ABSTRACT
Objective To compare the curative effects of three fixed methods in the management of distal humeral fractures in adults.Methods From January 2012 to December 2015,120 adults patients with distal humeral fractures admitted to our hospital were enrolled in this prospectively study.According to the principle of random digital table,all patients were randomly signed into single plate fixation group,Y type plate fixation group or double plates fixation group.The primary outcomes included surgical approach,elbow function recovery and postoperative complica-tions.Results Significantly differences were observed among the three groups in fracture union time[(99.48 ± 11.81)d vs.(108.93 ±11.05)d vs.(111.35 ±11.11)d,F =12.274,P =0.000)];there was no difference in fracture union time between the single plate fixation group and Y type plate fixation group (t =0.979,P =0.331). However,patients in double plates fixation group got a significantly shorter fracture union time when compared with the single plate fixation group or Y type plate fixation group (t =3.696,4.632,both P =0.000).Significantly differences were observed among the three groups in Mayo elbow performance score three months after the operation[(88.63 ±7.35)points vs.(79.98 ±6.06)points vs.(79.60 ±6.5)points,F =12.274,P =0.000)].There was no difference in Mayo elbow performance score between the single plate fixation group and Y type plate fixation group (t =0.266, P =0.791).However,the patients in the double plates fixation group got a significantly higher Mayo elbow perform-ance score (t =5.742,5.799,both P =0.000).There was no difference among the three groups in operation duration,intraoperative bleeding volume,failure rate of internal fixation,surgical site infection,ulnar neuritis,myositis ossificans and loosening of the plate (all P >0.05).Conclusion Double plates is more in line with the biomechanical characteristics of the distal humerus,and it is beneficial to the functional recovery of elbow joint.
ABSTRACT
Objective To investigate the treatment effects of different fixation for fracture and dislocation of ankle joint and to sum up the experience for clinical treatment.Methods One hundred and fifty patients with fracture and dislocation of ankle joint using 5 different internal fixation surgeries were involved with this research:simple cross Kirschner wire fixation,intramedullary fixation ordinary screws,cancellous lag screw fixation,4 holes common plate fixation,tension band fixation.Patients were followed up and evaluated by the American Orthopedic Foot and Ankle Society Score for scoring,and investigated the postoperative recovery and the occurrence of postoperative infections and complications in patients.Results After followed up from 12 to 24 months with an average follow-up time of 19 months,of 150 patients,there were 29 cases with excellent result,65 cases with good result,44 cases with general and 12 cases with poor result,the excellent and good rate was 62.6％ (94/150).One case with nonunion,6 cases with malunion,7 cases with traumatic arthritis,10 cases with wound pain,the incidence of postoperative complications was 16.0％ (24/150).There were 10 cases with shallow infection,5 cases with deep infection,and 11 cases with severe skin irritation; The incidence of postoperative infection was 17.3％ (26/150).Conclusion Surgical treatment is the main treatment of fracture and dislocation of ankle joint,5 different methods of internal fixation of ankle fractures had good therapeutic effect.