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Objective To determine the factors influencing the results of open reduction and internal fixation for displaced intra-articular calcaneal fracture (DIACF).Methods From May 2009 to June 2013, 80 patients with DIACF involving in 91 feet were treated by open reduction and internal fixation.Mean age was 38.7 years (range, 18-72 years).Patients were grouped according to the possible factors related to the operative results, including the Sanders classification of fracture, quality of fracture reduction, postoperative B(o)hler angle, width of postoperative calcaneus, and time to surgery after injury.Clinical result was evaluated and compared within each group.Results Mean duration of follow-up was 18.3 months (range, 14-26 months).The clinical results were excellent for 67 feet (74％), good for 12 feet (13％), fair for 7 feet (8％) and poor for 5 feet (5％), which yielded 87％ good to excellent results.Good to excellent results in Sanders Ⅱ , Ⅲ and Ⅳ groups reached 94％, 85％ and 53％ respectively, in quality of fracture reduction ≤ 2 mm and ＞ 2 mm groups reached 93％ and 30％ respectively, in postoperative B(o)hler angle ＜ 15° and ≥15° groups reached 33％ and 90％ respectively;in broadening of postoperative calcaneus ＜ 1 cm and ≥ 1 cm groups reached 92％ and 17％ respectively, in time to surgery after injury ≤14 days and ＞ 14 days groups reached 91％ and 43％ respectively, in age ≤60 years old and ＞ 60 years old groups reached 85％ and 88％ respectively.Except for the age group, the clinical result differed significantly within group (P ＜ 0.05).Conclusions Fracture type, reduction quality, postoperative B(o)hler angle, width of postoperative calcaneus, time to surgery after injury are the factors influencing on the operative results of patients with displaced intra-articular calcaneal fracture.Thereupon the unfavorable influences should be avoided to improve the operative results.
ABSTRACT
[Objective]To investigate the therapeutic results of grafting with bioactive glass and autologous bone marrow for simple bone cyst in teenagers. [Method]From April 2005 to October 2007,16 teenagers with simple bone cyst were reported.There were ten males and six females with a mean age of 18.5 years(range 12 to 30 years).Eight cysts were in the proximal humerus,five in the proximal femur,two in the proximal tibial and one in the distal end of radius.Lining of cavity was removed thoroughly with a curet.The cyst cavity was filled with the mixtures of 45s bioactive glass and autogenous red bone marrow.Five cases of pathologic fracture were fixed with steel plate or intramedullary nail.[Result]All 16 cases of cysts were ossified radiolo gically within six months,with an average time to syst healing of 18 week.A follow-up of 6 to 32 months(mean 18 months) showed satisfactory healing without complications.[Conclusion]The combined grafting with bioactive glass and autologous bone marrow appears to be an effective and simple treatment for simple bone cyst in teenagers.
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[Objective]To compare clinical results of the mini midvastus approach with the traditional medial parapatellar approach for totall knee arthroplasty and to evaluate their advantages.[Methods]Sixty total knee arthroplasty(56 patients)have been freated during May 2002 to May 2006,28 patients(30 knee) were underwent TKA using either mini midvastus approach or traditional medial parapatellar approach.Two groups were compared according to skin incision length,postoperative pain score,total amount of drains,postoperative amount of decreasing Hb,active straight-leg raise time,postoperative length of stay,radiographic alignment of all the components,postoperative range of motion at 6 weeks and 12 weeks and 1 year,postoperative HSS score at 1 year.[Results]All the patients were followed from 1 to 1.5 year(mean,13.2 months).Position of all the components was normal in all patients except one case with abnormal position of tibial prosthesis in both groups.In the MIS group,the average skin incision length was 11.3 cm,average visual analog pain scale was 2.76 score,while the control group was 20.6 cm and 3.8 score.In the MIS group,the total amount of drains was 96.8 ml,postoperative amount of decreasing Hb was 22.5 g,while the control group was 276.3 ml and 32.5 g.In the MIS group,active straight-leg raise time was 3.8 days,postoperative length of stay was 8.6 days,while the control group was 5.8 days and 12.1 days.In the MIS group,the mean ROM at 6 weeks postoperatively was 107?and 117?at 12 weeks,while the control group was 98?and 108?.The differences between each factor group and operative results were significant(P0.05).[Conclusion]The mini midvastus approach wis associated with a more rapid functional recovery and a more satisfactory short-term result.