Background Accurate and precise preoperative planning can provide information instrumental for performing less invasive articular fracture surgery. The purpose of this study was to determine that computer-assisted pre...Background Accurate and precise preoperative planning can provide information instrumental for performing less invasive articular fracture surgery. The purpose of this study was to determine that computer-assisted preoperative planning （CAPP） has the potential to improve efficiency and time in the operating room. Methods Sixty-four patients with proximal humeral fractures were treated using locking plates by minimally invasive plate osteosynthesis （MIPO） with CAPP. The time needed for virtual segmentation, reduction, and fixation of the fracture fragments were recorded. Intra and interobserver reliabilities were analyzed using the intraclass correlation coefficient. The clinical function was analyzed using Constant Score and radiology. Results The mean total time required for CAPP of two-part, three-part, and four-part proximal humeral fractures were （13.63±1.38） minutes, （23.14±2.18） minutes, and （39.61±3.01） minutes, respectively. The intra and interobserver reliabilities for all variables were high, ranging from 0.785 to 0.992. The mean operation time was （50.1±6.7） minutes. Fifty- two patients were followed up with an average time of 34.2 months. The mean Constant Score of the injury side was （82.5 ± 9.9）. Three of the fifty-two patients had four complications. Conclusion The application of CAPP was efficient and reliable, and provided excellent clinical and radiographic outcomes for the treatment of proximal humerus fractures by MIPO.展开更多
BACKGROUND Humeral shaft fractures are relatively common in adults.Rotational malalignment is reported as one complication but severe rotational deformity of the humerus is extremely rare.To our knowledge,only three c...BACKGROUND Humeral shaft fractures are relatively common in adults.Rotational malalignment is reported as one complication but severe rotational deformity of the humerus is extremely rare.To our knowledge,only three cases of symptomatic humeral malrotation have been reported.There are sparse literature reports of humeral reconstruction correction.CASE SUMMARY We present a case of extreme rotational deformity of the humerus(180°)after humeral shaft fracture.The patient complained of pain and difficulties with activities of daily living.In addition,she found the deformity cosmetically unacceptable.Therefore,she was searching for surgical correction.Neurolysis of the radial nerve followed by derotational osteotomy of the humerus and internal fixation were performed.Postoperatively,the patient demonstrated transient iatrogenic radial nerve palsy which recovered completely during postoperative follow-up.The Disabilities of the Arm,Shoulder,and Hand score improved from 55 preoperatively to 16 at the final 2-year follow-up.CONCLUSION Single-stage radial neurolysis,derotational osteotomy and stable fixation is a feasible option to improve anatomic and functional problems of severely malrotated humeral shaft fractures.展开更多
Objective: The purpose of this meta-analysis is to determine whether plating or intramedullary nailing(IMN) for adult diaphyseal both-bone forearm fractures(BBFF) provides better clinical outcomes. Methods: MEDLINE, E...Objective: The purpose of this meta-analysis is to determine whether plating or intramedullary nailing(IMN) for adult diaphyseal both-bone forearm fractures(BBFF) provides better clinical outcomes. Methods: MEDLINE, EMBASE, Google Scholar and The Cochrane Library were comprehensively searched until July 31, 2016.Both retrospective study and prospective trails about comparison of dual IMN or hybrid fixation versus dual plating fixation in the treatment of adult diaphyseal BBFF were included. Using Rev Man5.3 software, data of functional recovery, the union time,operating time and complication was extracted for meta-analysis. Results: The pooled analysis showed similar results in the union time, functional recovery and the rates of complications, but showed a significant difference in operating time. Conclusion: This meta-analysis demonstrates similar radiographic outcomes, functional outcomes and complications with plates or IMN used in the treatment of adult diaphyseal BBFF. IMN fixation for these fractures seems to be an alternative and effective treatment with shorter operating times and minimally invasive.展开更多
文摘Background Accurate and precise preoperative planning can provide information instrumental for performing less invasive articular fracture surgery. The purpose of this study was to determine that computer-assisted preoperative planning （CAPP） has the potential to improve efficiency and time in the operating room. Methods Sixty-four patients with proximal humeral fractures were treated using locking plates by minimally invasive plate osteosynthesis （MIPO） with CAPP. The time needed for virtual segmentation, reduction, and fixation of the fracture fragments were recorded. Intra and interobserver reliabilities were analyzed using the intraclass correlation coefficient. The clinical function was analyzed using Constant Score and radiology. Results The mean total time required for CAPP of two-part, three-part, and four-part proximal humeral fractures were （13.63±1.38） minutes, （23.14±2.18） minutes, and （39.61±3.01） minutes, respectively. The intra and interobserver reliabilities for all variables were high, ranging from 0.785 to 0.992. The mean operation time was （50.1±6.7） minutes. Fifty- two patients were followed up with an average time of 34.2 months. The mean Constant Score of the injury side was （82.5 ± 9.9）. Three of the fifty-two patients had four complications. Conclusion The application of CAPP was efficient and reliable, and provided excellent clinical and radiographic outcomes for the treatment of proximal humerus fractures by MIPO.
文摘BACKGROUND Humeral shaft fractures are relatively common in adults.Rotational malalignment is reported as one complication but severe rotational deformity of the humerus is extremely rare.To our knowledge,only three cases of symptomatic humeral malrotation have been reported.There are sparse literature reports of humeral reconstruction correction.CASE SUMMARY We present a case of extreme rotational deformity of the humerus(180°)after humeral shaft fracture.The patient complained of pain and difficulties with activities of daily living.In addition,she found the deformity cosmetically unacceptable.Therefore,she was searching for surgical correction.Neurolysis of the radial nerve followed by derotational osteotomy of the humerus and internal fixation were performed.Postoperatively,the patient demonstrated transient iatrogenic radial nerve palsy which recovered completely during postoperative follow-up.The Disabilities of the Arm,Shoulder,and Hand score improved from 55 preoperatively to 16 at the final 2-year follow-up.CONCLUSION Single-stage radial neurolysis,derotational osteotomy and stable fixation is a feasible option to improve anatomic and functional problems of severely malrotated humeral shaft fractures.
文摘Objective: The purpose of this meta-analysis is to determine whether plating or intramedullary nailing(IMN) for adult diaphyseal both-bone forearm fractures(BBFF) provides better clinical outcomes. Methods: MEDLINE, EMBASE, Google Scholar and The Cochrane Library were comprehensively searched until July 31, 2016.Both retrospective study and prospective trails about comparison of dual IMN or hybrid fixation versus dual plating fixation in the treatment of adult diaphyseal BBFF were included. Using Rev Man5.3 software, data of functional recovery, the union time,operating time and complication was extracted for meta-analysis. Results: The pooled analysis showed similar results in the union time, functional recovery and the rates of complications, but showed a significant difference in operating time. Conclusion: This meta-analysis demonstrates similar radiographic outcomes, functional outcomes and complications with plates or IMN used in the treatment of adult diaphyseal BBFF. IMN fixation for these fractures seems to be an alternative and effective treatment with shorter operating times and minimally invasive.
