Arthroscopic treatment of tibial intercondylar ridge avulsion fracture with double-root line double tunnel fixation technique / 中国骨伤

<p><b>OBJECTIVE</b>To discuss arthroscopic technique of double-root line double tunnel fixation for tibial intercondylar ridge avulsion fracture and its short-term followvup observational results.</p><p><b>METHODS</b>From May 2012 to June 2017, 21 cases of tibial intercondylar ridge avulsion fractures were treated with arthroscope double line double tunnel. Among the patients, 16 males and 5 females were ranging in age from 17 to 45 years old, with an average of 29.6 years old, and injury to surgery time 3 to 6 days, with an average of 3.6 days. All the patients underwent arthroscopic exploration, fracture reduction, double root line fixation. The knee function was assessed at 3 and 6 months postoperatively using the Lysholm knee score, and the healing and resection of the patients were followed by X-ray examination.</p><p><b>RESULTS</b>All patients were followed up for 7 to 23 months, with an average of 12.8 months. All patients after fracture were bone healing, knee activity were gained their previous normal levels (ranged, 0° to 130 °), and no limb dysfunction. The average scores of Lysholm knee were(93.52±7.10) and(95.95±6.34) points in 3 months and 6 months after operation.</p><p><b>CONCLUSIONS</b>Arthroscopic treatment of tibial intercondylar ridge avulsion fractures with double root line is simple and reliable, and can provide an ideal internal fixation method for tibial intercondylar ridge avulsion fractures.</p>

Therapeutic effects of titanium elastic nails for the treatment of clavicular fractures in elder children / 中国骨伤

<p><b>OBJECTIVE</b>To research the application and clinical effect of titanium elastic nails (TEN) for the treatment of closed clavicular fracture in elder children.</p><p><b>METHODS</b>From October 2010 to December 2012,16 elderly children with clavicular fracture of elder children were treated with internal fixation, including 9 boys and 7 girls with an average age of 14.2 yeats old ranging from 9 to 17 years. The mean time between injury and surgery was 2 to 6 days. Thirteen patients had a transverse fractures; 3 patients had a oblique fractures, excluding the long-oblique patients. Neer function score after 3 months follow-up and the shoulder activity degree after 3 weeks followed were compared respectively between the injured side and healthy side. Fracture reduction and healing were followed up by X-rays to analyze internal fixation with TEN technique.</p><p><b>RESULTS</b>All patients were healed well after surgery. There were 2 cases with soft tissue irritation. No cases of infection, TEN broken, delayed healing or skin bursting were observed. All patients were followed up for 3 to 10 months,with an average of 7.2 months. There were no significant differences (t=2.12, P>0.05) between the healthy side (98.75±2.70) and injured side(96.69±6.22)of Neer score at 3 months during followed up. The shoulder activity at 3 weeks during followed up was different between both sides (P<0.05). The intramedullary nail was removed after X-rays at 12-18 weeks during followed up showed good bone healing,and the shoulder function was recovered well.</p><p><b>CONCLUSION</b>Internal fixation with TEN for the treatment of clavicular fracture has advantages of a limited invasion, beauty, safety and reliability. This technique provides an ideal fixation option for the treatment of clavicular fracture in elder children.</p>

Internal fixation for the treatment of anteromedial facet fracture of the coronoid process of ulna / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the effect of operative treatment for anteromedial facet fracture of the coronoid process of ulna,and to study its surgical exposures and fixation techniques.</p><p><b>METHODS</b>From March 2005 to March 2010,18 patients with anteromedial facet fracture of the coronoid process of ulna were treated with open reduction and internal fixation. There were 12 males and 6 females with an average age of 37.8 years. A single midline posterior incision was used to expose the entire elbow joint. After elevating the full-thickness skin flaps, a lateral incision was made to expose and repair the lateral collateral ligament. Three intervals in the flexor-pronator musculature were used to gain access to the coronoid,depending on the size of the fracture fragment and the planned fixation technique. Fractures were fixed by using mini-plate or with screws. The therapeutic effects were evaluated by Mayo Elbow Performance Score (MEPS) and system of Broberg & Morrey.</p><p><b>RESULTS</b>Seventeen patients were followed up, no patient complained pain and elbow unstable at a mean follow-up period of 38 months(1 to 6 years). The fractures were clinically healed at an average time of 11.6 weeks(ranged from 8 to 16 weeks). The average MEPS was 95.4+/-4.6 (ranged, 82 to 100). The average functional rating of system of Broberg & Morrey was 92.3+/-5.8 (ranged,75 to 100).</p><p><b>CONCLUSION</b>Open reduction and internal fixation is effective to reach anatomical reduction and strong fixation for the treatment of anteromedial facet fracture of the coronoid process of ulna.</p>

Treatment of chronic osteomyelitis with antibiotic-loaded calcium phosphate cement / 中国骨伤

The antibiotic delayed release system which has the characteristics of high local antibiotic concentration,few adverse effects, slow release and long duration, has became one of important methods of treating chronic osteomyelitis. Because of its double action as drug carrier and bone repair material which can induce bone growth and degrade synchronously, drug impregnated calcium phosphate cement (diCPC) is an ideal and safe antibiotic slow release carrier. After clearing focus thoroughly, defect implant with diCPC is an effective method, which has the virtues of convenient operation, good effects and short staying time etc. This paper aims to summarize the biological properties, experimental study and clinical application of diCPC.

Clinical application of the combination of postural reduction and kyphoplasty for traumatic thoracolumbar spine fractures / 中国骨伤

<p><b>OBJECTIVE</b>To determine the efficacy and feasibility of the combination of postural reduction and percutaneous kyphoplasty for traumatic thoracolumbar spine fractures.</p><p><b>METHODS</b>Thirty-seven patients with single level traumatic thoracolumbar spine fractures were included in this study. There are 28 males and 9 females, with an average age of 48 years (range 24 to 79 years). Patients were treated with postural reduction and then percutaneous vertebroplasty with Calcium Phosphate Cement (CPC) were performed on the fractured vertebra. The results were quantitatively evaluated, according to the concept of estimated vertebral height loss and kyphotic angle of the vertebral fractures by preoperative and postoperative plain standing lateral radiographs. Visual analog scale (VAS) and the fracture vertebra shape changes were recorded.</p><p><b>RESULTS</b>Patients were followed up for 9 to 24 months (average 13 months), pain was significantly relieved compared with the preoperative, VAS was reduced averagely from 7.6 +/- 2.5 to 1.8 +/- 1.5, the anterior and middle vertebral height was restored and kyphotic angle was corrected. During the period of follow up, outcomes were satisfactory, without notable correction loss.</p><p><b>CONCLUSION</b>If the indications are correctly handled, the combination of postural reduction and percutaneous kyphoplasty for the treatment of traumatic thoracolumbar spine fractures can provide significant pain relieve and restore the vertebral height and kyphotic angle.</p>