Application of locking compression plates as type 1 external fixators to treat unilateral mandibular fractures in four equids and one dromedary
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Abstract:
To describe a novel fixation of open, unstable, unilateral mandibular fractures applying a locking compression plate as an external skeletal fixator (ESF-LCP).Four horses and one dromedary.Short case series.Animals presented with unstable, open, unilateral fractures of the mandible. Fracture fixation was performed under general anesthesia. A 4.5/5.5 narrow LCP was applied externally above the level of the skin and combined with intraoral tension band wiring.Fracture fixation was achieved successfully using an ESF-LCP. Minimal tissue manipulation was required during application and removal of the construct. The ESF-LCPs provided adequate access to the wounds at the fracture site, were well tolerated, and did not interfere with any objects in the animals' environment. Mild drainage at the screw-skin interface developed in all cases, requiring early implant removal due to surgical site infection in one case. The use of longer plates was associated with superficial pressure necrosis of the skin in the masseter area in two cases. Implants were removed after 3 to 12 weeks, and the long-term functional outcome after 11 to 41 (median 13) months was good in all cases.Stabilization of mandibular fractures with ESF-LCP led to good outcomes in this case series. The use of longer plates positioned more caudally and in a ventrolateral position seemed associated with surgical site infection and pressure necrosis of the skin.Use of a locking compression plate as an external skeletal fixator seems to offer a viable alternative to treat unilateral mandibular fractures, especially when these are open and/or infected.Keywords:
Mandibular fracture
The technique of external fixator has been used widely in the treatment of trauma and has become an important method of orthopaedic treatment.The author has studied clinically and basically and introduced the application of external fixator in bone trauma,meanwhile,summarized how to use more effectively external fixator.
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External fixators are an effective way of fixing broken bones while at the same time optimising patients’ mobility. In this article Julie Santy describes the major issues nurses need to be aware of to contribute effectively to patient care.
Patient Care
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Unstable distal radius fractures cannot be immobilized in a plaster cast: mal-unions (and later arthrosis of the wrist) are the result. Most symptoms are attributable to the shortening of the radius. Retention by means of an external fixator is the therapy of choice in such cases. Various fixator systems have become known. In this paper, a new fixator is presented which has the following advantages: It is very mobile and adaptable, and corrections are possible after attachment of the fixator. The screws can be inserted depending on the anatomical situation. The fixator is handy and light. The fixator has proved its effectiveness for a long time and is also suitable for complicated wrist injuries.
Distal radius fracture
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Objective:To evaluate application of circumandibular fixation in treating with child mandibular fracture.Methods:7 children selected from 12 cases received circumandibular fixation since 1995, and the effect of treatment was assessed. Results:Circumandibular fixation has no injure to permanent teeth germ,an excellent fracture-repositon, stable fixation, no interferece with eating and is beneficial of mouth clearness. Conclusions:It is an effective method of fixation for child mandibular fracture.
Mandibular fracture
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Objective To discuss the application value of external fixator to treat the fractures of children according to the characteristics of the fracture of chidren. Methods 25 cases of different complicated fractures of children were treated with external fixator from Jan,1999 to Aug.2001, and given function exercises in the earlier periode after operation. Results The mean follow up time was 10 months. All the fractures healed.The recovery of function was excellent in 88%cases.The long effect is to be observed. Conclusions Using of external fixator to treat the complicated unstable fractures of children can make definite reduction,help to observe and manage the limb and skin after operation,and greatly meet the needs of the fractures of children.The external fixator has a great clinical application value in treating different complicated fractures of children.
Fracture reduction
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Fifty fractures of the distal radius in 49 patients were treated by either a Roger Anderson device or a Hoffman C-series external fixator. The radiographic and clinical results were evaluated for comparison of the use of the two fixators. The follow-up period for the entire group averaged 15.9 months. For 12 patients personally examined and 12 returning a questionnaire, the follow-up period averaged 27.7 months. The Hoffman fixator and Roger Anderson device gave predictably good results in the treatment of comminuted intra-articular fractures of the distal radius when used in the active age group. Neither was found to yield superior functional results over the other, although the Hoffman fixator had a more rigid configuration. Serious complications may result from the use of external fixators, but these can be minimized by proper technique and care.
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An external fixator is very useful in the management of open fractures. A typical external fixator has provision only for a specific diameter of pins. This is a description of a simple external fixator which can accommodate any diameter of pins. KEY WORDS: External fixator, any diameter, pins Nigerian Journal of Orthopaedics and Trauma Vol.3(1) 2004: 61-63
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Based on the review of the literature, the author tries to establish the criteria for the external fixator that increase the safety of treatment and rise up positive outcome. According to the author's opinion the requirements for constructional properties of the external fixator are to be fulfilled if modern computer simulation techniques are employed.
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Fifty fractures of the distal radius in 49 patients were treated by either a Roger Anderson device or a Hoffman C-series external fixator. The radiographic and clinical results were evaluated for comparison of the use of the two fixators. The follow-up period for the entire group averaged 15.9 months. For 12 patients personally examined and 12 returning a questionnaire, the follow-up period averaged 27.7 months. The Hoffman fixator and Roger Anderson device gave predictably good results in the treatment of comminuted intra-articular fractures of the distal radius when used in the active age group. Neither was found to yield superior functional results over the other, although the Hoffman fixator had a more rigid configuration. Serious complications may result from the use of external fixators, but these can be minimized by proper technique and care.
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