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Shaft Fractures (shaft + fractures)
Selected AbstractsA rat model for evaluating physiological responses to femoral shaft fracture reduction using a surgical robotJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 12 2008Markus Oszwald Abstract The first step in treatment of displaced femoral shaft fractures is adequate reduction of the fracture fragments. Manually performed, reduction can be challenging, and is frequently associated with soft tissue damage, especially when repeated reduction attempts are made. The magnitude of local and systemic inflammatory responses caused by prolonged and repeated reduction maneuvers has not been fully established. We devised an operative technique utilizing a robotic reduction device for use in a rat. A femoral fracture was simulated by means of an osteotomy. The robot enabled reproduction of both manual and guided precision reductions, performed in a single path movement. An external fixator was designed specifically to manipulate the rat femur and also for fixation of the osteotomy region. First, reduction accuracy was assessed in eight femurs, then the quality of fixator placement and reduction accuracy was analyzed in 22 femurs. In the first case, 100% of the femurs were accurately reduced. In the second case, 91% had successful stable fixation and an accurate reduction was achieved in 86% of the specimens. We demonstrated the feasibility of a model of robot-assisted fracture reduction that could be used to analyze the effects of reduction on the surrounding soft tissue via biochemical and histopathological means. A future aspect will be to evaluate whether the robot confers an advantage in fracture reduction versus the conventional technique, which would have significant implications for the use of robotic devices in orthopaedic surgery. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res [source] Pre-bent elastic stable intramedullary nail fixation for distal radial shaft fractures in childrenORTHOPAEDIC SURGERY, Issue 3 2010Yi-hua Ge MD Objective:, To investigate the functional and radiographic outcomes of pre-bent elastic stable intramedullary nail in treatment of distal radial shaft fractures in children. Methods:, From January 2006 to December 2008, 18 children with distal radial shaft fracture were treated by close reduction and internal fixation with a pre-bent elastic stable intramedullary nail. The age range was from 5 years to 15 years, with an average of 9 years and 8 months. The minimum follow-up was 12 months. Results:, All fractures maintained good alignment postoperatively, and 94.4% (17/18) of the patients regained a full range of rotation of the forearm. One patient has limitation of rotation to less than 10°, this had improved by final follow-up. Complications included soft tissue irritation at the site of nail insertion in one patient and transient scar hypersensitivity in another. Conclusion:, Fixation with a pre-bent elastic stable intramedullary nail is an effective, safe and convenient method for treating distal radial shaft fractures in children. [source] Soft tissue anatomy around the hip and its implications for choice of entry point in antegrade femoral nailingCLINICAL ANATOMY, Issue 6 2008C.M. Ansari Moein Abstract Antegrade intramedullary nailing is an accepted method of treatment for femoral shaft fractures. Entrance of the nail through the trochanteric fossa is currently recommended by some surgeons. This approach results in some cases, however, in loss of abduction strength and persistent pain. Nail insertion at the tip of the greater trochanter may be more favorable. In this study the anatomical relationships of the trochanteric fossa and of the tip of the greater trochanter were explored. Dissection was carried out in 10 fresh human cadaver femurs. The risks and safety of the two entry points with respect to the adjacent soft tissues were assessed. Abductor muscles and tendons, branches of the medial circumflex femoral artery and the hip joint capsule were at risk during nail insertion through the trochanteric fossa. These structures were not endangered during insertion through the trochanteric tip. The reported clinical morbidity after nailing through the trochanteric fossa may result from direct soft tissue injury and may be reduced by choosing the route through the greater trochanter. Clin. Anat. 21:568,574, 2008. © 2008 Wiley-Liss, Inc. [source] | ||||||||||