Utilizing 2.0 mm Plates as a Supplemental Fixation Aid

2019 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Zachary L. Telgheder ◽  
Matthew P. Sullivan
Keyword(s):  
Supplemental Fixation

Miniplate Suture Button Augmentation for Soft Tissue Graft Tibial Fixation in Anterior Cruciate Ligament Reconstruction

2021 ◽  
Vol 104 (2) ◽  
pp. 277-285
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Interference Screw ◽  
Tibial Fixation ◽  
Suture Button ◽  
Soft Tissue Graft ◽  
Anterior Cruciate ◽  
Supplemental Fixation

Background: Anterior cruciate ligament (ACL) reconstruction requires reliable and rigid graft fixation. Tibial-sided fixation is frequently cited as the “weak point” of the femur-graft-tibia construct. Some authors have recommended supplemental fixation with a staple or screw suture to post improve the strength and stiffness of the fixation. However, with these fixations, there is a risk for symptomatic hardware. Miniplate is flatter than screw or staple and does not penetrate the bone when attached. It is used as a button for suspensory fixation to enhance interference screw tibial fixation. Objective: To evaluate the clinical outcomes of the miniplate suture button for supplemental soft tissue graft tibial fixation in ACL reconstruction. Materials and Methods: A retrospective study was carried out between August 2016 and December 2019. A total of 40 patients had undergone primary ACL reconstruction, performed with hamstring tendon grafts that were secured using a miniplate suture button for supplemental interference screw tibial fixation. A total of 18 patients were excluded, leaving 22 patients at 1-year follow-up. Results: At least 1-year follow-up, the remaining 22 patients had significant difference between preoperative and postoperative outcome of anterior drawer test, Lachman test and pivot shift test (p<0.05). Lysholm knee scores improved significantly from 54.0±12.53 to 90.04±5.38. However, 3 patients (13.6%) experienced symptomatic hardware pain and 3 patients (13.6%) tendered around the miniplate site. There were no radiographic changes in miniplate displacement, deformed or broken plate, and bony reaction around miniplate. Conclusion: The use of a miniplate suture button as a supplemental fixation showed adequate fixation strength and showed good results in postoperative manual ligament laxity test and functional scores at minimum 1-year follow-up. However, there is still symptomatic pain at the hardware site. Keywords: Anterior cruciate ligament reconstruction, Supplemental fixation, Suture button

A Biomechanical Analysis of Lateral Interbody Construct and Supplemental Fixation in Adjacent-Segment Disease of the Lumbar Spine

2019 ◽  
Vol 128 ◽  
pp. e694-e699
Author(s):  
M. Craig McMains ◽  
Nikhil Jain ◽  
Azeem Tariq Malik ◽  
Emily Cerier ◽  
Alan S. Litsky ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Biomechanical Analysis ◽  
Adjacent Segment Disease ◽  
Adjacent Segment ◽  
Supplemental Fixation ◽  
Lateral Interbody

15. Supplemental fixation of lateral mass screws: a strategy to improve fixation strength

2021 ◽  
Vol 21 (9) ◽  
pp. S8
Author(s):  
Robert M. Havey ◽  
Muturi Muriuki ◽  
Suguna Pappu ◽  
Nader S. Dahdaleh ◽  
Kenneth R. Blank ◽  
...  
Keyword(s):  
Fixation Strength ◽  
Lateral Mass ◽  
Lateral Mass Screws ◽  
Supplemental Fixation

Biomechanics of lateral lumbar interbody fusion constructs with lateral and posterior plate fixation

2014 ◽  
Vol 20 (3) ◽  
pp. 291-297 ◽  
Author(s):  
Guy R. Fogel ◽  
Rachit D. Parikh ◽  
Stephen I. Ryu ◽  
Alexander W. L. Turner
Keyword(s):  
Interbody Fusion ◽  
Plate Fixation ◽  
Spinous Process ◽  
Pedicle Screws ◽  
Axial Rotation ◽  
Interbody Cage ◽  
Lateral Bending ◽  
Lateral Plate ◽  
Flexion Extension ◽  
Supplemental Fixation

Object Lumbar interbody fusion is indicated in the treatment of degenerative conditions. Laterally inserted interbody cages significantly decrease range of motion (ROM) compared with other cages. Supplemental fixation options such as lateral plates or spinous process plates have been shown to provide stability and to reduce morbidity. The authors of the current study investigate the in vitro stability of the interbody cage with a combination of lateral and spinous process plate fixation and compare this method to the established bilateral pedicle screw fixation technique. Methods Ten L1–5 specimens were evaluated using multidirectional nondestructive moments (± 7.5 N·m), with a custom 6 degrees-of-freedom spine simulator. Intervertebral motions (ROM) were measured optoelectronically. Each spine was evaluated under the following conditions at the L3–4 level: intact; interbody cage alone (stand-alone); cage supplemented with lateral plate; cage supplemented with ipsilateral pedicle screws; cage supplemented with bilateral pedicle screws; cage supplemented with spinous process plate; and cage supplemented with a combination of lateral plate and spinous process plate. Intervertebral rotations were calculated, and ROM data were normalized to the intact ROM data. Results The stand-alone laterally inserted interbody cage significantly reduced ROM with respect to the intact state in flexion-extension (31.6% intact ROM, p < 0.001), lateral bending (32.5%, p < 0.001), and axial rotation (69.4%, p = 0.002). Compared with the stand-alone condition, addition of a lateral plate to the interbody cage did not significantly alter the ROM in flexion-extension (p = 0.904); however, it was significantly decreased in lateral bending and axial rotation (p < 0.001). The cage supplemented with a lateral plate was not statistically different from bilateral pedicle screws in lateral bending (p = 0.579). Supplemental fixation using a spinous process plate was not significantly different from bilateral pedicle screws in flexion-extension (p = 0.476). The combination of lateral plate and spinous process plate was not statistically different from the cage supplemented with bilateral pedicle screws in all the loading modes (p ≥ 0.365). Conclusions A combination of lateral and spinous process plate fixation to supplement a laterally inserted interbody cage helps achieve rigidity in all motion planes similar to that achieved with bilateral pedicle screws.

scholarly journals Radiographic Outcomes of Lisfranc Injuries Treated with a Suture Button Device

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0016
Author(s):  
Connor Delman ◽  
Christopher Kreulen ◽  
Trevor Shelton ◽  
Brent Roster ◽  
Robert Boutin ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Hybrid Technique ◽  
Hybrid Fixation ◽  
Suture Button ◽  
Radiographic Outcomes ◽  
Radiographic Measurements ◽  
Second Metatarsal ◽  
Significant Difference ◽  
Supplemental Fixation ◽  
Lisfranc Injuries

Category: Midfoot/Forefoot Introduction/Purpose: Controversy exists regarding the optimal treatment of Lisfranc injuries of the midfoot. There has been increasing interest in using a suture button device in lieu of traditional screw fixation. Biomechanical studies comparing screw fixation with suture button devices have demonstrated conflicting results. This study evaluates the radiographic outcomes of patients with Lisfranc injuries treated with a suture button device or a hybrid technique with supplemental fixation. Methods: Forty-three patients with a Lisfranc injury were treated operatively with either a suture button device (Tightrope, Arthrex, Naples, FL) or a hybrid technique with supplemental hardware fixation. The distances between the first and second metatarsal (M1-M2) and the medial cuneiform and second metatarsal (C1-M2) were measured on weightbearing radiographs. These measurements were used to assess the accuracy of reduction, maintenance of reduction, and magnitude of reduction. The accuracy of reduction was determined by comparing weightbearing AP radiographs of the uninjured foot with weightbearing radiographs of the operatively treated foot at 6 weeks postoperatively. The magnitude of reduction was assessed via a comparison of weightbearing AP radiographs of the injured foot preoperatively to the operatively treated foot at 6 weeks postoperatively. The maintenance of reduction was determined by comparing radiographic measurements at 6 weeks postoperatively to measurements taken at 12 weeks postoperatively. Results: An accurate reduction was obtained in both treatment groups with no significant difference in the M1-M2 and C1-M2 measurements at 6 weeks postoperatively compared to the uninjured foot. The magnitude of reduction was greater and statistically significant for the hybrid fixation group but was not maintained (Hybrid fixation M1-M2 magnitude of reduction: -1.39, p < .001; C1-M2 magnitude of reduction: -1.77, p < .001). The suture button treatment group attained a satisfactory reduction that was maintained with no statistically significant difference in the M1-M2 and C1-M2 distances at 6 weeks and 12 weeks postoperatively (Tightrope M1-M2 maintenance of reduction: 0.04, p=0.88; C1-M2 maintenance of reduction: 0.39, p=0.21). Conclusion: After open reduction of Lisfranc injuries, the suture button device appears to adequately maintain the reduction when patients have returned to full activity. Based on radiographic parameters, the suture button construct provides an effective alternative to traditional screw fixation for the treatment of Lisfranc injuries.

scholarly journals Complications of Radial Column Plating of the Distal Radius

Hand ◽  
2018 ◽  
Vol 14 (5) ◽  
pp. 614-619 ◽  
Author(s):  
Samuel E. Galle ◽  
Neil G. Harness ◽  
Jacques H. Hacquebord ◽  
Raoul J. Burchette ◽  
Brett Peterson
Keyword(s):  
Distal Radius ◽  
Normal Function ◽  
Distal Radius Fractures ◽  
Consecutive Series ◽  
Dash Score ◽  
Radius Fractures ◽  
Outcomes Measures ◽  
Valuable Adjunct ◽  
Supplemental Fixation

Background: Distal radius fractures treated with open reduction and internal fixation are commonly stabilized with a volar locking plate; however, more complex fracture patterns may require supplemental fixation with fragment-specific implants. The objective of this study was to evaluate the outcomes of distal radius fractures treated with radial column plates. Methods: A consecutive series of 61 patients who sustained distal radius fractures underwent radial column plating alone or in conjunction with other implants between August 2006 and January 2014. Thirty-one patients returned for follow-up or returned a mailed questionnaire at an average of 4.1 years. The outcomes measures included Visual Analog Scale (VAS); Disabilities of the Arm, Shoulder and Hand (DASH); and Patient-Rated Wrist Evaluation (PRWE) scores. Results: Sixty-one patients with a mean age of 55 years (range, 20-87) met inclusion criteria and were available for follow-up or chart review at an average of 5.2 years (range, 1.6-9.0 years). Seventeen of 61 (28%) underwent radial column plate removal. Twenty patients returned for final follow-up examination, and 11 completed questionnaires via mail. Subjective scores included a mean postoperative VAS of 0.72, DASH score of 17.2, and PRWE score of 15.7. Hardware sensitivity and wrist stiffness were the most common complications at final follow-up. Conclusions: Radial column plating of the distal radius is a safe treatment modality and a valuable adjunct in the setting of complex distal radius fractures, but patients should be counseled that there is a 28% chance that hardware removal may be required. Our retrospective review found evidence of few complications and objective scores consistent with return to normal function.

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