RESUMO
PURPOSE: To evaluate the results of five-pin external fixation, with the fifth pin stabilizing the distal radius articular fragment, for unstable distal radial fractures. MATERIALS AND METHODS: Twenty cases of unstable distal radial fractures were treated with five-pin external fixation (5-pin group). The fifth pin was inserted into the distal articular fragment and attached to the external fixation frame. Metacarpal pins were removed at sixth week in 12 cases and at third in 8 cases, and radial pins were removed at eighth or ninth week. The radiographic results of 5-pin group were compared with those of 20 cases of traditional four-pin external fixation (4-pin group). RESULTS: The postoperative radial inclination was 23.1 degrees in 5-pin group and 22.2 degrees in 4-pin group; while at last follow-up 21.8o and 15.1 degrees respectively. Postoperative volar tilt was 8.5 degrees and 7.3o; while at last follow-up 6.3 degrees and 0.1 degrees respectively. Postoperative radial shortening was 0.3 mm, 0.4 mm; while at last follow-up 1.1 mm and 2.1 mm respectively. In 5-pin group, there were no significant differences in results whether the metacarpal pins were removed at sixth or third week. CONCLUSION: Five-pin external fixation, with the fifth pin stabilizing the distal articular fragment, enhanced early motion of the wrist maintaining fracture stability in unstable fractures of the distal radius.
Assuntos
Seguimentos , Rádio (Anatomia) , PunhoRESUMO
PURPOSE: To evaluate the short term results of a periacetabular rotational osteotomy in early and moderate osteoarthritis of hip dysplasia by comparing the clinical findings and radiological measurements. MATERIALS AND METHODS: Thirty-six cases (34 patients) who received periacetabular rotational osteotomy for hip dysplasia with pain and could be followed up for more than one year were reviewed. The clinical findings were evaluated by the range of motion and HHS. The radiological measurements were evaluated using the center edge angle (CE angle), Sharp angle, acetabular-head index (A-H index) and Tonnis grade. RESULTS: The average Harris hip score improved from 79.4 points (60 to 89 points) to 95.1 points (82 to 100 points). The average range of motion did not change significantly. The mean CE angle increased from 7.1degrees (-7degrees to 19degrees) to 33.8degrees (27degrees to 44degrees), the mean sharp angle increased from 43.5degrees (26degrees to 53degrees) to 39.7degrees (30degrees to 49degrees), the mean A-H index increased from 56% (34% to 72%) to 90% (73% to 99%). The Tonnis grade had remained unchanged in 25 cases, improved in 9, and worsened in two. One case underwent total hip arthroplasty. CONCLUSION: The periacetabular rotational osteotomy is the preferred method for treating hip dyaplasia and preventing secondary osteoarthritis. However, a skillful technique is mandatory.
