ABSTRACT
BACKGROUND:The ankle fusion is an important treating means of end-stage ankle joint disease. Internal fixation of implant has become the preferred way of fixation, but fixation of different implants has different effects. OBJECTIVE:To explore the value of different internal fixation methods in ankle fusion. METHODS:A retrospective analysis was performed in 64 cases of ankle fusion from September 2012 to March 2015. They were divided into the observation group (32 cases) and control group (32 cases) according to the way of internal fixation of implant. The observation group underwent headless compression screw fixation. The control group underwent interlocking compression plate fixation. Length of incision, operation time, postoperative drainage volume, postoperative complications, healing time of bone and functional recovery of ankle-hindfoot were observed and compared between the two groups. RESULTS AND CONCLUSION:(1) There was no statistical significance in operation time and healing time of bone between the two groups (P>0.05). (2) Length of incision and postoperative drainage volume were significantly greater in the control group than in the observation group. The incidence of postoperative complications was significantly higher in the control group than in the observation group (P0.05), but the score was significantly higher in the observation group than in the control group in final fol ow-up (P<0.05). (4) These findings suggest that compared with the interlocking compression plate, headless compression screw treatment for ankle fusion can obtain better effect, smal trauma, less postoperative complications, fixed firmly, more in line with the physiological and biomechanical requirements.
ABSTRACT
BACKGROUND:Pedicle screw fixation in the treatment of thoracolumbar fracture can effectively restore vertebral body height and physiological radian, and are widely used in the clinic. In the clinic, we found that different surgical methods on restoration of vertebral height are different. Simultaneously, there are differences in relevant factors before repair, which causes that the recovery of vertebral body height is not consistent. OBJECTIVE:To explore the related factors influencing the recovery of vertebral height of pedicle screw fixation system for treating thoracolumbar fracture. METHODS:Clinical data of 63 patients with thoracolumbar fracture, who were treated by posterior pedicle screw fixation system from September 2012 to March 2015, were summarized. The fracture types were A3 or A4 type in the AO spine thoracolumbar injury classification system, including 32 cases of transpedicular screw fixation (group A) and 31 cases of beyond-injured-vertebral fixation (group B). The related factors including age, course of disease (within 3 weeks), bone mineral density, preoperative degree of vertebral compression and preoperative sagittal Cobb’s angle were recorded. The degree of vertebral height restoration was also observed. Intergroup analysis was conducted using independent samplet-test. Intragroup analysis was performed using bivariate regression analysis in single factor analysis. Multivariate linear regression analysis was applied for multivariate analysis so as to explore the factors related to vertebral height restoration. RESULTS AND CONCLUSION:No significant difference in preoperative rate of vertebral compression or Cobb’s angle was detected between the two groups (P > 0.05). Postoperative rate of vertebral height restoration of group A was significantly greater than group B (P 0.05). Multiple linear regression analysis showed that the preoperative degree of vertebral compression and the course of disease were the predominant factors affecting the vertebral height restoration. The standardized partial regression coefficients were 0.225, -0.621, respectively. These results demonstrate that transpedicular screw fixation can more effectively restore vertebral height than traditional beyond-injured-vertebral internal fixation. The preoperative vertebral compression and course of diseases are the predominant factors affecting the vertebral height restoration, which can predict postoperative vertebral height restoration.