ABSTRACT
From January 2013 to December 2017, 8 patients with deep burns of upper limbs were admitted to our hospital, including 6 males and 2 females, aged 23-48 years. The wound area of full-thickness burns to burns with tendon and bone injury was 4.5 cm×2.0 cm-20.0 cm×10.5 cm. After debridement, thin abdominal flaps with subdermal vascular network in the size of 5.0 cm×2.5 cm-22.0 cm×12.0 cm were applied to cover the wounds, and the donor sites were sutured directly by relaxation. The disposable suction tubes with holes cut on side walls were used as drainage tubes. The part of drainage tubes with holes were wrapped with nano-silver antimicrobial dressings and then placed at the lowest position of pedicle and donor site of abdominal flap and the space between the injured limb and the abdominal wall. The loose nano-silver antibacterial dressing was used to fill the webs of fingers and the gap between the injured limb and the abdominal wall. The transparent film dressing was used to close the surgical area and then connected with a low negative voltage electric suction device to continuously suck at a negative pressure of -15 to -10 kPa. The self-made vacuum sealing drainage device was replaced at intervals of 4 to 5 days until pedicle breakage was performed 2 to 3 weeks after operation. The pedicled abdominal flaps of 8 patients had no torsion or avulsion, no pedicle blood supply disorder, and no infection or skin erosion in the operation area, and all the flaps survived after pedicle breakage.
ABSTRACT
BACKGROUND:Anterior decompression, bone graft fusion, plate and screw fixation are commonly used in clinic for the treatment of thoracolumbar burst or comminuted fractures. The posterior surgery including decompression laminectomy and pedicle screw internal fixation. OBJECTIVE:To explore the biomechanical changes of spine after thoracolumbar fracture and dislocation treated with pedicle screw internal fixation. METHODS:Forty-six patients with thoracolumbar fracture and dislocation were treated with pedicle screw internal fixation, and then the recovery of spinal cord injury and fracture reduction were observed after internal fixation, immediately after internal fixation and 1-year fol ow-up. RESULTS AND CONCLUSION:Al the 46 cases were fol owed-up. Frankel function classification assessment was used to evaluate the spinal cord injury grade. There was no significant difference in the percentage of A grade between periods (P>0.05), and there were significant differences in the percentage of B-E grades when compared between immediately postoperative period, 1-year fol ow-up period and preoperative period (P0.05). The anterior height percentage, posterior height percentage and Cobb angle indicators were used to assess the fracture reduction, and the results showed there was no significant difference in posterior height between periods (P>0.05), and there was significant difference in Cobb angle when compared between immediately postoperative period, 1-year fol ow-up period and preoperative period (P0.05). The results indicate that pedicle screw internal fixation system for the treatment of thoracolumbar spinal fracture and dislocation is conducive to the fracture reduction and functional recovery.