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Objective To evaluate the clinical use of delayed open reduction and internal fixation technique in the treatment of Rud?i Ⅲ Pilon fractures. Methods From May 1997 to June 2003, 38 patients with Rud?i Ⅲ Pilon fractures underwent immediate calcaneal traction as well as treatment with methylprednisolone and mannitol. After 5-8 days, all patients underwent regular open reduction and internal fixation with cloverleaf buttress plates. One week after the operation, ankle joint began to exercise with no weight bearing. Results All patients were followed up for average 18 months and evaluated subjectively and objectively by using systems of Teeny and Wiss, which showed good results for 74 %, mild for 21% and poor for 5%. All fractures healed within an average of 5.7 months except for two cases of infections and one soft tissue complication. Conclusion Delayed open reduction and internal fixation offers acceptable way for treatment of severe Pilon fractures.
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Objective To study the application of extended tibia tubercle osteotomy in revision of total knee arthroplasty. Methods Retrospective study was carried out in 12 cases that had received extended tibia tubercle osteotomy in Zhongshan Hospital from May 1998 to October 2002. Results After osteotomy, all knees were healed clinically and radiologically at 6th month postoperatively. Average range of joint motion increased from 79 degrees to 95 degrees. Average knee score improved from 60 to 85. Conclusion Extended tibia tubercle osteotomy can improve the exposure of operation and knee joint function.
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PurposePresent study investigated the role of metal on metal surface replacement of the hip in treating the young patients suffering rheumatoid arthritis or aseptic necrosis of femoral head.Methods Between Jan. 1995 and Dec. 1996.16 patients with 17 hips( rheumatoid arthritis 14, aseptic necrosis of femoral head 3) were resurfaced with hybrid metal on metal surface replacement prothesis. Patients were evaluated by self assessment form,hip function examination. Radiographs and Harris hip score. The average follow up time was 58.2 months. ResultsNo patient received revision. Radiographs showed that all implants were in position satisfyingly. No loosening were revealed. The result of self assessment showed that patients were satisfied with 16 hips. The Harris score rose from preoperative 44(31 - 52) to postoperative 91 (79- 96). ConclusionsThe metal on metal surface replacement of hip is a useful treatment to release pain and keep the hip function of young patients suffering rheumatoid arthritis or aseptic necrosis of femoral head.
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0.05). Radiographic analysis showed quite good results in 77 cases. Complications included delayed union in six cases, severe stiffness in one and neuropraxia in two. Conclusions Open reduction and internal fixation of intracondylar humeral fractures is a safe and effective technique. Meanwhile, triceps-split approach and olecranon osteotomy can obtain same clinical outcome for intracondylar humeral fractures.
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Objective To investigate clinical results of shoulder hemiarthroplasty in treating comminuted proximal humeral fractures. Methods Shoulder hemiarthroplasty was performed from May 1997 to June 2004 in 28 cases with comminuted proximal humeral fractures who were followed up for mean 2.1 years. American Shoulder & Elbow Surgeon (ASES) score was adopted for evaluating pain after operation, range of active movement and function of daily work. Results Mean ASES score was 87.9(67-96 scores), with mean forward flexion of 132?, external rotation of 40?, mean VAS score of 2.6 and internal rotation at T_ 10 level. Strength and function of 23 cases reached 80% of the normal side six months postoperatively and 90% of the normal side one year postoperatively. Of all cases, 82% were satisfied with the treatment. Conclusion Only reconstruction of normal humeral length, tuberosity fixation and persevering rehabilitation can contribute to a successful result of hemiarthroplasty for the comminuted proximal humeral fractures.