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At least 127 records · Page 7Linked to original sources
PubMed2005

The influence of practice schedules in the learning of a complex bone-plating surgical task.

BACKGROUND: Practicing surgical tasks on bench models can be arranged in 3 ways: as the entire task, or as individual skills practiced separately in blocked or random order. The issue of the optimal practice schedule for the acquisition of surgical tasks is critical for enhancing training programs. METHOD: An orthopedic bone-plating task was practiced as a whole, or in parts in either a random or a blocked order. Learning was assessed on global ratings, checklists, and final product analysis before, immediately after, and an hour after practice. RESULTS: Checklists, and final product analysis, but not the global ratings showed that practicing the entire task resulted in the most learning, followed by the random practice. Practice of the skills in a blocked order yielded the least amount of learning. CONCLUSIONS: It is recommended that surgical tasks composed of several discrete skills should be practiced as a whole. However, if part practice is necessary, these skills should be arranged in random order to optimize learning.

Analysis of Variance↗
PubMedDate not supplied

Design and development of a biomechanical apparatus to test the integrity of the Luque orthopaedic internal bone-plate fixation system.

This paper describes the design and construction of a biomechanical model that will determine the pull-out strengths and fatigue failure of internal fixation devices used at the lumbosacral junction. Fusions at this junction have the highest failure rate. It is suggested that devices that successfully fix this vertebral unit will be effective at other levels of the spine. A model that tests any device designed for use at the lumbosacral junction will therefore provide a uniform measure of the effectiveness of different kinds of instrumentation at the L5-S1 vertebral unit. It will also provide predictive values for fixation systems at other spinal levels. A real-time data-acquisition system was also designed and used to define and determine the failure of the Luque orthopaedic bone-plate fixation device.

Biomechanical Phenomena↗
PubMed1996

[Treatment of pseudarthrosis of the clavicle by bone plate with screw fixation and autologous spongiosa graft].

PURPOSE OF THE STUDY: The authors review and evaluate the operative treatment of mid-shaft clavicular non-union by compression plate osteosynthesis and most frequently by decortication and autogenous bone grafting. MATERIAL AND METHODS: From 1979 to 1990, 11 consecutive patients, 9 males and 2 females, mean age 33.5 years, with symptomatic non-union of mid-shaft clavicular fracture were operated and followed-up for an average of 4 years. The pseudarthrosis was atrophic in 10 and hypertrophic in 1 patient. The initial treatment of the fracture was always conservative. RESULTS: All patients achieved bone union by 3-7 months post operatively. The functional results were excellent in 9 patients. The remaining two patients had mild symptoms such as occasional pain related to weather, soreness of the muscles with overhead lifting and discomfort of the shoulder. Minor complications were noted such as 1 delayed wound healing, 3 cheloid scars and 1 transient partial paresis of the brachial plexus. DISCUSSION: Symptomatic non-union of the mid-shaft clavicular is a rare complication, mainly after non-operative treatment (11 cases in 12 years in our series). Factors responsible for non-union are the initial high velocity injury, the cominution, the overlapping and great displacement, the paucity of cancellous bone at this site and the trapezius interposition. Internal fixation by compression plating, decortication and bone grafting in atrophic non-union often encountered is a safe reliable method allowing uncomplicated healing and acceptable functional results.

Adolescent↗
PubMedDate not supplied

Changes of the mineralization pattern in the subchondral bone plate of the glenoid cavity in the shoulder joints of the throwing athletes.

The distribution of mineralization in the subchondral bone plate (DMSB) is used as a parameter for individual stress distribution of shoulder joints. We have analyzed 28 shoulder joints of throwing athletes by DMSB of the glenoid with computed tomography osteoabsorptiometry and described their mineralization patterns. The throwing motion imposes a heavy rotational load on the shoulder joint, and this, in turn, may lead to excessive translation of the humeral head on the glenoid. This could explain why the two most frequent density maxima were localized to the anterior and posterior portions of the glenoid. Our finding of a frequent bicentric density distribution of the shoulder joints of throwing athletes should be useful in any future analysis of the relationship between the DMSB and the bone morphology of the glenoid.

Adolescent↗
PubMed1999

Subdural haematomas in the elderly: experience with treatment by trephine craniotomy and not closing the dura or replacing the bone plate.

A surgical technique was devised to treat chronic subdural haematomas (SDH) in elderly patients. Initial good results encouraged the author to use this technique in elderly patients with acute SDH. This small group is also reported. The goal was to do definitive, not expectant or incremental surgery on these fragile patients who have a high incidence of co-morbid conditions and cerebral atrophy, and to obliterate the subdural space by allowing the skin to sink into the cranial defect. The surgical technique consists of trephine craniotomy and not closing the dura or replacing the bone plate. Experience with six elderly patients with acute SDH and 23 patients with chronic SDH is reported. Of six patients with acute SDH, mean age 80 years, 2 months, three died, all with a Glasgow Coma Score (GCS) less than 9. Three recovered to preoperative status, one with initial GCS of 7 and the other of 8. Of 23 patients with chronic SDH, mean age 77 years, 21 recovered to preoperative status. The two deaths were in patients with GSC of 5 and 7. There were no recurrent SDH or postoperative surgical or cosmetic complications. All patients were followed for at least 6 months. These excellent results suggest that the procedure could be considered as a first procedure in the elderly patient. At first glance, the operation appears to be overly aggressive, but it is an example of 'aggressive-conservative' treatment which produces good long-term results with few complications and no need for second operations.

Acute Disease↗
PubMed2003

Healing of periapical lesions with complete loss of the buccal bone plate: a histologic study in the canine mandible.

This study evaluated periapical healing of induced apical lesions with concomitant loss of the buccal bone plate in a dog model using four foxhounds. In an initial surgery, pulp cavities of mandibular premolars were exposed to induce apical lesions. In the same session, the cortical bone covering the buccal root surfaces was surgically removed to simulate buccal bone loss. After radiographic confirmation of the development of apical lesions, sites were reentered for surgical treatment. Following apical and buccal debridement, root-end resection, and root-end filling, sites were subjected to three different treatment modalities: (1) flap readaptation (controls); (2) placement of a collagen membrane covering the apical defect and denuded root surface; or (3) placement of an anorganic bovine bone filler into the apical defect and onto the exposed buccal root surface, with additional application of a collagen membrane. Animals were sacrificed 7 months following the second surgery. Step sections were analyzed histometrically and morphometrically for periapical healing. Sites with membrane + filler showed a statistically significantly lower mean percentage of new bone formation within the former defect compared to both membrane-alone and control sites. No significant differences were found for tissue components deposited on the cut root face across treatment groups. Formation of a continuous thin layer of new cementum covering the exposed dentin surface and root-end filling material was a frequent finding. Analysis of the tissue regeneration on the buccal root aspect as well as the clinical periodontal parameters will be presented in a separate article.

Absorbable Implants↗
PubMed2000

Torsional strength of the radius after osteofasciocutaneous free flap harvest with and without primary bone plating.

The osteocutaneous radial forearm free flap (OCRFFF) has not gained widespread popularity in mandibular reconstruction, primarily because of concerns about pathologic fracture of the weakened radius. This study examines the effectiveness of plate fixation of the radius bone after harvest of the OCRFFF as a mechanism to minimize donor-site morbidity and increase the usefulness of the OCRFFF. Matched pairs of fresh human cadaveric radius bones were used in this study. Two study groups were designed. The first group was used to define the amount of strength lost after a typical bone graft harvest. The second group was designed to demonstrate how much torsional strength was regained by the application of an orthopedic reconstruction plate. Statistically significant results were obtained for both groups. In group 1, the strength of the cut bones compared with that of the unaltered bones was significantly decreased by 82% (P = 0.016). In group 2, the cut bones reinforced with a plate were 75% stronger (P = 0.002) than the bones that were only cut. Although the radius bone is significantly weakened by the harvest of a graft, much of this strength can be regained with plate fixation of the radius.

Biomechanical Phenomena↗
PubMed1978

[Flap trepanation of the skull with removal of the bone plate and its replantation in traumatic brain compression].

The results of 104 operations for traumatic compression of the brain have been studied. The advantages of bone-plastic approach are demonstrated. The indications for a primary removal of a flat bone graft plate in acute and subacute traumatic compression of the brain are precised. The results of a delayed plasty of skull defects following decompression trepanation are analysed. The flap bone plates, removed (on indications) during decompression trepanation through bone-plastic approach and kept in a weak formalin solution were used as grafts. Good results were obtained in the most of cases.

Brain Injuries↗