Angular Stable Fixation in the Hand: Where Does It Make Sense?

2008 ◽  
pp. 49-55
Author(s):  
Renato Fricker
Keyword(s):  
Stable Fixation

scholarly journals Failure analysis and recommendations for treatment of posttraumatic non-unions of the distal humerus during childhood

2021 ◽  
Vol 47 (2) ◽  
pp. 313-324 ◽  
Author(s):  
Dirk Walther Sommerfeldt ◽  
Peter Paul Schmittenbecher
Keyword(s):  
Failure Analysis ◽  
Revision Surgery ◽  
Distal Humerus ◽  
Implant Removal ◽  
Supracondylar Fractures ◽  
Stable Fixation ◽  
Non Union ◽  
Pediatric Traumatology ◽  
Clinical Cases

Abstract Purpose Non-unions of the distal humerus are rare complications of common children’s fractures such as radial condyle fractures and supracondylar fractures. The aim of this paper was to update the knowledge about etiology, reasons, management, and results of these troublesome, and sometimes debilitating entities. Methods The sparse literature concerning nonunions following condylar or supracondylar fractures was analyzed together with the presentation of some typical clinical cases. Results In most of the cases, non-unions were induced by neglect, unstable fixation, too early implant removal, too much revision surgery, and an inconsequent transfer of follow-up algorithms, or combinations of the above. Treatment of non-union should start as early as possible because the effort of required surgery increases with time that the nonunion has been neglected. Often a combination of stable fixation of the pseudarthrosis and correction of the elbow axis are necessary to achieve a satisfying outcome. Conclusion In pediatric traumatology, qualified and consequent care for children’s fractures of the distal humerus can prevent rare complications such as non-unions in almost any situation. If such a disturbance of healing is noticed, immediate and adequate, i.e. children specific surgical consequences achieve best results.

scholarly journals Mechanical evaluation of six techniques for stable fixation of the sagittal split osteotomy after counterclockwise mandibular advancement

2016 ◽  
Vol 54 (5) ◽  
pp. 573-578 ◽  
Author(s):  
Leandro Benetti De Oliveira ◽  
Jose Mauricio Nunes Reis ◽  
Rubens Spin-Neto ◽  
Marisa Aparecida Cabrini Gabrielli ◽  
Yener Oguz ◽  
...  
Keyword(s):  
Mandibular Advancement ◽  
Stable Fixation ◽  
Sagittal Split Osteotomy

COMPARATIVE ANALYSIS FOR THREE FIXTURES OF PAUWELLS-II BY THE BIOMECHANICAL FINITE ELEMENT METHOD

2019 ◽  
Vol 20 (01) ◽  
pp. 1950079
Author(s):  
MATTHEW JIAN-QIAO PENG ◽  
HONGWEN XU ◽  
HAI-YAN CHEN ◽  
XIANGYANG JU ◽  
YONG HU ◽  
...  
Keyword(s):  
Finite Element ◽  
Numerical Models ◽  
Femoral Shaft ◽  
3D Models ◽  
Procedure Time ◽  
Stable Fixation ◽  
Secondary Fracture ◽  
Solid Models ◽  
Acute Correction ◽  
Hip Screw

Little is known about why and how biomechanics govern the hypothesis that three-Lag-Screw (3LS) fixation is a preferred therapeutic technique. A series models of surgical internal-fixation for femoral neck fractures of Pauwells-II will be constructed by an innovative approach of finite element so as to determine the most stable fixation by comparison of their biomechanical performance. Seventeen sets of CT scanned femora were imported onto Mimics extracting 3D models; these specimens were transferred to Geomagic Studio for a simulative osteotomy and kyrtograph; then, they underwent UG to fit simulative solid models; three sorts of internal fixators were expressed virtually by Pro-Engineer. Processed by Hypermesh, all compartments were assembled onto three systems actually as “Dynamic hip screw (DHS), 3LS and DHS+LS”. Eventually, numerical models of Finite Elemental Analysis (FEA) were exported to AnSys for solution. Three models for fixtures of Pauwells-II were established, validated and analyzed with the following findings: Femoral-shaft stress for [Formula: see text](3LS) is the least; Internal-fixator stress (MPa) for [Formula: see text]; Integral stress (MPa) for [Formula: see text]; displacement of femoral head (mm) for a[Formula: see text](DHS+LS) = 0.735; displacement of femoral shaft (mm) for [Formula: see text]; and displacement of fixators for [Formula: see text]. Mechanical comparisons for other femoral parks are insignificantly different, and these data can be abstracted as follows: the stress of 3LS-system was checked to be the least, and an interfragmentary displacement of DHS+LS assemblages was assessed to be the least”. A 3LS-system should be recommended to clinically optimize a Pauwells-II facture; if treated by this therapeutic fixation, breakage of fixators or secondary fracture is supposed to occur rarely. The strength of this study is that it was performed by a computer-aided simulation, allowing for design of a preoperative strategy that could provide acute correction and decrease procedure time, without harming to humans or animals.

INTERNAL FIXATION OF RADIAL HEAD FRACTURES WITH AN INTRAMEDULLARY NAIL

2013 ◽  
Vol 25 (01) ◽  
pp. 1350007
Author(s):  
Matija Krkovic ◽  
Miha Brojan ◽  
David Bombac ◽  
Dejan Hermann
Keyword(s):  
Intramedullary Nail ◽  
Radial Head ◽  
Radial Head Fracture ◽  
Vascular Supply ◽  
General Idea ◽  
Stable Fixation ◽  
Radial Head Fractures ◽  
Design And Manufacturing ◽  
Comminuted Fractures ◽  
Thin Walled

Comminuted fractures of the radial head still present significant technical and surgical challenges. In this article, we describe a novel fixation of comminuted radial head fractures with the help of an intramedullary nail. Experiments with solid, conventionally machined intramedullary nails showed some major drawbacks in the fixation of radial head fractures. Several design and manufacturing procedures were proposed. The general idea behind the new design was the concept of a nail which would eliminate the need for prefabricated bores. Experiments with a selective laser sintered thin-walled nail, designed with the help of CT images, fulfilled expectations. This thin-walled proximal radius nail thus offers a stable fixation of the radial head fracture fragments, with the ability to preserve the existing vascular supply to the radial head fragments, and therefore not just use the reconstructed radial head as a bioprosthesis.

scholarly journals Surgical management of complex intra-articular distal femoral and bicondylar Hoffa fracture

2016 ◽  
Vol 98 (8) ◽  
pp. e168-e170 ◽  
Author(s):  
D Giotikas ◽  
M Nabergoj ◽  
M Krkovic
Keyword(s):  
Distal Femur ◽  
Sagittal Plane ◽  
Distal Humerus ◽  
Complex Case ◽  
Parallel Plates ◽  
Stable Fixation ◽  
Range Of Movement ◽  
Left Femur ◽  
Hoffa Fracture ◽  
Metaphyseal Fracture

Bicondylar Hoffa’s fractures of distal femur are rare. We report the case of an 18-year-old male who sustained a closed complex fracture of both femoral condyles of the left femur on the sagittal plane (Hoffa fracture), combined with distal metaphyseal fracture. He was treated using parallel plates and interdigitating screws, with our technique based on an extrapolation of the principles of distal humerus fixation. The fracture united clinically and radiologically at 16 weeks. Twelve months postoperatively, the range of movement in the knee was 5°–115°. In this complex case, our technique provided stable fixation of the fragments and a satisfactory final functional outcome.

scholarly journals Treatment of Proximal Femur Fractures on the Background of Osteoporosis

2004 ◽  
Vol 11 (1) ◽  
pp. 27-31 ◽  
Author(s):  
A F Lazarev ◽  
E I Solod ◽  
A O Ragozin ◽  
M G Kakabadze ◽  
A F Lazarev ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Proximal Femur ◽  
Femoral Neck Fractures ◽  
Mineral Density ◽  
Stable Fixation ◽  
Fracture Characteristics ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Choice Of Treatment ◽  
Density Evaluation

Analysis of treatment of 526 patients with proximal femur fractures (362 patients with femoral neck fractures and 164 patients with trochanteric zone fractures) was performed. Patients' age ranged from 34 to 92 (mean 67). Algorithm of differentiated choice of operative tactics depending on fracture characteristics and injury term was presented. Low invasive osteosynthesis of femoral neck with bundle of stressed V-shaped pins was suggested. Theoretical and practical ground of that technique was given. Stress within fixative-bone system created after osteosynthesis by V-shaped pins, provided stable fixation even in marked osteoporosis. The importance of bone mineral density evaluation for the choice of treatment tactics as well as the necessity of medicamental correction of the disturbed bone remodeling after surgical treatment was noted.

Arthroplasty Revision for Aseptic Failure. Our Experience

1992 ◽  
Vol 2 (1) ◽  
pp. 21-26
Author(s):  
A. Surace ◽  
L. Pietrogrande ◽  
M. Sartoris
Keyword(s):  
Radiographic Study ◽  
Stable Fixation ◽  
Secondary Failure ◽  
Arthroplasty Revision ◽  
Aseptic Failure

35 cases of arthroplasty revision are reviewed with mean follow-up time of 56 m. (range 24 to 107), by clinical and radiographic study. The results were satisfactory, having only one case of secondary failure (2.8%), also in comparison with other studies. The reason of this probably lies in the adaptability of our technique: in fact we use without preconcepts both cement and cementless fixations with many types of stems and cotyles; this allows us to obtain a stable fixation also taking in consideration the bone characteristics of each case.

Epoxy-Pin External Skeletal Fixation for Management of Open Bone Fractures in Calves and Foals: A Review of 32 Cases

2019 ◽  
Vol 32 (03) ◽  
pp. 257-268
Author(s):  
Hari Aithal ◽  
Prakash Kinjavdekar ◽  
Abhijit Pawde ◽  
Prasoon Dubey ◽  
Rohit Kumar ◽  
...  
Keyword(s):  
Bone Fractures ◽  
Weight Bearing ◽  
Fracture Site ◽  
Open Fractures ◽  
Adhesive Tape ◽  
Stable Fixation ◽  
Early Weight Bearing ◽  
Pin Fixation ◽  
Bone Fragments ◽  
The Subject

Objective The aim of this study was to evaluate epoxy-pin external skeletal fixation technique for the treatment of open fractures in calves and foals. Study Design Twenty-eight calves and four foals (weighing 45–105 kg) with fractures distal to the stifle or elbow made the subject for the retrospective study. The pins (2.0–3.0-mm Kirschner wires, crossed at 60–90°) were fixed at least at two locations in both proximal and distal bone fragments as per the case situation. The pins in the same plane were bent (∼2 cm from the skin) towards the fracture site or joint and were joined using an adhesive tape (additional pins used when required) to make a temporary scaffold of connecting bars or rings. Thoroughly mixed epoxy putty was applied along the pin scaffold (the epoxy columns were 20–25 mm diameter) and allowed to set for 45 to 60 minutes. All animals were evaluated based on various clinical and radiographic observations made at regular intervals. Results The epoxy-pin fixation was easy to apply and provided stable fixation of bone as indicated by early weight bearing, and fracture healing within 45 to 60 days (17/32 cases). The functional recovery was good to very good in 14 animals and satisfactory in nine cases by 12 months after removal of the fixator. Conclusions The multiplanar epoxy-pin external skeletal fixation provides stable fixation of unstable open fractures distal to the stifle or elbow joint; hence, it can be used to treat a variety of fractures in calves and foals weighing up to approximately 100 kg, especially open infected fractures of lower limb, which are difficult to treat by conventional techniques.

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