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

scholarly journals Can the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score Be Reliably Administered Over the Phone? A Randomized Study

2018 ◽  
Vol 6 (8) ◽  
pp. 232596711879151 ◽  
Author(s):  
Brandon J. Erickson ◽  
Peter N. Chalmers ◽  
Jon Newgren ◽  
Marissa Malaret ◽  
Michael O’Brien ◽  
...  
Keyword(s):  
Functional Assessment ◽  
Power Analysis ◽  
Assessment Tool ◽  
A Priori ◽  
Randomized Study ◽  
Intraclass Correlation ◽  
Level Of Evidence ◽  
Orthopaedic Clinic ◽  
Significant Difference ◽  
A Priori Power Analysis

Background: The Kerlan-Jobe Orthopaedic Clinic (KJOC) shoulder and elbow outcome score is a functional assessment tool for the upper extremity of the overhead athlete, which is currently validated for administration in person. Purpose/Hypothesis: The purpose of this study was to validate the KJOC score for administration over the phone. The hypothesis was that no difference will exist in KJOC scores for the same patient between administration in person versus over the phone. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Fifty patients were randomized to fill out the KJOC questionnaire either over the phone first (25 patients) or in person first (25 patients) based on an a priori power analysis. One week after the patients completed the initial KJOC on the phone or in person, they then filled out the score via the opposite method. Results were compared per question and for overall score. Results: There was a mean ± SD of 8 ± 5 days between when patients completed the first and second questionnaires. There were no significant differences in the overall KJOC score between the phone and paper groups ( P = .139). The intraclass correlation coefficient comparing paper and phone scores was 0.802 (95% CI, 0.767-0.883; P < .001), with a Cronbach alpha of 0.89. On comparison of individual questions, there were significant differences for questions 1, 3, and 8 ( P = .013, .023, and .042, respectively). Conclusion: The KJOC questionnaire can be administered over the phone with no significant difference in overall score as compared with that from in-person administration.

scholarly journals Efficiency of phototherapy in patients with mycosis fungoides: preliminary results of a comparative non-randomized study

2020 ◽  
Vol 96 (5) ◽  
pp. 24-30
Author(s):  
A. E. Karamova ◽  
M. B. Zhilova ◽  
L. F. Znamenskaya ◽  
A. A. Vorontsova
Keyword(s):  
Mycosis Fungoides ◽  
Assessment Tool ◽  
Research Evaluation ◽  
Therapy Group ◽  
Randomized Study ◽  
Skin Lesions ◽  
Puva Therapy ◽  
Level Of Evidence ◽  
European Organization ◽  
Significant Difference

Clinical reasoning. There is a need to optimize the use of UV-B-311 nm and PUVA-therapy in patients with mycosis fungoides to determine the duration of the treatment regimen, the number of sessions per week, and ultraviolet irradiation regimen. Goal of research. Evaluation of the effect of the type and duration phototherapy on efficacy in patients with mycosis fungoides. Principle. A comparative, non-randomized study of the effectiveness of phototherapy in patients with mycosis fungoides in the early stages. Evaluation of the effectiveness of UV-B-311 nm and PUVA therapy was performed using the BSA index (area of skin lesions) and Modified Severity-Weighted Assessment Tool (mSWAT), as well as according to the criteria proposed by the International Society for Skin Lymphomas (ISCL), the European Organization for the Study and Cancer Treatment (EORTC) and United States Cutaneous Lymphoma Consortium (USCLC). Results. The study included 14 patients with mycosis fungoides, 5 of whom received treatment with UV-B-311 nm, 9 PUVA therapy. A strong correlation was found between the duration of UV-B-311 nm therapy with mSWAT delta (R = 0.90; p = 0.038) and BSA delta (R = 0.90; p = 0.038), while similar correlation was not found in the PUVA-therapy group (mSWAT (R = 0.24; p = 0.527); BSA (R = 0.09; p = 0.823)). When comparing the effectiveness of therapy between the treatment group UV-B-311 nm and PUVA therapy, delta mSWAT and BSA at the 20th procedure, delta mSWAT and BSA after the end of therapy did not have a statistically significant difference between the UVB-311 nm and PUVA groups. Conclusion. Statistically significant correlation was found between the number of procedures and the effectiveness of therapy In the UV-B-311 nm group. An increase in the number of PUVA therapy procedures (after 20) does not lead to a statistically significant increase in the effectiveness of treatment. Additional research is needed to increase the level of evidence of the results and develop optimal phototherapy regimens.

scholarly journals Comminuted olecranon fractures: locking compression plate fixation verses conventional plate fixation

2021 ◽  
Vol 7 (5) ◽  
pp. 1001
Author(s):  
Neetin P. Mahajan ◽  
Mrugank A. Narvekar ◽  
Lalkar L. Gadod ◽  
G. S. Prasanna Kumar
Keyword(s):  
Plate Fixation ◽  
Normal Function ◽  
Locking Compression Plate ◽  
Locking Plates ◽  
Plate Group ◽  
Significant Difference ◽  
Compression Plate ◽  
Conventional Plate ◽  
Olecranon Fractures

<p class="abstract"><strong>Background:</strong> A variable consensus exists on the optimal management strategies for olecranon fractures. Though the mechanical properties of the conventional plates and the locking plates used show no difference, pre-contoured locking plates provide a significant advantage over non-locking plates in unstable fractures. The aim of the study was to compare clinical and radiological outcomes in the management of the comminute olecranon fractures by anatomically pre-contoured locking compression plates and the conventional plates.</p><p class="abstract"><strong>Methods:</strong> The present study was a prospective study of 50 patients with comminuted olecranon fracture, with 25 patients each randomized into two groups, those that underwent fixation of the fracture using a pre-contoured locking compression plate (group LCP) and those fixed using a conventional plate (3.5 mm reconstruction plate) (group CP). Patients were followed up to 1 year with functional outcome assessed at each follow-up with Mayo elbow performance score.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean MEPS (LCP vs CP) at 1.5 (47 vs. 43.4) and 3 (67.4 vs 61.6) months follow up showed a statistically significant difference between the two groups, but the difference was not significant at 6 (86.4 vs 85.6) and 12 (88.4 vs 87) months. The time to union (4.3 months vs 5.0 months) was not significantly different between the groups. There were 11 complications in group LCP and 12 complications in group CP.</p><p class="abstract"><strong>Conclusions:</strong> In the present study, we suggest that the use of a pre-contoured locking compression plate provides better outcomes at earlier periods as compared to the conventional plate; thus, returning the patient to normal function at the earliest.</p>

scholarly journals A comparison of subtraction MRI with the standard contrast-enhanced imaging in Perthes’ disease

2019 ◽  
Vol 13 (1) ◽  
pp. 82-88 ◽  
Author(s):  
K. Jamil ◽  
T. Walker ◽  
E. Onikul ◽  
C. F. Munns ◽  
D. G. Little
Keyword(s):  
Femoral Head ◽  
Randomized Study ◽  
Perfusion Index ◽  
Perthes Disease ◽  
Diagnostic Study ◽  
Subtraction Technique ◽  
Level Of Evidence ◽  
Enhanced Mri ◽  
Significant Difference ◽  
Before And After

Purpose Perthes’ disease (PD) results from loss of blood supply to the hip and can progress to femoral head deformity. MRI in the early course of the disease can provide data on the initial extent of infarct. Vascularity of the femoral head is assessed by gadolinium-enhanced MRI (contrast MRI), which may be improved by the digital subtraction technique (subtraction MRI). We hypothesized that gadolinium-enhanced MRI without subtraction was comparable with subtraction MRI in depicting the femoral head perfusion. Methods In all, 34 patients (34 hips) with unilateral PD had gadolinium-enhanced MRI as part of a prospectively randomized study. Nine patients had three MRIs, 15 had two and ten had a single MRI. Measurement of perfusion of the femoral head (MRI perfusion index) was obtained using digital image analysis on all the MRIs, including both before and after subtraction. A paired sample t-test was performed to compare the measurements. Results The mean age of the patients was 8.9 years (sd 1.6). At the time of diagnosis, the subtraction MRI did not elicit a statistically significant difference in MRI perfusion index measurements when compared with the contrast MRI (p = 0.19). The same findings were found when including all patients at various stages of the disease (p = 0.30). Qualitatively, although some subtraction MRI images showed superior delineation of epiphysis, there are no significant differences throughout the whole series. Conclusion Although the current literature supports the increasing role of the subtraction MRI for PD management, our study proposed that the contrast MRI without subtraction technique appears adequate in assessing femoral head perfusion. Level of Evidence: Level I - Diagnostic study

Comparison of digital nerve sensory recovery after repair using loupe or operating microscope magnification

2014 ◽  
Vol 40 (6) ◽  
pp. 608-613 ◽  
Author(s):  
P. R. Thomas ◽  
R. J. Saunders ◽  
K. R. Means
Keyword(s):  
Nerve Repair ◽  
Operating Microscope ◽  
Digital Nerve ◽  
Nerve Injuries ◽  
Level Of Evidence ◽  
Visual Analogue Pain ◽  
Pain Scores ◽  
Significant Difference ◽  
Sensory Recovery ◽  
Loupe Magnification

Our purpose was to determine whether there was a significant difference in sensory recovery after digital nerve repair using loupe magnification or an operating microscope. We identified patients aged 21–75 who had primary proper digital nerve repairs at least 24 months before our study. A total of 12 patients with 13 digital nerve injuries repaired with loupe magnification and nine patients with 12 digital nerve injuries repaired using the operating microscope, agreed to return for assessment by a therapist blinded to treatment. We found no significant difference in sensory recovery between the two groups as measured by static two-point discrimination, moving two-point discrimination, and Semmes–Weinstein monofilament. There were also no significant differences in average Disabilities of the Arm Shoulder and Hand or visual analogue pain scores. Level of evidence: IV

Clinical comparison of hook plate fixation versus extension block pinning for bony mallet finger: a retrospective comparison study

2015 ◽  
Vol 40 (8) ◽  
pp. 832-839 ◽  
Author(s):  
M. A. Acar ◽  
Y. Güzel ◽  
A. Güleç ◽  
G. Uzer ◽  
M. Elmadağ
Keyword(s):  
Return To Work ◽  
Plate Fixation ◽  
Hook Plate ◽  
Dash Score ◽  
Level Of Evidence ◽  
Plate Group ◽  
Retrospective Comparison ◽  
Intraoperative Fluoroscopy ◽  
Distal Interphalangeal ◽  
Joint Range

The aim of this retrospective study was to determine whether traumatic mallet fractures had better outcomes when treated by hook plate fixation (13 patients) or extension block pinning (19 patients). We assessed outcomes using Crawford’s criteria; distal interphalangeal joint range of motion; the DASH score; and a visual analogue scale score for pain. We measured radiological parameters. No significant differences were observed in functional and clinical outcomes and in complications. Whereas the operative time was longer in the hook plate group, intraoperative fluoroscopy use, time to bone union and time to return to work were greater in the extension block group. Although the hook plate method is more technically demanding, it provides good stable reduction, earlier mobilization and an earlier return to work. The extension block pinning technique is easier and as effective but it requires greater peri-operative fluoroscopy. Level of evidence: Level III

scholarly journals CLINICAL EVALUATION OF THE TREATMENT OF CLAVICLE FRACTURES: INTRAMEDULLARY NAIL × PLATE

2021 ◽  
Vol 29 (1) ◽  
pp. 34-38
Author(s):  
THIAGO MEDEIROS STORTI ◽  
MAURÍCIO SIQUEIRA CAMILO ◽  
RAFAEL FRANCISCO ALVES SILVA ◽  
RAFAEL SALOMON SILVA FARIA ◽  
CAROLINA LIMA SIMIONATTO ◽  
...  
Keyword(s):  
Intramedullary Nail ◽  
Plate Fixation ◽  
Clavicle Fracture ◽  
Nail Plate ◽  
Surgical Techniques ◽  
Pain Scale ◽  
Shoulder Function ◽  
Level Of Evidence ◽  
Plate Group ◽  
Clavicle Fractures

ABSTRACT Objective: Studies confirm the benefit of surgical treatment for fixation of displaced midshaft clavicle fractures. Plate fixation and intramedullary nail are the two most used techniques. Our study seeks to compare these two surgical techniques. Methods: This is a retrospective study, conducted by the evaluation of patients treated for displaced midshaft clavicle fracture with intramedullary nail, and plate and screws. Socioeconomic variables were collected, a visual pain scale questionnaire was applied, the shoulder function was measured using CONSTANT and UCLA scores, and radiography was performed to verify the consolidation and evaluation of the final clavicle shortening. Results: Sixty-five patients were evaluated, 36 (55.4%) of which were subjected to clavicle fixation with plate and screws and 29 (44.6%) with intramedullary nail. The median shortening was 0.1mm for plate and 5.8mm for nail (p = 0.001). The UCLA score shows an average of 35 in the plate group and 35 in the intramedullary group. The median CONSTANT scores were 96.5 for plate and 95 for nail, without significance. In all groups, 13 (20%) complications were registered, 9 fixed with plate and 4 fixed with intramedullary nail. The most common complication was skin erosion with exposure of the synthetic material. Conclusion: The two techniques present satisfactory results for the treatment of displaced midshaft clavicle fractures. Level of Evidence III, Therapeutic Studies Investigating the Results of Treatment.

scholarly journals Biomechanical analysis of occipitocervical stabilization techniques: emphasis on integrity of osseous structures at the occipital implantation sites

2020 ◽  
Vol 33 (2) ◽  
pp. 138-147
Author(s):  
Bryan W. Cunningham ◽  
Kyle B. Mueller ◽  
Kenneth P. Mullinix ◽  
Xiaolei Sun ◽  
Faheem A. Sandhu
Keyword(s):  
Fatigue Testing ◽  
Plate Fixation ◽  
Axial Rotation ◽  
Biomechanical Analysis ◽  
Lateral Bending ◽  
Mineral Density ◽  
Plate Group ◽  
Significant Difference ◽  
Flexion Extension ◽  
Implantation Sites

OBJECTIVEThe objective of the current study was to quantify and compare the multidirectional flexibility properties of occipital anchor fixation with conventional methods of occipitocervical screw fixation using nondestructive and destructive investigative methods.METHODSFourteen cadaveric occipitocervical specimens (Oc–T2) were randomized to reconstruction with occipital anchors or an occipital plate and screws. Using a 6-degree-of-freedom spine simulator with moments of ± 2.0 Nm, initial multidirectional flexibility analysis of the intact and reconstructed conditions was performed followed by fatigue loading of 25,000 cycles of flexion-extension (x-axis, ± 2.0 Nm), 15,000 cycles of lateral bending (z-axis, ± 2.0 Nm), and 10,000 cycles of axial rotation (y-axis, ± 2.0 Nm). Fluoroscopic images of the implantation sites were obtained before and after fatigue testing and placed on an x-y coordinate system to quantify positional stability of the anchors and screws used for reconstruction and effect, if any, of the fatigue component. Destructive testing included an anterior flexural load to construct failure. Quantification of implant, occipitocervical, and atlantoaxial junction range of motion is reported as absolute values, and peak flexural failure moment in Newton-meters (Nm).RESULTSAbsolute value comparisons between the intact condition and 2 reconstruction groups demonstrated significant reductions in segmental flexion-extension, lateral bending, and axial rotation motion at the Oc–C1 and C1–2 junctions (p < 0.05). The average bone mineral density at the midline keel (1.422 g/cm3) was significantly higher compared with the lateral occipital region at 0.671 g/cm3 (p < 0.05). There were no significant differences between the occipital anchor and plate treatments in terms of angular rotation (degrees; p = 0.150) or x-axis displacement (mm; p = 0.572), but there was a statistically significant difference in y-axis displacement (p = 0.031) based on quantitative analysis of the pre- and postfatigue fluoroscopic images (p > 0.05). Under destructive anterior flexural loading, the occipital anchor group failed at 90 ± 31 Nm, and the occipital plate group failed at 79 ± 25 Nm (p > 0.05).CONCLUSIONSBoth reconstructions reduced flexion-extension, lateral bending, and axial rotation at the occipitocervical and atlantoaxial junctions, as expected. Flexural load to failure did not differ significantly between the 2 treatment groups despite occipital anchors using a compression-fit mechanism to provide fixation in less dense bone. These data suggest that an occipital anchor technique serves as a biomechanically viable clinical alternative to occipital plate fixation.

scholarly journals Intramedullary nail fixation versus locking plate fixation for adults with a fracture of the distal tibia: the UK FixDT RCT

2018 ◽  
Vol 22 (25) ◽  
pp. 1-148 ◽  
Author(s):  
Matthew L Costa ◽  
Juul Achten ◽  
Susie Hennings ◽  
Nafisa Boota ◽  
James Griffin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Locking Plate ◽  
Plate Fixation ◽  
Distal Tibia ◽  
Locking Plate Fixation ◽  
Fixation Group ◽  
Plate Group ◽  
Significant Difference

BackgroundThe best treatment for fractures of the distal tibia remains controversial. Most of these fractures require surgical fixation, but the outcomes are unpredictable and complications are common.ObjectivesTo assess disability, quality of life, complications and resource use in patients treated with intramedullary (IM) nail fixation versus locking plate fixation in the 12 months following a fracture of the distal tibia.DesignThis was a multicentre randomised trial.SettingThe trial was conducted in 28 UK acute trauma centres from April 2013 to final follow-up in February 2017.ParticipantsIn total, 321 adult patients were recruited. Participants were excluded if they had open fractures, fractures involving the ankle joint, contraindication to nailing or inability to complete questionnaires.InterventionsIM nail fixation (n = 161), in which a metal rod is inserted into the hollow centre of the tibia, versus locking plate fixation (n = 160), in which a plate is attached to the surface of the tibia with fixed-angle screws.Main outcome measuresThe primary outcome measure was the Disability Rating Index (DRI) score, which ranges from 0 points (no disability) to 100 points (complete disability), at 6 months with a minimum clinically important difference of 8 points. The DRI score was also collected at 3 and 12 months. The secondary outcomes were the Olerud–Molander Ankle Score (OMAS), quality of life as measured using EuroQol-5 Dimensions (EQ-5D), complications such as infection, and further surgery. Resource use was collected to inform the health economic evaluation.ResultsParticipants had a mean age of 45 years (standard deviation 16.2 years), were predominantly male (61%, 197/321) and had experienced traumatic injury after a fall (69%, 223/321). There was no statistically significant difference in DRI score at 6 months [IM nail fixation group, mean 29.8 points, 95% confidence interval (CI) 26.1 to 33.7 points; locking plate group, mean 33.8 points, 95% CI 29.7 to 37.9 points; adjusted difference, 4.0 points, 95% CI –1.0 to 9.0 points;p = 0.11]. There was a statistically significant difference in DRI score at 3 months in favour of IM nail fixation (IM nail fixation group, mean 44.2 points, 95% CI 40.8 to 47.6 points; locking plate group, mean 52.6 points, 95% CI 49.3 to 55.9 points; adjusted difference 8.8 points, 95% CI 4.3 to 13.2 points;p < 0.001), but not at 12 months (IM nail fixation group, mean 23.1 points, 95% CI 18.9 to 27.2 points; locking plate group, 24.0 points, 95% CI 19.7 to 28.3 points; adjusted difference 1.9 points, 95% CI –3.2 to 6.9 points;p = 0.47). Secondary outcomes showed the same pattern, including a statistically significant difference in mean OMAS and EQ-5D scores at 3 and 6 months in favour of IM nail fixation. There were no statistically significant differences in complications, including the number of postoperative infections (13% in the locking plate group and 9% in the IM nail fixation group). Further surgery was more common in the locking plate group (12% in locking plate group and 8% in IM nail fixation group at 12 months). The economic evaluation showed that IM nail fixation provided a slightly higher quality of life in the 12 months after injury and at lower cost and, therefore, it was cost-effective compared with locking plate fixation. The probability of cost-effectiveness for IM nail fixation exceeded 90%, regardless of the value of the cost-effectiveness threshold.LimitationsAs wound dressings after surgery are clearly visible, it was not possible to blind the patients to their treatment allocation. This evidence does not apply to intra-articular (pilon) fractures of the distal tibia.ConclusionsAmong adults with an acute fracture of the distal tibia who were randomised to IM nail fixation or locking plate fixation, there were similar disability ratings at 6 months. However, recovery across all outcomes was faster in the IM nail fixation group and costs were lower.Future workThe potential benefit of IM nail fixation in several other fractures requires investigation. Research is also required into the role of adjuvant treatment and different rehabilitation strategies to accelerate recovery following a fracture of the tibia and other long-bone fractures in the lower limb. The patients in this trial will remain in longer-term follow-up.Trial registrationCurrent Controlled Trials ISRCTN99771224 and UKCRN 13761.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 22, No. 25. See the NIHR Journals Library website for further project information.

scholarly journals Clinical outcomes of Ahmed glaucoma valve implantation without fixation of a plate: The free plate technique

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241886
Author(s):  
Han Min Lee ◽  
Kee Sup Park ◽  
Yoo Young Jeon ◽  
Woo Jin Kim ◽  
Nam Ho Lee ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Success Rate ◽  
Plate Fixation ◽  
Case Series ◽  
Good Alternative ◽  
Ahmed Glaucoma Valve ◽  
Refractory Glaucoma ◽  
Case Series Study ◽  
Significant Difference ◽  
Hypertensive Phase

Objective This study compared surgical outcomes between free plate Ahmed glaucoma valve (FPAGV) implantation without plate fixation and conventional Ahmed glaucoma valve (CAGV) implantation with plate fixation. Methods A retrospective, comparative case series study. Patients with refractory glaucoma who underwent FPAGV or CAGV implantation and were followed >1 year were enrolled consecutively. We reviewed medical records, including data on postoperative intraocular pressure (IOP) and postoperative complications. The success rate and early postoperative hypertensive phase were compared between groups. Results A total of 74 patients with CAGV implantations and 36 patients with FPAGV implantations were studied. The average follow-up periods were 23.3 ± 2.6 months (CAGV) and 22.8 ± 2.8 months (FPAGV; p = 0.424). The surgery time was significantly shorter in the FPAGV group than in the CAGV group (42.6 ± 4.1 vs. 47.3 ± 5.4 min; p < 0.001). Postoperative IOP at 1 week and 1 month were significantly lower in the FPAGV group than in the CAGV group (11.8 ± 3.6 and 14.0 ± 5.3 mmHg vs. 18.7 ± 5.5 and 22.2 ± 5.2 mmHg; p = 0.012 and p = 0.002, respectively). An early postoperative hypertensive phase occurred in 62 eyes, and the frequency was greater in the CAGV group (50 eyes) than the FPAGV group (12 eyes; p = 0.001). There was no significant difference in postoperative complications between the two groups (p = 0.735). The success rate was 84.2% in the FPAGV group and 80.6% in the CAGV group 24 months after surgery (p = 0.367). Conclusion FPAGV implantation was associated with a shorter surgery time, without any change in the extent of IOP reduction or complication rate. This procedure may be considered a good alternative for CAGV implantation in patients with refractory glaucoma.

Sign in / Sign up

Export Citation Format

Share Document