Wire fixation versus rigid titanium plate after sternotomy – Results of a randomized, prospective, multi-center trial

The purpose of this study was to review the application of the titanium plate fixation system in sternum transverse incisions and assess its advantages over the conventional methods of steel wire fixation. Sternal healing of 249 patients who underwent a thymectomy and/or excision of the thymoma with a transverse sternal incision was compared between patients who underwent titanium plate fixation or steel wire fixation. Short-term results: The stability of the sternum was significantly superior in the titanium plate group compared with the steel wire group ( P < 0.01). Out-of-bed activities started earlier for patients in the titanium plate group compared with the steel wire group ( P < 0.01). Long-term results: The sternal healing rate in the titanium plate group was significantly higher than the steel wire group ( P < 0.05). Titanium plate fixation improves the postoperative sternal stability in patients with transverse sternal incisions for thymectomy and/or excision of a thymoma. Titanium plate fixation also reduces postoperative pain, enhances the patient's physical activity, and decreases the long-term nonunion rate of the sternum.

Download Full-text

Fractures of the Zygomaticomaxillary Complex and Their Treatment: A Case Report

Balkan Journal of Dental Medicine ◽

10.1515/bjdm-2016-0006 ◽

2016 ◽

Vol 20 (1) ◽

pp. 40-43

Author(s):

Esat Bardhoshi

Keyword(s):

Case Report ◽

Screw Fixation ◽

Kirschner Wire ◽

Rigid Fixation ◽

Facial Fractures ◽

Titanium Plate ◽

Kirschner Wire Fixation ◽

Wire Fixation ◽

Wire Osteosynthesis ◽

Zygomaticomaxillary Complex

SummaryFractures of the zygomaticomaxillary complex are the second most common of all facial fractures. Several fixation methods have been used over the years, including wire osteosynthesis, lag screw fixation, transfacial Kirschner wire fixation, titanium plate and screw fixation, and more recently, resorbable plating system. Internal fixation with titanium plates and screw provides the most rigid fixation and thus greater immobility of the fracture segments. The degree of immobilization created with titanium plates and screws also allows fixation at fewer anatomic points.

Download Full-text

A new combination technique of the modified Robicsek wire fixation and plate fixation achieves effective repair of transverse sternal fracture: a report of two cases

Surgical Case Reports ◽

10.1186/s40792-021-01267-8 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Yoshifumi Fuke ◽

Tomoki Ushijima ◽

Sho Matsuyama ◽

Satoshi Kimura ◽

Hiromichi Sonoda ◽

...

Keyword(s):

Plate Fixation ◽

Flail Chest ◽

Respiratory Movement ◽

New Combination ◽

Fulminant Myocarditis ◽

Limiting Factor ◽

Titanium Plate ◽

Sternal Fracture ◽

Advantages And Disadvantages ◽

Wire Fixation

Abstract Background To maximize the therapeutic effect for complicated sternal fracture, we should know advantages and disadvantages of each surgical repositioning technique, and the choice of an appropriate procedure is essential. We report two successful cases for which a combination of two existing techniques, modified Robicsek wire fixation and locked titanium plate fixation, was applied to transverse sternal fracture with flail chest. Case presentation One patient experienced a transverse sternal and rib fracture due to a traffic injury. Flail chest due to a highly displaced transverse sternal fracture made withdrawal of the ventilator impossible. Another patient, who developed fulminant myocarditis, experienced a transverse sternal fracture resulting from chest compression during cardiopulmonary resuscitation. Severe paradoxical respiratory movement was a limiting factor for cardiac and respiratory rehabilitation. In both cases, a transverse sternal fracture was difficult to correct non-invasively and indicated surgical repair. The surgical repositioning and fixation greatly contributed to the improvement of the respiratory movement, and the patients were successfully withdrawn ventilator support. Conclusion The combination of modified Robicsek wire fixation and locked titanium plate fixation for a complicated sternal fracture employs the complementary and comparative advantages of each procedure and effective fixation may be achieved.

Download Full-text

A New Posterior Extensor Attachment-Point Reconstruction Technique for Cervical Spondylotic Myelopathy Involving C2 Segment: Clinical Outcome and Safety

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0040-1719102 ◽

2020 ◽

Author(s):

Hai-Yun Yang ◽

Yun-Ge Zhang ◽

Dong Zhao ◽

Gui-Ming Sun ◽

Yi Ma ◽

...

Keyword(s):

Cervical Spondylotic Myelopathy ◽

Plate Fixation ◽

Japanese Orthopaedic Association ◽

Neurological Dysfunction ◽

Reconstruction Technique ◽

Open Door ◽

Titanium Plate ◽

Attachment Point ◽

Curvature Index ◽

Axial Symptoms

Abstract Background and Study Aim Cervical spondylotic myelopathy (CSM) is a common degenerative disease that mainly occurs in elder patients, leading to different degrees of neurological dysfunction. Spinal cord involvement is mainly distributed at the C3–C7 segments, but it may also involve up to the C2 level. This study aimed to assess the clinical efficacy and safety of open-door laminoplasty using a new extensor attachment-point reconstruction technique for treating CSM involving the C2 segment. Patients and Methods Fifty-nine patients with CSM involving the C2 segment and undergoing open-door laminoplasty were included in this retrospective study. Based on the titanium plate used in the operation, patients were divided into two groups, a reconstructed titanium plate fixation (RPF) group (n = 28) and a conventional titanium plate fixation (CPF) group (n = 31). Improvements in neurological function, cervical range of motion (ROM), cervical curvature index (CCI), preservation of posterior cervical muscle mass, and axial symptoms were compared between the two groups. Results There were no significant differences in operative time and intraoperative blood loss between the groups (p > 0.05). The Japanese Orthopaedic Association (JOA) score significantly increased in both groups postsurgery (p < 0.05); the neurological recovery rate was similar between the two groups (64.1 ± 13.3% vs. 65.9 ± 14.7%, p > 0.05). There was no significant loss of cervical ROM in either group (p > 0.05). The anteroposterior dural sac diameter at the C2 level was significantly enlarged in both groups (p < 0.05). Alternatively, CCI was significantly reduced in the CRP group (p < 0.05) but unchanged in the RPF group (p > 0.05). The cross-sectional area of the posterior cervical muscles was also significantly reduced in the CPF group (p < 0.05) but maintained in the RPF group (p > 0.05). Finally, axial symptoms were more severe in the CPF group than in the RPF group (p < 0.05). Conclusion Laminoplasty is an effective surgical procedure for CSM involving the C2 segment. The reconstructed titanium plate achieved superior maintenance of cervical curvature and reduced both muscle atrophy and severity of axial symptoms compared with titanium conventional plates.

Download Full-text

Temporary Kirschner wire fixation of the first metatarsophalangeal joint before osteotomy for hallux valgus

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2021.106104 ◽

2021 ◽

pp. 106104

Author(s):

Ichiro Tonogai ◽

Koichi Sairyo

Keyword(s):

Hallux Valgus ◽

Kirschner Wire ◽

Metatarsophalangeal Joint ◽

First Metatarsophalangeal Joint ◽

Kirschner Wire Fixation ◽

Wire Fixation

Download Full-text

Fixation stability and implant-associated complications in periacetabular osteotomy: a comparison of screw and K-wire fixation

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-021-04112-7 ◽

2021 ◽

Author(s):

Vincent Justus Leopold ◽

Juana Conrad ◽

Robert Karl Zahn ◽

Christian Hipfl ◽

Carsten Perka ◽

...

Keyword(s):

Soft Tissue ◽

Screw Fixation ◽

Periacetabular Osteotomy ◽

Implant Migration ◽

Major Complications ◽

Significant Difference ◽

Duration Of Surgery ◽

Wire Fixation ◽

Fixation Stability ◽

Screw Group

Abstract Aims The aim of this study was to compare the fixation stability and complications in patients undergoing periacetabular osteotomy (PAO) with either K-wire or screw fixation. Patients and methods We performed a retrospective study to analyze a consecutive series of patients who underwent PAO with either screw or K-wire fixation. Patients who were treated for acetabular retroversion or had previous surgery on the ipsilateral hip joint were excluded. 172 patients (191 hips: 99 K-wire/92 screw fixation) were included. The mean age at the time of PAO was 29.3 years (16–48) in the K-wire group and 27.3 (15–45) in the screw group and 83.9% were female. Clinical parameters including duration of surgery, minor complications (soft tissue irritation and implant migration) and major complications (implant failure and non-union) were evaluated. Radiological parameters including LCE, TA and FHEI were measured preoperatively, postoperatively and at 3-months follow-up. Results Duration of surgery was significantly reduced in the K-wire group with 88.2 min (53–202) compared to the screw group with 119.7 min (50–261) (p < 0.001). Soft tissue irritation occurred significantly more often in the K-wire group (72/99) than in the screw group (36/92) (p < 0.001). No group showed significantly more implant migration than the other. No major complications were observed in either group. Postoperative LCE, TA and FHEI were improved significantly in both groups for all parameters (p = < 0.0001). There was no significant difference for initial or final correction for the respective parameters between the two groups. Furthermore, no significant difference in loss of correction was observed between the two groups for the respective parameters. Conclusion K-wire fixation is a viable and safe option for fragment fixation in PAO with similar stability and complication rates as screw fixation. An advantage of the method is the significantly reduced operative time. A disadvantage is the significantly higher rate of implant-associated soft tissue irritation, necessitating implant removal. Level of evidence III, retrospective trial.

Download Full-text

Motion and Strength Analysis of 2-Tine Staple and K-Wire Fixation in Scapholunate Ligament Stabilization in a Cadaver Model

Journal of Hand Surgery Global Online ◽

10.1016/j.jhsg.2020.12.004 ◽

2021 ◽

Vol 3 (2) ◽

pp. 67-73

Author(s):

Daniel Hess ◽

Anthony Archual ◽

Zachary Burnett ◽

Hans Prakash ◽

Emily Dooley ◽

...

Keyword(s):

Strength Analysis ◽

Scapholunate Ligament ◽

Wire Fixation

Download Full-text

Staged Management of Severely Displaced Calcaneal Fractures With Transarticular Pinning: A Damage Control Strategy

Foot & Ankle International ◽

10.1177/10711007211013012 ◽

2021 ◽

pp. 107110072110130

Author(s):

Kyeong-Hyeon Park ◽

Chang-Wug Oh ◽

Joon-Woo Kim ◽

Hee-June Kim ◽

Dong-Hyun Kim ◽

...

Keyword(s):

Soft Tissue ◽

Internal Fixation ◽

Kirschner Wire ◽

Wound Complications ◽

Calcaneal Fractures ◽

Simple Method ◽

Wire Fixation ◽

The Mean ◽

Radiographic Union

Background: Severely displaced calcaneal fractures can result in considerable morphology derangement and may be accompanied by soft tissue compromise. Delayed operative restoration of the calcaneal morphology may result in acute retensioning of the damaged soft tissue with associated wound-related complications. In this study, we describe a staged treatment of displaced intra-articular calcaneal fractures that uses temporary transarticular Kirschner wire (K-wire) fixation and staged conversion to definite fixation. Methods: We identified all of the patients who were treated at our institution for calcaneal fractures between 2015 and 2019. A total of 17 patients with 20 calcaneal fractures were selectively treated with 2-stage management. Temporary transarticular K-wire fixation was performed 24 hours after the injury to restore calcaneal morphology and the surrounding soft tissue. After the soft tissue was considered safe, delayed open reduction and internal fixation was performed. The time to definite surgery, radiographic alignment, wound complications, time to radiographic union, and hindfoot American Orthopaedic Foot & Ankle Society (AOFAS) scores were recorded. Results: The average follow-up period was 17 months (range, 12-43). The average Böhler angle increased from a mean of −22 degrees (range, −109 to 25) to 25 degrees (range, 0 to 47) after temporary transarticular K-wire fixation. The mean time from temporary pinning to conversion to definite internal fixation was 20 (range, 10-32) days. There were no immediate postoperative complications. The average time to radiographic union was 13.7 (range, 10-16) weeks. The mean AOFAS score was 87 (range, 55-100). No infections or wound complications were reported during the follow-up period. Conclusion: Temporary transarticular pinning for staged calcaneal fracture treatment is safe and effective in restoring the calcaneal morphology. This novel and relatively simple method may facilitate delayed operation and decrease wound-related complications. Level of Evidence: Level IV, retrospective case series.

Download Full-text