Simple Internal Fixation Method Using Barbed Thread for Transconjunctival Orbital Fat Repositioning

2020 ◽  
Vol 22 (2) ◽  
pp. 112-113
Author(s):  
Jeong Min Park ◽  
Jeong Hyuk Kim
Keyword(s):  
Internal Fixation ◽  
Fixation Method ◽  
Orbital Fat ◽  
Fat Repositioning

scholarly journals Internal Fixation Method Using EZ-Tcon for Transconjunctival Fat Repositioning: Clinical Outcomes and Efficacy

2020 ◽  
Vol 44 (5) ◽  
pp. 1-12
Author(s):  
Cheol Ho Chang ◽  
Juyoung Bae ◽  
Myung Kyu Cha ◽  
Sa Ik Bang ◽  
Kyeong-Tae Lee
Keyword(s):  
Internal Fixation ◽  
Fixation Method ◽  
Full Description ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Advantages And Disadvantages ◽  
Tear Trough ◽  
Tear Trough Deformity ◽  
If Technique ◽  
Fat Repositioning

Abstract Background Transconjunctival fat repositioning is the gold standard for the correction of tear trough deformity. For fixation of fat pedicle, the internal fixation (IF) and externalized percutaneous suture (EPS) techniques are used, which have their own advantages and disadvantages. The present study aimed to introduce a new IF technique using a devised needle (EZ-Tcon) and to compare its outcomes with those of the conventional EPS technique. Methods Patients with primary tear trough deformity who underwent transconjunctival fat repositioning were reviewed and categorized into two cohorts according to the fixation technique: cohort 1 consisted of patients treated using the conventional EPS technique and cohort 2 consisted of those in whom the new IF technique using EZ-Tcon was adopted. Post-operative complications and aesthetic outcomes were assessed using a four-scale grading system. Results A total of 545 patients, 211 from cohort 1 and 344 from cohort 2 were evaluated with a median follow-up of 70 days. Compared to cohort 1, cohort 2 showed significantly lower rates of long-standing conspicuous scars on lower eyelid, re-operation and overall complications. In the analysis of aesthetic outcomes, 88.9 percent of cohort 2 showed grade 0 (no deformity) or I (mild deformity) post-operatively. The rate of excellent outcomes (improvements of ≥ two grades) was significantly higher in cohort 2 than in cohort 1 (p-value < 0.001). Conclusion Our technique using EZ-Tcon could possess advantages of the conventional IF and EPS techniques, showing lower complication rates and aesthetically satisfactory outcomes, and could be a safe and reliable method of transconjunctival fat repositioning. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Fat Repositioning With a Combination of Internal Fixation and External Fixation in Transconjunctival Lower Blepharoplasty

2021 ◽  
Author(s):  
Jianwu Chen ◽  
Tao Zhang ◽  
Xuanru Zhu ◽  
Wenhua Huang
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Internal Fixation ◽  
External Fixation ◽  
Fixation Method ◽  
Resonance Imaging ◽  
Facial Soft Tissue ◽  
Level Of Evidence ◽  
Tear Trough ◽  
Fat Repositioning

Abstract Background Various methods on transconjunctival fat repositioning have been promoted to treat tear trough deformities in patients with eye bags. Objectives The authors present a modified approach based on the facial soft-tissue spaces with the combined fixation method. Methods A total 226 patients underwent this procedure. Through a preseptal approach, the premaxillary and prezygomatic spaces were sequentially separated. Orbital fat was repositioned into the spaces together with the septum. The proximal part of the septum-fat flap was sutured to orbital rim with internal fixation, and their distal stumps were fixed to the end of the soft spaces with externalized percutaneous sutures. Surgical outcome was assessed by surgeons based on Hirmand’s grading system. Patients’ satisfaction and quality of life were measured using FACE-Q scales. Magnetic resonance imaging was employed to assess the long-term fate of the transposed fat. Results Tear trough deformities were eliminated in 86.7% of cases. Scores of lower eyelid FACE-Q decreased significantly (P &lt; 0.05). Patients demonstrated enhanced social confidence (P &lt; 0.05) and high satisfaction (74.3 ± 17.2) and were satisfied with their decision to undergo blepharoplasty (78.2 ± 18.7). Undercorrection occurred in 1 patient. Additional complications included transient granulomas, dye eye, unexplained swelling, and numbness, which resolved in all patients. Magnetic resonance imaging confirmed viability of the transposed fat within 6 to 8 months follow-up. Conclusions Transconjunctival fat repositioning, utilizing a combination of internal fixation and external fixation, is an effective approach to treat eye bags and tear trough deformities with good patient and surgeon satisfaction. Level of Evidence: 4

Guided Internal Fixation Technique for Transconjunctival Orbital Fat Transposition

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Lehao Wu ◽  
Tailing Wang ◽  
Jianjun You ◽  
Chang Zhang ◽  
Jiaqi Wang
Keyword(s):  
Internal Fixation ◽  
Fixation Technique ◽  
Orbital Fat

A Biomechanical Study of an Alternative Internal Fixation Method for Transverse Patella Fractures

Orthopedics ◽  
2018 ◽  
Vol 41 (5) ◽  
pp. e643-e648
Author(s):  
Shuai Han ◽  
Dongdong Li ◽  
Peixun Zhang ◽  
Xiaofeng Yin ◽  
Yuhui Kou ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Biomechanical Study ◽  
Fixation Method ◽  
Patella Fractures

A novel internal fixation method for open book injuries of the pubic symphysis— A biomechanical analysis

2020 ◽  
Vol 77 ◽  
pp. 105009 ◽  
Author(s):  
Tobias Fritz ◽  
Laura Mettelsiefen ◽  
Friedemann Strobel ◽  
Benedikt J. Braun ◽  
Steven C. Herath ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Pubic Symphysis ◽  
Biomechanical Analysis ◽  
Fixation Method ◽  
Open Book

Ankle spanning external fixator with limited internal fixation for distal tibial extra-articular fractures

2017 ◽  
Vol 5 (10) ◽  
pp. 4355
Author(s):  
Siddharth Goel ◽  
Abhay Elhence
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
External Fixation ◽  
External Fixator ◽  
Tibial Fractures ◽  
Fixation Method ◽  
Ankle Pain ◽  
Distal Tibial Fractures ◽  
Tract Infections

Background: Fractures of the distal tibia are among the most difficult fractures to treat. The short distal segment presents difficulty in choosing the appropriate fixation method. The greatest challenge lies in the relatively tight soft tissue around the ankle. As a result, it has been a recent interest in treating these fractures with external fixation and limited internal fixation. The external stable fixation methods used are tubular or ring fixators, with or without immobilising the ankle. This minimally invasive nature of the surgery can avoid catastrophic wound complications like dehiscence, implant exposure and infection.Methods: 18 patients with extra-articular distal tibial fractures (AO Type 43A) were treated with the technique of ankle spanning external fixation. Lag screws or K-wires were supplemented for limited internal fixation when required. Fibula was stabilised in all cases. Intra- articular and Compound fractures were excluded. In addition to union at fracture site, ankle pain and motion was noted in each follow-up.Results: The mean follow-up was 25 months. Of the 18 patients included all but one fractures united with an average healing time of 16 to 18 weeks. Ankle pain and motion was graded according to Mazur modified by Teeny and Wiss clinical scoring system. 15 of them had excellent or good results, 2 had fair results. One patient had poor result. Five pin tract infections occurred. 17 patients had no evidence of osteoarthritis after completing follow up of at least 2 years.Conclusions: Distal tibial fractures are complex injuries, not only regarding the bony component, but also in terms of the management of the soft tissue problem. Ankle Spanning External Fixator with Limited Internal fixation is a relatively simple and cost-effective method for treating these fractures, achieving union and also maintaining ankle function.

scholarly journals Distal tibial pilon fractures (AO/OTA type B, and C) treated with the external skeletal and minimal internal fixation method

2013 ◽  
Vol 70 (9) ◽  
pp. 836-841 ◽  
Author(s):  
Sasa Milenkovic ◽  
Milorad Mitkovic ◽  
Ivan Micic ◽  
Desimir Mladenovic ◽  
Stevo Najman ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Ankle Joint ◽  
Fixation Method ◽  
Universal Method ◽  
Type B ◽  
Tibial Pilon ◽  
Post Surgery ◽  
Articular Fractures ◽  
Type C ◽  
Pilon Fractures

Background/Aim. Distal tibial pilon fractures include extra-articular fractures of the tibial metaphysis and the more severe intra-articular tibial pilon fractures. There is no universal method for treating distal tibial pilon fractures. These fractures are treated by means of open reduction, internal fixation (ORIF) and external skeletal fixation. The high rate of soft-tissue complications associated with primary ORIF of pilon fractures led to the use of external skeletal fixation, with limited internal fixation as an alternative technique for definitive management. The aim of this study was to estimate efficacy of distal tibial pilon fratures treatment using the external skeletal and minimal internal fixation method. Methods. We presented a series of 31 operated patients with tibial pilon fractures. The patients were operated on using the method of external skeletal fixation with a minimal internal fixation. According to the AO/OTA classification, 17 patients had type B fracture and 14 patients type C fractures. The rigid external skeletal fixation was transformed into a dynamic external skeletal fixation 6 weeks post-surgery. Results. This retrospective study involved 31 patients with tibial pilon fractures, average age 41.81 (from 21 to 60) years. The average follow-up was 21.86 (from 12 to 48) months. The percentage of union was 90.32%, nonunion 3.22% and malunion 6.45%. The mean to fracture union was 14 (range 12-20) weeks. There were 4 (12.19%) infections around the pins of the external skeletal fixator and one (3.22%) deep infections. The ankle joint arthrosis as a late complication appeared in 4 (12.90%) patients. All arthroses appeared in patients who had type C fractures. The final functional results based on the AOFAS score were excellent in 51.61%, good in 32.25%, average in 12.90% and bad in 3.22% of the patients. Conclusion. External skeletal fixation and minimal internal fixation of distal tibial pilon fractures is a good method for treating all types of inta-articular pilon fractures. In fractures types B and C dynamic external skeletal fixation allows early mobility in the ankle joint.

scholarly journals Outcomes of Open Reduction and Internal Fixation of Bilateral Fractures of the Distal Radius

2019 ◽  
Vol 11 (02) ◽  
pp. 117-120
Author(s):  
Jack G. Graham ◽  
Sreeram Penna ◽  
Daniel Fletcher ◽  
Moody Kwok ◽  
Daren J. Aita ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Internal Fixation ◽  
Distal Radius ◽  
Open Reduction ◽  
Fixation Method ◽  
X Rays ◽  
Volar Approach ◽  
Patient Demographics ◽  
Radiographic Measurements

Abstract Background Bilateral distal radius fracture (DRF) is an uncommon injury. We described the outcomes of 10 consecutive cases of bilateral DRF treated with open reduction and internal fixation (ORIF) at our institution. Materials and Methods We retrospectively searched our electronic medical records data for all patients 18 years of age or older treated surgically for bilateral DRF over a 6-year period (2011–2016). Patient demographics, fracture classification, fixation method, postoperative complications, QuickDASH (Quick Disabilities of the Arm, Shoulder and Hand) questionnaire scores, wrist range of motion (ROM), and radiographic measurements of X-rays at final follow-up were collected and analyzed. Results Ten patients (8 women; 2 men; mean age: 63 years) with 20 fractures were assessed. A volar approach for ORIF was used in 90% of cases. Six of 20 (30%) wrists experienced postoperative complications and required hardware removal. Mean QuickDASH score was 24.8 at final follow-up. On average, ROM reached 58-degree extension, 52-degree flexion, 75-degree pronation, and 75-degree supination. Mean measurements of radial shortening, radial inclination, and volar tilt taken from final postoperative radiographs were 1.3 mm, 21.2 degrees, and 7.8 degrees, respectively. Conclusion In bilateral DRF treated with concomitant ORIF, functional outcomes, recovery of wrist ROM, and restoration of radiographic parameters are comparable to those seen in patients with ipsilateral DRF.

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