RESUMO
Objective:To study the clinical effect of internal combined with external fixation in the treatment of pelvic fracture and its effect on the serum alkaline phosphatase (ALP),tumor necrosis factor-a (TNF-α) and transforming growth factor-β (TGF-β).Methods:Eighty-six patients with pelvic fractures admitted in our hospital from August 2014 to July 2015 were selected and divided into the observation group and control group according to the admission order.Conventional internal fixation was used in the control group,and the internal combined with extemal fixation was performed in the observation group.The clinical curative effect,operative time,blood loss,fracture healing time and incidence of complication were compared between two groups.The levels of serum ALP,TNF-α and TGF-β in the two groups were compared before and after treatment between two groups.Results:The excellent rate of observation group was significantly higher than that of the control group [81.40％ (35/43) vs 41.86％ (18/43)] (P ＜0.05).The operative time,blood loss and fracture healing time in the observation group were significantly shorter or less than those of the control group (P＜0.05).There was no significant difference in the serum ALP,TNF-α and TGF-β levels between the two groups before treatment (P＞0.05).After treatment,the serum ALP levels in the two groups were significantly higher than before treatment (P＜0.05).The levels of TNF-α and TGF-β were significantly lowe than those before treatment(P＜0.05),the ALP levels in the observation group was significantly higher than that of the control group (P ＜0.05),and the levels of TNF-c and TGF-β were significantly lower than those of the control group 0.05).The incidence of complications of observation group was significantly lower than that of the control group [0.00％ (0/43) vs 11.63％ (5/43)] (P ＜0.05).Conclusion:Internal and external fixation was effective and safe in the treatment of pelvic fractures,which could significantly increase the serum ALP level and reduce the levels of TNF-α and TGF-β.
RESUMO
[Objective]To analyze the early diagnosis and treatment of the popliteal artery injury associated with the dislocation and fracture of the knee.[Method]A total of 71 cases of popliteal artery injury associated with the dislocation and fracture of the knee were treated from March 1998 to May 2005.Properative(vascular examization) and operative(methods of arterial repair,venous repair-ligation,anticoagulation-thrombolytic therapy,fracture reduction and internal fixation,fasciotomy) treatment were studied.[Result]Totally 15 cases were primary amputation and 56 cases were performed vascular repair and the fractures and dislocations were reduced and fixed by internal or external fixation.Two cases had thrombosis at the repaired site confirmed by Doppler and had to perform second operation to remove thrombus and repair the popliteal by autograft of the saphena magna vein.At the follow-up,2 cases had chronic osteomyelitis and 2 cases had traumatic arthritis.[Conclusion]It is postulated that a rational and prompt diagnosis and treatment of popliteal artery injury associated with dislocation and fracture around the knee would decrease the adverse effects of ischemia and reduce the overall morbidity.