ABSTRACT
Objective To compare the clinical effect between proximal femoral anatomic locking plate (ALP) and proximal femoral nail anti-rotation (PFNA) in the treatment of elderly patients with intertrochanteric fracture.Methods A total of 89 elderly patients with intertrochanteric fracture were selected from January 2014 to May 2017 in the Third Affiliated Hospital of Xinxiang Medical University.The patients were divided into ALP group (n =43) and PFNA group (n =46) according to the internal fixation,the patients in ALP group were treated with ALP,and the patients in PFNA group were treated with PFNA.The effect was compared between the two groups.Results The incision length,operation time and hospitalization time in the PFNA group were significantly shorter than those in the ALP group(P ＜ 0.05),and the intraoperative blood loss and postoperative drainage volume in PFNA group were significantly less than those in ALP group (P ＜ 0.05).The fineness rate in PFNA group and ALP group was 86.96％ (40/46) and 67.44％ (29/43) respectively,and the fineness rate in PFNA group was significantly higher than that in ALP group (x2 =4.858,P ＜0.05).The incidence of complications in PFNA group and ALP group was 6.52％ (3/46) and 20.93％ (9/43) respectively,and the incidence of complications in PFNA group was significantly lower than that in ALP group (x2 =3.955,P ＜ 0.05).Conclusion The effect of PFNA and ALP in the treatment of elderly patients with intertrochanteric fractures was affirmatory.Compared with ALP,PFNA internal fixation has the advantages of less surgical trauma,short operation time,less intraoperative bleeding,quick postoperative recovery and fewer complications.
ABSTRACT
Objective To observe the clinical effect of minimally invasive with AO joint anatomic locking plate under arthroscope and traditional internal fixation on treatment of severe comminuted fracture of tibial plateau.Methods Thirty-six cases of patients with severe comminuted fracture of tibial plateau were treated in Zhongshan Hospital Affiliated to Dalian University from June 2013 to June 2015 were selected.All patients received minimally invasive treatment with AO joint anatomic locking plate under arthroscope.At the same time,35 cases of patients under traditional fixation were selected as the control group.General surgery information including operation time,intraoperative blood loss,length of incision,limb shortening,knee flexion degree and knee HSS score of patients in both two groups were observed.Results The operation time,intraoperative blood loss,length of incision of the research group were (95.1 ± 20.4) min,(385.4 ± 40.7) ml and (1.9±0.7) cm respectively,(77.6±14.3) min,(456.7±45.1) ml and (4.0±1.2) cm for the control group,the differences were significant (t =4.175,6.997,9.038;P ＜ 0.05).The limb shortening,knee flexion degree of the research group were (0.9±0.7) mm and (112.1 ± 14.8) ° respectively,(2.5± 1.8) mm and (90.1± 10.6) ° for the control group,the differences were significant (t =4.962,7.183;P＜ 0.05).After treatment,the knee joint HSS score of the research groups was (84.9±9.7),(69.1±7.3) for the control group,the difference was significant(t =7.738,P＜0.05).Conclusion The clinical effect of minimally invasive treatment of severe comminuted fracture of tibial plateau with AO joint anatomic locking plate under arthroscope is significant,with smaller invasion,better postoperative recovery than traditional fixation,and can promote the recovery of neural function.
ABSTRACT
Objective To study the clinical efficacy and safety of Bryan-Morrey approach combined with anatomic locking plate fixation for the treatment of type C fractures of distal humerus.Methods Performed a prospective study from from Mar.2011 to Aug.2014.Thirty-three cases of distal humerus fracture were included in our study,and the mean age was (37.3 ±4.1) years old.The fracture type of distal humerus was 13-C according to Mayo classification.All the fractures treated with a Bryan-Morrey approach and anatomic locking plates.In the follow-up,Mayo scores of elbow,measurement of range of motion,elbow flexion and extension muscle strength were recorded and analysed.Results In this study,there were no serious complications,such as nonunion,rupture of triceps tendon and the infection,except partial sensory function injury of ulnar nerve in 5 cases.At the last time of the follow-up,elbow flexion muscle strength and extension muscle strength did not significantly decreased significantly compared with strength of the normal side.The mean flexion of the injured side was (134.5 ± 10.1) degrees,and the mean extension was (-1 1.5 ± 8.1) degrees.According to Mayo elbow performance score,the average scores of elbow was (86.2 ± 7.8),84％ of the patients got excellent or very excellent function results.Conclusion The Bryan-Morrey approach combined with anatomic locking plate fixation is a good choice for the treatment of distal humerus fractures of AO C type.