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https://www.readbyqxmd.com/read/28108751/-compatibility-and-allergies-of-osteosynthesis-materials
#1
M Thomsen, P Thomas
Metal implants for osteosynthesis are nowadays standard in orthopedic and trauma surgery. Steel implants, especially cerclages, bands and wires, can show more corrosion due to friction and lead to encapsulation in connective tissue with fluid borders even without loosening. Corrosion and fluid borders are potentially more susceptible to incompatibility and infections. Titanium implants have the advantage of better allergic compatibility. Problems may occur in material removal, especially with titanium implants because material fractures occur more frequently...
January 20, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28108750/-titanium-or-steel-as-osteosynthesis-material-systematic-literature-search-for-clinical-evidence
#2
Alexander Joeris, Sabine Goldhahn, Elke Rometsch, Dankward Höntzsch
BACKGROUND: The selection of the appropriate implant material, stainless steel or titanium, is still the decision of the surgeon and/or the affiliated institution. Additionally, remarkable international differences can be found between the different markets, which cannot really be explained. OBJECTIVE: A systematic literature search was performed to verify whether there is clinical evidence for the preference of one material over the other. MATERIAL AND METHODS: The systematic literature search was performed utilizing the internet databases PubMed, Cochrane and Web of Science...
January 20, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28100253/minimally-invasive-percutaneous-osteosynthesis-versus-orif-for-sanders-type-ii-and-iii-calcaneal-fractures-a-prospective-randomized-intervention-trial
#3
Cong Jin, Dong Weng, Wanlei Yang, Wei He, Wengqing Liang, Yu Qian
BACKGROUND: This randomized controlled trial compared the clinical outcomes and complications of a novel minimally invasive percutaneous osteosynthesis (MIPO) with those of conventional treatment via an extended L-shaped lateral approach for calcaneal fractures. METHODS: Sixty-four patients with displaced intraarticular calcaneal fractures were enrolled. The patients were randomly allocated to receive either MIPO (29 patients) or open reduction and internal fixation via an extended L-shaped lateral approach (35 patients)...
January 18, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28093609/periprosthetic-fracture-around-a-stable-femoral-stem-treated-with-locking-plate-osteosynthesis-distal-femoral-locking-plate-alone-versus-with-cerclage-cable
#4
Young-Soo Shin, Seung-Beom Han
To promote rapid bone healing, an adequate stable fixation implant with a percutaneous reduction instrument should be used for Vancouver type B1 or C fractures. The objective of this study was to describe radiographic and clinical outcomes of patients with periprosthetic fracture (PPF) around a stable femoral stem, treated with a distal femoral locking plate alone or with a cerclage cable. A total of 21 patients with PPF amenable to either a reverse distal femoral locking plate (LCP DF(®)) alone or with a cerclage cable, with a mean age of 75...
January 16, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28093251/malalignment-after-minimally-invasive-plate-osteosynthesis-in-distal-femoral-fractures
#5
Joon-Woo Kim, Chang-Wug Oh, Jong-Keon Oh, Il-Hyung Park, Hee-Soo Kyung, Kyeong-Hyeon Park, Seong-Dae Yoon, Seong-Min Kim
INTRODUCTION: Although minimally invasive plate osteosynthesis (MIPO) is a preferred operative treatment for fractures of the distal femur, malalignment is a significant concern because of indirect reduction of the fracture. The purpose of this study, therefore, was to evaluate radiologic alignment after MIPO for distal femoral fractures. PATIENTS AND METHODS: Of the 138 patients with fracture of the distal femur who underwent MIPO, we enrolled 51 patients in whom bilateral rotational alignment could be assessed by postoperative computed tomography (CT)...
January 10, 2017: Injury
https://www.readbyqxmd.com/read/28088940/indirect-reduction-technique-using-a-distraction-support-in-minimally-invasive-percutaneous-plate-osteosynthesis-of-tibial-shaft-fractures
#6
Wen-Wei Dong, Zeng-Yuan Shi, Zheng-Xin Liu, Hai-Jiao Mao
PURPOSE: To describe an indirect reduction technique during minimally invasive percutaneous plate osteosynthesis (MIPPO) of tibial shaft fractures with the use of a distraction support. METHODS: Between March 2011 and October 2014, 52 patients with a mean age of 48 years (16-72 years) sustaining tibial shaft fractures were included. All the patients underwent MIPPO for the fractures using a distraction support prior to insertion of the plate. Fracture angular deformity was assessed by goni- ometer measurement on preoperative and postoperative images...
December 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28073141/-current-recommendations-for-the-therapy-of-dislocated-talus-fractures-weber-and-marti-type-iv-literature-research
#7
Hans-Joachim Riesner, Falk von Lübken, Sonja Förster, Patricia Lang, Fabian Stuby, Benedikt Friemert, Hans-Georg Palm
Introduction Talar dislocation fractures of type IV (Marti and Weber) are extremely rare injuries with special challenges to the surgeon and poor results. Due to their low incidence and the sparse literature, it is unclear what is the optimal treatment and how complications can be minimised. Material and Methods A literature research was carried out using the online medical database "PubMed". The findings of the literature were then applied to a clinical case of type IV talar dislocation fracture (Marti and Weber)...
January 10, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28073140/-clinical-and-radiological-results-after-anterior-cervical-corpectomy-with-cage-fusion-a-retrospective-comparison-of-peek-vs-titanium-cages
#8
Chris Schulz, Uwe Max Mauer, René Mathieu
Background Anterior cervical corpectomy and fusion (ACCF) has become a standard procedure for patients with spondylotic myelopathy due to multisegmental stenosis of the cervical canal. Beside the fusion technique using autogenous bone grafts, synthetic cages have been increasingly used in recent years. Published information on the clinical and radiological results of different cage materials for ACCF is still limited. The study presented here is the largest series to date reporting clinical and radiological outcomes and complication rates after one- to three-level ACCF using structural polyetheretherketone (PEEK) or titanium cages augmented by anterior plate-screw osteosynthesis...
January 10, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28073094/the-role-of-lesser-trochanter-fragment-in-unstable-pertrochanteric-a2-proximal-femur-fractures-is-refixation-of-the-lesser-trochanter-worth-the-effort
#9
Christian Ehrnthaller, Alain Christoph Olivier, Florian Gebhard, Lutz Dürselen
BACKGROUND: Instability of osteoporotic pertrochanteric fractures is defined by loss of medial/lateral cortical integrity with the posteromedial fragment including the lesser trochanter being pivotal for load distribution. Literature addressing the importance of lesser trochanter refixation is scarce. To clarify the effect of lesser trochanter refixation on primary stability in these fractures, following study was performed. METHODS: 21 femora were match-paired in 3 groups and osteotomized, creating pertrochanteric fractures (AO-31A2)...
December 30, 2016: Clinical Biomechanics
https://www.readbyqxmd.com/read/28070629/-susceptibility-to-infections-and-behavior-of-stainless-steel-comparison-with-titanium-implants-in-traumatology
#10
Patrick Haubruck, Gerhard Schmidmaier
BACKGROUND: Despite modern treatment options, implant-associated infections (IAI) remain a severe and challenging complication in the treatment of trauma patients. Almost 30 years after the introduction of implants made of titanium alloy into the treatment of trauma patients, there is still no uniform consensus regarding the clinical benefit of titanium alloy in the context of patients with IAI. OBJECTIVE: We sought to determine if implants made of titanium alloy have been proven to be less susceptible regarding IAI in contrast to implants made of stainless steel...
January 9, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28063081/submuscular-plating-of-the-femur-through-an-anterior-approach-after-bone-distraction
#11
Federico Persico, Gabriel Fletscher, Mauricio Zuluaga
The method of osteogenesis by distraction is a known technique in orthopaedics for the management of bone defects secondary to trauma, infections or tumours. New strategies have been developed for decreasing the external fixator time. The use of the minimally invasive plate osteosynthesis technique is a secure approach through a percutaneous fixation technique in the anterior aspect of the femur that permits minimal dissection of the soft tissues while preventing cross-contamination with the pin tracts of the external fixators...
January 7, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28058496/-traumatology-in-the-elderly-multimodal-prevention-of-delirium-and-use-of-augmentation-techniques
#12
D Wähnert, A Roos, J Glasbrenner, K Ilting-Reuke, P Ohrmann, G Hempel, T Duning, N Roeder, M J Raschke
Recent data show that 20-80% of surgery patients are affected by delirium during inpatient clinical treatment. The medical consequences are often dramatic and include a 20 times higher mortality and treatment expenses of the medical unit increase considerably. At the University Hospital of Münster a multimodal and interdisciplinary concept for prevention and management of delirium was developed: all patients older than 65 years admitted for surgery are screened by a specialized team for the risk of developing delirium and treated by members of the team if there is a risk of delirium...
January 5, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28057632/are-two-retrograde-3-5-mm-screws-superior-to-one-7-3-mm-screw-for-anterior-pelvic-ring-fixation-in-bones-with-low-bone-mineral-density
#13
Y P Acklin, I Zderic, S Grechenig, R G Richards, P Schmitz, B Gueorguiev
OBJECTIVES: Osteosynthesis of anterior pubic ramus fractures using one large-diameter screw can be challenging in terms of both surgical procedure and fixation stability. Small-fragment screws have the advantage of following the pelvic cortex and being more flexible.The aim of the present study was to biomechanically compare retrograde intramedullary fixation of the superior pubic ramus using either one large- or two small-diameter screws. MATERIALS AND METHODS: A total of 12 human cadaveric hemipelvises were analysed in a matched pair study design...
January 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28054122/-steel-or-titanium-for-osteosynthesis-a%C3%A2-mechanobiological-perspective
#14
M Heyland, G N Duda, S Märdian, M Schütz, M Windolf
BACKGROUND: An implant used for stabilizing a fracture creates a mechanical construct, which directly determines the biology of bone healing. The stabilization of fractures places high mechanical demands on implants and therefore steel and titanium are currently almost exclusively used as the materials of choice. OBJECTIVES: The possible range of attainable mechanobiological stimulation for mechanotherapy as a function of plate stiffness depending on the selection of the plate material and the physical and mechanical properties of the material options are discussed...
January 4, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28054110/-periprosthetic-acetabular-fractures-in-geriatric-patients
#15
S C Herath, M F R Rollmann, T Histing, J H Holstein, T Pohlemann
Periprosthetic acetabular fractures in geriatric patients are rare injuries; however, the incidence is increasing because of the current demographic developments. For diagnosis of periprosthetic acetabular fractures, conventional X‑ray images are regularly complemented by computed tomography (CT). For exclusion of loosening of the prosthesis more advanced techniques, such as single photon emission CT (SPECT/CT) are applied. In addition to classification of periprosthetic acetabular fractures by the traditional system of Letournel there are several other classification systems, which take into account the etiology of the fracture and the stability of the prosthesis...
January 4, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28050549/bilateral-stress-fracture-of-femoral-neck-in-non-athlete-case-report
#16
Ubiratan Stefani de Oliveira, Pedro José Labronici, André João Neto, Alexandre Yukio Nishimi, Robinson Esteves Santos Pires, Luiz Henrique Penteado Silva
Bilateral stress fracture of femoral neck in healthy young patients is an extremely rare entity, whose diagnostic and treatment represent a major challenge. Patients with history of hip pain, even non-athletes or military recruits, should be analyzed to achieve an early diagnosis and prevent possible complications from the surgical treatment. This report describes a 43-year-old male patient, non-athlete, without previous diseases, who developed bilateral stress fracture of femoral neck without displacement...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28050546/medial-migration-of-the-intramedullary-gamma-3-nail-a-case-report
#17
Ana Costa Pinheiro, Bruno Alpoim, António Félix, Carlos Alves, Cristina Sousa, António Rodrigues
Intertrochanteric femur fractures are very common in patients over 65 years old, and are often associated with osteoporosis. Proximal femoral nails are preferred because of their biomechanical advantages in the treatment of these fractures, especially if the fracture is unstable. However, many complications associated with intramedullary fracture fixation have been described. The medial migration of the intramedullary gamma nail is a rare complication. The authors report an uncommon but potentially fatal complication, medial and intrapelvic migration of the intramedullary Gamma 3 nails, recorded after one month of osteosynthesis...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28050533/total-ruptures-of-the-extensor-apparatus-of-the-knee
#18
Diogo Moura, Fernando Fonseca
OBJECTIVE: This was a retrospective case-control study on total ruptures of the extensor apparatus of the knee, aimed to compare patella fractures with tendinous ruptures. METHODS: The sample included 190 patients and 198 total ruptures of the knee extensor apparatus. All patients were evaluated by the same examiner after a minimum one-year follow-up. RESULTS: Tendinous ruptures occurred most frequently in men, in younger patients, and had better clinical and functional outcomes when compared with patella fractures; however, the former presented higher levels of thigh atrophy...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28043849/clavicle-fractures
#19
REVIEW
M Ropars, H Thomazeau, D Huten
Management of clavicle fracture has progressed over the last decade, notably with wider use of surgery in midshaft fracture, and new techniques for lateral fracture. Midshaft clavicle fracture treatment needs to be personalized and adapted to the patient's activity level. Whichever the segment involved, treatment for non-displaced fracture is functional; elbow-to-body sling immobilization seems the best tolerated. Apart from regular surgical indications (shoulder impaction, floating shoulder, open fracture or fracture with neurovascular complications), surgery is recommended in case of bone shortening exceeding 1...
December 30, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28040089/success-rate-and-risk-factors-of-failure-of-the-induced-membrane-technique-in-children-a-systematic-review
#20
Jean-Charles Aurégan, Thierry Bégué, Guillaume Rigoulot, Christophe Glorion, Stéphanie Pannier
The induced membrane technique was designed by Masquelet et al. to address segmental bone defects of critical size in adults. It has been used after bone defects of traumatic, infectious and tumoral origin with satisfactory results. Recently, it has been used in children but, after an initial enthusiasm, several cases of failure have been reported. The purpose of this study was to assess the success rate and the risk factors of failure of the induced membrane for children. We conducted a systematic review of all the studies reporting the results of the induced membrane technique to address bone defects of critical size in children...
December 2016: Injury
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