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Results for “Fracture Fixation, Internal”

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PubMed1980

[Internal fixation for fractures of the lateral malleolus with titanium "crown"-plates (author's transl)].

This team of authors constructed a so called "crown"-plate from titanium, suitable for fixation of lateral malleolar fractures. The plate seems to be ideal for Weber-B type fractures, which are level with the joint space, and it can be applied in the more distal (Weber-A) and proximal (Weber-C) fractures too. The titanium plate was used in 166 fractures with good results. On the basis of the follow up assessment of 151 healed cases the authors feel encouraged to suggest the use of the titanium crown plate for internal fixation of lateral malleolar fractures.

Ankle Injuries↗
PubMed2003

[Our experiences with change of osteosynthesis from external fixator to internal fixation in fractures of the lower limb].

INTRODUCTION: In polytrauma patients and fractures with severe soft tissue damage of the lower limb the use of external fixator is indicated. To show the possibilities and limits of change of external fixation to internal osteosynthesis we performed a retrospective analysis. PATIENTS AND METHODS: Between 1.1.1993 to 30.6.1997 671 cases were primarily treated with external fixator. After a mean of 16.5 days a change of osteosynthesis was performed in 75 cases. RESULTS: 5 infections of the pin tracks, 3 infections of the wound, two thromboses, one case of thromboembolism and one osteomyelitis were seen in these 75 cases. One patient died due to severe brain damage after head injury. No further operations were necessary, all fractures showed primary healing. Taking the severe soft tissue damages and severe multiple trauma into account only few complications were observed. CONCLUSION: The main problems and risks of internal fixation occur in the early phase of treatment, whereas complications after external fixation are more likely to occur in later stages. By a change from external fixation to internal osteosynthesis the advantages of both methods can be combined.

Accidents, Traffic↗
PubMed1998

"Biological" internal fixation of long bone fractures: a biomechanical study of a "noncontact" plate system.

Based on existing knowledge of noncontact plates, an experimental prototype of a nonperiosteal contact internal fixation implant ("noncontact internal fixator") has been designed. The construct rigidity of osteotomised synthetic composite femora, fixed with the noncontact fixator and a reamed, statically-locked intramedullary nail were compared in axial compression, two plane bending and torsion in four types of diaphyseal fractures. With the exception of axial loading in the presence of extensive comminution, the fixation stability provided by the noncontact fixator is significantly higher than that of the tested intramedullary nail. Any degree of cortical contact between the two main fragments is important for the stability of this nonperiosteal contact fixation system under axial load. Appropriately-designed "internal fixators" could provide not only a number of biological and technical advantages, but also fixation stability comparable and in certain aspects superior to that of other fixation methods.

Biomechanical Phenomena↗
PubMed1992

Rigid internal fixation of mandibular fractures. An analysis of 270 fractures treated using the AO/ASIF method.

The results are reported on 214 patients treated for 270 mandibular fractures, using rigid internal fixation. Of these, 172 fractures (63.7%) in 131 patients had been re-evaluated at final follow-up in connection with plate and screw removal, on average 15.2 months, postoperatively. Although one-third of the patients had a history of alcohol abuse, and 86% were treated with a delay of more than 24 h (mean 3.2 days), good primary bone healing was observed in 93.9% of the patients. Infections, seen in 6.1% of the patients, were related exclusively to inadequate stability of the fracture. Malocclusion, observed in 18.2% of 159 dentate patients, was caused by incorrect plate bending and insufficient fracture reduction. Immediate postoperative dysfunction of the inferior alveolar nerve in 58.1% of the cases, and of the mandibular branch of the facial nerve in 12.7%, was followed by almost total recovery 1 year after operation. It is concluded that rigid internal fixation is a reliable method of treatment, especially indicated for patients with reduced healing capacity and poor co-operation.

Adolescent↗
PubMed1995

Free flap reconstructions of tibial fractures complicated after internal fixation.

The cases of 15 patients are presented where microvascular soft-tissue reconstructions became necessary after internal fixation of tibial fractures. Primarily, seven of the fractures were closed. Eleven fractures had originally been treated by open reduction and internal fixation using plates and screws, and four by intramedullary nailing. All of the patients suffered from postoperative complications leading to exposure of the bone or fixation material. The internal fixation material was removed and radical revision of dead and infected tissue was carried out in all cases. Soft tissue reconstruction was performed using a free microvascular muscle flap (11 latissimus dorsi, three rectus abdominis, and one gracilis). In eight cases the nonunion of the fracture indicated external fixation. The microvascular reconstruction was successful in all 15 patients. In one case the recurrence of deep infection finally indicated a below-knee amputation. In another case, chronic infection with fistulation recurred postoperatively. After a mean follow-up of 26 months the soft tissue coverage was good in all the remaining 13 cases. All the fractures united. Microvascular free muscle flap reconstruction of the leg is regarded as a reliable method for salvaging legs with large soft-tissue defects or defects in the distal leg. If after internal fixation of the tibial fracture the osteosynthesis material or fracture is exposed, reconstruction of the soft-tissue can successfully be performed by free flap transfer. By radical revision, external fixation, bone grafting, and a free flap the healing of the fracture can be achieved.

Adult↗
PubMed2004

[Hip arthroplasty after failed internal fixation of the trochanteric fractures in aged patients with co-existent osteoporosis].

The authors present the results of hip arthroplasty of 67 patients treated after failed internal fixation of the osteoporotic, trochanteric fractures of the femur, which were primary stabilised with angular plate AO in 39 patients and with dynamic hip screw (DHS) in 28 patients. In the discussed material 16 persons were male and 51 female, in the age between 51 and 83 years old. According to the Evans classification in 4 cases we diagnosed type I of fracture, in 10--type II, 31--type III and in 22--type IV. Hip arthroplasty was made from the 3rd to the 39th week after primary fixation of the fracture. In 42 patients we made total hip arthroplasty, in 14 cases Austin-Moore hemiarthroplasty, and in 11 patients bipolar arthroplasty. According to the Postel and Merle d'Aubigne classification there were obtained 29 very good, 21 good and 17 satisfactory results.

Aged↗
PubMed1987

Delayed internal fixation of femoral shaft fractures--is there an advantage? A review of 320 fractures.

We have reviewed 402 traumatic fractures of the femoral shaft, 320 of which had been treated by operation and had a long follow-up. Of these, 228 closed fractures and 37 open fractures had been stabilised by plating. There was no significant difference in healing between those stabilised early and those having delayed internal fixation. Re-fracture after removal of the implant occurred more often after early operation. All 55 fractures treated by intramedullary nailing healed and there were no re-fractures after nail removal. We found no correlation between delay before operation and the incidence of postoperative infection.

Adolescent↗
PubMed1981

The advantages of titanium alloy over stainless steel plates for the internal fixation of fractures. An experimental study in dogs.

An experimental study is reported of fracture healing in the femora of 36 Beagle dogs, comparing the results of using stainless steel plates with those of using less rigid titanium alloy plates. The alloy plates led to the appearance of a small amount of periosteal callus without any histological evidence of fracture instability, thus allowing the radiological assessment of fracture union. This also produced less bone loss during the remodelling phase. Radiological measurements 24 weeks after osteotomy showed cortical thickness to be reduced by six per cent under titanium alloy and by 19 per cent under stainless steel, while histological measurements showed a total bone loss of 3.7 per cent under titanium alloy and of 11 per cent under stainless steel plates. Removal of the titanium alloy plates after eight weeks followed by a recovery period of 16 weeks produced an increase of cortical thickness of 69 per cent and a gain in total bone mass of 30 per cent. Titanium alloy plates also produced less soft-tissue reaction than stainless steel plates. It is concluded that this alloy is a promising material for internal fixation devices.

Alloys↗