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1
Slone, R. M., M. M. Heare, R. A. Vander Griend, and W. J. Montgomery. "Orthopedic fixation devices." RadioGraphics 11, no. 5 (September 1991): 823–47. http://dx.doi.org/10.1148/radiographics.11.5.1947319.
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Richardson, M. L., R. F. Kilcoyne, K. A. Mayo, J. G. Lamont, and W. Hastrup. "Radiographic evaluation of modern orthopedic fixation devices." RadioGraphics 7, no. 4 (July 1987): 685–701. http://dx.doi.org/10.1148/radiographics.7.4.3329363.
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Filip, Nina, Iulian Radu, Bogdan Veliceasa, Cristiana Filip, Mihaela Pertea, Andreea Clim, Alin Constantin Pinzariu, Ilie Cristian Drochioi, Remus Lucian Hilitanu, and Ionela Lacramioara Serban. "Biomaterials in Orthopedic Devices: Current Issues and Future Perspectives." Coatings 12, no. 10 (October 14, 2022): 1544. http://dx.doi.org/10.3390/coatings12101544.
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In orthopedics, bone fixation imposes the use of implants in almost all cases. Over time, the materials used for the implant have evolved from inert materials to those that mimic the morphology of the bone. Therefore, bioabsorbable, biocompatible, and bioactive materials have emerged. Our study aimed to review the main types of implant materials used in orthopedics and present their advantages and drawbacks. We have searched for the pros and cons of the various types of material in the literature from over the last twenty years. The studied data show that consecrated metal alloys, still widely used, can be successfully replaced by new types of polymers. The data from the literature show that, by manipulating their composition, the polymeric compounds can simulate the structure of the different layers of human bone, while preserving its mechanical characteristics. In addition, manipulation of the polymer composition can provide the initiation of desired cellular responses. Among the implanting materials, polyurethane is distinguished as the most versatile polymeric material for use both as orthopedic implants and as material for biomechanical testing of various bone reduction and fixation techniques.
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Yan, Lamei, Meiling Zhang, Mihang Wang, Yuhui Guo, Xiangquan Zhang, Junhua Xi, Youwei Yuan, and Alireza Mirzasadeghi. "Bioresorbable Mg-Based Metastable Nano-Alloys for Orthopedic Fixation Devices." Journal of Nanoscience and Nanotechnology 20, no. 3 (March 1, 2020): 1504–10. http://dx.doi.org/10.1166/jnn.2020.17350.
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This research has been accomplished using the advanced selective laser melting (SLM) technique as well as HIP post-treatment in order to improve mechanical properties and biocompatibility of Mg– Ca–Sr alloy. Through this research it becomes clearly noticeable that the Mg–1.5Ca–xSr (x = 0.6, 2.1, 2.5) alloys with Sr exhibited better mechanical properties and corrosion potentials. This is more particular with the Mg–1.5Ca–2.5Sr alloy after HIP post-treatment allowing it to provide a desired combination of degradation and mechanical behavior for orthopedic fracture fixation during a desired treatment period. In vivo trials, there was a clear indication and exhibition that this Mg–1.5Ca–2.5Sr alloy screw can completely dissolve in miniature pig’s body which leads to an acceleration in growth of bone tissues. Mg–Ca–Sr alloy proved potential candidate for use in orthopedic fixation devices through Our results concluded that Mg–Ca–Sr alloy are potential candidate for use in orthopedic fixation devices through mechanical strength and biocompatibility evaluations (in vitro or In vivo).
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Stevenson, M. E., M. E. Barkey, and R. C. Bradt. "Fatigue failures of austenitic stainless steel orthopedic fixation devices." Practical Failure Analysis 2, no. 3 (June 2002): 57–64. http://dx.doi.org/10.1007/bf02719191.
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Vilensky, Viktor Aleksandrovich, Aleksander Pavlovich Pozdeev, Edgar Valentinovich Bukharev, Andrey Aleksandrovich Pozdeev, Timur Faizovich Zubairov, and Leonid Nikolaevich Solomin. "Orthopedic hexapods: history, present and prospects." Pediatric Traumatology, Orthopaedics and Reconstructive Surgery 3, no. 1 (March 15, 2015): 61–69. http://dx.doi.org/10.17816/ptors3161-69.
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The article is dedicated to computer-assisted external fixation devices, so-called hexapods. The main advantage of these frames is capability to make mathematically precise correction of bone fragments in three planes and six degrees of freedom on the base of calculations made in special software application. Recently these devices are mostly applied in long bone deformity correction but the sphere of its effective useis not limited by only this direction. The article presents the history of investigation of these devices, their development, implemented comparative analysis of the basic hexapods: TSF (Taylor Spatial Frame), IHA (Ilizarov Hexapod Apparatus) and Ortho-SUV Frame.
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Bartolomei, Jonathan, Shanthan C. Challa, Kenneth J. Hunt, and Daniel K. Moon. "Current Practices in the Treatment of Syndesmotic Injuries: A Global Perspective." Foot & Ankle Orthopaedics 5, no. 4 (October 1, 2020): 2473011420S0011. http://dx.doi.org/10.1177/2473011420s00113.
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Category: Ankle; Sports Introduction/Purpose: There exists little consensus regarding optimal treatment protocols for syndesmotic injuries. Orthopedic clinicians have implemented a variety of treatment strategies, ranging from immobilization to screw fixation to new flexible fixation devices. While the body of literature is growing with regard to both the biomechanics and clinical outcomes for various constructs and rehabilitation protocols, there is little consensus on the optimal treatment and return to sport strategy for these injuries. We endeavored to assess current approaches to syndesmotic injuries by orthopedic foot and ankle specialists around the world in six athlete scenarios with increasing degrees of injury. Commensurate with the lack of available data to guide treatments, we hypothesize that there will be great variability in the treatment and management of syndesmotic injuries. Methods: A REDcap survey was created with 27 questions, including respondent demographics, indications for treatment of syndesmotic injuries, preferred treatment, preferred technique for repairing the syndesmosis, and post-operative management. Respondents were asked to choose their preferred fixation device and post-operative return to play protocols in six different athlete scenarios (moderate impact, high impact, and very high impact and each with/without complete deltoid injury). The survey was disseminated among the memberships of 18 North American and International medical societies. Society members were surveyed via three emails distributed two weeks apart. Frequencies and percentages were calculated for all categorical responses. Results: A total of 596 providers responded to the survey, including 337 American surgeons and 259 members of various international societies. There was a 70% survey completion rate with a wide geographic distribution among respondents. Flexible devices were the preferred fixation construct (48%), followed by screws (27%), hybrid fixation (19%) and other (6%). There was a higher preference for flexible devices among sports medicine trained providers (58%) relative to non-sports medicine trained providers (44%). 62% of respondents noted that their rehabilitation protocols would not change for each athlete scenario. Considerable variability was present in anticipated full return to sport, ranging from immediately following injury to six months post-op. 33% stated that they would repair the deltoid ‘greater than 50%’ of the time if injured. Conclusion: There is a wide variety of indications and treatment constructs employed by orthopedic surgeons for athletes with ligamentous syndesmotic injuries requiring fixation. Although flexible fixation devices are the preferred choice among all respondents, there was considerable variability in device choices. Fellowship training also appears to affect the preferred fixation method. There was no overall difference between device preference between North American and International respondents (Fig1). There also exists substantial variability in expected return to play for every athlete scenario. The diversity in approaches and post-operative recommendations underscores the need for evidence-based guidelines regarding the management of syndesmotic injuries.
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Boydstun, Seth, Lisa Nash, and Ghazi M. Rayan. "Distal Radius Fracture Fixation Devices and Their Radiographs." Journal of Hand Surgery (Asian-Pacific Volume) 24, no. 04 (November 5, 2019): 412–20. http://dx.doi.org/10.1142/s2424835519500528.
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Background: Distal radius fractures are among the most common fractures encountered in orthopedic practices. If treated operatively, most implants are retained after the fracture heals unless there is hardware failure, limitation of wrist motion, pain, infection, tendon rupture, or tenosynovitis. Complications have been reported during hardware removal, including not knowing the exact implant prior to its removal. If a patient presents for plate removal to a surgeon who did not perform the initial fracture fixation, having a preoperative visual aid can help the treating surgeon choose the right instruments for their removal. Methods: To identify many of the available distal radius fixation devices, we searched the Internet and contacted local industry representatives. We also approached industry personnel at the commercial exhibit of a national hand society meeting to provide us with implants they manufacture. The implants were placed on the volar and dorsal aspects of sawbone models of the distal radius and in one case the radial styloid, using the screws, screwdrivers and accessories in the standard implant set and then posteroanterior and lateral x-rays of the implants were obtained. We created an atlas and a list of the screwdriver(s) used for each. Results: We obtained radiographs and photographs for 28 implants that were manufactured by 14 different companies. Two companies sent us radiographs and photographs placed on either a sawbone or cadaveric model. We found that 7 of the implants were outliers and could be identified easily on the x-rays, whereas 21 implants had similar design of shaft and distal components. Conclusions: To aid the orthopedic surgeon in their removal, we compiled a comprehensive list of most distal radius fixation devices on the market including plates and their corresponding screws and screwdrivers. The goal was to help the surgeon when removing the plate to identify the implant on radiographs.
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Zahaf, Samir, and Said Kebdani. "Study and Analysis of Mechanical Behavior between Rigid and Dynamic Fixation Systems Analyzed by the Finite Element Method." Journal of Biomimetics, Biomaterials and Biomedical Engineering 33 (July 2017): 12–31. http://dx.doi.org/10.4028/www.scientific.net/jbbbe.33.12.
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Orthopedic fixation devices are widely used in treatment of spinal diseases. It is expected that application of dynamic stabilization confers valuable movement possibility besides its main role of load bearing. Comparative investigation between pedicle screw model rigid fixation and (B Dyne, Elaspine, Bioflex, Coflexe rivet) models dynamic fixation systems may elucidate the efficacy of each design. The goal of the present study is to evaluate the efficacy of five fixation systems mounted on L4-L5 motion segment. In this numerical study, a 3D precious model of L4, L5 and their intervertebral disc has been employed based on CT images. five fixation devices have been also implanted internally to the motion segment. Finite element method was used to evaluate stress distribution in the disc and determine the overall displacement of the segment as a measure of movement possibility. The results show that The Coflex rivet implantation can provide stability in all motions and reduce disc annulus stress at the surgical segment (L4-L5), on the other hand, Maximum stress in the disc has been observed in dynamic systems but within the safe range. The greater movement of the motion segment has been also appeared in dynamic fixations. Existence of the fixation systems reduced the stress on the intervertebral disc which might be exerted in intact cases. Use of the fixation devices can considerably reduce the load on the discs and prepare conditions for healing of the injured ones. Furthermore, dynamic modes of fixation confer possibility of movement to the motion segments in order to facilitate the spinal activities.
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Honda Saito, Guilherme, Marcelo Pires Prado, Alberto Abussamra Moreira Mendes, Danilo Ryuko Nishikawa, Beatriz Devito, and Leticia Devito. "PO 18198 - Treatment of distal tibiofibular syndesmosis injury in ankle fractures with suture button." Scientific Journal of the Foot & Ankle 13, Supl 1 (November 11, 2019): 43S. http://dx.doi.org/10.30795/scijfootankle.2019.v13.1031.
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Introduction: Distal tibiofibular syndesmosis (DTFS) injuries in ankle fractures are conventionally treated by DTFS fixation with stabilizing screws. However, screws may cause problems due to their inherent rigidity. Therefore, the popularity of fixation devices that allow DTFS mobility has increased. The objective of the present study is to describe the outcomes of the surgical treatment of ankle fractures with DTFS injury using suture button syndesmosis fixation. Methods: Forty-four patients surgically treated with a suture button for ankle fractures associated with DTFS injury were retrospectively analyzed. The mean follow-up time was 14.7 months. Patient functioning was assessed using the American Orthopedic Foot and Ankle Society (AOFAS) score, the visual analog scale (VAS), the rate of complications and the need for reoperation. Results: The mean AOFAS score at the last follow-up visit was 92 (35-100). The mean VAS was 0.8 (0-7). Eight patients (18%) developed complications, the most common of which were posttraumatic osteoarthrosis and peroneal tendinopathy. Reoperations were performed in 6 patients (13.5%) and included orthopedic hardware removal, peroneal tenoplasty, neurolysis or distal tibiofibular arthrodesis. Only one patient was unable to resume previous activities. Conclusion: Suture button is a reliable alternative for DTFS fixation in ankle fractures, providing excellent functional outcomes with a low rate of complications. This device has the theoretical advantage of allowing physiological mobility of the distal tibiofibular joint and generally requires no subsequent orthopedic hardware removal.
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Langlotz, Frank, Michael Liebschner, Heiko Visarius, Yvan Bourquin, Teija Lund, and Lutz-P. Nolte. "A Pilot Study on Computer-Assisted Optimal Contouring of Orthopedic Fixation Devices." Computer Aided Surgery 4, no. 6 (January 1999): 305–13. http://dx.doi.org/10.3109/10929089909148183.
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Dobbins, J. J., D. Seligson, and M. J. Raff. "Bacterial Colonization of Orthopedic Fixation Devices in the Absence of Clinical Infection." Journal of Infectious Diseases 158, no. 1 (July 1, 1988): 203–5. http://dx.doi.org/10.1093/infdis/158.1.203.
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Langlotz, Frank, Michael Liebschner, Heiko Visarius, Yvan Bourquin, Teija Lund, and Lutz-P. Nolte. "A pilot study on computer-assisted optimal contouring of orthopedic fixation devices." Computer Aided Surgery 4, no. 6 (1999): 305. http://dx.doi.org/10.1002/(sici)1097-0150(1999)4:6<305::aid-igs2>3.3.co;2-8.
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Rahimov, Chingiz R., Ismayil M. Farzaliyev, HamidReza Fathi, Mahammad M. Davudov, Anar Aliyev, and Emin Hasanov. "The Application of Virtual Planning and Navigation Devices for Mandible Reconstruction and Immediate Dental Implantation." Craniomaxillofacial Trauma & Reconstruction 9, no. 2 (June 2016): 125–33. http://dx.doi.org/10.1055/s-0035-1566159.
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Routine reconstruction of subtotal defects of the mandible and orthopedic rehabilitation supported by dental implants is achieved by means of detailed planning and lasts over a year. This article shows the outcomes of single-stage surgical treatment and immediate orthopedic rehabilitation performed with the help of preoperative virtual computer simulation. 3D investigation of pathological and donor sites, virtual simulation of tumor resection, positioning of the dental implants into fibula, virtual flap bending and transfer, virtual bending of fixing reconstruction plates, and fabrication of navigation templates and bridge prosthesis supported by dental implants were done preoperatively. The surgery included tumor resection, insertion of dental implants into fibula, elevation of fibula osteocutaneous free flap, rigid fixation within recipient site, and immediate loading by bridge orthopedic device. On 10-month follow-up, functional and esthetic results were asses as reasonable. Radiography showed dental implants to be integrated and positioned appropriately. We found that successful rehabilitation of the patients with extensive defects of the jaws could be achieved by ablative tumor resection, dental implants insertion prior to flap elevation guided by navigation templates, further osteotomy, modeling of the flap based on navigation template, flap transfer, and rigid fixation within recipient site by prebended plates, with application of prefabricated prosthesis.
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Herdiman, Lobes, Ilham Priadythama, Susy Susmartini, Yusuf Priyandari, I. Nyoman Suci Anindya Murdiyantara, and Durkes Herlina Apriani. "Redesign of OrthoLPPDUNS External Fixation for Bone Reconstruction Using the Function Analysis System Technique (FAST) Method." Jurnal Ilmiah Teknik Industri 19, no. 2 (December 23, 2020): 117–30. http://dx.doi.org/10.23917/jiti.v19i2.10732.
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Taylor Spatial Frame (TSF) better known as an external fixation product from several types of fixation devices in the orthopedic field. The Laboratory of Product Planning and Design has manufactured TSF or called OrthoLPPDUNS external fixations. The OrthoLPPDUNS design found that frame instability forming ring-strut angles caused by strut screw rotations was feeling rough due to backlash. The purpose is how to redesign an OrthoLPPDUNS with a Function Analysis System Technique (FAST). FAST method is applied at each stage of starting from the information stage to the interpretation of the results. The OrthoLPPDUNS design with the joint system uses custom components that cause weakness in frame stability. The use of standard components in joint systems can provide solutions to external fixations, although there are still weaknesses in the ring-strut angle. The OrthoLPPDUNS redesign has a better success rate in terms of stability parameters, allowing more precise bone reconstruction.
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Schiff, Adam P., Jayanth Kumar, Robert R. Burnham, Kamran S. Hamid, and Michael S. Pinzur. "Initial Experience with a Bioresorbable Polymer Anchor." Foot & Ankle Orthopaedics 7, no. 1 (January 2022): 2473011421S0043. http://dx.doi.org/10.1177/2473011421s00436.
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Category: Ankle; Ankle Arthritis Introduction/Purpose: Anchors are frequently used in reconstructive orthopedic surgery to achieve fixation of soft tissue to bone. Anchors vary with respect to material composition, configuration, and methods of fixation at the site of attachment. The fixation component of anchoring devices has generally evolved from metal-fabricated implants to various types of bioresorbable anchors. The SonicAnchorTM (Stryker, Kalamazoo, MI USA) polymer implant provides a unique form of anchor fixation using SonicFusionTM technology to achieve interdigitation within cancellous bone while being radiolucent and providing a small footprint. Methods: During a four-year period, 116 patients underwent a reconstructive orthopedic foot and ankle surgical procedure with the use of at least one bioresorbable polymer anchor (SonicAnchor implant). There were 59 males and 57 females, with an average age of 42 years (range: 12-83 years). Results: A total of 233 bioresorbable anchor (SonicAnchor) implants were used in 116 patients. Of the 116 patients, 108 (93.1%) achieved successful clinical healing of their surgery at their most recent follow-up. The average follow-up duration was 309 days (range: 14-1,429 days). Eight (6.9%) patients were lost to follow-up prior to clinical healing. Two (1.7%) patients underwent reoperation. Also, 65 (56%) patients had at least six months of follow-up and 36 (31%) had at least one year of follow-up. Conclusion: This preliminary clinical trial of patients undergoing soft tissue repair or reconstruction with a bioresorbable polymer appears to perform comparably to other commercially available devices. The lack of adverse events, mechanical failures, or infections further supports the safety of this device.
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Rokhoev, S. A., and L. N. Solomin. "Usage of External Fixation in the Treatment of Adult Patients with Knee Joint Stiffness: Review." Traumatology and Orthopedics of Russia 27, no. 1 (April 15, 2021): 185–97. http://dx.doi.org/10.21823/2311-2905-2021-27-1-185-197.
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Relevance. Knee contractures have an impact on quality of life and are also a common cause of disability. The use of external fixation devices has a certain place in the treatment of this pathology.Purpose. Using the world literature, to identify the modern position, problems, and prospectives of external fixation in the treatment of knee flexion and extension contractures in adult patients.Methods. EMBASE, Medline, Google Scholar, PubMed, e-LIBRARY, and Cyber resources were used. The analysis included publications relative treatment of knee joint stiffness using external fixation in patients over 18 years old, regardless of gender. At analysis several criterial were used: frame ability to provide movements in the knee joint according with its natural kinematics (biomechanics), stable fixation of the femur and tibia, and possibility inserting wires and halfpins in projection of Reference Positions (RP).Results. The devices used in the treatment of knee joint contractures in adult patients were conditionally divided, depending on the type of hinge, into 4 groups: non-hinged, uniaxial, reproducing, and virtual. It has been established that only orthopedic hexapods, based on virtual hinge, can meet all of the criteria mentioned above. However the technology of any orthopedic hexapod hardware and software usage for the treatment of contractures of the knee joint, was not developed till now.Conclusion. The necessity of developing hex-based technology for treatment patients with knee joint contractures was justified by world literature review. Hexapod hardware must provide possibilities of any inclination angle of any ring, and struts fixation not only to base and mobile rings, but to stabilizing as well. Software should be equipped with multi-total residual option. Ortho-SUV Frame (OSF) meets these requirements.
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Ellington, J. Kent, and Kathy Stecco. "Cyclic Fatigue and Creep Resistance Testing of the PUMA SystemTM." Foot & Ankle Orthopaedics 7, no. 1 (January 2022): 2473011421S0018. http://dx.doi.org/10.1177/2473011421s00186.
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Category: Ankle; Basic Sciences/Biologics; Trauma Introduction/Purpose: The PUMA System (Panther Orthopedics, Sunnyvale, CA) is an FDA cleared. superelastic, nitinol based fixation device for the ankle syndesmosis which provides stabilization without over-compression or loosening due to creep from cyclic loading. Objective The objective of this study was to test resistance to lengthening (creep) of the PUMA System in cyclic fatigue testing. Methods: Five PUMA System devices, each having a nitinol Body consisting of six layers, were cycle-tested between 20/40 pounds per cubic foot (lb/ft3) polyurethane foam Bone Blocks (Figure 1).[1] The PUMA System devices were set up with an initial device Active Length of approximately 66 millimeters (mm) between their polyether ether ketone (PEEK) Anchor buttons. All devices were tightened to a minimum of 11.1 Newtons (2.5 pounds force) and cycled at 5 cycles per second (5 Hz) for 4500 cycles to 2.4 mm displacement. Device Active Length was recorded pre- and post-testing. Devices were visually inspected for any break in the 30 nitinol layers. [1] ASTM F1839: Standard Specification for Rigid Polyurethane Foam for Use as a Standard Material for Testing Orthopedic Devices and Instruments. Results: None of the 30 layers incorporated in the 5 PUMA SystemTM device Bodies failed due to cyclic fatigue. Also, there was little-to-no difference between pre- and post-testing Active Length ( Figure 2 ). More specifically an average increase of only 0.2% in length with a with a Standard Deviation of 0.16% evidences no significant creep (Table 1). Conclusion: The PUMA SystemTM allows for ankle syndesmosis repair with an implant that experiences no significant creep as demonstrated in cyclic-fatigue testing under challenging displacement cycle testing.
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Moore, R. M., R. A. Bright, L. L. Jeng, C. M. Sharkness, S. E. Hamburger, and P. M. Hamilton. "The prevalence of internal orthopedic fixation devices in children in the United States, 1988." American Journal of Public Health 83, no. 7 (July 1993): 1028–30. http://dx.doi.org/10.2105/ajph.83.7.1028.
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Arciola, C. R., Y. H. An, D. Campoccia, M. E. Donati, and L. Montanaro. "Etiology of Implant Orthopedic Infections: A Survey on 1027 Clinical Isolates." International Journal of Artificial Organs 28, no. 11 (November 2005): 1091–100. http://dx.doi.org/10.1177/039139880502801106.
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In spite of the recent achievements derived from modern protocols of prophylaxis, orthopedic surgical infections still remain unacceptably frequent, especially in light of the often devastating outcomes of septic complications. The spectrum and the prevalence of the bacteria most frequently involved in orthopedic infections are here explored, with particular reference to those infections associated to implant biomaterials, which were grouped based on device typology. During a 30 months period (from September 2000 to April 2003), 1027 microbial strains were consecutively isolated from 699 patients undergoing revision surgery at the Rizzoli Orthopedic Institute. 775 (75.5%) of all these microorganisms were identified as belonging to the Staphylococcus genus, 82 (8%) to the Enterobacteriaceae family, 75 (7.3%) to the Pseudomonas genus, 54 (5.3%) to the Enterococcus genus and 20 (1.9%) to the Streptococcus genus. While confirming the importance of staphylococci as the most diffuse cause of infection, our data indicate an unexpectedly high prevalence of S. epidermidis on infected hip and knee arthroprostheses, respectively of 42% and 44%. The spectrum of bacteria infecting either internal or external fracture fixation devices appears to differ from that of hip and knee arthroprostheses and more closely resembles that of infections non-associated to medical devices, being characterized by a relatively higher prevalence of Staphylococcus aureus (over 40%) and Pseudomonas aeruginosa. Enterobacteriaceae and members of the Streptococcus and Corynebacterium genera are frequently associated with implants in which surgical incisions were made near the perineum, determining a completely altered spectrum.
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Hunt, Kenneth, Shanthan Challa, Pieter D’Hooghe, Pam Kumparatana, Phinit Phisitkul, Jeremy McCormick, and Annunziato Amendola. "The Evolving Approach to Treating Syndesmotic Injuries in the Elite Athlete: An International Perspective." Foot & Ankle Orthopaedics 4, no. 4 (October 1, 2019): 2473011419S0003. http://dx.doi.org/10.1177/2473011419s00034.
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Category: Ankle, Sports Introduction/Purpose: There exists little consensus regarding optimal treatment protocols for syndesmotic injuries. Orthopaedic clinicians have implemented a variety of treatment strategies, ranging from immobilization to screw fixation to new flexible fixation devices. While the body of literature is growing with regard to both the biomechanics and clinical outcomes for various constructs and rehabilitation protocols, there is little consensus on the optimal treatment and return to sport strategy for these injuries. We endeavored to assess current approaches to syndesmotic injures by orthopedic foot and ankle specialists around the world in 6 athlete scenarios with increasing degree of injury. Commensurate with the lack of available data to guide treatments, we hypothesize that there will be variability in the treatment and management strategies for syndesmotic injuries. Methods: A REDcap survey was created with 27 questions, including respondent demographics, indications for treatment of syndesmotic injuries, preferred treatment, preferred technique for repairing the syndesmosis and post-operative management. Respondents were asked to choose their preferred fixation device and post-operative return to play protocols in six different athlete scenarios (moderate impact, high impact and very high impact and each with/without complete deltoid injury). The survey was disseminated among the memberships of 18 North American and International medical societies. Society members were surveyed via three emails disseminated 2 weeks apart. Frequencies and percentages were calculated for all categorical responses. Results: A total of 596 providers responded to the survey, including 337 American surgeons and 259 members of various international societies. There was a 70% survey completion rate with a wide geographic distribution among respondents. Flexible devices were the preferred fixation construct (48.1%), followed by screws (27.5%), hybrid fixation (18.5%) and other (5.9%). There was a higher preference for flexible devices among sports medicine trained providers. 62% of respondents noted that their rehabilitation protocols would not change for each athlete scenario. Considerable variability was present in anticipated full return to sport, ranging from immediately following injury to 6 months post-op (Fig 1). One-third of respondents indicated that they repair the deltoid greater than 50% of the time when injured. Conclusion: We found a wide variety of indications and treatment constructs employed by orthopaedic surgeons for athletes with ligamentous syndesmotic injuries requiring fixation. Although, flexible fixation devices are the preferred among all respondents but there was a considerable variability in device choices. Fellowship training also appears to affect the preferred fixation device choice. There also exists substantial variability in expected return to play for every athlete scenario (Fig 1). The diversity in approaches and post-operative recommendations underscores the need for evidence-based guidelines to inform management of syndesmotic injuries.
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Sadoughi, Farahnaz, Ali Behmanesh, Farid Najd Mazhar, Mohammad Taghi Joghataei, Shahram Yazdani, Roshanak Shams, Hassan Morovvati, Sareh Najaf Asaadi, and Araz Vosough. "Bone Healing Monitoring in Bone Lengthening Using Bioimpedance." Journal of Healthcare Engineering 2022 (April 7, 2022): 1–13. http://dx.doi.org/10.1155/2022/3226440.
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The most common technique of orthopedic surgical procedure for the correction of deformities is bone lengthening by “distraction osteogenesis,” which requires periodic and ongoing bone assessment following surgery. Bone impedance is a noninvasive, quantitative method of assessing bone fracture healing. The purpose of this study was to monitor bone healing and determine when fixation devices should be removed. The left tibia of eight male New Zealand white rabbits (2.4 ± 0.4 kg) undergoing osteotomy was attached with a mini-external fixator. The bone length was increased by 1 cm one week after surgery by distracting it 1 mm per day. Before and after osteotomy, as well as every week after, bone impedance was measured in seven frequency ranges using an EVAL-AD5933EBZ board. Three orthopedic surgeons analyzed the radiographs using the Radiographic Union Scale for Tibial (RUST) score. The Kappa Fleiss coefficient was used to determine surgeon agreement, and the Spearman rank correlation coefficient was used to find out the relationship between impedance measurements and RUST scores. Finally, the device removal time was calculated by comparing the bone impedance to the preosteotomy impedance. The agreement of three orthopedic surgeons on radiographs had a Fleiss’ Kappa coefficient of 49%, indicating a moderate level of agreement. The Spearman rank correlation coefficient was 0.43, indicating that impedance and radiographic techniques have a direct relationship. Impedance is expected to be used to monitor fractured or lengthened bones in a noninvasive, low-cost, portable, and straightforward manner. Furthermore, when used in conjunction with other qualitative methods such as radiography, impedance can be useful in determining the precise time of device removal.
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Bartolomei, Jonathan, Kenneth Hunt, and Shanthan Challa. "The Evolving Approach to Treating Syndesmotic Injuries in the Elite Athlete: An International Perspective." Orthopaedic Journal of Sports Medicine 8, no. 7_suppl6 (July 1, 2020): 2325967120S0040. http://dx.doi.org/10.1177/2325967120s00400.
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Objectives: There exists little consensus regarding optimal treatment protocols for syndesmotic injuries. Orthopaedic clinicians have implemented a variety of treatment strategies, ranging from immobilization to screw fixation to new flexible fixation devices. While the body of literature is growing with regard to both the biomechanics and clinical outcomes for various constructs and rehabilitation protocols, there is little consensus on the optimal treatment and return to sport strategy for these injuries. We endeavored to assess current approaches to syndesmotic injures by orthopedic foot and ankle specialists around the world in 6 athlete scenarios with increasing degree of injury. Commensurate with the lack of available data to guide treatments, we hypothesize that there will be great variability in the treatment and management of syndesmotic injuries. Methods: A REDcap survey was created with 27 questions, including respondent demographics, indications for treatment of syndesmotic injuries, preferred treatment, preferred technique for repairing the syndesmosis and post-operative management. Respondents were asked to choose their preferred fixation device and post-operative return to play protocols in six different athlete scenarios (moderate impact, high impact and very high impact and each with/without complete deltoid injury). The survey was disseminated among the memberships of 18 North American and International medical societies. Society members were surveyed via three emails disseminated 2 weeks apart. Frequencies and percentages were calculated for all categorical responses. Results: A total of 596 providers responded to the survey, including 337 American surgeons and 259 members of various international societies. There was a 70% survey completion rate with a wide geographic distribution among respondents. Flexible devices were the preferred fixation construct (48%), followed by screws (27%), hybrid fixation (19%) and other (6%). There was a higher preference for flexible devices among sports medicine trained providers (58%) relative to non-sports medicine trained providers (44%). 62% of respondents noted that their rehabilitation protocols would not change for each athlete scenario. Considerable variability was present in anticipated full return to sport, ranging from immediately following injury to 6 months post-op (Fig 1). 33% stated that they would repair the deltoid ‘greater than 50%’ of the time if injured. Conclusion: There is a wide variety of indications and treatment constructs employed by orthopaedic surgeons for athletes with ligamentous syndesmotic injuries requiring fixation. Although, flexible fixation devices are the preferred among all respondents but there was a considerable variability in device choices. Fellowship training also appears to affect the preferred fixation device choice. There also exists substantial variability in expected return to play for every athlete scenario (Fig 1). The diversity in approaches and post-operative recommendations underscores the need for evidence-based guidelines regarding management of syndesmotic injuries.
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Walker, Brett, Chad Amato, Olena Palyvoda, Sharada Vangipuram, Martin Weaver, Zain Sayeed, Muhammad Talha Padela, and Walid K. Yassir. "Prevalence of Bacterial Contamination of Casting Material in a Pediatric Population." International Journal of Pediatrics 2020 (January 22, 2020): 1–5. http://dx.doi.org/10.1155/2020/4717385.
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Surgical site infection is a relatively common and devastating complication following pediatric orthopedic surgery. Many infections have been determined to be the result of settled airborne particles on surgical equipment and the sterile field. Fiberglass casts are commonly used orthopedic fixation devices before and after surgery; however, fiberglass casting material is expelled during the removal process and represents an uninvestigated area for the possibility of cast saw dust as a source of airborne bacterial contamination in an operating room setting. This study evaluates the prevalence and distribution of microbiota on 90 pediatric casts by collecting and culturing fiberglass cast material from 90 pediatric casts. Bacterial identification was performed using a Bruker Biotyper Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry device. 81 out of 90 casts (90%) showed evidence of microbial contamination. Isolated species were very diverse and ranged from normal skin flora to opportunistic pathogens. The 5 most commonly isolated organisms were Acinetobacter pittii, Enterobacter cloacae, Micrococcus luteus, Staphylococcus epidermidis, and Staphylococcus hominis. Further investigation is required to determine if casting material is truly a cause of surgical site infection.
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Udin Hassan, Hassan. "Functional Outcome of Ilizarov Technique in Managing Proximal Tibial Fracture in Combined Military Hospital, Rawalpindi." Journal of Islamabad Medical & Dental College 11, no. 4 (January 3, 2023): 204–10. http://dx.doi.org/10.35787/jimdc.v11i4.760.
Full textAbstract:
Background: Tibial plateau fractures involve injuries affecting the major weight-bearing joint and result in functional impairment which can be prevented by implying competent treatment techniques including dual column plating, assisted reduction, internal fixation with plating and Ilizarov circular fixator. The objective of this study was to evaluate the functional outcome of Ilizarov technique in treating closed tibial plateau fractures.
Methodology: A Quasi experimental study was conducted in the Orthopedic department of Combined Military Hospital, Rawalpindi from 30th July 2019 to 29th January 2020. A total of 100 patients with tibial plateau fractures of Schatzker type III to VI, 20 to 60 years of age of either gender were included. In all patients, Ilizarov technique was performed. Data were entered in SPSS 22. Descriptive analysis was done for quantitative variables and percentages were calculated for qualitative variables. Chi square test was applied to determine association of variables with functional outcome.
Results: Mean age of patients was 37.42 ± 8.94 years. Out of 100 patients, 70% were males and 30% were females, 76% patients managed with Ilizarov technique in treating closed tibial plateau fracture had excellent functional outcome, 15% good outcome, 5% fair and 4% poor outcome. Functional outcome with respect to age, gender, BMI and DM showed statistically significant difference with p value 0.017, 0.016, 0.004 and 0.001 respectively.
Conclusion: Functional outcome of Ilizarov technique in treating closed tibial plateau fracture is significantly better.
Keywords: Ilizarov Technique, Orthopedic Fixation Devices, Tibial Fractures
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Paiva, José C. C., Luís Oliveira, Maria Fátima Vaz, and Sofia Costa-de-Oliveira. "Biodegradable Bone Implants as a New Hope to Reduce Device-Associated Infections—A Systematic Review." Bioengineering 9, no. 8 (August 22, 2022): 409. http://dx.doi.org/10.3390/bioengineering9080409.
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Bone fractures often require fixation devices that frequently need to be surgically removed. These temporary implants and procedures leave the patient more prone to developing medical device-associated infections, and osteomyelitis associated with trauma is a challenging complication for orthopedists. In recent years, biodegradable materials have gained great importance as temporary medical implant devices, avoiding removal surgery. The purpose of this systematic review was to revise the literature regarding the use of biodegradable bone implants in fracture healing and its impact on the reduction of implant-associated infections. The systematic review followed the PRISMA guidelines and was conducted by searching published studies regarding the in vivo use of biodegradable bone fixation implants and its antibacterial activity. From a total of 667 references, 23 studies were included based on inclusion and exclusion criteria. Biodegradable orthopedic implants of Mg-Cu, Mg-Zn, and Zn-Ag have shown antibacterial activity, especially in reducing infection burden by MRSA strains in vivo osteomyelitis models. Their ability to prevent and tackle implant-associated infections and to gradually degrade inside the body reduces the need for a second surgery for implant removal, with expectable gains regarding patients’ comfort. Further in vivo studies are mandatory to evaluate the efficiency of these antibacterial biodegradable materials.
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Hunt, Kenneth, Daniel Moon, Phinit Phisitkul, Jeremy McCormick, and Annunziato Amendola. "Evolving and Innovative Treatments for Syndesmosis Injuries." Foot & Ankle Orthopaedics 3, no. 3 (July 1, 2018): 2473011418S0025. http://dx.doi.org/10.1177/2473011418s00256.
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Category: Sports Introduction/Purpose: Despite extensive research of syndesmotic fixation techniques, there is little consensus regarding optimal treatment and return to play protocols for isolated syndesmotic injuries. As competing treatment goals may exist, orthopedic clinicians have resorted to a wide variety of treatment strategies, ranging from screw fixation to suture fixation in various constructs. Given the myriad techniques and constructs, it is increasingly important to understand the rationale and intended patient setting for selecting particular implants and constructs. Undoubtedly, a multitude of factors contribute to the range of outcomes following syndesmotic fixation. While there are various theoretical arguments made for selecting one construct over another, this study seeks to assess the distribution of current practice approaches to syndesmotic injuries by foot and ankle orthopaedic surgeons at large. Methods: This cross-sectional study collected data from trained, licensed orthopedic surgeons (i.e. MD, DO, etc.) practicing in North America that treat isolated syndesmotic injuries. A one-time online survey was disseminated to the AOFAS membership. The survey contained questions regarding participant demographics, indications for treating syndesmotic injuries, preferred technique for repairing the syndesmosis and post-operative management, as applied to six athlete scenarios (moderate, high, and very high impact athletes with complete syndesmosis injury, with and without complete deltoid injury), and post-operative return to play protocols. Frequencies and percentages were calculated for all categorical responses using STATA 14.2. Free text responses were analyzed for common themes by fellowship trained, licensed orthopedic surgeons. Results: 273 of 337 responses were complete. Radiographic widening of greater than 2 mm at the syndesmosis was a sole indication for surgery for 83% of respondents, and arthroscopic widening of the syndesmosis was a sole indication for 75%. No clinical exam or MRI finding reached a threshold of 50% as a sole indication. In moderate and high-impact athletes with complete syndesmotic injury, the majority of respondents use one or two flexible fixation devices (61.5% and 50.5%, respectively), 25% use screws only, and 23.7% use a combination. More than 70% do not change their treatment construct choice in the presence of a complete deltoid injury. There was considerable variability in anticipated return to sport amongst respondents for all injury scenarios, ranging from 2 weeks to 6 months. Conclusion: There is a wide variety of indications and treatment constructs employed by orthopaedic surgeons for athletes with ligamentous syndesmotic injuries requiring fixation. Despite absent consensus, several trends were evident. Flexible devices were utilized by a majority of respondents in all scenarios, even with ‘very high impact’ scenarios. Hybrid constructs are also common. The presence of a complete deltoid injury impacted fixation constructs for very few respondents. There is substantial variability in expected return to play for all athlete and injury scenarios. The diversity of approaches highlights the need for evidence-based guidelines regarding management of syndesmotic injuries.
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Ducheyne, Paul. "Stimulation of Biological Function With Bioactive Glass." MRS Bulletin 23, no. 11 (November 1998): 43–49. http://dx.doi.org/10.1557/s0883769400030992.
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An estimated 11 million people in the United States have at least one medical-device implant. Orthopedic implants account for 51.3% of all implants. They include fixation devices (usually fracture fixation) and artificial joints, used in 77% and 23% of the cases, respectively. Among the joint-replacement procedures, hip and knee surgeries represent 90% of the total and in 1988 were performed 310,000 times in this country. Currently more than half the joint-reconstruction devices are used with bone cement, which is a polymer grout that keeps the prosthesis components in place in the bone. The fixation in the other cases depends on the bone's ability to grow in contact with the device. This can be achieved by making the prosthesis surface porous such that bone grows into interstices or by making the surface chemically reactive with bone tissue such that a continuous, uninterrupted transition is formed from tissue to device. Bioactive glasses (BGs) and ceramics are the materials of choice to achieve this effect on bone-tissue bonding. Bone-growth stimulation is also sought in the treatment of difficult fractures. In the United States alone, there are 1.23 million fractures that require a bone plate. Of that total, approximately 1 million require between 10 cm3 and 100 cm3 of graft material to stimulate bone repair. At this time, autogenous bone graft represents the gold standard: This graft is typically bone tissue taken from the patient's own pelvic bone. Given the morbidity associated with this procedure and the frequently insufficient quantities available, extensive efforts for suitable alternatives are currently under way. Calcium phosphate ceramics and glasses, either by themselves or as carriers for bone (or “osteogenic”) cells or various bone-growth factors, are also prime candidates for these applications.
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Wang, Jiang Bo, Zai Yan Shang, Zhi Shan Yuan, Jin Zhou, Zhao Wei Feng, Wei Dong Miao, and Ming Zhu. "Study on the Mechanical Property and Microstructure of Surgical Implanted Ti-6Al-7Nb Titanium Alloy." Advanced Materials Research 535-537 (June 2012): 945–49. http://dx.doi.org/10.4028/www.scientific.net/amr.535-537.945.
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Ti-6Al-7Nb titanium alloy is attractive to medical device industry for orthopedic applications, such as total hip replacement systems, fracture fixation plates, intermedullary rods and nails, spinal devices, screws, and wires. Substituting Niobium for Vanadium as the beta stabilizing element, Ti-6Al-7Nb titanium alloy shows higher biocompatability than Ti-6Al-4V titanium alloy. The present research is designed to investigate the influence of annealling temper on the mechanical properties and microstructures of Ti-6Al-7Nb titanium alloy, by optical microscopic (OM) and scanning electron microscopic (SEM), and tensile test. The results show that the microstructures after recrystalization heat treatment comprise a mount of equiaxed α grains in the matrix of equiaxed β phase with α (hcp)/ β (bcc) platelets. The microstructures with partial recrystalization α phase possess better mechanical properties which conform to the ASTM F 1295 standard and ISO 5832-11 standard. Compared with Ti-6Al-4V titanium alloy and CP titanium alloy, Ti-6Al-7Nb titanium alloy is suitable to be used as implanted biomaterial devices to replace ill-functioning or missing tissues or organs.
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Fox, Rabun S., Ryan G. Rogero, Daniel Corr, Steven M. Raikin, David I. Pedowitz, Joseph Larwa, Joseph T. O’Neil, and Daniel J. Fuchs. "Outcomes of Suture-Button Fixation for Treatment of Maisonneuve Injuries." Foot & Ankle Orthopaedics 5, no. 4 (October 1, 2020): 2473011420S0021. http://dx.doi.org/10.1177/2473011420s00213.
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Category: Ankle; Trauma Introduction/Purpose: The purpose of this study was to evaluate the radiographic and functional outcomes of suture-button devices for treatment of Maisonneuve injuries, which present unique considerations due to the proximal one-third fibular fracture, through which the distal fibular segment can potentially shorten. Methods: Patients undergoing operative management of Maisonneuve injuries from 2014-2018 utilizing suture-button devices with 2 fellowship-trained foot and ankle orthopedic surgeons were included. Exclusion criteria included use of a transosseous syndesmotic screw, fixation of the proximal fibular fracture, or less than 12 months follow-up. Medial clear space, tibiofibular clear space, tibiofibular overlap, talocrural angle, and distal fibular congruency on the injured and non-injured ankles were measured. Patients also completed the Foot & Ankle Ability Measure (FAAM)-Activities of Daily Living (ADL) and -Sports subscales and Visual Analog Scale (VAS) for pain (n/100). Thirty-three patients were included. Results: Three (9.1%) patients experienced a postoperative complication, including 1 wound dehiscence and 2 requiring hardware removal. No significant differences were demonstrated in radiographic parameters measured between 6-week and final radiographs on the injured ankle, as well between final radiographs taken of the injured and uninjured ankles (Table 1). At mean follow-up of 34.7 (range, 12-58) months, patients had a mean FAAM-ADL of 91.1, FAAM-Sports of 81.7, and VAS pain of 14.3. Conclusion: This study demonstrates that isolated use of suture-button devices for syndesmotic fixation in Maisonneuve injury patterns is effective at maintaining fibular length and reduction of the syndesmosis, as well as achieving satisfactory patient outcomes. [Table: see text]
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Bazhenov, Viacheslav, Anna Li, Artem Iliasov, Vasiliy Bautin, Sofia Plegunova, Andrey Koltygin, Alexander Komissarov, Maxim Abakumov, Nikolay Redko, and Kwang Seon Shin. "Corrosion Behavior and Biocompatibility of Hot-Extruded Mg–Zn–Ga–(Y) Biodegradable Alloys." Journal of Functional Biomaterials 13, no. 4 (December 12, 2022): 294. http://dx.doi.org/10.3390/jfb13040294.
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Fixation screws and other temporary magnesium alloy fixation devices are used in orthopedic practice because of their biodegradability, biocompatibility and acceptable biodegradation rates. The substitution of dissolving implant by tissues during the healing process is one of the main requirements for biodegradable implants. Previously, clinical tests showed the effectiveness of Ga ions on bone tissue regeneration. This work is the first systematic study on the corrosion rate and biocompatibility of Mg–Zn–Ga–(Y) alloys prepared by hot extrusion, where Ga is an additional major alloying element, efficient as a bone-resorption inhibitor. Most investigated alloys have a low corrosion rate in Hanks’ solution close to ~0.2 mm/year. No cytotoxic effects of Mg–2Zn–2Ga (wt.%) alloy on MG63 cells were observed. Thus, considering the high corrosion resistance and good biocompatibility, the Mg–2Zn–2Ga alloy is possible for applications in osteosynthesis implants with improved bone tissue regeneration ability.
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Damrongdej, Piyabongkarn. "Benefit of dorsal laminectomy without lumbosacral stabilization in lumbosacral traumatic cat." Ukrainian Journal of Veterinary and Agricultural Sciences 2, no. 1 (March 26, 2019): 24–26. http://dx.doi.org/10.32718/ujvas2-1.05.
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Two cats were diagnosed with depression of caudal equina spinal nerve and lumbosacral spinal trauma that revealed rapid improving clinical signs after 1 month of dorsal laminectomy at the region of lumbar and sacral vertebrae without internal and external stabilization devices. This report showed that dorsal laminectomy was a powerful procedure for decompression caudal equina spinal injuries in stable lumbosacral vertebral trauma in cats without ancillary fixation methods. Dorsal laminectomy is valuable technique for correction of fracture/luxation of vertebrae that this procedure can reduce spinal cord edema, and axonal disruption. Stabilization of vertebrae by the orthopedic implants may be not necessary in small cat that has enough vertebral stability as the same in two these cases.
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Borghi, B., E. Pignotti, G. Famelli, and S. Baroncini. "Autotransfusion in Major Orthopedic Surgery: Postoperative Evaluation." International Journal of Artificial Organs 21, no. 6_suppl (May 1998): 88–94. http://dx.doi.org/10.1177/039139889802106s18.
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The aim of this prospective study was to assess the postoperative progress of autotransfused patients (predonated blood + intra and postoperative blood salvage) in major orthopedic surgery. Patients 1,785 consecutively treated patients (1,198 females, 587 males), mean aged 62± 11 years, basal Hb 13.4± 1,4 g/dl. Surgery Total hip arthroplasty (THA, 1,229 pts), THA after the removal of internal fixation devices (RFD+THA THA 18), total knee arthroplasty (TKA 263 pts), hip revision (HR) (cup+stem THR 197, cupR 53, stemR 16 pts) and knee revision (KR 9 pts). Results Homologous tranfusions were carried out in 130 patients (7.3%). The need to use homologous transfusions was significantly associated to the female sex (8.5% vs 4.7%, p=0.0049), older age (67.8 vs 62.1 years; p=0.0001), lower baseline Hb (12.3 vs 13.5g/dl p=0.0001), use of Calcium Heparin (CaHe) for antithromboembolic prophylaxis (CaHe 18% vs low molecular weight heparin 7.8% vs Indobufen 5% p=0.0001), lower number of predeposits (zero 62.5% vs one 16.2% vs two 5.2% vs three 6.4% vs four 5.5%, p=0.0001), type of surgery (THR 16.2% vs cupR 11.3% vs RPS+THA 11.1% vs stemR 6.2% vs THA 6.1% vs TKA 5.7% vs KR 0%, p=0.0001), presence of coexisting diseases like coronary heart disease (15.7% vs 6.2%, p=0.0001), and nephropathy (18.7 vs 7.1%, p=0.031), higher ASA (ASA4 18.7% vs ASA3 10.1% vs ASA2 6.6% vs ASA1 0%, p=0.0001). Postoperative hospitalization was significantly shorter in patients only autotransfused (12.3 vs 16.5 days, p=0.0001). The result confirms the central role of the anesthesiologist in the application of blood saving techniques.
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Sukotjo, Cortino, Tiburtino J. Lima-Neto, Joel Fereira Santiago Júnior, Leonardo P. Faverani, and Michael Miloro. "Is There a Role for Absorbable Metals in Surgery? A Systematic Review and Meta-Analysis of Mg/Mg Alloy Based Implants." Materials 13, no. 18 (September 4, 2020): 3914. http://dx.doi.org/10.3390/ma13183914.
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Magnesium (Mg) alloys have received attention in the literature as potential biomaterials for use as absorbable implants in oral and maxillofacial and orthopedic surgery applications. This study aimed to evaluate the available clinical studies related to patients who underwent bone fixation (patients), and received conventional fixation (intervention), in comparison to absorbable metals (comparison), in terms of follow-up and complications (outcomes). A systematic review and meta-analysis were performed in accordance with the PRISMA statement and PROSPERO (CRD42020188654), PICO question, ROBINS-I, and ROB scales. The relative risk (RR) of complications and failures were calculated considering a confidence interval (CI) of 95%. Eight studies (three randomized clinical trial (RCT), one retrospective studies, two case-control studies, and two prospective studies) involving 468 patients, including 230 Mg screws and 213 Titanium (Ti) screws, were analyzed. The meta-analysis did not show any significant differences when comparing the use of Mg and Ti screws for complications (p = 0.868). The estimated complication rate was 13.3% (95% CI: 8.3% to 20.6%) for the comparison group who received an absorbable Mg screw. The use of absorbable metals is feasible for clinical applications in bone surgery with equivalent outcomes to standard metal fixation devices.
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Papay, Frank A., Louis Morales, David S. Motoki, and Duane K. Yamashiro. "Presurgical Orthopedic Premaxillary Alignment in Cleft Lip and Palate Reconstruction." Cleft Palate-Craniofacial Journal 31, no. 6 (November 1994): 494–98. http://dx.doi.org/10.1597/1545-1569_1994_031_0494_popaic_2.3.co_2.
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Premaxillary malposition is a difficult problem in cleft lip and palate repair. Orthopedic palatal devices are excellent in positioning the premaxilla, though they are somewhat cumbersome and require complex techniques in adjusting precisely the position of the premaxilla prior to repair. A new technique has been developed for premaxillary repositioning in conjunction with palatal shelf expansion and obturation. The procedure implements microplate fixation anterior to the premaxillary segment and linked to a palatal splint by adjustable elastics. The microplate is Inserted through a nasal floor incision and secured by a tight submucosal tunnel through minimal dissection between the prolabium and premaxllla. The last hole of each mlcroplate protrudes through the mucosa and is attached to a pin-retained palatal splint by an elastic chain. Differential tension is applied to the chains to allow gradual repositioning of the protruding maxilla while the splint expands and maintains positioning of the lateral palatal segments. These elastic retractors can be adjusted by staff in the outpatient office. During the past 2 years, this technique has been used successfully in 21 consecutive patients with unilateral or bilateral cleft lip and palate. Its technical ease and design allows simple adjustments to control premaxillary positioning and growth before definitive surgical closure.
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Alam, Muhammad Junayed, and AKM Mustafa Kamal Pasha. "Epidemiological Features of Hospital Acquired Infection in a Tertiary Military Hospital." Ibrahim Cardiac Medical Journal 9, no. 1-2 (March 5, 2020): 29–35. http://dx.doi.org/10.3329/icmj.v9i1-2.53984.
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Background & objective: Hospital Acquired Infections (HAIs) are the major concern in developing countries commonly affecting the ill patients in hospital settings. This study was conducted among the surgical patients admitted in the Combined Military Hospital (CMH), Dhaka to see the prevalence of HAI and factors influencing it.
Method: The present cross-sectional study was carried out on patients admitted in the Combined Military Hospital (CMH), Dhaka between 01 July to 31 December 2018 to find the epidemiological features of Hospital Acquired Infection (HAI). Patients who acquired infection while admitted in CMH in whom the infection was not present at admission or who were incubating pathogenic microorganisms at the time of admission and manifested signs and symptoms after discharge were the study population. However, psychologically abnormal patients were excluded. A total of 200 patients were selected consecutively. The variables included in the study were demographic characteristics, co-morbidity, immunosuppressive conditions, immunosuppressive therapy.
Result: Out 200 patients, 24(12%) developed HAI. Analysis of demographic features revealed that age and sex of the patients did not act as determinants of HAI (0.378 and p = 0.635 respectively). Patients dependent on others for most of their day-to-day activities tend to develop HAI more often than those who did not require assistance in their daily activities (p = 0.005). Patients inserted with an invasive device were more likely to develop HAI (14.9%) than those who were not inserted with such devices (7.6%) (p = 0.121). The patients of chronic respiratory disease and diabetes mellitus frequently develop HAI than the patients with other illnesses (p = 0.040). Colostomy tube was the prime source of HAI (50%) followed by gastrostomy tube (33.3%), urinary catheter (20.6%), orthopedic fixation device (20%) and mechanical ventilation (16.7%) (p< 0.001) with longer the use of invasive devices the higher is the chance of HAI (p = 0.001). No association was observed between immunosuppressive condition of the patients and development of HAI (p = 0.558). Association between immunosuppressive therapy and HAI was not found to be significant (p = 0.495). HAI demonstrated their significant presence in patients with emergency operation compared to that in patients with routine operation (p = 0.047).
Conclusion: The study concluded that every one in eight patients admitted in CMH may develop HAI. Patients dependent on others for their daily activities and patients inserted with an invasive device more often develop HAI than those who are independent or without an invasive device. Patients of chronic respiratory disease and diabetes mellitus are more prone to develop HAI. Colostomy and gastrostomy tube also act as the main source of HAI. So does the urinary catheter, orthopedic fixation device and mechanical ventilation with longer the use of invasive devices the higher is the chance of HAI. Emergency operation also tends to be associated with HAI.
Ibrahim Card Med J 2019; 9 (1&2): 29-35
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Filip, Alexandru, Ovidiu Alexa, Paul Dan Sirbu, Cristiana Filip, Liviu Andrusca, IonuȚ-Alin Pascal, Stefan Oprea, and Oana Viola Badulescu. "Assessment of the Mechanical Properties of Orthopedic Screws Coated with Polyurethane Acrylate Containing Hydroxyapatite, Intended to Fix the Fragility Fractures." Materiale Plastice 56, no. 4 (December 30, 2019): 1028–32. http://dx.doi.org/10.37358/mp.19.4.5302.
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The fragility fracture fixation confronts with the major problem of implant loosening due to the altered bone structure. Techniques used to fragility fracture stabilization includes metals devices, cements or adhesives. Different types of cements and adhesive can be obtained by chemical manipulation in order to provide a more efficient transition between the metal surface and the real bone. Thus, by selecting the appropriate chemical composition and ration between the components, synthetic cement and adhesive can provide a proper interface that ensure a perfect cohesion between the implant material and the natural bone. Most of the studies point the benefit of these synthetic materials in improving screw fixation strength. That is why, currently, the synthetic materials used in prosthesis are improved by associating with natural components of the bone, such as hydroxyapatite. For osteoporosis, which is characterized by demineralization, the association of the implanted material with hydroxyapatite is expected to be a suited solution for bone matrix regeneration after implantation. The aim of the current study was to assess the mechanical properties of orthopedic screws coated with a new polyurethane acrylate polymer containing hydroxyapatite in order to improve the stability of the screw for the subsequent fixation of the fragility fracture. To test the efficiency of the new hydroxyapatite containing polymer, the mechanical behavior of the coated screws was evaluated. Our data show that the augmented screw can be obtained by incorporating lower hydroxyapatite concentrations.
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Saibaba, Balaji, Nirmal R. Gopinathan, Prateek Behera, and Siva S. Santhanam. "Prospective Role of Uniplanar Compressible External Fixation Devices in the Management of Pathological Diaphyseal Fractures Secondary to Osteomyelitis in Children." Journal of Postgraduate Medicine, Education and Research 51, no. 1 (2017): 17–21. http://dx.doi.org/10.5005/jpmer-51-1-17.
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ABSTRACT Introduction Management of pathological diaphyseal fractures secondary to osteomyelitis in children still remains a nightmare for the treating orthopedic surgeon owing to the highly unpredictable clinical course and lack of certainty in achieving successful results. This study highlights the potential role of rail fixator in the management of pathological femur fracture secondary to osteomyelitis in children. Materials and methods A total of five children (8—13 years age group) with pathological diaphyseal fractures of femur (four cases) and tibia (one case), operated between January 2014 and December 2014, were included in the study. Chronic osteomyelitis was the underlying etiology in all the cases. The surgical management consisted of thorough debridement, lavage, freshening of fractured bone ends, opening of the bone ends, reduction and external stabilization using pediatric monorail fixator. All patients received postoperative antibiotics, based on intraoperative culture and sensitivity reports, for 6 weeks (intravenously for the initial 3 weeks, orally for the remaining 3 weeks). Weight bearing and knee range of motion were started in the early postoperative period as soon as the children were pain free. Results Staphylococcus aureus was the causative organism in all the cases. Out of five cases, four fractures united: Three femurs (between 9 and 12 weeks) and one tibia (11 weeks). There was one case of delayed union of femur (18 weeks). Septic pin tract loosening was seen in one case (femur) requiring prolonged antibiotic usage. Minimal limb length discrepancy (1—1.5 cm) was observed in all the cases. Conclusion Compression fixation achieved by monorail fixator can be considered as a viable option for the management of pediatric diaphyseal fractures secondary to active bony infection. It has the advantage of promoting bony union, aiding in early weight bearing, establishing successful joint mobilization, providing an option for future restoration of limb length, and improved patient comfort. How to cite this article Saibaba B, Gopinathan NR, Dhillon MS, Behera P, Santhanam SS. Prospective Role of Uniplanar Compressible External Fixation Devices in the Management of Pathological Diaphyseal Fractures Secondary to Osteomyelitis in Children. J Postgrad Med Edu Res 2017;51(1):17-21.
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Shchepkina, E. A., N. L. Solomin, K. L. Korchagin, and F. K. Sabirov. "Bone transport over the nail vs Ilizarov method in the treatment of posttraumatic defects of the femur and tibia." Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations, no. 2 (June 2, 2021): 80–88. http://dx.doi.org/10.25016/2541-7487-2021-0-2-80-88.
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Relevance. From the point of view of using the advantages of both external fixation and internal osteosynthesis, the method “Bone transport over the nail” (BTON) deserves attention.Intention: To compare the effectiveness of the BTON and Ilizarov method in the treatment of patients with post-traumatic defects of the long bones of the lower extremities.Methodology. We analyzed 24 BTON cases and 47 cases of defects replacement via the Ilizarov method. The analysis included patients with segmental defects of the tibia, femur and knee joint bone defects complicated by chronic osteomyelitis.Results and Discussion. The external fixation period in BTON group was 3 times less than in the comparison group, as was the external fixation index. In case of monolocal defect replacement, the external fixation period and external fixation index in the BTON group was 4 times less than in the Ilizarov defect replacement group. With bifocal replacement of the defect, the external fixation period was 2.5 times less, and the external fixation index was 2 times less. BTON interventions were associated with complications in 31 cases (129.2 %) vs 82 cases for the Ilizarov method (174.5 %). The most pronounced decrease (3 times) was noted for cases of transosseous elements inflammation.Conclusion. The “Bone transport over the nail” technique reduces the external fixation period by an average of 3 times. This facilitates management of the outpatient phase and reduces the number of complications, especially the pin-tract infection. Cable technique combined with an orthopedic hexapod allows bifocal replacement of extended defects of the distal femur and knee joint applying the apparatus only to the lower leg. Risks of jamming the transported bone fragments by the intramedullary nail are thus excluded. To avoid breaking the traction cable, only designated devices should be used.
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Afonso, Carolina Tiago, António José Pereira de Andrade, Miguel Martins Pereira Pinto de Freitas, and Afonso Salgado Ruano. "First-generation total ankle arthroplasty." Scientific Journal of the Foot & Ankle 13, no. 3 (September 30, 2019): 228–31. http://dx.doi.org/10.30795/scijfootankle.2019.v13.976.
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Ankle prostheses are a source of disagreement within the orthopedic community due to the poor initial results. The lack of alternatives to arthrodesis has promoted the evolution of arthroplasties. Biomechanical compatibility has been improved, new surgical techniques and instrumentation devices have been developed, and biological techniques for fixation of the various components have been introduced. The first-generation arthroplasty prostheses introduced in the 1970s were cemented and had a stable constrictive design, but because they required extensive bone resection for implantation, they failed due to loosening and extensive osteolysis. We report a case of left total ankle arthroplasty performed in 1980 that is still “in situ”. Based on the bibliographic research performed, this case seems to represent the longest-lasting implant reported to date. Level of Evidence V; Therapeutic Studies; Expert Opinion.
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Jabalameli, Mahmood, Sepehr Khosravi, Delaram Delbari, Abolfazl Bagheri Fard, and Nariman Latifi. "Use of 4.5 Non-locking Plate As an Alternative Device in Open Wedge High Tibial Osteotomy for Treating Varus Deformity." Journal of Research in Orthopedic Science 7, no. 2 (May 1, 2020): 55–60. http://dx.doi.org/10.32598/jrosj.7.2.683.1.
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Background: High Tibial Osteotomy (HTO) is an approved surgical technique for varus knee deformity. For open wedge HTO multiple fixation methods and devices have been used. Advantages and disadvantages of these methods and devices are reported in various studies. Few studies have been conducted on use and final outcome of correction of varus knee deformity by implementation of non locking plates and benefits of this method is not fully evaluated. Objectives: To assess clinical and radiographic features of non-locking 4.5 millimeter L-buttress plate and T-buttress plate, which is used in open wedge High Tibial Osteotomy (HTO), and to find out whether this device is efficient enough or not. Methods: This cross-sectional study was conducted on 39 patients with tibial deformity recruited from a referral orthopedic hospital in Iran. Patients’ information, including their baseline characteristics, Range of Motion (ROM) of the knee, comorbidities, time of weight-bearing, union time in x-ray, graft type, and time of follow-up were reported at two stages: before and after the operation. Radiographic images were taken from their legs in both stages. Although different surgeons operated on the cases, they all used the same method. After the surgery, they were checked up in 2, 6, 12, and 24 weeks and a second alignment view was taken from the patients. Results: Thirty-nine patients underwent surgery for the correction of genu varus deformity and the follow-up time was between 6-48 months. There was no case of non-union and the ROM was perfectly restored in all the patients. Conclusion: Although the rate of the success in the use of the locking plate in HTO is higher, the use of a 4.5-mm non-locking plate seems to have decent results, too; therefore, it could be used as an alternative yet functional fixation tool in HTO.
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Bujoli, Bruno, Jean Michel Bouler, Jerome Guicheux, Olivier Gauthier, and Pascal Janvier. "Calcium Phosphates / Biphosphonates Combinations…Towards a Therapeutic Synergy." Key Engineering Materials 377 (March 2008): 99–110. http://dx.doi.org/10.4028/www.scientific.net/kem.377.99.
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The integration of drugs and devices is a growing force in the medical industry. The incorporation of pharmaceutical products not only promises to expand the therapeutic scope of device technology but to access combination products whose therapeutic value stem equally from both the structural attributes of the device and the intrinsic therapy of the drug. For example, the orthopedic industry is exploring drug-coated hip, knee and bone reconstruction implants capable of promoting healing as an added therapeutic benefit for device recipients. In this context, the drug is eluted locally, being targeted in a specific site of interest, thus offering a convenient strategy to avoid adverse effects commonly observed for systemic treatments of some diseases, as an additional benefit. In addition, these new technologies are generally well adapted to the development of minimally invasive surgery for their implantation. In this context, given the wide use of calcium phosphates (CaPs) and bisphosphonates (BPs) for the therapy of bone-related affections, there was great interest to investigate the chemistry taking place when combining the two systems since: (i) it could provide better insight in the mechanism of BP fixation on bones (ii) such combination could act as efficient BP delivery systems when implanted in bone defects.
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Wiktor, Łukasz, and Ryszard Tomaszewski. "Results of Anterior Cruciate Ligament Avulsion Fracture by Treatment Using Bioabsorbable Nails in Children and Adolescents." Children 9, no. 12 (December 2, 2022): 1897. http://dx.doi.org/10.3390/children9121897.
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(1) Background: Anterior cruciate ligament avulsion fractures are characteristic for skeletally immature patients, and appropriate treatment is currently debated in the literature. The study aimed to evaluate the clinical and functional outcomes in patients with tibial eminence fractures treated with bioabsorbable nails in one orthopedic clinic. (2) Methods: After retrospective evaluation, we found 17 patients with tibial eminence fractures treated in orthopedic departments between January 2013 and July 2022 using bioabsorbable fixation nails. The study group comprised 12 boys and five girls aged 5 to 15.2 (average 10.1). The mean follow-up was 28 months. We diagnosed five type II fractures, ten type III fractures, and two type IV fractures according to Meyers–McKeever classification. (3) Results: We obtained a high healing rate—17 patients with the complete union on the control radiographs. We diagnosed two cases of malunion, of which one required revision surgery. Only one patient showed a slight anterior knee laxity. The treatment effect at follow-up was assessed using the Lysholm Knee Score and IKDC Score. The median Lysholm Score was 96.64 (SD 4.54), and the median IKDC Score was 84.64 (SD 3.10), which were both excellent results. (4) Conclusions: Based on our results, surgery using bioabsorbable devices for type II, III, and IV tibial eminence fractures in young individuals is an effective alternative, allowing good outcomes and restoring proper knee stability. The crucial factor for a good effect is a stable fracture fixation. Arthroscopic surgery gives good outcomes with minimal invasion. It is important not to prolong the attempts of arthroscopic reduction and to perform the open reduction to shorten the procedure’s time and avoid complications.
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Tappa, Karthik, Udayabhanu Jammalamadaka, Jeffery Weisman, David Ballard, Dallas Wolford, Cecilia Pascual-Garrido, Larry Wolford, Pamela Woodard, and David Mills. "3D Printing Custom Bioactive and Absorbable Surgical Screws, Pins, and Bone Plates for Localized Drug Delivery." Journal of Functional Biomaterials 10, no. 2 (April 1, 2019): 17. http://dx.doi.org/10.3390/jfb10020017.
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Additive manufacturing has great potential for personalized medicine in osseous fixation surgery, including maxillofacial and orthopedic applications. The purpose of this study was to demonstrate 3D printing methods for the fabrication of patient-specific fixation implants that allow for localized drug delivery. 3D printing was used to fabricate gentamicin (GS) and methotrexate (MTX)-loaded fixation devices, including screws, pins, and bone plates. Scaffolds with different infill ratios of polylactic acid (PLA), both without drugs and impregnated with GS and MTX, were printed into cylindrical and rectangular-shaped constructs for compressive and flexural strength mechanical testing, respectively. Bland PLA constructs showed significantly higher flexural strength when printed in a Y axis at 100% infill compared to other axes and infill ratios; however, there was no significant difference in flexural strength between other axes and infill ratios. GS and MTX-impregnated constructs had significantly lower flexural and compressive strength as compared to the bland PLA constructs. GS-impregnated implants demonstrated bacterial inhibition in plate cultures. Similarly, MTX-impregnated implants demonstrated a cytotoxic effect in osteosarcoma assays. This proof of concept work shows the potential of developing 3D printed screws and plating materials with the requisite mechanical properties and orientations. Drug-impregnated implants were technically successful and had an anti-bacterial and chemotherapeutic effect, but drug addition significantly decreased the flexural and compressive strengths of the custom implants.
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Başarır, Kerem, Mahmut Kalem, Ercan Şahin, Emre Anıl Özbek, Mustafa Onur Karaca, İbrahim Küçükkarapınar, and Ergin Tönük. "The Relationship Between Arthroplasty Surgeons’ Experience Level and Optimal Cable Tensioning in the Fixation of Extended Trochanteric Osteotomy." Geriatric Orthopaedic Surgery & Rehabilitation 12 (January 2021): 215145932110633. http://dx.doi.org/10.1177/21514593211063324.
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Introduction In this study, our aim was to examine the relationship between the arthroplasty surgeons’ experience level and their aptitude to adjust the cable tension to the value recommended by the manufacturer when asked to provide fixation with cables in artificial bones that underwent extended trochanteric osteotomy (ETO). Materials and Methods A custom-made cable tensioning device with a microvoltmeter was used to measure the tension values in Newtons (N). An ETO was performed on 4 artificial femur bones. Surgeons at various levels of experience attending the IXth National Arthroplasty Congress were asked to fix the osteotomized fragment using 1.7-mm cables and the tensioning device. The participants’ demographic and experience data were investigated and recorded. The surgeons with different level of experience repeated the tensioning test 3 times and the average of these measurements were recorded. Results In 19 (35.2%) of the 54 participants, the force applied to the cable was found to be greater than the 490.33 N (50 kg) value recommended by the manufacturer. No statistically significant difference was determined between the surgeon’s years of experience, the number of cases, and the number of cables used and the tension applied over the recommended maximum value ( P = .475, P = .312, and P = .691, respectively). Conclusions No significant relationship was found between the arthroplasty surgeon’s level of experience and the adjustment of the cable with the correct tension level. For this reason, we believe that the use of tensioning devices with calibrated tension gauges by orthopedic surgeons would help in reducing the number of complications that may occur due to the cable.
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Chagnon, Madeleine, Louis-Georges Guy, and Nicolette Jackson. "Evaluation of Magnesium-based Medical Devices in Preclinical Studies: Challenges and Points to Consider." Toxicologic Pathology 47, no. 3 (February 3, 2019): 390–400. http://dx.doi.org/10.1177/0192623318816936.
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Absorbable metallic implants have been under investigation for more than a century. Animal and human studies have shown that magnesium (Mg) alloys can be safely used in bioresorbable scaffolds. Several cardiovascular and orthopedic biodegradable metallic devices have recently been approved for use in humans. Bioresorbable Mg implants present many advantages when compared to bioabsorbable polymer or nonabsorbable metallic implants, including similar strength and mechanical properties as existing implant-grade metals without the drawbacks of permanence or need for implant removal. Imaging visibility is also improved compared to polymeric devices. Additionally, with Mg-based cardiovascular stents, the risk of late stent thrombosis and need for long-term anti-platelet therapy may be reduced as the host tissue absorbs the Mg degradation products and the morphology of the vessel returns to a near-normal state. Absorbable Mg implants present challenges in the conduct of preclinical animal studies and interpretation of pathology data due to their particular degradation process associated with gas production and release of by-products. This article will review the different uses of Mg implants, the Mg alloys, the distinctive degradation features of Mg, and the challenges confronting pathologists at tissue collection, fixation, imaging, slide preparation, evaluation, and interpretation of Mg implants.
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Solomin, Leonid N., Dmitriy V. Gavrilov, Maxim A. Baushev, and Viktor A. Vilensky. "Angulation and Translation Capabilities of a Minimized Orthopedic Hexapod Ortho-SUV Frame: An Experimental Study." Orthopedics Research and Traumatology – Open Journal 7, no. 1 (December 30, 2022): 1–4. http://dx.doi.org/10.17140/ortoj-7-123.
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Introduction Orthopedic hexapods demonstrated effectiveness and accuracy in deformity correction of limbs in both adults and children. Previous studies demonstrated the best reduction capabilities of the orthopedic hexapod Ortho-SUV Frame (OSF) versus other models of this group of external fixation devices. Minimized version of this hexapod (minimized Ortho-SUV Frame (OSFm)) was created to reduce common for this group disadvantages: large bulkiness and weight and limitation on working with “short segments”. However, the reduction capabilities of the OSFm have not yet been studied. Aim To evaluate translation and angulation capabilities of OSFm with standard struts size and to compare results to OSF with short struts size. Materials and Methods The experimental study was performed using plastic models of the tibia with osteotomy at the middle third of the shaft. Proximal and distal bone fragments were fixed with one-ring modules. The reduction capabilities of OSFm in the first series and OSF in the second series of the experiment were studied. According to the method of fixing the struts to the rings, experiments were divided into three groups: directly to the ring, using straight plates, and using Z-shaped plates. Translation and angulation capabilities were evaluated by the maximum displacement of the distal bone fragment relative to the proximal one until any of the struts reached its minimum or maximum possible length. Results In translation OSFm outperforms OSF by 2.8-9.5% fixed the struts directly to the rings, by 4.8-9.7% using straight plates, and by 27.3-29.3% using Z-plates. In angulation OSFm with struts fixed directly to the rings outperforms OSF by 33.9-55.4%, by 36.9-47.3% using straight plates, and by 29.6-36% using Z-plates. Conclusion OSFm exceeds OSF in translation and angulation capabilities in all series of experiment. Distraction and rotation capabilities and the bone fragments fixation rigidity should be evaluated as further research to prove application of OSFm as a possible better candidate for deformity correction of limbs in children and foot deformity correction.
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Kim, Yu D., D. S. Shitikov, N. A. Knyazev, N. E. Likholatov, and O. A. Shafiev. "Current approaches to treatment of patients with closed fractures of the patella." Genij Ortopedii 27, no. 5 (October 2021): 597–609. http://dx.doi.org/10.18019/1028-4427-2021-27-5-597-609.
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Abstract. Introduction Treatment of patients with acute fractures of the patella is the task of the trauma and orthopedic service and should provide restoration of the integrity of the bone tissue and the extensor apparatus of the knee joint for its early mobilization. There is an opinion that conservative treatment cannot meet requirements of patients’ quality of life, and therefore, most traumatologists are inclined to surgically treat patellar fractures. Purpose Based on the available literature data, to determine the most rational way to treat patients with patellar fractures Materials and methods Available studies published in the last 10 years were analyzed. The databases NCBI Pubmed, Healio Orthopedics, Medline were searched. Results Such osteosynthesis methods as patella suture, osteosynthesis with plates, special internal devices, external fixation devices, Kirschner wires and wire cerclage, various screws were covered. The question of clinical application of patellectomy was touched upon; the contribution of the Department of Traumatology, Orthopedics and Urgent Surgery of the Krasnov Samara State Medical University to the development of operative techniques of osteosynthesis of the patella, the basic concepts of scientific research, and also the most optimal ways of treating patients with patellar fractures were described. Conclusion The conservative method of treating patients with patellar fractures is most relevant if there are contraindications to surgery. It inevitably leads to persistent arthrogenic contracture. The best functional results of treatment have been achieved with surgical treatment due to the possibility of early mobilization of the knee joint. According to the data of available studies, plates and screws as well as osteosynthesis with Kirschner wires and wiring cerclage show maximum stability. There is evidence of a direct correlation between the risk of developing infectious complications and pain in the postoperative period and the number of elements of subcutaneous metal implants. Thus, the most optimal way to treat closed fractures of the patella is osteosynthesis with the use of wires and wire cerclage according to the tension band principle.
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Zorina, Yuliya, Oleg Oreshaka, and Anton Ganisik. "MODERN TYPES OF IMPRESSIONS IN DENTISTRY (review article)." Actual problems in dentistry 18, no. 3 (November 23, 2022): 32–39. http://dx.doi.org/10.18481/2077-7566-2022-18-3-32-39.
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To restore the impaired or lost functions of the dental system, the dentist often resorts to the manufacture of dentures and devices. To achieve high quality of such structures, it is necessary to obtain a precision impression. The precision of the impression is its striving for maximum dimensional accuracy. The article presents the characteristics of impressions and impression masses that affect the accuracy of future orthopedic structures. A poor-quality impression can lead to errors in the manufacture of orthopedic structures and the development of the following complications: caries (cervical or under the crown), diseases of the marginal periodontal, pulpitis or pulp necrosis with subsequent periodontitis, cracks, chips of the lining; premature violation of the fixation of the structure. To reduce the risks of complications, new technologies for obtaining impressions are being introduced into the clinical reception of orthopedic dentists, to increase the quality of finished structures. There are a large number of methods for obtaining refined prints, each of which has its advantages and disadvantages. This diversity can be explained by the modernization of the group of elastic impression materials and the appearance of masses of different viscosity. The development of methods for obtaining impressions is currently an urgent area of dentistry. In addition to traditional types of impressions, digital technologies, namely optical impression, are increasingly being introduced into dental practice. The result of which is a three-dimensional (3D) model of the prepared teeth, for the manufacture of indirect restorations of teeth using CAD/CAM systems.
The article describes various modern methods of obtaining precision prints in dentistry. The comparative characteristics of laboratory and clinical scanners for obtaining optical impressions are given.
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Cardona Salcedo, Manuel Alejandro, Mercedes Teresita Oropeza Guzmán, Grecia Isis Moreno Grijalva, Arturo Zizumbo López, Juan Antonio Paz González, and Yadira Gochi Ponce. "Polylactic acid/multi walled carbon nanotubes (PLA/MWCNT) nanocomposite for 3D printing of medical devices." Revista de Ciencias Tecnológicas 4, no. 4 (December 9, 2021): 388–98. http://dx.doi.org/10.37636/recit.v44388398.
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In recent years, the composite nanomaterials area has had a great development impact in health sciences. Biomaterials depict as one of the most promising since they are compatible with additive manufacturing (AM) techniques. It is also possible to use them to mold specific medical parts. Composite nanomaterials have shown good biocompatibility and low toxicity to have benefits equal to or greater than metals (i.e., Co-Cr alloy). The purpose of this study is to develop a nanocomposite biomaterial (PLA/MWCNTf) from Polylactic Acid (PLA) and functionalized Multi Walled Carbon Nanotubes (MWCNTf) to evidence its potential application in 3D printing of orthopedic fixation devices. PLA/MWCNTf nanocomposite was prepared by solution blending technique, incorporating a proportion of 0.5 wt% of MWCNTf to the PLA matrix. TGA analysis of the PLA/MWCNTf was used to determine the thermal stability, a slight increase was found compared to the PLA. FTIR spectroscopy confirmed the presence of carboxylic acid groups in the MWCNTf which improves good incorporation of the nanotubes in the PLA matrix. Additionally, Raman spectroscopy, SEM, and AFM micrographs were used to verify MWCNTf reached the PLA surface homogeneously. Additive manufacturing preparation was done by extrusion molding of PLA/MWCNTf as well as its 3D printing.