Abstract:
OBJECTIVE:The open reduction and internal fixation of radial shaft fractures and osteotomies with standard 3.5-mm plates can be complicated by tendon irritation, hardware prominence, and fracture through the screw holes. With the advent of locking plate technology, implant companies and some surgeons have recommended expanding the indications for these devices; for example, using smaller, low-profile locking plates to suffice where a standard, larger plate would traditionally be used. We analyzed whether there is merit to this strategy. We hypothesized that, in an established cadaveric fracture fixation model, a smaller, low-profile plate with multiple locking screws could maintain adequate fixation stiffness with the potential to minimize hardware-related complications. METHODS:Seven matched pairs of fresh-frozen cadaver radii were used. A 5-mm osteotomy gap was created at the midpoint of each specimen and the simulated fracture in one radius from each pair was fixed with a 3.5-mm plate and six nonlocking, standard screws. The contralateral radius was fixed using an equivalent-length 2.7-mm plate with eight locking screws. The radii were subjected to controlled bending and torsional loads and the bending and torsional stiffnesses were documented. Cyclic dorsal-to-volar bending was then applied and resistance to fatigue bending assessed. RESULTS:The 2.7-mm locking plate was approximately one third as stiff as the 3.5-mm nonlocking plate (P < 0.02). Under physiological loading conditions, the 3.5-mm plate was superior to the 2.7-mm plate with respect to bending stiffness in all four directions, torsional stiffness in both directions, osteotomy gapping, and osteotomy angulation (P < 0.02 for all tests). The performance gap did not narrow with cyclic testing. CONCLUSIONS:The theoretical structural benefit from the locking screws did not make up for the smaller size of the 2.7-mm plate. This held true in all bending planes, torsion, and cyclic loading, and outweighed any biologic differences between the specimens, including the presence or absence of osteoporosis. This is the first study to rigorously compare these two constructs and we conclude that the mechanical properties of the standard 3.5-mm plate are superior to the locking 2.7-mm plate in all regimes tested.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Garrigues GE,Glisson RR,Garrigues NW,Richard MJ,Ruch DSdoi
10.1097/BOT.0b013e3181f8bf9bsubject
Has Abstractpub_date
2011-06-01 00:00:00pages
347-54issue
6eissn
0890-5339issn
1531-2291pii
00005131-201106000-00006journal_volume
25pub_type
杂志文章abstract::Although there is little doubt that arthroplasty of one form or another is appropriate treatment for many patients with a displaced femoral neck fracture, there is ongoing controversy about the relative merits of different types of arthroplasty among specific groups of patients. In particular, total hip arthroplasty i...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e3181761490
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:This study tests the bone debridement efficacy and damage to cancellous bone produced by different wound irrigation methods. METHODS:Cancellous bone slices of bovine distal femurs (3 cm x 3 cm) were divided into eight test groups and scored with a saw in a latticed pattern. Four test groups were contaminated...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31802b41e2
更新日期:2006-11-01 00:00:00
abstract::A retrospective review of 39 fractures of the femur in 37 patients caused by low- and mid-velocity handgun missiles treated with static interlocking nailing within 18 h of injury was conducted to evaluate the efficacy, safety, and cost savings of immediate intramedullary nailing in these injuries. Patients were follow...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199404000-00010
更新日期:1994-01-01 00:00:00
abstract::When attempting to remove an intramedullary nail, the extraction device can fail. This can occur due to stripping of the proximal threads or, more rarely, due to entrapped broken metal devices (impacted cap screws; broken introducers, extractors, or taps). This latter situation is particularly problematic if access to...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199702000-00012
更新日期:1997-02-01 00:00:00
abstract::We report an isolated anterior dislocation of the radial head in an adult after sustaining a fall on the outstretched arm. Based on history and presentation, we speculate that the injury occurred in a position of hyperextension and supination. Reduction was achieved by a pronation maneuver. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199505000-00014
更新日期:1995-01-01 00:00:00
abstract:OBJECTIVE:To determine if cancellous screw (CS) and sliding hip screw (SHS) technical factors during low-energy femoral neck fracture fixation affects a 24-month revision surgery rate and health-related quality of life (HRQL). DESIGN:Prospective randomized controlled study. SETTING:International, multicenter. PATIEN...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001891
更新日期:2021-02-01 00:00:00
abstract:OBJECTIVE:To determine whether stimulation with low-intensity ultrasound will reduce the radiologic healing time of fresh tibial shaft fractures fixed with a reamed and statically locked intramedullary rod. DESIGN:Prospective, randomized, double blinded, and placebo controlled. PATIENTS AND METHODS:Thirty-two adult p...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005131-199905000-00005
更新日期:1999-05-01 00:00:00
abstract::Salvage of limb length following oblique proximal foot amputations is presented. The technique, results, and follow-up of this procedure are described and compared with other standard procedures. A prospective study was done on 3 adolescents who presented consecutively during years 1999 and 2000. The salvage procedure...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000164168.94365.49
更新日期:2005-04-01 00:00:00
abstract::The current literature tends to favor rigid internal fixation with plates for symptomatic midclavicular nonunions. From 1985 to 1992, 14 patients with clavicular nonunions were treated by open reduction and intramedullary Steinman pin fixation with onlay iliac crest bone grafting. The average age of patients was 36 ye...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199404000-00002
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:Evaluate the ability of osteogenic protein-1 to induce formation of de novo bone in the presence of bacterial infection and metal in an intramuscular osteoinduction model in the rat. DESIGN:Prospective experimental design with assessment time points of up to 4 weeks. SETTING:Intramuscular pocket surgically ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200408000-00008
更新日期:2004-08-01 00:00:00
abstract:OBJECTIVE:This review aims to summarize current knowledge regarding the underlying patho-mechanisms of delayed fracture healing in polytraumatized patients. DATA SOURCES AND STUDY SELECTION:The following search terms were used: "fracture", "hemorrhage," "chest trauma," "inflammation," "inflammatory response," "fractur...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,meta分析,评审
doi:10.1097/BOT.0000000000000489
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES:To compare the risks of surgical site infection (SSI) and postoperative complications after acetabular fracture open reduction internal fixation (ORIF) in patients receiving topical intrawound antibiotic powder compared to those not receiving antibiotic powder (control group). DESIGN:Retrospective cohort SE...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001943
更新日期:2020-09-02 00:00:00
abstract:OBJECTIVE:To report our experience with computed tomography (CT) scans to detect traumatic arthrotomies of the knee (TAK) joint based on the presence of intra-articular air. DESIGN:Retrospective review. SETTING:Level I trauma center. PATIENTS:Sixty-two consecutive patients (63 knees) underwent a CT scan of the knee ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31828219bc
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine the results of computed tomography angiography (CTA) obtained in patients with high-energy tibial plafond fractures and assess if the information gleaned from CTA could be useful to the treating orthopedic surgeon. DESIGN:Consecutive patient series. SETTING:Level 2 t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31815cf6e9
更新日期:2008-01-01 00:00:00
abstract::A prospective randomized study was set up, comparing a compression hip screw with the Vandeputte (VDP) endoprosthesis treatment for fresh, unstable peritrochanteric fractures, according to the Evans-Jensen and AO systems. Ninety patients, ages > or = 70 years, 47 of whom were treated with a compression hip screw and 4...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005131-199509040-00004
更新日期:1995-01-01 00:00:00
abstract:OBJECTIVES:The aim of this study was analyze modes of mechanical failure in a consecutive cohort of patients and establish possible risk factors. DESIGN:This was a retrospective cohort study. SETTING:The study was conducted at an academic level-1 trauma center. PATIENTS:Twenty-nine patients (mean age 56 years, range...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318251930d
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Fractures of the femur above a total knee arthroplasty (TKA) are becoming increasingly common in the osteoporotic, aging populations of developed countries. Treatment of these fractures is complicated by the presence of a knee prosthesis, frequently limiting the bone available for distal fracture fixation. T...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31822c050b
更新日期:2012-07-01 00:00:00
abstract::A case is presented of scaphocapitate fracture syndrome associated with a Salter-Harris type II fracture of the distal radius and ulna occurring in an 11-year-old girl. The proximal fragment of the fractured capitate was rotated 180 degrees. The injury was treated by open reduction and internal fixation. One year afte...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199704000-00017
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVES:Controversy exists regarding optimum management of lateral compression type 1 (LC1) pelvic ring injuries (OTA type 61-B2.1), particularly in patients with complete sacral fractures. We hypothesized that nonoperative treatment would result in acceptable functional outcomes. DESIGN:Database review. SETTING:L...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000130
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVES:The stiffness of locking plates provide increased stability for early fracture healing but may limit late interfragmentary motion (IFM) necessary for secondary bone healing. An ideal plating construct would provide early rigidity and late flexibility to optimize bone healing. A novel screw plate construct ut...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001664
更新日期:2020-03-01 00:00:00
abstract::Difficulty in maintaining the reduction of displaced radial fractures has prompted the use of numerous techniques to address this problem. The purpose of this study was to determine if four or five 0.045-in Kirschner pins when placed percutaneously through the ulna into the radius could maintain the reduction of this ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-198906000-00004
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVES:To compare the strength of fixation of percutaneous screw versus plate/screw fixation in a paired cadaver model of OTA 41-B3 (Schatzker type II) split-depression fractures of the lateral tibial plateau. METHODS:Six matched pairs of cadaveric knees were acquired. An OTA 41-B3 (Schatzker type II) split-depres...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001177
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVES:Long bone fractures that fail to heal or show a delay in healing can lead to increased morbidity. Bone marrow aspirate concentrate (BMAC) containing bone mesenchymal stem cells (BMSCs) has been suggested as an autologous biologic adjunct to aid long bone healing. The purpose of this study was to systematical...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000453
更新日期:2016-01-01 00:00:00
abstract::We present a case of a 19-year-old woman with a closed diaphyseal femur fracture and who had fixation of the fracture using a newer lateral entry nail, which resulted in an intraoperative proximal femur fracture. The patient underwent revision the following day and subsequently returned to regular activity without sig...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181a53790
更新日期:2010-04-01 00:00:00
abstract::Understanding complex acetabular fractures is difficult and may require three-dimensional reformatted computed tomographic (CT) images. This paper evaluates a technique, digital rotational imaging (DRI), that displays multiple oblique images of the pelvis and acetabulum. When viewed statically, DRI provides optimal il...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199801000-00011
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVES:To compare reports of implant fatigue failure submitted to the FDA of 2 commonly used cephalomedullary nails. METHODS:In total, 2724 medical device reports from the FDA's MAUDE database from Jan 2015 to Oct 2019 were reviewed for the Trochanteric Femoral Nail-Advanced (TFNa) and Gamma 3 implants. RESULTS:D...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001864
更新日期:2021-02-01 00:00:00
abstract:OBJECTIVES:To compare the abductor muscle function and trochanteric tenderness in patients operated with hemiarthroplasty using the direct lateral (DL) or posterolateral (PL) approach for displaced femoral neck fracture. DESIGN:Prospective cohort study. SETTING:A secondary teaching hospital. PARTICIPANTS:We enrolled...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000532
更新日期:2016-06-01 00:00:00
abstract::In our search for an osteosynthesis device that would tolerate the surgical errors of the inexperienced surgeon, we tested in vitro femoral stiffness in 75 human osteoporotic femora after internal fixation of a cervical neck osteotomy using three commonly used devices: two von Bahr screws (A. Ericsson AB, Sweden), two...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199608000-00009
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVE:To determine if a dual-purpose bone graft can regenerate bone and reduce infection in highly contaminated bone critical size defects in rats. METHODS:Biodegradable polyurethane (PUR) scaffolds were loaded with recombinant human bone morphogenetic protein-2 (BMP-2) and vancomycin (Vanc). The release kinetics ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31821f624c
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVES:This cadaveric study sought to evaluate the accuracy of syndesmotic reduction using direct visualization via an anterolateral approach compared with palpation of the syndesmosis through a laterally based incision. METHODS:Ten cadaveric specimens were obtained and underwent baseline computed tomography (CT) ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001322
更新日期:2019-01-01 00:00:00