ABSTRACT
[Objective]To study the safety,clinical effect and therapeutic characteristics of distraction apparatus for correcting flexion contracture deformities of the knee joint by evaluating the clinical outcomes and investigating the results of biomechanic test.[Method]Forty-nine patients (included 52 knees) were treated by the standardized distraction apparatus and the comprehensive assessment standard was adopted to evaluate the clinical outcomes.Five patients were examined by three-dimensional CT of the knee joints pre-operatively and post-operatively to observe the changes in the knee structure.To observe the effect of distraction on the popliteal artery and the limb nerves,the popliteal artery diameter and blood flow speed were examined in 15 patients and the regio cruris electromyogram and nerve conduction velocity were examined in 6 patients before and after treatment.Three different means of distraction and measurement were underwent in 3 patients so as to observe the changes in the flexion curve and force of posterior soft tissues of the knee.[Result]All patients (52 knees) regained congruous structure and better function,the final excellent and good result rate was 65%.Three-dimensional CT examination of 5 patients showed that the postoperative knee joint structures were superior to the preoperative ones and there weren't damage of articular surface.The statistic results indicated that the popliteal arteries weren't obviously disturbed by distraction,whereas the limb nerves were probably disturbed temporarily.Three methods of distraction and measurement in 3 patients showed different outcomes,indicating that the effect of distraction on soft tissues was influenced by the distraction method,the ages of patients and the extents of deformities of the limb.[Conclusion]The distraction speed of therapeutic method is safe,reasonable and effective in correcting flexion contracture of the knee joint;The distraction force on posterior soft tissues of the knee is influenced by various elements,thus,the distraction speed should be individualized.Low-load and steady stretch are advantageous to soft tissue regeneration and safer.
ABSTRACT
Subject(s)
Adult , Animals , Humans , Rats , Absorptiometry, Photon , Bone Density , Euthanasia , Latency Period, Psychological , Mandible , Mandibular Osteotomy , Molar , Osteogenesis, Distraction , Osteomyelitis , Osteotomy , Radiography , Wound HealingABSTRACT
STUDY DESIGN: A retrospective analysis of the distribution and patterns of posterior column injury in flexion-distraction injuries of the thoracolumbar spine. OBJECTIVES: To recognize the various types of posterior column injury in terms of the path of the distraction force in flexion-dis-traction injuries of the thoracolumbar spine. SUMMARY OF LITERATURE REVIEW: As posterior column injuries are associated with instability of the spine, many authors have described and classified posterior column injuries. However, there are no descriptions or classifications in terms of the path of the distraction force in the literature. MATERIALS AND METHOD: The preoperative plain X-rays, axial CT, MRI (in 5 patients) and operation records of 34 patients were reviewed in relation to the patterns of posterior column injury. RESULTS: Posterior column injuries can be classified into two main types. In Type I(30/34), the distraction failure started from the spinous process one level above the fractured body (Type IA) or the posterior ligament complex between the spinous processes of the fractured and the level above (Type IB). In Type II(4/34), the distraction failure started from the spinous process of the fractured vertebra and from the interspinous ligament between the fractured level and the level below. CONCLUSIONS: Posterior column injuries can be described according to their starting point and the extent of the distraction force. Of these, Type IB was the most common. Using this classification, the injury of the posterior column in injuries of the thora-columbar spine fracture can be predicted.