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Objective To study the effect of interlocking intramedullary nail on fixing transverse olecranon fracture. Methods Nine pairs of fresh ulna specimens were collected and the transverse fracture model of olecranon was established. Kirschner wire tension band and interlocking intramedullary nail were used to repair the fracture. Cyclic dynamic tension loads with amplitude of 25 N, mean value of 45 N and frequency of 05 Hz were applied to the triceps tendon under simulated elbow flexion conditions of 30°, 45° and 60°, respectively. The fracture displacements of specimens within 300 cycles were recorded in three groups. ResultsAt 30° flexion angle, the fracture displacement of interlocking intramedullary nail group and Kirschner wire tension band group was (1.831±0.333) mm and (3.723±2.390) mm, respectively. At 45° flexion angle, the fracture displacement of interlocking intramedullary nail group and Kirschner wire tension band group was (1.167±0.374) mm and (2.455±0.609) mm, respectively. At 60° flexion angle, the fracture displacement of interlocking intramedullary nail group and Kirschner wire tension band group was (1.407±0.342) mm and (3.112±1.025) mm, respectively. The fracture displacement of interlocking intramedullary nail was smaller. Conclusions The mechanical properties of interlocking intramedullary nail are better than those of Kirschner wire tension band, and the interlocking intramedullary nail is more stable and firmer for fixing transverse olecranon fracture. Moreover, the interlocking intramedullary nail is installed with the operating tool, thus the operation is more accurate and faster, and the operation efficiency is greatly improved.
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@#Introduction: Screws placement may influence the stress distribution and stability of the plate and bone. Implant failures are normally happened in clinical practise when inappropriate number of screws is implemented. Therefore, intensive investigations are needed to provide additional quantitative data on the use of different number of screws. Therefore, this study was conducted to investigate the biomechanical performance of different number of screws configurations on Locking compression plate (LCP) assembly when treating transverse fractures of the tibia bone. Methods: Finite element method was used to simulate tibia bone fracture treated with LCP in standing phase simulation. To accomplish this, a three-dimensional tibia model was reconstructed using CT dataset images. 11 holes of LCP and 36mm of locking screws were developed using SolidWorks software. From this study, there are three models in total have been developed with different number of screws and screw placements. A diaphysis transverse tibia fracture of 4 mm was constructed. Results: In terms of stress distribution, all configurations provide sufficient stress and do not exceeding the yield strength of that material. Conclusion: In conclusion, eight numbers of screws were the optimum configurations in order to provide ideal stability to the bone with displacement of 0.37 mm and 0.91 mm at plate and bone, respectively.
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Background: Patella is the largest sesamoid bone in the body situated in the quadriceps tendon1. The main function of patella is to improve the efficiency of quadriceps muscle by improving the mechanical leverage of the quadriceps muscle. Patellar fractures are common and it constitutes about 1% of all skeletal injuries resulting from either direct or indirect trauma2.The subcutaneous location of the patella makes it vulnerable to direct trauma.Aims of the study were to evaluate the clinical outcome of Transverse fractures of patella treated with modified tension band wiring. The objectives of the study are to study the advantages of modified tension band wiring fixation in patellar fracture, the complications associated with this method of fixation and to assess the role of early mobilization with this technique. Methods: This prospective study is done in Department of Orthopaedics at R L Jalappa Hospital and Research Center, attached to Sri DevarajUrs Medical College, Kolarduring the period from December 2010 to June 2012. This study consists of 30 cases of displaced transverse fracture patella treated by modified tension band wiring. The cases were selected based on inclusion and exclusion criteria. After pre anaesthetic fitness patient, patient was operated (tension band wiring). Operatedknee was immobilized in extension in an above knee posterior slab, and advised to do straight leg raising test.Weight bearing was started from 3rd post-operative day. Sutures were removed on 12th to 14thpost operative day. The discharged patients were advised to report for follow up every month, during each follow up the patients were examined for both subjective symptoms and objective signs which was recorded. The patients were questioned about subjective complaints like pain, difficulty in walking, squatting, climbing and getting down stairs and ability to perform routine work. The patient’s objective assessment was done for Extensor lag, Range of knee movement, circumference of thigh (wasting) and Efficacy of quadriceps (power).Results: The range of age of fracture of patella in our series was between 19-70 years, the mean age was 42 years and the incidence was high in the age group of 31-40 years. In a total of 30 cases, 24 fractures were in men and 6 fractures were in females.22 fractures were as a result of indirect mechanism and 8 cases were due to direct trauma to the patella as in RTA. 17 patients had fracture on the right side and 13 patients had fracture on the left side.Average duration between injuries to hospital admission was about 1.16 days. The average duration between the days of admission to the day of surgery is about 2.93 days and the average duration of stay in hospital is about 13.2 days (ranging from 11 to 22 days).No intra operative complications like fragmentation at wiring, difficulty in closure were encountered. Results were excellent in 26 cases, good in 3 cases and bad in 1 caseasper west’s criteria. Conclusion: Thus we conclude that anatomical reduction and stable fixation in patellar fracture is necessary for the normal integrity and stability of the joint.Early post-operative physiotherapy plays an important role in final outcome, which helps in reducing complication like stiffness of knee and in providing good functional. Our outcome was not influenced by the associated injuries. Long-term follow up is necessary to assess late complications like osteoarthritis and late functional outcome.
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Objective: To explore the effectiveness of high strength suture fixation in treatment of patellar transverse fracture. Methods: Between June 2014 and June 2016, 38 patients with the patellar transverse fracture were treated with high strength suture internal fixation. There were 24 males and 14 females with the age of 26 to 64 years (mean, 45 years). There were 6 cases of accident injury and 32 cases of crashing injury. The time interval between injury and surgery was 2-8 days (mean, 5 days). The preoperative visual analogue scale (VAS) score, Lysholm score, and range of motion (ROM) of patients were 84.3±8.4, 44.5±7.2, and (62±12)°, respectively. Results: All patients' incisions healed by first intention after operation. There was no neurovascular injury, deep venous thrombosis of lower limbs, or local foreign matter irritation reaction. The X-ray films showed that the reduction of patella and the location of internal fixator were good at 2 days after operation. All the 38 patients were followed up 12-18 months (mean, 16 months). All fractures healed and the healing time was 2-4 months (mean, 3 months). At last follow-up, according to the Böstman criteria, 36 patients were rated as excellent and 2 as good, with an excellent and good rate of 100%. The VAS score, Lysholm score, and ROM of patients were 10.2±6.6, 93.1±6.4, and (124±14)°, respectively, showing significant differences when compared with preoperative ones ( t=42.759, P=0.000; t=31.099, P=0.000; t=20.727, P=0.000). Conclusion: Application of high strength suture fixation in the treatment of patellar transverse fracture has advantages of simple to operate, effective fixation, and less complication. It can avoid reoperation of removing the internal fixators. The satisfied ROM and function of the knee joint can be obtained after operation.
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Arthroscopy is recognized as an important adjunct in treatment of intra-articular fractures. The author reports on successful treatment of a displaced transverse glenoid cavity fracture, reduced and fixed with arthroscopic assist, using two cannulated screws perpendicular to the fracture surface, in a patient with frail chest. One screw passed through the Neviaser portal, and the other screw passed through the base of the coracoid process. Arthroscopy assisted reduction and 2 cannulated screw fixation through the Neviaser portal and coracoid base appears to be a good method for treatment of transverse glenoid fractures.
Subject(s)
Humans , Arthroscopy , Glenoid Cavity , Intra-Articular Fractures , Methods , ThoraxABSTRACT
Arthroscopy is recognized as an important adjunct in treatment of intra-articular fractures. The author reports on successful treatment of a displaced transverse glenoid cavity fracture, reduced and fixed with arthroscopic assist, using two cannulated screws perpendicular to the fracture surface, in a patient with frail chest. One screw passed through the Neviaser portal, and the other screw passed through the base of the coracoid process. Arthroscopy assisted reduction and 2 cannulated screw fixation through the Neviaser portal and coracoid base appears to be a good method for treatment of transverse glenoid fractures.
Subject(s)
Humans , Arthroscopy , Glenoid Cavity , Intra-Articular Fractures , Methods , ThoraxABSTRACT
The transverse sacral fracture is rare; however, if it accompanies neurological injury or instability, difficult surgical treatment may be necessary. We performed surgical decompression and laminoplasty in a patient with neurological deficits and anterior displacement of S2 on S1. The patient showed a successful clinical outcome by neurological improvement.
Subject(s)
Humans , Decompression , Decompression, Surgical , SacrumABSTRACT
PURPOSE: To assess the indication and effect of screw fixation in the transverse patellar fractures. MATERIALS AND METHODS: We analysed the results of 14 transverse patellar fractures fixed with screws from January 1991 to May 2005. Mean follow-up period was 47 months (range, 12~143 months). We analysed the radiologic union, operation time, ROM and postoperative Lysholm score. RESULTS: All fractures healed uneventfully. The mean displacement was decreased from 2.2 mm preoperatively to 0.3 mm postoperatively (p=0.001, Wilcoxon signed rank test). The mean operation time was 34 minutes (range, 20 to 60 minutes). Normal range of motion was achieved in 13 knees (92.9%). Average Lysholm score was 95.9 at final follow-up. CONCLUSION: Screw fixation seemed to be useful for treatment of transverse patellar fracture even in comminuted fractures with large fragments. The advantage of this technique was the preservation of extensor mechanism, simplicity, short operation time and good cosmesis.
Subject(s)
Follow-Up Studies , Fractures, Comminuted , Knee , Patella , Reference ValuesABSTRACT
Most sacral fractures have generally been treated with a nonoperative method. However, the authors of this study treated, with an operative method, a transverse sacral fracture that was displaced forward into the pelvic cavity and the patient also had extensive neurologic injury and instability. Fracture site stabilization and decompression proved to be successful management and the patient experienced a remarkably good outcome. In selected cases, surgical treatment is a good option for the management of transverse sacral fracture.
Subject(s)
Humans , Decompression , SacrumABSTRACT
PURPOSE: To evaluate the radiographic and clinical results of displaced transverse patellar fractures using a tensioned anterior figure-eight wire placed through two cannulated screws MATERIALS AND METHODS: 9 patients with displaced transverse patellar fractures treated with cannulated screws and figure-eight wiring were analyzed retrospectively. The mean age was 53 years (range, 22 to 68 years). Controlled passive range of motion exercise were started on the first postoperative day. Full weight bearing was allowed as tolerated. The patients were evaluated with radiographs, clinical examination and Levack's scoring system. RESULTS: All fractures healed and mean time elapsed for union was 9.4 weeks (range, 8 to 12 weeks). All patients regained full knee range of motion. Clinical results according to the Levack's scoring system were excellent in 8 cases and good in 1 case. We found no complications like loss of reduction and soft tissue irritation caused by the wire and screw, loosening or migration of hardware. CONCLUSION: Anterior figure-eight wiring through paired cannulated screws is appropriate for transverse patellar fractures, is possible early knee motion exercise and weight bearing.
Subject(s)
Humans , Knee , Patella , Range of Motion, Articular , Retrospective Studies , Weight-BearingABSTRACT
Among many kinds of internal fixation techniques for the transverse fracture of the patella, AO modified tension band wiring technique and Pyrford technique have been widely used. However, it seems that those techniques are not strong enough to withstand immediate full weight bearing and full range of motion exercise postoperatively. Instead, a load sharing wiring technique seems to be more effective fixation technique. A comparative study was performed to evaluate the load sharing wiring technique using porcine patellae. Transverse fractures of thirty knees were made and were fixed with 3 different fixation technique. 1) AO modified tension band wiring technique, 2) Pyrford technique, and 3) Load sharing wiring technique. Then, those knees were mounted on the material testing system (Instron 4204(R)) and longitudinal traction was applied. The result showed that the separation of the fracture fragments was much less with the load sharing wiring technique than with the AO modified tension band wiring technique and the Pyrford tehchnique when 5 kg to 25 kg of traction was applied(P<0.05). The load sharing wiring technique showed less than 0.4mm of separation at 25~50kg of traction, where other techniques led specimen to failure. From this study, it was suggested that the load sharing wiring technique was proved to be more effective fixation technique compared to other techniques.