Objective:To compare the efficacy of open reduction and volar locking plate internal fixation with closed reduction and external fixation in the treatment of distal radius fractures by using meta analysis.Methods:The ...Objective:To compare the efficacy of open reduction and volar locking plate internal fixation with closed reduction and external fixation in the treatment of distal radius fractures by using meta analysis.Methods:The databases of CNKI,Wanfang,Weipu,Chinese biomedical literature,Pubmed,Embase,and Cochrane Library were retrieved,and the randomized controlled studies that directly compared the efficacy of plate internal fixation and closed reduction external fixation in the treatment of distal radius fractures published publicly from the establishment of the database to April 2023 were collected.The two researchers independently screened the retrieved literature according to the inclusion and exclusion criteria,extracted data,used Cochrane risk bias assessment tool for quality assessment,and used RevMan 5.4 software for meta analysis.Results:A total of 10 randomized controlled trials were included,all of which were in English.There were 1042 patients in total,and 9 of them were rated as low risk.Meta analysis results showed that one year after the treatment of distal radius fracture with volar locking plate internal fixation,DASH score[MD=-5.64,95%CI(-7.21,-4.06),P<0.00001];One year later,PRWE score[MD=-5.90,95%CI(-8.88,-2.92),P=0.001];Palm flexion[MD=5.92,95%CI(1.29,10.55),P=0.01];Pronation[MD=2.48,95%CI(0.59,4.36),P=0.01];Postrotation[MD=4.73,95%CI(2.15,7.31),P=0.0003];Grip strength[MD=0.61,95%CI(0.12,1.10),P=0.02];palmar tilt angle[MD=9.84,95%CI(5.66,14.02),P<0.00001];Radial inclination[MD=4.33,95%CI(2.97,5.69),P<0.00001]was superior to closed reduction plaster or splint external fixation.One year later,the European Five dimensional Health Scale(EQ-5D-5L)score[MD=0.02,95%CI(-0.01,0.05),P=0.27];Back extension[MD=2.22,95%CI(-4.15,8.59),P=0.49];Ulnar deviation[MD=3.49,95%CI(-0.80,7.78),P=0.11];Radial deviation[MD=2.05,95%CI(-2.39,6.50),P=0.37];Ulnar variance[MD=-1.14,95%CI(-3.16,0.88),P=0.27];There was no significant difference in complications[MD=0.77,95%CI(0.54,1.10),P=0.16](P>0.05).Conclusion:Based on the current clinical data,internal fixation with volar locking plate is more conducive to mid-term DASH score and grip strength recovery than closed reduction plaster or splint external fixation,but there is no significant difference in the quality of life and complications of patients.For adult distal radius fractures,surgical indications should be carefully grasped,and non operative treatment should be given priority.展开更多
Objective: To evaluate the effect of open reduction and internal fixation on radial head fracture and assess the post-operative function. Methods: This prospective observational study was conducted from June 2016 to J...Objective: To evaluate the effect of open reduction and internal fixation on radial head fracture and assess the post-operative function. Methods: This prospective observational study was conducted from June 2016 to July 2017 at Liaquat National Hospital and Medical College, Karachi. Altogether, 28 patients with radial head and neck fractures were enrolled in our study. These patients were admitted to the hospital and their fractures were fixed with open reduction and internal fixation. Baseline information of the patients was collected, and patient-rated elbow evaluation scores were calculated. Results: Out of the 28 patients, 21 were male and 7 were female. Besides, 16 fractures were on the right side and 12 were on the left side and 17 involving the dominant hands. In addition, 8 patients had Mason type Ⅱ fracture and 20 had Mason type Ⅲ fracture. The mean age of patients was (31.0 ± 8.0) years, and the mean follow-up is (1.2 ± 0.5) years. The mean average patient-rated elbow evaluation scores were (27.64 ± 1.60) at 1-year follow-up. Conclusions:The majority of the patients who had radial head fractures and treated by open reduction and internal fixation have attained an excellent range of motion postoperatively.展开更多
Objective: Acetabular fractures are common injuries in Iran. We assess the functional outcome of open reduction and internal fixation management of displaced Complex acetabular fractures. Materials and Methods: We ana...Objective: Acetabular fractures are common injuries in Iran. We assess the functional outcome of open reduction and internal fixation management of displaced Complex acetabular fractures. Materials and Methods: We analyzed a case series of patients with open reduction and internal fixation (ORIF) for complex acetabular fractures. Two hundred patients (132 men, 68 women) in four age groups including with a mean age of 43.39 ± 6.18 years (range 20 - 59 years) and a mean follow-up of 82.34 ± 12.48 months (range 18 - 109 months) met the inclusion criteria. Functional outcome at final follow-up was graded assessed according to Harris score. Factors affecting were defined. Results: Anatomic reduction was achieved in 192 hips, imperfect in 8 and poor in none. Radiological outcome revealed excellent results in 128 (64%) hips, good in eight, fair in five and none in poor. Harris score were excellent in 139 (69.5%) hips, good in 43 (21.5%) and fair in 18 (9%) and poor in none. The anatomical reduction results had a favorable final functional outcome. (0.003) However, BMI (P Conclusion: Optimal functional and radiological outcomes have been achieved with anatomic postoperative reduction. Also experience of specialist, on time surgery and good recovery lead to receiving excellent functional outcome with at least complications.展开更多
Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children...Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children.Methods From February 2015 to August 2019,73 patients with Gartland’s type II and III supracondylar fractures were treated with this modified method.Totally,68 of all patients were followed up for 3–12 months(mean 8.25 months).The evaluation results included fracture nonunion,ulnar nerve injury,pin track infection,carrying angle and elbow joint Flynn score.Results The results showed that bone union was observed in all children,one case had an iatrogenic ulnar nerve injury,and the symptoms were completely relieved in 4 months after removing of the medial-side pin.All children had no cubitus varus deformity and no pin track infection,and the rate of satisfactory results according to Flynn’s criteria score was 100%.Conclusion The modified closed reduction and Kirschner wires internal fixation could effectively reduce the rate of open reduction,the risk of iatrogenic ulnar nerve injury,and the incidence of cubitus varus deformity in treatment of supracondylar humerus fractures in children.展开更多
Objective:To evaluate the clinical effect of posterior internal fixation and fusion in the treatment of thoracolumbar fractures.Methods:36 patients with thoracolumbar fractures from January 2018 to December 2020 were ...Objective:To evaluate the clinical effect of posterior internal fixation and fusion in the treatment of thoracolumbar fractures.Methods:36 patients with thoracolumbar fractures from January 2018 to December 2020 were selected and divided into study group and control group according to the random number table model.The control group was treated with anterior internal fixation,while the study group was treated with posterior internal fixation and fusion.The indexes of the two groups were compared and analyzed.Results:Compared with the operation related indexes of the two groups,the study group had more advantages(P<0.05);The postoperative kyphosis Cobb angle,height of anterior and posterior vertebral body,wedge index of the two groups were better than those before operation(P<0.05),and there was no significant difference between the two groups(P>0.05);There was no significant difference between the two groups(P>0.05).Conclusion:The clinical effect of posterior internal fixation and fusion in the treatment of thoracolumbar fractures is significant,and the body damage is slight,which is worthy of comprehensive promotion.展开更多
BACKGROUND Open reduction and internal fixation(ORIF)is the traditional surgical treatment for patellar fractures,and unicompartmental knee arthroplasty(UKA),especially Oxford UKA,has been increasingly used in patient...BACKGROUND Open reduction and internal fixation(ORIF)is the traditional surgical treatment for patellar fractures,and unicompartmental knee arthroplasty(UKA),especially Oxford UKA,has been increasingly used in patients with medial knee osteoarthritis(OA).However,the process of choosing treatment for patients with both patellar fractures and anteromedial knee OA remains unclear.We present the case of a patient with a patellar fracture and anteromedial OA.CASE SUMMARY We present the case of a 72-year-old woman with a history of bilateral medial compartment OA of the knees and a right Oxford UKA.She also experienced a recent left patellar fracture.ORIF and Oxford UKA were performed in a single stage.The patient showed excellent postoperative clinical results.CONCLUSION ORIF and Oxford UKA can be performed simultaneously for patients with patellar fracture and anteromedial OA on the same knee.展开更多
Children's fractures are very common,and many children's fractures need internal fixation.When the children are treated and recovered,it needs to be internally fixed and then taken out.With the development of ...Children's fractures are very common,and many children's fractures need internal fixation.When the children are treated and recovered,it needs to be internally fixed and then taken out.With the development of internal fixation materials,the research of surgical methods and the improvement of surgical skills,postoperative removal of orthopedic surgery patients has gradually been included in daytime surgery.While ensuring the safety of children's surgery,it is necessary to shorten the postoperative limb and joint function recovery time,promote the recovery of limb and joint function,the healing of wounds and bones,and reduce the occurrence of these complications.In order to reduce the occurrence of these complications,carry out early rehabilitation education and development early rehabilitation training is very necessary.This paper puts forward the concept of early rehabilitation based on shared decision model,in which doctors,nurses,children and family members participate in the treatment of children before,during and after operation.The effect of early rehabilitation education in the daytime ward after removal of internal fixation was examined.Moreover,through the analysis of the control trial also confirmed that the clinical effect of early rehabilitation in improving and optimizing the rehabilitation of fracture in children is significant.展开更多
In recent times, research into mandibular fracture has gained momentum from advances in scanning techniques, software/algorithm developments and improvements, and numerical structural modeling using the finite-element...In recent times, research into mandibular fracture has gained momentum from advances in scanning techniques, software/algorithm developments and improvements, and numerical structural modeling using the finite-element method (FEM). In this work, the FEM is used to model a mandibular fracture (using an inhomogeneous and orthotropic jaw model) simulating the effect of different bite tasks/forces on the stability of the fixated fracture. Specifically, bilateral and unilateral clenches (using muscle data) were studied using a low-profile 3D 4 × 2 hole mini-plate deployed for fracture fixation. Here, the mandible bone was treated as orthotropic and spatially inhomogeneous. Although the results of stress and displacement analyses, for this fixation hardware, indicate sufficient fixation under normal biting conditions, the results show that the unilateral and ipsilateral bites develop, in general, the highest stresses or displacements. Such results can guide post-surgery recommendation on bite behavior.展开更多
Introduction: Despite extensive experience with civilian gunshot fractures or wounds, no consensus exists on a standard protocol to manage these injuries. Many authors recommended immediate debridement, but the optima...Introduction: Despite extensive experience with civilian gunshot fractures or wounds, no consensus exists on a standard protocol to manage these injuries. Many authors recommended immediate debridement, but the optimal timing of internal fixation and the use of antibiotic have not been determined. The purpose of this paper is to present and discuss our experience. Material and methods: In January 2007, a treatment protocol was put in place for the evaluation and management of fractured extremities resulting from civilian gunshot wounds. Sixty-three patients with 64 fractures had been managed by this protocol for gunshot fractures between January 2005 and January 2012. There were 56 male and seven female. Their mean age was 33.1 years (range: 17 - 61 years). Thirteen patients (20.6%) were able to provide a description of the weapon. Only 15 patients had entry and exit wounds. The mean follow-up period was 27 (range, 20 - 58) months. The main factors assessed were the surgical site infection, the fracture union and the functional status. Results: Out of the 63 patients, 14 patients developed a wound infection (five superficial and seven deep infections). Wound infection was significantly associated with associated injuries (p = 0.0388), fractures sites requiring fixation (p = 0.024), the fracture pattern (p = 0.0412), operative modalities (p = 0.0400). There were nine cases (14.1%) of fracture non-union. The mean time to union was 15 weeks (range: 5 - 32 weeks). Five patients developed chronics osteomyelitis. The average SMFA score for all of the patients was 23.8 (range: 0 - 56.3). The mean dysfunctional and bother indexes were 18.3 (range: 0 - 52.7) and 22.6 (range: 0 - 66.1), respectively. The SMFA total score and dysfunction index had a significant correlation based on presence or absence of associated injuries (p < 0.0001). But bother index did not show the same correlation (p = 0.452). The average length of hospital stay was 11.3 days (range: 3 - 64). Conclusion: In civilian’s gunshot induced fractures, internal fixation can be made according to standard protocol, with acceptable result.展开更多
<strong>Objective: </strong>To explore the therapeutic effect of autologous blood reinfusion combined with controlled hypotension in surgical spinal fixation during the outbreak of COVID-19. <strong>...<strong>Objective: </strong>To explore the therapeutic effect of autologous blood reinfusion combined with controlled hypotension in surgical spinal fixation during the outbreak of COVID-19. <strong>Methods: </strong>30 patients with spinal internal fixation autologous blood transfusion combined with controlled hypotension were selected as the subjects during the epidemic period from December 2019 to June 2020 in our hospital and during the operation, on the basis of routine blood pressure reduction, the American Haemonetice Corporation autologous blood continuous reinfusion system was used to infuse the blood recovered during the operation to the patient through filtration and other procedures. <strong>Results:</strong> 30 patients had no complications such as fever and hemolysis;And after the operation, the tube was dialed according to the drainage volume, the cervical thoracic and lumbar brace was customized, and the patient walked on the ground for one week;After no abnormalities, the patient was discharged. Intraoperative comparison of white blood cells (WBC), red blood cells (RBC), red blood cell pressure (HCT), hemoglobin (HGB), and coagulation time (PT) of patients with autologous blood before and after transfusion showed statistically significant differences before and after surgery (P < 0.001). <strong>Conclusion:</strong> During the new coronavirus pneumonia epidemic, the internal fixation of spinal surgery used a recovery machine to collect intraoperative blood for reinfusion. Intraoperative antihypertensive drugs were used to control blood pressure within a certain safe range. The postoperative clinical observation effect was significant and safe;especially at present the clinical significance during the epidemic was significant.展开更多
Objective To explore the efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) technique and locking compression plate (LCP) for open tibial shaft fractures.Methods From March 2005 to May 2009,16 ca...Objective To explore the efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) technique and locking compression plate (LCP) for open tibial shaft fractures.Methods From March 2005 to May 2009,16 cases with open tibial展开更多
Objective To evaluate effects of manipulative reduction,dynamic external fixator combined with limited internal fixation for the treatment of Pilon fractures.Methods From January 2007 to June 2009,manipulative reducti...Objective To evaluate effects of manipulative reduction,dynamic external fixator combined with limited internal fixation for the treatment of Pilon fractures.Methods From January 2007 to June 2009,manipulative reduction,dynamic external展开更多
Objective To explore the effects of the anterior internal fixation systems on the post-operative lateral angulation in treatment of thoracolumbar fractures.Methods A retrospective study was done to analyze the 172 pat...Objective To explore the effects of the anterior internal fixation systems on the post-operative lateral angulation in treatment of thoracolumbar fractures.Methods A retrospective study was done to analyze the 172 patients who had展开更多
Objective To report five cases of puerile (【9 years) atlantoaxial instability which underwent C1-C2 pedicle screw internal fixation by posterior approach,and to introduce the surgical technique and the key point
Objective To study the effect of using improved 2D computer-assisted fluoroscopic navigation through simulating 3D vertebrae image to guide pedicle screw internal fixation.Methods Posterior pedicle screw internal fixa...Objective To study the effect of using improved 2D computer-assisted fluoroscopic navigation through simulating 3D vertebrae image to guide pedicle screw internal fixation.Methods Posterior pedicle screw internal fixation,distraction展开更多
To assess the effect of using buttress plate associated with antografting of fibula and iliac bone for the treatment of distal femoral C3 type fracture.Methods Seventeen cases of distal femoral C3 type fracture usin...To assess the effect of using buttress plate associated with antografting of fibula and iliac bone for the treatment of distal femoral C3 type fracture.Methods Seventeen cases of distal femoral C3 type fracture using buttress plate associated with antografting of fibula and iliac bone were analyzed retrospectively.Results All cases were followed up for an average of 24 months（8～55 months）.The average time of octets bridge forming were 4 months（3～5 months） while the average time for bone union were 8 months （6～14 months）.According to Shelbourne rating system,result of all 18 cases were excellent and no malunion,infection were found.Conclusion Buttress plate associated with antografting of fibula and iliac bone is an effective alternative for the treatment of distal femoral C3 type fracture.It can provide more stable fixation to the bone and earlier functional exercises can be achieved.5 refs,3 figs,1 tab.展开更多
The fixation stability achieved with the use of plates and screws in oral and maxillofacial surgery is a decisive factor in treatment success. The mechanical and structural properties of the internal fixation material...The fixation stability achieved with the use of plates and screws in oral and maxillofacial surgery is a decisive factor in treatment success. The mechanical and structural properties of the internal fixation materials have direct influence on the dimensional stability and resistance of a fixation system, thus influencing treatment outcomes. This study proposed to analyze the dimensional and resistance patterns of titanium plates used for obtaining stable fix<span style="font-family:Verdana;">ation in orthognathic surgery and craniofacial trauma. For this study, 30 conventional 2.0</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">mm straight four hole plates with bridge from three brands commercialized in Brazil, were subjected to macroscopic, microscopic, strength and hardness analysis. The dimensional measurements were performed using a digital caliper. Energy-dispersive X-ray spectroscopy analysis was performed by scanning electron microscopy to analyze the chemical composition of the samples. The mechanical resistance tests were performed with a universal testing machine. The samples were then submitted to Vickers hardness analysis, complying with the standards of ASTM E92. The data collected from the dimensional study was submitted to statistical analysis of the coefficient of variation, while the values obtained during the mechanical tests were analyzed by variance (ANOVA) and Tukey’s test (p <</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">0.05). The sample groups presented different performances in resistance, hardness, size and surface, even though they were reported to be chemically similar compounds that allowed us to conclude the plates from Group 2 were more resistant than groups 1 and 3.</span>展开更多
At present,effective fixation and anti-infection implant materials represent the mainstay for the treatment of open fractures.However,external fixation can cause nail tract infections and is ineffective for fixing sma...At present,effective fixation and anti-infection implant materials represent the mainstay for the treatment of open fractures.However,external fixation can cause nail tract infections and is ineffective for fixing small fracture fragments.Moreover,closed reduction and internal fixation during the early stage of injury can lead to potential bone infection,conducive to bone nonunion and delayed healing.Herein,we designed a bone adhesive with anti-infection,osteogenic and bone adhesion fixation properties to promote reduction and fixation of open fractures and subsequent soft tissue repair.It was prepared by the reaction of gelatin(Gel)and oxidized starch(OS)with vancomycin(VAN)-loaded mesoporous bioactive glass nanoparticles(MBGNs)covalently cross-linked with Schiff bases.Characterization and adhesion experiments were conducted to validate the successful preparation of the Gel-OS/VAN@MBGNs(GOVM-gel)adhesive.Meanwhile,in vitro cell experiments demonstrated its good antibacterial effects with the ability to stimulate bone marrow mesenchymal stem cell(BMSCs)proliferation,upregulate the expression of alkaline phosphatase(ALP)and osteogenic proteins(RunX2 and OPN)and enhance the deposition of calcium nodules.Additionally,we established a rat skull fracture model and a subcutaneous infection model.The histological analysis showed that bone adhesive enhanced osteogenesis,and in vivo experiments demonstrated that the number of inflammatory cells and bacteria was significantly reduced.Overall,the adhesive could promote early reduction of fractures and antibacterial and osteogenic effects,providing the foothold for treatment of this patient population.展开更多
Purpose:This meta-analysis compared the clinical outcome of three-dimensional(3D)printing combined with open reduction and internal fixation(ORIF)to traditional ORIF in the treatment of acetabular fractures.Methods:We...Purpose:This meta-analysis compared the clinical outcome of three-dimensional(3D)printing combined with open reduction and internal fixation(ORIF)to traditional ORIF in the treatment of acetabular fractures.Methods:We searched the Cochrane Library,PubMed,Embase,VIP database,CNKI,and Wanfang data-base with keywords"acetabular fracture","3D printing","three-dimensional printing","open reduction and internal fixation","Acetabulum","Acetabula"from January 2000 to March 2020.Two reviewers independently selected articles,extracted data,assessed the quality evidence and risk bias of included trials using the Cochrane Collaboration’s tools and/or Newcastle-Ottawa scale.When the two analysts had different opinions,they would ask the third analyst for opinion.Randomized controlled trials or retrospective comparative studies of 3D printing combined with ORIF(3D printing group)versus traditional ORIF(conventional group)in the treatment of acetabular fractures were selected.The data of operation time,intraoperative blood loss,intraoperative fluoroscopy times,incidence of complications,excellent and good rate of Matta score for reduction,and excellent and good rate of hip function score were extracted.Stata14.0 statistical software was used for data analysis.Results:Altogether 9 articles were selected,including 5 randomized controlled trials and 4 retrospective studies.A total of 467 patients were analyzed,250 in the conventional group,and 217 in the 3D printing group.The operation time in the 3D printing group was less than that in the conventional group and the difference was statistically significant(standardized mean difference(SMD)=-1.19,95%CI:-1.55 to-0.82,p<0.05).The intraoperative bleeding volume of the 3D printing group was significantly lower than that of the conventional group(SMD=-1.08,95%CI:-1.65 to-0.51,p<0.05).The fluoroscopy times were less in the 3D printing group than in the conventional group and the difference was statistically significant(SMD=-1.64,95%CI:-2.35 to-0.93,p<0.05).The total incidence of complications in the 3D printing group was significantly lower than that in the conventional group(OR=0.43,95%CI:0.24-0.79,p<0.05).There was no significant difference in the excellent and good rate of Matta score for reduction between the two groups(OR=0.60,95%CI:0.34-1.06,p>0.05).There was no significant difference in the excellent and good rate of hip function score at the end of postoperative follow-up between the two groups(OR=0.84,95%CI:0.46-1.56,p>0.05),but the follow-up time varies from 6 months to 40 months.Conclusion:Compared with traditional ORIF,3D printing combined with ORIF has certain advantages in terms that 3D printing not only helps surgeons to understand acetabular fractures more intuitively,but also effectively reduces operation time,intraoperative blood loss,intraoperative fluoroscopy times,and postoperative complications.However,there were no significant differences in the excellent and good rate of Matta score for reduction and the excellent and good rate of hip function score at the end of follow-up.展开更多
基金2022 Key Specialty Construction Project of Traditional Chinese Medicine:Traditional Chinese Orthopedics and Traumatology Department (No.962042)2020 Regional Traditional Chinese Medicine (Orthopedics and Traumatology)Diagnosis and Treatment Center (Jin Wei Zhong[2020]No.5)。
文摘Objective:To compare the efficacy of open reduction and volar locking plate internal fixation with closed reduction and external fixation in the treatment of distal radius fractures by using meta analysis.Methods:The databases of CNKI,Wanfang,Weipu,Chinese biomedical literature,Pubmed,Embase,and Cochrane Library were retrieved,and the randomized controlled studies that directly compared the efficacy of plate internal fixation and closed reduction external fixation in the treatment of distal radius fractures published publicly from the establishment of the database to April 2023 were collected.The two researchers independently screened the retrieved literature according to the inclusion and exclusion criteria,extracted data,used Cochrane risk bias assessment tool for quality assessment,and used RevMan 5.4 software for meta analysis.Results:A total of 10 randomized controlled trials were included,all of which were in English.There were 1042 patients in total,and 9 of them were rated as low risk.Meta analysis results showed that one year after the treatment of distal radius fracture with volar locking plate internal fixation,DASH score[MD=-5.64,95%CI(-7.21,-4.06),P<0.00001];One year later,PRWE score[MD=-5.90,95%CI(-8.88,-2.92),P=0.001];Palm flexion[MD=5.92,95%CI(1.29,10.55),P=0.01];Pronation[MD=2.48,95%CI(0.59,4.36),P=0.01];Postrotation[MD=4.73,95%CI(2.15,7.31),P=0.0003];Grip strength[MD=0.61,95%CI(0.12,1.10),P=0.02];palmar tilt angle[MD=9.84,95%CI(5.66,14.02),P<0.00001];Radial inclination[MD=4.33,95%CI(2.97,5.69),P<0.00001]was superior to closed reduction plaster or splint external fixation.One year later,the European Five dimensional Health Scale(EQ-5D-5L)score[MD=0.02,95%CI(-0.01,0.05),P=0.27];Back extension[MD=2.22,95%CI(-4.15,8.59),P=0.49];Ulnar deviation[MD=3.49,95%CI(-0.80,7.78),P=0.11];Radial deviation[MD=2.05,95%CI(-2.39,6.50),P=0.37];Ulnar variance[MD=-1.14,95%CI(-3.16,0.88),P=0.27];There was no significant difference in complications[MD=0.77,95%CI(0.54,1.10),P=0.16](P>0.05).Conclusion:Based on the current clinical data,internal fixation with volar locking plate is more conducive to mid-term DASH score and grip strength recovery than closed reduction plaster or splint external fixation,but there is no significant difference in the quality of life and complications of patients.For adult distal radius fractures,surgical indications should be carefully grasped,and non operative treatment should be given priority.
文摘Objective: To evaluate the effect of open reduction and internal fixation on radial head fracture and assess the post-operative function. Methods: This prospective observational study was conducted from June 2016 to July 2017 at Liaquat National Hospital and Medical College, Karachi. Altogether, 28 patients with radial head and neck fractures were enrolled in our study. These patients were admitted to the hospital and their fractures were fixed with open reduction and internal fixation. Baseline information of the patients was collected, and patient-rated elbow evaluation scores were calculated. Results: Out of the 28 patients, 21 were male and 7 were female. Besides, 16 fractures were on the right side and 12 were on the left side and 17 involving the dominant hands. In addition, 8 patients had Mason type Ⅱ fracture and 20 had Mason type Ⅲ fracture. The mean age of patients was (31.0 ± 8.0) years, and the mean follow-up is (1.2 ± 0.5) years. The mean average patient-rated elbow evaluation scores were (27.64 ± 1.60) at 1-year follow-up. Conclusions:The majority of the patients who had radial head fractures and treated by open reduction and internal fixation have attained an excellent range of motion postoperatively.
文摘Objective: Acetabular fractures are common injuries in Iran. We assess the functional outcome of open reduction and internal fixation management of displaced Complex acetabular fractures. Materials and Methods: We analyzed a case series of patients with open reduction and internal fixation (ORIF) for complex acetabular fractures. Two hundred patients (132 men, 68 women) in four age groups including with a mean age of 43.39 ± 6.18 years (range 20 - 59 years) and a mean follow-up of 82.34 ± 12.48 months (range 18 - 109 months) met the inclusion criteria. Functional outcome at final follow-up was graded assessed according to Harris score. Factors affecting were defined. Results: Anatomic reduction was achieved in 192 hips, imperfect in 8 and poor in none. Radiological outcome revealed excellent results in 128 (64%) hips, good in eight, fair in five and none in poor. Harris score were excellent in 139 (69.5%) hips, good in 43 (21.5%) and fair in 18 (9%) and poor in none. The anatomical reduction results had a favorable final functional outcome. (0.003) However, BMI (P Conclusion: Optimal functional and radiological outcomes have been achieved with anatomic postoperative reduction. Also experience of specialist, on time surgery and good recovery lead to receiving excellent functional outcome with at least complications.
基金supported by Program of the National Natural Science Foundation of China(No.82074233)Scientific Research Foundation for Advanced Talents,Xiang’an Hospital of Xiamen University(No.PM201809170009).
文摘Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children.Methods From February 2015 to August 2019,73 patients with Gartland’s type II and III supracondylar fractures were treated with this modified method.Totally,68 of all patients were followed up for 3–12 months(mean 8.25 months).The evaluation results included fracture nonunion,ulnar nerve injury,pin track infection,carrying angle and elbow joint Flynn score.Results The results showed that bone union was observed in all children,one case had an iatrogenic ulnar nerve injury,and the symptoms were completely relieved in 4 months after removing of the medial-side pin.All children had no cubitus varus deformity and no pin track infection,and the rate of satisfactory results according to Flynn’s criteria score was 100%.Conclusion The modified closed reduction and Kirschner wires internal fixation could effectively reduce the rate of open reduction,the risk of iatrogenic ulnar nerve injury,and the incidence of cubitus varus deformity in treatment of supracondylar humerus fractures in children.
文摘Objective:To evaluate the clinical effect of posterior internal fixation and fusion in the treatment of thoracolumbar fractures.Methods:36 patients with thoracolumbar fractures from January 2018 to December 2020 were selected and divided into study group and control group according to the random number table model.The control group was treated with anterior internal fixation,while the study group was treated with posterior internal fixation and fusion.The indexes of the two groups were compared and analyzed.Results:Compared with the operation related indexes of the two groups,the study group had more advantages(P<0.05);The postoperative kyphosis Cobb angle,height of anterior and posterior vertebral body,wedge index of the two groups were better than those before operation(P<0.05),and there was no significant difference between the two groups(P>0.05);There was no significant difference between the two groups(P>0.05).Conclusion:The clinical effect of posterior internal fixation and fusion in the treatment of thoracolumbar fractures is significant,and the body damage is slight,which is worthy of comprehensive promotion.
文摘BACKGROUND Open reduction and internal fixation(ORIF)is the traditional surgical treatment for patellar fractures,and unicompartmental knee arthroplasty(UKA),especially Oxford UKA,has been increasingly used in patients with medial knee osteoarthritis(OA).However,the process of choosing treatment for patients with both patellar fractures and anteromedial knee OA remains unclear.We present the case of a patient with a patellar fracture and anteromedial OA.CASE SUMMARY We present the case of a 72-year-old woman with a history of bilateral medial compartment OA of the knees and a right Oxford UKA.She also experienced a recent left patellar fracture.ORIF and Oxford UKA were performed in a single stage.The patient showed excellent postoperative clinical results.CONCLUSION ORIF and Oxford UKA can be performed simultaneously for patients with patellar fracture and anteromedial OA on the same knee.
基金supported by Nanjing Medical Science and Technology Development Project(No.YKK13138).
文摘Children's fractures are very common,and many children's fractures need internal fixation.When the children are treated and recovered,it needs to be internally fixed and then taken out.With the development of internal fixation materials,the research of surgical methods and the improvement of surgical skills,postoperative removal of orthopedic surgery patients has gradually been included in daytime surgery.While ensuring the safety of children's surgery,it is necessary to shorten the postoperative limb and joint function recovery time,promote the recovery of limb and joint function,the healing of wounds and bones,and reduce the occurrence of these complications.In order to reduce the occurrence of these complications,carry out early rehabilitation education and development early rehabilitation training is very necessary.This paper puts forward the concept of early rehabilitation based on shared decision model,in which doctors,nurses,children and family members participate in the treatment of children before,during and after operation.The effect of early rehabilitation education in the daytime ward after removal of internal fixation was examined.Moreover,through the analysis of the control trial also confirmed that the clinical effect of early rehabilitation in improving and optimizing the rehabilitation of fracture in children is significant.
文摘In recent times, research into mandibular fracture has gained momentum from advances in scanning techniques, software/algorithm developments and improvements, and numerical structural modeling using the finite-element method (FEM). In this work, the FEM is used to model a mandibular fracture (using an inhomogeneous and orthotropic jaw model) simulating the effect of different bite tasks/forces on the stability of the fixated fracture. Specifically, bilateral and unilateral clenches (using muscle data) were studied using a low-profile 3D 4 × 2 hole mini-plate deployed for fracture fixation. Here, the mandible bone was treated as orthotropic and spatially inhomogeneous. Although the results of stress and displacement analyses, for this fixation hardware, indicate sufficient fixation under normal biting conditions, the results show that the unilateral and ipsilateral bites develop, in general, the highest stresses or displacements. Such results can guide post-surgery recommendation on bite behavior.
文摘Introduction: Despite extensive experience with civilian gunshot fractures or wounds, no consensus exists on a standard protocol to manage these injuries. Many authors recommended immediate debridement, but the optimal timing of internal fixation and the use of antibiotic have not been determined. The purpose of this paper is to present and discuss our experience. Material and methods: In January 2007, a treatment protocol was put in place for the evaluation and management of fractured extremities resulting from civilian gunshot wounds. Sixty-three patients with 64 fractures had been managed by this protocol for gunshot fractures between January 2005 and January 2012. There were 56 male and seven female. Their mean age was 33.1 years (range: 17 - 61 years). Thirteen patients (20.6%) were able to provide a description of the weapon. Only 15 patients had entry and exit wounds. The mean follow-up period was 27 (range, 20 - 58) months. The main factors assessed were the surgical site infection, the fracture union and the functional status. Results: Out of the 63 patients, 14 patients developed a wound infection (five superficial and seven deep infections). Wound infection was significantly associated with associated injuries (p = 0.0388), fractures sites requiring fixation (p = 0.024), the fracture pattern (p = 0.0412), operative modalities (p = 0.0400). There were nine cases (14.1%) of fracture non-union. The mean time to union was 15 weeks (range: 5 - 32 weeks). Five patients developed chronics osteomyelitis. The average SMFA score for all of the patients was 23.8 (range: 0 - 56.3). The mean dysfunctional and bother indexes were 18.3 (range: 0 - 52.7) and 22.6 (range: 0 - 66.1), respectively. The SMFA total score and dysfunction index had a significant correlation based on presence or absence of associated injuries (p < 0.0001). But bother index did not show the same correlation (p = 0.452). The average length of hospital stay was 11.3 days (range: 3 - 64). Conclusion: In civilian’s gunshot induced fractures, internal fixation can be made according to standard protocol, with acceptable result.
文摘<strong>Objective: </strong>To explore the therapeutic effect of autologous blood reinfusion combined with controlled hypotension in surgical spinal fixation during the outbreak of COVID-19. <strong>Methods: </strong>30 patients with spinal internal fixation autologous blood transfusion combined with controlled hypotension were selected as the subjects during the epidemic period from December 2019 to June 2020 in our hospital and during the operation, on the basis of routine blood pressure reduction, the American Haemonetice Corporation autologous blood continuous reinfusion system was used to infuse the blood recovered during the operation to the patient through filtration and other procedures. <strong>Results:</strong> 30 patients had no complications such as fever and hemolysis;And after the operation, the tube was dialed according to the drainage volume, the cervical thoracic and lumbar brace was customized, and the patient walked on the ground for one week;After no abnormalities, the patient was discharged. Intraoperative comparison of white blood cells (WBC), red blood cells (RBC), red blood cell pressure (HCT), hemoglobin (HGB), and coagulation time (PT) of patients with autologous blood before and after transfusion showed statistically significant differences before and after surgery (P < 0.001). <strong>Conclusion:</strong> During the new coronavirus pneumonia epidemic, the internal fixation of spinal surgery used a recovery machine to collect intraoperative blood for reinfusion. Intraoperative antihypertensive drugs were used to control blood pressure within a certain safe range. The postoperative clinical observation effect was significant and safe;especially at present the clinical significance during the epidemic was significant.
文摘Objective To explore the efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) technique and locking compression plate (LCP) for open tibial shaft fractures.Methods From March 2005 to May 2009,16 cases with open tibial
文摘Objective To evaluate effects of manipulative reduction,dynamic external fixator combined with limited internal fixation for the treatment of Pilon fractures.Methods From January 2007 to June 2009,manipulative reduction,dynamic external
文摘Objective To explore the effects of the anterior internal fixation systems on the post-operative lateral angulation in treatment of thoracolumbar fractures.Methods A retrospective study was done to analyze the 172 patients who had
文摘Objective To report five cases of puerile (【9 years) atlantoaxial instability which underwent C1-C2 pedicle screw internal fixation by posterior approach,and to introduce the surgical technique and the key point
文摘Objective To study the effect of using improved 2D computer-assisted fluoroscopic navigation through simulating 3D vertebrae image to guide pedicle screw internal fixation.Methods Posterior pedicle screw internal fixation,distraction
文摘To assess the effect of using buttress plate associated with antografting of fibula and iliac bone for the treatment of distal femoral C3 type fracture.Methods Seventeen cases of distal femoral C3 type fracture using buttress plate associated with antografting of fibula and iliac bone were analyzed retrospectively.Results All cases were followed up for an average of 24 months（8～55 months）.The average time of octets bridge forming were 4 months（3～5 months） while the average time for bone union were 8 months （6～14 months）.According to Shelbourne rating system,result of all 18 cases were excellent and no malunion,infection were found.Conclusion Buttress plate associated with antografting of fibula and iliac bone is an effective alternative for the treatment of distal femoral C3 type fracture.It can provide more stable fixation to the bone and earlier functional exercises can be achieved.5 refs,3 figs,1 tab.
文摘The fixation stability achieved with the use of plates and screws in oral and maxillofacial surgery is a decisive factor in treatment success. The mechanical and structural properties of the internal fixation materials have direct influence on the dimensional stability and resistance of a fixation system, thus influencing treatment outcomes. This study proposed to analyze the dimensional and resistance patterns of titanium plates used for obtaining stable fix<span style="font-family:Verdana;">ation in orthognathic surgery and craniofacial trauma. For this study, 30 conventional 2.0</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">mm straight four hole plates with bridge from three brands commercialized in Brazil, were subjected to macroscopic, microscopic, strength and hardness analysis. The dimensional measurements were performed using a digital caliper. Energy-dispersive X-ray spectroscopy analysis was performed by scanning electron microscopy to analyze the chemical composition of the samples. The mechanical resistance tests were performed with a universal testing machine. The samples were then submitted to Vickers hardness analysis, complying with the standards of ASTM E92. The data collected from the dimensional study was submitted to statistical analysis of the coefficient of variation, while the values obtained during the mechanical tests were analyzed by variance (ANOVA) and Tukey’s test (p <</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">0.05). The sample groups presented different performances in resistance, hardness, size and surface, even though they were reported to be chemically similar compounds that allowed us to conclude the plates from Group 2 were more resistant than groups 1 and 3.</span>
基金This work was supported by the Guangzhou Science and Technology Program Key Projects(No.202002020001)Science and Technology Planning Project of Guangdong Province(No.2020A0505100039)+1 种基金Autonomous region science and technology branch Xinjiang project plan(No.2022E02040)Clinical Key Specialty in Ningde City,Fujian Province.
文摘At present,effective fixation and anti-infection implant materials represent the mainstay for the treatment of open fractures.However,external fixation can cause nail tract infections and is ineffective for fixing small fracture fragments.Moreover,closed reduction and internal fixation during the early stage of injury can lead to potential bone infection,conducive to bone nonunion and delayed healing.Herein,we designed a bone adhesive with anti-infection,osteogenic and bone adhesion fixation properties to promote reduction and fixation of open fractures and subsequent soft tissue repair.It was prepared by the reaction of gelatin(Gel)and oxidized starch(OS)with vancomycin(VAN)-loaded mesoporous bioactive glass nanoparticles(MBGNs)covalently cross-linked with Schiff bases.Characterization and adhesion experiments were conducted to validate the successful preparation of the Gel-OS/VAN@MBGNs(GOVM-gel)adhesive.Meanwhile,in vitro cell experiments demonstrated its good antibacterial effects with the ability to stimulate bone marrow mesenchymal stem cell(BMSCs)proliferation,upregulate the expression of alkaline phosphatase(ALP)and osteogenic proteins(RunX2 and OPN)and enhance the deposition of calcium nodules.Additionally,we established a rat skull fracture model and a subcutaneous infection model.The histological analysis showed that bone adhesive enhanced osteogenesis,and in vivo experiments demonstrated that the number of inflammatory cells and bacteria was significantly reduced.Overall,the adhesive could promote early reduction of fractures and antibacterial and osteogenic effects,providing the foothold for treatment of this patient population.
文摘Purpose:This meta-analysis compared the clinical outcome of three-dimensional(3D)printing combined with open reduction and internal fixation(ORIF)to traditional ORIF in the treatment of acetabular fractures.Methods:We searched the Cochrane Library,PubMed,Embase,VIP database,CNKI,and Wanfang data-base with keywords"acetabular fracture","3D printing","three-dimensional printing","open reduction and internal fixation","Acetabulum","Acetabula"from January 2000 to March 2020.Two reviewers independently selected articles,extracted data,assessed the quality evidence and risk bias of included trials using the Cochrane Collaboration’s tools and/or Newcastle-Ottawa scale.When the two analysts had different opinions,they would ask the third analyst for opinion.Randomized controlled trials or retrospective comparative studies of 3D printing combined with ORIF(3D printing group)versus traditional ORIF(conventional group)in the treatment of acetabular fractures were selected.The data of operation time,intraoperative blood loss,intraoperative fluoroscopy times,incidence of complications,excellent and good rate of Matta score for reduction,and excellent and good rate of hip function score were extracted.Stata14.0 statistical software was used for data analysis.Results:Altogether 9 articles were selected,including 5 randomized controlled trials and 4 retrospective studies.A total of 467 patients were analyzed,250 in the conventional group,and 217 in the 3D printing group.The operation time in the 3D printing group was less than that in the conventional group and the difference was statistically significant(standardized mean difference(SMD)=-1.19,95%CI:-1.55 to-0.82,p<0.05).The intraoperative bleeding volume of the 3D printing group was significantly lower than that of the conventional group(SMD=-1.08,95%CI:-1.65 to-0.51,p<0.05).The fluoroscopy times were less in the 3D printing group than in the conventional group and the difference was statistically significant(SMD=-1.64,95%CI:-2.35 to-0.93,p<0.05).The total incidence of complications in the 3D printing group was significantly lower than that in the conventional group(OR=0.43,95%CI:0.24-0.79,p<0.05).There was no significant difference in the excellent and good rate of Matta score for reduction between the two groups(OR=0.60,95%CI:0.34-1.06,p>0.05).There was no significant difference in the excellent and good rate of hip function score at the end of postoperative follow-up between the two groups(OR=0.84,95%CI:0.46-1.56,p>0.05),but the follow-up time varies from 6 months to 40 months.Conclusion:Compared with traditional ORIF,3D printing combined with ORIF has certain advantages in terms that 3D printing not only helps surgeons to understand acetabular fractures more intuitively,but also effectively reduces operation time,intraoperative blood loss,intraoperative fluoroscopy times,and postoperative complications.However,there were no significant differences in the excellent and good rate of Matta score for reduction and the excellent and good rate of hip function score at the end of follow-up.
