Retrospective study on the modified Uhl technique of closed reduction and percutaneous pin in the treatment of Colles' fracture / 中国骨伤

OBJECTIVE@#To retrospectively assess the advantages of the modified Uhl technique in the treatment of Colles' fracture guided by the principles of Chinese osteosynthesis (CO) concept.@*METHODS@#A retrospective study was conducted on 358 patients with Colles' fracture treated with the modified Uhl technique of closed reduction and percutaneous pin between January 2016 and June 2021. Out of these, 120 eligible cases were selected and categorized into two groups according to different surgical methods:the closed reduction and percutaneous pin group, and the open reduction group. Sixty-eight patients in the closed reduction and percutaneous pin group were treated with the modified Uhl technique, while fifty-two patients in the open reduction group were treated with open reduction and internal fixation using plates. The modified Sarmiento imaging score, Gartland-Werley wrist score, operation time, hospital stay, and treatment costs between the two groups were compared at a 6-month postoperative follow-up.@*RESULTS@#There were no significant differences in terms of gender, age, affected side, injure factors, time of injury to surgery, Sarmiento imaging score, and Gartland-Werley wrist joint score (P>0.05). The closed reduction and percutaneous pin group exhibited an operation time of (35.88±14.11) minutes, hospitalization stay of (9.78±2.48) days, and treatment costs of (16 074.91±1 964.48) yuan, while the open reduction group demonstrated comparatively longer operation time of (65.48±14.26) minutes, hospitalization stay of (15.88±2.00) days, and treatment costs of (20 451.27±1 760.22) yuan (P<0.01).@*CONCLUSION@#The modified Uhl technique presents notable advantages in the management of Colles' fracture, including reliable fixation, less trauma, shorter operation time, less pain, shorter hospital stay, and cost-effectiveness. This technique exhibits promising potential for broader clinical application. However, it is important to note that the pin could potentially damage tendons, and in cases of Colles' fractures with osteoporosis and comminuted fragments, additional techniques may be required for reliable fixation.

Malignant Pleural Effusion: A Continued Relevance of Closed Needle Pleural Biopsy

Introduction: Thoracocentesis and pleural biopsy are recommended for the evaluation of undiagnosed exudative pleural effusion. There are multiple etiologies associated with them, out of which malignancy is one of them. Hence, the diagnosis of malignant pleural effusion (MPE) has been proposed in recent perspectives. We aimed to find the profile of MPE, efficacy of percutaneous closed needle pleural biopsy (PCNPB) in diagnosing MPE, overall yield, and complication rate to evaluate the continued relevance of this traditional procedure. Methods: This was a prospective study carried out on consecutive consenting patients at the Department of Pulmonary Medicine at a tertiary care hospital from July 2016 to May 2018. The diagnosis was based on cytobiochemical, microbiological, and histopathological results along with clinical history. Data were analyzed with respect to pleural fluid assessment in terms of cytobiochemical and microbiological evaluation; while pleural biopsy was studied histopathologically. Results: Two hundred and fifty patients with exudative pleural effusion were enrolled. Tuberculosis (218, 87.2%) was the most common etiology followed by malignancy (22, 8.8%). The most common presenting complaint was chest pain (100%) followed by dyspnea (90.47%). Metastatic adenocarcinoma was found in 81.81% followed by mesothelioma in 18.18%. The sensitivity of pleural biopsy for malignancy was found to be 63.63% (p < 0.003, odds ratio [OR]: 2.01), and those fulfilling Leung's criteria, sensitivity was found to be 90.90% (p < 0.001, OR: 3.67). The sensitivity of pleural fluid for malignancy was 18.18% (p < 0.05, OR: 1.51). All cases of mesothelioma have asbestos exposure. The complication in the form of mild post-pleural biopsy pain was encountered in 10%, which required mild analgesics. Other complications in the form of self-resolving pneumothorax were seen in 6%, which increased hospital stay to 2�days and self-resolving hematoma (3%). Conclusion: In this modern era, PCNPB still holds high sensitivity, efficacy rate, and relevance for diagnosing MPE with less complication rate, less hospital stay, and can be done on a daycare basis. Also, we have very less research and paperwork regarding this topic.

The application of closed needle- free style injection connector in endoscopic nasobiliary drainage / 中国实用护理杂志

Objective To observe the nursing effect of closed needle-free style injection connector in endoscopic nasobiliary drainage (ERCP). Methods From June 2013 to June 2014, 400 patients of the common bile duct stones underwent ERCP technique and placed nasobiliary were divided into two groups according to chronological. Between June 1st, 2013 and December 20th, 200 patients were set as control group, between December 21th, 2013 and June 30, 2014, 200 patients were set as experimental group. For the control group, the nasobiliary duct was directedly connected to the disposable drainage bag. For the experimental group, the nasobiliary duct was connected to closed needle-free style injection connector, and then to the drainage bag. The incidences of the detached connection, the fracture of the connection with the nasobiliary duct, bile leakage from the connection, and post-ERCP infection were compared between two groups. Results The incidence of bile leakage, crack pipes, separation and postoperative infection occurred at the junction nasobiliary rates in the experimental group were 0,0,0,2%(4/200), which were far lower than 35% (70/200),11% (22/200), 6% (12/200), 6%(12/200) of the control group. The difference was statistically significant (χ2=31.75~169.60, P < 0.01). Conclusions The application of closed needle-free style injection connector can effectively avoid the detachment and fracture of the connection, the occurrence of bile leakage, and post-ERCP infection. This will be helpful to decrease the burden of nursing care and increase patients′satisficationdegree.