Screw Versus Plate Fixation of Proximal First Metatarsal Crescentic Osteotomy

2009 ◽  
Vol 30 (02) ◽  
pp. 142-149 ◽  
Author(s):  
Kevin E. Varner ◽  
Victoria Matt ◽  
Jerry W. Alexander ◽  
James D. Johnston ◽  
Shiraz Younas ◽  
...  
Keyword(s):  
Plate Fixation ◽  
First Metatarsal

First Metatarsal-Phalangeal Joint Arthrodesis: A Biomechanical Assessment of Stability

2003 ◽  
Vol 24 (4) ◽  
pp. 332-337 ◽  
Author(s):  
Joel Politi ◽  
John Hayes ◽  
Glen Njus ◽  
Gordon L. Bennett ◽  
David B. Kay
Keyword(s):  
Plate Fixation ◽  
Kirschner Wire ◽  
High Rate ◽  
Fixation Method ◽  
Materials Testing ◽  
Dorsal Plate ◽  
Kirschner Wires ◽  
First Metatarsal ◽  
Lag Screw ◽  
Kirschner Wire Fixation

Background: First metatarsal phalangeal joint (MTP) arthrodesis is a commonly performed procedure for the treatment of hallux rigidus, severe and recurrent bunion deformities, rheumatoid arthritis and other less common disorders of the joint. There are different techniques of fixation of the joint to promote arthrodesis including oblique lag screw fixation, lag screw and dorsal plate fixation, crossed Kirschner wires, dorsal plate fixation alone and various types of external fixation. Ideally the fixation method should be reproducible, lead to a high rate of fusion, and have a low incidence of complications. Methods: In the present study, we compared the strength of fixation of five commonly utilized techniques of first MTP joint arthrodesis. These were: Surface excision with machined conical reaming and fixation with a 3.5 mm cortical interfragmentary lag screw. Surface excision with machined conical reaming and fixation with crossed 0.062 Kirschner wires. Surface excision with machined conical reaming and fixation with a 3.5 mm cortical lag screw and a four hole dorsal miniplate secured with 3.5 mm cortical screws. Surface excision with machined conical reaming and fixation with a four hole dorsal miniplate secured with 3.5 mm cortical screws and no lag screw. Planar surface excision and fixation with a single oblique 3.5 mm interfragmentary cortical lag screw. Testing was done on an Instron materials testing device loading the first MTP joint in dorsiflexion. Liquid metal strain gauges were placed over the joint and micromotion was detected with varying loads and cycles. Results: The most stable technique was the combination of machined conical reaming and an oblique interfragmentary lag screw and dorsal plate. This was greater than two times stronger than an oblique lag screw alone. Dorsal plate alone and Kirschner wire fixation were the weakest techniques. Conclusions: First MTP fusion is a commonly performed procedure for the treatment of a variety of disorders of the first MTP joint. The most stable technique for obtaining fusion in this study was the combination of an oblique lag screw and a dorsal plate. This should lead to higher rates of arthrodesis.

Screw Versus Plate Fixation of Proximal First Metatarsal Crescentic Osteotomy

2009 ◽  
Vol 30 (2) ◽  
pp. 142-149 ◽  
Author(s):  
Kevin E. Varner ◽  
Victoria Matt ◽  
Jerry W. Alexander ◽  
James D. Johnston ◽  
Shiraz Younas ◽  
...  
Keyword(s):  
Plate Fixation ◽  
First Metatarsal

scholarly journals Clinical and Radiographic Outcomes of Midfoot Arthrodesis Using Different Fixation Methods

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0002
Author(s):  
Lorena Bejarano-Pineda ◽  
Jeannie Huh ◽  
James DeOrio ◽  
Alexander Lampley ◽  
Mark Easley
Keyword(s):  
Patient Reported Outcomes ◽  
Screw Fixation ◽  
Plate Fixation ◽  
Fixation Methods ◽  
First Metatarsal ◽  
Radiographic Outcomes ◽  
Fixation Group ◽  
Metatarsal Angle ◽  
Patient Reported

Category: Midfoot/Forefoot Introduction/Purpose: Midfoot arthritis is a disabling condition, causing chronic foot pain and functional disability. The goals of midfoot arthrodesis are to a plantigrade, stable, and pain-free foot. The procedure can be technically demanding and associated with a number of complications. The use of midfoot-specific plate fixation has become more popular as an alternative to screw-only fixation. The purpose of this study was to compare the clinical and radiographic outcomes following midfoot arthrodesis using different fixation methods. Methods: This was a retrospective study of all midfoot arthrodeses performed at a single institution between January 2005 and December 2014. Patients qualified if they had a minimum of 12 months follow-up, specifically with patient-reported outcomes. Demographic and surgical information were collected. Final post-operative outcomes were reviewed and consisted of patient-reported functional measures, union rate, complications, and radiographic outcomes. Patient-reported functional measures included the American Orthopedic Foot and Ankle Score (AOFAS) midfoot scale, Visual Analogue Scale (VAS) for pain, and Lower Extremity Functional Score (LEFS). Radiographic outcomes included alignment in the antero-posterior (AP) and lateral views, as measured by the talo-first metatarsal angle during the pre-operative and final follow-up visits. Outcomes were compared among the following groups: Screw fixation group (SFG), plate fixation group (PFG), and combined fixation group (CFG), which had screw and plate fixation. Results: A total of 79 midfoot fusions in 75 patients had a mean follow-up of 61 months (range 13-122) with patient-reported outcome measures. At final follow-up, the SFG had a higher median LEFS (72.5 versus 53 in the PFG and 56 in the CFG; p>0.1) and a higher mean AOFAS score (87 versus 78 in the PFG and 77 in the CFG; p>0.15). The complication and nonunion rate was highest in the PFG, with 13 (50%) and 4 (50%) cases, respectively; however, the differences were not statistically significant. The talo-first metatarsal angle improved in all three groups from a median of 6.4 degrees pre-operatively to 3.9 degrees on final post-operative imaging. Conclusion: Although not statistically significant, there was a trend towards higher patient-reported outcomes, union rate, and less complication rate in midfoot fusions treated with screw fixation compared to plate fixation and combined fixation. There was no difference in radiographic correction among the difference fixation methods. Although new techniques and implants continue to be introduced, we found no significant difference in outcomes when compared to the traditional technique of screw fixation.

Radiographic Evaluation of Hallux Valgus Treated with Opening Wedge Osteotomy

2009 ◽  
Vol 30 (5) ◽  
pp. 427-431 ◽  
Author(s):  
Sunil Randhawa ◽  
Dean Pepper
Keyword(s):  
Hallux Valgus ◽  
Plate Fixation ◽  
Radiographic Evaluation ◽  
Wedge Osteotomy ◽  
Opening Wedge ◽  
First Metatarsal ◽  
Plate Group ◽  
Low Profile ◽  
Contemporary Practice

Background: There are many techniques described for treatment of hallux valgus. The role of proximal osteotomies of the 1st metatarsal is well documented. However the opening wedge osteotomy has become less popular in contemporary practice. The purpose of this paper was to report our experience with an opening wedge osteotomy for the treatment of hallux valgus using L-Plate fixation. Materials and Methods: Twenty-nine patients underwent 31 basal opening wedge osteotomies of the first metatarsal. Fixation was achieved with the Arthrex® low profile titanium plate. The IMA on the WB radiograph preoperatively, and at least 12 months postoperatively was measured. Four patients received a 3.5-mm plate, 15 received a 4.0-mm plate, and 12 received a 5.0-mm plate. Results: The 3.5-mm group had a mean preoperative IMA of 13.8 degrees (range, 6 to 18), and postoperative IMA of 5.8 (range, 3 to 8), with a mean correction of 8.0. The 4.0-mm plate group had a mean preoperative IMA of 16.9 (range, 11 to 30) and postoperative IMA of 8.9 (range, 4 to 11) with a mean correction of 9.0. The 5.0-mm plate group had a mean preoperative IMA of 24.7 (range, 15 to 35) and postoperative IMA of 9.8, (range, 3 to 22) with a mean correction of 14.9. Conclusion: We report on a successful method for correcting hallux valgus with a basilar first metatarsal opening wedge osteotomy. It was highly effective for correcting moderate to severe intermetatarsal deformities.

Plate Fixation of Fractures of the Mid and Upper Face

1987 ◽  
Vol 20 (3) ◽  
pp. 559-572 ◽  
Author(s):  
Robert M. Kellman ◽  
Wilfried Schilli
Keyword(s):  
Plate Fixation ◽  
Upper Face

COMPARATIVE ANALYSIS OF CLOSED REDUCTION AND EXPERT TIBIA NAILING WITH OPEN REDUCTION AND PLATE & SCREW FIXATION IN THE TREATMENT OF PROXIMAL TIBIA EXTRAARTICULAR FRACTURES

2018 ◽  
Author(s):  
Anil Pandey ◽  
Setul Shah ◽  
Deepak S Maravi ◽  
S Uikey
Keyword(s):  
Intramedullary Nailing ◽  
Closed Reduction ◽  
Proximal Tibia ◽  
Plate Fixation ◽  
Surgical Site Infections ◽  
Delayed Union ◽  
Large Sample Size ◽  
Multicentric Study ◽  
Group A ◽  
Group B

Introduction:- Extra-articular proximal tibial fractures account for 5–10 % of all tibial shaft fractures and it result from high-velocity trauma. Closed reduction with minimally invasive plating and locked intramedullary  nailing have been widely used for treatment of proximal tibia extraarticular fractures. Our pupose is to compare the pros and cons of these two methods. Materials and methods:- 22 patients were included in this study for a period of 2 years. Patients treated with IMN were kept in group A patients treated with percutaneus plating were kept in group B. Standard approach of nailing and plating were used and proper follow up were taken for next upcoming 1 year. Results:- Combined average age was 38years. Male were more commonly affected than female (13:8). Majority of fracture were of type A33. Operative time was < 2 hours in both groups. Less blood loss occurred during intramedullary nailing as compared to locking plate fixation. Surgical site infections (SSIs) were seen in two patients in the PTP group. Delayed union occurred in two patients in the IMN group. The average range of motion was 119.7(range 90-150, SD= 19.18) in group A and 115.2(range 80-150, SD = 17.28) in group B. Conclusion:- in treatment of proximal tibia extra articular fracture use of IMN and PTLCP gives comparable results. To validate this issue further a large sample size multicentric study is recommended   Key words: intramedullary nailing (IMN), Extraarticular tibialn fracture, Surgical site infection.

Atypical Femoral Fracture in McCune-Albright Syndrome

2020 ◽  
Vol 7 (3) ◽  
pp. 147-152
Author(s):  
Salman Ghaffari ◽  
◽  
Mehran Razavipour ◽  
Parastoo Mohammad Amini ◽  
◽  
...  
Keyword(s):  
Femoral Fracture ◽  
Dynamic Compression ◽  
Plate Fixation ◽  
Medullary Canal ◽  
Mccune Albright Syndrome ◽  
Café Au Lait Spots ◽  
History Of ◽  
Albright Syndrome ◽  
Mccune Albright

McCune-Albright Syndrome (MAS) is characterized by endocrinopathies, café-au-lait spots, and fibrous dysplasia. Bisphosphonates are the most prescribed treatment for reducing the pain but their long-term use has been associated with atypical fractures of cortical bones like femur in patients. We present a 23-year-old girl diagnosed with MAS. She had an atypical mid-shaft left femoral fracture that happened during simple walking. She also had a history of long-term use of alendronate. Because of the narrow medullary canal, we used 14 holes hybrid locking plate for the lateral aspect of the thigh to fix the fracture and 5 holes dynamic compression plate (instead of the intramedullary nail) in the anterior surface to double fix it, reducing the probability of device failure. With double plate fixation and discontinuation of alendronate, the complete union was achieved five months after surgery

Radiation Exposure of Anaesthetists Visualised by Real-time Dosimetry

2019 ◽  
Vol 15 (2) ◽  
pp. 220-226
Author(s):  
Marcus Christian Müller ◽  
Michael Windemuth ◽  
Sophie Frege ◽  
Eva Nadine Striepens
Keyword(s):  
Radiation Exposure ◽  
Real Time ◽  
Vertebral Fractures ◽  
Plate Osteosynthesis ◽  
Plate Fixation ◽  
Femoral Fractures ◽  
Dose Monitoring ◽  
Osteoporotic Vertebral Fractures ◽  
Radiation Dose Monitoring ◽  
Dosimetry System

Background: Chronic exposure to occupational ionising radiation is seen as one reason for elevated cancer prevalence. </P><P> Objective: The aim of this retrospective study was to evaluate radiation exposure of anaesthetists by real-time dosimetry. Methods: Data of 296 patients were analyzed. Ten types of trauma operation procedures including osteosynthesis of upper and lower extremity fractures and minimally invasive stabilisation of traumatic and osteoporotic vertebral fractures were accomplished. Evaluation was performed by an occupational dosimetry system, which visualises anaesthetists radiation exposure feedback compared to surgeons in real-time. Results: A significantly lower radiation exposure to anaesthetists compared to surgeons was observed in four types of operative procedures: Plate fixation of proximal humerus fractures, osteosynthesis of proximal femoral fractures, stabilisation of traumatic and osteoporotic vertebral fractures. In four types of operations (plate osteosynthesis of proximal humeral, distal radial and tibial fractures and intramedullary nailing of the clavicle), anaesthetists` amount of radiation exceeded one-third of the surgeons' exposure, especially if the C-arm tube was positioned close to the anaesthetists work station at the patients' head. Conclusion: By using the occupational radiation dose monitoring system, radiation exposure to anaesthetists was visualised in real-time during trauma operations. Radiation exposure of anaesthetists depends on the type of operation and the position of the C-arm. The system may help to increase anaesthetists` awareness concerning radiation exposure and to enhance compliance in using radiation protection techniques.

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