the horizontal and vertical plane showed statistically significant skeletal stability. CONCLUSION: This case series suggests that anterior internal fixation alone in cases of 1-piece Le Fort I maxillary superior repositioning with advancement has good late postoperative skeletal stability.

Adolescent↗
PubMed2006

Short-term outcomes of total hip arthroplasty after complications of open reduction internal fixation for hip fracture.

Failed open reduction internal fixation (ORIF) of the proximal femur can render patients severely disabled. This study analyzed the short-term functional results and complications of total hip arthroplasty (THA) for complications of ORIF after hip fracture. A retrospective arthroplasty database review identified 36 patients treated with a THA for complications of ORIF of the hip. These patients were matched to a cohort of 36 patients who underwent primary unilateral THA for osteoarthritis. Study results indicate that THA for failed ORIF of the hip is a successful procedure despite concerns of increased intraoperative difficulty and risk of fracture.

Aged↗
PubMedDate not supplied

Technique for internal fixation of capitellum and lateral trochlea fractures.

Internal fixation for fractures of the humeral capitellum is a technically challenging procedure. Controversy exists regarding the optimal surgical approach and fixation technique. The benefit of stable fixation of the capitellum fragment is early mobilization. Our preferred technique involves anatomic reduction of the capitellar fragment and fixation with headless screws placed from anterior to posterior. When possible, the surgical exposure employed preserves the lateral ulnar collateral ligament (LUCL) and minimizes disruption of the soft tissues posterior to the capitellum.

Bone Screws↗
PubMed1990

Zygomatic fractures: comparison of methods of internal fixation.

We have analyzed different methods of internal fixation of simple displaced fractures of the zygoma in an attempt to define the simplest method(s) of achieving postreduction stability. Twenty-five combinations of interfragmentary wiring and miniplate and screw fixation of fractured zygomas on human skulls were compared for postreduction rotational stability against stresses simulating the muscular forces that act to displace the zygoma once it has been reduced. Analysis of the data suggests that while three-point fixation using either miniplates or interosseous wires allows for virtually no displacement, two-point fixation and in some cases one-point fixation provide acceptable stability. In general, stable fixation is achieved by methods that involve the use of at least one miniplate and incorporate the frontozygomatic suture line as one of the points of fixation.

Adolescent↗
PubMed1989

[Treatment of patellar fracture using an internal fixator of shape-memory alloy].

An internal fixator made of memory alloy, that can autonomously exert pressure centripetally on fragments from multi-directions (5 to 9), but mainly longitudinal (23 to 28 kg), had been designed to treat lateral fracture. Its application on 33 cases of such fracture manifested that it could restore the shape of communicated patella through progressive pressure and maintain the anatomical position until bony union. On account of firm and stable fixation, the patient was able to start drilling the limb in 1 to 7 days after surgery, and regained full extension and flexion of knee joint in 6.8 weeks on average. All of the patients resumed excellent limb function without complication.

Adult↗
PubMedDate not supplied

Mandibular reconstruction: open reduction and internal fixation of mandibular fractures.

Open reduction and internal fixation of mandibular fractures by intraosseous wiring in conjunction with intermaxillary fixation remains the mainstay of mandibular fracture treatment despite the availability of newer methods. The principles of treatment are reviewed, including indications for use of this technique and its advantages and disadvantages. Various surgical techniques are also reviewed and key points in their application emphasized.

Adult↗
PubMed2003

Long-term outcome of patients with avascular necrosis, after internal fixation of femoral neck fractures.

We retrospectively reviewed 84 patients who underwent internal fixation of an intracapsular femoral neck fracture. The mean age was 58 years and the time from injury to operative treatment was 5.3 days. The mean follow-up was 4.7 years (range, 2-8 years). At the latest follow-up, in the 46 patients with undisplaced (Garden I, II) fractures, nonunion occurred in two patients and avascular necrosis of the femoral head in nine. Six of these nine patients had a good or excellent result, one had a fair result, and two had a poor result. Of 35 patients with no sign of avascular necrosis, 32 patients had a good or excellent result, two a fair and one had a poor result. In the group of 38 patients with displaced (Garden III, IV) fractures, nonunion occurred in six patients and avascular necrosis of the femoral head in 15. Of these 15 patients, 10 had a good or excellent result, two had a fair result, and three had a poor result. Of 17 patients with no sign of avascular necrosis, 14 had an excellent result and three patients a poor result. Overall only five of the 24 patients who developed avascular necrosis of the femoral head had undergone total hip arthroplasty. Internal fixation remains a simple and safe, method of treatment for both undisplaced and displaced femoral neck fractures in middle-age patients. Despite the relatively high rate of avascular necrosis after internal fixation of femoral neck fractures, only a few of these patients (20%) required further surgical treatment in the follow-up period of this study.

Adolescent↗
PubMed1985

The hazards of internal fixation in podiatry.

There are several ways to avoid the iatrogenic complications or hazards of internal fixation. The surgical approach should be planned well in advance. The instruments and materials to be used intraoperatively should be checked before beginning the operation to assure that there are adequate materials of appropriate length and thickness. Also, all materials should be checked for major defects (see Fig. 11A). Good tissue dissection and atraumatic surgical technique is essential to limit excessive tissue destruction. Reduction of the fracture fragments should be obtained prior to fixation. While applying fixation devices, the fragments should be held stable. Intraoperative radiographs are necessary to demonstrate appropriate positioning of the internal fixation device and the proper alignment of the fracture fragments. If the alignment is not satisfactory, repositioning of the devices can and should be made. Preoperative practice and familiarity with the fixation devices is an essential part of shortening the operative time and helping to assure optimum fixation stability. A poor time to learn the techniques for internal fixation is during surgery. Good postoperative care is essential to optimize fracture fragment healing results.

Bone Nails↗
PubMed2006

[The use of minimally invasive injectable graft and internal fixation in tibial plateau fractures].

OBJECTIVE: To value the use of an injectable minimally invasive calcium sulfate cement for displaced tibial plateau fractures. METHODS: Thirteen patients with lateral tibial plateau fractures treated with internal fixation and bone grafting were matched with 13 patients treated using internal fixation and an injectable calcium sulfate cement. The clinical data were retrospectively analyzed. All patients were followed up for a minimum of one year. The peri-operative complication, quality of reduction, maintenance of reduction, function assessment and development of post-traumatic osteoarthritis was compared in both groups. RESULTS: Ten patients in the internal fixation and bone graft group had excellent anatomical reductions as judged on immediate post-operative radiographs but some loss of reduction on follow-up at one year was observed in 8 of the 13 (61%) cases. Twelve patients from the MIIG group had an excellent reduction on immediate post-operative radiographs but 3 (23%)demonstrated some loss of reduction of the plateau at one year follow-up (P < 0.05). CONCLUSIONS: The use of MIIG and internal fixation is associated with more favourable clinical results than conventional treatment with internal fixation and bone grafting for lateral tibial plateau fractures.

Adult↗
PubMed1994

Internal fixation or hemiarthroplasty for undisplaced fractures of the femoral neck in octogenarians.

We compared the reoperation rate after internal fixation for minimally displaced or impacted intracapsular fractures of the femoral neck in patients aged 80 years and above with that in similar patients aged 65 to 79 years. We also compared the results of internal fixation with those of hemiarthroplasty for displaced intracapsular fracture in an age- and sex-matched group of elderly patients. We found that a significantly greater proportion of the older patients treated by internal fixation required reoperation than either the younger group or the age-matched group treated by hemiarthroplasty. Our results indicate that internal fixation may not be the best treatment for extremely elderly patients with minimally displaced or impacted intracapsular fractures of the femoral neck.

Aged↗
PubMed1975

[Internal fixation in the presence of soft-tissue damage in childhood (author's transl)].

Internal fixation is considered for the treatment of 10 percent at most of all fractures that occur in childhood. Only minimal fixation should be applied, to avoid the induction of an epiphyseal lesion in addition to the original fracture. Internal fixation allowing stability during weight-bearing or exercise immediately is not necessary in a child. Concomitant soft-tissue damage hardly affects internal fixation in childhood, except in the case of unstable reduction when there is extensive soft-tissue damage.

Age Factors↗
PubMed2004

Outcome of open reduction and internal fixation of surgical neck nonunions of the humerus.

OBJECTIVE: The purpose of this study was to evaluate the results of open reduction and internal fixation of nonunions of the surgical neck of the humerus. DESIGN: Retrospective review of patients who underwent operative treatment of a surgical neck of the humerus nonunion. SETTING: Shoulder and elbow service at two university centers. PATIENTS: Thirteen patients with a two-part nonunion of the surgical neck of the humerus who were treated with open reduction and internal fixation with bone graft with a minimum of 12 months' follow-up were included. Patients with avascular necrosis, posttraumatic arthritis, severe humeral head bone loss, or a nonunion of one of the two tuberosities were excluded. INTERVENTION: Open reduction and internal fixation with either a blade plate or a T-plate and autogenous bone graft. MAIN OUTCOME MEASURES: Medical records, operative reports, physical examination, and preoperative and postoperative radiographs were reviewed. Outcome was assessed using Neer's criteria for the evaluation of total shoulder arthroplasty, visual analogue pain scale, range of motion, and ability to perform activities of daily living.RESULTS The results were excellent in 11 patients, satisfactory in 1 patient, and poor in 1 patient. The 11 nonunions in patients with excellent results healed within 6 months. The patient with the poor result initially had a persistent nonunion and required revision, open reduction and internal fixation, and bone grafting. This patient healed and went on to have an excellent result at final follow-up. All fractures were healed at the time of this study. Pain scores decreased from an average of 4.2 preoperatively to 1.2 postoperatively on a 5-point pain scale. Forward elevation in the scapular plane improved from 24 degrees preoperatively to 144 degrees postoperatively. All patients but one were able to attain overhead elevation. All patients were able to perform activities of daily living, such as dressing, bathing, combing hair, and performing perineal care, at final follow-up. Overall satisfaction increased from an average of 1.0 to 9.4 on a 10-point visual analogue scale. CONCLUSIONS: Open reduction and internal fixation with autogenous bone graft results in excellent outcomes even in patients >65 years old and patients with significant medical problems. This treatment method offers predictable fracture healing and has a low complication rate.

Activities of Daily Living↗
PubMed1995

Traditional methods vs rigid internal fixation of mandible fractures.

OBJECTIVE: To compare traditional methods (ie, intermaxillary fixation with interosseous wiring or external fixation) with newer techniques (ie, plating, use of lag screws) of open reduction and fixation of mandible fractures. DESIGN: Retrospective analysis of data from medical records. SETTING: Academic urban medical center. PATIENTS: Nonrandomized sample of 356 patients admitted to the hospital for treatment of mandible fractures from 1987 through 1991; 155 patients treated with open reduction and fixation were studied. INTERVENTIONS: Sixty-nine patients were treated with interosseous wire fixation or external fixation, 86 patients with rigid internal fixation. MAIN OUTCOME MEASURES: Presence of infection, nerve impairment, nonunion, malunion, operative time, and follow-up. RESULTS: No significant difference was noted between the two groups for sex, treating service, delay in presentation, antibiotic coverage, mechanism of injury, or type of fracture. The incidence of infection, nerve injury, and unavailability for follow-up were greater in patients treated by the newer techniques. Overall expense and operative time were greater in the group treated with plates and lag screws. CONCLUSIONS: We advocate traditional techniques for patients with mandible fractures requiring open reduction and fixation.

Bone Plates↗
PubMed2004

[Dynamic internal fixation of the periprosthetic femoral fractures after total hip arthroplasty].

Periprosthetic fractures of the femur after total hip arthroplasty are a big orthopaedic problem, particularly in elderly patients and quite a challenge for orthopaedic surgeons. There is no universal method in treating these fractures. Rigid plates fixation can be limited and aggravated especially in the proximal part of the femur where the endoprosthesis stem does not allow for an undisturbed fixation of both femur cortexes by means of screws. Mitkovic's dynamic internal fixator is an original implant allowing for an undisturbed fixation of both femur cortexes regardless of the presence of the endoprosthesis stem. Fixation is made possible by means of movable clamps and a convergent possibility to place screws. A dynamic internal fixator can fix all types of periprosthetic femoral fractures. The paper shows the early experience in fixating periprosthetic femoral fractures after total hip arthroplasty in 14 patients, average age 69.7. According to Vancouver classification, 3 patients had the type A fracture, 9 patients had the type B fracture, and 2 patients had the type C fracture. All fractures were fixed by Mitkovic's dynamic internal fixator. The fracture occurred 2-12 years after primary total hip arthroplasty. The follow-up of the operated patients was 12 months. The method is less invasive than the methods described in books. Mechanical complications are not likely to appear due to the fracture dynamics along the femoral shaft axis, which is made possible by this implant. Our initial experience in femur fracture fixation after hip arthroplasty ahows that it is modern and effective dynamic implant which will contribute significantly to the improving of the treatment of these often very complicated fractures.

Aged↗
PubMed1979

[An experimental study on various internal fixations in fracture of a long bone (author's transl)].

In the operative treatment of a long bone fracture, the most important point is to secure the bone healing and to strengthen the bone after removal of internal fixation materials. In this regards, the author has analyzed the mechanical strength of various internal fixation methods (a plate, a medullary nail, screws and encircling wires) on the bone by using acrylics models. Experimental studies of their influences on the bone have also been performed especially investigating the decrease in the bone strength in rabbits. All of internal fixation materials are made of 316L stainless steel. Recently, there has been a tendency to use larger materials for internal fixations such as an AO compression plate or a Küntscher type medullary nail. However, it was found that the rigid plate fixation greatly affects the bone strength. A medullary nail produced less impairment to the bone. But this method is restricted in its application because of the weak fixability of the torsional load. On the other hand, the internal fixations with screws or encircling wires are weaker than the other methods especially against the bending load. Therefore the commencement of postoperative treatment will be delayed. But, these two methods have little influence on the bone during fixation.

Animals↗