Dual tension band wiring for adolescent supracondylar fractures of the humerus: mechanical assessment and a clinical series.

Background: The optimal fixation technique of adolescent supracondylar fractures of the humerus (A-SCFH) remains inconclusive. To prove the efficacy of Dual Tension Band Wiring (DTBW), the mechanical performance was compared to the other pinning constructs, i.e.

Comparative cadaveric study of the Kocher-Langenbeck approach with and without trochanteric osteotomy in extended posterior wall fractures of the acetabulum.

Introduction: Standard exposure, such as the Kocher-Langenbeck (KL) approach, has a limited ability to access the cranial and anterior portions of the posterior wall with an extended fracture line into the acetabular dome. Augmentation of the KL approach with trochanteric osteotomy (TO) enhances the exposure in this area. We compared the area of surgical exposure in the KL approach with and without additional TO and identified the most anterior exit point of the posterior wall in each surgical approach.

How wide of a distal metaphyseal femoral fracture gap is a high risk of varus collapse and fixation failure? A finite element study.

Background: Severe metaphyseal comminution and sizable bone defect of the distal femur are high risks of fixation failure. To date, no exact magnitude of comminution and bone loss is determined as an indication for augmentation of fixation construct. The present study aimed to investigate the influence of metaphyseal gap width, working length, and screw distribution on the stability of the fixation construct.

Concurrent plate fixation and pedicled flap coverage for open fractures complicated by soft tissue loss of the tibia in pediatric cohort: a clinical series.

Background: The optimal treatment of open fractures complicated by soft tissue loss of pediatric tibial fractures remains inconclusive. The author described a protocol of concurrent plate fixation and pedicled flap coverage and retrospectively reviewed the outcomes of such injuries.

Methods: A total of 25 pediatric cases with Gustilo lllB open tibial fracture were treated by single-stage plate fixation and pedicled flap reconstruction.

U-Turn Design Metatarsal Artery Flap: Reliable Solution in Distal Forefoot Defect.

Background: In distal forefoot defect, finding wound closure is challenging because of the distal site and small blood vessels involved. One possible resolution is the utilization of a metatarsal artery flap in a 'U-turn' design. This method offers several advantages, including its long length and a viable option for distal forefoot defect.

The application of inverted lateral clavicle locking compression plate for medial clavicle fractures: biomechanical study and clinical implementation.

Background: There has been no absolute consensus on the optimal implant for fixation of medial clavicle fracture. The purpose of the present study was to test the biomechanical efficacy of inverted lateral clavicle locking compression plate (LCP-LC) in fixation of this specific fracture location by finite element analysis.

Methods: Transverse and comminuted medial clavicle fracture simulated models stabilized by three different devices including inverted LCP-LC, superior clavicle LCP (LCP-SC), and dual reconstruction (LCP-RP) with LCP-SC were investigated biomechanical performance under three loading conditions, i.

Comparative study of mechanical performance of various fixation constructs in multifragmentary distal humeral shaft fracture: a finite element analysis.

Background: There has been no scientific mechanical assessment demonstrating the optimal fixation technique in multifragmentary fractures of the distal humeral shaft. The purpose of the present study was to compare the biomechanical performance of 5 fixation constructs as used in minimally invasive plating osteosynthesis (MIPO) for distal humeral shaft fractures.

Methods: Three-dimensional (3D) humerus model with 20 mm distal humeral shaft fracture gap simulating multifragmentary fracture was created from computed tomography data and virtually fixed by 5 fixation techniques as MIPO, i.

Simultaneous internal fixation and latissimus dorsi pedicle flap coverage: A reliable regimen for open fractures with accompanying sizable soft tissue loss of the upper extremities.

Background: The optimal treatment protocol for open fractures with accompanying sizable soft tissue defect of the upper extremities has not been specifically delineated. The authors described the concurrent use of internal fixation and latissimus dorsi (LD) pedicle flap coverage in managing such complex fractures.

Methods: Twenty patients with open fractures accompanied by large soft tissue defect of the upper extremities (8 clavicle fractures and 12 humeral fractures) were treated by fix & LD pedicle flap.

Nonvascularized fibular graft with locking screw fixation for metaphyseal bone loss of distal femur: biomechanical assessment validated by a clinical case series.

Background: The optimal modality to surgically treat significant bone loss of distal femur remains inconclusive. The objectives of the present study were to assess the mechanical performance of nonvascularized fibular graft (NVFG) with locking screw fixation in distal femur fixation construct by finite element analysis and to retrospectively describe the outcomes of the present technique in clinical cases.

Methods: Four constructs which the fractured femur was stabilized by LCP-DF alone, dual plating, LCP-DF combined with NVFG, and LCP-DF combined with NVFG (LCP-DF-NVFG-S) with locking screw were assessed the biomechanical performance under physiological loads.

Dual plating for fixation failure of the distal femur: Finite element analysis and a clinical series.

Background: The optimal technique for managing distal femur fixation failure remains inconclusive. The author studied the efficacy of a combined proximal humerus locking compression plate (LCP-PH) and 3.5 mm reconstruction plate (LCP-RP) by finite element (FE) analysis and retrospectively described the clinical outcomes of the present technique in such difficult circumstances.

Comparative biomechanical performance of two configurations of screw constructs and types used to stabilize different sites of unstable Pauwels type II femoral neck fractures: A finite element analysis.

Background: A smaller dimension of the femoral neck in the Asian population may have difficulty placing inverted triangle multiple screws configuration for treatment. Posterior triangle configuration, which is suitable in limited space of the femoral neck, is a promising alternative treatment approach. This study aimed to investigate the biomechanical performance of inverted and posterior triangles of multiple screws fixation configuration for both cannulated and standard solid-core screws in stabilizing Pauwels type II femoral neck fracture sub-capital, mid-cervical, and basilar regions using Finite Element (FE) method.

The utility of reverse distal femur locking compression plate in minimally invasive osteosynthesis for type C subtrochanteric fractures of the femur: technical description and a clinical series of 50 cases.

Background: Establishing fracture consolidation and avoiding postoperative complications of comminuted subtrochanteric fractures of the femur are technically challenging. The authors delineated a technical description of minimally invasive plate osteosynthesis (MIPO) by using a reverse distal femur locking compression plate (LCP-DF) and retrospectively reviewed the outcomes of these particular fractures.

Methods: Fifty patients with 51 type C subtrochanteric fractures of the femur were operated on by MIPO and reverse LCP-DF fixation.

Utilizing the various forms of the gastrocnemius muscle in fix & flap protocol: a reliable remedy for open proximal tibial fractures with accompanying soft tissue defect.

Background: Open proximal tibial fractures accompanied by soft tissue loss are substantially challenging to accomplish both bony consolidation and wound healing. The authors retrospectively delineated the utility of the various forms of the gastrocnemius muscle in fix & flap regimen for management of such complicated injuries.

Methods: Thirty-one patients with open fracture accompanied by soft tissue loss of proximal tibia were managed by the protocol of fix & gastrocnemius flap.

Danger zone for screw placement in minimally invasive plate osteosynthesis (MIPO) of diaphyseal fractures of forearm: a cadaveric study.

Purposes: To identify the anatomical relationship between neurovascular structures and screws and to evaluate the danger zone of screw placement during minimally invasive plate osteosynthesis (MIPO) technique following the volar approach for the radius and the subcutaneous approach for the ulna in diaphyseal forearm fractures.

Methods: Sixteen cadaveric forearms were fixed with a 3.5-mm, 14-hole, locking compression plate (LCP) using the MIPO technique with a volar approach of the radius.

Single lag screw and reverse distal femur locking compression plate for concurrent cervicotrochanteric and shaft fractures of the femur: biomechanical study validated with a clinical series.

Background: The optimal surgical management of concurrent cervicotrochanteric and shaft fractures of the femur has not been consensual. The authors investigated the reliability of combined single lag screw and reverse distal femur locking compression plate (LCP-DF) by finite element (FE) study and retrospectively described the present technique for these dual fractures.

Method: Intact femurs were derived from CT data, and the implant models were created by using CAD software.

Concurrent internal fixation and soft tissue reconstruction by distally based sural flap: a practicable scheme for complex distal tibial fractures.

Background: It is difficult to establish both fracture union and wound healing of open fractures complicated with soft tissue defects of the distal tibia. We describe the simultaneous use of internal fixation and soft tissue coverage by a distally based sural flap (DBSF) for these complex injuries.

Methods: Seventeen patients with Gustilo IIIB open fractures of the distal tibia were operated on by internal fixation and DBSF coverage.

Simultaneous internal fixation and soft tissue coverage by soleus muscle flap and variances: a reproducible strategy for managing open fractures of tibial shaft.

Background: The role of internal fixation and local muscle flaps for open tibial fractures is still not specifically determined. We describe the integration of internal fixation and soleus muscle flap for open fractures complicated with soft tissue loss of the tibial shaft.

Methods: Twenty-seven patients with Gustilo IIIB open fractures of the tibial shaft were operated on by internal fixation and soft tissue coverage by soleus muscle flaps and variances.

Combined medial gastrocnemius and hemisoleus flap: a reproducible alternative for open tibial fractures complicated with large or double soft tissue defects.

Background: Utilization of combined local muscle flaps for Gustilo type IIIB open tibial fractures has not been clearly delineated. We describe a combination of medial gastrocnemius and hemisoleus flaps for managing open tibial fractures accompanying large or double soft tissue defects.

Methods: Twelve patients with Gustilo IIIB open fractures of the tibial shaft with large (9) or double (3) defects were operated on by fracture stabilization and combined medial gastrocnemius and hemisoleus flap coverage.

Anterior minimally invasive plating osteosynthesis using reversed proximal humeral internal locking system plate for distal humeral shaft fractures.

Objective: To describe the surgical application of anterior minimally invasive plating osteosynthesis (MIPO) using reversed proximal humerus internal locking system (PHILOS) plate for multifragmentary distal humeral shaft fractures.

Methods: Twelve patients with distal humeral shaft fractures (type 12B, n = 6 and type 12C, n = 6) were operated on by anterior MIPO and reversed PHILOS plate fixation. The amount of intact bone in the distal fragment was measured by fracture-to-coronoid distance (FCD).

Outcomes Following Temporary Kapandji Pinning Technique and Distal Radial LCP Fixation for Intra-Articular Fractures of the Displaced Distal Radius.

In partially or completely displaced intra-articular fracture of the distal radius , achieving satisfactory reduction and maintenance of good reduction before applying the plate may be difficult. Especially to accomplish the anatomic volar tilt remains a problem. Typically, the Kapandji technique has been described to reduce and stabilize a large displaced and extra-articular fracture of the distal radius.

Closed flexor pulley rupture of the thumb: case report and review of literature.

Closed flexor pulley rupture of the thumb is extremely rare. We report a case with this condition. The anatomic and biomechanical studies, clinical and operative finding as well as the management of the closed flexor pulley rupture of the thumb are discussed.

Recovery of brachial plexus injury after shoulder dislocation.

Brachial plexus injury is an underestimated complication from anterior dislocation of the shoulder. To our knowledge, there is limited information available about the factors that influence neurological recovery of this injury. We reviewed 15 upper extremities in 14 patients with brachial plexus injuries caused by anterior shoulder dislocation.