scholarly journals Anatomical reduction and precise internal fixation of intra-articular fractures of the distal radius with virtual X-ray and 3D printing

2019 ◽  
Vol 43 (1) ◽  
pp. 35-47
Author(s):  
Jing Xu ◽  
Guodong Zhang ◽  
Zaopeng He ◽  
Shizhen Zhong ◽  
Yongshao Chen ◽  
...  
Keyword(s):  
3D Printing ◽  
Internal Fixation ◽  
Locking Plate ◽  
Wrist Joint ◽  
Digital Design ◽  
Joint Surface ◽  
Distal Radial Fracture ◽  
Anatomical Reduction ◽  
X Ray ◽  
Articular Fractures

Abstract To evaluate and precisely internal fix intra-articular distal radial fracture (IDRF) using the virtual X-ray and three-dimensional (3D) printing technologies. Twenty-one patients with IDRF were recruited, and the data from digital design group (DDG) and real surgery group (RSG) were collected and analyzed. In DDG, the data from thin-slice computed tomography scan, virtual X-ray measurement parameters, including volar tilt, palmar tilt, radius length (D1), ulnar variation (D2), locking plate position parameter (D3) and distance between key nail and joint surface (D4) were collected. The bone was virtually fixed with the locking plate, and the final model of radius with the screw was obtained by 3D printing. In RSG, the locking plate was precisely pre-bended and used in surgery. During the surgery, the key K-wire was accurately placed and the locking plate was adjusted with the aid of the U-shaped navigation arm. The C-arm was used to observe the positions of key K-wires and the locking plate, and the same above-mentioned parameters were measured intra- and post-operatively. The data from RSG and DDG were compared statistically by t test. This approach proved to be successful in all 21 patients, and none of the screws pierced through the wrist joint surface. All the measured parameters, including the volar tilt, palmar tilt, D1–4, in RSG were not significantly different from preoperative DDG data. Virtual X-ray measurement of anatomical reduction parameters and 3D printing can help the anatomical reduction and precise internal fixation by providing quantitative references, preoperatively, intraoperatively and postoperatively.

scholarly journals Application of 3D printing and framework internal fixation technology for high complex rib fractures

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xuetao Zhou ◽  
Dongsheng Zhang ◽  
Zexin Xie ◽  
Yang Yang ◽  
Menghui Chen ◽  
...  
Keyword(s):  
3D Printing ◽  
Internal Fixation ◽  
Locking Plate ◽  
Rating Scale ◽  
Preoperative Planning ◽  
Numerical Rating Scale ◽  
Chest Ct ◽  
Rib Fractures ◽  
X Rays ◽  
With Screws

Abstract Objective To explore the clinical effect of 3D printing combined with framework internal fixation technology on the minimally invasive internal fixation of high complex rib fractures. Methods Total 16 patients with high complex rib fractures were included in the study. Before the procedure, the 3D rib model was reconstructed based on the thin-layer chest CT scan. According to the 3D model, the rib locking plate was pre-shaped, and the preoperative planning were made including the direction of the locking plate, the location of each nail hole and the length of the screw. During the operation, the locking plate was inserted from the sternum to the outermost fracture lines of ribs with screws at both ends. In addition, the locking plate was used as the frame to sequentially reduce the middle fracture segment and fix with screws or steel wires. Chest x-rays or chest CT scans after surgery were used to assess the ribs recovery. All patients were routinely given non-steroidal anti-inflammatory drugs (NSAIDS) for analgesia, and the pain level was evaluated using numerical rating scale (NRS). Results The preoperative planning according to the 3D printed rib model was accurate. The reduction and fixation of each fracture segment were successfully completed through the framework internal fixation technology. No cases of surgical death, and postoperative chest pain was significantly alleviated. Five to 10 months follow up demonstrated neither loosening of screws, nor displacement of fixtures among patients. The lungs of each patients were clear and in good shape. Conclusion The application of 3D printing combined with framework internal fixation technology to the high complex rib fractures is beneficial for restoring the inherent shape of the thoracic cage, which can realize the accurate and individualized treatment as well as reduces the operation difficulty.

scholarly journals Application of 3D Printing and Framework Internal Fixation Technology for High Complex Rib Fractures

2020 ◽  
Author(s):  
Xuetao Zhou ◽  
Dongsheng Zhang ◽  
Zexin Xie ◽  
Yang Yang ◽  
Menghui Chen ◽  
...  
Keyword(s):  
3D Printing ◽  
Internal Fixation ◽  
Locking Plate ◽  
Rating Scale ◽  
Preoperative Planning ◽  
Numerical Rating Scale ◽  
Chest Ct ◽  
Rib Fractures ◽  
X Rays ◽  
With Screws

Abstract Objective To explore the clinical effect of 3D printing combined with framework internal fixation technology on the minimally invasive internal fixation of high complex rib fractures. Methods Total 16 patients with high complex rib fractures were included in the study. Before the procedure, the 3D rib model was reconstructed based on the thin-layer chest CT scan. According to the 3D model, the rib locking plate was pre-shaped, and the preoperative planning were made including the direction of the locking plate, the location of each nail hole and the length of the screw. During the operation, the locking plate was inserted from the sternum to the outermost fracture lines of ribs with screws at both ends. In addition, the locking plate was used as the frame to sequentially reduce the middle fracture segment and fix with screws or steel wires. Chest x-rays or chest CT scans after surgery were used to assess the ribs recovery. All patients were routinely given non-steroidal anti-inflammatory drugs (NSAIDS) for analgesia, and the pain level was evaluated using numerical rating scale (NRS). Results The preoperative planning according to the 3D printed rib model was accurate. The reduction and fixation of each fracture segment were successfully completed through the framework internal fixation technology. No cases of surgical death, and postoperative chest pain was significantly alleviated. Five to ten months follow up demonstrated neither loosening of screws, nor displacement of fixtures among patients. The lungs of each patients were clear and in good shape. Conclusion The application of 3D printing combined with framework internal fixation technology to the high complex rib fractures is beneficial for restoring the inherent shape of the thoracic cage, which can realize the accurate and individualized treatment as well as reduces the operation difficulty.

Distal Tibial Articular Fractures in Racing Greyhounds: A Review of Six Cases

1993 ◽  
Vol 06 (03) ◽  
pp. 146-152 ◽  
Author(s):  
J. F. Dee ◽  
R. Weiss ◽  
P. M. Montavon
Keyword(s):  
Conservative Treatment ◽  
Internal Fixation ◽  
Functional Results ◽  
Tibial Fractures ◽  
Anatomical Reduction ◽  
Distal Tibial Fractures ◽  
Rigid Internal Fixation ◽  
Articular Fractures ◽  
Fracture Patterns ◽  
Methods Of Treatment

SummarySix spontaneously occurring distal tibial fractures extending into the posterior articular margin of young racing greyhounds were reviewed. Concomitant fractures of both malleoli occurred in three cases. Fracture patterns, methods of treatment and functional results were determined. Open anatomical reduction and rigid internal fixation promoted healing with minimal osseous reaction and showed better results than conservative treatment. Complications adversely affecting the outcome were periarticular deformity and osteoarthritis, these were observed as early as five to seven weeks following the operations.Six spontaneously occurring distal tibial fractures extending into the posterior articular margin of young racing greyhounds were reviewed. Fracture patterns, methods of treatment and functional results were determined.

scholarly journals Plating as an operative management of intra articular fractures of the upper end of tibia: a prospective clinical study

2017 ◽  
Vol 3 (6) ◽  
pp. 1223
Author(s):  
Namdev Gorgile ◽  
Vinod Jagtap ◽  
Yash Shah ◽  
Vikas Rokade ◽  
Girish Bartakke
Keyword(s):  
Internal Fixation ◽  
Tibial Plateau ◽  
High Energy ◽  
Early Mobilisation ◽  
Anatomical Reduction ◽  
Plating Technique ◽  
Knee Stiffness ◽  
Articular Fractures ◽  
Buttress Plate ◽  
Stable Internal Fixation

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Tibial plateau fracture management is challenging because of the severe displacement of the bony fragments, the concomitant depression and impaction of the cancellous subchondral bone, and the inevitable associated cartilage injury.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A prospective cohort study of 25 patients who suffered high energy intra-articular fractures of proximal tibia was done and they were diagnosed and classified according to Schatzker’s classification. The study was done to study the outcomes of surgical management of high energy tibial plateau fractures with buttress plate, to achieve anatomical reduction and absolute stable internal fixation to prevent malunion, to achieve early mobilisation, to prevent post-operative knee stiffness and also to determine timing of operation after trauma and sequence of fixation of bicondylar fractures. All patients were treated with open reduction and internal fixation with a buttress plate either a lateral, medial or bicondylar plating</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Average radio-graphic bony union time was 12 weeks. Average full weight bearing time was 13 weeks. Knee stiffness improved with physiotherapy and full range was achieved on an average in 8 weeks, mean range of movement 0-124.5º was achieved. 4 patients (16%) developed infection. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Fractures of upper end of tibia can be treated with the plating technique, to achieve anatomical reduction and stable internal fixation with 82% good functional outcome. The plating technique facilitates early mobilisation of injured joint and attains good range of movements. Minimal mal reduction does not seem to vitiate the results. The infection rate of 16% is of concern with this procedure, but responds well to antibiotics and surgical debridement.</span></p>

scholarly journals Application of 3D printing and framework internal fixation technology for high complex rib fractures

2020 ◽  
Author(s):  
Xuetao Zhou ◽  
Dongsheng Zhang ◽  
Zexin Xie ◽  
Yang Yang ◽  
Menghui Chen ◽  
...  
Keyword(s):  
3D Printing ◽  
Internal Fixation ◽  
Locking Plate ◽  
Rating Scale ◽  
Preoperative Planning ◽  
Numerical Rating Scale ◽  
Chest Ct ◽  
Rib Fractures ◽  
X Rays ◽  
With Screws

Abstract Objective: To explore the clinical effect of 3D printing combined with framework internal fixation technology on the minimally invasive internal fixation of high complex rib fractures.Methods: Total 16 patients with high complex rib fractures were included in the study. Before the procedure, the 3D rib model was reconstructed based on the thin-layer chest CT scan. According to the 3D model, the rib locking plate was pre-shaped, and the preoperative planning were made including the direction of the locking plate, the location of each nail hole and the length of the screw. During the operation, the locking plate was inserted from the sternum to the outermost fracture lines of ribs with screws at both ends. In addition, the locking plate was used as the frame to sequentially reduce the middle fracture segment and fix with screws or steel wires. Chest x-rays or chest CT scans after surgery were used to assess the ribs recovery. All patients were routinely given non-steroidal anti-inflammatory drugs (NSAIDS) for analgesia, and the pain level was evaluated using numerical rating scale (NRS). Results: The preoperative planning according to the 3D printed rib model was accurate. The reduction and fixation of each fracture segment were successfully completed through the framework internal fixation technology. No cases of surgical death, and postoperative chest pain was significantly alleviated. Five to ten months follow up demonstrated neither loosening of screws, nor displacement of fixtures among patients. The lungs of each patients were clear and in good shape.Conclusion: The application of 3D printing combined with framework internal fixation technology to the high complex rib fractures is beneficial for restoring the inherent shape of the thoracic cage, which can realize the accurate and individualized treatment as well as reduces the operation difficulty.

COMMINUTED INTRA-ARTICULAR FRACTURE OF THE DISTAL RADIUS — THE TECHNIQUE OF OPEN REDUCTION AND INTERNAL FIXATION WITH PLATING

Hand Surgery ◽  
1999 ◽  
Vol 04 (02) ◽  
pp. 175-180 ◽  
Author(s):  
S. P. Chow ◽  
W. Y. Ip ◽  
T. L. Poon
Keyword(s):  
Internal Fixation ◽  
Distal Radius ◽  
Open Reduction ◽  
Wound Closure ◽  
Dorsal Surface ◽  
Articular Fracture ◽  
X Ray ◽  
Articular Fractures ◽  
Technical Details ◽  
Double Plating

The technical details of open reduction and internal fixation with double plating for a patient with comminuted intra-articular fractures of the distal radius were described. The vital steps included the exposure, initial dorsal reduction, ventral reduction and fixation, checking of reduction, return to dorsal surface with final reduction and X-ray check, and wound closure. Special attention and other technical tips were also highlighted, and hopefully will shorten the learning curve of others who would like to use this rather demanding technique for their patients.

scholarly journals Indirect Reduction Technique in Proximal Humeral Fractures Stabilized by Locking Plates

2014 ◽  
Vol 17 (1) ◽  
pp. 2-9 ◽  
Author(s):  
Yong Girl Rhee ◽  
Nam Su Cho ◽  
Sang Won Cha ◽  
Seong Cheol Moon ◽  
Sang Phil Hwang
Keyword(s):  
Internal Fixation ◽  
Proximal Humerus Fracture ◽  
Locking Plate ◽  
Proximal Humerus ◽  
Humerus Fracture ◽  
Indirect Reduction ◽  
Anatomical Reduction ◽  
Medial Cortex ◽  
Group A ◽  
Group B

BACKGROUND: Indirect reduction technique offers a valid option in the treatment of proximal humerus fracture. The purpose of this study is to evaluate the functional outcome and the complication rate after indirect reduction and internal fixation of unstable proximal humeral fractures with use of a locking plate.METHODS: Twenty four patients with acute proximal humerus fracture were managed with indirect reduction and internal fixation with a locking plate. The mean follow-up period was 15.5 months.RESULTS: The anatomical reduction of the medial cortex buttress was seen in 16 patients (66%) of the Group A and the non-anatomical reduction was seen in 8 patients (33%) of the Group B. Mean union time was 3.2 +/- 1.9 months; it was 2.2 +/- 0.6 months in the Group A and 5.3 +/- 2.2 months in the Group B (p < 0.05). In our series, there were 6 cases of complications and these include 2 cases of varus malunion, 2 cases of shoulder stiffness, 1 case of heterotrophic ossification, 2 cases of screw perforation and 1 case of impingement.CONCLUSIONS: We conclude from our studies that indirect reduction and internal fixation using locking plate for acute proximal humerus fracture can give good results with bony union and predictable good overall functional outcome. If the medial cortex buttress is well maintained, a better anatomical reduction would be achieved, the union would be prompted, the pain would be further reduced and the range of the motion would be recovered more promptly.

scholarly journals To determine frequency of union with orthogonal double locking plate in distal humeral fracture.

2020 ◽  
Vol 27 (05) ◽  
pp. 1059-1064
Author(s):  
Muhammad Javaid Iqbal ◽  
Shahzad Mahmood Shahid ◽  
Afzal Javid ◽  
Anoosh Qayyum ◽  
Usman Akmal ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Locking Plate ◽  
Callus Formation ◽  
Case Series ◽  
Humeral Fracture ◽  
Radiographic Evaluation ◽  
Locking Plates ◽  
Non Union ◽  
Distal Humeral Fracture ◽  
Articular Fractures

Objectives: To determine frequency of union with orthogonal double locking plate in distal humeral fracture. Study Design: Descriptive, case series. Setting: Orthopedic department Punjab Medical College. Period: From April 2, 2017 to October, 2017. Material & Methods: 75 consecutive patients with distal humeral fractures were managed by open reduction of internal fixation with double locking plates in orthogonal configuration. Radiographic evaluation was done to see the callus formation after 12 weeks of treatment. Results: There were 54 (72%) males and 21 (28%) female patients having the average age 43.5±15.9 years. Union was seen in 71 (94.7%) patients. In 4 (5.3%) patients there was non-union. Conclusion: Anatomically pre-contoured distal humeral locking plates are useful in providing stable internal fixation for complex distal articular fractures, and hence allowing early rehabilitation.

scholarly journals 2D–3D reconstruction of distal forearm bone from actual X-ray images of the wrist using convolutional neural networks

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ryoya Shiode ◽  
Mototaka Kabashima ◽  
Yuta Hiasa ◽  
Kunihiro Oka ◽  
Tsuyoshi Murase ◽  
...  
Keyword(s):  
Wrist Joint ◽  
High Accuracy ◽  
Training Data ◽  
Small Data ◽  
Data Set ◽  
Accuracy Estimation ◽  
X Ray ◽  
Learning Network ◽  
Forearm Bone ◽  
Deep Learning Network

AbstractThe purpose of the study was to develop a deep learning network for estimating and constructing highly accurate 3D bone models directly from actual X-ray images and to verify its accuracy. The data used were 173 computed tomography (CT) images and 105 actual X-ray images of a healthy wrist joint. To compensate for the small size of the dataset, digitally reconstructed radiography (DRR) images generated from CT were used as training data instead of actual X-ray images. The DRR-like images were generated from actual X-ray images in the test and adapted to the network, and high-accuracy estimation of a 3D bone model from a small data set was possible. The 3D shape of the radius and ulna were estimated from actual X-ray images with accuracies of 1.05 ± 0.36 and 1.45 ± 0.41 mm, respectively.

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