Application of rafting K-wire technique for tibial plateau fractures / 中国骨伤

<p><b>OBJECTIVE</b>To summarize application of rafting K-wires technique for tibial plateau fractures.</p><p><b>METHODS</b>From January 2013 to January 2015,45 patients with tibial plateau fractures were treated by locking plate with rafting K-wires, including 33 males and 12 females with an average of 44.2 years old ranging from 22 to 56 years old. According to Schatzker classification, 6 cases were type II, 8 were type Ill, 4 were type IV, 4 were type V, and 5 were type VI. Allogeneic bone graft were performed for bone defects. All patients were fixed with two to five K-wires. Part of weight loading were encouraged at 3 months after operation,and full weight-loading were done at 5 months after operation. Postoperative complications were observed,and Rasmussen clinical and radiological assessment were used to evaluate clinical results.</p><p><b>RESULTS</b>All Patients were followed up from 10 to 23 months with average of 14 months. According to Rasmussen clinical and radiological assessment, clinical scores 23.58 ± 6.33, radiological scores were 14.00 ± 6.33; and excellent and good rates were 82.2% and 77.8% respectively. Four patients occurred severe osteoporosis and collapse of articular surface; 5 patients occurred traumatic arthritis.</p><p><b>CONCLUSION</b>Rafting K-wires technique with anatomized armor plate could effective fix and support platform collapse and joint bone fragments, increase support surface area and reduce postoperative reduction loss rate.</p>

Latest advances of the cause and preventive strategies of adjacent vertebral body fracture after percutaneous vertebroplasty / 中国骨伤

Percutaneous vertebroplasty (PVP) is widely used as an effective treatment for compression fracture, additional adjacent vertebral body fractures are frequently reported after operation, but the relationship between the vertebroplasty and adjacent vertebral body fracture remains unknown. The possible causes of refracture after operation include mechanical force factor, bone cement and clinical factors. Except for the changes of stress and stiffness of the adjacent vertebral bodies, the extravasation of cement and osteoporosis itself of the vertebral bodies should be concerned about. To aim at above-mentioned reasons, simultaneously, preventive strategies, such as prophylactic cement injection into adjacent non-fractured vertebrae, additional PVP and injectable copolymer hydrogel are approached in this review.