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Meta-analysis of the efficacy of volar plate internal fixation versus closed reduction and external fixation in the treatment of adult distal radius fractures
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作者 CHEN Jian-ge ZHANG Hai-ning +4 位作者 ZHAO Hong-zhou LIU Ming-jun XING Jia-hui WANG Ping WANG Wei-min 《Journal of Hainan Medical University》 CAS 2023年第19期44-56,共13页
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
关键词 Volar plate internal fixation Closed reduction External fixation PLASTER SPLINT Distal radius fracture Meta analysis
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Open reduction and internal fixation for radial head fractures: A prospective observational study 被引量:4
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作者 Imran Khan Mangi Arslan Ahmed Abro +4 位作者 Muhammad Naveed Memon Shahjahan Siyal Naveed Khan Nouman Memon Muhammad Kazim Rahim Najjad 《Journal of Acute Disease》 2020年第4期166-169,共4页
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
关键词 Radial head fractures open reduction and internal fixation Functional outcome
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Functional Outcomes of Traumatic Complex Acetabulum Fractures with Open Reduction and Internal Fixation: 200 Cases 被引量:3
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作者 Keykhosro Mardanpour Mahtab Rahbar +2 位作者 Maryam Rahbar Nyosha Mardanpour Sourena Mardanpour 《Open Journal of Orthopedics》 2016年第12期363-377,共15页
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
关键词 Complex Acetabular Fracture internal fixation open reduction OUTCOME
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Treatment of a femoral neck fracture combined with ipsilateral femoral head and intertrochanteric fractures: A case report
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作者 Xiang Yu Yu-Zhi Li +1 位作者 Hai-Jian Lu Bing-Li Liu 《World Journal of Orthopedics》 2024年第10期973-980,共8页
BACKGROUND This article presents a rare case of a complex hip fracture involving the ipsilateral femoral neck,trochanter,and femoral head,that was accompanied by hip dislocation.Currently,there is no established stand... BACKGROUND This article presents a rare case of a complex hip fracture involving the ipsilateral femoral neck,trochanter,and femoral head,that was accompanied by hip dislocation.Currently,there is no established standard treatment method for this specific type of fracture.Therefore,it is crucial to comprehensively consider factors such as patient age,fracture type,and degree of displacement to achieve a successful outcome.CASE SUMMARY A 38-year-old man sustained a comminuted fracture of his right hip as a result of a car accident.The injuries included a fracture of the femoral head,a fracture of the femoral neck,an intertrochanteric fracture of the femur,and a posterior dislocation of the hip on the same side.We opted for a treatment approach combining the use of a proximal femoral locking plate,cannulated screws,and Kirschner wires.Following the surgery,we developed an individualized rehabil-itation program to restore patient limb function.CONCLUSION For this complex fracture,we selected appropriate internal fixation and for-mulated individualized rehabilitation,which ultimately achieved good results. 展开更多
关键词 Locking plate Femoral neck fracture Femoral head fracture Intertrochanteric fracture open reduction and internal fixation Case report
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Internal fixation and unicompartmental knee arthroplasty for an elderly patient with patellar fracture and anteromedial osteoarthritis:A case report
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作者 Shao-Kui Nan Hai-Feng Li +2 位作者 Dong Zhang Jian-Ning Lin Li-Sheng Hou 《World Journal of Clinical Cases》 SCIE 2021年第16期3919-3926,共8页
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
关键词 Patellar fracture Anteromedial osteoarthritis open reduction and internal fixation Unicompartmental knee arthroplasty Elderly patient Case report
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经皮撬拨复位空心钉内固定术对SandersⅡ、Ⅲ型跟骨骨折足踝功能的影响
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作者 罗开祥 《实用手外科杂志》 2024年第2期231-234,共4页
目的探讨经皮撬拨复位空心钉内固定术对SandersⅡ、Ⅲ型跟骨骨折足踝功能的影响。方法选择长沙医学院附属澧县人民医院2020年4月-2023年4月收治的SandersⅡ、Ⅲ型跟骨骨折97例,按随机数字表法分为对照组48例与观察组49例。对照组行切开... 目的探讨经皮撬拨复位空心钉内固定术对SandersⅡ、Ⅲ型跟骨骨折足踝功能的影响。方法选择长沙医学院附属澧县人民医院2020年4月-2023年4月收治的SandersⅡ、Ⅲ型跟骨骨折97例,按随机数字表法分为对照组48例与观察组49例。对照组行切开复位内固定术,观察组行经皮撬拨复位空心钉内固定术。比较两组围术期指标、影像学指标、足踝功能及术后并发症。结果观察组手术及住院时间短于对照组,术中出血量及术后24 h引流量少于对照组,差异有统计学意义(P<0.05);术后观察组跟骨宽度、跟骨高度、Bohler角、Gissane角与对照组比较,差异无统计学意义(P>0.05);观察组Maryland足功能评分的各维度分值均高于对照组,并发症率低于对照组,差异有统计学意义(P<0.05)。结论采取经皮撬拨复位空心钉内固定术治疗SandersⅡ、Ⅲ型跟骨骨折更具微创优势,可有效促进足踝功能恢复,降低术后并发症率。 展开更多
关键词 跟骨骨折 SandersⅡ、Ⅲ型 经皮撬拨复位空心钉内固定术 切开复位内固定术 足踝功能
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不同术式治疗GartlandⅢ型不稳定性肱骨髁上骨折患儿的效果对比
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作者 孙少松 邓斌 张星晨 《西藏医药》 2024年第1期13-15,共3页
目的 分析不同术式治疗GartlandⅢ型不稳定性肱骨髁上骨折患儿的效果。方法 选取本院2020年1月~2023年1月收治的GartlandⅢ型不稳定性肱骨髁上骨折患儿80例。随机分为观察组40例(采用闭合复位外侧两枚克氏针固定术)和对照组40例(采用切... 目的 分析不同术式治疗GartlandⅢ型不稳定性肱骨髁上骨折患儿的效果。方法 选取本院2020年1月~2023年1月收治的GartlandⅢ型不稳定性肱骨髁上骨折患儿80例。随机分为观察组40例(采用闭合复位外侧两枚克氏针固定术)和对照组40例(采用切开复位双侧交叉克氏针内固定术)。比较两组手术效果、临床相关指标以及并发症情况。结果 两组优良率比较差异无统计学意义(P>0.05);观察组手术时间、术中出血量以及住院时间低于对照组,并发症发生率高于对照组(P<0.05);骨折愈合时间:观察组与对照组比较差异不显著(P>0.05)。结论 两组术式对效果差异不大,但观察组并发症较多,而对照组手术时间、住院时间较长且术中出血较多,两种术式对GartlandⅢ型不稳定性肱骨髁上骨折患儿治疗均有优劣,可根据患儿状况进行选择。 展开更多
关键词 肱骨髁上骨折 闭合复位外侧两枚克氏针固定术 切开复位双侧交叉克氏针内固定术
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Clinical effect of distal radius fracture treated with open reduction and internal plate fixation 被引量:8
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作者 ZHANG Pei-xun XUE Feng DANG Yu WANG Tian-bing CHEN Jian-hai XU Hai-lin FU Zhong-guo ZHANG Dian-ying JIANG Bao-guo 《Chinese Medical Journal》 SCIE CAS CSCD 2012年第1期140-143,共4页
Background For some specific comminuted unstable intra-articular fracture,the plaster cast can not maintain the alignment of the articular surface effectively.The aim of this study was to evaluate the clinical effects... Background For some specific comminuted unstable intra-articular fracture,the plaster cast can not maintain the alignment of the articular surface effectively.The aim of this study was to evaluate the clinical effects of distal radius fracture treated with open reduction and internal plate fixation retrospectively.Methods From January 2002 to March 2010,539 cases of distal radius fracture were treated with open reduction and internal fixation,including 184 males and 355 females aging 21-72 years (mean 57 years).Fractures were caused by falling to the ground in 459 cases,by traffic accident in 62 cases and by athletic injuries in 18 cases.Of 539 cases,there were 523 cases of closed fracture and 16 cases of open fracture.According to Arbeitsgemeinschaft fur Osteosynthesefragen (AO) standards of classification,there were 14 cases of A2 type,22 of A3 type,18 of B1 type,24 of B2 type,62 of B3 type,91 of C1 type,162 of C2 type and 146 of C3 type.The time from injury to operation was 1-16 days (mean 5 days).All patitents received open reduction and internal plate screw fixation.Forty-seven patients with bone defect were given 6-15 g autologous ilium and 75 cases were given 5 ml calcium sulphate artificial aggregate after reduction.Results All incisions healed by first intention after operation.Patients were followed up for 15 to 32 months postoperatively (mean 22 months).The fractures healed within 10-18 weeks after operation (mean 12 weeks).During the last follow-up,the mean palmar tilt was (7.0±0.9)° and the mean ulnar variance was (21.0±4.2)°,showing significant difference when compared with preoperation ((-5.0±1.2)° and (8.0±3.8)°).The radial heights were not abbreviated.According to Gartland and Werley assessment system,the results were excellent in 314 cases,good in 163 cases,fair in 46 cases,and poor in 16 cases 12 weeks after operation,the excellent and good rate was 88.5%.Conclusions The clinical effect of distal radius fracture treated with open reduction and internal plate fixation was relatively satisfactory.Meticulous operation procedure and individual rehabilitation strategy contribute to the wrist joint functional recovery. 展开更多
关键词 open reduction fracture fixation internal recovery of function radius fracture
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Efficacy of open reduction and internal fixation with a miniplate and hollow screw in the treatment of Lisfranc injury 被引量:17
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作者 Baoliang Li Wenbo Zhao Lei Liu Fuguo Huang Guanglin Wang Yue Fang 《Chinese Journal of Traumatology》 CAS CSCD 2015年第1期18-20,共3页
Purpose: To investigate efficacy of open reduction and internal fixation with the miniplate and hollow screw in the treatment of Lisfranc injury. Methods: Ten cases of Lisfranc injury treated by open reduction, mini... Purpose: To investigate efficacy of open reduction and internal fixation with the miniplate and hollow screw in the treatment of Lisfranc injury. Methods: Ten cases of Lisfranc injury treated by open reduction, miniplate and hollow screw in our hospital were retrospectively analyzed. There were 6 males and 4 females with age ranging from 25 to 45 years (mean 32 years). Among them, one case was classified as Type A, six Type B and three Type C. Injury mechanism included road traffic accidents (3 cases), fall from height (5 cases) and hit by heavy object (2 cases). All injuries were closed without cerebral trauma or other complicated injuries. The time interval between injury and operation was 6-10 days (average 6.6 days). Postoperatively, the foot function was assessed using Visual Analogue Scales (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) Scales. Healing time and complications were observed. Results: All patients were followed up for 18-24 months (average 20 months). Anatomic reduction was achieved in all patients on images. There was statistical significance between preoperative score (Z89 ± 0.34) and score at postoperative 8 weeks (0.67 ± 0.13). According to the AOFAS score, 5 cases were defined as excellent, 3 cases as good and 2 cases as fair. During follow-up, there was no wound infection or complications except for osteoarthritis in 2 cases. Healing time ranged from 3 to 6 months with an average of 3.6 months. Conclusion: Anatomical reduction of Lisfranc injury can be achieved by open reduction and internal fixation with the miniplate and hollow screw. Normal structure of Lisfranc joint is regained to a great extent; injured ligaments were also repaired. Therefore, this method offers excellent curative effect and can avoid postoperative complications and improve the patients' quality of life. 展开更多
关键词 Lisfranc injury open reduction and internal fixation MiniplatesScrews
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微创接骨板内固定治疗Sanders Ⅱ型跟骨关节内骨折的三维有限元分析及临床疗效评估 被引量:2
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作者 韦留胜 顾文奇 +2 位作者 刘仕英 唐子鹏 吴俊彬 《生物骨科材料与临床研究》 CAS 2023年第2期42-47,共6页
目的 通过三维有限元分析评价跟骨微创锁定接骨板的稳定性,并评价采用跟骨微创锁定接骨板治疗Sanders Ⅱ型跟骨关节内骨折的临床疗效。方法 建立三种微创锁定接骨板固定Sanders Ⅱ型跟骨关节内骨折的三维有限元模型,模拟加载700 N应力... 目的 通过三维有限元分析评价跟骨微创锁定接骨板的稳定性,并评价采用跟骨微创锁定接骨板治疗Sanders Ⅱ型跟骨关节内骨折的临床疗效。方法 建立三种微创锁定接骨板固定Sanders Ⅱ型跟骨关节内骨折的三维有限元模型,模拟加载700 N应力后进行三维有限元分析,评价微创锁定接骨板的生物力学稳定性。自2020年1月至2021年5月,珠海市第五人民医院共收治26例Sanders Ⅱ型跟骨关节内骨折患者,其中男17例,女9例,平均年龄(43.3±8.2)岁(21~61岁)。所有患者择期行经跗骨窦切口有限切开复位跟骨微创锁定接骨板内固定。术后定期随访复查摄片,测量B?hler角及Gissane角,同时采用美国骨科足踝外科协会(AOFAS)踝关节与后足评分及视觉模拟量表评分(VAS)评估治疗效果,并记录相关并发症。结果 三维有限元分析结果显示内植物的最大应力值均低于其屈服强度,三种固定方式的骨块最大移位值均位于载距突。临床研究中2例患者失随访,其余24例患者获平均14.5个月(12~18个月)随访。除1例患者出现伤口延迟愈合外,余未见软组织并发症。术后3个月复查摄片明确骨折端愈合。术后末次随访时摄片B?hler角从术前10.9°±5.3°增加至术后末次随访时31.3°±2.3°(P<0.05),而Gissane角从术前108.3°±24.2°改善至术后末次随访时113.3°±5.5°(P>0.05)。末次随访时AOFAS踝关节与后足评分平均为(88.9±6.6)分(76~100分),VAS平均(1.0±0.9)分(0~3分)。除1例患者复查CT见关节面复位欠佳外,余患者未见骨不连、畸形愈合、固定失效、创伤性关节炎等并发症。结论 采用跟骨微创锁定接骨板固定治疗SandersⅡ型跟骨关节内骨折具有创伤小、术后并发症少、固定稳定性可靠等优势,是一种安全、有效的治疗技术。 展开更多
关键词 跟骨关节内骨折 微创 锁定接骨板 有限元 有限切开复位内固定
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外侧横切口联合双侧撑开技术(LTBT)在SandersⅡ、Ⅲ型跟骨骨折中的应用 被引量:3
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作者 杨虎 何知弢 +2 位作者 钟齐刚 方家刘 詹俊锋 《生物骨科材料与临床研究》 CAS 2023年第1期42-46,共5页
目的 探讨跟骨外侧横切口联合双侧撑开技术(LTBT)处理SandersⅡ、Ⅲ型关节内跟骨骨折的临床疗效。方法 自2016年1月至2020年12月,43例患者于安徽医科大学第二附属医院接受了外侧横切口联合双侧撑开技术处理跟骨骨折。记录患者术前,术后1... 目的 探讨跟骨外侧横切口联合双侧撑开技术(LTBT)处理SandersⅡ、Ⅲ型关节内跟骨骨折的临床疗效。方法 自2016年1月至2020年12月,43例患者于安徽医科大学第二附属医院接受了外侧横切口联合双侧撑开技术处理跟骨骨折。记录患者术前,术后1 d,1、3、6个月及术后1年的跟骨长度、高度、宽度及B?hler角和Gissanes角变化情况,并记录住院时间、手术时间等资料,于术前及术后1年采用VAS评分及AOFAS评分评价临床疗效。结果43例患者均获得随访,平均随访时间(14.70±1.63)个月。患者术后1 d,1、3、6个月及术后1年的跟骨长度、高度、宽度、B?hler角和Gissanes角均较术前显著改善(P<0.05)。手术时间(79.67±9.39) min。术后1年VAS评分为(0.72±1.03)分,AOFAS踝后足评分为(87.14±5.42)分,其中优13例,良28例,一般2例。且术后均未出现伤口并发症,1例患者出现腓肠神经损伤症状,2例患者出现行走后疼痛,经休息及康复理疗等处理后症状均得到改善。结论 LTBT是一种有效处理SandersⅡ、Ⅲ型跟骨骨折的手术方式。既提供了良好的手术视野,提高了解剖复位的效果,术后患者跟骨的长度、高度、宽度、B?hler角和Gissanes角均得到了明显的改善并且在末次随访中得到了良好的维持,同时降低了术后切口并发症及腓肠神经损伤的发生率。 展开更多
关键词 关节内跟骨骨折 克氏针撑开器 横切口 切开复位内固定
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组合式全螺纹空心钉与传统钢板内固定治疗SandersⅡ型和Ⅲ型跟骨骨折的疗效
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作者 孔德伟 范鑫斌 +4 位作者 宋超 吴铭 吴亮 杨铁毅 张岩 《国际骨科学杂志》 2023年第6期392-398,共7页
目的探讨组合式全螺纹空心钉内固定与传统钢板内固定治疗SandersⅡ型和Ⅲ型跟骨骨折的临床疗效。方法回顾性分析上海公利医院2016年1月至2022年12月收治的80例跟骨骨折患者资料。其中39例采用组合式全螺纹空心钉内固定治疗,41例采用传... 目的探讨组合式全螺纹空心钉内固定与传统钢板内固定治疗SandersⅡ型和Ⅲ型跟骨骨折的临床疗效。方法回顾性分析上海公利医院2016年1月至2022年12月收治的80例跟骨骨折患者资料。其中39例采用组合式全螺纹空心钉内固定治疗,41例采用传统钢板内固定治疗。比较两组患者围术期情况、影像学及长期随访资料。结果两组患者术前一般资料比较均无统计学差异(P>0.05),具有可比性。空心钉组和钢板组术前准备时间分别为(3.7±2.1)d和(4.6±2.2)d,住院时间分别为(8.8±3.7)d和(15.9±7.3)d,手术时间分别为(129.9±34.5)min和(140.7±34.4)min,术中出血量分别为(37.4±25.9)mL和(65.5±53.6)mL,以上项目两组间差异均有统计学意义(P<0.05)。术后伤口并发症空心钉组4例(10.2%)、钢板组9例(21.9%),两组间无统计学差异(P>0.05)。两组患者Gissane角、Bohler角术后即刻均较术前改善(P<0.05),而两组间比较术前、术后均无统计学差异(P>0.05)。所有患者术后平均获(14.9±3.65)个月(12~26个月)随访,术后12个月空心钉组美国骨科协会足踝外科分会(AOFAS)评分为(89.0±7.8)分,优22例,良14例,可3例,优良率为92.3%;钢板组AOFAS评分为(87.8±9.6)分,优18例,良19例,可4例,优良率为90.2%,两组AOFAS评分无统计学差异(P>0.05)。结论与传统钢板内固定相比,组合式全螺纹空心钉内固定在达到相同优良率的基础上,具有创伤小、术前准备时间及住院时间短等优势。 展开更多
关键词 微创手术 跟骨骨折 全螺纹空心钉 钢板 内固定
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外侧“L”形切口切开复位内固定治疗SandersⅢ、Ⅳ型跟骨骨折的效果分析 被引量:2
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作者 陈敬煌 王贤月 彭方成 《中国实用医药》 2023年第20期63-66,共4页
目的分析外侧“L”形切口切开复位内固定治疗SandersⅢ、Ⅳ型跟骨骨折的效果。方法选取58例(61足)收治并获得完整随访的SandersⅢ、Ⅳ型跟骨骨折患者为研究对象,均行经典外侧“L”形切口切开复位内固定治疗。观察患者的随访结果。结果58... 目的分析外侧“L”形切口切开复位内固定治疗SandersⅢ、Ⅳ型跟骨骨折的效果。方法选取58例(61足)收治并获得完整随访的SandersⅢ、Ⅳ型跟骨骨折患者为研究对象,均行经典外侧“L”形切口切开复位内固定治疗。观察患者的随访结果。结果58例(61足)随访时间12~25个月,平均16.5个月;跟骨骨性愈合时间2~4个月,平均3.1个月;完全负重时间3~4个月,平均3.3个月。近期并发症:皮瓣坏死1足(范围1.0 cm×2.0 cm),在术后第10天,皮瓣坏死后积极负压封闭引流技术(VSD)持续负压吸引,积极预防感染,术后2.5个月取出钢板,行局部旋转皮瓣术,术后恢复良好。远期并发症:距下关节炎并疼痛5足,腓骨长短肌腱肌腱炎3足。Maryland Foot Score系统评分:优29足,良24足,可3足,差5足,优良率为86.9%(53/61)。术后1年,患者的跟骨Bohler角(29.5±2.9)°、高度(57.4±3.8)mm、长度(57.2±3.2)mm大于术前的(8.2±8.6)°、(48.3±3.5)mm、(43.1±4.3)mm,Gissane角(123.8±8.7)°、宽度(35.3±2.3)mm小于术前的(142.2±10.2)°、(42.3±3.4)mm,差异具有统计学意义(P<0.05)。结论SandersⅢ、Ⅳ型跟骨骨折患者通过经典外侧“L”形切口切开复位内固定治疗,能够获得较满意的解剖复位,且固定可靠,疗效满意。 展开更多
关键词 跟骨骨折 外侧“L”形切口 切开复位内固定
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跗骨窦切口与切开复位内固定术治疗SandersⅡ、Ⅲ型跟骨骨折的预后对比 被引量:1
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作者 陈宇斐 赖建鸿 +1 位作者 梁杰威 廖烨明 《广州医科大学学报》 2023年第3期50-53,共4页
目的:对比研究跗骨窦切口与切开复位内固定术治疗SandersⅡ、Ⅲ型跟骨骨折的临床效果及预后情况。方法:回顾性选取2020年1月到2022年7月南海区第五人民医院的62例SandersⅡ、Ⅲ型跟骨骨折患者的临床资料,根据手术方法的不同分为研究组... 目的:对比研究跗骨窦切口与切开复位内固定术治疗SandersⅡ、Ⅲ型跟骨骨折的临床效果及预后情况。方法:回顾性选取2020年1月到2022年7月南海区第五人民医院的62例SandersⅡ、Ⅲ型跟骨骨折患者的临床资料,根据手术方法的不同分为研究组与对照组,每组31例。研究组采用跗骨窦切口微创手术治疗,对照组采用切开复位内固定术治疗。比较两组手术时间、失血量、住院时间、伤口愈合时间及伤口并发症。于术后3个月进行随访,采用跟骨侧轴位X线片测量Bohler角、Gissane角,采用Maryland足部功能评分评估足部功能恢复情况。结果:与对照组相比,研究组的手术时间、住院时间、伤口愈合时间更短,失血量更少(P<0.05);对照组浅表感染、血肿等术后伤口并发症发生率25.81%(8/31)高于研究组3.23%(1/31)(P<0.05);末次随访时研究组Bohler角、Gissane角均大于对照组,Maryland评分高于对照组(均P<0.05)。结论:与切开复位内固定术相比,用跗骨窦切口微创手术治疗SandersⅡ、Ⅲ型跟骨骨折的效果较好,不仅可有效地改善患者的围手术期指标,还能降低其术后伤口并发症的发生率,促进其足踝功能的恢复。 展开更多
关键词 跟骨骨折 切开复位内固定术 跗骨窦切口 微创
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两种切口钢板内固定治疗胫骨平台骨折的疗效比较 被引量:2
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作者 岑景盛 涂泽松 +1 位作者 谭志韵 李宁 《临床骨科杂志》 2024年第1期112-116,共5页
目的比较两种切口钢板内固定治疗胫骨平台骨折的疗效。方法将108例胫骨平台骨折患者按照切口不同分为观察组(采用微创切口钢板内固定治疗,54例)和对照组(采用传统切开复位钢板内固定治疗,54例)。记录两组切口长度、住院时间、骨痂形成... 目的比较两种切口钢板内固定治疗胫骨平台骨折的疗效。方法将108例胫骨平台骨折患者按照切口不同分为观察组(采用微创切口钢板内固定治疗,54例)和对照组(采用传统切开复位钢板内固定治疗,54例)。记录两组切口长度、住院时间、骨痂形成时间、骨折愈合时间、开始部分负重行走时间、并发症发生情况、膝关节活动度、膝关节功能优良率。结果患者均获得随访,时间12~18个月。切口长度、住院时间、骨痂形成时间、骨折愈合时间、开始部分负重行走时间观察组均短(早)于对照组(P<0.05)。术后6个月,膝关节功能优良率观察组高于对照组(P<0.01),膝关节屈曲、伸直活动度观察组均优于对照组(P<0.05)。术后并发症发生率观察组低于对照组(P<0.05)。结论与传统切开复位钢板内固定相比,微创切口钢板内固定治疗胫骨平台骨折具有创伤小、住院时间短、并发症发生率低的优点,更利于骨折愈合、患者早期功能锻炼及膝关节功能的恢复。 展开更多
关键词 微创切口 切开复位 钢板内固定 胫骨平台骨折 膝关节功能
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不同治疗方式对于跟骨骨折手术情况及预后的影响
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作者 安志辉 陈月 苗洁 《科学技术与工程》 北大核心 2024年第28期12065-12070,共6页
为研究不同治疗方式对于跟骨骨折手术情况及预后的影响。选择80例跟骨骨折患者为研究对象,根据随机数字分配方法,将他们分成两组。A组采用经皮撬拨手法复位结合有限切开钛板固定术治疗,B组采用足外侧“L”形切口复位内固定术。对两组患... 为研究不同治疗方式对于跟骨骨折手术情况及预后的影响。选择80例跟骨骨折患者为研究对象,根据随机数字分配方法,将他们分成两组。A组采用经皮撬拨手法复位结合有限切开钛板固定术治疗,B组采用足外侧“L”形切口复位内固定术。对两组患者术后并发症等各项指标进行比较。结果表明:两组术前术后Bohler角、跟骨宽度、Gissane角、Maryland足部功能评分比较,差异无统计学差异(P>0.05)。组内比较,两组患者经过治疗后,Bohler、Gissane角和跟骨中部宽度均高于治疗前,差异有统计学意义(P<0.05);两组的治疗时间、术中出血量和术后并发症的发生率均有显著性差异(P<0.05)。在跟骨骨折的治疗中,用两种不同方式进行对比分析,经皮撬拨手法固定治疗方式,能够获得较满意的解剖复位,且稳定性可靠,跗骨窦入路较外侧L形切口入路创伤小,可有效避免皮缘坏死和感染的发生,更有利于提高患者的临床疗效。 展开更多
关键词 跟骨骨折 钛板固定 复位内固定 “L”形切口
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两种治疗方案对老年人桡骨远端骨折的疗效比较
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作者 穆合甫尔·买合斯托夫 胥伯勇 +1 位作者 张晓岗 买买提明·赛依提 《中国中西医结合外科杂志》 CAS 2024年第3期358-362,共5页
目的:探讨采用保守治疗和切开复位内固定两种方案对65岁以上老年人桡骨远端骨折(DRF)的疗效。方法:选择我院于2020年6月—2022年2月收治的DRF患者81例,分为手法组(46例)与切开组(35例)。手法组采用骨折手法复位高分子聚酯绷带固定治疗;... 目的:探讨采用保守治疗和切开复位内固定两种方案对65岁以上老年人桡骨远端骨折(DRF)的疗效。方法:选择我院于2020年6月—2022年2月收治的DRF患者81例,分为手法组(46例)与切开组(35例)。手法组采用骨折手法复位高分子聚酯绷带固定治疗;切开组采用切开复位内固定手术治疗。使用X线片对比患者治疗前后的尺偏角、掌偏角和桡骨高度,以评估治疗情况。统计患者末次随访的改良Mayo腕关节评分(MMWS)、DASH-Chinese上肢功能评分以及并发症,对患者预后评价。结果:两组治疗后尺偏角、掌偏角和桡骨高度较治疗前增加(P<0.05);切开组治疗后尺偏角、掌偏角和桡骨高度高于手法组(P<0.05)。两组治疗后MMWS较治疗前增加,而DASH-Chinese上肢功能评分较治疗前降低(P<0.05);切开组治疗后MMWS高于手法组,而DASH-Chinese上肢功能评分低于手法组(P<0.05)。切开组并发症发生率低于手法组(P<0.05)。结论:切开复位内固定术治疗老年人DRF有明显的临床优势,可以促进患者腕关节和上肢功能恢复。 展开更多
关键词 桡骨远端骨折 老年人 高分子聚酯绷带固定 保守治疗 切开复位内固定
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切开复位内固定治疗新鲜Lisfranc关节损伤疗效观察
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作者 边冲 陈广南 +5 位作者 徐俊 黄中岳 张懿鸣 周开锋 殷潇凡 谷辉杰 《海南医学》 CAS 2024年第19期2773-2777,共5页
目的观察新鲜Lisfranc关节损伤治疗中引入切开复位内固定方案的治疗效果。方法回顾性分析2018年4月至2022年8月复旦大学附属闵行医院骨科收治的56例新鲜lisfranc关节损伤患者的临床资料。所有患者均通过足背侧的纵向切口进行手术,复位... 目的观察新鲜Lisfranc关节损伤治疗中引入切开复位内固定方案的治疗效果。方法回顾性分析2018年4月至2022年8月复旦大学附属闵行医院骨科收治的56例新鲜lisfranc关节损伤患者的临床资料。所有患者均通过足背侧的纵向切口进行手术,复位后应用钢板、螺钉固定内侧柱和中间柱,克氏针固定外侧柱。术后随访8个月,记录随访结果,比较手术前及末次随访足功能恢复情况[美国足踝外科协会(AOFAS)踝与后足功能评分、疼痛视觉模拟评分(VAS)],并记录并发症发生情况。结果45例患者得到有效随访,骨折愈合时间10~14周,平均12.6周;术后77.78%的患者(35/45)切口愈合良好,有3例因第一跖骨基底部粉碎性骨折行跖跗关节融合术;术后6个月影像学评估结果显示39例获得解剖复位,解剖复位率为86.7%。术后末次随访AOFAS踝与后足功能评分为(84.05±6.17)分,明显高于术前的(37.12±9.33)分,而VAS评分为(1.70±0.51)分,明显低于术前的(6.81±2.20)分,差异均有统计学意义(P<0.05);随访期间3例发生内固定断裂,4例患者出现足背皮肤激惹症状,并发症发生率为15.56%(7/45)。结论切开复位内固能够明确关节损伤的范围,解剖复位骨折脱位及可靠固定,是治疗新鲜Lisfranc关节损伤的有效方法。 展开更多
关键词 新鲜Lisfranc关节损伤 切开复位内固定 足部功能 AOFAS评分 疗效
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后交叉韧带胫骨止点撕脱骨折应用缝线桥悬吊固定与切开复位内固定对膝关节损伤的疗效观察
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作者 李杰 吕剑 +1 位作者 王新民 刘飞 《临床和实验医学杂志》 2024年第17期1869-1873,共5页
目的 分析后交叉韧带胫骨止点撕脱骨折应用缝线桥悬吊固定与切开复位内固定对膝关节损伤疗效的影响。方法 前瞻性选取2020年3月至2022年3月秦皇岛市第一医院收治的90例后交叉韧带胫骨止点撕脱骨折患者作为研究对象,按照信封法将患者分... 目的 分析后交叉韧带胫骨止点撕脱骨折应用缝线桥悬吊固定与切开复位内固定对膝关节损伤疗效的影响。方法 前瞻性选取2020年3月至2022年3月秦皇岛市第一医院收治的90例后交叉韧带胫骨止点撕脱骨折患者作为研究对象,按照信封法将患者分为观察组45例和对照组45例。观察组接受关节镜下缝线桥悬吊固定疗法,对照组接受切开复位内固定疗法。比较两组临床指标情况(手术时间、术后引流量、住院时间、骨折愈合时间),记录并比较两组术前及术后1、3、6个月的膝关节活动功能[关节活动度(ROM)、Lysholm膝关节功能评分、Tegner运动水平评分及国际膝关节文献委员会膝关节评估表(IKDC)评分]及术后并发症发生情况。结果 观察组手术时间、住院时间分别为(44.46±5.64) min、(6.98±2.16) d,均短于对照组[(67.26±6.89) min、(11.23±1.26) d],差异均有统计学意义(P<0.05),观察组和对照组患者的术后引流量及骨折愈合时间比较,差异均无统计学意义(P>0.05)。观察组与对照组在术前及术后1、3、6个月时的ROM比较,差异均无统计学意义(P>0.05);两组术后1、3、6个月的ROM均高于术前,差异均有统计学意义(P<0.05)。术后1、3、6个月,两组患者的Lysholm评分均较术前升高,且观察组术后1、3、6个月的Lysholm评分分别为(69.98±1.02)、(88.44±3.49)、(94.56±1.23)分,均高于对照组[(67.46±1.45)、(80.55±2.98)、(90.22±0.98)分],差异均有统计学意义(P<0.05)。术后1、3、6个月,两组患者的Tegner评分均较术前升高,且观察组术后1、3个月的Tegner评分分别为(2.33±0.51)、(4.05±0.31)分,均高于对照组[(2.11±0.45)、(3.55±0.45)分],差异均有统计学意义(P<0.05),但在术后6个月时组间Tegner评分比较,差异无统计学意义(P>0.05)。术后1、3、6个月,两组患者的IKDC评分均高于术前,且同时间点组间比较,观察组的IKDC评分分别为(57.32±2.98)、(86.46±3.19)、(94.21±1.65)分,均高于对照组[(53.27±2.08)、(82.01±2.01)、(90.01±1.02)分],差异均有统计学意义(P<0.05)。观察组随访期内并发症发生率为11.11%,低于对照组(28.89%),差异有统计学意义(P<0.05)。结论 后交叉韧带胫骨止点撕脱骨折患者应用缝线桥悬吊固定可以提高治疗效果,与切开复位内固定相比,术后膝关节功能恢复情况更好,能有效缩短手术时间和住院时间,具有较高的临床应用价值。 展开更多
关键词 后交叉韧带 胫骨骨折 缝线桥悬吊固定 切开复位内固定 膝关节
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Three-dimensional printing combined with open reduction and internal fixation versus open reduction and internal fixation in the treatment of acetabular fractures:A systematic review and meta-analysis 被引量:3
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作者 Dong-Peng Tu Yi-Kang Yu +3 位作者 Zhen Liu Wen-Kai Zhang Xin Fan Chao Xu 《Chinese Journal of Traumatology》 CAS CSCD 2021年第3期159-168,共10页
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
关键词 Three-dimensional printing Acetabular fractures open reduction and internal fixation META-ANALYSIS
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