Manipulative reduction with minimally invasive percutaneous plate osteosynthesis for 60 patients with distal tibiofibular fractures / 中国骨伤

<p><b>OBJECTIVE</b>To explore clinical effects of manipulative reduction with minimally invasive percutaneous plate osteosynthesis in treating distal tibiofibular fractures.</p><p><b>METHODS</b>From 2009 to 2011, 60 patients with distal tibiofibular fractures were treated by manipulative reduction with minimally invasive percutaneous plate osteosynthesis. Among them, there were 32 males and 28 females aged from 14 to 70 years old with an average of 41.22 +/- 2.06. According to AO classification of fractures,5 cases were type A1, 22 cases were type A2,21 cases were type A3 and 12 cases were type C1. Operation time, blood loss,time of callus and fracture healing were observed, Mazur scoring of ankle joint were used to evaluate therapeutic.</p><p><b>RESULTS</b>Fifty-eight incisions were healed at stage I ,and 2 cases were infected at distal tibial. Operation time was with an average of (62.34 +/- 5.66) min ranged 45 to 90 min;blood loss was 30 to 150 ml with an average of (80.57 +/- 5.59) ml;formation of callus appeared from 4 to 12 weeks,with an average of (8.24 +/- 2.06) weeks, and fracture healing time was from 3 to 6 months, with an average of (4.50 +/- 1.13) months. According to Mazur scoring of ankle joint 40 cases got excellent results, 18 good, and 2 fair.</p><p><b>CONCLUSION</b>Manipulative reduction with minimally invasive percutaneous plate osteosynthesis can obtain reliable fixation. It is a good choice of treating distal tibiofibular fractures by protecting blood supply of fractures.</p>

Case-control study on bone setting manipulation for the treatment of over degree II supination-eversion fractures of ankle joint / 中国骨伤

<p><b>OBJECTIVE</b>To explore therapeutic effects of bone setting manipulation for the treatment of over degree II supination-eversion fractures of ankle,and analyze manipulative reduction mechanism.</p><p><b>METHODS</b>From 2005 to 2008, 95 patients with over degree II supination-eversion fractures of ankle were treated respectively by manipulation and operation. There were 43 cases [11 males and 32 females with an average age of (44.95 +/- 12.65) years] in manipulation group, and 2 cases were degree II, 11 cases were degree III, and 30 cases were degree IV. There were 52 cases [21 males and 31 females with an average age of (39.96 +/- 13.28) years] in operative group,and 6 cases were degree II, 18 cases were degree III, and 28 cases were degree IV. Bone setting manipulation and hard splint external fixation were applied to manipulative group. Operative reduction internal fixation was performed in operative group. X-ray was used to evaluate reduction of fracture before and after treatment, 2 months after treatment. Ankle joint function was evaluated according to Olerud-Molander scoring system after 6 months treatment.</p><p><b>RESULTS</b>All patients were followed up with good reduction. Three cases occurred wound complication in operative group, but not in manipulative group. In manipulation group, 19 cases got excellent results, 20 cases good and 4 cases fair; while in operative group, 30 cases got excellent results, 20 cases good and 2 cases poor. There were no significant differences in fracture reduction and ankle joint function recovery between two groups (P > 0.05). Efficacy of operative treatment was better than that of manipulative treatment at degree IV fracture (P < 0.05).</p><p><b>CONCLUSION</b>Bone setting manipulation is a good method for treating supination-eversion ankle joint fractures, which has advantages of simple and safe operation, reliable efficacy. For ankle join fracture at degree IV, manipulative reduction should be adopted earlier, and operative treatment also necessary</p>

Treatment of forearm double fracture with manipulative reduction and hard paper splints / 中国骨伤

<p><b>OBJECTIVE</b>To explore the therapeutic effects and complications of manipulative reduction and hard paper splints in treating forearm double fracture.</p><p><b>METHODS</b>From November 2005 to December 2010,38 patients with forearm double fracture were treated with manipulative reduction and hard paper splints immobilization, including 26 males and 12 females, aged from 18 to 66 years (averaged 28 years). The time from injury to manipulation was 20 min to 2 d with an average of 8 hours. Before treatment, the patients manifested swelling, pain, deformity,abnormal activity of injured limbs, dysfunction of elbow and wrist extension-flexion and forearm supination-pronation; X-rays showed fractures occurred in radius and ulna. Fracture healing, flexion function of elbow and wrist, supination-pronation function of forearm were used to evaluated the therapeutic effects.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 3 to 8 months,with a mean of 5.7 months. According to Anderson grade criterion of forearm fractures, 33 cases were excellent and fracture healing, which loss of elbow or wrist flexion and extension ranging <10% and forearm rotation <25%; 5 cases were good and fracture healing,which loss of elbow or wrist flexion and extension ranging <20% and forearm rotation loss <50%; there was no dissatisfactory or failure cases.</p><p><b>CONCLUSION</b>This method makes the fixation firmly, safely and utility, prevents the sore of pressing and necrosis, and worths further clinical applications.</p>