目的探讨小切口治疗单纯桡骨头骨折的临床疗效。方法对2016年1月至2016年12月我院收治的18例Mason II型伴前臂旋转受限的桡骨头骨折患者,采用小切口复位螺钉固定术进行治疗,其中男11例,女7例,年龄18～63岁,平均(37.8±12.1)岁;左侧8...目的探讨小切口治疗单纯桡骨头骨折的临床疗效。方法对2016年1月至2016年12月我院收治的18例Mason II型伴前臂旋转受限的桡骨头骨折患者,采用小切口复位螺钉固定术进行治疗,其中男11例,女7例,年龄18～63岁,平均(37.8±12.1)岁;左侧8例,右侧10例。术后18个月根据Broberg&Morrey评分标准评定肘关节功能。结果 18例术后均获18～24个月,平均19个月随访。平均手术时间35 min (25～50 min),伤口平均长度为2.5 cm (2.0～3.2 cm)。本组均在术后3个月内愈合,愈合时间为4～10周,平均9.8周。术后18个月Broberg&Morrey评分:优12例,良6例,优良率为100%。患者均未发生伤口感染、神经损伤、骨折移位及内固定失效等并发症。结论小切口治疗桡骨头骨折可获得满意的治疗效果,值得临床推广。展开更多
Background The correlation between the plasma D-dimer level and deep vein thrombosis has not been conclusive in various studies. The aim of this research was to study the relationship between plasma D-dimer levels and...Background The correlation between the plasma D-dimer level and deep vein thrombosis has not been conclusive in various studies. The aim of this research was to study the relationship between plasma D-dimer levels and the severity of orthopedic trauma by retrospective examination of orthopedic trauma cases. Methods Clinically acute trauma and non-acute trauma patients were selected and their plasma D-dimer levels were measured. Plasma D-dimer levels in patients of these two groups were compared. The relationship between the plasma D-dimer level and the severity of the trauma was also studied. Results There were 548 cases in the acute trauma group and 501 cases in the non-acute trauma group. The levels of plasma D-dimer were significantly higher in the acute trauma group than in the non-acute trauma group （P 〈0.01）. In the acute trauma group, the correlation between the D-dimer level and the number of fractures was a positive linear correlation （r=0.9532）. Conclusions Elevated plasma D-dimer is common in trauma patients. The D-dimer level and the number of fractures in the trauma patients are closely correlated. D-dimer is not only an indicator for the diagnosis of deep vein thrombosis and pulmonary embolus, but also an indicator of the severity of trauma in acute trauma patients.展开更多
Background Operative decision-making of Pilon fractures are of great challenges until now. The aim of this study was to investigate the guidance of the four-column theory in decision-making therapeutic strategies for ...Background Operative decision-making of Pilon fractures are of great challenges until now. The aim of this study was to investigate the guidance of the four-column theory in decision-making therapeutic strategies for Pilon fractures and its result. Methods One hundred and ten cases （107 patients） of Pilon fractures classified by the four-column theory and treated by ORIF, were reviewed. According to the four-column classification scheme, lateral column of 85 cases, posterior column of 66 cases, medial column of 77 cases, and anterior column of 61 cases are involved. Among all the 110 cases, single column of 14 cases, two columns of 46 cases, three columns of 17 cases, and all of four columns of 33 cases are involved. Results One hundred and eight cases have been followed up. The average follow up time is 14.7 months, varying between 7 and 52 months. The average healing time is 3.6 months, ranging from 2.5 to 8.0 months. Reduction of 86.1% reviewed Pilon cases are good or acceptable according to Burwell and Charley＇s Radiology Evaluation System. Ankle function of 87.1% cases are excellent or good according to the AOFAS evaluation system. Conclusion As a simple and comprehensive classification, the four-column classification can contribute to reasonable operation decision-making and good prognosis of Pilon fracture.展开更多
Background Currently, there are no uniform standards and methods for perioperative glycemic control in bone fracture patients with Type 2 diabetes mellitus （T2DM）. We retrospectively analyzed the efficacy and safety...Background Currently, there are no uniform standards and methods for perioperative glycemic control in bone fracture patients with Type 2 diabetes mellitus （T2DM）. We retrospectively analyzed the efficacy and safety of two intensive insulin therapy regimens administered to bone fracture patients with T2DM in the perioperative period, to explore the best method of achieving perioperative glycemic control. Methods A number of 159 bone fracture patients with T2DM were divided into two groups. One group （n=81） received multiple subcutaneous insulin injections （MSII group） and the other （n=78） received continuous subcutaneous insulin infusion （CSII group）. Blood glucose （BG） levels, time to achieve glycemic target, insulin dosage, and the incidence of hypoglycemia and complications were compared between groups. Results Both regimens reduced BG to desired levels before surgery. The time to reach glycemic target in CSII group （2.5 days） was significantly shorter than that in the MSII group （7.3 days; P〈0.001）. Mean insulin dosage in the CSII group （0.66 IU·kg^-1·d^-1） was significantly lower than that in the MSII group （0.74 IU·kg^-1·d^-1; P=0.005）, as were the incidences of hypoglycemia （15.4% vs 32.1%） and infection （6.4% vs. 23.5%）. Multiple regression analysis showed that the time to reach glycemia target was associated with the insulin therapy regimen and dosage. The insulin dosage on reaching glycemia target was positively associated with body mass index （BMI）, diabetes mellitus course, glycated hemoglobin Alc （HbAlc）, and β-hydroxybutyric acid, and was negatively associated with age. Conclusion The efficacy and safety of CSII was superior to that achieved with MSII, suggesting that CSII should be considered as initial therapy to control perioperative BG in bone fracture patients with T2DM.展开更多
文摘目的探讨小切口治疗单纯桡骨头骨折的临床疗效。方法对2016年1月至2016年12月我院收治的18例Mason II型伴前臂旋转受限的桡骨头骨折患者,采用小切口复位螺钉固定术进行治疗,其中男11例,女7例,年龄18～63岁,平均(37.8±12.1)岁;左侧8例,右侧10例。术后18个月根据Broberg&Morrey评分标准评定肘关节功能。结果 18例术后均获18～24个月,平均19个月随访。平均手术时间35 min (25～50 min),伤口平均长度为2.5 cm (2.0～3.2 cm)。本组均在术后3个月内愈合,愈合时间为4～10周,平均9.8周。术后18个月Broberg&Morrey评分:优12例,良6例,优良率为100%。患者均未发生伤口感染、神经损伤、骨折移位及内固定失效等并发症。结论小切口治疗桡骨头骨折可获得满意的治疗效果,值得临床推广。
文摘Background The correlation between the plasma D-dimer level and deep vein thrombosis has not been conclusive in various studies. The aim of this research was to study the relationship between plasma D-dimer levels and the severity of orthopedic trauma by retrospective examination of orthopedic trauma cases. Methods Clinically acute trauma and non-acute trauma patients were selected and their plasma D-dimer levels were measured. Plasma D-dimer levels in patients of these two groups were compared. The relationship between the plasma D-dimer level and the severity of the trauma was also studied. Results There were 548 cases in the acute trauma group and 501 cases in the non-acute trauma group. The levels of plasma D-dimer were significantly higher in the acute trauma group than in the non-acute trauma group （P 〈0.01）. In the acute trauma group, the correlation between the D-dimer level and the number of fractures was a positive linear correlation （r=0.9532）. Conclusions Elevated plasma D-dimer is common in trauma patients. The D-dimer level and the number of fractures in the trauma patients are closely correlated. D-dimer is not only an indicator for the diagnosis of deep vein thrombosis and pulmonary embolus, but also an indicator of the severity of trauma in acute trauma patients.
文摘Background Operative decision-making of Pilon fractures are of great challenges until now. The aim of this study was to investigate the guidance of the four-column theory in decision-making therapeutic strategies for Pilon fractures and its result. Methods One hundred and ten cases （107 patients） of Pilon fractures classified by the four-column theory and treated by ORIF, were reviewed. According to the four-column classification scheme, lateral column of 85 cases, posterior column of 66 cases, medial column of 77 cases, and anterior column of 61 cases are involved. Among all the 110 cases, single column of 14 cases, two columns of 46 cases, three columns of 17 cases, and all of four columns of 33 cases are involved. Results One hundred and eight cases have been followed up. The average follow up time is 14.7 months, varying between 7 and 52 months. The average healing time is 3.6 months, ranging from 2.5 to 8.0 months. Reduction of 86.1% reviewed Pilon cases are good or acceptable according to Burwell and Charley＇s Radiology Evaluation System. Ankle function of 87.1% cases are excellent or good according to the AOFAS evaluation system. Conclusion As a simple and comprehensive classification, the four-column classification can contribute to reasonable operation decision-making and good prognosis of Pilon fracture.
文摘Background Currently, there are no uniform standards and methods for perioperative glycemic control in bone fracture patients with Type 2 diabetes mellitus （T2DM）. We retrospectively analyzed the efficacy and safety of two intensive insulin therapy regimens administered to bone fracture patients with T2DM in the perioperative period, to explore the best method of achieving perioperative glycemic control. Methods A number of 159 bone fracture patients with T2DM were divided into two groups. One group （n=81） received multiple subcutaneous insulin injections （MSII group） and the other （n=78） received continuous subcutaneous insulin infusion （CSII group）. Blood glucose （BG） levels, time to achieve glycemic target, insulin dosage, and the incidence of hypoglycemia and complications were compared between groups. Results Both regimens reduced BG to desired levels before surgery. The time to reach glycemic target in CSII group （2.5 days） was significantly shorter than that in the MSII group （7.3 days; P〈0.001）. Mean insulin dosage in the CSII group （0.66 IU·kg^-1·d^-1） was significantly lower than that in the MSII group （0.74 IU·kg^-1·d^-1; P=0.005）, as were the incidences of hypoglycemia （15.4% vs 32.1%） and infection （6.4% vs. 23.5%）. Multiple regression analysis showed that the time to reach glycemia target was associated with the insulin therapy regimen and dosage. The insulin dosage on reaching glycemia target was positively associated with body mass index （BMI）, diabetes mellitus course, glycated hemoglobin Alc （HbAlc）, and β-hydroxybutyric acid, and was negatively associated with age. Conclusion The efficacy and safety of CSII was superior to that achieved with MSII, suggesting that CSII should be considered as initial therapy to control perioperative BG in bone fracture patients with T2DM.
