The Experts below are selected from a list of 129 Experts worldwide ranked by ideXlab platform
B Bernstein - One of the best experts on this subject based on the ideXlab platform.
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FIRST CLINICAL USE OF A NOVEL PLASMA-BASED BIOMATERIAL TO AUGMENT THE HEALING OF Open TIBIAL FractureS
2018Co-Authors: Sithombo Maqungo, David North, M Nortje, B BernsteinAbstract:Purpose:To examine the performance of a novel blood plasma-based bone putty for augmenting the treatment of Open tibia Fractures. The putty was manufactured from pooled blood plasma and contains a concentration of both plasma and platelet-derived regenerative factors. Based on clinical reports of the use of autologous platelet-rich plasma to treat injuries, we hypothesized that the putty would accelerate healing of Fractures and surrounding soft tissues.Methods:Two-arm, randomized controlled study including 20 treatment patients and 10 controls. Follow-up examinations occurred at 14, 30, 60, 90, 180, and 365 days. The product was provided in a syringe containing 3 cc of putty in a double-pouched, sterile box. The putty was placed at the Fracture site during Open Fracture Reduction and mechanical stabilization.Results:Both treatment and control groups were well balanced with a mean age of 35. Seventy percent were Gustillo IIIA and IIIB injuries, 67% were active smokers, and 70% received external fixation.N...
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FIRST CLINICAL USE OF A NOVEL PLASMA-BASED BIOMATERIAL TO AUGMENT THE HEALING OF Open TIBIAL FractureS
Journal of Bone and Joint Surgery-british Volume, 2014Co-Authors: Sithombo Maqungo, David North, M Nortje, B BernsteinAbstract:Purpose: To examine the performance of a novel blood plasma-based bone putty for augmenting the treatment of Open tibia Fractures. The putty was manufactured from pooled blood plasma and contains a concentration of both plasma and platelet-derived regenerative factors. Based on clinical reports of the use of autologous platelet-rich plasma to treat injuries, we hypothesized that the putty would accelerate healing of Fractures and surrounding soft tissues. Methods: Two-arm, randomized controlled study including 20 treatment patients and 10 controls. Follow-up examinations occurred at 14, 30, 60, 90, 180, and 365 days. The product was provided in a syringe containing 3 cc of putty in a double-pouched, sterile box. The putty was placed at the Fracture site during Open Fracture Reduction and mechanical stabilization. Results: Both treatment and control groups were well balanced with a mean age of 35. Seventy percent were Gustillo IIIA and IIIB injuries, 67% were active smokers, and 70% received external fixation. No adverse events related to the use of the putty were noted. The use of the putty significantly reduced infections at 90 days (p = 0.002), accelerated bone bridging at 90 and 180 days, and provided more rapid wound closure at 30 days. In the subset of patients with IIIA/IIIB injuries, the putty group demonstrated more significantly reduced infections (p = 0.0007), with accelerated bone healing and wound closure approaching statistical significance. There were statistically fewer adverse events with the putty (42.1%) compared to controls (80.0%). Conclusions: The potential for using a concentration of natural plasma and platelet-derived regenerative factors to augment the healing of traumatic injuries makes this first-in-man study relevant and exciting. The putty performed as expected, promoting more rapid healing of both Fractures and wounds. The dramatic Reduction in infections was unanticipated and is likely related to antimicrobial peptides in plasma and platelets.
Michael E. Hoellwarth - One of the best experts on this subject based on the ideXlab platform.
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HOW TO MINIMIZE COMPLICATIONS IN THE TREATMENT OF PEDIATRIC RADIAL NECK FractureS
2011Co-Authors: Robert Eberl, Georg Singer, J. Fruhmann, Annelie Weinberg, Christoph Castellani, Michael E. HoellwarthAbstract:Introduction: Pediatric radial neck Fractures account for 5 to 10 % of all elbow Fractures. Depending on the degree of radial head displacement either operative intervention or conservative treatment is recommended. Open Reduction offers anatomic Fracture fixation but compromises the vulnerable blood supply. Intramedullary nailing combines the advantages of closed Reduction and stable internal Fracture fixation. The purpose of the presented study was to evaluate the outcome of treatment of a series of pediatric radial neck Fractures. Special contributions in our algorithm were made to the age dependant capacity for spontaneous Fracture remodelling. Materials and Methods: The medical data of all children with Fractures of the radial head between 1999 and 2008 were retrospectively analyzed. Fractures were classified according to the classification system described by Judet et al. Depending on the angulation of the Fracture and on the age of the patient the treatment algorithm was defined. Type I Fractures were treated conservatively and Type IV Fractures operatively independent of age. Type III Fractures in patients younger than 6 years of age were treated conservatively without Reduction and Type II Fractures were reduced in children older than 12 years of age. The functional outcome was graduated from excellent to poor according to the score of Linscheid and Wheeler. Results: In our study 168 patients, 88 male and 80 female, were included. The average age of the patients was 9 years (range 3 to 16 years). There were 103 Type I injuries, 21 Type II, 30 Type III and 14 Type IV injuries. Conservative treatment was possible in 124 (73.8%) patients (103 Type I, 12 Type II, 9 Type III injuries). Operative intervention was performed in 44 (26.2%) patients (9 Type II, 21 Type III, 14 Type IV injuries). In 10 patients a K-wire was used to leverage the radial head percutaneous. Open Fracture Reduction was required in 4 patients. Necrosis of the radial head was found in 2 patients with Open Reduction. One child presented with hypoesthesia in the area of the superficial radial nerve. The latest follow up examination was performed after 26 months mean (range 11 months to 7 years). We found excellent results in 158 patients, good results in 5, fair in 3 and poor in 2 patients. Discussion: An intact vascular supply to the radial head is essential to avoid complications. The iatrogenic impact to the nutritive vessels should be kept to a minimum. Closed Fracture Reduction and intramedullary nailing has improved the prognosis. Spontaneous Fracture remodeling might successfully replace unnecessary maneuvers for Fracture Reduction. However, the proximal physis of the radius is responsible for only 20–30% of the growth of the radius and therefore spontaneous Fracture remodeling is restricted. Following our treatment algorithm we found excellent results in the majority of cases.
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Intramedullary nailing for the treatment of dislocated pediatric radial neck Fractures.
European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie, 2010Co-Authors: Robert Eberl, Georg Singer, J. Fruhmann, Amulya K. Saxena, Michael E. HoellwarthAbstract:INTRODUCTION: Pediatric radial neck Fractures represent 5-10% of all elbow Fractures. Open Reduction allows anatomic Fracture fixation but compromises the vulnerable blood supply of the radial head. Intramedullary nailing combines the advantages of closed Reduction and stable internal Fracture fixation. MATERIAL AND METHODS: During a 6-year-period the medical records of all children sustaining a radial neck Fracture treated operatively at our institution were analyzed retrospectively. RESULTS: Forty-two patients with dislocated Fractures of the radial neck were treated with intramedullary nailing. The average age of the patients was 8 years. Thirty-eight patients (90%) could be treated with closed Fracture Reduction and retrograde nailing. Open Fracture Reduction was required in 4 (10%) patients, and in 2 patients necrosis of the radial head occurred. Loss of Reduction was seen in 7 (17%) patients. Excellent results were found in 38 patients, good results in 2 patients, and poor results in another 2. CONCLUSION: The retrograde nailing technique for the treatment of dislocated Fractures of the radial neck in pediatric patients is a simple, short and safe procedure.
Sithombo Maqungo - One of the best experts on this subject based on the ideXlab platform.
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FIRST CLINICAL USE OF A NOVEL PLASMA-BASED BIOMATERIAL TO AUGMENT THE HEALING OF Open TIBIAL FractureS
2018Co-Authors: Sithombo Maqungo, David North, M Nortje, B BernsteinAbstract:Purpose:To examine the performance of a novel blood plasma-based bone putty for augmenting the treatment of Open tibia Fractures. The putty was manufactured from pooled blood plasma and contains a concentration of both plasma and platelet-derived regenerative factors. Based on clinical reports of the use of autologous platelet-rich plasma to treat injuries, we hypothesized that the putty would accelerate healing of Fractures and surrounding soft tissues.Methods:Two-arm, randomized controlled study including 20 treatment patients and 10 controls. Follow-up examinations occurred at 14, 30, 60, 90, 180, and 365 days. The product was provided in a syringe containing 3 cc of putty in a double-pouched, sterile box. The putty was placed at the Fracture site during Open Fracture Reduction and mechanical stabilization.Results:Both treatment and control groups were well balanced with a mean age of 35. Seventy percent were Gustillo IIIA and IIIB injuries, 67% were active smokers, and 70% received external fixation.N...
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FIRST CLINICAL USE OF A NOVEL PLASMA-BASED BIOMATERIAL TO AUGMENT THE HEALING OF Open TIBIAL FractureS
Journal of Bone and Joint Surgery-british Volume, 2014Co-Authors: Sithombo Maqungo, David North, M Nortje, B BernsteinAbstract:Purpose: To examine the performance of a novel blood plasma-based bone putty for augmenting the treatment of Open tibia Fractures. The putty was manufactured from pooled blood plasma and contains a concentration of both plasma and platelet-derived regenerative factors. Based on clinical reports of the use of autologous platelet-rich plasma to treat injuries, we hypothesized that the putty would accelerate healing of Fractures and surrounding soft tissues. Methods: Two-arm, randomized controlled study including 20 treatment patients and 10 controls. Follow-up examinations occurred at 14, 30, 60, 90, 180, and 365 days. The product was provided in a syringe containing 3 cc of putty in a double-pouched, sterile box. The putty was placed at the Fracture site during Open Fracture Reduction and mechanical stabilization. Results: Both treatment and control groups were well balanced with a mean age of 35. Seventy percent were Gustillo IIIA and IIIB injuries, 67% were active smokers, and 70% received external fixation. No adverse events related to the use of the putty were noted. The use of the putty significantly reduced infections at 90 days (p = 0.002), accelerated bone bridging at 90 and 180 days, and provided more rapid wound closure at 30 days. In the subset of patients with IIIA/IIIB injuries, the putty group demonstrated more significantly reduced infections (p = 0.0007), with accelerated bone healing and wound closure approaching statistical significance. There were statistically fewer adverse events with the putty (42.1%) compared to controls (80.0%). Conclusions: The potential for using a concentration of natural plasma and platelet-derived regenerative factors to augment the healing of traumatic injuries makes this first-in-man study relevant and exciting. The putty performed as expected, promoting more rapid healing of both Fractures and wounds. The dramatic Reduction in infections was unanticipated and is likely related to antimicrobial peptides in plasma and platelets.
Robert Eberl - One of the best experts on this subject based on the ideXlab platform.
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HOW TO MINIMIZE COMPLICATIONS IN THE TREATMENT OF PEDIATRIC RADIAL NECK FractureS
2011Co-Authors: Robert Eberl, Georg Singer, J. Fruhmann, Annelie Weinberg, Christoph Castellani, Michael E. HoellwarthAbstract:Introduction: Pediatric radial neck Fractures account for 5 to 10 % of all elbow Fractures. Depending on the degree of radial head displacement either operative intervention or conservative treatment is recommended. Open Reduction offers anatomic Fracture fixation but compromises the vulnerable blood supply. Intramedullary nailing combines the advantages of closed Reduction and stable internal Fracture fixation. The purpose of the presented study was to evaluate the outcome of treatment of a series of pediatric radial neck Fractures. Special contributions in our algorithm were made to the age dependant capacity for spontaneous Fracture remodelling. Materials and Methods: The medical data of all children with Fractures of the radial head between 1999 and 2008 were retrospectively analyzed. Fractures were classified according to the classification system described by Judet et al. Depending on the angulation of the Fracture and on the age of the patient the treatment algorithm was defined. Type I Fractures were treated conservatively and Type IV Fractures operatively independent of age. Type III Fractures in patients younger than 6 years of age were treated conservatively without Reduction and Type II Fractures were reduced in children older than 12 years of age. The functional outcome was graduated from excellent to poor according to the score of Linscheid and Wheeler. Results: In our study 168 patients, 88 male and 80 female, were included. The average age of the patients was 9 years (range 3 to 16 years). There were 103 Type I injuries, 21 Type II, 30 Type III and 14 Type IV injuries. Conservative treatment was possible in 124 (73.8%) patients (103 Type I, 12 Type II, 9 Type III injuries). Operative intervention was performed in 44 (26.2%) patients (9 Type II, 21 Type III, 14 Type IV injuries). In 10 patients a K-wire was used to leverage the radial head percutaneous. Open Fracture Reduction was required in 4 patients. Necrosis of the radial head was found in 2 patients with Open Reduction. One child presented with hypoesthesia in the area of the superficial radial nerve. The latest follow up examination was performed after 26 months mean (range 11 months to 7 years). We found excellent results in 158 patients, good results in 5, fair in 3 and poor in 2 patients. Discussion: An intact vascular supply to the radial head is essential to avoid complications. The iatrogenic impact to the nutritive vessels should be kept to a minimum. Closed Fracture Reduction and intramedullary nailing has improved the prognosis. Spontaneous Fracture remodeling might successfully replace unnecessary maneuvers for Fracture Reduction. However, the proximal physis of the radius is responsible for only 20–30% of the growth of the radius and therefore spontaneous Fracture remodeling is restricted. Following our treatment algorithm we found excellent results in the majority of cases.
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Intramedullary nailing for the treatment of dislocated pediatric radial neck Fractures.
European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie, 2010Co-Authors: Robert Eberl, Georg Singer, J. Fruhmann, Amulya K. Saxena, Michael E. HoellwarthAbstract:INTRODUCTION: Pediatric radial neck Fractures represent 5-10% of all elbow Fractures. Open Reduction allows anatomic Fracture fixation but compromises the vulnerable blood supply of the radial head. Intramedullary nailing combines the advantages of closed Reduction and stable internal Fracture fixation. MATERIAL AND METHODS: During a 6-year-period the medical records of all children sustaining a radial neck Fracture treated operatively at our institution were analyzed retrospectively. RESULTS: Forty-two patients with dislocated Fractures of the radial neck were treated with intramedullary nailing. The average age of the patients was 8 years. Thirty-eight patients (90%) could be treated with closed Fracture Reduction and retrograde nailing. Open Fracture Reduction was required in 4 (10%) patients, and in 2 patients necrosis of the radial head occurred. Loss of Reduction was seen in 7 (17%) patients. Excellent results were found in 38 patients, good results in 2 patients, and poor results in another 2. CONCLUSION: The retrograde nailing technique for the treatment of dislocated Fractures of the radial neck in pediatric patients is a simple, short and safe procedure.
Wolf Mutschle - One of the best experts on this subject based on the ideXlab platform.
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flexible intramedullary nailing for stabilization of displaced midshaft clavicle Fractures technique and results in 87 patients
Acta Orthopaedica, 2007Co-Authors: M Kettle, Matthias Schieke, Volke Aunstei, Matthias Konig, Wolf MutschleAbstract:Background Elastic, stable intramedullary nailing (ESIN) with titanium nails is a promising minimally treatment for displaced midclavicular Fractures, which may be an alternative to plate fixation (ORIF) or even nonoperative treatment. We describe the surgical technique and outcome in 87 patients.Methods The nail was inserted at the medial inferior end of the clavicle in 83 patients and in the acromial end in 12 patients. An Open Fracture Reduction via an additional small incision was necessary in 53 patients and closed manoeuvre was successful in 42. Implant removal was performed in 82 patients.Results The functional status of 87 patients after 13 months reached 6.8 (0–43) points on the DASH score and 81 (46–100) points on the self-reported Constant score. The Fracture healed in correct anatomical axis in 80 of 87 patients, 2 cases ended in a nonunion. Implant migration of the nail occurred in 4 patients, who required early implant removal. Repeated nailing was necessary in 2 patients in whom the nail mi...
