OBJECTIVETo evaluate the effect of less invasive surgical treatment for high-energy tibia plateau injury with half-ring external fixation combined with minimum internal fixation.

METHODSFrom January, 2003 to May,2006, 16 cases of high-energy tibia plateau fracture were treated with half-ring external fixation combined with minimum internal fixation including 10 cases of type V and 6 cases of type VI according to Schatzker's classification. The average age of the patients was 42.4 years (range 25 to 50 years).

RESULTSAll patients were followed for an average of 16 months (range 5 to 27 months). All the fractures healed after an average time of 3.5 months. Two patients developed infections of the pin holes. According to the criteria of Rasmussen, excellent results were achieved in 10, good results in 4 cases, moderate in 2, and poor in none.

CONCLUSIONHalf-ring external fixation combined with minimum internal fixation can be ideal for treatment of complex tibia plateau fracture.

Adult ; External Fixators ; Female ; Follow-Up Studies ; Fracture Fixation ; instrumentation ; methods ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery ; Treatment Outcome

Bone Plates ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Minimally Invasive Surgical Procedures ; instrumentation ; methods ; Tibial Fractures ; surgery

Acromioclavicular Joint ; anatomy & histology ; injuries ; surgery ; Fracture Fixation ; instrumentation ; methods ; Humans ; Male ; Shoulder Dislocation ; surgery

Acetabular is an important human joint for weight bearing. Quadrilateral plate is a crucial structure of medial acetabulum with special morphology and important function. Quadrilateral plate fractures are common fracture in acetabulum. Quadrilateral plate fracture is hard to expose and reduction because it is in the medial of acetabulum. At the same time,the bone in the quadrilateral plate is not easy to fixed for thinning bones and adjacent to the articular cavity. The operator should know well about the anatomy and choose the suitable internal fixation. After quadrilateral plate fractures, the femur head maybe displace medially even break into pelvis. That make reduction and treatment always be a challenge. With different kinds of fractures,the efficacy of treatment is not the same. This paper intend to review the relation of anatomic features,approaches, internal fixations, key point of treatment and efficacy.
Acetabulum ; injuries ; surgery ; Animals ; Fracture Fixation, Internal ; instrumentation ; methods ; trends ; Fractures, Bone ; surgery ; Humans

Bone Nails ; Bone Plates ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Humans ; Tibial Fractures ; surgery

PURPOSETo describe our clinical experience with a system named SureShot? Distal Targeting (Smith & Nephew, Memphis, USA) based on magnetic field presence and discuss our suggestions on this technique.

METHODSWe analysed prospectively 47 patients affected by humeral, tibial or femoral fractures, treated in our institution during a 3-year period of time (August 2010 to September 2013). We considered the following parameters: the time to set up, the time to position a single screw, the effectiveness of the system (drilling ad screwing), the irradiation exposure time during distal locking procedure and surgical complications.

RESULTSA total number of 96 screws were inserted. The mean preparation time of the device was 5.1 min ± 2 min (range 3-10 min). The mean time for single screw targeting was 5.8 min ± 2.3 min (range 4-18 min). No major complications occurred. Only a few locking procedures were needed to be practiced in order to obtain the required expertise with this targeting device.

CONCLUSIONAccording to our results, this device is reliable and valid whenever the correct technique is followed. It is also user friendly, exposes to lower radiation and needs less surgical time compared to relative data from the literature. However, the surgeon should always be aware of how to use the free hand technique in case of malfunctioning of the system.

Bone Screws ; Fracture Fixation, Intramedullary ; adverse effects ; instrumentation ; methods ; Humans ; Magnetic Fields ; Prospective Studies

Fixation of proximal humerus fractures with precontoured, fixed angle devices has improved operative management of these difficult injuries, particularly in patients with osteoporosis. However, recent data has revealed that fixation with these constructs is not without complications, particularly screw cut-out and loss of reduction. Multiple strategies have been developed to decrease the number of complications. We offer a surgical technique combining suture augmentation of the proximal humerus with locked plate fixation utilizing short screws.
Bone Plates ; Bone Screws ; Fracture Fixation/*instrumentation/*methods ; Humans ; Shoulder Fractures/rehabilitation/*surgery

OBJECTIVETo study the biomechanical characteristics of Ni-Ti shape-memory alloy-enclosed interlocking intramedular nail Ni-Ti En for clinical application.

METHODSSix transverse fractures were induced in 6 fresh humeral shafts and fixed with Ni-Ti En, plate, interlocking intramedullary nail, and Ender nail, respectively. The specimens then underwent stress analysis for comparison of the bending strength, twisting force, and flexibility.

RESULTSThe bending strength of Ni-Ti En was not significantly different from that of the plate and better than ender's nail; the twisting force of the interlocking intramedullary nail was comparable with the plate, but better than Ender nail.

CONCLUSIONNi-Ti Enpossess good biomechanical property to meet the demand of osteosynthesis, and its less stress protection, freedom of distant nail locking, flexibility and stable fixation may accelerate fracture healing.

Biomechanical Phenomena ; Bone Nails ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Humans ; Humeral Fractures ; physiopathology ; surgery ; Nickel ; Titanium

OBJECTIVETo summarize application of rafting K-wires technique for tibial plateau fractures.

METHODSFrom January 2013 to January 2015,45 patients with tibial plateau fractures were treated by locking plate with rafting K-wires, including 33 males and 12 females with an average of 44.2 years old ranging from 22 to 56 years old. According to Schatzker classification, 6 cases were type II, 8 were type Ill, 4 were type IV, 4 were type V, and 5 were type VI. Allogeneic bone graft were performed for bone defects. All patients were fixed with two to five K-wires. Part of weight loading were encouraged at 3 months after operation,and full weight-loading were done at 5 months after operation. Postoperative complications were observed,and Rasmussen clinical and radiological assessment were used to evaluate clinical results.

RESULTSAll Patients were followed up from 10 to 23 months with average of 14 months. According to Rasmussen clinical and radiological assessment, clinical scores 23.58 ± 6.33, radiological scores were 14.00 ± 6.33; and excellent and good rates were 82.2% and 77.8% respectively. Four patients occurred severe osteoporosis and collapse of articular surface; 5 patients occurred traumatic arthritis.

CONCLUSIONRafting K-wires technique with anatomized armor plate could effective fix and support platform collapse and joint bone fragments, increase support surface area and reduce postoperative reduction loss rate.

Adult ; Bone Wires ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery

OBJECTIVETo investigate the influence on fracture stability by different pin construct during percutaneous pinning for the treatment of proximal humerus fractures.

METHODSEighteen pairs (36) adult fresh-frozen humeri were match-paired and divided into 4 groups. Dual-energy bone density scan had been used in order to rule out the influence by different degrees of osteoporosis of the cadaver. Two-part surgical neck fracture model was carried out unanimously in all 36 humeri. Four terminal threaded pins (2.5 mm in diameter) were used in fixation for all specimen. Parallel type pinning (box type) were carried out in 2 groups and convergent type pinning (fan shape) in the other 2 groups. Instron5566 biomechanical tester was applied in determining both anti-shear and anti-torsion ultimate load of each specimen.

RESULTSThere was no statistical difference between parallel pin construct and convergent construct in regard of anti-shear resistance (P = 0.73). But by mean of anti-torsion resistance, the parallel construct had significant advantage over the convergent construct (P = 0.04).

CONCLUSIONAccording to our biomechanical data, parallel pin construct seems to have better torsional stability. We suggest that parallel pin fixation should be applied whenever possible. Convergent pin construct should be considered when parallel construct is not possible or the distance between pins are too small (< 1 cm).

Biomechanical Phenomena ; Bone Nails ; Cadaver ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Shoulder Fractures ; physiopathology ; surgery