scholarly journals Outcome of Tibial Fractures Cleaned and Irrigated with Tetrachlorodecaoxygen Solution and Primary Plate Fixation

2009 ◽  
Vol 3 (1) ◽  
pp. 64-67
Author(s):  
D Ismono ◽  
H Herman
Keyword(s):  
Plate Fixation ◽  
Tibial Fractures ◽  
Primary Plate

Comparison between External Locking Plate Fixation and Conventional External Fixation for Extraarticular Proximal Tibial Fractures: A Finite Element Analysis

2021 ◽  
Author(s):  
Dejan Blažević ◽  
Janoš Kodvanj ◽  
Petra Adamović ◽  
Dinko Vidović ◽  
Zlatko Trobonjača ◽  
...  
Keyword(s):  
Finite Element ◽  
External Fixation ◽  
External Fixator ◽  
Tibial Fracture ◽  
Locking Plate ◽  
Plate Fixation ◽  
Tibial Fractures ◽  
Proximal Tibial Fracture ◽  
Locking Plate Fixation ◽  
Maximum Stiffness

Abstract BackgroundGood clinical outcomes for locking plates as an external fixator to treat tibial fractures have been reported. However, external locking plate fixation is still generally rarely performed. This study aimed to compare the stability of external locking plate fixator with that of conventional external fixator for extraarticular proximal tibial fractures, using finite element analysis. MethodsThree models were constructed: (1) external locking plating of proximal tibial fracture with lateral proximal tibial locking plate and 5-mm screws (ELP), (2) conventional external fixation of proximal tibial fracture with an 11-mm rod and 5-mm Schanz screws (EF-11), and (3) conventional external fixation of proximal tibial fracture with a 7-mm rod and 5-mm Schanz screws (EF-7). The stress distribution, displacement at the fracture gap, and stiffness of the three finite element models at 30-, 40-, 50-, and 60-mm plate–rod offset from the lateral surface of the lateral condyle of the tibia were determined. ResultsThe conventional external fixator showed higher stiffness than did the external locking plate fixator. In all models, the stiffness decreased as the distance of the plate–rod from the bone surface increased. The maximum stiffness was 121.06 N/mm in the EF-11 model with 30-mm tibia–rod offset. In the EF-7 model group, the maximum stiffness was 40.00 N/mm in the model with 30-mm tibia–rod offset. In the ELP model group, the maximum stiffness was 35.79 N/mm in the model with 30-mm tibia–plate offsetConclusionsExternal locking plate fixation is more flexible than conventional external fixation, which can influence secondary bone healing. External locking plate fixation requires the placement of the plate as close as possible to the skin, which allow low-profile design, because the increased distance of the plate from bone can be too flexible for bone healing.

scholarly journals Studies on Bending Limitations for the Optimal Fit of Orthopaedic Bone Plates

2012 ◽  
Vol 602-604 ◽  
pp. 1181-1185 ◽  
Author(s):  
Javad Malekani ◽  
Beat Schmutz ◽  
Prasad Gudimetla ◽  
Yuan Tong Gu ◽  
Michael Schuetz ◽  
...  
Keyword(s):  
Stainless Steel ◽  
Comparative Analysis ◽  
Postoperative Complications ◽  
Large Deformations ◽  
Plate Fixation ◽  
Tibial Fractures ◽  
Patient Specific ◽  
Bone Morphology ◽  
Stainless Steel 316L ◽  
Distal Tibial Fractures

Distal tibial fractures are now commonly treated via intermedullary plate fixation due to higher rates of union and lower rates of postoperative complications. However, patient specific bone morphology demands manual deformation of the plate to ensure appropriate fit along the bone contours, and depending on the material of the plate, different outcomes have been reported along with postoperative complications. A comparative analysis of Stainless Steel 316L and Ti-6Al-4V alloys was carried to estimate the safe bending limit for appropriate fits. The results from the ANSYS FEA simulations were validated with experiments based on ASTM F382-99. It is found that SS316L is better suited for large deformations (up to 16˚ in proximal tip and 7.5˚ in distal end) and Ti for smaller deformation contours (up to 3˚ in proximal tip and 1.8˚ in distal end). The results of this study have profound implications for the choice of plates based on preliminary radiographical fracture examinations to ensure better fixation and higher rates of union of distal tibial fractures.

scholarly journals Comparative analysis between locking compression plate and Joshi's external stabilization system in the management of proximal tibial fractures

2020 ◽  
Vol 7 (1) ◽  
pp. 56
Author(s):  
Amit Dwivedi ◽  
Anupinder Sharma ◽  
Vaibhav Ashta ◽  
Robium Nairobi ◽  
Sunandan Nandi
Keyword(s):  
Plate Osteosynthesis ◽  
Plate Fixation ◽  
Deep Infection ◽  
Open Reduction Internal Fixation ◽  
Tibial Fractures ◽  
Stabilization System ◽  
Superficial Infection ◽  
Bone Consolidation ◽  
Proximal Tibial Fractures ◽  
External Stabilization

<p><strong>Background:</strong> Proximal tibial fractures present with a variety of patterns. They are mostly treated using plate osteosynthesis or Joshi's external stabilization system (JESS) depending upon the injury configuration and surgeon preference. We have compared the efficacy of plate fixation to JESS in the treatment of complex proximal tibial fractures.<strong></strong></p><p><strong>Methods</strong>: 36 patients of proximal tibial fractures with a mean age of 47 years were included in the study, 20 were treated using plate osteosynthesis while the other 16 were treated using JESS, they were followed up at regular intervals till 24 weeks and the progress was recorded in accordance with the knee society score (KSS) parameters<strong></strong></p><p><strong>Results</strong>: 20 patients were treated using plate osteosynthesis, 18 of them had excellent KSS scores, 2 patients recorded good scores, average range of flexion was 126<sup>o</sup>, no incidences of superficial or deep infections were seen in any of them. Bone consolidation was achieved around 12 weeks in plate fixation group of the16 patients treated using JESS, 12 had excellent scores, 4 recorded a good score, average range of flexion was 118<sup>o</sup>, superficial infection was seen in 2 patients, with no incidence of deep infection. Bone consolidation was achieved around 16 weeks in JESS group.</p><p><strong>Conclusions</strong>: Both open reduction internal fixation (ORIF) with plating and JESS appear to be adequate fixation methods for complex proximal tibial fractures, but as per our study plate fixation resulted in earlier bone consolidation and gave a slightly better functional outcome compared to JESS.</p>

scholarly journals Comparative study of plating versus conservative treatment in mid shaft fractures of clavicle

2021 ◽  
Vol 8 (1) ◽  
pp. 14
Author(s):  
Johney Juneja ◽  
Ankit Damor ◽  
A. K. Mehra ◽  
Anurag Talesra ◽  
Dharmendra Kumar Jatav ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Range Of Motion ◽  
Plate Fixation ◽  
Shoulder Function ◽  
Non Union ◽  
Scapular Fractures ◽  
Primary Plate ◽  
Early Primary ◽  
Function Range ◽  
Fracture Types

<p><strong>Background</strong>: Clavicle fractures represent up to 4% and 1% of all fractures, respectively. Historically, both fracture types have been treated conservatively with acceptable outcomes. The surgical correction of these fractures is currently being investigated as a viable alternative to conservative management.</p><p><strong>Methods</strong>: A systematic search of PubMed was performed to identify articles comparing open reduction and internal fixation (ORIF) with conservative treatment for clavicular fractures. Specific outcomes of interest were shoulder function, pain, strength, range of motion, and risk of non-union. </p><p><strong>Results</strong>: ORIF of midshaft clavicular fractures results in increased shoulder function within 6 weeks following treatment and a decreased risk of non-union. After 1 year, there was no longer a difference in shoulder function between groups. There was no difference in pain between treatment groups. Both ORIF and conservative treatment of extraarticular scapular fractures yield comparable results in shoulder function, range of motion, and strength following treatment.</p><p><strong>Conclusions</strong>: This study, early primary plate fixation of comminuted mid shaft clavicular fractures results in improved patient-oriented outcomes, improved surgeon-oriented outcomes, earlier return to function and decreased rates of non-union and malunion. </p>

Percutaneous Plating of Distal Tibial Fractures

2002 ◽  
Vol 23 (9) ◽  
pp. 818-824 ◽  
Author(s):  
Amal Khoury ◽  
Meir Liebergall ◽  
Eli London ◽  
Rami Mosheiff
Keyword(s):  
Sagittal Plane ◽  
Dynamic Compression ◽  
Plate Fixation ◽  
Varus Deformity ◽  
Valgus Deformity ◽  
Tibial Fractures ◽  
Superficial Infection ◽  
Distal Tibial Fractures ◽  
Type Fracture ◽  
Anatomical Fixation

This article presents our experience with 24 patients who had distal tibial fractures and were treated by percutaneous plate fixation. Distribution of the fractures according to the AO/OTA classification was as follows: five patients suffered from a 43 A type fracture, six from a 43 B type fracture, and 13 from a 43 C type fractures. Four of the fractures were open. Exclusion criteria included 43 C3 fractures and Gustilo III open fractures. All fractures showed radiographic signs of union enough to enable full weightbearing within an average time of 12.3 weeks. All patients showed a good range of motion (average dorsiflexion 12° and average plantiflexion 18°). Two fractures united with mal-union: one with an 8° valgus deformity and another with a 7° varus deformity. Both cases, which had a metaphyseal component, were treated by means of a “soft” (flexible and manually adjustable) AO 3.5 mm reconstruction plate. Except for one case of superficial infection, no infections were detected in any of the patients. The biological percutaneous plate fixation of distal tibial fractures with no extensive intra-articular involvement is a good soft tissue preserving technique. It provides a rigid and anatomical fixation in most cases. We conclude that type B fractures with one intact column can be fixed with either “soft” or “rigid” plates, and type A and C fractures with a metaphyseal component should be fixed with “rigid” plates (AO 4.5 mm Dynamic Compression Plate). In these fractures the reduction should be performed cautiously due to the tendency of sagittal plane mal-reduction.

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