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Ugeskrift For Laeger Jan 2023Fractures in the lower leg are common in children and are most often due to accidental falls. A significant part of the fractures involves the growth plates. This review... (Review)
Review
Fractures in the lower leg are common in children and are most often due to accidental falls. A significant part of the fractures involves the growth plates. This review describes a broad range of techniques for treatment ranging from immobilization in a cast to open reduction and fixation with K-wires, screws, or flexible intramedullary nails. Premature growth arrest is relatively common following the physeal fractures in proximal or distal tibia. We recommend early consultation with a tertiary care centre for guidance and planning of the best treatment.
Topics: Humans; Child; Leg; Bone Nails; Tibial Fractures; Lower Extremity; Growth Plate
PubMed: 36760152
DOI: No ID Found -
The Bone & Joint Journal May 2015Implant-associated infection is a major source of morbidity in orthopaedic surgery. There has been extensive research into the development of materials that prevent... (Review)
Review
Implant-associated infection is a major source of morbidity in orthopaedic surgery. There has been extensive research into the development of materials that prevent biofilm formation, and hence, reduce the risk of infection. Silver nanoparticle technology is receiving much interest in the field of orthopaedics for its antimicrobial properties, and the results of studies to date are encouraging. Antimicrobial effects have been seen when silver nanoparticles are used in trauma implants, tumour prostheses, bone cement, and also when combined with hydroxyapatite coatings. Although there are promising results with in vitro and in vivo studies, the number of clinical studies remains small. Future studies will be required to explore further the possible side effects associated with silver nanoparticles, to ensure their use in an effective and biocompatible manner. Here we present a review of the current literature relating to the production of nanosilver for medical use, and its orthopaedic applications.
Topics: Animals; Anti-Bacterial Agents; Bacterial Infections; Bone Nails; Durapatite; Humans; Nanoparticles; Orthopedic Procedures; Postoperative Complications; Prosthesis Design; Prosthesis-Related Infections; Silver
PubMed: 25922449
DOI: 10.1302/0301-620X.97B5.33336 -
Journal of Orthopaedic Surgery (Hong... Dec 2015
Topics: Bone Nails; Bone Plates; Female; Femoral Fractures; Fracture Fixation, Intramedullary; Fractures, Ununited; Humans; Male
PubMed: 27101638
DOI: 10.1177/230949901502300335 -
Orthopaedics & Traumatology, Surgery &... Feb 2022Geriatrics continues to evolve as a specialty by adapting itself to increasingly older patients. Musculoskeletal injuries are common in these patients, who can maintain... (Review)
Review
Geriatrics continues to evolve as a specialty by adapting itself to increasingly older patients. Musculoskeletal injuries are common in these patients, who can maintain their physical capacities and autonomy for a long time, but whose bone solidness is frequently reduced by osteoporosis. Falls increase with age and because of certain medical conditions. Trauma in the geriatric population involves specific risks; thus, the treatment must be adapted not only to the fracture, but to the local conditions and the patient. Ankle injuries are particularly frequent in general traumatology but even more in geriatric traumatology. They can lead to complete loss of autonomy if the treatment is delayed and/or not adapted to the local conditions or the patient. The functional prognosis is brought into play, along with the patient's life due to loss of autonomy and general complications occurring in patients who are bed-ridden. The treatment of bimalleolar ankle fractures in older adults requires rigorous analysis at all points, which starts by evaluating the cutaneous status and viability of the soft tissues upon admission. The benefit-risk balance of the various treatment options will be assessed with the main goal being that patients recover their autonomy. This article will review this topic by answering 7 questions: 1) What are the distinctive features of elderly? Dependence on others, comorbidities, bone and soft tissue fragility are the main ones, explaining these high-risk situations and frequent complications. 2) When should a bimalleolar ankle fracture be treated surgically? The surgery must be done early, preferably within 8hours of the injury occurring, once the comorbidities have been controlled. The local conditions (skin and soft tissue damage) must be evaluated carefully as they determine the treatment. Errors are not allowed in these patients, who are often fragile and in precarious health. Definitive fixation is preferred if the skin status allows it, but one must keep temporary external fixation in mind as an option. 3) Is there still a role for conservative treatment of displaced fractures? This will produce good results when it is well done; however, the indications are rare and must be selected carefully. The main risks are secondary displacement and skin lesions inside the cast, which are sources of infection. 4) Is fixation with anatomical locking plates an advance? This is definitely an advance for these fragility fractures, which are often comminuted, as it allows return to weight bearing in certain conditions. However, the implantation rules must be followed exactly, and it is preferable to use thinner plates. 5) Does transplantar Steinmann pin fixation still have a role? It has few indications, limited to salvage situations (catastrophic local conditions, very poor general condition). External tibiocalcaneal fixation, alone or in combination, is a better option. 6) Is immediate transarticular fixation with a retrograde or antegrade locked nail a reasonable option? Fixation can be done by retrograde nailing or antegrade nailing. It is proposed to patients who are not very autonomous with a poor cutaneous status and/or severe osteoporosis. It is preferable to transplantar nailing. 7) Is immediate protected weight bearing, with or without fixation, possible? This can be considered on a case-by-case basis depending on the extent of the trauma, patient compliance and treatment carried out. LEVEL OF EVIDENCE: V, Expert opinion.
Topics: Aged; Ankle Fractures; Bone Nails; Bone Plates; Fracture Fixation, Internal; Fracture Fixation, Intramedullary; Humans; Osteoporosis; Treatment Outcome
PubMed: 34757182
DOI: 10.1016/j.otsr.2021.103137 -
Singapore Medical Journal Jan 2010Fingertip injuries are commonly seen by family and emergency physicians. Many of the cases are simple to treat and do not need specialised treatment by a hand surgeon.... (Review)
Review
Fingertip injuries are commonly seen by family and emergency physicians. Many of the cases are simple to treat and do not need specialised treatment by a hand surgeon. However, there are certain conditions where early intervention by a hand surgeon is warranted for better functional and aesthetic outcomes. Common injuries include mallet finger injury, crush injuries to the fingertip with resultant subungual haematoma, nail bed laceration, partial or complete amputation of the fingertips, pulp amputations and fractures of the distal phalanges.
Topics: Amputation, Traumatic; Bone Nails; Finger Injuries; Fracture Fixation; Fractures, Bone; Hematoma; Humans; Nails; Suture Techniques
PubMed: 20200781
DOI: No ID Found -
Zhongguo Xiu Fu Chong Jian Wai Ke Za... May 2021To review the research progress of intramedullary lengthening nail technology. (Review)
Review
OBJECTIVE
To review the research progress of intramedullary lengthening nail technology.
METHODS
The foreign literature on the development history, types, advantages and disadvantages, indications and contraindications, complications, and effectiveness of intramedullary lengthening nail were reviewed and analyzed.
RESULTS
The intramedullary lengthening nail system mainly includes mechanical type, electric motor drive type, and magnetic drive type. Compared with traditional external fixation and lengthening technology, the intramedullary lengthening nail technology has certain advantages in incidence of complications, bone healing, postoperative functional rehabilitation, incision aesthetics, convenience, and patient satisfaction. However, there are also shortcomings, such as pain, uncontrollable distraction rate, device failure, etc. In the clinical application of intramedullary lengthening nails for limb lengthening, the indications should be grasped reasonably, and the related complications should be prevented and treated.
CONCLUSION
Intramedullary lengthening nails provide a new option for limb lengthening, and the initial effectiveness is good. It is one of the development direction of limb lengthening technology.
Topics: Bone Lengthening; Bone Nails; Femur; Fracture Fixation, Intramedullary; Humans; Leg Length Inequality; Technology; Treatment Outcome
PubMed: 33998220
DOI: 10.7507/1002-1892.202012084 -
Revista Da Associacao Medica Brasileira... 2011
Topics: Anesthesia; Arthroplasty, Replacement, Hip; Bone Nails; Bone Plates; Fracture Fixation; Hip Fractures; Humans
PubMed: 21537692
DOI: 10.1590/s0104-42302011000200003 -
Veterinary Surgery : VS Jul 2023To compare pin placement accuracy, intraoperative technique deviations, and duration of pin placement for pins placed by free-hand probing (FHP) or 3D-printed drill...
OBJECTIVE
To compare pin placement accuracy, intraoperative technique deviations, and duration of pin placement for pins placed by free-hand probing (FHP) or 3D-printed drill guide (3DPG) technique.
SAMPLE POPULATION
Four greyhound cadavers.
METHODS
Computed tomography (CT) examinations from T6-sacrum were obtained for determination of optimal pin placement and 3DPG creation. Two 3.2/2.4-mm positive profile pins were inserted per vertebra, one left and one right from T7-L7 (FHP [n = 56]; 3DPG [n = 56]) by one surgeon and removed for repeat CT. Duration of pin placement and intraoperative deviations (unanticipated deviations from planned technique) were recorded. Pin tracts were graded by two blinded observers using modified Zdichavsky classification. Descriptive statistics were used.
RESULTS
A total of 54/56 pins placed with 3DPGs were assigned grade I (optimal placement) compared with 49/56 pins using the FHP technique. A total of 2/56 pins placed with 3DPGs and 3/56 pins using the FHP technique were assigned grade IIa (partial medial violation). A total of 4/56 pins placed using the FHP technique were assigned grade IIIa (partial lateral violation). No pins were assigned grade IIb (full medial violation). Intraoperative technique deviations occurred with 6/56 pins placed using the FHP technique and no pins with 3DPGs. Overall, pins were placed faster (mean ± SD 2.6 [1.3] vs. 4.5 [1.8] min) with 3DPGs.
CONCLUSIONS
Both techniques were accurate for placement of spinal fixation pins. The 3DPG technique may decrease intraoperative deviations and duration of pin placement.
CLINICAL RELEVANCE
Both techniques allow accurate pin placement in the canine thoracolumbar spine. The FHP technique requires specific training and has learning curve, whereas 3DPG technique requires specific software and 3D printers.
Topics: Dogs; Animals; Bone Nails; Fracture Fixation; Tomography, X-Ray Computed; Printing, Three-Dimensional
PubMed: 37071824
DOI: 10.1111/vsu.13958 -
ANZ Journal of Surgery Apr 2021This study focuses on (i) the length of the intraosseous part of the supraacetabular pin using the insertion technique from the spina iliaca anterior inferior to the...
BACKGROUND
This study focuses on (i) the length of the intraosseous part of the supraacetabular pin using the insertion technique from the spina iliaca anterior inferior to the cortical part of the incisura ischiadica major, (ii) the angle of insertion of the supraacetabular pin in the transversal plane and (iii) gender-specific differences of the measured results.
METHODS
Images of uninjured pelves from 49 patients (64-line computed tomography scanner) were evaluated, and virtual external fixator pins were positioned using a three-dimensional reconstructions of computed tomography scans. The length of the pins and the insertion angle were investigated. Descriptive statistics were used, and gender-specific differences were calculated. A P-value of <0.05 was considered statistically significant.
RESULTS
The results showed significant differences between male and female pelves concerning both pin length and insertion angel. For male pelves, the mean screw length was 82.7 mm (SD 5.1; range 72.9-94.3). For females, this was statistically significantly shorter (P ≤ 0.001), with an average of 74.1 mm (SD 5.0; range 63.1-81.9). In the male subgroup, the insertion angle was a mean of 22.6° (SD 3.4; range 12.4-31.8), and the female pelves had an average angle of 19.7° (SD 4.0; range 11.7-24.5). These values differed statistically significantly (P = 0.0032).
CONCLUSION
Based on our measurements, we can confirm that both the length of the Schanz screws and the angle of insertion for the supraacetabular external fixator show a statistically significant difference between males and females.
Topics: Bone Nails; Bone Screws; External Fixators; Female; Fracture Fixation; Humans; Ilium; Male
PubMed: 33734540
DOI: 10.1111/ans.16694 -
Journal of Oral and Maxillofacial... May 1993
Review
Topics: Bone Nails; Bone Plates; Bone Transplantation; Dental Implantation, Endosseous; Humans; Mandible; Osteotomy; Surgery, Oral; Surgical Flaps
PubMed: 8478754
DOI: 10.1016/s0278-2391(10)80501-4