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Laminoplasty: Overview, Periprocedural Care, Technique

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Orthopaedic Implants - Basic Science - Orthobullets

The following data were collected for each patient: age, sex, location of the fracture, type of the osteosynthesis with number and lengths of the screws used, operating time, duration of immobilization, complications, and time until recovery. Recovery is calculated by the regained total active motion (TAM) and the Disabilities of the Arm, Shoulder, and Hand (DASH) score. Excellent TAM is defined as 220° to 260° in the finger and 120° to 140° in the thumb. The follow-up protocol included radiological and clinical control on the first postoperative day, 2,4, and 6 weeks after the surgery, and clinical control after 3 and 6 months. If there was no fracture healing radiologically, radiological controls followed every second week till healing. The follow-up period is up to 6 months.

Xray Pictures of Fractured Tibia | Bone and Spine

Both hemiarthroplasty and angle-stable locking compression plate osteosynthesis are used in the current treatment of dislocated three-and four-part fractures of the proximal humerus. There is a lack of level-1 studies comparing these two most-used surgical treatment options. This randomized controlled multicenter trial has been designed to determine which surgical treatment option provides the fastest recovery of functional capacity of the affected upper limb, and will provide better outcomes in pain, satisfaction, shoulder function, quality of life, radiological evaluation and complications.

Acta chirurgiae orthopaedicae et traumatologiae …

Tibia is the bone that spans from knee to ankle. Here are some xray pictures of fractured tibia

The main focus of this article is the percutaneous compression screw fixation of phalanx fractures. The 2 compression screw systems used are currently the thinnest screw available on the market and suitable for percutaneous fracture fixation of the phalanges even with small fragments. An advantage of these systems is the maintenance of reduction with the K-wire during the insertion of the cannulated screw. In addition, a stable osteosynthesis is achieved, allowing active movement of the affected joints. The surgical technique can be learned quickly and easily; nevertheless, the surgeon should select the patients very carefully.

The techniques used to treat phalangeal fracture (conservative, K-wires, compression cannulated screw, screw-pate osteosynthesis) are based on experiences gained in hand trauma practice. From our experience, we recommend the use of the cannulated compression screw fixation for phalangeal fractures, especially for intra-articular fractures, because of the aforementioned advantages of this technique, assuming a careful and patient-based indication.

Cervical Spine Trauma Evaluation - Spine - Orthobullets

Nov 25, 2015 · Four-corner fusion

Angle-stable locking plate osteosynthesis [Figure ] is performed with the patient in supine or beach-chair position on a radiolucent table and a deltopectoral approach is used. The fracture is reduced and provisionally stabilized with (threaded) Kirschner wires. The reduction is confirmed as adequate with use of image intensification. The angle-stable locking compression plate is positioned with the help of a mounted aiming device, at least 5-8 mm distally of the upper end of the greater tuberosity and 2 mm posteriorly to the bicipital groove. Care is taken to ensure that a sufficient gap is maintained between the plate and the tendon of the long head of the biceps. When fracture reduction and subsequent screw positioning is considered adequate, the plate is fixed definitively with the insertion of angular stable screws in the humeral head. The use of angular stable or standard cortical screws for the humeral shaft holes is left to the treating surgeon. A final image intensifier check to verify correct screw placement is performed.

A randomized controlled multicenter trial will be conducted. Patients older than 60 years of age with a dislocated three- or four-part fracture of the proximal humerus as diagnosed by X-rays and CT-scans will be included. Exclusion criteria are a fracture older than 14 days, multiple comorbidity, multitrauma, a pathological fracture, previous surgery on the injured shoulder, severely deranged function caused by a previous disease, "head-split" proximal humerus fracture and unwillingness or inability to follow instructions. Participants will be randomized between surgical treatment with hemiarthroplasty and angle-stable locking compression plate osteosynthesis. Measurements will take place preoperatively and 3 months, 6 months, 9 months, 12 months and 24 months postoperatively. Primary outcome measure is speed of recovery of functional capacity of the affected upper limb using the Disabilities of Arm, Shoulder and Hand score (DASH). Secondary outcome measures are pain, patient satisfaction, shoulder function, quality of life, radiological evaluation and complications. Data will be analyzed on an intention-to-treat basis, using univariate and multivariate analyses.

Sacral Fractures - Presentation and Treatment | Bone …
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  • Compression plate for osteosynthesis - Google Patents

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  • had passed between the first osteosynthesis and the ..

    There are several methods that can be used to increase the strength of an external fixation construct

  • COMPARATIVE STUDY BETWEEN OSTEOSYNTHESIS IN …

    Here the first 4 pages from the catalogue "Zimmer® Pulsavac® PlusAC Wound Debridement System"

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30-40% of the metal plates used for ankle osteosynthesis ought ..

AB - Osteosynthesis plates are clinically used to fixate and position a fractured bone. They should have the ability to withstand cyclic loads produced by muscle contractions and total body weight. The very high demand for osteosynthesis plates in developing countries in general and in Indonesia in particular necessitates the utilisation of local products. In this paper, we investigated the mechanical properties, i.e. proportional limit and fatigue strength of Indonesian-made Narrow Dynamic Compression Plates (Narrow DCP) as one of the most frequently used osteosynthesis plates, in comparison to the European AO standard plate, and its relationship to geometry, micro structural features and surface defects of the plates. All Indonesian-made plates appeared to be weaker than the standard Narrow DCP because they consistently failed at lower stresses. Surface defects did not play a major role in this, although the polishing of the Indonesian Narrow DCP was found to be poor. The standard plate showed indications of cold deformation from the production process in contrast to the Indonesian plates, which might be the first reason for the differences in strength. This is confirmed by hardness measurements. A second reason could be the use of an inferior version of stainless steel. The Indonesian plates showed lower mechanical behaviour compared to the AO-plates. These findings could initiate the development of improved Indonesian manufactured DCP-plates with properties comparable to commonly used plates, such as the standard European AO-plates.

Mechanical properties of Indonesian-made narrow …

Surgery begins with the closed reduction of the fracture and correction of any rotational abnormality. After successful reduction of the fracture with the assistance of a percutaneous reduction clamp or temporary K-wiring, a 0.7-mm guiding K-wire is placed under fluoroscopic control; the tip of the K-wire has to be on the same level as the second cortex in order to determine the correct length. After proper placement, a mini skin incision of approximately 0.5 cm is placed and the correct length of the screw is determined by using the same device that has been used to punch the first cortex. To verify the accuracy of the measurement, fluoroscopic control of the right position of the length gauge, which has to have contact with the first cortex, is advised (see Video 1). The self-cutting, cannulated compression screw is then inserted via the K-wire. After the penetration of the second cortex, compression between bone fragments is applied, which should be seen in the fluoroscopic picture (, see Video 2). After successful placement of the screw, K-wires and reduction clamps are removed. Where necessary, up to 3 screws were inserted ().

as one of the most frequently used osteosynthesis ..

N2 - Osteosynthesis plates are clinically used to fixate and position a fractured bone. They should have the ability to withstand cyclic loads produced by muscle contractions and total body weight. The very high demand for osteosynthesis plates in developing countries in general and in Indonesia in particular necessitates the utilisation of local products. In this paper, we investigated the mechanical properties, i.e. proportional limit and fatigue strength of Indonesian-made Narrow Dynamic Compression Plates (Narrow DCP) as one of the most frequently used osteosynthesis plates, in comparison to the European AO standard plate, and its relationship to geometry, micro structural features and surface defects of the plates. All Indonesian-made plates appeared to be weaker than the standard Narrow DCP because they consistently failed at lower stresses. Surface defects did not play a major role in this, although the polishing of the Indonesian Narrow DCP was found to be poor. The standard plate showed indications of cold deformation from the production process in contrast to the Indonesian plates, which might be the first reason for the differences in strength. This is confirmed by hardness measurements. A second reason could be the use of an inferior version of stainless steel. The Indonesian plates showed lower mechanical behaviour compared to the AO-plates. These findings could initiate the development of improved Indonesian manufactured DCP-plates with properties comparable to commonly used plates, such as the standard European AO-plates.

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