Radiographic evaluation and comparison of triple pelvic osteotomy with and without additional ventral plate stabilization in forty dogs - part 1

2002 ◽  
Vol 15 (03) ◽  
pp. 164-171 ◽  
Author(s):  
S. Kerwin ◽  
G. Hosgood ◽  
M. Rooney ◽  
E. Pluhar ◽  
D. Pelsue ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Pelvic Osteotomy ◽  
Implant Failure ◽  
Radiographic Evaluation ◽  
Screw Loosening ◽  
Ventral Plate ◽  
Additional Surgery ◽  
Additional Stabilization ◽  
And Migration ◽  
Hip Luxation

SummaryTriple pelvic osteotomies (IPO) were evaluated in 40 clinical cases. In 39 cases, these were young dogs with hip dysplasia; in one case, the TPO was used as a correction for a hip luxation. Unilateral TPOs were performed in twenty patients, twelve with traditional TPO (without additional ventral plate) and eight with additional ventral plate fixation. Bilateral TPOs were performed in twenty patients, thirteen with traditional TPO and seven with additional ventral plate. In traditional TPOs, evidence of implant failure occurred in 5 of 12 unilateral and 11 of 13 bilateral procedures. In TPOs with additional ventral plate fixation, minor screw loosening was detected in one of eight unilateral and zero of seven bilateral procedures. Statistically TPOs without additional ventral plate fixation had 9.2 times greater odds of screw loosening with significantly greater acetabular segment displacement (p < 0.01). Two traditional TPOs performed required additional surgery due to screw loosening. Other attempted additional stabilization techniques used with the TPO procedure included ilial body wiring, ischial body wiring, sacral screw purchase, and medial screw nuts, however these methods did not prevent loosening and migration. TPO with additional ventral plate fixation was highly effective at combating implant failure.

Biomechanical evaluation of triple pelvic osteotomy with and without additional ventral plate stabilization

2002 ◽  
Vol 15 (03) ◽  
pp. 145-149 ◽  
Author(s):  
G. Hosgood ◽  
A. Staatz ◽  
R. B. Fitch
Keyword(s):  
Hip Dysplasia ◽  
Plate Fixation ◽  
Weight Bearing ◽  
Pelvic Osteotomy ◽  
Osteotomy Site ◽  
Screw Loosening ◽  
Ventral Plate ◽  
Cyclical Loading ◽  
Biomechanical Evaluation

SummaryThe triple pelvic osteotomy (TPO) is commonly performed for immature dogs with hip dysplasia despite screw loosening being a prevalent complication. A technique to diminish the incidence of screw loosening by reducing motion at the ilial osteotomy and reducing implant migration, was evaluated. Standard triple pelvic osteotomies, and triple pelvic osteotomies with additional ventral plate stabilization, were performed and biomechanically evaluated in canine cadaver pelves. Additional ventral plate fixation was found to significantly improve axial bending stiffness of TPOs. In vitro cyclical loading, performed in a manner to approximate post-operative weight-bearing, determined that additional ventral plate fixation significantly decreased the incidence of screw loosening and motion at the osteotomy site.

Implant Complications in 20 Triple Pelvic Osteotomies

1993 ◽  
Vol 06 (04) ◽  
pp. 202-207 ◽  
Author(s):  
Cindy Fries ◽  
Audrey Remedios
Keyword(s):  
Postoperative Complication ◽  
Hip Dysplasia ◽  
Pelvic Osteotomy ◽  
Implant Failure ◽  
Screw Loosening ◽  
Common Complication ◽  
Implant Complications ◽  
Gait Abnormalities

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.

Treatment of mechanically failed triple pelvic osteotomies in four dogs - part 2

2002 ◽  
Vol 15 (03) ◽  
pp. 172-176 ◽  
Author(s):  
S. Kerwin ◽  
G. Hosgood ◽  
R. D. Marquis ◽  
E. Pluhar ◽  
S. T. Kudnig ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Screw Loosening ◽  
Ventral Plate ◽  
Highly Effective ◽  
Successful Outcomes

SummaryFour dogs treated with triple pelvic osteotomies (TPOs) with loss of fixation secondary to screw loosening are reported. Two of the patients were revised with an additional ventral plate with successful outcomes. Revision TPO, with additional ventral plate fixation, was highly effective as a salvage technique for failed TPOs.

scholarly journals Plate fixation of the anterior pelvic ring in patients with fragility fractures of the pelvis

2021 ◽  
Author(s):  
Michiel Herteleer ◽  
Mehdi Boudissa ◽  
Alexander Hofmann ◽  
Daniel Wagner ◽  
Pol Maria Rommens
Keyword(s):  
Pelvic Ring ◽  
Plate Osteosynthesis ◽  
Plate Fixation ◽  
Weight Bearing ◽  
Fragility Fractures ◽  
Pubic Symphysis ◽  
Osteoporotic Bone ◽  
Screw Loosening ◽  
Posterior Pelvic Ring ◽  
Pelvic Brim

Abstract Introduction In fragility fractures of the pelvis (FFP), fractures of the posterior pelvic ring are nearly always combined with fractures of the anterior pelvic ring. When a surgical stabilization of the posterior pelvis is performed, a stabilization of the anterior pelvis is recommended as well. In this study, we aim at finding out whether conventional plate osteosynthesis is a valid option in patients with osteoporotic bone. Materials and methods We retrospectively reviewed medical charts and radiographs of all patients with a FFP, who underwent a plate osteosynthesis of the anterior pelvic ring between 2009 and 2019. Patient demographics, fracture characteristics, properties of the osteosynthesis, complications and revision surgeries were documented. Single plate osteosynthesis (SPO) at the pelvic brim was compared with double plate osteosynthesis (DPO) with one plate at the pelvic brim and one plate anteriorly. We hypothesized that the number and severity of screw loosening (SL) or plate breakage in DPO are lower than in SPO. Results 48 patients with a mean age of 76.8 years were reviewed. In 37 cases, SPO was performed, in 11 cases DPO. Eight out of 11 DPO were performed in patients with FFP type III or FFP type IV. We performed significantly more DPO when the instability was located at the level of the pubic symphysis (p = 0.025). More patients with a chronic FFP (surgery more than one month after diagnosis) were treated with DPO (p = 0.07). Infra-acetabular screws were more often inserted in DPO (p = 0.056). Screw loosening (SL) was seen in the superior plate in 45% of patients. There was no SL in the anterior plate. There was SL in 19 of 37 patients with SPO and in 3 of 11 patients with DPO (p = 0.16). SL was localized near to the pubic symphysis in 19 of 22 patients after SPO and in all three patients after DPO. There was no SL in DPO within the first month postoperatively. We performed revision osteosynthesis in six patients (6/48), all belonged to the SPO group (6/37). The presence of a bone defect, unilateral or bilateral anterior pelvic ring fracture, post-operative weight-bearing restrictions, osteosynthesis of the posterior pelvic ring, and the presence of infra- or supra-acetabular screws did not significantly influence screw loosening in SPO or DPO. Conclusion There is a high rate of SL in plate fixation of the anterior pelvic ring in FFP. In the vast majority, SL is located near to the pubic symphysis. DPO is associated with a lower rate of SL, less severe SL and a later onset of SL. Revision surgery is less likely in DPO. In FFP, we recommend DPO instead of SPO for fixation of fractures of the anterior pelvic ring, which are located in or near to the pubic symphysis.

scholarly journals Modular tapered conical revision stem in hip revision surgery: mid- term results

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Loris Perticarini ◽  
Stefano Marco Paolo Rossi ◽  
Alberto Fioruzzi ◽  
Eugenio Jannelli ◽  
Mario Mosconi ◽  
...  
Keyword(s):  
Preoperative Assessment ◽  
Bone Defects ◽  
Implant Design ◽  
Harris Hip Score ◽  
Radiographic Evaluation ◽  
Stem Design ◽  
Additional Surgery ◽  
Prime Concern ◽  
Distal Fixation

Abstract Background The aim of this paper is to evaluate the clinical and radiological outcomes of a fluted tapered modular distal-fixation stem at medium to long-term follow-up. The hypothesis of this investigation was to verify if the use of this implant design may have provided potential advantages in femoral revisions and post-traumatic instances where the restoration of the anatomy was the prime concern. Methods We retrospectively reviewed 62 cases of femoral revision surgeries, performed in Paprosky type IIIA and IIIB bone defects between January 2001 and December 2011 with a mean follow-up of 8.5 ± 1.5 years (range 5.1–15.9 years) where a modular fluted stem was used. The clinical assessment was performed with the Harris Hip Score (HHS), and the radiographic evaluation was carried in order to assess the stability of the femoral component. Intra-operative and postoperative complications were recorded, and the rates of complications and revisions for any cause were determined. Results Mean HHS improved 35.4 points from the preoperative assessment. Radiographic evaluation showed a stable stem anchorage in 90.3% of the cases at the last follow-up. Five (8%) implants required additional surgery. Neither breakage of the stem nor loosening of the taper junction were recorded. Kaplan-Meier survivorship was 89.4% (CI: 88.8–90%) for any complication and 92.3% (CI: 91.8–92.7%) according to revision for any causes at 81 months follow-up. Conclusions Our findings suggest that this stem design is a reliable option in cases of complex femoral bone defects, as well as in cases with high functional deficiencies, with promising survivorship.

scholarly journals Analysis of Contoured Anatomic Plate Fixation versus Intramedullary Rod Fixation for Acute Midshaft Clavicle Fractures

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Juliann Kwak-Lee ◽  
Elke R. Ahlmann ◽  
Lingjun Wang ◽  
John M. Itamura
Keyword(s):  
Range Of Motion ◽  
Plate Fixation ◽  
Reoperation Rate ◽  
Healing Time ◽  
Implant Failure ◽  
Fracture Union ◽  
Early Results ◽  
Plate Group ◽  
Pin Fixation ◽  
Clavicle Fractures

The recent trend has been toward surgical fixation of displaced clavicle fractures. Several fixation techniques have been reported yet it is unclear which is preferable. We retrospectively reviewed one hundred one consecutive patients with acute midshaft clavicle fractures treated operatively at a level-1 trauma center. Thirty-four patients underwent intramedullary pin fixation and 67 had anatomic plate fixation. The outcomes we assessed were operative time, complications, infection, implant failure, fracture union, range of motion, and reoperation rate. There were 92 males and 9 females with an average age of 30 years (range: 14–68 years). All patients were followed to healing with an average followup of 20 months (range: 15–32 months). While fracture union by six months (P=0.8729) and range of motion at three months (P=0.6139) were similar, the overall healing time for pin fixation was shorter (P=0.0380). The pin group had more infections (P=0.0335) and implant failures (P=0.0245) than the plate group. Intramedullary pin fixation may have improved early results, but there was no long term difference in overall rate of union and achievement of full shoulder motion. The higher rate of implant failure with pin fixation may indicate that not all fracture patterns are amenable to fixation using this device.

scholarly journals Passage of an Anterior Odontoid Screw through Gastrointestinal Tract

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
L. Leitner ◽  
C. I. Brückmann ◽  
M. M. Gilg ◽  
G. Bratschitsch ◽  
P. Sadoghi ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Treatment Method ◽  
Preoperative Imaging ◽  
Screw Loosening ◽  
Gi Tract ◽  
Revision Operation ◽  
Odontoid Fractures ◽  
Esophagus Perforation ◽  
And Migration

Purpose. Anterior screw fixation has become a popular surgical treatment method for instable odontoid fractures. Screw loosening and migration are a rare, severe complication following anterior odontoid fixation, which can lead to esophagus perforation and requires revision operation. Methods. We report a case of screw loosening and migration after anterior odontoid fixation, which perforated the esophagus and was excreted without complications in a 78-year-old male patient. Results. A ventral dislocated anterior screw perforated through the esophagus after eight years after implantation and was excreted through the gastrointestinal (GI) tract. At a 6-month follow-up after the event the patient was asymptomatic. Conclusion. Extrusion via the GI tract is not safe enough to be considered as a treatment option for loosened screws. Some improvements could be implemented to prevent such an incident. Furthermore, this case is a fine example that recent preoperative imaging is mandatory before revision surgery for screw loosening.

scholarly journals Tibiotalar Arthrodesis Using a Hybrid Technique with a New Low-profile Anatomic Plate and Two Compression Screws: First One-year Results of Twenty Patients

2019 ◽  
Vol 13 (1) ◽  
pp. 232-238
Author(s):  
Christoph Eckstein ◽  
Bernd Füchtmeier ◽  
Franz Müller
Keyword(s):  
Plate Fixation ◽  
Weight Bearing ◽  
Case Series ◽  
Clinical Results ◽  
Ankle Arthrodesis ◽  
Implant Failure ◽  
Full Weight Bearing ◽  
Hybrid Technique ◽  
Low Profile ◽  
Tibiotalar Arthrodesis

Background: The aim of this prospective study was to evaluate and analyse the first clinical results of a recently developed low-profile anatomic plate in combination with two headless compression screws for tibiotalar arthrodesis. Methods: The case series involved 20 consecutive patients who underwent ankle arthrodesis using a hybrid technique. Radiographs were obtained at 6 and 12 weeks and 1 year postoperatively. The outcome was evaluated by using AOFAS and SF 12-questionnaire. Any complications related to the arthrodesis were recorded. Results: The follow-up rate was 100%. Patients mean age at the time of surgery was 60.1 years (range, 40-79). Arthrodesis with full weight-bearing occurred in every patient within 12 weeks postoperatively. There were no patients with delayed union, non-union, infection or implant failure. AOFAS Score and SF-12 scores increased considerably compared to preoperatively. Conclusion: The hybrid technique for ankle arthrodesis is a tibiotalar compression with screws in combination with rigid anterior plate fixation. Our clinical results demonstrated no implant failure, no infection and fusion in any of the 20 patients. Further studies are necessary to support our first results.

scholarly journals Screw loosening and Migration after Dynesys Implantation

2012 ◽  
Vol 9 (3) ◽  
pp. 300 ◽  
Author(s):  
Min Jae Cho ◽  
Chun Kee Chung ◽  
Chi Heon Kim
Keyword(s):  
Screw Loosening ◽  
And Migration
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