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Objective To introduce a novel femoral distractor which is applied in close reduction and internal fixation (CRIF) with antegrade intramedullary nail for femoral shaft fractures.Methods From September 2010 to March 2015,85 patients with femoral shaft fracture were treated by CRIF with antegrade intramedullary nail in which our self-designed novel distractor was used.They were 64 males and 21 females,with an average age of 36.6 years.By AO classification,we had 32 cases of type 32-A,40 cases of type 32-B,and 13 cases of type 32-C.The intervals between injury and surgery averaged 7.5 days (range,from 1 to 16 days).The fracture was located at the upper shaft in 26 cases,at the middle shaft in 57 cases,at the middle shaft and ipsilateral neck in one,and at the lower shaft and ipsilateral intertrochanteric site in one.Their operation time,intraoperative blood loss,intra-and post-operative complications,and fracture union time were recorded and analyzed.Results Successful close reduction was achieved in all the 85 patients with no iatrogenic injury to major vessels or nerves.Operation time averaged 105.5 minutes;time for X-ray exposure averaged 25.8 seconds;intraoperative blood loss averaged 209.2 mL.The 85 patients received follow-ups from 8 to 24 months (mean,16.3 months).Fracture union was achieved in 83 cases after an average duration of 7.8 weeks (range,from 4 to 12 weeks),but nonunion occurred in 2 cases.One-year follow-ups revealed recovery of normal function of the affected knee in all,with no limb shortening ＞ 10 mm,rotational angulation ＞ 15°,or lateral or anteroposterior angulation ＞ 10°.No incision infection,deep vein thrombosis or pulmonary embolism happened during the entire follow-up.Conclusion Our self-designed novel distractor can facilitate CRIF with antegrade intramedullary nail for femoral shaft fractures,and avoid the complications and inconvenience associated with a traction table.
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[Objective]To assess the effect of a new invented spondylolisthesis reduction system:elevating-pull reduction system for surgical treatment of lumbar spinal spondylolisthesis associated with isthmic spondylolysis.[Method]Sixty-two patients with lumbar spinal spondylolisthesis were treated with elevating-pull reduction system combined with SRS(spondylolisthesis reduction system),after surgery the patients were evaluated for symptom improvement,intervertebral bone graft fusion,and internal fixation.[Result]The patients were followed up from 1 to 6 years(average 2 years and 5 months) in 62 patients.According to the criterion,excellent results were in 43 patients,good in 16,moderate in 3.No patient showed worse.No internal fixation loosening and breakage were found.[Conclusion]The new invented spondylolisthesis elevating-pull reduction system combined with SRS are more effective and reliable,especially for those osteoporosis patients and serious cases,the reduction and fixation are more effectively.In this procedure the pedicle entrance mouth can be seen straightly and the pedicle screw is inserted more easily.It can prevent the nerve injury,save the operation time,reduce the blood lossing,and excellent outcome can be obtained.