nitinol and Fractures--Ununited

To summarize the effectiveness of nitinol memory alloy two foot fixator with autologous cancellous bone grafting in treating old scaphoid fracture and nonunion.. Between January 2013 and January 2017, 11 patients of old scaphoid fracture and nonunion were treated with nitinol memory alloy two foot fixator and autologous cancellous bone grafting. All patients were male with an average age of 26.1 years (range, 18-42 years). The fractures were caused by sport in 3 cases, falling in 7 cases, and a crashing object in 1 case. The interval between injury and operation was 6-18 months (mean, 8.9 months). Postoperative outcome measures included operation time, fracture healing time, grip strength, range of motion (ROM) of flexion, extension, ulnar deviation, and radial deviation, Mayo score, visual analogue scale (VAS) score, and the Disabilities of the Arm, Shoulder, and Hand (DASH) score.. The operation time was 35-63 minutes (mean, 48 minutes). All incisions had primary healing with no infection and loosening or breakage of internal fixator. All patients were followed up 12-30 months (mean, 20.7 months). X-ray films showed that fracture healing was achieved in all patients with an average time of 15 weeks (range, 12-25 weeks). All internal fixators were removed after 10-12 months of operation (mean, 11.2 months). At last follow-up, the grip strength, ROMs of flexion, ulnar deviation, and radial deviation were superior to those before operation (. For the old scaphoid fracture and nonunion, Ni-Ti arched shape-memory alloy fixator and autologous cancellous bone grafting can obtain good effectiveness, which is an effective treatment.. 总结镍钛记忆合金两脚固定器联合自体松质骨移植治疗舟骨陈旧性骨折并骨不连疗效。.. 2013 年 1 月—2017 年 1 月，应用镍钛记忆合金两脚固定器联合自体松质骨移植治疗 11 例舟骨陈旧性骨折并骨不连患者。患者均为男性；年龄 18～42 岁，平均 26.1 岁。致伤原因：运动伤 3 例，摔伤 7 例，重物砸伤 1 例。受伤至手术时间 6～18 个月，平均 8.9 个月。通过手术时间、骨折愈合时间、握力、腕关节活动度（屈曲、背伸、尺偏、桡偏），以及 Mayo 评分、疼痛视觉模拟评分（VAS）以及上臂、肩、手功能障碍评分（DASH）评价临床疗效。.. 手术时间 35～63 min，平均 48 min。术后切口均 Ⅰ 期愈合，无感染、内固定物松动及断裂等并发症发生。患者均获随访，随访时间 12～30 个月，平均 20.7 个月。X 线片检查骨折均愈合，愈合时间为 12～25 周，平均 15 周。所有患者内固定物于术后 10～12 个月取出，平均 11.2 个月。末次随访时，患侧握力以及腕关节屈曲、桡偏、尺偏活动度均较术前明显改善，差异有统计学意义（. 镍钛记忆合金两脚固定器联合松质骨移植治疗舟骨陈旧性骨折并骨不连可获得较好疗效，可作为一种治疗选择。.

Topics: Adolescent; Adult; Alloys; Bone Transplantation; Cancellous Bone; Fracture Fixation, Internal; Fractures, Ununited; Humans; Male; Range of Motion, Articular; Scaphoid Bone; Treatment Outcome; Young Adult

In the management of scaphoid fractures, nonunion is an important complication that can lead to carpal instability and early-onset arthritis. Various techniques have been described to treat scaphoid nonunions, yet a clear consensus on the superiority of one method is not yet established. The use of compression staple fixation has been described in the literature and may be a viable alternative to other fixation techniques. Volar Nitinol staple fixation avoids damage to the trapezium during retrograde fixation with a screw. It also avoids damage to the proximal dorsal cartilage, which occurs during anterograde screw fixation. Because of its shape and position on the volar aspect of the scaphoid, staple fixation provides compression, prevents graft extrusion, and avoids taking up space in the medullary canal of the scaphoid. Moreover, it may be technically easier than screw fixation. Despite these advantages, this technique has not been widely adopted. We describe the technique for utilizing Nitinol compression staples and bone grafting in the treatment of scaphoid nonunion.

Topics: Alloys; Fracture Fixation; Fractures, Bone; Fractures, Ununited; Humans; Ilium; Postoperative Care; Radius; Scaphoid Bone; Surgical Stapling

This report describes a case of repair of a nonunion pubic ramus fracture with intramedullary placement of a self-expanding nitinol stent across a fracture gap to provide a permeable scaffold for polymethylmethacrylate (PMMA) cement to track across the fracture gap and to restrict leakage into surrounding soft tissues. The patient presented with an 8-month history of pelvic pain and debility. His pain remains resolved after 14 months. Percutaneous repair of nonunion pubic rami fractures using a bridging metallic stent in combination with PMMA bone cement may be an effective treatment for these fractures.

Topics: Aged; Alloys; Bone Cements; Fracture Fixation, Internal; Fracture Healing; Fractures, Bone; Fractures, Ununited; Humans; Male; Pain Measurement; Pelvic Pain; Polymethyl Methacrylate; Prosthesis Design; Pubic Bone; Stents; Tomography, X-Ray Computed; Treatment Outcome

Preparation of the scorpion-like dynamic nitinol osteo-connector (NT-SDOC) and its clinical application in 57 cases were reported. The apparatus was designed with two longitudinal pressure hooks and two to eight semicircular fixation hooks, which could exert an axial continuing stress of 24-56kg on the fracture ends until bone union. Of the 57 cases 31 were fracture and 26 were nonunion, as no plaster cast was applied postoperatively, all patients could exercise their injured arms early. Follow-up was 4 to 32 months with an average of 13.7 months. The osteo-plate substitution was shown at the fracture site at an average of 2.2 months in 31 cases, and at the nonunion site with an average of 3.64 months in 26 cases. No postoperative infection, nonunion and other complications were observed NT-S DOC was removed in 46 cases at about 6 months postoperatively. No refracture occurred at the osteo-plate substitution site.

Topics: Adult; Aged; Alloys; Female; Fracture Fixation, Internal; Fractures, Ununited; Humans; Humeral Fractures; Internal Fixators; Male; Middle Aged; Nickel; Radius Fractures; Titanium; Ulna Fractures