scholarly journals From rigid bone plate fixation to stable dynamic osteosynthesis in mandibular and craniomaxillo-facial surgery: Historical evolution of concepts and technical developments

2019 ◽  
Vol 120 (3) ◽  
pp. 229-233 ◽  
Author(s):  
N. Pham Dang ◽  
I. Barthélémy ◽  
F. Bekara
Keyword(s):  
Plate Fixation ◽  
Bone Plate ◽  
Historical Evolution ◽  
Technical Developments ◽  
Facial Surgery

scholarly journals Bone plate fixation ability on the dorsal and lateral sides of a metacarpal shaft transverse fracture

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yung-Cheng Chiu ◽  
Cheng-En Hsu ◽  
Tsung-Yu Ho ◽  
Yen-Nien Ting ◽  
Ming-Tzu Tsai ◽  
...  
Keyword(s):  
Mechanical Strength ◽  
Locking Plate ◽  
Plate Fixation ◽  
Shaft Fracture ◽  
Bone Plate ◽  
Lateral Side ◽  
Lateral Plate ◽  
Fracture Force ◽  
Shaft Fractures ◽  
Metacarpal Shaft

Abstract Background Metacarpal shaft fractures are a common hand trauma. The current surgical fixation options for such fractures include percutaneous Kirschner wire pinning and nonlocking and locking plate fixation. Although bone plate fixation, compared with Kirschner wire pinning, has superior fixation ability, a consensus has not been reached on whether the bone plate is better placed on the dorsal or lateral side. Objective The purpose of this study was to evaluate the fixation of locking and regular bone plates on the dorsal and lateral sides of a metacarpal shaft fracture. Materials and methods Thirty-five artificial metacarpal bones were used in the experiment. Metacarpal shaft fractures were created using a saw blade, which were then treated with four types of fixation as follows: (1) a locking plate with four locking bicortical screws on the dorsal side (LP_D); (2) a locking plate with four locking bicortical screws on the lateral side (LP_L); (3) a regular plate with four regular bicortical screws on the dorsal side (RP_D); (4) a regular plate with four regular bicortical screws on the lateral side (RP_D); and (5) two K-wires (KWs). All specimens were tested through cantilever bending tests on a material testing system. The maximum fracture force and stiffness of the five fixation types were determined based on the force–displacement data. The maximum fracture force and stiffness of the specimens with metacarpal shaft fractures were first analyzed using one-way analysis of variance and Tukey’s test. Results The maximum fracture force results of the five types of metacarpal shaft fracture were as follows: LP_D group (230.1 ± 22.8 N, mean ± SD) ≅ RP_D group (228.2 ± 13.4 N) > KW group (94.0 ± 17.4 N) > LP_L group (59.0 ± 7.9 N) ≅ RP_L group (44.5 ± 3.4 N). In addition, the stiffness results of the five types of metacarpal shaft fracture were as follows: LP_D group (68.7 ± 14.0 N/mm) > RP_D group (54.9 ± 3.2 N/mm) > KW group (20.7 ± 5.8 N/mm) ≅ LP_L group (10.6 ± 1.7 N/mm) ≅ RP_L group (9.4 ± 1.2 N/mm). Conclusion According to our results, the mechanical strength offered by lateral plate fixation of a metacarpal shaft fracture is so low that even KW fixation can offer relatively superior mechanical strength; this is regardless of whether a locking or nonlocking plate is used for lateral plate fixation. Such fixation can reduce the probability of extensor tendon adhesion. Nevertheless, our results indicated that when lateral plate fixation is used for fixating a metacarpal shaft fracture in a clinical setting, whether the mechanical strength offered by such fixation would be strong enough to support bone union remains questionable.

Augmentation of diaphyseal fractures of the radius and ulna in toy breed dogs using a free autogenous omental graft and bone plating

2015 ◽  
Vol 28 (02) ◽  
pp. 131-139 ◽  
Author(s):  
S. Cooley ◽  
J. J. Warnock ◽  
S. Nemanic ◽  
S. M. Stieger-Vanegas ◽  
W. I. Baltzer
Keyword(s):  
Plate Fixation ◽  
Fracture Site ◽  
Implant Removal ◽  
Bone Plate ◽  
Term Outcome ◽  
Post Surgery ◽  
Retrospective Clinical Study ◽  
Diaphyseal Fractures ◽  
Omental Graft

SummaryObjectives: Evaluation of the short-term outcome, duration of bone healing, and complications following bone plate fixation in dogs weighing [uni2264]6 kg, with and without the use of a free autogenous greater omental graft (OG).Materials and methods: A retrospective clinical study reviewed the medical records of 25 dogs of body weight <6 kg with mid to distal diaphyseal fractures of the radius and ulna (29 fractures) treated with open reduction bone plate fixation. Thirteen out of 29 fractures were implanted with an additional 2–3 cm3 OG lateral, cranial, and medial to the fracture site, adjacent to the bone plate.Results: Median time to radiographic healing in OG fractures (n = 11) was 70 days (range 28–98) compared to 106 days (range: 56–144) in non-OG grafted fractures (n = 14). The OG dogs had no major complications; minor complications included oedema, erythema, and mild osteopenia. Six of the eight non-OG dogs for which follow-up could be obtained developed osteopenia necessitating implant removal, four of which re-fractured the radius one to five months after implant removal, with one dog re-fracturing the limb a second time and resulting in amputation. Telephone follow-up of owners of OG dogs (n = 11) three to 15 months (median 10) post-surgery did not identify any signs of lameness or other complications. Owners of the non-OG dogs (n = 8) reported that there were not any signs of lameness six to 48 months (median 36) post-surgery.Clinical relevance: Free autogenous omen-tal grafting of diaphyseal fractures of the radius and ulna was associated with radial and ulnar healing with minimal complications in dogs weighing less than 6 kg.

scholarly journals Experimental Fracture Model versus Osteotomy Model in Metacarpal Bone Plate Fixation

2011 ◽  
Vol 11 ◽  
pp. 1692-1698 ◽  
Author(s):  
S. Ochman ◽  
T. Vordemvenne ◽  
J. Paletta ◽  
M. J. Raschke ◽  
R. H. Meffert ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Plate Fixation ◽  
Maximum Load ◽  
Fracture Model ◽  
Bone Plate ◽  
Bending Test ◽  
Group I ◽  
Metacarpal Bones ◽  
Fixation Techniques ◽  
Fracture Models

Introduction. Osteotomy or fracture models can be used to evaluate mechanical properties of fixation techniques of the hand skeletonin vitro. Although many studies make use of osteotomy models, fracture models simulate the clinical situation more realistically. This study investigates monocortical and bicortical plate fixation on metacarpal bones considering both aforementioned models to decide which method is best suited to test fixation techniques.Methods. Porcine metacarpal bones () were randomized into 4 groups. In groups I and II bones were fractured with a modified 3-point bending test. The intact bones represented a further control group to which the other groups after fixation were compared. In groups III and IV a standard osteotomy was carried out. Bones were fixated with plates monocortically (group I, III) and bicortically (group II, IV) and tested for failure.Results. Bones fractured at a mean maximum load of 482.8 N  104.8 N with a relative standard deviation (RSD) of 21.7%, mean stiffness was 122.3  35 N/mm. In the fracture model, there was a significant difference () for maximum load of monocortically and bicortically fixed bones in contrast to the osteotomy model ().Discussion. In the fracture model, because one can use the same bone for both measurements in the intact state and the bone-plate construct states, the impact of inter-individual differences is reduced. In contrast to the osteotomy model there are differences between monocortical and bicortical fixations in the fracture model. Thus simulation of thein vivosituation is better and seems to be suitable for the evaluation of mechanical properties of fixation techniques on metacarpals.

The influence of screw torque in the application of bone plates

2001 ◽  
Vol 14 (02) ◽  
pp. 78-83 ◽  
Author(s):  
T.C. Hearn ◽  
T.D. Woodside ◽  
J.R. Field
Keyword(s):  
Contact Area ◽  
Plate Fixation ◽  
Clinical Situation ◽  
Surface Strain ◽  
Bone Plates ◽  
Bone Plate ◽  
Clinical Criteria ◽  
Axial Tension ◽  
Interface Contact ◽  
Plate Reconstruction

SummaryThe applied level of screw torque has a significant impact on both the mechanical and vascular environment in bone following the application of a bone plate. The amount of torque applied dictates the resultant level of axial tension generated in the screw and the compressive forces between the plate and underlying bone. The interface contact area between the plate and underlying bone is also affected. As a consequence, screw torque can be implicated in the pathogenesis of implant induced osteopenia and other pathological occurrences that follow bone plate fixation.The work performed was designed to evaluate the effect of the applied level of screw torque. The construction stiffness (rigidity) and bone surface strain was quantitated in response to variable levels of screw torque. This was performed utilizing intact and osteotomized cadaveric bone.The current level of screw torque applied in the clinical situation, for 4.5 mm cortical screws, is approximately 5 Newton metres (Nm). It appears from the work presented herein, that lowering the level of applied screw torque does not adversely affect the rigidity of the final construction. This fact may serve to ameliorate the pathological consequences of applying screws and plates using current clinical criteria.The amount of torque applied to screws in the application of bone plates has a profound effect on a number of elements, namely the interface contact area and force. The work presented examines the effect of screw torque on the rigidity and bone strain distribution of fractured bone following bone plate reconstruction. It appears that the use of lower levels of screw torque, than currently used in clinical practice, does not adversely effect the rigidity of the final construction. These findings support the notion that the level of screw torque applied may have a role in ameliorating the pathogenic response that occur following bone plate application, namely osteopaenia.

Bone plate fixation of mandibular fractures

1980 ◽  
Vol 9 (4) ◽  
pp. 267-273 ◽  
Author(s):  
K-E. Kahnberg ◽  
A. Ridell
Keyword(s):  
Plate Fixation ◽  
Bone Plate ◽  
Mandibular Fractures

scholarly journals Correction of Excessive Tibial Plateau Angle and Limb Shortening in a Juvenile Dog Using a Hinged Circular Fixator Construct and Distraction Osteogenesis

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Daniel D. Lewis ◽  
Stanley E. Kim ◽  
Justin Shmalberg ◽  
Sandra L. MacArthur
Keyword(s):  
Distraction Osteogenesis ◽  
Tibial Plateau ◽  
Plate Fixation ◽  
Limb Length Discrepancy ◽  
Calcaneal Fracture ◽  
Bone Plate ◽  
Tibial Osteotomy ◽  
Hinged Fixator ◽  
Pelvic Limb ◽  
The Right

An 18-week-old Rhodesian Ridgeback puppy that was hit by a car sustained a Salter-Harris type III fracture of the left proximal tibial physis and ipsilateral diaphyseal femoral and tibial fractures. The diaphyseal fractures were successfully stabilized with bone plate fixation. Premature closure of the caudal aspect of the proximal tibial physis, secondary to the proximal physeal fracture, resulted in an excessively high tibial plateau angle (TPA) of 50° with a limb length discrepancy of 13% by 24 weeks of age. The deformity was addressed by performing a proximal tibial osteotomy and subsequent distraction osteogenesis to reduce the TPA while concurrently lengthening the crus. A radial osteotomy was performed in the proximal metaphyseal region and the hinged fixator was applied. Distraction was initiated the day following surgery at a rate of 1 mm per day as measured along the caudal cortex of the tibia with a rhythm of three distractions daily. Distraction was terminated 19 days postoperatively. Sequential distraction of the osteotomy resulted in 17 mm of tibial lengthening and a final TPA of 3°. The fixator was removed 52 days after application. Complications included wire tract inflammation involving the wires securing the proximal segment and a calcaneal fracture which required bone plate stabilization. The left pelvic limb was only 8% shorter than the right pelvic limb and the dog had only a subtle lameness 12 months after surgery. The hinged circular fixator construct allowed for both the reduction of the TPA and limb segment lengthening in this dog.

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