Treatment of refractory lateral epicondylitis with modified Nirschl surgical technique / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical effects of modified Nirschl surgical techniique in treating refractory lateral epicondylitis.</p><p><b>METHODS</b>From March 2009 to January 2011,21 patients (21 elbows) with refractory lateral epicondylitis were treated in our hospital. There were 8 males and 13 females,ranged in age from 25 to 59 years with an average of (48.3+/-13.4) years and the duration time from 8 to 33 months with an average of (17.1+/-7.7) months;affected position in dominant sides of 16 cases and non-dominant sides of 5 cases. The patients had already received multiple non-operative treatments. Modified Nirschl surgical technique was performed,and operative origination from origin of musculus extensor carpi radialis brevis to discard process with small incision, the process place of extensor digitorum communis would be removed. The incisions were nursed by ice compress for 2 days after operation. Range of motion (ROM) and strengthening exercise of elbow joints started at the 1 week after plaster slab fixation; ROM and strengthening exercise of wrist joints also started at the 2 week after fixation. The pain, power of gripping and patient staisfaction were recorded after operation. Verhaar scaling were used to estimate the recovery.</p><p><b>RESULTS</b>Seventeen patients were followed up from 13 to 22 months with an average of 16.3 months. According to Verhaar standard, 15 cases obtained excellent results and 2 good. No postoperative complication such as instability was found.</p><p><b>CONCLUSION</b>Modified Nirschl surgical technique is an effective method in treating refractory lateral epicondylitis but correct to diagnosis and exclusion the coexisting diseases,accurate removal the process are important guarantee.</p>

Study of the treatment of comminuted fractures of proximal humerus with open reduction and internal fixation / 中国骨伤

<p><b>OBJECTIVE</b>To study the effect of the treatment for comminuted fractures of proximal humerus with open reduction and internal fixation, and the influence of the different internal fixation.</p><p><b>METHODS</b>From January 2003 to June 2007, 423 cases of comminuted fractures of proximal humerus were treated with open reduction and internal fixation. Among them, 139 patients included 51 males and 88 females were treated with the Kirschner needle with an average age of 55.8 years old ranging from 35 to 72 years, and the average course was 7 days (from 3 to 20 days); 103 patients included 48 males and 55 females were treated with the cloverleaf plate with an average age of 56.7 years old (from 22 to 76 years), and the average course was 8.5 days (from 3 to 23 days); 181 patients included 85 males and 96 females were treated with the locking plate with an average age of 57.1 years old (from 29 to 77 years), and the average course was 7.9 days (from 3 to 21 days). The pain, daily activities, orbit, and the strength of the shoulder were evaluated with the Constant's scale.</p><p><b>RESULTS</b>The wound of all the cases was primary healing. All patients were followed-up for over 12 months, the sings and symptoms of all the patients were improved very well. There was significant difference between, before and after operation on Constant's scoring. While there was not significant difference among the different internal fixation.</p><p><b>CONCLUSION</b>Open reduction and internal fixation is effective for comminuted fractures of proximal humerus. There is no significant difference on therapeutic efficacy in different internal fixation.</p>