ABSTRACT
BACKGROUND: The traditional surgical treatment of proximal tibial fractures has extensive dissection of the fracture site, and affects local blood circulation, increases the incidence of delayed union and nonunion. In recent years, the rising minimally invasive internal fixation system can protect the local soft tissue and blood circulation to the maximum extent, and provide better conditions for fracture healing. The application of new spreader also solves the problems of stability and durability of traditional manual traction reduction, and the combination of the two is gradually concerned. OBJECTIVE: To explore the effect of a new minimally invasive spreader assisted reduction and less invasive stabilization system for the treatment of proximal tibial fractures. METHODS: Twenty-two patients with proximal tibial fractures treated from May 2016 to October 2019 were studied and randomly assigned to control group and observation group (n=11 per group). Patients in the control group were treated with conventional manipulative reduction and conventional incision plate internal fixation. Patients in the observation group were treated with a new minimally invasive spreader assisted reduction and less invasive stabilization system. This study was approved by the Ethics Committee of Fifth Hospital, Guangzhou Medical University. RESULTS AND CONCLUSION: Compared with the control group, Rasmussen knee function score was better in the observation group at the last follow-up. Intraoperative blood loss, operation time, length of hospital stay, and weight-bearing time in the observation group were better than those in the control group. Postoperative complications such as joint limitation and delayed fracture healing were less in the observation group than in the control group. However, the healing time was not statistically significant between the two groups. Moreover, infection of the incision and loosening and fracture of the internal fixator were not statistically significant between the two groups. These indicated that the application of a new minimally invasive spreader combined with less invasive stabilization system for proximal tibial fractures can reduce surgical reduction time and local soft tissue damage, which is beneficial to early functional exercise and can reduce postoperative complications.
ABSTRACT
ObjectiveTo observe andanalyze the clinical efficacy of needle knife treatment for knee meniscus injury from improving knee biomechanical balance and to provide a therapeutic basis and method for clinical practice.MethodOne hundred patients (112 knees) with knee meniscus injury meeting the inclusion criteria were allocated, in order of visits, to observation and control groups, 50 cases each. They were treated with a needle knife and an injection of sodium hyaluronate injectio into knee joint cavity, respectively. Changes in the indices were observed and assessed in the two groups by recording the plantar pressure analysis score and the knee function score before and after treatment and at follow-up. The clinical therapeutic effects were evaluated in the two groups.ResultThemaximum load, time integral difference value and load ratio around the knee joint decreased significantly in both observation and control groups after treatment and at follow-up (P<0.05). The regulating effect on knee joint force balance was better in theneedle knife group than in the control group (P<0.05). The improving effect on knee joint function was significantly better in the observation group than in the control group (P<0.01). The excellence rate was significantly higher in the observation groupthan in the control group after treatment and at follow-up (P<0.05).ConclusionNeedle knife treatment restores the function of the knee joint by loosing focal soft tissues around the knee joint, improving knee joint load imbalance and correcting the mechanical equilibrium around the knee joint in patient with knee meniscus injury. It has a definite curative effect on the disease.
ABSTRACT
BACKGROUND:Knee society score of Peking Union Medical Col ege has been promoted and used in the 306th Hospital of PLA for 2 years and we have accumulated some clinical data. OBJECTIVE:To analyze the stability and feasibility for suitable clinical medical practice of knee society score of Peking Union Medical Col ege. METHODS:Fifty-five patients with osteoarthritis of the knee were included, and the patients were divided into three groups:the preoperative group;3 months postoperative fol ow-up group;6 months postoperative fol ow-up group. The measurement results obtained by the application of the scale were compared to those of the Western Ontario and McMaster Universityies Ostroarthritis Index, visual analog scale, and hospital for special surgery score, and then knee society score goodness-of-fit analysis was performed based on the structural equation model. RESULTS AND CONCLUSION:Knee society score performance assessment of the signs and symptoms of osteoarthritis of the knee patients was positively correlated with the pain severity of visual analog scale score;the overal knee society score of the patients after 6-month fol ow-up was significantly improved compared with that before treatment. The knee society score after 3-and 6-month fol ow-up was significantly higher than that before treatment, and the score was quite with the hospital for special surgery score. The overal assessment of the knee society score after treated for 3 and 6 months was improved for more than grade Ⅰ, the visual analog scale score was decreased for more than 30%. The pain assessment items and physiological functional assessment items of Western Ontario and McMaster Universityies Ostroarthritis Index after 6-month fol ow-up were significantly better than those before treatment (Pgoodness-of-fit analysis showed that the scale had good goodness which had scientific nature and application value.