Tag Archives: manufacturer

Femur Shaft Fractures (Broken Thighbone)

Our thighbone (femur) is the longest and strongest bone in our body. Because the femur is so strong, it usually takes a lot of force to break it. Motor vehicle collisions, for example, are the number one cause of femur fractures.

The long, straight part of the femur is called the femoral shaft. When there is a break anywhere along this length of bone, it is called a femoral shaft fracture. This type of broken leg almost always requires surgery to heal.

Types of Femoral Shaft Fractures

Femur fractures vary greatly, depending on the force that causes the break. The pieces of bone may line up correctly (stable fracture) or be out of alignment (displaced fracture). The skin around the fracture may be intact (closed fracture) or the bone may puncture the skin (open fracture).

Doctors describe fractures to each other using classification systems. Femur fractures are classified depending on:

  • The location of the fracture (the femoral shaft is divided into thirds: distal, middle, proximal)
  • The pattern of the fracture (for example, the bone can break in different directions, such as crosswise, lengthwise, or in the middle)
  • Whether the skin and muscle over the bone is torn by the injury

The most common types of femoral shaft fractures include:

Transverse fracture. In this type of fracture, the break is a straight horizontal line going across the femoral shaft.

Oblique fracture. This type of fracture has an angled line across the shaft.

Spiral fracture. The fracture line encircles the shaft like the stripes on a candy cane. A twisting force to the thigh causes this type of fracture.

Comminuted fracture. In this type of fracture, the bone has broken into three or more pieces. In most cases, the number of bone fragments corresponds with the amount of force needed to break the bone.

Open fracture. If a bone breaks in such a way that bone fragments stick out through the skin or a wound penetrates down to the broken bone, the fracture is called an open or compound fracture. Open fractures often involve much more damage to the surrounding muscles, tendons, and ligaments. They have a higher risk for complications—especially infections—and take a longer time to heal.


Femoral shaft fractures in young people are frequently due to some type of high-energy collision. The most common cause of femoral shaft fracture is a motor vehicle or motorcycle crash. Being hit by a car while walking is another common cause, as are falls from heights and gunshot wounds.

A lower-force incident, such as a fall from standing, may cause a femoral shaft fracture in an older person who has weaker bones.


A femoral shaft fracture usually causes immediate, severe pain. You will not be able to put weight on the injured leg, and it may look deformed—shorter than the other leg and no longer straight.

Credit to: orthoinfo

New Data Links High Volume TJA To Patient Outcomes

Researchers at the University of Rochester in New York have taken a deep look into the connection between the volume of revision total joint arthroplasty (TJA) surgeries and patient outcomes.

Co-author Benjamin Ricciardi, M.D. explained to OTW why this connection is especially important. “The association between hospital volume and primary total joint replacement has been well established but has not been studied extensively in revision total joint replacement. Revision surgery is more complicated than primary surgery, and we hypothesized that hospitals with higher volume would have improved early outcomes relative to lower volume hospitals.”

The researchers looked at records from 29,948 inpatient stays for revision TJA from 2008 to 2014 in the Statewide Planning and Research Cooperative System (SPARCS) database for New York State. They looked at the relationship between hospital revision volumes by quartile and the associated patient outcomes. The researchers also examined the top 5 percentile of hospitals as a separate cohort.

Dr. Ricciardi summarized the study results to OTW, “The most important results were hospitals in the highest 5% by volume for revision total joint replacement had lower 90-day readmissions relative to lower volume hospitals. Additionally, hospitals in the lowest quartile by volume had higher 90-day complications relative to higher volume hospital categories.”

“The results of this study suggest that regionalizing revision services to higher volume hospitals may be beneficial to early revision total joint replacement outcomes, however, further studies are needed to examine any negative impact on access to care that these policies may cause and define longer term outcomes of revision total joint replacement relative to hospital volume.”

According to the authors, “Disadvantages of regionalization include reduced access to care, increased patient travel distances, and possible capacity issues at receiving centers. Further studies are needed to evaluate the benefits and negative consequences of regionalizing revision TJA services to higher-volume revision TJA institutions.”


Reference from : ryortho.com

New Protocol May Decrease Hip Dislocation Risk

Researchers from NYU Langone Orthopedics, Hospital for Special Surgery, and Mayo Clinic have developed a hip-spine classification system for use in revision total hip arthroplasty that may help decrease the risk of recurrent instability.

Their work, “Evaluation of the Spine is Critical in Patients with Recurrent Instability after Total Hip Arthroplasty,” has been accepted for publication in an upcoming 2019 issue of The Bone & Joint Journal.

Co-author Jonathan M. Vigdorchik, M.D., at the time of the study an orthopedic surgeon in the Division of Adult Reconstructive Surgery at NYU Langone Orthopedics in New York City, noticed a trend which, as he explained to OTW, prompted this study. “In clinical practice, being at a tertiary referral center, we get many referrals for revision THA [total hip arthroplasty]. As we started looking at our revisions for dislocation, we began noticing a trend—patients all had spine fusions or spines that were in bad shape. So, this launched us on a research path about spine fusions and hip replacement.”

The researchers collected data on 111 patients undergoing revision THA for recurrent instability and matched 1:1 to 111 revisions specifically performed for instability not using this protocol (the control group).

Dr. Vigdorchik, now an orthopaedic hip and knee replacement surgeon at Hospital for Special Surgery in New York, told OTW, “We found that spinal fusion, and also the higher number of spinal levels fused, caused higher dislocation rates. We also found that patients with spinal deformity had higher rates of dislocation.”

“So, we had a combined spine surgeons and hip surgeons conference to discuss. As a hip surgeon, I started looking at the hip and the pelvis like a spine surgeon and began noticing certain trends. When we applied this to dislocating hips, it became very clear why they were dislocating and explains a large group of patients where the doctors could never figure out why the X-rays looked good (or so they thought).

“But they were just looking at the wrong X-rays. So that is why I came up with this protocol, to teach them the right X-rays to do and then what to do with what they found.”

“Revising a hip that is dislocating has a really high complication rate, especially recurrent dislocation.

From : www.ryortho.com/

Outcomes of superficial and deep irrigation and debridement in total hip and knee arthroplasty

Researchers performed a retrospective study of 176 patients. that underwent irrigation and debridement(I&D) within 28 days of  TJA, to examine the role and outcomes of both superficial and deep I&D in patients with wound-related issues and/or suspected periprosthetic joint infection (PJI). For superficial I&D, the overall success was 84.28% compared to 68.86% for deep I&D. Outcomes support the viability of superficial I&D in patients with wound-related issues as long as joint aspiration is performed to rule out infection involving the prosthesis. They suggest opening fascia and exploring deeper tissues in case there are findings of no fluid or purulence.


Read the Full Article On : https://www.arthroplastyjournal.org/article/S0883-5403(19)30255-4/fulltext?rss=yes

Time to seriously consider focused mris for injured spines

Is it sufficient to only examine the injured part of the spine via focused magnetic resonance imaging (FMRI) or will that lead to missed problems?

In patients who sustain blunt trauma, CT is the initial screening modality of choice in most emergency departments in the United States to look for injury to various parts of the body—including the spine. If a fracture is seen in the thoracic or lumbar spine on CT, sometimes an MRI of the injured segment of the spine is useful to provide additional information about the injury to help physicians decide on a treatment plan.”

“The problem is that MRI is a relatively expensive and time-consuming test compared to CT, so every time we were ordering MRIs of the entire spine in this scenario, it seemed somewhat excessive. Since we are mostly interested in looking at the part of the spine that we already know is injured (based on the CT), we asked ourselves if just imaging the injured portion of the spine by MRI (a focused MRI) would be adequate to provide the information we need to decide on a treatment plan. The concern with this approach is whether we would miss injuries by not looking at the entire spine by MRI.”

To answer the question, the investigators reviewed records for all adult trauma patients who presented to Mass General’s emergency department between 2008 and 2016 with one or more fractures of the thoracic and/or lumbar spine—as identified using computed tomography (CT) and who underwent MRI of the entire thoracic and lumbar spine within 10 days.

The most important result of the test, said Dr. Karim, was “that performing a focused MRI of only the injured portion of the spine would lead physicians to missing some sort of injury in another portion of the spine about 15% of the time, but none of these ‘missed injuries’ would lead to any change in treatment plan or patient care if they are known.”

“This is a very practical study from our perspective because it affects the day-to-day work of radiologists, emergency room physicians, and spine surgeons. If they see a fracture in the thoracic or lumbar spine on CT that they want to better characterize on MRI, they should be comfortable obtaining just a focused MRI of the injured portion of the spine—saving time, money, and patient discomfort.”

Reference From : https://ryortho.com

Patient relevant outcomes of unicompartmental vs total knee replacement

Between 1 January 1997 and 31 December 2018, via searching Medline, Embase, Cochrane Controlled Register of Trials (CENTRAL), and Clinical Trials.gov, researchers provided a clear and comprehensive summary of the published data on unicompartmental knee replacement (UKA) or total knee replacement (TKA), comparing domains of outcome that have been shown to be important to patients and clinicians in order to enable informed decision making. Findings suggested that TKA and UKA are both viable treatment options for isolated unicompartmental osteoarthritis arthritis. This investigation shows better results for UKA in several outcome domains by directly comparing the two treatments. The risk of revision surgery for TKA, however, was lower. This information should be available to patients when selecting treatment options as part of the shared decision-making process.

Read the Full Article : https://www.bmj.com/content/364/bmj.l352

Reference From : www.mdlinx.com


We participated in MOARCON  2019  Event held in NASIK from 1st to 3rd  March, 2019.

We exhibited all our Products & Instruments.

Lumbar Hyperlordosis

Lumbar lordosis refers to the inward curvature of the lumbar spine that is created by wedging of both the lumbar intervertebral discs and the vertebral bodies.

Deviations of the lumbar spine such as an increased lumbar lordosis have an impact on overall postural stability particularly in maintaining sagittal balance due to a degeneration of the sagittal spine curvature.

A greater lordosis angle is a risk factor for developing spondylolysis and ventral bulging of the affected vertebra, with researchers having proved a positive association between lumbar hyperlordosis angle and spondylolysis and isthmic spondylolisthesis.

Been and Kalichman gave a detailed description of the anatomy of lumbar lordosis stating that dorsal wedging of the vertebral bodies and discs increases the lordosis angle, whereas more ventral wedging of these structures reduces the lordosis angle ……………. Continue reading on mass4d.com: Lumbar Hyperlordosis

Copyright 2018 MASS4D® All rights reserved. This article or any portion thereof may not be reproduced without the prior written permission of MASS4D®

Nail Simplifies Two-Procedure Rotator Cuff Repair

A significant number of proximal humeral fractures occur with soft tissue injuries of the rotator cuff. Historically, fractures were treated separate from cuff tears with two procedures. Each procedure required different techniques and individual instruments. An innovative new utility patent has been issued to Dr. Michael Levy  for the creation of a technology that bridges the concept of treating the fracture and the rotator cuff. This patented implant combines a flexible humerus nail with an external tab to aid rotator cuff repairs.  This patent design work allowed him to get back into implant design, and integrate his surgical experience.

Prior to advances in bone and soft tissue anchors, implants, and arthroscopy, rotator cuff surgery was primarily performed via open incisions and cumbersome suture techniques. Operative treatment for the proximal humerus has run the gamut from pinning, plating, and nailing, to forward and reverse arthroplasty. Nails for the proximal metaphysis of the humerus have undergone a wide spectrum of design ideas including semi-rigid and flexible nails with and without cross locking. Little has been done to combine cuff repairs and fracture fixation.

Past treatment of both injuries involved a flexible nail that accepted sutures to hold down the cuff and cover the humeral head. This is commonly known as the parachute technique, employing two Enders flexible nails in the proximal humerus. The inspiration for the new patented nail with a tab was to simplify the cumbersome suturing required for cuff repairs, and incorporate an updated, more versatile nail with better fixation options.

The current nail design comes in three lengths: 240 mm, 260 mm, and 280 mm. The nail is designed with three staggered proximal holes angled for humeral head cross locking screw fixation. The proximal portion of the nail is 9 mm, while it tapers distally to 4 mm for ease of implantation. The flexible nail can be driven into the distal humerus, negating the need for difficult and dangerous distal cross locking. A locking dovetail holds the tab in position on the lateral footprint of the rotator cuff tear. Sutures pass through holes in the tab for ease of use.

Do spine fusion patients with hip arthroplasty risk dislocation?

Anew study of 42,300 patients explores the question of whether patients undergoing lumbar spinal fusion (LSF) before total hip arthroplasty (THA)—versus after—have an increased risk of dislocation and revision.

Study co-author Arthur Malkani, M.D. of the University of Louisville Adult Reconstruction Program, explained to OTWthe rationale for this large study: “There has been a significant increase in the number of patients undergoing primary THA with a history of prior lumbar spine fusion. Lumbar spine fusion is an independent risk factor for dislocation leading to increased risk of revision.”

“The prevalence of hip dislocation following primary THA in patients with prior lumbar spine fusion in the Medicare population is 7.4%. Lumbar spine fusion alters spino-pelvic anatomy leading to loss of the normal pelvic parameters during standing and sitting which could lead to hip impingement and instability.”

In the study, 28,668 patients underwent lumbar spine fusion and then total hip arthroplasty sometime later and 13, 632 had the reverse—total hip arthroplasty followed by lumbar spine fusion sometime after.

Dr. Malkani told OTW, “In our practice we are seeing more patients presenting with both lumbar spine disease and primary hip osteoarthritis. The purpose of this large database study was to determine if hip instability could be decreased if the hip replacement was done first prior to the lumbar fusion in patients with both lumbar spine disease and hip arthritis.”

“The results from this study suggest a significant advantage for patients to undergo THA first if concomitant lumbar spine and hip pathology are likely to require both lumbar spine fusion and THA.”

“There was a 46% increased risk of dislocation in patients with prior LSF compared to the group that had a THA done first followed by a LSF within 1 year, 60% increased risk of dislocation compared to THA first then LSF at 2 years and 106% increased risk compared to THA first and delayed LSF by 5 years. The greater the interval between index THA and proceeding LSF, the lower the risk of dislocation and THA revision.”

“Instability continues to be the leading cause of failure following primary THA leading to revision surgery. We need to identify high risk patients for instability prior to the primary THA. We need to start asking patients if they have any history of lumbar spine disease during the initial visit prior to the THA. In those patients with concomitant lumbar spine disease and hip osteoarthritis, the arthroplasty and spine surgeons need to collaborate to determine if the hip arthroplasty can be approached first with a delay in spine surgery.”

“Additional work is required to determine the ideal functional acetabular cup position in patients with a rigid lumbosacral-pelvic biomechanical relationship and altered pelvic parameters. Surgeons should look at multiple factors in patients undergoing THA with a history of prior lumbar spine fusion to minimize dislocation such as preoperative assessment of pelvic parameters, ideal surgical approach, maximizing head size, restoring offset, satisfactory implant alignment, and an intraoperative assessment of stability.”

    We offer a wide variety of safe and advanced Orthopedic Implants and fixators. At the helm of the company’s operations is Mr. Vinodbhai, the Director. His enterprising skills and experience in the industry continue to play a pivotal role in the company’s growth.We are based in Ahmedabad city West Part of India.


    Plot No.10, Phase-1, B|h. Prashant Eng., G.I.D.C.Vatva, Ahmedabad-382 445, Gujarat, (INDIA).


    +91 9375801932


    [email protected]