Reduction and Fixation of Sacroiliac joint Dislocation by the Combined Use of S1 Pedicle Screws and an Iliac Rod
Kai-Uwe Lewandrowski, Donald L. Wise, Debra J. Trantolo, Michael J. Yaszemski, Augustus A. White in Advances in Spinal Fusion, 2003
Internal fixation consists of the application of metal implants for a variety of conditions wherein the spine is to be maintained in a given configuration until grafts are fused. Since fixation devices, once implanted, allow external forces to be imparted, a pathological spine configuration can also be totally or partially corrected. Three types of spine instrumentations can be applied for internal fixation: laminar hooks, wires, and rods; pedicular screws; and interbody devices [ 15,28,29]. Although fads and industrial innovations may dictate the extinction of older instrumentations and the emergence of newer ones, each type of device is objectively characterized by mechanical properties that may be suitable to the surgical procedure to be performed for a given spinal disorder. Laminar hooks, wires, and rods allow for distraction, compression, and lateral deflection to be exerted on the spine, but they offer three main disadvantages: no rotational forces can be applied and no reduction in the sagittal plane can be carried out; the limited strength of the vertebral laminae restricts the magnitude of the applicable forces; selective segmental control cannot be accomplished [15].
Distal radius osteoporotic features
Peter V. Giannoudis, Thomas A. Einhorn in Surgical and Medical Treatment of Osteoporosis, 2020
With the enthusiasm of treating osteoporotic fractures growing due to the technological advance of angular stable internal fixation, a number of evidence-based studies have compared the outcomes of closed reduction to operative treatment. There is a significant body of literature that suggests that nonoperative treatment of displaced distal radius fracture yields acceptable results in the elderly, low-demand population. Functional outcome is not correlated to radiographic outcome in this population group as opposed to a younger, more active one (9). Egol et al. performed a case-controlled study with 90 patients comparing operative to nonoperative treatment of distal radius fractures in patients older than 65 years. The operative interventions included external and internal fixation techniques. The operative group had better radiographic measures and better grip strength; however, there was no difference in DASH score between the groups at 1 year. These findings were confirmed by Arora et al. (10) in a randomized study comparing closed reduction and immobilization to volar plating of unstable distal radius fractures. Grip strength and radiographic alignment were better in the operative group. DASH and PRWE scores were improved in the early postoperative period in the operative group; however, at 6 months and 1 year, there were no significant differences.
Management of diabetic foot
Maneesh Bhatia in Essentials of Foot and Ankle Surgery, 2021
Infection around the internal fixation devices is a major concern in this group of patients; however, most published literatures indicate low or acceptable infection rates (24–29). The generally accepted principle of internal fixation during Charcot foot reconstruction is the ‘Super-construct’ technique described by Sammarco et al., 2010, about a decade ago, which recommended a ‘long-segment fixation’ that involved extension of the bone fusion to beyond the zone of injury. This is achieved by extending the fixation to the adjacent joints that are not affected by CN (30). Since then, this principle has been refined further as ‘durable long-segment rigid fixation with optimal bone opposition’ as non-rigid fixation was found to have higher failure rates (27–29, 31, 32).
Perinatal pubic symphysis separation combined with pubic fracture: a case report and literature review
Published in Journal of Obstetrics and Gynaecology, 2022
Liang Deng, Liang-Yu Xiong, Ji-Huan Zeng, Qiang Xiao, Yuan-Huan Xiong
In terms of the treatment, for pubic symphysis separation with separation distance ≤ 40 mm, conservative treatment can be performed with a pelvic correction belt. The elasticity of the pelvic correction belt can fix the crotch, tighten the separated pelvis, protect the pubis, and relieve the pain of pubic. Hence, the mechanical distribution of pelvis, back and buttock can be further improved, and the pubic symphysis can be recovered and maintained in the normal anatomical position (Culligan et al. 2002). For the parturient with a separation distance > 40 mm or combined with the persistent pain and pelvic instability, the active surgical intervention may be a sensible choice. With regard to this, the common surgical methods include external fixation and internal fixation, in which the internal fixation is the preferred method (Sujana et al. 2017). The internal fixation mainly includes the screws and steel plates fixation, which can provide sufficient mechanical stability and effective compression resistance and anti-rotation ability. In recent years, the minimally invasive surgeries represented by percutaneous cannulated screws have obtained remarkable results, which can effectively reduce the surgical trauma, shorten the operation time, and further contribute to the rapid postoperative recovery (Saeed et al. 2015). In this case, we have applied the conventional open reduction and internal fixation, and fixed with screws and steel plates. After one year of follow-up, the screws and steel plates were still fixed firmly and the separation distance of pubic symphysis was also effectively controlled.
Mortality and revision risk after femoral neck fracture: comparison of internal fixation for undisplaced fracture with arthroplasty for displaced fracture: a population-based study from Danish National Registries
Published in Acta Orthopaedica, 2021
Bjarke Viberg, Trine Frøslev, Søren Overgaard, Alma Becic Pedersen
We used the Danish Multidisciplinary Hip Fracture Registry to identify the study population. All patients admitted to a hospital in Denmark with a hip fracture diagnosis code (ICD-10 DS720, DS721, DS722), surgical procedure code, and laterality were included. Using procedure codes (Nordic Medico-Statistical Committee 2012) the patients were categorized into an internal fixation or arthroplasty group. Internal fixation was defined as screw fixation or sliding hip screw and arthroplasty as hemiarthroplasty or THA (Table 1, see Supplementary data). If patient had bilateral hip fracture, only the first hip fracture was included in the study population. In the Danish Multidisciplinary Hip Fracture Registry, a code for undisplaced and displaced fracture exists. However, not all patients have the code and it has not been validated. Our national guidelines recommend arthroplasty for all displaced FNF patients above 70 years and IF for all undisplaced FNF. All patients above 70 years old treated with IF were therefore deemed to have an undisplaced FNF and those with arthroplasty as a displaced FNF.
One-stage posterior approach for treating multilevel noncontiguous thoracic and lumbar spinal tuberculosis
Published in Postgraduate Medicine, 2019
Rui-song Chen, Xin Liao, Mo-liang Xiong, Feng-rong Chen, Bo-wen Wang, Jian-ming Huang, Xiao-lin Chen, Gang-hui Yin, Hao-yuan Liu, Da-di Jin
In our series, we performed a one-stage posterior debridement and decompression, combined with an intervertebral fusion and posterior instrumentation to treat MNST. In our opinion, posterior internal fixation has the following advantages. First, this method is performed at a distance from the mediastinum and pleural cavity and has the advantages of less blood loss, anesthesia time and risk, total operative time, and morbidity, allowing for early rehabilitation for patients. Second, this method provides adequate exposure of the lesion and allows for adequate decompression, resulting in a good clinical outcome [30]. Third, posterior internal fixation instrumentation was performed distant from the TB focus, conducive for remediation of the TB. Last, posterior instrumentation with strong internal fixation may be superior to anterior correction of a kyphotic deformity and for maintenance of its treatment [28]. This is consistent with our study that the correct rate of kyphosis was 79.7% ± 20.1% with an average loss of 1.1° ± 1.7°. Moreover, favorable neurological improvement was obtained using this technique. The neurological function improved in all cases in the current study.
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