scholarly journals Plate on Plate Osteosynthesis for the Treatment of Nonhealed Periplate Fractures

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Georgios Arealis ◽  
Vassilios S. Nikolaou ◽  
Andrew Lacon ◽  
Neil Ashwood ◽  
Mark Hamlet
Keyword(s):  
Plate Osteosynthesis ◽  
Fracture Site ◽  
The Other ◽  
Locking Screws ◽  
Plate Technique ◽  
Solid Fusion

Purpose. The purpose of this paper is to present our technique for the treatment of periplate fractures. Methods. From 2009 to 2012 we treated three patients. In all cases the existing plate was left and the new one placed over the existing. Locking screws were placed through both plates. The other screws in the new plate were used as best suited the fracture. Results. In all cases less than 6 months had passed between fractures. None of the original fractures had healed. Mean followup was 2 years. All fractures proceeded to union within 7 months. No complications were recorded. All the patients returned to their normal activities and were satisfied with the results of their treatment. Conclusion. Our plate on plate technique is effective for the treatment of periplate fractures. A solid fusion can be achieved at the new fracture site without disturbing the previous fixation.

scholarly journals Dynamic plate osteosynthesis for fracture stabilization: how to do it

2010 ◽  
Vol 2 (1) ◽  
pp. 4 ◽  
Author(s):  
Juerg Sonderegger ◽  
Karl R. Grob ◽  
Markus S. Kuster
Keyword(s):  
Plate Osteosynthesis ◽  
Plate Fixation ◽  
Femoral Fractures ◽  
Fracture Site ◽  
Fixation Strength ◽  
Safe Procedure ◽  
Font Size ◽  
Biological Fixation ◽  
Fracture Stabilization ◽  
Anterior Knee

<!--StartFragment--> <p class="MsoNormal"><span style="font-family: 'Times New Roman', Arial, Helvetica, sans-serif; font-size: medium;"><span style="font-size: 16px;"><span style="font-family: Verdana, Arial, Helvetica, sans-serif; font-size: x-small;"><span style="font-size: 10px;"><p class="MsoNormal">Plate osteosynthesis is one treatment option for the stabilization of long bones. It is widely accepted to achieve bone healing with a dynamic and biological fixation where the perfusion of the bone is left intact and micromotion at the fracture gap is allowed. The indications for a dynamic plate osteosynthesis include distal tibial and femoral fractures, some midshaft fractures, and adolescent tibial and femoral fractures with not fully closed growth plates. Although many lower limb shaft fractures are managed successfully with intramedullary nails, there are some important advantages of open-reduction-and-plate fixation: the risk of malalignment, anterior knee pain, or nonunion seems to be lower. The surgeon performing a plate osteosynthesis has the possibility to influence fixation strength and micromotion at the fracture gap. Long plates and oblique screws at the plate ends increase fixation strength. However, the number of screws does influence stiffness and stability. Lag screws and screws close to the fracture site reduce micromotion dramatically. </p><p class="MsoNormal">Dynamic plate osteosynthesis can be achieved by applying some simple rules: long plates with only a few screws should be used. Oblique screws at the plate ends increase the pullout strength. Two or three holes at the fracture site should be omitted. Lag screws, especially through the plate, must be avoided whenever possible. Compression is not required. Locking plates are recommended only in fractures close to the joint. When respecting these basic concepts, dynamic plate osteosynthesis is a safe procedure with a high healing and a low complication rate. </p></span></span></span></span></p>

Elastic plate osteosynthesis of femoral shaft fractures in young dogs

2001 ◽  
Vol 14 (01) ◽  
pp. 40-45 ◽  
Author(s):  
Jean-Pierre Cabassu
Keyword(s):  
Clinical Trial ◽  
Elastic Plate ◽  
Femoral Fracture ◽  
Plate Osteosynthesis ◽  
Femoral Shaft ◽  
Fracture Site ◽  
Fracture Repair ◽  
Femoral Shaft Fractures ◽  
Flexible Segment ◽  
Bridge Plating

SummaryThe outcome of femoral fracture repair in young growing dogs using the principle of elastic osteosynthesis was evaluated in a retrospective clinical trial. Unilateral fractures in twenty four dogs, in the first phase of their growth, were repaired with a Veterinary Cuttable Plate (VCP). The plates were applied according to the principles of bridge plating. They were fixed with two screws at each end, positioned as far as possible from the fracture site, leaving a flexible segment between them.The plates contained between seven and 20 holes. The dogs soon used their treated limb and callus was often complete by four weeks. The plates were removed in 18 cases. A very good outcome was recorded in 21 dogs, one dog ran away after two months at which time the owner reported an excellent gait, one dog died of an unrelated problem and one other dog exhibited slight lameness which was attributed to stifle problems. In all of the cases the growing diaphysis was apparently undisturbed. It was concluded that adequate fixation of the fractures was achieved and conditions for rapid bone union was created.The successful use of Veterinary Cuttable Plates, VCP, for the treatment of fractured femurs in immature dogs, is reported

Sequentially Staged Resection and 2-Column Reconstruction for C2 Tumors Through a Combined Anterior Retropharyngeal–Posterior: Approach Surgical Technique and Results in 11 Patients

2011 ◽  
Vol 69 (suppl_2) ◽  
pp. ons184-ons194 ◽  
Author(s):  
Xinghai Yang ◽  
Zhipeng Wu ◽  
Jianru Xiao ◽  
Honglin Teng ◽  
Dapeng Feng ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Posterior Approach ◽  
Tumor Resection ◽  
The Other ◽  
Neurological Improvement ◽  
Experienced Pain ◽  
Alive With Disease ◽  
Solid Fusion ◽  
Deep Location

Abstract BACKGROUND Surgical treatment of C2 tumors remains challenging. Because of the deep location and unique anatomical complexity, anterior exposure in this region is considered difficult and dangerous, and few reports concerning anterior tumor resection and reconstruction exist. OBJECTIVE To describe a technique of sequentially staged resection and 2-column reconstruction for C2 tumors through a combined anterior retropharyngeal–posterior approach. METHODS Eleven patients with C2 tumors underwent sequentially staged tumor resection and 2-column reconstruction in our institute. Eight primary lesions and 3 metastases were involved. Tumor resections and anterior reconstructions with conventional constructs were accomplished by an anterior retropharyngeal approach, and occipitocervical fusions through posterior access were performed in the same anesthesia. RESULTS No operative mortality occurred in this series. All patients experienced pain relief and neurological improvement after surgery. Except for 1 incidence of screw pullout, which was corrected by revision surgery, solid fusion was achieved in all patients. A follow-up period of 12 to 37 months was available for this study. Two patients with chordoma relapsed; 1 died of disease, and the other was alive with disease. Two patients with metastasis died of multiple remote metastases. No evidence of local recurrence was found in the other patients. CONCLUSION The anterior retropharyngeal approach is a favorable route to treat tumor lesions of the C2 vertebral body that allows tumor resection and placement of anterior constructs between C1 and the subaxial vertebral body. Tumor resection and 2-column reconstruction could safely be accomplished simultaneously through the combined anterior retropharyngeal–posterior approach.

Limited Wrist Arthrodesis for the Salvage of SLAC Wrist

1997 ◽  
Vol 22 (4) ◽  
pp. 461-465 ◽  
Author(s):  
D. R. J. GILL ◽  
D. C. R. IRELAND
Keyword(s):  
Grip Strength ◽  
The Other ◽  
Salvage Procedure ◽  
Early Failure ◽  
Wrist Arthrodesis ◽  
Mild Pain ◽  
Solid Fusion ◽  
Slac Wrist

We report the results of limited wrist arthrodesis, a salvage procedure for SLAC wrist. It involves excision of the scaphoid, radial styloidectomy and fusion of the lunate to the capitate and the triquetrum to the hamate, using cancellous lag screws. Twenty-four wrists in 22 patients were reviewed retrospectively at an average follow-up of 23 months. Seventeen of the 22 patients had no pain or mild pain and had retained a mean arc of motion of 48°. Grip strength was 70% of the other side. Four of the 24 patients developed non-unions, two of which had successful revision to limited wrist arthrodesis. The other two required pan arthrodesis of the wrist. Two other patients with persisting pain in spite of solid fusion were also treated by pan arthrodesis of the wrist. Radial styloidectomy did not result in early failure of this procedure and secondary ulnar translocation of the carpus was not seen.

scholarly journals Dynamic locking screws in proximal humeral plate osteosynthesis demonstrate superior fixation properties: a biomechanical study

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Gunther Sandmann ◽  
Atesch Ateschrang ◽  
Thomas Freude ◽  
Ulrich Stöckle ◽  
Werner Schmölz ◽  
...  
Keyword(s):  
Humeral Head ◽  
Plate Osteosynthesis ◽  
Plate Fixation ◽  
Bending Test ◽  
Homogeneous Distribution ◽  
Screw Loosening ◽  
Plate Interface ◽  
Rotation Test ◽  
Locking Screws ◽  
Philos Plate

Abstract Purpose Angular stable implants reduced the complication rate in the treatment of humeral head fractures. But the failure rate is still high. To further reduce the risk of cut-out, cement augmentation of screws was introduced. A reason for failure of plate osteosynthesis might be the extremely high stiffness of the screw-plate interface leading to a loss of reduction and cut-out of screws. A more homogeneous distribution of the forces on all screws may avoid secondary dislocation. We hypothesize that dynamic osteosynthesis minimizes screw loosening and results in a higher load to failure than standard locking screws. Methods Twelve paired human humerus specimens were analysed. A standardized three-part fracture model with a metaphyseal defect was simulated. Within each pair of humeri, one was fixed with a Philos plate and standard locking screws (LS), whereas the other humerus was fixed with a Philos plate and dynamic locking screws (DLS). A cyclic varus-bending test or a rotation test with increasing loading force was performed until failure of the screw-bone-fixation. Results In the varus bending test, pairs failed by screw loosening in the humeral head. The LS-group reached 2901 (601–5201) load cycles until failure, while the DLS-group failed after 3731 (2001–5601) cycles. This corresponds to a median loading of 195 N for the LS-group and 235 N for the DLS-group (p = 0.028). In the rotation test the LS-group reached a median of 1101 (501–1501) load cycles until failure of fixation occurred, while the DLS-group failed after 1401 (401–2201) cycles (p = 0.225). Conclusions Plate fixation using dynamic locking screws for the treatment of proximal humerus fractures demonstrated more load cycles until failure compared to standard locking plate osteosynthesis.

scholarly journals Minimally invasive plate osteosynthesis using the oblong hole of a locking plate for comminuted distal fibular fractures

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Young Uk Park ◽  
Sung Jae Kim ◽  
Hyong Nyun Kim
Keyword(s):  
Minimally Invasive ◽  
Locking Plate ◽  
Plate Osteosynthesis ◽  
Rare Complication ◽  
Fracture Site ◽  
Fracture Reduction ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Trimalleolar Fractures ◽  
Peroneal Nerve Injury ◽  
High Degree

Abstract Background Nonunion is a rare complication for distal fibular fractures. However, when there is a high degree of comminution, nonunion may occur. In this article, we describe a novel technique that uses the oblong hole of a locking plate to lengthen the fibula for fracture reduction. This technique is straightforward and allows for easy control of the comminuted fracture to restore length and rotation at the time of plate application without opening the fracture site. Methods Thirty-five consecutive patients, who were treated with the minimally invasive plate osteosynthesis (MIPO) technique for comminuted distal fibular fractures were retrospectively studied. The study included 19 men and 16 women, with a mean age of 47.0 years (range, 20 to 72). There were 3 lateral malleolar fractures with deltoid injury, 11 bimalleolar fractures, 7 trimalleolar fractures, and 14 distal tibiofibular fractures. The quality of fracture reduction was assessed by comparing the radiologic parameters (fibular length, talocrural angle, and medial clear space) between the affected ankle and the contralateral uninjured ankle. Results Two patients were not reachable and 5 declined to visit the clinic. For these 7 patients, the latest outcomes that were measured prospectively were used. Postoperative radiographs showed well-aligned ankle mortise, with fibular length restoration. The mean Olerud-Molander ankle score was 82.1 ± 10.7 at a mean of 27.2 months (range, 12 to 58). There was one case of nonunion and one case of superficial peroneal nerve injury. Conclusion The MIPO technique, using the oblong hole of a locking plate, achieved satisfactory restoration of length and rotation, bone union, and clinical outcomes for the comminuted distal fibular fractures.

Condylar Advancement Osteotomy for Correcting Condylar Malunion of the Finger

2002 ◽  
Vol 27 (1) ◽  
pp. 31-35 ◽  
Author(s):  
L. C. TEOH ◽  
F. C. YONG ◽  
K. C. CHONG
Keyword(s):  
Avascular Necrosis ◽  
Joint Pain ◽  
Corrective Osteotomy ◽  
Fracture Site ◽  
The Other ◽  
Bone Fragment ◽  
Stable Fixation ◽  
Small Bone

Unicondylar fractures of proximal and middle phalanges of the finger can unite with intra-articular malunion, which may result in joint pain, stiffness and deformity. There is currently no satisfactory technique of corrective osteotomy for these fractures. Extra-articular osteotomies often do not give good results and existing techniques of intra-articular osteotomy through the healed fracture site are technically difficult due to the small bone fragment, difficulty achieving stable fixation and the risk of avascular necrosis. We propose a different method of intra-articular correction with a longitudinal osteotomy and advancement of the malunited condyle. The “condylar advancement osteotomy” can overcome problems encountered with the other techniques. Excellent results were obtained in six patients.

scholarly journals Dynamization at the Near Cortex in Locking Plate Osteosynthesis by Means of Dynamic Locking Screws

2015 ◽  
Vol 97 (3) ◽  
pp. 208-215 ◽  
Author(s):  
Henning Richter ◽  
Michael Plecko ◽  
Daniel Andermatt ◽  
Robert Frigg ◽  
Peter W Kronen ◽  
...  
Keyword(s):  
Locking Plate ◽  
Plate Osteosynthesis ◽  
Locking Screws ◽  
Locking Plate Osteosynthesis

scholarly journals Use of Calcium Sulfate as a Biomaterial in the Treatment of Bone Fractures in Rabbits – Preliminary Studies

2013 ◽  
Vol 57 (1) ◽  
pp. 119-122 ◽  
Author(s):  
Tomasz Szponder ◽  
Ewa Mytnik ◽  
Zbigniew Jaegermann
Keyword(s):  
Calcium Sulfate ◽  
Bone Fractures ◽  
Fracture Site ◽  
The Other ◽  
Tibial Osteotomy ◽  
Kirschner Wires ◽  
Radiological Findings ◽  
Intramedullary Pinning ◽  
New Zealand White Rabbits ◽  
Fracture Area

Abstract The paper presents preliminary results of the implantation of calcium sulfate type Hartform HF1 developed at the Institute of Glass and Ceramics in Warsaw. The study was conducted on 10 New Zealand White rabbits, in which after tibial osteotomy the biomaterial was implanted directly into the fracture site. The animals were divided into two groups based on the method of fracture stabilisation: intramedullary pinning using Kirschner wires in one group and acrylic external fixator in the other. After 12 weeks, bone union was observed in all animals as estimated by clinical and radiological findings. Histological tests revealed resorption of the biomaterial into the bone fracture area. It was concluded that type Hartform 1 calcium sulfate can be used as a biomaterial in veterinary orthopedics. Due to the lack of observable side effects during implantation and resorption, the material can be considered as a valuable ingredient in composite biomaterials containing calcium sulfate.

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