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1.
Arq. bras. med. vet. zootec. (Online) ; 73(3): 589-597, May-June 2021. tab, ilus
Article in English | ID: biblio-1278368

ABSTRACT

This study aimed to evaluate the effectiveness of bridge plating of simple tibial fractures in dogs by minimally invasive plate osteosynthesis (MIPO). Medical and radiographic records of twenty-nine dogs with simple tibial fractures that underwent bridge fixation by MIPO were retrospectively evaluated. The clinical outcome was classified considering the presence of lameness at the end of the treatment. The tibial mechanical joint angles were measured and compared with the values described in the literature. Additionally, fragment apposition and implant disposition were evaluated. Based on the modified Radiographic Union Scale for Tibial fractures, the moment of clinical union was determined. Clinically, at the end of treatment, only one patient presented lameness at a trot. While there was no significant difference between the bone alignment in the frontal plane values and the values described in the literature (P>0.05), the caudal proximal tibial angle was significantly higher (P=0.001). The median fragment apposition was considered acceptable. The average bridge plate ratio, plate working length, and plate screw density were 0.8, 0.57, and 0.48, respectively. The median time to clinical union was 30 days. Bridge plating in simple tibial fractures resulted in fast healing and low complication rates.(AU)


Objetivou-se avaliar a efetividade da estabilização em ponte de fraturas tibiais simples em cães utilizando-se a técnica de osteossíntese minimamente invasiva com placa (MIPO). Registros médicos e radiográficos de 29 cães com fraturas simples de tíbia, fixadas em ponte por meio da MIPO, foram retrospectivamente avaliados. O resultado clínico foi classificado com base na deambulação ao final do tratamento. Os ângulos articulares mecânicos da tíbia foram aferidos e comparados aos valores descritos na literatura. Adicionalmente, foram avaliadas a aposição dos fragmentos e a disposição dos implantes. Por meio da escala modificada de união radiográfica para fraturas de tíbia, determinou-se o momento de união clínica. Clinicamente, ao final do tratamento, apenas um animal apresentou claudicação ao trote. Não houve diferença significativa entre o alinhamento ósseo no plano frontal quando comparado com dados da literatura (P>0,05), enquanto, no plano sagital, o ângulo mecânico caudal proximal da tíbia foi significativamente maior (P=0,001). A mediana para aposição dos fragmentos foi considerada aceitável. As médias para relação placa em ponte, comprimento de trabalho da placa e densidade de parafusos da placa foram, respectivamente, 0,8; 0,57 e 0,48. A mediana para união clínica foi de 30 dias. A estabilização em ponte de fraturas tibiais simples resultou em rápida consolidação óssea, com baixas taxas de complicação.(AU)


Subject(s)
Animals , Dogs , Tibial Fractures/veterinary , Fracture Healing , Fracture Fixation, Internal/veterinary , Radiography/veterinary
2.
Arq. bras. med. vet. zootec. (Online) ; 73(3): 647-652, May-June 2021. ilus
Article in English | ID: biblio-1278370

ABSTRACT

The treatment of fractures from the thoracic limb in giant anteaters is extremely challenging. Unfamiliar and peculiar anatomical characteristics, robust musculature and the imminent need for an early return to limb function highlight such challenges. The objective of this report was to describe the successful use of anatomical osteosynthesis with a robust locking compression plate in a humeral fracture of an adult giant anteater. The patient was rescued on the highway after being run over and presented for treatment at the Veterinary Teaching Hospital. Surgical stabilization was performed using a craniomedial approach to the humerus, using a customized broad 3.5mm locking compression plate. The patient presented early limb support at 24 hours postoperatively. Radiographic monitoring was performed at 30, 60 and 90 days postoperatively, and bone healing was observed without any complications. It is concluded that the treatment of humerus fractures in giant anteaters requires robust fixation. The use of a reinforced locking compression plate system proved to be effective and adequate to the mechanical load that an adult individual of this species needs for early use of the thoracic limb and, at the same time, efficient in controlling interfragmentary movement, which allowed fracture consolidation.(AU)


O tratamento das fraturas do membro torácico dos tamanduás-bandeira (Myrmecophaga tridactyla) é extremamente desafiador. Características anatômicas pouco familiares e peculiares, musculatura muito desenvolvida e necessidade iminente de retorno precoce à função do membro destacam tais desafios. Objetivou-se, neste relato, descrever a utilização com sucesso da osteossíntese anatômica com placa bloqueada robusta em fratura umeral de um tamanduá-bandeira. O paciente foi resgatado em rodovia após atropelamento e atendido no Hospital Veterinário Universitário. Após sedação e avaliação física completa, foi realizado exame radiográfico, o qual revelou fratura completa oblíqua curta em diáfise média de úmero esquerdo. A estabilização cirúrgica foi realizada por abordagem craniomedial ao úmero, utilizando-se placa bloqueada (LCP) do sistema 3,5mm customizada. O paciente apresentou apoio precoce do membro com 24 horas de pós-operatório. Realizou-se acompanhamento radiográfico aos 30, 60 e 90 dias, sendo observada união clínica sem quaisquer complicações. Conclui-se que o tratamento das fraturas do úmero em tamanduás-bandeira exige robustez na fixação. A utilização de sistema reforçado de placa bloqueada mostrou-se efetiva e adequada à carga mecânica de que um indivíduo adulto dessa espécie necessita para uso precoce do membro torácico e, ao mesmo tempo, eficiente no controle da movimentação interfragmentária, o qual permitiu consolidação da fratura.(AU)


Subject(s)
Animals , Fracture Healing , Eutheria/surgery , Fracture Fixation, Internal/methods , Fracture Fixation, Internal/veterinary , Humeral Fractures/surgery , Humeral Fractures/veterinary , Bone Plates/veterinary , Animals, Wild/surgery
3.
Rev. bras. ortop ; 56(1): 109-113, Jan.-Feb. 2021. graf
Article in English | LILACS | ID: biblio-1288640

ABSTRACT

Abstract The method presented here consists of a minimally invasive surgical technique for osteosynthesis of transtrochanteric fractures with Dynamic Hip Screw (DHS) 135º. It is indicated in the treatment of 31-A1 and 31-A2 fractures (Arbeitsgemeinschaft für Osteosynthesefragen Classification - AO) that meet the prerequisites required for using DHS. The surgery is performed, preferably, before 48 hours after the fracture. With the use of the same instruments as the traditional surgical technique and the aid of the C-arm, a closed reduction of the fracture and implantation of the DHS is performed by a 2-cm surgical incision, through dissection of the underlying tissues, with minimal bleeding and damage to the soft parts. In the immediate postoperative period, the patient is encouraged to orthostatism and walk with full load, which anticipates hospital discharge and favors early functional rehabilitation. Outpatient return is scheduled at 2, 6, 12 and 24 weeks postoperatively, with radiographic evaluation to assess fracture healing.


Resumo O método aqui apresentado consiste em técnica cirúrgica minimamente invasiva para osteossíntese de fraturas transtrocantéricas com Dynamic Hip Screw (DHS) 135º. Esta técnica é indicada no tratamento de fraturas 31-A1 e 31-A2 (Classificação Arbeitsgemeinschaft für Osteosynthesefragen - AO) que cumpram os pré-requisitos exigidos para o uso do DHS. A cirurgia é realizada, preferencialmente, antes de 48 horas após o acometimento da fratura. Com a utilização do mesmo instrumental da técnica cirúrgica tradicional e auxílio do arco-C, realiza-se redução incruenta da fratura e implantação do DHS por incisão cirúrgica com 2 cm, através de dissecção dos tecidos subjacentes, com mínimo sangramento e agressão às partes moles. No pós-operatório imediato, o paciente é estimulado ao ortostatismo e à deambulação com carga total, o que antecipa a alta hospitalar e favorece a reabilitação funcional precoce. O retorno ambulatorial é agendado com 2, 6, 12 e 24 semanas de pós-operatório, com avaliação radiográfica, a fim de avaliar a consolidação da fratura.


Subject(s)
Humans , Fracture Healing , Minimally Invasive Surgical Procedures , Femoral Fractures , Fracture Fixation, Internal , Hip , Hip Fractures
4.
Article in Chinese | WPRIM | ID: wpr-880469

ABSTRACT

OBJECTIVE@#The design and development of split memory alloy sternum bone plate are discussed, and the effect of split memory alloy sternum bone plate internal fixation in the treatment of sternal fractures are analysed.@*METHODS@#The structure of the product is designed according to the anatomy and physiological characteristics of human bones, and the cross section shape of the product is designed according to the cross section shape of human bones. Internal fixation is effective in the treatment of sternal fracture.@*RESULTS@#The split memory alloy sternal plate was successfully designed and developed, and all the patients with sternal fractures treated by internal fixation were clinically healed, the hospitalization and fracture healing time were significantly shortened, and no obvious complications occurred.@*CONCLUSIONS@#The application of split memory alloy sternal plate internal fixation in the treatment of sternal fracture has the advantages of small trauma, simple operation, safety, reliable fixation, good histocompatibility and less complications, and is conducive to promoting fracture healing and respiratory function improvement.


Subject(s)
Alloys , Bone Plates , Fracture Fixation, Internal , Fracture Healing , Humans , Sternum/surgery
5.
Article in Chinese | WPRIM | ID: wpr-879431

ABSTRACT

OBJECTIVE@#To investigate the clinical effect of double plate combined with iliac bone graft in the treatment of femoral nonunion after intramedullary nailing.@*METHODS@#From December 2008 to December 2017, double plate combined with autogenous iliac bone graft was used to treat femoral nonunion after intramedullary nailing. There were 11 cases, including 10 males and 1 female, aged 35 to 62 years, and the time from fracture to nonunion was 12 to 20 months. According to Judet classification, there were 8 cases of atrophic nonunion and 3 cases of proliferative nonunion. Regular follow-up was conducted after operation to record the fracture healing time, load-bearing activity time and complications, and to observe the repair effect of double plate fixation combined with iliac bone graft on nonunion after femoral shaft fracture operation.@*RESULTS@#All patients were followed up for 12 to 22 months. The operation time was 70 to 130 min and the blood loss was 180 to 350 ml. After operation, 2 cases had knee stiffness, which recovered after passive exercise with CPM machine for 2 weeks;1 case had pain in iliac bone donor area, which was relieved after 3 months. The time of fracture healing was 24 to 40 weeks, and the time of complete weight-bearing activity was 14 to 32 weeks. SF-36 quality of life score at the final follow-up:body pain 70 to 82, activty 70 to 82, social function 72 to 83, the overall health 72 to 82. At the end of the follow-up, there were no complications such as limb shortening, infection, poor wound healing, internal fixation failure (fracture, loosening).@*CONCLUSION@#It is an effective method to treat nonunion of femur after intramedullary nailing by using double plate combined with autogenous iliac bone graft.


Subject(s)
Adult , Bone Nails , Bone Plates , Bone Transplantation , Female , Femoral Fractures/surgery , Femur , Fracture Fixation, Intramedullary , Fracture Healing , Fractures, Ununited/surgery , Humans , Male , Middle Aged , Quality of Life , Treatment Outcome
6.
Article in Chinese | WPRIM | ID: wpr-879387

ABSTRACT

OBJECTIVE@#To explore clinical effect of bridge-link combined fixation system(BCFS) in treating open middle and lower tibial fractures by external fixation.@*METHODS@#From October 2016 to September 2017, 11 patients with open middle and lower tibial fractures were treated with BCFS by external fixation, including 7 males and 4 females aged from 23 to 65 years old with an average of 44.2 years old;the course of disease ranged from 7 to 10 days. All fractures were open, middle and lower tibiofibular fractures. According to AO classification, 5 patients were type A, 5 patients were type B, and 1 patient was type C. All fractures were classified as typeⅡaccording to Gustilo-Anderson classification. The time of fracture healing, postoperative complications were observed, Johner-Wruhs standard were used to evaluate clinical effect.@*RESULTS@#All patients were followed up from 7 to 13 months with an average of 10.1 months. Fracture healing time ranged from 4 to 8 months with an average of 6.2 months. The removal time of BCFS ranged from 5 to 11 months with an average of 7.8 months. No screws loosening and BCFS breakage occurred after operation, while 1 patient occurred infection of proximal and distal tibia after operation which was healed by anti-inflammatory treatment and dressing change. According to Johner-Wruhs standard, 8 patients were excellent and 3 patients good at the latest follow-up.@*CONCLUSION@#BCFS could be used to treat open middle and lower tibial fractures by external fixation, which had features of small size, flexible use, solid and elastic fixation. It could not effectively reduce tissue injury and promote fracture healing, but also have advantages of less postoperative complications and better recovery of limb function.


Subject(s)
Adult , Aged , Bone Plates , External Fixators , Female , Fracture Fixation , Fracture Fixation, Internal , Fracture Healing , Fractures, Open , Humans , Male , Middle Aged , Tibial Fractures/surgery , Treatment Outcome , Young Adult
7.
Rev. bras. ortop ; 55(3): 347-352, May-June 2020. tab, graf
Article in English | LILACS | ID: biblio-1138027

ABSTRACT

Abstract Objective To evaluate radiographically the postoperative results of patients with fracture of the proximal humerus in two parts of the surgical neck treated with threaded percutaneous fixation. Methods We evaluated the radiographic results of percutaneous fixation with threaded pins on the treatment of proximal humerus fractures in our service. Preoperative and postoperative images of 42 patients were evaluated, evaluating radiographs until 8 weeks postoperatively. We considered on evaluation the fracture deviation on preoperative images, the loss of reduction and no consolidation. Results Our consolidation rate was 90.4%, with loss of reduction in 16.6% of the cases and no consolidation rates in just 4 operated cases. We observed a predominance of a specific fracture pattern in the cases with loss of reduction. Conclusion The present study allows us to consider the percutaneous fixation technique with threaded pins as an alternative in our therapeutic arsenal for the proximal humerus fracture of the surgical neck. Contraindications are considered for low fracture trait on the metaphysis and with medial/lateral cortical impairment.


Resumo Objetivo Avaliar radiograficamente os resultados pós-operatórios dos pacientes com fratura da extremidade proximal do úmero em duas partes do colo cirúrgico tratados com fixação percutânea com fios rosqueados. Métodos Avaliamos radiograficamente os resultados da fixação percutânea com fios rosqueados das fraturas da extremidade proximal do úmero realizadas em nosso serviço. Foram avaliadas as imagens pré- e pós-operatórias de 42 pacientes, avaliando-se radiografias com até 8 semanas de pós-operatório. Consideramos na avaliação o desvio da fratura pré-operatório, a perda da redução e a consolidação da fratura. Resultados O índice de consolidação nos casos avaliados foi de 90,4%, com perda da redução em 16,6% dos casos e não obtida a consolidação em apenas 4 casos. Foi observada uma predominância de determinado padrão de fratura nos casos que perderam a redução. Conclusão O estudo permitiu considerar a técnica de fixação percutânea com fios rosqueados uma alternativa no arsenal terapêutico da fratura da extremidade proximal do úmero do colo cirúrgico, com contraindicação para os traços de fratura baixos na metáfise e com acometimento da cortical medial/lateral.


Subject(s)
Humans , Male , Female , Therapeutics , Fracture Healing , Fractures, Bone , Fracture Fixation, Internal , Humeral Fractures , Neck
8.
Int. j. morphol ; 38(2): 309-315, abr. 2020. graf
Article in English | LILACS | ID: biblio-1056440

ABSTRACT

Stability is necessary to ensuring proper bone repair after osteotomies and fractures. The aim of this research was to analyze how the repair of pseudoarthrosis sites was affected by different conditions in related to soft tissue. An experimental study was designed with 18 New Zealand rabbits. Six study groups were formed. An osteotomy was performed on the mandibular body of each animal and muscle was installed at the osteotomy site to model pseudoarthrosis. Fixation by surgery was then carried out, using plates and screws. The animals were submitted to euthanasia after 21, 42 and 63 days to make a descriptive comparison of the histological results. No animal was lost during the experiment. In all the samples, bone formation was observed with different degrees of progress. Defects treated with or without removal of the tissue involved in pseudoarthrosis presented comparable bone repair, showing that stability of the bone segments allows the repair of adjacent tissue. In some samples cartilaginous tissue was associated with greater bone formation. Stabilization of the fracture is the key in bone repair; repair occurs whether or not the pseudoarthrosis tissue is removed.


La estabilidad de las osteotomías y de las fracturas son fundamentales para asegurar la adecuada reparación ósea; el objetivo de esta investigación fue analizar la reparación presente en sitios de pseudoartrosis realizando la limpieza de la zona previo a la fijación o manteniendo el tejido de la nounión en el mismo lugar durante la osteosíntesis. Se diseñó un estudio experimental incluyendo 18 conejos de raza Neozelandesa. Se formaron 6 grupos de estudios a quienes se relizó una osteotomía en el cuerpo mandibular y posterior instalación de músculo en el lugar de la osteotomía para fabricar un modelo de pseudoartrosis. En cirugía posterior se fijó con placa y tornillos. Se realizaron eutanasias a los 42 y 63 días para comparar los resultados de forma descriptiva mediante estudio histológico. No fue perdido ningún animal durante el experimento. En todas las muestras evaluadas se observó formación ósea en diferentes niveles de avance; defectos tratados con o sin el retiro del tejido involucrado en la pseudoartrosis presentaron una condición de reparación ósea comparables, determinando que la estabilidad de los segmentos óseos permite la reparación del tejido adyacente. El tejido cartilaginoso se presentó en algunas muestras asociadas a sectores con mayor presencia de formación ósea. La estabilización de la fractura es clave en la reparación ósea; la reparación se produce manteniendo o retirando el tejido presente en la pseudoartrosis.


Subject(s)
Animals , Rabbits , Fracture Healing , Fractures, Malunited/therapy , Mandibular Fractures/therapy , Osteotomy/adverse effects , Mandibular Fractures/surgery
10.
Article in English | WPRIM | ID: wpr-811188

ABSTRACT

A systematic search was conducted and relevant studies that evaluated the influence of osteoporosis medications (bisphosphonates [BPs], denosumab, selective estrogen receptor modulators [SERMs], recombinant human parathyroid hormone teriparatide [TPTD], and strontium ranelate [SrR]) on wrist, hip, and spine fracture healing, were selected. BPs administration did not influence fracture healing and clinical outcomes after distal radius fracture (DRF). Similar results were observed in hip fracture, but evidence is lacking for spine fracture. Denosumab did not delay the non-vertebral fractures healing in one well-designed study. No studies evaluated the effect of SERMs on fracture healing in humans. One study reported shorter fracture healing times in TPTD treated DRF patients, which was not clinically meaningful. In hip fracture, recent studies reported better pain and functional outcomes in TPTD treated patients. However, in spine fracture, recent studies found no significant differences in fracture stability between TPTD treated patients and controls. Evidence is lacking for SrR, but it did not influence wrist fracture healing in one study. In comparisons between TPTD and BPs, fracture healing and physical scores were not significantly different in hip fracture by 1 study. In spine fracture, controversy exists for the role of each medication to the fracture stability, but several studies reported that fracture site pain was better in TPTD treated patients than BPs treated patients. Considering no clinical data of negative fracture healing of the antiresorptive medication and the danger of subsequent fracture after initial osteoporotic fracture, there is no evidence to delay initiation of osteoporosis medications after fracture.


Subject(s)
Denosumab , Diphosphonates , Fracture Healing , Hip , Humans , Osteoporosis , Osteoporotic Fractures , Parathyroid Hormone , Radius Fractures , Selective Estrogen Receptor Modulators , Spine , Strontium , Teriparatide , Wrist
11.
Article in English | WPRIM | ID: wpr-811128

ABSTRACT

Distal radius fractures (DRFs) are one of the most common fractures seen in elderly people. Patients with DRFs have a high incidence of osteoporosis and an increased risk of subsequent fractures, subtle early physical performance changes, and a high prevalence of sarcopenia. Since DRFs typically occur earlier than vertebral or hip fractures, they reflect early changes of the bone and muscle frailty and provide physicians with an opportunity to prevent progression of frailty and secondary fractures. In this review, we will discuss the concept of DRFs as a medical condition that is at the start of the fragility fracture cascade, recent advances in the diagnosis of bone fragility including emerging importance of cortical porosity, fracture healing with osteoporosis medications, and recent progress in research on sarcopenia in patients with DRFs.


Subject(s)
Aged , Diagnosis , Fracture Healing , Hip Fractures , Humans , Incidence , Osteoporosis , Osteoporotic Fractures , Porosity , Prevalence , Radius Fractures , Radius , Sarcopenia
12.
Article in Chinese | WPRIM | ID: wpr-826327

ABSTRACT

Fracture healing has long been a major concern for orthopedists.Currently,about 10% of fracture patients still have poor fracture healing or bone nonunion.In recent years,research has found that nerve growth factor(NGF)can promote fracture healing.This article reviews the mechanism and research progress of NGF in promoting fracture healing.NGF can promote vascular regeneration and nerve growth at callus and plays an important role in the proliferation and migration of bone cells.New animal experiments and clinical trials have confirmed the role of NGF in promoting fracture healing and further revealed its possible mechanism of action.Further research on NGF can provide new ideas for promoting fracture healing,especially for treating nonunion.


Subject(s)
Animals , Fracture Healing , Humans , Nerve Growth Factor
13.
Article in Chinese | WPRIM | ID: wpr-828296

ABSTRACT

OBJECTIVE@#To explore the clinical effect of bridging system in the treatment of severe comminuted femoral fracture.@*METHODS@#From March 2016 to October 2018, 50 patients with severe comminuted femoral fracture including 35 males and 15 females, aged 48 to 72(54.6±8.7) years, were admitted. All cases were comminuted fractures of the femoral shaft, 16 with proximal femur fractures and 7 with distal femur fractures. All cases were all unilateral fractures, 23 on the left and 27 on the right. The time from injury to operation was 5 to 60 (26.7±13.3) hours. The cause of injury was traffic accident, 12 cases with high fall, 35 cases fell and 3 cases fell accidentally. The patients were treated with bridge combined internal fixation system, and the operative effect and fracture healing were analyzed.@*RESULTS@#The operation was successful in all patients. There was no change to other fixed operation. The operation time was (75.8±12.3) min, the amount of bleeding was(356.4±64.8) ml, and there was no serious postoperative complications such as infection, internal fixation displacement, re fracture and nonunion. After 6 to 36 months follow-up, the fracture healing was evaluated by Warden's score. With the extension of observation time, Warden's score gradually increased, and the time of bone healing was(5.5±0.9) months. Harris score and HSS score were used to evaluate the function of hip and knee joint respectively. With the extension of time, Harris score and HSS score increased gradually. Six months after operation, Harris score was 83.5±11.2, HSS score was 79.7±10.5. During the follow-up period, there were no serious complications such as internal fixation displacement, re-fracture, nonunion of fracture and deep vein thrombosis of lower extremity.@*CONCLUSION@#The bridge combined internalfixation system has better safety and effectiveness in the treatment of severe comminuted femoral fracture. As long as the requirements of local anatomy and biomechanics are strictly mastered and the operation risks are fully evaluated in combination with imaging, the better fixation effect can be achieved. The operation has less trauma, fewer complications and simple operation, which is believed to have a wider application potential. Due to the limited sample size and follow-up time, no clinical control was set up, the results of the study still need to be further verified by prospective trials.


Subject(s)
Aged , Female , Femoral Fractures , General Surgery , Fracture Fixation, Internal , Fracture Healing , Fractures, Comminuted , General Surgery , Humans , Male , Middle Aged , Prospective Studies , Treatment Outcome
14.
Article in Chinese | WPRIM | ID: wpr-828289

ABSTRACT

OBJECTIVE@#To evaluate the clinical effect of bridge combined internal fixation system in the treatment of periprosthesis fracture of femur after hip replacement.@*METHODS@#From October 2016 to June 2018, 5 patients of periprosthesis fractures of femur classified type B1 and type C in Vancouver were treated by open reduction and bridging combined with internal fixation, including 2 males and 3 females, with ages of 68, 70, 74, 75, 79 years;type B1 fractures in 4 and type C fractures in 1. Causes of injury:1 case of traffic injury, 4 cases of fall. After the operation, the patients were followed up for complications and fracture healing time by clinical and imaging examination, and Parker activity score was performed.@*RESULTS@#The wounds of 5 patients healed without infection. One case of DVT was confirmed by venography. Five patients were followed up, and the durations were 2, 8, 9, 10, 15 months. One patient died of myocardial infarction 2 months after operation. The average healing time was 12.5 weeks. No loss of reduction or failure of internal fixation was found. Two patients could walk without protection and 1 patient needed to rely on single crutch. One case of periprosthetic fracture had to walk with a single crutch before operation and move indoors with two crutches after operation. The average Parker activity score was 51.8% before operation.@*CONCLUSION@#The bridge combined internal fixation system can be used to fix the fracture after hip replacement with stable femoral prosthesis.


Subject(s)
Aged , Arthroplasty, Replacement, Hip , Bone Plates , Female , Femoral Fractures , General Surgery , Fracture Fixation, Internal , Fracture Healing , Humans , Male , Periprosthetic Fractures , General Surgery , Radiography , Reoperation , Retrospective Studies , Treatment Outcome
15.
Article in Chinese | WPRIM | ID: wpr-828288

ABSTRACT

OBJECTIVE@#To observe the clinical effect of elastic intramedullary nail in minimally invasive treatment of floating knee injury in children.@*METHODS@#From January 2009 to September 2017, 11 children with floating knee injury were treated with one-off open reduction and elastic intramedullary nail or external fixator fixation, including 7 males and 4 females, aged 5.0 to 11.0 years, with an average age of 8.3 years. The treatment results were evaluated according to karlstrom's standard.@*RESULTS@#Eleven patients were followed up for 8 to 48 months, with an average of 28 months. All the fractures healed at one time, and there were no complications such as nonunion, malunion and serious dysfunction of knee joint. The length of the affected limb in 2 cases was 1.2 to 1.5 cm longer than that in the opposite side without shortening. According to Karlstrom scoring standard, 8 cases were excellent, 1 case was good and 2 cases were middle.@*CONCLUSION@#Elastic intramedullary nail minimally invasive treatment of floating knee injury in children is a safe and effective treatment, which can effectively reduce the fracture and promote bone healing, which is conducive to early functional recovery.


Subject(s)
Bone Nails , Child , Child, Preschool , External Fixators , Female , Fracture Fixation , Fracture Fixation, Intramedullary , Fracture Healing , Humans , Internal Fixators , Knee Injuries , General Surgery , Male , Treatment Outcome
16.
Article in Chinese | WPRIM | ID: wpr-828254

ABSTRACT

OBJECTIVE@#To explore the clinical effects of convolution method in treating displaced midshaft clavicle fracture.@*METHODS@#From January 2018 to July 2019, 32 patients (21 males and 11 females) with displaced midshaft clavicle fracture were treated, ranging in age from 18 to 65 years old, with a median age of 41.5 years old. Nineteen patients had fractures on the left side and 13 patients had fractures on the right side. The duration from injury to treatment ranged from 30 minutes to 5 days. The patients were treated with convolution method and repeated push and rotation of the affected upper limb, followed by external fixation of clavicle band. The reduction and healing of the fracture and the functional recovery of shoulder joint were observed.@*RESULTS@#After operation, fracture reduction was evaluated by X ray film. Seven patients had an excellent result, 20 good and 5 fair. All the patients were followed up, and the duration ranged from 14 to 18 weeks. The mean Neer score was 89.75±6.88, which included pain score of 32.66±2.54, functional score of 26.44±2.91, range of motion score of 22.38±2.06, and anatomy score of 8.43±0.84;17 patients receive an excellent result, 14 good and 1 fair.@*CONCLUSION@#The rotation method combined with the repeated pushing and rotating of the upper limb of the affected side can well reduce the displaced fracture of the middle clavicle. Bandage and clavicle band can be performed after reduction. Functional exercise runs through the whole course of treatment. Functional recovery of shoulder joint is good and satisfactory therapeutic effect is achieved.


Subject(s)
Adolescent , Adult , Aged , Bone Plates , Clavicle , Female , Fracture Fixation , Fracture Fixation, Internal , Fracture Healing , Fractures, Bone , Humans , Male , Middle Aged , Shoulder Joint , Treatment Outcome , Young Adult
17.
Article in Chinese | WPRIM | ID: wpr-828218

ABSTRACT

OBJECTIVE@#To analyze and compare the hidden blood loss of minimally invasive percutaneous plate osteosynthesis(MIPPO) combined with locking plate fixation and intramedullary nail fixation in the treatment of tibial shaft fracture.@*METHODS@#One hundred and ninety-one cases of tibial shaft fracture treated from January 2017 to January 2019 were analyzed retrospectively. The patients were all treated with closed reduction and divided into two groups:group A (110 cases) and group B (81 cases). In group A, 78 males and 32 females were treated with MIPPO combined with locking plate. The age ranged from 19 to 74 (45.32±11.79) years old. According to AO classification, 42cases were type 42-A, 45 were type 42-B and 23 were type 42-C fractures. Group B was treated with intramedullary nail, including 65 males and 16 females, aged 19 to 84 (45.44± 14.32) years old. According to AO classification, there were 39 cases of type 42-A, 29 cases of type 42-B and 13 cases of type 42-C. The operation time, intraoperative blood loss and hidden blood loss were observed and compared between the two groups.@*RESULTS@#On the first day, the hidden blood loss was (155.27±47.89) ml in group A and (160.43±131.42) ml in group B, the difference was statistically significant (0.05).@*CONCLUSION@#In the treatment of tibial shaft fracture with intramedullary nail, there is obvious hidden blood loss, which is much higher than expected.


Subject(s)
Adult , Aged , Aged, 80 and over , Bone Nails , Bone Plates , Female , Fracture Fixation, Internal , Fracture Fixation, Intramedullary , Fracture Healing , Humans , Male , Middle Aged , Retrospective Studies , Tibial Fractures , Treatment Outcome , Young Adult
18.
Chinese Journal of Traumatology ; (6): 238-242, 2020.
Article in English | WPRIM | ID: wpr-827843

ABSTRACT

PURPOSE@#Tibial plateau fracture (TPF) is a devastating injury as it shatters lower articular surface of the largest joint. Apart from bony injury, TPF can lead to great soft tissue envelope compromise which affects the treatment plan and outcome. In the present study, clinical results were assessed in cases of high energy TPFs treated in staged manner.@*METHODS@#Twenty-three (20 males and 3 females) patients of high energy communited TPFs (Schatzker type V and VI) were consecutively treated. All the patient had compromise of overlying skin conditions. They were all successively scheduled for staged treatment plan which comprised of application of bridging knee external fixator on the first day of admission and definitive internal fixation after skin and soft tissue overlying the fracture were healed. Schatzker type I, II, III and IV were excluded from the study. Primary survey was done and patient who had head injury, chest and abdominal injury, pelvic injury and contralateral limb injury and open fractures were excluded from the study. The patients were also evaluated in terms of wound complications, axial and rotary alignment of limb, fixation failure, articular congruity and range of motion of the knees and post injury employment. Statistical analysis was done using SPSS software.@*RESULTS@#Maximum follow-up period was 13 months. All the fractures were united at final follow-up. Clinical evaluation was done with the Tegner Lysholm knee scoring scale. Excellent results were found in 78% cases and good and fair results in 22% cases. There was significant correlation between range of motion and the Tegner Lysholm knee score (p < 0.001, Pearson correlation coefficient = 0.741). The correlation between the score and the radiographical union duration was significant (p = 0.006, Pearson correlation coefficient = -0.554).@*CONCLUSION@#A staged treatment plan allows healing of soft tissue envelope, with avoidance of dreadful complications such as compartment syndrome and chronic infection. In addition, a staged treatment strategy does not hamper the fracture reduction, bony union and the functional results.


Subject(s)
Adult , Compartment Syndromes , Connective Tissue , Female , Fracture Fixation, Internal , Methods , Fracture Healing , Fractures, Comminuted , General Surgery , Humans , Knee , Male , Middle Aged , Range of Motion, Articular , Tibial Fractures , General Surgery , Treatment Outcome
19.
Article in Chinese | WPRIM | ID: wpr-879334

ABSTRACT

OBJECTIVE@#To investigate therapeutic effect of minimally invasive percutaneous plate internal fixation (MIPPO) through a single incision in treating open distal tibiofibula fractures.@*METHODS@#From March 2015 to February 2019, 10 patients with open distal tibiofibula fractures were treated with MIPPO technique through single anterolateral incision, including 8 males and 2 females, aged from 31 to 68 years old. According to Gustilo classification, 6 patients were typeⅠ, 3 patients were typeⅡand 1 patient was type ⅢA. Operative time, intraoperative blood loss and fracture healing were observed, Mazur ankle joint scoring was used to evaluate clinical effect.@*RESULTS@#All patients were followed up from 9 to 24 months. Operative time ranged from 85 to 120 min, intraoperative blood loss ranged from 80 to 200 ml, fracture healing time ranged from 18 to 30 weeks. Nine patients with Gustilo typeⅠandⅡachieved satisfactory healing wound, original wound of 1 patient with Gustilo type ⅢA was poor, and healed by skin flap transplantation at stageⅡ. No steel exposed and infection occurred. According to Mazur ankle scoring at the final following-up, total score was from 61 to 97, and 8 patients got excellent result, 1 good and 1 poor.@*CONCLUSION@#MIPPO technique through anterolateral single incision for the treatment of open distal tibiofibula fractures could protect original medial wound in opertaion, avoid plate exposed through anterolateral extensor tendon to cover internal fixation, and MIPPO technique could protect fracture end blood flow to improve fracture healing rate, and it is a kind of choice.


Subject(s)
Adult , Aged , Bone Plates , Female , Fracture Fixation, Internal , Fracture Healing , Fractures, Open , Humans , Male , Middle Aged , Minimally Invasive Surgical Procedures
20.
Article in Chinese | WPRIM | ID: wpr-879332

ABSTRACT

OBJECTIVE@#To investigate clinical effect of closed reduction and radial parallel Kirschner wire internal fixation in treating Gartland Ⅲ supracondylar fracture of humerus in children.@*METHODS@#From May 2015 to October 2019, 72 children with Gartland Ⅲ supracondylar fracture of humerus were treated by closed reduction and radial parallel Kirschner wire internal fixation, including 52 males and 20 females, aged from 3 to 10 years old with an average of (5.4±1.3) years old;39 patients classified to Gartland ⅢA and 33 patients classified to Gartland Ⅲ B. Operation time, fracture healing time, and functional exercise time were observed, Flynn elbow joint function score was used to evaluate clinical effects.@*RESULTS@#All patients were followed up from 2 to 6 months with an average of (3.5±1.4) months. Operation time was 25~90 (37.8±10.4) min, fracture healing time was 28~45(38.8±9.4) days, functional exercise time was 22~60(36.9±11.2) days. No cubitus varus, iatrogenic neurovascular injury, reduction loss, compartment syndrome, infection or other complications occurred. According to Flynn elbow joint function score, 60 patients got excellent results, 10 good and 2 fair.@*CONCLUSION@#Closed reduction and radial parallel Kirschner wire internal fixation in treating Gartland Ⅲ supracondylar fracture of humerus in children has advantages of minimally invasive, stable fixation, shorter operation time, easy to remove internal fixation, and less complications.


Subject(s)
Bone Wires , Child , Child, Preschool , Female , Fracture Fixation, Internal , Fracture Healing , Humans , Humeral Fractures/surgery , Humerus , Male
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