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OBJECTIVE@#To analyze the clinical outcomes of mini-plate combined with wireforms in the treatment of Type C distal radial fractures with marginal articular fragments.@*METHODS@#This retrospective study included a total of 10 cases, including 5 males and 5 females, with 6 cases involving the left side and 4 cases involving the right side, of Type C distal radial fractures with marginal articular fragments. The age of the patients ranged from 35 to 67 years old. All patients underwent surgical treatment utilizing mini-plate combined with wireforms for internal fixation.@*RESULTS@#The follow-up period ranged from 6 to 18 months. Complete fracture healing was observed in all cases, with healing times ranging from 10 to 16 weeks. During the entire follow-up period, patients reported high levels of satisfaction with the treatment outcomes, and there were no incidences of incision infection, chronic wrist pain, or wrist traumatic arthritis. At the final follow-up assessment, the Mayo score for the wrist joint ranged from 85 to 95, with 7 cases rated as excellent and 3 cases as good.@*CONCLUSION@#Mini-plate combined with wireforms proves to be an effective fixation method for Type C distal radial fractures with marginal articular fragments. The early initiation of wrist joint exercises, strong fixation, maintenance of proper reduction, minimal complications, and high rates of excellent and good outcomes demonstrate the reliability and efficacy of this treatment approach.
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Male , Female , Humans , Adult , Middle Aged , Aged , Retrospective Studies , Reproducibility of Results , Radius Fractures/surgery , Fracture Fixation, Internal/methods , Treatment Outcome , Wrist Fractures , Wrist Joint , Bone Plates , Range of Motion, ArticularABSTRACT
Objective:To compare the efficacy of double mini locking plate and anatomical locking plate in the treatment of comminuted olecranon fracture.Methods:The clinical data of 46 patients who underwent comminuted olecranon fracture in the Xi′an Honghui Hospital Affiliated to Xi′an Jiaotong University from March 2017 to May 2020 were analyzed retrospectively. Among them, 21 cases were treated with double mini locking plate (double plate group) and 25 cases with anatomical locking plate (single plate group). The operation time, patient satisfaction, range of motion, return to work time, soft tissue stimulation to remove internal fixation, Mayo elbow performance score (MEPS), disabilities of arm, shoulder and hand score (DASH) of the two fixation methods were statistically compared. Measurement data with normal distribution were represented as ( ± s), and comparison between groups was conducted using the t test. Comparison between groups of count data was conducted using the chi-square test or Fisher exact probability. Results:All 46 patients were followed up for to (19.17±2.79) months. All fractures healed after operation. There was no significant difference in operation time, range of motion, patient satisfaction, MEPS and DASH scores among the two groups( P>0.05). The time of returning to work was (8.47±2.13) weeks in the double plate group and (9.78±1.98) weeks in the single plate group, and the difference was statistically significant ( P< 0.05). There were 9 cases of internal fixation due to soft tissue stimulation, 1 cases in double plate group and 8 cases in single plate group, and the difference was statistically significant ( P<0.05). Conclusions:Compared with anatomical locking plate, the treatment of olecranon fracture with double mini locking plate can effectively reduce soft tissue stimulation and promote patients to return to work early, and the operation time is not significantly prolonged, and the biomechanical advantage is obvious, the clinical effect is satisfactory and the postoperative function is good, so it is an effective treatment.
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BACKGROUND: Pilon fractures usually happened during severe injury, associated with compression and comminution of metaphysis and soft tissue injury and primary articular cartilage damage in varying degrees The treatment is difficult and the prognosis is relatively poor. OBJECTIVE: To explore the clinical effect of application of meta-plate and mini-plate internal fixation for the treatment of anterior comminuted coronal plane Pilon fractures. METHODS: From January 2013 to June 2017, 17 patients of closed anterior comminuted coronal plane Pilon fractures were admitted in Department of Bone and Joint Surgery, Affiliated Hospital of Southwest Medical University. There were 7 males and 10 females, aged from 24 to 62 years, with an average age of 41.3 years. All patients signed the informed consent. This study was approved by the Hospital Ethics Committee. Preoperative CT scans and three-dimensional reconstruction confirmed that the main fracture line was in coronal plane and multiple fragments of distal tibial metaphysis were displaced obviously. According to Ruedi-Allgower classification, there were 3 cases of type and 14 cases of type III. Fracture fragments of articular surface were fixed with transverse metacarpophalangeal mini-plate and screws, and the distal tibial coronal fractures were fixed with anterior meta-plate. The ankle and hind foot score of the American Orthopaedic Foot and Ankle Society was used to evaluate the function after surgery. RESULTS AND CONCLUSION: (1) The 17 patients were followed up for 12 to 28 months. All incisions healed in the first stage without complications such as wound infection, skin necrosis, failure of internal fixation and neurovascular injury. Only one patient had redness on the edge of the incision after operation and healed after swelling reduction and dressing change. (2) Fractures healed within 3 to 6 months without delayed union or nonunion. (3) At the last follow-up, the American Orthopaedic Foot and Ankle Society ankle and hind foot score was excellent in 10 cases, good in 5 cases, and average in 2 cases. The excellent and good rate was 88%. (4) The application of transverse mini-plate and screws fixation can effectively support and fix the fracture fragments of articular surface. Combined with anterior meta-plate of distal tibia for the treatment of anterior comminuted coronal plane Pilon fractures can achieve good therapeutic effect, and strengthen biomechanical stability.
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Objective: To explore the effectiveness of proximal femoral nail antirotation (PFNA) combined with mini plate for reconstruction of lateral femoral wall in the treatment of type AO/Orthopaedic Trauma Association (AO/OTA) type 31-A3 intertrochanteric fracture. Methods: The clinical data of 70 elderly patients with AO/OTA type 31-A3 intertrochanteric fracture treated between January 2013 and January 2018 were retrospectively analyzed. They were divided into group A (PFNA alone, 35 cases) and group B (PFNA combined with mini plate reconstruction of lateral femoral wall, 35 cases). There was no significant difference in the general data of gender, age, side, cause of injury, time from injury to operation between the two groups ( P>0.05). The operation time, intraoperative blood loss, fracture healing time, postoperative complications, and the tip apex distance (TAD) at 2 months after operation were recorded and compared between the two groups. Harris hip score was used to evaluate the function at 12 months after operation. Results: Both groups were followed up 9-21 months, with an average of 16.6 months. The operation time and intraoperative blood loss in group A were significantly less than those in group B ( P70) was 77.14%; and the results were excellent in 7 cases, good in 11 cases, fair in 16 cases, and poor in 1 case in group B, the qualified rate was 97.14%; there was significant difference in the qualified rate between the two groups ( χ2=6.248, P=0.012). Conclusion: Compared with PFNA alone, the treatment of AO/OTA type 31-A3 intertrochanteric fracture with PFNA combined with mini plate reconstruction of lateral femoral wall can significantly reduce postoperative complications, promote fracture healing, and improve functional recovery of patients after operation.
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OBJECTIVE: The objective of this study was to analyze the patterns of tooth movements when distalization of mandibular molars using a mini-plate took place. A finite element analysis was applied to analyze patterns of tooth movements. METHODS: The model of the mandible and teeth were used to build a finite element analysis model, and a mini-plate was inserted in the mandibular ramus. Two different orthodontic forces were established for displacement of mandibular molars. Orthodontic forces were applied at the level of the bracket and at the level of the cemento-enamel junction in the mandibular canine respectively. RESULTS: orthodontic forces at the level of the cemento-enamel junction resulted in a greater biomechanical bodily movement in distalization of the mandibular molars compared to when the orthodontic forces were applied at the level of the bracket. Applying orthodontic forces to the cemento-enamel junction also resulted in unwanted greater extrusive movements in distalization of the mandibular molars compared to the bracket level. CONCLUSIONS: With considering the mode of orthodontic teeth movement, applying different vertical orthodontic forces for distalization of mandibular molars can lead to more effective distalization of teeth.
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Finite Element Analysis , Mandible , Molar , Tooth , Tooth Movement TechniquesABSTRACT
Objective To compare the clinical effects of mini phalangeal external fixation and mini plate in the treatment of intraarticular fractures of the metacarpal bone head,and to provide a theoretical basis for clinical selection of surgical plan. Methods Seventy?four cases of metacarpal bone head intraarticular fractures treated in Huizhou People′s Central Hospital from March 2014 to March 2016 were selected as the research object. All cases were closed fractures and were randomly divided into the external fixation group and the mini plate group,37 cases in each group and treated respectively with the mini phalangeal external fixator and mini AO plate. The patients were followed up for 6 months to 1 year,the function of the metacarpophalangeal joint,the union of the fracture and the incidence of side effects were compared between the two groups. Results The excellent rates of the external fixation group at 6 months and I year after operation were 91. 9% ( 34/37) and 97. 3%( 36/37) respectively,which were significantly higher than those of the mini plate group ( 73. 0%( 27/37) ,81. 2%( 30/37 ) ) , the difference was statistically significant (χ2 = 7. 120, 7. 062, P<0. 05 ) . The complication rate of the external fixation group was 2. 7%( 1/37) ,which was significantly lower than that of the mini plate group ( 24. 3% ( 9/37 ) ) , the difference was statistically significant ( P=0. 014 ) . The average fracture healing time in the external fixator group was (2. 6±0. 4) months,which was significantly lower than that in the mini plate group (3. 1±0. 7) months,the difference was statistically significant (t=2. 40,P<0. 001) . Conclusion In the treatment of metacarpal bone head fracture,the external fixation has small trauma,can do cross joint fixation,and maintain a good fixation strength,and promote the healing of fracture and the recovery of metacarpophalangeal joint function. It is worthy of clinical application.
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Objective To investigate the clinical efficacy of mini-plate fixation for ulnar coronoid process fracture via anteromedial approach.Methods A retrospective review was made on 28 cases of ulnar coronoid process fracture treated with open reduction and mini-plate fixation from April 2010 to December 2014.There were 18 males and 10 females,with age range of 21-60 years (mean,34.3 years).Causes of injury were falls in 21 cases and traffic accidents in 7 cases.According to the O' Driscoll classification,there were 14 cases of type Ⅰ,11 cases of type Ⅱ and 3 cases of type Ⅲ.Time from injury to operation was 2-10 d (mean,3.7 d).Reduction loss,fracture healing time and complications were documented.Elbow function was evaluated at the last follow-up by Mayo elbow performance score (MEPS) and Broberg & Morrey score.Results All cases were followed up for 12-25 months (mean,15.1 months).Restricted elbow activity was initiated one week after operation.Bone united in mean 10.6 weeks (range,8-14 weeks).No nerve injury or fracture redisplacement occurred.At the final follow-up,mean flexion was (124 ± 15)° (range,90°-140°),mean extension loss was (18 ± 20) °(range,0°-50°),mean pronation was (65 ± 18)°(range,40°-85°),and mean supination was (63 ±16)°(range,35°-85°),showing significant difference in comparison with the preoperative measure (P＜0.05).According to the MEPS,the results were excellent in 17 cases,good in 8,fair in 2 and poor in 1.According to the Broberg & Morrey score,the results were excellent in 16 cases,good in 8,fair in 3 and poor in 1.Conclusion Through anteromedial approach,mini-plate fixation of the ulnar coronoid process fracture provides rigid fixation,which benefits joint stability and bone union,and allows early functional exercise.
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AIM: To analyze the clinical efficacy and complications of titanium mini plate internal fixation and reconstructive surgery for patients with orbital fracture. METHODS: Fifty - seven cases (60 eyes) with orbital fracture from March 2013 to April 2014 in our hospital were researched. According to the random number table method, the patients were divided into observation group (29 cases with 30 eyes) and control group (28 cases with 30 eyes ). The control group was treated with hydroxyapatite artificial bone plate for internal fixation, and the observation group with titanium mini plate internal fixation and reconstructive surgery. The diplopia grading, grading of ocular movement disorder before and at 1, 3mo after treatment and postoperative complications ( prolapse, dislocation, infection ) were compared between the two groups. RESULTS: In both group, all the 60 eyes were healed without scar formation. The rate of diplopia grading as grade 0 1mo postoperatively of observation group and the control groups were 63% and 40% ( P CONCLUSION: The clinical curative effect of titanium mini plate internal fixation and reconstructive surgery has a good effect for orbital fractures, which can improve the therapeutic effect and reduce the incidence of adverse reactions.
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PURPOSE: We evaluated the complications, radiological and clinical results after operative treatment using a mini-plate for fixation of displaced talar neck fractures. MATERIALS AND METHODS: There were 20 cases of displaced talar neck fractures from May 2006 to December 2011; we performed a retrospective chart review of 15 patients treated by open reduction and internal fixation using a mini-plate who had more than 2 years of follow-up. According to Hawkin's classification, there were 7 cases of type II fractures and 8 cases of type III fractures. During postoperative 12-16 weeks we checked magnetic resonance imaging. The assessment of clinical results was based on the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale. RESULTS: Mean union period was 11.6 weeks (10-15 weeks). Nonunion and malunion did not occur in all cases. The mean AOFAS score was 88.2 points (80-97 points). There were 5 cases of avascular necrosis. Of these, there were 3 cases of body collapse and 4 cases of post-traumatic arthritis. In the statistical analysis, there was no correlation between the elements including gender, Hawkin's classification and union rates and clinical results. CONCLUSION: Mini-plate fixation of a displaced talar neck fracture is thought to be a good technique, with a low rate of malunion and also showed satisfactory results in radiological and clinical assessment.
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Humans , Ankle , Arthritis , Classification , Follow-Up Studies , Foot , Magnetic Resonance Imaging , Neck , Necrosis , Retrospective StudiesABSTRACT
OBJECTIVE: Speedy surgical orthodontics (SSO), an innovative orthodontic treatment, involves the application of orthopedic forces against temporary skeletal anchorage devices following perisegmental corticotomy to induce movement of specific dental segments. Herein, we report the biological effects of SSO on the teeth and periodontal structures. METHODS: Five beagle dogs were divided into 2 groups and their 6 maxillary incisors were retracted en masse by applying 500 g orthopedic force against a single palatal mini-plate. Retraction was performed without and with perisegmental corticotomy in groups I and II, respectively. All animals were killed on the 70th day, and their periodontal structures were processed for histologic analyses and scanning electronic microscopy (SEM). The linear distance between the third maxillary incisor and canine was used as a benchmark to quantify the retraction amount. RESULTS: Retraction was markedly faster and retraction amount greater in group II than in Group I. Surprisingly, Group II did not show any root resorption despite extensive retraction, while Group I showed prominent root surface irregularities. Similarly, SEM showed multiple resorption lacunae in Group I, but not in Group II. CONCLUSIONS: SSO is an effective and favorable orthodontic approach for major en masse retraction of the maxillary anterior teeth.
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Animals , Dogs , Electronics , Electrons , Incisor , Microscopy , Orthodontics , Orthopedics , Root Resorption , ToothABSTRACT
Fractures of metacarpals and phalanges are probably the most common fractures in the skeletal system and are often neglected as minor injuries. Most of the fractures are treated conservatively but some form of fixation is often indicated in unstable fractures, intra-articular fractures, open fractures and multiple fractures. Various implants ranging from K-wires to mini-plates are used. A retrospective analysis of 50 cases of metacarpal and phalangeal fractures treated by different methods over a period of one year was undertaken. The study showed that right hand was more commonly involved. Most common mechanism of injury was fall and second ray was most commonly involved. Most common fracture pattern was transverse and K-wires were frequently used as mode of fixation followed by mini-plates. The patients were followed up at regular intervals and union was achieved in 98% of fractures. From our study we would emphasize that operative management of metacarpal and phalangeal fractures has definitely an advantage over the closed methods of treatment especially in displaced, unstable, comminuted, intraarticular, open and multiple fractures. Operative management of hand fractures should be undertaken only if a definite indication exists. Indiscriminate use of it should be avoided. The operative management of metacarpal and phalangeal fractures results in accurate reduction of the fracture and joints should be mobilised early following fixation to prevent stiffness of the fingers and regain the desired range of motion at the joint.
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Objective To investigate the freatment outcome of internal fixation of the metacarpal and phalanx fracture using the pure fitanium mini plate.Methods 42 cases(78 lesions) of metacarpal and phalanx fracture were involved.Internal fixation with custom made pur titanium mini plate was done.Results Postoperative follow up rauged from 3 to 14 months and the fracture was healed in 42 cases.The bone union of roantgenographic eridence was 6 to 12 weeks.According to the functional evaluation of TAM ascles the excellent and good rate was 85.7%.Conclusion The AO mini-plate in treatment of the metacarpal and phalax fracture has a firm fixation.It is an optimal strategy for metarcarpal and phalanx fracture.