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Biomedical subjects

R Peine

Publications and source records attributed to R Peine.

5 recordsLinked to original sources

Comparison of three different plating techniques for the dorsum of the distal radius: a biomechanical study.

Three different plating techniques were used on experimentally produced dorsally displaced distal radius fractures in cadavers and were tested in 4-point bending: a AO 3.5-mm T plate (group 1), two 2. 0-mm titanium plates 60 degrees to each other (group 2), and the AO pi plate (group 3). A metaphyseal defect was simulated by a dorsally open wedge osteotomy. The tests show that the 2-mm double-plating technique has superior stiffness and statistically equivalent bending and bone gap to failure compared with the AO 3.5-mm T plate or the pi plate when applied to the unstable distal radius fracture model. (J Hand Surg 2000; 25A:29-33.

Biomechanical Phenomena↗

[Metastases compromising physical stability].

Multimodal therapy of tumor patients with osseous metastases is an interdisciplinary task. The surgical treatment requires optimal integration, in terms of timing and extent of the procedure, into the overall treatment plan. In addition to surgery, modern therapeutic approaches include systemic chemotherapeutic, hormonal and immunological therapy, radiotherapy, and other drug therapy (i.e. biophosphonates). We use classical stabilization methods with plates and bone cement or intramedullary nailing and also new implants with angular stability like an internal fixator and modular endoprothesis systems in operative therapy. Such stabilizing systems allow bridging of tumor defects in almost all parts of the skeleton. The ultimate goal of any treatment and especially of operative intervention is a mobile patient with little or no pain and a good quality of life.

Bone Neoplasms↗

A new ultrasound-based method for the assessment of torsional differences following closed intramedullary nailing of femoral fractures.

OBJECTIVE: A torsional difference of more than 15 degrees is found in up to 30% of patients following closed intramedullary nailing of femoral fractures. The diagnosis is usually established postoperatively by computed tomography. A torsional deformity of more than 15 degrees should be corrected by early derotation. In order to enable an intraoperative control and possible correction to avoid a second operation for the patient, a new ultrasound-based method suitable for the intraoperative setting has been developed, using the anterior condylar line as a distal reference line. DESIGN AND PATIENTS: In a prospective study the torsional difference after closed intramedullary nailing of femoral fractures was measured postoperatively by ultrasound in 32 patients and compared with standard CT readings. RESULTS: Torsional differences measured by ultrasound and CT showed a high correlation (r = 0.8) and a median difference of less than +/-3 degrees. CONCLUSIONS: By the introduction of the anterior condylar line as a distal reference line femoral torsion can accurately be assessed by ultrasound in a position required for intraoperative control and possible correction.

Adolescent↗

Initial fixation strength of modified patellar tendon grafts for anatomic fixation in anterior cruciate ligament reconstruction.

Recently it has been shown that anatomic tibial graft fixation in anterior cruciate ligament (ACL) reconstruction is preferable in order to increase isometry and knee stability. To facilitate anatomic patellar tendon graft fixation, customized graft length shortening is necessary. The purpose of this study was to compare the initial fixation strength of four different shortened patellar tendon grafts including three bone plug flip techniques and direct patellar tendon-to-bone interference fit fixation in a model with standardized bone density. Ninety calf tibial plateaus (22 to 24 weeks old) with adjacent patella and extensor ligaments were used. Tendon grafts were shortened by flipping the bone plug over the tendon leaving a tendon-tendon-bone (TTB) construct and, as the first modification in the opposite direction resulting in a tendon-bone-tendon (TBT) construct. The second modification consisted of the TBT construct with interference screw position at the lateral aspect of the bone plug (TBTlat). As the fourth modification the tendon graft was directly fixed (Tdirect) with an interference screw. In addition, a round-threaded titanium (RCI; Smith & Nephew DonJoy, Carlsbad, CA), a round-threaded biodegradable screw (Sysorb; Sulzer Orthopedics, Münsingen, Switzerland), and a conventional titanium interference screw (Arthrex Inc, Naples, FL) were compared. We found that TTB (mean 441 N for biodegradable screw, 357 N for RCI screw, 384 N for conventional screw) and TBT (mean 407 N for biodegradable screw, 204 N for RCI screw, 392 N for conventional screw) construct fixation achieves comparable fixation strength, although failure in the TTB was due to tendon strip off at its ligamentous insertion. The highest failure load was found in TBTlat fixation (mean 610 N for biodegradable screw, 479 N for RCI screw). Therefore, this technique should be recommended when using a tendon flip technique. The failure load for Tdirect fixation (mean 437 N for biodegradable screw, 364 N for RCI screw) was similar to that of TTB and TBT fixation, which may indicate that a patellar-tendon graft harvested without its patellar bone plug and directly fixed with an interference screw is equivalent to a flipped graft. This may additionally reduce harvest site morbidity and eliminates the risk of patellar fracture. The fixation strength of round-threaded biodegradable and conventional titanium interference screws was similar, whereas that of round-threaded titanium screws was significantly lower in the patellar tendon flip-techniques. However, it should be taken into consideration that round-threaded titanium screws are proposed for direct tendon-to-bone fixation.

Absorbable Implants↗