A tension system for angular correction of bent intramedullary nails: in vitro analysis.

Purpose: Although several techniques have been described for bent intramedullary nail removal, there is no universally accepted strategy. We hypothesized that a device based on the action principle of a three-point bend fixture could facilitate extraction of bent intramedullary nails; this paper describes its design and experimental testing.

Methods: Five large synthetic left femurs and five steel intramedullary nails were used.

Doctor, When Should I Start Walking? Revisiting Postoperative Rehabilitation and Weight-Bearing Protocols in Operatively Treated Acetabular Fractures: A Systematic Review and Meta-Analysis.

: Management of acetabular fractures is aimed at anatomically reducing and fixing all displaced or unstable fractures, as the accuracy of fracture reduction has been demonstrated to strongly correlate with clinical outcomes. However, there is a noticeable gap in the literature concerning the perioperative and postoperative care of patients with acetabular fractures, which ultimately can be potential risk factors for adverse outcomes and permanent disabilities. This study aimed to systematically review the available literature regarding rehabilitation practices, including weight-bearing protocols, across time points in surgically treated acetabular fracture patients and correlate these practices with functional outcomes.

In vitro biomechanical analysis of a locking self-compression screw model applied to Pauwels III and comminuted femoral neck fractures.

Femoral neck fractures (FNFs) affect the young adult population and are intimately related to high-energy trauma. Despite innovations in osteosynthesis materials, the rate of complications remains at 10%-59% in Pauwels type III (PIII) fractures. The authors thus propose a fixation model with a novel self-compression screw, comparing it to a sliding hip screw plate associated with a derotation screw in the fixation of a PIII fracture with posterior inferior comminution.

Comparison of sacroiliac screw techniques for unstable sacroiliac joint disruptions: a finite element model analysis.

Vertically unstable pelvic injuries associated with sacroiliac disruption are challenging. Although percutaneous iliosacral fixation using two screws at S1 vertebral body has been shown beneficial, the use of two transiliac screws at S1 has been proposed to increase the fixation strength of the construct. In the herein study, the finite element method (FEM) was performed to analyse the biomechanical behaviour of five different constructions using iliosacral screws only, transiliac screws only, and combining an iliosacral and a transiliac screw.

Syndesmosis dislocation and ankle ligament stress in the posterior malleolus fracture fixated - "in vitro analysis".

Purpose: The objectives of this study were to compare syndesmosis dislocation and ankle ligament stress after the fixation of the posterior malleolus fracture (PMF) with four different techniques by Finite Element Analysis (FEM).

Methods: Four internal fixation techniques used for fixation of PMF were assessed by FEM: posterior one-third tubular 3.5 mm buttress plate (PP) with one screw (PP 1 screw), PP with two screws (PP 2 screws), two cannulated 3.

In vitro mechanical analysis of X-shaped femoroplasty with polymethyl methacrylate boundary a fall on the greater trochanter.

To evaluate with mechanical testing (MT) using synthetic femurs, an X-shaped femoroplasty technique with polymethyl methacrylate (PMMA), analyzing the results applied to the prophylaxis of proximal femur (PF) fractures caused by low-energy trauma. MT was performed simulating a fall on the greater trochanter, using fifteen Sawbones™ models. They were divided into three experimental groups (n = 5): control (DP) group, drilled without augmentation (DWA) group, and X-shaped augmentation (DX) group.

Biomechanical Efficacy of Three Methods for the Fixation of Posterior Malleolar Fractures: A Three-Dimensional Finite Element Study.

We investigated the biomechanical behaviour of different fixations of the tibial posterior malleolus (TPM), simulating distinct situations of involvement of the tibiotalar articular surface (TTAS) through a finite element model (FEM). A 3D computer-aided design model of the left ankle was obtained. The materials used were divided according to their characteristics into ductile and non-ductile, and all materials were assumed to be linear elastic, isotropic, and homogenous.

Pipkin Type-II Femoral Head Fracture - A Biomechanical Evaluation by the Finite-Element Method.

 To evaluate the biomechanical capacity of two forms of fixation for Pipkin type-II fractures, describing the vertical fracture deviation, the maximum and minimum principal stresses, and the Von Mises equivalent stress in the syntheses used.  Two internal fasteners were developed to treat Pipkin type-II fractures through finite elements: a 3.5-mm cortical screw and a Herbert screw.

Reverse Shoulder Arthroplasty: Evaluation of the Clinical and Functional Outcomes per Etiology.

 The present study aimed to evaluate the clinical outcomes of reverse shoulder arthroplasty to treat several conditions.  Retrospective, longitudinal study analyzing the Constant and University of California at Los Angeles (UCLA) scores and range of motion of patients undergoing reverse shoulder arthroplasty.  In total, 28 patients were analyzed, with a mean age of 75.

Evaluation of a Locking Autocompression Screw Model in Pauwels Type-3 Femoral Neck Fracture: In Vitro Analysis.

Femoral neck fractures in young adults are uncommon, resulting from high-energy trauma. Despite their infrequency in this population, there is higher rate of complications, especially in the more vertical fracture line, classified by Pauwels as a type-3 femoral neck fracture. The implant type is of paramount importance for maintaining anatomical reduction, since it must resist the deforming forces that act on the fracture.

Arthroscopic Repair of Rotator Cuff Injury: An Analysis of Function, Muscular Strength and Pain Between Single Row and Double Row Techniques.

 To evaluate the patients submitted to arthroscopic repair of the rotator cuff (RC), comparing the functional results, muscle strength, and pain obtained after single row (SR) and double row (DR) techniques.  Data were collected at the postoperative follow-up (minimum of 12 months) of 128 patients submitted to arthroscopic RC repair from 2011 to 2018. The clinical-functional variables were collected through the clinical examination, and the demographic, surgical and injury variables of the RC were collected from the electronic medical records.

FUNCTIONAL EVALUATION OF THE RESULTS OF REPAIR OF PARTIAL AND COMPLETE ROTATOR CUFF TEARS.

Objective: To perform a comparative analysis of the results of arthroscopic surgical treatment of partial and complete rotator cuff (RC) injuries.

Methods: Eighty-four shoulders with partial or complete RC tear that underwent arthroscopic repair were retrospectively evaluated using UCLA and Constant scores, assessment of strength, and range of motion. Fifty-seven shoulders with complete injuries and 27 with partial injuries were identified.

FABREX: A NEW CLINICAL TEST FOR DIAGNOSIS GLUTEAL TENDINOPATHY.

Objective: This study aims to describe a simple and accurate semiological method executing a specific maneuver with the lower limb to direct the semiological investigation towards the tendinopathies in the gluteus medius and minimus.

Methods: Fifty patients participated in the study, with a mean age of 44.1 ± 13 years, with persistent pain on the side of the hip for more than three months.

Rotator Cuff Lesion and Obesity: A Demographic and Metabolic Evaluation.

 To analyze the relationship between the presence and severity of rotator cuff (RC) injury with obesity and the time of exposure to obesity. Secondarily, to evaluate the relationship and prevalence of demographic and metabolic factors in obese individuals with RC injury.  This is a cross-sectional study with 235 obese patients (body mass index [BMI] ≥ 30 kg/m ).

No clinical advantage of locking over nonlocking plate fixation of symphyseal disruptions.

Purpose: although locking plates have led to important changes in fracture management, becoming important tools in the orthopedic surgeon's arsenal, the benefits of locking plates for traumatic diastasis of the pubic symphysis have not been established. This study was conducted to assess the quality of life in its different domains among patients with traumatic diastasis of the pubic symphysis managed either with locking or nonlocking plate.

Methods: a prospective cohort study was undertaken at 3 level 1 trauma centres in Brazil.

DOES PARTIAL MENISCECTOMY AFFECT ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION RESULTS?

Objective: To compare the application of partial meniscectomy concomitant with primary ACL reconstruction, using the graft from the patellar tendon with individuals who underwent only ACL reconstruction, in clinical functional criteria and degree of osteoarthritis (OA), after 10 years of the surgical process.

Methods: This is a retrospective cross-sectional study with 37 patients who underwent ACL reconstruction with a graft from the patellar tendon, associated or not with partial meniscectomy, divided into 2 groups: with meniscal injury (n = 22) and without meniscal injury (n = 15). Anthropometric data and four outcome measures were used to analyze the results: SF-36 questionnaire, arc of motion assessment, Knee injury and Osteoarthritis Outcome Score (KOOS), and Ahlbäck Radiographic Classification.

Clinical Evaluation of the Reconstruction of the Biceps Brachii using Triceps Graft.

 Clinical and functional evaluation of the surgical treatment for chronic injury of the distal biceps brachii applying a surgical technique with grafting of the distal triceps brachii tendon.  A study based on a review of the medical records and clinical evaluation of the patients submitted to surgical treatment for chronic injury to the distal insertion of the biceps brachii between February 2015 and February 2017. In a 12-month-minimum postoperative follow-up, 7 patients were evaluated regarding the range of motion of the operated and non-operated elbows, flexion, upper-limb extension and supination with a digital dynamometer, the hook test, the satisfaction index, and the Disabilities of the Arm, Shoulder and Hand (DASH) and Mayo Elbow Performance Score (MEPS) intruments.

Proposal for a New Fixation Method for Pauwels Type III Femoral Neck Fracture-Metaphyseal Stem: A Finite-Element Analysis.

Objective: To evaluate the biomechanical behavior of a metaphyseal stem specifically designed for the fixation of Pauwels type-III femoral neck fractures using finite-element analysis.

Methods: Three different constructions were studied: the dynamic hip screw with a superior anti-rotation screw (DHS + ARS), multiple cannulated screws in an inverted triangle configuration (ASNIS), and the Metaphyseal Nailing System (MNS), a new implant developed by the authors. Vertical and total displacement, localized and total maximum and minimum principal, and the Von Mises peak stresses were evaluated.

Evaluation of the Reproducibility of Lauge-Hansen, Danis-Weber, and AO Classifications for Ankle Fractures.

 The present study aims to analyze the intra- and interobserver reproducibility of the Lauge-Hansen, Danis-Weber, and Arbeitsgemeinschaft für Osteosynthesefragen (AO) classifications for ankle fractures, and the influence of evaluators training stage in these assessments.  Anteroposterior (AP), lateral and true AP radiographs from 30 patients with ankle fractures were selected. All images were evaluated by 11 evaluators at different stages of professional training (5 residents and 6 orthopedic surgeons), at 2 different times.

Biomechanical comparison of four different posterior malleolus fixation techniques: A finite element analysis.

Purpose: The objective of this study was to compare the biomechanical behavior of four fixation methods for posterior malleolar fracture (PMF) by finite element analysis (FEM).

Methods: Four internal fixation techniques used for fixation of PMF were assessed by FEM - a computational study: posterior one-third tubular 3.5 mm buttress plate (PP) with one screw (PP 1 screw), PP with two screws (PP 2 screws), two cannulated 3.

Energy Required for Fracture in Synthetic Proximal Femoral Models After Synthesis Material Removal: a Biomechanical Study Using Cannulated Screws, Dynamic Hip Screws, and Proximal Femoral Nails.

 The present study aims to identify the energy required for synthetic proximal femoral fracture after removal of three implant types: cannulated screws, dynamic hip screws (DHS), and proximal femoral nail (PFN).  Twenty-five synthetic proximal femur bones were used: 10 were kept intact as the control group (CG), 5 were submitted to the placement and removal of 3 cannulated screws in an inverted triangle configuration (CSG), 5 were submitted to the placement and removal of a dynamic compression screw (DHSG), and 5 were submitted to the placement and removal of a proximal femur nail (PFNG). All samples were biomechanically analyzed simulating a fall on the greater trochanter using a servo-hydraulic machine to determine the energy (in Joules [J]) required for fracture.

CLINICAL EVALUATION OF THE TREATMENT OF CLAVICLE FRACTURES: INTRAMEDULLARY NAIL × PLATE.

Objective: Studies confirm the benefit of surgical treatment for fixation of displaced midshaft clavicle fractures. Plate fixation and intramedullary nail are the two most used techniques. Our study seeks to compare these two surgical techniques.

Biomechanical study of different internal fixations in Pauwels type III femoral neck fracture - A finite elements analysis.

Objective: To evaluate biomechanical behavior of different internal fixation methods for the treatment of Pauwels Type III femoral neck fractures.

Methods: Three internal fixators were developed to treat Pauwels Type III femoral neck fracture using finite elements: dynamic hip screw (DHS); DHS combined with anti-rotation screw; three cannulated screws in an inverted triangular configuration (ASNIS). Under the same conditions, vertical fracture displacement, and maximum and minimum principal, and Von Mises stresses were evaluated.

Mechanical Analysis after Proximal Femoral Reinforcement with Polymethylmethacrylate in Alternated Double Holes.

 To evaluate, through a biomechanical assay, the maximum load, energy, and displacement necessary for the occurrence of fractures in synthetic models of femurs after the removal of cannulated screws and the performance of a reinforcement technique with polymethylmethacrylate (PMMA) in different combined positions.  In total, 25 synthetic bones were used, and they were divided into 4 groups: the control group (CG), with 10 models without perforation, and the test groups (A, B and C), with 5 models each. The test groups were fixed with cannulated screws using the Asnis technique, and they had the synthesis removed, and two of the holes formed by the reinforcement technique with PMMA were filled.