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ObjectiveThis is a retrospective study of 98 diaphyseal forearm fractures in adults, treated by a percutaneous technique with intramedullar Kirchner wires. Materials and methodWe reviewed 64 patients with 98 forearm fractures with...
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ObjectiveThis is a retrospective study of 98 diaphyseal forearm fractures in adults, treated by a percutaneous technique with intramedullar Kirchner wires. Materials and methodWe reviewed 64 patients with 98 forearm fractures with a radiographic follow-up, assessing the presence of pseudoarthrosis or delayed bone union and evaluating functional outcomes with the Anderson and the Disability of the Arm, Shoulder and Hand scale. ResultsClinical and radiological bone union was achieved in an average of 12 weeks. We obtained 77% of excellent and good results following Anderson's scale. There were 4 cases of pseudoarthrosis and 6 cases of delayed bone union. ConclusionThis surgical technique provides several advantages, such as a low incidence of complications and a total absence of infections, refractures and iatrogenic neurovascular injuries. It allows a lower hospital stay and a shortening of the surgery time compared with other techniques such as plates and intramedullary nails, that have similar results, in terms of bone union and functional outcomes, as we have verified from the published literature.
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Данные обзорных статей зарубежных и отечественных авторов свидетельствуют о том, что современный стабильно-функциональный о...
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Данные обзорных статей зарубежных и отечественных авторов свидетельствуют о том, что современный стабильно-функциональный остеосинтез позволяет оптимально сочетать сроки сращения отломков костей при переломах и восстановление функции опоры и движения у 85—97% больных [4]. Вместе с тем естественное желание практикующих врачей применять в своей работе последние достижения мировой травматологии, не подкрепленное достаточными знаниями, опытом, наличием необходимого оснащения для обеспечения полноценной диагностики и оперативного лечения, приводит к возникновению ошибок и осложнений внутреннего остеосинтеза, существенно удлиняющих сроки лечения и требующих значительных экономических затрат [1, 3, 5].
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The aim of this study was to retrospectively assess the osteosynthesis material-related morbidity rates of third-generation (3.0) slotplates, and to compare those with the previously researched second-generation (2.0) slotplates.
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With 1% of all skeletal fractures patellar fractures are rare. The majority of cases are caused by adirect trauma to the flexed knee. The diagnosis is made via the injury mechanism as well as the physical and radiological findings...
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With 1% of all skeletal fractures patellar fractures are rare. The majority of cases are caused by adirect trauma to the flexed knee. The diagnosis is made via the injury mechanism as well as the physical and radiological findings. In conventional x-ray imaging the extent of injury often is underrated, which mostly leads to the necessity of acomputed tomography (CT) scan. The aim of the treatment is the reconstruction of the extensor mechanism and the anatomical reconstruction of the articular surface. The type of treatment depends on the fracture type. Tension band wiring still is the most frequently practiced technique. Complications, such as secondary dislocation or migration of the K-wires resulting in revision surgery have been described in up to 30% of the cases. Studies could already show ahigher biomechanical stability of osteosynthesis via cannulated screws. Especially in cases of comminuted fractures, osteosynthesis via alocking plate seems to have several advantages but long-term results are not yet available.
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The external osteosynthesis is one of the methods of healing bone fractures. The idea of external fixators design consists in inserting into the bone fragments elements, which are coupled outside the limb by an element, called the...
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The external osteosynthesis is one of the methods of healing bone fractures. The idea of external fixators design consists in inserting into the bone fragments elements, which are coupled outside the limb by an element, called the frame of the fixator, having the fracture set. The external fixation is based on the principle of " load transfer". The design of a new generation of external fixators ought to employ some methods of mechanical analysis. Selected problems related to the modelling and simulation of physical performance of the unilateral external mechatronic orthopaedic fixator-bone system are presented. The majority of works makes use of the rigid finite element method for analysing the orthopaedic device-bone system. The paper presents some problems regarding mechanics applied in the external osteosynthesis design.
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A review of the literature in 2002, analyzing 13 articles with 895 tibial shaft fractures treated by cast immobilization, fixation with plate and screws, and reamed or unreamed intramedullary nailing, concludes that the combined i...
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A review of the literature in 2002, analyzing 13 articles with 895 tibial shaft fractures treated by cast immobilization, fixation with plate and screws, and reamed or unreamed intramedullary nailing, concludes that the combined incidence of delayed union and nonunion was lower with operative, surgical treatment especially with plate osteosynthesis, than with closed treatment. This incidence was respectively 2.6% with plate fixation, 8.0% with reamed nailing, and 16.7% with unreamed nailing compared with 17.2% with closed treatment. On the contrary, the incidence of superficial infection was most common with plate infection,9.0%, compared with 2.9% for reamed nailing, 0.5% for unreamed nailing, and 0% for closed treatment. The incidence of osteomyelitis was similar for all groups. Rates of reoperations ranged from 4,7% to 23.1%. The dynamic compression plate (DCP) has been used for many years as a method of internal fixation of fractures. A problem that has created concern after plate fixation is the appearance of porous bone under the plate during the course of healing. This has been attributed to disruption of the blood supply near and beneath the plate. In an attempt to address this problem, plate designs that make only limited contact (LC-DCP), point contact (PC-Fix internal fixator), or noncontact plates (NCP) with the underlying bone surface have been designed.
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Operative treatment of long bones and jaw fractures was occasionally proposed during the nineteenth century; essentially, direct suturing of the bony fragments by wire suturing was advocated. It is only since work carried out by S...
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Operative treatment of long bones and jaw fractures was occasionally proposed during the nineteenth century; essentially, direct suturing of the bony fragments by wire suturing was advocated. It is only since work carried out by Sir Arbuthnot Lane but mainly by Lambotte (about 1906) that the technique of osteosynthesis (the term osteosynthesis was created by Lambotte, Lamertin, Bruxelles) has been organized according to principles which consider mechanical as well as biological concepts. A historical review is presented of the various methods which have been proposed to obtain osteosynthesis of the mandible, both before the time of Lambotte and since the introduction by Lambotte of the sound principles of osteosynthesis.
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Background: Comminuted patellar fractures are not rare, and the ideal treatment method remains controversial. The present study was conducted to evaluate effects and compare complications of two different methods used to treat com...
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Background: Comminuted patellar fractures are not rare, and the ideal treatment method remains controversial. The present study was conducted to evaluate effects and compare complications of two different methods used to treat comminuted patellar fractures. Methods: From March 2010 to August 2016, 102 cases of 34-C2 or 34-C3 comminuted patellar fractures were treated at our hospital, wherein patients received two different treatments: titanium cable tension band with cerclage method (group A) and intrafragmentary screws with X-shaped plating technique (group B). At follow-ups, articular step-off, range of motion (ROM), Lysholm scores, time of union, and complications were recorded and analyzed. Radiographic and clinical data as well as rate of complications were statistically analyzed. Results: In total, 87 patients were included in the final analysis (n = 47 in group A and n = 40 in group B). No significant differences were noted in terms of cost of implant, age, gender, rate of 34-C3 fractures, rate of layered inferior pole fractures, postoperative articular step-off and union time. At 2-year follow-up, average Lysholm scores, ROM and rate of complications were (89.0 +/- 4.5), (122 degrees +/- 12 degrees) and (27.7%) in group A and (90.2 +/- 3.9), (124 degrees +/- 11 degrees) and (17.5%) in group B, respectively, with no significant differences (p > 0.05). The mean time of surgery in group B was shorter than that in group A with significant difference (p < 0.05). Conclusions: Treatment using the intrafragmentary screws and plate method for amenable comminuted patellar fractures achieved similar complication rate and favorable functional outcomes at the 2-year follow-up, which was comparable to the titanium cable tension band with cerclage method. Thus, the intrafragmentary screws and plate method is effective, safe and convenient for 34-C2/C3 comminuted patellar fractures, especially appropriate for patients with layered fragments. (C) 2020 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
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