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Objective To explore the method and effect of treating thoracolumbar fracture with posterior bone grafts on first stage and transpedicular internal fixation .Methods The clinical data of 22 cases with thoraco-lumbar fracture ,treated with posterior bone grafts on first stage and transpedicular internal fixation at the same time , were analyzed and assessed .Results In this group,the vertebral height and physiological curve were recovered satis-factorily,no loss of which was found in the long-term follow-up.There were no loosening of internal fixation ,infection and iatrogenic nerve injury .All patients had achieved bone fusion in one year after the operation of posterior bone grafts,and their nerve functions were recovered .Conclusion The operation of transpedicular internal fixation is safe and reliable ,and is proved to be an effective method of treatment for patients with thoracolumbar fracture .
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Objective To explore the surgical method and effect of arthroscopy assisted minimally invasive therapy in the treatment of tibial plateau fractures .Methods Under arthroscopy surveillance ,32 patients with tibial plateau fracture ( Schatzker Ⅰ-Ⅳ) were taken reduction and fixation .Results All cases were followed up for 4-39 months .All fractures were unitied 3-6 months after operation ,and no joint infection compartment syndrome or ankylo-sis occurred.The results were excellent in 25 patients,good in 7 cases according to the HSS evaluating system 9 months after operation .Conclusion For tibial plateau fractures under arthroscopy assisted reduction and minimally invasive plate osteosynthesis has little injury ,exact reset fixation ,early recovery of the knee joint function ,the curative effect is satisfied .
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Objective To explore the method and effect of prosthetic replacement for the management of intertrochanteric fracture in the elderly.Methods 24 elderly patients with intertrochanteric fracture were treated with prosthetic replacement.According to the Evans classification,there were 4 cases of Evans Ⅱ,16 Evans Ⅲ and 4 Evans Ⅳ.Results The mean time to ambulation following the surgery was (6.0 ± 2.2) days.No prosthetic loosening or infection were observed in the follow-up of 6 to 27 months(average 12 months).According to the Harris hip score,the excellent and good rate was 83.3％.Conclusion Prosthetic replacement is safe and effective for intertrochanteric fractures in elderly patients,which allows early ambulation and have a relatively low rate of complications.
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Objective To explore the clinical effect of bone allograft plus interlock plate internal fixation in the treatment of tibial plateau fractures.Methods 43 patients with tibial plateau fractures were treated by open reduction,bone allograft,locking plate fixation and early knee joint function training.Results All patients were followed up for 8 ～ 14 months with an average of 10 months.All patients achieved bone union and the duration of union was averaged 6.9 months.Knee joint function was rated based on HSS score system as excellent in 30 cases,good in 9 cases,fair in 3 cases and poor in 1 case.The excellent and good rate was 90％.Conclusion Reliable effect can be achieved for fracture of tibial plateau treatment with bone allograft plus interlock plate internal fixation.It provides satisfactory function of the knee.It has many advantages,such as stable and durable fixation and avoidance of secondary compression of tibial plateau.