Three-dimensional printing opens up many opportunities for use in traumatology and orthopedics, because it takes into account personal characteristics of the patients. Modern methods of high-resolution medical imaging can process data to create threedimensional images for printing physical objects. Today, three-dimensional printers are able to create a model of any complexity of shape and geometry. The article provides a review of the literature about three-dimensional digital modeling in shaping implants for osteosynthesis. Data search was carried out on the Scopus, Web of Scince, Pubmed, RSCI databases for the period 2012–2022. The effectiveness of three-dimensional printing for preoperative modeling of bone plates has been confirmed: implants perfectly corresponds with the unique anatomy of the patient, since the template for it is based on the materials of computed tomography. Individual templates can be useful when the geometry of patients' bones goes beyond the standard, and when improved results of surgery are expected due to better matching of implants to the anatomical needs of patients.
We reviewed scientific literature on the problem of osteosynthesis of long tubular human bones, published during the last 10 years. The Scopus, Web of Scince, Pubmed, RSCI databases were searched for the articles reporting the results of clinical studies and biomechanical experiments using plate osteosynthesis. The advantages and disadvantages of minimally invasive plate osteosynthesis for different segments have been revealed. The articles reported a lower probability of displacement development in minimally invasive plate osteosynthesis in comparison with intramedullary osteosynthesis, good biological conditions for fracture healing, decreased rate of complications of postoperative wounds due to reduced incisions. In the concept of biological osteosynthesis, the advantage of axial dynamization and fracture micro-mobility over absolute rigidity was noted. The study also revealed the influence of the parameters of a plate and osteosynthesis technique on the rigidity of the plate-bone system, such as: the working length of the plate, the number of screws on the plate, types of screws (cortical or locking), the plate material and its profile. The bone osteosynthesis seemed to have new directions of evolution. These include far cortical locking screws allowing micromobility under the plate, providing a "controlled dynamization". An experimental technology of Active Locking Plates has been reported, where the screws with angular stability are locked in holes on elastic sliding elements providing micromobility of the screw relative to the plate. In general, all the visible results differed in various studies and, sometimes, contradicted each other.
Chronic lateral ankle instability is an extremely common disease in the active working population. Unfortunately, the study of this pathology in children and adolescents receives very little attention in the modern literature, although they also suffer from manifestations of ankle instability. We present a clinical example of surgical treatment of a 15-year-old patient suffering from chronic lateral ankle instability. The result of treatment after one year of observation was regarded as excellent. The symptoms of the disease were stopped, the patient has no restrictions in household activities and returned to the level of motor activity that was before the injury.
In the structure of injuries among patients with fractures of the patella, patients of working age prevail, placing high demands on the functional results of surgical treatment and terms of recovery. Given the low incidence of this pathology in the structure of all injuries of the musculoskeletal system, the authors are of the opinion that patients with patella fractures should receive specialized care that meets the requirements for certain types of fractures in trauma hospitals of any level. The described clinical example describes the medium-term results of treating a patient using a patented method of osteosynthesis of the patella that meets both the requirements of patients and the basic principles of osteosynthesis of intra-articular fractures. The data provided is characterized as good, the use of the patented method is regarded as expedient.
Abstract. Patients (n = 66) were divided into 2 groups. In the main group, tendon-muscle plasty was performed in the form of transposition and tenodesis of the tendon of the anterior tibial muscle in the cleft of the navicular bone, and in the control, a combination of this type of tendon-muscle plasty and subtalar arthroeresis. In the period from 2016-2021, the ortho-paediatric department of Clinic of the Samara State Medical University carried out a comprehensive treatment of 66 children with plano-valgus deformity of the feet, which included surgical correction, immobilization of the limb in the postoperative period and rehabilitation treatment for all periods of postoperative observation. Our results indicate the need for an integrated approach in the treatment of flat-valgus deformity of the feet, which includes the formation of an anatomically correct installation of all elements that make up the child's foot and ankle joint, correction of biomechanics and the development of the correct walking skill in the postoperative period.
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