Infection rate treating radial and ulnar fractures using bone plate fixation without antibiotic prophylaxis

2021 ◽  
Author(s):  
H. Schmökel ◽  
D. Skytte ◽  
M. Barsch
Keyword(s):  
Antibiotic Prophylaxis ◽  
Infection Rate ◽  
Plate Fixation ◽  
Bone Plate

scholarly journals Bone plate fixation ability on the dorsal and lateral sides of a metacarpal shaft transverse fracture

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yung-Cheng Chiu ◽  
Cheng-En Hsu ◽  
Tsung-Yu Ho ◽  
Yen-Nien Ting ◽  
Ming-Tzu Tsai ◽  
...  
Keyword(s):  
Mechanical Strength ◽  
Locking Plate ◽  
Plate Fixation ◽  
Shaft Fracture ◽  
Bone Plate ◽  
Lateral Side ◽  
Lateral Plate ◽  
Fracture Force ◽  
Shaft Fractures ◽  
Metacarpal Shaft

Abstract Background Metacarpal shaft fractures are a common hand trauma. The current surgical fixation options for such fractures include percutaneous Kirschner wire pinning and nonlocking and locking plate fixation. Although bone plate fixation, compared with Kirschner wire pinning, has superior fixation ability, a consensus has not been reached on whether the bone plate is better placed on the dorsal or lateral side. Objective The purpose of this study was to evaluate the fixation of locking and regular bone plates on the dorsal and lateral sides of a metacarpal shaft fracture. Materials and methods Thirty-five artificial metacarpal bones were used in the experiment. Metacarpal shaft fractures were created using a saw blade, which were then treated with four types of fixation as follows: (1) a locking plate with four locking bicortical screws on the dorsal side (LP_D); (2) a locking plate with four locking bicortical screws on the lateral side (LP_L); (3) a regular plate with four regular bicortical screws on the dorsal side (RP_D); (4) a regular plate with four regular bicortical screws on the lateral side (RP_D); and (5) two K-wires (KWs). All specimens were tested through cantilever bending tests on a material testing system. The maximum fracture force and stiffness of the five fixation types were determined based on the force–displacement data. The maximum fracture force and stiffness of the specimens with metacarpal shaft fractures were first analyzed using one-way analysis of variance and Tukey’s test. Results The maximum fracture force results of the five types of metacarpal shaft fracture were as follows: LP_D group (230.1 ± 22.8 N, mean ± SD) ≅ RP_D group (228.2 ± 13.4 N) > KW group (94.0 ± 17.4 N) > LP_L group (59.0 ± 7.9 N) ≅ RP_L group (44.5 ± 3.4 N). In addition, the stiffness results of the five types of metacarpal shaft fracture were as follows: LP_D group (68.7 ± 14.0 N/mm) > RP_D group (54.9 ± 3.2 N/mm) > KW group (20.7 ± 5.8 N/mm) ≅ LP_L group (10.6 ± 1.7 N/mm) ≅ RP_L group (9.4 ± 1.2 N/mm). Conclusion According to our results, the mechanical strength offered by lateral plate fixation of a metacarpal shaft fracture is so low that even KW fixation can offer relatively superior mechanical strength; this is regardless of whether a locking or nonlocking plate is used for lateral plate fixation. Such fixation can reduce the probability of extensor tendon adhesion. Nevertheless, our results indicated that when lateral plate fixation is used for fixating a metacarpal shaft fracture in a clinical setting, whether the mechanical strength offered by such fixation would be strong enough to support bone union remains questionable.

Augmentation of diaphyseal fractures of the radius and ulna in toy breed dogs using a free autogenous omental graft and bone plating

2015 ◽  
Vol 28 (02) ◽  
pp. 131-139 ◽  
Author(s):  
S. Cooley ◽  
J. J. Warnock ◽  
S. Nemanic ◽  
S. M. Stieger-Vanegas ◽  
W. I. Baltzer
Keyword(s):  
Plate Fixation ◽  
Fracture Site ◽  
Implant Removal ◽  
Bone Plate ◽  
Term Outcome ◽  
Post Surgery ◽  
Retrospective Clinical Study ◽  
Diaphyseal Fractures ◽  
Omental Graft

SummaryObjectives: Evaluation of the short-term outcome, duration of bone healing, and complications following bone plate fixation in dogs weighing [uni2264]6 kg, with and without the use of a free autogenous greater omental graft (OG).Materials and methods: A retrospective clinical study reviewed the medical records of 25 dogs of body weight <6 kg with mid to distal diaphyseal fractures of the radius and ulna (29 fractures) treated with open reduction bone plate fixation. Thirteen out of 29 fractures were implanted with an additional 2–3 cm3 OG lateral, cranial, and medial to the fracture site, adjacent to the bone plate.Results: Median time to radiographic healing in OG fractures (n = 11) was 70 days (range 28–98) compared to 106 days (range: 56–144) in non-OG grafted fractures (n = 14). The OG dogs had no major complications; minor complications included oedema, erythema, and mild osteopenia. Six of the eight non-OG dogs for which follow-up could be obtained developed osteopenia necessitating implant removal, four of which re-fractured the radius one to five months after implant removal, with one dog re-fracturing the limb a second time and resulting in amputation. Telephone follow-up of owners of OG dogs (n = 11) three to 15 months (median 10) post-surgery did not identify any signs of lameness or other complications. Owners of the non-OG dogs (n = 8) reported that there were not any signs of lameness six to 48 months (median 36) post-surgery.Clinical relevance: Free autogenous omen-tal grafting of diaphyseal fractures of the radius and ulna was associated with radial and ulnar healing with minimal complications in dogs weighing less than 6 kg.

scholarly journals Experimental Fracture Model versus Osteotomy Model in Metacarpal Bone Plate Fixation

2011 ◽  
Vol 11 ◽  
pp. 1692-1698 ◽  
Author(s):  
S. Ochman ◽  
T. Vordemvenne ◽  
J. Paletta ◽  
M. J. Raschke ◽  
R. H. Meffert ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Plate Fixation ◽  
Maximum Load ◽  
Fracture Model ◽  
Bone Plate ◽  
Bending Test ◽  
Group I ◽  
Metacarpal Bones ◽  
Fixation Techniques ◽  
Fracture Models

Introduction. Osteotomy or fracture models can be used to evaluate mechanical properties of fixation techniques of the hand skeletonin vitro. Although many studies make use of osteotomy models, fracture models simulate the clinical situation more realistically. This study investigates monocortical and bicortical plate fixation on metacarpal bones considering both aforementioned models to decide which method is best suited to test fixation techniques.Methods. Porcine metacarpal bones () were randomized into 4 groups. In groups I and II bones were fractured with a modified 3-point bending test. The intact bones represented a further control group to which the other groups after fixation were compared. In groups III and IV a standard osteotomy was carried out. Bones were fixated with plates monocortically (group I, III) and bicortically (group II, IV) and tested for failure.Results. Bones fractured at a mean maximum load of 482.8 N  104.8 N with a relative standard deviation (RSD) of 21.7%, mean stiffness was 122.3  35 N/mm. In the fracture model, there was a significant difference () for maximum load of monocortically and bicortically fixed bones in contrast to the osteotomy model ().Discussion. In the fracture model, because one can use the same bone for both measurements in the intact state and the bone-plate construct states, the impact of inter-individual differences is reduced. In contrast to the osteotomy model there are differences between monocortical and bicortical fixations in the fracture model. Thus simulation of thein vivosituation is better and seems to be suitable for the evaluation of mechanical properties of fixation techniques on metacarpals.

scholarly journals A prospective study of the bacteriological profile and risk factors of infection after internal fixation of close fractures of long bones

2020 ◽  
Vol 6 (2) ◽  
pp. 345
Author(s):  
Munin Borgohain ◽  
Debasish Bora ◽  
Aswin Deepak Rajan
Keyword(s):  
Risk Factors ◽  
Infection Rate ◽  
Plate Fixation ◽  
Antibiotic Sensitivity ◽  
Immunosuppressive Drugs ◽  
Long Bone ◽  
X Rays ◽  
North East India ◽  
North East ◽  
Bacteriological Profile

<p class="abstract"><strong>Background:</strong> Infection in implant related procedures is dreaded due to difficulty in getting rid of it. Disappointment to patients and surgeons, drainage of health care and patients’ resources is significant. Causes and risk factors are many related to host, environment and procedure. The bacteriological profile and antibiotic sensitivity have been changing trend with emerging resistance to many drugs.</p><p class="abstract"><strong>Methods:</strong> A prospective observational study of 941 patients with operative fixation of long bone closed fractures. The details of the procedure, host characteristics were noted. Followed up in ward post operatively and after discharge to identify the cases of surgical site infection. Once identified they were evaluated with X-rays and lab parameters. Wound swabs or pus samples taken to find out the organisms and cultured to find the sensitivity.<strong></strong></p><p class="abstract"><strong>Results:</strong> 116 patients (86 males and 30 females) developed SSI (incidence 12.42%). Plate fixation (18.20% infection rate), operative time &gt;1 and half hours (15.73% rate), fracture femur (16.66% rate), ORIF (14.38% rate), age &gt;60 yrs were some of the risk factors. Co-morbidities like anaemia, diabetes, liver disease, lung disease, immunosuppressive drugs, hypertension, smoking, alcoholics had significant association with SSI. <em>Staphylococcus aureus</em> was the most common organism. Gram positive showed highest sensitivity to linezolid, vancomycin and tetracycline. Gram negative showed highest sensitivity to colistin and tigecycline.</p><p class="abstract"><strong>Conclusions:</strong> Infection rate should be less than 1% and hence risk factors encompassing preoperative, intraoperative and postoperative period are to be controlled. Probably the first study from north east india showing the burden of orthopaedic SSI.</p>

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