ABSTRACT
Objective To explore the clinical effect of coracoclavicular ligament reconstruction with the autogenous anterior half of peroneus longus tendon (AHPLT) for distal clavicle fracture (Neer type Ⅱ-b).Methods The clinical data were retrospectively analyzed of 26 Neer type Ⅱ-b distal clavicle fracture surgically treated by coracoclavicular ligament reconstruction with autogenous AHPLT in Ganyu District People's Hospital of Lianyungang from June 2012 to May 2015.Among the 26 cases,16 males and 10 females,aged from 19-56 years (average 38.7 years).Fracture occurred in left side in 18 cases and in right side in 8 cases.Postoperative observations were done on fracture healing,shoulder and ankle-foot function recovery.Results For all the 26 cases,surgical incisions were healed well,and no infection,vascular and peroneal nerve injury and iatrogenic fracture occurred.Follow-up was carried out for 10-24 months with average of 15.3 months.All the fractures were healed within 12-20 weeks with an average of 14.6 weeks.One patient was found of losing the fracture reduction part during the follow-up process,and then got eventual healing by extending the limb brake time.Another patient was found of slight tendon sensation disorder with no significant effect on daily life and exercise,and the symptoms disappeared 6 months later.At the last follow-up,the Constant-Murley score was 92-100 with an average of 97.8 points.The ankle-hind foot score of American Society of Ankle and Orthopedics was excellent.Conclusion Reconstruction of coracoclavicular ligament with autogenous AHPLT is an effective treatment for Neer type Ⅱ-b distal clavicle fracture with good safety and without negative effect on the ankle-foot function,and thus it is worthy of wider clinical use.
ABSTRACT
Objective To investigate the clinical efficacy of lengthening osteotomy for leg bone defect. Methods The clinical data of 22 patients who received lengthening osteotomy for leg bone defect from February 2005 to March 2011 were retrospectively analyzed. Operative methods were designed according to the patients' general condition, condition of fracture nonunion and bone defect accompanied by osteomyelitis. They included Z-shaped, oblique, and cortical bone osteotomy. The modified Ilizarov external fixator was used after osteotomy. Bone lengthening was performed 1 week after the operation, and the lengthening rate was 0.5-1mm/d. Results The bone defects achieved bone union in the 22 patients by fixation and lengthening for 3-10 months (8 months on average), followed by external fixation for 6 months to achieve clinical union. The follow-up period for all the patients ranged from 12 to 15 months, and remediable complication was found in 2 patients (1 mild, 1 moderate), and no irredeemable complication was observed. Conclusions Lengthening osteotomy is safe, reliable, and easy to operate. Furthermore postoperative nursing care is simple and complications are less, thus it is an ideal surgical method for leg bone defect.