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Objective@#To explore the cross classification of tibial plateau fractures combined with avulsion fracture of medial femoral condyle.@*Methods@#The 16 patients were retrospectively analysed as an observation group who had been treated at Department of Lower Limbs, Sichuan Orthopaedic Hospital for tibial plateau fracture and avulsion fracture of the medial condyle of the same femur from January 2015 to December 2018. They were 9 males and 7 females, aged from 27 to 78 years (average, 51.5 years). By the Schatzker classification, there were 2 cases of type Ⅰ, 8 cases of type Ⅱ, 3 cases of type Ⅲ and one case of type Ⅳ; by the cross classification, there were 10 cases of type Ⅰe, one case of type Ⅱe and 2 cases of type Ⅲe and 3 cases of type Ⅰv. The 332 patients were included as a control group who had been treated at the same department for simple tibial plateau fracture from January 2010 to December 2015. The imaging data of the 2 groups were compared to find out the charateristics of cross type distribution; the widened distance of the lateral tibial plateau, collapse depth of the tibial plateau, separation of avulsion fracture of medial femoral condyle, maximum clearance of the medial knee and eversion angle of the tibial plateau were investigated in the patients with cross types e and Ⅰv in the observation group.@*Results@#In the observation group, the widened distance of the lateral tibial plateau averaged 7.18 mm, the collapse depth of the tibial plateau 8.74 mm, the separation of avulsion fracture of medial femoral condyle 3.44 mm, the maximum clearance of the medial knee 7.77 mm, and the eversion angle of the tibial plateau 87.03°. There was a significant difference in the cross type distribution of tibial plateau fractures between the 2 groups (P=0.002). In the observation group, the average widened distance of the lateral tibial platea for the 13 type e patients (8.49±4.26 mm)was significantly larger than that for the 3 type Ⅰv patients (1.51±2.11 mm) (t=2.706, P=0.017).@*Conclusion@#The cross classification of tibial plateau fractures with avulsion fracture of mediall condyle of the same femur may result mainly in types e and type Ⅰv. The widened distance of lateral tibial plateau helps distinction between types e and type Ⅰv.
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Objective To explore the cross classification of tibial plateau fractures combined with avulsion fracture of medial femoral condyle.Methods The 16 patients were retrospectively analysed as an observation group who had been treated at Department of Lower Limbs,Sichuan Orthopaedic Hospital for tibial plateau fracture and avulsion fracture of the medial condyle of the same femur from January 2015 to December 2018.They were 9 males and 7 females,aged from 27 to 78 years (average,51.5 years).By the Schatzker classification,there were 2 cases of type Ⅰ,8 cases of type Ⅱ,3 cases of type Ⅲ and one case of type Ⅳ;by the cross classification,there were 10 cases of type Ⅰe,one case of type Ⅱe and 2 cases of type Ⅲ e and 3 cases of type Ⅰv.The 332 patients were included as a control group who had been treated at the same department for simple tibial plateau fracture from January 2010 to December 2015.The imaging data of the 2 groups were compared to find out the charateristics of cross type distribution;the widened distance of the lateral tibial plateau,collapse depth of the tibial plateau,separation of avulsion fracture of medial femoral condyle,maximum clearance of the medial knee and eversion angle of the tibial plateau were investigated in the patients with cross types e and Ⅰv in the observation group.Results In the observation group,the widened distance of the lateral tibial plateau averaged 7.18 mm,the collapse depth of the tibial plateau 8.74 mm,the separation of avulsion fracture of medial femoral condyle 3.44 mm,the maximum clearance of the medial knee 7.77 mm,and the eversion angle of the tibia1 plateau 87.03°.There was a significant difference in the cross type distribution of tibial plateau fractures between the 2 groups (P =0.002).In the observation group,the average widened distance of the lateral tibial platea for the 13 type e patients (8.49 ± 4.26 mm)was significantly larger than that for the 3 type Ⅰv patients (1.51 ± 2.11 mm) (t =2.706,P =0.017) Conclusion The cross classification of tibial plateau fractures with avulsion fracture of mediall condyle of the same femur may result mainly in types e and type Ⅰv.The widened distance of lateral tibial plateau helps distinction between types e and type Ⅰv.
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@#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.
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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.
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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.
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BACKGROUND:There is always a controversy about nonsurgical and surgical repair of acute Achiles tendon rupture. Except retrospective analysis, there is a lack of high-level evidence-based medicine data. OBJECTIVE:To systemicaly evaluate the clinical effectiveness of the nonsurgical versus surgical treatment for acute closed rupture of the Achiles tendon. METHODS:The randomized controled trials about the nonsurgical versus surgical treatment for acute Achiles tendon rupture were searched in PubMed, EMbase, CBM, CNKI, Ovid, and WanFang Data by computer as wel as in relevant journals by hand, which were reported before February 2014. The Cochrane Library (Issue 1, 2014) was also retrieved. Two reviewers independently screened studies, extracted data, and evaluated the methodological quality according to the inclusion and exclusion criteria. Then Meta-analysis was conducted using RevMan 5.2 Software. RESULTS AND CONCLUSION:Nine randomized controled trials were included, and totaly 874 patients were involved, 441 cases in the nonsurgical group and 433 in the surgical group. The results of Meta-analysis showed that compared with the surgical group, the incidence of complications was lower [OR=0.41, 95%CI(0.26, 0.63), P< 0.000 1], but the rate of tendon re-rupture [OR=2.86, 95%CI(1.62, 5.02),P=0.000 2] and incidence of cicatricial adhesion [OR=0.07, 95%CI(0.03, 0.19),P < 0.000 1] were higher in the nonsurgical group. However, there were no significant differences between the two groups in patient satisfaction, superficial infection, motion recovery, and deep infection. Compared with the surgical treatment, the nonsurgical treatment can reduce the incidence of complications, but has a higher incidence of re-rupture. Because of sample-size and methodological quality restrictions, this conclusion needs further verification of large-sample, multicenter, and high-quality randomized controled trials.