Implant Complications: Implant Rotation and Waterfall Deformities

Author(s):  
Per Hedén
Author(s):  
Neill Y. Li ◽  
Alexander S. Kuczmarski ◽  
Andrew M. Hresko ◽  
Avi D. Goodman ◽  
Joseph A. Gil ◽  
...  

Abstract Introduction This article compares opioid use patterns following four-corner arthrodesis (FCA) and proximal row carpectomy (PRC) and identifies risk factors and complications associated with prolonged opioid consumption. Materials and Methods The PearlDiver Research Program was used to identify patients undergoing primary FCA (Current Procedural Terminology [CPT] codes 25820, 25825) or PRC (CPT 25215) from 2007 to 2017. Patient demographics, comorbidities, perioperative opioid use, and postoperative complications were assessed. Opioids were identified through generic drug codes while complications were defined by International Classification of Diseases, Ninth and Tenth Revisions, Clinical Modification codes. Multivariable logistic regressions were performed with p < 0.05 considered statistically significant. Results A total of 888 patients underwent FCA and 835 underwent PRC. Three months postoperatively, more FCA patients (18.0%) continued to use opioids than PRC patients (14.7%) (p = 0.033). Preoperative opioid use was the strongest risk factor for prolonged opioid use for both FCA (odds ratio [OR]: 4.91; p < 0.001) and PRC (OR: 6.33; p < 0.001). Prolonged opioid use was associated with an increased risk of implant complications (OR: 4.96; p < 0.001) and conversion to total wrist arthrodesis (OR: 3.55; p < 0.001) following FCA. Conclusion Prolonged postoperative opioid use is more frequent in patients undergoing FCA than PRC. Understanding the prevalence, risk factors, and complications associated with prolonged postoperative opioid use after these procedures may help physicians counsel patients and implement opioid minimization strategies preoperatively.


1993 ◽  
Vol 06 (04) ◽  
pp. 202-207 ◽  
Author(s):  
Cindy Fries ◽  
Audrey Remedios

SummaryIn 12 dogs with hip dysplasia, 20 triple pelvic osteotomies (eight bilateral and four unilateral) were performed. Screw loosening, occurring in six of 12 dogs (seven of 20 osteotomies), was the most common complication after surgery. Implants loosened from the cranial ilium in six hemipelvises (30%) and from both fragments in one hemipelvis, two to six weeks (mean — three) after the operation. Medial acetabular displace-ment caused pelvic narrowing (6 to 9%, mean = 8%) in three of four dogs. Medial ischial displacement decreased pelvic diameter (11 to 21%, mean = 17%) in four of seven osteotomies. All of the dogs with implant failure were treated conservatively with cage rest and in two cases Ehmer slings were used. Although none were lame, gait abnormalities were evident in three of seven dogs on follow-up examinations four to 12 months (mean = six) later.Screw loosening, occurring in seven of 20 hemipelvises, was the most common postoperative complication associated with triple pelvic osteotomy. Fixation failures were managed conservatively. Despite decreased pelvic diameter in four of seven animals, none were lame or showed signs of pelvic obstruction at follow-up examinations four to 12 months later.


VCOT Open ◽  
2020 ◽  
Vol 03 (02) ◽  
pp. e182-e186
Author(s):  
Anthony Malak ◽  
Andrew S. Levien

Abstract Objective This study is a case description of the clinical application of locking plates to repair fractures in the radius and ulna of a 9-month-old, male domestic rabbit. Study Design This study is a case report. Results Double-threaded locking adaptation plates of 1.5 mm were fixated to the radius and ulna of the rabbit using the principles of orthogonal plating. Radiographs of the left radius and ulna were obtained at 8 weeks postoperatively depicting complete osseous union of the fracture and no implant complications were observed. Clinical Significance The authors describe the first clinical report of 1.5 mm locking adaptation plates having been used in repairing radius and ulna fractures in a domestic rabbit.


Medicine ◽  
2020 ◽  
Vol 99 (38) ◽  
pp. e22184
Author(s):  
Xin-jie Liang ◽  
Wei-yang Zhong ◽  
Ke Tang ◽  
Zheng-xue Quan ◽  
Xiao-ji Luo ◽  
...  

2018 ◽  
Vol 79 (2) ◽  
pp. 91-98 ◽  
Author(s):  
Stefan Furrer ◽  
Kathrin Scherer Hofmeier ◽  
Leticia Grize ◽  
Andreas J. Bircher

VCOT Open ◽  
2019 ◽  
Vol 02 (01) ◽  
pp. e43-e49
Author(s):  
Barbro Filliquist ◽  
Sivert Viskjer ◽  
Susan M. Stover

Objectives The aim of this study was to describe a screw fixation method of the tibial tuberosity after transposition during surgical treatment of patellar luxation and to report complications and outcome of the procedure. Materials and Methods Medical records (2010–2016) of dogs treated for patellar luxation with tibial tuberosity transposition stabilization using a cortical bone screw placed adjacent to the tuberosity were retrospectively reviewed. Radiographs acquired immediately after surgery were evaluated for fissures. Proximal tibial dimensions and tibial tuberosity segments were measured. Intraoperative and postoperative complications were recorded. Results One-hundred and six dogs and 131 stifle surgeries were included. Implant complications associated with the screw occurred in 2/106 dogs (1.9%). Two dogs developed tibial tuberosity fracture and proximal displacement within 1 week of surgery and required stabilization with pin and tension band. Patellar reluxation rate following surgery was 6.9% (9/131 procedures). Presence of a fissure on postoperative radiographs increased the odds of tibial tuberosity fracture development (p < 0.001), while greater tibial tuberosity size (p = 0.023) and larger distal cortical attachment (p = 0.018) decreased the odds of fissure formation. Clinical significance Tibial tuberosity transposition can be achieved with a cortical screw placed lateral or medial to the tibial tuberosity.


2018 ◽  
Vol 6 (6) ◽  
pp. 800 ◽  
Author(s):  
Michelle Welborn ◽  
Daniel Bouton ◽  
Joseph Ivan Krajbich

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