• Title/Summary/Keyword: Surgical fixation devices

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Biomechanical Comparison of Spinal Fusion Methods Using Interspinous Process Compressor and Pedicle Screw Fixation System Based on Finite Element Method

  • Choi, Jisoo;Kim, Sohee;Shin, Dong-Ah
    • Journal of Korean Neurosurgical Society
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    • v.59 no.2
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    • pp.91-97
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    • 2016
  • Objective : To investigate the biomechanical effects of a newly proposed Interspinous Process Compressor (IPC) and compare with pedicle screw fixation at surgical and adjacent levels of lumbar spine. Methods : A three dimensional finite element model of intact lumbar spine was constructed and two spinal fusion models using pedicle screw fixation system and a new type of interspinous devices, IPC, were developed. The biomechanical effects such as range of motion (ROM) and facet contact force were analyzed at surgical level (L3/4) and adjacent levels (L2/3, L4/5). In addition, the stress in adjacent intervertebral discs (D2, D4) was investigated. Results : The entire results show biomechanical parameters such as ROM, facet contact force, and stress in adjacent intervertebral discs were similar between PLIF and IPC models in all motions based on the assumption that the implants were perfectly fused with the spine. Conclusion : The newly proposed fusion device, IPC, had similar fusion effect at surgical level, and biomechanical effects at adjacent levels were also similar with those of pedicle screw fixation system. However, for clinical applications, real fusion effect between spinous process and hooks, duration of fusion, and influence on spinous process need to be investigated through clinical study.

Medial Horizontal Suture Fixation of the Akin Osteotomy: A Technical Report (Akin 절골술의 내측 횡 봉합사 고정: 술기 보고)

  • Yune, Young-Phil;Kim, Sanghwan
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.4
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    • pp.197-200
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    • 2015
  • The Akin osteotomy is a complimentary procedure in hallux valgus surgery. Surgical techniques may vary depending on the operators or fixation devices. Suture fixation, for which a removal procedure is not necessary, can often be recommended. However, there is a risk of failure due to the thin cortex of the phalanx. We describe a new technique using Ethibond suture fixation in Akin osteotomy, which can lower the risk of phalangeal cortical failure and articular cartilage irritation. First, the Akin osteotomy was performed on the proximal phalanx 5 to 6 mm distal to the first metatarsophalangeal joint. Then bone holes were drilled from dorsum to plantar parallel to osteotomy with the Kirschner wire. The final procedure involved passing the Ethibond sutures connected to a straight needle through the holes and tying it. This fixation method offers an effective and easy technique for performance of Akin osteotomy.

용융방사-폴리락타이드 섬유의 구조와 물성

  • 김병철;임승순;김승규;조성무;이화섭
    • Proceedings of the Korean Fiber Society Conference
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    • 1998.10a
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    • pp.227-231
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    • 1998
  • Poly(lactic acid)(PLA)는 인체내에서 재흡수성(resorbability), 분해물의 비독성, 성형물의 높은 기계적 강도 등과 같은 바람직한 특성을 가지는 생체 친화성 고분자로서 fracture fixation devices, drug delivery system 및 surgical suture 등과 같은 의료용 소재로의 응용에 관한 연구가 활발히 진행되고 있다[1-2]. (중략)

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Radiological assessment and follow-up of a nonsurgically treated odontoid process fracture after a motor vehicle accident in Egypt: a case report

  • Ahmad Mokhtar Abodahab
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.411-415
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    • 2023
  • An odontoid process fracture is a serious type of cervical spine injury. This injury is categorized into three types based on the location of the fracture. Severe or even fatal neurological deficits can occur due to associated cord injury, which can result in complete quadriplegia. Computed tomography is the primary diagnostic tool, while magnetic resonance imaging is used to evaluate any associated cord injuries. These injuries can occur either directly from the injury or during transportation to the hospital if mishandled. There are two main treatment approaches: surgical fixation or external nonsurgical fixation, with various types and models of fixation devices available. In this case study, computed tomography follow-up confirmed that external fixation can yield successful results in terms of complete healing, even in cases complicated by other factors that may impede healing, such as pregnancy.

Biomechanical Comparative Study for Osteosynthesis of Pauwels Type III Femoral Neck Fractures: Conventional Devices versus Novel Fixed Angle Devices

  • Dae-Hyun Park;Young-Chae Seo;Yong-Uk Kwon;Soo-Hwan Jung;Seung-Jin Yoo
    • Hip & pelvis
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    • v.34 no.1
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    • pp.35-44
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    • 2022
  • Purpose: Osteosynthesis has been recommended for treatment of Pauwels type III femoral neck fractures in young patients. However, no implant of choice has been reported so far. This study was conducted in order to compare the fixation stability of two conventional fixation methods with three different novel fixed angle devices in this type of fracture. Materials and Methods: A total of 25 composite femurs (4th Generation Saw bone; Pacific Research Laboratories, USA) corresponding to human bone were used. Pauwels type III fracture type was uniformly reproduced. Specimens were fixed with a cannulated screw, cannulated screw with cable, and Intertan nail, dynamic hip screw, and IKEY nail. Measurement of failure loads and the rotational change of the femoral head fragment was performed for evaluation of fixation stability. Results: All implants were compared with cannulated screw and dynmaic hip screw. No meaningful improvement was observed for the cannulated screw with cable compared with the cannulated screw and dynamic hip screw. Meaningful improvement in load-to-failure and y-rotation and z-rotation was observed for both the Intertan nail and IKEY nail compared with the cannulated screw. However, compared with the dynamic hip screw, only the IKEY nail showed improvement in the same profile but the Intertan nail did not. Conclusion: Among novel fixed angle devices, meaningful improvement was observed for the IKEY nail compared with conventional implants. Strengths of this implant include biomechanical stability and simplicity of surgical technique, indicating that it may be another good option for osteosynthesis of Pauwels type III femoral neck fractures.

Efficacy of Temporal Fixation Using Threaded Trans-Calcaneal Pin in Patients with Ankle Fracture-Dislocation or Tibia Pilon Fractures (발목 골절 및 탈구 혹은 경골 천정 골절 환자들의 수술에 있어 경종골핀을 이용한 발목 외고정 장치를 적용했을 때의 임상적 효용성)

  • Park, Dae-Hyun;Gwak, Heui-Chul;Kim, Jung-Han;Lee, Chang-Rak;Kwon, Yong-Uk;Choo, Hye-Jung;Park, Chul-Soon
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.2
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    • pp.81-86
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    • 2020
  • Purpose: Ankle fractures with dislocations and pilon fractures at the distal tibia are usually associated with soft tissue damage caused by high-energy damage. Recently, a two-stage operation to perform internal fixation after the application of external fixation devices for stabilizing soft tissues has been accepted as the treatment of choice. This paper reports the clinical result of these injuries treated with threaded trans-calcaneal pin external fixation devices. Materials and Methods: Thirty-three patients diagnosed with ankle fractures with dislocations or tibial pilon fractures without open wounds. They underwent surgical treatment with threaded trans-calcaneal pin external fixation from January 2008 to February were enrolled in this study. This study evaluated the visual analogue scale (VAS), foot function index (FFI), and Olerud & Molander score as well as whether complications occurred. Results: The average VAS showed a meaningful decrease (p<0.001) from 7.4 before surgery to 2.6 after application of the external fixation device, and 1.4 at 12 months after surgery. The FFI also decreased significantly from 84.3 preoperatively to 20.3 at 12 months postoperatively (p<0.001). The Olerud & Molander score averaged 71.4 points, showing good clinical results. Complete bone union was observed in all patients. One patient each underwent debridement due to wound necrosis and infection in the pin insertion site. At the final follow-up, seven patients had posttraumatic ankle joint arthritis, according to a radiological examination. Conclusion: Manual reduction and external fixation using a threaded trans-calcaneal pin is a suitable surgical technique that is easy to perform and shows good clinical outcomes in stabilizing soft tissue damage in fractures and dislocations of ankle fracture or tibia pilon fractures in foot and ankle injury.

Vascularized Fibular Graft in the Treatment of Intractable Infected Nonunion of Femur - 3 Cases - (생비골 이식술을 통한 대퇴골의 난치성 감염성 불유합의 치료 - 3예 보고 -)

  • Chung, Duke-Whan;Jeong, Bi-O;So, Dong-Hyuk;Han, Chung-Soo
    • Archives of Reconstructive Microsurgery
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    • v.16 no.1
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    • pp.6-13
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    • 2007
  • Purpose: To report the clinical results of the vascularized fibular graft in the treatment of intractable infected nonunion of femur. Materials and Methods: We reviewed 3 patients who were performed vascularized fibular graft in treated for intractable infected nonunion of femur. They had received an average of 5.6 times($4{\sim}8\;times$) surgical treatment at different hospitals. 1 case was of a infected nonunion in a fracture treated with internal fixation, the fracture having occurred after resection of a malignant tumor and transplantation of pasteurized autologous bone. 2 cases occurred after internal fixation in closed fractures. Surgical treatment was performed an average of 4 times($3{\sim}5\;times$) at our hospital and in all of the cases debridement of necrotic tissue and sequestrectomy. And vascularized fibular graft was performed. In all cases unilateral external fixation devices were used, of these, 1 case was changed into internal fixation. The final conclusion was made by assessment of functional outcomes and complications according to the standards of Paley. Results: As a result, in all of the cases bone union was achieved, and in the last follow up the functional results were excellent in 2 cases and good in 1 case. There were not presented leg length discrepancy of more than 2 cm, and further loss of knee joint motion. After previous treatment, average 23.3 months($16{\sim}30\;months$) was taken to eliminate infection and achieve complete bone union via vascularized fibular graft in our hospital. Conclusion: In treatment of intractable infected nonunion of femur, fairly good results can be expected after firm fixation, through debridement and vascularized fibular graft.

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Short-Term Results of Surgical Treatment Using TightRopeTM for Acute Ankle Syndesmosis Injury (급성 족근 관절 원위 경비인대결합 손상에서 TightRopeTM를 이용한 수술의 단기 치료 결과)

  • Kim, Do Young;Lee, Jun Hyuck;Park, Jung Hyun;Cho, Jaeho
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.4
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    • pp.176-181
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    • 2016
  • Purpose: The purpose of this study was to evaluate the clinical and radiologic outcome of syndesmosis fixation using TightRope$^{TM}$ (Arthrex, Naples, FL, USA) in acute syndesmosis injuries. Materials and Methods: Twenty-five consecutive patients with acute syndesmosis injuries, treated using TightRope$^{TM}$, were reviewed. Patients were evaluated preoperatively and at the last follow-up (at least 12 months postoperatively). Clinical outcomes were assessed using American Orthopaedics Foot and Ankle Society (AOFAS) ankle-hindfoot score and self-subjective satisfaction survey. Three radiologic parameters were evaluated two times at the preoperative and final follow up from the nonweightbearing ankle anteroposterior radiographs. Results: The mean AOFAS ankle-hindfoot score was 95.5 at the final follow-up. According to the satisfaction survey, 21 patients chose excellent, and four patients chose good. All radiologic parameters, including the mean tibiofibular clear space, mean tibiofibular overlap, and mean medial clear space on nonweightbearing ankle anteroposterior view, significantly improved after surgery. Complications occurred in only one patient who experienced knot irritation with infection. Conclusion: The short-term surgical results of syndesmosis fixation using TightRope$^{TM}$ were good to excellent, both clinically and radiographically. These results suggest that the fixation using TightRope$^{TM}$ is a valid option for acute syndesmosis injury.

Rigid Fixation using Bioabsorbable Mesh and Screws in Facial Bone Fracture (흡수성 망상판과 나사를 이용한 안면골절의 견고정법)

  • Shin, Dong-Hyeok;Kim, Deok-Jung;Kim, Soo-Young;Hwang, Eun-A;Choi, Hyun-Gon;Kim, Soon-Heum;Uhm, Ki-Il
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.717-720
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    • 2010
  • Purpose: Absorbable plate and screw fixation is widely used technique for internal rigid fixation in craniomaxillofacial surgery. However, there are some potential problems associated with the use of plate. The purpose of this study is to evaluate the feasibility of bone fixation in facial fracture using absorbable mesh in place of absorbable plate. Methods: The records of 55 patients with zygomaticomaxilla fractures treated by open reduction, performed by the author from February 2008 to May 2009, were retrospectively reviewed. Patients were selected to receive absorbable mesh fixation. The incidence of all complications including infection, hypoesthesia, and deformity was examined. Analysis with postoperative computed tomography follow-up demonstrates degree of reduction. Results: Forty-six patients met criteria for inclusion in the study. All patients went on to satisfactory healing without complication. Postoperative computed tomography revealed good bony alignment similarly non affected side. Conclusion: This study demonstrates that the rigid internal fixation of fractured bone fragments using absorbable mesh is more effective than absorbable plate, especially in comminuted fracture of maxilla.

Bioabsorbable Screws Used in Hallux Valgus Treatment Using Proximal Chevron Osteotomy (무지외반증 환자의 근위 갈매기형 절골술에서 생체 흡수성 나사못을 이용한 고정)

  • Shin, Woo-Jin;Chung, Young-Woo;An, Ki-Yong;Seo, Jae-Woong
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.4
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    • pp.181-183
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    • 2018
  • Hallux valgus is a deformity that causes pain in the first metatarsophalangeal joint. Surgical methods are quite diverse and a range of osteotomies are used at the proximal and distal part of the metatarsal bone and proximal phalange. Fixation methods, such as plate, screw, K-wire, and others have been used in various ways. The fixation device is often removed with various side effects due to the fixation devices. In the case of instruments that are absorbed in vivo, these procedures are not necessary to remove and there is an advantage of not performing the second operation. Three patients were treated, in which a proximal chevron osteotomy was used with a bioabsorbable screw (K-$MET^{TM}$; U&I Corporation).