Injury
-
The effects of cerclage wiring in the open reduction and internal fixation of displaced associated anterior column and posterior hemi-transverse acetabular fractures were evaluated. ⋯ Cerclage wiring is very useful and effective in the reduction and fixation of displaced associated anterior column and posterior hemi-transverse acetabular fractures, and supplemental fixation with reconstruction plates and screws is necessary.
-
The use of open wedge high tibial osteotomy (HTO) to correct varus deformity of the knee is well established. However, the stability of the various implants used in this procedure has not been previously demonstrated. In this study, the two most common types of plates were analysed (1) the Puddu plates that use the dynamic compression plate (DCP) concept, and (2) the Tomofix plate that uses the locking compression plate (LCP) concept. ⋯ Coincidentally the amount of stresses subjected to this plate, 24.7 MPa, was also significantly lower (p<0.001). There was significant negative correlation (p<0.001) between implant stresses to that of the amount of fracture displacement which signifies a less stable fixation using Puddu plates. In conclusion, this study demonstrates that the Tomofix plate produces superior stability for bony fixation in HTO procedures.
-
Fixation of ankle fractures in elderly patients is associated with reduced stability conditioned by osteoporotic bone. Therefore, fixation with implants providing improved biomechanical features could allow a more functional treatment, diminish implant failure and avoid consequences of immobilisation. ⋯ Fixation of distal fibular fractures in osteoporotic bone with the contoured locking plate may be advantageous as compared to the nonlocking contoured plate. The locking plate with improved biomechanical attributes may allow a more functional treatment, reduce complications and consequences of immobilisation.
-
Articular cartilage has a very limited capacity to repair and as such premature joint degeneration is often the end point of articular injuries. Patients with chondral injury have asymptomatic periods followed by others in which discomfort or pain is bearable. The repair of focal cartilage injuries requires a precise diagnosis, a completed knee evaluation to give the correct indication for surgery proportional to the damage and adapted to each patient. ⋯ The future of cartilage repair should be based on an accurate diagnosis using new MRI techniques. Clinical studies would allow us to establish the correct indications and surgical techniques implanting biocompatible and biodegradable matrices with or without stem cells and growth factors. Arthroscopic techniques with the design of new instruments can facilitate repair of patella and tibial plateau lesions.
-
Comparative Study
Biomechanical analysis of a novel femoral neck locking plate for treatment of vertical shear Pauwel's type C femoral neck fractures.
The purpose of this study is to determine the biomechanical stability of a novel prototype femoral neck locking plate (FNLP) for treatment of Pauwels type C femoral neck fractures compared with other current fixation methods. ⋯ The results of this experiment show statistically significant increases in axial stiffness for the FNLP compared with three traditional fixation methods. The FNLP demonstrates increased mechanical stiffness and combines the desirable features of current fixation methods.