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1.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-324636

RESUMO

<p><b>OBJECTIVE</b>To observe the effect of different manipulative reduction for children's distal radioulnar fracture and dorsal dislocation.</p><p><b>METHODS</b>From June 2013 to June 2014, 80 children with distal radioulnar fracture and dorsal dislocation were treated by bone setting manipulative reduction including 51 males and 29 females with an average age of 6.5 years old ranging from 3 to 14 years old. Time from injury to treatment was 1 h to 6 d, 31 cases were on the right, 49 cases were on the left. Among them, 45 cases were type I of overlapping displacement, 35 cases were type II. The displacement of the fracture was observed by clinical manifestations and X-ray examination. Under fluoroscopy, different techniques were used for reduction and fixation. After 3 weeks of over wrist fixation, the splints were overturned and fixed again for 1 to 2 weeks, then were removed. The wrist joint function was evaluated based on Dienst criteria.</p><p><b>RESULTS</b>Eighty cases of fracture were successfully operated one time, all reached anatomic reduction or near anatomic reduction. Eighty children were followed up for 3 months to 1 year. All the fractures healed, and the healing time was 4 to 5 weeks with an average of 4.6 weeks. All patients removed the splint 3 months later, the results were excellent in 72 cases, good in 7 cases and fair in 1 case, the excellent and good rate was 98.75%.</p><p><b>CONCLUSIONS</b>Bone setting manipulation for children's distal radioulnar fracture and dorsal dislocation can get good reduction. At 1 month after the removal of the splint, wrist function and finger strength gradually recovered and returned to normal after 3 months.</p>

2.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-324645

RESUMO

<p><b>OBJECTIVE</b>To explore the clinical effect of closed reduction and minimally invasive treatment of humeral shaft fractures in children.</p><p><b>METHODS</b>From July 2011 to April 2015, 39 cases of pediatric humeral shaft fractures were treated by closed reduction and external fixation, including 27 males and 12 females with a mean age of 8.6 years old ranging from 3 to 14 years old. Time from injury to the treatment was 2 h to 7 days with an average of 2.7 days. There were 6 cases of upper fracture, 21 cases of middle fracture and 12 cases of lower fracture. All children were closed injury, appeared pain, swelling, local deformity and limited mobility and other symptoms after injury. X-ray examination showed humeral shaft fracture. Neer score of shoulder joint function and HSS score of elbow joint function were used to record and analyze the pain, function and activity of shoulder and elbow joint before and after treatment.</p><p><b>RESULTS</b>All the 39 cases were followed up for 6 to 12 months with a mean of 8.6 months. Two cases appeared postoperative superficial infection of the needle, and healed after dress; other cases gained good pinhole healing. There were significant differences in the pain, function and activity of the shoulder of Neer score before and after the treatment (<0.05). There were significant differences in the pain and function of the elbow of HSS before and after treatment (<0.05). According to the evaluation of Neer score of shoulder function, the total score was 88.82±2.50, 29 cases were excellent, 9 cases were good, and 1 case was fair. According to the evaluation of HSS score of elbow joint function evaluation, the total score was 91.51±5.09, 30 cases were excellent, 7 cases were good, 2 cases were general.</p><p><b>CONCLUSIONS</b>Manual closed reduction combined with external fixation for the treatment of humeral shaft fractures in children has advantages of less trauma, definite reduction effect, reliable fixation and benefit for early functional exercise of the shoulder and elbow joint. This therapy can be used as one of clinical methods for the treatment of humeral shaft fractures in children.</p>

3.
Eur Spine J ; 24(5): 1058-65, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25820353

RESUMO

PURPOSE: Meta-analysis was conducted to estimate whether MiTLIF could reduce the complication rate while maintaining the similar clinical result to that of open procedures. METHODS: A search of the literature was conducted on pubmed or EMBASE. A database including patient clinical information was created. A systematic review of eligible studies with multivariate regression analysis was performed to quantitatively review the correlation of VAS improvement rate and the performance of MiTLIF. RESULTS: Fourteen articles with a minimum of 12-month follow-up met our inclusion criteria. The hypothesis of homogeneity could be accepted. The fixed-effects model was used to calculate the summary risk ratio (odds ratio). In the pooled analysis, the summary risk ratio (odds ratio) in patients with MiTLIF against those with open procedure for fusion rate, complication rate and revision/readmission rate was 0.99 (p = 0.36), 1.15 (p = 0.5) and 2.59 (p = 0.003), respectively, suggesting that MiTLIF was a risk factor for revision/readmission. Multivariate regression analysis showed that the percentage of male patients and the length of surgery exert a significant impact on VAS improvement rate. The selection of MiTLF was not significant. CONCLUSION: Fusion rate and complication rate for both open and MiTLIF were similar. Moreover, the MiTLIF group tended to have a higher revision/readmission rate, which might be associated with the deep learning curve. Therefore, to achieve the level of surgical skill required of an MiTLIF surgeon, many years of training and experience are necessary. Otherwise, MiTLIF may yield unsatisfactory result upon patients.


Assuntos
Vértebras Lombares/cirurgia , Osseointegração , Readmissão do Paciente , Fusão Vertebral/métodos , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Reoperação , Escala Visual Analógica
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