Assessment of result of interlocking intramedullary SIGN nailing in treatment of femoral shaft fracture in adult patients at Viet Duc hospital from 2004 to 2005

Background: Femoral shaft fracture, in company with the development of morden society and the increase in means of transport, is increasing in the number of case and the complicated degree of injury. Objectives: 1. To note indication for interlocking intramedullary SIGN nailing in femoral shaft fracture in adult patients. 2. To assess result of interlocking intramedullary SIGN nailing in treatment of femoral shaft fracture in adult patients. Subjects and method: A prospective, descriptive study was conducted in the 40 patients between the ages of 17 and 80 who were dignosed femoral shaft fracture caused by injury and operated for bone union by interlocking intramedullary SIGN nailing at Viet Duc hospital, from April/2004 to July/2005. Results: In this study: 5 patients with I degree fracture (12.5%), 20 with II degree (25%) and most of patients with III and IV degree fracture (62.5%), of which 14 patients with IV degree (35%). Because the SIGN nailing\u2019s structure was solid, so it had a good capacity for patient\u2019s weight. 4 weeks after operation, 85% patients were able to move around without crutches. There was no complications. Conclusion: SIGN nailing enables surgeons to drive interlocking intramedullary nailing for long bone without image intensifier. It also enables both surgeons and patients to appoarch modern, high effective methods without needing expensive machines.

Results of emergency operation for thoracolumbar vertebral column fixation by combined two incisions (front and behind) at Viet Duc Hospital from January 2005 to July 2006

Background: Vertebral column injuries are severe and common injuries in sugical emergencies. In vertebral column injuries, thoracolumbar location damages commonly because of its anatomic features. Objective: To describe clinical, subclinical features, and results of treatment in patients with vertebral column injuries who operated by combined two incisions; To discuss operative indications for thoracolumbar Burst fracture injuries. Subjects and method: The prospective study was performed in patients with thoracolumbar vertebral column injuries who operated at Viet Duc, from January to December 2005. All patients were evaluated about clinical, subclinical features, operative indications and techniques, and results. Results: The time from the accident to the operation was 24-72 hours (54.8%), over 6 days (25.8%), 3-6 days (12.9%), and 6-24 hours (6.5%). 13 of 31 cases damaged in L2, and 12 cases damaged in L1. The average time of operation was 5 hours 43 minutes (ranged 4 hours to 8 hours 30 minutes). The average transfused blood amount was one unit (ranged from 0 to 4 units). For complete paralysis, most patients recovered fully. For thoracolumbar Burst fracture injuries with incomplete paralysis, it should operate by front incision. In Burst fracture injuries with clear-off vertebra, no paralysis; it also should operate by front incision. Conclusions: The operation with combined two incisions (front and behind) was safe and effective technique for thoracolumbar vertebral column fixation.

Preliminary remark on results of emergency surgery fixing thoracolumbar spine combined 2 ways (anterior and posterior ways) in Viet Duc Hospital from January, 2005 to July, 2006

Background: Spinal injury is a severe, common injury in surgical emergency. In Vietnam, there are only few studies on fixing thoracolumbar spine. Objectives: To assess and to provide some preliminary remarks on the results of emergency surgery fixing thoracolumbar spine, performed in Viet Duc Hospital. Subjects and method: A descriptive, prospective study was conducted on 31 patients with thoracolumbar spinal injury (22 males, 9 females, the average age 35 years old), operated in Viet Duc hospital from January, 2005 to July, 2006. Results:Patients with thoracolumbar spinal injury was common seen in working ages. 45.2% of them were farmers. 21/31 patients caused by falls. For non-complete paralysis patients, emergency surgery was required as soon as possible. The most of patients recovered completely. For thoracolumbar spinal injury, Burst-fracture and non complete paralysis, surgery with anterior way should be performed to release cord compression and bone graft. For cases of Burst-fracture, no paralysis, surgery with anterior way helped bone fractures were easy to heal, avoiding postoperative humpback recurrence. Conclusion: Combined surgery with 2 ways (before and after) guaranteed fixing spine, making bone healing was more better in case of rupture of vertebrae, releasing directly spinal cord and facilitating to the best recovery of the spinal cord.

Situation of extremity injury caused by traffic accident in Viet Duc hospital from 2000 to 2004

Background: Situation of extremity injury caused by traffic accidents and occupational accidents are increasing in Vietnam. Therefore, the prevention and fight against these accidents are one of the key objectives to reduce the burden on the families of victims as well as for society. Objectives: To outline situation of extremity injury patients caused by traffic accident, treated in Viet Duc hospital from 2000-2004. Subjects and method: A retrospective study was conducted on 19.845 patients (14.562 males, 5.283 females, aged from 1-97 years old). The subjects were divided into 3 main groups: alone upper extremity injury, alone lower extremity injury and multiple fractures. Results: Extremity injury was common seen in people of working age (78.1%), men more than women (2.76/1 ratio), left foot more than right foot and it was common been in multiple fracture situation due to complex mechanisms of injury (50.3%), alone extremity injury (49.7%). The lower extremity injury was more common seen than upper extremity injury. Open fracture injury (27.3%), in which open fractures in lower extremity were more common seen. Open fractures in both 2 leg bones was the most common seen, accounted for 57.4% among total of open fractures. Amputation accounted for 8.3% among all case of open fractures and 2.3% among all case of extremity injuries. Conclusion: Extremity injury (lower extremity and upper extremity) caused by traffic accidents is common seen. The average, there are 3 emergency surgeries due to open fracture injury were performed daily in Viet Duc hospital per a total of about 11 traumatic emergency surgeries.