ABSTRACT
Objective To explore the factors influencing postoperative function of elbow in adults with C-type fracture of distal humerus.Methods From March 2005 to June 2009,23 patients with C-type fracture of distal humerus were treated with open reduction and internal fixation.The function of the elbow was evaluated with Mayo elbow performance index.Related factors such as age,fracture classification,internal fixation method and initial time of postoperative rehabilitation were analyzed with Logistic regression model.Results The followed up time was 8 -36 (18.3 ± 2.1 ) months,the results demonstrated 6 excellent,8 good,4 fair and 5 poor,the excellent and good rate was 60.9%( 14/23 ).The excellent and good rate in the age ≤40 years old and ＞40 years old were 61.5%(8/13) and 60.0%(6/10)(P＞0.05);in C1,C2,C3 type fractures were 77.8% (7/9),62.5% (5/8),50.0% (3/6) respectively (P ＜ 0.05 );in plate patients and in Kirschner patients were 75.0% (9/12) and 54.5% (6/11)(P ＜ 0.05);in postoperative functional exercise ≤3 weeks and ＞ 3 weeks were 71.4%(10/14) and 55.6%(5/9 )(P＜ 0.05 ).Conclusions The fracture classification,internal fixation method and the initial time of postoperative rehabitation affect the functional restoration of distal fracture of humerus,and proper stable fixation with early suitable exercises according to the fracture classification will help improve the functional restoration.
ABSTRACT
Objective To introduce a new technique of treating tibial spinal fractures in children under arthroscope, and to assess its clinical outcomes. Methods From February 2001 to July 2003, 6 child patients with tibial spinal fracture were treated arthroscopically. The reduction and fixation were completed under the arthroscope. The wire was linked with the suture outside the joint, and then was pulled into the joint to fix the fracture fragment through the fundus of anterior cruciate ligament (ACL). Results The patients were followed up for 6 to 20 months. All the fractures healed without displacement 4 weeks after operation. 3 months postoperatively, the motion range of the knee returned to normal, and no knee instability was observed. The results of ADT (anterior drawer test) and Lachmanns sign were negative. Conclusion This technique is the first choice in treatment of tibial spinal fracture in children, because it facilitates the diagnosis and treatment of complicated knee problems and provides accurate reduction and reliable fixation. Besides, it is minimally invasive, simple and convenient.
ABSTRACT
Objective To evaluate the clinical value of application of supracondylar locked intramedullary nail under arthroscope for supracondylar femoral fractures. Methods Sixteen patients with supracondylar femoral fracture were treated by supracondylar locked intramedullary nail. After mini-incision open reductions were completed, the nails were inserted retrogradely into femoral intercondylar notch under arthroscope. Results Bony union was obtained in all the patients within 3 months. Follow-up for 6～18 months showed ranges of motion (ROM) of their knee joints were 110?or above. Conclusions Application of this nail for supracondylar femoral fracture is characterized by mini-invasion, reliability and rapid recovery. There is no need for traditional open operations on the knee joint, and no need for external fixation.