Journal of orthopaedic trauma
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Internal fixators with angular stability have been developed to provide high stability without compression of the plate on to the bone. Angular and axial stability of a plate-screw construct can be achieved using a conically threaded screw head undersurface and a corresponding conically threaded plate hole. Furthermore, the insertion angle of the screw must correspond precisely to the axis of the screw hole. This is not always achieved in clinical practice and may result in screw loosening. The objective of this study was to examine the relationship between the stability of the locked screw-plate on the insertion angle of the screw. ⋯ A locking head screw exhibits high stability with a moderate axis deviation in the angle of insertion of up to 5 degrees . However, there is a significant decrease in stability with increasing axis deviation (>5 degrees ). An aiming device is recommended to provide optimal fixation with angular stability.
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Orthopaedic injuries constitute a majority of the combat casualties in recent U. S. military conflicts. Orthopaedic injuries sustained in Operation Enduring Freedom from December 2001 to January 2003 that were treated in forward-deployed military medial facilities and evacuated to a U. ⋯ All arterial injuries underwent urgent revascularization in a field hospital. None of the arterial repairs required revision after evacuation to a medical center. Operation Enduring Freedom has been an excellent example of how early and aggressive intervention in a forward-deployed area has a significant effect on rehabilitative and reconstructive efforts at a rear echelon tertiary care center.
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To compare the biomechanical stability of extraarticular proximal tibia fractures reconstructed using a double-plate construct, locking plate system, hybrid external fixator, and single lateral periarticular plate, all from the same manufacturer. ⋯ For axial load applied to a wedge or gap osteotomy of the proximal tibia, the double-plate construct provided significantly more rigidity than the other constructs. The locking plate, periarticular plate, and hybrid external fixator tested provided similar rigidity for the wedge osteotomy, but for the gap osteotomy the external fixator could not support 600N without complete closure of the gap.