Case control study on postoperative rehabilitation of patellar fracture by modified seated position of different knee flexion angles / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical results of postoperative rehabilitation of patellar fracture by modified seated position of different knee flexion angles, thereby enrich the therapeutic tool of orthopaedics of traditional Chinese and western medicine and provide the evidences for refinement and modernization of traditional Chinese exercise therapy.</p><p><b>METHODS</b>From January 2009 to June 2012,90 patients with patellar transverse fractures were treated with open reduction and internal fixation by tension band wire and rehabilitation exercises. There were 52 males and 38 females, aged from 21 to 77 years old with an average of 50.0 years old. Three methods of rehabilitation exercises were adopted in the patients after fractures clinical union. There were 21 males and 14 females in group A (trained by modified seated position of knee flexion about 60 degree), 21 males and 14 females in group B (trained by modified seated position of knee flexion about 30 degree), 10 males and 10 females in group C (trained by walk). The rehabilitation-training time was 1 month. Fracture healing informations were observed by X-ray films. The Böstman patellar fracture function scores were compared before and after training among three groups.</p><p><b>RESULTS</b>Postoperative follow-up time was 6 months. All fractures obtained bone union and the average healing time was 3 months (ranged,2 to 4 months). Böstman patellar fracture function scores in group A, B, C before training were 18.89 ± 2.19, 18.74 ± 2.03, 18.85 ± 2.92, respectively; there was no significant differences in among three groups (P > 0.05). After training, Böstman patellar fracture function scores in group A, B, C were 29.40 ± 1.14, 26.09 ± 3.86, 25.70 ± 4.09, respectively; group A was highest than other two groups; and there was no significant differences between group A and group B.</p><p><b>CONCLUSION</b>Modified seated position of knee flexion about 60 degree was practical and effective training in postoperative rehabilitation for the treatment of patellar fracture, it can obtain the better clinical results than other training method such as walk or modified seated position of knee flexion about 30 degree.</p>

Minimally invasive percutaneous osteosynthesis with intramedullary nail and close reduction by manipulation for the treatment of femoral shaft fractures / 中国骨伤

<p><b>OBJECTIVE</b>To explore the technique and clinical results of close reduction by manipulation and minimally invasive percutaneous osteosynthesis with intramedullary nail for the treatment of femur shaft fractures. methods: A retrospective study was conducted to analyze 96 patients with the femur shaft fractures who had been treated with close reduction by manipulation and minimally invasive percutaneous osteosynthesis with intramedullary nail. There were 67 males and 29 females. The average age of patients was 39 years old (ranging from 16 to 88). According to AO fracture classification for the femur shaft fractures,there were 29 cases of type A,46 type B,21 type C.</p><p><b>RESULTS</b>All the patients were followed up and the duration ranged from 12 to 24 months (averaged, 15 months). All the fractures showed union. The time required for the bony union ranged from 3 to 10 months (averaged,4 months). The clinical results were evaluated by Thorsen classification system. At the latest follow-up, 87 patients obtained excellent results, 7 good, 2 fair.</p><p><b>CONCLUSION</b>This treatment method combines advantages of intramedullary nail with close manipulative reduction, so can get satisfactory clinical results for the treatment of femoral shaft fracture with minimal trauma.</p>

Close reduction by Chinese traditional manipulation and MIPPO for the treatment of tibial fractures in middle and distal segment / 中国骨伤

<p><b>OBJECTIVE</b>To explore the technique and clinical results of close manipulative reduction and minimally invasive percutaneous plate osteosynthesis (MIPPO) for the treatment of tibial fractures in the middle and distal segment.</p><p><b>METHODS</b>From Jan. 2005 to Dec. 2009, 40 patients with tibial fractures in middle and distal segment were treated with close manipulative reduction and MIPPO fixation, including 28 males and 12 females with an average age of 54 years old (ranging from 21 to 76). According to AO fractures classification for the tibial fractures in the middle and distal segment, there were 26 cases of type A, 8 of type B, 6 of type C.</p><p><b>RESULTS</b>All patients were followed up for 12 to 24 months (averaged 18 months). All the fractures gained bone healing, and the time required for the bony union ranged from 3 to 18 months (averaged 4 months). The patients were evaluated with respect to functional recovery according to Mazur Grating System for the ankle. The aggregate score was 96.67 +/- 3.91, involving pain 48.59 +/- 2.28, hills up 2.95 +/- 0.22, hills down 2.85 +/- 0.37, stairs down 2.92 +/- 0.35, run score 4.95 +/- 0.32, plantar flexion score 4.62 +/- 0.54, dorsiflexion score 4.13 +/- 0.61. The clinical results were excellent in 36 cases, good in 3 and fair in 1.</p><p><b>CONCLUSION</b>Close manipulative reduction and MIPPO fixation is a good method for the treatment of the tibial fractures in the middle and distal segment.</p>

Close reduction by manipulation and minimally invasive percutancous plate osteosynthesis for the treatment of supracondylar femur fractures / 中国骨伤

<p><b>OBJECTIVE</b>To explore the technique and clinical results of close reduction by manipulation and minimally invasive percutaneous plate osteosynthesis (MIPPO) for the treatment of supracondylar femur fractures.</p><p><b>METHODS</b>A retrospective study was conducted to analyze 39 patients with the supracondylar femur fractures who had been treated with close reduction by manipulation and MIPPO. There were 24 males and 15 females. The average age of the patients was 47 years old (ranged, 19 to 81 years). According to AO fracture classification for the distal femur fractures, there were 14 patients with type A1, 16 patients with type A2 and 9 patients with type A3.</p><p><b>RESULTS</b>All the patients were followed up, and the period ranged from 12 to 24 months (averaged 16 months). All the fractures showed union. The time required for the bony union ranged from 3 to 10 months (averaged 4 months). The patients were evaluated according to Kolmert distal femoral fracture functional evaluation system. Twenty-eight patients obtained an excellent result, 10 good and 1 fair.</p><p><b>CONCLUSION</b>This method for the treatment of supracondylar femur fracture can get satisfactory function, high rate of bone union and less complications. Familiar with the close reduction technique and the geometry shape of anatomic plate as well as femoral supracondyar area are important to treat the supracondylar femur fractures.</p>

Reasonable application of minimally invasive percutaneous plate osteosynthesis for the treatment of distal fractures of tibia / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the technique and clinical results of minimally invasive percutaneous plate osteosynthesis (MIPPO) for the treatment of the distal fractures of tibia by an appropriate plate.</p><p><b>METHODS</b>From Jan. 2005 to Dec. 2007, 56 patients with the distal tibia fractures were treated with MIPPO through two approaches and three types of plate involving clover plate in 35 cases, anterior L-shape anatomic plate in 12 cases, medial LCP in 9 cases. There were 38 males and 18 females with an average age of 41 years old ranging from 17 to 72 years. According to AO fracture classification for the distal tibial fractures, there were 28 cases of type A, 11 of type B, 17 type C.</p><p><b>RESULTS</b>All the patients were followed up from 12 to 24 months (averaged 16 months). All of the fractures showed bone union. The time required for the bony union ranged from 3 to 11 months (averaged 4 months). The patients were evaluated on functional recovery according to Mazur Grating System for the Ankle. The results were excellent in 51 cases, good in 5.</p><p><b>CONCLUSION</b>Choosing effective reasonable approach and plate for the treatment of the distal tibial fractures can obtain satisfactory function, high rate of bone union and less complications.</p>