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Objective To report the clinical outcomes of open reduction and internal fixation for capitellum fractures in adolescents.Methods From January 2010 to January 2015,14 adolescents with capitellum fracture were admitted to our department.They were 12 males and 2 females,aged from 12 to 16 years (13.7 years).By the Dubberley classification,we had 2 cases of type ⅠA,8 cases of type ⅡA,3 cases of type Ⅲ A and one of type Ⅲ B.We summarized their clinical characteristics and injury mechanisms.At the last follow-up,the therapeutic efficacy was assessed by the Mayo elbow function scores,and the ranges of motion of the elbow and forearm on the affected side were recorded.Results The 14 patients obtained an average follow-up of 12 months (from 6 to 18 months).All the cases achieved fracture union within 3 months,but malunion appeared in one.At the last follow-up,the ranges of flexion and extension of the affected elbow averaged 120.6° (from 110° to 135°),and the ranges of lateral rotation of the affected forearm averaged 160.3° (from 150° to 175°).According to the Mayo scores at the last follow-up,the elbow function was rated as excellent in 12 and as good in one.Mild traumatic arthritis occurred in 3 cases.Conclusions Capitellum fractures in adolescents are often Dubberley type A ones without a complicated fracture of the posterior condyle.Usually,the capitellum is impacted by the radial head in the process of elbow extension with valgus stress.After definite diagnosis,open anatomical reduction and reasonable and reliable internal fixation can result in good clinical results.
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Objective Measure the epicondyles of the distal femur on magnetic resonance image(MRI), in order to locate presicely the surgical transepicondylar axis(STEA) in total knee arthroplasty(TKA) and to provide theoretical basis for the designing of the size of the femoral component. Methods Totally 78 normal knees of Chinese individuals were studied. The images of coronal, sagittal and traverse sections of the knee were obtained by magnetic resonance image. Measurement included the width of the STEA, distance between the epicondyles and the joint line, anterior posterior width of the medial and lateral epicondyles, posterior condyle angle. Results The width of the STEA averaged(79.55±4.90)mm in males, and femles(71.18±4.22)mm. The distance from the epicondyles to the joint line was correlated with the width of the STEA, so was the anterior posterior width of epicondyles. PCA averaged(4.22±2.07)°. Conclusion The size of the epicondyles in Chinese is significantly smaller than that of the Westerns. The ratio between anterior posterior width of the medial epicondyle and the width of the STEA is 0.84, and is 0.87 between anterior posterior width of the lateral epicondyle and the width of the STEA. The distance from the epicondyles to the joint line is helpful to locate the STEA. The reliability is poor to locate the STEA by touch or PCL.
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Objective To discuss the diagnosis and treatment of spontaneous perforation of the large intestine.Methods The clinical data of 9 cases with spontaneous perforation of the large intestine admitted into our hospital since 1994 were analyzed retrospectively.Results All the 9 cases were over 60 years of age,had no specific clinical manifestations,and were misdiagnosed preoperatively.Among them,4 cases had a(longstanding) history of hypertension and arteriosclerosis,and 6 cases had habitual constipation.There was 1 case with perforation of transverse colon,1 case of descending colon,3 cases of sigmoid colon,and 4 cases of upper rectum.Four cases underwent exteriorization after a simple closure of the perforation,while in the other 5 cases closure of the perforation was followed by a loop colostomy.The postoperative complications included cardiac arrhythmia(1 case),lung infection(2 cases),and infection of incisional wound(1 case).All cases recovered smoothly and were discharged.Conclusions Spontaneous perforation of the large intestine usually presents in old patients,and frequeatly occurs in the rectum and sigmoid colon.It is usually misdiagnosed preoperatively,and surgical intervention should be performed as soon as possible.The operation should be simple.It is crucial to intensify management after operation.