ABSTRACT
The report describes the clinical efficacy of improved Krackow method combined with unilateral mattress suture for treating fresh Achilles tendon rupture. The clinical data of 19 patients, 18 males [94.7%] and one female [5.3%], with recent Achilles tendon rupture undergoing the above procedure at Department of Orthopaedics, Orthopaedic Hospital Guizhou Province, Guiyang, China, from May 2013 to May 2016, were retrospectively analysed. The enrolled patients were aged from 19 to 56 years. The injury time to operation time was 1-10 days with an average of 2.9 days. Postoperative curative effectiveness was evaluated according to the American Orthopedic Foot and Ankle Society [AOFAS] Ankle- Hindfoot postoperative function score. All patients remained under an OPD follow-up from 7 to 18 months [average 11.8 months]. Among them, incision of 16 patients healed by primary intention. Incision edge of three patients showed darkening and effusion, without recovery after change of dressings. No sural nerve injury or re-rupture of Achilles tendon were noted and the AOFAS score was 97.4. Improved Krackow method with unilateral mattress suture has good curative effectiveness to skin and tendon, reducing the risk of Achilles tendon re-rupture, skin infections, and necrosis
ABSTRACT
BACKGROUND:The key difference between closed reduction and open reduction for femoral neck fracture is the incision of joint capsule or not. As for this problem, scholars have different opinions, but there is no unified conclusion. OBJECTIVE:To compare reduction quality and the rate of femoral head necrosis of open reduction and closed reduction in the treatment of femoral neck fracture in middle-aged and young patients with displaced femoral neck fracture. METHODS: Clinical data of 102 middle-aged and young patients with femoral neck fracture, who were treated in the Department of Traumatic Orthopedics, Guizhou Orthopedic Hospital from June 2008 to June 2014, were analyzed. They were folowed up. According to the manner of reduction, they were divided into open reduction group (n=39) and closed reduction group (n=63). General data, postoperative fracture healing, the rate of femoral head necrosis and reduction quality were compared between the two groups. RESULTS AND CONCLUSION:No significant difference in general information, preoperative and postoperative hemoglobin difference, fracture healing time and fracture nonunion rate was detected between the two groups (P > 0.05). The rate of femoral head necrosis was lower in the open reduction group than in the closed reduction group, but reduction quality was higher in the open reduction group than in the closed reduction group (P < 0.05). These results indicate that in the treatment of displaced femoral neck fractures in middle-aged and young patients, postoperative femoral head necrosis rate of open reduction and fixation is low, and the quality of reduction is better. Open reduction has a certain advantage, but the case number and case study have a certain limitation. We should choose the appropriate way of operation treatment according to the patient’s condition.