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PubMed1994

Mandibular fractures treated by bone plating and intraosseous wiring. A comparative study.

We studied 79 cases of mandibular fractures treated with bone plates and 79 cases treated with intraosseous wiring. We encountered 3.8% major and 9% minor complications in the first group and 2.6% major and 31% minor complications in the second group. Bone plates were used in more complicated cases such as comminuted and infected fractures. It is our opinion that internal rigid fixation is a promising method of treating fractures of the facial skeleton, which is better tolerated by the patient but requires a certain experience.

Adult↗
PubMed1995

Late degradation tissue response to poly(L-lactide) bone plates and screws.

Patients with fractures of the zygomatic bone were treated with high molecular weight poly(L-lactic) acid (PLLA) bone plates and screws. Three years after implantation four patients returned to our department with a swelling at the site of implantation. At the recall of the remaining patients we found an identical type of swelling after the same implantation period. To investigate the nature of the tissue reaction, eight patients were reoperated for the removal of the swelling. The implantation period of the PLLA material varied from 3.3 to 5.7 years. Microscopic evaluation and molecular weight measurements were performed. The excised material showed remnants of degraded PLLA material surrounded by a dense fibrous capsule. Ultrastructural investigation showed crystal-like PLLA material internalized by various cells. The results of this investigation suggest that the PLLA material slowly degrades into particles with a high crystallinity. The intra- and extracellular degradation rate of these particles is very low. After 5.7 years of implantation, these particles were still not fully resorbed.

Acid Phosphatase↗
PubMed1997

In vivo study of stainless steel and Ti-13Nb-13Zr bone plates in a sheep model.

A sheep study was performed to compare the in vivo performance of bone plates of 316L stainless steel and a new titanium alloy, titanium + 13% niobium + 13% zirconium (Ti-13Nb-13Zr), which had been subjected to a diffusion hardening treatment to produce a blue, wear resistant surface. Bone plates and screws of stainless steel and diffusion hardened Ti-13Nb-13Zr were implanted in adult sheep, in one group (with unosteotomized femurs) for 16 weeks, and in the other (with osteotomized femurs) for 8 weeks. At harvest, the diffusion hardened Ti-13Nb-13Zr devices had superior fixation strength, with greater screw torque out strength and fewer loose screws. In the osteotomized animals, the femurs with diffusion hardened Ti-13Nb-13Zr plates had higher torsional strength after removal of the implants; however, the difference was not statistically significant. In the unosteotomized animals, the torsional strength of the femurs was identical for both materials. There was a slightly reduced incidence of infection (bacterial adhesion) for the sheep with diffusion hardened Ti-13Nb-13Zr implants. In a parallel in vitro study, the magnetic resonance imaging compatibility of Ti-13Nb-13Zr was significantly superior to that of stainless steel. This indicates that diffusion hardened Ti-13Nb-13Zr may be an attractive alternative material for osteosynthesis.

Alloys↗
PubMed1998

Fragment reconstruction and bone plate fixation versus bridging plate fixation for treating highly comminuted femoral fractures in dogs: 35 cases (1987-1997).

OBJECTIVE: To compare fragment reconstruction and bone plate fixation versus bridging plate fixation for treating highly comminuted (> 4 fragments) femoral fractures in dogs. DESIGN: Retrospective study. ANIMALS: 35 dogs with highly comminuted fractures of the femur. PROCEDURE: Medical records of all dogs included in this study were reviewed. Dogs had been treated with fragment reconstruction and bone plate application (n = 20) or major fragment alignment and bridging plate fixation (15). Postoperative and follow-up radiographs were evaluated. Operating and hospitalization times, bone alignment, bone healing, and complications were considered. RESULTS: There were no differences in hospitalization times, limb alignment, and complications between dogs with fractures treated with fragment reconstruction and dogs with fractures treated with bridging plate fixation. Dogs with fractures treated with bridging plate fixation had shorter operative times and faster times to radiographic evidence of bone healing. CLINICAL IMPLICATIONS: Bridging plate fixation is quicker to perform and results in faster healing than fragment reconstruction and bone plate fixation when used to treat comminuted femoral fractures.

Age Factors↗
PubMed1992

A retrospective study of advancement genioplasty using a special bone plate.

This study evaluates skeletal stability and the remodeling process of the advanced genial segment when a single bone plate is used to stabilize the segment following osteotomy of the inferior border of the mandible. Thirty-nine patients with a minimum of 6 months follow-up who had advancement genioplasty stabilized with a Paulus chin plate were analyzed using cephalometrics and clinical examination. The results showed that stability of the result was excellent; pogonion maintained its immediate postsurgical horizontal position at longest follow-up. The remodeling pattern observed was similar to that reported in other studies using alternate forms of fixation in spite of the fact that the bone plate covered the areas where most remodeling occurs.

Adolescent↗
PubMed2006

Histomorphometric analysis of articular cartilage, zone of calcified cartilage, and subchondral bone plate in femoral heads from clinically normal dogs and dogs with moderate or severe osteoarthritis.

OBJECTIVE: To quantify and compare the microscopic changes in articular cartilage (AC), zone of calcified cartilage (ZCC), and subchondral bone plate in femoral heads from clinically normal dogs and dogs with moderate or severe osteoarthritis. SAMPLE POPULATION: Femoral heads from clinically normal dogs (n = 16) and dogs with moderate (24) or severe (14) osteoarthritis. PROCEDURES: Femoral heads were allocated to 3 categories (normal, moderate, or severe osteoarthritis) on the basis of radiographic findings, macroscopic findings, and histologic grade determined by use of a modified Mankin scale. Equally spaced 2-mm sections were cut in each femoral head in a coronal or transverse plane. Thickness of the AC, ZCC, and subchondral bone plate was recorded. RESULTS: Mean thickness of AC was significantly greater in samples with moderate and severe osteoarthritis than those considered normal. Mean thickness of the ZCC was significantly greater in samples with moderate and severe osteoarthritis than those considered normal. Mean thickness of the subchondral bone plate in samples with severe osteoarthritis was significantly greater than those with moderate osteoarthritis and those considered normal. A significant decrease in AC thickness was detected in the proximomedial area of femoral heads with severe osteoarthritis, compared with those considered normal. CONCLUSIONS AND CLINICAL RELEVANCE: A cause and effect association between thickening of subchondral structures and thinning and loss of the overlying AC was not detected. Changes in AC were associated with changes in the subchondral bone plate, which is compatible with the theory of adaptation in response to altered load distribution.

Animals↗
PubMed1998

Paramedian sternal bone plate reinforcement and wiring for difficult sternotomy wounds.

Longitudinally oriented bone plates of stainless steel adapted to each sternal half after midline sternotomy provide a reinforced construct for transverse wiring. A method for placement of these 3.5-mm screw diameter plates in a supraperiosteal position is described. Clinical indications for use have included sternal osteoporosis, previous pull through of conventional wires, segmental sternal fractures, and obese body habitus. This technique is presented as a method to avoid sternal instability and potential wound infection for those patients at risk for sternal separation with standard wiring techniques.

Adult↗
PubMed2006

[Allogenous bone plate reconstructing spinal channel and grafting in treatment of thoracolumbar burst fracture with paraplegia].

OBJECTIVE: To evaluate the method of the allogenous bone plate reconstructing the spinal channel and grafting in treatment of thoracolumbar burst fracture with paraplegia. METHODS: Thirty-six patients with thoracolumbar burst fracture with paraplegia were included in this study. Their ages ranged from 18 to 56 (average, 38). The vertebral injury involved T11 in 3 patients, T12 in 10 patients, L1 in 14 patients, L2 in 7 patients, and L3 in 2 patients. Neurological deficits were classified by the Frankel grading. There were 9 patients in grade A, 11 patients in grade B, 13 patients in grade C, and 3 patients in grade D. All the patients were treated with the anterior approach, decompression of the spinal channel, interbody graft, and internal fixation. The grafting materials consisted of the allogenous femoral bone plate that was decreased in advance and implanted in the intervertebral posterior region, with cut ribs and bone mills during the decompression. RESULTS: Postoperative CT scanning showed clearance of the spinal cord compression and expansion of the spine channel. During the follow-up period averaged 2 years, almost all the patients showed an improvement in the neurological function. Spinal fusion occurred in 32 patients. There was no screw loosened or broken. Only 1 patient failed to achieve the fusion. CONCLUSION: The anterior approach, allograft bone plate reconstructing the spine channel is a safe and effective method in treatment of the thoracolumbar burst fracture with paraplegia, which may be a replacement of the autogenous iliac bone graft.

Adolescent↗
PubMed2005

Hydroxyapatite reinforced poly(3-hydroxybutyrate) and poly(3-hydroxybutyrate-co-3-hydroxyvalerate) based degradable composite bone plate.

Poly(3-hydroxybutyrate) (P3HB), its co-polymers with 3-hydroxyvalerate (HV) (PHBV8 and PHBV22), and their hydroxyapatite (HAp) containing composites (5 and 15%, w/w) were prepared by injection molding. PHBV bone plates with low valerate contents and 15% (w/w) HAp appear to have better mechanical properties than the others. Flexural strengths of 15% (w/w) HAp-loaded P3HB, PHBV8 and PHBV22 were 78.28, 63.45 and 39.38 MPa, respectively. Tensile strengths of 15% (w/w) HAp-loaded P3HB, PHBV8 and PHBV22 were 18.99, 15.44 and 11.02 MPa, respectively. For the ageing test, bone plates were incubated in phosphate-buffered saline PBS (0.1 M, pH 7.4) at 37 degrees C and at pre-determined time points they were removed and subjected to a three-point bending test. Incubation in PBS caused a sharp decrease in the mechanical properties within the first 24 h, followed either by a gradual decrease or no change for a period of about 1 month. SEM results showed that there was no significant material erosion in the 4-week incubation period. P3HB loaded with 15% HAp appeared to yield the most suitable bone plate, insofar as mechanical properties are concerned with potential for further testing in vivo.

Biocompatible Materials↗
PubMed2005

[An experimental study of the effect of biomechanical environment on the incorporation of cortical bone plates allografts].

Sixteen goats with fractures of right femur received cortical bone plates allografts on both the sides of femurs. The right allograft strut endured the stimulation of physiological stress, and the left allograft strut did not. Groups of goats were sacrificed and specimens were procured at 3, 6, 12, and 24 week after surgery for histology observation and image analysis of the vessels after Chinese ink perfusion, the rate of bone porosity, the integrated optical density (IOD) of tetracycline fluorescence labeling and new bone formation were investigated in order to evaluate the incorporation of the allograft strut. The allograft strut revascularized at 6 weeks after surgery in the fracture group, but at 3 weeks in the control group. The rate of area of vessels after Chinese ink perfusion, the rate of bone porosity, the integrated optical density (IOD) of tetracycline fluorescence labeling and new bone formation in the fracture group were worse than control from 3 weeks to 6 weeks, but the observed and measured values were better in the fracture group than in the control group beyond 6 weeks after surgery (P < 0.05). The stimulation of stress would be harmful to the allograft strut if the strut endured the stress at an earlier period postoperation. Yet, it would be beneficial to the revascularization, new bone formation, substitution, and internal re-building on the strut provided that the extremity was immobilized for 6 weeks; and if the cortical graft endured the stimulation of physiological stress from 6 weeks postoperation till cancellous conjunction between the ends of fractures, the revascularization on the allograft strut and the bone conjunction between partially allograft strut and host would be faciliated.

Allografts↗
PubMedDate not supplied

Bone plate fixation of distal radius and ulna fractures in small- and miniature-breed dogs.

Bone plate fixation was reviewed in 29 distal radial fractures of small- and miniature-breed dogs. Twenty-two fractures in 18 dogs were available for follow-up. Number of complications and return to function were evaluated. Complications occurred in 54% of the fractures. Catastrophic complications occurred in 18% of fracture repairs with follow-up, while minor complications occurred in 36%. Sixteen (89%) of 18 dogs had a successful return to function. Bone plate fixation is a successful repair method for distal radius and ulna fractures in small-breed dogs, compared to previously reported methods.

Animals↗
PubMed1999

Fracture fixation with screws and bone plates.

The treatment goal of fracture fixation is to restore the patient to normal function as quickly as possible. Fracture fixation can be accomplished by various means; fixation with screws and bone plates is not only a popular but a successful technique. In this article, the authors provide concepts that a surgeon must understand for successful screw and bone plate use. In addition, case examples demonstrating the application of many of the concepts are included.

Animals↗
PubMed1986

Comparison of porous titanium-surfaced and standard smooth-surfaced bone plates and screws in an unstable fracture model in dogs.

Bilateral midshaft femoral osteotomies were fixed with a 3-mm fracture gap in 6 dogs. In each dog, one femur was fixed with a porous titanium-surfaced bone plate and screws, whereas the opposite femur was fixed with a standard smooth-surfaced bone plate and screws. The mean removal torque for porous titanium-surfaced screws (32.3 kg X cm) was significantly (P less than 0.01) greater than the mean removal torque for standard screws (4.4 kg X cm). Osseous tissue ingrowth into the surface of porous titanium-surfaced screws was verified by histologic examination of the bone-screw interface. Radiographic and histologic examinations of the osteotomy gaps showed accelerated primary gap healing in osteotomies fixed with porous titanium-coated implants, compared with slower callus healing seen in osteotomies fixed with standard smooth-surfaced implants.

Animals↗
PubMed1995

Structural properties of mandibular bone following application of a bone plate.

PURPOSE: Similarities in strain patterns between long bones and the mandible suggest that plates may induce stress shielding, resulting in deleterious long-term changes. This study is an investigation of the use of bone plates on the mandible in four adult rhesus monkeys. MATERIAL AND METHODS: A stainless steel plate was attached facially along the inferior border of each mandibular corpus. On the left, a thick (2.5-mm) plate was engaged with four screws. On the right, a thin (0.5-mm) plate was attached with one screw. Monkeys were killed a year after plate placement. At the beginning and end of the experiments, bone strain was recorded inferior to each bone plate during evoked maximal incisal clenching. After death, bone was removed from the mandibles around and under the plates and examined. Gross dimensions and density were measured. An ultrasonic technique was used to measure the material properties, including the elastic and shear moduli. RESULTS: Bone strain inferior to the plates was reduced by 34% to 53% after attachment of the thick plates. Little change in strain was found after attachment of the thin plates. However, no significant differences in structural or mechanical measurements, such as density, cortical thickness, elastic and shear moduli, and Poisson's ratios, were detected between the two sides in each monkey. CONCLUSION: Long-term placement of bone plates, and the resulting stress shielding, were found to result in structural changes in the mandibular corpus.

Animals↗
PubMed1990

Regeneration of cranial suture and bone plate lesions in rabbits. Implications for positioning of osteotomies.

The positioning of osteotomies in intramembranous cranial bone was studied by exploring the pattern of bone regeneration in growth areas (the sutural region) as compared to that of the bone plate proper. Trephine defects in the left coronal suture area and the right parietal bone were produced in fifty-nine young rabbits. A pilot study to refine operative and analytical methods comprised 22 animals. The experiments were terminated at one, three, and six weeks after surgery. The bone regenerative response was assessed by x-ray planimetry, plain microscopy, enzyme histochemistry, and fluorescent labelling. Only minor divergences in healing capacity between the two defects were found. No adverse effects on the growth process were indicated. As to clinical management, the findings suggest that osteotomies designed to traverse sutural areas will, under normal circumstances, regenerate in a similar manner and rate to adjoining bone plates.

Acid Phosphatase↗
PubMed2003

Results of single-session bilateral triple pelvic osteotomy with an eight-hole iliac bone plate in dogs: 95 cases (1996-1999).

OBJECTIVE: To evaluate feasibility of single-session bilateral triple pelvic osteotomy with 8-hole iliac bone plates in dogs with bilateral hip dysplasia. DESIGN: Retrospective study. ANIMALS: 95 dogs with bilateral hip dysplasia. PROCEDURE: Medical records were reviewed, and information was obtained on signalment; body weight; angles of subluxation and reduction prior to surgery; durations of surgery and hospitalization; postoperative mobility; severity of lameness, radiographic grade of hip dysplasia, Norberg angle, and femoral head coverage before and after surgery; time required for radiographic evidence of iliac healing; change in pelvic diameter; implant integrity; and complications. RESULTS: Mean age at the time of surgery was 10.8 months, and mean weight was 35.2 kg (77.4 lb). Prior to surgery, mean angles of subluxation were 2.2 degrees on the right and 2.6 degrees on the left; mean angles of reduction were 25.9 degrees on the right and 27.3 degrees on the left. Mean surgical time was 95 minutes. All but 1 dog were able to walk on their own by the fourth day after surgery. Mean hospitalization time was 7.5 days. Clinical signs of lameness and radiographic grade of hip dysplasia were significantly improved during follow-up examinations. Mean time for radiographic iliac healing was 8 weeks. None of the plates and only 7 of the 1,520 (0.5%) screws loosened after surgery. Nineteen dogs had complications, but all complications were minor. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that single-session bilateral triple pelvic osteotomy with 8-hole iliac bone plates is effective for treatment of dogs with bilateral hip dysplasia.

Animals↗
PubMedDate not supplied

Use of a medial bone plate for repair of radius and ulna fractures in dogs and cats: a report of 22 cases.

OBJECTIVE: This study evaluates the technique of medial bone plating in the repair of radius fractures in dogs and cats. STUDY DESIGN: A retrospective study was made of patients diagnosed with fractures of the radius that were stabilized by application of a bone plate to the medial side of the bone. ANIMAL POPULATION: Sixteen client-owned dogs and 4 client-owned cats. The animals' ages varied from 5 months to 8 years, and their weight varied from 1.3 to 49 kgs. METHODS: Animals were evaluated using radiography or client assessment, or both. RESULTS: Medical plate application was technically easier to do than cranial plate application, the technique avoided the extensor tendons, and permitted greater versatility in the selection of smaller plates for the fixation of distal radius fractures. All fractures repaired by this method healed with no postoperative complications. CONCLUSIONS: Medial plate application may be used for osteosynthesis of distal or middiaphyseal radius fractures. Further studies are needed to evaluate the use of this technique in morphologically complex fractures. In patients with fractures of the proximal radius, cranial plate application is considered more appropriate. CLINICAL RELEVANCE: Medial plating of radial fractures has significant advantages compared with conventional plate application; it provides the surgeon with an alternative method of fixation for selected radius fractures in dogs and cats.

Animals↗