970 results on '"Plate osteosynthesis"'
Search Results
952. Segmental tibial shaft fractures
- Author
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øivind Langård and Olav Bø
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,law.invention ,Intramedullary rod ,External fixation ,Fractures, Open ,law ,medicine ,Humans ,Orthopedics and Sports Medicine ,Tibia ,Fractures, Closed ,Multiple fractures ,Osteosynthesis ,business.industry ,Osteomyelitis ,medicine.disease ,Surgery ,Radiography ,Tibial Fractures ,Plate osteosynthesis ,Evaluation Studies as Topic ,Concomitant ,Female ,business - Abstract
A series of 54 cases with multiple fractures of the tibia is reported. Sixty-eight per cent of the group were pedestrians hit by a car. Fifty-two per cent were open fractures. Osteosynthesis was performed in 33 cases, whereas 21 were treated conservatively. Plate osteosynthesis was accomplished in 23 cases, seven had intramedullary nailing, and two were treated by Hoffman's external fixation device. Only one patient sustained a severe complication, viz., deep wound infection and osteomyelitis; however, even this infection was transient. All fractures healed except those sustained by two patients who died within 3 months; these deaths were, however, without any causal relationship to the osteosynthesis. One patient had a traumatic vascular lesion concomitant with the fracture, and his leg was amputated 3 days after the injury. Another patient had his leg amputated 1 year after his accident, in this case also because of injury to the vessels and nerves. It was concluded from the present series that segmental or multiple tibial shaft fractures do not entail more complications nor do they exhibit a slower rate of union than simple tibial shaft fractures if the treatssue injury.
- Published
- 1976
953. Tibial shaft fractures. A comparison of conservative treatment and internal fixation with conventional plates or AO compression plates
- Author
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F. Wang Hansen, J. Steen Jensen, and J. Johansen
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Non union ,Fracture Fixation, Internal ,Fracture Fixation ,medicine ,Internal fixation ,Humans ,Orthopedics and Sports Medicine ,Aged ,Wound Healing ,Osteosynthesis ,business.industry ,Middle Aged ,Compression (physics) ,Surgery ,Conservative treatment ,Tibial Fractures ,Plate osteosynthesis ,Female ,business ,Bone Plates ,Follow-Up Studies - Abstract
Out of a series of 207 consecutive fractures of the tibial shaft, 102 were treated conservatively, 64 fractures were treated by AO compression plate osteosynthesis and 41 by internal fixation using Eggers or Lane plates. The choice of method was independent of the extent of soft tissue damage. A follow-up examination of 199 fractures, with a mean observation time of 3.4 years, revealed residual malalignment in 21 per cent of conservatively treated cases and in 8 per cent after conventional plate fixation, while the AO method resulted in anatomical restoration of the axis of the tibia in all cases. However, removal of the compression plates was followed by re-fractures, early and late, in 11 per cent. Implant failure occurred in 5 per cent of both types of plate fixation, and 3 per cent of the conservatively treated cases redislocated. Infection developed in 5 per cent of closed fractures and in 11 per cent of open fractures treated by operative means. Of the conservatively treated cases, only 3 per cent of the open fractures developed infection. The risk of infection following acute internal fixation is thus four times greater than with conservative treatment. AO compression plate fixation shortened the time of fracture healing considerably. The rate of non-union after conservative treatment was 6 per cent in closed and 21 per cent in open fractures. Similarly in conventional plate fixation there was non-union in 8 and 24 per cent, respectively. Non-union was not encountered after AO compression plate osteosynthesis. It is concluded that AO plate osteosynthesis is justified in the treatment of open tibial shaft fractures and also useful in closed fractures when conservative treatment does not lead to stable reduction with a good alignment.
- Published
- 1977
954. Corrective Osteotomies of the Femoral Shaft
- Author
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L. Gotzen, H. Tscherne, and A. Illgner
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body regions ,Orthodontics ,Plate osteosynthesis ,External rotation ,business.industry ,Femoral shaft ,Biomechanics ,Medicine ,Wedge osteotomy ,Symmetry (geometry) ,business ,Mechanical axis - Abstract
Physiologic symmetry of the lower extremities is essential for normal leg function on a long-term basis [6]. Deformities secondary to shaft fractures frequently shorten the limb and thus interfere with the normal biomechanics of both the lower extremity and the spine.
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- 1985
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955. Allogeneic Osteoarticular Grafts About the Knee
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G. P. Andersen, O. Korkala, T. Holmström, Erkki Karaharju, Antti Alho, and E Laasonen
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musculoskeletal diseases ,030203 arthritis & rheumatology ,030222 orthopedics ,medicine.medical_specialty ,business.industry ,Surgery ,Resection ,03 medical and health sciences ,0302 clinical medicine ,Plate osteosynthesis ,Reconstruction problem ,Partial weight bearing ,medicine ,business - Abstract
Osteoarticular resection of bone tumor results in a reconstruction problem which has not been solved satisfactorily. Allogeneic deep-frozen osteoarticular transplant is one of the alternatives.
- Published
- 1989
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956. Small plate osteosynthesis of mandibular fractures
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J.I. Cawood
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Adult ,Male ,Adolescent ,Mandibular fracture ,Dentistry ,Fixation (surgical) ,Normal body weight ,Fracture Fixation, Internal ,stomatognathic system ,Mandibular Fractures ,Fracture fixation ,Bone plate ,medicine ,Humans ,Child ,Aged ,Mouth ,Osteosynthesis ,business.industry ,Middle Aged ,medicine.disease ,Intermaxillary fixation ,Fracture Fixation, Intramedullary ,stomatognathic diseases ,Plate osteosynthesis ,Otorhinolaryngology ,Surgery ,Female ,Oral Surgery ,business ,Bone Plates - Abstract
Small plate osteosynthesis has been evaluated by comparing 50 successive cases of mandibular fracture treated by this technique alone with 50 successive cases of mandibular fracture treated by intermaxillary fixation. The plates show considerable advantages over other forms of fixation in that they are small, malleable and easy to insert. Furthermore, they achieve a high degree of stability. The rate of recovery of normal jaw function and normal body weight is significantly greater than with intermaxillary fixation.
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- 1985
957. External fixation as an alternative when treating 2nd and 3rd degree open lower leg fractures
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H. Schöttle, H. Schöntag, and K. H. Jungbluth
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Soft tissue ,General Medicine ,Compression (physics) ,Degree (temperature) ,Surgery ,Fracture Fixation, Intramedullary ,Orthopedic Fixation Devices ,External fixation ,Fractures, Open ,Plate osteosynthesis ,Fracture Fixation ,Blood circulation ,Orthopedic surgery ,Medicine ,Humans ,Orthopedics and Sports Medicine ,business ,Bone Plates ,Reduction (orthopedic surgery) ,Leg Injuries - Abstract
The infection rate of open lower leg fracture is extremely high. Surgical treatment guarantees a reduced risk of infection when compared with conservative treatments. But even osteosynthetic methods such as screw or compression plate fixation show unsatisfactory results because of the additional traumatization of the primarily injured soft tissue combined with a reduction of blood circulation. From July 1973 till September 1976 we treated 57 2nd and 3rd degree open shank fractures with osteosynthetic methods: 46 with compression plate osteosynthesis and 11 primarily or secondarily with external fixation. The osteitis-rate was 14%, in addition to that there was a soft-tissue infection rate of 5%. In order to change our therapeutical procedure we stabilized 2nd and 3rd degree open lower limb fractures and lower leg fractures complicated by soft-tissue damages consequently by external fixation. From October 1976 till May 1978 we treated 39 open shank fractures; 24 of them were 2nd and 3rd degree open fractures. They were treated by external fixation. This change in our surgical treatment resulted in an osteitis-rate of 2.6%, there was no case of soft-tissue inflammation. These results underline the superiority of treating 2nd and 3rd degree open lower leg fractures and fractures combined with soft-tissue injuries consequently and chiefly with AO external fixation.
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- 1980
958. Plate osteosynthesis for shaft fractures of the tibia
- Author
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Matti Yllö and Gudmundur Gudmundsson
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Adult ,Male ,Time Factors ,Adolescent ,Fracture Fixation, Internal ,Medicine ,Accidents, Occupational ,Humans ,Orthopedics and Sports Medicine ,Tibia ,Aged ,Orthodontics ,Osteosynthesis ,integumentary system ,business.industry ,Accidents, Traffic ,Middle Aged ,Tibial Fractures ,Plate osteosynthesis ,Accidents ,Delayed union ,Wounds and Injuries ,Surgery ,Female ,business ,Bone Plates - Abstract
Out of 46 tibial shaft fractures treated by the AO method 42 healed primarily and four had delayed union. Otherwise no serious complications were encountered.
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- 1982
959. Clinical study of the Pronator Quadratus muscle: anatomical features and feasibility of Pronator-Sparing Surgery
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Hong-Yi Cheng and Hsien-Yi Lo
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medicine.medical_specialty ,Radiography ,Pronator-sparing approach ,Upper Extremity ,Clinical study ,Fracture Fixation, Internal ,Rheumatology ,Fracture fixation ,Humans ,Medicine ,Orthopedics and Sports Medicine ,Prospective Studies ,Pronator quadratus muscle ,Muscle, Skeletal ,Fracture Healing ,business.industry ,Lunate bone ,Anatomy ,Surgery ,Treatment Outcome ,Plate osteosynthesis ,Scaphoid bone ,Orthopedic surgery ,Feasibility Studies ,Radius Fractures ,business ,Research Article ,Distal radius fracture - Abstract
Background No clinical data for the relationship of pronator quadratus (PQ) muscle to distal radius had been reported. The aim of this study was to investigate the anatomical features of the PQ muscle related to plate osteosynthesis for distal radius fractures in clinical cases. The feasibility of PQ muscle sparing surgery was investigated as well. Methods Fifty two distal radius fractures (23-A2) were enclosed in this study. The whole width of the muscle and the distance from the distal edge of the muscle to the joint surface of the distal radius were measured. The distance from the fracture site of the radius to the joint surface was measured as well. Results The average width of the pronator quadratus muscle was 37.6 mm. The average distance from the pronator quadratus muscle to the lunate fossa surface was 12.2 mm, and the average distance from the pronator quadratus muscle to the scaphoid fossa surface was 13.6 mm. The average distance from the lunate fossa of the distal radius to the fracture site was 12.2 mm (range, 7.3-17 mm), and the scaphoid fossa of the distal radius to the fracture site was 13.2 mm (range, 9.4-18.8 mm). Conclusions This PQ muscle sparing surgery is feasible and can be performed without difficulty. The data might provide a useful basis for the preservation of pronator quadratus muscle applied to a functionally reduced fracture regarding the potential efficacy of conventional volar plate osteosynthesis.
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960. Assessment of a novel biomechanical fracture model for distal radius fractures
- Author
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Baumbach, Sebastian Felix, Dall’Ara, Enrico, Weninger, Patrick, Antoni, Anna, Traxler, Hannes, Dörr, Martin, and Zysset, Philippe K
- Subjects
Aged, 80 and over ,Male ,lcsh:Diseases of the musculoskeletal system ,X-Ray Microtomography ,Middle Aged ,Elasticity ,Biomechanical Phenomena ,Osteotomy ,Weight-Bearing ,Biomechanical fracture model ,Bone Density ,Linear Models ,Humans ,Fresh-frozen ,Female ,Orthopedics and Sports Medicine ,Stress, Mechanical ,Plate osteosynthesis ,lcsh:RC925-935 ,Radius Fractures ,Bone Plates ,Research Article ,Aged ,Distal radius fracture - Abstract
Background Distal radius fractures (DRF) are one of the most common fractures and often need surgical treatment, which has been validated through biomechanical tests. Currently a number of different fracture models are used, none of which resemble the in vivo fracture location. The aim of the study was to develop a new standardized fracture model for DRF (AO-23.A3) and compare its biomechanical behavior to the current gold standard. Methods Variable angle locking volar plates (ADAPTIVE, Medartis) were mounted on 10 pairs of fresh-frozen radii. The osteotomy location was alternated within each pair (New: 10 mm wedge 8 mm / 12 mm proximal to the dorsal / volar apex of the articular surface; Gold standard: 10 mm wedge 20 mm proximal to the articular surface). Each specimen was tested in cyclic axial compression (increasing load by 100 N per cycle) until failure or −3 mm displacement. Parameters assessed were stiffness, displacement and dissipated work calculated for each cycle and ultimate load. Significance was tested using a linear mixed model and Wald test as well as t-tests. Results 7 female and 3 male pairs of radii aged 74 ± 9 years were tested. In most cases (7/10), the two groups showed similar mechanical behavior at low loads with increasing differences at increasing loads. Overall the novel fracture model showed a significant different biomechanical behavior than the gold standard model (p < 0,001). The average final loads resisted were significantly lower in the novel model (860 N ± 232 N vs. 1250 N ± 341 N; p = 0.001). Conclusion The novel biomechanical fracture model for DRF more closely mimics the in vivo fracture site and shows a significantly different biomechanical behavior with increasing loads when compared to the current gold standard.
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961. Anatomic basis of minimally invasive plate osteosynthesis in the femur
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Harald Tscherne, Osama Farouk, Galal Z. Said, Christian Krettek, and Peter Schandelmaier
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Orthodontics ,Plate osteosynthesis ,business.industry ,Medicine ,Orthopedics and Sports Medicine ,Femur ,business
962. [Untitled]
- Subjects
Orthodontics ,030222 orthopedics ,medicine.medical_specialty ,Proximal humerus ,Materials science ,Osteosynthesis ,High stiffness ,03 medical and health sciences ,Fixation (surgical) ,0302 clinical medicine ,medicine.anatomical_structure ,Plate osteosynthesis ,Orthopedic surgery ,medicine ,Orthopedics and Sports Medicine ,Humerus ,Cement augmentation ,030212 general & internal medicine - Abstract
Purpose Angular stable implants reduced the complication rate in the treatment of humeral head fractures. But the failure rate is still high. To further reduce the risk of cut-out, cement augmentation of screws was introduced. A reason for failure of plate osteosynthesis might be the extremely high stiffness of the screw-plate interface leading to a loss of reduction and cut-out of screws. A more homogeneous distribution of the forces on all screws may avoid secondary dislocation. We hypothesize that dynamic osteosynthesis minimizes screw loosening and results in a higher load to failure than standard locking screws. Methods Twelve paired human humerus specimens were analysed. A standardized three-part fracture model with a metaphyseal defect was simulated. Within each pair of humeri, one was fixed with a Philos plate and standard locking screws (LS), whereas the other humerus was fixed with a Philos plate and dynamic locking screws (DLS). A cyclic varus-bending test or a rotation test with increasing loading force was performed until failure of the screw-bone-fixation. Results In the varus bending test, pairs failed by screw loosening in the humeral head. The LS-group reached 2901 (601–5201) load cycles until failure, while the DLS-group failed after 3731 (2001–5601) cycles. This corresponds to a median loading of 195 N for the LS-group and 235 N for the DLS-group (p = 0.028). In the rotation test the LS-group reached a median of 1101 (501–1501) load cycles until failure of fixation occurred, while the DLS-group failed after 1401 (401–2201) cycles (p = 0.225). Conclusions Plate fixation using dynamic locking screws for the treatment of proximal humerus fractures demonstrated more load cycles until failure compared to standard locking plate osteosynthesis.
963. [Untitled]
- Subjects
030222 orthopedics ,medicine.medical_specialty ,business.industry ,Visual analogue scale ,medicine.medical_treatment ,Long bone ,Nonunion ,Retrospective cohort study ,medicine.disease ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Plate osteosynthesis ,medicine.anatomical_structure ,Orthopedic surgery ,Medicine ,Internal fixation ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,business ,Reduction (orthopedic surgery) - Abstract
Background Minimally invasive plate osteosynthesis (MIPO) has been reported to be superior to open reduction and internal fixation (ORIF) in the treatment of different long bone fractures. Nevertheless, in distal fibula fractures, the evidence of MIPO remains scarce. The aim of this retrospective study was to compare the clinical and radiological outcomes of the minimally invasive techniques applied to the distal fibula with open reduction and internal fixation within a 12 months follow-up. Methods A consecutive series of patients who underwent surgery using either ORIF or MIPO for the treatment of distal fibula fractures between 2010 and 2014 were retrospectively analyzed. All distal fibular fractures requiring an operative treatment (Danis-Weber type B ≙ AO type 44 B1, 2, 3 and Danis-Weber type C ≙ AO type 44 C1, 2) were included (ORIF n = 35, MIPO n = 35). Patients were assessed for postoperative pain using a visual analog scale (VAS) for pain (ranging from 0 to 10) and classified into 4 groups: “no pain” for VAS = 0, “low” for VAS = 1–3, “moderate” for VAS = 3–5, and “severe” for VAS = 5–10. In addition, complications of postoperative fracture-related infection, wound healing disorders, vascular and nerve injury and development of nonunion were evaluated and analyzed. Radiologic outcome measures assessing the talocrural angle, lateral and medial clear space, tibiofibular overlap, and talar tilt angle were evaluated postoperatively. Results The overall complication rate showed to be lower in the MIPO group compared to the ORIF group (14% vs. 37%, p = 0.029). Even though not statistically significant, specific surgery-related complications such as skin necrosis (3% vs. 9%, p = 0.275), nonunion (0% vs. 6%, p = 0.139), infections and wound healing disorders (9% vs. 20%, p = 0.141), as well as postoperative pain (17% vs. 26%, p = 0.5) were found more frequently in the ORIF group. The tibiofibular overlap demonstrated to be significantly lower in the ORIF group (3.3 mm vs. 2.7 mm, p = 0.033). The talocrural angle, talar tilt angle, and lateral and medial clear space showed to be equivalent in both groups. Conclusion In this retrospective single-center consecutive series, MIPO was superior to ORIF in the surgical treatment of distal fibula fractures with respect to the overall complication rate. Trial registration EKNZ Project-ID: 2019-02310, registered on the 20th of December 2019 with swissethics
964. Surgical approaches for minimally invasive plate osteosynthesis in dogs
- Author
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Antonio Pozzi and Daniel Lewis
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medicine.medical_specialty ,Surgical approach ,General Veterinary ,business.industry ,medicine.medical_treatment ,Fracture site ,Surgery ,Fracture Fixation, Internal ,Plate osteosynthesis ,Dogs ,Bone plate ,Fracture fixation ,medicine ,Internal fixation ,Animals ,Animal Science and Zoology ,Dog Diseases ,business ,Bone Plates - Abstract
SummaryFracture stabilisation techniques continue to evolve and to provide approaches which minimise the iatrogenic trauma associated with surgery. Minimally invasive plate osteo-synthesis (MIPO) is a recently described method of biological internal fixation performed by introducing a bone plate via small insertional incisions that are made remote to the fracture site. The plate is slid adjacent to the bone in an epiperiosteal tunnel connecting the two insertional incisions. Screws are placed in the plate through the insertional incisions or via additional stab incisions made over the holes in the plate. In this paper we describe the surgical approaches used to perform MIPO in humeral, radial, fe-moral and tibial fractures in dogs. We found that these approaches allowed safe insertion of the plate without grossly damaging neuro-vascular structures. Further studies are needed to evaluate the clinical outcome of MIPO in dogs.
965. [Untitled]
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030222 orthopedics ,medicine.medical_specialty ,business.industry ,Shoulder Fracture ,Radiography ,medicine.medical_treatment ,Dentistry ,030208 emergency & critical care medicine ,Avascular necrosis ,General Medicine ,Bone healing ,medicine.disease ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Plate osteosynthesis ,Bicipital groove ,Bone plate ,Medicine ,business ,Reduction (orthopedic surgery) - Abstract
Complex proximal humerus fractures with metaphyseal comminution remain challenging regarding reduction and stability. In most fracture patterns the hard bone of the bicipital groove remains intact. In this case series, we describe a novel technique of hybrid double plate osteosynthesis of complex proximal humerus fractures with metaphyseal comminution. In randomly chosen shoulder specimens and synthetic bones, pilot studies for evaluation of the feasibility of the technique were performed. Between 4/2010 and 1/2012 10 patients underwent hybrid double plate osteosynthesis. Seven patients (4 male, 3 female, mean age was 50 years (range 27–73)) were available for retrospective analysis. Based on plain radiographs (anterior-posterior and axial view), the fractures were classified according to the Orthopaedic Trauma Association classification (OTA) and by descriptive means (head-split variant (HS), diaphyseal extension or comminution (DE)). Follow-up radiographs demonstrated complete fracture healing in six patients and one incomplete avascular necrosis. None of the patients sustained loss of reduction. Three patients where reoperated. The medium, not adapted, Constant score was 80 Points (58–94). Patients subjective satisfaction was graded mean 3 (range: 0–6) in the visual analog scoring system (VAS). The technique of hybrid double plate osteosynthesis using the bicipital groove as anatomic landmark may re-establish shoulder function after complex proximal humerus fractures in two dimensions. Firstly the anatomy is restored due to a proper reduction based on intraoperative landmarks. Secondly additional support by the second plate may provide a higher stability in complex fractures with metaphyseal comminution.
966. Experience with functionally stable plate osteosynthesis after forward displacement of the upper jaw
- Author
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Serge Krupp
- Subjects
Orthodontics ,Plate osteosynthesis ,business.industry ,Medicine ,Surgery ,Displacement (orthopedic surgery) ,Anatomy ,business - Published
- 1981
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967. Advances in Rigid Fixation in Maxillofacial Surgery
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Arlen D. Meyers
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medicine.medical_specialty ,Osteosynthesis ,business.industry ,medicine.medical_treatment ,Fracture site ,Dentistry ,General Medicine ,equipment and supplies ,Osteotomy ,Intermaxillary fixation ,Surgery ,Fixation (surgical) ,Plate osteosynthesis ,Primary bone ,Otorhinolaryngology ,medicine ,business ,Plate fixation - Abstract
Plate osteosynthesis has become a popular method in securing rigid fixation at fracture and osteotomy sites in maxillofacial surgery. Plating provides an effective means of stabilizing bone, thereby providing an optimal environment for healing to occur. Because plate fixation does provide rigid osteosynthesis, in most cases intermaxillary fixation is not required. The plating systems currently available can be classified into compression and noncompression types. Compression plates, by virtue of their biomechanical design, provide active compression at the fracture site, thereby promoting primary bone healing. The holes in compression plates are oval and the screws are placed in an eccentric fashion in these holes. As the screws are tightened into the bone, the head of the screw contacts the side of the hole and then, as the screw further countersinks itself into the plate, it forces the bone ends together in an active compression fashion. These screws are typically bicortical in
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- 1988
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968. Finite-element-study of the stability of a femur plate osteosynthesis. Influence of the screw diameter and the screw plate connection
- Author
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K. Seide, D. Wolter, W. Zierold, and H.R. Kortmann
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Materials science ,Plate osteosynthesis ,business.industry ,Rehabilitation ,Biomedical Engineering ,Biophysics ,Orthopedics and Sports Medicine ,Femur ,Structural engineering ,business ,Finite element study ,Connection (mathematics) - Published
- 1989
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969. Plate osteosynthesis of 367 mandibular fractures
- Author
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Serge Krupp
- Subjects
Orthodontics ,Plate osteosynthesis ,business.industry ,Medicine ,Surgery ,business - Published
- 1988
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970. The Extent of Stress-protection After Plate Osteosynthesis in the Human Tibia
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Vidar Arnulf, Terje Terjesen, and Asbjørn Nordby
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Stress protection ,Stress, Physiological ,medicine ,Humans ,Orthopedics and Sports Medicine ,Tibia ,Reduction (orthopedic surgery) ,Plate fixation ,Osteosynthesis ,business.industry ,General Medicine ,Anatomy ,medicine.disease ,Tibial Fractures ,Osteopenia ,Plate osteosynthesis ,Orthopedic surgery ,Female ,Surgery ,Tomography, X-Ray Computed ,business ,Bone Plates ,Densitometry - Abstract
The extent of stress-protection was investigated in 12 patients with previous tibial fractures treated by steel plate fixation. They were examined by computed tomography (CT) scanning one or two days after plate removal. The cortical density and thickness were determined by the CT scans. In the previously plated segment, a significant reduction in cortical density was found, and the reduction was most pronounced in the quadrant directly beneath the plate. The osteopenia did not increase with increasing duration of plate application in excess of one year. No significant differences in cortical thickness between plated and control tibiae occurred. The results indicate that stress-shielding after rigid plating in the human tibia is less pronounced than that previously reported from experimental studies in animals.
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- 1986
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