ABSTRACT
Objective To study the clinical efficacy and safety of double incision double plate internal fixation in the treatment of complex fractures of tibial plateau .Methods According to the different treatment methods , 83 patients with tibial plateau complex fractures were divided into double plate group ( 51 cases ) and locking plate group ( 32 cases ) .The surgical indicators , treatment efficacy and complications were compared between the two groups .Results The time of implantation ,hospital stay and fracture healing time in the observation group were signif-icantly shorter than those in the control group [(9.36 ±2.14) d vs.(13.24 ±2.99) d;(11.71 ±1.32) d vs. (13.41 ±2.23)d;(13.27 ±1.83)weeks vs.(15.82 ±2.18)weeks],the differences were statistically significant (t=6.813,4.368,5.736,all P<0.05).The excellent rates of HSS score in the observation group and the control group were 94.12％and 93.75％,respectively,and there was no statistically significant difference (χ2 =0.746,P>0.05).The incidence rate of complications in the observation group was significantly lower than that in the control group(5.88％vs.21.88％) (χ2 =4.746,P<0.05).Conclusion Double-incision plate internal fixation surgery for tibial plateau complex fractures is effective ,has fast postoperative recovery ,high safety,and it is worthy of clinical application in a wide range of popularization .
ABSTRACT
Objective To explore the short-term efficacy of green channel surgery for hip fractures in the elderly patients.Methods A retrospective study was conducted of the 128 elderly patients with hip fracture who had been operatively treated at Department of Orthopaedics,The First People's Hospital of Beijing Fangshan from January 2015 to September 2017.They were 44 men and 84 women,aged from 65 to 91 years (average,75.5 years).The interval from injury to surgery ranged from 24 to 48 hours for the green channel group of 63 cases but exceeded 48 hours for the non-green channel group of 65 cases.The 2 groups were compared in terms of complications during hospitalization,mortality 3 months after operation and good to excellent rate of hip function.Results The 2 groups were compatible due to insignificant differences in age,gender,internal disease upon admission or fracture type (P ＞ 0.05).All the patients were followed up for 0.5 to 3.0 months (average,2.7 months).The total incidence of complications during hospitalization,and incidences of hypostatic pneumonia,acute cardiac and cerebrovascular accidents and venous thromboembolism were all significantly lower in the green channel group than in the non-green channel group (P ＜0.05).There were no significant differences between the 2 groups in terms of in delirium,sudden death,pressure sore,postoperative urinary infection,or mortality 3 months after operation (P ＞ 0.05).No wound infection or pulmonary embolism was observed in either group.According to the scoring system for hip functions modified by Li Zirong,the good to excellent rate was 76.6％ in the green channel group (36/47) and 68.6％ (35/51) in the non-green channel group,showing no significant difference between the 2 groups (P ＞0.05).Conclusions Establishment of green channel surgery and multidisciplinary collaboration can significantly reduce incidence of postoperative complications.Its effect on the mid-and long-term mortality in these patients needs further observation.