Case-control study on shoulder pain caused by hook palte for the treatment of acromioclavicular joint dislocation / 中国骨伤

<p><b>OBJECTIVE</b>To explore causes of shoulder pain and propose prevention measures in treating acromioclavicular joint dislocation.</p><p><b>METHODS</b>From January 2005 to January 2013, 86 patients with acromioclavicular joint dislocation (Tossy III) were treated with hook plate fixation, and were divided into two groups. Bsaed on recovery of shoulder function mostly, the patients who suffered from rest pain, motion pain were named as shoulder pain group, while the patients without pain were named as painless group. In shoulder pain group, there were 21 cases including 15 males and and 6 females ranging the age from 22 to 62 years old with an average of (40.6±11.2) years old. There were 8 cases were on the left side and 13 cases were on the right side. In painless group, there were 65 cases including 36 males and and 29 females ranging the age from 19 to 65 years old with an average of (40.0±11.3) years old. There were 33 cases were on the left side and 32 cases were on the right side. The time from injury to operation ranged from 3 h to 8 d with an average of 34.6 h. Shoulder function of all patients were normal before injuried. Postoperative pain, activity of daily living (ADL), range of motion, deltoid muscle strength were compared. Anteflexion,rear protraction, abduction and upthrow of shoulder joint were also compared. Postoperative complications between two groups were observed and compared.</p><p><b>RESULTS</b>All patients were followed up from 12 to 48 months with an average of 18.5 months. Constant-Murley score were used to evaluate clinical efficacy at the least following up, and 13 cases got an excellent results, 5 moderate, 2 good and 1 poor in shoulder pain group ; while 61 cases were obtained excellent results, 3 moderate and 1 good in painless group. There were significantly differences between two groups in Constant-Murley score and activity of shoulder joint (P<0.05). In shoulder pain group, 3 cases were disconnected, 1 case occurred stress fracture, 9 cases were subacromial impingement syndrome, 5 cases occurred subluxation, 1 case occurred plate breakage and 11 cases were acromioclavicular arthritis.</p><p><b>CONCLUSION</b>Chosing individual clavicular hook plate, fulfilling anatomic reset, paying attention to the repair of articular capsule ligament, and reducing hook and bone antagonism between stress is the key point of preventing and decreasing postoperative shoulder pain.</p>

Factors influencing brachial-ankle pulse wave velocity in people undergoing health examination and model evaluation: Report of 4 159 case / 第二军医大学学报

Objective To analyze the factors influencing brachial-ankle pulse wave velocity (baPWV) and to establish a logit model for predicting baPWV. Methods The data of 4 159 cases who underwent health examination from 2010 to 2014 in our hospital were retrospectively analyzed. The parameters included gender, age, systolic blood pressure, diastolic blood pressure, pulse, fasting glucose, triglyceride, cholesterol, alanine aminotransferase, glutamyl transpeptidase and cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), and uric acid. Logistic regression was used to explore the influencing factors of baPWV, and a regression model was established to predict baPWV and it was evaluated. Results Univariate analysis showed that, except for HDL, all the other parameters above were significantly different between normal baPWV group and abnormal baPWV group (P<0.05). Multivariable analysis yielded the following logit model: logit (p)=-17.888+0.001×uric acid 0.004×alanine aminotransferase 0.105×fasting glucose 0.023×pulse 0.032×diastolic blood pressure 0.061×systolic blood pressure 0.092×age 0.411×sex, which showed a correct predicting rate of 79.6% for baPWV in health examination population, with the ROC area being 0.869 (95%CI:0.859-0.879). Conclusion The baPWV values can be influenced by gender, age, systolic blood pressure, diastolic blood pressure, pulse, fasting blood glucose, alanine aminotransferase and uric acid levels, and logit model may serve as a satisfactory model for these types of study.

Locking internal fixator with minimally invasive plate osteosynthesis for the proximal and distal tibial fractures / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the efficacy of the locking internal fixator (LIF), which includes the locking compression plate (LCP) and the less invasive stable system (LISS), in the proximal and distal tibial fractures.</p><p><b>METHODS</b>We did a retrospective study on a total of 98 patients with either proximal or distal tibial fractures from January 2003 to January 2007, who had received the operation with LIF by the minimally invasive plate osteosynthesis (MIPO) technique. The data consisted of 43 proximal tibial fractures (type AO41C3) and 55 distal tibial fractures (type AO43C3).</p><p><b>RESULTS</b>No complications were observed in all patients after operation. The mean healing time was 8.4 months (range 5-14 months). Only two cases of delayed union occurred at postoperative 10 months. No infections were reported after the definitive surgery even in the cases of open fractures. All patients reached a full range of motion at postoperative 6 to 9 months and regained the normal functions of knee and ankle joints.</p><p><b>CONCLUSION</b>Using LIF in MIPO technique is a reliable approach towards the proximal and distal tibial fractures that are not suitable for intramedullary nailing.</p>

Strategy and analysis of early management on ninety multiple trauma patients / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the therapeutical effects through investigating the results of multiple traumas treated by means of damage control surgery (DCS) or early total care (ETC).</p><p><b>METHODS</b>The clinical data of 90 patients with severe multiple traumas admitted from June 2001 to June 2007 were analyzed retrospectively. Forty-five patients were classified to the DCS group, 45 patients to the ETC group as a control. These severely injured patients were selected with an ISS > 25 points.</p><p><b>RESULTS</b>Between the two groups, the recovery time of clearance of lactic acid, body temperature, prothrombin time (PT) and activated partial thromboplastin time (APTT) of DCS group was significantly shorter than that of ETC group (P < 0.05). Incidence of complications and mortality in DCS group was significant less than that in ETC group (P < 0.05). No significant differences existed in the volume of bleeding and duration of surgery (P > 0.05).</p><p><b>CONCLUSIONS</b>The concept of DCS could reduce multiple traumas patients' mortality rate and incidence of complications. The indication of DCS should be the combination of physical feature, mechanism and severity of injuries.</p>

Combination of volar buttress plate with external fixator for the distal radial fractures of type C3 caused by high-energy injuries / 中国骨伤

<p><b>OBJECTIVE</b>To preliminarily explore the effect of combination of volar buttress plate with external fixator for the distal radial fractures of type C3 caused by high-energy injuries.</p><p><b>METHODS</b>From January 2001 to June 2007, 13 patients with distal radial fracture of type C3, 9 males and 4 females aged from 26 to 47 (average 37 years), were treated with volar buttress plate combined with external fixator plus the techniques of K-wires and bone grafting as necessary, whose effects were evaluated preliminarily through comparing the volar tilt, radial inclination, radial shortening and wrist function.</p><p><b>RESULTS</b>Followed up from 7 to 29 months (average 18 months), the volar tilt, radial inclination, radial shortening and wrist function of all patients recovered remarkably. Nine patients achieved excellent and 4 good according to Sarmiento score (modified by Stewart) in the radiological manifestation, while 5 patients displayed excellent, 6 good, and 2 fair according to Gartland-Werley functional assessment system.</p><p><b>CONCLUSION</b>1) Volar buttress plate could support the valor cortex in order to prevent comminuted fragment from displacing and maintain volar tilt and to provide the volar fulcrum for external fixator. 2) External fixator, with the assistance of volar fulcrum, could maintain the volar tilt and the height of distal radius and help unload the fossa. 3) Supplemental K-wires fixation and the bone graft may assist fracture stable.</p>