Treatment of complex scapular body fractures by locking reconstructive plates / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the method and effect of treatment of complex scapular body fractures by locking reconstructive plate through modified posterior approach.</p><p><b>METHODS</b>From August 2005 to November 2009, 27 patients with complex scapula body fractures were treated by locking reconstruction bone plate fixation,including 19 males and 8 females with an average age of 36 years old ranging from 16 to 64 years. The time after injury was 0.5 hours to 11 days (averaged 3 days). Of all the patients, 9 cases were associated with ipsilateral clavicle fracture, 2 cases were associated with acromioclavicular joint dislocation,16 cases were associated with multiple rib fractures, 1 case were associated with humeral shaft fractures, 5 cases were associated with pleural effusion, atelectasis, lung contusion etc. After operating,shoulder functional recovery were followed up.</p><p><b>RESULTS</b>Twenty-four patients were followed up from 2 to 35 months with an average of 19 months. According to Hardegger shoulder function,the results were excellent in 15 cases, good in 7 cases, general in 2 cases.</p><p><b>CONCLUSION</b>This method had the advantage of less trauma and clear exposure, firm and reliable fixation, and early activities.</p>

Comparison between mini-traumatic bone-grafting and non-bone-grafting in percutaneous K-wire fixation to treat the calcaneal fractures / 中国骨伤

<p><b>OBJECTIVE</b>To compare the effect between mini-traumatic bone-grafting and non-bone-grafting in percutaneous K-wire fixation for treating the calcaneal fractures.</p><p><b>METHODS</b>From 2002 to 2006, 112 patients with the type II (Paley type) fractures of calcaneus were studied. There were 56 cases in bone-grafting group involving 36 males and 20 famales,aged from 21 to 65, averaged (42.0 +/- 2.3) years; 11 cases were in type II a and 45 were in type II b; the course was from 3 to 14 days, averaged (6.0 +/- 1.2) days. And there were 56 cases in non-bone-grafting group involving 38 males and 18 famales,aged from 22 to 67, averaged (43.0 +/- 2.5)years; 13 cases were in type II a and 43 were in type II b; the course was from 2 to 15 days, averaged (5.0-2.1) days. All the cases were treated by closed reduction and percutaneous K-wire fixation, and bone-grafting group(56 cases) were treated by mini-traumatic bone-grafting, but the other group (56 cases) were not. The collapsing rate and fineness rate were compared.</p><p><b>RESULTS</b>All the cases were followed up from 5 to 52 months. There were no collapsing cases in the bone-grafting group after operation, but 3 cases occurrenced re-collapsing in the non-bone-grafting group. According to the Zhang Tie-liang's evaluation criterion, in the bone-grafting group,the results were excellent in 43 cases, good in 12, fair in 1, the fineness rate was 98.2%. In the non-bone-grafting group,the results were excellent in 37 cases, good in 16, fair in 2, poor in 1, the fineness rate was 94.7%.</p><p><b>CONCLUSION</b>Treatment of the type II fracture of calcaneus with closed reduction, percutaneous K-wire fixation and mini-traumatic bone-grafting can prevent the posterior talar articular surface of caltaneus from collapsing again after operation, enhance the union of fracture, elevate the curative effect, thus it should be taken with the standard therapeutic regimen.</p>

The randomized controlled trial of the treatment for clavicular fracture by rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation / 中国骨伤

<p><b>OBJECTIVE</b>To study the curative effect and safety of rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation in treating clavicular fracture.</p><p><b>METHODS</b>All 201 cases of clavicular fractures were randomly divided into treatment group (101 cases) and control group (100 cases). The treatment group was treated by rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation. The control group was treated by open reduction and internal fixation with Kirschner pin. All cases were followed up for 4 to 21 months (mean 10.6 months). SPSS was used to analyze clinic healing time of fracture and shoulder-joint function in both two groups.</p><p><b>RESULTS</b>After operation, 101 cases of treatment group achieved union of fracture and the clinical healing time was 28 to 49 days (mean 34.5+/-2.7 days). In control group,there were 4 cases with nonunion of fracture,the other 96 cases were union,the clinical healing time was 36 to 92 days (mean 55.3+/-4.8 days). The excellent and good rate of shoulder-joint function was 100% in treatment group and 83% in control group. By t-test and chi2-test, there was significant difference between the two groups in curative effect (P<0.05).</p><p><b>CONCLUSION</b>Rotatory manual reduction with forceps holder and retrograde pinning transfixation can be used in various kinds of clavicular shaft fracture, with many virtues such as easy operation, reliable fixation, short union time of fracture, good functional recovery of shoulder-joint and no incision scar affecting appearance.</p>

Percutaneous suture in the treatment of patellar fracture / 中国骨伤

<p><b>OBJECTIVE</b>To study therapeutic effects of patella and femur fixation combined with percutaneous suture in the treatment of patellar fractures.</p><p><b>METHODS</b>In the study,23 patients with patellar fractures were treated with percutaneous Kirschner-pin transfixation and percutaneous suture after Kirschner pins transfixation of superior pole of patellar and condyle of femur. Among the patients, 17 patients were male and 6 patients were female, ranging in age from 18 to 73 years (mean 32.4 years). The therapeutic effects were evaluated according to Bistman criterion for patellar fracture.</p><p><b>RESULTS</b>All the patients were followed up and ranged from 6 to 38 months (mean 11 months). All the fractures were anatomically reduction or near-anatomical reduction. According to Böstman criterion for patellar fracture, 20 were excellent and 3 good.</p><p><b>CONCLUSION</b>The method of patella and femur fixation combined with suture for patellar fractures has such advantages as smaller invasion, less complication or sequel, fine reduction of fracture, good restoration of joint function and none operative cicatrix.</p>