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At least 19 recordsLinked to original sources

Reconstruction of internal orbital fractures with Vitallium mesh.

Trauma to the face frequently results in internal orbital fractures that may produce large orbital defects involving multiple walls. Accurate anatomic reconstruction of the bony orbit is essential to maintain normal appearance and function of the eye following such injuries. Autogenous bone grafts do not always produce predictable long-term support of the globe. Displacement and varying amounts of bone-graft resorption can lead to enophthalmos. This study examines the use of Vitallium mesh in the acute reconstruction of internal orbital defects. Fifty-four patients with 66 orbits underwent reconstruction of internal orbital defects with Vitallium mesh. Associated fractures were anatomically reduced and rigidly fixed. Forty-six patients and 57 orbits had adequate follow-up for analysis of results. The average follow-up was 9 months, with 85 percent of the patients followed 6 months or longer. There were no postoperative orbital infections, and none of the Vitallium mesh required removal. Large internal orbital defects can be reconstructed using Vitallium mesh with good results and little risk of infection. Vitallium mesh appears to be well tolerated in spite of free communication with the sinuses. Stable reconstruction of the internal orbit can be achieved and predictable eye position maintained without donor-site morbidity.

Adolescent

Alumina and zirconia coated vitallium oral endosteal implants in beagles.

The purpose of this study was to assess the addition of a ceramic coating upon a Vitallium implant to increase the implant's biologic acceptability in the oral environment. The mandibular premolar teeth in 9 adult beagle dogs were removed bilaterally and these areas allowed to heal for 6 weeks. Ceramic coating with either Al2O3 or ZrO2 was carried out by flame spray deposition upon Vitallium anchor implants (9 of each), and the implants placed into the 18 healed premolar areas. Clinical and radiographic evaluation was conducted by 2 independent investigators over a 32 week period. Implants which exhibited mobility greater than II on a scale of 0 to III, at intervals of one-half, were judged unsatisfactory. After 19 weeks, all 9 Al2O3 coated implants and 5 ZrO2 coated implants were rated unsatisfactory. After 32 weeks, 4 ZrO2 coated implants were in situ with 0 or I mobility. Radiographically the width of the peri-implant space increased in direct proportion to both time and mobility. Histologic sections demonstrated encapsulating dense fibrous connective tissue which was oriented parallel to both ZrO2 and Al2O3 implants. Results suggest the zirconia used is a superior ceramic coating to the alumina. Neither seemed to increase biologic acceptability over uncoated Vitallium implants.

Aluminum

A removal torque and histomorphometric study of bone tissue reactions to commercially pure titanium and Vitallium implants.

Screw-shaped commercially pure (CP) titanium and Vitallium implants were inserted in the rabbit tibial metaphysis. After a healing period of 3 months, it was demonstrated that a higher torque was needed to remove the CP titanium implants (average 24.9 Ncm) compared to Vitallium implants (average 11.7 Ncm). The histomorphometric part of the study revealed more bone-to-metal contact for the CP titanium implants (average 34.7%) compared to the Vitallium implants (average 21.7%). The results obtained in this study could be explained by differences in the topography or in biocompatibility of the metals, or a combination of these two factors.

Animals

Arthroplasty of the temporomandibular joint with use of a vitallium condyle prosthesis: report of three cases.

We have devised a Vitallium intramedullary prosthesis to replace the deformed arthritic condyle in cases that require bilateral condylectomy or in rare long-term failures of a single condylectomy. Experience has led to modification of this prosthesis. Recently a rectangular stem that prevents rotation of the prosthesis in the condylar stub has been added (Fig 11). In bilateral condylectomies, replacement of only one side by the Vitallium condylar prosthesis is adequate, because it stabilizes the mandible by maintaining its original fulcrum in the temporomandibular joint. Three cases of replacement with the Vitallium condyle prosthesis are reported, with follow-up studies of two to three years postoperatively. The results to date have been gratifying.

Adult

Reconstruction of midface bone defects with vitallium micromesh.

Complex midface defects following trauma and tumor resection present a challenging problem for maxillofacial surgeons. Regardless of the cause of these defects, restoration of accurate contour is essential to achieve both proper function and cosmetically acceptable appearance. Traditionally, bone grafts have been the preferred method of reconstruction. We present the first report of the use of Vitallium micromesh in reconstruction of midface bone and cartilaginous defects in 3 patients. In 1 patient, bone loss resulted from trauma; in the other 2, loss was due to tumor resection. In all 3 patients, Vitallium micromesh was used successfully as a replacement for the bony skeleton without morbidity or complications. Use of this material is contingent on its rigid fixation. We do not recommend use of this technique in the absence of rigid fixation.

Adult

Organic surface film contamination of Vitallium implants.

Conventional finishing and polishing techniques used to prepare Vitallium subperiosteal dental implant castings were found to produce low energy surfaces as measured by critical surface tension. Standard metallographic preparation gave slightly higher values. Glow discharge cleaning of both types of polished surface gave much higher critical surface tension values. This suggests the presence of an organic film after surface polishing of the implant which may later affect tissue reaction, in particular attachment, as has been noticed in related animal studies.

Adhesiveness

[Prosthesis of the head of the radius in long-term follow-up--vitallium versus silastic].

At the Graz Hospital for Accident Surgery, seven Vitallium prostheses were implanted in the period from 1964 to 1968, and nine Silastic prostheses in the period from 1984 to 1991. In January 1993 we were able to do control examinations in eleven patients. Five of them with fractures of type B2.3, five of B3.3 and one of C3.3 according to the AO-Classification. Secondary treatment was done in four patients by prosthetic substitution. All patients had to wear a cast postoperatively for two to eight weeks. Our results--like those already described in relevant literature--clearly confirm the markedly poorere outcome of secondary treatment by prosthetic substitution of the head of the radius. On the basis of our results we therefore recommend in all cases where resection seems to be unavoidable to perform primary atraumatic resection with complete removal of all bone splinters and subsequent prosthetic substitution of the head of radius, if it is not possible to an osteoynthetic operation without immobilisation. We did not find any correlation to the classivication of the fracture types.

Adult

Incorporation of stainless steel, titanium and Vitallium in bone.

Operative trauma, implant instability and corrosion are recognized as aetiological factors in the production of the soft-tissue capsule often present round a metal implant in bone. In the present experimental study, the isolated effect of corrosion was evaluated under standardized experimental conditions when operative trauma was minimal and implant movement was negligible. The reaction of bone to stainless steel, titanium and Vitallium was studied by histological and biomechanical methods, and compared to that provoked by copper. No soft-tissue capsule was found round the modern materials, but copper gave rise to a marked tissue reaction. It is concluded that a traumatic operative techniques and implant immobility are more effective for stable incorporation of metallic implants in bone than the nature of the implant itself, provided that one of the modern, low-corrosive metals or alloys is used.

Angiography

Treatment of protracted bilateral mandibular dislocation with Proplast-Vitallium prostheses.

A case of bilateral protracted mandibular dislocation complicated by the presence of unusual degenerative changes in the temporomandibular joints is presented. A synopsis of treatment modalities that have been used previously to treat similar conditions is given. Our treatment consisted of bilateral condylectomies, eminectomies, and insertion of Proplast-coated Vitallium condylar prostheses. These procedures resulted in the re-establishment of normal TMJ anatomy, the maintenance of proper posterior mandibular vertical dimension, correction of malocclusion, and relief of the patient's symptoms.

Adult

Vitallium-mold arthroplasty of the knee. A case report with 30-year follow-up study.

A case was reviewed of a 52-year-old woman who underwent vitallium-mold arthroplasty of the right knee in 1958. After more than 30 years her Hospital for Special Surgery knee score continued to show an excellent rating. The anatomic-designed implant, made of cobalt-chrome material and inserted cementless, appears to have withstood the test of time in the knee.

Adult

[Electron spectroscopy for chemical analysis. (ESCA). Examinations on formation and re-formation of the passive layer on vitallium (author's transl)].

The passive layer of a metal implant is responsible for its tolerance in a biological environment. A report is given on ESCA-investigations on the passive layer on Vitallium implants which consists largely of Cr-oxide and is only approx. 3-5 micrometer thick. This passive layer can easily be damaged with OP-instruments. The oxide layers rebuilt on exposure to air or on sterilization in boiling water were also investigated by ESCA. Oxide layers normally formed are very similar to the original passive layer. Accumulations of Co- and Mo-oxides are also observed, however. Some short implantation experiments show that the thin Cr-oxide layer is indeed effective as a passive layer. The analytical findings indicate that the formation or re-formation of the passive layer is due to a selective dissolution process. This accords with results obtained by the neutron activation analysis of the serum.

Chromium Alloys

Arthrodesis of the first metatarsophalangeal joint with Vitallium plate fixation.

Forty-seven patients (58 feet) underwent first metatarsophalangeal joint fusion with a small Vitallium plate (Howmedica, Inc., Rutherford, NJ). Congruous joint surfaces were prepared with either cone-shaped or cup-shaped reamers. At an average follow-up of 19.2 months, 98% (57 feet) were successfully fused. Ninety-three percent (54 feet) noted good or excellent results. Plate removal was necessary in only 7% (4 feet) of cases. Complications included nonunion with plate breakage in 2% (1 foot) and delayed union in 2% (1 foot) of cases. This technique was useful and predictable in achieving successful fusion of the first metatarsophalangeal joint.

Adolescent

[Investigations of contact tissues of Blount vitallium staples using the instrumental neutron activation analysis (author's transl)].

Instrumental neutron activation analysis with Gamma-spectroscopy is a very sensitive method for testing trace elements. Specimens of contact tissue around 5 Blount's vitallium clamps were, after preparation at the Nuclear Research Institute Jülich irradiated with thermic neutrons and their element-specific gamma spectra were measured after 33 and 125 days. In contact tissue a significant rise in concentration of the alloy-specific elements cobalt and chromium was found. The unspecific elements silver, caesium, iron, rubidium, antimon, scandium and zink were either within or very close to the normal. The metallosis of contact tissue is due to corrosion of the surfaces of cobalt-chromium implants.

Activation Analysis

[Allergic cobalt reaction (metallosis) following knee arthroplasty with vitallium endoprosthesis ad modum Walldius (author's transl)].

A case report is given on a woman with rheumatoid arthritis and deformed knee joints. She got a knee arthroplasty with a metal-to-metal Vitallium endoprosthesis ad modum Walldius. About one year after the arthroplasty she showed both a sterile fistulation from the knee joint and an eczema of the skin of the operated knee. An epicutaneous test for cobalt was positive. It is suggested that the metal-to-metal contact in the prosthesis and the proximity of the prosthesis to the skin is a possible explanation to the allergic reaction.

Adrenal Cortex Hormones

An unusual reaction in muscle in association with Vitallium plate: a report of possible metal hypersensitivity.

A case is reported in which fractures of the radius and ulna were fixed with Vitallium plates and screws. Seven years later a painful swelling appeared over the extensor aspect of the forearm. After eight years sarcoma was suspected and a pale tumour infiltrating muscle was found at operation. However, the histology excluded neoplasia and showed massive fibrosis and patchy necrosis of muscle, with chronic inflammatory changes peripherally. After the removal of the metal the swelling disappeared. A sinus down to the ulna followed operation and was not cured two years later. At this stage standard patch testing showed skin sensitivity to cobalt. Metal sensitivity is proposed as the cause of this extraordinary reaction in muscle.

Bone Plates

Use of vitallium prosthesis to relieve jaundice in patients with obstruction at the bifurcation of the hepatic duct.

Fourteen patients with hepatic duct obstruction were treated by inserting a Vitallium prosthesis through the strictured area. Eleven had proven cholangiocarcinoma; in 3 a definitive diagnosis wsa not obtained. Jaundice was relieved and patients were afforded good palliation. Obstruction of the prosthesis has not been a problem and the absence of external drainage tubes has been a factor in improving the quality of life of these patients. The simplicity of the operation is emphasized.

Adenoma, Bile Duct

The Moore vitallium femoral-head prosthesis in fractures of the femoral neck.

A follow-up is given of early and late results in 109 arthroplasties with the self-locking Austin T. Moore vitallium femoral head prosthesis in fractures of the femoral neck on 106 patients. Operative indication was usually fresh medical fracture of the femoral neck in an elderly woman, or its late complication. The surgery was performed in a unit for general surgery also engaged in pre- and postgraduate teaching activities. Many operations were performed by residents engaged in general surgery or orthopaedics. Point scores according to a modification of Merle D'Aubigné's classification showed excellent or at least good results in 81 per cent of the 69 mobile patients. Because of deteriorated general physical condition 11 patients were chronically bed-ridden. Five patients could not be reached. In three instances the prosthesis was removed. 21 patients died, three during the stay in hospital and 18 later for reasons not connected with the operative procedure. The mortality during 40 months of observation corresponded fairly well to that expected in the age group for the population as a whole.

Adult