ABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical experiment of cortical screw in the treatment of tibiofibular syndesmosis separation together with ankle fractures.</p><p><b>METHODS</b>From March 2008 to May 2012,42 patients with tibiofibular syndesmosis separation were treated with cortical screw, including 20 cases in the left and 24 cases in the right. All the patients had closed injury. According to Lauge-Hansen classification, there were 18 cases of supination-external rotation, in which 4 patients with injuries belong to type II, 8 patients with injuries belong to type III, 6 patients with injuries belong to type IV; 14 cases of pronation-external rotation, in which 6 patients with injuries belong to type III, 8 patients with injuries belong to type IV; and 12 cases of pronation-abduction, in which 4 patients with injuries belong to type II, 8 patients with injuries belong to type III. According to injury of ankle, 4 patients had injuries in one ankle, 28 patients had injuries in 2 ankles, and 12 patients had injuries in 3 ankles. All the patients were diagnosised definitely in sight of medical history, checking-up, iconography. The clinical effects were evaluated based on Baird-Jackson score and activity degree of ankle.</p><p><b>RESULTS</b>All the patient were followed up, and the duration ranged from 11 to 23 months, with an average of 15.7 months. No postoperative wound infection, nonunion, and tibiofibular syndesmosis separation again and other complications occurred. Postoperative Baird-Jackson score exhibited 91.56 ± 6.26 (75 to 99), and 26 patients got an excellent result, 10 good, 6 poor and 2 bad. One patient had nail broken after operation,and got good function after removing broken nail without external fixation. Other 1 patient had osteoarthritis to 1 degree, and got better result with the treatment of physical therapy and intra-articular injection.</p><p><b>CONCLUSION</b>Cortex screw is the effective treatment for tibiofibular syndesmosis separation. Clear diagnosis, delicate operation and postoperative reasonable functional exercise are primary factor of prognosis.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Ankle Fractures , General Surgery , Ankle Joint , General Surgery , Bone Screws , Fracture Fixation, Internal , Treatment OutcomeABSTRACT
Objective The goal of this study was to investigate the biomechanical compatibility effects of cancellous bone granule(CBG) augmentation of Optimesh and polymethylmethacrylate (PMMA) augmentation of Kyphoplasty on treated andadjacent non-treated vertebral bodies. Methods Three-dimensional, anatomically detailed finite element (FE) models of the L1–L2functional spinal unit (FSU) were developed on the basis of cadaver computed tomography (CT) scans. The material properties and plug forms of the L2 centrum were adapted to simulate osteoporosis, CBG and PMMA augmentation. The models assumed a three-column loading configuration as the following types: compression, flexion and extension. Results Compared with the osteoporotic model, changes in stress and strain at adjacent levels both of CBG and PMMA augmentation models were minimal, but stresses/strains within the two reinforcement material plugs were modified distinctly and differently. In addition, osteoporosis, CBG and PMMA augmentation had little effect on either the axial compressive displacement of the three columns or the average disc internal pressure in all models. Conclusion Both morcelized cancellous bone and PMMA augmentation restore the total strength and stiffness level of treated vertebral bodies and benefit the reconstruction of vertebral function. Regarding the biomechanical compatibility and the biocompatibility of the treated vertebral body and reinforcement material, however, the morcelized cancellous bone is better than PMMA augmentation.
ABSTRACT
<p><b>OBJECTIVE</b>To study the accuracy the pedicle screw placement in the thoracic spine using funnel technique and free hand technique.</p><p><b>METHODS</b>Eight cadavers including 5 males and 3 females were analysed. The age ranged from 57 to 82 years (mean 68 years). Cadawers were randomly assigned to one of two instrumentation groups. In four cadavers, "funnel technique" was used for screw placement. In the remaining four cadavers,free hand technique then was used. Success of pedicle screw placement was judged by CT scan. The rate of success of two ways was compared using statistic analysis.</p><p><b>RESULTS</b>Ninety-six screws were inserted by "funnel technique" and free hand technique respectively, 84 of "funnel technique" were successful, and 73 of free hand technique were successful. Significant differences were found between two ways (P < 0.05). Chanciness tresis occurred in "funnel technique" on 2 screws and free hand technique on 9 screws. There were significant differences in rates of chanciness tresis (P < 0.05).</p><p><b>CONCLUSION</b>Funnel technique is simple, safe and cost-effective alternative to any other thchnique for pedicle screw placement in thoracic spine,funnel technique is able to reduce the chance of critical injury of nerve root and dura.</p>