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1.
Background
The technique involving the free grafting of the mandibular condyle with a vertical ramus osteotomy was described by Philip Boyne in 1987 along with a series of 15 cases where a patient presented with a markedly displaced fracture dislocation of the mandibular condyle.Method
Twenty-one cases (25 condylar fractures) were treated with a modified Boyne technique.Results
Results showed that we had a complication rate of 12% (8% resorption, 4% fracture of the plate).Conclusion
The Boyne procedure should be thought of as a mainstream treatment method for the displaced fractured mandibular condyle.Key Words: Boyne procedure 相似文献2.
V Kulshrestha 《Medical Journal Armed Forces India》2008,64(3):208-211
Background
Recent studies have shown that displaced mid-shaft clavicular fractures do not have assured favourable outcomes with non-operative management and nonunion rates could be as high as 20%. In addition many malunite with significant shortening. Non-union or malunion causes functional deficit and many of them may benefit from primary internal fixation.Methods
We reviewed the results of twenty cases of displaced/comminuted midclavicular fractures, which were treated with primary open reduction and internal fixation with a reconstruction plate placed over the superior surface of clavicle.Result
All the fractures clinically united by eight weeks. As per Rowe criterion 12 had excellent, six good and two fair results. On an average patients had full functional recovery in four months.Conclusion
Primary internal fixation of displaced comminuted mid-shaft clavicular fractures leads to predictable and early return to function thus preventing unacceptably high complication rates of nonoperative management of these fractures.Key Words: Clavicle fracture, Displaced, Middle third, Open reduction, Plating 相似文献3.
Background
The technique involving the free grafting of the mandibular condyle with a vertical ramus osteotomy was described by Philip Boyne in 1987 along with a series of 15 cases where a patient presented with a markedly displaced fracture dislocation of the mandibular condyle.Method
Twenty-one cases (25 condylar fractures) were treated with a modified Boyne technique.Results
Results showed that we had a complication rate of 12% (8% resorption, 4% fracture of the plate).Conclusion
The Boyne procedure should be thought of as a mainstream treatment method for the displaced fractured mandibular condyle. 相似文献4.
Sherin Kamal Elhalawany Bassel Tarakji SN Azzeghaiby Ibrahim Alzoghaibi Kusai Baroudi Mohammad Zakaria Nassani 《Nigerian medical journal》2015,56(1):48-53
Background:
Many different systems are available for the treatment of fractures ranging from the heavy compression plates for mandibular reconstruction to low profile plates for mid-facial fixation, and are made either from stainless steel, titanium or vitallium. Recently, biodegradable, self-reinforced polylactide plates and screws have been used for the internal fixation of fractures of the mandible with good results.Aim of this study:
This study evaluated clinically the biodegradable bone plates for treatment of mandibular body fracture and to evaluate bone healing during the follow-up period using digital radiography.Materials and Methods:
Eight patients had been suffered from mandibular body fractures were treated using Inion CPSTM bioresorbable fixation system and the healing process were followed up using digitised panoramic radiography at first week and after 1, 3 and 6 months.Results:
Clinical examination of fractured segments revealed stable fixation across the fracture sites while visual and quantitative assessment of radiograph showed healing process was comparable with results previously reported by titanium bone plates.Conclusion:
Open reduction and internal fixation of mandibular fractures using bioresorbable fixation system with a brief period of inter-maxillary fixation have evolved to the point where the physical properties are sufficient to withstand the post-operative loads required for fracture repair of mandibular body fractures. The foreign body reaction is a major material-related problem which requires further studies. 相似文献5.
Suresh Menon Ravi Manerikar SK Roy Chowdhury S Murali Mohan 《Medical Journal Armed Forces India》2005,61(4):345-347
Background
The concept of Distraction Osteogenesis is applied in Maxillofacial surgery extensively in the recent past, revolutionizing the concept of management of facial deformities specially the mandible.Methods
This article describes intra oral mandibular distractors in managing mandibular deformities in 9 cases.Conclusion
Surgical intervention is possible in very young patients. Distraction Osteogenosis does not reduce the need for orthodontic intervention. A multifarious approach to the problem, should form the basis of treatment of mandibular deformities.Key Words: Distraction osteogenesis, Mandibular hypoplasia, Congenital deformities 相似文献6.
Background
Locking compression plate (LCP) fixation of juxta articular and diaphyseal fractures of upper limb is a new modality of operative management.Methods
Twenty-five consecutive cases of juxta articular and diaphyseal fractures of upper limb were fixed with LCP and results were analyzed.Results
All fractures healed in good anatomical position in 6–8 weeks with good functional outcome.Conclusion
LCP is a reliable fixation device for juxta articular and diaphyseal fractures of upper limb. 相似文献7.
Background
We evaluated the efficacy of intermaxillary fixation (IMF) screws in the treatment of mandibular fractures.Methods
Two hundred patients with mandibular fractures, treated by IMF using these screws, were evaluated by pre and postoperative panoramic radiographs. Clinical testing was carried out for vitality and abnormal mobility of teeth adjacent to the site of screw insertions. Other factors such as possible iatrogenic dental injuries, loss, breakage or screw cover by oral mucosa and postoperative occlusion were also studied.Result
The most important complication noticed was iatrogenic damage to dental roots.Conclusion
Use of intraoral cortical bone screws for IMF is a valid alternative to arch bars in the treatment of mandibular fractures. Iatrogenic injury to dental roots is the commonest problem which can be minimized by an experienced surgeon.Key Words: Intermaxillary fixation, Bone screws, Mandibular fractures, Iatrogenic injury 相似文献8.
Background
Open reduction and internal fixation using an interlocking plate system has gained popularity for the treatment of dorsally displaced distal radius fractures.Purpose
To evaluate the functional and radiological results of treating unstable distal radius fractures with the volar locking plate.Patients and methods
A retrospective review was conducted of patients from one institution using the volar locking plate to treat intra-articular and extra-articular distal radius fractures. Unstable distal radius fractures in 15 patients, comprising 3 men and 12 women with a mean age of 64.4 years (34–76 years), were treated with a volar locking compression plate (Acu-Loc distal radius plate system; Acumed, Oregon, USA) and followed up for a minimum of 1 year. Fractures were classified using the AO classification. Radiographic parameters of preoperative, postoperative, and final follow-up radiographs were compared. The time to initiation of active range of motion was determined. Final follow-up range of motion and complications were reported.Results
At final functional assessment, the scores of 5 patients were excellent, 7 patients good, and 3 patients fair according to Cooney''s Clinical Scoring Chart. No non-union or infection occurred. Rupture of the flexor pollicis longus tendon occurred in 1 patient.Conclusion
Treatment of unstable distal radius fractures with a volar locking plate leads to satisfactory results, provided the operative technique is carefully performed to prevent complications. 相似文献9.
Background
Rigid internal fixation with metals is a reliable method of achieving osteosynthesis while allowing the patient passive or even functional loading of the fracture or osteotomised bone segments. The disadvantages with metals have led to the introduction of resorbable polymers in rigid internal fixation.Methods
This study was conducted to evaluate the efficacy of these polymers as compared to titanium in fixation of bone segments fixation in 40 patients of zygomatic complex fractures and craniosynostosis management. The cases were followed up for one year.Result
The stability of the fixation was found to be comparable to metallic fixation though the armamentarium and procedure of fixation of resorbable system was more demanding and the technique sensitive.Conclusion
The resorbable system is a good system for rigid internal fixation in specific conditions where muscular and stress forces are not a determining factor in fragment displacement.Key Words: Zygomatic complex, Resorbable system, Osteosynthesis 相似文献10.
MG Venugopal R Sinha PS Menon PK Chattopadhyay SK Roy Chowdhury 《Medical Journal Armed Forces India》2010,66(1):14-17
Introduction
The incidence of maxillofacial injuries is on the rise due to motor vehicle accidents and increased incidence of violence in recent times. The aim of this retrospective study was to determine the incidence, aetiology, the pattern of fractures, their management with open reduction and internal fixation (ORIF) and complications, if any.Methods
A retrospective analysis of 621 fractures in 361 patients managed by ORIF over a four year period was carried out.Result
The average age of patients was 24.3 years with a male to female ratio of 21.2:1. Panfacial fractures comprised 4.7%, frontal bone fractures 8.9%, orbital fractures 0.7%, naso-orbito-ethmoid complex (NOE) fractures 0.7%, zygomatic complex fractures 23.5%, fracture maxilla 11.5% and mandibular fractures 52.2% of all facial fractures. All the cases were successfully managed by ORIF under general anaesthesia (GA). Complications were noticed in 6.8% of cases in the form of reactive implants in 3.6%, deranged occlusion in 1% and infection at operated site in 1% cases which were managed satisfactorily.Conclusion
The findings of this study reveal sharp annual increase in the number of cases of maxillofacial trauma. Road traffic accidents (RTA) were the commonest cause and the age group most affected was between 20-25 years. ORIF of these fractures was chosen for its obvious advantages of direct anatomical reduction, early return to function and minimal complications.Key Words: Road traffic accidents (RTA), Inter maxillary fixation (IMF), Open reduction and internal fixation (ORIF) 相似文献11.
Objective
This study was designed to evaluate the functional and radiological outcomes of patients with complex tibial plateau fractures treated with double-buttress plate fixation.Methods
Sixty five cases of complex (Schatzker type V and VI) tibial plateau fractures were treated with double-buttress plate fixation in our centre from September 2001 to September 2006 through two separate plate incisions. Fifty four patients were followed up for a period ranging from 12 to 48 months and evaluated for the functional and radiological outcomes by a series of standard questionnaire and measurement.Results
Due to the good exposure without any extensive soft-tissue dissection of the double-buttress plate fixation, the fractures in all 54 patients were healed and the treatment achieved greater than 90% of satisfactory-to-excellent rates of reduction. The mean time of bone union was 15.4 weeks (range, 12-30 weeks), and the mean time of full weight-bearing was 18.7 weeks (range, 14-26 weeks). At the final follow-up visit, no patients showed knee instability; the mean range of motion was 107.6° (range, 85°-130°). For all patients, no statistically significant difference in the functional outcomes was observed between their 6-months and final follow-up visits; or in the radiological findings between their immediate postoperative and final follow-up examinations.Conclusion
Double-buttress plate fixation is a feasible treatment option for bilcondylar and complex tibial plateau fractures. Although technically demanding, it offers reliable stability without additional postoperative adjuvant external fixation, and at the same time avoids extensive soft tissue dissection, allowing the early painless range of motion. 相似文献12.
Background
Patients using single maxillary denture against their natural mandibular teeth face the problem of midline fracture in their routine acrylic dentures. Various techniques have failed over the years to address the problem. In this study, flexible denture material (Lucitone) with injection moulding system has been used and evaluated for midline fracture in these patients.Methods
A total of 58 patients in the age group of 38 to 80 years, who had experienced midline fracture in their acrylic maxillary dentures were selected. They were provided with new dentures using flexible denture material. Various parameters, namely, mastication, phonetics, esthetics and comfort level were evaluated.Result
Only two cases reported slight crack in the palatal region of the-maxillary dentures after 18 months of use. Mastication and phonetics were found to be improved with flexible dentures.Conclusion
The flexible denture is a promising material for preventing midline fractures in a single maxillary denture. It is well tolerated by the patients as compared to the methyl meth-acrylate dentures.Key Words: Midline fracture, Single denture, Flexible denture 相似文献13.
Background
Standard treatment of Stress fracture includes rest, compression, elevation and passive stretching. Low level laser therapy (LLLT) has been described in treatment of joint conditions, tendophaties, musculofascial pains and dermatological conditions. A prospective randomized control study was carried out to assess efficacy of LLLT in treatment of stress fractures in tibia.Method
68 cases were enrolled. 34 each in control and test group. Control cases were treated with placebo and test group with laser-therapy. Complete resolution of pain and tenderness, and return to painless ambulation was taken as end point of therapy in both groups.Result
The test group showed earlier resolution of symptoms and painless ambulation with fewer recurrence.Conclusion
LLLT appears beneficial in treatment of stress fracture in this preliminary study. A larger multicentric study is indicated to prove the benefit conclusively.Key Words: Stress fracture tibia, Low level laser therapy 相似文献14.
Background
A study was conducted to evaluate the role of total hip replacement in cases of advanced avascular necrosis of the head of femur in patients admitted to two tertiary care military hospitals. 20 patients reporting with avascular necrosis of femoral head were taken for study.Methods
Out of 20 patients, 16 were males and 4 were females. In 7 cases there was history of chronic alcohol intake and among them one patient was on steroids for long time for the treatment of bronchial asthma. 2 patients developed avascular necrosis of the femoral head following pregnancy and in two cases, it was post-traumatic. In the remaining nine cases, no cause was found and were so considered idiopathic. They were evaluated pre-operatively and total hip replacement was done in all twenty cases.Results
Patients were evaluated using Harris hip score. There was improvement of the score in all cases.Conclusion
Total hip replacement is a boon for patients of advanced avascular necrosis of femoral head.Key Words: Avascular necrosis, Total hip arthroplasty, Harris hip score 相似文献15.
Background
Stress fracture is the single most common cause for the lost number of manpower days during training. The conventional treatment options begin with rest and cessation of precipitating activity. However the demands of military training provide little tolerance for prolonged periods of rest. In the recent past ultrasound therapy (UST) has been reported to speed up healing of stress fractures.Methods
In the present study, a total of 67 cases of stress fracture were studied for the effect of ultrasound therapy on healing time. Study protocol used was double blind placebo controlled.Result
Study results showed that the mean number of days of incapacitation was 25.46 days in the ultrasound treatment group as compared to 39.92 in the placebo group, a difference of 14 days, which was statistically highly significant.Conclusion
The results of the study convincingly prove that ultrasound treatment is effective in cases of stress fracture.Key Words: Stress fracture, Ultrasound therapy 相似文献16.
Thomas Henriques Bryan W. Cunningham Paul C. Mcafee Claes Olerud 《Upsala journal of medical sciences》2015,120(3):198-206
Purpose
Anterior plate fixation has been reported to provide satisfactory results in cervical spine distractive flexion (DF) injuries stages 1 and 2, but will result in a substantial failure rate in more unstable stage 3 and above. The aim of this investigation was to determine the biomechanical properties of different fixation techniques in a DF-3 injury model where all structures responsible for the posterior tension band mechanism are torn.Methods
The multidirectional three-dimensional stiffness of the subaxial cervical spine was measured in eight cadaveric specimens with a simulated DF-3 injury at C5–C6, stabilized with four different fixation techniques: anterior plate alone, anterior plate combined with posterior wire, transarticular facet screws, and a pedicle screw–rod construct, respectively.Results
The anterior plate alone did not improve stability compared to the intact spine condition, thus allowing considerable range of motion around all three cardinal axes (p > 0.05). The anterior plate combined with posterior wire technique improved flexion–extension stiffness (p = 0.023), but not in axial rotation and lateral bending. When the anterior plate was combined with transarticular facet screws or with a pedicle screws–rod instrumentation, the stability improved in flexion–extension, lateral bending, and in axial rotation (p < 0.05).Conclusions
These findings imply that the use of anterior fixation alone is insufficient for fixation of the highly unstable DF-3 injury. In these situations, the use of anterior fixation combined with a competent posterior tension band reconstruction (e.g. transarticular screws or a posterior pedicle screws–rod device) improves segmental stability. 相似文献17.
Background
The incidence of pseudoaneurysm has increased due to the large number of vascular procedures performed and the widespread use of anticoagulation therapy during procedures. Non-invasive methods for management of pseudoaneurysms comprise of ultrasound guided compression (USGC), thrombin therapy, arterial embolisation and endovascular stent graft insertion. We discuss our experience in the management of fourteen cases of pseudoaneurysms using non surgical techniques.Methods
During a two year period, fourteen patients presenting with pseudoaneurysms of different regions were treated.Result
Of the fourteen patients, eleven were iatrogenic and three were attributable to trauma. There were six cases of pseudoaneurysms of the femoral artery following coronary angiography studies. One patient developed pseudoaneurysm of right popliteal artery after external fixation of fracture right tibia and fibula. Three cases of renal artery pseudoaneurysms occurred following percutaneous nephrolithotomy (PCNL). The cases were evaluated using a varying combination of color doppler, multidetector computerised tomography (CT) and angiography. These cases were treated with ultrasound guided compression (USGC), stent graft and coil embolisation. The selection of method was based on the location and size of pseudoaneurysms besides the efficacy of the technique. USGC was performed in seven, of which six were in the femoral artery and one supraorbital. The technique was unsuccessful in three of the seven, wherein stent graft was deployed in the femoral artery. Coil embolisation was utilised in three cases of renal artery pseudoaneurysms following PCNL.Conclusion
Follow up with color doppler and CT angiography within a week, 6 and 12 months period showed successful regression of pseudoaneurysms in all cases.Key Words: Pseudoaneurysm, Arterial trauma, Ultrasound guided compression, Coil embolisation, Endovascular stent graft 相似文献18.
Klemens Horst Frank Hildebrand Roman Pfeifer Karin K?ppen Philipp Lichte Hans-Christoph Pape Thomas Dienstknecht 《European journal of medical research》2015,20(1)
Background
Increases in C-reactive protein (CRP) and white blood cell (WBC) counts after orthopedic surgical procedures can give evidence of postoperative infection. However, there is a lack of knowledge about the kinetics of these biomarkers in cases with an uneventful clinical course after osteosynthesis of upper limb fractures. This study investigated CRP and WBC serum levels after osteosynthesis or hemiarthroplasty of humeral head fractures.Methods
A retrospective study on patients with humeral head fractures who had open reduction and internal fixation via plate osteosynthesis (PO) (n = 64) or hemiarthroplasty (HA) (n = 28) without any complications in the postoperative clinical course. C-reactive protein serum levels (mg/l) and leukocyte counts (g/l) were assayed at several time points. Multiple regression analysis was performed to evaluate the influence of several confounding variables (the surgical procedure, duration of surgery, patient’s health status, and comorbidities) on the kinetics of CRP and WBC.Results
Our data showed that CRP levels were statistically significantly higher in the HA cohort when compared to the PO cohort (p = 0.003). Moreover, daily measurement of CRP levels during the postoperative course showed that CRP peaked on the 2nd and 3rd days postoperatively in both cohorts and started to decrease afterward, reaching normal values on day 8 to 10. However, WBCs did not show any significant differences between the HA and PO cohorts. Finally, the choice of surgical procedure and the patient’s health status were associated with higher peak levels of CRP.Conclusions
After osteosynthesis or hemiarthroplasty of humeral head fractures, CRP is a responsive serum parameter in the postoperative course of an uneventful inflammatory response. Abnormalities from these values should be interpreted carefully as they may give a hint as to postoperative complications such as infection. 相似文献19.
Background
India accounts for approximately 10 million orthopaedically handicapped children and adults with limb deformity. Ilizarov ring fixator could treat most of these deformities.Methods
Twenty cases of deformities of lower limb managed with Ilizarov technique during period between March 2001 and February 2003 were studied.Results
55% were in the age group of 11-30 years. Out of the 20 cases studied, 6 were congenital talipes equino varus, 8 were fixed flexion deformity of knee, 4 were equines deformity of the ankle and 2 were malunited fracture shaft of tibia.4 patients who had recurrence were operated for fixed flexion deformity of the knee. The main complication encountered was pin tract infection, which was seen in 15(75%) cases. In 16(80%) cases, the results were excellent with no recurrence of deformity and patients were able to walk independently. In 4 (20%) cases, recurrence was mild to moderate (10 to 20) but all of them were able to ambulate idependently and carry out their routine activities.Conclusion
Ilizarov ring fixator is a superior compared to conventional methods for correction of deformities of lower limb.Key Words: Ilizarov method, Ligamentotaxis, Distraction 相似文献20.