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Anna Jungwirth-Weinberger, Paul Borbas, Andreas Schweizer, Ladislav Nagy
Purpose Ulna-shortening osteotomy is one of the most established and most frequent operations in hand surgery. However, bone union is not always achieved and the use of plates implies potential risks and problems. The traditional points of criticism are the duration of bone healing, the incidence of nonunion, and the necessity of hardware removal due to the soft tissue irritation by the plate or the screws. These shortcomings have been addressed by an increasing standardization of the procedure and finally specific instruments and implants...
November 2016: Journal of Wrist Surgery
Noora Tuomilehto, Reetta Kivisaari, Antti Sommarhem, Aarno Y Nietosvaara
Background and purpose - The quality of pin fixation of displaced supracondylar humerus fractures in children has not been assessed, and the clinical value of radiographic examinations after pin fixation is unclear. We evaluated pin configuration, quality of osteosynthesis, and outcome in 264 supracondylar fractures. The clinical significance of postoperative radiographs was analyzed. Patients and methods - 252 Gartland-III and 12 flexion-type supracondylar humerus fractures were pin-fixed in the periods 2002-2006 and 2012-2014...
October 24, 2016: Acta Orthopaedica
Christopher Bliemel, Ludwig Oberkircher, Benjamin Bockmann, Eric Petzold, Rene Aigner, Thomas Jan Heyse, Steffen Ruchholtz, Benjamin Buecking
INTRODUCTION: Compromised bone quality and the need for early mobilization continue to lead to implant failure in elderly patients with distal femoral fractures. The cement augmentation of screws might facilitate improving implant anchorage. The aim of this study was to analyse the impact of cement augmentation of the condylar screws on implant fixation in a human cadaveric bone model. MATERIAL AND METHODS: Ten pairs of osteoporotic femora (mean age: 90 years, range: 84-99 years) were used...
October 18, 2016: Injury
Juho Suojanen, Junnu Leikola, Patricia Stoor
The use of virtual surgery, patient-specific saw and drill guides, and custom-made osteosynthesis plates is rapidly spreading from deformity surgery to orthognathic surgery. Most of the commercially available systems are using computer-aided design/computer-aided manufacture (CAD/CAM) wafers to produce patient-specific saw guides. However, most plate systems provided are still the conventional "in stock" mini plates that can be individually designed by pre-bending according to the stereolithographic model of the patient...
September 23, 2016: Journal of Cranio-maxillo-facial Surgery
Jennifer Kurowicki, Enesi Momoh, Jonathan C Levy
Periprosthetic humerus fractures are relatively uncommon occurrence that can be difficult to manage nonoperatively. Locking plate technology has enhanced the surgical management of these fractures. However, adequate fixation around the stem remains of some concern. We describe an osteosynthesis technique using a locking plate utilizing eccentrically placed screw holes to place "skive screws" in the proximal end of the plate to achieve fixation around the stem of the implant. A clinical series of 5 consecutive patients treated with this technique is presented with an average follow-up of 29 months (range, 12-48)...
November 2016: Journal of Orthopaedic Trauma
Norachart Sirisreetreerux, Babar Shafiq, Greg M Osgood, Erik A Hasenboehler
OBJECTIVES: To determine the location of distal medial neurovascular structures, identifying a medial "safe zone" for minimally invasive plate osteosynthesis to treat displaced femoral condylar fractures. METHODS: Eleven uninjured lower-half torsos were dissected on the bilateral medial lower thigh. A longitudinal incision was made at the midsagittal plane of the medial thigh starting 1 cm proximal to the knee joint and extending to the proximal one-third of the femur...
November 2016: Journal of Orthopaedic Trauma
Gareth Davies, Gerald Yeo, Mahendrakumar Meta, David Miller, Erik Hohmann, Kevin Tetsworth
OBJECTIVES: To compare the risk of major complications after either minimally invasive plate osteosynthesis (MIPO) or intramedullary nailing (IMN) of humeral shaft fractures. DESIGN: Retrospective, case-match controlled study. SETTING: A major metropolitan tertiary referral trauma center in Australia. PATIENTS: Thirty patients with fractures of the humeral shaft. INTERVENTION: Either MIPO or IMN were performed on 15 patients each with traumatic humeral shaft fractures...
November 2016: Journal of Orthopaedic Trauma
Mathieu Manassero, Adeline Decambron, Bui Truong Huu Thong, Véronique Viateau, Morad Bensidhoum, Hervé Petite
The use of tissue-engineered bone constructs is an appealing strategy to overcome drawbacks of autografts for the treatment of massive bone defects. As a model organism, the mouse has already been widely used in bone-related research. Large diaphyseal bone defect models in mice, however, are sparse and often use bone fixation which fills the bone marrow cavity and does not provide optimal mechanical stability. The objectives of the current study were to develop a critical-size, segmental, femoral defect in nude mice...
October 12, 2016: Journal of Visualized Experiments: JoVE
Jop P Verweij, Gert J M Hassing, Marta Fiocco, Pascal N W J Houppermans, J P Richard van Merkesteyn
The aim of this study was to analyse the incidence of removal of MESH plates because of symptoms after Le Fort I osteotomy (LF1). The medical files of patients treated with LF1 were retrospectively reviewed. The occurrence of MESH plate removal, indication for removal and time between insertion and removal were noted. The medical literature was reviewed to quantify the reported incidences of removal of titanium osteosynthesis material after LF1. A total of 158 patients were included in this study. LF1 was performed and fixed with MESH plates in 150 patients...
September 23, 2016: Journal of Cranio-maxillo-facial Surgery
Shintaro Sukegawa, Takahiro Kanno, Daiki Nagano, Akane Shibata, Yuka Sukegawa-Takahashi, Yoshihiko Furuki
INTRODUCTION: In recent years, bioresorbable plates have undergone remarkable development. However, there has been no attendant improvement in their strength, because strength requires thickness, and complications such as palpability are related to the thickness of bioresorbable plate systems. In this clinical study, we compared the surgical management of zygomatic fractures using newly developed thinner bioresorbable materials or conventional titanium miniplates. METHODS: Twelve patients with zygomatic fractures were randomly divided equally into 2 groups (6 with new bioresorbable osteosynthesis materials and 6 with standard titanium miniplates)...
October 14, 2016: Journal of Craniofacial Surgery
Charles E Anyanechi, Otasowie D Osunde, Birch D Saheeb
OBJECTIVE: To analyze cases of compound, unfavorable and non-comminuted mandibular angle fractures treated by trans-osseous wiring, presenting postoperative complications, in a low resource center. MATERIALS AND METHODS: This was a 13-year retrospective study of 1,324 fractures in 1,317 subjects. The predictor variables were age, gender, aetiology, time lag between injury and treatment, and concomitant mandibular and mid-facial fractures. The outcome variable was the development of complication(s) after treatment...
September 2016: Ghana Medical Journal
Marc Dreimann, Michael Hoffmann, Lennart Viezens, Lukas Weiser, Patrick Czorlich, Sven Oliver Eicker
PURPOSE: Metastatic epidural spinal cord compression (MESCC) often requires anterior-posterior decompression and stabilization. To reduce approach-related complications, single-stage posterolateral vertebrectomy and 360° fusion is often performed. However, a sufficient reduction of kyphotic deformity through this approach has not been reported. The purpose of this study is to investigate the efficacy of kyphotic deformity reduction by this approach in MESCC. METHODS: A retrospective analysis and chart review was performed for 14 consecutive patients who underwent a vertebrectomy and decompression from a posterolateral approach...
October 11, 2016: European Spine Journal
Justin J Mitchell, Chase S Dean, Jorge Chahla, Gilbert Moatshe, Tyler R Cram, Robert F LaPrade
Valgus knee alignment in excess of physiological valgus leads to excessive loading of the lateral compartment, which can potentially increase the risk of osteoarthritis and can place the medial knee structures at risk of chronic attenuation. Varus-producing distal femoral osteotomies have been proposed for correction of valgus malalignment, to relieve tension on medial-sided structures, as well as to off-load the lateral compartment. Understanding that symptomatic valgus deformity of the knee represents a complex problem that is magnified in the setting of lateral compartment arthritis or medial ligamentous incompetence, we present our preferred technique for a varus-producing distal femoral osteotomy using plate osteosynthesis and cancellous bone allograft...
August 2016: Arthroscopy Techniques
B Bickert, T Kremer, U Kneser
Closed tendon ruptures of the thumb that require secondary reconstruction can affect the extensor pollicis longus (EPL), extensor pollicis brevis (EPB) and flexor pollicis longus (FPL) tendons. Treatment of rupture of the EPB tendon consists of refixation to the bone and temporary transfixation of the joint. In the case of preexisting or posttraumatic arthrosis, definitive arthrodesis of the thumb is the best procedure. Closed ruptures of the EPL and FPL tendons at the wrist joint cannot be treated by direct tendon suture...
September 30, 2016: Der Unfallchirurg
Ángel Lázaro Gonzálvez, Javier Martínez Reina, Pedro Cano Luis, Juan Jiménez Baquero, José Sueiro Fernández, Miguel Ángel Giráldez Sánchez
OBJECTIVES: The current biomechanical work compares the symphyseal and sacroiliac stability obtained with two systems of bone osteosynthesis. The two methods of fixation compared were the 6-hole suprapubic non-locked plate and pubic fixation with two cannulated screws, a novel technique that can be applied percutaneously in the clinical practice. The aim of this study was to examine the validity of the use of two-cannulated-screws osteosynthesis in order to minimize the secondary effects of open fixation, especially in patients in whom an open reduction is contraindicated...
September 2016: Injury
Héctor J Aguado, Juan Mingo, Miguel Torres, Aranzazú Alvarez-Ramos, Miguel A Martín-Ferrero
INTRODUCTION: The objectives of this study were to describe the surgical technique of fixation of 3-4 part proximal humeral fractures with polyaxial locking plates utilising a minimally invasive approach and to evaluate the accuracy of reduction and stability of fixation. PATIENTS AND METHODS: We retrospectively reviewed 90 patients. Fractures were classified according to the Neer classification system. Different radiological parameters were measured to assess the quality of reduction and the stability of fixation...
September 2016: Injury
Javier Quintana Plaza, Lorena Benito Garzón, Beatriz Bravo Gimenez, Belén Fernández-Montes Moraleda, Francisco Collía, Luis M Rodríguez-Lorenzo
INTRODUCTION: The gradual aging of the population results in increased incidence of osteoporotic bone fractures. In a good quality bone, the fixation with the usual methods is adequate, but not in osteoporotic bone, in which consolidation delays and other complications are common, with failure rates for screws up to 25%. OBJECTIVE: To test fibronectin loaded hydroxyapatite as a complementary treatment for osteoporotic fractures. MATERIAL AND METHODS: This study was performed in a vivo model; 42 female osteoporotic adult rabbits 4-5kg (White New Zealand) were used...
September 2016: Injury
Natália Ferreira Sesoko, Sheila Canevese Rahal, Zara Bortolini, Natalie Bertelis Merlini, Carlos Roberto Teixeira
Anteater forelimbs are distinguished morphologically from domestic animals, especially due to their unique movement and their natural habits. A knowledge of the pectoral limb anatomy and the proper surgical approach are fundamental to success in osteosynthesis and other surgeries. This study aimed to describe the muscles and neurovascular structures of the pectoral limb and the surgical approach to the humeral shaft of the giant anteater ( Myrmecophaga tridactyla ). Dissections of the forelimbs of seven cadavers were performed to identify the major muscles and neurovascular structures...
September 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Kaiying Shen, Haiqing Cai, Zhigang Wang, Yunlan Xu
Elastic stable intramedullary nailing (ESIN) has became a well-accepted method of osteosynthesis of diaphyseal fractures in the skeletally immature patient for many advantages, the purpose of this study is to evaluate the preliminary results of this minimally invasive treatment for severely displaced distal tibial diaphyseal metaphyseal junction (DTDMJ) fractures.This study was carried out over a 6-year period. Twenty-one severely displaced DTDMJ fractures treated using ESIN were evaluated clinically and radiographically...
September 2016: Medicine (Baltimore)
Bin-Feng Yu, Liang-le Liu, Guo-Jing Yang, Lei Zhang, Xi-Peng Lin
BACKGROUND: The objective of this meta-analysis was to compare the efficacy and safety of minimally invasive plate osteosynthesis (MIPO) and conventional plate osteosynthesis (CPO) for humeral shaft fracture. METHODS: Potential academic articles were identified from the Cochrane Library, Medline (1966-2016.3), PubMed (1966-2016.3), Embase (1980-2016.3), and ScienceDirect (1966-2016.3). Gray studies were identified from the references of the included literature. Randomized controlled trials (RCTs) and non-RCT involving MIPO and CPO for humeral shaft fracture were included...
September 2016: Medicine (Baltimore)
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