• Title/Summary/Keyword: Plate fixation

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The Role of Angled Blade Plate in Treatment of Bone Tumor Occurred in Femur (대퇴골 골종양의 치료에 있어서의 Angled Blade Plate의 역할)

  • Kim, Tai-Seung;Kang, Chang-Nam;Chung, Ung-Seo
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.175-182
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    • 2005
  • Purpose: Bone tumor occurred in femur frequently involve proximal intertrochanteric region or distal metaphyseal region. Sometimes, the pathologic fracture can happen according to the size of tumor due to the substantial biomechanical stresses. Therefore, the prognosis can be improved biomechanically by the angled blade plate considering the anatomic configuration after the excision of tumor. Materials and Methods: Between October 1991 and April 2005, there were a total of 16 patients(17 cases) who were treated by the excision of tumor and internal fixation with the angled blade plate for bone tumor occurred in femur. After the excision of tumor, we filled the cavity by bone graft in 11 cases and bone cement in 6 cases. The internal fixation was used by angled blade plate in all cases. Result: The average follow-up time was 55.5 months(6-144 months) in 16 patients(17 cases). No metal failure occurred after the operation. Reoperation was performed in 4 cases due to tumor recurrence, and the internal fixation was firm until that. Conclusion: The angled blade plate can prevent the fracture until grafted bone incorporated to host bone, and protect fragile connection between cement and host bone.

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Clinical Features of Distal Tibial Fractures and Treatment Results of Minimally Invasive Plate Osteosynthesis (원위 경골 골절의 임상양상 및 최소 침습적 금속판 고정술의 결과)

  • Kim, Weon-Yoo;Ji, Jong-Hun;Kwon, Oh-Soo;Park, Sang-Eun;Kim, Young-Yul;Kil, Ho-Jin;Jeong, Jae-Jung
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.2
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    • pp.94-100
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    • 2012
  • Purpose: The purpose of this study is to analyze the clinical features of distal tibia fractures and to evaluate the treatment outcomes of minimally invasive plate osteosynthesis (MIPO). Materials and Methods: From January 2004 to December 2009, 84 cases of 81 patients treated with plate fixation for distal tibia fracture were enrolled in this retrospective review. We investigated age, sex, injury mechanism, fracture patterns, and complications, and the clinical features were analyzed. To evaluate the treatment outcomes of MIPO, we divided into two groups. MIPO group consisted of 55 patients were treated with MIPO technique and conventional group consisted of 18 patients were treated with open reduction and internal fixation with conventional anterolateral plating. The results were compared between two groups by assessing bony union time, operation time, amount of blood loss, range of ankle motion, clinical score by American Orthopaedic Foot and Ankle Society (AOFAS) score, and post-operative complications. Results: The mean age of 81 patients with distal tibia fracture was 54.8 years. According to AO classification, A1:2:3 were 16, 20, 16 patients, B1:2:3 were 2, 8, 7, C1:2:3 were 1, 3, 11 patients. According to injury mechanism, slip down injury was patients, traffic accident was 26, fall from height injury was 14 patients respectively. The type A fractures were lower energy trauma and more older patients. The type C fractures were higher energy trauma and younger patients. MIPO group was better than conventional group in operative time, blood loss, bony union time, and ankle joint motion. In complications, MIPO group showed no nonunion and infection, one malunion, one skin necrosis, nine skin irritations, and one screw breakage. Conventional group showed two nonunion, four infections, two skin necrosis, and one metal failure. Conclusion: Distal tibial fractures caused by low energy trauma were on the increase. Minimal invasive plate osteosynthesis was shorter bony union time and operation time, less blood loss, and larger ankle motions than conventional open reduction and plate fixation.

Straight-Forward versus Bicortical Fixation Penetrating Endplate in Lumbosacral Fixation-A Biomechanical Study

  • Karakasli, Ahmet;Acar, Nihat;Uzun, Bora
    • Journal of Korean Neurosurgical Society
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    • v.61 no.2
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    • pp.180-185
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    • 2018
  • Objective : Many lumbosacral fixation techniques have been described to offer a more screw-bone purchase. The forward anatomical fixation parallel to the endplate is still the most preferred method. Literature revealed little knowledge regarding the mechanical stability of lumbosacral trans-endplate fixation compared to the traditional trans-pedicular screw fixation method. The aim of this study is to assess the pull-out strength of lumbosacral screws penetrating the end plate and comparing it to the conventional trans-pedicular screw insertion method. Methods : Eight lumbar and eight sacral vertebrae, with average age 69.4 years, Left pedicles of the 5th lumbar vertebrae were used for trans-endplate screw fixation, group 1A, right pedicles were used for anatomical trans-pedicular screw fixation, group 1B. In the sacral vertebrae, the right side S1 pedicles were used for trans-endplate fixation, group 2A, left side pedicles were used for anatomical trans-pedicular screw fixation, group 2B. The biomechanical tests were performed using the axial compression testing machine. All tests were applied using 2 mm/min traction speed. Results : The average pull-out strength values of groups 1A and 1B were $403.78{\pm}11.71N$ and $306.26{\pm}17.55N$, respectively. A statistical significance was detected with p=0.012. The average pull-out strength values of groups 2A and 2B were $388.73{\pm}17.03N$ and $299.84{\pm}17.52N$, respectively. A statistical significance was detected with p=0.012. Conclusion : The trans-endplate lumbosacral fixation method is a trustable fixation method with a stronger screw-bone purchase and offer a good alternative for surgeons specially in patients with osteoporosis.

CLINICAL STUDY ON USE OF BIODEGRADABLE PLATE AND SCREW IN ORTHOGNATHIC SURGERY (턱교정 수술에 있어 흡수성 고정판 및 나사 사용에 대한 임상적 연구)

  • Park, Sung-Soo;Choi, Jin-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.2
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    • pp.127-135
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    • 2009
  • Objectives : The titanium fixation system has been used in orthognathic surgery for fixation of bone segments usually, but the biodegradable fixation system was developed and also being used. The strongest point in the biodegradable system is that no extra operation should be needed to remove fixation materials. In spite of this merit, oral & maxillofacial surgeons hesitate to use this system in fracture or orthognathic surgery. In this study, as we got some clinical experiences, we'd like to report the result of clinical study using the biodegradable fixation system in orthognathic surgery. Patients and Methods : A total of 35 patients composed of 17 males and 18 females with 25 osteotomies in maxilla and 34 osteotomies in mandible were fixated with the biodegradable fixation system(Inion $CPS^{(R)}$). We investigated methods of stabilization, fixation time, and complications on the basis of the method as above. Results : Four 2mm thick L shaped plates with 7 holes of which 1 hole was removed were fixed in maxilla with six $2.0{\times}7mm$ screws. Three $2.5{\times}16{\sim}18mm$ screws were used to fix superior ramus area and one mandibular angle area in mandible. It took about 27.4 minutes in maxilla, 25.3 minutes in mandible to perform the fixation which took longer time than the titanium system(9.5 minutes in maxilla, 8 minutes in mandible). Generally, there was no problem except 9 cases in which there were some complications. Conclusions : In most cases, the biodegradable fixation system can be used without problem in usual orthognathic surgery. But, this system is inferior to the titanium fixation one in some respects such as fixation time, size, and physical property. Some supplementations for such weak points as aforementioned should be needed for the universal use of biodegradable materials.

PHILOS Plate Osteosynthesis in Metaphyseal Fractures of the Distal Humerus through an Anterolateral Approach

  • Park, Jung Ho;Kim, Jung Wook;Oh, Chi Hun;Choi, Keun Seok;Hong, Jae Young;Kim, Jae Gyoon
    • Clinics in Shoulder and Elbow
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    • v.18 no.3
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    • pp.128-132
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    • 2015
  • Background: We described a surgical method for osteosynthesis and reported the resultant strength after application of a PHILOS plate through the anterolateral approach for the treatment of fractures of the distal humerus. Methods: Between February 2010 and March 2012, open reduction and internal fixation operations with the PHILOS plate for treatment of fracture of the distal humerus were performed on a total of nine patients (five men, four women). The mean age was 40.8 years (range, 24-50 years), and the average follow-up period was 9.1 months (range, 6-15 months). Clinical evaluations were performed 6 months after the operation. Clinical assessment included determination of the range of motion of the elbow, the Mayo and Oxford elbow scores, and any postoperative complications. Results: Fracture union was noted in all patients, with an average period of 12.4 weeks. The average Mayo elbow and Oxford elbow scores were 87.2 (of a total of 100) and 43.3 (of a total of 48), respectively. For the postoperative range of motion of the elbow, all patients showed complete recovery to the preoperative range of motion. No other conditions, such as neurolepsis, plate breakage, or rotational deformity, were observed. Conclusions: Open reduction and internal fixation of distal humerus fractures with a PHILOS plating system via anterolateral approach can be effective. A high rate of union with good outcomes can be assumed.

Indirect Reduction Technique in Proximal Humeral Fractures Stabilized by Locking Plates

  • Rhee, Yong Girl;Cho, Nam Su;Cha, Sang Won;Moon, Seong Cheol;Hwang, Sang Phil
    • Clinics in Shoulder and Elbow
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    • v.17 no.1
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    • pp.2-9
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    • 2014
  • Background: Indirect reduction technique offers a valid option in the treatment of proximal humerus fracture. The purpose of this study is to evaluate the functional outcome and the complication rate after indirect reduction and internal fixation of unstable proximal humeral fractures with use of a locking plate. Methods: Twenty four patients with acute proximal humerus fracture were managed with indirect reduction and internal fixation with a locking plate. The mean follow-up period was 15.5 months. Results: The anatomical reduction of the medial cortex buttress was seen in 16 patients (66%) of the Group A and the non-anatomical reduction was seen in 8 patients (33%) of the Group B. Mean union time was $3.2{\pm}1.9$ months; it was $2.2{\pm}0.6$ months in the Group A and $5.3{\pm}2.2$ months in the Group B (p < 0.05). In our series, there were 6 cases of complications and these include 2 cases of varus malunion, 2 cases of shoulder stiffness, 1 case of heterotrophic ossification, 2 cases of screw perforation and 1 case of impingement. Conclusions: We conclude from our studies that indirect reduction and internal fixation using locking plate for acute proximal humerus fracture can give good results with bony union and predictable good overall functional outcome. If the medial cortex buttress is well maintained, a better anatomical reduction would be achieved, the union would be prompted, the pain would be further reduced and the range of the motion would be recovered more promptly.

Comparison of Antiglide Plate Fixation and Lateral Plate Fixation for Danis-Weber Type B Isolated Lateral Malleolar Fractures (족관절 외과의 Danis-Weber B형 단독 골절에 있어서 활주 방지 금속판고정술과 외측 금속판고정술의 비교)

  • Ha, Joong-Won;Kim, Hyoung-Bok;Ko, Min-Suk;Yoon, Han-Kook
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.3
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    • pp.153-158
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    • 2011
  • Purpose: This study was performed retrospectively and to compare the clinical outcomes of the surgical management using Antiglide plating and lateral plating for Danis-Weber type B isolated lateral malleolar fractures. Materials and Methods: Between March 2004 and March 2009, 92 patients were followed up for more than 6 months after surgical treatment. 49 patients were treated with Antiglide plating, whereas the remaining 43 patients underwent lateral plating. The results of the two groups were analyzed both radiographically and clinically using Ankle scoring system. Results: Both groups were comparable for age, sex distribution, time to surgery, and operation time. Bone union was noted at average of 8 weeks in all fractures. The mean ankle score was similar in both groups (94% versus 93%). Conclusion: Antiglide plating for Danis-Weber type B isolated lateral malleolar fracture is one of the good methods which has some advantages such as early ankle motion, ambulation and smaller operative incision.

Minimally Invasive Plate Osteosynthesis of Radius-Ulna Fracture using Circular External Fixator in a Dog

  • Kwon, Yong-hwan;Kang, Jin-su;Kim, Young-ung;Cho, Hyoung-sun;Lee, Ki-chang;Kim, Nam-soo;Kim, Min-su
    • Journal of Veterinary Clinics
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    • v.34 no.1
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    • pp.47-49
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    • 2017
  • Fracture stabilization techniques continue to evolve and provide approaches that minimize the iatrogenic trauma associated with surgical procedures. Minimally invasive plate osteosynthesis (MIPO) is a recently described method of biological internal fixation performed by introducing a bone plate via small insertional incisions that are remote to the fracture site. Indirect reduction techniques can generally be utilized when performing MIPO. In this case report, we describe MIPO of a radius-ulna fracture by indirect reduction using circular external fixation for alignment and distraction in a dog.

Plate Fixation for Fractures of the Coronoid Process of the Ulna (금속판을 이용한 구상돌기 골절의 치료)

  • Shin, Dong-Ju;Byun, Young-Soo;Cho, Young-Ho;Park, Ho-Won;Youn, Hee-Min;Han, Jae-Hui
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.177-184
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    • 2008
  • Purpose: The purpose of this study was to evaluate the results of eight cases of coronoid process fractures that were fixed with a plate. Materials and Methods: Eight coronoid process fractures were treated by plating and these cases were reviewed retrospectively. Six patients were men and two were women. The average age was 41 years (range: 22-79) at the time of injury. According to Regan's classification, there were five type 2 and three type 3. According to O'Driscoll's classification, there were five anteromedial type and three base type. Open reduction and internal fixation with a plate were performed through a medial approach by splitting of the two heads of the flexor carpi ulnaris. The patients were follow-up for a mean of 15.8 months (range: 6-25). We evaluated the clinical outcomes with using the Mayo Elbow Performance Score. Results: The average active motion of the elbow joint was $120^{\circ}$. The average Mayo Elbow Performance Score was 86.9. There were 5 excellent results, 1 good result and 2 fair results. Summary: Plating through a medial approach of the elbow provided stable fixation and satisfactory union for treating displaced coronoid process fractures with the unstable elbow.