scholarly journals Robot-Bone Attachment Device for Robot-Assisted Percutaneous Bone Fragment Manipulation

10.29007/6wtt ◽  
2018 ◽  
Author(s):  
Giulio Dagnino ◽  
Ioannis Georgilas ◽  
Kostas Georgilas ◽  
Paul Köhler ◽  
Samir Morad ◽  
...  
Keyword(s):  
Bone Fragment ◽  
Robot Assisted ◽  
Percutaneous Reduction ◽  
Femur Fractures ◽  
Articular Fractures ◽  
Common Task ◽  
Joint Fractures ◽  
Human Cadavers ◽  
Attachment Device ◽  
Biological Cost

The treatment of joint-fractures is a common task in orthopaedic surgery causing considerable health costs and patient disabilities. Percutaneous techniques have been developed to mitigate the problems related to open surgery (e.g. soft tissue damage), although their application to joint-fractures is limited by the sub-optimal intra-operative imaging (2D-fluoroscopy) and by the high forces involved. Our earlier research toward improving percutaneous reduction of intra-articular fractures has resulted in the creation of a robotic system prototype, i.e. RAFS (Robot-Assisted Fracture Surgery) system.We propose a robot-bone attachment device for percutaneous bone manipulation, which can be anchored to the bone fragment through one small incision, ensuring the required stability and reducing the “biological cost” of the procedure. The device has been evaluated through the reduction of 9 distal femur fractures on human cadavers using the RAFS system.

scholarly journals Image-Guided Surgical Robotic System for Percutaneous Reduction of Joint Fractures

2017 ◽  
Vol 45 (11) ◽  
pp. 2648-2662 ◽  
Author(s):  
Giulio Dagnino ◽  
Ioannis Georgilas ◽  
Samir Morad ◽  
Peter Gibbons ◽  
Payam Tarassoli ◽  
...  
Keyword(s):  
Robotic System ◽  
Percutaneous Reduction ◽  
Image Guided ◽  
Joint Fractures

scholarly journals Internal Fixation of Displaced Intra-articular Fractures of the Hallux Through a Dorsomedial Approach: A Technical Tip

2017 ◽  
Vol 11 (1) ◽  
pp. 77-81 ◽  
Author(s):  
Danilo Ryuko Cândido Nishikawa ◽  
Fernando Aires Duarte ◽  
Cesar de Cesar Netto ◽  
Augusto César Monteiro ◽  
Rômulo Ballarin Albino ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Interphalangeal Joint ◽  
Rigid Fixation ◽  
Degenerative Arthritis ◽  
Soft Tissue Envelope ◽  
Articular Fractures ◽  
Extensor Hallucis Longus ◽  
Joint Fractures ◽  
Phalangeal Fractures ◽  
Type Of Injury

Phalangeal fractures of the toes represent common injuries of the forefoot. In the hallux, most fractures occur at the distal phalanx and frequently result from a direct crushing type of injury. Intra-articular fractures of the hallux are usually treated nonoperatively, except when the fragments are displaced and the joint is incongruent. Displaced fractures treated nonoperatively can result in degenerative arthritis of the interphalangeal joint, causing pain and range of motion limitation, hindering gait and weightbearing. The aim of this study was to present an option of operative approach in the treatment of displaced interphalangeal joint fractures of the hallux, along the medial border of the extensor hallucis longus tendon. It is our understanding that this approach minimizes injury to the soft tissue envelope, allowing a rigid fixation and early weightbearing and range of motion. Levels of Evidence: Level V: Expert opinion

Early rehabilitation after stable osteosynthesis of intra-articular fractures of the metacarpal base of the thumb

2013 ◽  
Vol 40 (4) ◽  
pp. 370-373 ◽  
Author(s):  
S. Uludag ◽  
Y. Ataker ◽  
A. Seyahi ◽  
O. Tetik ◽  
E. Gudemez
Keyword(s):  
Functional Results ◽  
Early Rehabilitation ◽  
Rehabilitation Programme ◽  
Activity Levels ◽  
Articular Fractures ◽  
Joint Fractures ◽  
Stable Osteosynthesis ◽  
Bony Healing ◽  
Active Rehabilitation ◽  
Stable Internal Fixation

The aim of this study was to investigate the radiological and functional results of anatomical reduction and stable fixation followed by an early rehabilitation programme in the treatment of fractures of the base of the thumb metacarpal. Sixteen consecutive patients (11 men and five women; mean age: 36.4 years) with intra-articular fractures of the thumb metacarpal base were treated with plate and/or screw fixation between April 2002 and March 2011 at our department. Patients were followed-up for an average period of 15.62 months. Bony healing was achieved in all cases and all patients were able to return to pre-trauma activity levels 12 weeks following surgery. Open reduction with stable internal fixation and an early active rehabilitation programme appears to be an efficient method in the treatment of trapeziometacarpal joint fractures with satisfactory functional and radiological results.

Imaging of Pelvic and Femoral Fixation Hardware: Normal Findings and Hardware Failure

2019 ◽  
Vol 23 (02) ◽  
pp. e1-e19
Author(s):  
Hatice Sanal ◽  
Christina Boulton ◽  
Cagri Neyisci ◽  
Yusuf Erdem ◽  
Jason Lowe
Keyword(s):  
Pelvic Ring ◽  
Classification Systems ◽  
Surgical Approaches ◽  
Acetabular Fractures ◽  
Limb Alignment ◽  
Femoral Fixation ◽  
Hardware Failure ◽  
Femur Fractures ◽  
Articular Fractures ◽  
Fracture Classification Systems

AbstractGood outcomes following treatment of pelvic ring injuries, acetabular fractures, and femur fractures rely on restoration of native pelvic or limb alignment, anatomical reduction and rigid stability of articular fractures, and early postoperative mobilization. Multiple surgical approaches, reduction aids, and orthopaedic implants are available to stabilize these fractures. Despite best practices, complications including hardware failure, nonunions, malunions, and infections occur. This article discusses common fracture classification systems, implants, and imaging findings associated with unwanted complications in fractures of the pelvis, acetabulum, and femur.

scholarly journals Assessment of efficacy of locking compression plate in distal femur fractures

2021 ◽  
Author(s):  
Faizal Ali A. A. ◽  
Govind Karunakaran ◽  
Hijas Hameed
Keyword(s):  
Functional Outcome ◽  
Distal Femur ◽  
Oxford Knee Score ◽  
Locking Compression Plate ◽  
Knee Score ◽  
Medial Condyle ◽  
Excellent Outcome ◽  
Femur Fractures ◽  
Articular Fractures ◽  
Compression Plate

Background: Distal femur fractures account for an estimated 6% of all femur fractures. Our study aims at evaluating the functional and radiological outcome in distal femur fractures treated with locking compression plate (DF-LCP).Methods: Patients undergoing LCP were assessed postoperatively both functionally and radiologically. Oxford Knee Score was used to assess the functional outcome. With a maximum score of 48, a score of more than 41 is scaled as excellent, 34 to 40 as good functional status, 27 to 33 as fair and score less than 27 as poor functional result.Results: Extra-articular fractures were the commonest (66.7%) type of fractures [simple-6.7%; metaphyseal wedge-20%; metaphyseal complex-40%] followed by complete articular fractures (26.7%) [Simple articular metaphyseal comminution-16.7%; metaphyseal and intra-articular comminution-10%] and partial articular fractures (6.7%) [Medial condyle-3.3%; coronal plane-3.3%]. Most of them had right sided femur injury (66.7%) and had history of fall (70%). Radiologically, 90% exhibited no complications and had united appropriately. Functionally the mean oxford knee score was 41.53±1.69 which ranged from a score of 38 to a maximum of 44. Highest proportion i.e., 63.3% had excellent outcome followed by good functional outcome and none showed fair or poor outcomes.Conclusions: LCP has shown very good radiological and functional outcomes with hundred percent union of the distal femur fractures. Hence it can be used successfully in distal femur fractures.

scholarly journals Assessment of functional outcome of distal femur intra-articular fractures treated with locking compression plate

2019 ◽  
Vol 6 (1) ◽  
pp. 145
Author(s):  
Neetin Pralhad Mahajan ◽  
Ved Ashish Ravesh ◽  
Prasanna Kumar G. S. ◽  
Ajay Chandanwale ◽  
Lalkar Gadod
Keyword(s):  
Functional Outcome ◽  
Distal Femur ◽  
Tertiary Care ◽  
Locking Compression Plate ◽  
Care Hospital ◽  
Excessive Bleeding ◽  
Femur Fractures ◽  
Medial Side ◽  
Articular Fractures ◽  
Compression Plate

<p class="abstract"><strong>Background:</strong> Intra-articular distal femoral fracture makes up to 6% of all femur fractures. Because they damage the cartilage surface of the bone, intra-articular fractures can be more difficult to treat. The locking compression plates have nowadays proven to be gold standard in treating both simple as well as complex intra-articular distal femur fractures. This study is to evaluate the complications, functional and anatomical outcome of distal femur fractures, treated by open reduction and internal fixation using distal femoral locking compression plate.</p><p class="abstract"><strong>Methods:</strong> This is<strong> </strong>a retrospective study of 30 patients with intra articular distal femur fractures operated with distal femur locking compression plate during the period of 2015 to 2018 in a tertiary care hospital with age range from 17 to 71 years and follow up till 2 years. Fractures were classified according to AO classification and functional outcome assessed by using Neer criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> 10 cases had excellent score (33%), 16 cases (52%) had satisfactory score, 3 cases (11%) had unsatisfactory score and only one case had poor score.<strong> </strong>85.1% of patients were in between satisfactory to excellent results. Complications observed were excessive bleeding, difficulty in reduction, superficial infections, knee stiffness, malalignment and limb length discrepancy.</p><p class="abstract"><strong>Conclusions:</strong> The distal femur locking compression plate is a good implant to be used for distal femur intra-articular fractures. Early surgery, anatomical reduction and early mobilisation are the prerequisites for good functional outcome. Comminution and bone defect on the medial side needs pillar reconstruction by fibular bone graft.</p>

scholarly journals An investigation of the acute management of closed intra-articular fractures of the proximal interphalangeal joint in Ireland

2020 ◽  
Vol 48 (1) ◽  
pp. 55-68
Author(s):  
Deirdre Harmon ◽  
Michelle Spirtos
Keyword(s):  
Health Service ◽  
Treatment Method ◽  
Service Development ◽  
Optimal Time ◽  
Cross Sectional ◽  
Content Type ◽  
Articular Fractures ◽  
Joint Fractures ◽  
Pip Joint ◽  
Trauma Surgeons

Purpose Many treatment methods for intra-articular fractures of the proximal interphalangeal (PIP) joint are described in the literature without a consensus on the most effective approach. The purpose of this study was to investigate the methods of treatment of PIP joint fractures being used by trauma surgeons in the Republic of Ireland currently and the timing of referral to therapy. Design/methodology/approach A cross-sectional descriptive study methodology was used to survey trauma surgeons, occupational therapists and physiotherapists in Ireland. An online platform was used. A total of 21 surveys were returned by surgeons and 37 by therapists. Descriptive statistical analysis was used to present the results. Findings Buddy strapping was reported as the primary treatment method for stable PIP joint fractures. All levels of fracture severity were reported to be treated using traction constructs, which include static and dynamic fixation and orthoses. Unstable fractures were managed using open reduction with internal fixation by 50 per cent of surgeons. Early timing of referral to therapy is reported by more surgeons than therapists. The majority of therapists indicated that they did not have the resources to see patients at the optimal time. Originality/value To the authors’ knowledge, this study provides the first description of the management of PIP joint fractures across the Irish health service. The findings of this study suggest that additional therapy resources are required within the health service executive to facilitate the desired early referral to therapy and to enable service development for this category of hand fractures.

Management of difficult intra-articular fractures or fracture dislocations of the proximal interphalangeal joint

2014 ◽  
Vol 40 (1) ◽  
pp. 16-23 ◽  
Author(s):  
E. Liodaki ◽  
S. G. Xing ◽  
P. Mailaender ◽  
F. Stang
Keyword(s):  
Articular Surface ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
External Fixators ◽  
Invasive Treatment ◽  
Articular Fractures ◽  
Joint Fractures ◽  
Fracture Dislocations ◽  
K Wires ◽  
Stable Reconstruction

Intra-articular fractures or fracture dislocations of the proximal interphalangeal joint are difficult clinically because the bone and soft tissue structures are small and intricate. Suboptimal treatment of intra-articular fractures typically leads to functional impairment of the hand. This article reviews the current methods of treatment, together with the senior author’s experience in treating difficult proximal interphalangeal joint fractures and dislocations. Besides conservative treatments, surgical treatments include open or closed reduction with traditional Osteosynthesis, such as K-wires, screws or plates. Among recent developments are the percutaneous application of thin cannulated compression screws and novel dynamic external fixators. After a preferred minimally invasive treatment with stable reconstruction of the articular surface, sufficient aftercare is necessary to improve surgical outcomes.

Pins and Rubber Traction System for Intra-Articular Proximal Interphalangeal Joint Fractures Revisited

2010 ◽  
Vol 35 (5) ◽  
pp. 396-401 ◽  
Author(s):  
G. Debus ◽  
A. Courvoisier ◽  
S. Wimsey ◽  
P. Pradel ◽  
F. Moutet
Keyword(s):  
Learning Curve ◽  
Simple Procedure ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
System A ◽  
Articular Fractures ◽  
Joint Fractures ◽  
Joint Flexion ◽  
Traction System

The Pins and Rubber Traction System (PRTS) can be used to treat proximal interphalangeal intra-articular fractures. Our experience is that outcomes are not always excellent and that many patients have reduced joint function or residual deformities. The aim of this study was to evaluate the reasons behind the poorer outcomes of some of the patients treated with this system. A retrospective clinical and radiological evaluation was performed on 15 patients after a minimum of 2 years’ follow-up. The mean interphalangeal joint flexion range was 66° (range 0—100) in our series. The review of the literature shows an average active interphalangeal joint flexion of 78° (range 64—95). Reasons for this difference include preoperative delay, technical deficiencies, the learning curve, a lack in postoperative physiotherapy and degenerative changes due to the longer follow-up. Although the Pins and Rubber Traction System seems a simple procedure, a learning curve is necessary to avoid pitfalls.

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