ABSTRACT
Objective To test the utility of a new type of inflatable rehabilitation boot in the treatment of Danis-Weber type-A stable external malleolus fractures. Methods Fifty-four patients with stable external malleolus fractures were randomized into two groups. After closed reduction, the observation group was treated by immobilisation with the inflatable rehabilitation boot and the control group with a plaster slab. All were instructed to avoid weight-bearing on the affected side. The swelling volume of the injured limb was measured by drainage measurement before treatment and at the 1st, 3rd and 7th days after treatment. Pain was evaluated using a visual analogue scale (VAS) score before treatment and after 12, 24 and 72 hours. All of the ankles were x-rayed to recheck for displacement after 2weeks. Results The average volume of the injured limbs in the observation group was significantly less than in the control group at every time point. The average VAS score in the observation group was significantly lower than that in the control group. Fracture displacement in the observation group was also significantly better. Conclusions The inflatable rehabilitation boot has better curative efficacy than the typical plaster slab for patients with stable external malleolus fractures in terms of improving edema in the injured limb, relieving pain and preventing fracture displacement.
ABSTRACT
[Objective]To explore improved operation treatment of fractures of olecranon and internal or external malleolus by fixing them internally with needle wire amend tension band.[Method]A total of 89 cases of olecranon fracture and 63 cases of internal and external malleolus fracture were treated by the amended traditional tension belt using needle wire nails.[Result]Sixty-eight and 55 of these cases(80.9%) had been followed-up respectively for 2.5 years in average,the longest follow-up period was 5 years and the shortest was 6 months.It shows through evaluation with Wolfgang post curative standard that 65 and 53 cases were excellent in curative effect(95.9%),3 and 2 cases had moderate result(4.1%),and there was no worse case.The average fracture cure time was 1.5 months.[Conclusion]The improvement of traditional tension belt in olecranon and internal or external malleolus fracture operation by using needle wire nails has the following advantages:(1)Simplifying operation procedures;(2)Reducing number of steel nails;(3)Keeping the biomechanical principle of the tension band and internal AO fixing advantage;(4)Reducing the phenomena of "tension loss" caused by expanded steel wire holes as a result of osteonecrosis,and avoiding internal loose complication.The disadvantage of this method is that the fixation has to be taken out through operation.
ABSTRACT
Objective To investigate the anatomical character and clinical application value of external malleolus periosteum bone flap pedicled with facia and external malleolus anterior artery. Methods Applied anatomy was studied with 10 adult corpse specimen after artery perfusion,observed the origin.trackway,and measured the external diameter and major vessel's length of external malleolus anterior artery,observed the composition of external malleolus artery net,and completed the performance in clinic in 10 patients and followed up for 6 months～6 years. Resultes The bone flap had abundant blood-supply,its pedicle was long enough for transfer,little injury to donor,the surgical procedure was easy to manipulate,and was used in clinic to treat talus fracture in 9 cases (fresh 5 and old 4) and old tibia fracture in 1 case,10 cases were involved with satisfactory outcome. Conclusion External malleolus periosteum bone flap pedicled with fascia and external malleolus anterior artery is a good new donor for the patients with fracture of talus or lower tibia,especially ununited case or osteonecrosis.