Stainless Steel Wire Loop Research Articles

Economical on table made reusable “J” Suture passer

Objective: To spread the knowledge about economical method and report its success with the on table, self-made, reusable suture loop with a commonly available stainless-steel wire loop. Materials and Method: We used 0.8 mm, 1.5mm and 2mm diameter size stainless steel wires to make suture loop with simple general instruments Results: Performed surgeries such as hip replacements capsule suturing, coracoclavicular ligament and acromioclavicular ligament reconstruction, trans calcaneal suture passage for tendo Achilles repair. Suture passage is much easier, quicker and very economical. Conclusion: Useful to every ortho surgeon wherever trans osseous and around bone passage of suture, tendon or wire is needed. ‘ J ’ Suture passer will save lots of money and work stress. Keywords: Jagan suture passer, J suture loop, Suture passer, Tendon passer.

Novel correction and fixation technique of forearm deformity in cases of hereditary multiple exostoses

We present three cases of forearm deformities which were corrected and fixed with a novel method using intra-osseous wire loops. Two cases of Masada Type I and one case of Masada type IIa forearm deformity were treated with an excision of the distal ulnar osteochondroma and corrective osteotomy of the radius at two sites with intramedullary nail, which was secured with two intra-osseous stainless steel wire loops. At 5 years follow-up of the first case, pronation improved from 35° pre-operatively to 70° post-operatively. At 3 years follow-up in the second case, pronation improved from 20° to 40°, whereas no significant improvement was noted in the third case at 2 years follow-up. The Radial Articular Angle and Carpal slip improved significantly for all the three cases. Thus, a good functional outcome can be obtained with this easy technique with minimal and cheap inventory.

Biomechanical analysis of tension band wiring (TBW) of transverse fractures of patella

PurposeTension band wiring is commonly used for fixation of simple transverse fractures. The popular configuration is parallel Kirschner wires (K-wires) and a stainless steel wire loop placed in a vertically oriented figure-of-8. MethodsWe used a wooden model of a patella with a midway transverse fracture and compared four different types of fixation. The first construct had a vertical figure-of-8 with one twist of wire. The second contained a vertical figure-of-8 with two twists of wire. The third was a vertical figure-of-8 with two twists of wire placed at adjacent corners while the last one had a horizontal figure-of-8 with two twists of wire placed at adjacent corners. Interfragmentary compression at the point of wire breakage was measured for each construct as well as permanent displacement on cyclic loading. ResultsPlacement of the figure-of-eight in a horizontal orientation with two wire twists at the corner improved interfragmentary compression by 63% (p < 0.05, Tukey post hoc test). On cyclic loading, all the constructs with vertical figure-of-eight but none with a horizontal construct failed (p = 0.01; Fisher's exact test). Permanent fracture displacement after cyclic loading was 67% lower with horizontal figure-of-eight constructs (p < 0.05; t test). ConclusionPlacing wire twists at the corner and a horizontal placement of figure-of-8 improves stability of the construct.

Surgical treatment of anterior cruciate ligament avulsion injuries in skeletally immature patients by cerclage wire loop technique

Introduction Tibial eminence avulsion fracture is the pediatric equivalent to a midsubstance anterior cruciate ligament (ACL) injury. It is most common between the ages of 8 and 19 years. Patients and methods From June 2009 to December 2012, 26 patients with ACL avulsion fractures were submitted to surgical treatment by means of a cerclage stainless steel wire loop. Seventeen patients were male and nine were female. Their ages ranged from 8 to 15 (mean: 12) years, and they were followed up for 6–22 (mean: 16) months. Results The Meyers & McKeever and Zaricznyj classifications were used for evaluating fractures for surgery. Radiographs in two views are often sufficient to establish a diagnosis. Cases were evaluated clinically by means of the anterior drawer test, which was negative in 21 patients, whereas four patients had residual laxity of about 2–3 mm increased manual anteroposterior tibial translation compared with the contralateral knee, without subjective feeling of instability. According to the Lyslholm scoring system excellent and good results were achieved in 24 (92%) cases, two patients showed fair results, and there were no poor results. Conclusion The use of a stainless steel wire loop cerclage by open technique gives excellent results, with benefits such as capture and control tension on ACL on each side of the avulsed fragment proper and adequate mechanical strength.

A novel operant-based behavioral assay of mechanical allodynia in the orofacial region of rats

BackgroundDetecting behaviors related to orofacial pain in rodent models often relies on subjective investigator grades or methods that place the animal in a stressful environment. In this study, an operant-based behavioral assay is presented for the assessment of orofacial tactile sensitivity in the rat. New methodsIn the testing chamber, rats are provided access to a sweetened condensed milk bottle; however, a 360° array of stainless steel wire loops impedes access. To receive the reward, an animal must engage the wires across the orofacial region. Contact with the bottle triggers a motor, requiring the animal to accept increasing pressure on the face during the test. To evaluate this approach, tolerated bottle distance was measured for 10 hairless Sprague Dawley rats at baseline and 30min after application of capsaicin cream (0.1%) to the face. The experiment was repeated to evaluate the ability of morphine to reverse this effect. ResultsThe application of capsaicin cream reduced tolerated bottle distance measures relative to baseline (p<0.05). As long as morphine did not cause reduced participation due to sedation, subcutaneous morphine dosing reduced the effects of capsaicin (p<0.001).Comparison with existing method: For behavioral tests, experimenters often make subjective decisions of an animal's response. Operant methods can reduce these effects by measuring an animal's selection in a reward-conflict decision. Herein, a method to measure orofacial sensitivity is presented using an operant system. ConclusionsThis operant device allows for consistent measurement of heightened tactile sensitivity in the orofacial regions of the rat.

Nuclear management in manual small incision cataract surgery by snare technique

Manual small incision cataract surgery has evolved into a popular method of cataract surgery in India. However, in supra hard cataract, bringing out the whole nucleus through the sclerocorneal flap valve incision becomes difficult. A bigger incision required in such cataracts loses its value action, as the internal incision and corneal valve slips beyond the limbus into sclera. Struggling with the supra hard cataracts through a regular small incision. Phacofracture in the anterior chamber becomes a useful option in these cases. In the snare technique, a stainless steel wire loop when lassoed around the nucleus in the anterior chamber constricts from the equator, easily dividing the hardest of the nuclei into two halves. The wire loop constricts in a controlled way when the second cannula of snare is pulled. The divided halves can easily be brought out by serrated crocodile forceps. This nuclear management can be safely performed through a smaller sclerocorneal flap valve incision where the corneal valve action is retained within the limbus without sutures, and the endothelium or the incision is not disturbed. However, the technique requires space in the anterior chamber to maneuver the wire loop and anterior chamber depth more than 2.5 mm is recommended. Much evidence to this wonderful technique is not available in literature, as its popularity grew through live surgical workshops and small interactive conferences.

Tension-band wiring of transverse fractures of patella. The effect of site of wire twists and orientation of stainless steel wire loop: a biomechanical investigation

Tension-band wiring is commonly used to treat transverse patella fractures. The most common configuration has parallel Kirschner (K) wires and a stainless steel wire loop placed in a vertically oriented figure of eight. Early mobilisation is important but can cause detrimental displacement at the fracture site. A wooden model of a transversely fractured patella was used to compare different fixation constructs. The fracture was fixed using two K wires and a stainless steel wire loop. One or two wire twists were used, placed either arbitrarily or at corners of the loop. The loop was oriented either vertically or horizontally. Interfragmentary compression at the point of wire breakage and permanent displacement on cyclic loading was measured for each construct. Placement of the figure of eight in a horizontal orientation with two wire twists at the corner improved interfragmentary compression by 63% (p<0.05, Tukey post hoc test). On cyclic loading, all constructs with vertical figure of eight but none with a horizontal construct failed (p=0.01; Fisher's exact test). Permanent fracture displacement after cyclic loading was 67% lower with horizontal figure of eight constructs (p<0.05; t test). Placing wire twists at the corner and a horizontal placement of figure of eight improves stability of the construct.

Sternal Approximation For Bilateral Anterolateral Transsternal Thoracotomy For Lung Transplantation

The traditional incision for bilateral sequential lung transplantation is the bilateral anterolateral transsternal thoracotomy with approximation of the sternal fragments with interrupted stainless steel wire loops; this technique may be associated with an unacceptable incidence of postoperative sternal disruption causing chronic pain and deformity. Approximation of the sternal ends was achieved with peristernal cables that passed behind the sternum two intercostal spaces above and below the sternal division, which were then passed through metal sleeves in front of the sternum, the cables tensioned, and the sleeves then crimped. Forty-seven patients underwent sternal closure with this method, and satisfactory bone union occurred in all patients. Six patients underwent removal of the peristernal cables: 1 for infection (with satisfactory bone union after the removal of the cables), 3 for cosmetic reasons, 1 during the performance of a median sternotomy for an aortic valve replacement, and 1 in a patient who requested removal before commencing participation in football. This technique of peristernal cable approximation of sternal ends has successfully eliminated the problem of sternal disruption associated with this incision and is a useful alternative for preventing this complication after bilateral lung transplantation.

Prosthesis for Aortic Arch Substitution

The risk of neurologic complications in aortic arch prosthetic substitution is directly related to the duration of the circulatory arrest. The purpose of this article is to report the experiments on animals of a device for simplifying and quickening the vascular anastomosis in aortic arch substitution. The device consists of expandable loops of stainless steel wire, sewn to the proximal end of a Dacron prosthesis. An actuating removable guide allows the stainless steel wire loops to be expanded and tightened, in such a way that the prosthesis diameter is varied, while maintaining a regular cylindric shape. The prosthesis end is then transformed into a rigid cylindrical ring, approximately half the maximal diameter in length, with a variable and controllable diameter. A composite graft was prepared, fitted with the expandable device at the distal end of the main prosthesis as well as at each end of the branches for the supraaortic trunks. Cardiopulmonary bypass was established by cannulation of the right atrium and left iliac artery. The prosthesis was positioned very easily and quickly during a brief hypothermic circulatory arrest; ascending aorta anastomosis was carried out by the standard technique after central nervous system reperfusion was resumed. Acute experiments were carried out in 5 swine. Four of 5 animals survived the procedure without detectable neurologic sequelae. At sacrifice the prosthesis was found to be properly sited without lumen distortion or thrombosis. The main advantages of this device and modality of arch substitution in a clinical setting would include drastic reduction of the circulatory arrest time, easy and reliable hemostasis of the anastomosis line, and accurate and firm approximation of the dissection layers in case of dissecting aneurysms.

Expandable prosthesis for sutureless anastomosis in thoracic aorta prosthetic substitution.

Most complications of descending aorta prosthetic substitution seem mainly to be related directly (ischemia to distal organs, i.e. liver, kidney, spinal cord) or indirectly (extracorporeal circulation or shunts and systemic heparinization complications) to the duration of blood flow interruption. the purpose of this study is to report the results of animal experimentation of a new device for sutureless prosthetic substitution of the descending thoracic aorta, with a very short cross-clamping phase. The device consists of expandable loops of stainless steel wires, sewn to the proximal end of a Dacron prosthesis. The stainless steel wire loops can be expanded and tightened by activating a removable guide in such a way that the prosthesis varies its diameter, while maintaining a regular cylindrical shape. The device was prepared in two different configurations, one for long segments (expandable prosthesis end) and the other to be used for very short segments or as an anastomotic ring between prosthetic or vascular stumps (quick anastomotic ring). The expandable prosthesis end was tested in swine experiments by performing the prosthetic substitution of the first 10 cm of descending cross-clamped aorta, the prosthesis being fixed with the device both at the proximal and the distal ends (six experiments). All animals survived the procedure, that was accomplished with a very short cross-clamping time. The quick anastomotic ring was used to anastomose two prosthesis ends, at the middle of the prosthetic segment used for descending aorta substitution (two swine), to perform the distal anastomosis in the same model of descending aorta substitution (one swine) and simply to re-anastomose a subtotally transected descending aorta (one swine). The present experience proved the reliability of the device to carry out a sutureless, accurate, simple and quick anastomosis. Its advantage over an intraluminal ringed prosthesis is much easier insertion of the retracted wired end into the vascular stumps, thus allowing for a prosthetic diameter appropriate to the substituted vessel. The reduced cross-clamping feature of the device would suggest its use mainly in thoracic aorta prosthetic substitution for the prevention of ischemic damage to distal organs; it can also be used to advantage wherever an end-to-end vascular or prosthetic anastomosis is indicated, providing an accurate, stented anastomosis.

The Use of Sublaminar Cables to Replace Luque Wires

Sublaminar wires have been used in conjunction with posterior instrumentation to stabilize the spine. Sublaminar wiring has fallen into disfavor because of an increase in neurologic complications with the Luque technique as well as wire breakage, dural tears, and difficulty of removal. A cable system consisting of two 49-stranded stainless steel cables connected to one malleable leader was designed to overcome these shortcomings. Biomechanical testing revealed that the maximum yield strength of a single stainless steel cable loop was 2.85-2.94 times greater than a double 0.05-in. stainless steel wire loop. The fatigue tests demonstrated that the stainless steel cables required 6-22 times more cycles to failure than the stainless steel wire. Many of the titanium cables failed immediately under higher loads (0-100 lb) because of slipping of the crimp. The preliminary clinical results after a mean of 19 months of follow-up of 245 cables are encouraging. There has been no breakage or loosening of the cables and no complications associated with the use of the cables. The stainless steel cables are very strong, but more important, the cable flexibility prevents repeated contusions to the spinal cord during insertion of the rods and tightening of wires. The cable conforms to the undersurface of the lamina. This may lead to a decrease in neurologic complications.

A new method for the collection of gastric secretion in conscious rats.

A new method has been devised for the collection of gastric secretion in conscious rats. A stainless steel wire loop was placed around the pylorus. Seven to 10 days later when the rat had recovered from the operation and was showing significant weight gains and food intake, it was starved for 48 h and collection of gastric juice was begun by tightening the wire loop. This effectively occluded the pylorus, and had the advantage that the animal remained conscious during the procedure. The rat was sacrificed after a certain period of time, and the gastric content was collected. After centrifugation, the total acidity of the supernatant was determined by titration with 0.01 N NaOH. With the present method, the total acid output as well as the rate of gastric secretion were significantly higher than those of similarly operated rats under restraint and those which were investigated using the Shay method. The gastric mucosa of each rat was examined and it was found that the incidence of gastric lesions in the control group using the present method was significantly lower than that in the other operated groups. This method is regarded as less unphysiological than the widely used Shay technique, in which pyloric ligation is performed in the unconscious rat immediately before the collection of gastric juice.

Traumatic intrusion of a maxillary central incisor

An intruded maxillary right central incisor was successfully removed from the nasal cavity of an auto accident victim. Removal was accomplished by use of a 25-gauge stainless steel wire loop.

Ranula in the dog--a surgical treatment.

SummaryA surgical treatment of ranula in the dog is described. The main features is the insertion of a stainless steel wire loop in a drainage incision. A permanent sinus or artificial puncta is hereby produced. The adaptability of this technique is illustrated in the two unusual cases presented.

Methods of marking the plane of section in the open lobotomy operation.

A number of methods have been devised for visualizing the plane of section following lobotomy. Lipiodol was used successfully for this purpose by Freeman and Watts (1), but in the “open” lobotomy the lipiodol may fall to the basal cisterns or enter the lateral ventricles and be distributed throughout the spinal fluid pathways of the brain and spinal cord. A gross method used by the authors and others has been the application of silver clips at the base, mid-portion, and apex of the vertical plane of section in the open operation. An angled clip applicator is useful for insertion of these clips at the base of the plane of section. Putnam (2) first suggested the use of tantalum wire markers in various types of lobotomy. For the standard open lobotomy operation and for cortical under cutting of selected areas of the prefrontal cortex (as performed by Scoville), the authors have used 30-gauge stainless steel wire loops as markers, bending the tips of the loops backward upon themselves in order to blunt them (...