Percutaneous Blunt Needle Reduction (PBNR) Needs Stable Fixation

Keyword(s):  
2021 ◽  
Vol 47 (2) ◽  
pp. 313-324 ◽  
Author(s):  
Dirk Walther Sommerfeldt ◽  
Peter Paul Schmittenbecher

Abstract Purpose Non-unions of the distal humerus are rare complications of common children’s fractures such as radial condyle fractures and supracondylar fractures. The aim of this paper was to update the knowledge about etiology, reasons, management, and results of these troublesome, and sometimes debilitating entities. Methods The sparse literature concerning nonunions following condylar or supracondylar fractures was analyzed together with the presentation of some typical clinical cases. Results In most of the cases, non-unions were induced by neglect, unstable fixation, too early implant removal, too much revision surgery, and an inconsequent transfer of follow-up algorithms, or combinations of the above. Treatment of non-union should start as early as possible because the effort of required surgery increases with time that the nonunion has been neglected. Often a combination of stable fixation of the pseudarthrosis and correction of the elbow axis are necessary to achieve a satisfying outcome. Conclusion In pediatric traumatology, qualified and consequent care for children’s fractures of the distal humerus can prevent rare complications such as non-unions in almost any situation. If such a disturbance of healing is noticed, immediate and adequate, i.e. children specific surgical consequences achieve best results.


2016 ◽  
Vol 54 (5) ◽  
pp. 573-578 ◽  
Author(s):  
Leandro Benetti De Oliveira ◽  
Jose Mauricio Nunes Reis ◽  
Rubens Spin-Neto ◽  
Marisa Aparecida Cabrini Gabrielli ◽  
Yener Oguz ◽  
...  

2019 ◽  
Vol 20 (01) ◽  
pp. 1950079
Author(s):  
MATTHEW JIAN-QIAO PENG ◽  
HONGWEN XU ◽  
HAI-YAN CHEN ◽  
XIANGYANG JU ◽  
YONG HU ◽  
...  

Little is known about why and how biomechanics govern the hypothesis that three-Lag-Screw (3LS) fixation is a preferred therapeutic technique. A series models of surgical internal-fixation for femoral neck fractures of Pauwells-II will be constructed by an innovative approach of finite element so as to determine the most stable fixation by comparison of their biomechanical performance. Seventeen sets of CT scanned femora were imported onto Mimics extracting 3D models; these specimens were transferred to Geomagic Studio for a simulative osteotomy and kyrtograph; then, they underwent UG to fit simulative solid models; three sorts of internal fixators were expressed virtually by Pro-Engineer. Processed by Hypermesh, all compartments were assembled onto three systems actually as “Dynamic hip screw (DHS), 3LS and DHS+LS”. Eventually, numerical models of Finite Elemental Analysis (FEA) were exported to AnSys for solution. Three models for fixtures of Pauwells-II were established, validated and analyzed with the following findings: Femoral-shaft stress for [Formula: see text](3LS) is the least; Internal-fixator stress (MPa) for [Formula: see text]; Integral stress (MPa) for [Formula: see text]; displacement of femoral head (mm) for a[Formula: see text](DHS+LS) = 0.735; displacement of femoral shaft (mm) for [Formula: see text]; and displacement of fixators for [Formula: see text]. Mechanical comparisons for other femoral parks are insignificantly different, and these data can be abstracted as follows: the stress of 3LS-system was checked to be the least, and an interfragmentary displacement of DHS+LS assemblages was assessed to be the least”. A 3LS-system should be recommended to clinically optimize a Pauwells-II facture; if treated by this therapeutic fixation, breakage of fixators or secondary fracture is supposed to occur rarely. The strength of this study is that it was performed by a computer-aided simulation, allowing for design of a preoperative strategy that could provide acute correction and decrease procedure time, without harming to humans or animals.


2013 ◽  
Vol 25 (01) ◽  
pp. 1350007
Author(s):  
Matija Krkovic ◽  
Miha Brojan ◽  
David Bombac ◽  
Dejan Hermann

Comminuted fractures of the radial head still present significant technical and surgical challenges. In this article, we describe a novel fixation of comminuted radial head fractures with the help of an intramedullary nail. Experiments with solid, conventionally machined intramedullary nails showed some major drawbacks in the fixation of radial head fractures. Several design and manufacturing procedures were proposed. The general idea behind the new design was the concept of a nail which would eliminate the need for prefabricated bores. Experiments with a selective laser sintered thin-walled nail, designed with the help of CT images, fulfilled expectations. This thin-walled proximal radius nail thus offers a stable fixation of the radial head fracture fragments, with the ability to preserve the existing vascular supply to the radial head fragments, and therefore not just use the reconstructed radial head as a bioprosthesis.


2016 ◽  
Vol 98 (8) ◽  
pp. e168-e170 ◽  
Author(s):  
D Giotikas ◽  
M Nabergoj ◽  
M Krkovic

Bicondylar Hoffa’s fractures of distal femur are rare. We report the case of an 18-year-old male who sustained a closed complex fracture of both femoral condyles of the left femur on the sagittal plane (Hoffa fracture), combined with distal metaphyseal fracture. He was treated using parallel plates and interdigitating screws, with our technique based on an extrapolation of the principles of distal humerus fixation. The fracture united clinically and radiologically at 16 weeks. Twelve months postoperatively, the range of movement in the knee was 5°–115°. In this complex case, our technique provided stable fixation of the fragments and a satisfactory final functional outcome.


2004 ◽  
Vol 11 (1) ◽  
pp. 27-31 ◽  
Author(s):  
A F Lazarev ◽  
E I Solod ◽  
A O Ragozin ◽  
M G Kakabadze ◽  
A F Lazarev ◽  
...  

Analysis of treatment of 526 patients with proximal femur fractures (362 patients with femoral neck fractures and 164 patients with trochanteric zone fractures) was performed. Patients' age ranged from 34 to 92 (mean 67). Algorithm of differentiated choice of operative tactics depending on fracture characteristics and injury term was presented. Low invasive osteosynthesis of femoral neck with bundle of stressed V-shaped pins was suggested. Theoretical and practical ground of that technique was given. Stress within fixative-bone system created after osteosynthesis by V-shaped pins, provided stable fixation even in marked osteoporosis. The importance of bone mineral density evaluation for the choice of treatment tactics as well as the necessity of medicamental correction of the disturbed bone remodeling after surgical treatment was noted.


1992 ◽  
Vol 2 (1) ◽  
pp. 21-26
Author(s):  
A. Surace ◽  
L. Pietrogrande ◽  
M. Sartoris

35 cases of arthroplasty revision are reviewed with mean follow-up time of 56 m. (range 24 to 107), by clinical and radiographic study. The results were satisfactory, having only one case of secondary failure (2.8%), also in comparison with other studies. The reason of this probably lies in the adaptability of our technique: in fact we use without preconcepts both cement and cementless fixations with many types of stems and cotyles; this allows us to obtain a stable fixation also taking in consideration the bone characteristics of each case.


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