scholarly journals Preliminary Clinical and Radiographic Evaluation of a Novel Resorbable Implant of Polylactic Acid (PLA) for Tibial Tuberosity Advancement (TTA) by Modified Maquet Technique (MMT)

Animals ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 1271
Author(s):  
Victoria Valiño-Cultelli ◽  
Óscar Varela-López ◽  
Antonio González-Cantalapiedra
Keyword(s):  
Bone Healing ◽  
Recovery Time ◽  
Functional Results ◽  
Radiographic Evaluation ◽  
3D Printer ◽  
Radiographic Study ◽  
Clinical Recovery ◽  
Metallic Implants ◽  
Healing Score

Our objectives were to determine whether PLA implants can be used in TTA with successful results; secondly, to observe whether they provide a faster bone healing; finally, to determine whether weight or age influences bone healing scores. PLA cages were created with a 3D printer. TTA by MMT with PLA implants was performed in 24 patients. Follow-ups were carried out pre-surgical, at 1, 2, and 5 months and consisted of a radiographic study and a lameness assessment. A comparison was performed in terms of weight and age. Patients data, time between follow-up examinations, healing score, and lameness score were compared between patients using commercial software for statistically significant differences p < 0.05. Eighteen dogs finished the study. The ossification degrees presented statistically significant differences between each other. PLA implants maintained the advancement in 100% of cases. Comparing weight and age did not present any statistically significant differences between groups. Lameness presented statistically significant differences between follow-up examinations. Complications were observed in 20.8%. PLA implants for TTA provide good functional results, presenting an acceptable rate of complications. They provide a faster bone healing of the osteotomy gap, which was not affected by age or body weight, and have a clinical recovery time similar to metallic implants.

Treatment with Circular External Fixation of Bicondylar Tibial Fractures: Potential in Accurate Reduction and Efficacy on Functional Results

2017 ◽  
Vol 31 (05) ◽  
pp. 459-466 ◽  
Author(s):  
Ettore Vulcano ◽  
Lorenzo Bettella ◽  
Rohoman Tasarib ◽  
Tania Tondolo ◽  
Francesco Sala ◽  
...  
Keyword(s):  
External Fixation ◽  
Proximal Tibia ◽  
Articular Surface ◽  
Functional Results ◽  
Deep Infection ◽  
Tibial Fractures ◽  
Surgical Reconstruction ◽  
Radiographic Evaluation ◽  
Bicondylar Fractures

AbstractSurgical reconstruction of bicondylar tibial fractures with external fixation relies on indirect fracture reduction that could affect anatomical restoration. The aim of the present study is to evaluate the radiographic and clinical outcomes of tibial bicondylar fractures treated with circular external fixation. A total of 20 bicondylar fractures of the proximal tibia in 20 patients treated with circular external fixation were included in the study. Two fractures were open. Mean clinical and radiographic follow-up was 37.3 months after frame removal. Angular, translation, and length deformities were assessed on nonweight-bearing anteroposterior, lateral, and two 45 degrees oblique views. The medial proximal tibia (MPTA) and posterior proximal tibia angles (PPTA) were calculated in all cases. The condylar widening was calculated in relation to the width of the femoral condyles. Joint depressions or gaps of the articular surface were identified on the four views of the knee. The modified Hospital for Special Surgery (HSS) knee scoring system was used for clinical evaluation. The MPTA was good in 18 (90%) and fair in 2 patients (10%). The PPTA was good in 13 (65%), fair in 6 (30%), and poor in 1 patient (5%). The articular reduction was good in 12 (60%) and fair in 8 patients (40%). The condylar widening was good in 15 (75%) and fair in 5 patients (25%). Mechanical axis deviation was within the normal range in 11/12 patients (91.7%). All fractures consolidated. One deep infection was successfully treated with local debridement, the mean modified HSS knee score at the latest follow-up was 90.5 (range: 67–100). Articular reconstruction and tibia alignment based on radiographic evaluation in the present study, along with functional results compare favorably with those of external and internal fixation presented in the literature.

Polyglycolide Bioabsorbable Screws in the Treatment of Ankle Fractures

1997 ◽  
Vol 18 (3) ◽  
pp. 128-131 ◽  
Author(s):  
W. David Hovis ◽  
Robert W. Bucholz
Keyword(s):  
Functional Results ◽  
Sinus Tract ◽  
Ankle Fractures ◽  
Medial Malleolus ◽  
Wound Infections ◽  
Inflammatory Reactions ◽  
Malleolar Fractures ◽  
Metallic Implants ◽  
Bioabsorbable Screws

Twenty-one patients with unstable medial malleolar, bimalleolar, or trimalleolar ankle fractures underwent open reduction and internal fixation of the medial malleolus with 4.5-mm polyglycolide screws. All lateral malleolar fractures were internally fixed with standard metallic implants. Radiographic and clinical follow-up results were available on 16 of 21 patients. All fractures healed at an average of 3.4 months (range, 3–6 months), and there were no medial wound infections. Eight of 16 patients developed an inflammatory reaction to the biodegradable polyester at 3 to 4 months after implantation, including one who developed a sterile draining sinus tract. No surgical or nonsurgical treatment was required in those eight patients. We conclude that whereas polyester screws yield union rates and functional results similar to those of metallic screws in the treatment of medial malleolar fractures, the use of polyglycolide screws is associated with an unacceptable rate of inflammatory reactions.

scholarly journals Novel piston technique versus Ilizarov technique for the repair of bone defect after lower limb infection

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jiafei Du ◽  
Zifei Yin ◽  
Pengfei Cheng ◽  
Pei Han ◽  
Hao Shen
Keyword(s):  
Bone Healing ◽  
Lower Limb ◽  
Joint Stiffness ◽  
Functional Results ◽  
Bone Defects ◽  
Ilizarov Technique ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Background We aimed to compare the effectiveness and complications of a novel piston technique versus the Ilizarov technique for the repair of bone defects after lower limb infection. Patients and methods We retrospectively reviewed 41 patients who had been treated at our department for lower extremity bone defects following osteomyelitis. There were 38 men and three women with a mean age of 43.41 (range, 12–69 years). The infected bone defects involved 36 tibias and five femurs. The piston technique (PT, group A) was used in 12 patients and the Ilizarov technique (IT, group B) in 29 patients. The mean follow-up period was 28.50 months (PT) and 29.90 months (IT). The modified Application of Methods of Illizarov (ASAMI) criteria was used to evaluate bone healing and functional recovery. Results Complete eradication of the infection and union of docking sites were accomplished in both groups. The mean external fixator index (EFI) was 42.32 days/cm in group A versus 58.85 days/cm in group B (p < 0.001). The bone outcomes were similar between groups A and B (p = 0.558) (excellent [9 vs. 19], good [3 vs.10]); group A showed better functional outcomes than group B (p < 0.05) (excellent [7 vs. 6], good [4 vs. 12], fair [0 vs. 10] and poor [1 vs. 1]). Pain was the most common complaint during follow-up, and group A had fewer cases of pin tract infection (1 vs. 6), adjacent joint stiffness (3 vs. 8), and delayed healing of the joint (0 vs. 3). Conclusions Satisfactory bone healing can be achieved by using both PT and IT, although PT demonstrated better functional results, lower EFI, and allowed early removal of the external fixation. We found that this novel piston technique can improve the comfort of patients, reduce the incidence of complications, and provide rapid and convenient rehabilitation.

Demineralized Bone Powder

1993 ◽  
Vol 18 (4) ◽  
pp. 487-490 ◽  
Author(s):  
D. WHITEMAN ◽  
P. T. GROPPER ◽  
P. WIRTZ ◽  
P. MONK
Keyword(s):  
Failure Rate ◽  
Bone Healing ◽  
Bone Defects ◽  
Radiographic Evaluation ◽  
Bone Powder ◽  
Autogenous Grafts ◽  
Demineralized Bone

The results of 20 consecutive cases of bone defects of the hand treated by curettage and implantation of demincralized bone powder compare well with a similarly matched retrospective group managed with autogenous grafts and curettage alone. Results revealed “excellent” (16 patients) or “good” bone healing (4 patients) in the bone powder group on independent radiographic evaluation. Bone bridging was noted at an average of 9.9 weeks. All defects healed without recurrence, resorption or refracture, with follow-up of 4 to 36 months. In the conventionally managed retrospective group there was a 25% failure rate necessitating re-operation. Demineralized bone powder provides a rapid, safe and effective method of management of bone defects of the hand.

scholarly journals Novel Piston Technique Versus Ilizarov Technique for The Repair of Bone Defect After Lower Limb Infection

2021 ◽  
Author(s):  
Jiafei Du ◽  
Zifei Yin ◽  
Pengfei Cheng ◽  
Pei Han ◽  
Hao Shen
Keyword(s):  
Bone Defect ◽  
Bone Healing ◽  
Lower Limb ◽  
Functional Results ◽  
Bone Defects ◽  
Ilizarov Technique ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Background We described the use of a novel Piston technique versus Ilizarov technique to compare the effectiveness and complications for the repair of bone defect after lower limb infection. Patients and methods: We retrospectively reviewed 41 patients who had been treated at our department for lower extremity bone defects following osteomyelitis. They were 38 males and 3 females with a mean age of 43.41 (range 12 to 69 years). The infected bone defects involved 36 tibias and 5 femurs. Piston technique (PT, group A) was used in 12 patients and Ilizarov technique (IT, group B) in 29 ones. The mean duration of follow-up was 28.50 months (PT) and 29.90 months (IT). The modified Application of Methods of Illizarov (ASAMI) criteria was used to evaluate the bone healing and functional recovery. Results Complete eradication of infection and union of docking sites were accomplished well in both groups. The mean external fixator index (EFI) was 42.32 days/cm in group A versus 58.85 days/cm in group B (p < 0.001). The bone outcomes were similar between group A and B (p = 0.558) [excellent (9 vs. 19), good (3 vs.10)]; group A showed better functional outcomes than group B (p < 0.05) [excellent (7 vs. 6), good (4 vs. 12), fair (0 vs. 10) and poor (1 vs. 1)]. Pain was complained most during follow-up and group A had fewer cases of pin tract infection (1 vs. 6), adjacent joint stiffness (3 vs. 8) and delayed healing of the joint (0 vs. 3). Conclusions Satisfactory bone healing can be obtained by using both PT and IT, while PT had better functional results, lower EFI and allowed early removal of the external fixation. We have found that this novel Piston technique can improve the comfort of patients, reduce the incidence of complications, and provide a rapid and convenient rehabilitation.

Clinical Analysis of Pyocele of Tunica Vaginalis in 56 Newborns

2021 ◽  
pp. 1-6
Author(s):  
Tian-Qu He ◽  
Li-Hui Zhu ◽  
Chuang-Ye Li ◽  
Qian-Long Peng ◽  
Jian-Cheng Zu ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Recovery Time ◽  
Pathogenic Bacteria ◽  
Color Doppler ◽  
Tunica Vaginalis ◽  
Term Infants ◽  
Surgical Exploration ◽  
Clinical Recovery

<b><i>Objective:</i></b> This study aimed to explore the clinical characteristics, treatment methods, and prognosis of neonatal pyocele of tunica vaginalis and to provide a reference for the clinical treatment. <b><i>Methods:</i></b> A total of 56 newborns with pyocele of tunica vaginalis were admitted to our hospital due to the scrotal emergency from January 2015 to January 2020. Our study retrospectively analyzed these 56 cases. Of the 56 cases, including 32 full-term infants and 24 premature infants, age ranged from 1 to 27 days. Initially, conservative treatment (intravenous antibiotic treatment) was applied to 42 cases, and surgery to 14 cases. Then, 7 underwent surgical exploration during the conservative treatment, and 2 cases with initial surgical treatment experienced orchiectomy because of complete necrosis. For 56 cases, the average follow-up time was 18 months. <b><i>Results:</i></b> The clinical recovery time of cases with conservative treatment ranged from 8 to 17 days, with an average of 11.02 ± 2.31 days. The clinical recovery time of cases with surgery ranged from 6 to 15 days, with an average of 9.28 ± 2.78 days. During the follow-up, for 56 cases, except for the 2 cases with orchiectomy, the testicular position and Doppler flow both went back to normal, of the 42 cases with initial conservative treatment, 1 case experienced testicular retardation, of the 14 cases with initial surgical treatment, 2 cases experienced testicular retardation, and hydrocele of 42 cases were self-healed. <b><i>Conclusions:</i></b> Neonatal pyocele of tunica vaginalis is mostly secondary to intra-abdominal infection. Color Doppler ultrasound is helpful for the diagnosis. The percutaneous aspiration is a way of collecting pathogenic bacteria during the conservative treatment. If the color Doppler suggests testicular involvement, surgical exploration should be performed.

scholarly journals Clinical and radiological follow-up after free vascularised fibula transplantation for bone defects of the upper extremity with MRI and MR-angiography

2019 ◽  
Author(s):  
Lisa Eckstein ◽  
Ariane Asmus ◽  
Sven Mutze ◽  
Sinan Bakir ◽  
Lyubomir Haralambiev ◽  
...  
Keyword(s):  
Contrast Agent ◽  
Upper Extremity ◽  
Bone Healing ◽  
Pearson Correlation ◽  
Wilcoxon Test ◽  
X Ray ◽  
Significant Difference ◽  
Vascular Patency ◽  
Healing Score

Abstract Background Vascular patency of free vascularised fibula grafts can be postoperatively assessed by island flap which is not always possible or angiography which is invasive. Bone healing is examined based on radiographs with scoring systems. We present data on MRI with contrast agent and a comparison of the Giessler bone healing score by X-ray and MRI and clinical scores in patients with operation on the upper extremity. Methods We reviewed the clinical and radiological outcome of 13 patients with a follow-up of at least 1 year after free vascularised fibula graft of the upper extremity. The examination included the DASH, MSTS, SF-36, Rosén-Lundberg-scores and MRI with contrast agent. We determined the Giessler bone healing score by most recent x-ray and MRI and the Weiland score and its modification for the upper extremity. For statistics, we used the Wilcoxon test and Pearson correlation. Results Vascular patency was directly or indirectly detectable all cases in the MRI with contrast agent. 5 patients did not return to work and 5 patients had ongoing pain medication. Median DASH was 21.7, MSTS of the upper extremity 76.7, of the lower extremity 93.3, the Rosén-Lundberg score for median nerve 2.43, for ulnar nerve 2.32. Giessler score for x-ray and MRI showed no significant difference for proximal or distal junction. Conclusions We could prove with MRI that it was indeed a vascularised graft and its vitality at time of follow-up by assessment of vascular patency, and that MRI can be used to determine the Giessler score similarly to X-ray.

Laparoscopic simple prostatectomy: complications and functional results after five years of follow-up

2020 ◽  
Vol 72 (4) ◽  
Author(s):  
Matteo Manfredi ◽  
Cristian Fiori ◽  
Dario Peretti ◽  
Federico Piramide ◽  
Enrico Checcucci ◽  
...  
Keyword(s):  
Functional Results ◽  
Simple Prostatectomy

scholarly journals Treatment Outcomes of Lesser Tuberosity Osteotomy Nonunion After Total Shoulder Arthroplasty

2018 ◽  
Vol 2 ◽  
pp. 247154921880777
Author(s):  
Zachary J Bloom ◽  
Cesar D Lopez, BA ◽  
Stephen P Maier ◽  
Brian B Shiu ◽  
Djuro Petkovic ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Shoulder Arthroplasty ◽  
Surgical Repair ◽  
Total Shoulder Arthroplasty ◽  
Case Series ◽  
Radiographic Evaluation ◽  
Lesser Tuberosity ◽  
Conservative Care ◽  
Conservative Group

Introduction Lesser tuberosity osteotomy (LTO) during anatomic total shoulder arthroplasty has a 13% nonunion rate. Treatment for LTO nonunion is controversial and poorly described in the literature. The purpose of this study was to compare the surgical and nonsurgical treatment outcomes of LTO nonunion. Methods A retrospective case series of 9 consecutive patients with LTO nonunion after primary anatomic shoulder arthroplasty at 1 institution from 2010 to 2016 were studied. Outcomes measured were radiographic evaluation of LTO on axillary X-ray, clinical range of motion (ROM), subscapularis strength, and pain at the time of LTO nonunion diagnosis and after either conservative care or surgical repair of the LTO nonunion. Results LTO nonunion was treated surgically in 4 and conservatively in 5 patients with average follow-up of 30 and 22 months, respectively. There were no significant differences in age, sex, or smoking status between groups. Treatment decision was a shared model of surgeon and patient. Displaced LTO nonunion was treated surgically in 2 and conservatively in 3 patients. There were no differences in LTO union rate of 50% in the surgical versus 60% in the conservative group. Abdominal compression test was abnormal in 50% of surgical versus 40% of conservative groups. At follow-up, ROM was lower in the surgical group with 128° forward elevation (FE) and 33° external rotation (ER) compared to 148° FE and 62° ER. Only 1 patient with LTO nonunion required conversion to reverse replacement. Conclusion LTO nonunion after shoulder arthroplasty is rare. Surgical repair of LTO nonunion does not significantly improve clinical or radiographic outcomes compared to conservative care.

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