Timing and implant selection in conversion from external to internal fixation of tibial shaft fracture / 中华创伤杂志

Objective To investigate the time and implant selection in conversion from external fixation to internal fixation of tibial shaft fracture.Methods Data of 57 cases of tibial shaft fracture fixed externally followed by internal fixation from February 2003 to February 2012 were analyzed.Internal fixation (intramedullary nails or plates) initiated within 2 weeks (Group A,n =.35) and over 2 weeks (Group B,n =22) were compared in outcomes.Results One infection (3％) and four poor bone healing (11％) were observed in Group A.Five infections (23％) and three poor bone healing (14％) occurred in Group B.For intramedullary nail fixation,no infection was observed in Group A but infection rate of44％ was found in Group B.For plate internal fixation,infection rate was 8％ for both groups.Conclusions The conversion from internal fixation to internal fixation had better start within 2 weeks,with better resuhs,lower rate of infection and safer in comparison with that over 2 weeks.In addition,pin-tract infection is the high risk factor for infection after the conversion of the fixation.

Effect comparison of nonoperative and operative treatment of fracture of scapular neck / 中国医师进修杂志

Objective To explore the effective method for treatment of fracture of scapular neck.Methods A retrospective analysis of 40 patients with fractures of scapular neck was done.The patients were treated by operation or non-operation from August 1995 to August 2005.According to the degree of displacement,40 cases included 22 mild displaced fractures(≤10 mm,≤40°),and 18 severe displaced fractures (＞10 mm,＞40°),26 cases were non-operation and 14 cases by operation.Herscovici score was adopted.Results Forty patients were followed up for 1-3 years.Among 26 patients treated by non-operation,Herscovici score showed that 16 cases achieved the excellent result,2 cases good,3 cases fair and 5 cases poor.of 14 patients treated by operation,Herscovici score showed that 12 cases achieved the excellent result,2 cases good. Conclusion Fractures of scapular neck with mild displacement can be treated by non-operation while fractures of scapular with severe displacement or associated with ipsilateral clavical fractures should be treated by operation to reconstruct the stabihty of shoulder and minimize the complications.

Treatment of Tibial Pilon Fracture by Minimally Invasive Percutaneous Plate Osteosynthesis / 昆明医科大学学报

Objective To study the methods and effect of minimally invasive percutaneous plate osteosynthesis(MIPPO) on tibial Pilon fracture.Methods 49 cases of tibial Pilon fracture hospitalized,23 cases(group A) with minimally invasive percutaneous plate osteosynthesis(MIPPO) by indirect reduction and 26 cases(group B) with open restoration internal fixation by prospective contrast investigation.Results Compared with group B,the amount of blood loss and complications in group A markedly decreased,the healing of fracture was faster,the functional rehabilitation of ankle joint was more satisfactory.Conclusion Minimally invasive percutaneous plate osteosynthesis(MIPPO)on tibial Pilon fracture can meet the requirements of biological osteosynthesis,degrade soft tissue operation injury,be beneficial to fracture healing and functional rehabilitation of ankle joint.MIPPO is a safe and effective technique of tibial Pilon fracture.