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Objective To evaluate the curative effect of conjoined tendon transfer for coracoclavicular ligament reconstruction in the treatment of Rockwood grades Ⅲ-Ⅳ acromioclavicular joint dislocation,c Methods A retrospective case control study was performed for 64 cases of acromioclavicular joint dislocation admitted from October 2007 to August 2014.There were 53 males and 11 females,with age of (43.8 ± 10.5) years (range,23 to 65 years).Rockwood grade Ⅲ was seen in 27 cases and grade-Ⅳ in 37.According to the treatments,26 cases underwent proximally based conjoined tendon transfer for coracoclavicular ligament reconstruction combined with clavicular hook plate (ligament reconstruction group) and 38 cases only treated with clavicular hook plate (internal fixation group).Visual analogue scale (VAS),Constant shoulder score and postoperative complications were compared between the two groups before and after operation.Results All patients were available for a mean follow-up of 3.7 months (range,2 to 4 months).VAS was (7.58 ± 1.03) points in ligament reconstruction group and (7.15 ± 1.03)points in internal fixation group before surgery (P ＞0.05),and was (2.38±0.94)points in ligament reconstruction group and (2.08 ± 0.99) points in internal fixation group 3 months after operation (P ＞ 0.05).Constant shoulder score was (86.46 ± 6.59) points in ligament reconstruction group and (87.68 ± 6.59) points in internal fixation group after operation (P ＞ 0.05).Six cases (16％) had recurrent joint dislocation in internal fixation group,while none of the patients in ligament reconstruction group had recurrence (P ＜ 0.05).Conclusion Improved procedure of proximally based conjoined tendon transfer for coracoclavicular ligament reconstruction can effectively reduce the recurrence rate of acromioclavicular joint dislocation.
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<p><b>OBJECTIVE</b>To evaluate the application of inferior vena cava filter (IVCF) in prevention of peri-operative pulmonary embolism (PE) in lower limb bone fracture patients with deep venous thrombosis (DVT).</p><p><b>METHODS</b>From January 2003 to December 2012, 2 248 cases of lower limb and pelvic fractures with DVT were retrospectively analyzed. Before the procedure of IVCF implantation began, January 2003 to December 2007, there were 1 052 cases of acute trauma patients with DVT were classified as the group of early none-IVCF. The IVCF implantation was began since January 2008. From that time to December 2012, 712 cases of bone fractures with DVT received filter implantation, which were classified as IVCF group. The other 484 patients who had not undergone filter deployment were divided as group of late none-IVCF. The baseline conditions of the three groups were significantly different in addition to the ages between group of early none-IVCF and IVCF group. The incidences of PE and mortality of PE in each group were recorded and analyzed by χ(2) test.</p><p><b>RESULTS</b>There were totally 31 cases of symptomatic PE, among which 12 cases died. Totally 712 filters were deployed successfully without any major complications. The incidences of symptomatic PE were 0.14% (1/712), 2.19% (23/1 052) and 1.45% (7/484) in IVCF group, group of early none-IVCF and group of late none-IVCF, respectively. The mortality of PE were 0 (0/712), 0.86% (9/1 052) and 0.62% (3/484) in these groups. The incidence of symptomatic PE in IVCF group was significantly different from that in the group of early and late none-IVCF (χ(2) = 11.762, P = 0.001; χ(2) = 7.395, P = 0.007, respectively). The mortality of IVCF group was also significantly lower compared with the other two groups (χ(2) = 6.122, P = 0.013; χ(2) = 4.424, P = 0.035, respectively).</p><p><b>CONCLUSION</b>IVCF implantation effectively prevents symptomatic and fatal PE of patients of lower limb and pelvic fractures with DVT in the peri-operative period.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Leg Injuries , Lower Extremity , Pulmonary Embolism , Retrospective Studies , Vena Cava Filters , Venous ThrombosisABSTRACT
AIM:The limitation of materials' strength results in the external fixation of patients with patellar fracture following absorbable screw fixation.This study was aimed to guide the patients do progressive rehabilitation and observe the recovery of knee joint function.METHODS:Totally 35 patients with patellar fractures were enrolled from the Sixth People's Hospital in Shanghai Jiao Tong University between June 2004 and June 2006,including 27 cases of transverse fractures and 8 cases of comminuted fractures.They were all treated with BIOFIX self-reinforced poly-lactide absorbable screws,which were produced by Finland BIONX Company.Postoperatively isometric contraction training of quadriceps femoris was followed,and then progressive knee joint range of motion was carried out.The curative effect was evaluated by the recovery of knee joint function and radiograph.Normal knee joint function was taken as excellent effect,while nearly normal knee joint function and slightly poor squatting were taken as good effect.RESULTS:All the patients completed the treatment and rehabilitation,followed up for no less than 12 months,with a mean of 22 months.The average healing time was 6 weeks,excellent result cases were seen in 29 patients and good in 6.There was two cases occurred postoperative complications(wound swelling).CONCLUSION:Self-reinforced poly-lactide absorbable screws for treatment of patellar fractures and appropriate postoperative rehabilitation is believed to prevent the second operations.
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[Objective]To evaluate the therapeutic effects of minimally invasive replacement in complicated femoral intertrochanteric fractures.[Method]A retrospective analysis was done for 49 patients with femoral intertrochanteric fractures in the author's department from March 2005 to August 2008.According to different ways of replacement,the patients were divided into Group A(n=21),open repositioning and Group B(n=28),minimally invasive replacement respectively.And PFN or Gamma nail was fixed after that.Operation time,bleeding volume,length of stay,time of weight loading and average time of fracture union,incidence rate of complications and hip function were recorded.[Result]There great significant differences in operation time,bleeding volume and average time of fracture union between Group B and Group A respectively(P0.05).Hip score(Harris) in Group B was significantly higher than that in group A(P