Cannulated Cancellous Screw Research Articles

Long term outcomes of neglected intracapsular fracture neck in young adults managed by modified double angle barrel plate (DABP) with intertrochanteric valgusosteotomy

Introduction: Fracture neck of femur in young adult have relatively higher incidence of complications such as nonunion, avascular necrosis (AVN) of femoral head, loss of fixation, screw cut-out, and delayed secondary osteoarthritis. Delayed presentation of these cases in developing countries such as India further compromises the outcome of these fractures. Situations like this in young adult lead to difficulty in fixation by simple cancellous screw because of lack of compression surface area. Replacement surgeries in these cases are a difficult choice in these patients; it is difficult to restrict squatting for lifelong due to social culture and lack of toilets. Now, days also preferences are given to head sparing surgeries and osteosynthesis. Materials and Methods: Cases were selected from the patients attending orthopedics outpatient department and emergency trauma center from August 2006 to August 2012. During this period, total 56 cases of neglected fracture neck femur came to our department. Of these 56 cases, 36 cases qualify for inclusion into this study. Of 36 cases, 22 were female and 14 were male with an age range from 22 years to 48 years and average age of 42 years. Average duration from injury to operative procedure was 4.9 weeks (34 days) and range from 2 weeks to 18 weeks. These cases were operated by modified double angle barrel plate (DABP) with intertrochanteric valgus osteotomy with one cannulated cancellous screw (CCS). Results: Total 36 cases were operated using DABP and trochanteric osteotomy. Final outcomes were evaluated using modified Askin and Bryan criteria. Of these 36 cases, 32 (88.8%) cases gave good to excellent results and completed their full follow-up. Rest four cases were unable to continue with same implant fixation. These were kept in failure group. These four cases showed failure due to loss of reduction, screw cut-out, and secondary collapse of femoral head after AVN. These cases further managed by replacement surgeries. Discussion: Neglected fracture neck femurs are not rare presentation in developing countries. Various modalities of treatment are fibular graft, iliac bone graft, multiple screws with fibular graft, muscle pedicle graft. In our case series, we had done combination of DABP with trochanteric osteotomy with CCS and achieved excellent to good results and this method can be used a primary method for management of neglected femoral neck fracture.

肩鎖関節脱臼を伴う烏口突起骨折に対するcannulated cancellous screwの使用経験

肩鎖関節脱臼を伴う烏口突起骨折に対するcannulated cancellous screwの使用経験

Avulsion Fracture of Calcaneal Tubercle Treated with Cannulated Cancellous Screws and Wire - Surgical Technique -

Avulsion Fracture of Calcaneal Tubercle Treated with Cannulated Cancellous Screws and Wire - Surgical Technique -

Biomechanical evaluation of the fixation methods for transcondylar fracture of the humerus:ONI plate versus conventional plates and screws.

We biomechanically evaluated the bone fixation rigidity of an ONI plate (Group I) during fixation of experimentally created transcondylar humerus fractures in cadaveric elbows, which are the most frequently observed humeral fractures in the elderly, and compared it with the rigidity achieved by 3 conventional fixation methods:an LCP reconstruction plate 3.5 using a locking mechanism (Group II), a conventional reconstruction plate 3.5 (CRP) with a cannulated cancellous screw (Group III), and a CRP with 2 cannulated cancellous screws (CS) in a crisscross orientation (Group IV). In the axial loading test, the mean failure loads were:Group I, 98.9+/-32.6;Group II, 108.5+/-27.2;Group III, 50.0+/-7.5;and Group IV, 34.5+/-12.2 (N). Group I fixations failed at a significantly higher load than those of Groups III and IV (p<0.05). In the extension loading test, the mean failure loads were:Group I, 34.0+/-12.4;Group II, 51.0+/-14.8;Group III, 19.3+/-6.0;and Group IV, 14.7+/-3.1 (N). Group IV fixations showed a significantly lower failure load than those of Group I (p<0.05). The fixation rigidities against mechanical loading by the ONI plate and LCP plate were comparable. These results suggested that an ONI system might be superior to the CRP and CS method, and comparable to the LCP method in terms of fixation rigidity for distal humerus fractures.

Bankart-Bristow 変法の術後合併症について

Bankart-Bristow 変法の術後合併症について

An 11-year-old Boy with Ankle Trauma

An 11-year-old Boy with Ankle Trauma

Clinical Results of Percutaneous Cannulated Cancellous Screw Fixation for a Coracoid Process Fracture

Clinical Results of Percutaneous Cannulated Cancellous Screw Fixation for a Coracoid Process Fracture

不安定型大腿骨転子部骨折に対するＤＨＳを用いた治療戦略

The purpose of the present study is to report a new method for treating unstable intertrochanteric fractures using DHS (dynamic hip screw), TP (trochanter stabilizing plate), CCS (cannulated cancellous screw), and β-TCP (β-tricalcium phosphate). We particularly report the effectiveness of β-TCP for medial bone defects at the femoral neck.Twenty-five subjects were treated by the new method from May 2004 to December 2004 and compared with twenty-one subjects, treated by the conventional method without β-TCP, from April 2003 to April 2004.The average neck shortening was 6.0 mm in the new method group, compared with 9.6 mm in the conventional method group.The results of the investigation suggest that β-TCP prevents neck shortening in unstable intertrochanteric fractures.

大腿骨頚部骨折に対する骨接合術の治療成績

We treated 48 cases of femoral neck fractures between March 1998 and April 2000. The patients, consisting of 10 males and 38 females with a mean age of 72 years, were treated using compression hip screw (CHS) and cannulated cancellous screw (CCS). The purpose of this study was to investigate their clinical results. The bony union rate was 89% in Garden stages I and II and 72% in stages III and IV. There was a significant difference between bony union and alignment index (P<0.05) value. The most important factor was the quality of reduction.

鎖骨骨幹部骨折に対する手術成績 中空海綿骨螺子を中心に

59 patients with fresh fractures of the middle third of the clavicle were treated surgically from August 1992 to December 1997. The surgical technique by intra-medullary nailing with a cannulated cancellous screw (CCS) was mainly performed. The age of the patients at surgery ranged from 14 to 83 years old (average age: 40 years old). They consisted of 44 males and 15 females, 32 right side and 27 left side. In the beginning, 10 patients were operated with K-wires. From December 1993, for the purpose of protecting against the K-wire and improving the fixation, intramedullary nailing surgery using CCS was performed on 46 patients. 3 patients were operated with 1/3 tubular plates because of the narrow intramedullary space for CCS. 34 patients who were operated with CCS with only a 1cm skin incision at an average time of 33 minutes. In this way, intramedulary nailing surgery using CCS was performed with small skin incision, short operation time and moderately good fixation. CCS was however dissatisfactory at the rotational fixation and 1 patient resulted in pseudoarthrosis.

大腿骨すべり症に対するＰｉｎｎｉｎｇ ｉｎ ｓｉｔｕ法のＸ線学的検討

Thirteen hips in 12 patients with adolescent slipped capital femoral epophysis (SCFE) were reviewed to examine the radiological changes which occurred after pinning using the in situ method. The duration of follow-up was more than 2 years. No hips showed further slipping after pinning was performed using one of three methods such as long neck screw (LNS), Kirschner wire and cannulated cancellous screw (CCS). Twelve of the hips had show complete epiphyseal chosure within a mean period of 11.8 months after operation.In the radiological course of epiphyseal closure, it was commonly seen that a focal narrowing with sclerosis of the proximal femoral growth plate appeared at the posterior portion shortly after pinning. This narrowing then proceeded toward the anterior portion, leading to complete epiphyseal closure.There were no severe complications such as avascular necrosis. chondrolysis and degenerative changes of the hip. However, residual short neck deformity as well as buried screw heads inside the cortex were seen in this series, especially following multiple CCS pinning. Contralateral slipping of the epiphysis was observed in one of the four patients who had not had prophylacitic pinning.