ISSN:0885-9698    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0885-9698    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The preferred surgical treatment of posterior dislocations of the shoulder is the Neer and Hawkins modification of the McLaughlin procedure. Technical “tips” are presented for three aspects of the procedure: preoperative planning with a CT scan, understanding the osteotomy angle, and preparing for a staged derotational osteotomy of the humerus in the event the shoulder is unstable after the McLaughlin procedure. The author hopes that these tips can prevent pitfalls and optimize the performance of this technically demanding procedure.

ISSN:0885-9698    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The use of absorbable polymers for fixation purposes is well established. Since 1970 various devices such as sutures, pins, screws, clips, and staples have been introduced, manufactured mostly from homopolymers and copolymers of glycolide and lactide. These synthetic materials possessed eminent advantages over the previous nonsynthetic materials, catgut and collagen. Control over uniformity, mechanical properties, and the rate of absorption was now possible. Modifications in the physicochemical properties of the materials have reduced the manifest cytotoxicity found in the early devices, and promising experimental devices, such as polymeric porous cell carriers, blocks, culture meshes, and tissue conduits, have opened the way for (guided) tissue engineering, and polymers which can be used as delivery systems for various growth factors. So far mere still needs to be caution with respect to the surgical indications for fixation devices: osteolytic bone lesions and sinus track formation have been relatively common side effects, as well as foreign body reactions and aseptic arthritis after intraarticular use of soluble fixation pins. Despite various self-reinforcement techniques in material fabrication, absorbable materials are not yet fully capable of replacing metallic devices. However, with improving techniques and new innovations, their future looks bright.

ISSN:0885-9698    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Bioabsorbable implants offer several advantages over metal implants when used in fracture fixation including gradual stress transfer to the healing bone and the elimination of secondary procedures for implant removal. However, the inferior mechanical properties of the polymeric implants have limited their widespread use. Research models to define these properties have been difficult to standardize secondary to the numerous factors governing thein vivobehavior of polymeric implants. Chemical composition, manufacturing processes, as well as physical and environmental factors influence the biomechanical characteristics when these implants are used in fracture fixation. The biomechanical properties change over time as the implants are degraded, influencing the clinical use of these implants.

ISSN:0885-9698    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Bioabsorbable implants have specific benefit in the treatment of certain children's fractures that have a high rate of implant removal where rigid fixation is needed only temporarily, and where implant removal would be difficult or costly. The bioabsorbable implant materials most commonly used today are polylevolactic acid (PLLA), polyglycolic acid (PGA), and poly-p-dioxanone (PDS). A technique for the fixation of a distal humerus lateral condyle fracture with bioabsorbable pins is described. A technique for the fixation of a Salter Harris IV transphyseal ankle fracture using bioabsorbable screws is also described. Specific complications and pitfalls associated with bioabsorbable fixation such as loss of fixation, soft tissue reaction, and osteolysis are discussed.

ISSN:0885-9698    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Osteochondral fractures of the femoral condyle are not uncommon in late childhood and adolescence, especially in connection with acute, traumatic dislocation of the patella. When the fragment is large, an open reduction and osteosynthesis is recommended. The best current solution to the technical problem of securing a thin osteochondral fragment is the use of resorbable pins, because resorbable pins allow immediate limited postoperative joint motion. In addition, some weight bearing is possible and can be performed without causing damage to other articular surfaces and without a risk of the fragment redislocating. No removal of the implants after fracture healing is necessary. The advantages of using biodegradable pins outweigh the risk for serious complications.

ISSN:0885-9698    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

This article deals with our own experience on the use of self-reinforced bioabsorbable devices in the fixation of humeral condylar fractures. The operative technique is presented also. A short discussion shows the advantages and disadvantages of this fairly new operative method. Bioabsorbable screws and rods seem to be suitable, especially for the fixation of displaced two-part fractures.

ISSN:0885-9698    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Bioabsorbable self-reinforced devices are a better choice for fracture fixation than biostable devices in which only the temporary presence of the device is needed. This article presents our own experience, especially operative technique, on the use of bioabsorbable devices in the fixation of olecranon and radial head fractures. It seems that these devices also offer certain advantages in these cancellous bone fractures.

ISSN:0885-9698    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Supplemental fixation is a useful technique for the treatment of displaced distal radius fractures. Bioabsorbable pins and screws can be used for this purpose in preference to metal Kirschner wires and conventional bone screws. The technique uses two pins placed at right angles. One pin is introduced from the radial styloid and is angled ulnarly and dorsally. The second pin is introduced from the dorsal ulnar corner of the distal radius and is angled volar and radialward. This method has been used successfully in our practice. The technique is described in detail in this article.

ISSN:0885-9698    

出版商:OVID    

年代:1998

数据来源: OVID