Titanium Plate Research Articles

Surgery First and Aligners: A Case Report Combining In-House Surgical Guides and Pre-Adapted Titanium Plates

Continuous advancements in technology have made it possible to integrate clear aligner therapy (CAT) with orthognathic surgery. This case report presents a novel, individually-planned workflow, combining CAT with a surgery-first orthognathic approach (SFOA) in collaborating with engineers for an in-house production of surgical guides and customized titanium plates. The patient was evaluated subjectively, using the Oral Health-Related Quality of Life-14 (OHIP-14) questionnaire and Orthognathic Quality of Life questionnaire (OQLQ), and objectively with the Peer Assessment Rating (PAR) index. The patient displayed the planned occlusal relationship with no report of discomfort in the temporomandibular joint (TMJ) or post-surgical complications. The surgical and occlusal outcomes have remained consistent and stable after debonding. A decreased score was reported in both questionnaires and the PAR after treatment, thereby indicating improvements in both subjective and objective evaluations. This case report demonstrates that with proper individual planning, satisfactory subjective and objective outcomes can be achieved when combining SFOA with CAT.

Case series study and finite element analysis of a new cervicothoracic fixation device

ObjectiveTo introduce a specialized device designed for the fixation of the cervical-thoracic spine and describe its surgical installation, finite element analysis, and clinical outcomes.MethodsA finite element model of the C6-T1 segment was developed and validated, and simulations of subtotal resection of anterior cervical vertebrae, artificial vertebrae placement, and titanium plate fixation were performed. The model was subjected to a 75 N load to simulate the weight of the head and a 1 N·m force to simulate flexion, lateral bending, and axial rotation. The analysis focused on range of motion, total stress, stress in the artificial vertebrae, and stress in the device. The clinical outcomes were evaluated in a retrospective case series of 140 patients with cervical spine fractures.ResultsUnder the same loading conditions, the maximum stresses on specialized anatomical and biomechanical devices for the fixation of the cervicothoracic segment of the spine during neutral, forwards flexion, backwards extension, left lateral bending, right lateral bending, left rotation, right rotation and other working conditions were 25.097 MPa, 149.480 MPa, 64.150 MPa, 67.804 MPa, 72.754 MPa, and 117.98 MPa, respectively. And, the maximum ROMs were 2.230 mm, 5.585 mm, 4.682 mm, 3.184 mm, 3.061 mm, 4.451 mm, and 4.645 mm. Compared with those in the preoperative period, the patients’ CL, OPCL, UCL, LCL, UROM, LROM, VAS score, NDI score, JOA score, intervertebral space height at the injured segment, cervical anterior kyphosis angle, Cobb angle, vertebral displacement, ASIA grade, fracture classification, and vertebral displacement improved (P < 0.05). Sixty-two patients had dysphagia, and 3 patients experienced leakage of cerebrospinal fluid.ConclusionThe design of the new cervicothoracic internal fixation device conforms to the anatomical structure of the cervicothoracic spine, which can provide immediate stability, better screw placement and adequate bone grafting, and reduce the risk of complications. Despite some disadvantages, it is a good device for segmental fixation of the cervical and thoracic spine.

Evaluation of cortical bone thickness at the nasomaxillary and zygomaticomaxillary buttresses using cone-beam computed tomography imaging for Le Fort I osteotomy

Background/PurposeStudies have indicated that 50%–55% of the population have malocclusion, and approximately 5%–10% require orthognathic surgery to correct this condition. Optimal placement of plates and screws significantly affects the success rate of the surgery and postoperative stability. This study evaluates the cortical thickness of the maxillary bone in the nasomaxillary and zygomaticomaxillary buttress regions in Taiwanese patients based on cone-beam computed tomography (CBCT) images. Materials and methods128 Patients undergoing Le Fort I osteotomy were selected for this study. Their CBCT images were input into medical imaging software to simulate the placement of titanium screws and plates. The cortical bone thickness at these positions was measured to assess the thickness in the nasomaxillary buttress (surrounding the nasal opening) and the zygomaticomaxillary buttress (surrounding the maxillary zygomatic process). Associations of these thicknesses with gender, age, and screw position were analyzed. ResultsIn the nasomaxillary region, cortical bone was thicker on the upper and lower vertical regions, with men generally having thicker bone. The zygomaticomaxillary region had increased thickness near the zygomatic end and distal region. Younger adults had significantly greater bone thickness in certain areas than those over 30 years. ConclusionThe nasomaxillary region's upper and lower vertical regions and the zygomatic end in the zygomaticomaxillary region provide optimal screw placement sites. Bone thickness differences by gender and age suggest occlusal force and age-related bone resorption as influencing factors.

Development of Hybrid Implantable Local Release Systems Based on PLGA Nanoparticles with Applications in Bone Diseases

The current strategy for treating osteomyelitis includes surgical procedures for complete debridement of the formed biofilm and necrotic tissues, systemic and oral antibiotic therapy, and the clinical use of cements and three-dimensional scaffolds as bone defect fillers and delivery systems for therapeutic agents. The aim of our research was to formulate a low-cost hybrid nanoparticulate biomaterial using poly(lactic-co-glycolic acid) (PLGA), in which we incorporated the therapeutic agent (ciprofloxacin), and to deposit this material on titanium plates using the matrix-assisted pulsed laser evaporation (MAPLE) technique. The deposited material demonstrated antibacterial properties, with all analyzed samples inhibiting the growth of tested bacterial strains, confirming the release of active substances from the investigated biocomposite. The poly(lactic-co-glycolic acid)-ciprofloxacin (PLGA-CIP) nanoparticle scaffolds displayed a prolonged local sustained release profile over a period of 45 days, which shows great promise in bone infections. Furthermore, the burst release ensures a highly efficient concentration, followed by a constant sustained release which allows the drug to remain in the implant-adjacent area for an extended time period.

Performance of carbon felt as cathodes in magnesium corrosion method to recover phosphate from swine wastewater

With the large-scale development of the livestock and poultry breeding industries, swine wastewater with high nitrogen and phosphorus concentrations has become an urgent problem. Given the continuous demand for phosphorus resources in industrial production, the study of phosphate recovery in phosphorus-rich wastewater is of great value for the sustainable utilization of phosphorus resources and for alleviating the eutrophication of aquatic ecosystems. In this study, a magnesium metal corrosion method was used to recover phosphorus resources from swine wastewater using carbon felt as the cathode instead of traditional cathode materials such as graphite and titanium plates. The effects of different cathode materials on the corrosion potential of magnesium metal plates were compared, and the effects of carbon felt as a cathode plate on the removal rate and pH of phosphate from wastewater were discussed. Additionally, the economic feasibility of phosphate recovery from swine wastewater was evaluated. The experimental results showed that the effect of carbon felt on the corrosion potential of the magnesium metal plate was more evident than that of the graphite and titanium plates (Ecorr = −1.74676). When carbon felt was used as the cathode plate, the most energy-saving reaction conditions were as follows: reaction time T = 30 min, ratio of wastewater volume to plate area V: S = 500 cm3:50 cm2, aeration rate Re = 8 L/min, stirring rate r = 400 rpm, phosphate recovery rate = 92.3%, and pH = 8.83. The economic feasibility assessment shows that the proposed method is $2.047 g-1 PO4-P without considering the reuse of carbon felt. Carbon felt has good stability and can be recycled eight times or more, and the proposed method achieves a more efficient phosphate recovery rate at a relatively low cost.

Numerical Optimization of Functionally Graded Ti-HAP Material for Tibial Bone Fixation System

Functionally graded materials (FGMs) are heterogeneous composites characterized by outstanding properties. They are built from two or more components with a gradient distribution of chemical composition along a given direction. A promising graded material for biomedical engineering as an implant could be a FGM made of titanium (Ti) and hydroxyapatite (HAP). It would allow us to counteract the difference between the stiffness modulus of pure titanium and bone tissue. Moreover, it can be a good solution to the problem of stress shielding for bone fixation plates made of conventional titanium or steel. The presented paper aims to perform micromechanical modeling and optimization of a functionally Ti-HAP graded plate, followed by numerical analysis of a fractured tibia stabilization system under specific boundary conditions. Finite element analysis was performed using ANSYS Workbench 2021 software. The models of the FGM plate and tibial fixation system were made using the Space Claim tool. The ANSYS software allowed the optimization of the model considered and the selection of the appropriate structural parameters of the FGM Ti-HAP material. In general, the results proved that the osteosynthesis plate built of graded Ti-HAP material resulted in lower bone stress compared to titanium and steel plates. The results obtained confirmed the validity of the design and the possibility to use functionally graded Ti-HAP bone fixation plates.

Development of an implantable sensor system for in vivo strain, temperature, and pH monitoring: comparative evaluation of titanium and resorbable magnesium plates

Biodegradable magnesium is a highly desired material for fracture fixation implants because of its good mechanical properties and ability to completely dissolve in the body over time, eliminating the need for a secondary surgery to remove the implant. Despite extensive research on these materials, there remains a dearth of information regarding critical factors that affect implant performance in clinical applications, such as the in vivo pH and mechanical loading conditions. We developed a measurement system with implantable strain, temperature, pH and motion sensors to characterize magnesium and titanium plates, fixating bilateral zygomatic arch osteotomies in three Swiss alpine sheep for eight weeks. pH 1–2 mm above titanium plates was 6.6 ± 0.4, while for magnesium plates it was slightly elevated to 7.4 ± 0.8. Strains on magnesium plates were higher than on titanium plates, possibly due to the lower Young's modulus of magnesium. One magnesium plate experienced excessive loading, which led to plate failure within 31 h. This is, to our knowledge, the first in vivo strain, temperature, and pH data recorded for magnesium implants used for fracture fixation. These results provide insight into magnesium degradation and its influence on the in vivo environment, and may help to improve material and implant design for future clinical applications.

PLLA/GO Scaffolds Filled with Canine Placenta Hydrogel and Mesenchymal Stem Cells for Bone Repair in Goat Mandibles.

Bone defects in animals can arise from various causes, including diseases, neoplasms, and most commonly, trauma. Comminuted fractures that exceed the critical size may heal poorly due to deficient or interrupted vascularization, resulting in an insufficient number of progenitor cells necessary for bone regeneration. In this context, 3D printing techniques using poly-L-lactic acid/graphene oxide (PLLA/GO) aim to address this issue by creating customized scaffolds combined with canine placenta hydrogel and mesenchymal stem cells for use in goat mandibles, compared to a control group using titanium plate fixation. Ten canine placentas were decellularized and characterized using histological techniques. A hydrogel derived from the canine placenta extracellular matrix (cpECM) was produced to improve cell attachment to the scaffolds. In vitro cytotoxicity and cell adhesion to the cpECM hydrogel were assessed by scanning electron microscopy (SEM). The resulting biomaterials, cpECM hydrogel and PLLA/GO scaffolds, maintained their functional structure and supported cell adhesion, maintenance, and proliferation in vitro. Thermography showed that PLLA/GO scaffolds with cpECM hydrogel performed effectively, similar to the control group. Computed tomography scans revealed bone calluses, suggesting an ongoing repair process. These findings demonstrate the innovative technological potential of these materials for use in surgical interventions. Future studies on PLLA/GO scaffolds will provide further insights into their effects on goat models.

Evaluation of the Effect of Pre-bent Z-shaped Titanium Plate on Narrowing of Zygomatic Arch in L-shaped Reduction Malarplasty

Objective: Pre-bent titanium plates are widely used for internal fixation in L-shaped zygomatic reduction. The aim is to evaluate the effect of pre-bent Z-shaped titanium plate on the narrowing of the zygomatic arch in L-shaped reduction malarplasty. Methods: Thirty cosmetic female patients were selected and scanned using computed tomography (CT). The CT images of pre-operation (T1) and post-operation(T2) were re-established through MIMICS26.0 (Materialise). After the 2 images were registered based on the skull base, the narrowing distance (ZRN) at the posterior end of the free zygomatic arch, as well as the preoperative and postoperative cross-sectional dimensions of the zygomatic arch, were measured. The ZRN and the altitude of the pre-bent titanium plate (TA) were compared using an independent t test, and their correlation was also analyzed using the Pearson coefficient. The preoperative and postoperative longest diameter (L1) and shortest diameter (L2) of the posterior zygomatic arch were compared using a paired t test. Results: The TA was 3.80±0.82 mm and the ZRN was 3.21±0.82 mm. The difference value was 0.59±0.41 mm, which was statistically significant. TA showed a strong correlation with ZRN (r=0.916, P=0.002). The L1 and L2 of the zygomatic arch root were slightly reduced postoperatively. Conclusion: The pre-bent Z-shaped titanium plate does not completely correspond to the zygomatic arch narrowing distance in the actual application of L-shaped reduction malarplasty. However, it can control the narrowing distance of the zygomatic arch predictably, and achieve satisfactory surgical outcomes.

Surgical management of costal margin rupture associated with intercostal hernia: Evolution of techniques

INTRODUCTION Costal margin rupture (CMR) injuries in association with intercostal hernia (IH) are rare and symptomatic and provide a significant surgical challenge. Surgical failure rates up to 60% are reported, and optimal techniques are unclear. We have characterized these injuries and describe the evolution of our surgical management techniques. METHODS Patients characterized by the Sheffield Classification where CMR and IH were both present, either CMR-IH or transdiaphragmatic intercostal hernia (TDIH), were identified prospectively, and injury characteristics, patient management, and follow-up data were recorded. Surgical techniques evolved according to patient outcomes from suture repair without and then with extrathoracic mesh, to three iterations of double-layer mesh repair (DLMR). The third iteration involved DLMR with biologic mesh, titanium buttress plates applied to the ribs adjacent to the IH with intercostal nerve-sparing suture placement. Associated surgical stabilization of rib fractures, or surgical stabilization of nonunited rib fractures, was performed when required, with costal margin plate fixation where possible. RESULTS Of 25 patients with CMR-IH and 11 with TDIH, 25 patients underwent surgery, with 6 reoperations in 5 patients. There were 8 suture repairs and 3 extrathoracic mesh repairs: DLMR was performed in 14 patients (3 Mark [Mk] 1, 5 Mk 2, and 6 Mk 3) with 2, 1, and 0 reoperations, respectively. Costal margin stabilization with titanium plates was successful twice at the level of the seventh but failed twice out of three times at the ninth costal cartilage. Reoperation after a failed mesh repair is particularly challenging and may require the placement of titanium buttress plates, surgical stabilization of rib fractures, and the use of stainless steel wire sutures. CONCLUSION Repair of CMR-IH/TDIH is challenging, but experience-based evolution of techniques has led to a durable and reproducible Mk 3 repair. LEVEL OF EVIDENCE Observational; Level III.

Arthroscopic Repair of Medial Meniscus Posterior Root Tear with Adjustable Titanium Plate Fixation.

Medial meniscus injury is one of the most prevalent knee disorders, with posterior root tears occurring in approximately 10% to 21% of affected individuals. A posterior root tear disrupts the meniscus's continuous annular structure, compromising its ability to absorb pressure and protect the knee's articular cartilage. If left untreated, this can result in increased stress on the cartilage, leading to conditions such as varus deformity and accelerated joint degeneration. Partial removal (resection) of the medial meniscus further exacerbates these issues, often leading to quicker joint deterioration. Repairing medial meniscus posterior root tears (MMPRTs) plays a crucial role in restoring the meniscus's structural integrity and improving knee biomechanics. Studies have shown that compared to partial medial meniscectomy or conservative treatments, repairing MMPRTs enhances clinical outcomes and significantly delays the onset of arthritis. This article details a surgical procedure that uses a single-suture, double-loop, adjustable titanium plate fixation technique under arthroscopy for effective MMPRT repair.

A Novel Approach for Improving Midface Aesthetics: A Pilot Study.

Asian individuals often seek solutions to address midface depression and enhance nasal alar base morphology to achieve Western facial aesthetics. Current treatment options, including injections and invasive procedures, have limited efficacy and safety. To address these challenges, we introduced the "modified A-10 surgery," which integrates the Point A-Koji method, titanium plates, and artificial dermis insertion. The efficacy of the modified A-10 surgery was illustrated using a case study of a 22-year-old woman. Surgical planning was based on dental cone-beam computed tomography data, with lateral cephalometric radiographs used to determine the titanium plate dimensions. The surgery involved customized plate alignment, fixation, and artificial dermis insertion. The modified A-10 surgery substantially improved facial aesthetics and structural parameters. Facial convexity increased from 15.5 degrees to 23.2 degrees, enhancing the 3-dimensionality. The nasolabial angle shifted from 91.9 degrees to 110.2 degrees, achieving the desired mouth projection. Other measurements, such as the E-line to the lower lip and the distance from point A to the subnasal point, contributed to refined aesthetics. The nasal alar base thickness increased by 2.2 mm (19.5%), correcting the depression. The modified A-10 surgery represents a minimally invasive and comprehensive solution for midface depression and nasal alar base enhancement. By combining the Point A-Koji method, titanium plates, and artificial dermis insertion, this surgery successfully achieved improved facial aesthetics and contours. The results validate its potential as a long-term solution, with implications for antiaging interventions and promising avenues for future research.

A recent algorithm for management of orbital floor fractures with the application of a novel minimally invasive endoscopic surgery

Orbital floor (OF) fractures present a dilemma, with controversies surrounding surgical indication, approach, and ideal material for reconstruction. Our study was conducted on cases of OF fracture admitted to a tertiary referral centre. Cases of OF associated with zygomaticomaxillary complex (ZMC) fracture were managed as follows: those with ophthalmological problems were subjected to endoscopically assisted transorbital reconstruction of the floor; cases without ophthalmological problems were subjected to reduction and fixation of the ZMC fracture only. The recently developed endoscopic endonasal transmaxillary approach was used to manage cases with pure OF fracture, while the same approach with added endoscopic transethmoidal reconstruction of the medial orbital wall (MOW) was applied to cases with associated MOW fracture. Outcome measurements were the correction of diplopia and enophthalmos, along with the restoration of normal globe function. The study included 80 patients, who were divided into four groups according to the proposed algorithm. OF reconstruction was performed in 32 cases with either septal cartilage (n = 4), titanium plate (n = 11), or porous polyethylene mesh (n = 17). Our study presents the novel role of minimally invasive endoscopic surgery in the management of OF fracture, together with a recently developed management plan that could maximize positive outcomes and decrease morbidity.

Analysis on the mechanism of titanium plate pretreated by ultrasonic shot peening in improving interfacial shear strength of Ti/Al laminated composite

Analysis on the mechanism of titanium plate pretreated by ultrasonic shot peening in improving interfacial shear strength of Ti/Al laminated composite

Comparative study of anodized TNTs and S-TNTs on Ti plates for effective methylene blue degradation under UV LED and direct sunlight

The key findings of this research are focused on enhancing the degradation of methylene blue dye with titania nanotubes acting as catalysts under benign UV LED and sunlight. By comparing pristine and sulfur-doped titania, the study reveals that the doped-titania with anatase phase demonstrates a superior photocatalytic activity than pristine titania with mixed phases, achieving a remarkable 98 % degradation of dye within 120 min under direct sunlight with a small amount of hydrogen peroxide. This enhanced performance is attributed to the 10.7 μm longer and well-arranged nanotubes, effective surface area, better bandgap of 2.39 eV, effective anatase phases, and a lower 20 nm crystallite size. The study underscores the importance of anodization and sulfur doping using titanium plates to tailor the properties of the resultant nanotubes. Also, it indicates a cost-effective dye removal method without secondary pollution, offering a practical and optimistic solution to environmental challenges. The effective titania nanotubes for photocatalytic application in environmental remediation were identified through field emission scanning electron microscope, energy dispersive X-ray analysis, X-ray diffraction analysis, and diffuse reflectance analysis, providing valuable insights and inspiring future research and application in this field.

Wartime penetrating traumatic brain injury of the anterior skull base involving the paranasal sinuses: a single-center, first-year experience from Dnipro, Ukraine.

Since February 2022, the number of casualties in the Russian-Ukrainian war have dramatically increased, with a high incidence of penetrating traumatic brain injuries (pTBIs). To date, there has been limited evaluation of pTBI of the anterior skull base involving the paranasal sinuses. The objective of this study was to highlight the authors' experience with this injury pattern and identify specific factors associated with favorable short-term (1-month) outcome and survival. The authors conducted a single-institution retrospective review of patient data collected from the 1st year of the Russian-Ukrainian war at a frontline civilian Ukrainian hospital. To prevent complications from conservative treatment of pTBI with paranasal sinus injury, a protocol of early primary neurosurgical treatment including debridement/hematoma evacuation, repair of dural defects with vascularized pericranial flaps, and titanium plating of external/skull base defects was implemented. Using 1-month postoperative Glasgow Outcome Scale scores, the authors defined a favorable outcome as good recovery/moderate disability and a poor outcome as severe disability/vegetative state/death. Patient demographics, injury characteristics, imaging findings, and postoperative complications were assessed. Logistic regression models were used to estimate the effect of patient characteristics on unfavorable outcome or survival. From February 2022 to February 2023, there were 141 pTBIs (20%) involving the paranasal sinuses, 134 (95%) due to blast fragmentation. One hundred eighteen patients (84%) had a favorable outcome. Most patients with pTBIs (69%) had other nonbrain-related injuries. While 48 patients (34%) presented with preoperative CSF leak, only 1 patient (0.7%) had persistent postoperative CSF leak, which was managed with lumbar drainage. High admission Glasgow Coma Scale (GCS) score, favorable injury lateralization (single hemisphere involved), and low Injury Severity Score (ISS) were associated with significantly increased odds of favorable short-term outcome, whereas high admission GCS scores and no midline shift were associated with significantly increased odds of survival. This was the largest single-year study on neurosurgical treatment of wartime pTBI involving the paranasal sinuses. Implementation of primary neurosurgical intervention at the time of presentation demonstrated promising early results and a shift away from expectant management of this injury pattern. The association of high admission GCS score, low ISS, favorable injury lateralization, and no midline shift on favorable short-term outcomes or survival has not been previously documented with this injury pattern.

Experimental and Histological Validation of Nanostructured Products Use in Maxillofacial Surgery

The aim of the study is using experimental histological techniques to validate the beneficial potential of specific medical devices made of nanostructured titanium, and compare their effect with factorymade products currently applied in maxillofacial surgery. Material and methods. The study involved 50 sexually mature male Chinchilla rabbits. An open fracture of the lower jaw was simulated in the animals. In the 1st series of the experiment, the fragments were fixed using nanostructured miniplates and miniscrews made of Grade 4 titanium. In the 2nd series, they were fixed with standard miniplates and miniscrews from Konmet LLC. The material for the study was taken on the 7th, 14th, 21st, 28th and 40th days after the operation. In all series the object of the study was the extirpated lower jaw in the fracture area. The prepared histological sections were stained with Mayer's hematoxylin and eosin. The immunohistochemistry technique was used to identify cells with signs of proliferation (synthesizing the Ki67 protein), to assess the expression of the synthesis of proteins p53, caspasa 3 and the anti-apoptotic protein bcl-2. The surfaces of titanium structures were studied by scanning electron microscopy. The results were processed statistically. Results. The study investigated the effect of miniplates and miniscrews made of nanostructured and standard titanium on rabbits. The data obtained revealed the nature of the proliferative and apoptotic potentials of osteoblasts in the regenerate, and also indicated an increase in the ratio of the number of cambial cells and cells with an apoptotic dominant in the zone contacting with the nanostructured surface of the titanium screw compared to the titanium screw manufactured by Konmet LLC. Taken together, the obtained data indicate that the use of nanostructured titanium Grade 4 for the production of miniplates and miniscrews has an optimizing effect on reparative osteogenesis. The mechanism of this effect is determined by the presence of osseointegration properties of titanium. Conclusion. Nanostructured titanium is advisable to use for the production of implants, reconstructive titanium plates and other products for bone grafting.

Welding Characteristics of Medium Titanium Plates with Autogenous Laser Welding and Narrow-Gap Laser Filling Welding Modes.

Titanium and titanium alloys with a medium thickness of 5 to 12 mm are widely used for ocean platforms, military equipment and in other fields because of their light weight, appropriate strength and corrosion resistance. In this study, autogenous laser welding and narrow-gap laser welding processes were researched and compared, and the welding characteristics, weld microstructure and joint strength were analyzed. The results showed that autogenous laser welding had higher efficiency, narrower weld width and higher microstructure uniformity. Autogenous laser welding can achieve the single pass weld penetration at laser keyhole mode. The weld width of narrow-gap laser welded joint was 12.5 mm, which was nearly three times than that of autogenous laser welding. The grain size of autogenous laser welding was obviously smaller and more uniform in depth than that of narrow-gap laser welding. In the weld zone, the coarse columnar α grains grew from the fusion line, while in the heat-affected zone, equiaxed α grains with needle and sawtooth α morphologies were presented. The microhardness of the heat-affected zone was higher than in the weld zone and the base metal due to the denser needle microstructure. The tensile samples all fractured at the base metal, indicating the welded joint strength efficiency was greater than 1.

Advancements in Metacarpal Fracture Management: A Narrative Review of Rehabilitative Strategies.

Metacarpal fractures are prevalent injuries that can significantly impact hand functionality if not managed effectively. This narrative review examines recent advancements in treatment strategies, comparing conservative and surgical interventions, and evaluates the role of early mobilization and innovative rehabilitation techniques. We analyze evidence showing that surgical treatment with low-profile titanium plates provides superior stabilization, enabling earlier mobilization and better functional outcomes compared to conservative methods or K-wire fixation. Early mobilization, facilitated by metacarpal braces or controlled active exercises, enhances recovery and reduces the need for extended physical therapy. We also explore the integration of technology in rehabilitation, which has improved patient adherence and satisfaction. The review highlights the importance of personalized treatment plans and discusses the potential of novel rehabilitation approaches to optimize metacarpal fracture management. Future research should focus on refining these strategies and developing standardized protocols to enhance hand function and patient satisfaction.

Alternating magnetic fields (AMF) and linezolid reduce Staphylococcus aureus biofilm in a large animal implant model

We aimed to evaluate the effectiveness of alternating magnetic fields (AMF) combined with antibiotics in reducing Staphylococcus aureus biofilm on metal implants in a large animal model, compared to antibiotics alone. Metal plates were inoculated with a clinical MRSA strain and then implanted into thirty-three ewes divided into three groups: positive control, linezolid only, and a combination of linezolid and AMF. Animals had either titanium or cobalt-chrome plates and were sacrificed at 5or 21 dayspost-implantation. Blood and tissue samples were collected at various time points post-AMF treatment. In vivo efficacy studies demonstrated significant biofilm reduction on titanium and cobalt-chrome implants with AMF-linezolid combination treatment compared to controls. Significant bacterial reductions were also observed in surrounding tissues and bones. Cytokine analysis showed improved inflammatory responses with combination therapy, and histopathology confirmed reduced inflammation, necrosis, and bacterial presence, especially at 5 days post-implantation. This study demonstrates that combining AMF with antibiotics significantly reduces biofilm-associated infections on metal implants in a large animal model. Numerical simulations confirmed targeted heating, and in vivo results showed substantial bacterial load reduction and reduced inflammatory response. These findings support the potential of AMF as a non-invasive treatment for prosthetic joint infections.