ABSTRACT
Objective Unstable intertrochanteric hip fractures are characterized by comminution of the posteromedial cortex and a fragment of variable size containing the lesser trochanter. This paper is to discuss whether it is necessary to perform reduction and fixation for this fragment. Methods 67 cases of intertrochanteric fractures were treated by dynamic hip screw (DHS) fixation between March 2001 and September 2002 and followed up for a minimum of 1 year. Their treatment results were retrospectively analyzed. Results No nonunion, coxa vara or failure of internal fixation occurred in all these patients. Conclusion If DHS provides stability, screw fixation of the lesser trochanteric fragment is unnecessary.
ABSTRACT
Objective To evaluate the effects of treatment for the distal radial osteoporotic fractures in elder patients with Volar Locking Compression Plating (LCP)fixation. Methods 30 old patients who suffered from the severe osteoporotic distal radial fractures were treated with LCP. In this group all the fractures were more severe than type 2B according to Melone classification. The results of treatment were evaluated by comparing pre and post operative functions and X rays of involved wrists. Results 26 of the 30 patients experienced no wrist pain and were satisfied with the functions of the suffered wrists in their daily postoperative activities. 2 patients still felt wrist pain and needed to take some pain killers and other 2 experienced mild finger movement limitations. These data were improved postoperatively to the average palmar tilt of 3.38 degrees, radial inclination of 18.9 degrees and the radial length 0.9cm longer between the ulnar head and the tip of the radial styloid. The radial length was found 0.2 mm shorter in 2 cases in the latest follow up than that measured before. No severe complications were found in this group. Conclusion For the unstable distal radial osteoporotic fractures in the elderly patients, Volar Locking Compression plating (LCP)fixation is one of the effective treatments, because this procedure can restore and sustain the distal radial length and smooth articular surface after the fracture reduction.
ABSTRACT
Objective To evaluate the results of less invasive surgical treatment of high energy tibial plateau fracture, which involves limited open reduction, percutaneous screw fixation and Hybrid external fixation. Methods From 1999 to 2002, 12 cases of high energy tibial plateau fracture were treated with Hybrid external fixation. They were 8 males and 4 females. According to Schatzker classification, there were 9 cases of Type Ⅴand 3 cases of Type Ⅵin the group. The average age of the patients was 39.3 years old (ranging from 27 to 48). Results All were followed up for an average of 15 months (ranging from 6 to 27). All the fractures got united, with an average healing time of 3.2 months. All patients achieved 0 to 5 degrees of extension and more than 100 degrees of flexion. The patients had an average knee score of 88.7 and an average functional score of 85.2(Knee Society clinical rating system). 1 case had infection of pin holes, and 2 knees had Grade 2 arthrosis at radiographic check up two years after the operation. Conclusion Hybrid external fixation combined with limited open reduction is appropriate for treatment of the complex tibial fractures, especially those with a poor soft tissue envelope.