The Experts below are selected from a list of 27 Experts worldwide ranked by ideXlab platform
Hillard T Spencer - One of the best experts on this subject based on the ideXlab platform.
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volar plate fixation failure for volar shearing distal radius fractures with small lunate facet fragments
Journal of Hand Surgery (European Volume), 2014Co-Authors: John D Beck, Neil G. Harness, Hillard T SpencerAbstract:Purpose To determine the percentage of AO B3 distal radius fractures that lose reduction after operative fixation and to see whether fracture morphology, patient factors, or fixation methods predict failure. We hypothesized that initial fracture displacement, amount of lunate facet available for fixation, plate position, and screw fixation would be significant risk factors for loss of reduction. Methods A prospective, observational review was conducted of 51 patients (52 fractures) with AO B3 (volar shearing) distal radius fractures treated operatively between January 2007 and June 2012. We reviewed a prospective distal radius registry to determine demographic data, medical comorbidities, and physical examination findings. Radiographs were evaluated for AO classification, loss of reduction, length of volar cortex available for fixation, and adequacy of stabilization of the lunate facet fragment with a volar plate. Preoperative data were compared between patients who maintained radiographic alignment and those with loss of reduction. A multivariate logistic regression analysis was completed to determine significant predictors of loss of reduction. Results Volar shearing fractures with separate scaphoid and lunate facet fragments (AO B3.3), preoperative lunate subsidence distance, and length of volar cortex available for fixation were significant predictors for loss of reduction; the latter was significant in multivariate analysis. Plate position and number of screws used to stabilize the lunate facet were not statistically different between groups. Conclusions Patients with AO B3.3 fractures with less than 15 mm of lunate facet available for fixation, or greater than 5 mm of initial lunate subsidence, are at risk for failure even if a volar plate is properly placed. In these cases, we recommend additional fixation to maintain reduction of the small volar lunate facet fracture fragments in the form of plate extensions, pins, Wires, Suture, Wire forms, or mini screws. Type of study/level of evidence Therapeutic III.
Alberto Guardoli - One of the best experts on this subject based on the ideXlab platform.
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easy and safe all inside Suture technique for posterior horn tears of lateral meniscus using standard anteromedial and anterolateral portals
Arthroscopy techniques, 2013Co-Authors: Gennaro Fiorentino, Francesca De Caro, Riccardo Cepparulo, Alberto Guardoli, Luca Berni, Marco Delcogliano, Alice RitaliAbstract:The importance of the lateral meniscus in weight bearing, distribution of force, shock absorption, articular cartilage protection, proprioception, stabilization of the joint, and joint lubrication is well known. Surgeons currently agree on the importance of preserving the menisci. Different Suture techniques have been standardized. These include outside-in, inside-out, and all-inside techniques. The all-inside technique can be used to repair lesions of the posterior horn of the lateral meniscus. However, this technique presents important disadvantages, such as the necessity for an accessory portal and a high risk of neurovascular damage. For these reasons, we have developed a technique in which a Suture hook and a shuttle relay are used to pass the Suture Wire through the meniscal lesion of the posterior horn of the lateral meniscus with an all-inside technique, without the use of accessory portals and cannulas, with a standard 30° arthroscopic camera.
John D Beck - One of the best experts on this subject based on the ideXlab platform.
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volar plate fixation failure for volar shearing distal radius fractures with small lunate facet fragments
Journal of Hand Surgery (European Volume), 2014Co-Authors: John D Beck, Neil G. Harness, Hillard T SpencerAbstract:Purpose To determine the percentage of AO B3 distal radius fractures that lose reduction after operative fixation and to see whether fracture morphology, patient factors, or fixation methods predict failure. We hypothesized that initial fracture displacement, amount of lunate facet available for fixation, plate position, and screw fixation would be significant risk factors for loss of reduction. Methods A prospective, observational review was conducted of 51 patients (52 fractures) with AO B3 (volar shearing) distal radius fractures treated operatively between January 2007 and June 2012. We reviewed a prospective distal radius registry to determine demographic data, medical comorbidities, and physical examination findings. Radiographs were evaluated for AO classification, loss of reduction, length of volar cortex available for fixation, and adequacy of stabilization of the lunate facet fragment with a volar plate. Preoperative data were compared between patients who maintained radiographic alignment and those with loss of reduction. A multivariate logistic regression analysis was completed to determine significant predictors of loss of reduction. Results Volar shearing fractures with separate scaphoid and lunate facet fragments (AO B3.3), preoperative lunate subsidence distance, and length of volar cortex available for fixation were significant predictors for loss of reduction; the latter was significant in multivariate analysis. Plate position and number of screws used to stabilize the lunate facet were not statistically different between groups. Conclusions Patients with AO B3.3 fractures with less than 15 mm of lunate facet available for fixation, or greater than 5 mm of initial lunate subsidence, are at risk for failure even if a volar plate is properly placed. In these cases, we recommend additional fixation to maintain reduction of the small volar lunate facet fracture fragments in the form of plate extensions, pins, Wires, Suture, Wire forms, or mini screws. Type of study/level of evidence Therapeutic III.
Petrini L. - One of the best experts on this subject based on the ideXlab platform.
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Nickel-Titanium self-knotting Suture Wire for deep surgical field: A validated numerical model
'Elsevier BV', 2020Co-Authors: Berti F., Nespoli A., Villa E., Passaretti F., Pennati G., Migliavacca F., Petrini L.Abstract:The aim of this work is to set a finite element model of a Ni-Ti self-knotting Suture, designed for deep neurosurgical applications, and to provide a reliable tool for evaluating its functionality before entering clinical practice. A closed shape is memorized through specific heat treatments; once implanted in the open configuration the surgeon does not need to pack any knots since the Suture closes by itself only using some drops of physiological solution. A material user-subroutine allows the modeling of the shape memory effect which governs its functionality. Experiments of increasing complexities, involving shape-recovery behavior, are designed to validate the model. Indeed, accordingly with the most recent Standards, validation is the fundamental step for allowing the use of numerical models for predicting device performance and taking a decision on the design that may affect patient safety or health. Herein, once validated, the numerical approach is used for investigating the effects of the device preparatory phase on the clinical performance
David C Ackland - One of the best experts on this subject based on the ideXlab platform.
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the use of Suture tape and Suture Wire in arthroscopic rotator cuff repair a comparative biomechanics study
Injury-international Journal of The Care of The Injured, 2018Co-Authors: Lachlan S Huntington, Jasamine Colesblack, Martin Richardson, Tony Sobol, Jonathon Caldow, Jason Chuen, David C AcklandAbstract:Abstract Background Rotator cuff repair surgery aims to create a secure, pressurized tendon-bone footprint to permit re-establishment of the fibrovascular interface and tendon healing. Flat-braided Suture-tape is an alternative Suture material to traditional Suture-Wire that has potential to reproduce a larger repair construct contact area. The objective of this study was to compare contact pressure, area as well as the mechanical fatigue strength between Suture-Wire and Suture-tape Suture-bridge repair constructs in an ovine model. Methods Sixty lamb infraspinatus tendons were harvested and randomly allocated to three- and four-anchor Suture-bridge repairs performed using either Suture-Wire or Suture-tape. Thirty-two specimens were cyclically loaded for 200 cycles in an Instron testing machine, while tendon gap formation was recorded using a high speed digital motion analysis system. Loading to failure was then performed to evaluate construct ultimate tensile strength and stiffness. The remaining 28 specimens were assessed for repair contact pressure and area using pressure-sensitive film. Results There was a significantly greater average tendon contact pressure (mean difference: 0.064 MPa, p = 0.04) and area (mean difference: 2.71 mm2, p = 0.03) in fiber-tape repair constructs compared to those in fiber-Wire constructs for the three-anchor Suture-bridge configuration. The four-anchor Suture-tape constructs had a significantly larger ultimate tensile strength than that of the four-anchor Suture-Wire constructs (mean difference: 56.4 N, p = 0.04). There were no significant differences in gap formation or stiffness between Suture-tape and Suture-Wire constructs (p > 0.05). Conclusion Suture-tape offers greater pressurised tendon-bone contact than Suture-Wire in three-anchor Suture-bridge repairs, while greater mechanical strength is achieved with the use of Suture-tape in four-anchor Suture-bridge constructs.
