STUDY DESIGN: Review of the literatures. OBJECTIVES: To provide the principles of fusion and internal fixation for the degenerative lumbar disc diseases. SUMMARY OF LITERATURE REVIEW: Lumbar spine stabilization can be achieved with fusion that eliminates the motion of the lumbar motion segment. MATERIALS AND METHODS: Fusion only or fusion with internal fixation, anterior or posterior approach, additional use of interbody fusion and cages as well as decompression have been used for the treatment of degenerative lumbar disc diseases. RESULTS: Various radiological and clinical results, fusion rates and complications have been reported on each fusion techniques and internal fixation devices in the literatures. CONCLUSIONS: Stabilization is considerd to be useful therapeutic option for degenerative lumbar disc diseases but not absolute one. Therefore, careful consideration should be required for its applications of degenerative lumbar disc diseases.
Decompression ; Internal Fixators ; Spine*

Subtrochanteric fracture is well known for its difficulty in management, though various devices of rigid fixation have been developed. Each internal fixation device requires a lot of surgical instruments and the surgeon must be skillful in using them. Osteo self-compression plate which was preoperatively bent to fit the contour of the lateral surface of the subtrochanteric region was proved to be technically easy to fix these fractures without causing major complication. Present authors recommend to use this prebent Osteo self-compression device to treat this fracture when the surgical instruments are not fully equipped, and suitable fixation devices are not available, and/or the surgeon has no experience in handling the newly developed surgical instruments for the subtrochanteric fracture.
Internal Fixators ; Surgical Instruments

PURPOSE: We examined the torsional change of eyeballs according to fixation using fundus photography. METHODS: We took fundus photographs of both eyes of the following patients: group 1, 10 unilateral superior oblique (SO) palsy patients; group 2, 20 exotropia (XT) patients without vertical strabismus or oblique dysfunction; and group 3, 20 normal subjects, from March 2002 to February 2005, using a fundus camera with and without fixation on the internal fixation device. We examined the torsional angle (alpha) between the horizontal line through the optic disc center and the line connecting to optic disc center with fovea using the Scion Image Program, and compared the torsional change according to fixation. RESULTS: The torsional angle (alpha) was 17.92 degrees with fixation and 18.79 degrees without fixation in paretic eyes of group 1 (p=0.46), and 8.78 degrees with fixation and 9.23 degrees without fixation in sound eyes of group 1 (p=0.36). The torsional angle was 6.35 degrees with fixation and 6.86 degrees without fixation in the right eyes of group 2 (p=0.39), and 6.40 degrees with fixation and 6.95 degrees without fixation in the left eyes of group 2 (p=0.28). In group 3, torsional angle was 6.95 degrees with fixation and 7.25 degrees without fixation in the right eyes (p=0.72), and 7.42 degrees with fixation and 7.48 degrees without fixation in the left eyes (p=0.89). Torsional angle with fixation was smaller than without fixation in all groups, but the differences were not statistically significant. CONCLUSIONS: There was no torsional change according to fixation by fundus photography in unilateral SO palsy patients, XT patients without vertical strabismus or oblique dysfunction, and normal subjects.
Exotropia ; Humans ; Internal Fixators ; Paralysis ; Photography ; Strabismus

Fifty six patients with unstable thoracolumbar bursting fractures were treated using variable internal fixation devices such as the Kaneda Anterior Fixation System(Kaneda device), the Z-Plate-ATL(TM) Anterior Fixation System(Z-Plate ATL(TM) device), the Harrington device, Cotrel-Ducousset(CD) or Compact Contrel Dubousset(CCD) device or Steffee Transpedicular System with or without decompression. Such internal fixation devices were grouped into anterior and posterior internal fixation devices and compared with each other in the aspect of the degree of neurological improvement, the changes of the vertebral height and the kyphotic angle, the duration of admission, and postoperative complications. In conclusion, the anterior internal fixation device appears to be of more benefit in the management of patients with unstable thoracolumbar bursting fracture.
Decompression ; Humans ; Internal Fixators ; Postoperative Complications

Orthopaedic wire has been used widely as a good internal fixator in cases of fracture, the ligament reconstruction, and for the stabilization of cervical spine. But if it is used inappropriately, a wire can be easy to fail by elongation, untwisting, or breakage. Among them, the most common failure of wire is breakage. To clarify the mechanism and the causes of wire failure, the authors analysed serial roentgenograms and scanning electronmicroscopic findings of broken wire in total 13 cases, which were experienced at the department of orthopaedic surgery, St. Mary's Hospital, Catholic University Medical College From January 1981 to December 1987. The results obtained were as follows :1. The mechanism of wire failure were classified into the 4 types ; minor continual flexing motion in 6 cases, repeated minor back and forth torsion in 1 case, tension failure in 2 cases and combined type in 4 cass. 2. The causes of wire failure were in appropriate use and inadequte application, a lack of s ufficient mechanical strength, micromotion due to inadequate postoperative imm obilization, early mobilization before tissue healing as well as certain injuries to the wire during handling in operation.
Early Ambulation ; Fatigue ; Internal Fixators ; Ligaments ; Spine

Locking plate technology offers improved fixation stability in osteopenic bone and for comminuted and periarticular fractures. The additional stability per screw compared with that of conventional nonlocking fixation enhances the application of minimally invasive fracture techniques. The application of locking plates is somewhat more difficult than the placement of conventional plates. Fracture reductions are often done indirectly, the locking screw must be carefully aligned along the axis of the receiving hole to ensure proper tightness, and the length of the plate must be selected carefully. The use of locking plates will likely increase, particularly with the increasing prevalence of osteopenic fractures on our aging population and the increase in high-energy fractures in younger patients severe trauma.
Bone Plates ; Fracture Fixation, Internal ; methods ; Humans ; Internal Fixators

Bone Plates ; Bone Screws ; Humans ; Internal Fixators ; Mandible ; surgery

Humans ; Internal Fixators ; Spine ; surgery ; Tuberculosis, Spinal ; surgery

Casts, Surgical ; Humans ; Internal Fixators ; Spine ; surgery ; Tuberculosis, Spinal ; surgery

PURPOSE: To analyze the results of posterior reduction with AO internal fixator or screw-rod system in thoracolumbar fracture and to find an adequate method of treatment. MATERIALS AND METHODS: We analyzed 40 cases of unstable thoracolumbar fractures who were operated with posterior approach without additional anterior approach. All cases were divided into two groups by the instrument used: Group A (25 cases) with AO internal fixator and Group B (15 cases) with screw-rod system. They were classified according to AO classification. RESULTS: There was no significant difference in correction and maintenance of sagittal index among types of AO classification except neurological recovery which was better in Type A. AO internal fixator had better results than screw-rod system in correction and maintenance of sagittal index, but no difference in neurological recovery. Eleven cases had more than 5 degrees of correction loss at final follow-up. In these cases, we found several findings; decreased vertebral body height, decreased disc height, bony collapse around screw at superior segment, metal loosening between rod and screw and metal breakage of screw. CONCLUSIONS: We concluded that AO internal fixator was good for the posterior reduction of thoracolumbar fracture in this study. But we think that continuous follow-up and further study are needed.
Body Height ; Classification ; Follow-Up Studies ; Internal Fixators