Implant Reconstruction of the Femoral Diaphysis: II—Short-Segment Dynamic Compression Stem

2021 ◽  
pp. 181-187
Author(s):  
Lee Jae Morse ◽  
Andrew S. Fang ◽  
James O. Johnston
Keyword(s):  
Dynamic Compression ◽  
Femoral Diaphysis ◽  
Short Segment ◽  
Implant Reconstruction

scholarly journals A comparative study of fracture shaft of femur in adults treated with broad dynamic compression plate versus intramedullary interlocking nail

2016 ◽  
Vol 12 (2) ◽  
pp. 66-69
Author(s):  
Sushil Thapa ◽  
Shrawan Kumar Thapa ◽  
Shankar Dhakal ◽  
Rudra Marasini ◽  
Bhadra Hamal ◽  
...  
Keyword(s):  
Dynamic Compression ◽  
Femoral Shaft ◽  
Plate Versus ◽  
Femoral Diaphysis ◽  
Medical Sciences ◽  
Significant Difference ◽  
Lost To Follow Up ◽  
Mean Time ◽  
Time From Injury

Background and Objectives: Diaphyseal femur fracture is one of the commonest fractures to present in an emergency room. The objective of the study was to compare femoral shaft fractures treated using nail with those using plate and screws. Patients and Methods: We studied a total of 62 patients of fracture shaft of femur admitted in the Bharatpur Hospital, Bharatpur, Chitwan and National Academy of Medical Sciences, BirHospital,Kathmandu. Two cases were lost to follow up. Thirty cases were treated with plating and 30 cases with nailing. The age group was from 16-30 years. Fifty-three were male and seven were females. Fifty-eight patients had closed fracture and two had Gustillo Anderson grade I openfracture. Result: Time from injury to surgery was 19 days on an average. Mean time for union was more in patients treated by plating, 19.46 weeks as compared to nailing 14.78 weeks. We found one case of infection with plating and breakage of plate in four patients. One patient with nailing did not show any signs of healing and two had failure in case of nailing. Our series revealed 23(38.3%) excellent, five (8.3%) good and two (3.3%) poor results in patients who had nailing while 15 (25.5%) excellent, nine (15%) good, one (1.7%) fair and five (8.3%) poor in patients who had plating out of 30 patients in each group. Conclusion:In our study we found that there was no significant difference in outcomes between plating and intramedullary nailing of femoral diaphysis fracture in terms of union, infection and implant failure.JCMS Nepal. 2016;12(2):66-9.

scholarly journals Effect of the screw tightening sequence on the stress distribution of a dynamic compression plate: A pilot finite element study

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901987607
Author(s):  
Xiaoreng Feng ◽  
Weichen Qi ◽  
Chengyong Wang ◽  
Frankie Leung ◽  
Bin Chen
Keyword(s):  
Finite Element ◽  
Stress Distribution ◽  
Dynamic Compression ◽  
Von Mises Stress ◽  
Femoral Diaphysis ◽  
Element Analysis ◽  
Dynamic Compression Plate ◽  
Compression Plate ◽  
The Stability ◽  
Von Mises

Objective: Although the optimal screw tightening sequence is a common question orthopaedists encounter during fractures fixation with a dynamic compression plate (DCP), the effect of the screw tightening sequence on the stability of the plate has never been explored. This study explores the effect of the screw tightening sequence on the stress distribution of a DCP using a finite element method. Methods: Idealized finite element analysis models of the femoral diaphysis with six-hole or eight-hole DCPs were constructed. The screw tightening preload was simulated using ‘bolt load’ in ABAQUS. Two screw tightening sequences were studied for the six-hole plate and six sequences were studied for the eight-hole plate. U magnitude and Von Mises stress were used to evaluate the deformation and stress distribution of the plate, respectively. Deformation and stress distribution plots from different sequences were compared. Results: The different screw tightening sequences showed different deformation processes, while all had the same final deformation after all the screws were tightened. Each screw tightening step of different tightening sequences showed different stress distributions in the plate, while all had the same stress distribution after all the screws were tightened. Conclusion: Using different screw tightening sequences to fix the same DCP can produce the same stability, which means in terms of fixation stability, after the two screws nearest to the fracture line are tightened, surgeons do not need to hesitate about the order in which the rest screws should be inserted during the surgery.

Implant Reconstruction of the Femoral Diaphysis: I: Intercalary Femur Prosthesis

2021 ◽  
pp. 177-180
Author(s):  
Joseph Benevenia ◽  
Zachary Cavanaugh ◽  
Joseph Ippolito ◽  
Jennifer Thomson ◽  
Luis Guinand
Keyword(s):  
Femoral Diaphysis ◽  
Implant Reconstruction

scholarly journals Reosteosintezių po šlaunikaulio diafizės lūžių analizė

2011 ◽  
Vol 9 (1-2) ◽  
pp. 0-0
Author(s):  
Andrius Vaitiekus ◽  
Mykolas Liubauskas ◽  
Igoris Šatkauskas
Keyword(s):  
Intramedullary Nailing ◽  
Intramedullary Nail ◽  
Dynamic Compression ◽  
Femoral Shaft ◽  
Femoral Diaphysis ◽  
Emergency Hospital ◽  
Mechanical Complications ◽  
Femur Fractures ◽  
Vilnius University ◽  
Medical Histories

Andrius Vaitiekus, Mykolas Liubauskas, Igoris Šatkauskas Vilniaus universiteto Reumatologijos, traumatologijos-ortopedijos ir rekonstrukcinės chirurgijos klinika, Ortopedijos ir traumatologijos centras, Vilniaus greitosios pagalbos universitetinė ligoninė, Šiltnamių g. 29, LT-04130 VilniusEl. paštas: [email protected] Tikslas: Nustatyti reosteosintezių dažnį ir priežastis po šlaunikaulio diafizės vidurinio trečdalio osteosintezių. Ligoniai ir metodai: Retrospektyviai išanalizuotos 237 pirminės šlaunikaulių osteosintezės Vilniaus universitetinės greitosios pagalbos ligoninės (VGPUL) Ortopedijos ir traumatologijos centre nuo 2003 iki 2010 metų. Į galutinę analizę įtrauktos 229 osteosintezės. Visi ligoniai pagal taikytą osteosintezės metodą suskirstyti į grupes: osteosintezė DCP plokštele, intramedulinė osteosintezė vinimi (IMV) ir išorinė fiksacija AO aparatu (IF). Ieškota reosteosintezės priežasčių: mechaninių komplikacijų, pseudoartrozės, supūliavimo. Rezultatai: Pagal AO (32) klasifikacija A tipo lūžis diagnozuotas 133 (56,1 %) pacientams, B tipo – 67 (28,3 %), C tipo – 37 (15,6 %). DCP grupėje iš 150 pacientų 29 (19,3 %) peroperuoti dėl mechaninių komplikacijų, 17 (11,3 %) – dėl pseudoartrozės ir 4 (2,6 %) – dėl supūliavimo. IMV grupėje iš 52 operuotųjų nė vienas neperoperuotas dėl mechaninių komplikacijų, 3 (5,8 %) peroperuoti dėl pseudoartrozės ir 1 (1,9 %) – dėl supūliavimo. IF grupėje iš 27 operuotųjų 7 (26 %) peroperuoti dėl mechaninių komplikacijų, 10 (27 %) – dėl pseudoartrozės ir 10 (27 %) – dėl supūliavimo. Išvados: Osteosintezė intrameduline vinimi yra pranašesnis metodas už osteosintezę plokštele, nes pastarojoje grupėje reosteosintezių dažnis buvo didesnis. Rekomenduojame, jei įmanoma, šlaunikaulio diafizės lūžius gydyti osteosinteze intrameduline vinimi. Reikšminiai žodžiai: reosteosintezė plokštele, intramedulinė fiksacija, šlaunikaulio osteosintezės plokštele komplikacijos, pseudoartrozės. The analysis of reosteosynthesis after diaphyseal femur fractures Andrius Vaitiekus, Mykolas Liubauskas, Igoris Šatkauskas Vilnius Universitety, Clinic of Reumatology, Traumatology-Orthopedics and Reconstructive Surgery, Orthopedics and Traumatolgy Centre, Vilnius University Emergency Hospital,Šiltnamių Str. 29, LT-04130 Vilnius, LithuaniaE-mail: [email protected] Objective: To evaluate the rate of and reasons for reosteosynthesis after osteosynthesis of the middle third of the femoral diaphysis. Materials and Methods: Retrospectively, 237 medical histories of patients with diaphyseal femur fractures, who underwent primary femoral osteosynthesis in the Centre of Traumatology and Orthopaedics of the Vilnius University Emergency Hospital in 2003–2010 were analyzed; 229 osteosyntheses were enrolled into the final study. All patients, by the osteosynthesis method, were grouped into three groups: osteosynthesis with Dynamic Compression Plate (DCP), intramedullary nailing (IMN), and AO external fixation apparatus (EF). These groups were investigated for the reasons of reosteosynthesis (pseudarthrosis, mechanical complications, suppuration). Results: A fracture type (by AO classification) was diagnosed to 133 (56.1%), B type – 67 (28.3%), and C type to 37 patients (15.6%).In first group (DCP) there were 150 cases of osteosynthesis, from which 29 (19.3%) were reoperated on because of mechanical complications, 17 (11.3%) because of pseudarthrosis, and 4 (2.6%) because of suppuration. In the second group, there were 52 IM nailing cases, from which none were reoperated because of mechanical complications, altthough 3 (5.8%) had to be reoperated because of pseudarthrosis and one (1.9%) because of suppuration. In the third group, there were 27 external fixations of which 7 (26%), 10 (27%) and 10 (27%) were reoperated on because of mechanical complications, pseudarthrosis and suppuration, respectively. Conclusions: Osteosynthesis with intramedullary nail is a superior method to internal fixation with DCP, because the rate of reosteosynthesis after intramedullary nailing was lower. We recommend, when possible, to perform osteosynthesis with intramedullary nail for the treatment of diaphyseal femur fractures. Keywords: DCP plating, femoral shaft intramedullary nailing, femur plating complications, pseudoarthrosis.

Atypical Femoral Fracture in McCune-Albright Syndrome

2020 ◽  
Vol 7 (3) ◽  
pp. 147-152
Author(s):  
Salman Ghaffari ◽  
◽  
Mehran Razavipour ◽  
Parastoo Mohammad Amini ◽  
◽  
...  
Keyword(s):  
Femoral Fracture ◽  
Dynamic Compression ◽  
Plate Fixation ◽  
Medullary Canal ◽  
Mccune Albright Syndrome ◽  
Café Au Lait Spots ◽  
History Of ◽  
Albright Syndrome ◽  
Mccune Albright

McCune-Albright Syndrome (MAS) is characterized by endocrinopathies, café-au-lait spots, and fibrous dysplasia. Bisphosphonates are the most prescribed treatment for reducing the pain but their long-term use has been associated with atypical fractures of cortical bones like femur in patients. We present a 23-year-old girl diagnosed with MAS. She had an atypical mid-shaft left femoral fracture that happened during simple walking. She also had a history of long-term use of alendronate. Because of the narrow medullary canal, we used 14 holes hybrid locking plate for the lateral aspect of the thigh to fix the fracture and 5 holes dynamic compression plate (instead of the intramedullary nail) in the anterior surface to double fix it, reducing the probability of device failure. With double plate fixation and discontinuation of alendronate, the complete union was achieved five months after surgery

STRAIN CHARACTERISTICS OF SOIL AND METHODS OF THEIR DETERMINATION

2018 ◽  
pp. 39-43
Author(s):  
K.S. Sultanov ◽  
P.V. Loginov ◽  
Z.R. Salikhova
Keyword(s):  
Dynamic Loading ◽  
Dynamic Compression ◽  
Loess Soil ◽  
Seismic Loads ◽  
Static Compression ◽  
Plastic Model ◽  
Laboratory Conditions ◽  
Coefficient Of Viscosity ◽  
Wave Problems

The method to define strain characteristics of soil under dynamic loading is proposed based on the results of experiments on dynamic compression of soils on the device for dynamic loading in laboratory conditions; the method allows solving wave problems with the statement similar to the statement of experiments. Using the proposed method, the modulus of dynamic and static compression, the modulus of unloading, the coefficient of viscosity of loess soil in the range of seismic loads are determined in accordance with elastic-visco-plastic model of soil developed by G.M.Lyakhov.

scholarly journals Functional outcomes of patients with short-segment Hirschsprung disease after transanal endorectal pull-through

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gunadi ◽  
Gabriele Ivana ◽  
Desyifa Annisa Mursalin ◽  
Ririd Tri Pitaka ◽  
Muhammad Wildan Zain ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Hirschsprung Disease ◽  
Treatment Method ◽  
Strongly Correlated ◽  
Short Segment ◽  
Multicenter Studies ◽  
Operative Complications ◽  
Pull Through ◽  
Larger Sample ◽  
Post Operative Complications

Abstract Background Transanal endorectal pull-through (TEPT) is considered the most preferable treatment method for Hirschsprung disease (HSCR) since it is less invasive and has fewer morbidities than transabdominal pull-through. Here, functional outcomes in short-segment HSCR patients after TEPT were assessed and associated with the prognostic factors. Methods Krickenbeck classification was used to assess the functional outcomes in patients with HSCR after TEPT surgery at our institution from 2012 to 2020. Results Fifty patients were involved in this study. Voluntary bowel movement (VBM) was achieved in 82% of subjects. Nine (18%) subjects had soiling grade 1, while two (4%) and two (4%) patients suffered constipation that was manageable with diet and laxative agents, respectively. Patients who underwent TEPT at ≥ 4 years old tended to have soiling more than patients who underwent TEPT at < 4 years old (OR = 16.47 [95% CI 0.9–301.61]; p = 0.06), whereas patients with post-operative complications had 10.5-fold higher risk for constipation than patients without post-operative complications (p = 0.037; 95% CI 1.15–95.92). Multivariate analysis showed male sex was significantly associated with VBM (OR = 9.25 [95% CI 1.34–63.77]; p = 0.024), while post-operative complications were strongly correlated with constipation (OR = 10 [95% CI 1.09–91.44]; p = 0.04). Conclusions The functional outcomes of HSCR patients after TEPT in our institution are considered relatively good. Moreover, the VBM, soiling, and constipation risk after TEPT might be affected by sex, age at TEPT performed, and post-operative complications, respectively, while the age at TEPT performed might not be associated with functional outcomes. Further multicenter studies with a larger sample size are necessary to clarify and confirm our findings.

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