– Discussion: – lag screw: (see: lag screw theory) – in oblique or wedge fractures 3.5 mm cortex screws are inserted as lag screws either separately first or thru the plate; – radial frx: – radial plate is most … Read more
– Discussion: – there is inherent graft weakness during period after implantation when allograft& autograft tissues undergo necrosis, revascularization, and cellular proliferation; – weakest link initially is graft fixation site; – it is important to achieve strong fixation initially; … Read more
– Technique: – at this point, No 2 Ethibond stay sutures will have already been passed thru drill holes made in each bone plug; – proposed tibial bone plug should have an additional stay suture passed thru the bone-tendon interval (as a safety feature should the interference screws … Read more
– See: Essentials in Osteodynamics” – Discussion: – bone remodeling functions reshaping or replacement of of bone during growth and following injury; – in the first year of life, almost 100% of the skeleton is replaced; – in adults, remodeling procedes at about 10% … Read more
– See: Bone Topics – Discussion: – woven bone healing: – ref: Distal radial fractures heal by direct woven bone formation – stages of enchondral bone healing: – hematoma / inflammation: – shortest stage of fracture healing – disruption of vascular flow through the marrow and periosteum … Read more
– Discussion: – see fracture healing menu and plate biomechanics menu and bone healing with locking plates – where bone is under compression w/ no gap, dead bone is reabsorbed, & resorption cavities, produced by cutting cones of osteoclasts, traverse the fracture plane; – clinically the ideal result of rigid plating should … Read more
– See: – Bone Patella Bone Allografts – Non Bone Patella Bone Reconstruction – Discussion: – Anatomy of ACL; – ACL Biomechanics; – Graft Tunnel Sites / Isometry: – Graft Biomechical Characteristics: – … Read more
– See: Scaphoid Frx Menu: – scaphoid nonunions: – Discusssion: – bone grafting may be indicated for scaphoid malunion or non union; – malunion: – indicators of scaphoid malunion: classic findings are a dorsal humpback deformity and DISI deformity; – indications for bone grafting include radiographic deformity along with pain, weakness, and loss … Read more
– See: Tibial Non Unions – Discussion: – up to 60% of high energy open tibial will fail to heal by 20 weeks, and therefore MD must decide which fractures require early bone grafting and which do not; – large tibial defects: – w/ defects less than 6 cm iliac crest bone grafting may be sufficient; … Read more
– Discussion: – blood supply to skin around the knee is random (as opposed to axial) – there are multiple small overlapping vessels that are interrupted by multiple small incisions; – random supply is sustained by both intrinsic and extrinsic sources; – intrinsic contributors to … Read more