Abstract:
:Transverse fractures at the distal tip of a well-fixed femoral prosthesis are difficult to stabilize using plates and screws due to the presence of the underlying intramedullary stem. The attachment of plates using cerclage wires obviates the need for screws, but the stability provided by cerclage plating is a clinical concern. In this study we compared the mechanical performance of three wire-cerclage plating techniques: (a) simple cerclage (each wire wrapped around the bone and plate once); (b) double cerclage (each wire wrapped around the bone and plate twice); and (c) a new method that used small stainless steel inserts that fit into the plate holes and permit the direct coupling of the cerclage wires to the plate. To compare the performance of the three fixation constructs, synthetic femora were osteotomized, stabilized with a wire cerclage plating technique, and subjected to monotonic and cyclic loading using a Materials Testing System (Minneapolis, MN) servo-hydraulic testing system. The performance of each construct was evaluated using seven different mechanical parameters (four monotonic, three cyclic). Double cerclage performed significantly better than did simple cerclage for three of the seven mechanical parameters. The insert technique performed significantly better than did the simple and double cerclage techniques for all seven of the measured mechanical parameters. For both monotonic and cyclic loading, the use of inserts resulted in an improvement in fixation strength and stability in comparison with conventional simple and double cerclage plating techniques. The insert technique shows promise in the treatment of this difficult type of fracture at the distal tip of a well-fixed femoral prosthesis.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Stevens SS,Irish AJ,Vachtsevanos JG,Csongradi J,Beaupré GSdoi
10.1097/00005131-199505000-00004subject
Has Abstractpub_date
1995-01-01 00:00:00pages
381-7issue
5eissn
0890-5339issn
1531-2291journal_volume
9pub_type
杂志文章abstract:PURPOSE:There are an estimated 1.2 million deaths from road traffic injuries annually, disproportionately affecting patients in low-resource settings. The purpose of this scoping review is to identify knowledge gaps in global orthopaedic trauma in an effort to help prioritize future research. METHODS:Using the 6-stage...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000001293
更新日期:2018-10-01 00:00:00
abstract::The fracture classification systems currently used most frequently were not developed or validated by rigorous scientific evaluation methods. This paper discusses the classification of fractures from an epidemiological and clinical decision-making perspective and proposes a standardized methodological concept for thei...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/01.bot.0000155310.04886.37
更新日期:2005-07-01 00:00:00
abstract::Although opioids are widely used for the management of pain in patients with hip fracture, these medications are known to have a wide range of adverse effects that can result in suboptimal outcomes or serious life-threatening complications. Common opioid-related adverse events include gastrointestinal effects, central...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000563
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to report the efficacy of the Kapandji technique performed in the prone position for humeral supracondylar fractures in children. DESIGN:Retrospective. SETTING:Level I trauma center. PATIENTS/PARTICIPANTS:We retrospectively reviewed 34 children with Gartland type III supracond...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000015
更新日期:2014-06-01 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::Reamed intramedullary nailing was used to treat 102 closed tibial shaft fractures. Although a high rate of union was achieved (98%), we noted a higher incidence of complications than previously reported. Thirty-five (37%) patients exhibited one or more components of malunion. In 17 (18%) patients, further operative pr...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199509060-00004
更新日期:1995-01-01 00:00:00
abstract::Standard 5-mm AO Schanz pedicle screws were biomechanically compared with a new design, featuring 6-mm threads with a 5-mm core diameter continuous with the shaft. One each of the two screw designs was surgically inserted into the matching pedicles of 32 cadaveric vertebrae. The pull-out strengths of the screws were t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199308000-00015
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy of anesthetic type on clinical outcomes after operative treatment of distal radius fractures. DESIGN:Retrospective review of prospectively collected data. SETTING:Academic medical center. PATIENTS:One hundred eighty-seven patients with a distal radius fracture (OTA type 23) were ide...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318238becb
更新日期:2012-09-01 00:00:00
abstract::Intracapsular femoral neck fractures are common in the elderly population after a simple fall. However, femoral neck fractures in the physiologically young are less common. Regardless, femoral neck fractures can be a source of significant morbidity and mortality if not treated correctly. Multiple management strategies...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000288
更新日期:2015-04-01 00:00:00
abstract::Fractures of the femur have long been a major cause of morbidity and mortality in developing countries and are most frequently caused by road traffic accidents. Intramedullary nail fixation has become the gold standard of care for diaphyseal fractures of the femur. However, modern techniques require proper implants, a...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,多中心研究
doi:10.1097/BOT.0000000000001407
更新日期:2019-05-01 00:00:00
abstract::Long-bone deformity may be significantly symptomatic. A uniplanar corrective osteotomy uses a single cut to correct coronal, sagittal, and axial plane deformity simultaneously. Careful preoperative planning is required in addition to a comprehensive understanding of the magnitude and plane of the true deformity of the...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001519
更新日期:2019-08-01 00:00:00
abstract::Although Kirschner wires are useful implants in many situations, migration of the wire and irritation of the surrounding soft tissues are common complications. Seven steps are described herein, which result in a Kirschner wire that is bent 180° angle, providing a smooth anchor into bone. Use of this technique produces...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318290f818
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVES:The stacked hexapod bone transport technique is an effective treatment for infected tibial nonunions with bone loss. The purpose of this study was to evaluate the patients' risk factors and timing for requiring adjunctive stabilization. DESIGN:Retrospective cohort study. SETTING:Level 1 trauma center. PAT...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000840
更新日期:2017-07-01 00:00:00
abstract::Fifteen patients with fractures of the extremities and associated arterial injuries treated from 1976 to 1987 were retrospectively analyzed. Complete ischemia was present in only two cases; in four cases with partial ischemia, the vascular injury presented late after 12 h-14 days. All limbs could be preserved, but com...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199103000-00005
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:Ankle fractures are one of the most common operatively treated lower extremity fractures. Several studies indicate that patients often have residual effects after this injury. The purpose of this study is to use the SF-36 questionnaire at two times to assess patients' functional recovery and residual effects ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200201000-00007
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVES:To explore the effect of intramedullary pin size on the biology of a healing fracture, specifically endochondral angiogenesis. We hypothesized that fracture fixation with a smaller pin would permit greater interfragmentary strain resulting in increased total amount of vascular endothelial growth factor withi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001555
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVES:We investigated the role of negative pressure therapy (NPT) in postoperative primary wound treatment and closure. To date, extensive evidence exists demonstrating the benefit of negative pressure dressings in the treatment of open wounds; our experiment tested the hypothesis that negative pressure dressings ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318211363a
更新日期:2011-12-01 00:00:00
abstract::The maximum pullout force in the distal metaphysis of cadaver femurs was investigated using a commercially available, pneumatically inserted staple. In paired studies, a significantly greater pullout force was required in the power-driven staples than in an almost identical sized hand-driven staple. A nonlinear relati...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199004020-00009
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVES:Report the technical aspects, radiographic results, and complications after minimum 1-year follow up of the anterior intra-pelvic (AIP or modified Rives-Stoppa) approach as an alternative to the ilioinguinal approach for the treatment of acetabular fractures. DESIGN:Retrospective review. SETTING:Level I tr...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181dd0b84
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVES:For intramedullary nailing of tibial shaft fractures, a recent study has determined that the entry site should be just medial to the lateral tibial spine at the anterior margin of the articular surface. Gaining access to this site is often through a medial parapatellar or transpatellar approach. Several stud...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200211000-00001
更新日期:2002-11-01 00:00:00
abstract::Recent studies on ankle syndesmosis injuries have shown that a significant amount of rotational malediction of the distal fibula are missed and may lead to poor functional outcome. A new set of radiographic criteria were developed to help detect distal fibula internal and external rotation using conventional fluorosco...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31828f89a9
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVES:To compare single versus multiple procedures in the same surgical setting. We hypothesized that complication rates would not be different and length of stay would be shorter in patients undergoing multiple procedures. DESIGN:Prospective, cohort. SETTING:Level 1 trauma center. PATIENTS/PARTICIPANTS:A total...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000556
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVES:Malalignment has been frequently reported after intramedullary stabilization of distal tibia fractures. Nails have also been associated with knee pain in several studies. Historically, plate fixation has resulted in increased risks of infection and nonunion. Our purposes were to compare plate and nail stabil...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,随机对照试验
doi:10.1097/BOT.0b013e318213f709
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVES:The diagnosis and treatment of syndesmotic ankle fractures is controversial. This systematic review was performed to clarify the current understanding addressing several clinical questions that arise in the treatment of such injuries. DATA SOURCES:The English language literature was searched using PubMed, E...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000937
更新日期:2018-01-01 00:00:00
abstract::Successful operative intervention in displaced intra-articular calcaneal fractures depends in part on the maintenance of an anatomic reduction of the posterior facet. This guide describes our use of bioabsorbable implants to solve this problem. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181ca38ce
更新日期:2010-12-01 00:00:00
abstract::In patients who are candidates for a total knee arthroplasty and suffer a periarticular fracture of the femur, the arthroplasty may be performed after bony union of the fracture or immediately, in conjunction with the fracture repair. Herein we present the case of a sixty-year-old female with rheumatoid arthritis and ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199906000-00014
更新日期:1999-06-01 00:00:00
abstract::After completing an orthopaedic trauma fellowship, what challenges will you have as regard to maintaining balance and perspective in your new position in society? How will you view yourself, family, and your profession? These are simple suggestions on maintaining passion for your profession. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000431
更新日期:2015-11-01 00:00:00
abstract::This case report describes a Gustilo Anderson type IIIB tibia fracture associated with extensive segmental bone loss at the proximal meta-diaphyseal junction associated with a tibial plateau fracture and an avulsion of the tibial tubercle. After the tibial plateau fracture was stabilized using cannulated lag screws, t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200209000-00010
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVE:To determine whether open reduction and internal fixation of intra-articular pilon fractures using a staged treatment protocol results in minimal surgical wound complications. DESIGN:Retrospective. SETTING:Level 1 trauma center. PATIENTS/PARTICIPANTS:Between January 1991 and December 1996, 226 pilon fractu...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199902000-00002
更新日期:1999-02-01 00:00:00
abstract:OBJECTIVES:Fellowship-trained orthopaedic traumatologists are presumably taught skill sets leading to "best practice" outcomes and more efficient use of hospital resources. This should result in more favorable economic opportunities when compared with general orthopaedic surgeons (GOSs) providing similar clinical servi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182a59d6b
更新日期:2014-05-01 00:00:00