Open reduction and osteosynthesis of common minimally invasive percutaneous plate osteosynthesis in treat-ment of high energy tibial fracture / 中国基层医药

Objective To open the reset common bone and open ordinary osteosynthesis(MIPPO)(in effect in the treatment of high energy tibial fracture.Methods High energy tibial fracture in 42 cases of patients,according to the condition of the patient and the treatment were divided into two groups,using open reduction and bone treatment (open group,22 cases),treated with MIPPO technique(MIPPO group,20 cases).The indicators of operation,postop-erative complications and clinical efficacy of the two groups were observed.Results The operation time,intraopera-tive bleeding volume,fracture healing time of the MIPPO group were (75.2 ±9.7)min,(107.3 ±11.3)mL,(13.1 ± 3)weeks,which of the open group were (73.4 ±10)min,(208.5 ±16.3)mL,(18.2 ±4.7)weeks,the two groups had no statistically significant differences in operative time(P >0.05),two groups of blood loss,fracture healing time, the differences were statistically significant(t =23.153,4.143,all P <0.05);the complication rate in the MIPPO group was 10.0%,tibial shaft fracture healing function excellent rate was 95.0%.The complication rate of the open groupwas healing function excellent rate was 72.7%,36.4% tibial shaft fracture,there were significant differences between the two groups(χ2 =12.316,22.964,all P <0.01).Conclusion MIPPO technology in the treatment of high energy tibial shaft fractures,with less bleeding,fracture healing fast,and the characteristics of a significant effect, which is worth promoting.

The value of different imaging methods on classification in displaced proximal humeral fractures / 中华放射学杂志

Objective To investigate the influence of common X-ray, two-dimensional computed tomography (2D-CT), spiral computed tomography (SCT), and three-dimensional (3-D) reconstruction on the classification in displaced proximal humeral fractures. Methods Three groups were divided on the basis of various imaging methods, including group A (common X-ray), group B (common X-ray and 2D-CT), and group C (3-D reconstruction of SCT and 2D-SCT). 46 cases of displaced proximal humeral fractures were classified with Neer system. The true rate of fracture classification by use of three methods was compared with each other, and clinical significance of SCT and 3-D reconstruction was evaluated.Results Based on operation, 46 cases of displaced proximal humeral fractures in group A included 26 cases of Neer two-part fractures, 13 cases of three-part fractures, and 7 cases of four-part fractures. The true cases of common X-ray were 22 in Neer two-part fractures and 8 in three and four-part fractures, there was significant difference between Neer two-part fractures and Neer three and four-part fractures (P

Spiral computerized tomographic SSD and MPR imaging of complex shoulder fractures / 中华骨科杂志

Objective To investigate the clinical value of spiral computerized tomographic shaded surface display (SSD) and multiplanar(MPR) imaging of complex shoulder fractures. Methods Twenty four cases of complex shoulder fractures including 16 cases with displaced proximal humeral fractures and 8 cases with displaced fractures of glenoid fossa were examined preoperatively with X ray, 15 cases of them were examined with SSD and MPR. On the basis of X ray or SSD and MPR of SCT all fractures were classified with Neer and modified Ideberg system; the true rate of fracture classification by use of two methods was compared with each other. Results Evidenced by intraperative observation, 10 of 16 displaced proximal humeral fractures cases were Neer three part fractures, 6 were four part fractures cases. Among the 8 cases of glenoid fossa fractures, there were 2 cases of type Ⅲ, 3 cases of type Ⅳ and 3 cases of type Ⅴ. The true rate of SSD and MPR of SCT is 93.3%(14/15) while X rays is 41.7%(10/24); there was significant difference between two methods (Fishers exact test, P=0.02). All SSD and MPR of SCT play an important role in the treatment of complex shoulder fractures. Conclusion SSD and MPR of SCT is able to clearly display complex shoulder fractures three dimensionally. It is helpful to correctly classify the fractures, select appropriate surgical approach, prepare surgical instruments and understand the complexity of the fractures.