ABSTRACT
Objective:To compare the curative efficacy in the treatment of humeral surgical neck fractures between open reduction and locking plating versus closed reduction and interlocking intramedullary nailing.Methods:From July 2018 to July 2020, 60 patients with humeral surgical neck fracture were treated at Department of Orthorpaedic Trauma, Jiangmen Wuyi Hospital of Traditional Chinese Medicine. They were 24 males and 36 females, aged from 40 to 70 years and injured at the left side in 35 cases and at the right side in 25 ones. Of them, 30 underwent open reduction and locking plating (open group) and the other 30 closed reduction and interlocking intramedullary nailing (closed group). The 2 groups were compared in terms of operation time, intraoperative blood loss, surgical incision length, fracture healing time, Neer shoulder function scoring 3 months after surgery, and postoperative complications.Results:There were no statistically significant differences between the open and closed groups in preoperative general data, showing they were comparable ( P>0.05). The length of surgical incision [(5.2±1.1) cm], operation time [(34.3±12.7) min], intraoperative blood loss [(52.5±7.3) mL] and fracture healing time [(9.2±1.5) weeks] in the closed group were significantly better than those in the open group [(11.1±2.5) cm, (69.4±21.4) min, (123.5±5.2) mL and (14.2±3.4) weeks)] ( P<0.05). The excellent and good rate by Neer shoulder function scoring at 3 months after operation in the closed group (93.3%, 28/30) was significantly higher than that in the open group (66.7%, 20/30) ( P<0.05). There were no postoperative complications in either group. Conclusion:In the treatment of humeral surgical neck fractures, the curative efficacy of closed reduction and interlocking intramedullary nailing is better than that of open reduction and locking plating.
ABSTRACT
[Objective]To compare curative effects of radial head resection with internal fixation in treatment of Mason type-Ⅱ、Ⅲ fracture of radial head.[Method]Forty-five patients with Mason type-Ⅱ、Ⅲ fracture of radial head were dividered into 2 groups(A and B).The patients in group A(n=23) were performed with radial head resection.The patients in group B(n=22) were performed with open reduction and internal fixation.The results of the two groups were assessed for statistical analysis on the following aspects: pain,motion,strength and X-ray finding.Broberg and Morrey criterion were used to compared curative effect of elbow function between the two groups.[Result]The patients in the two groups were followed up for a mean time of 8 years(group A) or 3 years(group B).The difference of the pain VAS score,mean flexion/extension of the elbow,Broberg and Morrey elbow scores,carrying angle and shift of radius between the two groups were with statistical significance(P0.05).[Conclusion]In comparing with the radial head resection,open reduction and internal fixation can obtain more satisfactory elbow motion,greater muscle strength and better joint function m the treatment of Mason type-Ⅱ、Ⅲ fracture of radial head.
ABSTRACT
Objective To compare the clinical results of femoral head replacement for femoral in- tertrochanteric fractures and femoral neck fractures in aged patients.Methods Forty cases of femoral in- tertrochanteric fractures and 45 cases of femoral neck fractures (aged over 80 years) underwent femoral head re- placement from August 1996 to April 2002 in our department.The clinical results of the two groups were retro- spectively compared and analyzed statistically.Their follow-up periods,ranging from 3 to 7 years,averaged 4.6 years in the intertrochanteric fracture group and 5.5 years in the neck fracture group.Results The differences in time of hospitalization,perioperative blood loss,postoperative drainage,ambulation trine,early compiications be- tween the two groups were of no statistical significance (P＞0.05).The differences in operation time and inequality in leg length after operation between the two groups were of statistical significance (P＜0.05).The operation time was longer and more limb-length inequality occurred in the intertrochanteric fracture group than in the neck fracture group.There was no significant difference in Harris score at the last follow-up between the two groups.The X-ray at the final follow-up showed that there was insignificant difference in postoperative hip joint space,hip pain,or stem loosening between the two groups (P＞0.05).The stem revision incidences were of no statistical significance be- tween the two groups (P＞0.05).The two groups reported no acetabular protrusion.Conclusion With standard cemented prostheses,femoral head replacements can achieve as similar functional outcomes for patients with in- tertrochanteric fractures as for those with femoral neck fractures.