Case-control study on the treatment of Hawskins type II fractures of talar neck with minimally invasive or traditional approach / 中国骨伤

<p><b>OBJECTIVE</b>To compare the differences of radiographical and functional outcomes between traditional and minimally invasive approach in treating Hawskins type I fractures of the talar neck.</p><p><b>METHODS</b>From February 2000 to February 2008, 37 patients underwent reduction and internal fixation using two different approaches. In minimally invasive approach group, there were 16 males and 2 females, ranging in age from 20 to 47 years, averaged (35.2 +/- 3.1) years, and in traditional approach group, there were 15 males and 4 females, ranging in age from 22 to 44 years, averaged (35.3 +/- 2.3)years. All the patients had Hawskins type I fractures. The following data were compared between two groups: operation time, blood loss, length of incision and function of ankle joint. All the patients were graded by Hawkins points-scoring system after operation.</p><p><b>RESULTS</b>All patients were followed up. The duration ranged from 2 to 10 years, with an average of 5.6 years. The index such as operation time, blood loss and the length of incision of patients in minimally invasive approach group were significantly less than those of patients in traditional approach group. According to AOFAS points-scoring system, the score of minimally invasive group was higher than that of traditional approach group.</p><p><b>CONCLUSION</b>Compared with traditional approach, minimally invasive approach can protect blood supply better, get better clinical effects,which is worth of choosing to treat Hawskins type II fractures of talar neck.</p>

Application of elastic intramedullary nail in treating bilateral femoral shaft fractures in children / 中国骨伤

<p><b>OBJECTIVE</b>To explore the curative effects and complications of elastic intramedullary nail in treating children's bilateral femoral shaft fractures.</p><p><b>METHODS</b>Form February 2005 to March 2008, 7 patients with bilateral femoral shaft fractures were treated by closed reduction and internal fixation with elastic intramedullary nail. There were 5 males and 2 females. The age ranged from 3 to 13 years with the mean of 8.3 years. Six injuries caused by road accident and 1 injury caused by fall from high. Two cases associated with pulmonary contusion, 3 cases brain injuries, 1 case fracture of calcaneus and 1 case bladder injuries. All the cases were closed fractures without nerve and blood vessel injury. A cast external fixation had been used after operation for a month in two cases.</p><p><b>RESULTS</b>All the patients were followed up for 21-37 months with an average of 30.3 months. No infecton of incisional wound, displacement fracture, internal fixation fail, delayedunion and malunion were found. All fracture obtained healing for 7-12 weeks with an average of 8.7 weeks. Inequality of lower limb was found in 1 case (length differences was 5 mm). According to Flynn scoring,all fractures were excellent.</p><p><b>CONCLUSION</b>Treatment of femoral shaft fractures in children with elastic intramedullary nail according with biological principle. The method has little trauma, less complication, outstanding effect and it is a good way to treat bilateral femoral shaft fractures result from high-energy injuries.</p>