RESUMO
BACKGROUND:Radial head re-dislocation is one of the alarming complications of old Monteggia fracture. Many treatment methods have described the necessary of fracture and annual ligament reconstruction during treatment, but stil unclear. OBJECTIVE:To emphasize the practicality of annular ligament reconstruction through comparing the children’s treatment in two groups. METHODS:Twelve patients with children’s old Monteggia fracture were included for retrospective analysis. Al the patients were treated with radial head open reduction and internal fixation. Among them, five cases received ulna extending osteotomy and annual ligament reconstruction, and seven cases received ulna extending osteotomy without annual ligament reconstruction. The course was 3-18 months from damage to the clinical manifestations (an average of 9 months). Ten cases with Bado type Ⅰ and two cases were Bado type Ⅱ andⅢ. The reliability of ligament reconstruction was evaluated before and after treatment with Kim standard. RESULTS AND CONCLUSION:Al the 12 cases were fol owed-up for 22 months (8-26 months). Evaluation according to the Kim standard after treatment showed excel ent in 10 cases without abnormalities and pain, the range of motion>250 °, and no elbow was limited, the activities of daily living was 25 points;good in two cases with mild deformity and mild or intermittent pain, the range of motion was 200°-250° with elbow limited, activities of daily living was 15 points;no poor (serious deformity, pain, range of motionosteotomy was 8 weeks (6-14 weeks). The wounds were healed primarily without infection and nonunion. The results indicate that ulna extending osteotomy has great significance in keeping stability of radial head, and annular ligament reconstruction is determined by the time of injury, surgical procedures and intraoperative radial head stability.
RESUMO
BACKGROUND:Sodium hyaluronate injection after arthroscopic debridement of knee osteoarthritis can reduce postoperative pain and improve joint function, but there is a controversy on the time for the hyaluronate injection after arthroscopic debridement of knee osteoarthritis. OBJECTIVE:To observe the time of hyaluronate injection after arthroscopic debridement of knee osteoarthritis, and to compare recent rehabilitation effect of knee sodium hyaluronate injection for knee function after arthroscopic debridement of knee osteoarthritis between injection just after knee arthroscopy and injection 2 weeks after knee arthroscopy. METHODS:The clinical data of 100 knee osteoarthritis patients undergoing sodium hyaluronate injection immediately and 2 weeks after arthroscopic debridement were analyzed with prospective randomized control ed trial method, and the preoperative visual analog scale score, Lysholm score, 6 weeks postoperative visual analog scale score, 3 months postoperative visual analog scale score, and 3 months postoperative Lysholm score were recorded. The effects of recently rehabilitation of knee joint after surgery in two groups were compared. RESULTS AND CONCLUSION:There was no significant difference in postoperative visual analog scale score between immediate injection group (6.52±2.38) and 2 weeks postoperative injection group (6.54±2.37). The preoperative Lysholm score in the immediate injection group (43.44±16.18) was lower than that in the 2 weeks postoperative injection group (51.12±16.3). The 6 weeks postoperative visual analog scale score in the immediate injection group (3.2±2.46) was significantly higher than that in the 2 weeks postoperative injection group (5.1±2.68). The 3 months postoperative visual analog scale score/Lysholm score in the immediate injection group (2.72±2.70)/(80.58±15.63) were significantly higher than those in the 2 weeks postoperative injection group (4.72±3.07)/(64.96±21.68). The results indicate that sodium hyaluronate injection immediately after arthroscopic debridement of knee osteoarthritis is more favorable for recent rehabilitation.
