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At least 19 recordsLinked to original sources

Assessment of mechanical stability of a parallel wire bone transport system for use with an Ilizarov frame.

A novel fine wire bone transport system for use with Ilizarov frames has been used in Bristol. It uses parallel wires instead of crossed wires. Its stiffness has been tested and compared with a crossed wire construct. In its basic form it is not as stiff to bending and shear loading, however, by modification it can be made at least as stiff. A parallel wire construct does not transfix as much soft tissue as a crossed wire construct when used in the leg. This is advantageous, because soft tissue transfixion causes pain and limb swelling, which impair patient mobilization.

Biomechanical Phenomena↗

Why fine-wire fixators work: an analysis of pressure distribution at the wire-bone interface.

Tensioned fine-wire external fixator systems have been used successfully for the treatment of fractures, mal-unions and for limb lengthening for many years. When used in metaphyseal bone, this type of fixator has a lower loosening rate than half-pin fixators. The differing mechanical properties of these fixator systems have been investigated extensively; however, most studies have centered on the mechanical properties of the fixator as a whole. Our knowledge of the interactions occurring at the interface between implant and bone remains sparse. In order to investigate this interaction, we devised a simple experimental model to characterise the distribution of pressure in cancellous bone surrounding a tensioned wire under loading conditions. Comparison was then made to a similar model of a half-pin fixator. Pressure was measured using pressure sensitive film at various distances away from the implant-bone interface. Static, single cycle loading of the model was performed with a Universal Testing Machine. Pressure distribution in the fine-wire model was found to occur in three regions: polar, beam loading and uniform. Polar patterns were seen closest to the wire with pressure concentrated at the entry and exit points of the wire. Beam loading was seen at a distance of 1.5 mm from the wire and pressure reached a uniform distribution at 4.0 mm. Most of the pressure measured was less than 2 MPa, which is less than the yield strength of cancellous bone (2-7 MPa). Higher loads produced higher stresses but the distribution pattern was similar. In contrast, the half-pin model showed far higher pressures (20 MPa), which were present deeper in the bone specimen. These results further our understanding of the biomechanics of fine-wire fixators and may explain the lower loosening rate of this type of fixator when compared to half-pin fixators used in metaphyseal bone.

Biomechanical Phenomena↗

Tension band wiring-bone grafting for spondylolysis and spondylolisthesis. A clinical and biomechanical study.

Patients with spondylolysis or spondylolisthesis with persistent symptoms often require surgical treatment. The purpose of this article is to present a new surgical technique and clinical results of 13 patients with symptomatic spondylolysis/spondylolisthesis who were treated with tension band wiring (intra- or intersegmental) and bone grafting techniques. This article also presents the results of biomechanical effects of these tension band wiring methods on canine lumbar spines with experimental spondylolytic defects. Thirteen adult patients, three with spondylolysis, and ten with spondylolytic spondylolisthesis, were treated with intrasegmental or intersegmental wiring with bone grafting technique, and the clinical results were evaluated at the mean follow-up period of 20 months. Patients with spondylolysis were treated with intrasegmental wiring (transverse processes to the spinous process of the same segment) with bone grafting at the lytic defect. Patients with spondylolytic spondylolisthesis were treated with intersegmental wiring (transverse process of the segment with defect to the spinous process of the same segment and to the spinous process of the segment below) with bone grafting to the defect and one-level fusion. All 13 patients had a solid spinal fusion and/or healing of the defect at the follow-up evaluation. Eleven had excellent clinical results; one a good, and one a fair result. The results of the biomechanical study showed that the experimental spondylolytic defect produced a significant decrease in bending stiffness (flexion-extension), and the wiring techniques (both the intra- and intersegment) increased the bending stiffness to that of the normal intact spinal segment.

Adult↗

[Bundled central medullary bone wiring. Method of choice in the treatment of fractures of the neck of the fifth metacarpal necessitating a reduction. 30 cases].

The authors present a short series of 30 displaced fractures of the neck of the fifth metacarpal. All fractures were treated by K-wire nailing according to the method described by Fourcher in 1976. The good results confirm the advantages of this technique, allowing early mobilization and rehabilitation. The poor results are due to faults in the use of the method, and the authors emphasize these technical errors.

Adolescent↗

[Reduction and osteosynthesis of displaced fractures of the distal third of the fifth metacarpal with central medullary bone wires].

We conducted a retrospective study of 80 patients who underwent axial K-wire osteosynthesis for a fracture of the distal third of the fifth metacarpal over an eight year period. We used a technique derived from Foucher's technique. After closed reduction, the fracture was maintained with two or three distal smoothed curved intra-medullary axial K-wires. The final functional result was identical to the opposite side in every case, although with persistent palmar tilt of 14 degrees +/- 11 degrees. The complications were rare. Rotation displacement was always well controlled. In comparison with functional treatment, we recommend this technique in cases of rotation displacement, absence of contact between the fractured ends and marked palmar tilt of the distal fragment.

Bone Wires↗

[Treatment of fresh subcutaneous flexor tendon rupture of the distal joint of long fingers with temporary bone wire arthrodesis].

Drop-finger at the distal joint or mallet-finger from injury occurs because of the extensor apparatus is so much weaker than the flexor tendon that it breaks under strain. We report on 100 cases treated by internal splinting with longitudinal applied Kirschner wire in the distal and middle phalanx of the finger. It affords an absolute immobilisation of the distal interphalangeal joint in slight hyperextension with relaxation of the extensor apparatus. The wire was removed after six weeks. The results evaluated in 76 patients by follow-up four to 84 months were classified as excellent in 86.8% (full range of motion), good in 11.9% (loss of motion 5 to 15 degrees), and poor in 1.3% (loss of motion more than 15 degrees). The excellent and good results emphasize that internal splinting in ruptures of the extensor apparatus near the distal interphalangeal joint.

Adolescent↗

Tensile strength of wire-reinforced bone cement and twisted stainless-steel wire.

To assess the tensile strength of wire-reinforced bone cement as used for posterior spine fusion, standardized bone-cement specimens reinforced with stainless steel and Vitallium wires 0.5 and one millimeter in diameter were tested in tension. The results showed that tensile strength of bone cement was increased significantly by reinforcing it with metal wires, the increase in strength being proportional to the number of wires used. Even after failure of the cement, the reinforcing wires still carried an appreciable amount of load, thus avoiding the catastrophic failure of the cement alone. Specimens reinforced with Vitallium wires in general failed at higher loads than specimens reinforced with similar stainless-steel wires. Pull-out studies showed that a hook or a loop at the embedded end of straight wires significantly increased the load necessary to pull the wires out. The tensile strength of twisted stainless-steel wire composed of two 0.5-millimeter strands increased with the number of turns up to about eight turns per inch (2.54 centimeters) and then decreased.

Bone Cements↗

Complications of mandibular fractures.

Timely repair of mandibular fractures remains an effective means to reduce pain, restore function, and prevent complications. This study addresses the effect of the time interval between injury and treatment on the overall complication rate, the complication rate between various treatment modalities (mandibular-maxillary fixation [MMF] alone, MMF with intraosseous wire bone fixation, and MMF with rigid internal fixation), and the relationship of inpatient vs. outpatient management. Cost was also examined with respect to choice of management. We report a retrospective series of 308 consecutive patients managed at the University of Miami/Jackson Memorial Hospital. Patients who received treatment 3 to 10 days following injury were found to have a lower complication rate than earlier or later repair. We postulate that most patients with mandibular fractures may be managed on an outpatient basis, which represents a considerable savings in cost.

Adolescent↗

Posterior cervical fusion with methylmethacrylate, wire, and bone: technical note.

Surgical stabilization of non-neoplastic spinal lesions with methylmethacrylate and wire remains a controversial issue. In this report we offer a method of posterior cervical arthrodesis that combines using midline wire and acrylic with a lateral bony fusion. This construct allows for immediate as well as long-term stability. The technique is simple and safe, requires no special instrumentation, and is also easily extended to include the occipital bone. Rigid postoperative external immobilization is not required.

Adult↗

Interspinous wiring without bone grafting for nonunion or delayed union following anterior spinal fusion of the cervical spine.

Nine patients who had unsuccessful anterior interbody fusion or subtotal spondylectomy and fusion for cervical spondylosis were treated by interspinous wiring without bone grafting. Bone union was confirmed during a mean postoperative period of 2 years and 2 months in seven patients by the disappearance of clear zones observed preoperatively in the disc space, and by continuity of the trabeculae in radiograms. One of the two patients in whom the procedure failed to unite the site of nonunion had received technically inadequate wiring with slight mobility at the wiring site; in the other patient, the grafted bone had collapsed and no sclerotic shadow of the nonunion site was seen at the time of surgery. Both patients underwent wiring after considerable intervals from the time of the initial anterior spinal fusion. We found that satisfactory bone union can be obtained for nonunion or delayed union following anterior cervical spinal fusion by interspinous wiring without further bone grafting if applied to properly selected patients.

Adult↗

Interspinous process segmental instrumentation with bone-button-wire for correction of scoliosis.

From May 1985 to May 1988, 55 patients with scoliosis were given interspinous process segmental spinal instrumentation with bone button-wire. The Harrington distraction rod and Luque's rod were placed separately in the concave and convex sides of the curvature fixed with bone button-wire. The fixations were subjected to biomechanical analysis, and the patients were followed up for an average of 18 months with satisfactory results. The curves were corrected from 69.4 degrees to 33.2 degrees, with a corrective rate of 47.8%. The merits of this procedure lie in (1) no injury to the spinal cord and minimal neurological complications, (2) strong fixation for correcting deformities, and (3) minimal blood loss and short time for operation.

Adolescent↗

Insertion of K-wires by hammer generates less heat. A study of drilling and hammering K-wires into bone.

Laboratory tests were carried out on cadaver animal bones to evaluate the thermal effect of inserting K-wires with a pneumatic hammer as compared to drilling. The mean maximum bone temperature 0.5 mm from the K-wires was 34 (22-72) degrees C using the hammer and 54 (19-100) degrees C for drilling, 1.0 mm from the K-wire the mean maximum temperature was 31 (19-52) degrees C for hammering and 47 (17-91) degrees C for drilling. The mean time for the temperature exposure in the cases of drilling was 50 s and for hammering 41 s. The hammering device may reduce the risk of heat-induced injury.

Animals↗