The primary aim of this study was to identify the rate of osteoarthritis in
Background.
Purpose. Knowing the morphology of any fracture, including
Purpose. Knowing the morphology of any fracture, including
Background. In suspected
Introduction. Up to 16% of
Introduction.
Percutaneous fixation of
Introduction.
Objective. To compare the ability of a new composite bio-absorbable screw and two conventional metal screws to maintain fixation of scaphoid waist-fractures under dynamic loading conditions. Methods. Fifteen porcine radial carpi, with morphology comparable to human scaphoids, were osteotomised at the waist. Specimens were randomised in three groups: Group I were fixed with a headed metal screw, group II with a headless tapered metal screw and group III with a bio-absorbable composite screw. Each specimen was oriented at 45° and cyclically loaded using four blocks of 1000 cycles, with peak loads of 40, 60 (normal load), 80 and 100 N (severe load) respectively. Permanent displacement and translation (step-off) at the fracture site was measured after each loading block from a standardised high-magnification photograph using image analysis software (Roman v1.70, Institute of Orthopaedics, Oswestry). Statistical analysis was by ANOVA and tolerance limits. Results. No gross failure or fracture gap displacement occurred. Average translations (step-off) at the fracture site after 4000 cycles up to 100N were 0.05mm±0.02SD (headed metal), 0.14mm±0.14SD (headless metal) and 0.29mm±0.11SD (composite) and differed significantly (p<0.01). Using tolerance limits, the data allowed us to predict that, with 95% certainty, the maximum average translation (step-off) following severe loading in 95% of any sample fixed with a headed metal screw will be below 0.17mm, headless metal screw below 0.74mm, and composite screw below 0.76mm. Conclusion. We observed only small average translations (step-off) for all three screws. Moreover, translations of more than 1mm that would predispose to non-union were highly unlikely for any of the screws, even after severe cyclic loading. We therefore conclude that a new bio-absorbable composite screw can serve as an alternative to conventional screws when fixing
True
The diagnosis of a clinical
Background.
A retrospective review of 51 consecutive patients undergoing fixation of
Acute
Purpose. The surgical treatment of
Longstanding un-united
Introduction and Aims:. The surgical treatment of fractures of the scaphoid with delayed presentation or with established non-union pose a formidable challenge with reported failure rates between 15% and 45%. The aim of this study is to report the results of percutaneous versus open fixation with bone grafting of these fractures. Method:. 34 Consecutive patients who underwent surgery between 2009 and 2013 for delayed presentation and established non-union of