• Title/Summary/Keyword: metal fixation

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Frontotemporal Craniotomy for Clipping of Unruptured Aneurysm Using a Diamond-Coated Thread Wire Saw and Reconstruction Using Calcium Phosphate Cement without Metal Fixation

  • Hiroyuki Koizumi;Daisuke Yamamoto;Hajime Handa;Wakiko Saruta;Satoru Shimizu;Takuichiro Hide;Toshihiro Kumabe
    • Archives of Plastic Surgery
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    • v.50 no.3
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    • pp.248-253
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    • 2023
  • Metal fixation systems for cranial bone flaps cut by a drill are convenient devices for cranioplasty, but cause several complications. We use modified craniotomy using a fine diamond-coated threadwire saw (diamond T-saw) to reduce the bone defect, and osteoplasty calcium phosphate cement without metal fixation. We report our outcomes and tips of this method. A total of 78 consecutive patients underwent elective frontotemporal craniotomy for clipping of unruptured intracranial aneurysms between 2015 and 2019. The follow-up periods ranged from 13 to 66 months. The bone fixation state was evaluated by bone computed tomography (CT) and three-dimensional CT (3D-CT). The diamond T-saw could minimize the bone defect. Only one wound infection occurred within 1 week postoperatively, and no late infection. No pain, palpable/cosmetically noticeable displacement of the bone flap, fluid accumulations, or other complications were observed. The condition of bone fixation and the cosmetic efficacy were thoroughly satisfactory for all patients, and bone CT and 3D-CT demonstrated that good bone fusion. No complication typical of metal fixation occurred. Our method is technically easy and safety, and achieved good mid-term bone flap fixation in the mid-term course, so has potential for bone fixation without the use of metal plates.

Three-dimensional finite element analysis of the stress distribution and displacement in different fixation methods of bilateral sagittal split ramus osteotomy

  • Yun, Kyoung In;Cho, Young-Gyu;Lee, Jong-Min;Park, Yoon-Hee;Park, Myung-Kyun;Park, Je Uk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.5
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    • pp.271-275
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    • 2012
  • Objectives: This study evaluated a range of fixation methods to determine which is best for the postoperative stabilization of a mandibular osteotomy using three-dimensional finite element analysis of the stress distribution on the plate, screw and surrounding bone and displacement of the lower incisors. Materials and Methods: The model was generated using the synthetic skull scan data, and the surface model was changed to a solid model using software. Bilateral sagittal split ramus osteotomy was performed using the program, and 8 different types of fixation methods were evaluated. A vertical load of 10 N was applied to the occlusal surface of the first molar. Results: In the case of bicortical screws, von-Mises stress on the screws and screw hole and deflection of the lower central incisor were minimal in type 2 (inverted L pattern with 3 bicortical repositioning screws). In the case of plates, von-Mises stress was minimal in type 8 (fixation 5 mm above the inferior border of the mandible with 1 metal plate and 4 monocortical screws), and deflection of the lower central incisor was minimal in types 6 (fixation 5 mm below the superior border of the mandible with 1 metal plate and 4 monocortical screws) and 7 (fixation 12 mm below the superior border of the mandible with 1 metal plate and 4 monocortical screws). Conclusion: Types 2 and 6 fixation methods provide better stability than the others.

The study of stability of absorbable internal fixation after mandibular bilateral sagittal split ramal osteotomy (하악골 양측 하악지 시상분할 골절단술 후 흡수성 고정의 안정성에 관한 연구)

  • Choi, Byoung-Hwan;Park, Su-Won;Jang, Soo-Mi;Son, Han-Na;Park, Bong-Chan;Son, Jang-Ho;Cho, Yeong-Cheol;Sung, Iel-Yong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.4
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    • pp.255-261
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    • 2010
  • Introduction: To evaluate the skeletal stability after a bilateral sagittal split osteotomy (BSSO) setback of the mandible fixed with a biodegradable internal fixation device or metal internal fixation device. Materials and Methods: Thirty consecutive patients underwent mandibular setback via BSSO. Fifteen patients were fixed with a biodegradable internal fixation device or metal internal fixation device respectively. Posteroanterior (PA) and lateral cephalograms were taken preoperatively and at two days, 5.5 months and 14.5 months postoperatively. The relevant skeletal points were traced and digitized to evaluate the skeletal changes postoperatively. The relapse rates were analyzed and compared statistically. Results: There was no statistically significant differences in postoperative stability between the two groups.(P<0.05) Conclusion: The biodegradable internal fixation device may make an effective device alternative to a metal internal fixation device for setback BSSO.

Clinical usefulness of fixation of absorbable implants with cyanoacrylate in comminuted fractures of the maxilla

  • Ju, Gang San;Son, Kyung Min;Choi, Woo Young;Cheon, Ji Seon
    • Archives of Craniofacial Surgery
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    • v.20 no.4
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    • pp.233-238
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    • 2019
  • Background: The open reduction of craniofacial bone fractures requires internal fixation using metal plates and screws, which have been considered the gold standard. However, metal implants pose a risk of palpation, protrusion, and foreign body reaction, and they may require an additional operation for removal. Recently, good results have been reported for absorbable implants which complement the disadvantages of metal implants. This study presents the results of using absorbable mesh, plates, and screws with cyanoacrylate for more accurate and firmer fixation of comminuted fractures of the maxilla. Methods: In total, 235 patients underwent operations for comminuted fractures of the maxilla. From January 2012 to December 2014, absorbable mesh and screws were used in 114 patients, while from January 2015 to December 2017, absorbable mesh, plates, and screws with cyanoacrylate were used in 121 patients. Open reduction of the bone fragments was performed, after which absorbable implants were accurately molded and fixed by screws. Results: All patients underwent postoperative computed tomography scans, which showed highly accurate reduction and firm fixation in the patients who underwent procedures using absorbable implants, screws, and cyanoacrylate. There were no postoperative complications or cases of abnormal facial contour. Conclusion: When absorbable implants and screws are used for maxillary fractures, no additional surgery to remove the metal plate is required. In addition, the use of cyanoacrylate enables accurate and firm fixation of the tiny bone fragments that cannot be fixed with screws.

Changes of Nitrogen Fixation Activity and Heavy Metal Accumulation of Vicia amoena Community from Kumho Riverside (금호강유역 갈퀴나물군락의 중금속 축적과 질소고정 활성의 변화)

  • 박태규;박용목;송은주;송승달
    • The Korean Journal of Ecology
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    • v.22 no.3
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    • pp.131-137
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    • 1999
  • This study was carried out to investigate the activity of nitrogen fixation and accumulation of heavy metal and inorganic matter in Vicia amoena community at lower region in Kumho riverside, including Youngchon, Chimsangyo, Paldalgyo, Talseochon and Kumhogyo. The contents of inorganic matter and heavy metal of Kumho riverside soil increased in the down stream in each organ of the plant growing in the riverside. Generally, V. amoena community showed rapid growth of shoot and high value of Top/Root ratio. V. amoena community showed higher water content of shoot at late growth stage and higher chlorophyll content. The root nodule of V. amoena community appeared in April and increased by 0.30, 0.27, 0.24, 0.06 and 0.14 g/plant, and nitrogen fixation activity of nodule attained 20.1, 16.8, 15.4, 8.5 and 5.3 μmol·C₂H₄·g fw nodule/sup -1/·h/sup -1/ for non-contaminated area Youngchon, Chimsangyo, Paldalgyo, Talseochon and Kumhogyo, respectively, in June:. Nodule formation and nitrogen fixation activity were reduced in the down stream by the soil contamination and heavy metal accumulation and showed minimum values. at Talseochon and Paldalgyo. V. amoena showed growth adaptation against heavy metal toxicity by restricting heavy metal such as Pb, Cu, Zn, Fe from transport, and by accumulating high Ca ion in shoot, nitrogen and phosphorus in root at late growth stage than those at early one, respectively, but total heavy metal per plant showed higher values in shoot than those in root by high T/R ratio of plant growth.

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Additional fixation using a metal plate with bioresorbable screws and wires for robinson type 2B clavicle fracture

  • Shin, Woo Jin;Chung, Young Woo;Kim, Seon Do;An, Ki-Yong
    • Clinics in Shoulder and Elbow
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    • v.23 no.4
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    • pp.198-202
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    • 2020
  • Simple clavicle fractures can achieve satisfactory results through conservative treatment, and the less frequency of nonunion. Non-union or malunion can occur in displaced clavicle fractures or comminuted shaft fractures. Treatment of displaced comminuted clavicle shaft fractures is performed by holding together the free fragments with interfragmentary screws or wires and fixing them to the clavicle with a plate. Therefore, we performed interfragmentary fixation using open reduction and internal fixation with bioresorbable screws (Mg-Ca alloy, Resomet bioresorbable bone screw; U&I Corp.) and bioresorbable wires (Mg-Ca alloy, Resomet bioresorbable K-wire and pin, U&I Corp.) for displaced comminuted clavicle fractures (Robinson type 2B) and additionally used a metal plate. We expected decreased irritation and infection due to absorption after surgery. We report four cases that were treated in this way.

Regulation of heavy metal and Growth Adaptation of Meliotus suaveolens Seedlings Treated with Pb (Pb처리에 따른 전동싸리 유식물의 생장적응과 증금속의 조절)

  • 박태규;송승달
    • The Korean Journal of Ecology
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    • v.21 no.3
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    • pp.179-186
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    • 1998
  • Effects of lead(Pb) and calcium(Ca) on growth responses, accumulation of heavy metals and nitrogen fixation activities of Melilotus suaveolens seedlings were quantitatively analyzed during growing period. Pb contents of the root treated with 30, 100 ppm Pb and 100 ppm Pb added 100 ppm Ca were 54.1, 90.9 and 26.1 folds higher than that of the control, respectively, at pH 4.2 in 28th days, and heavy metal content of plant increased with increasing of pH and Pb concentration. The melilot plant was classified as a Pb accumulator by higher accumulation of Pb in shoot than that of root. Pb treatments resulted in inhibiton of height and chlorophyll contet, and Ca treatment increased height and chlorophyll content insignificantly at pH 4.2 in 28 days. The plant biomass reduced 49, 60 and 54% at pH 4.2 and 47,53 and 50% at pH 6.5, respectively, by 30, 100 ppm Pb and 100 ppm Pb added 100 ppm Ca treatment. Specific nitrogen fixation of nodules reduced 68.4% and 46.6% by 100 ppm Pb treatment and 3.7% and 24.9% by 100 ppm Pb added 100 ppm Ca at pH 4.2 and pH 6.5, respectively, so Ca inhibited significantly Pb activity and toxicity in acdic pH. Nodule formation were reduced to 33, 33 and 50% at pH 4.2 and 50, 33 and 38% at pH 6.5 by 30, 100 ppm Pb and 100 ppm Pb added 100 ppm Ca, respectively.

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CLINICAL AND RADIOLOGICAL COMPARISON BETWEEN TITANIUM AND BIODEGRADABLE MINIPLATE MONOCORTICAL OSTEOSYNTHESIS IN MANDIBULAR ANGLE FRACTURES (Monocortical Osteosynthesis 이론에 따른 하악골 우각부 골절 수술시 Titanium miniplate와 Biodegradable miniplate의 임상적, 방사선학적 비교 연구)

  • Choi, Eun-Joo;Nam, Woong;Jung, Young-Soo;Kim, Ki-Ho;Kim, Hyung-Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.3
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    • pp.222-225
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    • 2006
  • The treatment objective of mandibular fracture is a return to normal function. According to Champy, a rigid fixation of mandibular angle fracture is performed by using 4 or 6 holes titanium miniplates on the external oblique ridge of mandible. However, the limitations of metal plate such as hypersensitivity, interference with the cranio-facial growth of growing child, secondary bone resorption around the plate, foreign body reaction, declination of primary callus formation, and bone atrophy due to the lack of normal stress reaction of the bone have been reported. Recently, biodegradable miniplate has been introduced and used as an alternative to the metal plate despite its lower strength than that of the titanium plate and the side effect caused by the resorption in the body. In this study, 61 patients diagnosed as mandibular angle fracture and treated from Jan. 1998 to Dec. 2004 in our department have been reviewed. Metal plate fixation was used in 50 patients and biodegradable plate fixation in 11 patients on the external oblique ridge around the fractured mandibular angle according to the principle of monocortical osteosynthesis by Champy. We compared the incidence of side effects and the degree of bony union at the mandibular inferior border in two different fixation methods. In conclusion, we have found that one miniplate regardless of matter could provide enough strength to grasp bony fragments of the tension site and compress the inferior border of mandible without any complications.

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.