Internal fixation with lag screws plus an anti-sliding plate for the treatment of Hoffa fracture of the lateral femoral condyle / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical effects of internal fixation with lag screws plus an anti-sliding plate for the treatment of Hoffa fractures of the lateral femoral condyle.</p><p><b>METHODS</b>From May 2006 to May 2014, 17 patients with Hoffa fractures of the lateral femoral condyle were treated with lag screws plus an anti-sliding plate. There were 13 males and 4 females, ranging in age from 27 to 59 years, with a mean of 32.5 years. All the fractures were fresh and closed fractures. According to the Letenneur's classification, 8 cases were type I, 4 cases were type II, 5 cases were type III. All the patients had no injuries of the cruciate ligament and the another part of the knee. Operative incision and fracture healing time were observed, knee joint function was evaluated by Letenneur system and HSS standard.</p><p><b>RESULTS</b>The patients were followed up from 10 to 24 months with a mean of 14.6 months. All incisions achieved primary healing, and no internal fixation breakage, malunion, femoral candyle necrosis, deep vein thrombosis of lower extremity were found. Fracture healing time was from 4 to 9 months with an average of 4.7 months. According to Letenneur's functional assessment, 10 patients got an excellent results, 4 good, 3 fair. Total HSS score was 91.1 +/- 4.7 on average,15 cases obtained excellent results, 2 good.</p><p><b>CONCLUSION</b>Internal fixation with lag screws and an anti-sliding plate can result in excellent effects for Hoffa fractures of the lateral femoral condyle. The key to a successful surgery is an anatomic reduction and rigid fixation of the fracture.</p>

Case-control study on local injection of autoallergic platelet rich plasma or whole blood for the treatment of tennis elbow / 中国骨伤

<p><b>OBJECTIVE</b>To compare therapeutic effects of local injection with autoallergic platelet rich plasma (PRP) or autoallergic whole blood (AWB) for the treatment of chronic tennis elbow.</p><p><b>METHODS</b>From January 2011 to January 2014, 40 patients with chronic tennis elbow were divided into 2 groups, 20 cases in each group: PRP group and AWB group. There were 20 patients in PRP group treated with local injection of autoallergic platelet rich plasma, including 5 males and 15 females, with an average age of (47.50 ± 9.86) years old; and the average course of disease was (4.67 ± 3.27) months. Among the 20 patients in AWB group treated with local injection of autoallergic whole blood, 3 patients were male and 17 patients were female, with an average age of (46.50 ± 9.96) years old;and the average course of disease was (4.53 ± 2.27) months. The elbow joint was fixed with elastic stockings after injection. All the patients were guided to do strengthening and extension exercises during the follow-up period. Visual analog scale (VAS), Mayo scores for elbow and pressure pain threshold (PPT) were used to evaluate clinical effects after injection immediately and 4,8 weeks after treatment. Results:All the patients were followed up,there were no infections and swelling occurred. The VAS, Mayo and PPT scores of patients in PRP group were improved from pre-therapy 7.22 ± 1.32, 56.71 ± 10.90 and 17.47 ± 4.62 to 2.73 ± 1.00, 91.59 ± 6.95 and 21.35 ± 4.80 respectively 8 weeks after treatment. The VAS, Mayo and PPT scores of patients in AWB group were improved from pre-therapy 7.16 ±1.27, 54.72 ± 8.36 and 17.06 ± 4.83 to 3.81 ± 1.36, 82.06 ± 7.89 and 20.12 ± 4.97 respectively 8 weeks after treatment. All the pain and functional variables including VAS, PPT, and Mayo scores were improved significantly in both groups 4 weeks after injection. On the 4th week after injection, there was no statistically significant difference in PPT between two groups; while the VAS and Mayo score of AWB group were lower than those of PRP group. On the 8th week after injection, the VAS of AWB group was higher than that of PRP group; but the Mayo and PPT scores of AWB group were lower than those of PRP group.</p><p><b>CONCLUSION</b>PRP and AWB injections are both effective to treat chronic lateral epicondylitis. Compared with AWB injection, PRP injection may be more effective in releasing pain and improving function for a longer time.</p>

Balloon kyphoplasty for the treatment of osteoporotic Kummell's disease / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical efficacy of the percutaneous kyphoplasty for the treatment of osteoporotic Kummell's disease.</p><p><b>METHODS</b>From May 2010 to February 2012, 8 patients with osteoporotic Kummell's disease were treated with percutaneous balloon kyphoplasty. There were 2 males and 6 females, with a mean age of 73.4 years. All the patients suffered from lower back pain for 4.7 months, which affected seriously the patient's quality of life. The anterior vertebral height and Cobb angel was measured on standing lateral radiograph at pre- and post-operatively (2 days after operation) and during the final follow-up. Visual analog scale (VAS), Japanese Orthopedic Association (JOA) and Oswestry disability index (ODI) were used to evaluate pain and function.</p><p><b>RESULTS</b>Incision of all patients healed normally without infection. The level of back pain decreased remarkably after surgery. The mean time of ambulation was 4.3 days (ranged, 1 to 10 days). Cement leakage occurred in 1 case with no symptom. The anterior vertebral height and Cobb angel of the fractured vertebra recovered respectively from preoperative (30.4 +/- 7.4)% and (31.3 +/- 9.9) degree to (70.3 +/- 3.3)% and (9.1 +/- 3.0) degree at the 2nd day after operation. VAS and JOA scores, ODI improved from preoperative 8.7 +/- 1.2, 12.3 +/- 1.7 and (93.3 +/- 4.6)% to 3.1 +/- 1.1, 24.9 +/- 1.6 and (32.2 +/- 5.4)% respectively at the 2nd day after operation. All the patients were followed up, and the duration ranged from 3 to 24 months, with a mean of 4.7 months. At the latest follow-up, the anterior vertebral height and Cobb angel of the fractured vertebra were (69.9 +/- 3.2)% and (10.9 +/- 2.4) degree; the VAS and JOA scores and ODI were 2.2 +/- 1.0, 26.4 +/- 1.4 and (29.2 +/- 4.5)% respectively, which had no obvious difference compared to those results at the 2nd day after operation.</p><p><b>CONCLUSION</b>Balloon kyphoplasty is safe and effective treatment for osteoporotic Kummell's disease.</p>

Discerning the femoral neck anteversion (FNA) from the torsion angle on 3D CT / 中国骨伤

<p><b>OBJECTIVE</b>To discern the differences between femoral neck anteversion (FNA) and torsion angle through 3D CT reconstruction.</p><p><b>METHODS</b>From March 2010 to October 2010,30 healthy adult volunteers' femur were reconstructed by 3D CT, included 15 males and 15 females with an average age of (43.66 +/- 7.57) years old ranging from 25 to 65 years. Display the FNA and the torsion angle by image post-processing, measuring torsion angle by "Center way" and direct measurement of FNA.</p><p><b>RESULTS</b>FNA was the angle between the axle wire of femoral neck and the shape face of femoral,the angle were (13.326 +/- 6.085) degrees. Torsion angle was the angle between the macropinacoid of cross section of femoral neck and the shape face of femoral, the angle were(31.335 +/- 2.079) degrees. There was no significant difference in left and right femur.</p><p><b>CONCLUSION</b>FNA is different from torsion angle. FNA is the angle between the line and the surface with the sharp angle towards the lower outside. The torsion angle is the angle between the two surfaces with the sharp angle towards the lower back.</p>

Analysis of treatment of osteoporotic intertrochanteric fracture of femur with the locking compression plate (LCP) / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the therapeutic effect and operating technique on the treatment of osteoporotic intertrochanteric fracture of femur with the locking compression plate (LCP).</p><p><b>METHODS</b>From Feb. 2006 to Oct. 2009, 49 patients with osteoporotic intertrochanteric fracture of femur were treaded with different internal fixation methods, concluded 22 males and 27 females with an average age of (74.68 +/- 5.94) years old ranging from 63 to 90 years. Among them, 29 patients were treaded with LCP, and the other 22 cases with DHS. According to X-ray and Ultrasound bone mineral desity, all cases were diagnosed in osteoporosis. The operative time, blood loss, fluoroscopy exposure frequency, bone healing time and the time of first away from bed.</p><p><b>RESULTS</b>All patients were followed up from 6 to 35 months. The operative time, fluoroscopy exposure frequency, the bone healing time and the time of being away from bed were compared between two groups, there were no statistical differences (t=1.347, 1.603, 1.973, 1.032, P>0.05). As compared with DHS group, the intraoperative blood loss in LCP group was less than that of DHS group, there were statistical differences (t=2.14, P<0.05).</p><p><b>CONCLUSION</b>The LCP is an effective method in the treatment of intertrochanteric fracture of femur. The method has the advantages such as small wound and early recovery, especially appropriate for older patients. But the procedure as well should be demanded strictly.</p>