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Fulltext Nonunion of Lateral Humeral Condylar Fracture in A Child with Cubitus Varus

Sulaiman, A.R., Munajat, I., Mohd, E.F., Sharifudin, M.A.

Malays Orthop J, 2010;4(3):29-31.
MyJurnal

Patients with cubitus varus deformity secondary to malunited supracondylar fracture are at risk for lateral humeral condylar (LHC) fracture. This report describes a child presenting with preexisting malunion of supracondylar fracture presenting along with nonunion of a LHC fracture following a recent injury. The patient underwent resection osteotomy of the metaphyseal proximal fragment of the fracture surface, reduction of the displaced LHC fragment and screw fixation. This procedure corrected the cubitus varus and treated the nonunion of the lateral condyle thus avoiding a supracondylar osteotomy procedure. Treatment resulted in solid union, good range of motion and no avascular necrosis.

Matched MeSH terms: Bone Screws
Fulltext Use of the Tip-Apex Distance in predicting Dynamic Hip Screw Cut Out in Intertrochanteric Fracture of the Femur in Asian Population

Malays Orthop J, 2011;5(2):24-27.
MyJurnal

The objective of this study was to assess the rate of screw cut out in elderly patients treated with the dynamic hip screw and the relationship to the Tip Apex Distance (TAD). This is a retrospective radiological evaluation of 100 cases of elderly patients with intertrochanteric fracture treated with dynamic hip screw fixation surgically treated between 1998 and 2002. The incidence of screw cut out was assessed and correlation of risk of cut out with the TAD was assessed. The rate of screw cut out was 9.0% and the average length of time to screw cut out was 3.8 months (range, 1 to 6 months) postoperatively. The incidence of screw cut out increased significantly when the TAD was 20 mm or more. The screw cut out rates were 2.9%, 20.0%, 30.8%, 50% and 100% for TAD of 20-24 mm, 25-29 mm, 30-34 mm, 35-44 mm and > 45 mm respectively. Overall, a TAD of 20mm or more was associated with a statistically significant screw cut out risk in this Malaysian population

Matched MeSH terms: Bone Screws
Fulltext Residence time distribution of tapioca starch-poly(lactic acid)- cloisite 10A nanocomposite foams in an extruder

Lee, S.Y.

Pertanika Journal of Science & Technology, 2012;20(1):103-108.
MyJurnal

Tapioca starch, poly(lactic acid) and Cloisite 10A nanocomposite foams were prepared by twin screw extrusion. Residence time distribution (RTD) in an extruder is a useful means of determining optimal processing conditions for mixing, cooking and shearing reactions during the process. RTD was obtained by inputting a pulse-like stimulus and measuring its profile at the exit or other point in the extruder. During processing, after the steady state had been reached, a fixed amount of tracer was instantaneously fed into the extruder and its concentration was measured from the samples collected at fixed time intervals in the extruder exit. The tracer concentration was the value of the redness, a* was used as a measure of red colour intensity of the concentration of tracer in the extrudate. Meanwhile, the effects of two screw configurations (compression and mixing screws) and two barrel temperatures (150 and 160ºC) on RTD of nanocomposite foams were also studied. The influences of screw configurations and barrel temperatures on RTD were analyzed using the mean residence time (MRT) and variance. Screw configurations and temperatures had significant effects (P

Matched MeSH terms: Bone Screws
Kesan Komposisi Gentian dan Kaedah Pemprosesan ke atas Sifat Mekanik Komposit NR/LLDPE diperkuat Twaron (Effect of Fiber Composition and Processing Methods on the Mechanical Properties of Twaron Reinforced NR/LLDPE Composites)

Ishak Ahmad, Mohd Khairil Saat, Ibrahim Abdullah, Azizah Baharum

Sains Malaysiana, 2004;33.

Blends of fibre-reinforced rubber based on natural rubber-thermoplastic (NR/LLDPE) reinforced by aramid fibre have been done using melt blending process. Two different processing methods were used; internal mixer and extrusion compounding in twin screw extruder. Twaron loading in the system was varied from 0 to 30%. It was found that increasing the amount of aramid fibre led to an increase in the tensile strength, tensile modulus and hardness of the composites while the strain decreased rapidly. The results showed that the optimum composition of filler loading in NR/LLDPE blend is 20%. The ,echanical behaviour was caused by the strong Twaron-matrices interaction in the composites and effective stress concentrating function of Twaron. Composites prepared using the twin-screw extruder have a higher tensile strength and tensile using the twin-screw extruder have a higher tensile stength and tensile modulus but lower impact strength compared to those prepared using internal mixer. Study of the fracture surface by scanning electron microscopy showed that the composite prepared using the internal mixer produced random fiber orientation while the twin-screw extruder produced the fibers aligned to the longitudinal direction. The results indicate that the mechanical properties of the composite were significantly influenced by the processing technique.
Penyediaan komposit getah asli termoplastik daripada NR/LLDPE yang diperkuat gentian Twaron telah dijalankan melalui proses adunan leburan. Dua kaedah penyediaan yang berbeza digunakan iaitu menggunakan mesin pencampur dalaman manakala kaedah kedua menggunakan pengekstrud skru kembar. Kandungan Twaron di dalam komposit telah diubah daripada 0 hingga 30%. Keputusan menunjukkan bahawa penambahan Twaron telah meningkatkan nilai tegasan maksima, modulus Young dan kekuatan hentaman komposit tetapi menurunkan nilai terikan maksima. Kandungan Twaron yang optimum adalah 20%. Kehadiran Twaron telah membentuk satu jaringan saling tindak gentian-matriks menyebabkan kekuatan regangan komposit meningkat. Twaron juga berfungsi sebagai penyerap hentaman yang berkesan. Penyediaan komposit menggunakan pengekstrud skru berkembar telah menghasilkan nilai kekuatan regangan yang lebih tinggi berbanding penggunaan pencampur dalaman sebaliknya kekuatan hentaman yang lebih rendah. Kajian morfologi menggunakan mikroskop imbasan elektron mendapati komposit yang disediakan menggunakan pencampur dalaman menghasilkan gentian dengan orientasi rawak manakala pengekstrud skru kembar menghasilkan orientasi gentian yang selari. Keputusan ini menunjukkan bahawa sifat mekanik komposit NR/LLDPE yang diperkuat Twaron sangat dipengaruhi oleh teknik pemprosesan.

Matched MeSH terms: Bone Screws
Mechanical properties of alumina trihydrate filled polypropylene/ethylene propylene diene monomer composites for cable applications

Reza Hashemi Farzad, Azman Hassan, M. Jawaid, M.A.M. Piah

Sains Malaysiana, 2013;42:801-810.

Polymeric materials such as polypropylene (PP), polyethylene (PE) and ethylene propylene diene monomer (EPDM) are widely used as insulators for cable applications. We investigated the effect of alumina trihydrate (ATH) loading on the mechanical properties of PP/EPDM blend. Preliminary study showed that PP/EPDM (60:40) was the optimum composition. ATH filled PP/EPDM composites was prepared by using twin screw extruder. In this study, the tensile properties and hardness of the composites were evaluated. The tensile modulus and hardness increased while elongation at break and tensile strength decreased with increasing ATH content. Scanning electron microscope was used to study the morphology of ATH in PP/EPDM blend.

Matched MeSH terms: Bone Screws
Flame retardancy and mechanical properties of kenaf filled polypropylene (PP) containing ammonium polyphosphate (APP)

Atikah Ismail, Azman Hassan, Aznizam Abu Bakar, Jawaid M

Sains Malaysiana, 2013;42:429-434.

The effects of ammonium polyphosphate (APP) as flame retardant and kenaf as fillers on flammability, thermal and mechanical properties of polypropylene (PP) composites were determined. Test specimens were prepared by using a corotating twin screw extruder for the compounding process followed by injection molding. The flame retardancy of the composites was determined by using limiting oxygen index (LOI) test. Addition of flame retardant into kenaf-PP composites significantly increased the LOI values that indicated the improvement of flame retardancy. Thermogravimetric analysis was done to examine the thermal stability of the composites. The addition of kenaf fiber in PP composites decreased the thermal stability significantly but the influence of APP on thermal properties of the kenaf-filled PP composites was not significant. The flexural strength and modulus of the composites increased with the addition of APP into kenaf filled
PP composite. The addition of APP into kenaf filled PP causes increase in the impact strength while increasing the APP content in the kenaf filled PP composite show decrease in impact strength.

Matched MeSH terms: Bone Screws
Elastic reversible valves on centrifugal microfluidic platforms

Aeinehvand MM, Weber L, Jiménez M, Palermo A, Bauer M, Loeffler FF, et al.

Lab Chip, 2019 Feb 20.
PMID: 30785443 DOI: 10.1039/c8lc00849c

Reversible valves on centrifugal microfluidic platforms facilitate the automation of bioanalytical assays, especially of those requiring a series of steps (such as incubation) in a single reaction chamber. In this study, we present fixed elastic reversible (FER) valves and tunable elastic reversible (TER) valves that are easy to fabricate, implement and control. In the FER valve the compression of an elastic barrier/patch against a microchamber's outlet prevents the release of liquid. The valve sealing pressure was determined by adjusting the engraving depth of the valve-seat at which the elastic patch was located, this allows to set the sealing pressure during disc fabrication. In the TER valve, the patch compression value and sealing pressure is controlled by the penetration depth of a plastic screw into the valve-seat. The ER valves prevent liquid flow until the centrifugal force overcomes their sealing pressure. Moreover, at a constant spin speed, turning the screw of a TER valve reduces its sealing pressure and opens the valve. Therefore, the TER valve allows for controlling of the liquid transfer volume at various spin speeds. The FER and TER valves' behavior is mathematically described and equations for the prediction of their operation under centrifugal forces are provided. As a point-of-care (POC) application of ER valves, we have developed a microfluidic disc with a series of TER valves and peptide microarrays for automated multiplexed detection of five different proteins from a single serum sample.

Matched MeSH terms: Bone Screws
Fulltext Surgical Fixation and Inter-phalangeal Arthrodesis of Symptomatic Non-union of Fracture of a Lesser Toe Distal Phalanx: A Case Report

Foo GL, Wee L

Malays Orthop J, 2019 Nov;13(3):69-71.
PMID: 31890114 DOI: 10.5704/MOJ.1911.012

Distal phalanx fractures of the toes are common injuries. The majority of them are treated conservatively with good outcome. We present the case of a painful non-union fracture of the distal phalanx of the 4th toe in a 60-year-old female patient with symphalangism of the 4th and 5th toes. She underwent surgical fixation of the fracture with concomitant inter-phalangeal joint (IPJ) arthrodesis for better stability. A transverse dorsal incision was made just distal to the IPJ to allow preparation of both the fracture site and IPJ. Fibrous tissue at the fracture non-union site was removed and the opposing surfaces drilled with a 0.88mm K-wire. Cartilaginous tissue at the IPJ was removed and similarly drilled with the 0.88mm K-wire. Stabilisation was achieved with a percutaneous headless compression screw. Radiographic union was achieved and the patient had resolution of symptoms 16 weeks after the surgery. The patient continued to be symptom-free at one year follow-up. This is the first case report of a surgically treated symptomatic non-union of distal phalanx fracture of a lesser toe in the literature.

Matched MeSH terms: Bone Screws
Fulltext Antibiotic-laden Arthroplasty with a Novel Design of Cement Mould and Metallic Endoskeleton for Treatment of Hip Infection, an Inexpensive Alternative: A Preliminary Report of Two Cases

William C, Simmrat S, Suhaeb AM

Malays Orthop J, 2017 Jul;11(2):78-81.
PMID: 29021886 MyJurnal DOI: 10.5704/MOJ.1707.015

Infection of the hip after implant fixation is an uncommon yet devastating complication that results in poor long-term outcome. The gold standard treatment for chronic infection after hip arthroplasty is a two-stage protocol: eradication of infection, follow by re-implantation arthroplasty. The use of interim antibiotic-laden cement spacer has become a popular procedure to maintain hip joint function and provide antibiotic elution simultaneously before re-implantation. However, antibiotic cement spacer is mechanically weak and breaks if overloaded. Therefore, we designed a cement mould with metallic endoskeleton with the aim of creating a stronger, inexpensive, antibiotic-impregnated spacer resembling a unipolar arthroplasty. We report two cases of severe hip joint infection after implant fixation (bipolar hemiarthroplasty, screw fixation neck of femur). Both patients had undergone first stage surgery of debridement and articulating antibiotic cement insertion using our design. Although the second stage surgery was planned for these patients, both patients delayed the operation in view of good functional status after a year walking with the antibiotic cement spacer. These cases showed that the mechanical property of the new antibiotic cement spacer was promising but further mechanical studies upon this new endoskeleton design are required.

Matched MeSH terms: Bone Screws
Fulltext Effect of extrusion barrel temperatures on residence time and physical properties of various flour extrudates

Sue Shan, L., Sulaiman, R., Sanny, M., Nur Hanani, Z.A.

International Food Research Journal, 2015;22(3):965-972.
MyJurnal

The aim of this study was to evaluate the effect of barrel temperature and flour types on the residence time and physical properties of various flour extrudates. Corn flour, rice flour, corn flour with potato starch (30% w/w, d.b), and rice flour with potato starch (30%w/w, d.b) were extruded at screw speed of 75rpm, feed moisture at 25% (w/w, w.b.), barrel temperature ranging from 80°C to 140°C and die size of 1.88mm. The extrudates were dried at 50°C overnight and further analysed. Results showed that an increase in extruder barrel temperature decreased the residence time of the flours in the extruder (from 4.11-11.32min to 2.24-6.76min), but increased the expansion ratio, rehydration ratio, water absorption index, water solubility index and b value of the extrudate (p≤0.05). The extrudates had the mean residence time and physical properties of rice flour

Matched MeSH terms: Bone Screws
Analysis of duration of different stages of surgery in posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) patients: comparison between severe versus non-severe AIS

Chandirasegaran S, Chan CYW, Chiu CK, Chung WH, Hasan MS, Kwan MK

Eur Spine J, 2024 Apr;33(4):1683-1690.
PMID: 38294535 DOI: 10.1007/s00586-023-08124-2

PURPOSE: Prolonged surgical duration in severe adolescent idiopathic scoliosis (AIS) patients is associated with increased blood loss and perioperative complications. The aim of this study was to compare the duration of each stage of posterior spinal fusion (PSF) in severe AIS (Cobb angle ≥ 90°) with non-severe AIS patients. This analysis will identify the most time-consuming stage of PSF and help surgeons formulate strategies to shorten operative time.
METHODS: Retrospective study whereby 90 AIS patients (Lenke type 2, 3, 4, and 6) who underwent PSF from 2019 to 2023 were recruited. Twenty-five severe AIS patients were categorized in Gp1 and 65 non-severe AIS patients in Gp2. Propensity score matching (PSM) with one-to-one with nearest neighbor matching (match tolerance 0.05) was performed. Outcomes measured via operation duration of each stage of surgery, blood loss, number of screws, fusion levels and screw density.
RESULTS: Twenty-five patients from each group were matched. Total operative time was significantly higher in Gp1 (168.2 ± 30.8 vs. 133.3 ± 24.0 min, p

Matched MeSH terms: Bone Screws
Fulltext Impact of Bone Cement Augmentation on the Fixation Strength of TFNA Blades and Screws

Sermon A, Hofmann-Fliri L, Zderic I, Agarwal Y, Scherrer S, Weber A, et al.

Medicina (Kaunas), 2021 Aug 28;57(9).
PMID: 34577822 DOI: 10.3390/medicina57090899

Background and Objectives: Hip fractures constitute the most debilitating complication of osteoporosis with steadily increasing incidences in the aging population. Their intramedullary nailing can be challenging because of poor anchorage in the osteoporotic femoral head. Cement augmentation of Proximal Femoral Nail Antirotation (PFNA) blades demonstrated promising results by enhancing cut-out resistance in proximal femoral fractures. The aim of this study was to assess the impact of augmentation on the fixation strength of TFN-ADVANCEDTM Proximal Femoral Nailing System (TFNA) blades and screws within the femoral head and compare its effect when they are implanted in centre or anteroposterior off-centre position. Materials and Methods: Eight groups were formed out of 96 polyurethane low-density foam specimens simulating isolated femoral heads with poor bone quality. The specimens in each group were implanted with either non-augmented or cement-augmented TFNA blades or screws in centre or anteroposterior off-centre positions, 7 mm anterior or posterior. Mechanical testing was performed under progressively increasing cyclic loading until failure, in setup simulating an unstable pertrochanteric fracture with a lack of posteromedial support and load sharing at the fracture gap. Varus-valgus and head rotation angles were monitored. A varus collapse of 5° or 10° head rotation was defined as a clinically relevant failure. Results: Failure load (N) for specimens with augmented TFNA head elements (screw/blade centre: 3799 ± 326/3228 ± 478; screw/blade off-centre: 2680 ± 182/2591 ± 244) was significantly higher compared with respective non-augmented specimens (screw/blade centre: 1593 ± 120/1489 ± 41; screw/blade off-centre: 515 ± 73/1018 ± 48), p < 0.001. For both non-augmented and augmented specimens failure load in the centre position was significantly higher compared with the respective off-centre positions, regardless of the head element type, p < 0.001. Augmented off-centre TFNA head elements had significantly higher failure load compared with non-augmented centrally placed implants, p < 0.001. Conclusions: Cement augmentation clearly enhances the fixation stability of TFNA blades and screws. Non-augmented blades outperformed screws in the anteroposterior off-centre position. Positioning of TFNA blades in the femoral head is more forgiving than TFNA screws in terms of failure load.

Matched MeSH terms: Bone Screws
Stability of cervical spine after one-level corpectomy using different numbers of screws and plate systems

Rosli R, Abdul Kadir MR, Kamarul T

Proc Inst Mech Eng H, 2014 Apr;228(4):342-9.
PMID: 24622982 DOI: 10.1177/0954411914527074

Anterior corpectomy and reconstruction using a plate with locking screws are standard procedures for the treatment of cervical spondylotic myelopathy. Although adding more screws to the construct will normally result in improved fixation stability, several issues need to be considered. Past reports have suggested that increasing the number of screws can result in the increase in spinal rigidity, decreased spine mobility, loss of bone and, possibly, screw loosening. In order to overcome this, options to have constrained, semi-constrained or hybrid screw and plate systems were later introduced. The purpose of this study is to compare the stability achieved by four and two screws using different plate systems after one-level corpectomy with placement of cage. A three-dimensional finite-element model of an intact C1-C7 segment was developed from computer tomography data sets, including the cortical bone, soft tissue and simulated corpectomy fusion at C4-C5. A spinal cage and an anterior cervical plate with different numbers of screws and plate systems were constructed to a fit one-level corpectomy of C5. Moment load of 1.0 N m was applied to the superior surface of C1, with C7 was fixed in all degrees of freedom. The kinematic stability of a two-screw plate was found to be statistically equivalent to a four-screw plate for one-level corpectomy. Thus, it can be a better option of fusion and infers comparable stability after one-level anterior cervical corpectomy, instead of a four-screw plate.

Matched MeSH terms: Bone Screws*
Translaminar screw fixation of the cervical spine in Asian population: feasibility and safety consideration based on computerized tomographic measurements

Yusof MI, Shamsi SS

Surg Radiol Anat, 2012 Apr;34(3):203-7.
PMID: 21947622 DOI: 10.1007/s00276-011-0869-8

Cervical translaminar screw fixation has been shown to be safe, efficient and provides alternative for cervical fixation. However, its use in the Asian population should be considered cautiously because the cervical lamina diameter may not be adequate to accommodate the standard lamina screw size. We studied the average transverse lamina diameter of the cervical spine in the Malaysian population to evaluate the feasibility and safety of lamina screw fixation in this population.

Matched MeSH terms: Bone Screws*
A radiological evaluation of the morphometry and safety of S1, S2 and S2-ilium screws in the Asian population using three dimensional computed tomography scan: an analysis of 180 pelvis

Kwan MK, Jeffry A, Chan CY, Saw LB

Surg Radiol Anat, 2012 Apr;34(3):217-27.
PMID: 22194086 DOI: 10.1007/s00276-011-0919-2

Studies of sacral pedicle anatomy have been reported in the European population. However, the feasibility for the use of S1, S2 and S2-ilium screws has not been fully investigated in the Asian population.

Matched MeSH terms: Bone Screws*
A biomechanical study comparing plate fixation using unicortical and bicortical screws in transverse metacarpal fracture models subjected to cyclic loading

Afshar R, Fong TS, Latifi MH, Kanthan SR, Kamarul T

J Hand Surg Eur Vol, 2012 Jun;37(5):396-401.
PMID: 22019989 DOI: 10.1177/1753193411424557

The use of bicortical screws to fix metacarpal fractures has been suggested to provide no added biomechanical advantage over unicortical screw fixation. However, this was only demonstrated in static loading regimes, which may not be representative of biological conditions. The present study was done to determine whether similar outcomes are obtained when cyclic loading is applied. Transverse midshaft osteotomies were created in 20 metacarpals harvested from three cadavers. Fractures were stabilised using 2.0 mm mini fragment plates fixed with either bicortical or unicortical screw fixation. These fixations were tested to failure with a three-point bending cyclic loading protocol using an electromechanical microtester and a 1 kN load cell. The mean load to failure was 370 N (SD 116) for unicortical fixation and 450 N (SD 135) for bicortical fixation. Significant differences between these two constructs were observed. A biomechanical advantage was found when using bicortical screws in metacarpal fracture plating.

Matched MeSH terms: Bone Screws*
Internal morphometry of thoracic pedicles in the immature spine

Hassan E, Liau KM, Ariffin I, Halim Yusof A

Spine (Phila Pa 1976), 2010 Jun 1;35(13):1253-6.
PMID: 20461037 DOI: 10.1097/BRS.0b013e3181c1172b

A cross sectional study of thoracic pedicle morphometry in the immature spine of Malaysian population using reformatted computed tomographic (CT) images.

Matched MeSH terms: Bone Screws*
Fulltext The assessment of immediate post-operative scoliosis correction using pedicle screw system by utilising the fulcrum bending technique

Chan CY, Kwan MK, Saravanan S, Saw LB, Deepak AS

Med J Malaysia, 2007 Mar;62(1):33-5.
PMID: 17682567 MyJurnal

Assessment of the curve flexibility is a crucial step in a surgeon's pre-operative planning for scoliosis surgery. Many techniques have been described. These include traction films, supine side bending films, push prone techniques, traction under general anaesthesia as well as fulcrum bending film. In this study, we studied the pre- and immediate post-operative radiographs of twenty eight adolescent idiopathic scoliosis (AIS) patients who were corrected using pedicle screw systems between January 2004 and August 2006. There were twenty two females and six male patients. The mean age of the patients were 17.5 years with a range of 12 to 38 years. Skeletal maturity of the patients was assessed by Risser's score. The majority was Risser 4 (15 cases, 53.6%). Based on King and Moe's classification, the most common curve was type 3 curve (15 cases, 53.6%). Among the twenty eight patients, twenty three patients underwent only posterior correction, while 5 patients underwent additional anterior release surgery. The mean pre-operative Cobb's angle for the posterior surgery group was 65.5 +/- 13.9 degrees and the mean post-operative Cobb's angle was 32.9 +/- 12.6 degrees. There was no difference between the mean correction estimated by fulcrum bending films (Fulcrum Flexibility) and the post- operative Correction Rate figures (44.2% vs. 49.9%). The mean Fulcrum Bending Correction Index (FBCI) in this group of patients is 112.8%. In the group of patients who underwent additional anterior release, their curves were noted to be larger and less flexible with the mean pre-operative Cobb's angle and Fulcrum Flexibility of 90.4 degrees +/- 9.3 degrees and 23.4% respectively. The Fulcrum Bending Correction Index (FBCI) for this group of patients was significantly higher than the posterior surgery group: i.e. 164.0% vs 112.8%. Thus, anterior release does help to improve the correction significantly. The fulcrum bending films give good pre-operative estimation of the amount of correction to be expected post-operatively. The fulcrum bending films can help to identify the curve types which might require anterior release in order to improve the scoliosis correction. Using the Fulcrum Bending Correction Index (FBCI) will also enable surgeons to quantify more accurately the amount of correction achieved by taking into account the inherent flexibility of the spine.

Matched MeSH terms: Bone Screws*
Fulltext Screw osteosynthesis of displaced lateral humeral condyle fractures in children: a mid-term review

Loke WP, Shukur MH, Yeap JK

Med J Malaysia, 2006 Feb;61 Suppl A:40-4.
PMID: 17042228

Displaced humeral condyle fractures in children are traditionally fixed with smooth Kirschner wire at the expense of a risk of secondary displacement following removal of wire. Screw fixation of such fractures has recently been advocated as it provides stable fixation. We have been using screw osteosynthesis for treatment of displaced lateral humeral condyle fractures in children in our institution since the turn of this century. This study provides a midterm review of treatment of such injuries with special regards to growth disturbances after screw osteosynthesis and to assess rate of union with a view to formulate guidelines for screw removal. We review the outcomes of screw osteosynthesis for displaced lateral condyle fracture of the humerus (19 Milch type-1 and 15 Milch type-II) in 34 children treated in our institution from January 2000 to March 2004. The average age of the patients was 6.1 years. The average follow up was 24.5 months. Screw osteosynthesis led to union (average 6.9 weeks) in all patients with excellent results in 28 patients. Growth disturbances in the form of lateral condyle overgrowth (2 patients), valgus deformity secondary to lateral condyle avascular necrosis (2 patients) and fishtail deformity ((3 patients) were recognized. The implants should not be removed until fracture union is established. Screw osteosynthesis of the lateral humeral condyle fracture prevents secondary fracture redisplacement and lateral condyle overgrowth is probably related to hyperemic response to metaphyseal fixation and early removal of implant before radiological union.

Matched MeSH terms: Bone Screws*
Fulltext Sliding compression screw fixation for delayed union/non-union of femoral neck fracture: is it a viable option

Faisham WI, Sulaiman AR, Zulmni W

Med J Malaysia, 2006 Feb;61 Suppl A:36-9.
PMID: 17042227

Femoral neck fracture non-unions often present with significant difficult treatment decision as regards to surgical options and the risk of complication. We present three cases of femoral neck non-union treated with double screw stabilization technique using sliding compression hip screw and anti-rotational screw. The rationale for opting to these simple implants in our setting is discussed.

Matched MeSH terms: Bone Screws*

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