Cannulated Lag Screw Fixation of Displaced Lateral Humeral Condyle Fractures Is Associated With Lower Rates of Open Reduction and Infection Than Pin Fixation

Patients with an isolated spiral or long oblique fracture of the proximal phalanx were randomized into two groups. One was treated by closed reduction and Kirschner wire fixation and the second treated by open reduction and lag screw fixation. An independent observer assessed function, pain, movement, grip strength and intrinsic muscle function. X-rays were assessed for malunion. Thirty-two patients were entered the study and 15 in the Kirschner wire and 13 in the lag screw group were reviewed at a mean follow-up of 40 months. There was no significant difference in the functional recovery rates or in the pain scores for the two groups. X-rays showed similar rates of malunion and there were no statistically significant differences in range of movement or grip strength.

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Mini-Plate and Screw Fixation Technique for Comminuted Flexor Digitorum Profundus Avulsion Fracture

Archives of Hand and Microsurgery ◽

10.12790/ahm.19.0042 ◽

2020 ◽

Vol 25 (1) ◽

pp. 33-38

Author(s):

Hye Yeon Choi ◽

Jeong Hwan Kim ◽

Young Ju Noh

Keyword(s):

Open Reduction ◽

Avulsion Fracture ◽

Screw Fixation ◽

Flexor Digitorum Profundus ◽

Fixation Technique ◽

Avulsion Fractures ◽

Pin Fixation ◽

Flexor Digitorum ◽

Mini Plate ◽

Pull Out Suture

Avulsion fracture of flexor digitorum profundus (FDP) tendon is relatively rare fracture at the distal phalangeal base than avulsion fracture of terminal extensor tendon. Terminal extensor avulsion fracture, known as bony mallet finger, could be successfully treated by closed reduction and pinning, such as extension block technique. However, most of FDP avulsion fracture, known as Jersey’s finger, needed open reduction, because of the proximal migration of fracture fragment and difficulty of pin fixation. Up to date, most of FDP avulsion fractures were treated by open reduction and fixation by pull-out suture or suture anchor technique. We report a case of comminuted FDP avulsion fracture, successfully treated by open reduction and mini-plate and screw fixation technique.

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Complications of lateral plate fixation compared with tension band wiring and pin or lag screw fixation for calcaneoquartal arthrodesis

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-12-07-0089 ◽

2013 ◽

Vol 26 (06) ◽

pp. 445-452 ◽

Cited By ~ 5

Author(s):

C. S. Knudsen ◽

M. Gosling ◽

M. McKee ◽

R. G. Whitelock ◽

G. I. Arthurs ◽

...

Keyword(s):

Postoperative Complications ◽

Screw Fixation ◽

Plate Fixation ◽

Tension Band ◽

Complication Rates ◽

Lateral Plate ◽

Lag Screw ◽

Tension Band Wire ◽

Plate Group ◽

Pin Fixation

SummaryObjective: To compare complication rates and the outcomes of these complications after lateral plate fixation with figure-ofeight tension-band-wire and pin or lag screw fixation for arthrodesis of the calcaneoquartal joint, following non-traumatic disruption of the plantar tarsal ligament in dogs.Methods: Data were collected retrospectively from five UK referral centres. Diplomate specialists and their residents performed all procedures. Referring veterinarians were contacted for long-term follow-up.Results: Seventy-four procedures were undertaken in 61 dogs. There were 58 arthrodeses in the lateral plate group (Plate), nine in the pin and tension-band-wire group (Pin), and seven in the lag screw and tension-band wire-group (Screw). Compared to Plate (17%), further surgical intervention was required more frequently following Pin (56%, OR = 3.2) or Screw (43%, OR = 2.5) fixation. Clinical failure of arthrodesis occurred less frequently with Plate (5%) compared with Screw (43%, OR = 8.6) and Pin fixation (22%, OR = 4.4). Cases managed with external coaptation postoperatively were more likely to suffer from postoperative complications (OR = 2.2).Clinical significance: Lateral plating was associated with fewer postoperative complications than pin and tension-band-wire fixation for arthrodesis of the calcaneoquartal joint in dogs with non-traumatic disruption of the plantar tarsal ligament.

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Incomplete ossification of the humeral condyle as the cause of lameness in dogs

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1632736 ◽

2002 ◽

Vol 15 (03) ◽

pp. 187-194 ◽

Cited By ~ 16

Author(s):

V. Heinen ◽

M. Fehr ◽

I. Nolte ◽

A. Meyer-Lindenberg

Keyword(s):

Computed Tomography ◽

Screw Fixation ◽

Osteochondrosis Dissecans ◽

Prospective Trial ◽

Olecranon Fracture ◽

Lag Screw ◽

Post Operation ◽

One Year ◽

Condylar Fractures ◽

Humeral Condyle

SummaryIn a retrospective and prospective trial over six years, 17 joints from 13 dogs presented with incomplete ossification of the humeral condyle (IOHC) were included. All dogs showed lameness of the forelimb but no humeral condylar fractures. One dog showed a fracture of the olecranon. Four of the bilaterally affected dogs showed only unilateral lameness. 53.8% of the dogs (7/13) were younger than one year. With regard to breed distribution, the German Wachtel was most frequently represented with three dogs. In 12 dogs the diagnosis was made by radiography in a craniocaudal view, and seven dogs could be further investigated by computed tomography. In one dog the diagnosis was only made during arthroscopy. Two joints showed an additional fragmented medial coronoid process of the ulna and another two an osteochondrosis dissecans of the medial humeral condyle. During arthroscopy, all joints showed a clearly visible fissure line in the joint cartilage between the humeral condyles. In ten joints the I0HC was treated with a transcondylar lag screw under arthroscopic control. Three of the four bilaterally affected dogs were treated only unilaterally because of a lack of lameness on the other side. In the dog with the olecranon fracture, only the fracture was treated. The patients were rechecked clinically and radiologically (n = 10) or by means of a questionnaire (n = 1) at an average of 26 months post operation. Seven cases, six of them treated by lag screw fixation, did not show any lameness. Three joints (one dog with olecranon fracture, two unilaterally affected dogs with lag screw fixation) showed some degree of lameness after heavy strain and one dog showed a continuous slight lameness. The four bilaterally affected and only unilaterally treated dogs showed no lameness on the untreated joint. With regard to development of arthrosis, six radiographically examined joints showed no increase in arthroses. In five joints the increase was mild and in two joints moderate. In six joints with lag screw fixation, the IOHC was radiographically unified and was confirmed by computed tomography in three cases.

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Comparison of open reduction versus minimally invasive surgical approaches on screw position in canine sacroiliac lag-screw fixation

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-16-02-0030 ◽

2016 ◽

Vol 29 (04) ◽

pp. 290-297 ◽

Cited By ~ 5

Author(s):

Danielle Marturello ◽

Laurent Guiot ◽

Reunan Guillou ◽

Charles DeCamp ◽

Loïc Déjardin

Keyword(s):

Minimally Invasive ◽

Open Reduction ◽

Screw Fixation ◽

Screw Placement ◽

Surgical Approaches ◽

Minimally Invasive Osteosynthesis ◽

Pilot Hole ◽

Lag Screw ◽

Multiplanar Reconstructions ◽

Minimally Invasive Surgical

Summary Objective: To compare accuracy and consistency of sacral screw placement in canine pelves treated for sacroiliac luxation with open reduction and internal fixation (ORIF) or minimally invasive osteosynthesis (MIO) techniques. Methods: Unilateral sacroiliac luxations created experimentally in canine cadavers were stabilized with an iliosacral lag screw applied via ORIF or MIO techniques (n = 10/group). Dorsoventral and craniocaudal screw angles were measured using computed tomography multiplanar reconstructions in transverse and dorsal planes, respectively. Ratios between pilot hole length and sacral width (PL/SW-R) were obtained. Data between groups were compared statistically (p <0.05). Results: Mean screw angles (±SD) were greater in ORIF specimens in both transverse (p <0.001) and dorsal planes (p <0.004). Mean PL/SW-R was smaller (p <0.001) in the ORIF group, yet was greater than 60%. While pilot holes exited the first sacral end-plate in three of 10 ORIF specimens, the spinal canal was not violated in either group. Conclusions: This study demonstrates that MIO fixation of canine sacroiliac luxations provides more accurate and consistent sacral screw placement than ORIF. With proper techniques, iatrogenic neurological damage can be avoided with both techniques. The PL /SW-R, which relates to safe screw fixation, also demonstrates that screw penetration of at least 60% of the sacral width is achievable regardless of surgical approach. These findings, along with the limited dissection needed for accurate sacral screw placement, suggest that MIO of sacroiliac luxations is a valid alternative to ORIF.

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Functional outcome of fixation of tibial bony avulsion of the posterior cruciate ligament with open reduction and cancellous screw fixation using posteromedial approach

National Journal of Clinical Orthopaedics ◽

10.33545/orthor.2019.v3.i4a.174 ◽

2019 ◽

Vol 3 (4) ◽

pp. 16-19

Author(s):

Dr. Akula Srinivasa Rao ◽

Dr. Vella Sandeep ◽

Dr. Chintala Manoj

Keyword(s):

Functional Outcome ◽

Posterior Cruciate Ligament ◽

Open Reduction ◽

Screw Fixation ◽

Cruciate Ligament ◽

Cancellous Screw ◽

Bony Avulsion

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Single column plate plus other column lag screw fixation vs. both column plate fixation for anterior column with posterior hemitransverse acetabular fractures – a biomechanical analysis using different loading protocols

Injury ◽

10.1016/j.injury.2020.12.041 ◽

2021 ◽

Author(s):

Huy Le Quang ◽

Werner Schmoelz ◽

Richard A. Lindtner ◽

Dietmar Dammerer ◽

Peter Schwendinger ◽

...

Keyword(s):

Screw Fixation ◽

Plate Fixation ◽

Biomechanical Analysis ◽

Anterior Column ◽

Acetabular Fractures ◽

Lag Screw ◽

Single Column

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Biomechanical Evaluation of Tarsometatarsal Fusion Comparing Crossing Lag Screws and Lag Screw With Locking Plate

Foot & Ankle International ◽

10.1177/10711007211033541 ◽

2021 ◽

pp. 107110072110335

Author(s):

Sarah Ettinger ◽

Lisa-Christin Hemmersbach ◽

Michael Schwarze ◽

Christina Stukenborg-Colsman ◽

Daiwei Yao ◽

...

Keyword(s):

Locking Plate ◽

Screw Fixation ◽

Operative Procedure ◽

Fixation Technique ◽

Lag Screw ◽

Group 15 ◽

Fresh Frozen ◽

Biomechanical Evaluation ◽

The Stability ◽

End Stage

Background: Tarsometatarsal (TMT) arthrodesis is a common operative procedure for end-stage arthritis of the TMT joints. To date, there is no consensus on the best fixation technique for TMT arthrodesis and which joints should be included. Methods: Thirty fresh-frozen feet were divided into one group (15 feet) in which TMT joints I-III were fused with a lag screw and locking plate and a second group (15 feet) in which TMT joints I-III were fused with 2 crossing lag screws. The arthrodesis was performed stepwise with evaluation of mobility between the metatarsal and cuneiform bones after every application or removal of a lag screw or locking plate. Results: Isolated lag-screw arthrodesis of the TMT I-III joints led to significantly increased stability in every joint ( P < .05). Additional application of a locking plate caused further stability in every TMT joint ( P < .05). An additional crossed lag screw did not significantly increase rigidity of the TMT II and III joints ( P > .05). An IM screw did not influence the stability of the fused TMT joints. For TMT III arthrodesis, lag-screw and locking plate constructs were superior to crossed lag-screw fixation ( P < .05). TMT I fusion does not support stability after TMT II and III arthrodesis. Conclusion: Each fixation technique provided sufficient stabilization of the TMT joints. Use of a lag screw plus locking plate might be superior to crossed screw fixation. An additional TMT I and/or III arthrodesis did not increase stability of an isolated TMT II arthrodesis. Clinical Relevance: We report the first biomechanical evaluation of TMT I-III arthrodesis. Our results may help surgeons to choose among osteosynthesis techniques and which joints to include in performing arthrodesis of TMT I-III joints.

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Transverse Lag Screw Fixation in Midline Mandibulotomy

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940010900318 ◽

2000 ◽

Vol 109 (3) ◽

pp. 334-339 ◽

Cited By ~ 7

Author(s):

Joseph M. Serletti ◽

John U. Coniglio ◽

Salvatore J. Pacella ◽

John D. Norante

Keyword(s):

Reliable Method ◽

Screw Fixation ◽

Postoperative Radiotherapy ◽

Major Complication ◽

Recurrent Tumor ◽

Minor Complication ◽

Anterior Cortex ◽

Lag Screw ◽

The Mean

Vertical midline mandibulotomy has provided a relatively simple and efficient means of obtaining access to intraoral tumors that are too large or too posterior to be removed transorally. Midline mandibulotomy has had the advantage of nerve and muscle preservation and places the osteotomy outside the typical field of radiotherapy, in contrast to lateral and paramedian osteotomies. Plate and screw fixation has been the usual means of osteosynthesis for these mandibulotomies; however, plate contouring over the symphyseal surface has been a time-consuming process. Unless the plate was contoured exactly, mandibular malalignment and malocclusion in dentulous patients has occurred. Use of parallel transverse lag screws has become a popular method of osteosynthesis for parasymphyseal fractures, and we have extended their use for mandibulotomy fixation. This paper reports our clinical experience with transverse lag screw fixation of midline mandibulotomies in 9 patients from 1994 to 1997. There were 7 men and 2 women with a mean age of 56 (range 35 to 71 years). The pathological diagnosis in all patients was squamous cell carcinoma; 8 cases were primary, and 1 patient presented with recurrent tumor. No tumors involved the mandibular periosteum. One patient had had previous radiotherapy, and 3 patients underwent postoperative radiotherapy. The mean follow-up has been 17 months (range 9 to 27). There was 1 minor complication and 1 major complication related to our technique. The major complication was a delayed nonunion of the mandibulotomy. This occurred because the 2 parallel screws were placed too close to one another, and this placement resulted in a delayed sagittal fracture of the anterior cortex and subsequent nonunion. Transverse lag screw fixation has not affected occlusion in our dentulous patients. Speech and diet were normal in the majority of our patients. Transverse lag screw fixation of the midline mandibulotomy has been a relatively safe, rapid, and reliable method for tumor access and postextirpation mandibular stabilization and has significant advantages over other current methods of mandibulotomy and fixation.

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