جستجوی مقالات مرتبط با کلیدواژه "bone screw" در نشریات گروه "پزشکی"

The isolated trochlea fracture is a rare condition that has been previously reported in different settings and times. However, there is still a lack of data regarding the diagnosis and treatment of this condition. Hence, we sought to clarify various aspects of isolated trochlea fracture. The case presented was a young man referred to our hospital following a high-energy motor-car accident. The diagnosis was made via anteroposterior and lateral X-ray and   with 3-dimensional computed tomography. Following diagnosis, open reduction and internal fixation with medial approach were selected for the patient. Finally, the patient’s follow-up revealed that the range of motion of the affected elbow reached its normal range six months after the operation.

Use of miniscrews has become very common in orthodontic treatment of patients. Following tissue manipulation during miniscrew placement, bacteremia may occur, which is important in patients susceptible to infective endocarditis. This study aimed to investigate the possibility of bacteremia following orthodontic miniscrew placement.

The present quasi-experimental study was conducted on 30 orthodontic patients, including 11 males (36.7%) and 19 females (63.3%) with a mean age of 23.67±4.87 years, who required miniscrew placement in their treatment plan. Two blood samples were taken from the patients for aerobic and anaerobic cultures right before and 30-60 seconds after miniscrew placement. To investigate the presence of bacteremia, the blood samples were incubated in an automated blood culture machine for five days. The standard biological methods were used for the positive sample(s) to identify the type of bacteria. Data analysis was performed using the McNemar test.

The blood samples of 29 patients were negative for the bacteria before and after miniscrew placement. Blood sample of one patient was positive for aerobic and anaerobic bacteria after miniscrew placement. However, bacteremia was negative in the initial (preplacement) blood samples for both aerobes and anaerobes.

Miniscrew placement in orthodontic patients was not associated with bacteremia.

Hamstring graft tendon for anterior cruciate ligament (ACL) reconstruction is a common approach worldwide. Tibial side graft fixation to achieve appropriate stability is a serious concern, worldwide. The current study aims to compare the outcomes of mere use of interference screw for fixation of hamstring tendon graft versus the use of interference screw plus supplementary staple.

This is a randomized clinical trial conducted on 53 patients who underwent ACL reconstruction from 2016 to 2018. The study population was randomly divided into two groups: graft fixation with interference screw only and interference screw plus supplementary staple. Postoperative recovery time, postoperative clinical examinations, and the scale of the International Knee Documentation Committee were assessed for participants and compared between two groups.

Comparison of two groups regarding demographic information, including age, gender distribution, postoperative recovery time, and body mass index, showed no statistical difference (P > 0.05). Postoperative Pivot test was insignificantly positive in 4 (16.7%) cases of screw interference with supplementary staple while it was positive in 3 (10.7%) cases with screw interference only approach (P = 0.98). IKCD index was not statistically different between two groups postoperatively (P = 0.72), while IKCD scores changed significantly following the surgical procedure, regardless of the type of the surgical procedure (P < 0.001).

Use of supplementary staple beside interference screw was as successful as mere use of interference screw for fixation of hamstring tendon autologous graft of the ACL reconstruction, regarding force withstanding. The comparison of the two approaches revealed no remarkable difference.

The sacrum bone is an integral part of pelvis and spinal column. It protects lumbosacral neurologic plexus and maintains the spinal column and pelvic alignment. Therefore, injury to the sacrum may lead to neurologic deficit, pain and disability. Due to difficulties in radiologic diagnosis and associated injuries, sacral fractures are usually missed or diagnosed late.
To evaluate the clinical and functional outcome of surgical treatment of high-energy traumatic sacral fractures.
Patients and All patients with sacral fractures, who had undergone surgical treatment, were evaluated retrospectively and data were collected. Fracture type, preoperative and postoperative neurologic examination, according to the American spinal injury association (ASIA) score and Gibbons’ classification and visual analogue scale (VAS) were evaluated. In addition, postoperative complications, such as infection, deep venous thrombosis (DVT), rod breakage, screw loosening and dislodgment were assessed.
Of the 27 patients with sacral fracture that were treated surgically, 15 (55.4%) patients were female and 12 (44.6%) were male. Fourteen (51.8%) patients underwent percutaneous iliosacral screw fixation and 13 (48.1%) patients underwent spinopelvic fixation. Three (11.1%) patients had neurologic deficit. After neurologic decompression, two of them recovered completely (with preoperative Gibbon’s grade 2, 3) and one of them, with Gibbons’ grade 4, improved incompletely in motor power and also remained incontinent after a year postoperatively. None of them developed postoperative infection, DVT, rod breakage or screw loosening or breakage. Only one patient, in the unilateral spinopelvic fixation group, developed asymptomatic rod dislodgment from distal (iliac) fixation. In all patients, VAS score changed substantially from mean 8, preoperatively, to mean 1, postoperatively.
For no displaced or minimally displaced sacral fractures and fractures without comminution, especially in young and non-osteoporotic patients, (Denis type 1 and 2) percutaneous iliosacral screw fixation could be an ideal treatment. For Denis type 3, spinopelvic dissociation, comminuted Denis type 1 and 2 and for sacral fracture in osteoporotic or elder patients, spinopelvic fixation may be the treatment of choice, with acceptable outcome.

Although intramedullary nailing (IMN) is used in a reamed or unreamed fashion for treatment of long bone fractures, the locked nails may also be used in the unlocked form if so decided by the orthopedic surgeon.

We describe a 50-year-old man who had a shaft fracture of his right humerus. The fracture was treated with a reamed, locked IMN using unlocked technique.

The functional outcome 22 months post injury showed that although primary treatment method uses locked IMN in humeral shaft fractures, unlocked IMN can be used in appropriate cases. Less injury risk to the axillary and radial nerve, short period of surgery, and less radiation can be considered as advantages of this technique.

Appropriate treatment of acromioclavicular joint dislocation is controversial. Acroplate fixation is one of the most common treatment methods of acromioclavicular joint (ACJ) dislocation. Based on the risk of re-dislocation after Acroplate fixation, we assumed that combined fixation with an Acroplate and a coracoclavicular screw helps improve the outcome.. The main purpose of the current study was to compare the outcome of ACJ dislocation treated with an Acroplate alone and in combination with coracoclavicular screw..Patients and This study was carried out on 40 patients with ACJ dislocation types III to VI who were divided randomly into two equal groups: Acroplate group (P) and Acroplate in combination with coracoclavicular screw group (P + S). The screws were extracted 3-6 months postoperatively. The patients were followed for 1 year and Imatani’s score was calculated. Finally, the data were compared between the groups.. The mean Imatani’s score was significantly higher in P + S group (83.4 ± 14.1) than P group (81.2 ± 10.3) (P < 0.001). The mean duration of surgery was the same in the two groups (59.8 ± 9.4 minutes in group P V.s 64.3 ± 10.9 minutes in group P + S; P = 0.169). There were no cases of re-dislocation, degenerative changes and ossification and all patients returned to their previous jobs or sporting activities.. Using a coracoclavicular screw combined with an Acroplate can improve the patients’ function after ACJ disruption without any significant increase in surgical duration. Authors recommend this technique in the fixation of ACJ dislocation..