Clinical effect of platelet-rich plasma combined with bone graft on bone defect in humeral condylar / 局解手术学杂志

Objective To investigate the effect of platelet-rich plasma(PRP) combined with bone graft in the treatment of humeral condylar bone defect.Methods A total of 135 patients with humeral condylar bone defect in Ankang central hospital from January 2012 to December 2015 were divided into the PRP combined group(n =69) and the conventional group(n =66) according to the order of admission time.The patients of PRP combined group were treated with platelet-rich plasma combined with autologous bone graft,and patients of conventional group received autologous bone graft,respectively.The surgery time,hospitalization time,wound healing,fracture union and the motion of elbow joint at postoperative 1 year between two groups were compared.The Kaplan-Meier survival curve was used to reflect the bone healing in both groups,and the log-rank test was used to compare the result.Results There was no statistically significant difference in the surgery time,hospitalization time,wound healing and motion of elbow joint at postoperative 1 year between the two groups(P ＞ 0.05).But the average time of wound healing (3.8 ± 0.72) weeks and the time of bone union (18.8 ± 3.50) weeks in PRP combined group were significantly shorter than (6.4 ±0.58) weeks and (22.7 ± 1.55) weeks in the conventional group(P =0.000),the differences were significant.The KaplanMeier survival curve of the bone union in the PRP combined group was also significantly better than that in the conventional group.Conclusion PRP can promote the healing of fracture in patients with humeral condylar bone defect after autologous bone graft,which contributes to the recovery of elbow function.

The internal fixation with double steel plate by the olecranon osteotomy approach in the treatment of severe condyle humeral intercondylar splintered fracture / 中国基层医药

ObjectiveTo explore the effect and surgical management of the internal fixation with double steel plate by the olecranon osteotomy approach in the treatment of severe condyle humeral intercondylar splintered fracture.Methods50 patients with severe condyle humeral intercondylar splintered fractures were treated by double plate internal fixation through olecranon osteotomy.ResultsAll patients(50 cases) were followed up for 6 months to 2 years.The complications such as bone defect,ossifyingmyositis,tardive ulnar nerve compression,and internal fixation fail were not found.According to Aitken Rorabeck scale,the function of the elbow showed excellent in 35 cases,good in 9 cases,fair in 6 cases,the excellent and good rate was 88％.ConclusionThe internal fixation with double steel plate by the olecranon osteotomy approach in the treatment of severe condyle humeral intercondylar splintered fracture was a good approach.Anatomical reduction surgically reconstructed stabilization of the elbow and early active rehabilitation were crucial factors of functional rehabilitation of the elbow.

In Situ Late Metaphyseal Osteosynthesis for the Fractures of the Lateral Humeral Condyle in Children

PURPOSE: To evaluate the efficacy of the in situ late osteosynthesis for slightly displaced fractures of the lateral humeral condyle. MATERIALS AND METHODS: From 2000 to 2004, 12 patients (8 boys and 4 girls) were managed with in situ late osteosynthesis for fractures of the lateral humeral condyle. The average age at the time of operation was 6 years 1 month (1 year 7 months~9 years 1 month), and the mean amount of fragment displacement was 3.3 mm (2.0~4.5 mm). The operative procedure included curettage and in situ fixation of the fragment RESULTS: Bony union was achieved in all cases after avg. 48 months (33~73 months) follow-up assessment. According to the score system of Dhillon et al, 7 patients had excellent, 3 had good, 2 had fair results. None of the patients developed avascular necrosis or premature closure of the epiphysis. CONCLUSION: We suggest that in situ fixation is an effective method for the late treatment of slightly displaced fracture of the lateral humeral condyle.

Surgical Treatment for the Neglected Non-union of the Lateral Humeral Condyle / 대한정형외과학회잡지

PURPOSE: To assess the clinical results of surgical treatment for established nonunion of the lateral humeral condyle and to determine the factors necessary for successful outcome. MATERIALS AND METHODS: 12 patients with nonunion of the lateral humeral condyle underwent open reduction, autogenous iliac bone graft and internal fixation with two smooth or treated K-wires between 1994 and 1999. Mean age was 16 years and the mean follow-up period was 2 years and 8 months. RESULTS: All of the patients achieved solid union at the nonunion site and were free of pain in the elbow upon strenuous activities. Average union time was 7.2 weeks after the surgery. Aggressive anatomical reduction of the fragment must not be undertaken because it may disturb a well adapted joint congruity in adults. Rigid internal fixation with iliac bone graft and preservation of the blood supply of the distal fragment are important factors for a successful outcome. The range of motion of the elbow joint decreased 10.5 degrees on average after surgery. Valgus deformity improved in four of six patients. CONCLUSION: The patients with symptomatic established nonunion are good candidates for surgery, even adults.

Change of Carrying Angle in Fracture of the Lateral Humeral Condyle in Children / 대한정형외과학회잡지

From June 1980 to May 1986, 24 fractures of the lateral condyle of humerus in children ranging in age from 1 to 11 years were treated at the Department of Orthopedic Surgery, Kyungpook National University Hospital. Authors have been analized all cases of fractures clinically, especially the change of carryin angle by radiographic examination in follow-up periods. The results were as follows : 1. Fractures are more common in male than female. Mean age at time of fracture was 5.4 years. Fractures were predominated in the left side by 66.7%. 2. By the classification of epiphyseal injury, all cases were Salter-Harris type IV. By the classification of fragment displacement, Wadsworth type II fracture was most comrnon in 66.7%. They were treated with open reduction and internal fixation in 20 and with conservative treatment in 4. 3. The range of change in carrying angle was distributed from 9 degree decrease to 8 degree increase with a mean of 4.1 degrees. The range of change in carrying angle was influenced by degree of fragment displacement at the time of initial injury and longer period of follow-up. 4. The complications were lateral condylar voergrowth(20.8%), premature epiphyseal fusion(8.4%), snd nonunion(4.1%). By the criteria of Hardacre et al, 8 cases(33.3%) showed excellent result, 15 cases (6. 2%) showed good result, and 1 case (4.2%) showed poor result.