• Title/Summary/Keyword: Screw fracture

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Screw Fixation Techniques for Talar Neck Fractures (Anterior versus Posterior insertion) (거골 경부 골절의 나사못 고정 방향에 따른 결과 비교)

  • Shin, Dong-Eun;Yoon, Hyung-Ku;Choi, Woo-Jin;Lee, Yoon-Seok;Han, Seung-Chul
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.79-83
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    • 2010
  • Purpose: To compare the clinical and radiological results between the anterior and posterior screw fixation for the treatment of talar neck fracture. Materials and Methods: Among 30 patients who received surgical treatment for talar neck fracture from 2001 to 2008. Twenty-seven patients with a follow-up period of more than 1 year were divided into two groups. Twelve patients were treated with anterior screw fixation and 15 patients with posterior approaches. We analyzed preoperative, postoperative and follow-up radiographs. Clinical results were evaluated by Hawkins criteria. Results: The posteriorly inserted screws were placed across the more central portion of the talar neck and perpendicular to the plane of fracture (p<0.05). There were no difference in clinical results, the duration of union, and complications including avascular necrosis between two groups. However, 2 patients complained of pain around the talonavicular joint in the anterior insertion group. Conclusion: Although the clinical results were good irrespective of insertion methods, the posterior approach of screw fixation for talar neck fractures allows for a better mechanical advantage than anterioly placed screws. This may allow early motion with a reduced risk of failure of fixation or of displacement of the fracture.

Fixation with Bioabsorbable Polylactide Plate and Screws for the Treatment of the Ankle Fractures (생체 흡수성 판과 나사못을 이용한 족근 관절 골절의 치료)

  • Kwon, Duck-Joo;Lee, Yong-Beom;Shin, Jun
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.1
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    • pp.80-84
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    • 2009
  • Purpose: The purpose of this article is to assess the efficacy of a bioabsorbable polylactide (PLA) plate and screw for treating injuries of ankle fractures. Materials and Methods: 24 patients who underwent an open reduction and internal fixation operation for ankle fractures from July 2005 to March 2007 were enrolled into the study. There were 15 men and 9 women. The average age of the patients was 44 years and the average follow-up period was 16 years and two months (16.2 months). All cases were divided into low grade fracture patient (11) who belongs in type A and B of Danis-Weber classification and high grade fracture patient (13) who belongs in type C1, C2 of Danis-Weber classification, and each groups were analyzed by clinical (Meyer score) and radiological finding at the time of their last follow-up evaluation. Results: The clinical results according to Meyer scoring system, showed that all patient with low grade fracture had good to excellent result, but only 54% of patient with high grade fracture had good to excellent result. According to Cedell's radiologic finding, there were 91% cases above fair in low grade fracture. But there were 62% of patient above fair result in high grade fracture, the reduction losses were seen in 38% of patient with high grade fracture. Conclusion: Bioabsorbable PLA plate and screw is good internal fixation device which doesn't have additional operation for removal of implant because of slow absorption within the human body. It showed sufficient strength for acquisition and maintenance of reduction in low grade fracture, but need attention to use because of many cases of reduction loss in high grade fracture. So, it seems to be safe and effective when used in heeling of low grade fracture under considering about type of fracture sufficiently.

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Ulnar Nerve Injury Caused by the Incomplete Insertion of a Screw Head after Internal Fixation with Dual Locking Plates in AO/OTA Type C2 Distal Humerus Fractures

  • Shin, Jae-Hyuk;Kwon, Whan-Jin;Hyun, Yoon-Suk
    • Clinics in Shoulder and Elbow
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    • v.20 no.4
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    • pp.236-239
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    • 2017
  • After dual plating with a locking compression plate for comminuted intraarticular fractures of the distal humerus, the incidence of ulnar nerve injury after surgery has been reported to be up to 38%. This can be reduced by an anterior transposition of the ulnar nerve but some surgeons believe that extensive handling of the nerve with transposition can increase the risk of an ulnar nerve dysfunction. This paper reports ulnar nerve injuries caused by the incomplete insertion of a screw head in dual plating without an anterior ulnar nerve transposition for AO/OTA type C2 distal humerus fractures. When an anatomical locking plate is applied to a distal humeral fracture, locking screws around the ulnar nerve should be inserted fully without protrusion of the screw because an incompletely inserted screw can cause irritation or injury to the ulnar nerve because the screw head in the locking system usually has a slightly sharp edge because screw head has threads. If the change in insertion angle and resulting protruded head of the screw are unavoidable for firm fixation of fracture, the anterior transposition of the ulnar nerve is recommended over a soft tissue shield.

Surgical Treatment of Using Acutrak Screw for Ankle Medial Malleolar Fracture (Acutrak 나사를 이용한 족관절 내과 골절의 치료)

  • Kim, Kwang-Yeol;Kim, Hyoung-Cheon;Ahn, Su-Han;Yun, Hyoung-Jo;Cho, Sung-Jun
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.84-89
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    • 2010
  • Purpose: The purpose of this study is to evaluate the clinical and radiologic results of using Acutrak screws for treating ankle medial malleolar fracture. Materials and Methods: We reviewed 38 cases of ankle medial malleolar fracture treated with Acutrak screws from February 2005 to May 2008. Results: In clinical result, there were 30 exellent cases, 7 good cases, 1 fair case. In radiologic result, there is no case with reduction loss. Average union time is 10.5 weeks. Conclusion: We conclude that Acutrak screw fixation is a useful method for ankle medial malleolar fracture, there are many advantages in accurate anatomical reduction, small incision, short operative time.

Assessment of Xenogenic Bone Plate and Screw using Finite Element Analysis

  • Heo, Su-young;Lee, Dong-bin;Kim, Nam-soo
    • Journal of Veterinary Clinics
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    • v.35 no.3
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    • pp.83-87
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    • 2018
  • The aim of this study was to evaluate the biomechanical behavior of xenogenic bone plate system (equine bone) using a three-dimensional finite element ulna fracture model. The model was used to calculate the Von Mises stress (VMS) and stress distribution in fracture healing periods with metallic bone plate and xenogenic bone plate systems, which are installed while the canine patient is standing. Bone healing rate (BHR) (0%) and maximum VMS of the xenogenic plate was similar to the yield strength of equine bone (125 MPa). VMS at the ulna and fracture zones were higher with the xenogenic bone plate than with the metallic bone plate at BHRs of 0% and 1%. Stress distributions in fracture zone were higher with the xenogenic bone plate than the metallic bone plate. This study results indicate that the xenogenic bone plate may be considered more beneficial for callus formation and bone healing than the metallic bon plate. Xeonogenic bone plate and screw applied in clinical treatment of canines may provide reduced stress shielding of fractures during healing.

Repairment of abutment and abutment screw fracture in implant prosthesis: A case report (지대주 혹은 지대주 나사 파절이 발생한 임플란트 보철물에서 효과적인 수리 방법)

  • Kim, Jae Hoon;Yoo, Jin Joo;Kim, Man Yong;Yoon, Joon-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.1
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    • pp.37-41
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    • 2019
  • Dental implants are an effective and predictable treatment for restoration of missing teeth. However, as the use of implants increases, complications are also increasing. The mechanical complications are not only highly frequent, but also increasing as life span of an implant increases, thus, solutions should be prepared. In this report, we will present a case dealing with abutment fracture and abutment screw fracture which are the most common mechanical complication of the implant, focusing on preserving and reusing existing components by reconstructing only the damaged parts.

Treatment of Anterior Glenoid Rim Fracture with Comminuted Fragment Using Arthroscopic Reduction and AO Headless Compression Screw Fixation - A Case Report - (관절경하 AO 무두 압박 나사를 이용한 견갑골 전방 관절와 분쇄 골절의 치료 - 증례 보고 -)

  • Kim, Hyung-Sik;Koh, Il-Hyun;Kim, Sung-Guk;Chun, Yong-Min;Kim, Sung-Jae;Kang, Ho-Jung
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.94-98
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    • 2011
  • Purpose: We present a case of anterior glenoid rim comminuted fracture that was treated with arthroscopic reduction and an AO headless compression screw (HCS) fixation. Materials and Methods: A 31-year old man complained of left shoulder pain after falling down on stairs. The anterior glenoid comminuted fragments were arthroscopically reduced. Fixation with an AO HCS was done after placement of 1.1 mm Kirschner wire as a guide pin through a standard cannulated anterosuperior portal. Results: Twelve months after the operation, union of the fracture was achieved and the range of motion was fully recovered. He did not complain of any discomfort during his activities of daily living. Conclusion: An AO HCS had various screw sizes and this was good for fixation of a small glenoid fracture and a long drill bit and screw driver were useful for fixation of deep seated glenoid fracture. A short guide wire could be replaced by a 1.1 mm K-wire. An AO HCS was useful for fixation of an anterior glenoid rim comminuted fracture.

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.

C7 Posterior Fixation Using Intralaminar Screws : Early Clinical and Radiographic Outcome

  • Jang, Sang-Hoon;Hong, Jae-Taek;Kim, Il-Sup;Yeo, In-Sung;Son, Byung-Chul;Lee, Sang-Won
    • Journal of Korean Neurosurgical Society
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    • v.48 no.2
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    • pp.129-133
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    • 2010
  • Objective : The use of segmental instrumentation technique using pedicle screw has been increasingly popular in recent years owing to its biomechanical stability. Recently, intralaminar screws have been used as a potentially safer alternative to traditional fusion constructs involving fixation of C2 and the cervicothoracic junction including C7. However, to date, there have been few clinical series of C7 laminar screw fixation in the literature. Thus, the purpose of this study is to report our clinical experiences using C7 laminar screw and the early clinical outcome of this rather new fixation technique. Methods : Thirteen patients underwent C7 intralaminar fixation to treat lesions from trauma or degenerative disease. Seventeen intralaminar screws were placed at C7. The patients were assessed both clinically and radiographically with postoperative computed tomographic scans. Results : There was no violation of the screw into the spinal canal during the procedure and no neurological worsening or vascular injury from screw placement. The mean clinical and radiographic follow up was about 19 months, at which time there were no cases of screw pull-out, screw fracture or non-union. Complications included two cases of dorsal breech of intralaminar screw and one case of postoperative infection. Conclusion : Intralaminar screws can be potentially safe alternative technique for C7 fixation. Even though this technique cannot be used in the cases of C7 laminar fracture, large margin of safety and the ease of screw placement create a niche for this technique in the armamentarium of spine surgeons.

Pulmonary Embolism after Screw Fixation for a Greater Tubercle Fracture of Humerus

  • Kang, Suk;Chung, Phil Hyun;Kim, Jong Pil;Kim, Young Sung;Lee, Ho Min;Jang, Han Gil
    • Clinics in Shoulder and Elbow
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    • v.17 no.4
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    • pp.201-204
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    • 2014
  • Pulmonary embolism is a serious complication, which is well known in patients undergoing total hip or total knee arthroplasty or lower extremity fracture surgery. But, there are few literatures concerning pulmonary embolism after upper extremity surgery. Pulmonary embolism after minor upper extremity fracture surgery is extremely rare. We report a case of 66-year-old female patient that developed pulmonary embolism after percutaneous cannulated screw fixation for a greater tubercle fracture of the proximal humerus with literature review.