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Objective:To investigate the efficacy of the posterior axillary approach in the treatment of some scapular fractures.Methods:Retrospectively analyzed were the data of 41 patients with scapular fracture who had been treated through the posterior axillary approach at Department of Traumatology, The Second Hospital of Jilin University from April 2018 to July 2021. There were 32 males and 9 females, aged from 24 to 83 years (average, 52.4 years). Of them, 7 were complicated with multiple injuries, 16 with other fractures, and 4 with brachial plexus injury. Recorded were length of surgical incision, intraoperative blood loss, operation time, and range of shoulder motion, Disability of Arm Shoulder and Hand (DASH) score, Constant shoulder score and postoperative complications at the last follow-up.Results:In this cohort, length of incision ranged from 7 to 12 cm (average, 9.3 cm), intraoperative blood loss from 80 to 150 mL (average, 110.5 mL), exposure time of the posterior axillary approach from 5 to 10 min (average, 7.9 min), and fracture operation time from 85 to 140 min (average, 110.8 min). The 41 patients were followed up for 6 to 36 months (mean, 14.3 months) after surgery. At the last follow-up, the average ranges of shoulder motion were 177° (from 150° to 180°) in flexion, 175° (from 140° to 180°) in abduction and 47° (from 30° to 50°) in extension, the average DASH score was 36.4 points (from 34 to 46 points), and the average Constant score 96.0 points (from 84 to 100 points). There were no complications like loss of fracture reduction, loosening or breakage of plate or screw during follow-up. Incision healing was delayed in 2 patients and mild heterotopic ossification occurred in 2 patients.Conclusion:As a new surgical approach for some scapular fractures, the posterior axillary approach allows internal fixation of the fractures of the scapular glenoid, neck and body under direct vision, leading to good-looking postoperative wound and reliable curative effects.
RESUMO
BACKGROUND:Mechanical property test is an important method for assessing the therapeutic effect of drug therapy in osteoporosis animal models. But there are rare reports on the three-point bending mechanical test for evaluating the therapeutic effects of a variety of drugs on a female rat model of senile osteoporosis. OBJECTIVE: To explore the interventional effects ofDanqi particles, premarin, ipriflavone and αD3 in a rat model of osteoporosis through the three-point bending mechanical test. METHODS:Forty-eight female Wistar rats were randomized into six groups, and animal models of senile osteoporosis were made in al rats except for those in the normal control group. Then, the rats were givenDanqi particles (0.9g/kg/d), ipriflavone (1 mg/kg/d), αD3 (0.1 mg/ka/d) and premarin (0.3 mg/kg/d) in theDanqi, ipriflavone, αD3 and premarin groups, respectively. An electronic universal testing machine was used to perform the three-point bending mechanical test on the bilateral tibiae of rats. RESULTS AND CONCLUSION: Compared with the model group, the maximum load, maximum stress, maximum bending moment, maximum stress, elastic modulus of the tibia were significantly higher in theDanqi, ipriflavone and premarin intervention groups (P 0.05). There were also no significant differences in the maximum load, maximum stress and maximum strain between the Danqi and normal control groups (P> 0.05). These findings indicate thatDanqi, ipriflavone and premarin interventions have good achievements in the three-point bending mechanical test, and theDanqi particles have the best intervention effects. αD3 has no obvious effects on the three-point bending mechanical performance.