Introduction: The localization of bone tuberculosis at the level of the olecranon is rare and can pose a problem of differential diagnosis with a tumoral affection. Only the biopsy allows the diagnosis of certainty. T...Introduction: The localization of bone tuberculosis at the level of the olecranon is rare and can pose a problem of differential diagnosis with a tumoral affection. Only the biopsy allows the diagnosis of certainty. The goal was to report our first case to do a review of the literature. Clinical Observation: This was a 64-year-old patient who consulted 2 years after the onset of symptoms for swelling and mechanical pain in the left elbow. On clinical examination there was a firm consistent mass measuring 6/4 cm in diameter, not very painful and hot on the posterior surface of the left elbow, accompanied by paresthesias in the territory of the ulnar nerve associated with partial functional impotence of the left forearm with little altered general condition. The X-rays of the left elbow showed extensive bone lysis of the olecranon with fracture of the base of the olecranon. The CT Scan of the elbow performed showed osteolysis of the olecranon with extensive bone reactions at the distal end of the humerus. The biopsy carried out with histological examination concluded with an aspect of tuberculous osteitis and the culture came back sterile. A curettage was performed associated with anti-tuberculosis treatment for 12 months as well as the placement of a posterior splint. The evolution at 9 months was unsatisfactory with persistence of paresis and stiffness of the elbow. Conclusion: Tuberculous osteitis of the olecranon can simulate a malignant tumor with non-specific signs of bone tuberculosis. Only the anatomopathological examination is definitive for the diagnosis. The treatment is multidisciplinary. Orthopedic evolution is difficult to predict.展开更多
Introduction: Olecranon fractures represent approximately 10% of upper limb fractures, orthopedic treatment is often doomed to failure and surgical treatment consists of fixing the fracture sites. Patients and Methods...Introduction: Olecranon fractures represent approximately 10% of upper limb fractures, orthopedic treatment is often doomed to failure and surgical treatment consists of fixing the fracture sites. Patients and Methods: This study retrospectively analyzed 130 patients, 90 men and 40 women, aged on average 48.7 ± 11.9 years (30 to 65) treated between 2018 and 2020 in the Orthopedics and trauma department at the Moulins-Yzeure hospital center, for olecranon fracture using the Medartis H-locked plate. The study aimed to evaluate the results of this surgical method, particularly with regard to postoperative complications. Results: Among the 130 patients, there were 90 men and 40 women, with an average age of 48.7 ± 11.9 years (30 to 65). 50% of all patients were aged over 51 years. The plate used was standard, the same for the 130 patients with the same operating technique. The left side was more affected at 53.8%, the dominant side was less affected at 46%;the majority of patients had been temporarily immobilized with a posterior cast splint before surgery. The average time between trauma and operation was 9 days with a minimum time of 1 day and a maximum of 30 days. At a maximum follow-up of 2 years postoperatively, all patients reported satisfactory results with a return to their previous activities within 60 days after surgery. Conclusion: Medartis H-locked plate osteosynthesis is a reliable solution for the surgical treatment of olecranon fractures.展开更多
Consistent with an aging population, the overall number of distal humeral fractures in the elderly is increasing. Indications for application of acute total elbow arthroplasty (TEA) in the setting of distal humeral fr...Consistent with an aging population, the overall number of distal humeral fractures in the elderly is increasing. Indications for application of acute total elbow arthroplasty (TEA) in the setting of distal humeral fractures are still being defined. A variety of factors including chronologic age, physiologic age, bone quality, presence of pre-existing arthritis and pre-existing medical conditions need to be considered. Optimally the decision to proceed with TEA verses open reduction internal fixation (ORIF) is made preoperatively. The need to abandon ORIF may be not be apparent until after fracture exposure, and the presence of an olecranon osteotomy makes performing TEA challenging. A case is presented of acute conversion from ORIF to TEA following olecranon osteotomy, utilizing internal fixation bridging the ulnar component and its cement mantle.展开更多
Anterior transolecranon dislocation of the elbow is rarely observed in children, reported in only a small series. The present case involves an anterior transolecranon dislocation of the left elbow joint in a 7-year-ol...Anterior transolecranon dislocation of the elbow is rarely observed in children, reported in only a small series. The present case involves an anterior transolecranon dislocation of the left elbow joint in a 7-year-old child, which was surgically treated. Two attempts of closed reduction failed because the radial head had buttonholed via the joint capsule. After its release, open reduction was easily performed; osteosynthesis of the olecranon was not performed. Remarkably, good result was obtained, despite a mild flexion deformity at the last follow-up. This case report aims to highlight this treatment method, which may be considered for such an uncommon injury.展开更多
Olecranon bursal involvement due to tuberculosis is not often seen in literature. Involvement is often seen in the subdeltoid and trochanteric bursa, with concomitant skeletal involvement. We report a patient with iso...Olecranon bursal involvement due to tuberculosis is not often seen in literature. Involvement is often seen in the subdeltoid and trochanteric bursa, with concomitant skeletal involvement. We report a patient with isolated tuberculous granuloma of the olecranon bursa with no comorbid illness.展开更多
AIM: To determine whether use of a precontoured olecranon plate provides adequate fixation to withstand supraphysiologic force in a comminuted olecranon fracture model.METHODS: Five samples of fourth generation compos...AIM: To determine whether use of a precontoured olecranon plate provides adequate fixation to withstand supraphysiologic force in a comminuted olecranon fracture model.METHODS: Five samples of fourth generation composite bones and five samples of fresh frozen human cadaveric left ulnae were utilized for this study. The cadaveric specimens underwent dual-energy X-ray absorptiometry(DEXA) scanning to quantify the bone quality. The composite and cadaveric bones were prepared by creating a comminuted olecranon fracture and fixed with a pre-contoured olecranon plate with locking screws. Construct stiffness and failure load were measured by subjecting specimens to cantilever bending moments until failure. Fracture site motion was measured with differential variable resistance transducer spanning the fracture. Statistical analysis was performed with two-tailed Mann-Whitney-U test with Monte Carlo Exact test.RESULTS: There was a significant difference in fixation stiffness and strength between the composite bones and human cadaver bones. Failure modes differed in cadaveric and composite specimens. The load to failure for the composite bones(n = 5) and human cadaver bones(n = 5) specimens were 10.67 nm(range 9.40-11.91 nm) and 13.05 nm(range 12.59-15.38 nm) respectively. This difference was statistically significant(P ? 0.007, 97% power). Median stiffness for composite bones and human cadaver bones specimens were 5.69 nm/mm(range 4.69-6.80 nm/mm) and 7.55 nm/mm(range 6.31-7.72 nm/mm). There was a significant difference for stiffness(P ? 0.033, 79% power) between composite bones and cadaveric bones. No correlation was found between the DEXA results and stiffness. All cadaveric specimens withstood the physiologic load anticipated postoperatively. Catastrophic failure occurred in all composite specimens. All failures resulted from composite bone failure at the distal screw site and not hardware failure. There were no catastrophic fracture failures in the cadaveric specimens. Failure of 4/5 cadaveric specimens was defined when a fracture gap of 2 mm was observed, but 1/5 cadaveric specimens failed due to a failure of the triceps mechanism. All failures occurred at forces greater than that expected in postoperative period prior to healing.CONCLUSION: The pre-contoured olecranon plate provides adequate fixation to withstand physiologic force in a composite bone and cadaveric comminuted olecranon fracture model.展开更多
Olecranon bursitis is rarely seen in patients with stroke, but reflex sympathetic dystrophy syndrome is not. Here, we report a stroke case, which represented the clinical symptom of reflex sympathetic dystrophy syndro...Olecranon bursitis is rarely seen in patients with stroke, but reflex sympathetic dystrophy syndrome is not. Here, we report a stroke case, which represented the clinical symptom of reflex sympathetic dystrophy syndrome after development of olecranon bursitis in few days, and describe his clinical association between both conditions. Sonographicpicture of the right elbow in this case is shown.展开更多
Introduction: Pseudoarthrosis is one of the most dreadful complications of olecranon fractures. It seriously compromises the function of the elbow. Objectives: To determine the epidemiological factors of this complica...Introduction: Pseudoarthrosis is one of the most dreadful complications of olecranon fractures. It seriously compromises the function of the elbow. Objectives: To determine the epidemiological factors of this complication in order to prevent them and to assess the results of the therapeutic management. Material and method: This was a retrospective study that involved patients with olecranon pseudoarthrosis who were treated in the department between January 2006 and December 2016. The diagnosis of pseudoarthrosis was made at least 6 months after the management of the fracture. There were 16 men and 5 women. We analyzed the epidemiological factors, the treatment of pseudoarthrosis, and the postoperative outcome. Results: The incriminated factors were the complexity of the fracture line and the quality of treatment of the recent fracture. The osteosynthesis of pseudoarthrosis is similar to that of recent fractures. It requires in some cases a bone graft. The results of the treatment are satisfactory with 100% of consolidation, and a good functional result in 75% of the cases. Conclusion: The treatment of olecranon pseudoarthrosis is based above all on prevention by an optimal management of the recent fractures. The curative treatment gives satisfactory functional results.展开更多
Background: The olecranon fractures in children are relatively rare articular fractures. The aim of this work is to study the epidemiological, clinical and therapeutic particularities of this fracture in children at O...Background: The olecranon fractures in children are relatively rare articular fractures. The aim of this work is to study the epidemiological, clinical and therapeutic particularities of this fracture in children at Owendo University Teaching Hospital. Patients and Methods: This was a retrospective analytical, monocentric study over 2 years from January 1, 2018 to January 1, 2020 at the Owendo University Hospital in Libreville and relating to the medical files of patients treated for a fracture of the olecranon in children in the service and regularly followed in outpatient consultation. Results: We collected 21 patients with an average age of 8.7 years. Falls dominated the etiologies. The Bracq classification was the one used in our series with the predominance of type D. The treatment was orthopedic in 33.3% of cases and surgical in 66.7% of cases. With an average follow-up of 12 months, the results were good in 71.5%, average in 19.0% and poor in 9.5%. Conclusion: The analysis of our results compared to those of the authors of the literature according to the precise parameters seems satisfactory.展开更多
【目的】鹰嘴桃是岭南地区的特色水果,因其良好的风味和品质被评为“岭南十大佳果”。通过分析鹰嘴桃过敏原蛋白的抗原表位,为过敏原重组抗原的制备提供研究基础,也为阐述食品加工过程中鹰嘴桃过敏原的特性变化和致敏特性提供研究依据...【目的】鹰嘴桃是岭南地区的特色水果,因其良好的风味和品质被评为“岭南十大佳果”。通过分析鹰嘴桃过敏原蛋白的抗原表位,为过敏原重组抗原的制备提供研究基础,也为阐述食品加工过程中鹰嘴桃过敏原的特性变化和致敏特性提供研究依据。【方法】利用磷酸缓冲液提取鹰嘴桃冻干粉中的粗蛋白,采用SDS-PAGE蛋白电泳方法鉴定并联合蛋白质谱方法分析粗蛋白中存在的过敏原,通过蛋白数据库UniProt进行筛选比对,并采用生物信息学方法分析致敏蛋白的理化性质、空间结构和抗原表位等生物学特性。【结果】从鹰嘴桃中鉴定出7种致敏蛋白(A0A251RBV3、P86888、M5X697、M5WV03、M5WTQ8、Q2I6V8、Q9LED1),主要归属于病程相关蛋白(Pru p 1)、类甜蛋白(Pru p 2)、非特异性脂质转移蛋白家族(Pru p 3)和赤霉素调节蛋白(Pru p 7)4类过敏原蛋白。7种鹰嘴桃过敏原蛋白具有较高稳定性,分子量为6.91~26.04 kD,脂肪族氨基酸指数为29.37~81.54。M5WTQ8和Q2I6V8过敏原蛋白为酸性蛋白,其余过敏原蛋白为碱性蛋白。除Q9LED1蛋白外,其余过敏原蛋白均为亲水蛋白。筛选抗原表位、亲水性和柔韧性大于0且表面可及性大于1的区域,并结合二、三级蛋白结构分析蛋白键能较低的区域,获得鹰嘴桃过敏原的抗原表位分别为Pru p 1(EIP、GSQ、KEN、NL、KG、EIK、HPD)、Pru p 2(TGDQKPQ、SP、NQ、PPNDKPETCPPT、DDKSS、RP)、Pru p 3(RT、VN)和Pru p 7(AGY、GTYGN、LKNSKGN)。【结论】通过对鹰嘴桃过敏原蛋白的结构、亲水性、表面可及性、柔韧性和抗原指数进行分析,获得过敏原蛋白的多个抗原表位,可为鹰嘴桃过敏原在食品加工中的致敏特性研究提供研究基础。展开更多
目的评估完全清醒局部麻醉无止血带技术(Wide awake local anesthesiatourniquet,WALANT)在治疗尺骨鹰嘴滑囊炎中的疗效。方法回顾性分析保守治疗无效且病程超过6个月的尺骨鹰嘴滑囊炎患者临床资料,所以患者均采用关节镜手术治疗,按麻...目的评估完全清醒局部麻醉无止血带技术(Wide awake local anesthesiatourniquet,WALANT)在治疗尺骨鹰嘴滑囊炎中的疗效。方法回顾性分析保守治疗无效且病程超过6个月的尺骨鹰嘴滑囊炎患者临床资料,所以患者均采用关节镜手术治疗,按麻醉方式不同分为WALANT组和臂丛麻醉组。主要观察指标包括手术时长、手术费用、术前与术后疼痛评分(VAS)和Mayo肘关节功能评分系统(MEPS)评分。结果研究发现,WALANT组手术时长和费用均显著低于臂丛麻醉组;两组术后VAS评分较术前均显著下降,且术后6、24 h VAS评分无显著差异;术后两组MEPS评分较术前均显著提高,且术后1~6个月两组MEPS评分无显著差异;术后6个月随访两组均未出现复发。结论WALANT技术在尺骨鹰嘴滑囊炎关节镜治疗中表现出良好的疗效和经济效益。展开更多
Background:The open reduction and internal fixation(ORIF)was a standard treatment approach for fracture at distal humerus intercondylar,whereas the optimal way before ORIF remains inconclusive.We,therefore,performed a...Background:The open reduction and internal fixation(ORIF)was a standard treatment approach for fracture at distal humerus intercondylar,whereas the optimal way before ORIF remains inconclusive.We,therefore,performed a systematic review and meta-analysis to assess the efficacy and safety of olecranon osteotomy vs.triceps-sparing approach for patients with distal humerus intercondylar fracture.Methods:The electronic searches were systematically performed in PubMed,EmBase,Cochrane library,and Chinese National Knowledge Infrastructure from initial inception till December 2019.The primary endpoint was the incidence of excellent/good elbow function,and the secondary endpoints included Mayo elbow performance score,duration of operation,blood loss,and complications.Results:Nine studies involving a total of 637 patients were selected for meta-analysis.There were no significant differences between olecranon osteotomy and triceps-sparing approach for the incidence of excellent/good elbow function(odds ratio[OR]:1.37;95%confidence interval[CI]:0.69-2.75;P=0.371),Mayo elbow performance score(weight mean difference[WMD]:0.17;95%CI:-2.56 to 2.89;P=0.904),duration of operation(WMD:4.04;95%CI:-28.60 to 36.69;P=0.808),blood loss(WMD:33.61;95%CI:-18.35 to 85.58;P=0.205),and complications(OR:1.93;95%CI:0.49-7.60;P=0.349).Sensitivity analyses found olecranon osteotomy might be associated with higher incidence of excellent/good elbow function,longer duration of operation,greater blood loss,and higher incidence of complications as compared with triceps-sparing approach.Conclusions:This study found olecranon osteotomy did not yield additional benefit on the incidence of excellent/good elbow function,while the duration of operation,blood loss,and complications in patients treated with olecranon osteotomy might be inferior than triceps-sparing approach.展开更多
Purpose:Olecranon fractures are particularly vulnerable to distraction and subsequent fracture dislocation due to the high tensile forces.Surgical treatment aims at reducing the fracture and restoring the anatomical j...Purpose:Olecranon fractures are particularly vulnerable to distraction and subsequent fracture dislocation due to the high tensile forces.Surgical treatment aims at reducing the fracture and restoring the anatomical joint surface condition,as well as neutralizing the strain inhibiting fracture healing.The XS nail®(Intercus GmbH,Bad Blankenberg,Germany),an intramedullary implant exerting compression across the entire fracture surface,unlike plates,leaves a minimal extra-cortical profile,and can be secured with threaded locking wires,thereby retaining the anatomical reduction without displacement or steps within the articular surface,which was often found in tension band wiring.After encouraging initial results,the long-term outcome was assessed.Methods:This retrospective study evaluated the long-term outcome of patients surgically treated at our trauma center between January 2002 and December 2005 using the XS nail®.Patients over the age of 18 years eligible for the study must have undergone surgery for isolated,recent(less than 14 days)traumatic olecranon fractures,without concomitant injuries to the ipsilateral elbow and forearm.Further exclusion criteria were pseudarthrosis,re-fractures and osteotomy for distal humerus surgery,as well as polytraumatized patients unable to aid in their own recovery.Data were retrospectively gathered by standardised questionnaire and patient records,as well as surgery and anesthesiology reports.Data analysis was performed using Microsoft Office Excel?2016.Results:There were 32 patients,13 males(mean age 49.0 years)and 19 females(mean age 68.9 years)with 11 Schatzkers type D,7 each type A and C,5 type B and 2 type E at an average of 55.2 months,all showing complete consolidation.Of them,6 patients had a loss of range of motion with more than 10°in the sagittal plane,and only 1 patient exceeded 10°reduction of supination.Twenty-five patients reported being pain-free under all circumstances,and all but 2 patients(93.75%)had returned to their previous activity level.The average disabilities of the arm,shoulder and hand score was 21.15(range 0-88.3),and the overall Mayo elbow performance index was 91.87,without complications,such as wound infection,neurovascular impairment or premature hardware removal.Conclusion:Using the XS nail®system,all fracture types can be successfully treated and the rate of complications was lower than that treated by standard methods published in current literature.An excellent functional outcome,high range of motion as well as good retention of reduction without soft tissue irritation makes this a very suitable implant for fractures subject to tension.展开更多
Tuberculosis （TB） occurring after a closed bone fracture in the patient with no history of TB and no evidence of TB infection at the time of initial fracture is a rare entity. We report one such case of a 48-year-ol...Tuberculosis （TB） occurring after a closed bone fracture in the patient with no history of TB and no evidence of TB infection at the time of initial fracture is a rare entity. We report one such case of a 48-year-old female, who presented in the emergency department with an olecranon fracture which was open reduced and inter- nally fixed with tension band wiring. Patient presented in the outpatient department with serosanguineous discharge at 3 weeks after surgery. The discharge was sent for culture and sensitivity tests, and the patient was managed by anti- biotics and daily dressings. There was wound dehiscence and the underlying implant was exposed, which was removed at 12 weeks after surgery. Repeat debridements and dressings continued for 6 months, but the discharge from the wound site continued. X-rays of the elbow performed at 6 months raised the suspicion of TB, which was confirmed by Ziel-Neelsen staining and histopathological examination of the debrided tissue. Following the confirmation, patient was put on antitubercular drugs. The patient responded to anti- tubercular drug therapy （ATT）, the purulent discharge from the wound ceased, and eventually the wound healed after 2 months of starting ATT.展开更多
文摘Introduction: The localization of bone tuberculosis at the level of the olecranon is rare and can pose a problem of differential diagnosis with a tumoral affection. Only the biopsy allows the diagnosis of certainty. The goal was to report our first case to do a review of the literature. Clinical Observation: This was a 64-year-old patient who consulted 2 years after the onset of symptoms for swelling and mechanical pain in the left elbow. On clinical examination there was a firm consistent mass measuring 6/4 cm in diameter, not very painful and hot on the posterior surface of the left elbow, accompanied by paresthesias in the territory of the ulnar nerve associated with partial functional impotence of the left forearm with little altered general condition. The X-rays of the left elbow showed extensive bone lysis of the olecranon with fracture of the base of the olecranon. The CT Scan of the elbow performed showed osteolysis of the olecranon with extensive bone reactions at the distal end of the humerus. The biopsy carried out with histological examination concluded with an aspect of tuberculous osteitis and the culture came back sterile. A curettage was performed associated with anti-tuberculosis treatment for 12 months as well as the placement of a posterior splint. The evolution at 9 months was unsatisfactory with persistence of paresis and stiffness of the elbow. Conclusion: Tuberculous osteitis of the olecranon can simulate a malignant tumor with non-specific signs of bone tuberculosis. Only the anatomopathological examination is definitive for the diagnosis. The treatment is multidisciplinary. Orthopedic evolution is difficult to predict.
文摘Introduction: Olecranon fractures represent approximately 10% of upper limb fractures, orthopedic treatment is often doomed to failure and surgical treatment consists of fixing the fracture sites. Patients and Methods: This study retrospectively analyzed 130 patients, 90 men and 40 women, aged on average 48.7 ± 11.9 years (30 to 65) treated between 2018 and 2020 in the Orthopedics and trauma department at the Moulins-Yzeure hospital center, for olecranon fracture using the Medartis H-locked plate. The study aimed to evaluate the results of this surgical method, particularly with regard to postoperative complications. Results: Among the 130 patients, there were 90 men and 40 women, with an average age of 48.7 ± 11.9 years (30 to 65). 50% of all patients were aged over 51 years. The plate used was standard, the same for the 130 patients with the same operating technique. The left side was more affected at 53.8%, the dominant side was less affected at 46%;the majority of patients had been temporarily immobilized with a posterior cast splint before surgery. The average time between trauma and operation was 9 days with a minimum time of 1 day and a maximum of 30 days. At a maximum follow-up of 2 years postoperatively, all patients reported satisfactory results with a return to their previous activities within 60 days after surgery. Conclusion: Medartis H-locked plate osteosynthesis is a reliable solution for the surgical treatment of olecranon fractures.
文摘Consistent with an aging population, the overall number of distal humeral fractures in the elderly is increasing. Indications for application of acute total elbow arthroplasty (TEA) in the setting of distal humeral fractures are still being defined. A variety of factors including chronologic age, physiologic age, bone quality, presence of pre-existing arthritis and pre-existing medical conditions need to be considered. Optimally the decision to proceed with TEA verses open reduction internal fixation (ORIF) is made preoperatively. The need to abandon ORIF may be not be apparent until after fracture exposure, and the presence of an olecranon osteotomy makes performing TEA challenging. A case is presented of acute conversion from ORIF to TEA following olecranon osteotomy, utilizing internal fixation bridging the ulnar component and its cement mantle.
文摘Anterior transolecranon dislocation of the elbow is rarely observed in children, reported in only a small series. The present case involves an anterior transolecranon dislocation of the left elbow joint in a 7-year-old child, which was surgically treated. Two attempts of closed reduction failed because the radial head had buttonholed via the joint capsule. After its release, open reduction was easily performed; osteosynthesis of the olecranon was not performed. Remarkably, good result was obtained, despite a mild flexion deformity at the last follow-up. This case report aims to highlight this treatment method, which may be considered for such an uncommon injury.
文摘Olecranon bursal involvement due to tuberculosis is not often seen in literature. Involvement is often seen in the subdeltoid and trochanteric bursa, with concomitant skeletal involvement. We report a patient with isolated tuberculous granuloma of the olecranon bursa with no comorbid illness.
文摘AIM: To determine whether use of a precontoured olecranon plate provides adequate fixation to withstand supraphysiologic force in a comminuted olecranon fracture model.METHODS: Five samples of fourth generation composite bones and five samples of fresh frozen human cadaveric left ulnae were utilized for this study. The cadaveric specimens underwent dual-energy X-ray absorptiometry(DEXA) scanning to quantify the bone quality. The composite and cadaveric bones were prepared by creating a comminuted olecranon fracture and fixed with a pre-contoured olecranon plate with locking screws. Construct stiffness and failure load were measured by subjecting specimens to cantilever bending moments until failure. Fracture site motion was measured with differential variable resistance transducer spanning the fracture. Statistical analysis was performed with two-tailed Mann-Whitney-U test with Monte Carlo Exact test.RESULTS: There was a significant difference in fixation stiffness and strength between the composite bones and human cadaver bones. Failure modes differed in cadaveric and composite specimens. The load to failure for the composite bones(n = 5) and human cadaver bones(n = 5) specimens were 10.67 nm(range 9.40-11.91 nm) and 13.05 nm(range 12.59-15.38 nm) respectively. This difference was statistically significant(P ? 0.007, 97% power). Median stiffness for composite bones and human cadaver bones specimens were 5.69 nm/mm(range 4.69-6.80 nm/mm) and 7.55 nm/mm(range 6.31-7.72 nm/mm). There was a significant difference for stiffness(P ? 0.033, 79% power) between composite bones and cadaveric bones. No correlation was found between the DEXA results and stiffness. All cadaveric specimens withstood the physiologic load anticipated postoperatively. Catastrophic failure occurred in all composite specimens. All failures resulted from composite bone failure at the distal screw site and not hardware failure. There were no catastrophic fracture failures in the cadaveric specimens. Failure of 4/5 cadaveric specimens was defined when a fracture gap of 2 mm was observed, but 1/5 cadaveric specimens failed due to a failure of the triceps mechanism. All failures occurred at forces greater than that expected in postoperative period prior to healing.CONCLUSION: The pre-contoured olecranon plate provides adequate fixation to withstand physiologic force in a composite bone and cadaveric comminuted olecranon fracture model.
文摘Olecranon bursitis is rarely seen in patients with stroke, but reflex sympathetic dystrophy syndrome is not. Here, we report a stroke case, which represented the clinical symptom of reflex sympathetic dystrophy syndrome after development of olecranon bursitis in few days, and describe his clinical association between both conditions. Sonographicpicture of the right elbow in this case is shown.
文摘Introduction: Pseudoarthrosis is one of the most dreadful complications of olecranon fractures. It seriously compromises the function of the elbow. Objectives: To determine the epidemiological factors of this complication in order to prevent them and to assess the results of the therapeutic management. Material and method: This was a retrospective study that involved patients with olecranon pseudoarthrosis who were treated in the department between January 2006 and December 2016. The diagnosis of pseudoarthrosis was made at least 6 months after the management of the fracture. There were 16 men and 5 women. We analyzed the epidemiological factors, the treatment of pseudoarthrosis, and the postoperative outcome. Results: The incriminated factors were the complexity of the fracture line and the quality of treatment of the recent fracture. The osteosynthesis of pseudoarthrosis is similar to that of recent fractures. It requires in some cases a bone graft. The results of the treatment are satisfactory with 100% of consolidation, and a good functional result in 75% of the cases. Conclusion: The treatment of olecranon pseudoarthrosis is based above all on prevention by an optimal management of the recent fractures. The curative treatment gives satisfactory functional results.
文摘Background: The olecranon fractures in children are relatively rare articular fractures. The aim of this work is to study the epidemiological, clinical and therapeutic particularities of this fracture in children at Owendo University Teaching Hospital. Patients and Methods: This was a retrospective analytical, monocentric study over 2 years from January 1, 2018 to January 1, 2020 at the Owendo University Hospital in Libreville and relating to the medical files of patients treated for a fracture of the olecranon in children in the service and regularly followed in outpatient consultation. Results: We collected 21 patients with an average age of 8.7 years. Falls dominated the etiologies. The Bracq classification was the one used in our series with the predominance of type D. The treatment was orthopedic in 33.3% of cases and surgical in 66.7% of cases. With an average follow-up of 12 months, the results were good in 71.5%, average in 19.0% and poor in 9.5%. Conclusion: The analysis of our results compared to those of the authors of the literature according to the precise parameters seems satisfactory.
文摘【目的】鹰嘴桃是岭南地区的特色水果,因其良好的风味和品质被评为“岭南十大佳果”。通过分析鹰嘴桃过敏原蛋白的抗原表位,为过敏原重组抗原的制备提供研究基础,也为阐述食品加工过程中鹰嘴桃过敏原的特性变化和致敏特性提供研究依据。【方法】利用磷酸缓冲液提取鹰嘴桃冻干粉中的粗蛋白,采用SDS-PAGE蛋白电泳方法鉴定并联合蛋白质谱方法分析粗蛋白中存在的过敏原,通过蛋白数据库UniProt进行筛选比对,并采用生物信息学方法分析致敏蛋白的理化性质、空间结构和抗原表位等生物学特性。【结果】从鹰嘴桃中鉴定出7种致敏蛋白(A0A251RBV3、P86888、M5X697、M5WV03、M5WTQ8、Q2I6V8、Q9LED1),主要归属于病程相关蛋白(Pru p 1)、类甜蛋白(Pru p 2)、非特异性脂质转移蛋白家族(Pru p 3)和赤霉素调节蛋白(Pru p 7)4类过敏原蛋白。7种鹰嘴桃过敏原蛋白具有较高稳定性,分子量为6.91~26.04 kD,脂肪族氨基酸指数为29.37~81.54。M5WTQ8和Q2I6V8过敏原蛋白为酸性蛋白,其余过敏原蛋白为碱性蛋白。除Q9LED1蛋白外,其余过敏原蛋白均为亲水蛋白。筛选抗原表位、亲水性和柔韧性大于0且表面可及性大于1的区域,并结合二、三级蛋白结构分析蛋白键能较低的区域,获得鹰嘴桃过敏原的抗原表位分别为Pru p 1(EIP、GSQ、KEN、NL、KG、EIK、HPD)、Pru p 2(TGDQKPQ、SP、NQ、PPNDKPETCPPT、DDKSS、RP)、Pru p 3(RT、VN)和Pru p 7(AGY、GTYGN、LKNSKGN)。【结论】通过对鹰嘴桃过敏原蛋白的结构、亲水性、表面可及性、柔韧性和抗原指数进行分析,获得过敏原蛋白的多个抗原表位,可为鹰嘴桃过敏原在食品加工中的致敏特性研究提供研究基础。
文摘目的评估完全清醒局部麻醉无止血带技术(Wide awake local anesthesiatourniquet,WALANT)在治疗尺骨鹰嘴滑囊炎中的疗效。方法回顾性分析保守治疗无效且病程超过6个月的尺骨鹰嘴滑囊炎患者临床资料,所以患者均采用关节镜手术治疗,按麻醉方式不同分为WALANT组和臂丛麻醉组。主要观察指标包括手术时长、手术费用、术前与术后疼痛评分(VAS)和Mayo肘关节功能评分系统(MEPS)评分。结果研究发现,WALANT组手术时长和费用均显著低于臂丛麻醉组;两组术后VAS评分较术前均显著下降,且术后6、24 h VAS评分无显著差异;术后两组MEPS评分较术前均显著提高,且术后1~6个月两组MEPS评分无显著差异;术后6个月随访两组均未出现复发。结论WALANT技术在尺骨鹰嘴滑囊炎关节镜治疗中表现出良好的疗效和经济效益。
基金This study was supported by the grants from the Beiing Municipal Health Commission(No.BMHC2019-9)Beiing Natural Science Foundation(No.L192049)Beiing Jishuitan Hospital's“Discipline new star”Plan(No.XKXX201604)。
文摘Background:The open reduction and internal fixation(ORIF)was a standard treatment approach for fracture at distal humerus intercondylar,whereas the optimal way before ORIF remains inconclusive.We,therefore,performed a systematic review and meta-analysis to assess the efficacy and safety of olecranon osteotomy vs.triceps-sparing approach for patients with distal humerus intercondylar fracture.Methods:The electronic searches were systematically performed in PubMed,EmBase,Cochrane library,and Chinese National Knowledge Infrastructure from initial inception till December 2019.The primary endpoint was the incidence of excellent/good elbow function,and the secondary endpoints included Mayo elbow performance score,duration of operation,blood loss,and complications.Results:Nine studies involving a total of 637 patients were selected for meta-analysis.There were no significant differences between olecranon osteotomy and triceps-sparing approach for the incidence of excellent/good elbow function(odds ratio[OR]:1.37;95%confidence interval[CI]:0.69-2.75;P=0.371),Mayo elbow performance score(weight mean difference[WMD]:0.17;95%CI:-2.56 to 2.89;P=0.904),duration of operation(WMD:4.04;95%CI:-28.60 to 36.69;P=0.808),blood loss(WMD:33.61;95%CI:-18.35 to 85.58;P=0.205),and complications(OR:1.93;95%CI:0.49-7.60;P=0.349).Sensitivity analyses found olecranon osteotomy might be associated with higher incidence of excellent/good elbow function,longer duration of operation,greater blood loss,and higher incidence of complications as compared with triceps-sparing approach.Conclusions:This study found olecranon osteotomy did not yield additional benefit on the incidence of excellent/good elbow function,while the duration of operation,blood loss,and complications in patients treated with olecranon osteotomy might be inferior than triceps-sparing approach.
文摘Purpose:Olecranon fractures are particularly vulnerable to distraction and subsequent fracture dislocation due to the high tensile forces.Surgical treatment aims at reducing the fracture and restoring the anatomical joint surface condition,as well as neutralizing the strain inhibiting fracture healing.The XS nail®(Intercus GmbH,Bad Blankenberg,Germany),an intramedullary implant exerting compression across the entire fracture surface,unlike plates,leaves a minimal extra-cortical profile,and can be secured with threaded locking wires,thereby retaining the anatomical reduction without displacement or steps within the articular surface,which was often found in tension band wiring.After encouraging initial results,the long-term outcome was assessed.Methods:This retrospective study evaluated the long-term outcome of patients surgically treated at our trauma center between January 2002 and December 2005 using the XS nail®.Patients over the age of 18 years eligible for the study must have undergone surgery for isolated,recent(less than 14 days)traumatic olecranon fractures,without concomitant injuries to the ipsilateral elbow and forearm.Further exclusion criteria were pseudarthrosis,re-fractures and osteotomy for distal humerus surgery,as well as polytraumatized patients unable to aid in their own recovery.Data were retrospectively gathered by standardised questionnaire and patient records,as well as surgery and anesthesiology reports.Data analysis was performed using Microsoft Office Excel?2016.Results:There were 32 patients,13 males(mean age 49.0 years)and 19 females(mean age 68.9 years)with 11 Schatzkers type D,7 each type A and C,5 type B and 2 type E at an average of 55.2 months,all showing complete consolidation.Of them,6 patients had a loss of range of motion with more than 10°in the sagittal plane,and only 1 patient exceeded 10°reduction of supination.Twenty-five patients reported being pain-free under all circumstances,and all but 2 patients(93.75%)had returned to their previous activity level.The average disabilities of the arm,shoulder and hand score was 21.15(range 0-88.3),and the overall Mayo elbow performance index was 91.87,without complications,such as wound infection,neurovascular impairment or premature hardware removal.Conclusion:Using the XS nail®system,all fracture types can be successfully treated and the rate of complications was lower than that treated by standard methods published in current literature.An excellent functional outcome,high range of motion as well as good retention of reduction without soft tissue irritation makes this a very suitable implant for fractures subject to tension.
文摘Tuberculosis （TB） occurring after a closed bone fracture in the patient with no history of TB and no evidence of TB infection at the time of initial fracture is a rare entity. We report one such case of a 48-year-old female, who presented in the emergency department with an olecranon fracture which was open reduced and inter- nally fixed with tension band wiring. Patient presented in the outpatient department with serosanguineous discharge at 3 weeks after surgery. The discharge was sent for culture and sensitivity tests, and the patient was managed by anti- biotics and daily dressings. There was wound dehiscence and the underlying implant was exposed, which was removed at 12 weeks after surgery. Repeat debridements and dressings continued for 6 months, but the discharge from the wound site continued. X-rays of the elbow performed at 6 months raised the suspicion of TB, which was confirmed by Ziel-Neelsen staining and histopathological examination of the debrided tissue. Following the confirmation, patient was put on antitubercular drugs. The patient responded to anti- tubercular drug therapy （ATT）, the purulent discharge from the wound ceased, and eventually the wound healed after 2 months of starting ATT.
