Miniature Plates Research Articles

Long-Term Functional Results of Intra- and Extra-Articular Hand Fractures Treatment With Titanium Miniature Plates and Screws With Minimum Follow-Up of 24 Months

IntroductionThe purpose of this study was to evaluate the long-term outcome of an extended range of hand fractures treated with titanium, low profile plates, and screws.Materials and methodsThis retrospective study included adult patients with at least one phalangeal and/or metacarpal fracture, treated with mini titanium plates and screws, between 2004-2016, in a single trauma center, that were followed-up for at least 24 months and with complete, intact medical records.Results90 patients (79 men and 11 women) with 114 hand (46 phalangeal, 68 metacarpal) fractures fulfilled the inclusion criteria. Thirty-two fractures were open (28.07%), 27 were intra-articular (23.68%), and 12 were both open and intra-articular fractures. The mean age of the patients was 36.02 years (range 17-75). Mean follow-up was 95.3 months (range 24 to 138). Open fractures had a reduced mean grip strength and total active motion. No difference was observed between intra-articular and extra-articular fractures (for grip strength and total active motion). Predictors of the final outcome included the severity of the initial injury (open vs closed) and not the anatomic location (intra- or extra-articular, metacarpal, or phalangeal) of the fracture.ConclusionsLow-profile plates and screws can successfully be used to establish union and restore the alignment of the fractured bone while achieving a satisfactory clinical outcome, even in cases of open or intra-articular fractures.

A prospective study to analyse various methods of surgical fixation of metacarpal & phalangeal fractures

Introduction: Fractures of metacarpals and phalanges are among the most common injuries seen in emergency departments, constituting between 14% to 28% of all visits. Though large number of hand fractures can be treated conservatively, but in some fractures like unstable, intraarticular and malrotated fractures, operative treatment is indicated. The present study was undertaken to evaluate the results of surgical stabilisation of metacarpal and phalange fractures of the hand. Method: A total of 25 patients of metacarpals and phalanges fractures of hand were included in this prospective study during the period April 2010-July 2013. Fractures were fixed with various fixation method as indicated. I.e. ORIF with Plate, ORIF with Screws, CRIF with Kirschner wires or External Fixator. Final evaluation of patients was done at the end of six months, based on criteria for American society for Surgery of Hand. Results: A total of 34 digits were involved in 25 patients. 32.35% of the fractures were spiral/ long oblique followed by 29.41% short oblique followed by comminuted and transverse fractures. Most of the patients were treated by Open reduction and internal fixation with plates and screws (47%) followed by fixation with screws and kirschner wire. A total of 12 minor complications were observed in 10 patients out of a total of 25. Finger stiffness was the most commonly observed complication. Overall end result was graded as acceptable in 97.03% (excellent to good) and non-acceptable in 02.94% (fair) cases. Conclusion: In conclusion, our series suggests that in low-severity fractures treated with miniature plates and screws, very favourable outcomes should be expected. Screw fixation was observed to give excellent results in spiral fractures of metacarpals and phalanges, while fixing fractures with kirschner wires trans fixation of joints should be avoided to get optimum results. Early mobilization is the key to get excellent functional results in all hand fractures.

Composite Patch Array Antenna with Built-In Polarizer and Its Road Clutter Reduction Effect for 76 GHz Automotive Radars

A composite patch array antenna with built-in polarizer has been developed to reduce road clutter noise by 20 dB for 76 GHz automotive radars. A polarizer is placed in front of Tx and Rx patch arrays within their reactive near-field region to suppress cross-polarized sidelobe radiation from their feeding lines while maintaining a low-profile characteristic with 4 mm thickness. Additional metal-lined absorbers within the composite antenna structure, while terminating cross-polarized waves undesirably excited by the patch arrays, also serve as miniature clutter plates to further reduce sidelobes toward the road surface. The resultant composite antenna achieved sidelobe levels of ―45 dB, a 20 dB improvement over standard patch arrays, at elevation angles close to 90°.

Photoelectronic analog-to-digital conversion: sampling and quantizing at 100 Gs/s

In high-speed analog-to-digital conversion of microwave bandwidth signals, jitter on the sampling pulse train limits speed and resolution. The use of a mode-locked laser pulse train to minimize jitter has been previously reported; in such previous study, the laser pulses are converted to electrical pulses through photoconduction. Here, we report initial results on a technique in which the conversion is performed by photoelectron emission. The electron pulse train serves as the sampling comb and is emitted from a photocathode illuminated by 266-nm 1.3-ps laser pulses. Each pulse is deflected by the analog voltage applied at a pair of miniature deflector plates to land on a code plate made up of an array of electron detectors. We report results of sampling and quantizing at 100 Gs/s using a metal photocathode. Our measurements indicate that our analog-to-digital converter achieves a 3-bit resolution. Experiments are now underway that employ 200-fs 730-nm pulses and an AlGaAs/GaAs photocathode and should show at least 4-bit resolution at 100 Gs/s.

Low-severity metacarpal and phalangeal fractures treated with miniature plates and screws

The results reported in the literature of metacarpal and phalangeal fractures treated with miniature plates and screws are scarce and contradictory. The aim of our study was to evaluate the functional results after low-severity metacarpal and phalangeal fractures treated by miniature plates and screws. We retrospectively reviewed 44 patients of a consecutive series with 56 low-severity metacarpal and/or phalangeal fractures stabilized with miniature plates and screws with a mean follow-up of 24 months to assess objective and subjective outcomes and complications. The objective assessment included measurement of the range of motion (ROM) of the involved finger, prehension, sensory function and strength. The subjective evaluation assessed the impairment and pain felt by the patient. At the final check-up, average total active movement of the involved digit was 256 degrees (range 175 degrees -260 degrees ), and average score for prehension was 49.3 (range 30-50), with 41 patients with a full score. The Jamar test pointed to a significant reduction in grip strength (-5.2%) of the injured hand compared with the other hand. Average subjective impairment score for all the fractures was 15.5 (range 10-16), with 39 patients having a score between 16 and 14 (no impairment). Fracture reduction was anatomic in 42 fractures (75%), satisfactory in 11 (19.6%) and unsatisfactory in 3 (5.4%). There were no contractures, non-unions, infections or tendon ruptures. Twenty patients (45%) presented with one or more complications in 23 fractures (41.1%). These very favourable results suggest that miniature plates and screws are a possible choice in the treatment of these fractures.

Spallation strength of single crystal and polycrystalline copper

The spallation strength of single crystal copper foils 100 micrometers thick of the and orientations and of polycrystalline copper foils has been determined. Laser driving was used to launch miniature plates. Also, the spallation strength of polycrystalline copper was measured using conventional gas gun techniques and plates for comparison. Experimental measurements include VISAR records of the free surface particle velocity and micrographs of recovered flyers. A 1D hydrocode was used to simulate the VISAR records to determine the dynamic pressure history of the spallation process. Judging by the calculated pressures, it was found that the foils were somewhat stronger than the foils, which were about twice as strong as the polycrystalline foils. These were, in turn, substantially stronger than the larger sample plates (1.5 mm thick) of the gas gun. In the polycrystalline foils, small voids are found in recovered samples impacted at flyer plate velocities almost producing spallation in the gas gun, indicating that this sparse damage in the foils is able to grow substantially more in the much larger gas gun plates and under much slower gas gun loading.

Carbohydrate Counting – A Practical Application

Carbohydrate counting is a practical meal planning strategy that provides opportunity for variety in meals and snacks for people with diabetes. This method of meal planning allows teenagers to participate in the daily activities that are an important part of life without sacrificing blood glucose control. The teaching tool is designed to be used in follow-up medical nutrition sessions as opposed to the initial session. The tool consists of a board game “A Tour of Ourtown”. The roll of a die determines progression through the board. The objective is to complete the trail. When the player lands on a space, situations are encountered that force the player to make food selection decisions based on a predetermined food plan. Miniature plates with food pictures are used. The food plates also display the number of carbohydrate grams or serving size from the exchange list. The events of the day that the player encounters are typical for a day in the life of a teenager. For example, the player may be attending a ball game and have blood glucose of 60 mg/dl or be on the way to grandmother's house for lunch. One or more players may participate. After adequate time is allowed, the educator and the client can discuss the selections made and review the teaching material. This game can be used to measure of the client's understanding of the carbohydrate counting meal-planning strategy for blood glucose control. The game also allows the educator to assess the client's understanding of basic personal nutrition.

MINIATURE PLATES AND SCREWS IN ACUTE COMPLEX HAND INJURY

Thirty-six patients with 72 metacarpal and phalangeal fractures with associated injuries to the neurovascular bundle, tendon, soft tissue, or bone following acute complex hand injury were treated with miniature plates and screws and reconstruction of the disrupted and missing structures. The results were judged according to the criteria of the American Society for Surgery of the Hand. The overall results were good in 46.3%, fair in 32.2%, and poor in 21.5%. Although traditional wiring techniques are certainly useful in complex hand injuries, internal osteosynthesis with miniature plates and screws has definite indications in cases requiring stable and rigid internal fixation.

Fixation of metacarpal and phalangeal fractures with miniature plates and screws

Fifty-two unstable metacarpal and phalangeal fractures were treated with miniature plates and screws as internal fixation devices with excellent results based on the criteria of the American Society for Surgery of the Hand (total active range of motion greater than 220 degrees). This technique stabilizes the skeleton, preserves the gliding tissues, and thus allows immediate active range of motion exercises. Transverse, spiral, oblique, and condylar fractures of the metacarpals and phalanges are best suited for this method.