ABSTRACT
Objective:To analyze the application value of tibial transverse transport (TTT) microvascular reconstruction combined with antibiotic bone cement in the limb salvage of diabetic foot.Methods:Seventy-seven patients with diabetic foot admitted to the Traditional Chinese Medicine Hospital of Zhongshan from January 2018 to January 2021 were enrolled retrospectively, and they were divided into the control group (performed TTT microvascular reconstruction, 47 cases) and the combined group (performed TTT microvascular reconstruction combined with antibiotic bone cement, 30 cases) according to the surgical method. Wound healing rate, limb salvage rate, the ulcer healing time, bone window healing time, wound infection control status, affected side lower limb vascular blood supply situation, and peripheral nerve function recovery were compared between the two groups.Results:The amputation rate between the two groups had no significant difference ( P>0.05), but the healing rate in the combined group was higher than that in the control group: 90.00%(27/30) vs. 68.08%(32/47); and the ulcer healing time, bone window healing time in the combined group were shorter than those in the control group: (12.55 ± 2.14) weeks vs. (15.01 ± 3.17) weeks, (17.47 ± 2.09) weeks vs. (19.00 ± 2.58) weeks, there were statistical differences ( P<0.05). The positive percentage of bacteria culture in wound secretions in the combined group after the surgery for 6 d was lower than that in the control group: 20.00%(6/30) vs. 44.68%(21/47), there was statistical difference ( P<0.05). After the surgery for 3 months, the dorsal skin temperature and ankle brachial index in the combined group were higher than those in the control group: (31.05 ± 1.74) ℃ vs. (29.27 ± 1.66) ℃, 0.93 ± 0.29 vs. 0.80 ± 0.19, there were statistical differences ( P<0.05), but the scores of visual analog scale (VAS) and 10 g nylon line test values between the two groups had no significant differences ( P>0.05). Conclusions:TTT combined with antibiotic bone cement can achieve better wound healing and infection control effect in the limb salvage of diabetic foot, and the blood supply improvement of the affected limb is more significant.
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Objective To explore the effects of Bawei Shangke Huoxue Tablets on hypercoagulable state of patients with hip fracture. Methods Seventy-two hip fracture patients at hypercoagulable state were randomly divided into treatment group and control group, 36 cases in each group. Both groups were given conventional orthopedic treatment including raising up the affected limb, external application of Huoxue Zhitong Paste on the affected area, and instructions for affected limb functional exercise. Additionally, the treatment group was given oral use of Bawei Shangke Huoxue Tablets together with subcutaneous injection of low-molecular-weight heparin calcium, and the control group was given subcutaneous injection of low-molecular-weight heparin calcium. Before and after treatment, we observed the plasma D-dimer (D-Di) and blood von Willebrand factor(vWF) levels as well as the incidence of deep venous thrombosis (DVT) of both groups before and after treatment. Results (1) All of the cases of both groups completed the clinical trial, and no severe adverse reaction such as increased bleeding occurred. (2) On the admission day, the D-Di and vWF levels of both groups were higher than the normal levels, and were decreased obviously one day before the operation (P 0.05). Conclusion Bawei Shangke Huoxue Tablets are effective on improving hypercoagulable state of patients with hip fracture, and can be used at early stage and are beneficial to lowering the risks of anticoagulant drugs. Bawei Shangke Huoxue Tablets plus low-molecular-weight heparin calcium have certain effect on preventing DVT.
ABSTRACT
Objective To investigate the anatomical features of different types of unstable fractures of pelvic ring,and to observe the therapeutic effect of open reduction and internal fixation combined with three-stage syndrome differentiation and treatment.Methods Nineteen patients with pelvic fracture were classified according to Tile's classification for pelvic fracture.Of 19 patients,12 were classified into type B(6 being type B1,3 type B2,and 3 type B3),and 7 into type C(3 being type C1,2 type C2,and 2 type C3).All of the patients received pelvic reconstruction through open reduction and internal fixation with titanium plate.After treatment,three-stage syndrome differentiation and treatment were carried out: Taohe Chengqi Decoction was used in the early stage of fractures,Xugu Huoxue Decoction in the middle stage and Yangjin Jiangu Decoction in the late stage.Meanwhile,traumatic ointment was applied on the affected region after the union of operation wound.Results After operation,the follow-up was carried out in all of the patients for 12 ～ 36 months,averaged 18 months.The results of follow-up showed that the fractures and dislocation of all the patients were healed within 3 ～ 6 months,and the patients obtained the normal life and walking function.The results of Majeed's classification showed that 17 were effective,2 ineffective and the effective rate was 89.47%.Conclusion According to the classification of pelvic fractures,it is a better method for pelvic fractures by pelvic reconstruction through different methods of open reduction and internal fixation with titanium plate,and then by three-stage syndrome differentiation and treatment.