95 results match your criteria General Principles of Internal Fixation

In Memoriam : Robert Danis, an inspiration for Maurice Müller and origins of the AO Foundation.

Acta Orthop Belg 2020 Dec;86(4):577-579

Robert Danis (1880-1962) was a Belgian general surgeon mostly remembered for his contributions in the field of bone and joint surgery, a medical subdiscipline currently known as orthopaedic trauma surgery. He initiated this with his first book (1) on the subject in 1932. Danis was the first to develop a concept for biomechanically stable internal fracture fixation, creating and producing his own screws and plates with self-developed machine tools. Read More

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December 2020

[Open reduction and internal fixation of posterior malleolus fractures].

Oper Orthop Traumatol 2021 Apr 25;33(2):112-124. Epub 2021 Mar 25.

Sektion Fuß- und Sprunggelenkchirurgie Campus Großhadern & Innenstadt, Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Klinikum der Universität München, LMU München, Nussbaumstr. 20, 80336, München, Deutschland.

Objective: Stabilization of the syndesmotic complex by open reduction and internal fixation (ORIF) of the posterior malleolus, restoration of the tibial articular surface, stability of the ankle, posterior tibiofibular ligament and the incisura tibiae, reduction of the fibula into the incisura tibiae by ligamentotaxis.

Indications: Unstable ankle fractures (OTA/AO type 44-B3, C1.3, C2. Read More

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Posterior shoulder fracture-dislocation: A systematic review of the literature and current aspects of management.

Chin J Traumatol 2021 Feb 6;24(1):18-24. Epub 2020 Sep 6.

The Rowley Bristow Unit, Ashford & St Peter's Hospitals, NHS Foundation Trust, Chertsey, Surrey, United Kingdom; Shoulder and Elbow Centre - Reading Shoulder Unit, United Kingdom; Surrey Orthopaedic Clinic, United Kingdom. Electronic address:

Purpose: Posterior fracture-dislocation of shoulder is an infrequent traumatic event; however, most orthopaedic surgeons may face the challenge of treating it. The aim of this study is to review and summarise systematically the current principles of the management of this complex injury, and create a treatment algorithm.

Methods: Both PubMed and Scopus Databases were systematically searched for the terms "posterior shoulder fracture-dislocation" or "posterior glenohumeral fracture-dislocation" or "posterior glenoid fracture-dislocation" for articles written in English and published in the last decade. Read More

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February 2021

[External fixator: temporary fixation and soft tissue management of the ankle].

Oper Orthop Traumatol 2020 Oct 18;32(5):421-432. Epub 2020 Sep 18.

UniversitätsCentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Carl Gustav Carus, Fetscherstr. 74, 01307, Dresden, Deutschland.

Objective Of Surgery: Joint-spanning transfixation of the ankle joint aims at mostly temporary retention of the reduction, i.e. restoring length and axial alignment and stabilization of the ankle mortise in highly unstable fractures around the ankle and under critical soft tissue conditions. Read More

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October 2020

Indications and Clinical Results of Radial Head Replacement: Has Anything Changed?

J Orthop Trauma 2019 Dec;33 Suppl 8:S1-S6

Department of Orthopaedic Surgery, University of Arizona College of Medicine-Phoenix, Phoenix, AZ.

Radial head fractures are common injuries comprising 1/3 of the fractures about the elbow. As a secondary valgus stabilizer of the elbow, radial head fractures can compromise elbow stability leading to long-term pain, dysfunction, and degenerative change. Furthermore, radial head fractures can be accompanied by associated injuries including ligamentous lesions that can further exacerbate elbow instability, leading to long-term sequelae. Read More

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December 2019

General treatment principles for fracture-related infection: recommendations from an international expert group.

Arch Orthop Trauma Surg 2020 Aug 29;140(8):1013-1027. Epub 2019 Oct 29.

Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA.

Fracture-related infection (FRI) remains a challenging complication that creates a heavy burden for orthopaedic trauma patients, their families and treating physicians, as well as for healthcare systems. Standardization of the diagnosis of FRI has been poor, which made the undertaking and comparison of studies difficult. Recently, a consensus definition based on diagnostic criteria for FRI was published. Read More

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Lessons Learned from Long-Term Management of Hip Fracture in Patients with Osteopetrosis: A Report of Nine Hips in Five Patients.

J Bone Metab 2019 Aug 31;26(3):201-206. Epub 2019 Aug 31.

Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

Background: Treating patients with osteopetrosis is very challenging even in very skilled surgeons with many experiences. We present an account of 5 patients treated for hip fracture related problems occurring throughout their life due to this disease. Difficulties encountered during their treatment prompted us to present some general management principles. Read More

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Trauma to the medial ray of the foot: A classification of patterns of injury and their management.

Injury 2019 Aug 4;50(8):1483-1488. Epub 2019 Jun 4.

Department of Trauma & Orthopaedics, Northern General Hospital, Sheffield, UK.

Aims: Fractures and dislocations of the midfoot are relatively uncommon but can be life changing injuries. Within the literature, there has been scant specific reference to the identification and management of medial ray injuries in midfoot trauma. Moreover, it is appreciated that these injuries are associated with poor outcomes. Read More

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General principles for treatment of femoral head fractures.

J Clin Orthop Trauma 2019 Jan-Feb;10(1):155-160. Epub 2017 Jul 29.

Departamento de Radiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

Femoral head fractures occur almost exclusively as a result of a traumatic hip dislocation. Treatment is typically an emergency and includes the reduction of the dislocated hip under anesthesia. As a rule, the earlier the reduction, the better the outcome. Read More

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What Factors Are Associated With Outcomes Scores After Surgical Treatment Of Ankle Fractures With a Posterior Malleolar Fragment?

Clin Orthop Relat Res 2019 04;477(4):863-869

D. T. Meijer, B. D. J. G. Deynoot, S. A. Stufkens, G. M. M. J. Kerkhoffs, J. N. Doornberg, Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, The Netherlands D. T. Meijer, Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands I. N. Sierevelt, Slotervaart Center of Orthopedic Research and Education, Department of Orthopaedic Surgery, Medical Centre Slotervaart, Amsterdam, The Netherlands J. C. Goslings, Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands G. M. M. J. Kerkhoffs, Academic Center for Evidence-based Sports Medicine, Amsterdam Collaboration for Health and Safety in Sports, IOC Research Center, Amsterdam, The Netherlands J. N. Doornberg, Flinders University, Adelaide, Australia.

Background: Psychosocial factors, such as depression and catastrophic thinking, might account for more disability after various orthopaedic trauma pathologies than range of motion and other impairments. However, little is known about the influence of psychosocial aspects of illness on long-term symptoms and limitations of patients with rotational-type ankle fractures, including a posterior malleolar fragment. Knowledge of the psychosocial factors associated with long-term outcome after operative treatment of trimalleolar ankle fractures might improve recovery. Read More

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[Olecranon fractures].

Rev Med Suisse 2018 Dec;14(631):2264-2267

Service de chirurgie orthopédique et traumatologique, Département de l'appareil locomoteur, CHUV, 1011 Lausanne.

Olecranon fractures represent 5 % of all adult fractures. Management is most often surgical. Conservative treatment is recommended for non-displaced fractures or patients who would be poor surgical candidates. Read More

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December 2018

[Reduction techniques for osteosynthesis of intra-articular fractures].

Unfallchirurg 2019 Feb;122(2):110-119

Klinik für Unfallchirurgie, Departement Chirurgie, Kantonsspital Graubünden, Loëstr. 170, 7000, Chur, Schweiz.

The cornerstones for treatment of articular fractures are gentle handling of soft tissues and anatomical reconstruction of the articular surface with stable fixation, which enables a functional aftercare. By respecting these principles, satisfactory functional and radiological results with low complication rates can be achieved even for complex fracture patterns. Fracture complexity varies with the energy load during the trauma mechanism. Read More

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February 2019

Why and how do locking plates fail?

Injury 2018 Jun;49 Suppl 1:S56-S60

Department of Trauma, Hand and Reconstructive Surgery, University Hospital Jena, Jena, Germany.

Locking plates have led to important changes in bone fracture management, allowing flexible biological fracture fixation based on the principle of an internal fixator. The technique has its indications and limitations. Most of the typical failure patterns arise from basic technical errors. Read More

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Reconstructing a Traumatic Empty Orbit: Principles, Difficulties of Treatment, and Literature Review.

J Oral Maxillofac Surg 2018 09 21;76(9):1952.e1-1952.e4. Epub 2018 Apr 21.

Consultant Oral and Maxillofacial Surgeon, Northampton General Hospital, Northampton, UK.

Purpose: This report describes the case of a serious orbital injury in which the globe was completely displaced into the nasal cavity and the orbit was clinically empty. The authors discuss the difficulties encountered in the management of this patient and their principles in the reconstruction of a complex defect.

Materials And Methods: In this rare case of severe injury, the authors used a combined transconjunctival and ethmoidal approach to retrieve the displaced globe from the nasal cavity. Read More

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September 2018

Spinopelvic injuries. Facts and controversies.

Injury 2018 Mar;49(3):449-456

Academic Department of Trauma & Orthopaedic Surgery, University of Leeds, Clarendon Wing, Floor A, Great George Street, Leeds General Infirmary, LS1 3EX Leeds, United Kingdom.

Spinopelvic injuries result from high energy trauma with overloading through the sacrum. These lesions can accomplish either bone fractures, ligament injuries or, most commonly, both. They may be accompanied with other associated life threatening injuries and cause biomechanical instability with potential fracture non-union, mal-union and subsequent lifetime pain and disability. Read More

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Complex Tibial Plateau Fractures Treated by Hybrid External Fixation System: A correlation of followup computed tomography derived quality of reduction with clinical results.

Indian J Orthop 2018 Mar-Apr;52(2):161-169

Fourth Department of Orthopaedics and Traumatology, KAT Hospital, Kifissia, 2 Nikis Street, 145 61, Athens, Greece.

Background: Tibial plateau fractures are common due to high energy injuries. The principles of treatment include respect for the soft tissues, restoring the congruity of the articular surface and reduction of the anatomic alignment of the lower limb to enable early movement of the knee joint. There are various surgical fixation methods that can achieve these principles of treatment. Read More

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The principles and practice of open fracture care, 2018.

Chin J Traumatol 2018 Aug 21;21(4):187-192. Epub 2018 Feb 21.

Department of Orthopaedics, Harvard Medical School, Chief Orthopaedic Trauma Service, Massachusetts General Hospital, Boston, MA, USA. Electronic address:

The principles of open fracture management are to manage the overall injury and specifically prevent primary contamination becoming frank infection. The surgical management of these complex injuries includes debridement & lavage of the open wound with combined bony and soft tissue reconstruction. Good results depend on early high quality definitive surgery usually with early stable internal fixation and associated soft tissue repair. Read More

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A Review of Subbrow Approach in the Management of Non-Complicated Anterior Table Frontal Sinus Fracture.

Arch Craniofac Surg 2016 Dec 23;17(4):186-189. Epub 2016 Dec 23.

Department of Plastic Surgery, Konkuk University School of Medicine, Seoul, Korea.

Frontal sinus fractures, particularly anterior sinus fractures, are relatively common facial fractures. Many agree on the general principles of frontal fracture management; however, the optimal methods of reduction are controversial. The subbrow approach enables accurate reduction and internal fixation of the fractures in the anterior table of the frontal sinus by allowing direct visualization of the fracture. Read More

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December 2016

Current treatment of infected non-union after intramedullary nailing.

Injury 2017 Jun 9;48 Suppl 1:S82-S90. Epub 2017 May 9.

Department of Trauma and Orthopaedics, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK.

Non-union is a devastating consequence of a fracture. Non-unions cause substantial patient morbidity with patients suffering from loss of function of the affected extremity, increased pain, and a substantial decrease in the quality of life. The management is often associated with repeated, unsuccessful operations resulting in prolonged hospital stays, which has social and economic consequences to both the patient and the healthcare system. Read More

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Repair of comminuted fracture of the lower patellar pole.

Ulus Travma Acil Cerrahi Derg 2017 Mar;23(2):150-155

Department of Orthopaedic, Sohag Teaching Hospital, General Organization for Teaching Hospitals and Institutes, Egypt.

Background: Comminuted fracture of the lower patellar pole has characteristics of both patellar fracture and avulsion of the patellar tendon. Therefore, components of both injury types should be considered during treatment. None of the traditional techniques has proven sufficient alone. Read More

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Tension band wiring for simple olecranon fractures: evaluation of surgical technique.

J Orthop Traumatol 2017 09 28;18(3):275-281. Epub 2017 Feb 28.

Orthotrauma Research Center, University of Amsterdam Orthopaedic Residency Program (PGY 4), Amsterdam, The Netherlands.

Background: In some settings, specific techniques for open reduction and internal fixation are preferred based on the eminence of a surgeon or professional organization. An emphasis on technical aspects of surgery that are not proved superior and vary substantially from surgeon to surgeon can be confusing for trainees. This study applied a numerical grading of the technical aspects of tension band wire (TBW) fixation for olecranon fracture; assessed the interobserver agreement of each criterion; and measured the correlation of the technical grading and objective and subjective long-term outcomes. Read More

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September 2017

Current management of open fractures: results from an online survey.

Arch Orthop Trauma Surg 2016 Dec 15;136(12):1663-1672. Epub 2016 Sep 15.

Department of Trauma, Reconstructive Surgery and Rehabilitation Medicine, Ferdinand-Sauerbruch-Str., 17475, Greifswald, Germany.

Background: Open fractures are orthopaedic emergencies that carry a high risk for infection, non-union and soft tissue complications. Evidence-based treatment is impeded by the lack of high-quality evidence-based studies. The aim of this investigation was to elucidate the current practice of open fracture management in Germany and to determine major differences in treatment. Read More

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December 2016

Return to Sport After Tibial Shaft Fractures: A Systematic Review.

Sports Health 2016 Jul 18;8(4):324-30. Epub 2015 Aug 18.

Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, Edinburgh, UK.

Context: Acute tibial shaft fractures represent one of the most severe injuries in sports. Return rates and return-to-sport times after these injuries are limited, particularly with regard to the outcomes of different treatment methods.

Objective: To determine the current evidence for the treatment of and return to sport after tibial shaft fractures. Read More

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Experimental study on treatment of acetabular anterior column fractures: applyment of a minimally invasive percutaneous lag screw guide apparatus.

BMC Musculoskelet Disord 2016 Jan 15;17:27. Epub 2016 Jan 15.

Department of Orthopedics, Chinese PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, 100853, People's Republic of China.

Background: The aim of this study was to design a new minimally invasive percutaneous lag screw guide apparatus and to verify its adjuvant treatment of acetabular anterior column fracture on pelvis specimens.

Methods: This guide apparatus was self-developed based on the principles of "two points form a line" and "Rectangle". Using C-arm fluoroscopy, this guide apparatus was used to conduct minimally invasive percutaneous lag screw internal fixation of acetabular anterior column fractures. Read More

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January 2016

Results of surgical treatment in metacarpal shaft fractures using low profile mini plates.

Ulus Travma Acil Cerrahi Derg 2015 Jul;21(4):279-84

Department of Hand and Upper Extremity Surgery, Metin Sabancı Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Turkey.

Background: Metacarpal fractures are among the most common fractures of the hand. They may lead to loss of function if treated improperly. These injuries can be treated conservatively. Read More

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Circummandibular Wires for Treatment of Dentoalveolar Fractures Adjacent to Edentulous Areas: A Report of Two Cases.

Karl Maloney

Craniomaxillofac Trauma Reconstr 2015 Sep 13;8(3):246-50. Epub 2015 Jan 13.

Department of Oral and Maxillofacial Surgery, St. Luke's Hospital, Bethlehem, Pennsylvania.

In general, dentoalveolar fractures are a common injury seen in emergency departments, dental offices, and oral and maxillofacial surgery practices. These injuries can be the result of direct trauma or indirect trauma. Direct trauma more often causes trauma to the maxillary dentition due to the exposure of the maxillary anterior teeth. Read More

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September 2015

Development and Clinical Evaluation of MatrixMANDIBLE Subcondylar Plates System (Synthes).

Craniomaxillofac Trauma Reconstr 2015 Jun 31;8(2):94-9. Epub 2014 Oct 31.

Gradute School of Maxillo-facial Surgery, University of Bari, Bari, Italy.

In this article, authors report the different steps of development and clinical validation of MatrixMANDIBLE Subcondylar Plates (Synthes, Soletta, Switzerland), a specialized osteosynthesis system developed by Synthes during the past 4 years. Between 2009 and 2013, a total of 62 patients were treated for subcondylar and condylar neck fractures via a preauricular or retromandibular/transparotid approach. The MatrixMANDIBLE Subcondylar Plates System consists of a Trapezoidal Plate, a three-dimensional (3D) 4-hole 1. Read More

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Imaging the knee in the setting of metal hardware.

Magn Reson Imaging Clin N Am 2014 Nov 28;22(4):765-86. Epub 2014 Aug 28.

Radiology Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA; Department of Radiology, University of California San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103, USA.

Magnetic resonance (MR) imaging is an established modality for the evaluation of musculoskeletal structures, including the knee. Metallic implants are increasingly used and techniques to minimize artifacts are continuously improving. This article reviews the general principles behind the effects of metal on MR imaging, various MR imaging techniques that are available or have been recently described in the literature, and abnormalities that can be encountered during MR imaging of patients related to knee arthroplasty, hardware after internal fixation, or hardware used for soft tissue fixation. Read More

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November 2014

Subbrow approach as a minimally invasive reduction technique in the management of frontal sinus fractures.

Arch Plast Surg 2014 Nov 3;41(6):679-85. Epub 2014 Nov 3.

Department of Plastic and Reconstructive Surgery, Konkuk University School of Medicine, Chungju, Korea.

Background: Frontal sinus fractures, particularly anterior sinus fractures, are relatively common facial fractures. Many agree on the general principles of frontal fracture management; however, the optimal methods of reduction are still controversial. In this article, we suggest a simple reduction method using a subbrow incision as a treatment for isolated anterior sinus fractures. Read More

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November 2014

Immunohistochemistry in surgical pathology: principles and practice.

Clive R Taylor

Methods Mol Biol 2014 ;1180:81-109

Department of Pathology, HMR 311, Keck School of Medicine, University of Southern California, 2011 Zonal Avenue, 90033, Los Angeles, CA, USA,

The extent to which data from immunohistochemical (IHC) staining are useful is critically dependent not only upon the proper performance and control of the method but also upon appropriate interpretation. A decade ago an individual pathologist may have nurtured a reasonable expectation of achieving a comprehensive understanding of the IHC literature across the whole field of pathology. Today such an expectation is clearly unreasonable with a simple Medline search of the IHC literature postdating the general adoption of antigen retrieval (arbitrarily 1996), yielding more than 100,000 "relevant" articles. Read More

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February 2015