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Objective To evaluate the efficacy and accuracy of hammering reverse guide wire technique for safe placement of anterior column retrograde intramedullary screw in pelvic and acetabular surgery.Methods From September 2015 to March 2018,46 patients with pelvic or/and acetabular fracture involving the anterior column were treated with hammering reverse guide wire technique for safe placement of anterior column retrograde intramedullary screw at Department of Orthopaedics,Lishui Municipal Central Hospital.They were 28 men and 18 women,aged from 21 to 85 years (mean,55.6 years).There were 34 pelvic ring fractures,9 acetabular fractures and 3 combined pelvic ring and acetabular fractures.After the anterior lateral spine of pubic tuberosity was drilled by a guide pin and drill bit as the entry point,a reverse guide wire was knocked into the bone lightly by a hammer.For each retrograde intramedullary screwing into the acetabular anterior column,we recorded operation time,fluoroscopic frequency,and attempts to establish an acceptable screw pathway by the guide pin.The accuracy of screwing and the quality of fracture reduction were evaluated by imaging examination.For each patient,we recorded fracture union time and complications.Functional recovery of the pelvis and acetabulum was assessed by postoperative physical examination at the last follow-ups.Results The operation time of retrograde intramedullary screwing for the 46 patients averaged 28.9 minutes (from 16 to 55 minutes);the fluoroscopy frequency averaged 16.3 times (from 9 to 35 times);an acceptable screw pathway was established by the first attempt in 43 of the 46 patients (93.5％) and re-established after adjustment of the guide pin in the other 3.Forty patients were followed up for an average of 15.2 months(from 6 to 36 months).Postoperative CT scan and three-dimensional reconstruction showed that all the screws had been placed safely and accurately in the acetabular anterior column.Implant loosening and fracture displacement occurred in one case and lower limb thrombosis in another.No nail breakage,fracture nonunion,incision necrosis or infection,neurovascular injury or femoral head necrosis was observed.All fractures united after an average of 14.7 weeks (from 12 to 18 weeks).According to the Majeed scoring at the last follow-ups,the pelvic and acetabular function was evaluated as excellent in 29 cases,as good in 9,and as fair in 2,giving an excellent and good rate of 95.0％.Conclusion Hammering reverse guide wire technique is an effective method for safe placement of anterior column retrograde intramedullary screw in pelvic and acetabular surgery,because it can increase accuracy of screwing and reduce intraoperative radiation,operation time and incidence of complications though it is simple.
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Objective To investigate the primary clinical efficacy of Collinear clamp assisted reduction and proximal femoral nail antirotation(PFNA) in the treatment of medial-lateral irreducible intertrochanteric fractures.Methods From January 2012 to December 2016,a total of 21 cases of medial-lateral irreducible intertrochanteric fractures of femur who were treated with Collinear clamp assisted reduction and PFNA in Lishui Hospital of Zhejiang University were selected.There were 12 males and 9 females,with a mean age of 76.7 years(ranged 51 to 91).According to Arbeitsge-meinschaft für Osteosynthesefragen/The Association for the Study of Internal Fixation (AO/ASIF) classification,there were 6 cases of type 31-A1 fractures,11 cases of type 31-A2 fractures,4 cases of type 31-A3 fractures.All patients were followed and the clinical results and functional rehabilitation were evaluated during perioperative period and after short term followed-up.Results The mean operation time was 61.7min (ranged 40-1 10min).The mean intraoperative blood loss was 131.7mL (ranged 45-450mL).The average hospitalization days was 13.6d(ranged 7-29d).There were no severe complications and exacerbation of coexisting medical disease.All patients were followed up for 10 to 18 months (average 13.3 months) after treatment.The fracture union was obtained in all patients at the final follow-up.No poor healing,failure of internal fixation,cut-out of proximal screws,varus deformity,re-fractures occurred after operation.The clinical results were evaluated according to Harris hip score,6 cases achieved excellent results,13 cases were good,2 cases were fair at last follow-up.The excellent and good rate of the hip joint function was 90.5％.Conclusion Surgical treatment of medial-lateral irreducible intertrochanteric fractures with Collinear clamp assisted reduction and PFNA can result in excellent reduction and function.This technique has less injury and faster recovery.However,the long-term effect needs to evaluate by follow-up.
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Objective@#To investigate the primary clinical efficacy of Collinear clamp assisted reduction and proximal femoral nail antirotation(PFNA) in the treatment of medial-lateral irreducible intertrochanteric fractures.@*Methods@#From January 2012 to December 2016, a total of 21 cases of medial-lateral irreducible intertrochanteric fractures of femur who were treated with Collinear clamp assisted reduction and PFNA in Lishui Hospital of Zhejiang University were selected.There were 12 males and 9 females, with a mean age of 76.7 years(ranged 51 to 91). According to Arbeitsge-meinschaft für Osteosynthesefragen/The Association for the Study of Internal Fixation(AO/ASIF) classification, there were 6 cases of type 31-A1 fractures, 11 cases of type 31-A2 fractures, 4 cases of type 31-A3 fractures.All patients were followed and the clinical results and functional rehabilitation were evaluated during perioperative period and after short term followed-up.@*Results@#The mean operation time was 61.7min(ranged 40-110min). The mean intraoperative blood loss was 131.7mL(ranged 45-450mL). The average hospitalization days was 13.6d(ranged 7-29d). There were no severe complications and exacerbation of coexisting medical disease.All patients were followed up for 10 to 18 months (average 13.3 months) after treatment.The fracture union was obtained in all patients at the final follow-up.No poor healing, failure of internal fixation, cut-out of proximal screws, varus deformity, re-fractures occurred after operation.The clinical results were evaluated according to Harris hip score, 6 cases achieved excellent results, 13 cases were good, 2 cases were fair at last follow-up.The excellent and good rate of the hip joint function was 90.5%.@*Conclusion@#Surgical treatment of medial-lateral irreducible intertrochanteric fractures with Collinear clamp assisted reduction and PFNA can result in excellent reduction and function.This technique has less injury and faster recovery.However, the long-term effect needs to evaluate by follow-up.
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Objective To study the efficacy of fixation with knee arthroscopy as adjuvant therapy for lateral tibial plateau fracture. Methods 72 cases with lateral tibial plateau fracture of our hospital from September 2011 to September 2014 were divided into experimental group (36 cases) and control group (36 cases), according to different operation method, the experimental group using arthroscopic, while the control group using traditional incision surgery. Then the incision length, operative time, hospital stay, wound healing, bone healing time were compared. Complications, knee function and reduction of the fracture were compared. Results The incision length of experimental group was significantly lower than the control group, the difference was statistically significant (P <0.05). Operative time, hospital stay, wound healing time, the bone healing time were significantly lower than the control group, the differences were statistically significant (P < 0.05). Delay healing, joint stiffness and traumatic arthritis were significantly lower than the control group, the differences were statistically significant (P < 0.05). RASMUSSEN function score and radiographic scores in the experimental group were significantly higher than the control group, the differences were statistically significant (P < 0.05). Conclusion Fixation with knee arthroscopy as adjuvant therapy for lateral tibial plateau fracture has advantages of smaller incision, shorter operative time and hospital stay and healing time, lower complication rate while better reduction of the fracture and function than conventional methods.
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Objective This investigation was launched to characterize the relationship between some popular sports and the meniscus injury as well as the impairment extent due to practice duration.Methods The overall 819 women aged 20-49 years from clinic service,hospital,community and gymnasium were selected to join the investigation.The participants practice yoga or any other popular sports including badminton,jogging,climbing hills for at least one hour per day.The subjects were diagnosed with meniscus injury by means of physical examination and MR imaging.All of the subjects were therefore divided into the case(273)and the control(546)pools.The nested case-control model was applied to assess the relative risk of the meniscus.The 181 yoga subjects had been further divided into three sub-groups of 3-6 months,6-12 months and over 12 months,and they were accordingly analyzed with the variables of the age,body mass index(BMI)and Lysholm score.Results The study showed that yoga was associated with higher risk(OR=1.621,P=0.008)of meniscus injury,but the other sports showed no statistically significant risk (badminton 0R=1.028,jogging OR=1.116,climbing hills OR=1.259).The trainees appeared to be statistically different between the groups of 3-6 months and over 12 months on the items of the Lysholm score(P=0.006)and BMI(P=0.003).Conclusion Yoga plays a risky role on the issue of meniscus injury comparing some other popular sports among young women.The yoga players who exercise longer got lower Lysholm scores and lighter weight.