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At least 19 recordsLinked to original sources

Clinical outcome after spinal fusion with a rigid versus a semi-rigid pedicle screw system.

Several biomechanical studies have evaluated the quality of fusion obtained with a rigid versus a semi-rigid pedicle screw implant. Some studies indicate that increased rigidity of the implant system results in an increased strength of the fusion mass. Other reports have underlined the risk of stress shielding due to rigid implant systems. Based on these findings some authors have recommended the use of a semi-rigid system. There are, however, few studies focusing on any possible difference in clinical outcome between the two different types of implant systems. Questionnaires were sent to 89 patients who had undergone primary spinal fusion with either a rigid or a semi-rigid pedicle-screw-based implant system. In every case the diagnosis was spondylolisthesis or degenerative lumbar disease. The questionnaires were analysed using forward stepwise logistic regression analysis. Eighty (90%) of the questionnaires were returned. There was a mean follow-up of 4 years (range 2-8 years). It was not possible to demonstrate any difference in clinical outcome between patients undergoing lumbar fusion with a rigid implant system and those given a semi-rigid system. The overall patient satisfaction rate was 69%, with no difference between the two types of implant. No difference in clinical outcome between the two types of implant was found. Considering the fact that the primary goal of spinal fusion procedure is to obtain a solid fusion mass, biomechanical tests favour the used of a rigid pedicle screw system. This fact combined with the fact that early mobilisation is possible with rigid implants justifies the use of rigid implant systems, although no difference in clinical outcome could be demonstrated in this study.

Adolescent↗

Semi-rigid vs rigid glass fibre casting: a biomechanical assessment.

OBJECTIVES: To determine if semi-rigid synthetic casts provide any measurable advantages compared to rigid synthetic casts. BACKGROUND: Glass fibre bandages are now commonly applied immediately post-injury to provide rigid immobilisation of the limb, for both weight bearing and non-weight bearing casts. However, composite casts that have inherent flexibility are also available and it is claimed they provide some functionality. METHODS: Five members of the orthopaedic department each applied a rigid and a semi-rigid below elbow (Colles) and a below knee walking cast to a single volunteer subject. Joint immobilisation and functional movement was assessed using electrogoniometry and limb support using pressure transducers. RESULTS: Semi-rigid Colles casts provided slightly greater immobilisation at the wrist while allowing full finger function and greater support to the forearm during hand movements. Similarly, semi-rigid below knee walking casts produced greater immobilisation at the ankle while allowing more forefoot movement and were less of an impediment to walking. CONCLUSIONS: Semi-rigid casting techniques have measurable advantages compared to rigid synthetic casts and represent a further development in the conservative management of fractures and soft tissue injuries. RELEVANCE: Semi-rigid casting is a relatively new technique that can reduce some of the problems of rigid cast immobilisation and could potentially shorten the rehabilitation phase following injury. Information about the performance of these casts to assess their value in specific applications is very limited.

Ankle Injuries↗

Striatal and nigral neuron subpopulations in rigid Huntington's disease: implications for the functional anatomy of chorea and rigidity-akinesia.

Neuropeptide immunohistochemistry was used to test several hypotheses of the anatomical bases of chorea and rigidity-akinesia. To test the hypothesis that elevated concentration of striatal somatostatin causes chorea, we visually compared the density of striatal neurons containing somatostatin and neuropeptide Y in brains affected by choreic or rigid-akinetic Huntington's disease (HD). The density of these neurons was elevated in both rigid-akinetic and choreic HD specimens with an apparently normal total number of these neurons, indicating that elevated somatostatin concentration, by itself, does not lead to chorea. We tested the hypothesis that rigid-akinetic HD results from deficient dopaminergic nigrostriatal neurotransmission by examining tyrosine hydroxylase-immunoreactive (TH-IR) neurons in the substantia nigra. In rigid-akinetic HD brains, there was no obvious reduction of nigral TH-IR neurons, indicating that rigid-akinetic HD is probably not due to loss of nigral dopaminergic neurons. Finally, we also examined the status of striatal projection neurons and found near total loss of all striatal neurons projecting to the lateral globus pallidus, medial globus pallidus, and substantia nigra in brains affected by rigid-akinetic HD in contrast to the preservation of neurons projecting to the medial globus pallidus in choreic HD. These results are consistent with the hypothesis that chorea results from preferential loss of striatal neurons projecting to the lateral globus pallidus and that rigid-akinetic HD is a consequence of the additional loss of striatal neurons projecting to the medial segment of the pallidum.

Adult↗

Rigid and non-rigid kinetic depth effect with rotating discrete helices.

To examine the conditions in which human observers fail to recover the rigid structure of a three-dimensional object in motion we used simulations of discrete helices with various pitches undergoing either pure rotation in depth (rigid stimuli) or rotation plus stretching (non-rigid stimuli). Subjects had either to rate stimuli on a rigidity scale (Experiments 1 and 2) or to judge the amount of rotation of the helices (Experiments 3 and 4). We found that perceived rigidity depended on the pitch of the helix rather than on objective non-rigidity. Furthermore, we found that helices with a large pitch/radius ratio were perceived as highly non-rigid and that their rotation was underestimated. Experiment 5 showed that the detection of a pair of dots rigidly related (located on the helix) against a background of randomly moving dots is easier at small phases in which the change of orientation across frames is also small. We suggest that this is because at small phases the grouping of dots in virtual lines does occur and that this may be an important factor in the perceived nonrigidity of the helices.

Adult↗

Craniofacial growth in rabbits after rigid or semi-rigid fixation of the frontonasal suture.

Treatment of craniofacial dysostosis involves complex remodeling of the cranium and facial bones. Maintenance of the newly positioned segments may be achieved by rigid fixation using plates; however, there is concern that, over time, these plates may interfere with normal growth. The purpose of this study was to test a method of "semi-rigid" fixation of an osteotomy of the frontonasal suture in juvenile rabbits by comparing standardized parameters of craniofacial growth after conventional suture plating with the experimental plating method and with growth after sham operation. Forty-five, 6-week-old, weanling rabbits were divided into three groups of 15 each (12 for cephalometry, 3 for histological examination): (group 1) control, sham operated; (group 2) rigid fixation; (group 3) semi-rigid fixation. Rabbits were maintained for 14 weeks. Craniofacial growth was assessed using three-dimensional image analysis techniques. Measurements were subjected to statistical analysis (one-way analysis of variance) to compare the three treatment groups. Pairwise comparison of means between the treatment groups was done using Bonferroni's method at the 0.05 significance level. Semi-rigid fixation permitted significantly more normal growth of the developing rabbit head than rigid fixation in total snout length, total vault length, left and right midface height, and left orbital length. Both semi-rigid and rigid fixation significantly restricted growth compared with sham operated animals in left and right posterior midface height, right orbital length, right and left nasal bone length, and left parietal width. There were no significant differences in the growth of all other parameters measured.

Animals↗

Rigid spine syndrome and rigid spine sign in myopathies.

We studied eight patients with rigid spine syndrome aged 8 to 20 years at the time of first examination. Muscle weakness, rigid spine, and flexion contracture of elbows and ankles were noted in the first 6 years of age. Radiological study of the cervical spine revealed considerable reduction not only of flexion, but also of extension, of the neck. The "alligator sign" was demonstrated. Progression of scoliosis and of contractures reduced the functional capacity in six patients. A restrictive ventilatory syndrome was observed in all, while central apneas with oxygen desaturation were shown in two. Cardiac arrhythmias were observed in four. We suggest that a distinction should be made between myopathic rigid spine and rigid spine syndrome. Myopathic rigid spine is a clinical sign which is rarely sought but is present in several types of well-defined myopathies, meaning the myopathic involvement of the extensor muscles of the spine. Rigid spine syndrome is an axial myopathy with peculiar clinical and radiographic signs and a characteristic natural history.

Adolescent↗

Transtracheal aspiration using rigid bronchoscopy and a rigid needle for investigating mediastinal masses.

BACKGROUND: Use of the flexible needle via the fibreoptic bronchoscope to aspirate mediastinal nodes or masses has largely superseded the use of the rigid needle via the rigid bronchoscope. However, the yield at fibreoptic bronchoscopy is relatively low, although this improves with the use of a wider gauge needle. In this study the sensitivity and the safety of rigid needle sampling of the mediastinum in the diagnosis of lung cancer is evaluated. METHODS: Transtracheal needle aspiration (TTNA) was performed with the rigid bronchoscope and a rigid aspiration needle under general anaesthesia using a previous computed tomographic (CT) scan as a guide to the sample site. A cytopathologist immediately examined the specimens for adequacy and preliminary diagnosis, thus determining the number of aspirations. RESULTS: Twenty four patients were evaluated. The diagnostic sensitivity of TTNA was 88%. This led to a management decision in 21 patients. There were no false positives and no complications. CONCLUSIONS: TTNA using the rigid bronchoscope with CT scanning and a cytopathologist present is a sensitive and safe way of diagnosing lung cancer in patients with a mediastinal mass or enlarged mediastinal nodes.

Adult↗

Maximizing rigidity: the incremental recovery of 3-D structure from rigid and nonrigid motion.

The human visual system can extract 3-D shape information of unfamiliar moving objects from their projected transformations. Computational studies of this capacity have established that 3-D shape can be extracted correctly from a brief presentation, provided the moving objects are rigid. The human visual system requires a longer temporal extension, but it can cope with considerable deviations from rigidity. It is shown how the 3-D structure of rigid as well as nonrigid objects can be recovered by maintaining an internal model of the viewed object and modifying it at each instant by the minimal nonrigid change that is sufficient to account for the observed transformation. The results of applying this incremental rigidity scheme to rigid and nonrigid objects in motion are described and compared with human perception.

Computers↗

A comparative biomechanical analysis of resorbable rigid fixation versus titanium rigid fixation of metacarpal fractures.

Linear (two-dimensional) and three-dimensional (3D) plating systems (Poly-Medics) composed of the resorbable copolymer of polyglycolic acid (PGA) and poly-l-lactic acid (PLLA) (Lactosorb) were studied in vitro. The plates were applied to osteotomized fresh frozen human cadaveric metacarpal bones that were then tested for torsional rigidity and three-point bending strength and rigidity. The results were compared to those from another study of two low-profile titanium plating systems (Leibinger and Synthes). Analysis of variance revealed that the linear-flat Lactosorb plate and screws had apex dorsal rigidity and force-to-displacement measurements equal to all but two of the titanium plates (3D). The 3D-flat Lactosorb plate had the highest torsional rigidity of the resorbable system, but it was only moderately rigid compared to the titanium plating systems. This in vitro biomechanical study of the copolymer PGA-PLLA plating system indicates that, in clinical applications, it may be better suited for metacarpal fractures rather than proximal phalangeal fractures due to the lower demands of torsional loading compared to apex bending.

Biomechanical Phenomena↗

Rigidity, sensitivity and quality of attachment: the role of maternal rigidity in the early socio-emotional development of premature infants.

The associations between a mother's rigidity, her sensitivity in early (3 month) interaction and the quality of her premature infant's attachment at 13 months were investigated. Rigidity as a personality characteristic was not found to be significantly associated with sensitivity or quality of attachment. Rigid attitudes to child rearing were related to sensitivity and to the responsivity of the infant. Rigid attitudes were not related to security of attachment. Infants who were rated less responsive at 3 months, however, tended to be less securely attached, and high Attitude Rigidity in the mother increased their chances of an insecure attachment.

Adult↗

Transport properties of rigid bent-rod macromolecules and of semiflexible broken rods in the rigid-body treatment. Analysis of the flexibility of myosin rod.

The translational diffusion coefficients, rotational relaxation times and intrinsic viscosities of rigid bent rods, composed by two rodlike arms joined rigidly at an angle alpha, have been evaluated for varying conformation using the latest advances in hydrodynamic theory. We have considered semiflexible rods in which the joint is an elastic hinge or swivel, with a potential V(alpha) = 1/2Q alpha 2 with constant Q. Accepting the rigid-body treatment, we calculate properties of broken rods by averaging alpha-dependent values for rigid rods. The results are finally used to interpret literature values of the properties of myosin rod. Q is regarded as an adjustable parameter, and the value fitted is such that the average bending angle of myosin rod is approximately 60 degrees.

Mathematics↗

The perceived rigidity of rotating eight-vertex geometric forms: extracting nonrigid structure from rigid motion.

In four experiments, subjects examined four categories of rotating eight-vertex geometric forms in parallel projection. Some of the figures appeared to deform, even though rigid three-dimensional interpretations were possible mathematically. Our results from several deformation-rating tasks indicated that most of the configurations maintained a rigid appearance throughout their rotations, although one category of stimuli appeared to deform more frequently than the others. Configurations from the category that contained a high proportion of stimuli that appeared to deform were also shown to be more difficult to discriminate from stimuli that had no rigid three-dimensional interpretation (measured using a signal detection task). To account for these findings, a theory was formulated based on the use of monocular depth cues in the perception of shape. Static monocular depth cues we define as those which are present in non-moving stimuli and Dynamic monocular depth cues are those that are only present in moving stimuli. We conclude that static cues dominate the perception of shape when humans respond to parallel (and, most likely, polar) projections of rotating objects with rigid three-dimensional interpretations. Further, subjects cannot respond to the motion or acceleration profile of part of such a stimulus without responding to the figure as a whole.

Adult↗

Comparison of the results of short-term rigid and semi-rigid cast immobilization for the treatment of grade 3 inversion injuries of the ankle.

In this prospective, randomized study, short-term immobilization with semi-rigid (Soft Cast) and rigid (Scotchcast Plus) synthetic cast materials were compared for the functional treatment of acute grade 3 lateral ligament injuries of the ankle. Degree of ligament injury was assessed by clinical criteria. Duration of immobilization was 2 weeks for both groups and home physiotherapy was started thereafter. Fifty-seven patients completed the study and both materials were found to be equally effective in providing a stable ankle at the end of 6 weeks follow-up. Soft Cast group had better range of motion and could walk better at 2 weeks, but these differences diminished at 6 weeks. With the Soft Cast, patient satisfaction was higher, need for a support for walking was less and return to work was earlier. When combined with the reduced cost of application, Soft Cast is the material of choice for the initial short-term immobilization for the functional treatment of acute ankle ligament injuries.

Adolescent↗

The relative transit time of high-rigidity and low-rigidity cosmic rays through the solar system.

A study of neutron monitor count rates with vertical cut-off rigidities from 0.6 to 13 GV indicates that high-energy and low-energy galactic cosmic rays arrive at earth orbit with small time differences compared to a month. This is in contradiction to the theory of the deceleration potential which states that cosmic-ray particles with rigidities greater than 36 V arrive at earth orbit about three months before cosmic-ray particles with lesses rigidines.

Cosmic Radiation↗

Rigid fixation of the calvaria in craniosynostosis without using "rigid" fixation.

Early observations of intracranial translocation of metal wires, plates, and screws used for infant skull surgery have led some surgeons to investigate alternative forms of fixation. The purpose of this study was to review a series of infants and children in whom absorbable suture fixation was used as the sole method of fixation in cranial vault remodeling. Standard osteotomies were successfully modified to permit the use of this less rigid form of fixation. Over a 6-year period, 142 cranial vault procedures were performed, primarily for craniosynostosis, using absorbable sutures (2-0 polydioxanone). Patients who did not have absorbable suture fixation, or who had a combination of absorbable sutures with another form of fixation, were excluded from this review. Records were reviewed for results (assessed by both the treating surgeon and an independent anthropologist) and for complications. The average age of patients was 2 years, 7 months (range, 1 month to 16 years). The clinical results were judged as follows: grade I (excellent), 49 percent; grade II (minor imperfections), 48 percent; grade III (small surgical procedure needed), 2 percent; and grade IV (complete reoperation required), 1 percent. Anthropologic results were similarly distributed: excellent, 36 percent; good, 56 percent; fair, 8 percent; and poor, 0 percent. Those 3 to 8 percent of patients who were found to have the poorest results were all noted to have syndromes, and it appeared that an inherent lack of growth was the primary basis for the low score. There were no deaths or major complications in this series of patients. The smaller complications identified were infections [four cases (2.8 percent)] and transient cerebrospinal fluid leak [two cases (1.4 percent)]. The most important factor in determining whether absorbable suture fixation was sufficient was the size of a preexisting calvarial defect. Although concerns have been raised about a possible link between absorbable suture fixation and subsequent poor reossification, no such association was noted in this review. The primary disadvantage of using absorbable sutures was the lack of rigidity provided. Advantages included lower costs, speed of application, and the absence of observed intracranial translocation. In conclusion, the use of absorbable suture fixation (with modifications in osteotomy design) was associated with both acceptable aesthetic outcomes and low complication rates. Craniofacial surgeons may wish to consider the use of absorbable sutures as another option for bone fixation in treatment of craniosynostosis.

Absorption↗

Ultra-low wear rates for rigid-on-rigid bearings in total hip replacements.

With the increased clinical interest in metal-on-metal and ceramic-on-ceramic total-hip replacements (THRs), the objective of this hip simulator study was to identify the relative wear ranking of three bearing systems, namely CoCr-polyethylene (M-PE), CoCr-CoCr (M-M) and ceramic-on-ceramic (C-C). Volumetric wear rates were used as the method of comparison. The seven THR groupings included one M-PE study, two M-M studies and four C-C studies. Special emphasis was given to defining the 'run-in' phase of accelerated wear that rigid-on-rigid bearings generally exhibit. The hypothesis was that characterization of the run-in and steady state wear phases would clarify not only the tribological performance in vitro but also help correlate these in vitro wear rates with the 'average' wear rates measured on retrieved implants. The implant systems were studied on multichannel hip simulators using the Paul gait cycle and bovine serum as the lubricant. With 28 mm CoCr heads, the PE (2.5 Mrad/N2) wear rates averaged 13 mm3/10(6) cycles duration. This was considered a low value compared with the clinical model of 74 mm3/year (for 28 mm heads). Our later studies established that this low laboratory value was a consequence of the serum parameters then in use. The mating CoCr heads (with PE cups) wore at the steady state rate of 0.028 mm3/10(6) cycles. The concurrently run Metasul M-M THRs wore at the steady state rate of 0.119 mm3/10(6) cycles with high-protein serum. In the second Metasul M-M study with low-protein serum, the THR run-in rate was 2.681 mm3/10(6) cycles and steady state was 0.977 mm3/10(6) cycles. At 10 years, these data would predict a 70-fold reduction in M-M wear debris compared with the clinical PE wear model. All M-M implants exhibited biphasic wear trends, with the transition point at 0.5 x 10(6) cycles between run-in and steady state phases, the latter averaging a 3-fold decrease in wear rate. White surface coatings on implants (coming from the serum solution) were a confounding factor but did not obscure the two orders of magnitude wear performance improvement for CoCr over PE cups. The liners in the alumina head-alumina cup combination wore at the steady state rate of 0.004 mm3/10(6) cycles over 14 x 10(6) cycles duration (high-protein serum). The zirconia head-alumina cup THR combination wore at 0.174 and 0.014 mm3/10(6) cycles for run-in and steady state rates respectively (low-protein serum). The zirconia head and cup THR combination wore slightly higher initially with 0.342 and 0.013 mm3/10(6) cycles for run-in and steady state rates respectively. Other wear studies have generally predicted catastrophic wear for such zirconia-ceramic combinations. It was noted that the zirconia wear trends were frequently masked by the effects of tenacious white surface coatings. It was possible that these coatings protected the zirconia surfaces somewhat in this simulator study. The experimental ceramic Crystaloy THR had the highest ceramic run-in wear at 0.681 mm3/10(6) cycles and typical 0.016 mm3/10(6) cycles for steady state. Since these implants represented the first Crystaloy THR sets made, it was likely that the surface conditions of this high-strength ceramic could be improved in the future. Overall, the ceramic THRs demonstrated three orders of magnitude wear performance improvement over PE cups. With zirconia implants, while the cup wear was sometimes measurable, head wear was seldom discernible. Therefore, we have to be cautious in interpreting such zirconia wear data. Identifying the run-in and steady state wear rates was a valuable step in processing the ceramic wear data and assessing its reliability. Thus, the M-M and C-C THRs have demonstrated two to three orders of reduction in volumetric wear in the laboratory compared with the PE wear standard, which helps to explain the excellent wear performance and minimal osteolysis seen with such implants at retrieval operations.

Aluminum Oxide↗