ABSTRACT
OBJETIVO: Medir o volume ocupado pelos dispositivos de fixação interna mais difundidos para o tratamento das fraturas de colo femoral, usando como aproximação os primeiros 30, 40 e 50mm de cada parafuso. O estudo visa observar qual desses implantes causa menor agressão óssea. MÉTODOS: Foram avaliados cinco modelos de parafusos canulados e quatro modelos de parafusos deslizantes (DHS) encontrados no mercado nacional através de diferença de volume por deslocamento de água. RESULTADOS: A fixação com dois parafusos canulados apresentou volume significativamente menor do que com DHS nas inserções de 30, 40 e 50mm (p=0,01, 0,012 e 0,013, respectivamente), a fixação com três parafusos não apresentou significância estatística (p=0,123, 0,08 e 0,381, respectivamente) e a fixação com quatro parafusos canulados apresenta volumes maiores que o DHS (p=0,072, 0,161 e 0,033). CONCLUSÕES: A fixação da cabeça femoral com dois parafusos canulados ocupa menor volume quando comparada ao DHS com diferença estatisticamente significativa. A maioria das outras combinações de parafusos não atingiram significância estatística, apesar de a fixação com quatro parafusos canulados apresentar, em média, volumes maiores que o ocupado pelo DHS.
OBJECTIVE: The objective of this paper is to measure the volume occupied by the most widely used internal fixation devices for treating femoral neck fractures, using the first 30, 40 and 50 mm of insertion of each screw as an approximation. The study aimed to observe which of these implants caused least bone aggression. METHODS: Five types of cannulated screws and four types of dy namic hip screws (DHS) available on the Brazilian market were evaluated in terms of volume differences through water displace ment. RESULTS: Fixation with two cannulated screws presented significantly less volume than shown by DHS, for insertions of 30, 40 and 50 mm (p=0.01, 0.012 and 0.013, respectively), fixa tion with three screws did not show any statistically significant difference (p= 0.123, 0.08 and 0.381, respectively) and fixa tion with four cannulated screws presented larger volumes than shown by DHS (p=0.072, 0.161 and 0.033). CONCLUSIONS: Fixa tion of the femoral neck with two cannulated screws occupied less volume than DHS, with a statistically significant difference. The majority of screw combinations did not reach statistical significance, although fixation with four cannulated screws pre sented larger volumes on average than those occupied by DHS.
Subject(s)
Fracture Fixation, Internal , Femoral Neck Fractures/surgery , Hip/surgeryABSTRACT
Objective To explore surgical opportunity and management of high-energy Pilon fractures.Methods Twenty-five cases of the high-energy Pilon fractures were treated with anatomic type plate one-staged or ses of type III fractures.8 cases were open fractures and 17 cases were close fractures.8 cases open fractures and 6 cases close fractures were treated with anatomic type plate one-staged.11 cases close fractures with serious soft tissue swell were treated two-staged delayed.The combined fibular fractures were fixed accordingly.All cases were followed up for 32 months after operation in average( range 17 to 76 months).Results According to Mazur's criteria,the surgical result was evaluated as excellent in 10 patients,goed in 11 ,fair in 3 and poor in 1.Postoperative complication ineluded infection in 2 cases,necrosis of skin in 1 case and traumatic arthritis of the ankle joint in 2 cases.Conclusion In order to get a satisfactory result,it is important to choose the right timing of surgery and correct procedure in high-energy Pilon fracture.
ABSTRACT
Aim To evaluate the clinical value of two cervical spinallocking plates, Orion and Zephir, and a new anterior cervical instrumentalsystem combining an intradiscal cage with an integrated plate(PCB) afteranterior cervical decompression surgery. Methods 47 patients were followedup for 7 - 26 months with an average of 15 months after surgery. Of them, 30were treated with Orion, 1 1 with Zephir and another 6 with PCB. Results 26cases with preoperative intervertebral space constriction and 18 cases withchanges of cervical physiological protrusion all achieved satisfying effect ofrebuilding intervertebral space height after operation. The cases with obviousintervertebral space height loss were not seen after follow up. The physio-logical curvature corrected by operation was well kept. Neurological functionwas improved in 43 cases on different extent after operation. The other 4cases with no obvious recovery of neurological function were all that withcomplete paraplegia after trauma. Conclusion PCB is suitable for treatmentof the acute cervical protrusion or the cervical spondylotic myelopathy at onelevel. Zephir and Orion are suitable to all kinds of cervical vertebra lesions atmore than one level and complex lesion at one level, which helps the re-covery of cervical physiological curvature and height of disc space.
ABSTRACT
Objective To analyze the etiology and features of Pilon fractures and to explore their best operative method.Methods 92patients with pilon fracture were treated operatively and followed up between1991and 2001.According to the Ovadi a -Beals' s classification,there were 7cases of Type I fracture,12of II,30of III,26of IV,17of V.During the o peration,55patients had limited in ternal fixation with calcaneal trac-tion,18with calcaneal traction and plaster splint,10with tibial and fi bula internal fixation,9with external fixation apparatus.Results92patients were followed up for an av erage time of 53months(ranging from 4～103months).According to Mazur ' s criteria,the results of the treatm ent were rated as excellent in 42patients,good in 34,fair in 11and poor in 5.Conclusion The pilon fracture is caused by both t he force of falling from a high altitude and the force of rebounding which act in the distal end of tibia an d fibula.Limited internal fixation with calcaneal traction is a right choice of operative method to treat pilon fr actures.[