Treatment of displaced humeral supracondylar fractures in children with external fixation using plaster or splint / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the therapeutic effects of closed reduction and external fixation (plaster or splint) for the treatment of displaced humeral supracondylar fractures in children.</p><p><b>METHODS</b>From March 2007 to September 2009,33 children (15 female and 18 male) with humeral supracondylar fractures treated in our hospital, ranging from 3 to 12 years old with an average of 6.4 years old. All the fractures were extension-type injuries, the flexion injures were excluded in our study. The humeral supracondylar fractures were classified according to Gartland classification. There were 21 Type H and 12 type III. In the initial treatment, all the patients were treated with closed reduction and external immobilization. The blood supply of the damaged upper extremity was evaluated before and after treatment. Clinical assessment was obtained at final follow-up using Flynn criteria, and radiologic assessment was obtained using Baumann and lateral humerocapitellar angles.</p><p><b>RESULTS</b>All the children were treated successfully with closed reduction in the initial time; 24 children maintained limb alignment by external immobilization. Nine patients lost position due to the swelling around the elbow which affected unstable external fixation during the follow-up, 5 of which were treated with a repeated closed reduction and internal fixation with Kirschner wires, 4 of which were treated with traction. Thirty-one patients had a satisfactory outcome and 2 patients had an unsatisfactory outcome according to the Flynn criteria at the latest follows-up.</p><p><b>CONCLUSION</b>Closed reduction and external stabilization is an important method for the treatment of displaced humeral supracondylar fractures in children. Making regular follow-up visits after closed reduction and casting is important for patients to maintain acceptable alignment, avoid complications and diagnose any loss of reduction.</p>

Comparison percutaneous cervical disc nucleoplasty and cervical discectomy for the treatment of cervical disc herniation / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the therapeutic effect of percutaneous cervical disc nucleoplasty (PCN group) and percutaneous cervical discectomy (PCD group) for the treatment of cervical disc herniation.</p><p><b>METHODS</b>A retrospective study was carried out from July of 2002 to December of 2004, and there were 80 cervical disc herniation cases who were operated by PCN (42 cases) or PCD (38 cases). The time of operation, clinical result and the stability of cervical spine after operation were evaluated and compared between 2 groups.</p><p><b>RESULTS</b>All cases had been followed up from 6 months to 26 months, average (12 +/- 5) months on the PCN group and (12 +/- 4) months on the PCD group, and there was no significant difference on 2 groups (t = -0.06, P = 0.953). All cases had been successfully operated. There was significant difference in the operation time between 2 groups (t = -21.70, P = 0.000). There was significant difference in the pre- and post-operation scores of each group (PCN group: t = 14.05, P = 0.000; PCD group: t = -14.79, P = 0.000). There was no significant difference in 2 groups of the clinical outcomes (z = -0.377, P = 0.706, > 0.05). There was no instability of cervical spine cases in 2 groups after operation (P > 0.05), and the cervical spine stability was no significant difference in pre- and-operation in each group.</p><p><b>CONCLUSIONS</b>PCN and PCD for the treatment of cervical disc herniation achieves good outcomes and no difference on the stability of cervical spine. PCN and PCD is a safe, minimally invasive, short time of operation, less traumatic operation and excellent clinical outcome.</p>