Clinical Study of Volar Median Approach Combined with Lateral Radial Auxiliary Approach in Treatment of C-Type Distal Radius Fractures: Our Clinical and Radiological Results.

BACKGROUND The aim of the study was to explore the clinical implications of median approach combined with radial auxiliary plate in the treatment of C-type distal radius fractures. MATERIAL AND METHODS From January 2017 to January 2022, a total of 20 cases were collected, including 6 male and 14 female patients with closed fresh distal radius fractures. All patients received volar medium approach T-shaped locking plate treatment, as well as radial auxiliary plate open reduction and internal fixation. We recorded the incidence of median nerve injury, incidence of radial artery and vein or their branches injury, postoperative X-ray measurement of radial styloid process height, ulnar declination, palmar inclination, and Gartland-Werley score. RESULTS All surgical procedures were successful, and all patients were monitored for 3 to 12 months after the procedure. In the postoperative follow-up, there was no obvious loss of reduction. At the last follow-up, all patients' articular surface flatness was less than 2 mm, and the mean values for palmar inclination and ulnar declination were (14.36°±3.55°) and (19.79°±2.57°), respectively. The average height of a radial styloid was 117±2.42 mm; functional evaluation: excellent in 12 (60%), good in 6 (30%), and fair in 2 cases (10%) cases. Five patients showed slight nerve injury, but all recovered quickly within 6 months. CONCLUSIONS The volar median approach, which combines a T-locking plate with a radial auxiliary plate for open reduction and internal fixation, is an effective treatment for unstable distal radius fractures.

Implementation of USSD Technology to Improve Quality of Routinely Reported Health Data in a Resource-Limited Setting.

Health decision-making is heavily premised on routinely reported data from lower levels of healthcare delivery to the national level. The reported data are of best use if their quality is high. Unfortunately, in many resource-limited settings in sub-Saharan Africa, the quality of reported data is often poor. Among the reasons attributed for poor data quality is use of sub-optimal modalities for collecting and transmitting data, such as paper-based and Short Message Service (SMS). Through a user-centered approach, we developed and implemented an Unstructured Supplementary Service Data (USSD)-based health data reporting intervention in a district in Uganda. The impact of the developed system on report accuracy, timeliness and completeness was evaluated against the expected 100% rates by the Ministry of Health (MoH). A total of 224 reports were submitted over the two-month study period. Of the submitted reports, 171 (76.3%) were complete (p<0.0001) compared to MoH's required 100%). 161 (71.9%) were accurate (P<0.0001), and 158 (70.5%) of the reports were submitted on time (p<0.0001). The deficiencies were largely attributed to a few facilities, as only 17.9% of facilities had data discrepancies with a mean of - 2.11 (P=0.38), 96.4% (0.130) of the facilities had complete reports and 87.4% (0.100) of the facilities reported on time. Poor network coverage was an outstanding challenge to reporting.