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At least 19 recordsLinked to original sources
PubMedDate not supplied

Physical and biological aspects of fracture healing with special reference to internal fixation.

Fracture healing is a repair process of a mechanical discontinuity loss of force transmission, and pathological mobility of bone. Through a sequence of changes of tissue development and geometry, the original structural integrity is restored. The recovery of rigidity and strength is related to tissue differentiation. In unified theory of non-operative and operative stabilized fractures, the mechanics of primary bone healing involves a complex interplay of physical and biological factors. The different patterns of bone repair respond to physical influences including strain tolerance.

Animals↗
PubMed1979

[An experimental study on various internal fixations in fracture of a long bone (author's transl)].

In the operative treatment of a long bone fracture, the most important point is to secure the bone healing and to strengthen the bone after removal of internal fixation materials. In this regards, the author has analyzed the mechanical strength of various internal fixation methods (a plate, a medullary nail, screws and encircling wires) on the bone by using acrylics models. Experimental studies of their influences on the bone have also been performed especially investigating the decrease in the bone strength in rabbits. All of internal fixation materials are made of 316L stainless steel. Recently, there has been a tendency to use larger materials for internal fixations such as an AO compression plate or a Küntscher type medullary nail. However, it was found that the rigid plate fixation greatly affects the bone strength. A medullary nail produced less impairment to the bone. But this method is restricted in its application because of the weak fixability of the torsional load. On the other hand, the internal fixations with screws or encircling wires are weaker than the other methods especially against the bending load. Therefore the commencement of postoperative treatment will be delayed. But, these two methods have little influence on the bone during fixation.

Animals↗
PubMed1977

8. Self-compressing implants in the management of fractures.

Internal fixation of fractures has become increasingly important since the introduction of self-compressing implants. Rigidity of fixation thus ensured permits primary bone healing. Two types of self-compressing implants are available--screws and plates. The former produces compression between fracture fragments, the latter, along the long axis of the bone. Two common types of plates are the dynamic compression plate and the Osteo self-compressing plate. Use of self-compressing implants requires familiarity with the technique, a definite plan of operation, and strict asepsis and lack of infection in the patient. Indications for the technique include failure or unsuitability of closed reduction of fractures, care of associated serious soft-tissue injuries, and displaced intra-articular fractures. Use of self-compressing plates hastens rehabilitation, lessens joint stiffness and reduces the duration of hospitalization. The incidence of nonunion with self-compression techniques is lower than with traditional methods of fracture management.

Bone Plates↗
PubMed1976

Methylmethacrylate as an adjunct in internal fixation of pathological fractures. Experience with three hundred and seventy-five cases.

In 323 patients with 375 pathological fractures or impending fractures, local tumor resection and internal fixation supplemented by intramedullary methylmethacrylate proved highly successful. One hundred and thirty-nine patients had metastases from breast carcinoma; 142, metastases from other tumors; and forty-two, myeloma or lymphoma. The mean survival for the 210 patients who had undergone operation two years or more before final evaluation was 15.4 months. Ninety-four per cent of the patients who were ambulatory before fracture regained the ability to walk. Eighty-five per cent had excellent or good pain relief and in only five was pain relief rated poor. There were four failures of fixation and six functionally poor results. Twenty patients died within four weeks of operation, but the remaining patients benefited from the procedure in terms of pain relief, improved mobility, and ease of nursing care.

Acetabulum↗
PubMed1979

Internal fixation of fractures of the third phalanx in three horses.

The technique of internal fixation of intra-articular fractures of the third phalanx using lag screw interfragmentary compression is described. Three cases are discussed and the successful treatment of infection and osteomyelitis described in one of them. Despite this potential complication internal fixation offers a better prognosis and also a more rapid return to work than non-operative treatments.

Animals↗
PubMedDate not supplied

Internal fixation of fractures: evolution of concepts.

The recognized goal of any fracture treatment is the restoration of normal function to the injured part(s). Historically, this was first achieved with non-operative techniques and more recently with operative fixation of fractures. Newer systems utilizing the principles of rigid internal fixation and a sophisticated armamentarium have proved useful in fractures of both bones of the forearm, major intra-articular joint fractures and the multiply injured patient. With these methods "fracture disease" (i.e. muscle atrophy, joint stiffness and bony demineralization) is decreased by early mobilization without external support. The penalties for inadequate surgery are nonrigid fixation and/or infection, emphasizing that the operative treatment of fractures is a technique to be mastered.

Europe↗
PubMed1975

Primary internal fixation of femoral neck fractures.

The principles in treatment of femoral neck fractures by primary internal fixation have been reviewed. In the rare, undisplaced stress or fatigue fracture, early internal fixation with threaded pins is recommended. Impacted fractures should be treated by primary internal fixation in patients who do not follow orders and patients whose general condition is poor and would require early weight bearing. Displaced fractures may be treated by primary internal fixation at any age and regardless of the patient's general condition. The following principles are emphasized: early operation, anatomical reduction and slight valgus in some cases, compression and impaction of fragments, and firm immobilization of fragments with a device that has a sliding mechanism and provides lateral cortical fixation.

Bone Nails↗
PubMed1977

[Minimal internal fixation of fractures in elder children (author's transl)].

The fractures in elder children (9--17 years) need a special treatment. Regarding the exact reposition they have to be handled like the fractures of adults. Regarding localisation, morphology of the bone and the way of internal fixation they have to be treated like those of smaller children. The "Minimal-Osteosynthesis" primarily means adaptation, refixation and continuous retention. The procedure is less traumatizing, however the indication should be as strictly as in other cases. The minimal osteosynthesis is giving more respect to the growing bone. The material of internal fixation may be removed much earlier than in adults. Stability for early physical exercises is rarely necessary in children. Even different types of minimal internal fixation are possible. A number of cases are demonstrated.

Accidents, Home↗
PubMed1979

Methylmethacrylate as an adjunct in the internal fixation of pathologic fractures.

The authors evaluated methylmethacrylate as an adjunct to internal fixation of 47 pathologic fractures of long bones (10 of the humerus and 37 of the femur) in 43 patients with metastatic disease. In their experience this method proved to be vastly superior to other methods of internal fixation. All patients were relieved of pain and, if able to walk, could do so almost immediately after fixation of the fracture. In the others comfort was enhanced and nursing greatly facilitated. The surgical technique of internal fixation is described in detail. Correct selection of the metal implant, meticulous attention to the biomechanical considerations and restoration of bone continuity by means of methylmethacrylate are most important if a gratifying result is to be obtained.

Adult↗
PubMed1977

The management of secondary neoplastic deposits in long bones by prophylactic internal fixation.

Pathological fracture through a secondary neoplastic deposit is a distressing event. Prevention of such a fracture is clearly of considerable benefit. To determine which secondary deposits are liable to fracture the notes and X-rays of 57 patients with 91 secondary deposits were examined. Fractures are unlikely (2.4%) to develop where the deposit involves less than 50% of the cortex as seen on radiological examination, but 2 out of 3 deposits with over 50% involvement will fracture. As the benefits of internal fixation in those that would otherwise fracture are so great, it is recommended that all deposits involving over 50% of the cortex of a long bone should be treated by prophylactic internal fixation. The results of 26 patients treated by prophylactic internal fixation are summarized. Apart from fracture-prevention, the benefits of such internal fixation were found to be: pain relief, simple operation, rapid postoperative recovery, facilitation of administration of radiotherapy and maintenance of the independance of the patient. The possible effects on local and general tumour spread are not considered to be a contraindication to operation.

Adult↗
PubMedDate not supplied

The role of early internal fixation in the management of open fractures.

A series of 101 victims of multiple trauma and open fractures were treated by early open reduction and internal fixation. Some of the fractures included associated vascular injury. Some of the patients had extensive intraarticular fractures. Femur fractures in the elderly were included. All wounds were left open. In 94 patients, the early infection rate was 1.9% in small clean open (type I) wounds, 8% in large open (type II) wounds, and 41% in extensively contused large open (type III) wounds. In 94 cases the overall infection rate was 10.6%. In only one infection (1%) a long-term chronic osteomyelitis ensued; there were no non-unions in long bone fractures. Open fractures with type I wounds have the same infection rate as reported for closed fractures. In fractures with types II and III wounds salvage of limb, life, or joint function must justify the high risk of infection. Immediate plate fixation of severe open fractures of the tibia could save a limb from amputation. Closed intramedullary nailing of open fractures of the femur carries a high rate of success.

Adolescent↗