ABSTRACT
OBJECTIVE@#To compare the clinical effects of closed reduction and internal fixation with limited transtarsal sinus incision in the treatment of Sanders type II calcaneal fractures.@*METHODS@#From June 2015 to February 2018, 60 patients with Sanders type II calcaneal fractures were treated by minimally invasive method. According to the different treatment methods, they were divided into two groups: closed prying reduction and internal fixation with hollow nails(group A) and limited transtarsal sinus incision internal fixation (group B). There were 34 cases in group A, including 22 males and 12 females, aged 21 to 60(38.90±3.25) years old, 14 cases of Sanders type IIA, 14 cases of Sanders type IIB and 6 cases of Sanders type IIC. There were 20 cases in group B, including 14 males and 6 females, aged 20 to 59(39.20±2.96) years old, 8 cases of Sanders type IIA, 9 cases of Sanders type IIB and 3 cases of Sanders type IIC. Calcaneal height, calcaneal width, Gissane angle and Bohler angle were measured before and after operation. The complications, hospitalization time and cost were compared. Functional evaluation was performed by AOFAS score system one year after operation.@*RESULTS@#Fifty-four cases were followed up for 6 to 16(11.40±2.55) months and 6 cases were lost. All the wounds healed in grade A without complications such as skin infection and necrosis. There were 1 case of nerve injury in group A, 2 cases of tendon entrapment, 2 cases of nerve injury in group B, there was no significant difference(>0.05). There was no significant difference in calcaneal width, height, Bohlers angle and Gissane angle between group A and group B (>0.05). There was no significant difference in AOFAS score between group A and group B(89.2±4.7 vs 88.7±4.8, >0.05). The hospitalization expenditure and length of stay in group A were(5 021.25±1 047.19) yuan, (6.31±4.75) d, and those in group B were(13 591.35±1 975.21) yuan, (9.65±3.42) d, respectively, with significant difference(<0.05).@*CONCLUSIONS@#Closed reduction and internal fixation is as effective as transtarsal sinus incision reduction and internal fixation for Sanders typeIIfracture. It has the advantages of less trauma and fewer complications. Closed reduction and hollow nail fixation group can significantly shorten hospitalization time, reduce hospitalization costs, and is more economical. It is worth recommending, but attention should be paid to avoid choosing to comminute serious calcaneal fracture.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Ankle Injuries , Calcaneus , Fracture Fixation, Internal , Fractures, Bone , Treatment OutcomeABSTRACT
Objective The active ingredient was used as index to optimize the extraction and enrichment process of anti-in-flammatory and analgesic active-fraction(ARF)of Dianbaizhu. Methods Methyl salicylate triglycoside-B was chosen as index com-ponent to extract and enrich methyl salicylate glycosides. Extraction and elution solvents were optimized. The HPLC fingerprint was ob-tained with Thermo Hypersil Gold C18(250 mm×4.6 mm,5μm)column and a gradient elution with the mobile phase consisting of ace-tonitrile(A)-0.2％acetic acid(B)at a flow rate of 1.0 ml/min. And the detection wavelength was set at 294 nm. Results The opti-mized extraction solvent of Dianbaizhu was the 30％ethanol and the optimized elution solvent of ARF enriched by AB-8 macroporous resins was the 35％ethanol. The methodological study on similarity and RSD in ARF HPLC fingerprint of three batches of samples cor-responded to related regulations. Conclusion The extraction and enrichment process of ARF is stable and repeatable.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the efficacy of one stage or staging treatment of cervical spondylotic myelopathy through combined posterior and anterior approaches.</p><p><b>METHODS</b>From June 2001 to October 2008, 45 patients with pinching cervical spondylotic myelopathy and developmental stenosis of cervical spinal canal were decompressed through combined posterior and anterior approaches in one stage or staging operation. Among the patients, 35 patients were male and 10 patients were female, ranging in age from 45 to 72 years, with an average of 53 years. Five patients were decompressed through combined posterior and anterior approaches in one-stage operation, and other 40 patients were treated in staging operation. All the patients were treated with open-door posterior cervical expansive laminoplasty and anterior decompression, bone graft and titanium plate internal fixation. JOA scores were used to evaluate the therapeutic effects at the 3rd month and one year after operation.</p><p><b>RESULTS</b>After the treatment, 44 patients were followed up from 13 to 62 months, with an average of 30 months. One patient was dead of lung infection at the 21th day after operation. The nerve root palsy of C5 was found in 3 cases. One patient had postoperative hoarseness. Axial symptoms were found in 14 cases. Two patients had donor site complications. There were no screws broken or back out, no screw loosening, no moving or sinking of bone block or Ti-net, no door re-closer and cervical deformity. Forty-four patients got spinal fusion. According to JOA score criteria: the average preoperative JOA score was (9.36 +/- 2.24) points, JOA score was (12.34 +/- 2.64) points in 3 months after operation, (12.77 +/- 2.61) points in one year after operation. Among 44 cases, 16 got an excellent result, 19 good, 6 fair, 3 invalid. There were statistically differences between preoperative score and 3 months or one year after operation.</p><p><b>CONCLUSION</b>Decompression through combined posterior and anterior approaches for the treatment of pinching cervical spondyoltic myelopathy and developmental stenosis of cervical spinal canal has good efficacy, as well as a safety operation method. The operation method with one or staging decompression through combined anterior and posterior approach should be chosen according to the conditions of the patients and the operations. Anterior decompression, bone graft and titanium plate internal fixation could restore the height of vertebral body effectively and prevent fusion complication.</p>