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At least 19 recordsLinked to original sources
PubMed1989

Tension band wiring-bone grafting for spondylolysis and spondylolisthesis. A clinical and biomechanical study.

Patients with spondylolysis or spondylolisthesis with persistent symptoms often require surgical treatment. The purpose of this article is to present a new surgical technique and clinical results of 13 patients with symptomatic spondylolysis/spondylolisthesis who were treated with tension band wiring (intra- or intersegmental) and bone grafting techniques. This article also presents the results of biomechanical effects of these tension band wiring methods on canine lumbar spines with experimental spondylolytic defects. Thirteen adult patients, three with spondylolysis, and ten with spondylolytic spondylolisthesis, were treated with intrasegmental or intersegmental wiring with bone grafting technique, and the clinical results were evaluated at the mean follow-up period of 20 months. Patients with spondylolysis were treated with intrasegmental wiring (transverse processes to the spinous process of the same segment) with bone grafting at the lytic defect. Patients with spondylolytic spondylolisthesis were treated with intersegmental wiring (transverse process of the segment with defect to the spinous process of the same segment and to the spinous process of the segment below) with bone grafting to the defect and one-level fusion. All 13 patients had a solid spinal fusion and/or healing of the defect at the follow-up evaluation. Eleven had excellent clinical results; one a good, and one a fair result. The results of the biomechanical study showed that the experimental spondylolytic defect produced a significant decrease in bending stiffness (flexion-extension), and the wiring techniques (both the intra- and intersegment) increased the bending stiffness to that of the normal intact spinal segment.

Adult↗
PubMed1991

[Bundled central medullary bone wiring. Method of choice in the treatment of fractures of the neck of the fifth metacarpal necessitating a reduction. 30 cases].

The authors present a short series of 30 displaced fractures of the neck of the fifth metacarpal. All fractures were treated by K-wire nailing according to the method described by Fourcher in 1976. The good results confirm the advantages of this technique, allowing early mobilization and rehabilitation. The poor results are due to faults in the use of the method, and the authors emphasize these technical errors.

Adolescent↗
PubMed1989

[Treatment of fresh subcutaneous flexor tendon rupture of the distal joint of long fingers with temporary bone wire arthrodesis].

Drop-finger at the distal joint or mallet-finger from injury occurs because of the extensor apparatus is so much weaker than the flexor tendon that it breaks under strain. We report on 100 cases treated by internal splinting with longitudinal applied Kirschner wire in the distal and middle phalanx of the finger. It affords an absolute immobilisation of the distal interphalangeal joint in slight hyperextension with relaxation of the extensor apparatus. The wire was removed after six weeks. The results evaluated in 76 patients by follow-up four to 84 months were classified as excellent in 86.8% (full range of motion), good in 11.9% (loss of motion 5 to 15 degrees), and poor in 1.3% (loss of motion more than 15 degrees). The excellent and good results emphasize that internal splinting in ruptures of the extensor apparatus near the distal interphalangeal joint.

Adolescent↗
PubMed1977

Tensile strength of wire-reinforced bone cement and twisted stainless-steel wire.

To assess the tensile strength of wire-reinforced bone cement as used for posterior spine fusion, standardized bone-cement specimens reinforced with stainless steel and Vitallium wires 0.5 and one millimeter in diameter were tested in tension. The results showed that tensile strength of bone cement was increased significantly by reinforcing it with metal wires, the increase in strength being proportional to the number of wires used. Even after failure of the cement, the reinforcing wires still carried an appreciable amount of load, thus avoiding the catastrophic failure of the cement alone. Specimens reinforced with Vitallium wires in general failed at higher loads than specimens reinforced with similar stainless-steel wires. Pull-out studies showed that a hook or a loop at the embedded end of straight wires significantly increased the load necessary to pull the wires out. The tensile strength of twisted stainless-steel wire composed of two 0.5-millimeter strands increased with the number of turns up to about eight turns per inch (2.54 centimeters) and then decreased.

Bone Cements↗
PubMed1986

Interspinous wiring without bone grafting for nonunion or delayed union following anterior spinal fusion of the cervical spine.

Nine patients who had unsuccessful anterior interbody fusion or subtotal spondylectomy and fusion for cervical spondylosis were treated by interspinous wiring without bone grafting. Bone union was confirmed during a mean postoperative period of 2 years and 2 months in seven patients by the disappearance of clear zones observed preoperatively in the disc space, and by continuity of the trabeculae in radiograms. One of the two patients in whom the procedure failed to unite the site of nonunion had received technically inadequate wiring with slight mobility at the wiring site; in the other patient, the grafted bone had collapsed and no sclerotic shadow of the nonunion site was seen at the time of surgery. Both patients underwent wiring after considerable intervals from the time of the initial anterior spinal fusion. We found that satisfactory bone union can be obtained for nonunion or delayed union following anterior cervical spinal fusion by interspinous wiring without further bone grafting if applied to properly selected patients.

Adult↗
PubMed1990

Interspinous process segmental instrumentation with bone-button-wire for correction of scoliosis.

From May 1985 to May 1988, 55 patients with scoliosis were given interspinous process segmental spinal instrumentation with bone button-wire. The Harrington distraction rod and Luque's rod were placed separately in the concave and convex sides of the curvature fixed with bone button-wire. The fixations were subjected to biomechanical analysis, and the patients were followed up for an average of 18 months with satisfactory results. The curves were corrected from 69.4 degrees to 33.2 degrees, with a corrective rate of 47.8%. The merits of this procedure lie in (1) no injury to the spinal cord and minimal neurological complications, (2) strong fixation for correcting deformities, and (3) minimal blood loss and short time for operation.

Adolescent↗
PubMed1976

Atlanto-axial fusion in rheumatoid arthritis. A new method of fixation with wire and bone cement.

Twenty-eight occipito-cervical fusions performed over the past 4 years in patients with rheumatoid arthritis are discussed. All of the patients with one exception had signs of neurological involvement preoperatively due to pressure on occipital nerve roots, spinal cord and/or vertebral arteries. A surgical technique using wire, pin and bone cement and permitting early mobilization without external fixation was used and is described in detail. The clinical results were excellent in 21 cases with an additional five patients showing improvement. One patient did not benefit from surgery and one had no symptoms preoperatively. The results are encouraging and the possibility of early mobilization (the day after surgery) is of the utmost importance for this group of patients.

Adult↗
PubMed1979

Bending properties of wire-reinforced bone cement for applications in spinal fixation.

PMMA beam specimens were tested in four-point bending to determine if the bending strength of acrylic bone cement, as used in posterior spinal fusion, could be improved by metal-wire reinforcement. The result showed that the load-carrying capacities of 1- and 0.5-mm diam stainless-steel-wire-reinforced PMMA specimens in bending were significantly higher than similar unreinforced normal PMMA samples. On an average, steel reinforcement comprising approximately 1% of the cross-sectional area of the PMMA specimens caused a 15% increase in bending strength. Even after the cement fractured, the reinforcing wires still sustained an appreciable amount of bending moment, thus preventing catastrophic failure of cement alone.

Bone Cements↗
PubMedDate not supplied

Effect of cerclage wires on periosteal bone in growing dogs.

Three diameters of wire were placed circumferentially around the femora of six 22 week old puppies. The wires were placed over the periosteum on one limb and under the periosteum on the other limb. The effect of the wires on actively growing bone was evaluated 3 and 8 weeks after placement. Diffuse growth of periosteal new bone occurred in immature dog femora in which cerclage were placed under the periosteum. This reaction corresponded with dramatically increased medullary and periosteal microvascularity coupled with histologic active trabecular bone formation. In femora in which wires were placed over the periosteum, even though the placement of the wires should supposedly have been the most detrimental, there were active vessels within the cortex directly under all wires. In both preparations, cerclage wires were becoming encased in the growing cortical bone 8 weeks after placement. Cerclage wires did not devitalize immature bone nor did it restrict adjacent appositional bone growth.

Angiography↗
PubMed1979

[Craniofacial trauma. Value and methods of early treatment. 70 cases (author's transl)].

The two essential problems posed by craniofacial trauma are assessed in the light of 70 collected cases. Firstly, the "time" of treatment. Immediate surgery by two teams, neurosurgical and maxillofacial, may be justified in the presence of craniocerebral lesions. This occurs rarely. The cranial problem is often explored during the first 3 or 4 days and with the exception of certain cases of immediate or delayed coma, maxillofacial treatment may be undertaken early. The treatment of cerebrospinal fluid fistulae remains controversial. Secondly, the surgical technique. Accent is placed upon two points which are still discussed : cutaneous phase and bone phase in open trauma ; reconstruction of the cranial level and the facial mass by fixation using plates or steel wire, bone grafts or inert materials, with in particular surgery for fractures of the floor of the orbit in all cases. A number of clinical cases suggest that suitability of eclectism in this surgical approach to craniofacial trauma.

Adolescent↗
PubMed1992

Application and postoperative management of external skeletal fixators.

Application of external skeletal fixation involves preoperative assessment of the fracture with regards to healing potential of the bone and stabilizing requirements of the fixator. The fixator can be used alone or with supplemental (IM pin, cerclage, hemicerclage, Kirschner wires, bone screws) fixation to counteract shear, bending, and torsional forces at the fracture site. In addition, cancellous bone grafting can be used to enhance fracture healing. Rigid frames should be based on predrilling pilot holes followed by slow speed or hand insertion of smooth and threaded pins. Precise knowledge of regional anatomy precludes iatrogenic neurovascular or muscular tissue damage, which, subsequently, improves patient morbidity. Postoperative care of the fixator consists of bulky wraps to control pin-skin motion and cleaning of pin tract drainage sites. "Dynamization" or bone loading can be performed during fracture healing to stimulate osteosynthesis. This involves staged disassembly and reduction of frames by removing pins and connecting rods.

Animals↗
PubMed1988

The uncemented total hip arthroplasty. Intraoperative femoral fractures.

Intraoperative fractures of the proximal femur occurred in 40 (38 patients) of 630 (6.3%) biological ingrowth total hip arthroplasties performed between January 1984 and July 1986. Twenty-three of these fractures occurred during 131 revision arthroplasties (17.6%) and 17 during 499 primary arthroplasties (3.5%). All but two of the fractures were recognized during surgery. Thirty-seven were treated with either Parham bands or cerclage wires. Bone graft was added to the fracture site in 31 fractures. All of the fractures healed. Three of the patients failed to achieve stable fixation and have required revision surgery. An additional patient has thigh pain with 2 mm of subsidence noted with serial roentgenographs. Femoral fractures can be prevented by preoperative templating of roentgenograms containing markers to measure magnification, routine overreaming of the femoral canal when implanting long-stemmed prostheses, and prophylactically applying wires or bands to femurs requiring the removal of screws.

Bone Cements↗
PubMed1989

Pseudarthrosis of the radius treated by free vascularised bone graft.

We report a case of pseudarthrosis of the radius successfully treated by free vascularised bone grafting. After a comprehensive review of the literature, we recommend this as the treatment of choice in this condition. We also report the use of callus distraction of an incorporated vascularised bone graft to achieve bone lengthening.

Bone Lengthening↗
PubMed1992

Occipital-cervical instability.

A retrospective clinicoroentgenographic study was done on 26 patients with atlantoaxial instability, 17 traumatic and nine nontraumatic. All were treated by means of surgical C1-C2 and occipital-C2 stabilization. The traumatic instability was associated with lesions of the odontoid process and the atlas transverse ligament. Instability may be endogenous or associated with fracture of the atlas. Surgical indication was determined by the level of the fracture line, neurologic symptoms, age, and presence of multiple lesions. C1-C2 stabilization by means of wiring and iliac graft was the selected treatment. Fusion between the occipital and C2 segment was indicated in case of irreducible dens pseudoarthrosis. Fracture on the os odontoideum was very unstable and required greater C1-C2 fusion. Nontraumatic C1-C2 instability was either congenital or secondary to pathologic fractures. Rheumatoid arthritis, which produces anterior displacement of the atlas over the dens to more than 10 mm, neurologic symptoms, or untreatable pain must be stabilized by means of C1-C2 fusion. When elevation of the dens or irreducible displacement of the atlas exists, the results were relatively poor. Tumorous instability produced pathologic fracture of the body of the axis and had to be treated with C1-C2 wiring on bone cement. Down's syndrome instability required occipitoaxial fusion and strict postoperative immobilization.

Adolescent↗
PubMed1989

[Experience in posterior wiring and fusion in atlanto-axial luxation].

From 1980 to 87, 29 cases, aged 31 years on average range, 10 to 65 years, of atlantoaxial dislocation were treated by posterior wiring and bone grafting. They were brought to us as late as 12 days to 157 months (24.4 months on average) after injury. 19 of them had been suffering from paralysis quadriplegia, Brown Sequard syndrome, pharyngeal nerve palsy etc.) of various degrees. Follow-up study, after an average period of 2.5 years (1 to 6.5 years.) revealed that 21 patients (72.4%) had resumed their previous work or study; 6 patients had been able either to do light work (3; 10.3%) or to take care of themselves in daily life (3; 10.3%); the rest 2 (7%) had died of unrelated illness. On physical examination, the 27 alive patients had restored full neck motion, but lack of less than 30 degrees of rotation in some cases. Roentgenograms showed bony union of graft in every case, anatomical reduction of luxation in 19, and A-D distance remained 1 to 4 mm. in 10. It is obvious that this operative measure is simple, safe and effective. Some hazards encountered in 4 cases during operation but recovered later, are described. Pre and postoperative managements; as well as operative procedures are given in steps; the former are particularly emphasized on account of their roles, very important to success.

Adolescent↗