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Changwei Yang – 1st expert on this subject based on the ideXlab platform
combination of volar Buttress Plate with external fixator for the distal radial fractures of type c3 caused by high energy injuriesChina Journal of Orthopaedics and Traumatology, 2009Co-Authors: Yingsheng Deng, Qiulin Zhang, Qiugen Wang, Fang Ji, Hao Tang, Jianhong Wu, Fang Wang, Xuri Tang, Zhengmao Guan, Changwei YangAbstract:
OBJECTIVE: To preliminarily explore the effect of combination of volar Buttress Plate with external fixator for the distal radial fractures of type C3 caused by high-energy injuries. METHODS: From January 2001 to June 2007, 13 patients with distal radial fracture of type C3, 9 males and 4 females aged from 26 to 47 (average 37 years), were treated with volar Buttress Plate combined with external fixator plus the techniques of K-wires and bone grafting as necessary, whose effects were evaluated preliminarily through comparing the volar tilt, radial inclination, radial shortening and wrist function. RESULTS: Followed up from 7 to 29 months (average 18 months), the volar tilt, radial inclination, radial shortening and wrist function of all patients recovered remarkably. Nine patients achieved excellent and 4 good according to Sarmiento score (modified by Stewart) in the radiological manifestation, while 5 patients displayed excellent, 6 good, and 2 fair according to Gartland-Werley functional assessment system. CONCLUSION: 1) Volar Buttress Plate could support the valor cortex in order to prevent comminuted fragment from displacing and maintain volar tilt and to provide the volar fulcrum for external fixator. 2) External fixator, with the assistance of volar fulcrum, could maintain the volar tilt and the height of distal radius and help unload the fossa. 3) Supplemental K-wires fixation and the bone graft may assist fracture stable.
Marc F Swiontkowski – 2nd expert on this subject based on the ideXlab platform
angulated screw placement in the lateral condylar Buttress Plate for supracondylar femoral fracturesInjury-international Journal of The Care of The Injured, 1998Co-Authors: Peter T Simonian, Greg J Thompson, Will Emley, Richard M Harrington, Stephen K Benirschke, Marc F SwiontkowskiAbstract:
Abstract Certain supracondylar femoral fractures are not amenable to internal fixation with fixed angle devices. In these instances, the condylar Buttress Plate is the recommended alternative; however, this is a less rigid device. Because of the decreased rigidity and strength of this device, there is a tendency toward varus angulation and malunion. In six fresh-frozen human knee specimens, segmental osteotomies were created to mimic supracondylar femoral fractures. The medical cortex was completely removed to make the fracture unstable to varus deformity. The fracture was fixed with a lateral condylar Buttress Plate using 4.5 mm screws. Each specimen was tested once with all the screws installed perpendicular to the Plate, and again with the middle screw, just proximal to the fracture, angled 45 degrees diagonally across the fracture into the subchondral bone of the medial femoral condyle. For the construct with all screws placed perpendicular to the Buttress Plate, the initial stiffness was 410 N/mm, and after 1000 cycles it was 230 N/mm. With a screw placed diagonally across the fracture site, stiffness increased to 833 N/mm on the first cycle, and 796 N/mm after 1000 cycles. In all specimens with the screws placed perpendicular to the Plate, the distal fragment had a permanent varus deformity after 1000 cycles, under no load, of 0.91 mm. For the diagonal screw condition, the average magnitude for all six specimens was 0.42 mm. This simple means of screw angulation in the Plate strengthened the overall construct to resist the tendency toward varus deformity. The attractive features include the ease of application, and the use of an existing construct.
Adel Ghoneim – 3rd expert on this subject based on the ideXlab platform
the unstable nonunited scaphoid waist fracture results of treatment by open reduction anterior wedge grafting and internal fixation by volar Buttress PlateJournal of Hand Surgery (European Volume), 2011Co-Authors: Adel GhoneimAbstract:
Purpose The purpose of this study is to evaluate the results of treatment of unstable nonunited scaphoid waist fracture by anterior wedge graft and internal fixation with the use of volar Buttress Plate and screws. Methods Fourteen adult male patients with unstable nonunited scaphoid waist fracture with a humpback deformity were treated by reduction of the collapse deformity, insertion of anterior wedge graft, and internal fixation with the use of volar Buttress Plate and screws. The mean patient age was 26 years, and the mean duration of the nonunion before surgery was 16.5 months. The follow-up time ranged from 9 to 19 months (mean, 11 mo). Thirteen of the fourteen nonunions healed with sound radiographic union. Pre-existing avascular necrosis was a major adverse factor for achievement of union in one patient, even after a second bone-grafting procedure. Results Union was achieved in a mean of 3.8 months. Most of the patients had satisfactory correction of scaphoid deformity and the associated dorsal intercalated segment instability. Postoperatively, improvements were seen in the range of wrist flexion and extension, grip strength, and degree of dorsal intercalated segment instability. Conclusions The results of the series suggest that the method of anterior wedge graft and internal fixation with the use of volar Buttress Plate and screws is effective for the treatment of unstable nonunited scaphoid waist fractures. Type of study/level of evidence Therapeutic IV.