The three-dimensional (3-D) Titanium miniplate system is one of the newest internal rigid fixation for the maxillo-mandibular surgery in recent years. The geometry of the plate assures a good stability in the three-dimensions of the fracture sits. Thirty patients suffering from maxillo-mandibular fractures had been operated on using the 3-D Titanium miniplates since 1991. The group of the patient included 16 cases of mandibular fractures, 8 cases of maxillary fractures and 6 cases of maxillo-mandibular fracture. All of the patient had very good result without any complication. The follow-up was 6 months to 3 years. The 3-D Titanium miniplate as an ideal easy to use, good resistance against torque forces and, compact forms of the miniplate were the some of the advantages. Clinical examples had been provided to illustrate the actual usage of the 3-D miniplate in the field of the surgical treatment for the maxillo-mandibular fracture. It is the author’s opinion that the internal rigid fixation by 3-D Titanium miniplates is a promising method of treating fractures of the maxilla and is to be better tolerated by the patients and surgeons.
This study was aimed to compare the mechanical characteristics under different physiological load conditions with three-dimensional finite element model of rigid fixation and elastic fixation in the lumbar. We observed the stress distribution characteristics of a sample of healthy male volunteer modeling under vertical, flexion and extension torque situation. The outcomes showed that there existed 4-6 times pressure on the connecting rod of rigid fixation compared with the elastic fixations under different loads, and the stress peak and area of force on elastic fixation were much higher than that of the rigid fixations. The elastic fixation has more biomechanical advantages than rigid fixation in promoting interbody lumbar fusion after surgery.
ObjectiveTo compare the effectiveness of flexible fixation and rigid fixation in the treatment of ankle pronation-external rotation fractures with distal tibiofibular syndesmosis.MethodsA retrospective analysis was made on the clinical data of 50 patients with ankle pronation-external rotation fractures and distal tibiofibular syndesmosis treated between January 2013 and December 2015. Suture-button fixation was used in 23 patients (flexible fixation group) and cortical screw fixation in 27 patients (rigid fixation group). There was no significant difference in age, gender, weight, side, fracture type, and time from trauma to surgery between 2 groups (P>0.05). The operation time, medial clear space (MCS), tibiofibular clear space (TFCS), tibiofibular overlap (TFO), American Orthopaedic Foot and Ankle Society (AOFAS) score, and Foot and Ankle Disability Index (FADI) score were compared between 2 groups.ResultsThe operation time was (83.0±9.1) minutes in the flexible fixation group and was (79.6±13.1) minutes in the rigid fixation group, showing no significant difference (t=1.052, P=0.265). All patients achieved healing of incision by first intention. The patients were followed up 12-20 months (mean, 14 months). The X-ray films showed good healing of fracture in 2 groups. There was no screw fracture, delayed union or nounion. The fracture healing time was (12.1±2.5) months in the flexible fixation group and was (11.3±3.2) months in the rigid fixation group, showing no significant difference between 2 groups (t=1.024, P=0.192). Reduction loss occurred after removal of screw in 2 cases of the rigid fixation group. At last follow-up, there was no significant difference in MCS, TFCS, TFO, AOFAS score and FADI score between 2 groups (P>0.05).ConclusionSuture-button fixation has similar effectiveness to screw fixation in ankle function and imaging findings, and flexible fixation has lower risk of reduction loss of distal tibiofibular syndesmosis than rigid fixation.