Metallic Button Research Articles

Short-term outcome of unicortical, intramedullary repair of distal biceps ruptures – A retrospective cohort study

Modern distal biceps reconstruction techniques generally have satisfactory outcomes, but are not without complications. Posterior interosseous nerve (PIN) palsy is a rare but potentially devastating complication of bicortical metal button fixation. Recently, a unicortical, intramedullary, repair technique utilizing a suture anchor has been described. The primary aim of this study was to compare short-term functional and patient-reported outcomes and complication rates in patients receiving unicortical intramedullary repair (UR) with suture anchor against those receiving bicortical repair (BR) with metallic button. We hypothesized that UR would have equally satisfactory outcomes without the complication profile. Retrospective chart review was conducted for all patients undergoing operative fixation of distal biceps tendon ruptures from 2015 to 2021 at our tertiary referral center. Twenty patients received BR, and eight patients received UR. Patient demographics and surgical complications were compared. QuickDASH scores at two-month and latest in-person and telehealth postoperative visits, as well as elbow and forearm range of motion at last clinical visit, were collected and analyzed. Average patient age in the BR & UR cohorts were 49.3±9.3 and 42.1±6.2 years, respectively, with a male predominance. There was no statistical difference in patient age, sex, hand dominance, injury laterality, injury chronicity, and follow-up duration. Range of motion was comparable and excellent in both groups. Latest follow-up was 3.0±0.5 years in the BR and 1.5±0.4 years in the UR cohorts. QuickDASH scores improved between the two-month and latest time points in each cohort however did not differ significantly in head-to-head comparison. Complications included a case of PIN palsy, distal biceps tendon rerupture, and lateral antebrachial cutaneous nerve (LABC) neuropraxia in the BR group and two cases of LABC neuropraxia in the UR group. The number needed to treat (NNT) for the prevention of one additional case of PIN palsy using UR is 22 patients. Short-term functional and patient-reported outcomes in traditional BR and newly reported UR of distal biceps tendon ruptures are comparable and excellent. UR did not have higher failure rate despite follow-up periods beyond what is typically reported for tendon reruptures. In this limited retrospective cohort study, UR also did not encounter postoperative PIN palsy and had an NNT of 22 patients. In the appropriate clinical setting, this provides early evidence supporting the utilization of unicortical intramedullary suture anchor fixation of distal biceps tendon ruptures as well as associated perioperative interventions such as preoperative nerve blocks.

Minimally invasive suture anchor – metallic button construct for acute acromioclavicular dislocations: A functional outcome pilot study in military cohort

Context: The best technique to achieve the optimum functional outcome in acute acromioclavicular (AC) injuries in young, active patients continues to be a matter of debate. Aims: The aim of this study is to evaluate the functional outcome of a minimally invasive technique for acute AC dislocation in military soldiers. Settings and Design: The study design involves prospective study from 2012 to 2016 at a tertiary care Military Orthopaedic center. Materials and Methods: Patients with an acute Rockwood Type III, IV, and V AC injury were included polytrauma, injury older than 2 weeks or requiring an open reduction, ipsilateral limb, and neurological injuries were excluded from the study. All patients underwent minimally invasive, percutaneous reduction and fixation with a suture anchor–metallic button construct. Patients were followed up at 6, 12, 24 weeks, 1 year, and 2 years postoperatively for radiological and functional assessment (Constant score). Statistical Analysis: Using analytical tests in SPSS software for comparison of coracoclavicular (CC) distance on the injured and healthy sides. Results: There were 25 male soldiers and cadets with a mean age of 24.5 ± 5.5 years. The mean follow-up duration was 37.9 ± 6.26 weeks. Twenty-four (96%) patients achieved pain-free, overhead shoulder abduction at 24 weeks follow-up with a mean constant score of 88.4 ± 7.43. The mean constant score at the last follow-up was 94.5 ± 5.67. Twenty-three (92%) patients had a well reduced AC joint; mean CC distance on the affected side was 9.1 ± 1.2 mm, comparable to mean distance of 8.9 ± 1.4 mm on the healthy side without any evidence of sclerosis or osteolysis till the last follow-up, while one patient had a recurrent dislocation. Conclusions: Suture anchor metallic button construct is a simple, surgeon friendly technique for young, high-demand patients to restore AC biomechanics in a minimally invasive manner.

Minimally invasive technique for coxofemoral luxation stabilisation using transarticular toggle system: a cadaveric study.

To present a novel, semi-closed, surgical technique for coxofemoral luxation stabilisation using a transarticular toggle rod. Cadaveric study. Craniodorsal luxation was generated by transecting the ligamentum teres in 12 coxofemoral joints and was then reduced using a closed technique. Anteversion and inclination angles were measured using fluoroscopic projections. An arthroscope was inserted through a bone tunnel drilled from the third trochanter through the femoral neck. Following retraction of the arthroscope, a hole was drilled through the acetabular fossa via the femoral bone tunnel. A standard Arthrex® TightRope toggle button was pushed through the femoral bone tunnel into the acetabular fossa hole and tied over the oval metallic button above the third trochanter site. The exit point of the drill hole over the femoral head and that in the acetabular fossa were evaluated by surgical exposure of the coxofemoral articular surfaces. The TightRope entrance point into the acetabular fossa was accurate in all joints, with a mean distance from the acetabular fossa centre of 0·06 ±0·1 mm. The measured distance of the TightRope exit point from the femoral head to the fovea capitis was 2·04 ±1·7 mm. Femoral head cartilage damage was detected in nine of 12 joints. Closed reduction and stabilisation of coxofemoral luxations can be achieved using this minimally invasive technique. Refinements to the technique may be needed for its application in clinical cases due to relative high incidence of femoral head cartilage damage.

Ex vivo biomechanical stability of 5 cricoid-suture constructs for equine laryngoplasty.

To determine the biomechanical properties of 5 suture constructs in the equine cricoid under cyclic loading and load to failure testing. Ex vivo study. Seventy-five equine cadaver larynges. Each larynx was implanted with 1 of 5 cricoid-suture constructs. The standard laryngoplasty, where a suture is passed once through the cricoid, including its caudal edge, was used in 2 constructs: 1 with 5 USP Ethibond (ES) and 1 with 2 mm Fibertape (FS). In the third construct, the 2 mm Fibertape was passed twice through the cricoid including its caudal edge (Double Loop-DL). Constructs 4 and 5 used 2 mm Fibertape in a U-shaped loop passed through the cricoid but excluding its caudal edge. One construct was supported with a metallic button (MB) on the caudo-ventral aspect of the cricoid while the other included only the U-shaped loop (U). Constructs were subjected to cyclic loading and to single cycle to failure. Reduction of the left-to-right arytenoid angle quotient (LRQ), suture migration, and load at failure were compared. LRQ reduction after cyclic loading was lower in MB and U than ES constructs. During cyclic loading, suture migration was reduced in MB, U, and DL compared to ES constructs. Mean load at failure was lower in FS and U than in ES constructs. Loss of abduction after equine laryngoplasty may be reduced and pullout forces increased by applying a MB construct in the cricoid cartilage. In vivo testing is required to verify these results.

G-Shaped Dual Band Wearable Button Antenna for ISM Band Applications

Performance of a dual-band wearable button antenna is presented. The designed radiation structure has a metallic G-shaped layer connected with a cylindrical base through metallic cylindrical tube. The modeled design has the structure and the dimensions of a standard metallic cuff button. The proposed wearable antenna is designed to cover the dual ISM bands for both WLAN/Bluetooth (at 2.45 GHz) and Hiper LAN (at 5.8 GHz) applications with omni-directional radiation patterns. Very good agreement between simulations and measurements in terms of radiation performance is observed.

A Study of Factors Affecting Wrist Channel Characteristics for Walking Postures Using Motion Capture

The creation of a 3D animated human model (avatar) to be used in electromagnetic (EM) simulation software is described for low outage body area network application such as healthcare. Scanned surface data of a human model is combined with movement data from a Motion Capture system to simulate an on-body channel between two dual band metallic button antennas (DBMBAs) mounted on the wrist and chest and the wrist and hip during walking. An investigation of how different factors such as human geometry parameters, arm swing and wrist twisting can affect the body-centric channel during walking action is presented together with the relative significance of each of these factors on predicting body-centric channel gain.

Considerations on Embroidered Textile Antennas for Wearable Applications

Planar inverted-F antennas (PIFAs) made of woven conductive textiles and of patterns embroidered with conductive threads are investigated. The influence of conductive thread density on antenna properties is considered in both cases. The effect of lockstitch on antenna resonant frequency is quantified. A metallic button is proposed as the transition between textile antennas and classical circuits. A full-textile prototype of a PIFA is designed and shown to operate properly in the ISM 2.4 band.

In Vitro Mechanical Testing of an Alternate Laryngoplasty System(ALPS) for Horses

Mechanical evaluation of a novel alternate laryngoplasty system (ALPS). Experimental. Cadaveric horse larynges (n = 10). Arytenoid and cricoid cartilages were embedded for testing. A novel laryngoplasty system consisting of a metallic anchor, 2 stands of #2 suture material, and a metallic button were evaluated. A traditional laryngoplasty using a single strand of #5 Ethibond was evaluated in parallel. Constructs were evaluated in cyclic testing oscillating from 30 to 50 N for 3600 cycles. Constructs subsequently underwent a single cycle to failure. Distraction during cyclic testing was recorded. Load at failure and stiffness were calculated from single-cycle failure testing. There was no difference in mean arytenoid single-cycle load-to-failure for the Ethibond (206.9 ± 13.1 N) constructs compared with ALPS (220.6 ±17.1 N) constructs (P = .486). In the cricoid under single-cycle testing, the ALPS (236.0 ± 23.4 N) constructs were significantly stronger than the Ethibond (161.5 ± 12.2 N) constructs (P = .013). The combined distraction was significantly greater for Ethibond (6.29 ± 1.24 mm) constructs compared to the ALPS (3.43 ± 0.28 mm) constructs (P = .033). The ALPS construct was stiffer and at least as strong as the traditional laryngoplasty construct in single cycle failure in both the arytenoid and cricoid cartilages. Combined distraction was significantly reduced using the ALPS compared to the traditional laryngoplasty in vitro under cyclic testing.

Pistoale balcanice cu cremene din colecţia Muzeului Banatului Timișoara / Flint Balkan Pistols from the Collection of Banat Museum in Timișoara

Pistoale balcanice cu cremene din colecţia Muzeului Banatului Timișoara / Flint Balkan Pistols from the Collection of Banat Museum in Timișoara

Dual-band wearable metallic button antennas and transmission in body area networks

A dual-band metallic antenna with the appearance of a button on a pair of jeans for use with wearable computer networks, emergency rescue scenarios and future wireless medical applications is presented. The design operates at 2.4 GHz WLAN and the HiperLAN/2 bands and a parametric study is given to aid the design process together with measurement and simulation of the structure on a body. A study of transmission between pairs of on-body antennas is presented to give insight into on-body propagating line of sight and non-line of sight channels. A term ‘body gain’ is defined to quantify how the body attenuates the channel.

Acromioclavicular Joint Reduction, Repair and Reconstruction Using Metallic Buttons-Early Results and Complications

Acromioclavicular joint (ACJ) dislocation is a common injury often affecting young adults. Its sequalae range from an asymptomatic shoulder to one that is painful with significant loss of strength in the affected upper limb. The management of ACJ dislocation has revolved around expert neglect for asymptomatic low-grade dislocation to complex surgical reconstruction. The authors describe their early experience with a new technique to reduce and maintain reduction of the coracoclavicular interval using a low-profile double-metallic button technique (Tightrope; Arthrex Inc, Naples, Fla). The fixation device comprises of a no. 5 Fibrewire suture that is tensioned and secured at both ends by metallic buttons against the cortices of the clavicle and the coracoid. The proposed advantages include a non rigid fixation of the AC joint that maintains reduction yet allowing for normal movement at the joint. The "snow shoe" hold on cortical bone means that the implant should withstand cyclic loading without cutting out from the bone. With these reasons, and because it is relatively low profile, there is no need for removal of implant. The authors have used this fixation technique on 8 patients. All the patients had strong intraoperative fixation. Immediate and 2-week postoperative radiographs demonstrated excellent reduction of the coracoclavicular interval and the AC joint. However, there were 4 patients with loss of reduction between 2 and 6 weeks postoperatively without additional injury. The mode of fixation failure is unclear at present. While the concept of metallic button fixation may have promise, the authors recommend further biomechanical assessment to evaluate potential weak link of the implant before its clinical use.

Polyethylene Failure of the Patellar Component in New Jersey Low-Contact Stress Total Knee Arthroplasties

In a postoperative 5- to 12-year follow-up study of 598 New Jersey low-contact stress total knee arthroplasties, 32 required revision. All retrieved patellar components were examined for polyethylene damage. These 32 cases had 3 types of failure: split rupture (7 cases), peripheral wear (21), and cantilevering breakage (4), respectively 75%, 64.3%, and 100% of which showed subluxation and/or tilting of the patellar component on the prerevision roentgenograms. Misalignment at the joint contact surfaces and rotational blockage of the mobile patellar component were considered the major causes of the failure. A design of a flatter metallic button (giving larger focal thickness of the polyethylene) and a dome-shaped polyethylene (reducing stress concentration at the pinnacle) may alleviate the failure driving mechanism should subluxation or tilting of the patellar component take place.

XIV. Description of a New Ore of Tellurium.

It occurs coarsely disseminated, and crystallized in perfect hexagonal plates striped on the edges. It has the whitish hue of tin. Its fracture displays a perfect foliation, but only in one direction. It has a strong metallic lustre; a moderate flexibility; considerable softness, and feels heavy. Before the blowpipe it burns with the colour and smell of tellurium, and has the same action with acids. The precipitate by water burns upon charcoal like tellurium; but after its sublimation a small metallic button remained of the colour of silver, malleable, but too minute for further examination; for on account of the rarity of the substance, I could only devote a single grain to this examination. It is found in the Orndal copper mine, accompanied by copper pyrites, and a small intermixture of sulphuret of molybdenum. The mine is called Mosnap, and has been full of water for several years. The vein lies in mica slate. I met with the same ore in Hungary, in the collection of my friend M. Gerhard, who gave me a specimen of it; but as he did not know from what part of Hungary it came, he did not value it. For this reason I omitted taking notice of it in the journal of my travels through Hungary and the Bannat of Temeswar. It is easily distinguished from molybdena, by its colour and its habitude before the blowpipe.