scholarly journals Corrective Osteotomy of Malunited Diaphyseal Fractures of the Forearm Simplified Using 3-Dimensional CT Data: Proposal of Our Simple Strategy Through Case Presentation

Hand ◽  
2017 ◽  
Vol 12 (5) ◽  
pp. NP95-NP98 ◽  
Author(s):  
Yoshitaka Hamada ◽  
Hiroyuki Gotani ◽  
Kousuke Sasaki ◽  
Yoshitaka Tanaka ◽  
Hiroshi Egawa ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Corrective Osteotomy ◽  
Mirror Image ◽  
Full Scale ◽  
Ct Reconstruction ◽  
Bone Model ◽  
3 Dimensional ◽  
Simple Strategy ◽  
Diaphyseal Fractures ◽  
Ct Data

Background: Reconstruction of malunited diaphyseal fractures of the forearm is one of the most difficult treatments due to its complicated structure. Widespread usage of Digital Imaging and Communications in Medicine (DICOM) data of 3-dimensional (3D) computed tomography (CT) and 3D printing can make estimating the true plane of the deformity easy. Methods: A 21-year-old man with limited supination due to left forearm nonunion deformity initially treated by locking plate fixation was referred to our hospital. We evaluated the deformity by superimposing the mirror image bone model of the contralateral normal bone onto a model of the affected bone and 3D real full-scale bone model. Results: The patient underwent a manual corrective osteotomy according to our planning. He had satisfactory improvement of his symptoms with no complications. Conclusions: We postulated that our simple preoperative simulation and manual osteotomy with the aid of 3D CT reconstruction and 3D real full-scale bone model fit in the clinical practice as a recent trend.

scholarly journals Accuracy comparison of various quantitative [99mTc]Tc-DPD SPECT/CT reconstruction techniques in patients with symptomatic hip and knee joint prostheses

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Martin Braun ◽  
Michal Cachovan ◽  
Felix Kaul ◽  
Federico Caobelli ◽  
Markus Bäumer ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Quantitative Data ◽  
Diagnostic Tools ◽  
Ct Reconstruction ◽  
Knee Prostheses ◽  
Uptake Quantification ◽  
Ct Data ◽  
Joint Prostheses ◽  
Painful Hip ◽  
Xspect Bone

Abstract Background There is a need for better diagnostic tools that identify loose total hip and knee arthroplasties. Here, we present the accuracy of different 99mTc-dicarboxypropandiphosphate ([99mTc]Tc-DPD) SPECT/CT quantification tools for the detection of loose prostheses in patients with painful hip and knee arthroplasties. Methods Quantitative reconstruction of mineral phase SPECT data was performed using Siemens xSPECT-Quant and xSPECT-Bone, with and without metal artefact reduction (iMAR) of CT-data. Quantitative data (SUVmax values) were compared to intraoperative diagnosis or clinical outcome after at least 1 year as standard of comparison. Cut-off values and accuracies were calculated using receiver operator characteristics. Accuracy of uptake quantification was compared to the accuracy of visual SPECT/CT readings, blinded for the quantitative data and clinical outcome. Results In this prospective study, 30 consecutive patients with 33 symptomatic hip and knee prostheses underwent [99mTc]Tc-DPD SPECT/CT. Ten arthroplasties were diagnosed loose and 23 stable. Mean-SUVmax was significantly higher around loose prostheses compared to stable prostheses, regardless of the quantification method (P = 0.0025–0.0001). Quantification with xSPECT-Bone-iMAR showed the highest accuracy (93.9% [95% CI 79.6–100%]) which was significantly higher compared to xSPECT-Quant-iMAR (81.8% [67.5–96.1%], P = 0.04) and xSPECT-Quant without iMAR (77.4% [62.4–92.4%], P = 0.02). Accuracies of clinical reading were non-significantly lower compared to quantitative measures (84.8% [70.6–99.1%] (senior) and 81.5% [67.5–96.1%] (trainee)). Conclusion Quantification with [99mTc]Tc-DPD xSPECT-Bone-iMAR discriminates best between loose and stable prostheses of all evaluated methods. The overall high accuracy of different quantitative measures underlines the potential of [99mTc]Tc-DPD-quantification as a biomarker and demands further prospective evaluation in a larger number of prosthesis.

A comparison of intramedullary cannulated screws versus miniplates for fixation of unstable metacarpal diaphyseal fractures

2021 ◽  
pp. 175319342110215
Author(s):  
Birkan Kibar ◽  
Ali Cavit ◽  
Abdullah Örs
Keyword(s):  
Plate Fixation ◽  
Randomized Study ◽  
Good Alternative ◽  
Active Movement ◽  
Cannulated Screws ◽  
Level Of Evidence ◽  
Visual Analogue Pain ◽  
Plate Group ◽  
Significant Difference ◽  
Diaphyseal Fractures

We carried out a prospective randomized study to compare the clinical and radiological results of metacarpal diaphyseal fractures treated with retrograde intramedullary headless cannulated screws (IHCS) and plates. Fractures were fixed with IHCS in 34 patients (37 metacarpals) and locked miniplates in 35 patients (40 metacarpals). The mean age was 33 years (range 18–61) in the IHCS group and 32 years (range 17–68) in plate group. All patients were followed up for 1 year. All fractures in the IHCS group united but there was one nonunion in the plate group. At final follow-up, there was no significant difference between the groups in total active movement, visual analogue pain score, Disabilities of the Arm, Shoulder, and Hand score and grip strength, although the study was not sufficiently powered to exclude differences with certainty. IHCS is a safe and fast technique that is a good alternative to plate fixation in metacarpal diaphyseal fractures. Level of evidence: I

Management of feline tibial diaphyseal fractures using orthogonal plates performed via minimally invasive plate osteosynthesis

2017 ◽  
Vol 20 (1) ◽  
pp. 6-14 ◽  
Author(s):  
Andrew Craig ◽  
Philip G Witte ◽  
Tristram Moody ◽  
Karen Harris ◽  
Harry W Scott
Keyword(s):  
Minimally Invasive ◽  
Bone Healing ◽  
Plate Osteosynthesis ◽  
Plate Fixation ◽  
Major Complication ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
Diaphyseal Fractures

Objectives The objective was to assess the medium- and long-term outcomes (radiographic and owner questionnaire) of feline tibial diaphyseal fractures with orthogonal plate fixation via a minimally invasive plate osteosynthesis (MIPO) approach. Methods Medical records and radiographs of cats that had tibial diaphyseal fractures stabilised with orthogonal plates were obtained (2012–2016). Immediate postoperative radiographs were reviewed to assess the construct configuration and follow-up radiographs (where available) were used to assess bone healing and implant-related complications. An owner-completed questionnaire (feline musculoskeletal pain index [FMPI]) was used at a minimum of 6 months following surgery to assess the cats’ ability to perform normal activities. Results Eight feline tibial diaphyseal fractures met the inclusion criteria. One major complication was observed, most likely due to an operative technical error. There were no further complications following revision surgery. Six of the eight cases that had radiographic follow-up either had clinical bone union or showed evidence of bone healing. All cases were classified as successful according to FMPI. Conclusions and relevance Orthogonal plating of feline tibial diaphyseal fractures via an MIPO approach resulted in successful outcomes and a lower complication rate compared with previously reported techniques.

Detecting dorsal screw penetration following volar plate fixation of the distal radius – A validation study in a saw bone model

Trauma ◽  
2016 ◽  
Vol 19 (1) ◽  
pp. 46-53 ◽  
Author(s):  
William EC Poole ◽  
Daniel Marsland ◽  
Piyush Durani ◽  
Chris M Hobbs ◽  
Philip S Sauvé
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Plate Fixation ◽  
Lateral View ◽  
Volar Locking Plate ◽  
Perfect Agreement ◽  
Bone Model ◽  
Observer Reliability ◽  
Screw Penetration ◽  
Screw Threads

Background The fluoroscopic detection of dorsal screw protrusion following volar locking plate fixation of distal radius fractures remains difficult. The carpal shoot through view has recently been reported to result in a 17% intra-operative screw exchange rate. The aim of the current study was to assess the sensitivity of the carpal shoot through view in comparison to conventional fluoroscopic views for detecting dorsal cortical and distal radio-ulnar joint screw penetration. Methods A volar locking plate was applied to a saw bone model and fluoroscopic views taken with the distal screws inserted flush or protruding by two full screw threads. Images were then shown to 10 orthopaedic surgeons who were asked to identify excessively long screws. Results The CST view demonstrated the greatest sensitivity for detection of dorsal screw penetration (78%). Its inter-observer reliability was 0.66 (substantial agreement) and intra-observer reliability 0.86 (near perfect agreement). The dorsal skyline had a sensitivity of 51%; the elevated lateral view had a sensitivity of only 16%. Conclusions The current study confirms that the elevated lateral view cannot be relied upon alone for the detection of dorsal screw penetration. The CST view is a valid technique demonstrating the greatest sensitivity in comparison to established intra-operative views.

Development of Advanced Mechanical System for 3-D Full-Scale Earthquake Testing Facility

2002 ◽  
Author(s):  
Shintaro Watanabe ◽  
Kazuhiko Maekawa ◽  
Yasuyuki Tanaka ◽  
Akesi Koike ◽  
Yukiharu Yamasaki
Keyword(s):  
Full Scale ◽  
Shaking Table ◽  
Test Facility ◽  
Wave Form ◽  
Low Friction ◽  
3 Dimensional ◽  
Large Size ◽  
Testing Facility ◽  
Ring Seal ◽  
Hyogo Prefecture

The largest 3-dimensional vibration test facility is being constructed in Japan’s Hyogo Prefecture. The objective of this facility is to assist the investigation on the process of the collapsing phenomena of a full-scale structure in an earthquake. This facility has a large size shaking table (15 m × 20 m), with a payload of 12 MN. Actuators are connected to the shaking table via 3-D links. In order to reduce the distortion of accelaration wave form, low friction tribo-elements are employed in the actuators; a hydrostatic bearing for rod supports, a pressure balanced seal for pistons, a floating ring seal for 3-dimensional joints. Since these elements are large and heavily loaded, the deformation of them are relatively large compared to the oil film gap in the elements and make design difficult. The paper exhibits the tribological performance of the actuators and joints.

Usefulness of Three-dimensional Full-scale Models for Simulating and Facilitating Corrective Osteotomy of Malunited Forearm Bones

2011 ◽  
Vol 36 (8) ◽  
pp. 44-45 ◽  
Author(s):  
Kazuki Kuniyoshi ◽  
Shinobu Saito ◽  
Jin Takahashi ◽  
Takane Suzuki ◽  
Nahoko Iwakura ◽  
...  
Keyword(s):  
Corrective Osteotomy ◽  
Three Dimensional ◽  
Full Scale ◽  
Scale Models ◽  
Forearm Bones

scholarly journals 3D Alternating Direction TV-Based Cone-Beam CT Reconstruction with Efficient GPU Implementation

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Ailong Cai ◽  
Linyuan Wang ◽  
Hanming Zhang ◽  
Bin Yan ◽  
Lei Li ◽  
...  
Keyword(s):  
Total Variation ◽  
Cone Beam Ct ◽  
Cone Beam ◽  
Ct Reconstruction ◽  
Image Size ◽  
Numerical Accuracy ◽  
Alternating Direction ◽  
Heavy Burden ◽  
Ct Data ◽  
Gpu Implementation

Iterative image reconstruction (IIR) with sparsity-exploiting methods, such as total variation (TV) minimization, claims potentially large reductions in sampling requirements. However, the computation complexity becomes a heavy burden, especially in 3D reconstruction situations. In order to improve the performance for iterative reconstruction, an efficient IIR algorithm for cone-beam computed tomography (CBCT) with GPU implementation has been proposed in this paper. In the first place, an algorithm based on alternating direction total variation using local linearization and proximity technique is proposed for CBCT reconstruction. The applied proximal technique avoids the horrible pseudoinverse computation of big matrix which makes the proposed algorithm applicable and efficient for CBCT imaging. The iteration for this algorithm is simple but convergent. The simulation and real CT data reconstruction results indicate that the proposed algorithm is both fast and accurate. The GPU implementation shows an excellent acceleration ratio of more than 100 compared with CPU computation without losing numerical accuracy. The runtime for the new 3D algorithm is about 6.8 seconds per loop with the image size of256×256×256and 36 projections of the size of512×512.

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