Pectus excavatum repair using bridge fixation system

2019 ◽  
Vol 27 (5) ◽  
pp. 374-380
Author(s):  
Vu Huu Vinh ◽  
Huynh Quang Khanh ◽  
Nguyen Hoang Binh ◽  
Nguyen Van Khoi
Keyword(s):  
Postoperative Complications ◽  
Pectus Excavatum ◽  
Fixation Method ◽  
Fixation Techniques ◽  
Pectus Bar ◽  
Skin Surgery ◽  
The Stability ◽  
Skin To Skin ◽  
Average Skin ◽  
Fixation System

Background The stability of the pectus bar is an important determinant of the success of pectus excavatum repair surgery. In practice, several different types of fixation method are in use for stabilizing pectus bars. The aim of this study was to compare the performance of the bridge fixation system with previous fixation systems for stabilizing pectus bars. Methods We performed a retrospective review of 1760 pectus excavatum repair cases conducted in the Thoracic Department of Choray Hospital and its satellite hospitals, between 2007 and 2017. We compared the results of 560 patients who had the bridge fixation system with the previous 1200 patients who had other fixation techniques. Results The bridge fixation system with 2 bars in 560 patients gave better results in terms of bar stabilization, operative time, and postoperative complications, compared to the previous 1200 patients who had other stabilization techniques. The average skin-to-skin surgery time using the bridge fixation system was 55 min. Of the 560 cases, only one patient showed trivial one bar dislocation, and one had a postoperative complication (pneumothorax). Conclusions We found the bridge fixation system to be superior not only in terms of stabilizing the bars but also for minimizing the time of surgery and postoperative complications, compared to other fixation systems. The bridge fixation system with 2 bars showed excellent results. Use of 3 bars is not necessary. One bar was used in the other fixation techniques and the results were found to be inferior compared to those using 2 bars.

scholarly journals A Novel Fixation System for Acetabular Quadrilateral Plate Fracture: A Comparative Biomechanical Study

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Guo-Chun Zha ◽  
Jun-Ying Sun ◽  
Sheng-Jie Dong ◽  
Wen Zhang ◽  
Zong-Ping Luo
Keyword(s):  
Plate Fixation ◽  
Biomechanical Properties ◽  
Biomechanical Study ◽  
Pelvic Brim ◽  
Quadrilateral Plate ◽  
Plate Fracture ◽  
Fixation Techniques ◽  
Biomechanical Experiment ◽  
Fixation System

This study aims to assess the biomechanical properties of a novel fixation system (named AFRIF) and to compare it with other five different fixation techniques for quadrilateral plate fractures. This in vitro biomechanical experiment has shown that the multidirectional titanium fixation (MTF) and pelvic brim long screws fixation (PBSF) provided the strongest fixation for quadrilateral plate fracture; the better biomechanical performance of the AFRIF compared with the T-shaped plate fixation (TPF), L-shaped plate fixation (LPF), and H-shaped plate fixation (HPF); AFRIF gives reasonable stability of treatment for quadrilateral plate fracture and may offer a better solution for comminuted quadrilateral plate fractures or free floating medial wall fracture and be reliable in preventing protrusion of femoral head.

scholarly journals Sternal elevation techniques during the minimally invasive repair of pectus excavatum

2019 ◽  
Vol 29 (4) ◽  
pp. 497-502 ◽  
Author(s):  
Frank-Martin Haecker ◽  
Thomas Krebs ◽  
Gregor J Kocher ◽  
Ralph A Schmid ◽  
Sergio B Sesia
Keyword(s):  
Side Effects ◽  
Minimally Invasive ◽  
Pectus Excavatum ◽  
Skin Incision ◽  
Technical Equipment ◽  
Nuss Procedure ◽  
Review Of The Literature ◽  
Different Types ◽  
Pectus Bar ◽  
Number Of Authors

Summary The aim of the review was to evaluate the routine use of sternal elevation techniques (SETs) during minimally invasive repair of pectus excavatum (MIRPE, the Nuss procedure). We performed a review of the literature between January 1998 and September 2018 with focus on different methods of SET during MIRPE. Reported effects and side effects were evaluated and compared with our own experience concerning the routine use of the vacuum bell for sternal elevation during MIRPE during the last 13 years. SET is more often used in adult patients than in adolescents. SET improves visualization and safety of MIRPE. Advancement of the pectus introducer, retrosternal dissection and placement of the pectus bar are easier. The risk of cardial and/or pericardial lesion is reduced significantly. Different types of retractors, a crane combined with a wire and/or customized hooks are reported to be used as SET. Furthermore, routine use of a subxiphoid incision is reported. However, more technical equipment, and in some SETs additional incisions are necessary. In contrast, no additional skin incision is necessary for the vacuum bell. The routine intraoperative use of the vacuum bell was safe and effective in 131 patients. It facilitates the retrosternal dissection and the insertion of the pectus bar like other SETs. Besides a temporary mild hematoma, no relevant side effect was observed. In conclusion, an increasing number of authors report on the routine use of SET during MIRPE to improve safety of the procedure. We recommend the routine intraoperative use of the vacuum bell during MIRPE.

Inter-relationships of Metacarpals 1 to 5, Regarding Their Length, Metaphyseal Midshaft Width, Articular Surface Area of Head and Base, Age, and Sex: A Cadaveric Study

Hand ◽  
2019 ◽  
pp. 155894471988002 ◽  
Author(s):  
Andrew Sephien ◽  
Claire F. Bethel ◽  
Danielle Gulick ◽  
Christa Nairn ◽  
Felicia Ourn ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Articular Surface ◽  
Standard Of Care ◽  
Epidemiological Data ◽  
Screw Design ◽  
Surgical Implants ◽  
Fixation Techniques ◽  
The Right ◽  
Metacarpal Dimensions ◽  
Age And Sex

Background: Metacarpal factures are common, comprising up to 50% of hand fractures. More work is needed to further our understanding of metacarpal anatomy to improve fixation techniques and reduce postoperative complications following surgical implants. The purpose of this anatomic study was to evaluate the length, midshaft metaphyseal width, and area of the articular surface of the head (AH) and base (AB) of metacarpals 1 to 5. Methods: This prospective study assessed measures from 17 cadavers at 1 institution’s anatomy lab. The anatomic dimensions of the metacarpals in both the right and left hands were measured. Epidemiological data including sex and age at death were also collected. Results: In all, 29 hands were dissected for metacarpal anatomic measurements, for a total of 145 metacarpals. The second metacarpal was longest, at 69.58 mm. Multivariate analysis of variance revealed a significant effect of sex overall, with greater metacarpal dimensions in men. Increasing age was associated with decreasing dimensions, except for AH of metacarpal 1 ( F = 3.43, P = .02) and AB of metacarpal 1 ( F = 11.54, P < .001) and 4 ( F = 4.21, P = .01). Multiple metacarpal dimensions were also significantly correlated with each other. Conclusion: Our data reveal further information regarding metacarpal dimensions of length, midshaft width, and AH and AB. The results allow for potential to improve surgical management through improving metacarpal implants, developing an optimal plate and screw design, techniques to better accommodate anatomical differences based on age and sex, reducing postoperative complications and improving the standard of care.

The Predictive Value of Haller Index in Patients Undergoing Pectus Bar Repair for Pectus Excavatum

2011 ◽  
Vol 170 (1) ◽  
pp. 104-106 ◽  
Author(s):  
Vincent E. Mortellaro ◽  
Corey W. Iqbal ◽  
Frankie B. Fike ◽  
Susan W. Sharp ◽  
Daniel J. Ostlie ◽  
...  
Keyword(s):  
Predictive Value ◽  
Pectus Excavatum ◽  
Haller Index ◽  
Pectus Bar

scholarly journals Distal femoral complications following antegrade intramedullary nail placement

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Amanda J. Fantry ◽  
Gregory Elia ◽  
Brian G. Vopat ◽  
Alan H. Daniels
Keyword(s):  
Postoperative Complications ◽  
Knee Joint ◽  
Intramedullary Nailing ◽  
Case Series ◽  
Fixation Method ◽  
Radius Of Curvature ◽  
Careful Study ◽  
X Rays ◽  
Femur Fractures ◽  
Cortical Perforation

While antegrade nailing for proximal and diaphyseal femur fractures is a commonly utilized fixation method with benefits including early mobilization and high rates of fracture union, both intraoperative and postoperative complications may occur. Intraoperative errors include leg length discrepancy, anterior cortical perforation, malreduction of the fracture, and neurovascular injury, and postoperative complications include nonunion, malunion, infection, and hardware failure. This case series reviews complications affecting the distal femur after intramedullary nailing including fracture surrounding a distal femoral interlocking screw (Case #1), nonunion after dynamization with nail penetration into the knee joint (Case #2), and anterior cortical perforation (Case #3). Prevention of intraoperative and postoperative complications surrounding intramedullary nailing requires careful study of the femoral anatomy and nail design specifications (radius of curvature), consideration of the necessity of distal interlocking screws, the need for close radiographic follow-up after nail placement with X-rays of the entire length of the nail, and awareness of possible nail penetration into the knee joint after dynamization.

Correction of Pectus Excavatum With Breast Hypoplasia Using Simultaneous Pectus Bar Procedure and Augmentation Mammoplasty

2014 ◽  
Vol 73 (2) ◽  
pp. 190-195 ◽  
Author(s):  
Hyung Joo Park ◽  
Ja Hea Gu ◽  
Joon Chul Jang ◽  
Eun-Sang Dhong ◽  
Eul-Sik Yoon
Keyword(s):  
Pectus Excavatum ◽  
Augmentation Mammoplasty ◽  
Breast Hypoplasia ◽  
Pectus Bar

scholarly journals The Influence of Posterior Tibial Slope on the Mid-term Clinical Effect of Medial-pivot Knee Prosthesis

2021 ◽  
Author(s):  
Weipeng Shi ◽  
Yaping Jiang ◽  
Xuan Zhao ◽  
Haining Zhang ◽  
Yingzhen Wang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Knee Joint ◽  
Knee Prosthesis ◽  
Tibial Slope ◽  
Joint Line ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Medial Pivot ◽  
Group A ◽  
The Stability

Abstract Objective: To evaluate the effect of posterior tibial slope (PTS) on the mid-term clinical outcome following a medial-pivot (MP) prosthesis. Method: 233 patients from this hospital, who had undergone a total knee arthroplasty (TKA) with MP prosthesis between January 2015 and December 2015, were retrospectively included in this study. They were divided 3 groups according to postoperative PTS: A ≤ 5°; B 5-7° and C ≥ 7°. Multiple assessments were made on the patient postoperatively and recorded in the three groups, the measurements of this study included: The range of motion (ROM), knee scoring system (KSS), Western Ontario and McMaster universities osteoarthritis index (WOMAC), posterior condylar offset (PCO), joint line height and postoperative complications. Results: The average post-operative ROM for groups B and C were 108°and 110°respectively, this was significantly higher than that of group A (98°, P < 0.001). The WOMAC scores of patients in group C were significantly lower than those in groups A and B (p < 0.05). However, there were no significant differences in KSS, PCO, joint line height among the 3 groups (P>0.05). Only 2 cases of postoperative complications occurred in group C, these were recovered after operation. Conclusion: With an increase to PTS, the postoperative ROM can be significantly increased for the patient, however, the knee joint function will not be significantly improved, and the stability of knee joint will not be affected within the appropriate PTS.

scholarly journals Kangaroo Mother Care and Swaddling Methods In Low Born Weight Babies In Community Settings: A Systematic Review

2020 ◽  
Vol 9 (2) ◽  
pp. 1186-1195
Author(s):  
S. Tauriana ◽  
Joni Haryanto ◽  
Retnayu Pradanie
Keyword(s):  
Systematic Review ◽  
Birth Weight ◽  
Body Temperature ◽  
Low Birth Weight ◽  
Kangaroo Mother Care ◽  
Fat Reserves ◽  
Skin Contact ◽  
Low Weight ◽  
The Stability ◽  
Skin To Skin

Infants born with low birth weight or LBW are very susceptible to hypothermia due to the thin fat reserves under the skin and immature heat regulating centers in the brain. The search for articles consisted of five databases, namely Scopus, Science Direct, PubMed, Garuda, and Proquest. Analysis of 25 articles on kangaroo mother care and self-care showed that kangaroo mother care can keep the baby's body temperature stable and reduce the risk of hypothermia in newborns with low weight and make it easier for the baby to breastfeed. This systematic review shows that the kangaroo mother care method has a more significant impact on baby weight gain and the stability of the baby's body temperature by maintaining skin to skin contact between mother and baby for later implementation in the community. This method is more effective than the swaddling method.  Keyword: Kangaroo Mother Care; Swaddling; Low Birth Weight; Community  

scholarly journals Primary Stability in Hip Revision Arthroplasty: Comparison of the Stability of Cementless Fixed Augments on a Modular Acetabular Cage System with and without Cranial Straps

2021 ◽  
Vol 10 (17) ◽  
pp. 4002
Author(s):  
Max Jaenisch ◽  
Hendrik Kohlhof ◽  
Dieter Christian Wirtz ◽  
Frank Alexander Schildberg ◽  
Nicholas A. Beckmann ◽  
...  
Keyword(s):  
Relative Motion ◽  
Revision Arthroplasty ◽  
Primary Stability ◽  
Fourth Generation ◽  
Group Assignment ◽  
Cage System ◽  
Fixation Techniques ◽  
Prior Investigation ◽  
The Stability

The goal of this study is to evaluate the primary stability of a cementless augment-and-modular-cage system with and without the addition of cranial straps in a standardized in vitro setting. As the surrogate parameter for the evaluation of primary stability, the measurement of relative motion between the implant components themselves and the bone will be used. Acetabular revision components with a trabecular titanium augment in combination with a large fourth-generation composite left hemipelvis were assembled. These constructs were divided into two groups with (S) and without cranial straps (nS). A total of 1000 cycles was applied at each of three load levels. Relative movements (RM) between the components were measured. Load levels display a significant effect on the amount of RM at all interfaces except between shell/augment. The group assignment appears to have an effect on RM due to significantly differing means at all interfaces. Between bone/shell RM increased as load increased. NS displayed significantly more RM than S. Between shell/augment RM remained constant as load increased. Between shell/cup S showed more RM than nS while both groups’ RM increased with load. We conclude a significant increase of primary stability between the shell and the bone through the addition of cranial straps. Relative motion between components (shell/cup) increases through the addition of cranial straps. A clinical impact of this finding is uncertain and requires further investigation. Finally, the cementless fixation of the augment against the rim-portion of the shell appears stable and compares favorably to prior investigation of different fixation techniques.

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