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Objective To evaluate the clinical outcome and discuss the method of treatment both-bone forearm fracture in children (4 to 15 years old) with elastic intramedullary nail (EIN).Methods We retrospectively analyzed the clinical result of forty-five cases to treat both-bone forearm fracture in children (4 to 15 years old) with elastic intramedullary nail from April,2008 to June,2014.Then we Discussed and analyzed the complication,surgery technique,limb function.Patients were followed up for more than 24 to 30 months after the surgery to continuously evaluate the limb function and fracture healing by physical examination and x-ray image.Results There were 38 children with excellent recovery,7 good and no fair by followed up for 24 to 30 months,9 cases with observed complication due by prominent nail ends,3 patients slightly declined after the surgery,1 patient was observed with ulna fracture delayed recovery during 3 to 8 months of fracture healing.Apposition rate in all cases was ＞50％ in anterior-posterior view and the apposition rate ＞90％ in lateral view.No fracture of ESIN,Nerve injuries,severe displacement were observed during this study.Conclusion The elastic intramedullary nail is a good method to treat children both-bone forearm fracture with lower surgery technique,minimall invasion,if less complications,does not interfere with growth,has good forearm function recovery.
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PURPOSE: Bifocal fracture of the proximal ulna is a fracture of the olecranon accompanied by fracture of the coronoid process. The purpose of the current study was to analyze the clinical results of the author's technique in bifocal fracture of the proximal ulna. MATERIALS AND METHODS: Fifteen patients (10 men, 5 women) treated at CHA Bundang Medical Center from April 2006 to October 2014 were analyzed retrospectively. All patients underwent internal fixation using a locking compression plate (LCP) with retrograde screw fixation of the coronoid process through a screw hole of the plate. Mean age of the patients was 42.6 years and the mean follow-up period was 18.6 months. Comminuted coronoid fractures with hard to screw fixation, complex injuries combined with open damage, and complete ligament rupture were excluded. Fracture union and articular congruity were examined on the follow-up radiographs. Range of motion, disability of the arm, shoulder and hand (DASH) score, and Mayo elbow performance score were evaluated for functional analysis. RESULTS: Fracture union was achieved and articular step off was less than 2 mm in all patients on the follow-up radiographs. The mean value of modified Mayo elbow score was 92.14 (80–100) and DASH score was 7.11 at last follow-up. The mean range of motion of elbow was 128o. There was one case of small heterotopic ossification as a radiographic complication which had no functional deficit. CONCLUSION: Internal fixation of bifocal multifragmentary articular fractures of the proximal ulna with anatomically contoured LCP olecranon plate and retrograde long screws could be a recommendable surgical procedure. This study showed that the precontoured plate with retrograde coronoid process screw fixation can produce good clinical and radiographic outcomes in bifocal fractures of the proximal ulna. We recommend this procedure in this type of fracture.
Subject(s)
Humans , Male , Arm , Elbow , Follow-Up Studies , Hand , Ligaments , Olecranon Process , Ossification, Heterotopic , Range of Motion, Articular , Retrospective Studies , Rupture , Shoulder , UlnaABSTRACT
[Objective]To discuss the difference of mechanical stability in using different fixation methods in treating radius and ulna fracture,in order to provide a theoretical basis for clinical applications.[Method]In the experiment,15 pieces of fresh radius and ulna were used to produce middle-part transverse fracture models(A3.2)which were fixed by three different methods(double plate fixation group,double-intramedullary nail fixation group,ulnar intramedullary nailing + radial plate group).Through biomechanical tests,axial stiffness,bending stiffness,torsional stiffness and the equivalent stiffness were compared.[Result]There were no difference between double-plate group and ulnar intramedullary nailing + radial plate group,the stability in these two groups were higher than that in double-intramedullary nail fixation group.[Conclusion]Ulnar intramedullary nailing + radial plate has a good biomechanical property,it can provide firm fixation and with less trauma.So it is a good fixation.
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Objective To develop a new method of treating fractures and nonunion of radial and ulnar diaphyses. Methods We designed a kind of radius-ulna shape memory connector (RSMC) on the basis of the shape memory property of nitinol alloy and the anatomic characteristics of radial and ulnar diaphyses. It is capable of providing 3-D fixation and exerting continually longitudinal compression upon fracture sites. It was used in 31 cases (57 bones) of fresh fractures and 39 cases (53 bones) of nonunion, totaling 70 cases (110 bones). Results The mean follow-up time was 1.5 years(from 7 months to 2 years). In the fresh fracture group, no delayed union or nonunion was observed, and the solid bone healing time averaged 2.3 months. In the nonunion group, all the cases were cured at one time and the solid bone healing time averaged 3.5 months, but two cases were complicated with slight skin infection which had little influence on the internal fixation and bone healing. Conclusion RSMC can provide a new and efficacious method for the treatment of fracture and nonunion of radial and ulnar diaphyses.