• Title/Summary/Keyword: rigid fixation

Search Result 161, Processing Time 0.033 seconds

Treatment for Tarsometatarsal Fracture-Dislocation (족근-중족 관절 골절 탈구의 치료경험)

  • Chung, Yung-Khee;Yoo, Jung-Han;Park, Yong-Wook;Noh, Dong-Geun;Ha, Sung-Han
    • Journal of Korean Foot and Ankle Society
    • /
    • v.1 no.2
    • /
    • pp.112-118
    • /
    • 1997
  • Tarsometatarsal fracture-dislocation is uncommon but severe lesion. Since this lesion is sometimes difficult to recognize by roentgenography, it is easily overlooked. Three patients were treated with open reduction and internal fixation with 3.5 mm cannulated screw and K-wire, two had treatment with open reduction and internal fixation with 3.5 mm cannulated screw only and two had treatment with dosed reduction and short leg cast only between January 1994 and May 1996. The duration of follow-up ranged from twelve to twenty-nine months after the diagnosis. Results were assessed by a subjective questiormaire, physical examination, and radiographic analysis. Multiple fixation techniques for maintaining the reduction of tarsometatarsl joint have been introduced. We recent]y used the 3.5 mm cannulated screw for internal fixation of the tarso-first and second metatarsal fracture-dislocation. We think cannulated screw fixation has several advantages; 1. The cannulated screw fixation is more rigid than the K-wire fixation. 2. There is an decreased risk of screw breakage with early weight bearing. 3. It is possible to compress the involved joints, if necessary. There were no disability in all patients. One patient who was treated with delayed open reduction and internal fixation with 3.5 mm cannulated screw and K-wire had a radiographic mild degenerative arthritis. And one patient who was treated with dosed reduction and short leg cast had a mild metatarsus adductus. But. these two patients were symptom free. There was no correlation between the severity of the diastasis and the patient s functional result.

  • PDF

Comparison between Accurate Anatomical Reduction and Unsuccessful Reduction with a Remaining Gap after Open Reduction and Plate Fixation of Midshaft Clavicle Fracture

  • Kim, Joon Yub;Choe, Jung Soo;Chung, Seok Won
    • Clinics in Shoulder and Elbow
    • /
    • v.19 no.1
    • /
    • pp.2-7
    • /
    • 2016
  • Background: The purpose of this study is to compare the radiological and clinical outcomes after open reduction and plate fixation of midshaft clavicle fractures between patients who achieved successful anatomical reduction and those who had a remaining fracture gap even after open reduction and plate fixation, and were thus treated with additional demineralized bone matrix (DBM). Methods: This retrospective analysis was conducted on 56 consecutive patients who underwent open reduction and internal fixation using a locking compression plate for acute displaced midshaft clavicle fractures, and who underwent radiographic and clinical outcome evaluations at least 6 months postoperatively. The outcomes between those who achieved perfect anatomical reduction without remnant gap (n=32) and those who had a remaining fracture gap even after open reduction and plate fixation treated with additional DBM (n=24) were evaluated. Results: There were no differences in the use of lag screws or wiring and operation time (all p>0.05) between those with and without remnant gap. No difference in the average radiological union time and clinical outcomes (satisfaction and Constant score) was observed between the two groups (all p>0.05). However, significantly faster union time was observed for AO type A fracture compared with other types (p=0.012), and traffic accident showed association with worse clinical outcomes compared with other causes of injury. Conclusions: Surgical outcome of midshaft clavicle fracture was more affected by initial fracture type and event, and re-reduction and re-fixation of the fracture to obtain a perfect anatomical reduction spending time appears to be unnecessary if rigid fixation is achieved.

Biomechanical Study of Posterior Pelvic Fixations in Vertically Unstable Sacral Fractures: An Alternative to Triangular Osteosynthesis

  • Chaiyamongkol, Weera;Kritsaneephaiboon, Apipop;Bintachitt, Piyawat;Suwannaphisit, Sitthiphong;Tangtrakulwanich, Boonsin
    • Asian Spine Journal
    • /
    • v.12 no.6
    • /
    • pp.967-972
    • /
    • 2018
  • Study Design: Biomechanical study. Purpose: To investigate the relative stiffness of a new posterior pelvic fixation for unstable vertical fractures of the sacrum. Overview of Literature: The reported operative fixation techniques for vertical sacral fractures include iliosacral screw, sacral bar fixations, transiliac plating, and local plate osteosynthesis. Clinical as well as biomechanical studies have demonstrated that these conventional techniques are insufficient to stabilize the vertically unstable sacral fractures. Methods: To simulate a vertically unstable fractured sacrum, 12 synthetic pelvic models were prepared. In each model, a 5-mm gap was created through the left transforaminal zone (Denis zone II). The pubic symphysis was completely separated and then stabilized using a 3.5-mm reconstruction plate. Four each of the unstable pelvic models were then fixed with two iliosacral screws, a tension band plate, or a transiliac fixation plus one iliosacral screw. The left hemipelvis of these specimens was docked to a rigid base plate and loaded on an S1 endplate by using the Zwick Roell z010 material testing machine. Then, the vertical displacement and coronal tilt of the right hemipelves and the applied force were measured. Results: The transiliac fixation plus one iliosacral screw constructions could withstand a force at 5 mm of vertical displacement greater than the two iliosacral screw constructions (p=0.012) and the tension band plate constructions (p=0.003). The tension band plate constructions could withstand a force at $5^{\circ}$ of coronal tilt less than the two iliosacral screw constructions (p=0.027) and the transiliac fixation plus one iliosacral screw constructions (p=0.049). Conclusions: This study proposes the use of transiliac fixation in addition to an iliosacral screw to stabilize vertically unstable sacral fractures. Our biomechanical data demonstrated the superiority of adding transiliac fixation to withstand vertical displacement forces.

Ankle Arthrodesis Using an Anterior T Plate in treating the Charcot joint of Ankle in a diabetic patient - A Case Report - (당뇨환자의 불안정 족관절에 있어서의 전방 T자형 금속판을 이용한 족관절 고정술)

  • Hwang, Kuhn-Sung;Sung, Il-Hoon;Cho, Soo-Hyun
    • Journal of Korean Foot and Ankle Society
    • /
    • v.5 no.1
    • /
    • pp.23-27
    • /
    • 2001
  • It has been known that the ankle arthrodesis is a common surgical procedure for treating the ankle arthrosis and deformity that do not respond to the non-operative treatment. To date, various surgical techniques for the ankle arthrodesis have been reported. Clinical and biomechanical trials have shown that the rigid internal fixation leads the increased rate of the union. The ankle arthrodesis may be complicated with the nonunion, delayed union, malunion, and infection. In cases of the Charcot joint of the ankle in diabetic patients, however, arthrodesis could reduce the disadvantage of the nonoperative treatment, such as the loss of the reduction, progressive collapse, multiple ulcerations and infection. The object of this case report is to report our experience of a successful ankle arthrodesis using an anterior T plate in treating the unstable ankle of a diabetic patient, associated with the ankle fracture and the neuropathy. The surgical approach of this technique is simple so that it would allow less soft tissue injury, and this procedure would be regarded as one alternative to provide the rigid internal fixation in the ankle arthrodesis.

  • PDF

Intra-sinus rigid fixation of a resorbable barrier membrane to repair a large perforation of the sinus membrane: a technical note

  • Won-Jun Joung;Seo-Hyoung Yun;Yongjin Kim;Yong-Seok Cho;Won-Woo Lee;Jin-Won Seo;Marco Tallarico;Kyung-Gyun Hwang;Chang-Joo Park
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.49 no.5
    • /
    • pp.297-303
    • /
    • 2023
  • A resorbable barrier membrane is commonly used for the repair of perforated sinus membranes during sinus lifting surgeries. However, repairing largescale perforations poses challenges for clinicians as the protection and isolation of graft material remain uncertain. With this technique, we aimed to prevent graft material loss and subsequent sinus-related complications using intra-sinus rigid fixation of the resorbable barrier membrane in cases with a large perforation of the sinus membrane.

Operative Treatment of Displaced Talar Neck Fracture (전위된 거골 경부 골절의 수술적 치료)

  • Ahn, Jae-Hoon;Baek, Chang-Hyun;Choy, Won-Sik;Kim, Yong-In
    • Journal of Korean Foot and Ankle Society
    • /
    • v.10 no.2
    • /
    • pp.190-195
    • /
    • 2006
  • Purpose: To evaluate the results of open reduction and internal fixation for displaced talar neck fracture. Materials and Methods: Fourteen patients were followed for more than 1 year after open reduction and internal fixation of displaced talar neck fracture. The mean age was 41.5 years, and the mean follow-up period was 3.8 years. There were 10 type II, 3 type III and 1 type IV fractures per Hawkins. There were 3 open fractures. Clinically AOFAS ankle-hindfoot scale and Hawkins criteria were utilized. Radiologically quality of reduction, duration of bony union, avascular necrosis and posttraumatic arthritis were evaluated. Results: At last follow-up, AOFAS scale was mean 89.1 points. There were 8 excellent, 4 good, and 2 fair results according to Hawkins criteria. Radiologically anatomical reduction was obtained in 13 cases. Mean duration of bony union was 11.8 weeks. There were 3 avascular necrosis and 2 post-traumatic arthritis. There was no significant difference in the incidence of avascular necrosis between early operation group and surgically delayed group. Conclusion: Accurate open reduction and rigid internal fixation seem to be prerequisites for satisfactory treatment of a displaced talar neck fracture.

  • PDF

Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

  • Choi, Kang-Young;Yang, Jung-Dug;Chung, Ho-Yun;Cho, Byung-Chae
    • Archives of Plastic Surgery
    • /
    • v.39 no.4
    • /
    • pp.291-300
    • /
    • 2012
  • The incidence of condylar fractures is high,but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture.

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
    • /
    • v.8 no.1
    • /
    • pp.86-91
    • /
    • 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.

  • PDF

CLINICAL STUDY ON ORTHOGNATHIC SURGERY FOR 8 YEARS IN OUR DEPARTMENT (최근 8년간 본교실에서 시행한 악교정수술의 임상적 검토)

  • Kwon, Tae-Geon;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.17 no.1
    • /
    • pp.1-9
    • /
    • 1995
  • We observed 117 orthognathic surgery cases with dentofacial deformity for 8 years from Jan. 1986 to Dec. 1993. The ratio of male female was 1 : 1.4 and the mean age was 23.0 years ranged from 16 to 35 years. The most dominant group was related to mandibular prognathism (75.0%). Surgery method were divided into 88 cases of mandible surgery, 6 cases of maxilla surgery and 23 cases of two jaw surgery. Sagittal split osteotomy were performed on 84 cases (71.8%). Rigid fixation was increased after 1989 and total percent of rigid fixation was 66%. We used autotransfusion method from 1992 to all orthognathic surgery patient. Lower lip numbness caused by Inferior alveolar nerve injury is the most common problem after operation, and it was 63 cases (53.8%) of total operation cases. In our clinic, we performed 5 cases of re-operation because of segment malalignment, condylar sag, and fixation instability.

  • PDF