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Objective To investigate the clinical efficacy of double-plate fixation combined with bone graft on SchatzkerⅤ/Ⅵ tibial plateau fractures.Methods Totally 35 cases with tibial plateau fractures from April 2013 to October 2015 were selected into an observation group,and treated with dual plate fixation combined with bone graft.Another 35 cases with tibial plateau fractures from March 2011 to March 2013 were enrolled in a control group,and treated with conventional anatomical plate.The data of the two groups were analyzed.Results Pain scores in observation group were lower than those in the control group,and the knee joint function scores in observation group were higher than those in the control group (P＜0.05);the healing degree was 65.7％ in the control group,which is significantly less than that (91.4％) in the observation group (P＜0.05);the complication incidence rate was 8.6％ in the observation group which was obviously lower than that (34.3％) in the control group (P＜0.05).Conclusion Double-plate fixation combined with bone graft in the treatment of tibial plateau fracture shows a high efficacy,and is worthy of clinical application and promotion.
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<p><b>OBJECTIVE</b>To discuss the efficacy of a new double plate self locking interbody fusion device(ROI-C) in the anterior cervical discectomy and fusion(ACDF) to treat traumatic cervical disc herniation(TCDH) without segmental instability, fracture or dislocation.</p><p><b>METHODS</b>ACDF with stand alone ROI-C was performed in 17 selective TCDH patients between December 2011 and December 2013. There were 12 males and 5 females, aged from 24 to 41 years old with a mean of 32.9 years, including 11 patients with single segment, 4 patients with double segments and 2 patients with three segments. Japanese Orthopaedics Assiciation (JOA), visual analogue scale(VAS) score and the Neck Disability Index(NDI) were recorded before and after operation in order to evaluate the clinical outcome, meanwhile, the preoperative and postoperative X ray films were collected to measure the intervertebral space height and whole cervical curvature. According to Vaccraro criteria to observe the bone fusion. The clinical effects were assessed according to Odom criteria.</p><p><b>RESULTS</b>All patients were followed up from 12 to 33 months with an average of 18.5 months. JOA score was increased significantly from preoperative 4.3±3.8 to 13.9±2.5 at final follow up (<0.05). VAS, NDI were decreased from preoperative (6.5±2.2) scores and (38.2±11.7) % to (1.0±0.9) scores and (8.7±3.4) % in final follow up, respectively (<0.05). Intervertebral space height and cervical curvature were increased from preoperative (5.2±1.7) mm and (5.1±7.5) ° to (7.8±0.6) mm and (10.5±5.1) °, respectively(<0.05). Hoarseness occurred in one patient and dysphagia occurred in 2 patients and they recovered spontaneously in 2 weeks and 3 months after operation, respectively. All the segments (25 levels) of the 17 cases achieved bony fusion in 6 months after operation. No displacement, subsidence and failure of ROI-C were found during follow up. According to Odom's criteria to evaluate clinical effects at the last follow up, 13 cases got excellent results, 3 good, and 1 fair.</p><p><b>CONCLUSIONS</b>ACDF with stand alone ROI-C is an effective, minimally invasive and reliable method in treating TCDH without segmental instability, fracture or dislocation, it can obtain satisfactory clinical outcomes and has advantage of less complications, high fusion rate.</p>
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Clavicle medial end fracture is rare, and it has not been studied extensively. Although there is debate regarding its treatment methods, because of the complications of conservative treatment, surgical treatment has been considered more than conservative treatment. This study describes a surgical method using double-plate fixation for treatment of clavicle medial end fractures in which plates were used on each anterior and superior border according to the anatomical structure of the clavicle. In addition, we report operative results of three patients treated by double-plate fixation.
Subject(s)
Humans , ClavicleABSTRACT
Clavicle medial end fracture is rare, and it has not been studied extensively. Although there is debate regarding its treatment methods, because of the complications of conservative treatment, surgical treatment has been considered more than conservative treatment. This study describes a surgical method using double-plate fixation for treatment of clavicle medial end fractures in which plates were used on each anterior and superior border according to the anatomical structure of the clavicle. In addition, we report operative results of three patients treated by double-plate fixation.
Subject(s)
Humans , ClavicleABSTRACT
[Objective] To investigate and analyze the clinical effect of double-plate method on complex tibia plateau fracture. [Methods] A total of 62 pa-tients that had complex tibia plateau fracture from October 2010 to December 2012 in our hospital, were divided into the experimental group and the control group randomly, 31 patients per group. Patients of the experimental group received double steel plate internal fixation with double incision, and patients of the control group received locking plate internal fixation, and the clinical efficacy of two groups were compared. [Results] The excel ent rate of the experimental group was better than that of the control group(87.1% vs 64.5% χ2=4.309 P=0.038), and the difference of complications rate of two groups had no statistical significance(3.2%vs 6.5% χ2=0.350 P=0.554). [Conclusion] The clinical effect of double-plate method for complex tibia plateau fracture is good, and the complications rate is low, worthy of clinical promotion.
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PURPOSE: To analyze the clinical result of a contoured plate fixation using a bicortical screw and a double plate fixation in the surgical treatment of an adult's comminuted olecranon fracture. MATERIALS AND METHODS: A total of 22 patients were classified by Mayo classification as Type IIB (17) and Type IIIB (5). All patients enrolled in the study were treated between July 2002 and September 2009. Twelve patients were operated on using the contoured plate internal fixation using a bicortical screw procedure classified as group 'A'. The 10 patients operated on by a double plate fixation were classified as group 'B'. The Mayo elbow performance score was used to compare postoperative clinical results based on total points in 4 categories: pain, range of motion, articular stability, and articular function. RESULTS: The clinical results of using the Mayo elbow performance score of group 'A' were that 10 scored in the 'excellent' range and 2 scored in the 'good' range the following: in group 'B' were in the excellent range and 3 were in the good range. Both groups showed satisfactory results. Postoperative elbow exercises in group 'A' commenced 7.8 (5-14) days on average, postoperatively. For 'B' group, post-operative elbow exercises began 4.5 (3-7) days following the operation. With regard to the exercise and the range of elbow motion, group 'A' averaged 113.5 degrees and group 'B' averaged 112 degrees. After surgery, the average durations until the bone union were 3.8 (2.4-5.6) months for group 'A' and 4 (2.5-5) months for group 'B', respectively. CONCLUSION: There was no significant difference in the clinical results between patients treated with the contoured plate internal fixation using a bicortical screw or the internal fixation using a double plate in the surgical treatment of adults with comminuted olecranon fracture or dislocation. Therefore, both types of operative approach are acceptable.
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Adult , Humans , Joint Dislocations , Elbow , Exercise , Olecranon Process , Range of Motion, Articular , Retrospective StudiesABSTRACT
PURPOSE: The purpose of this study was to review the outcome of fixation of distal humerus fractures using recently-introduced double parallel plate system in sagittal plane. MATERIALS AND METHODS: From May 2004 to June 2008, seventeen patients with distal humerus fractures underwent primary open reduction and internal fixation with double parallel plates. According to the AO classification, there were 2 A3, 2 C1, 7 C2, and 6 C3 type fractures. Outcome assessment was performed by using the Mayo Elbow Performance index (MEPI). RESULTS: At a mean follow up of 18 (range, 12 to 32) months, 4 patients were rated as excellent, 8 as good, and 5 as fair in terms of MEPI. The average arc of elbow flexion after primary operation was 116 (range, 90~140) degrees with a mean flexion contracture of 13 (range, 0 to 30) degrees. One patient required reoperation due to fixation failure and six patients underwent capsulolysis and three patients underwent ulnar nerve neurolysis. The time to begin elbow motion exercise had negative correlation with total elbow range of motion and multiple trauma patients had significantly lower MEPI functional score compared to those without combined injury. CONCLUSION: Double parallel plating allowed adequate fixation for distal humerus fractures regardless of patient age and fracture pattern. Partial ankylosis and unlar nerve compression symptoms were the main causes of reoperation.
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Humans , Ankylosis , Contracture , Elbow , Follow-Up Studies , Humerus , Multiple Trauma , Range of Motion, Articular , Reoperation , Ulnar NerveABSTRACT
Objective:To evaluate the clinical effect of open reduction and internal fixation for the intercondylar distal humeral fracture with double-plate fixation.Method:A total of 26 cases with intercondylar distal humeral fracture were treated with the double-plate fixation via olecroanon approach.According to the AO/ASIF classification,there were 3 cases with C1,19 cases with C2 and 4 cases with C3.Cassebaum numerical rating system was employed to evaluated postoperative function of the involved elbow.Results:The post-operative function in 26 cases was evaluated according to the Cassebaum numerical rating system,follow-up averaged 15 months,and the results were:excellent in 19 cases(65.4%);good in 9 cases(23.1%);fair in 2 cases(7.7%);poor in 1 case(3.8%).The excellent rate was 88.5%.Conclusion:Double-plate fixation is characterized by stable fixation,minor complication and high satisfaction,and hence is an effective method for intercondylar distal humeral fracture.