Treatment of pediatric radial neck fractures with elastic intramedullary nail:a report of 16 patients / 中华创伤杂志

Objective To discuss the clinical effect of titanium elastic intrameduUary nail (TEIN)in treatment of pediatric radial neck fractures. Methods A total of 16 children with radial neck fractures were treated TEIN from February 2008 to February 2010.Long arm cast immobilization was used one week postoperatively and functional exercise was done after removal of the external fixation.Results All the patients were followed up for average 5.3 months (3.5-14.0 months),which showed the average period of bony union for 5.8 weeks(4-7 weeks).Except for one patient who aroused skin soft-tissue irritation symptoms at the nail end,no other complication was found.The range of motion of the elbow and forearm in injury side of all patients Was the same as the normal side. Conclusions The application of TEIN has advantages of minimal invasive lesion,nil effect on pheseal plate,good fracture union,rapid functional rehabilitation and little compliations and hence is one of ideal choices in treatment of pediatric radial neck fracture.

Endoscope Disinfection in 8 Hospitals of One City:Present Situation and Countermeasure / 中华医院感染学杂志

OBJECTIVE To know the present situation of management of endoscope disinfection in order to improve the disinfection quality.METHODS A questionnaire and on-spot-survey were sent to 8 hospitals equipped with endoscope.RESULTS Eight different grade hospitals had a system of endoscope management established and integrated into their quantity management system.One hospital had isolated cleaning and sterilizing rooms,of which 3 hospitals were well ventilated;6 hospitals had special storage cabinets for endoscope,for endoscope as well as cleaning and sterilizing troughs.All of the hospitals used multienzymes and timers when doing cleaning.CONCLUSIONS There are some problems in the present situation.The way of management monitoring and occupational protection must be further improved to reduce the nosocomial infection.

Comparative study of elastic stable intramedullary nailing and bone plate set in treatment of femoral shaft fractures in children / 中华创伤杂志

Objective To investigate and evaluate the efficacy of elastic stable intramedullary nailing (ESIN) and bone plate set (BPS) in the treatment of femoral shaft fractures in children. Methods The study involved 39 children with femoral shaft fractures, of whom 18 children were treated with ESIN (ESIN group) and the other 21 with BPS (BPS group). In ESIN group, the nails were insert-ed through a micro incision in the medial and lateral epicondyle after closed reduction under C - arm ob-servation. In BPS group, the plates were placed on the lateral side of femur by means of open reduction and internal fixation. Results All the patients were followed up for 4-20 months (mean 10 months), which showed fracture healing in all the patients. The mean operation time, incision length, perioperative blood loss, length of hospital stay, time of fracture healing and time of weight bearing were (40.0±17.0) minutes, (2.0±0.6) cm, (30.0±8.0) ml, (7.0±1.5) days, (8.0±1.2) weeks and (6.0 ±1.0) weeks respectively in ESIN group, and (70.0±25.0) minutes, (12.0±1.1) cm, (150.0±30.0) ml, (14.0±5.2) days, (13.0±1.9) weeks and (4.0±1.3) weeks respectively in BPS group, with statistical difference between two groups (P < 0.05). Conclusions Compared with BPS, ESIN has the advantages of less operation wound, less perioperative blood loss and shorter time for fracture healing. ESIN can protect the microenvironment important for the fracture healing, and is one of ideal op-tions for treatment of femoral shaft fracture in children.

Curative effect of minimally invasive plate osteosynthesis for complex fractures of the distal femur / 中华创伤杂志

Objective To evaluate the clinical results of minimally invasive plate osteosynthesis (MIPO) in treatment of complex fractures of the distal femur. Methads From July 2005 to December 2006, 41 patients with complex distal femur fractures induced by high energy trauma were treated with MIPO plus locking compression plate(LCP). There were 31 males and 10 females, at average age of 38 years(17-65 years). According to the AO/OTA fracture classification system, there were 11 patients with type A3 fractures, 22 with type C2 and 8 with type C3. There were 16 patients with open fractures. The clinical result was evaluated by using function examination and radiographic assessment. Results All patients were followed up for average 8 months(2-18 months), which showed fracture healing, with mean healing time of 13 weeks(7. 16 weeks). There was only 1 patient with superficial infection but no fixation failure or implant breakage were found. The average knee range of motion was 110°(45°-135°). Hospital for special surgery knee rating scale(HSS) showed excellent or good results in 36 patients (88%). No patient with greater than 5°difference in either varus or valgus was detected when compared 2 days after operation with latest follow-up. Conclusion In treatment of complex distal femur frac-tures, MIPO plus LCP have advantages of minor trauma, stable fLxation, slight interference on soft tis-sues, early fracture healing and few complications.

The biomechanical study of rotating-arm self-locking intramedullary nails in comminuted femoral shaft fractures / 生物医学工程学杂志

This study was sought to compare and evaluate the biomechanical properities of rotating-arm self-locking intramedullary nails (RSIN) with domestic femoral intramedullary nail (DFIN) in communited femoral shaft fractures. A 2 cm midshaft defect was created on seven pairs of cadaver femur, and fixed with two kinds of intramedullary nails. Then the torsion, four-point bending and axial loading to failure were tested on these models. The load versus deformation curve was generated from the load recorded by the load cell and the deformation simultaneously recorded by the linear variable displacement transducer. The mean torsional stiffness of the femora fixed with RSIN was 0.98 Nm/degree, which was significantly less than that fixed with the similar nails reported in documents, and the mean value of bending stiffness of the femur fixed with DFIN was larger than that of the femur fixed with RBIN, but there was no significant statistic difference. For use in fracture models under compression load beyond 1200 N, the RBIN was more rigid than DFIN, which provided the biggest load. All the parameters of the test with nails were greater than that for femur fixed with nails. In conclusion, FBIN probably provides enough strength and rigidity for use in communited femoral shaft fractures.

Analysis of the causes of the 583 cases of hip fracture / 中国矫形外科杂志

[Objective]To study the tendency of hip fracture by analyzing morbidity factors to provide an basis for preventing the fracture.[Method]All of the case records of hip fractures treated at west china hospital between 2000-1 and 2005-12 were checked and 583 inpatients were selected for analysis.[Result]The major injury cause was fall in the old and female was more susceptible.High energy injury was the major cause in younger 50. Osteoporosis and fall contributed best to the hip fracture in elderly.Concomitant disease and environmental factors increased the risk.[Conclusion]Osteoporosis and fall contribute most to the hip fracture in elderly,accordingly,to prevent fall and osteoporosis is vital to the old.

A preliminary clinical study on absorbable screws / 生物医学工程学杂志

To evaluate the application of self-reinforced ploy-DL-lactide (SR-PDLLA) absorbable screws in the treatment of spongy bone and intra-articular fractures, the internal fixation with SR-PDLLA absorbable screw was performed on 58 cases,of which 25 were medial malleolus fractures, 14 condyle of humerus fractures, 9 tibial plateau fractures, 7 ulnar olecranon fractures, and 3 lateral malleolus fractures. Observations were made on the orthopaedic operation sites and overall conditions frequently and radiography was performed for periodic analysis. The results showed that SR-PDLLA absorbable screws were particularly effective and reliable, they had good biocompatibility in the treatment of spongy bone and intra-articular fractures and could be used safely in clinical practice.

Biomechanical study on rotating-arm self-locking intramedullary nail in the treatment of tibial shaft fracture / 生物医学工程学杂志

We have designed a new kind of self-locking intramedullary nail for the treatment of unstable fracture of the middle and distal tibial shaft and have compared it with the interlocking nail by means of biomechanical experiments. The data could be used as a basis for clinical application. Fourteen formalin-fixed tibials of adults were made into unstable fracture models with a 2cm bone defect each. They were divided into 2 groups. Group 1 was fixed with self-locking intramedullary nail and group 2 was fixed by interlocking nail. All specimens were submitted to biomechanical test. The data were analysed by t test. The results showed there is no difference in anti-bending stiffness between the self-locking intramedullary nail and the interlocking nail. The anti-rotating and anti-compressing stiffness of interlocking nail is slightly better than that of self-locking intramedullary nail, but still the firmmess of the self-locking intramedullary nail in resisting rotation can meet the requirement of biological fixation. Its structure is reasonable, simple, practical, and it can resist certain harmful stress.