Choice of surgical opportunity and management of high-energy Pilon fractures / 中国基层医药

Objective To explore surgical opportunity and management of high-energy Pilon fractures.Methods Twenty-five cases of the high-energy Pilon fractures were treated with anatomic type plate one-staged or ses of type III fractures.8 cases were open fractures and 17 cases were close fractures.8 cases open fractures and 6 cases close fractures were treated with anatomic type plate one-staged.11 cases close fractures with serious soft tissue swell were treated two-staged delayed.The combined fibular fractures were fixed accordingly.All cases were followed up for 32 months after operation in average( range 17 to 76 months).Results According to Mazur's criteria,the surgical result was evaluated as excellent in 10 patients,goed in 11 ,fair in 3 and poor in 1.Postoperative complication ineluded infection in 2 cases,necrosis of skin in 1 case and traumatic arthritis of the ankle joint in 2 cases.Conclusion In order to get a satisfactory result,it is important to choose the right timing of surgery and correct procedure in high-energy Pilon fracture.

The use of three kinds internal fixators in improving spinal stability postoperatively / 中国组织工程研究

Aim To evaluate the clinical value of two cervical spinallocking plates, Orion and Zephir, and a new anterior cervical instrumentalsystem combining an intradiscal cage with an integrated plate(PCB) afteranterior cervical decompression surgery. Methods 47 patients were followedup for 7 - 26 months with an average of 15 months after surgery. Of them, 30were treated with Orion, 1 1 with Zephir and another 6 with PCB. Results 26cases with preoperative intervertebral space constriction and 18 cases withchanges of cervical physiological protrusion all achieved satisfying effect ofrebuilding intervertebral space height after operation. The cases with obviousintervertebral space height loss were not seen after follow up. The physio-logical curvature corrected by operation was well kept. Neurological functionwas improved in 43 cases on different extent after operation. The other 4cases with no obvious recovery of neurological function were all that withcomplete paraplegia after trauma. Conclusion PCB is suitable for treatmentof the acute cervical protrusion or the cervical spondylotic myelopathy at onelevel. Zephir and Orion are suitable to all kinds of cervical vertebra lesions atmore than one level and complex lesion at one level, which helps the re-covery of cervical physiological curvature and height of disc space.