• Title/Summary/Keyword: internal fixation

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Intramedullary fibula strut bone allograft in a periprosthetic humeral shaft fracture with implant loosening after total elbow arthroplasty

  • Jo, Young-Hoon;Lee, Seung Gun;Kook, Incheol;Lee, Bong Gun
    • Clinics in Shoulder and Elbow
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    • v.23 no.3
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    • pp.152-155
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    • 2020
  • Periprosthetic fracture after total elbow replacement surgery is a difficult complication to manage, especially when it comes together with implant loosening. If stem revision and internal fixation of the periprosthetic fracture are performed simultaneously, this would be a very challenging procedure. Most of total elbow replacement implants are cemented type. Cement usage at periprosthetic fracture site may interfere healing of fractured site. Authors underwent internal fixation with use of locking plate and cerclage wire for periprosthetic fracture, allogenous fibular strut bone inserted into the humerus intramedullary canal allowing the fractured site to be more stable without cement usage. At 10-month follow-up, the complete union and good clinical outcome was achieved. We present a novel technique for treating periprosthetic fracture with implant loosening after total elbow replacement surgery, using intramedullary allogenous fibula strut bone graft.

APPLICATION OF FIBRIN ADHESIVE IN DISK REPLACEMENT AFTER MENISCECTOMY (관절원판 절제술후 중간삽입물 고정에 피브린 접착제의 응용)

  • Chung, Hoon;Kim, Hyeong-Keun;Kim, Young-Soo;Yu, Ki-Jun;Ahn, Byoung-Guen
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.14 no.3
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    • pp.175-184
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    • 1992
  • Meniscectomy is indicated for the internal derangement of disk with perforation and gross morphological changes, nonreactive to conservative treatment procedures. After the meniscectomy, permanent disk replacement can be followed. Variable materials have been introduced for disk replacement. Of them, relatively harder replacing materials should have been fixed with surgical wire only. This poor fixation method provide inadequate retentive force and conclusively can be attributed to postoperative noise, poor prognosis. We tried to use biocompatible fibrin adhesive in order to obtain additional fixation force in the method above mentioned and treated two patients with the late stage of internal derangement of disk In both cases, satisfactory results were obtained.

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Open reduction and internal fixation of metacarpal fractures using a thermoplastic splint as a surgical instrument

  • Papavasiliou, Theodora;Park, Paul Dain;Tejero, Ricardo;Allain, Niklaas;Uppal, Lauren
    • Archives of Plastic Surgery
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    • v.48 no.4
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    • pp.384-388
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    • 2021
  • Adequate positioning of the hand is a critical step in hand fracture operative repair that can impact both the clinical outcome and the efficiency of the operation. In this paper, we introduce the use of a thermoplastic splint with an added thumb stabilizing component as a means to increase the surgeon's autonomy and to streamline the patient care pathway. The thermoplastic splint is custom fabricated preoperatively by the specialist hand therapist. The splint is used prior, during, and post operation with minimal modification. The thumb component assists maintaining the forearm in a stable pronated position whilst drilling and affixing metal work. This is demonstrated in the video of removal of metal work and open reduction and internal fixation of a metacarpal fracture.

ATOM technique: Anatomic reduction using screw-wire Traction for Open reduction and internal fixation of Mandibular fractures

  • Ingole, Pranav D.;Rajguru, Jignesh G.;Budhraja, Nilima J.;Shenoi, Ramakrishna S.;Karmarkar, Jui S.;Dahake, Rahul N.
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.2
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    • pp.122-124
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    • 2022
  • Various techniques are well documented to obtain anatomic reduction, such as reduction forceps, manual reduction, or a combination of these methods. However, these techniques have inherent drawbacks. We propose a new intra-operative technique for anatomic reduction using screw-wire traction for open reduction and internal fixation of mandibular fractures.

Comparison of the Results after the Surgical Treatments of the Trimalleolar Ankle Fractures (족관절 삼과 골절에 대한 치료 후 결과 비교)

  • Rha, Jong-Deuk;Park, Hyun-Soo;Lim, Chang-Suk;Jang, Yeung-Soo;Park, Sang-Won;Chung, Tae-Won;Jeon, Yong-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.86-91
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    • 2004
  • Purpose: To evaluate the methods and results of the surgical treatment in the trimalleolar fracture of the ankle. Materials and Methods: We analysed the results of the ankle trimalleolar fracture which were treated with open reduction and internal fixation from January 1999 till September 2003. There were 45 patients who had at least six months follow up, 16 men, and 29 women. We have analysed the mechanism of injury, methods of operation and postoperative complications. Results: The results were assessed on ankle AP, lateral and mortise X-rays and retrospective chart review. There were 30 supination-external rotation, 13 pronation-external rotation, 2 pronation-abduction in the mechanism of injury by Lauge-Hansen classification. Cases of the posterior malleolar fracture which involved more than 25% of the weight bearing surface were 7 (15.6%). Medial malleolar mono-fixation was done in 5 cases, fibular mono-fixation in 2 cases, bimalleolar fixation in 32 cases, trimalleolar fixation in 6 cases. 38 cases (84.4%) were good or excellent in clincal assessment and 39 cases (86.7%) were good or excellent in radiological assessment according to the criteria of the Meyer. There was no difference of results among the surgical treatment methods. Conclusion: The results of our study indicate that the rigid fixation with early ankle motion and weight bearing is needed in ankle trimalleolar fracture. But minimal fixation is not bad in slight displaced fracture. Both anterior approach and posterior approach were useful methods to stabilization the posterior malleolar fracture. And pre-operative evaluation to detect the hidden soft tissue injuries and fracture mechanism is very important to avoid the failure.

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Is All Anterior Oblique Fracture Orientation Really a Contraindication to Anterior Screw Fixation of Type II and Rostral Shallow Type III Odontoid Fractures?

  • Cho, Dae-Chul;Sung, Joo-Kyung
    • Journal of Korean Neurosurgical Society
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    • v.49 no.6
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    • pp.345-350
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    • 2011
  • Objective : It is debatable whether an anterior oblique fracture orientation is really a contraindication to anterior odontoid screw fixation. The purpose of this study was to investigate the feasibility of anterior odontoid screw fixation of type II and rostral shallow type III fracture with an anterior oblique fracture orientation. Methods : The authors evaluated 16 patients with type II and rostral shallow type III odontoid fracture with an anterior oblique fracture orientation. Of these 16 patients, 8 (group 1) were treated by anterior odontoid screw fixation, and 8 (group 2) by a posterior C1-2 arthrodesis. Results : Of the 8 patients in group 1, seven patients achieved solid bone fusion (87.5%), and one experienced screw back-out of the C-2 body two months after anterior screw fixation. All patients treated by posterior C1-C2 fusion in group 2 achieved successful bone fusion. Mean fracture displacements and fracture gaps were not significantly different in two groups. (p=0.075 and 0.782). However, mean fracture orientation angles were $15.3{\pm}3.2$ degrees in group 1, and $28.6{\pm}8.1$ degrees in group 2 (p=0.002), and mean fragment angulations were $3.2{\pm}2.1$ degrees in group 1, and $14.8{\pm}3.7$ degrees in group 2 (p=0.001). Conclusion : Even when the fracture lines of type II and rostral shallow type III fractures are oriented in an anterior oblique direction, anterior odontoid screw fixation can be feasible in carefully selected patients with a relatively small fracture orientation angle and relatively small fragment angulation.

Treatment of Metacarpal Bone Fracture Using Biodegradable Plates and Screws (흡수성 고정판과 나사를 이용한 중수골 골절의 치료)

  • Cho, Jeong-Mok;Eun, Seok-Chan;Baek, Rong-Min
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.458-464
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    • 2011
  • Purpose: Metacarpal fractures are common hand injury that may require operative intervention to ensure adequate reduction and stabilization. Traditionally, titanium miniplate was used for rigid fixation of bone fractures. However, the use of permanent plate lends itself to multiple complications such as infection, exposure of the hardware, tendon adhesions, tendon rupture, prolonged pain, bony atrophy and osteoporosis (stress shielding), metal sensitization, and palpation under the skin. This study evaluated the usefulness and stability of biodegradable plates and screws for treatment of metacarpal bone fractures. Methods: There was 17 patients who had surgery for metacarpal bone fracture from April 2007 to June 2010. All patients had open reduction and internal fixation. We used absorbable plates and screws (Inion CPS$^{(R)}$) for internal fixation. Postoperative results were assessed with x-ray. Stability of plates and screws, healing process and its complications were observed by clinical and radiographic assessment. Results: All patients were successfully reduced of bone fracture, and fixations with absorbable plates and screws were stable. The mean follow up period was 7.1 months. 2 patients complained postoperative pain, but they were relieved with analgesics. All patients experienced transient stiffness, but they were relieved with active assistive range of motion after removal of splint. No patients suffered complications which could be occurred by using metallic plate. Conclusion: There was no critical complications such as re-fracture or nonunion among patients. No patients suffered side effects related with metallic implants. Biodegradable implants can offer clinically stable and attractive alternative to metallic implants to stabilize metacarpal bone fractures in the hand.

A Review of Subbrow Approach in the Management of Non-Complicated Anterior Table Frontal Sinus Fracture

  • Kim, Jeenam;Choi, Hyungon
    • Archives of Craniofacial Surgery
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    • v.17 no.4
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    • pp.186-189
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    • 2016
  • Frontal sinus fractures, particularly anterior sinus fractures, are relatively common facial fractures. Many agree on the general principles of frontal fracture management; however, the optimal methods of reduction are controversial. The subbrow approach enables accurate reduction and internal fixation of the fractures in the anterior table of the frontal sinus by allowing direct visualization of the fracture. Given the surgical success in reduction and rigid fixation, patient satisfaction, and aesthetic benefits, the transcutaneous approach through a subbrow incision is superior to other reduction techniques used in the management of an anterior table frontal sinus fracture.

Zygomaticomaxillary complex fracture after two-jaw surgery

  • Park, Joseph Kyu-hyung;Kim, Sang Wha
    • Archives of Craniofacial Surgery
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    • v.21 no.5
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    • pp.301-304
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    • 2020
  • Orthognathic surgeries often utilize rigid fixation for stabilization of the osteotomy site. The longterm fate of rigid fixations is still under investigation, and whether they should be routinely removed is under debate despite their low complication rates. Here, we report a case where a 26-year-old man suffered high-velocity trauma to his face 7 years after a two-jaw surgery. Computed tomography examination revealed a zygomaticomaxillary complex fracture, and open reduction and internal fixation was performed along with anterior maxillary wall reconstruction using absorbable mesh. Intraoperative examination revealed a broken L-shaped titanium plate near the fracture site with multiple bony fragments near each titanium screw. The rigid titanium system may have caused comminution of the fracture pattern, worsening the severity of the fracture.