scholarly journals Palatal Fracture Fixation on Severe Panfacial Fracture: Is There Any Clinical Significance?

2021 ◽  
Vol 3 (1) ◽  
pp. 21
Author(s):  
Arif Tri Prasetyo ◽  
Magda Rosalina Hutagalung ◽  
Lobredia Zarasade
Keyword(s):  
Hard Palate ◽  
Plate Fixation ◽  
Open Reduction Internal Fixation ◽  
Fracture Site ◽  
Occlusal Plane ◽  
Wound Complications ◽  
Midfacial Fractures ◽  
Horizontal Stability ◽  
Upper Face ◽  
Panfacial Fracture

Background: Fractures of the hard palate are infrequent. They are found in less then 10% of patients with midfacial fractures. They practically never occur in isolation and are usually part of alveolar process fractures or more complex midfacial fractures of the Le Fort type. Treatment of palatal fractures is planned and performed with the goal of restoring the transverse width of the palate, the anteroposterior projection of the maxillary arch, and the patient’s pretraumatic occlusal plane, as well as maintaining horizontal stability of the midface.Case Presentation: Reporting patient female 17 years old with panfacial fracture due to traffic accident. There was slight epidural haemorrhage on frontal area. The fractures are on upper face, midface, and lower face including the hard palate. We performed open reduction internal fixation on palate to correct the arch of the upper jaw. The other fracture site can be corrected easier. The approaches that we done are bicoronal, subsilier, and intraoral. The patient was successfully treated using bottom-up and outside-in sequence by accessing all facial injuries. Postoperatively, radiograph examination revealed good reduction and fixation of titanium plates, and physical examination revealed good functional and aesthetic outcomes.Conclusion: Palate fractures are relatively uncommon and are associated with significant rates of malocclusion and wound complications. These injuries are typically managed with plate fixation of the alveolar ridge with variable approaches to the palatal vault

Plate Fixation of Fractures of the Mid and Upper Face

1987 ◽  
Vol 20 (3) ◽  
pp. 559-572 ◽  
Author(s):  
Robert M. Kellman ◽  
Wilfried Schilli
Keyword(s):  
Plate Fixation ◽  
Upper Face

scholarly journals Is Perpendicular Double Two-Hole Plates Fixation Superior to Single Four-Hole Plate Fixation to Treat Mandibular Symphysis Fracture?—A Finite Element Study

2021 ◽  
Vol 11 (18) ◽  
pp. 8629
Author(s):  
Li-Ren Chang ◽  
Ya-Pei Hou ◽  
Ting-Sheng Lin
Keyword(s):  
Finite Element ◽  
Plate Fixation ◽  
Mandibular Condyle ◽  
Fracture Site ◽  
Von Mises Stress ◽  
Stress Concentrations ◽  
Element Analysis ◽  
Mandibular Symphysis ◽  
Lower Border ◽  
Von Mises

The effectiveness of a single four-hole plate (S4HP), perpendicularly oriented four-hole and two-hole plate (Per4H2HP), and perpendicularly oriented double two-hole plate (PerD2HP) for the fixation of a mandibular fracture was studied. A finite element analysis of the mandibular symphysis fractures treated with S4HP, Per4H2HP, and PerD2HP was performed. All surface nodes were fixed in the mandibular condyle region and occlusal muscle forces were applied. The maximal von Mises stress (MaxVMS) values of the plates, screws and screw holes were investigated. The displacement of the fracture site on the lower border of the mandibular symphysis was recorded. The displacement on the lower border of the fracture sites in the S4HP group was greater than that in the Per4H2HP group and the PerD2HP group. There was no eversion at the fracture site among all groups. Both the S4HP and Per4H2HP groups showed stress concentrations on the screws close to the fracture site. The MaxVMS increased when the number of screw holes on the mandibular anterior lower border decreased. The displacement of the fracture site and eversion with Per4H2HP and PerD2HP were far lower than those with S4HP. PerD2HP is a stable and green fixation technique for mandibular symphysis fractures.

scholarly journals Dynamic plate osteosynthesis for fracture stabilization: how to do it

2010 ◽  
Vol 2 (1) ◽  
pp. 4 ◽  
Author(s):  
Juerg Sonderegger ◽  
Karl R. Grob ◽  
Markus S. Kuster
Keyword(s):  
Plate Osteosynthesis ◽  
Plate Fixation ◽  
Femoral Fractures ◽  
Fracture Site ◽  
Fixation Strength ◽  
Safe Procedure ◽  
Font Size ◽  
Biological Fixation ◽  
Fracture Stabilization ◽  
Anterior Knee

<!--StartFragment--> <p class="MsoNormal"><span style="font-family: 'Times New Roman', Arial, Helvetica, sans-serif; font-size: medium;"><span style="font-size: 16px;"><span style="font-family: Verdana, Arial, Helvetica, sans-serif; font-size: x-small;"><span style="font-size: 10px;"><p class="MsoNormal">Plate osteosynthesis is one treatment option for the stabilization of long bones. It is widely accepted to achieve bone healing with a dynamic and biological fixation where the perfusion of the bone is left intact and micromotion at the fracture gap is allowed. The indications for a dynamic plate osteosynthesis include distal tibial and femoral fractures, some midshaft fractures, and adolescent tibial and femoral fractures with not fully closed growth plates. Although many lower limb shaft fractures are managed successfully with intramedullary nails, there are some important advantages of open-reduction-and-plate fixation: the risk of malalignment, anterior knee pain, or nonunion seems to be lower. The surgeon performing a plate osteosynthesis has the possibility to influence fixation strength and micromotion at the fracture gap. Long plates and oblique screws at the plate ends increase fixation strength. However, the number of screws does influence stiffness and stability. Lag screws and screws close to the fracture site reduce micromotion dramatically. </p><p class="MsoNormal">Dynamic plate osteosynthesis can be achieved by applying some simple rules: long plates with only a few screws should be used. Oblique screws at the plate ends increase the pullout strength. Two or three holes at the fracture site should be omitted. Lag screws, especially through the plate, must be avoided whenever possible. Compression is not required. Locking plates are recommended only in fractures close to the joint. When respecting these basic concepts, dynamic plate osteosynthesis is a safe procedure with a high healing and a low complication rate. </p></span></span></span></span></p>

Dorsal Spanning Plate for Perilunate Dislocations

2021 ◽  
Author(s):  
Duc M. Nguyen ◽  
Allison L. Boden ◽  
Megan K. Allen ◽  
Tamara John ◽  
Greg M. Knoll ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Open Reduction Internal Fixation ◽  
Minimal Change ◽  
Inclusion Criteria ◽  
Cast Immobilization ◽  
Traditional Treatment ◽  
Perilunate Dislocation ◽  
Radiographic Outcomes ◽  
Removal Of Hardware ◽  
Relevant Variation

Abstract Purpose The purpose of this study was to compare radiographic outcomes in patients treated with the traditional method of open reduction, internal fixation (ORIF) and casting as compared with those treated with ORIF and dorsal spanning plate (DSP) fixation. We hypothesized that the application of a DSP to augment the repair of perilunate dislocations would maintain carpal stability while also allowing early loadbearing through the carpus. Materials and Methods This is a retrospective radiographic review of patients with a perilunate dislocation, who were treated with ORIF and casting or ORIF with a dorsal spanning plate between 2012–2018. Scapholunate (SL) and lunotriquetral (LT) intervals were measured immediately after the index surgery and after scheduled hardware removal. A total of 28 patients met inclusion criteria, including 13 cases with traditional treatment and 15 cases with dorsal spanning plate fixation. Results Comparison of the change in SL interval and LT interval between the 13 patients in the traditional treatment group and the 15 patients in the DSP group did not yield any clinically relevant variation after statistical analysis. Both groups demonstrated minimal change in the radiographic markers of carpal stability from postoperative radiographs obtained immediately after the index repair and after the removal of hardware. Conclusion DSP fixation placed at the index surgery with early loadbearing for the treatment of perilunate dislocation is not inferior to the current mainstay of treatment consisting of cast immobilization without loadbearing and does not confer any increased carpal instability in comparison to ORIF and casting.

Arthroscopy Mini-plate Fixation with the Posterior Trans-septal Portal for Treating Posterior Cruciate Ligament Tibial Avulsion Fractures

2020 ◽  
Author(s):  
Chunlei Wang ◽  
Haisen Zhang ◽  
Longjie Li ◽  
Si Chen ◽  
Chang Liu
Keyword(s):  
Posterior Cruciate Ligament ◽  
Plate Fixation ◽  
Cruciate Ligament ◽  
International Knee Documentation Committee ◽  
Fracture Site ◽  
Avulsion Fractures ◽  
Conventional Open Surgery ◽  
Mini Plate ◽  
Pcl Avulsion

Abstract Background Posterior cruciate ligament (PCL) avulsion fractures are rare and difficult to treat. The present work aimed to examine the effect of an innovative arthroscopy method for the treatment of PCL tibial avulsion fractures using mini-plate reduction and fixation through two tibial tunnels and the posterior trans-septal portal.Methods Totally 19 patients (median age, 33 years; range, 23–43 years) with PCL tibial avulsion fractures who underwent treatment with an arthroscopic suture bridge method were retrospectively assessed. Knee function pre-operation and at last follow up was assessed via Lysholm and Tegner scores. A KT-2000 arthrometer was employed for determining knee stability, the range of motion (ROM), and side-to-side differences. Plain radiography and International Knee Documentation Committee (IKDC) exams were performed for patient evaluation.Results No patient was switched to conventional open surgery due to difficult intraoperative procedures. Mean post-surgical Lysholm and Tegner scores (P < 0.001) were significantly improved in comparison with presurgical values. KT-2000 examination revealed markedly reduced side-to-side differences at last follow-up than observed preoperatively (1.2 ± 0.6 VS. 9.3 ± 2.2; P < 0.001). Radiography at the final follow up revealed solid union at the fracture site in the totality of 19 cases.Conclusions This new arthroscopy mini-plate fixation and posterior trans-septal method for posterior cruciate ligament tibial avulsion fractures resulted in good clinico-radiological outcomes, with adequate stability and fracture site healing. It could be employed to repair avulsion fragments of various sizes.Level of evidence IV

scholarly journals Escherichia hermannii as the sole cause of osteomyelitis in a patient with an open tibial shaft fracture

2019 ◽  
Vol 12 (11) ◽  
pp. e231206
Author(s):  
Jocelyn Compton ◽  
Malynda Wynn ◽  
Michael C Willey ◽  
Poorani Sekar
Keyword(s):  
Shaft Fracture ◽  
Open Reduction Internal Fixation ◽  
Fracture Site ◽  
Tibia Fracture ◽  
Tibial Shaft Fracture ◽  
Primary Wound Closure ◽  
Irrigation And Debridement ◽  
Open Tibia Fracture ◽  
Monomicrobial Infection

Escherichia hermannii is a rare monomicrobial cause of infection in humans. E. hermannii has never before been reported as the sole isolate from an infected open tibia fracture. We present a case of E. hermannii infection after a type III open tibia fracture. The patient was initially treated with irrigation and debridement, open reduction internal fixation and primary wound closure. However, after 8 weeks, he developed a draining wound and infection at the fracture site. He required a repeat debridement, hardware removal, external fixation and 6 weeks of intravenous ceftriaxone for treatment. At 2-year follow-up, he remains infection free, asymptomatic and continues to work with excellent functional outcomes. This case adds to the growing literature that evidences E. hermannii as an organism that can be pathogenic, virulent and cause monomicrobial infection.

Augmentation of diaphyseal fractures of the radius and ulna in toy breed dogs using a free autogenous omental graft and bone plating

2015 ◽  
Vol 28 (02) ◽  
pp. 131-139 ◽  
Author(s):  
S. Cooley ◽  
J. J. Warnock ◽  
S. Nemanic ◽  
S. M. Stieger-Vanegas ◽  
W. I. Baltzer
Keyword(s):  
Plate Fixation ◽  
Fracture Site ◽  
Implant Removal ◽  
Bone Plate ◽  
Term Outcome ◽  
Post Surgery ◽  
Retrospective Clinical Study ◽  
Diaphyseal Fractures ◽  
Omental Graft

SummaryObjectives: Evaluation of the short-term outcome, duration of bone healing, and complications following bone plate fixation in dogs weighing [uni2264]6 kg, with and without the use of a free autogenous greater omental graft (OG).Materials and methods: A retrospective clinical study reviewed the medical records of 25 dogs of body weight <6 kg with mid to distal diaphyseal fractures of the radius and ulna (29 fractures) treated with open reduction bone plate fixation. Thirteen out of 29 fractures were implanted with an additional 2–3 cm3 OG lateral, cranial, and medial to the fracture site, adjacent to the bone plate.Results: Median time to radiographic healing in OG fractures (n = 11) was 70 days (range 28–98) compared to 106 days (range: 56–144) in non-OG grafted fractures (n = 14). The OG dogs had no major complications; minor complications included oedema, erythema, and mild osteopenia. Six of the eight non-OG dogs for which follow-up could be obtained developed osteopenia necessitating implant removal, four of which re-fractured the radius one to five months after implant removal, with one dog re-fracturing the limb a second time and resulting in amputation. Telephone follow-up of owners of OG dogs (n = 11) three to 15 months (median 10) post-surgery did not identify any signs of lameness or other complications. Owners of the non-OG dogs (n = 8) reported that there were not any signs of lameness six to 48 months (median 36) post-surgery.Clinical relevance: Free autogenous omen-tal grafting of diaphyseal fractures of the radius and ulna was associated with radial and ulnar healing with minimal complications in dogs weighing less than 6 kg.

Three-Dimensional Finite Element Analysis of a Simplified Compression Plate Fixation System

1984 ◽  
Vol 106 (4) ◽  
pp. 295-301 ◽  
Author(s):  
E. J. Cheal ◽  
W. C. Hayes ◽  
A. A. White ◽  
S. M. Perren
Keyword(s):  
Finite Element ◽  
Strain Gage ◽  
Composite Beam ◽  
Plate Fixation ◽  
Three Dimensional ◽  
Beam Theory ◽  
Fracture Site ◽  
Test Model ◽  
Element Analysis ◽  
Compression Plate

A three-dimensional, linear finite element model was generated for an intact plexiglass tube with an attached six-hole stainless steel compression plate. We examined external forces representing axial, off-center axial, and four-point bending, along with superimposed plate and screw pretension. Strain gage experiments were conducted to test model validity and the finite element results were contrasted to a composite beam theory solution. Excellent correspondence was observed between finite element and strain gage data for the most significant strain components. Composite beam theory tended to overestimate the neutral axis shift which results from plate application. The model also demonstrated fracture site distraction due to plate pretension, and the tendency for outer screw failure for the combination of bending-closed with a preload in the plate and screws.

scholarly journals Comparative analysis between locking compression plate and Joshi's external stabilization system in the management of proximal tibial fractures

2020 ◽  
Vol 7 (1) ◽  
pp. 56
Author(s):  
Amit Dwivedi ◽  
Anupinder Sharma ◽  
Vaibhav Ashta ◽  
Robium Nairobi ◽  
Sunandan Nandi
Keyword(s):  
Plate Osteosynthesis ◽  
Plate Fixation ◽  
Deep Infection ◽  
Open Reduction Internal Fixation ◽  
Tibial Fractures ◽  
Stabilization System ◽  
Superficial Infection ◽  
Bone Consolidation ◽  
Proximal Tibial Fractures ◽  
External Stabilization

<p><strong>Background:</strong> Proximal tibial fractures present with a variety of patterns. They are mostly treated using plate osteosynthesis or Joshi's external stabilization system (JESS) depending upon the injury configuration and surgeon preference. We have compared the efficacy of plate fixation to JESS in the treatment of complex proximal tibial fractures.<strong></strong></p><p><strong>Methods</strong>: 36 patients of proximal tibial fractures with a mean age of 47 years were included in the study, 20 were treated using plate osteosynthesis while the other 16 were treated using JESS, they were followed up at regular intervals till 24 weeks and the progress was recorded in accordance with the knee society score (KSS) parameters<strong></strong></p><p><strong>Results</strong>: 20 patients were treated using plate osteosynthesis, 18 of them had excellent KSS scores, 2 patients recorded good scores, average range of flexion was 126<sup>o</sup>, no incidences of superficial or deep infections were seen in any of them. Bone consolidation was achieved around 12 weeks in plate fixation group of the16 patients treated using JESS, 12 had excellent scores, 4 recorded a good score, average range of flexion was 118<sup>o</sup>, superficial infection was seen in 2 patients, with no incidence of deep infection. Bone consolidation was achieved around 16 weeks in JESS group.</p><p><strong>Conclusions</strong>: Both open reduction internal fixation (ORIF) with plating and JESS appear to be adequate fixation methods for complex proximal tibial fractures, but as per our study plate fixation resulted in earlier bone consolidation and gave a slightly better functional outcome compared to JESS.</p>

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