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PubMedDate not supplied

Repair of radial fractures in toy breed dogs with self-reinforced biodegradable bone plates, metal screws, and light-weight external coaptation.

OBJECTIVE: To describe a surgical technique for, and outcome after, treatment of radial fractures with biodegradable self-reinforced polylactide plates and metal screws, and external coaptation. STUDY DESIGN: Prospective clinical study. SAMPLE POPULATION: Eleven Toy breed dogs. METHODS: Radial fractures were repaired by application of a single or 2 stacked biodegradable self-reinforced polylactide plates (poly-L/D, L-lactide, stereocopolymer [LL-and DL-lactide ratio 70/30]; SR-PLA (70/30) implants) secured with metal screws, and light-weight external coaptation. Healing was evaluated clinically and by radiography at 2, 4, 6, 8, 9, 12, 24-26 weeks, and at 1 and 2 years. Owners were interviewed 3 years after surgery. RESULTS: Radial fracture lines disappeared within 4-14 weeks in 10 dogs; an implant failed in 1 dog. Ambulation was excellent for healed fractures. Excessive skin tension led to removal of implants in 1 dog and suture repair in another dog. No foreign body reaction from implant degradation was observed and the plate was usually no longer palpable at 2 years. One dog had a fracture through a screw hole at 1 year. CONCLUSION: Healing and complication rates after repair of radial fractures with SR-PLA (70/30) plates were considered similar or better than reported after repair with metallic plates or external fixation in Toy breed dogs. No radiographic signs of osteopenia were identified under the plate during follow-up. CLINICAL RELEVANCE: Biodegradable polylactide plates could be considered as an alternative to metal plates for radial fracture repair in Toy breed dogs, however available plates are likely not strong enough when used as a single plate. Implant removal is usually not needed.

Absorbable Implants↗
PubMed1994

Correction of open bite by maxillary osteotomy. A comparison between bone plate and wire fixation.

A clinical and cephalometric standardized study of surgical correction of open bite deformity was performed on 19 individuals. The mode of fixation of the maxilla after surgical correction was by direct wires in 9 of the patients combined with suspension wires to the infraorbital rim and in 10 patients plate fixation. The follow-up time was 18 months and the results in both groups were clinically and cephalometrically stable in the short (2 and 6 months) and medium terms (18 months). No statistically significant difference was found between the groups regarding tendency to relapse. It was, however, concluded that the advantages of plate fixation both on clinical grounds and for patient comfort are factors in favour of using miniplates for maxillary surgical procedures.

Adolescent↗
PubMed1980

[Treatment of supracondyloid fractures of the femur with Judet's bone plate and screws].

Severe fractures of the distal end of the femur, which have become increasingly numerous as a result of the multiplication of road accidents, frequently require surgical treatment. The Authors, updating to 1979 the cases of the "G. Pini" Orthopedic Institute in the field of Judet's screw-plate, document the validity of this means of synthesis as confirmed by the quality of the results.

Adolescent↗
PubMed1979

Use of the mandibular staple bone plate in the deformed mandible.

Seven cases have been presented to demonstrate the reconstructive potential and the longevity of the mandibular staple in a variety of unusual cases. The use of the staple provides a surgical method to rehabilitate various types of mandibular deformities. Functional success without major complications has occurred in 90% of cases recently reported.

Adult↗
PubMed1997

[Treatment results for ankle fracture with subluxation using bone plates for fixation of the fibula].

The results of surgical treatment of 16 patients (9 females, 7 males) for ankle fracture/subluxation have been presented. Tibio-fibular syndesmosis was reconstructed and the fibula was fixed with an appropriately bent metal plate and screws. Medial malleolus was fixed with a screw or Kirschner wires. Advantages of stable ankle fixation have been discussed. Lateral malleolus fixation facilitates reduction and fixation of the medial one. External immobilization has been abandoned in some patients. The early results of such a treatment are favourable.

Adolescent↗
PubMed1975

Chalmers J. Lyons memorial lecture: Metal implants and the mandibular staple bone plate.

To briefly summarize our results, two of the five three-pin staples (40%) have survived and have functioned well for more than six years. Four of the five four-pin staples (80%) have survived five years or longer and are functioning well. Twenty-four of the 25 seven-pin staples (96%) are functioning well, some for a period of 4-1/2 years; a few in this group have been used a little less than a year. Our total percentage of survival with good function is 30 of 35, or 86%, which includes our pilot study of the three- and four-pin staples. A more significant statistic, however, might be those patients with staples who we feel have been free of any significant trouble; these are 27 of 35, or 77%. All of our patients have been subjected to peer review examination and grading by members of the oral surgery staff at Sinai Hospital. They were examined and graded according to three criteria. The first was clinical appearance which included firmness of the staple and clinical appearance of the gingiva (Fig 16). The second was radiographic evidence of bone loss along the transosteal pins and retentive pins (Fig 17). The third category was patient evaluation of improved function and stability of the lower denture (Fig 18). The peer review group used marks A, B, C, D, as excellent, good, fair, and failure. Four points were assigned to A, 3 points to B, 2 points to C, and 1 point to D, so that the grade averages for all three categories were as follows: clinical appearance, 3.6; radiographic appearance, 3.5; and patient evaluation, 3.9. The conclusion of the review group was that the mandibular staple was functioning well and that it was clinically useful. I have presented an overview of some of the characteristics of metallic implants that make them implantable devices, and some of the qualities of the host tissues that will allow placement of foreign material. We do not yet understand all of the factors that make alloplastic materials biocompatible or some of the reasons for rejection by the host. We need continued research in animal models to study new devices and new materials that might permit biologic attachments of the host to implant. We also need controlled clinical studies with peer review to establish reliability of those devices that are clinically useful. The mandibular staple has had an initial clinical trial that seems very promising and is worthy of continued clinical study and clinical application.

Atrophy↗
PubMed1992

Computer-aided optimization of choice and positioning of bone plates and screws used for internal fixation of mandibular fractures.

The present study describes a biomechanical integrated model of the mandibular system in which the maxilla and mandible, the masticatory muscles, and the temporomandibular joints are regarded as one system. In this model, strains in plate-osteosynthesis devices for internal fixation of mandibular fractures can be minimized by optimizing their positions. The model evaluates maximal bite force strategies on all possible dental elements; it uses a linear programming technique and a muscle architecture model, resulting in muscle recruitment patterns. The shape of a "standard" lower jaw is digitized by means of a three-dimensional (3-D) coordinate retrieval device and drawn on a computer screen after its dimensions have been changed according to the clinical case at hand. The 3-D location of the fracture as well as the anatomic restrictions for screw placement can be indicated on the screen. Osteosynthesis devices can be indicated in terms of dimensions, number, and material properties.

Biomechanical Phenomena↗
PubMed1993

Foreign body reactions to resorbable poly(L-lactide) bone plates and screws used for the fixation of unstable zygomatic fractures.

In a previous article in the Journal of Oral and Maxillofacial Surgery, the initial results of treating 10 patients with solitary, unstable, displaced zygomatic fractures using resorbable poly(L-lactide) (PLLA) plates and screws was reported (Bos et al, 1987). This article describes the long-term results in these patients. Three years postoperatively, four patients returned because they were concerned about an intermittent swelling at the site of implantation. The remaining patients were recalled after the same postoperative period. All patients were examined clinically, and six patients were operated on again for evaluation of the swelling and to investigate the nature of the tissue reaction. The explanted material showed remnants of degraded PLLA surrounded by a dense fibrous capsule. The swelling was classified as a nonspecific foreign body reaction to the degraded PLLA material. Ultrastructural investigation of the degraded material showed an internalization of crystal-like PLLA material in the cytoplasm of various cells.

Adult↗