RESUMO
Objective:To evaluate the efficacy of dual-tuberosity locking plate for the treatment of proximal humeral fractures.Methods:This study retrospectively analyzed data of patients with proximal humeral fractures treated with a new locking plate from July 2017 to July 2019. Finally, 19 eligible patients were included, including 12 females and 7 males, with an average age of 64.0±12.8 years (range, 32-85 years). According to the Neer classification of proximal humeral fractures, 1 case was two-part fractures, 9 cases three-part fractures and 9 cases four-part fractures. Among them, 9 cases combined with greater and lesser tuberosities fractures and 10 cases with isolated greater tuberosity fractures. Constant-Murley and disabilities of the arm shoulder and hand (DASH) scores, the change of neck-shaft angle, the change of humeral head height, tuberosity consolidation and other complications were recorded at the latest follow-up.Results:The mean follow-up time was 16.1 months (range, 12-18 months). All fractures were healed within follow-up period. Mean Constant-Murley score was 84.2±11.0 (range, 55-98), DASH score was 19.4±11.6 (range, 2.3-47.8) and VAS was 1.6±1.3 (range, 0-4) at the latest follow-up. As for the radiographic results, 19 patients had a mean neck-stem angle of 141.9°±9.8° (range, 132.17°-162.66°) on the first day after surgery, and a mean humeral head height of 18.0±5.9 mm (range, 7.45-27.12 mm). The mean neck-stem angle was 148.6°±7.5° (range, 132.70°-159.39°) and the mean humeral head height was 17.4± 5.5 mm (range, 5.02-27.31 mm) at the latest follow-up. The average change of neck-stem angle was 3.29° (range, 0.68°-33.10°), and mean change of humeral head height was 0.68 mm (range, 1.32-6.56 mm). No fractures developed greater or lesser tuberosity absorption or malunion, but 4 cases suffered loss of fixation and 1 developed primary intra-articular screw penetration as well as wound infection.Conclusion:In the open reduction and internal fixation of the proximal humeral fractures, the new locking plate can fix greater and lesser tuberosity fractures simultaneously, which helps reduce their displacement and deformity of tuberosities. By given that, satisfactory radiographic outcomes and shoulder functions can be obtained.
RESUMO
Objective To investigate the diagnostic values of DCE-MRI quantitative evaluation of the activity of sacroiliac joints in ankylosing spondylitis.Methods Forty two patients (36 male and 6 female) with ankylosing spondylitis in our hospital were enrolled prospectively according to the standard of diagnostic criteria for ankylosing spondylitis revised in 1984.All of them were evaluated with the blood sedimentation,C-reactive protein and ankylosing spondylitis activity index (BASDAI).We divided the patients with ankylosing spondylitis into stationary phase group and active phase group.We analyzed each of the MRI images of the two patients groups using the extended Tofts model to determine the quantitative parameters of DCE-MRI,such as contrast transfer coefficient (Ktrans),reflux constant (Kep),extravascular extracellular volume fraction (Ve),plasma volume fraction (Vp).And then the differences of quantitative data between the two groups were compared.Spearman correlation analysis was performed between the parameters with statistically significant difference and BASDAI scores.Results Among the 42 patients,22 patients (18 male and 4 female) were in active phase group and the other 20 patients (18 male and 2 female) were in stationary phase group.Ktrans,Kep,Ve were (0.750± 1.130)/min,(1.008±0.732)/min,0.460± 1.735;(0.163±0.401)/min,(0.505 ± 0.902)/min,0.345 ±3.460 for active phase group and the stationary phase group,respectively.The results of the active phase group was significantly higher than the stationary phase group (Z=3.727,2.317,3.696,respectively;all P＜0.05).The Vp had no statistically significance for the active phase group (0.125 ± 0.310) and the stationary phase group (0.160 ± 0.329) (Z=1.209,P＞0.05).Strong correlations existed between Ktrans,Kep,Ve and BASDAI score,the correlation coefficients were 0.714,0.430,and 0.676 (P＜0.05).Conclusions Quantitative DCE-MRI parameters can evaluate the activity of the ankylosing spondylitis.Strong correlations exist between Ktrans,Kep,Ve and BASDAI score.