ABSTRACT
BACKGROUND: Hook plate is usual and satisfactory for the treatment of acromioclavicular joint dislocation, but there are still many problems. The comparative analysis is seldom reported between reconstruction of coracoclavicular ligament by autogenous tendon combined with hook plate and simple hook plate. OBJECTIVE: To compare the clinical efficacy of reconstruction of coracoclavicular ligament combined with hook plate and simple hook plate fixation for acromioclavicular joint dislocation. METHODS: A total of 38 patients with acromioclavicular dislocation were randomly divided into two groups. The patients were treated with plantar tendon "V" reconstruction with coracoclavicular ligament combined with hook plate fixation (combination group) and with a simple hook plate fixation (simple hook plate group). We compared the operation time, blood loss, hospitalization days, average hospitalization costs, the time taken for internal fixation, the motion range of shoulder joint at postoperative 12 months, the Constant-Murley function score, the reduction of shoulder joint and the Visual Analogue Scale scores between the two groups. RESULTS AND CONCLUSION: (1) Patients in both groups were followed up for 12 months. In the combination group, the hook plate was removed at postoperative 3 months. In the simple hook plate group, the hook plate was removed at approximately postoperative 12 months. In follow-up, no dislocation appeared in both groups. (2) No significant difference in hospitalization days, motion range of shoulder joint, Constant-Murley function score, the reduction of shoulder joint and the Visual Analogue Scale scores was determined between the two groups (P > 0.05). (3) Operation time was longer; blood loss was more; and average hospitalization costs were higher in the combination group than in the simple hook plate group (P < 0.05). (4) These findings indicate that plantar tendon reconstruction of coracoclavicular ligament combined with hook plate meets biomechanical requirements in the treatment of acromioclavicular joint dislocation. The plate can be removed early using a fixator. The lower extremity has an incision, but the follow-up results are satisfactory. Simple hook plate fixation for acromioclavicular joint dislocation takes a long time, and can obtain average effect, but there is the risk of re-dislocation (this case does not experience re-dislocation). The appropriate treatment can be chosen according to the patient's condition, needs, and economic conditions.
ABSTRACT
<p><b>OBJECTIVE</b>To compare clinical effects between percutaneous compressing plating (PCCP) and proximal femoral nail antirotation (PFNA) for the treatment of patients with intertrochanteric fracture with risk external wall.</p><p><b>METHODS</b>From September 2007 to June 2010, 43 patients with intertrochanteric fracture with risk external wall were treated by PCCP or PFNA according to different kinds of internal fixations. There were 22 cases in PCCP, including 9 males and 13 females with an average age of 68.4 (ranged, 60 to 86) years old, and 13 cases with type A2.2 and 9 cases with type A2.3; while 21 cases in PFNA, including 7 males and 14 females with an average age of 67.7 (ranged, 57 to 93) years old, and 10 cases with type A2.2 and 11 cases with type A2.3. Blood loss, operation time, hospital stay, fracture healing time, complications and Harris score after 1 years' following-up were observed and compared.</p><p><b>RESULTS</b>All patients were followed up for 12 to 22 (means 18.4) months, and all patients were obtained fracture healing, and recovered walking ability as before injury. There were no significant differences in blood loss, operation time, hospital stay, fracture healing time, complications and Harris score after 1 years' following-up (P>0.05). One case occurred displacement on the top of greater trochanter, and 1 case injuried weakness of hip abduction. One case occurred screw breakage in PCCP, while 1 case occurred hip joint pain in PFNA.</p><p><b>CONCLUSION</b>Both of PCCP and PFNA in treating patients with intertrochanteric fracture with risk external wall can receive good clinical effects, while the effects and therapy strategy for displacement of bone on the top of lateral wall should further study.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Bone Nails , Bone Plates , Case-Control Studies , Fracture Fixation, Intramedullary , Fracture Healing , Hip Fractures , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To investigate the effects of modified vacuum sealing drainage (VSD) technique in treating refractory sinus in the lower leg.</p><p><b>METHODS</b>From January 2010 to December 2011, 11 patients with refractory sinus in the lower leg, including 7 males and 4 females, with an average age of 34.5 years (ranged,23 to 56). These patients were treated with modified VSD technique after thorough cleaning sinus and continuous washing. After 14 to 21 days of treatment, removed VSD and re-debrided the sinus and sutured wound.</p><p><b>RESULTS</b>Infections got control after operation, sinus in the lower leg healed. All patients were followed up from 6 to 14 months with an average of 10 months, no recidivations were found.</p><p><b>CONCLUSION</b>Modified VSD technique is an effective method in the treatment of stubborn sinus in the lower leg.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Drainage , Methods , Fracture Fixation, Internal , Leg Bones , Wounds and Injuries , General Surgery , Postoperative Complications , Therapeutics , VacuumABSTRACT
Objective To report the surgical method and treatment outecome of transfer of free upper limb lateral bone-skin flap for repair of bone defects and nonunion in hand and forearm.Methods 17 cases of hand composite trauma,5 cases of forearm composite trauma and 2 cases of nonunion in forearm were treated with free bone-skin flaps in distal humerus,whose pedicle was the posterior branch of radical collateral artery. Area of the flap was 2cm?3cm to 8cm?10cm,length of exseeted bone was 3～6 cm.Results All the bone-skin flaps completely survived,the donor area all achieved primary healing,On postoperative 1～4 years follow-up,the texture of the flap was excellent,and bone union was obtained in all transplants,the donor area of distal lateral humerus became thicker and thicker with new cortical bones formed.According to the upper arm function assessment criterion issued by hand surgery association of Chinese medical association.The hand function had excellent results in 17 cases and good results in 2 cases.Conclusion The bone-skin flap has following advantages:easy dissection,reliable blood supply,and no major vessel needed to be sacrificed,so it is an effective method for repair of skin and soft tissue with bone defects in hand and forearm,It.also can be used to repair refractory nonunion in ulna and radius.