Internal fixation for the treatment of anteromedial facet fracture of the coronoid process of ulna / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the effect of operative treatment for anteromedial facet fracture of the coronoid process of ulna,and to study its surgical exposures and fixation techniques.</p><p><b>METHODS</b>From March 2005 to March 2010,18 patients with anteromedial facet fracture of the coronoid process of ulna were treated with open reduction and internal fixation. There were 12 males and 6 females with an average age of 37.8 years. A single midline posterior incision was used to expose the entire elbow joint. After elevating the full-thickness skin flaps, a lateral incision was made to expose and repair the lateral collateral ligament. Three intervals in the flexor-pronator musculature were used to gain access to the coronoid,depending on the size of the fracture fragment and the planned fixation technique. Fractures were fixed by using mini-plate or with screws. The therapeutic effects were evaluated by Mayo Elbow Performance Score (MEPS) and system of Broberg & Morrey.</p><p><b>RESULTS</b>Seventeen patients were followed up, no patient complained pain and elbow unstable at a mean follow-up period of 38 months(1 to 6 years). The fractures were clinically healed at an average time of 11.6 weeks(ranged from 8 to 16 weeks). The average MEPS was 95.4+/-4.6 (ranged, 82 to 100). The average functional rating of system of Broberg & Morrey was 92.3+/-5.8 (ranged,75 to 100).</p><p><b>CONCLUSION</b>Open reduction and internal fixation is effective to reach anatomical reduction and strong fixation for the treatment of anteromedial facet fracture of the coronoid process of ulna.</p>

Treatment of chronic osteomyelitis with antibiotic-loaded calcium phosphate cement / 中国骨伤

The antibiotic delayed release system which has the characteristics of high local antibiotic concentration,few adverse effects, slow release and long duration, has became one of important methods of treating chronic osteomyelitis. Because of its double action as drug carrier and bone repair material which can induce bone growth and degrade synchronously, drug impregnated calcium phosphate cement (diCPC) is an ideal and safe antibiotic slow release carrier. After clearing focus thoroughly, defect implant with diCPC is an effective method, which has the virtues of convenient operation, good effects and short staying time etc. This paper aims to summarize the biological properties, experimental study and clinical application of diCPC.

Clinical application of the combination of postural reduction and kyphoplasty for traumatic thoracolumbar spine fractures / 中国骨伤

<p><b>OBJECTIVE</b>To determine the efficacy and feasibility of the combination of postural reduction and percutaneous kyphoplasty for traumatic thoracolumbar spine fractures.</p><p><b>METHODS</b>Thirty-seven patients with single level traumatic thoracolumbar spine fractures were included in this study. There are 28 males and 9 females, with an average age of 48 years (range 24 to 79 years). Patients were treated with postural reduction and then percutaneous vertebroplasty with Calcium Phosphate Cement (CPC) were performed on the fractured vertebra. The results were quantitatively evaluated, according to the concept of estimated vertebral height loss and kyphotic angle of the vertebral fractures by preoperative and postoperative plain standing lateral radiographs. Visual analog scale (VAS) and the fracture vertebra shape changes were recorded.</p><p><b>RESULTS</b>Patients were followed up for 9 to 24 months (average 13 months), pain was significantly relieved compared with the preoperative, VAS was reduced averagely from 7.6 +/- 2.5 to 1.8 +/- 1.5, the anterior and middle vertebral height was restored and kyphotic angle was corrected. During the period of follow up, outcomes were satisfactory, without notable correction loss.</p><p><b>CONCLUSION</b>If the indications are correctly handled, the combination of postural reduction and percutaneous kyphoplasty for the treatment of traumatic thoracolumbar spine fractures can provide significant pain relieve and restore the vertebral height and kyphotic angle.</p>