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At least 379 records · Page 21Linked to original sources
PubMed1999

The influence of clinically induced variability on the distribution of compressive fracture strengths of a hand-mixed zinc phosphate dental cement.

OBJECTIVES: Conventional approaches to comparing dental cements use standard property tests under manufacturers' specified conditions. Zinc phosphate cements are supplied in powder/liquid form and manipulation frequently involves mixing the components by eye so a range of mixing ratios will inevitably occur in practice. Unfortunately, the physical, chemical, biological and mechanical properties of cements are known to be dependent on the mixing ratio. METHODS: Forty dental nurses prepared a series of three cement samples to a luting consistency they considered acceptable for use in practice. RESULTS: It was found that each dental nurse produced consistent cement mixes, although, the mixing ratios varied from 1.7 to 3.2 g/ml between nurses. The mean compressive strength, standard deviation and associated Weibull Moduli (m) of the cements were determined as a function of this mixing ratio range and showed considerable variation ranging from 33.5 +/- 3.2 MPa (m = 11.0) at 1.7 g/ml to 71.4 +/- 8.4 MPa (m = 8.6) at 2.6 g/ml and 42.5 +/- 10.0 MPa (m = 5.0) at 3.2 g/ml. SIGNIFICANCE: An analytical approach was adopted which facilitated an integrated analysis of the mixing ratio variability with the strength data. It was found for the test group of dental nurses that 25% of cement mixes produced would have achieved strengths below 40 MPa whilst strengths below the standard value were produced in at least 70% of mixes. These results indicate that a simple analysis of the properties of cements manipulated under optimum conditions, provides little information on the material characteristics obtained in practice because of clinically induced variability.

Analysis of Variance↗
PubMed2001

Percutaneous vertebroplasty: a new technique for treatment of painful compression fractures.

Vertebroplasty is an effective technique in which polymethyl methacrylate, a surgical cement, is injected into a vertebral body. This technique provides increased strength and pain relief in vertebrae weakened by osseous lesions as metastases, multiple myeloma, and aggressive hemangiomas, and from osteoporotic fractures. Infrequent serious complications are mainly related to polymethyl methacrylate leakage into the spinal canal and around vital soft tissue structures. Complications are decreased by careful fluoroscopic guidance and meticulous radiological technique. Indications should be dictated by a multidisciplinary team approach.

Back Pain↗
PubMed1992

Severe osteopenia and vertebral compression fractures after complete remission in an adolescent with acute leukemia.

Acute leukemia frequently presents with skeletal symptoms; however, the etiologies of bone pain and osteopenia are poorly understood. We present the case of an adolescent girl with acute leukemia who developed vertebral fractures after being in complete remission for 3 months. Bone mineral density was very low (less than 0.6 g/cm2) but remained stable during the subsequent 3 months despite continuation therapy with methotrexate and prednisone. Findings of a bone biopsy were consistent with a recent episode of aggressive bone resorption. We suggest that paracrine secretion of lymphokines may mediate loss of bone mass during the active phase of acute leukemia, although clinical bone disease may not develop until after complete remission is achieved.

Acute Disease↗
PubMed1998

[Distal, metaphyseal compression fractures of the radius. Results of open reposition, stable defect replacement with cortico-cancellous iliac crest bone and plate osteosynthesis].

Conservative treated distal radius fractures with extended metaphyseal void and missing cortical support resulted in loss of reduction. From 1988 till 1994 117 fractures of the distal radius were treated by open reduction, filling the metaphyseal void with a corticocancellous iliac bone graft and plate fixation. In this retrospective study results after surgical reconstruction were evaluated radiologically and clinically and were discussed to conservative treatment. 30 patients suffering from extraarticular metaphyseal distal radius fracture were evaluated after a mean of 42 months (minimum 20, maximum 68 months) after surgery. Ulnar variance was restored in 70% to the uninvolved side. Ulnar minus variance up to 2 mm persisted in 30%. Radial joint angles were restored to normal in 53%. In 40% of the patients a loss of reduction up to 10 degrees and in 7% up to 25 degrees occured. Active range of motion in the sagittal and frontal plane was equivalent to the non involved side in 30%. 70% of the patients showed reduced range of motion up to 20%. Rotation was unlimited in 77%, reduced up to 10% in 23%. Subjective results were excellent in 90%, good in 10%. Compared to conservative therapie, surgery showed superior results.

Adolescent↗
PubMed2004

[Balloon kyphoplasty of vertebral compression fractures with a new calcium phosphate cement].

QUESTION: Can the same levels of pain reduction and increase in function be achieved in kyphoplasty procedures with Calcibon as with polymethylmethacrylate (PMMA) cement? PATIENTS AND METHODS: In a prospective, interdisciplinary single-center study, 99 patients (173 vertebral fractures) were treated with kyphoplasty. Augmentation was performed with PMMA in 66 cases (127 vertebral bodies) and with Calcibon in 33 patients (46 vertebral bodies). Outcome data were obtained with a VAS spine score and by radiomorphometric evaluation of X-rays before and after treatment. RESULTS: Pain and function improved in 87% of the patients; an average of 16% of the lost vertebral height was regained. A 9% cement leakage rate was observed with PMMA and 10% with Calcibon. There was no significant difference in pain reduction and radiomorphometric evaluation between the two techniques. CONCLUSION: Kyphoplasty is a reliable, minimally invasive method to stabilize fractured vertebral bodies. Augmentation with Calcibon improves pain and function and enables the treated vertebral body to regain of height.

Aged↗
PubMed2003

Injectable calcium phosphate bone cement Norian SRS for the treatment of intra-articular compression fractures of the distal radius in osteoporotic women.

BACKGROUND: Distal radius fracture often presents a metaphyseal void which is more extended in elderly, osteoporotic patients. Bone graft and bone substitutes are reported to be beneficial in maintaining metaphyseal reduction. METHODS: We performed a prospective study on 52 menopausal, osteoporotic women with unstable intra-articular distal radius fractures to compare the outcome of percutaneous pinning and immobilisation in a cast for 6 weeks with that using injectable calcium phosphate bone cement (Norian Skeletal Repair System, SRS) to supplement pin and screw fixation and immobilisation in a cast for 3 weeks. All patients were reviewed 2 years (range 21-29 months) after surgery. RESULTS: Patients treated with SRS had better functional outcome, restoration of movement and grip strength ( p<0.001). In this group there was 1 mm loss of radial length, 3 degrees loss of radial inclination and 7 degrees loss of palmar tilt. In the control group radial length decreased 3 mm, radial inclination decreased 11 degrees and palmar tilt 12 degrees. Loss of reduction was significantly higher in the control group ( p<0.001). CONCLUSION: We conclude that the use of Norian SRS to supplement pin and screw fixation is effective in maintaining the reduction of unstable intra-articular distal radius fractures in osteoporotic patients and provides a better clinical outcome than percutaneous pinning.

Aged↗
PubMed2000

Percutaneous transpedicular vertebroplasty with PMMA: operative technique and early results. A prospective study for the treatment of osteoporotic compression fractures.

Vertebroplasty-percutaneous cement augmentation of osteoporotic vertebrae is an efficient procedure for the treatment of painful vertebral fractures. From a prospectively monitored series of 70 patients with 193 augmented vertebrae for osteoporotic and metastatic lesions, we analysed a group of 17 patients suffering from back pain due to osteoporotic fractures. The reinforcement of 45 vertebral bodies in these patients led to a significant and lasting pain reduction (P < 0.01 ). The presented technique is useful, as, in one session, at least four injections can be performed when required, allowing the prophylactic reinforcement of adjacent vertebrae as well. The use of a low-viscosity polymethyl methacrylate (PMMA) in combination with a non-ionic liquid contrast dye provides a reliable and safe procedure. Extraosseous cement leakage was seen in 20% of the interventions; however, none of them had clinical sequelae.

Aged↗
PubMedDate not supplied

Seizure-induced thoracic spine compression fracture: case report.

BACKGROUND: Vertebral fracture caused solely by a convulsive seizure has rarely been reported in the neurosurgical literature. CASE DESCRIPTION: We describe a 34-year-old male with severe back pain from a thoracic fracture occurring in association with a seizure during hospitalization for treatment of temporal lobe epilepsy. Bone mineral densities in the lumbar spine and the femoral neck were decreased, possibly by long-term anti-epileptic medication. Muscle contractions during a seizure can result in vertebral fractures, especially at the thoracic levels. CONCLUSION: A complaint of back pain after a convulsive seizure should prompt radiologic investigation for vertebral fracture, even in the absence of external trauma.

Absorptiometry, Photon↗