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Mehmet Volkan Harput, Ayda Parnian Fard, Ugur Türe
Intramedullary tumors of the spinal cord are rare and account for 2% to 8.5% of all central nervous system tumors. In adults, ependymomas are the most common intramedullary tumors. The primary choice of treatment should be radical surgical removal, as this is curative for most tumors. Adequate tumor exposure is crucial and mostly achieved through standard laminectomy followed by midline myelotomy. However, extensive removal of posterior spinal elements may lead to worsening kyphotic deformities. After obtaining patient consent, this 3-dimensional video publication was prepared to present microneurosurgical removal of a C3-C6 cervical intramedullary tumor using right-sided hemilaminoplasty...
December 12, 2018: Operative Neurosurgery (Hagerstown, Md.)
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
Lei Shi, Kai Shen, Rui Deng, Zheng-Jian Yan, Kai-Lu Liang, Liang Chen, Zhen-Yong Ke, Zhong-Liang Deng
PURPOSE: To investigate the anatomical and biomechanical feasibility of the unilateral C1 double screw [pedicle screw (PS) + lateral mass screw (LMS)] and ipsilateral C2 PS combined with contralateral C2 laminar screw (LS)-rod fixation for atlantoaxial instability by comparison with traditional posterior fixation methods. METHODS: Fifteen sets of complete dry bony specimens of atlas were used for morphometric analysis. The working length, width and thickness of the C1 PSs and LMSs were manually measured...
December 11, 2018: European Spine Journal
Jun Fu, Ming Ni, Jiying Chen, Xiang Li, Wei Chai, Libo Hao, Guoqiang Zhang, Yonggang Zhou
Purpose: The purpose of this study was to establish the finite element analysis (FEA) model of acetabular bone defect reconstructed by 3D printed Ti6Al4V augment and TM augment and further to analyze the stress distribution and clinical safety of augments, screws, and bones. Methods: The FEA model of acetabular bone defect reconstructed by 3D printed Ti6Al4V augment was established by the CT data of a patient with Paprosky IIIA defect. The von Mises stresses of augments, screws, and bones were analyzed by a single-legged stance loading applied in 3 increments (500 N, 2000 N, and 3000 N)...
2018: BioMed Research International
Won-Bum Lee, Won-Hyuk Choi, Hyeong-Geun Lee, Na-Rae Choi, Dae-Seok Hwang, Uk-Kyu Kim
Background: After the resection at the mandibular site involving oral cancer, free vascularized fibular graft, a type of vascularized autograft, is often used for the mandibular reconstruction. Titanium mesh (T-mesh) and particulate cancellous bone and marrow (PCBM), however, a type of non-vascularized autograft, can also be used for the reconstruction. With the T-mesh applied even in the chin and angle areas, an aesthetic contour with adequate strength and stable fixation can be achieved, and the pores of the mesh will allow the rapid revascularization of the bone graft site...
December 2018: Maxillofacial Plastic and Reconstructive Surgery
Rune D Bech, Ole Ovesen, Jens Lauritsen, Claus Emmeluth, Peter Lindholm, Søren Overgaard
Background and purpose: Local infiltration analgesia (LIA) supports early mobilization after hip and knee arthroplasty. Inspired by this, we studied the effectiveness of wound infiltration with the long acting local anesthetic ropivacaine in an effort to decrease the need for postoperative opioids after osteosynthesis of extracapsular hip fracture. Methods: Forty-nine patients undergoing osteosynthesis with a sliding hip screw were randomized into two groups in a double-blind study (ClinicalTrials...
2018: Pain Research & Management: the Journal of the Canadian Pain Society
Raquel Alonso-Pérez, José F Bartolomé, Alberto Ferreiroa, María P Salido, Guillermo Pradíes
OBJECTIVES: To assess the internal accuracy, mechanical behaviour under static load and screw loosening before and after cyclic loading of implant-supported crowns restored with original components or with two compatible non-original brands. MATERIALS AND METHODS: Sixty-three dental implants were divided into three groups (n = 21 each): Group 1 used original components, and groups 2 and 3 used non-original components. Internal accuracy was measured throughout a cross section of the sample groups (n = 8) using scanning electron microscopy (SEM) to evaluate the fit for implant-abutments, implant-crowns and crown-abutments...
November 22, 2018: Clinical Oral Implants Research
Florian Gras, Henry Wendt, Heiko Gottschling, Manuel Schröder, Ivan Marintschev, Gunther O Hofmann, Rainer Burgkart
(1) Can iliosacral osseous corridor diameters in sacral dysmorphism be enlarged by in-out-in screw placement at the posterior iliosacral recessus? (2) Are lumbosacral transitional vertebra (LSTV) the anatomical cause for sacral dysmorphism? (3) Are there sex-specific differences in sacral dysmorphism? 594 multislice CT scans were screened for sacral dysmorphism and 55 data-sets selected. Each pelvis was segmented manually and cylindrical iliosacral corridors (S1 and S2 vertebra) were semi-automatically determined...
December 11, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Yi Liu, Wu Zhou, Tian Xia, Jing Liu, Bo-Bin Mi, Liang-Cong Hu, Zeng-Wu Shao, Guo-Hui Liu
This study is aimed to explore the clinical application of the guiding template designed by three-dimensional printing data for the insertion of sacroiliac screws. A retrospective study of 7 cases (from July 2016 to December 2016), in which the guiding template printed by the threedimensional printing technique was used for the insertion of sacroiliac screws of patients with posterior ring injuries of pelvis, was performed. Totally, 4 males and 3 females were included in template group, aged from 38 to 65 years old (mean 50...
December 2018: Current medical science
Xingyi Hua, Shuang G Yan, Yiliang Cui, Zongsheng Yin, Anna J Schreiner, Florian Schmidutz
PURPOSE: Pelvic ring fractures are challenging injuries and require effective treatment due to the frequently compromised patient condition. The aim of this study was to evaluate the outcome of unstable pelvic ring injuries treated with a minimally invasive pedicle screw-rod system. METHODS: Retrospective analysis was performed for patients with an unstable pelvic ring injury that were treated with a minimally invasive anterior internal pelvic fixator (INFIX) with or without a posterior pedicle screw-rod fixator (6/2012-4/2015)...
December 8, 2018: Archives of Orthopaedic and Trauma Surgery
Francesco Ferrini, Paolo Capparé, Raffaele Vinci, Enrico F Gherlone, Gianpaolo Sannino
Objectives: The aim of the study was to evaluate and compare digital and traditional prosthetic workflow for posterior maxillary restorations supported by an upright and a distally tilted implant at 3-year follow-up. Materials and Methods: Twenty-four patients were treated in the posterior maxilla with 24 immediately loaded axial and 24 distally tilted implants supporting 3-unit or 4-unit screw-retained prostheses. Three months after initial loading patients were randomly stratified into two groups: definitive traditional impressions were carried out in the control group, while digital impressions were performed in the test group...
2018: BioMed Research International
Avinash Kumar Rai, Rajesh Goel, Chirag Bhatia, Sumer Singh, Srikiran Thalanki, Ashwin Gondane
Purpose: The purpose of this study is to describe a method of inserting cement in the femoral head before fixation with dynamic hip screw to prevent screw cut out due to osteoporosis and to evaluate its clinical outcome in these patients. Materials and Methods: In this prospective study, 30 patients aged 60 years and older with intertrochanteric fracture were included. Bone mineral density was measured. After reaming of the femoral head and neck with a triple reamer and polymethyl methacrylate, bone cement was introduced into the femoral head using a customized nozzle and a barrel fitted on a cement gun...
December 2018: Hip & Pelvis
Cheon-Gon Park, Taek-Rim Yoon, Kyung-Soon Park
Purpose: Internal fixation using compression hip screws (CHS) and traction tables placing patients in the supine position is a gold standard option for treating intertrochanteric fractures; however, at our institution, we approach this treatment with patients in a lateral decubitus position. Here, the results of 100 consecutive elderly (i.e., ≥45 years of age) patients who underwent internal fixation with CHS in lateral decubitus position are analyzed. Materials and Methods: Between March 2009 and May 2011, 100 consecutive elderly patients who underwent internal fixation with CHS for femoral intertrochanteric fracture were retrospectively reviewed...
December 2018: Hip & Pelvis
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
Hiroshi Uei, Yasuaki Tokuhashi, Masafumi Maseda, Masahiro Nakahashi, Hirokatsu Sawada, Koji Matsumoto, Hiroyuki Miyakata, Hirotoki Soma
Purpose: Minimally invasive spine stabilization (MISt) using percutaneous pedicle screws plays a significant role in palliative surgery for metastatic spinal tumors. However, few studies have investigated surgical outcomes based on the epidural spinal cord compression scale (ESCCS). The purpose of this study was to examine outcomes of metastatic spinal tumors as evaluated by ESCCS in patients treated by MISt. Methods: The subjects were 56 patients who underwent MISt for metastatic spinal tumors, including 34 patients with ESCCS 2 or milder (group A) and 22 patients with ESCCS 3 (group B)...
2018: BioMed Research International
Tilman Hees, Wolf Petersen
Increased tibial slope can be a cause of recurrent instability after anterior cruciate ligament reconstruction. This article presents a technique for an anterior closing-wedge osteotomy for slope correction. The indications for this procedure are patients with recurrent instability after anterior cruciate ligament reconstruction with a neutral leg axis or slightly varus deformity and a posterior slope of more than 12°. The exposure of the anterior aspect of the tibia is best made through an anterior approach approximately 1 to 2 cm medial to the tibial tuberosity...
November 2018: Arthroscopy Techniques
Segen Aklilu, David P Barei, Felix S Chew
Some proximal femur fractures may be treated surgically with the use of fracture fixation hardware such as the sliding hip screw and its variants. These devices allow the femoral head and neck fragment to compress against the trochanteric or shaft fragment as the hip screw telescopes into the barrel of the side plate. We describe an unusual complication in which the hip screw disengaged in the opposite direction, migrated through the hip joint, and came to rest inside the pelvic cavity. The separated components of the device were surgically removed without further complication...
February 2019: Radiology Case Reports
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