Treatment of Pauwels type III femoral neck fractures with modified percutaneous compression plate / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the preliminary effects of modified percutaneous compression plate in treating femoral neck fractures of Pauwels type III.</p><p><b>METHODS</b>From March 2012 to March 2016, 35 patients with femoral neck fracture were treated by closed reduction and internal fixation with a modified percutaneous compression plate, including 21 males and 14 females with an average age of 45 years old ranging from 23 to 62 years old. The anatomical position of fracture was divided into 8 cases of lower head type, 27 cases of head and neck. According to the Garden classification, there were 8 cases of type II, 18 of type III, and 9 of type IV fractures. All patients were closed injury. The general information, reduction quality, fracture healing time, postoperative complications were recorded and evaluated. Harris scoring was used to evaluate the hip joint function.</p><p><b>RESULTS</b>All patients were followed up for 15 to 24 months with an average of 20 months. All the incisions were primary healing. The reduction quality of the femoral neck fracture was evaluated according to the Garden's alignment Index, and the quality of reduction was grade I reduction in 29 cases and grade II reduction in 6 cases. No nonunion, femoral avascular necrosis, implant failure and hip varus was observed during follow-up. Harris score was(92.70±4.60) points at final follow-up, the results of the treatment was evaluated as excellent in 26 cases, good in 8 cases, fair in 1 case. No complications such as internal fixation loosening, nail breaking, and heterotopic ossification occurred.</p><p><b>CONCLUSIONS</b>Internal fixation with modified percutaneous compression plate has an advantages of decreased trauma, simple operation, rigid fixation, good function outcome, and low risk of complications.</p>

Operative treatment for proximal humeral fracture with rotator cuff tear in elderly patients / 中国骨伤

<p><b>OBJECTIVE</b>To explore operative clinical outcomes of proximal humeral fracture with rotator cuff tear in elderly patients.</p><p><b>METHODS</b>From March 2010 to August 2014,54 elderly patients with proximal humeral fractures with rotator cuff tear were performed operation, including 30 males and 24 females aged from 68 to 83 years old with an average of 71.5 years old. Thirty patients were caused by falling down, 24 cases were caused by traffic accident. According to Neer classification, 3 cases were part I, 11 cases were part II, 21 cases were part III and 19 cases were part IV. All patients were operated with open reduction and plate internal fixation, 46 cases suffered from rotator cuff tear and carried out repair of rotator cuff; 8 cases were not suffered from rotator cuff tear. Postoperative Neer evaluation of shoulder's function were used to assess clinical results.</p><p><b>RESULTS</b>Forty-six patients with rotator cuff tear were followed up from 8 to 21 months with an average of 11 months. All fractures were obtained bone union. No incision infection, axillary nerve injury,loosening screw, plate breakage, shoulder joint dislocation and humeral head osteonecrosis were occurred. According to Neer evaluation of shoulder's function, total score was 88.60 ± 5.12, and 30 cases got excellent results, 7 cases good, 7 cases moderate and 2 cases poor.</p><p><b>CONCLUSION</b>For osteoporotic proximal humeral fractures with rotator cuff tear in elderly patients' plate with rivet repair at stage I is an effective stable method, and provide advantages for earlier exercise of shoulder joint, then receive good clinical effects in further.</p>

Design of the reduction fixator and its clinical application in treating fracture of lesser trochanter of femur / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the clinical significance of the reduction and fixation for femoral lesser trochanteric fragment in treating the femoral comminuted intertrochanteric fractures.</p><p><b>METHODS</b>From January 2012 to December 2013,32 patients with intertrochanteric fractures were treated by surgery, and self-designed reduction fixators were used in the patients for the fixation of lesser trochanter of femur. There were 11 males and 21 females, ranging in age from 45 to 81 years old with an average of 64 years old. According to the Evans typing, 12 cases were type II, 13 cases were type III and 7 cases were type IV. Simple lag screw fixed in 19 cases and steel wire fixed in 13 cases. Hip joint function was evaluated according Harris score and the complications such as coxa adducta,cutting of femoral head and neck,implants breakage were observed.</p><p><b>RESULTS</b>Thirty-two patients were followed up from 9 to 24 months with an average of 13 months. Coxa adducta occurred in 1 case,no cutting of femoral head and neck occurred and implants breakage were found. The mean Harris score was 91.80 ± 3.05 in 32 patients.</p><p><b>CONCLUSION</b>The reconstruction and fixation for the posterior medial bone cortex continuity is a key factor on affect the stability of femoral intertrochanteric fracture. Self-designed reduction fixators can effective reduce and fix the lesser trochanter of femur, it has advantage of fast reduction and fixation, and simple operation.</p>

Transpedicular porking and grafting for the treatment of thoracolumbar spinal fracture / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the application of transpedicular porking repositor, thread device and transpedical interbody bone grafting apparatus in the treatment of thoracolumbar spinal fracture.</p><p><b>METHODS</b>From March 2008 to March 2011, 17 males and 15 females with thoracolumbar spinal fracture were treated by using self-designed transpedicular porking reposito, thread device and transpedical interbody bone grafting apparatus. The average age was 39.4 years (ranged from 25 to 65 years). All the cases were checked by X-ray and CT before and one week, one year after operation, removal of internal fixation. The angle of injured vertebral sagittal, cobbs angle and injured vertebral height were measured.</p><p><b>RESULTS</b>All patients were followed up, and the duration ranged for 14 to 21 months (averaged 16 months). The content of following up included loss of ithycyphos and height of spinal, fracture healing and implant fixation. Nerve vascular complication caused by implantation didn't occurred; interverbral body fusion was good. The results preoperative, 1 week and year postoperative and 3 months after taking out the internal fixation showed injured spinal height maintained well, loss and collapse of height and angle did not occurred.</p><p><b>CONCLUSION</b>Treating thoracolumbar spinal fracture can obtained satisfactory effects by using transpedicular porking repositor, thread device and transpedical interbody bone grafting apparatus. It has advantages of minimal invasive, and can promote fracture healing earlier, recover spinal height, rebuild stability of spinal, prevent loss and collapse of vertebral body height to avoid anterior lumbar surgery on the late stage.</p>