Lag screw fixation of dorsal cortical stress fractures of the third metacarpal bone in 116 racehorses

2010 ◽  
Vol 42 (7) ◽  
pp. 586-590 ◽  
Author(s):  
S. L. JALIM ◽  
C. W. McILWRAITH ◽  
N. L. GOODMAN ◽  
G. A. ANDERSON
Keyword(s):  
Screw Fixation ◽  
Metacarpal Bone ◽  
Stress Fractures ◽  
The Third ◽  
Lag Screw

Secondary Fractures Following Internal Fixation in Two Horses

1989 ◽  
Vol 02 (03) ◽  
pp. 125-128
Author(s):  
E. M. Gaughan ◽  
N. G. Duchar
Keyword(s):  
Internal Fixation ◽  
Sagittal Plane ◽  
Proximal Phalanx ◽  
Fracture Repair ◽  
Fracture Line ◽  
Carpal Bone ◽  
Fracture Plane ◽  
The Third ◽  
Lag Screw ◽  
Secondary Fractures

SummaryImplant associated fractures have not been reported in horses. Two horses were evaluated for fractures in the fore limbs, occurring subsequent to previous fracture repair. Previously, the horses had sustained fractures of unusual configurations which were repaired using internal fixation. Following repair and healing of the fractures, secondary fractures occurred in the same bone, but in a different (more common) configuration. The first horse was evaluated ten months following lag screw fixation of a longitudinal fracture of the proximal phalanx in a frontal plane. This horse presented with a more typical comminuted fracture in the sagittal plane with the screws from the first fixation lying in the fracture line. This fracture was successfully treated with a cast. The second horse was examined eightteen months after repair of a medial sagittal slab fracture of the third carpal bone. The horse presented with a more typical dorsal slab fracture of the third carpal bone with the previously placed lag screw lying in the fracture line. The screw was removed and a lag screw was placed perpendicular to the new fracture plane through the dorsal surface of the third carpal bone to repair the fracture.

scholarly journals Effect of oblique headless compression screw fixation for metacarpal shaft fracture: a biomechanical in vitro study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yung-Cheng Chiu ◽  
Tsung-Yu Ho ◽  
Yen-Nien Ting ◽  
Ming-Tzu Tsai ◽  
Heng-Li Huang ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Screw Fixation ◽  
Shaft Fracture ◽  
Metacarpal Bone ◽  
Entry Point ◽  
Fixation Method ◽  
Exit Point ◽  
Compression Screw ◽  
Headless Compression Screw ◽  
Metacarpal Shaft

Abstract Background Metacarpal shaft fracture is a common fracture in hand trauma injuries. Surgical intervention is indicated when fractures are unstable or involve considerable displacement. Current fixation options include Kirschner wire, bone plates, and intramedullary headless screws. Common complications include joint stiffness, tendon irritation, implant loosening, and cartilage damage. Objective We propose a modified fixation approach using headless compression screws to treat transverse or short-oblique metacarpal shaft fracture. Materials and methods We used a saw blade to model transverse metacarpal neck fractures in 28 fresh porcine metacarpals, which were then treated with the following four fixation methods: (1) locked plate with five locked bicortical screws (LP group), (2) regular plate with five bicortical screws (RP group), (3) two Kirschner wires (K group), and (4) a headless compression screw (HC group). In the HC group, we proposed a novel fixation model in which the screw trajectory was oblique to the long axis of the metacarpal bone. The entry point of the screw was in the dorsum of the metacarpal neck, and the exit point was in the volar cortex of the supracondylar region; thus, the screw did not damage the articular cartilage. The specimens were tested using a modified three-point bending test on a material testing system. The maximum fracture forces and stiffness values of the four fixation types were determined by observing the force–displacement curves. Finally, the Kruskal–Wallis test was adopted to process the data, and the exact Wilcoxon rank sum test with Bonferroni adjustment was performed to conduct paired comparisons among the groups. Results The maximum fracture forces (median ± interquartile range [IQR]) of the LP, RP, HC, and K groups were 173.0 ± 81.0, 156.0 ± 117.9, 60.4 ± 21.0, and 51.8 ± 60.7 N, respectively. In addition, the stiffness values (median ± IQR) of the LP, HC, RP, and K groups were 29.6 ± 3.0, 23.1 ± 5.2, 22.6 ± 2.8, and 14.7 ± 5.6 N/mm, respectively. Conclusion Headless compression screw fixation provides fixation strength similar to locked and regular plates for the fixation of metacarpal shaft fractures. The headless screw was inserted obliquely to the long axis of the metacarpal bone. The entry point of the screw was in the dorsum of the metacarpal neck, and the exit point was in the volar cortex of the supracondylar region; therefore the articular cartilage iatrogenic injury can be avoidable. This modified fixation method may prevent tendon irritation and joint cartilage violation caused by plating and intramedullary headless screw fixation.

Stress fracture of the palmar, distal cortex of the third metacarpal bone: A diagnostic challenge with a good prognosis

2021 ◽  
Author(s):  
Ran Shan ◽  
Anna S. Johnston ◽  
Sarah M. Rosanowski ◽  
John O'Shea ◽  
Christopher M. Riggs
Keyword(s):  
Stress Fracture ◽  
Good Prognosis ◽  
Metacarpal Bone ◽  
Diagnostic Challenge ◽  
The Third

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

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.

Transverse Lag Screw Fixation in Midline Mandibulotomy

2000 ◽  
Vol 109 (3) ◽  
pp. 334-339 ◽  
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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