Analysis of the effectiveness of sequential plate internal fixation in correction of Madelung deformity after ulnar osteotomy and shortening / 中国修复重建外科杂志

OBJECTIVE@#To investigate the effectiveness of sequential plate internal fixation in the correction of Madelung deformity after ulnar osteotomy and shortening.@*METHODS@#The clinical data of 13 patients with Madelung deformity admitted between September 2015 and July 2021 were retrospectively analyzed. There were 5 males and 8 females with an average age of 18.3 years ranging from 17 to 23 years. The disease duration ranged from 12 to 24 months, with an average of 17 months. Three cases had a clear history of trauma. All patients had external radial deviation deformity and limited movement of the ulnar deviation, and the ulnar impact pain was significant during ulnar deviation movement; 9 patients had limited wrist joint supination movement, and the supination movement was normal. In the first stage, ulnar osteotomy and shortening combined with external fixator were used to correct wrist deformity in 13 patients. After operation, bone transfer was performed 6 times per day, with adjustments made every 4 hours, which was 1 mm per day. After the osteotomy was in place, the ulnar plate internal fixation was performed to reconstruct the ulnar stability in the second stage. The Cooney wrist joint score was used to assess the pain, function, range of motion, flexion and extension range of motion, and grip strength of the wrist joint before operation and before the removal of internal fixator. The subjective feeling and appearance satisfaction of patients were recorded.@*RESULTS@#After the second-stage operation, all the 13 patients were followed up 10-22 months, with an average of 15 months. The deformity of wrist joint disappeared after operation, and the flexion, extension, and ulnar deviation were basically normal. There was no complication such as ulnar impingement sign, nonunion or infection. Wrist function, pain, and range of motion were significantly improved after operation, except for 1 patient who had no significant improvement in rotation and pain. The ulnar internal fixator was removed at 10-18 months after the second-stage operation. The scores of pain, function, range of motion, flexion and extension range of motion, and grip strength in the Cooney wrist score before removal of internal fixator significantly improved when compared with those before operation ( P<0.05). Subjective and appearance satisfaction of patients were excellent in 9 cases, good in 3 cases, and fair in 1 case.@*CONCLUSION@#Ulnar osteotomy and shortening with sequential plate internal fixation for correction of Madelung deformity, with mild postoperative pain, can effectively avoid bone nonunion, improve wrist joint function, and have significant effectiveness.

Comparative study of the effects of intramedullary nail fixation and minimally invasive percutaneous plate internal fixation technique on platelet activation and serum transforming growth factor-β1(TGF-β) 1 and bone morphogenetic protein-2 (BMP-2) in patients with tibial and fibular fracture / 中国骨伤

OBJECTIVE@#To investigate the effect of intramedullary nail fixation (IMN) and minimally invasive percutaneous plate internal fixation (MIPPO) techniques on tibiofibular fractures and their effect on platelet activation and serum transforming growth factor-β1 (TGF-β1) and bone morphogenetic protein-2 (BMP-2).@*METHODS@#Total of 105 patients with tibiofibular fractures from February 2019 to February 2020 were selected and divided into 53 cases in the MIPPO group and 52 cases in the IMN group. There were 29 males and 24 females with an average age of (41.74±6.05) years old in MIPPO group;in IMN group, 31 males and 21 females with an average age of (40.59±5.26) years old. The perioperative surgical indexes, postoperative complications, ankle function recovery at 12 months postoperatively, platelet activation indexes at 3 and 7 days preoperatively and postoperatively, and serum TGF-β1 and BMP-2 levels at 4 and 8 weeks preoperatively and postoperatively were compared between the two groups.@*RESULTS@#The operating time and fracture healing time in the MIPPO group were shorter than those in the IMN group(P<0.05); Compared with the preoperative period, the levels of GMP-140, PAC-1, CD63, and CD61 increased in both groups at 3 and 7 days after surgery, but were lower in the MIPPO group than in the IMN group(P<0.05);the levels of serum TGF-β1 and BMP-2 increased in both groups at 4 and 8 weeks after surgery compared with the preoperative period, and the postoperative complication rate in the MIPPO group was lower than that in the IMN group(P<0.05);the difference was not statistically significant in the excellent rate of ankle function recovery at 12 months follow-up after surgery between two groups(P>0.05).@*CONCLUSION@#Both intramedullary nail fixation and MIPO technique for treatment of tibia and fibula fractures can improve ankle joint function, but the latter has the advantages of short operation time, fast fracture healing, fewer complications, and light platelet activation. Serum TGF-β1, BMP-2 level improves quickly.

Comparison of clinical efficacy between closed reduction combined with semi-circular external fixator and minimally invasive percutaneous plate osteosynthesis (MIPPO) in the treatment of middle and distal tibia fractures / 中国骨伤

OBJECTIVE@#To compare the clinical efficacy between closed reduction combined with semi-circular external fixator and minimally invasive percutaneous plate osteosynthesis (MIPPO) in the treatment of middle anddistal tibia fractures.@*METHODS@#The clinical data of sixty patients with middle and distal tibia fractures admitted between January 2019 and November 2022, were retrospectively analyzed. These patients were categorized into external fixation group (n=30) and internal fixation group (n=30). There were 18 males and 12 females in the external fixation group, with an average age of (49.29±2.35) years old. Among them, 14 patients presented with fractures on the left side, and 16 patients presented with fractures on the right side. Closed reduction, arched wire, and semi-circular external fixator were used for treatment. There were 20 males and 10 females in the internal fixation group, with an average age of (48.96±1.87) years old. Among them, 15 patients presented with fractures on the left side, and 15 patients presented with fractures on the right side. MIPPO technique was used for the treatment. Perioperative parameters, including time injury to surgery, surgical duration, incision length, intraoperative bleeding, time to active activity, and incision healing level, were compared between the two groups. Clinical outcomes were also assessed, including Johner-Wruhs scores, time to minimum pain-adapted full weight-bearing, visual analog scale (VAS), SF-36 scale, and complications.@*RESULTS@#The external fixation group exhibited a significantly shorter incision length (1.36±0.86) cm and lower intraoperative bleeding (10.83±5.73) ml compared to the internal fixation group (12.74±3.12) cm and (86.47±8.90) ml, respectively(P<0.05). The postoperative active activity time (1.50±0.54) days and minimum pain-adapted full weight-bearing activity time(108.87±3.43) days in the external fixation group were slightly delayed than the internal fixation group(1.15±0.98) days and (105.27±3.68) days, respectively(P<0.05). Over a mean postoperative follow-up duration of (6.23±1.89) months, both groups showed improved VAS and SF-36 scale scores. There were no statistically significant differences in VAS and SF-36 scale scores 1, 3, 6 months post-operatively between the two groups(P>0.05). The intraoperative surgical time in the external fixation group (35.42±9.31) minutes was shorter than that in the internal fixation group(74.22±7.81) minutes (P<0.05). There was no intraoperative vascular or nerve injury, nor postoperative skin necrosis in the external fixation group. However, skin necrosis was observed in 6 patientsin the internal fixation group, representing a statistically significant difference (P<0.05).@*CONCLUSION@#Both external fixation and plate internal fixation are effective methods for the treatment of middle and distal tibia fractures. External fixation exhibits the advantage of less surgical trauma and a lower incidence of complications.

Effect of titanium plate internal fixation combined with titanium nail intermaxillary traction on jaw fractures / 中华医学美学美容杂志

Objective:To observe the difference in the effect of simple titanium plate internal fixation and titanium plate internal fixation combined with titanium nail intermaxillary traction in the treatment of jaw fractures and their impact on the oral and maxillofacial function of patients.Methods:From August 2016 to May 2021, 94 patients with jaw fractures admitted to the Department of Stomatology, Linyi Central Hospital, Shandong (supplementing the gender, age range and average age of the patients), were divided into 47 cases in the control group, and the titanium plates were used alone, combined operation group 47 cases, titanium plate internal fixation combined with intermaxillary traction with titanium nails. The changes of oral and maxillofacial function and fracture healing were measured before operation and 3 months after operation, and the perioperative indicators and postoperative complications were recorded.Results:Three months after operation, the scores of maxillofacial function, mouth function and masticatory function in the combined operation group (0.52±0.09 points, 0.67±0.12 points, 0.58±0.08 points) were significantly lower than those in the control group (1.05±0.21 points, 1.14±0.22 points, 1.02±0.21 points) ( t=15.90, 12.86, 13.42, P<0.05). The effective rate of the combined operation group was 95.74% (45/47), which was significantly higher than that of the control group (80.85%, 38/47) (χ 2=5.05, P<0.05); there was no significant difference in operation time and hospitalization time between the groups ( P>0.05), the fracture healing time in the combined surgery group (65.02±7.06) d was significantly shorter than that in the control group (82.69±10.25) d ( t=9.73, P<0.05). The postoperative complication rate of combined treatment group was 6.38% (3/47), which was significantly lower than the control group 21.28% (10/47) (χ 2=4.37, P<0.05). Conclusions:In the treatment of jaw fractures, titanium plate internal fixation combined with titanium nail intermaxillary traction treatment can significantly improve the oral and maxillofacial function of patients, promote postoperative fracture healing, improve curative effect and reduce the incidence of complications compared with simple titanium plate internal fixation.

Analysis of Revision Content and Evaluation Attentions on Guidance for Registration of Metallic Bone Plate Internal Fixation System (Revised in 2021) / 中国医疗器械杂志

This study briefly introduces the revised content of Guidance for Registration of Metallic Bone Plate Internal Fixation System (Revised in 2021) compared to the original guidance, mainly including the principles of dividing registration unit, main performance indicators of standard specification, physical and mechanical performance research, and clinical evaluation. At the same time, in order to provide some references for the registration of metallic bone plate internal fixation system, this study analyzes the main concerns in the review process of these products based on the accumulation of experience combining with the current review requirements.

Modified knee spreader combined with minimally invasive percutaneous plate internal fixation for complex tibial plateau fractures / 中国组织工程研究

BACKGROUND: Studies have shown that the adjuvant use of long bone distraction device for unstable tibial plateau fractures achieved satisfactory results, but the safety of its use of long bone distraction device is not high, and the device could easily lead to soft tissue damage. OBJECTIVE: To compare the clinical efficacy of modified knee joint spreader combined with minimally invasive percutaneous plate internal fixation and traditional incision reduction plate internal fixation for the treatment of complex tibial plateau fractures. METHODS: A total of 71 patients with complicated tibial plateau fractures admitted to Xiangdong Hospital Affiliated to Hunan Normal University from January 2016 to January 2018 were included, including 48 males and 23 females. The 34 patients in the experimental group received modified knee spreaders combined with minimally invasive percutaneous plate internal fixation treatment. The 37 patients in the control group received traditional open reduction and plate internal fixation. The incision length, operation time, intraoperative blood loss, hospital stay, the time of fracture healing and the incidence of postoperative complications were compared between the two groups. Knee HSS scores were assessed at 1 month and at the last follow-up. The trial was approved by the Ethics Committee of Xiangdong Hospital Affiliated to Hunan Normal University. RESULTS AND CONCLUSION: (1) The operation time, intraoperative blood loss, incision length, and hospital stay were shorter in the experimental group than in the control group (P 0.05). (2) One case of joint stiffness and one case of traumatic arthritis were found in the experimental group. One case of postoperative infection, five cases of joint stiffness, one case of traumatic arthritis and one case of loosening of the internal fixation were found in the control group. The incidence of complications in the experimental group was less than that in the control group (P 0.05). (4) The results showed that compared with the traditional open reduction and internal fixation, the modified knee spreader combined with minimally invasive percutaneous plate internal fixation for complex tibial plateau fractures can improve the operation efficiency, reduce surgical trauma, reduce the incidence of postoperative complications, and shorten hospital stay for patients.

Comparison of clinical effect between bridge locking anatomical plate with supported plate based four column in type III Rüedi-Allgower Pilon fracture / 解剖学报

Objective: To explore the clinical effect between bridge locking anatomical plate with supported plate based four column in type III Riiedi-Allgower Pilon fracture. Methods: Retrospective study was performed on the clinical data of type III Riiedi-Allgower Pilon fracture undergoing surgery. Patients were divided into two groups according to internal fixation. Some parameters including operation time, blood loss, and drainage, healing time, full burden time, functional score and pain score were analyzed. Results: There was no significant difference between the operation time, blood loss and drainage between the two groups(t = 0. 37, P>0. 05;t = 0. 71, P>0. 05;t = 0. 24,/>>0.05). The healing time and full burden time of experimental group was lower than control group significantly ((=1.56, P<0. 05;i = 2.43, P<0.05). For American Orthopaedic Food and Ankle Society(AOFAS) score and visual analogue score(VAS) in postoperative 1 month, there was no significant difference between the two groups. For AOFAS score and VAS score in experimental group was lower than control group after 3 months (P<0. 05). There was no significant difference between two groups in reduction quality Burwell-Charnley score and complication between two groups. Conclusion Supported plate based four column could improve the life quality of patietns with Pilon fracture, which is worth to recommed in clinical application.

Needle 'double reverse' traction reset and fixation with MiPPO for tibial plateau fractures / 局解手术学杂志

Objective To analyze the indications and evaluate the efficacy of the needle to 'double reverse' traction reset,inside and outside double column locking plate internal fixation with MiPPO for tibial plateau fractures.Methods From August 2015 to March 2017,a total of 31 patients with tibial plateau fractures in our hospital were divided into treatment group and control group.The treatment group with 12 cases were treated with the needle to be 'double reverse' traction reset,inside and outside double column locking plate MiPPO fixation.The control group with 19 cases received open reduction and internal fixation with locking plate.Results In treatment group,the operation time was (51.3±6.5)minutes,the intraoperative bleeding was (60±8.7)mL.In the control group,the operation time was (68.5±6.6)minutes,the intraoperative bleeding was (230±7.8)mL.The operation time and blood loss of treatment group were less than those of control group,the differences were statistically significant(P<0.05).The postoperative X ray film of fracture showed that the bone plate and screw position were ideal compared with those before operation,no complication occurred.Conclusion The needle 'double inverse' traction and locking plate MiPPO fixation treatment have good clinical effect for patients of Schatzker Ⅴ,Ⅵ tibia platform fracture,with less complication.

Analysis of clinical efficacy and complications of titanium mini plate internal fixation and reconstructive surgery for patients with orbital fracture / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the clinical efficacy and complications of titanium mini plate internal fixation and reconstructive surgery for patients with orbital fracture. METHODS: Fifty - seven cases (60 eyes) with orbital fracture from March 2013 to April 2014 in our hospital were researched. According to the random number table method, the patients were divided into observation group (29 cases with 30 eyes) and control group (28 cases with 30 eyes ). The control group was treated with hydroxyapatite artificial bone plate for internal fixation, and the observation group with titanium mini plate internal fixation and reconstructive surgery. The diplopia grading, grading of ocular movement disorder before and at 1, 3mo after treatment and postoperative complications ( prolapse, dislocation, infection ) were compared between the two groups. RESULTS: In both group, all the 60 eyes were healed without scar formation. The rate of diplopia grading as grade 0 1mo postoperatively of observation group and the control groups were 63% and 40% ( P CONCLUSION: The clinical curative effect of titanium mini plate internal fixation and reconstructive surgery has a good effect for orbital fractures, which can improve the therapeutic effect and reduce the incidence of adverse reactions.

Above two-level segment interbody fusion with double-way connection intervertebral fusion device / 中国组织工程研究

10.3969/j.issn.2095-4344.2013.26.007

Clinical analysis of internal fixation with grip-type of Ni-Ti alloy plate in treatment of multiple ribs fractures / 中国基层医药

ObjectiveTo analyze the clinical effect of internal fixation with grip-type of Ni-Ti alloy plate in treatment of multiple ribs fractures.MethodsClinical data of 50 patients with multiple ribs fractures treated by internal fixation t with grip-type of Ni-Ti alloy plate were retrospectively analyzed.ResultsThe chest pain alleviated,the shape of bony thorax recovered, paradoxical respiration vanished, and dyspnea relieved significantly in all cases after operation.Two months after operation, chest X-ray indicated healed fractures, internal fixation without loosening and breaking off, no chest deformity in all patients.Followed up 2 to 14 months,an average of 9 months,and no complication was found.ConclusionThe internal fixation with grip-type of Ni-Ti alloy plate in treatment of multiple ribs fractures was simple ,convenient,less invasive ,good tissue compatibility, stable fixation, less complications, and clinical results were satisfactory.

Effect of Internal Fixation of Plates on Displaced Intra-articular Fracture of Calcaneus / 中国康复理论与实践

@#Objective To investigate the effect of internal fixation of plates on displaced intra-articular fracture of the calcaneus. Methods 27 patients with calcaneal fracture and treated surgically with open reduction and internal fixation were analyzed retrospectively. Results All the cases are closed fracture. According to the Sanders classification, 18 cases were type 2 calcaneal fractures, and 9 were type 3. 6 cases (22.2%) showed wound-healing problems. The average Bohler's angle before and after surgery was 7.5° and 27.54° respectively. 20 patients were followed up for average 16.8 months, and all showed excellent walking ability and normal gait, and no shoe wear complaints. Conclusion Open reduction and internal fixation can guarantee the anatomic reduction of displaced calcaneal fractures, and the outcomes are satisfied.

Open reduction,bone autografting and calcaneus reconstruction internal fixatin of intra-articular fractures of the calcaneus / 中国矫形外科杂志

[Objective] To evaluate the results of open reduction with bone autografting and calcaneus reconstruction with internal fixation in treatment of intra-articular calcaneus fracture. [Methods]From January 2005 to May 2007, 17 cases/19 feet of intra-articular calcaneus fractures received treatment of reconstruction plate and bone autografting, with 15 male/18 feet, 2 female/ 2 feet. Patients’ age ranged from 19 to 67 years (mean, 37.5 years). Fracture occurred in left side in 9 cases, right in 6 cases, both sides in 2 cases. All patients received treatment of open reduction with bone autografting and calcaneus reconstruction with internal fixation.[Results]All the patients achieved bone union. One stage union was achieved in 15 feet. Poor blood-supply was found in 3 feet and bone union was achieved after systematic treatment. Wound exudation was found in 1 feet, and bone union was achieved after dressing change treatment. All patients were followed up for an average of 19.7 months (10-38 months). The average union time was 2.5 months, without infection found.X-ray and CT were used to measure Bhler angle, width and axial length, all the indexed showed significant difference (P

Internal fixation with locked plate and bone cement in treatment of long bone pathologic fractures due to metastatic carcinoma / 中国矫形外科杂志

[Objective] To investigate internal fixation with locked plate and bone cement in treatment of long bone pathologic fractures due to metastatic carcinoma. [Methods]From February 2005 to February 2008, 15 patients suffering from pathologic fractures caused by metastatic lesions of the humerus(3 cases), ulna(2 cases), radius(1 cases), femur(5 cases) and tibia(4 cases) have been surgically treated with internal fixation with locked plate and bone cement.[Results]All patients were followed up after operation for ranging from 24~46 months. Pain relief was achieved in 14 patients(93.3%). Thirteen(86.7%) patients got excellent Enneking scores at 2 weeks postoperatively. The quality of life had significant difference betwen before and after operation (P

Effective comparison between nonoperative and operative treatment in calcaneal fractures / 中国矫形外科杂志

[Objective]To evaluate the effect of nonoperative and operative treatment in calcaneal fractures.[Method]Operative effect of 38 cases of calcaneal fracture of all kinds(42 foots)were analyzed.Accordind Essex-Loprestis classification,6 foots suffered type I tongue fracture,28 foots suffered compressed fracture(type Ⅱ),8 foots suffered serious comminuted fracture(type Ⅲ).All patients underwent open reduction interal fixation by Buttress plate(AO calcaneal fracture plate or simulated AO calcaneal fracture plate made domestically) from the extended "L" lateral approach.Postoperatively,no patient needed plaster fixation.All patients started non-weight-bearing fuctional exercise at 2-3days,gradual weight-bearing walking at 6-8 weeks.The result of operated group was compared with nonoperative treatment group.The follow-up period was from 10 months to 36 months,with an average of 17monthes.[Result]Assessed the effect by Maryland foot score,the base line included every foot.Total excellent and good rate in operative group was 93%,it was 100% in type I fracture group,96% in type Ⅱ fracture group,75% in type Ⅲ fracture group.The result of nonoperative treatment group was:total excellent and good rate was 67%,it was 92% in type I fracture group,77% in type Ⅱ fracture group,there was not excellent and good patients in type Ⅲ fracture group.[Conclusion]It is important to regain the flatness of subtalar joint and calcaneocuboid joint,maintain the normal shape of foot.The authors recommend that type Ⅱ and type Ⅲ fractures of calcaneus according Essex-Loprestis classification were treated with open reduction and interal fixation by Buttress plate.By selecting the appropriate approach,proper reducting and postoperative treating rightly,it is an ideal measure to treat calcaneal fracture by selection of treatment method acciding to patient's individual status and fracture type.

Diagnosis and treatment of radial nerve injury following internal fixation for humeral shaft fracture / 中华创伤骨科杂志

Objective To explore the etiology and treatmen t of radial nerve injury following in ternal fixa-tion for humeral shaft fracture.Methods 15patients were treated in our department from 1997to 2003for radial nerve injury following steal-plate internal fixation.They were selected for this study and followed up from6to 18months.Their injury cause,clinica l manifestation,methods of treatme nt,diagnosis and prognosis were retrospec-tively analyzed.Results The symptoms of nerve injury disappeared in all patients.Their muscle strength of wrist and digit extension returned to grad e V.The electromyogram showed that t heir nerve conduction velocity and l atent period returned to normal.Conclusions Excessive traction,careless manip ulation and steel plate compression are the main causes for iatrogenic radia l nerve injury.The nerve function can be completely recovered with early diag-nosis and early neurolysis.[