Gradual traction-unlocking closed reduction technique for Tile C old pelvic fractures / 中华创伤骨科杂志

Objective:To explore the technical points and efficacy of gradual traction-unlocking closed reduction technique (GT-UCRT) for Tile C old pelvic fractures.Methods:From August 2012 to June 2021, 6 patients with Tile C old pelvic fracture were treated and followed up at Department of Orthopedics, The Fourth Medical Center, General Hospital of Chinese PLA. They were 4 males and 2 females with an age of (35.8±10.5) years. By Tile classification: 4 cases of type C1.2, 1 case of type C1.3, and 1 case of type C2; time from injury to surgery: 153.8 (64.3, 204.8) days. The 6 patients were treated with GT-UCRT. The time for gradual traction reduction, operation time, hospital stay, intraoperative blood loss and complications were recorded. The modified Matta score was used to evaluate the reduction quality of pelvic fractures, and the Majeed score was used to evaluate the pelvic function at the last follow-up.Results:The 6 patients were followed up for (40.3±22.9) months (from 12 to 72 months) after surgery. The time for gradual traction reduction was (26.7±4.6) days, operation time (119.2±4.6) minutes, hospital stay (11.5±2.9) days, and intraoperative blood loss (533.3±189.6) mL. By the modified Matta score, the pelvic reduction after surgery was rated as satisfactory in 5 cases and as unsatisfactory in 1 case. The length disparity between both lower limbs in the 6 patients was (6.9±1.6) cm before surgery and (1.0±0.4) cm immediately after surgery, showing a statistically significant difference ( t=11.135, P<0.001). One fracture healed 3 months after surgery and 5 fractures 6 months after surgery. The Majeed pelvic score at the last follow-up was (80.8±9.0) points for the 6 patients, yielding 2 excellent cases, 3 good cases and 1 fair case. Delayed wound healing was reported in 1 patient, calf intermuscular venous thrombosis in 2 cases, and emotional anxiety and sleep disorder in 1 patient. No new lumbosacral plexus injury was found in any patient. Conclusions:In the treatment of Tile C old pelvic fractures, since our self-designed GT-UCRT combines the advantages of Ilizarov technique and unlocking closed reduction technique, it can not only protect the lumbosacral plexus but also obtain satisfactory reduction of the fracture.

Reconstructing thumb opposition function using modified transfer of proper extensor tendon of the fifth digit: 5-year follow-up of 21 cases / 中国组织工程研究

Reconstructing thumb opposition function using modified transfer of proper extensor tendon of the fifth digit is one of the methods to treat old median nerve injury-induced thumb opposition dysfunction. To explore the long-term effect of this method, 97 patients undergoing modified transfer of proper extensor tendon of the fifth digit to reconstruct thumb opposition function in Department of Hand Surgery, Affiliated Hospital of Beihua University between January 2003 and December 2007 were retrospectively analyzed, and 21 were followed up. The thumb opposition function postoperatively was evaluated using Changing of Hand Function Evaluation Standard. After reconstructing thumb opposition function, length of thumb (T), distance moving to (mo) and moving away from (Mo) centre of palm in opposition, i.e. during closing and leaving centre of palm distance between middle point of thumb interdigit transverse striation and middle point of middle finger MP joint transverse striation. In addition, their ratios were calculated. The patients were followed-up for 7.5 years (ranging 1-14 years). It is a good therapy to reconstruct thumb opposition function using modified transfer of proper extensor tendon of the fifth digit.

Reconstructing thumb opposition function using modified transfer of proper extensor tendon of the fifth digit:5-year follow-up of 21 cases / 中国组织工程研究

Reconstructing thumb opposition function using modified transfer of proper extensor tendon of the fifth digit is one of the methods to treat old median nerve injury-induced thumb opposition dysfunction.To explore the long-term effect of this method,97 patients undergoing modified transfer of proper extensor tendon of the fifth digit to reconstruct thumb opposition function in Department of Hand Surgery,Affiliated Hospital of Beihua University between January 2003 and December 2007 were retrospectively analyzed,and 21 were followed up.The thumb opposition function postoperatively was evaluated using Changing of Hand Function Evaluation Standard.After reconstructing thumb opposition function,length of thumb (T),distance moving to (mo) and moving away from (Mo) centre of palm in opposition,i.e.during closing and leaving centre of palm distance between middle point of thumb interdigit transverse striation and middle point of middle finger MP joint transverse striation.In addition,their ratios were calculated.The patients were followed-up for 7.5 years (ranging 1-14 years).It is a good therapy to reconstruct thumb opposition function using modified transfer of proper extensor tendon of the fifth digit.