RESUMO
Objective To investigate the clinical results of arthroscopic double-pulley double row suture technique for the treatment of bigger Ideberg Ⅰa glenoid fracture.Methods From January 2014 to July 2017,data of patients with Ideberg Ⅰa glenoid fracture who were treated by arthroscopic double-pulley double row suture technique were retrospectively analyzed.Totally 24 patients were enrolled of whom 13 were males and 11 were females.The mean age was 50.14±10.60 years (range,34-67).In those patients,there were 8 cases of glenoid fracture alone,4 cases of glenoid fracture associated with greater tuberosity fracture,5 cases of glenoid fracture with rotator cuff tear,4 cases of glenoid fracture with shoulder anterior dislocation and greater tuberosity fracture,2 cases of glenoid fracture with shoulder anterior dislocation and rotator cuff tear,and 1 case of shoulder anterior dislocation with ipsilateral distal radius fracture.The fragment accounts for 28.91±5.35％ (range,25.1％-38.5％) of the glenoid articular surface.According to the size of the fragment,one medial row anchor was used to implant at the medial edge of the fracture bed of the anterior edge of the glenoid;two to four lateral row suture anchors were used to implant at the margin of the glenoid joint surface sequentially from low level to higher level,and simplified double-pulley technique was finally used to fix the fragment.The situation of fracture reduction and healing and the post-operative complications were evaluated.The Constant-Murley,DASH and VAS were also recorded.Results Satisfactory fracture reduction and fixation were achieved in all 24 patients.The mean followup time was 19.5 months (range,12-36).Mean VAS was 0.8±0.8 (range,0-2).The range of motion at the latest follow-up was:anterior flexion 145°-180° (mean,161.00°±5.77°),external rotation at the side 35°-60° (mean,46.43°±6.63°),internal rotation L3-T10 level.The mean Constant-Murley score was 88.1±3.7 (range,81-93),and mean DASH score was 8.4±4.7 (range,0-40.4).All cases except one showed no dislocation or disability of the shoulder.The CT scans showed:19 cases of which the step-off of articular surface was less than 2 mm;4 cases of which the step-off was between 2 mm to 4 mm and 1 case of which the step-off was more than 4 mm.No severe osteoarthritis was identified at the latest follow-up,and only 1 patient at the age of 67 showed slight osteoarthritis.Two patients with shoulder anterior dislocation and rotator cuff tear committed significant restricted shoulder range of motion.Conclusion The arthroscopic simplified double-pulley double row suture technique was identified safe,effective and reliable for treating the bigger Ideberg Ⅰa glenoid fracture.The technique is able to provide clear visulization of the fracture and achieve excellent clinical results.
RESUMO
Objective@#To investigate the clinical results of arthroscopic double-pulley double row suture technique for the treatment of bigger Ideberg Ia glenoid fracture.@*Methods@#From January 2014 to July 2017, data of patients with Ideberg Ia glenoid fracture who were treated by arthroscopic double-pulley double row suture technique were retrospectively analyzed. Totally 24 patients were enrolled of whom 13 were males and 11 were females. The mean age was 50.14±10.60 years (range, 34-67). In those patients, there were 8 cases of glenoid fracture alone, 4 cases of glenoid fracture associated with greater tuberosity fracture, 5 cases of glenoid fracture with rotator cuff tear, 4 cases of glenoid fracture with shoulder anterior dislocation and greater tuberosity fracture, 2 cases of glenoid fracture with shoulder anterior dislocation and rotator cuff tear, and 1 case of shoulder anterior dislocation with ipsilateral distal radius fracture. The fragment accounts for 28.91±5.35% (range, 25.1%-38.5%) of the glenoid articular surface. According to the size of the fragment, one medial row anchor was used to implant at the medial edge of the fracture bed of the anterior edge of the glenoid; two to four lateral row suture anchors were used to implant at the margin of the glenoid joint surface sequentially from low level to higher level, and simplified double-pulley technique was finally used to fix the fragment. The situation of fracture reduction and healing and the post-operative complications were evaluated. The Constant-Murley, DASH and VAS were also recorded.@*Results@#Satisfactory fracture reduction and fixation were achieved in all 24 patients. The mean follow-up time was 19.5 months (range, 12-36). Mean VAS was 0.8±0.8 (range, 0-2). The range of motion at the latest follow-up was: anterior flexion 145°-180° (mean, 161.00°±5.77°), external rotation at the side 35°-60° (mean, 46.43°±6.63°), internal rotation L3-T10 level. The mean Constant-Murley score was 88.1±3.7 (range, 81-93), and mean DASH score was 8.4±4.7 (range, 0-40.4). All cases except one showed no dislocation or disability of the shoulder. The CT scans showed: 19 cases of which the step-off of articular surface was less than 2 mm; 4 cases of which the step-off was between 2 mm to 4 mm and 1 case of which the step-off was more than 4 mm. No severe osteoarthritis was identified at the latest follow-up, and only 1 patient at the age of 67 showed slight osteoarthritis. Two patients with shoulder anterior dislocation and rotator cuff tear committed significant restricted shoulder range of motion.@*Conclusion@#The arthroscopic simplified double-pulley double row suture technique was identified safe, effective and reliable for treating the bigger Ideberg Ia glenoid fracture. The technique is able to provide clear visulization of the fracture and achieve excellent clinical results.
RESUMO
@#Objective To compare the effects of peripatellar peripheral nerve partially and totally depolarized in total knee arthroplasty (TKA). Methods 66 TKA patients were divided into partially depolarized group (A, 42 knees) and totally depolarized group (B, 38 knees). The scores of knee-joint, Feller and Visual Analogue Scale were recorded. Results There was no significant difference in all the scores between 2 groups before operation (P>0.05). All the scores improved after operation (P<0.05), however, there was still no significant difference between 2 groups (P>0.05). Conclusion Patellar peripheral nerve partially depolarization technique can reduce postoperative knee pain, which has the same effect with totally depolarization.
RESUMO
Objective To compare the effects of peripatellar peripheral nerve partially and totally depolarized in total knee arthroplasty (TKA). Methods 66 TKA patients were divided into partially depolarized group (A, 42 knees) and totally depolarized group (B, 38 knees). The scores of knee-joint, Feller and Visual Analogue Scale were recorded. Results There was no significant difference in all the scores be-tween 2 groups before operation (P>0.05). All the scores improved after operation (P0.05). Conclusion Patellar peripheral nerve partially depolarization technique can reduce postoperative knee pain, which has the same effect with totally depolarization.
RESUMO
BACKGROUND:Tranexamic acid is a synthetic anti-fibrinolytic drug, and can effectively control blood loss after total knee arthroplasty through vein. OBJECTIVE:To evaluate the effectiveness and safety of tranexamic acid in reducing blood loss after primary unilateral total knee arthroplasty. METHODS:From 2014 to 2015, 100 patients from the Department of Lower Limb, Sichuan Orthopaedic Hospital underwent primary unilateral total knee arthroplasty, and randomly divided into test group which used tranexamic acid and control group which used tranexamic acid, with 50 cases in each group. 1 g tranexamic acid was infused into the vein at 10 minutes before total knee arthroplasty in the test group, but tranexamic acid was not given in the control group. RESULTS AND CONCLUSION:The amount of total blood loss, postoperative wound drainage in 24 hours, and the amount of blood transfusion were significantly less in the test group than in the control group (P < 0.05). No significant differences in intraoperative blood loss and the number of patients receiving blood transfusion were found between the test and control groups. No significant difference in preoperative hemoglobin levels was detected before surgery, but hemoglobin levels were decreased after surgery between the two groups. Postoperative hemoglobin levels were apparently higher in the test group than in the control group after surgery. At 24 hours after surgery, no significant difference in coagulation was detectable between the two groups. At 6 days, double lower limb vein color Doppler ultrasound examination did not reveal deep vein thrombosis in both groups. These findings verify that treatment with tranexamic acid in the vein before primary unilateral total knee arthroplasty can evidently diminish the amount of perioperative blood loss and blood transfusion, reduce the risk and cost of blood transfusion, which is good for rehabilitation and does not increase the risk of deep vein thrombosis.