ABSTRACT
Objective To compare the curative effects of three fixed methods in the management of distal humeral fractures in adults.Methods From January 2012 to December 2015,120 adults patients with distal humeral fractures admitted to our hospital were enrolled in this prospectively study.According to the principle of random digital table,all patients were randomly signed into single plate fixation group,Y type plate fixation group or double plates fixation group.The primary outcomes included surgical approach,elbow function recovery and postoperative complica-tions.Results Significantly differences were observed among the three groups in fracture union time[(99.48 ± 11.81)d vs.(108.93 ±11.05)d vs.(111.35 ±11.11)d,F =12.274,P =0.000)];there was no difference in fracture union time between the single plate fixation group and Y type plate fixation group (t =0.979,P =0.331). However,patients in double plates fixation group got a significantly shorter fracture union time when compared with the single plate fixation group or Y type plate fixation group (t =3.696,4.632,both P =0.000).Significantly differences were observed among the three groups in Mayo elbow performance score three months after the operation[(88.63 ±7.35)points vs.(79.98 ±6.06)points vs.(79.60 ±6.5)points,F =12.274,P =0.000)].There was no difference in Mayo elbow performance score between the single plate fixation group and Y type plate fixation group (t =0.266, P =0.791).However,the patients in the double plates fixation group got a significantly higher Mayo elbow perform-ance score (t =5.742,5.799,both P =0.000).There was no difference among the three groups in operation duration,intraoperative bleeding volume,failure rate of internal fixation,surgical site infection,ulnar neuritis,myositis ossificans and loosening of the plate (all P >0.05).Conclusion Double plates is more in line with the biomechanical characteristics of the distal humerus,and it is beneficial to the functional recovery of elbow joint.
ABSTRACT
Objective To investigate the application value of damage control orthopedic surgery in the man-agement of unstable pelvic fractures.Methods From January 2011 to December 2015,107 patients with unstable pelvic fractures were retrospectively studied.All patients were signed into the damage control surgery group (59 cases)or open reduction and internal fixation in stage I group (48 cases).The postoperative complications, Lindahl evaluation of the quality of fracture reduction,Majeed function score,hospital duration and mortality were observed.Results Compared with the open reduction and internal fixation in stage I group,patients in the damage control surgery group got a significantly lower rate of multiple organ dysfunction (23.73% vs.45.84%,χ2 =5.793, P =0.016);a higher excellent and good rate of Lindahl evaluation of the quality of fracture reduction (93.22% vs. 79.17%,χ2 =4.597,P =0.032 );a higher level of Majeed function score three months after the operation [(84.41 ±10.33)vs.(74.85 ±10.72),t =4.678,P =0.000];and a higher rate of hospital mortality(15.25% vs. 31.25%,χ2 =3.892,P =0.049).There were no differences between the two groups in sepsis,disseminated intravas-cular coagulation,pulmonary embolism,deep vein thrombosis,pulmonary infection,intestinal obstruction and hospital duration (all P >0.05).Conclusion Damage control orthopedic surgery reduced the postoperative complications of unstable pelvic fractures,improved the pelvic function recovery,and decreased the hospital mortality.