Three fixation instruments for Schatzker Ⅵ tibial plateau fractures :a biomechanical comparison / 中国基层医药

Objective To compare the biomechanical effect of three fixation instruments for SchatzkerⅥtibial plateau fractures.Methods Twenty four fresh knee specimens were made into models of SchatzkerⅥtibial plateau fractures.The specimens were divided randomly into three groups.Group A were fixed with a lateral periar- ticular plate and a posteromedial antiskid plate,and group B with a lateral periarticutar plate and an anteromedial lim- ited contact dynamic compression plate(LC-DCP),and group C with a lateral periarticular plate and a medical exter- nal fixator.Each model was tested for its biomechanical performance in resisting compression,bending and rotation. Results The performance of group B was higher than group A in anti-compression,anti-bending and anti-rotation, and group C was the poorest,there was no significant difference between group A and group B,and there was signifi- cant difference between group B and group C.Conclusion The biomechanical performance of group B was good. The method might have clinical applications in the treatment of SchatzkerⅥtibial plateau fractures.

Percutaneous reduction and fixation of osteoporotic fractures for the proximal humerus in a geriatric population / 中华外科杂志

<p><b>OBJECTIVE</b>To appraise the value of clinical treatment of percutaneous reduction and fixation of osteoporotic fractures for the proximal humerus in a geriatric population.</p><p><b>METHODS</b>Postoperation complication, mortality in hospital and within the first three months postoperation, operation time, blood transfusion requirement, the functional outcome of the shoulder had been analysed and observed in 37 cases for open and closed fixation.</p><p><b>RESULTS</b>Closed reduction provided the benefit of obtaining and holding adequate reduction without the soft-tissue dissection of open reduction and internal fixation. The general complication and mortality in the first three months postoperation in the open reduction and internal fixation cases were more severe than the percutaneous cases.</p><p><b>CONCLUSIONS</b>Open operation increases the risk of the geriatric population with osteoporotic proximal humerus fracture; percutaneous reduction and fixation may be preferable.</p>

The use of minimally invasive injectable graft and internal fixation in tibial plateau fractures / 中华外科杂志

<p><b>OBJECTIVE</b>To value the use of an injectable minimally invasive calcium sulfate cement for displaced tibial plateau fractures.</p><p><b>METHODS</b>Thirteen patients with lateral tibial plateau fractures treated with internal fixation and bone grafting were matched with 13 patients treated using internal fixation and an injectable calcium sulfate cement. The clinical data were retrospectively analyzed. All patients were followed up for a minimum of one year. The peri-operative complication, quality of reduction, maintenance of reduction, function assessment and development of post-traumatic osteoarthritis was compared in both groups.</p><p><b>RESULTS</b>Ten patients in the internal fixation and bone graft group had excellent anatomical reductions as judged on immediate post-operative radiographs but some loss of reduction on follow-up at one year was observed in 8 of the 13 (61%) cases. Twelve patients from the MIIG group had an excellent reduction on immediate post-operative radiographs but 3 (23%)demonstrated some loss of reduction of the plateau at one year follow-up (P < 0.05).</p><p><b>CONCLUSIONS</b>The use of MIIG and internal fixation is associated with more favourable clinical results than conventional treatment with internal fixation and bone grafting for lateral tibial plateau fractures.</p>

Three different fixation instruments for tibial fractures:a biomechanical comparison / 中华创伤骨科杂志

Objective To compare the biomechanical performance of three different fixation instruments for tibial fractures.Methods Fourteen fresh tibial specimens were made into models of oblique fracture.Seven models were fixed with unilateral axial dynamic fixation(UADF),and seven with limited contact dynamic compression plate(LC-DCP).After biomechanical tests had been done for the UADF group,an extra screw was used at the oblique fracture site to reinforce the fixation with extra limited internal fixation.Each model was tested for its hiomechanical performance in resisting compression,bending and rotation.Results The performance of UADF was significantly poorer than that of LC-DCP and UADF with limited internal fixation in anti-compression,an- ti-bending and anti-rotation(P＜0.05).There was no significant difference in the rigidity between LC-DCP and UADF with limited internal fixation(P＞0.05).Conclusion UADF with extra limited internal fixation is a recommendable method for tihial fractures because it cart provide the same effective fixation as LC-DCP does.

Treatment of tibial plateau fracture with minimal invasion spinal surgery in 36 cases / 中华创伤杂志

Objective To investigate the clinical results of minimal invasion spinal surgery (MISS) in treating tibial plateau fractures to provide best procedure for such treatment.Methods The study involved 36 cases with tibial plateau fractures resulted from traffic injury,fall-from-height injury and strain injury including 24 males and 12 females at age of 19-65 years (average 42.6 years).According to Schatzker classification,there were seven cases of typeⅠ,five typeⅡ,five typeⅢ,five type IV,sev- en typeⅤand seven typeⅥ.All cases were treated by different methods of MISS.Results Follow up for 8-24 months in 35 cases showed fracture healing within 3-4 months,without severe complications such as poor wound healing,infection or osteofascial compartment syndrome.Meanwhile,no traumatic knee osteoarthritis,inversion or eversion of the knee were found.The mean range of knee motion was 94?,with fine knee function in 32 cases (91.4%) according to Merchant score.Conclusions Treatment of tibi- al plateau fractures should adopt limit incision,indirect reduction and biofixation to take place widespread exposure and rigid plate fixation.MISS is safe and effective for tibial plateau fractures.