scholarly journals Temporary Internal Bracing for Pediatric Odontoid Synchondrosis Fracture

Cureus ◽  
2021 ◽  
Author(s):  
Ayman W Taher ◽  
Cody J Falls ◽  
Paul S Page ◽  
James A Stadler
Keyword(s):  
Internal Bracing

Internal Bracing in Multiple-Ligament Knee Reconstruction

2019 ◽  
pp. 475-488 ◽  
Author(s):  
Nicholas A. Trasolini ◽  
Adam Lindsay ◽  
Joseph Cooper ◽  
George F. “Rick” Hatch
Keyword(s):  
Knee Reconstruction ◽  
Internal Bracing

Biomechanical Functional Elbow Restoration of Acute Ulnar Collateral Ligament Tears: The Role of Internal Bracing on Gap Formation and Repair Stabilization

2020 ◽  
Vol 48 (8) ◽  
pp. 1884-1892
Author(s):  
Samuel Bachmaier ◽  
Coen A. Wijdicks ◽  
Nikhil N. Verma ◽  
Laurence D. Higgins ◽  
Stefan Greiner
Keyword(s):  
Primary Repair ◽  
Ulnar Collateral Ligament ◽  
Analysis Of Covariance ◽  
Torsional Stiffness ◽  
Gap Formation ◽  
Initial Stiffness ◽  
Collateral Ligament ◽  
Time Zero ◽  
Torsional Resistance ◽  
Internal Bracing

Background: Biomechanical studies have compared augmented primary repair with internal bracing versus reconstruction techniques of the anterior ulnar collateral ligament (aUCL) in the elbow. However, aUCL repair alone has not been compared with augmented repair or reconstruction techniques. Hypothesis: Internal bracing of aUCL repair provides improved time-zero stabilization in terms of gap formation, torsional stiffness, and residual torque compared with both repair alone and the modified docking technique, with enhanced valgus stability restoration to that of the native ligament. Study Design: Controlled laboratory study. Methods: We randomized 8 matched pairs of cadaveric elbows to undergo either augmented aUCL repair or a modified docking technique through use of the palmaris longus tendon. Valgus laxity testing was consecutively performed at 90° of flexion on the intact, torn, and repaired conditions as well as the previously assigned techniques. First, intact elbows were loaded up to 10 N·m valgus torque to evaluate time-zero ligament rotations at valgus moments of 2.5, 5.0, 7.5, and 10 N·m. Rotation controlled cycling was performed (total 1000 cycles) for each surgical condition. Gap formation, stiffness, and residual torque were analyzed. Finally, these elbows and 8 additional intact elbows underwent torque to failure testing (30 deg/min). Results: Repair alone revealed low torsional resistance and gapping, similar to the torn state. The augmented repair technique showed significantly higher torsional stiffness ( P < .001) and residual torque ( P < .001) compared with all other conditions and restored native function. Although reconstruction revealed similar initial stiffness and residual torque compared with an intact ligament, a steady decrease of torsional resistance led to a completely loose state at higher valgus rotations. Analysis of covariance between all groups showed significantly less gap formation for augmented repair ( P < .001). The native failure load and stiffness were significantly higher and were similar to those of augmented repair ( P = .766). Conclusion: Internal bracing of aUCL repair restored valgus stability to the native state with statistically improved torsional resistance, loading capability, and gap formation compared with reconstruction, especially at the upper load range of native aUCL function in the elbow. Clinical Relevance: We found that aUCL repair with an internal brace effectively improves time-zero mechanical characteristics and may provide stabilized healing with accelerated and reliable recovery without the need for a tendon graft.

scholarly journals Biomechanical Evaluation of a Modified Internal Brace Construct for the Treatment of Ulnar Collateral Ligament Injuries

2019 ◽  
Vol 7 (10) ◽  
pp. 232596711987413 ◽  
Author(s):  
Ekaterina Urch ◽  
Orr Limpisvasti ◽  
Neal S. ElAttrache ◽  
Yasuo Itami ◽  
Michelle H. McGarry ◽  
...  
Keyword(s):  
Ulnar Collateral Ligament ◽  
Reconstruction Technique ◽  
Full Extension ◽  
Failure Characteristics ◽  
Intact State ◽  
The Sublime ◽  
Load To Failure ◽  
Internal Bracing ◽  
Internal Brace ◽  
Reconstruction Group

Background: Ulnar collateral ligament (UCL) repair augmented with the “internal brace” construct for the management of acute UCL injuries has recently garnered increasing interest from the sports medicine community. One concern with this technique is excessive bone loss at the sublime tubercle, should revision UCL reconstruction be required. In an effort to preserve the bony architecture of the sublime tubercle, an alternative internal brace construct is proposed and biomechanically compared with the gold standard UCL reconstruction. Hypothesis: The internal brace repair construct will restore valgus laxity and rotation to its native state and demonstrate comparable load-to-failure characteristics with the 3-strand reconstruction technique. Study Design: Controlled laboratory study. Methods: For this study, 8 matched pairs of fresh-frozen cadaveric elbows were randomized to undergo either UCL reconstruction with the 3-ply docking technique or UCL repair with a novel internal brace construct focused on augmenting the posterior band of the anterior bundle of the ligament (modified repair-IB technique). Valgus laxity and rotation measurements were quantified through use of a MicroScribe 3DLX digitizer at various flexion angles of the native ligament, transected ligament, and repaired or reconstructed ligament. Laxity testing was performed from maximum extension to 120° of flexion. Each specimen was then loaded to failure, and the method of failure was recorded. Results: Valgus laxity was restored to the intact state at all degrees of elbow flexion with the modified repair-IB technique, and rotation was restored to the intact state at both full extension and 30°. In the reconstruction group, valgus laxity was not restored to the intact state at either full extension or 30° of flexion ( P < .001 and P = .004, respectively). Laxity was restored at 60° of flexion, but the elbow was overconstrained at 90° and 120° of flexion ( P = .027 and P = .003, respectively). In load-to-failure testing, the reconstruction group demonstrated significantly greater yield torque (19.1 vs 9.0 N·m; P < .005), yield angle (10.2° vs 5.4°; P = .007), and ultimate torque (23.9 vs 17.6 N·m; P = .039). Conclusion: UCL repair with posterior band internal bracing was able to restore valgus laxity and rotation to the native state. The construct exhibited lower load-to-failure characteristics when compared with the reconstruction technique. Clinical Relevance: In selected patients with acute, avulsion-type UCL injuries, ligament repair with posterior band internal bracing is a viable alternative surgical option that, by preserving bone at the sublime tubercle, may decrease the complexity of future revision procedures.

scholarly journals Is the Independent Tape Reinforcement a valid technique to reduce the rerupture rate of ACL reconstructions? A technical instruction and case series with 2-year follow up

2020 ◽  
Vol 8 (5_suppl4) ◽  
pp. 2325967120S0030
Author(s):  
Stefan Schneider ◽  
René Kaiser ◽  
Ansgar Ilg ◽  
Johannes Holz
Keyword(s):  
Acl Reconstruction ◽  
Case Series ◽  
Technical Instruction ◽  
Clinical Instability ◽  
Internal Bracing ◽  
Internal Brace ◽  
Prospective Case Series ◽  
One Year ◽  
A Minor ◽  
Proprioceptive Function

Aims and Objectives: Although there is an ongoing development in ACL reconstruction techniques, a rerupture rate up to 20% still is discussed in the literature. Is the ACL reconstruction using a quadriple semitendinosus in combination with a polyurethane tape reinforcement a valid technique to reduce the retare rate? A clinical trial with 35 Patients compared to 320 patients using an isolated semitendinosus reconstruction without internal bracing. Materials and Methods: Additionally, to the quadruple semitendinosus technique with cortical button fixation, the transplant is parallelly stabilized by a polyurethane tape which is individually fixed in the femoral button. The tape secures the transplant during the remodeling episode since repeated small tensions on the transplant during this time are discussed as a reason for a rerupture. In this prospective case series 35 patients were treated with this technique, reexamined and VAS, Tegner, KOOS Jr. and SANE are preoperatively, two and six weeks, three and six month and after one, two and five years recorded using a PROMS system. Clinical instability and proprioceptive function were also surveyed at these timepoints. The results and rerupture rates were compared with 320 patients of our database who underwent a comparable reconstruction without using the internal brace. Patients with fractures and multi-ligament injuries were excluded. Results: Until now no reruptures were reported, there are no significant subjective or objective differences compared to the group without internal bracing. The two years results are pending. Preoperatively the VAS score was 2.2 +/- 2.0. Two weeks after the surgery 2.1 +/- 1.8 and one year postoperatively 0.5 +/- 0.7. Tegner score preoperatively: 4.6 +/- 2.7 after one year 4.7 +/- 3.0. KOOS jun. improves in both groups around 15%. Conclusion: Until now the ACL reconstruction using an internal brace seems to be a safe and effective technique. Biomechanical studies show beneficial stabilizing results and a minor rerupture rate might be possible due to reduced microlesions during the remodeling period. The study is still ongoing, longtime results are pending.

Internal bracing in hallux valgus reconstruction

2017 ◽  
Vol 23 ◽  
pp. 117-118
Author(s):  
C. Kinast ◽  
M. Karray
Keyword(s):  
Hallux Valgus ◽  
Internal Bracing

Soil Parameter Identification Based on Field Monitoring Value of Displacement and Stress in Pit Retaining Structure

2011 ◽  
Vol 90-93 ◽  
pp. 323-327
Author(s):  
Fei Wang ◽  
Jian Xue Song
Keyword(s):  
Yellow River ◽  
Structure Design ◽  
Soil Reaction ◽  
Equilibrium Equations ◽  
Steel Pipes ◽  
Retaining Structure ◽  
Axial Forces ◽  
Reinforced Concrete Piles ◽  
Internal Bracing ◽  
Set Up

Parameter-M is the proportion factor of horizontal soil reaction when the soil is compressed horizontally, and the corresponding method of pit retaining structure analysis is named as M-method. M-method is widely used to determine the working state of pit retaining structures in China, however, parameter-M varies significantly when deduced by different approaches. An analysis unit is chosen in the subway station pit in Zhengzhou, center of China, on the bank of Yellow River. The retaining structure consists of reinforced concrete piles, internal bracing struts made of steel pipes. The horizontal displacements of retaining piles and the axial forces in pipe bracing struts are monitored in-situ. Then, calculation assumption is taken as that during the elastic deformation stage, parameter-M for each soil keeps constant. Then a series of equilibrium equations of forces acting on retaining structure are set up to determine the values of M for each soil corresponding to deferent stages of excavation. When the identified values of M are applied in the later projects, it shows the validity and accuracy of the method. Precise values of M are applied in the similar geological sites to optimize the retaining structure design.

Calculation of Pressure and Density in Solar Power Plant Chimneys

2003 ◽  
Vol 125 (1) ◽  
pp. 127-129 ◽  
Author(s):  
Theodor W. von Backstro¨m
Keyword(s):  
Power Plants ◽  
Average Density ◽  
Wall Friction ◽  
Solar Power Plant ◽  
Calculation Methods ◽  
Solar Chimney ◽  
Flow Area ◽  
Density Distributions ◽  
Internal Bracing ◽  
Mach Numbers

This technical brief develops calculation methods for the pressure drop in very tall chimneys, as in solar chimney power plants. The methods allow for density and flow area change with height, for wall friction and internal bracing drag. It presents equations for the vertical pressure and density distributions in terms of Mach number. One of these is a generalization of the adiabatic pressure lapse ratio equation to include flow at small Mach numbers. The other is analogous to the hydrostatic relationship between pressure, density, and height, but extends it to small Mach numbers. Its integration leads to an accurate value of the average density in the chimney.

Internal Bracing Augmentation for Scapholunate Interosseous Ligament Repair: A Cadaveric Biomechanical Study

2020 ◽  
Vol 45 (10) ◽  
pp. 985.e1-985.e9 ◽  
Author(s):  
Il-Jung Park ◽  
Mauro Maniglio ◽  
Steven S. Shin ◽  
Dohyung Lim ◽  
Michelle H. McGarry ◽  
...  
Keyword(s):  
Biomechanical Study ◽  
Ligament Repair ◽  
Interosseous Ligament ◽  
Internal Bracing

XV.—Experiments and Observations on Crustacea: Part IV. Some Structural Features Pertaining to Glyptonotus

1918 ◽  
Vol 37 ◽  
pp. 246-303 ◽  
Author(s):  
John Tait
Keyword(s):  
Colour Change ◽  
Structural Features ◽  
The Body ◽  
Secondary Development ◽  
Structural Peculiarities ◽  
Internal Bracing ◽  
University Of Edinburgh ◽  
Internal Volume ◽  
The Cost ◽  
The University

SUMMARY1. Advantage has been taken of the large size of Glyptonotus to study certain structural features, especially skeletal, which cannot be so readily investigated in smaller isopods. Where possible, an attempt has been made to correlate structural peculiarities with functional use.2. The Legs.—The peculiar articulation, analogous to a spheroidal bony joint, between the coxopodites and basipodites of the thoracic limbs, is described in detail. A comparison is instituted between the full flexion-complex of the isopodan and of the brachyuran walking limb. The peræopods are contrasted with the gnathopods of Glyptonotus, and functional peculiarities pertaining to each group of limbs are discussed.3. The Peræon.—The medial split in the thoracic sternites is interpreted as a device for allowing of distension of the body, say, after a meal. The arched thoracic somites articulate with each other in a special way, not by a crossed articulation, like that in a pair of scissors, but by a rocker articulation, like that in a spring clothes-pin; this combination of arch and rocker articulation is interpreted as a means of preventing change of internal volume in body flexion. The phenomena pertaining to the moulting process throw light upon the numerical grouping of the successive fusions of coxæ with somites which have occurred in isopods.4. The Pleon.—The pleon consists of four movable portions, the last four of the seven constituent pieces being welded together. Of the four fused segments, only the first has a complete sternite, like those of somites 1, 2, and 3. In the skeleton of the pleonic floor a wide opening is thus left posteriorly, which is closed by a diaphragm of soft cuticle; part of this diaphragm is elevated into two long parallel folds or valves, one on each side of the anus.5. The Pleonic Appendages.—The protopodite of each of the anterior three pleopods is composed of two complete pieces; a third piece more proximally situated is interpreted, not as evidence of an additional primitive segment, but as a secondary development in the articular membrane. The uropods have acquired their present position by a forward rotation of the sternite of the sixth primitive somite, and the gill-directed surface of the uropod corresponds to the posterior surface of the pleopods. It follows that what has commonly been called the exopodite of the uropod is a real exopodite. In addition to the pleopods, the internal walls of the whole uropodal chamber subserve a respiratory function.6. The Cephalosome.—Two thoracic somites are fused with the head to form a cephalosome. By welded inturnings of the anterior border of these two and of the posterior border of the mandibular cephalic somite a strong internal bracing is formed. The tergites of the maxillary somites have apparently disappeared from the dorsal aspect of the cephalon; the endo-skeletal structures described by Lloyd in Bathynomus, and by him named “sternal alæ,” functionally correspond to these tergites in so far as they serve for attachment of muscles for the maxillæ. These “sternal alæ” (which also appear to form a covering for the maxillary excretory gland) with other ventral endoskeletal structures are described in detail. All are rigidly fixed to the maxillo-sternal framework, which is capable of independent movement.7. The Alimentary Canal.—The foregut of Glyptonotus is not a gastric mill; the muscle-provided involutions of its wall (exactly analogous to those in Bathynomus) are concerned simply with onward propulsion of the food, i.e. with swallowing. Between the midgut and the hindgut, the two opposed ends of which are not in exact alignment, is a strongly contractile part of the gut, which acts as a sphincter. The hepatic cæca could not be examined. Glyptonotus is carnivorous.8. The Eyes and the Chromatophore-System.—By experiment on colour change of Idotea it has been shown that the eye of this animal acts as a double mechanism, the ventral half being functionally separable from the dorsal. Glyptonotus has retractile chromatophores, and probably undergoes colour change in accordance with différent modes of eye illumination. Its eye is divided into two entirely separate parts, one lying on the dorsal the other on the ventral aspect of the cephalon.The cost of providing the illustrations which accompany this paper was defrayed by a grant from the Earl of Moray Endowment for the promotion of research in the University of Edinburgh; and the expense of preparing the blocks was defrayed by a grant from the Carnegie Trust.I have to record my thanks to Dr W. S. Bruce, not only for the material provided, but for information relating to the quarters inhabited by Glyptonotus.

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