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Fracture Fixation, Internal

Fracture Fixation, Internal is a medical procedure used to stabilize and heal broken bones within the body.
This process involves the use of internal devices, such as plates, screws, or rods, to hold the fractured bone fragments in proper alignment while they heal.
Internal fixation is often preferred over external fixation methods as it provides more stable support and allows for earlier mobilization of the affected limb.
The goal of Fracture Fixation, Internal is to facilitate bone union, restore function, and minimize the risk of complications, such as non-union or malunion.
This MeSH term describes the surgical techniques and implants used to manage internal fractures of the skeletal system.

Most cited protocols related to «Fracture Fixation, Internal»

Determining Minimal Clinically Important Difference in Distal Radius Fractures

Cited 13 times

Our prospective cohort study was conducted alongside two ongoing clinical trials that are coordinated from our institution, an academic Level-1 trauma center in The Netherlands. The medical ethical review committee granted approval before initiation of this parallel study, without the need for informed consent from patient participants.
Patients for our cohort study were recruited from the two ongoing clinical trials between January 2011 and July 2014, during their first visit to the outpatient clinic. To increase the size of our cohort study population, we also recruited patients with distal radius fractures at the outpatient clinic who were not enrolled in the clinical trials. The patients who were not participants of the clinical trial were enrolled in our study between January 2014 and July 2014.
Our study population consisted of 102 patients with distal radius fractures. Patients were excluded if they: (1) did not want to complete the questionnaire at the outpatient clinic; (2) did not complete the anchor questions; (3) were unable to understand the study information; or (4) had sustained their distal radius fracture more than 1 year before their visit to the outpatient clinic.
Of the two concurrent clinical trials occurring during our prospective cohort study, the first trial [3 (link)] included 42 patients who underwent a study of two- and three-dimensional imaging. This trial provided 42 adult patients with intraarticular distal radius fractures who were treated with open reduction and internal fixation with a volar locking plate.
The second trial [25 (link)] randomized patients with displaced extraarticular distal radius fractures (AO types A2 and A3 [17 ]) between treatment with either open reduction and internal fixation with a volar locking plate or plaster immobilization. This trial provided 39 patients.
Additionally, during the first 6 months of 2014, we identified 55 patients who were not enrolled in either clinical trial but who were eligible for participation in our study. All adult patients with a distal radius fracture were eligible for inclusion, regardless of the type of treatment they received. After exclusion, an additional 21 patients with a distal radius fracture who were not enrolled in either of the two trials were included in our study cohort.
There are two methods to define the MCID: (1) a distribution-based and (2) an anchor-based approach [5 (link)]. The distribution-based approach is used to evaluate if the observed effect is attributable to true change or simply the variability of the questionnaire. It examines the distribution of observed scores in a group of patients. The magnitude of the effect is interpreted in relation to variation of the instrument [9 (link)]. In other words, is the observed effect attributable to true change or simply the variability of the questionnaire?
The anchor-based approach uses an external criterion (the anchor) to determine the MCID. Possible anchors include objective measurements, such as prehensile grip strength and ROM, or patient-reported anchor questions. The purpose of a patient-reported anchor question is to “anchor” the changes observed in the PRWE score to patients’ perspectives of what is clinically important [13 (link)].
Anchor-based methods to determine the MCID are preferred because an external criterion is used to define what is clinically important [7 (link)]; however, the anchor-based method does not take into account the measurement error of the instrument, so it is valuable to use the anchor- and distribution-based approaches [7 (link)]. To avoid confusion, the distribution-based method generally is referred to as minimum detectable change (MDC), and the anchor-based method as MCID [7 (link)]. We use the same terms to identify the methods.
Data were collected prospectively. Patients completed the Dutch version of the PRWE questionnaire during two visits at approximately 6 to 12 weeks and approximately 12 to 52 weeks after distal radius fracture injury.
At the second visit, patients were asked to indicate the degree of clinical change they had noticed since the previous visit for each domain (pain and function). Patients noted their answers on a global rating of change scale (GRC) from −5 (much worse) to +5 (much better) (Fig. 1) [11 (link)]. The purpose of this question was to “anchor” the changes observed in the PRWE score to patients’ perspectives regarding what is clinically important [13 (link)].Fig. 1

The global rating of change (GRC) scale used in the Patient-rated Wrist Evaluation (PRWE) questionnaire is shown. The anchor questions allowed patients to assess their current health status regarding wrist function and wrist pain, and compare their status with that of their previous visit.

There is no consensus regarding the required sample size to determine the MCID [19 (link)]. We made a sample size estimation based on a conservatively estimated MCID of 12 points, with a SD of ± 14 [12 (link), 20 (link), 22 (link)]. To achieve an α of 0.05 and a power of 80%, we required 18 data points representing no change, and 18 data points representing minimal improvement.

Walenkamp M.M., de Muinck Keizer R.J., Goslings J.C., Vos L.M., Rosenwasser M.P, & Schep N.W. (2015). The Minimum Clinically Important Difference of the Patient-rated Wrist Evaluation Score for Patients With Distal Radius Fractures. Clinical Orthopaedics and Related Research, 473(10), 3235-3241.

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Publication 2015

Adult Clinic Visits Distal Radius Fractures Fracture Fixation, Internal Immobilization Injuries Open Fracture Reductions Pain Patients Wrist

Open Distal Tibia Fractures: Fixation Techniques

Cited 11 times

The inclusion criteria for this study is as follow: (1) open fracture of distal tibia and fibula, fracture type: AO-42; (2) surgical methods: simple external fixation, external fixation combined with plate-screw osteosynthesis, external fixation combined with K-wire intramedullary fixation; (3) regular follow-up. Exclusion criteria: (1) ankle joint surface damaged severely, normal correspondence congruence and joint space can’t be restored through fixation; (2) associated with serious hypertension, heart disease and other serious diseases, reduced operative-tolerance; (3) associated with brain and spinal nerve functional impairment, severely affected the function of the lower limbs; (4) previous history of severe degenerative arthritis, rheumatoid arthritis, cerebral infarction, and dyskinesia in the lower extremities.
From January 2017 to July 2019, 91 cases of open fractures of distal tibia and fibula were enrolled into this study, among which 35 patients were treated by simple external fixation (group A, n = 35), 30 patients were treated by external fixation combined with plate-screw osteosynthesis (group B, n = 30), and 26 patients were treated by external fixation combined with K-wire (2.0–3.0 mm) intramedullary fixation (group C, n = 26). There was no significant difference in gender, age, cause of injury, Gustilo classification and AO classification among the three groups (P > 0.05) (Table 1).

Table 1

General information

Group	Patients (n)	Gender		Age (years, x ± s)	Mechanism of injury		Gustilo classification			AO classification
Group	Patients (n)	Male	Female	Age (years, x ± s)	Traffic injuries	Others	I	II	III	42-A	42-B	42-C
A	35	27	8	46.83 ± 15.83	25	10	4	12	19	13	16	6
B	30	25	5	44.27 ± 12.37	21	9	7	11	12	11	14	5
C	26	22	4	44.96 ± 14.48	19	7	3	7	16	11	11	4
P	–	>0.05		>0.05	>0.05		>0.05			>0.05

Group A: simple external fixator fixation

Group B: external fixator combined with plate-screw osteosynthesis

Group C: external fixator combined with k-wire intramedullary fixation

Sun D.D., Lv D., Zhou K., Chen J., Gao L.L, & Sun M.L. (2021). External fixator combined with three different fixation methods of fibula for treatment of extra-articular open fractures of distal tibia and fibula: a retrospective study. BMC Musculoskeletal Disorders, 22, 1.

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Publication 2021

Brain Cerebral Infarction Degenerative Arthritides Dyskinesias External Fixation Devices Fibula Fracture, Bone Fracture Fixation, Internal Heart Diseases High Blood Pressures Immune Tolerance Injuries Joints Joints, Ankle Kirschner Wires Lower Extremity Operative Surgical Procedures Patients Rheumatoid Arthritis Sex Characteristics Spinal Nerves Tibial Fractures

Femoral Neck Fracture and Depression Risk

Cited 11 times

The statistical package SAS was used for the analyses in this study. SAS was used to select the study and comparison groups (SAS Institute Inc., Cary, NC, USA). Descriptive analyses of the independent variables (patient characteristics, demographics, personal history at baseline, surgical interventions, the amount of time between fracture and the onset of depression and other comorbidities) are reported as percentages or the mean ± standard deviation (SD). The X² test was used to make between-groups comparisons of patient demographics, including economic status (monthly income: USD$>1000, USD$601∼1000, USD$<600), urbanization of their home city (level 1 to 4), the geographic location of patients’ residence (northern, central, southern, and eastern Taiwan), personal history at baseline (diabetes mellitus, hypertension, renal failure, liver cirrhosis, stroke and osteoporosis) and mortality rate between patients with fracture and non-fracture. The urbanization of patients’ home city was defined by population and certain indicators of the city’s level of development. Level 1 urbanization was defined as having a population greater than 1,250,000 people and a specific status of political, economic, cultural and metropolitan development. Level 2 urbanization was defined as having a population between 500,000 and 1,250,000 and an important role in the Taiwanese political system, economy and culture. Urbanization levels 3 and 4 were defined as having a population between 150,000 and 500,000 and less than 150,000, respectively. Furthermore, a crude hazard ratio (HR) was calculated using Cox’s stratified proportional hazards model (stratified with age, sex and the number of years since index hospitalization) to analyze the risk of new-onset major depression between the study and comparison groups. The covariate-adjusted HR was analyzed after adjusting for diabetes mellitus, hypertension, renal failure, liver cirrhosis, stroke, osteoporosis, geographic regions, post-fracture co-morbidities, monthly income and urbanization of patients’ home cities. In addition, we used SAS to analyze the eight most common post-fracture comorbidities during the study period. The relationship between post-fracture comorbidities and major depression was also analyzed. We used the Kaplan-Meier method and Log-rank test to estimate survival curves and compare the 3-year major depression-free survival rate between patients with femoral neck fracture and those without. Among the femoral neck fracture patients, the amount of time before the onset of major depression was recorded and divided into 6 periods (<200, 201–400, 401–600, 601–800, 801–1000 and >1000 days). Additionally, the relationship between surgical interventions (including hip replacement and open reduction of internal fixation of the hip) and the chance of suffering new-onset major depression was analyzed for this group (X² test). Hip replacement included hip arthroplasty in this study. A p-value <0.05 was considered to be statistically significant.

Chang C.Y., Chen W.L., Liou Y.F., Ke C.C., Lee H.C., Huang H.L., Ciou L.P., Chou C.C., Yang M.C., Ho S.Y, & Lin Y.R. (2014). Increased Risk of Major Depression in the Three Years following a Femoral Neck Fracture–A National Population-Based Follow-Up Study. PLoS ONE, 9(3), e89867.

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Publication 2014

Arthroplasty Cerebrovascular Accident Diabetes Mellitus Femoral Neck Fractures Fracture, Bone Fracture Fixation, Internal High Blood Pressures Hospitalization Kidney Failure Liver Cirrhosis Major Depressive Disorder Open Fracture Reductions Operative Surgical Procedures Osteoporosis Patients Replacement Arthroplasties, Hip Urbanization

Incidence and Mortality of Hip Fractures in Korea

Cited 9 times

Records from the Korean NHI claims database from 2002 and 2004 were used to identify patients with hip fractures and to monitor their 1-year mortality. The incidence of hip fractures was defined as patients having a claim record with a diagnosis of hip fracture and a hip fracture-related operation. Since identifying hip fracture cases solely based on diagnosis is likely to cause misclassification problems due to potential miscoding, we combined the information from both diagnosis and surgical records. This conservative approach underestimates the real incidence rate of hip fractures in Korea, but improves the validity of the incidence cases identified from insurance claims data.
All claims records of outpatient visits or hospital admissions of patients aged 50 or older containing a diagnosis of femur fracture (fracture of femur [International Classification of Diseases (ICD)-10 diagnostic code: S72], fracture of the neck of the femur [S72.0, S72.00], pertrochanteric fracture [S72.1, S72.10]) and hip fracture-related operation (open reduction & internal fixation [ICD-10 procedure code: N0601], closed reduction and percutaneous fixation [N0991], total hip replacement [N0711], or hip hemiarthroplasty [N0715]) from January 1 to December 31, 2003 were identified from the NHI claims database. The diagnosis and operation code for hip fracture was selected based on previous epidemiologic studies [1 (link),14 (link)] and was confirmed by a panel of four orthopedic clinicians working in four different general hospitals in Korea. The cases having more than one claim record that satisfied the inclusion criteria during 2003 were counted only once.
In general, not all operations are carried out during the first fracture visit or admission. However, most of the operations are performed within a month following the first visit, according to a consultation of orthopedic clinicians in Korea. Thus, we additionally defined the incidence cases as patients who did not have a record of a hip fracture-related operation in the claim record of the initial visit or admission, but had it within a month after the initial visit.
The 6-month period prior to 2003 (i.e., July - December, 2002) was set as a 'window period,' such that patients were defined as incident cases only if their first record of a fracture visit or admission was observed after this 6-month period. Since most of the follow-up treatments for hip fracture are completed within 6 months after the initial fracture, we assumed that the absence of any claims record with a diagnosis of hip fracture and hip-fracture-related operation in the previous 6 months assured that the fracture was a new case.
NHI claims data were merged with national mortality data provided by the National Statistical Office to determine the survival status of individual patients at the 12 months following the incidence.

Kang H.Y., Yang K.H., Kim Y.N., Moon S.H., Choi W.J., Kang D.R, & Park S.E. (2010). Incidence and mortality of hip fracture among the elderly population in South Korea: a population-based study using the National Health Insurance claims data. BMC Public Health, 10, 230.

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Publication 2010

Diagnosis Femoral Fractures Femoral Neck Fractures Fracture, Bone Fracture Fixation, Internal Hemiarthroplasty Hip Fractures Koreans Open Fracture Reductions Outpatients Patient Admission Patients Total Hip Arthroplasty

Predicting Osteoarthritis Progression in Participants

Cited 8 times

A total of 159 participants (118 female, 41 male) were enrolled in the NIH sponsored Strategies to Predict Osteoarthritis Progression (POP) study, approved and in accordance with the policies of the Duke Institutional Review Board. Participants were recruited primarily through Rheumatology and Orthopaedic clinics and met the American College of Rheumatology criteria for symptomatic OA of at least one knee. In addition, all participants met radiographic criteria for OA with a Kellgren-Lawrence (KL) [13 (link)] score of 1–3 in at least one knee. Exclusion criteria included the following: bilateral knee KL4 scores; exposure to a corticosteroid (either parenteral or oral) within 3 months prior to the study evaluation; knee arthroscopic surgery within 6 months prior to the study evaluation; known history of avascular necrosis, inflammatory arthritis, Paget's disease, joint infection, periarticular fracture, neuropathic arthropathy, reactive arthritis, or gout involving the knee, and current anticoagulation. A total of 186 participants were screened to identify the final 159 participants with radiographic and symptomatic knee OA of at least one knee who were willing to undergo arthrocentesis. Of the total 318 knees available for analysis, 10 knees were excluded from evaluation on the basis of knee replacement for a total of 308 knees included in the final analyses. The final knee sample included 8 participants that had undergone unilateral hip replacement for OA and one subject who had unilateral internal hip fixation secondary to a traumatic fracture. Knee symptoms were ascertained by the NHANES I criterion [14 (link)] of pain, aching or stiffnes on most days of any one month in the last year; for subjects answering yes, symptoms were quantified as mild, moderate, or severe yielding a total score of 0–4 for each knee. Current analgesic medication use was recorded (numbers of participants using): acetaminophen (32), narcotics (9), tramadol (2), non-selective non-steroidals (67), cycloxygenase inhibitors (45), glucosamine and chondroitin sulfate (51), and any of these analgesics (118).

Kraus V.B., McDaniel G., Worrell T.W., Feng S., Vail T.P., Varju G, & Coleman R.E. (2008). Association of Bone Scintigraphic Abnormalities with Knee Malalignment and Pain. Annals of the rheumatic diseases, 68(11), 1673-1679.

Publication 2008

A 159 Acetaminophen Adrenal Cortex Hormones Analgesics Arthritis Arthritis, Reactive Arthrocentesis Arthroscopic Surgical Procedures Avascular Necrosis of Bone Disease Progression Ethics Committees, Research Fracture, Bone Fracture Fixation, Internal Glucosamine Gout Infection inhibitors Joints Knee Knee Replacement Arthroplasty Males Narcotics Neurogenic Arthropathy Osteitis Deformans Osteoarthritis Of Hip Pain Parenteral Nutrition Replacement Arthroplasties, Hip Sulfates, Chondroitin Tramadol Woman X-Rays, Diagnostic

Most recents protocols related to «Fracture Fixation, Internal»

Retinal Microvascular Imaging in Parkinson's Disease

All included patients and healthy subjects underwent spectral-domain OCT (SD-OCT; Spectralis, Heidelberg Engineering, Heidelberg, Germany) that provided 40,000 A-scans per second with 7-μm optical and 3.5-μm digital axial resolution. An internal fixation target was used, and the patient’s other eye was covered during scanning. OCT peripapillary RNFL circular scans centered on the optic disc of each patient were obtained. In addition, macular thickness measurements in the central 1-mm area and in each quadrant in the 3- and 6-mm areas were obtained. Swept-source OCT (DRI OCT Triton Plus; Topcon Corporation, Tokyo, Japan) coupled with non-invasive OCTA technology was also completed for all PD patients and healthy subjects. The details have been previously described^{43 (link),44 (link)}. The SRCP slab was automatically segmented from 3 µm under the internal limiting membrane (ILM) to 15 µm below the IPL, and the DRCP slab was automatically segmented from 15 to 70 µm under the IPL following a formerly corroborated method by Park et al.^{45 (link)}. The radial peripapillary capillary (RPC) segment ranged from the ILM to the posterior boundary of the RNFL. Vessel density was determined as the percentage of the total area occupied by vessels and microvasculature, quantitatively expressed as color-coded vessels in a localized region that was obtained by automatically applying an Early Treatment Diabetic Retinopathy Study (ETDRS) grid overlay containing the two inner rings of the ETDRS grid pattern to the fovea, which yielded a calculation of the density in each layer. The parafoveal ring divided the macular region into the temporal, nasal, inferior, and superior sections (Fig. 3). All participants completed both OCT and OCTA imaging within 1 day. The software generated TopQ image quality values for each OCTA scan and vessel density measurement. To assess scan quality, we included the scan images based on the quality assessment criteria suggested by Fenner et al.^{46 (link)}. Expert graders reviewed and verified all images (D.L. and K.-A.P.). In patients with PD and healthy controls, bilateral eyes were analyzed except OCTA images, which are difficult to analyze due to motion artifacts or incomplete acquisitions.Fig. 3Representative fundus photography and OCTA images of the macular area in a healthy control.

Macular OCTA measurement was obtained by automatically applying an Early Treatment Diabetic Retinopathy Study (ETDRS) grid overlay containing the two inner rings of the ETDRS grid pattern to the fovea, which yielded the vessel density in each layer. C center, T temporal quadrant, I inferior quadrant, N nasal quadrant, S superior quadrant.

Ahn J.H., Kang M.C., Lee D., Cho J.W., Park K.A, & Youn J. (2023). Central retinal microvasculature damage is associated with orthostatic hypotension in Parkinson’s disease. NPJ Parkinson's Disease, 9, 36.

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Publication 2023

Blood Vessel Capillaries Diabetic Retinopathy Eye Fingers Fracture Fixation, Internal Healthy Volunteers Macula Lutea microvasculature Nose Optic Disk Patients Radionuclide Imaging Temporal Lobe Tissue, Membrane Vision

Lateral Condylar Humeral Fractures in Children

Children with lateral condylar humeral fractures who were admitted to Ganzhou Maternal and Child Health Hospital between October 2020 and October 2021 made up a total of 106 instances that were used as study participants. The individuals were split into two groups, one receiving the standard surgical anesthetic (n = 51) and the other receiving the experimental anesthesia (n = 55), with the control group included 33 males and 28 females aged 2–10 (mean = 5.26 ± 1.42 years). Participants ranged in age from 2 to 10 years old (5.30 ± 1.41) with the majority (36) being male and the majority (29) being female. Between the two groups, there was no statistically significant difference in demographics like age and gender (P > 0.05). Internal fixation surgery was used to treat each kid in each of the two groups. A brachial plexus block was used in conjunction with general anesthesia on the study group, while the control group just got general anesthesia.

Li F., Yang Q., Yi J, & Chen A. (2023). The recovery of upper limb function and postoperative pain in children with lateral humeral condyle fractures were examined retrospectively in relation to the effects of brachial plexus block given in conjunction with general anesthesia. Journal of Orthopaedic Surgery and Research, 18, 181.

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Publication 2023

Anesthesia Anesthetics Brachial Plexus Block Child Children's Health Females Fracture Fixation, Internal General Anesthesia Lateral Condyle Fracture of Humerus Males Mothers Operative Surgical Procedures

MRI-guided HDR Brachytherapy for Cervical Cancer

The dose of the pelvic EBRT was 45–50.4 Gy, with a 1.8–2 Gy/fraction. Some patients were treated with concurrent or sequential therapy with a total lymph node boost dose of 57.5–65 Gy. The EBRT techniques included three-dimensional conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT), or volume modulated radiotherapy (VMAT). In Arm 1 and Arm 2, 52 (82.5%) and 49 (86.0%) of the patients received concurrent platinum-based chemotherapy, and 11 (17.5%) and 8 (14.0%) of the patients received radiotherapy only. All the patients received treatment by using the MRI-guided ¹⁹²Ir HDR after-loading the therapy equipment (Micro-Selectron HDR V2), and the BT was performed after completion of the EBRT.
The implantation of the BT applicator and needle was performed as described below: the applicator was selected before the surgery, according to the disease conditions of patients. The tumor location, size, shape, para-uterine invasion, and relationship with surrounding organs were verified from the MRI images before and after the EBRT, as well as gynecological examination. The bowel preparation was performed on the day before the operation, and vaginal irrigation was performed on the day of operation. Combined intravenous and inhalation anesthesia was administered to the patients, then the patients were disinfected routinely, and the Foley urethral catheter was placed, with the balloon at the site of the vesical neck. The color ultrasound-assisted implantation of the applicator and needle was performed. The applicators used included the Utrecht interstitial Fletcher CT/MRI applicator set, interstitial ring CT/MRI applicator set, vaginal CT/MRI multi-channel applicator set, and self-made 3D-printed applicator. In patients that the para-uterine invasion has reached the pelvic wall, trans-perineal manual implantation was performed in addition to the above-mentioned applicators to meet the demands of dose distribution, and the depth of the needle was guided under the assistance of ultrasound. After the completion of the implantation, the applicator and needles were fixed. For one BT fraction in one application and two BT fractions every other day in one application, the fixation method of the applicator and needles remained the same. First, the needles were fixed on the applicator using the guiding tube, which was assembled on the applicator. Next, the applicator was filled with gauze for internal fixation, and then it was externally fixed on the patient's body with a T-shaped fixing belt. And then the rectum was pushed by the rectal pressure plate. The MRI was performed after the patient has been awakened. The application of analgesic drugs was decided based on the level of pain in patients. The analgesic drugs included were as follows: patient-controlled intravenous analgesia (PCIA), subcutaneous injection of opiates, and/or anti-inflammatory analgesics. The analgesic drugs were used in the recovery and treatment periods according to the requirements.
T2W MRI of each BT fraction was used for the delineation of target volume and OARs, as referred to in the GEC-ESTRO recommendations [4 (link)]. The high-risk clinical target volume (HR-CTV) was applied for the range of tumors that showed by the MRI and physical examinations following the EBRT, as well as the overall uterine cervix examination. The intermediate-risk clinical target volume (IR-CTV) was applied for the range of cervical cancer before the EBRT and for the extension of HR-CTV. The OARs included the bladder, small intestine, sigmoid colon, and rectum.
All the patients received the HDR-IGABT treatment at the 28 Gy/4f. The MRI was performed on the day when the operation has been completed. The patients in Arm 1 have received one BT fraction, and then the applicator or needles have been removed, while the patients in Arm 2 have received the first BT fraction. CT has been performed 16–24 h later to verify the locations of the applicator and needles. The second BT fraction was performed after confirmation.
All the patients received routine medical nursing, and stretch socks were worn to prevent deep venous thrombosis (DVT). Continuous electrocardiogram (ECG), blood pressure, and blood oxygen saturation were monitored during the waiting period. Antiemetics and anxiolytics were provided based on patient assessment. For the patients who received BT fractions every other day in one application, the segmental pressing massager was used in the waiting period, and corresponding nursing practices were also adopted during the waiting period to maintain the patients in the supine position. In addition, one doctor and two nurses were assigned for nursing and closely monitoring the continuous BT patients.

Song S., Han D., Zhang N., Mao Z., Guo X, & Cheng G. (2023). The MRI-guided two adaptive brachytherapy fractions versus one adaptive brachytherapy fraction in one application for the cervical cancer: a retrospective study. Radiation Oncology (London, England), 18, 46.

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Publication 2023

Analgesics Analgesics, Anti-Inflammatory Anesthesia, Inhalation Anti-Anxiety Agents Antiemetics Blood Pressure Cervical Cancer Cervix Uteri Deep Vein Thrombosis Electrocardiography Fracture Fixation, Internal Gynecological Examination Human Body Intestines Intestines, Small Neck Needles Neoplasms Neoplasms by Site Nodes, Lymph Nurses Opiate Alkaloids Ovum Implantation Oximetry Pain Patient-Controlled Analgesia Patients Pelvis Perineum Pharmacotherapy Physical Examination Physicians Platinum Pressure Radiotherapy Radiotherapy, Conformal Radiotherapy, Intensity-Modulated Rectum Sigmoid Colon Subcutaneous Injections Surgery, Day Ultrasonics Urethral Catheters Urinary Bladder Uterus Vagina Vaginal Douching Volumetric-Modulated Arc Therapy

Comparative Efficacy of Orthognathic Surgical Techniques

All procedures were performed under a standardized surgical protocol. Patients were randomized to one of the two study intervention arms: IVRO group or SSRO group. Other orthognathic procedures were performed in a routine manner and sequence if indicated. The surgeries were performed under general anesthesia. The surgical procedures used in the two study arms are described below.
In the IVRO group, a vestibular incision was made at the buccal sulcus. A mucoperiosteal flap was raised to expose the lateral ramus. A sigmoid notch retractor and a posterior border retractor were placed for retraction. A vertical osteotomy from the sigmoid notch to the gonion of the mandible was made with an angled oscillating saw. The osteotomy was completed with a curved osteotome. The occlusion was achieved with an acrylic wager. No internal fixation was applied. IMF was secured with wire and custom-made arch bars for 6 weeks postoperative. The wound was closed with resorbable polyglactin sutures.
In the SSRO group, a standardized SSRO procedure with the Dal Pont-Hunsuck modification was performed. After vestibular incision at the buccal sulcus, a mucoperiosteal flap was raised. A short lingual osteotomy bisecting the upper and lower occlusal plane above the lingula was made. The anterior vertical osteotomy was made on the buccal cortex in the molar region. The lingual and buccal osteotomies were joined along the external oblique ridge. The osteotomies were completed with osteotomes and split to separate the proximal and distal segments. The buccal cortex was trimmed for segment adaptation. The occlusion was established with an acrylic wafer. One titanium miniplate was fixed on each side with four screws. The wounds were closed with resorbable polyglactin sutures. Light guiding elastics were used for 3–4 weeks postoperatively.
For both groups, routine medications including analgesics (paracetamol and codeine phosphate if not allergic), antibiotics (penicillin V if not allergic, for 2 days), and steroids (dexamethasone for 2 days) were given. Standard postoperative instructions were given in the same manner to both groups of patients.

Wong N.S, & Leung Y.Y. (2023). Comparison of the quality of life changes of patients receiving sagittal split ramus osteotomy or intraoral vertical subsigmoid osteotomy for mandibular prognathism. Clinical Oral Investigations, 27(4), 1435-1448.

Publication 2023

Acclimatization Acetaminophen Analgesics Antibiotics, Antitubercular Arm, Upper Codeine Phosphate Cortex, Cerebral Dental Occlusion Dexamethasone External Abdominal Oblique Muscle Fracture Fixation, Internal General Anesthesia Light Mandible Molar Occlusal Plane Operative Surgical Procedures Osteotomy Patients Penicillin V Pharmaceutical Preparations Poly(Lactide-Co-Glycoside) Sigmoid Colon Steroids Surgical Flaps Sutures Titanium Tongue Vestibular Labyrinth Vestibule of the Mouth Wounds

Surgical Management of Terrible Triad Elbow Injuries in Elderly Patients

From January 2015 to December 2020, 15 consecutive cases with terrible triad injuries of the elbow in patients age over 65 years were treated using the described technique by a single surgeon (CHM) (Table 1). A minimum of 1 year of follow-up (range, 16-36 months) was fulfilled for all cases. There were eight men and seven women with a mean age of 70.6 years (range, 66-78 years). The mechanism of injury was falls (9 patients) and traffic accidents (6 patients). The study was approved by the institutional review board (EMRP-109-157), and informed consent was obtained from each patient.Table 1.

Patients’ Demographic Data.

Case	Sex/Age	Mechanism	Classification and Treatment		Associated Injury	Comorbidity
Case	Sex/Age	Mechanism	Radial Head	Coronoid	Associated Injury	Comorbidity
1	F/68	Fall	Type I-ORIF	Type I		DM
2	F/67	Traffic accident	Type III-PR	Type II-ORIF		HTN, CAD
3	M/70	Traffic accident	Type II-ORIF	Type III-ORIF	Intracranial hemorrhage
4	F/66	Traffic accident	Type III-ORIF	Type I		Liver cirrhosis, child A
5	M/78	Fall	Type III-PR	Type I
6	M/72	Fall	Type II-ORIF	Type II-ORIF	Ipsilateral distal radial fracture
7	F/78	Fall	Type II-ORIF	Type I		ESRD, DM, HTN
8	M/70	Fall	Type II-ORIF	Type III-ORIF
9	M/71	Traffic accident	Type III-ORIF	Type II-ORIF	Epidural hemorrhage	DM
10	M/73	Fall	Type I-ORIF	Type I
11	M/69	Fall	Type II-ORIF	Type I
12	F/74	Traffic accident	Type III-PR	Type II-ORIF	Ipsilateral clavicle fracture
13	F/66	Fall	Type III-PR	Type I
14	F/70	Traffic accident	Type II-ORIF	Type I		Rheumatoid arthritis
15	M/68	Fall	Type II-ORIF	Type I		DM, HTN

F, female; M, male; ORIF, open reduction internal fixation; PR, prothesis radius; DM, diabetes mellitus; CAD, cardiovascular disease.

Plain radiography and computed tomography (CT) were performed to evaluate osseous abnormalities in all patients preoperatively (Figure 1(A)), and plain radiographic exams in two views were arranged at each post-surgery visit (Figure 1(B) and 1(C)). The Regan-Morrey classification was used to classify coronoid fractures based on the results of CT scans preoperatively.^{8 (link)} Radial head fractures were classified according to the original Mason classification.^{9 (link)}Figure 1.

(A1) Preoperative three-dimensional computed tomography (CT) reconstruction, (A2) lateral radiograph of a 67-year-old woman who sustained a right “terrible triad injury” with a type II coronoid fracture. (B1) Anteroposterior and (B2) lateral radiographs of the patient status post open reduction of the elbow joint, fixation of the coronoid process with screws, radial head arthroplasty, lateral collateral ligament repair, and internal joint stabilizer implantation. (C1) Anteroposterior and (C2) lateral radiographs of the patient showing a stable elbow joint after removing the internal joint stabilizer. Functional range of motion observed at the 1-year follow-up showing (D1) extension, (D2) flexion, (D3) pronation, and (D4) supination.

Chiu Y.C., Wu C.H., Tsai K.L., Jou I.M., Tu Y.K, & Ma C.H. (2023). Using an Internal Joint Stabilizer Through a Single Posterior Approach for Elderly Patients With Terrible Triad Injury. Geriatric Orthopaedic Surgery & Rehabilitation, 14, 21514593231162193.

Publication 2023

Arthroplasty Bones Cardiovascular Diseases Child Clavicle Congenital Abnormality Diabetes Mellitus Elbow Injuries Ethics Committees, Research External Lateral Ligament Fracture, Bone Fracture Fixation, Internal Head Injuries Joints Joints, Elbow Liver Cirrhosis Males Open Fracture Reductions Operative Surgical Procedures Ovum Implantation Patients Pronation Radial Head Fractures Radionuclide Imaging Radius Reconstructive Surgical Procedures Regan isoenzyme Supination Surgeons Traffic Accidents Triad resin Woman X-Ray Computed Tomography X-Rays, Diagnostic

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What are the different types of internal fixation devices used for Fracture Fixation?

The most common internal fixation devices used for Fracture Fixation include plates, screws, intramedullary nails, and external fixators. Each device has its own unique advantages and is used depending on the location and severity of the fracture. For example, plates are often used for long bone fractures, while screws are commonly used for smaller bone fragments. Intramedullary nails are inserted into the medullary cavity of long bones to provide stabilization, and external fixators are used for complex or open fractures that require additional support.

What are some of the key benefits of using internal fixation for Fracture Fixation?

The main benefits of internal fixation for Fracture Fixation include improved bone alignment, faster healing times, and earlier mobilization of the affected limb. Internal devices provide more stable support compared to external fixation, which allows for earlier weight-bearing and rehabilitation. This can lead to better functional outcomes and a reduced risk of complications like non-union or malunion. Additionally, internal fixation is less visible and can be more comfortable for the patient during the recovery process.

How can PubCompare.ai help researchers optimize their research protocols for Fracture Fixation, Internal?

PubCompare.ai's AI-driven platfomr can help researchers streamline their research process for Fracture Fixation, Internal in several ways. First, the platform allows you to efficiently scren protocol literature from published studies, preprints, and patents to identify the latest and most relevant procedures. Second, the platform's AI-driven analysis can highlight critical insights, such as key differences in protocol effectiveness, enabling you to choose the best option for reproducibility and accuracy. This can be particularly helpful when comparing different internal fixation techniques or devices for specific fracture types or patient populations. By leveraging PubCompare.ai, researchers can stay ahead of the curve and optimize their research protocols for Fracture Fixation, Internal.

Are there any common challenges or considerations when using internal fixation for Fracture Fixation?

One of the main challenges with internal fixation for Fracture Fixation is the potential for complications, such as infecxion, hardware failure, or implant migration. Proper surgical technique and postoperative care are crucial to mitigate these risks. Additionally, some patients may be unsuitable for internal fixation due to factors like osteoporosis, poor bone quality, or co-existing medical conditions. In these cases, alternative treatment options like external fixation or non-operative management may be more appropriate. It's important for clinicians to carefully evaluate the patient's individual circumstances and select the most suitable internal fixation approach to optimize the chances of successful bone healing and functional recovery.

More about "Fracture Fixation, Internal"

Fracture Fixation, Internal is a medical procedure used to stabilize and heal broken bones within the body.
This process, also known as internal fixation, involves the use of internal devices such as plates, screws, rods, and nails (e.g., Gamma 3 nail, Periarticular Locking Plate (ZPLP®)) to hold the fractured bone fragments in proper alignment while they heal.
This technique is often preferred over external fixation methods as it provides more stable support and allows for earlier mobilization of the affected limb.
The goal of Fracture Fixation, Internal is to facilitate bone union, restore function, and minimize the risk of complications, such as non-union or malunion.
Surgeons may use various surgical techniques and implants to manage internal fractures of the skeletal system, including the use of Technovit 4071, Visante OCT, Sensation Cardiac, 11-gauge bone marrow biopsy needle, Cirrus HD-OCT, Visante, and Spectralis HRA + OCT MultiColor.
Internal fixation is commonly used to treat fractures in bones such as the femur, tibia, humerus, and other long bones, as well as fractures of the pelvis, wrist, and ankle.
The procedure may involve the use of metal plates, screws, and rods to hold the bone fragments in place, facilitating the healing process.
In some cases, internal fixation may be combined with external fixation methods, such as casts or braces, to provide additional support and stability during the healing process.
Additionally, the surgeon may use antibiotics, such as those effective against S. aureus ATCC 25923, to prevent infection.
Overall, Fracture Fixation, Internal is a critical surgical technique that plays a crucial role in the management of internal fractures, helping to restore limb function, reduce the risk of complications, and improve patient outcomes.