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Cannulated screw

Jeffrey M Toth, Mei Wang, Chetan K Patel, Akshi Arora
Background: The effects of recombinant human bone morphogenetic protein-2 (rhBMP-2) on pedicle screw pullout force and its potential to improve spinal fixation have not previously been investigated. rhBMP-2 on an absorbable collagen sponge (ACS) carrier was delivered in and around cannulated and fenestrated pedicle screws in a sheep lumbar spine instability model. Two control groups (empty screw and ACS with buffer) were also evaluated. We hypothesized that rhBMP-2 could stimulate bone growth in and around the cannulated and fenestrated pedicle screws to improve early bone purchase...
September 2018: Journal of Spine Surgery (Hong Kong)
Ashley E Levack, Elizabeth B Gausden, Aleksey Dvorzhinskiy, Dean G Lorich, David L Helfet
In physiologically young patients with displaced femoral neck fractures, surgical treatment is aimed at achieving fracture union while preserving native hip anatomy and biomechanics. The intracapsular environment, tenuous vascular supply, and unfavorable hip biomechanics contribute to the high complication rates seen after osteosynthesis of these fractures. Conventional fixation methods for osteosynthesis of femoral neck fractures include multiple cancellous screws, fixed-angle dynamic implants, and fixed-angle length-stable constructs...
January 2019: Journal of Orthopaedic Trauma
Peter Augat, Emily Bliven, Simon Hackl
Fractures of the femoral neck can occur in young healthy individuals due to high loads occurring during motor vehicle accidents, impacts, or falls. Failure forces are lower if impacts occur sideways onto the greater trochanter as compared with vertical loading of the hip. Bone density, bone geometry, and thickness of cortical bone at the femoral neck contribute to its mechanical strength. Femoral neck fractures in young adults require accurate reduction and stable internal fixation. The available techniques for fracture fixation at the femoral neck (cannulated screws, hip screw systems, proximal femur plates, and cephallomedullary nails) are reviewed with respect to their competence to provide biomechanical stability...
January 2019: Journal of Orthopaedic Trauma
Matthew Duffin, Holly T Pilson
Fixation of young femoral neck fractures represents a challenge in the field of orthopaedic trauma surgery. Conventional methods, including cannulated screw and sliding hip screw constructs, have been studied and found to have similar results with regards to patient outcomes, which has made choosing an optimum fixation strategy difficult. In all of these cases, quality of reduction has been shown to be the most important factor when it comes to creating a favorable environment for fracture healing. Some of these patients, however, continue to have negative sequelae including nonunion, avascular necrosis, femoral head collapse, and poor hip function as a result...
January 2019: Journal of Orthopaedic Trauma
F Neubrech, A Terzis, J Seegmüller, M Sauerbier
BACKGROUND: Fractures of the scaphoid bone are common but can easily be overlooked in standard X‑rays. Inadequate diagnostics and therefore inappropriate treatment of scaphoid fractures often leads to problems in healing with formation of non-union and painful osteoarthritis of the wrist. OBJECTIVE: This review summarizes the current practical recommendations in the diagnostics and treatment of acute scaphoid fractures. METHODS: An analysis and review of selected literature including the current S3 guidelines were performed...
December 11, 2018: Der Unfallchirurg
Vincenzo Giordano, Alexandre Leme Godoy-Santos, Felipe Serrão de Souza, Hilton Augusto Koch, Cesar de Cesar Netto, Stefan Rammelt
Avulsion fractures of the calcaneal tuberosity represent a rare injury pattern that is caused by a powerful tension force from the Achilles tendon and is usually seen following minor trauma, especially in elderly patients. The objective of this study is to describe a surgical technique using cerclage wiring through cannulated screws in the treatment of extra- and intra-articular avulsion fractures of the calcaneal tuberosity and to present our results in a small patient's cohort. Through a 5.0 cm longitudinal skin incision over the posterolateral aspect of the calcaneus, after adequate debridement of the fracture fragments and while keeping the ankle in plantarflexion, the calcaneal tuberosity is anatomically reduced with the help of a periarticular reduction clamp and an accessory plantar longitudinal approach...
2018: Case Reports in Orthopedics
Alisdair J Felstead, Joideep Phadnis
Articular fractures of the elbow require direct reduction and interfragmentary fixation to restore anatomic stability. The fragments are often small, with limited bone stock, hence implants are often placed through the articular surface to gain maximal purchase. Traditional techniques involve the use of countersunk cortical screws or cannulated headless compression screws. We describe a technique in which small locking screws are used independently from a plate as a substitute for headless or other traditional screws...
December 5, 2018: Techniques in Hand & Upper Extremity Surgery
Jialiang Guo, Weichong Dong, Bing Yin, Lin Jin, Zhe Lin, Zhiyong Hou, Yingze Zhang
OBJECTIVE: Unstable femoral neck fractures are typically high-angled shear fractures caused by high-energy trauma. Internal fixation of femoral neck fractures with placement of parallel cannulated screws in an inverted triangle configuration is commonly performed in the clinical setting. This study was performed to investigate the primary results of intramedullary nailing with cannulated screws for the treatment of unstable femoral neck fractures in young and middle-aged patients. METHODS: In total, 96 consecutive patients with no history of hip surgery using inverted triangular cannulated compression screws or construction nails with cannulated screws were reviewed...
December 11, 2018: Journal of International Medical Research
Bushu Harna, Dhananjaya Sabat
Background Divergent trapezium-trapezoid fracture dislocation is a rare and complex injury. The authors present an unusual case of dislocation of the trapezium-trapezoid complex with scaphoid fracture. Case Description A 25-year-old man suffered a road traffic accident leading to complex carpal injury due to axial and rotation forces (steer wheel injury) on the left wrist. X-rays and computed tomographic (CT) scan were done showing trapezium-trapezoid dissociation with fracture of distal pole of scaphoid and ulna styloid...
December 2018: Journal of Hand and Microsurgery
Gabriele Falzarano, Giuseppe Rollo, Michele Bisaccia, Valerio Pace, Riccardo Maria Lanzetti, Esteban Garcia-Prieto, Paolo Pichierri, Luigi Meccariello
INTRODUCTION: The treatment of the sacroiliac joint (SIJ) vertical instability is a matter of current discussions and remains controversial. The aim of our study is the evaluation of the surgical management of SIJ vertical instability involving the use of cannulated screws introduced under CT guidance and local anesthesia. MATERIALS AND METHODS: In the set time frame of 7 years, 96 poly-trauma patients with Tile's type C fracture of the pelvis with vertical instability of the SIJ were treated...
2018: SICOT-J
Dayane de Melo Costa, Lillian Kelly de Oliveira Lopes, Anaclara Ferreira Veiga Tipple, Khalid Johani, Honghua Hu, Anand Kumar Deva, Evandro Watanabe, Karen Vickery
BACKGROUND: To determine the effect of multiple use and processing cycles on instrument quality over the life of stainless steel, complex designed clinical surgical instruments. METHODS: Steam sterilised surgical instruments due to be discarded from Australian hospitals, because of loss of functionality, were assessed for contaminating protein and bacteria using the bicinchoninic acid protein assay and microbial culture, respectively. Biofilm presence and instrument damage were visually confirmed by scanning electron microscopy (SEM)...
March 2018: Infection, disease & health
Loukia K Papatheodorou, Dean G Sotereanos
PURPOSE: We retrospectively reviewed the results of 89 patients with proximal pole scaphoid nonunion, 58 with avascular necrosis, treated with a capsular-based vascularized distal radius graft. METHODS: Seventy-one male and eighteen female patients with symptomatic nonunion at the proximal pole of the scaphoid were included in this study. No patient had a humpback deformity. In all patients, the vascularized bone graft was harvested from the dorsum of the distal radius and was attached to a capsular flap of the dorsal wrist capsule...
November 24, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Ivan Lvov, Andrey Grin, Aleksandr Talypov, Anton Kordonskiy, Vladimir Smirnov, Iliya Grigoriev, Ulugbek Khushnazarov, Vladimir Krylov
PURPOSE: This study aimed to evaluate the impact of several factors, including patients' intraoperative position, intraoperative visualization technique, fixation method, and type of screws and their parameters, on the frequency of intraoperative screw-associated complications in posterior transarticular C1-C2 fixation. METHODS: A systematic review of the PubMed database between January 1986 and March 2018 was performed. The key inclusion criteria comprised detailed descriptions of the surgical technique and post-operative screw-associated complications...
November 22, 2018: European Spine Journal
Tao Li, Qing-Song Zhang
BACKGROUND: We studied the safety and efficacy of dynamic locking plate vs. other implants (cannulated cancellous screws [CCS] or sliding hip screw [SHS]) in patients undergoing intracapsular hip fracture (ICHF). METHODS: We searched Pubmed, Embase, Web of Science, Cochrane library and Google database from inception to March 25, 2018. We selected any studies comparing dynamic locking plate for treatment ICHF. Non-union rate, osteonecrosis rate, cutout rate, revision rate, the replacement rate, and Harris hip scores were the outcomes...
November 2018: Medicine (Baltimore)
W S Nijmeijer, E C Folbert, M Vermeer, M M R Vollenbroek-Hutten, J H Hegeman
In the past 10 years after implementation, the orthogeriatric treatment model led in general to consistent outcomes for 1555 older adults in terms of most of the complications and mortality. Surgery was more often delayed to 24-48 h after arrival at the hospital, while the length of hospital stay shortened. INTRODUCTION: Since 1 April 2008, patients aged ≥ 70 years presenting themselves with a hip fracture at Ziekenhuisgroep Twente (ZGT) have been treated according to the orthogeriatric treatment model...
November 19, 2018: Archives of Osteoporosis
Eric So, Bryan Van Dyke, Maria R McGann, Roberto Brandao, David Larson, Christopher F Hyer
The Lapidus bunionectomy is performed to treat hallux valgus. Recurrence of the deformity remains a concern. A transverse intermetatarsal screw spanning the base of the first metatarsal to the base of the second can increase stability. The neurovascular bundle is located within the proximity of this screw. In this study, we assessed the structures at risks with the use of this technique. In 10 specimens, a guide wire was placed, and a 4.0-mm cannulated screw was inserted. The neurovascular bundle was dissected and inspected for direct trauma to the neurovascular bundle, and the proximity of the screw was measured using a digital caliper...
November 15, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Rajkumar Selvanayagam, Vivek Tiwari, Saubhik Das, Vivek Trikha
Due to the inherent stability of the hip joint, hip dislocations constitute a relatively small proportion of all the traumatic dislocations encountered in the emergency department. Among them, the anterior type of hip dislocation is less common than the posterior type of dislocation. Anterior dislocations are usually associated with an injury to other, nearby structures like the acetabulum and femoral head. An ipsilateral greater trochanter fracture with anterior hip dislocation is very sparsely reported in the literature...
September 11, 2018: Curēus
Y Zhao, C Q Jiang, T Sun, D J Xin, Z H Wang, D Wang, S D Zhang
Objective: To introduce a robot-assisted modified method of sacroiliac screw path planning in order to reduce the incidence of screw misplacement. Methods: The study involved 13 patients suffering from posterior pelvic injuries treated by percutaneous sacroiliac screw in Yantai Shan Hospital from August 2016 to May 2018. The patients included 9 males and 4 females, aged from 18 to 70 years (mean age 46.2 years). Causes of injury were traffic accidents ( n =7), crushing injury ( n =4) and fall from height ( n =2)...
November 6, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
James P Ledgard, Javariah Siddiqui, Matthew H Pelletier, William R Walsh, Peter J Scougall
BACKGROUND: Midcarpal arthrodesis is a treatment of choice in patients with midcarpal arthritis. Traditionally a four corner fusion has been favoured, however recent research has shown improved results when the triquetrum and scaphoid are excised. There is no clear evidence as to which remaining bones should be fused or which implants should be used. The purpose of this study is to compare the biomechanics of midcarpal arthrodesis after scaphoid and triquetrum excision, using memory staples or cannulated screws, in recognised construct patterns...
December 2018: Journal of Hand Surgery Asian-Pacific Volume
Onur Kocadal, Murad Pepe, Zafer Gunes, Ertugrul Aksahin, Semra Duran, Cem Nuri Aktekin
In this biomechanical study, the strength of five different fixation techniques -anterior tension band wiring with K-wires, separate vertical wiring, headless compression screws with anterior tension band wiring, cannulated screws with tension band wiring and memory shape patellar fixator- for distal patellar fractures were compared. Forty calf knees were used for the biomechanical testing. Each specimen was pre-loaded with 10 N at 1 N/s. The distraction forces were applied consistently with the velocity of 5 mm/s...
December 2017: Acta Orthopaedica Belgica
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