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Objective To compare the severity and incidence of tibial malrotation after treatment with minimally invasive plate osteosynthesis (MIPO), intramedullary nail technique (INT) and 3D printing auxiliary MIPO (3D-MIPO) for tibial fracture patients. Methods A total of 180 unilateral tibial fracture patients aged 16 to 60 years were enrolled from Shuguang Hospital of Shanghai University of Traditional Chinese Medicine between Jan. 2015 and Aug. 2017. Without consideration of the fracture classification, the patients were divided into MIPO group, INT group and 3D-MIPO group according to the order of the patients entering the study, with 60 cases in each group. The average ages of the patients in the MIPO, INT and 3D-MIPO groups were (39.18±9.10), (39.28±9.23) and (39.07±10.40) years old, respectively. Post-operative CT scanning was carried out at bilateral knee and ankle joint levels, and the differences of rotation angles between the affected side and the healthy side were measured and calculated. The absolute value of the difference that was greater than 10° was defined as malrotation. The severity and incidence of tibial malrotation were compared among the three groups. Results The MIPO, INT and 3D-MIPO groups had no significant differences in the gender, age, or fracture type. All the cases recovered smoothly without infection or loosening of internal fixation, and the wound exudation in individual patients was healed after dressing change. Mean difference value of rotation angle of the MIPO group was (6.85±3.82)°; 9 cases had internal rotation and 51 had external rotation; and 7 (11.67%) cases were diagnosed as tibial malrotation. The mean difference value of the INT group was (6.34±3.44)°, 10 internal and 50 external rotation, 6 (10.00%) tibial malrotation. And the mean difference value of the 3D-MIPO group was (3.96±2.24)°, including 8 internal and 52 external rotation, and 1 (1.67%) tibial malrotation. The mean difference value of rotation angle of the three groups was significantly different (F＝13.80, P0.01). The incidence of tibial malrotation in the 3D-MIPO group was significantly lower than those in the MIPO group and INT group (both P0.05). Conclusion 3D printing technology can help to reduce the incidence of tibial malrotation after treatment with MIPO.
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PURPOSE: To report the clinical results from surgical treatment for clavicle shaft fracture by percutaneous intramedullary fixation with Steinmann pins. MATERIALS AND METHODS: Between January 2004 and June 2014, the medical records of 135 patients who underwent percutaneous intramedullary fixation with Steinmann pins were reviewed. The mean follow-up periods were 15 months. The functional results were evaluated with The Disabilities of the Arm, Shoulder and Hand (DASH) score and Constant score. The clinical results were evaluated with the shortened length of the clavicle, length of surgical wound, operation time and Kang's criteria. RESULTS: The mean bone union period was 11.6 weeks (8–16 weeks). The mean DASH score was 11.8. The mean Constant score was 91.2. The mean shortened length of the clavicle was less than 20 mm. The mean length of surgical wound was 1.2 cm (0.7–1.5 cm). The mean operation time was 18 minutes (10–35 minutes). Using Kang's criteria, 131 out of 135 patients (97.0%) showed good results. Complications included were 3 pin migrations and 2 non-unions. CONCLUSION: Percutaneous intramedullary fixation with Steinmann pins showed good results for treating clavicle shaft fracture.
Subject(s)
Humans , Arm , Clavicle , Follow-Up Studies , Hand , Medical Records , Shoulder , Wounds and InjuriesABSTRACT
PURPOSE: To report the clinical results of surgical treatment of clavicle shaft fracture by percutaneous reduction with towel clips and percutaneous intramedullary pin fixation. MATERIALS AND METHODS: This study reviewed the results of 80 cases of clavicle shaft fracture treated by percutaneous reduction with towel clips and percutaneous intramedullary pin fixation with Steinmann pins from January 2002 to August 2010, after follow-up for 12 months or more. We evaluated the clinical results, such as union time and complications. RESULTS: Bone union was evident in all cases and the mean time for bone union to appear on radiological findings was 10.3 weeks. Using Kang's criteria, 78 of the 80 patients (97.5%) showed good results and there were no severe complications. CONCLUSION: Percutaneous reduction with towel clips and the percutaneous intramedullary pin fixation method showed good results for treating clavicle shaft fracture.
Subject(s)
Humans , Clavicle , Follow-Up StudiesABSTRACT
O papagaio galego (Amazona xanthops Spix,1824) foi encaminhado ao Hospital Veterinário da Universidade Federal de Uberlândia com suspeita de fratura no terço proximal do osso tibiotarso direito, sendo o diagnóstico confirmado por meio de exames radiográficos. Para a estabilização da fratura a técnica utilizada foi a introdução de pino intramedular de Steimann. Após 15 dias o animal apresentou quadro de claudicação e, mediante um novo exame radiográfico, constatou-se a migração do pino para a articulação do joelho. Realizou-se um novo procedimento cirúrgico para remoção do pino, culminando com a restauração das funções normais do membro e total recuperação da ave.
A Galician parrot (Amazona xanthops Spix, 1824), in captivity, was attended at the Veterinary Hospital of the Federal University of Uberlândia, Minas Gerais, Brazil, showing a fracture in the third right proximal tibiotarsus bone, and the diagnosis was confirmed by radiographic examination. The utilized technique for the fracture stabilization was the introduction of a Steimann intramedullary pin. After 15 days, the animal showed lameness and, through a new radiographic examination, it was verified that the pin had migrated to the knee joint. There was then a new surgical procedure to remove the pin, resulting in the restoration of normal functions of the limb and the total recovery of the bird.
El papagayo gallego (Amazona xanthops Spix,1824) ha sido encaminado al Hospital Veterinario de la Universidad Federal de Uberlândia con sospecha de fractura en el tercio proximal del hueso tibio tarso derecho, siendo el diagnóstico confirmado por medio de exámenes radiográficos. Para estabilización de la fractura, la técnica utilizada fue la introducción de un pasador intramedular de Steimann. Después de 15 días el animal presentó cuadro de claudicación y, a través de un nuevo examen radiográfico, se constató la migración del pasador para la articulación de la rodilla. Se realizó un nuevo procedimiento quirúrgico para remoción del pasador, culminando con la restauración de las funciones normales del miembro y total recuperación del ave.
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PURPOSE: To evaluate the results of surgical treatment for diaphyseal fractures of both forearm bones in adolescents. MATERIALS AND METHODS: Between March 2005 and February 2009, fifteen adolescents with diaphyseal fractures in both forearm bones were treated with a compression plate for the ulnar fractures and intramedullary pin fixation for the radial fractures. They were clinically and radiologically evaluated retrospectively. RESULTS: The mean time for radiological bone union was 9.2 weeks. At the last follow up, the rotational deformity and angulation were within seven degrees and evaluations of the functional results were excellent in all cases. One patient had a refracture of the ulna after plate removal, which was treated with a long-arm cast. CONCLUSION: The use of a compression plate for the ulnar fractures and intramedullary pin fixation for the radial fractures can be an effective method for unstable displaced diaphyseal fractures of both forearm bones in adolescents.
Subject(s)
Adolescent , Humans , Congenital Abnormalities , Follow-Up Studies , Forearm , UlnaABSTRACT
PURPOSE: To evaluate the results of surgical treatment for diaphyseal fractures of both forearm bones in adolescents. MATERIALS AND METHODS: Between March 2005 and February 2009, fifteen adolescents with diaphyseal fractures in both forearm bones were treated with a compression plate for the ulnar fractures and intramedullary pin fixation for the radial fractures. They were clinically and radiologically evaluated retrospectively. RESULTS: The mean time for radiological bone union was 9.2 weeks. At the last follow up, the rotational deformity and angulation were within seven degrees and evaluations of the functional results were excellent in all cases. One patient had a refracture of the ulna after plate removal, which was treated with a long-arm cast. CONCLUSION: The use of a compression plate for the ulnar fractures and intramedullary pin fixation for the radial fractures can be an effective method for unstable displaced diaphyseal fractures of both forearm bones in adolescents.
Subject(s)
Adolescent , Humans , Congenital Abnormalities , Follow-Up Studies , Forearm , UlnaABSTRACT
ObjectiveTo investigate the clinical treatment of multi-severe of long bone. MethodsTo observe 145 fractures of 76 patients with multi-severe comminuted fracture of long bone,and apply expandable intramedullary nailing, interlocking intramedullary nail fixation, plate fixation, external fixation, artificial joint replacement on these subjects respectively. ResultsThe followed-up period were from 6 months to 21 months after operation, fracture union occurred in two to twelve months. Among all the 145 fractures, bone healing 122 (86. 2％), nonunion 8(5.5％) ,inalunion in 12 cases(8.3％ ). The average healing time:closed fractures (5.5 ± 1.5) months,and open fractures(6.8 ± 1.2 ) months. Expandable intramedullary nailing group, only 1 case of malunion. Interlocking nail group,only 2 cases of nonunion and malunion, and the incidence of nonunion malunion was significantly lower than that of external fixation group and the plate fixation group(P ＜0.05 ) ;In the external fixation group, the healing rate was significantly lower than plate fixation( P ＜ 0. 05) ,but the impact on the adjacent joints in external fixation group was much larger than the intramedullary nail group and the plate fixation group( P ＜ 0.05 ). ConclusionThere was no uniform standard of how to select the treatment of long bone fracture currently, surgery should be selected according to the specific injuries of different treatment methods. Expandable intramedullary nailing, interlocking intramedullary nailing were new type of internal fixation material which developed in recent years, and there were fewer complications of the application of interlocking intramedullary nail fixation in fracture healing, and it worths further clinical application in the long bone fracture.
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PURPOSE: To evaluate the efficacy of Flexible intramedullary pin fixation in pediatric forearm diaphyseal fractures. MATERIALS AND METHODS: In this retrospective study, we reviewed 15 cases of forearm diaphyseal fractures operated using flexible intra-medullary nail fixation technique between January 2000 and December 2004. Of these 15 children, there were 11 boys and 4 girls with an average age of 11.6 years (range, 7~15 years). The implants were introduced in the distal radius and proximal ulna in all patients. An average duration of fixation was 5.3 months in the radius, 4.7 months in the ulna. After operation, all patient were applied with a long arm cast and the duration of immobilization was 5.2 weeks (range, 4~6 weeks) on average. RESULTS: All fractures in this series healed with normal range of supination (average 80.0) and pronation (average, 71.6 degrees). Average operation time including anesthesia was 123 minutes and hospital stay was 5.4 days. Time to union was 8.4 weeks on average. Range of motion and functional results were satisfactory in all cases. There were one case of incomplete ulnar nerve injury and two cases of refracture which were treated conservatively without any permanent complication. CONCLUSION: Flexible intramedullary pin fixation technique is a good method in case of unstable displaced fracture and difficult or failed closed treatment.