To assess whether patients receiving the DCP plate are receiving adequate fracture care, the stiffness of each plate design was tested in simulated models of types A, B, and C diaphyseal femoral fractures AO classification [ 18 ].
Materials and methods Inclusion and exclusion criteria All titles and abstracts of relevant studies were reviewed with a set of predefined inclusion and exclusion criteria.
The Schuhli nut is applied underneath a plate, between the plate and bone on the near cortex. Static Bending Test of the Plates Four-point static bending tests were conducted on hole 4.
Disagreement was resolved by group discussion, with arbitration by the senior author PK where differences remained. Acknowledgments The authors would like to thank Synthes Brazil for supplying the bone plates and the Faculty of Mechanical Engineering of the University of Campinas for supplying laboratory facilities.
No significant differences could be found between the plates for type A fracturesTable 2. Refracture after forearm plate removal. Bone graft is applied both beneath the plate and in the fracture site. In our study, no statistically significant differences were found between the plates for type A fractures, which is in agreement with the conclusion of Karnezis [ 26 ], who compared the rigidity characteristics of bridging and wave plating.
Synovial psuedoarthrosis can form in the presence of a loose implant. It also distributes bending stresses over a greater area of the plate, thus limiting the potential for fatigue failure under cyclic loading.
In Schone22 first used the silver nails for radial and ulnar medullary fixation, and subsequently various nails were developed to stabilize forearm fractures.
It is likely that these techniques disrupted the blood supply to the bone and limited the biological capacity of the bone to heal Previous article in issue. Radius was comminuted and ulna had transverse fracture.
An increased number of screws helps resist torsional loads, particularly if the screws are oriented in diverging directions The fixation remains stable in the two patients with persistent fracture lines, suggesting fibrous union.
Studies concerning several types of nonunions were included if the femoral shaft nonunions could be evaluated separately. Again, marked functional improvements were recorded both subjectively and objectively.
The LCP design minimizes contact with the bone, which reduces the damage to the periosteum and the resulting bone necrosis as well. Angle between the load application line and the specimen centerline: Two failures in group 1 was because, in 1 case patient was uncooperative or technical fault of surgeon and in 2nd case because of infection.
The first four holes relative to the plate end were used to anchor the osteosynthesis plates to the test specimens Figure 2. Rene Marti in Amsterdam, Dr. Despite this abundant callus a mechanical block to the forearm rotation had not been reported to our knowledge The principles of plate placement are detailed for both the epiphysis and diaphysis, including the number and position of screws and respect of the soft tissues, with the greatest success assured by the minimally invasive and even percutaneous techniques.
Septic and aseptic nonunions were included.
Ununited Fractures of the Proximal Humerus In a combined series with Michael McKee, MD in Toronto, we have reviewed the treatment of 25 patients with ununited fractures of the proximal humerus using blade plate fixation Intramedullary nailing of humeral shaft fractures with a locking flexible nail.
Ununited Fractures of the Humerus: Techniques for Enhancing the Fixation of Osteopenic Bone. David Ring, MD and Jesse B. Jupiter, MD Wave plate osteosynthesis consists of a plate contoured to stand away from the bone about _ to 1 centimeter at the fracture site.
Bone graft is applied both beneath the plate and in the fracture site. The wave plate shifts the neutral axis toward the lateral cortical region, so that the bone is in compression, while the plate is in tension [11, 12]. Ring et al. [ 13 ] used the wave plate and reported bone consolidation in 41 of 42 patients.
From the point of view of the stiffness, the DCP can still be safely used for the osteosynthesis the of healthy (non-osteoporotic) bones, either as wave plate for simple fractures or as straight plate for complex fractures, in situations where the high cost of the.
G. Blatter and B.
G. Weber: Wave plate osteosynthesis Fig. 2. a Intramedullary nailing after three failed platings, b The IM nail was being pushed out proximally because of shortening at. Plate augmentation and bone grafting without removing the nail had more advantages such as shorter operation time, less invasiveness and early weight bearing after surgery than plate fixation after removing the nail.
The Wave plate is a fixation system for open reduction and internal fixation (ORIF) of calcaneal fractures designed to be performed through a sinus tarsi approach. The system provides locking fixation applied through a minimally invasive approach.Wave-plate osteosynthesis