目的:探讨氨甲环酸在踝关节骨折围术期的临床有效性。方法:根据纳入标准,回顾性筛选2021年4月至2023年03月于喀什地区第二人民医院骨科行踝关节骨折切开复位钢板内固定术的178例患者,根据围术期是否应用氨甲环酸分成对照组和治疗组,对照...目的:探讨氨甲环酸在踝关节骨折围术期的临床有效性。方法:根据纳入标准,回顾性筛选2021年4月至2023年03月于喀什地区第二人民医院骨科行踝关节骨折切开复位钢板内固定术的178例患者,根据围术期是否应用氨甲环酸分成对照组和治疗组,对照组(n = 74)予以治疗踝关节骨折切开复位钢板内固定术,治疗组(n = 104)在对照组治疗基础上加用氨甲环酸治疗,观察2组术前与术后第1天和第5天血常规指标(红细胞、血红蛋白、红细胞压积、血小板、红细胞平均体积和平均血红蛋白浓度),比较两组血清总蛋白、白蛋白和血清铁离子的变化。结果:① 术前资料:术前两组患者的年龄、性别构成、体质量指数、高血压、糖尿病、骨质疏松症、手术时间以及血红蛋白、血小板、红细胞平均体积、平均血红蛋白浓度、血清总蛋白和白蛋白指标进行比较,差异均无显著性意义(P > 0.05);② 两组患者术后第1,5天血小板和红细胞平均体积比,差异均无显著性意义(P > 0.05);术后第1,5天血红蛋白比,差异有显著性意义(P Objective: To investigate the clinical effectiveness of tranexamic acid in perioperative ankle fracture. Methods: According to the inclusion criteria, retrospective screening of 178 patients undergoing open reduction plate internal fixation of ankle fracture in the orthopedic department of the second people’s hospital of Kashgar Region from April 2021 to March 2023, according to the application of tranexamic acid during the perioperative period, the control group (n = 74) was treated with open reduction plate fixation, the treatment group (n = 104) added tranexamic acid to the control group, observe the 2 blood routine indexes (red blood cells, hemoglobin, hematocrit, platelet, red blood cell volume and mean hemoglobin concentration before and postoperative days 1 and 5), changes in serum total protein, albumin and serum iron ions were compared between the two groups. Results: ① Preoperative data: Age, sex composition, body mass index, hypertension, diabetes, osteoporosis, operation time, mean hemoglobin, platelet, red blood cell volume, mean hemoglobin concentration, serum total protein and albumin index of the two groups, no difference was significant (P > 0.05);② Aan volume ratio of platelets to red blood cells at 5 days, none of the differences were significant (P > 0.05);Postoperative number 1, the 5-day hemoglobin ratio, the difference was significant (P < 0.05);Hematocrit ratio on postoperative day 1 in both groups, the difference was significant (P < 0.05);Red blood BC, mean hemoglobin concentration, and total serum protein, albumin, and serum ferritin ratio, the difference was significant (P < 0.05). Conclusion: The results show that the treatment group showed effective hemostasis, and improved serum total protein, albumin and serum ferritin. Therefore, the author suggested that tranexamic acid was preferred as the hemostasis drug.展开更多
Objective：Debate continues regarding the management of calcaneal fractures,between open reduction and internal fixation and closed treatment.Hence we aim at evaluating the radiological and functional outcomes of open...Objective：Debate continues regarding the management of calcaneal fractures,between open reduction and internal fixation and closed treatment.Hence we aim at evaluating the radiological and functional outcomes of open reduction and internal fixation in displaced joint depression type of calcaneal fractures fixed with locking calcaneal plate.Methods：In this series,28 patients （26 unilateral and 2 bilateral） with joint depression type of calcaneal fractures as per Essex-Lopresti classification system were operated on with locking calcaneal plate within 3 weeks of injury.Patients were evaluated in terms of associated injuries and X-rays of anteroposterior,lateral and axial views of the calcaneum.CT scan was done to assess the amount ofcomminution and articular depression.Patients were followed up clinically and radiologically at least for 1 year.Radiological assessment was done by Bohler＇s angle and Gissane＇s angle along with measurement ofcalcaneal height and width.Functional outcome was assessed using the American Orthopaedics Foot and Ankle Society （AOFAS） scale.Results：At average follow-up of 14.5 months,average AOFAS score was 86.3 （range 66 to 97）,with 86% having excellent to good results and 2 （7.7%） and 1 （3.7%） having fair and poor results respectively.All patients had stable ankle joint with all having dorsiflexion and plantar flexion more than 30°.Average subtalar range of motion was 17°.The mean Bohler＇s angle,mean Gissane＇s angle,calcaneal height and width were 25.47°,121.3°,4.32 cm and 3.81cm respectively at final follow-up.Three patients had flap necrosis at incision site and one had superficial and deep infection.Subtalar arthritis was seen in 5 patients,whereas sural nerve hypoaesthesia in 1 patient.None of the patients had compartment syndrome,heel pad problems,peroneal tendinitis,reflex sympathetic dystropy or implant failure.Conclusion：Open reduction and internal fixation with locking calcaneal plate gives sound functional outcome,i.e.restoring anatomically reconstruction of height,width,Bohler＇s and Gissiane＇s angles of the calcaneum,and allowing early mobilization.展开更多
文摘目的:探讨氨甲环酸在踝关节骨折围术期的临床有效性。方法:根据纳入标准,回顾性筛选2021年4月至2023年03月于喀什地区第二人民医院骨科行踝关节骨折切开复位钢板内固定术的178例患者,根据围术期是否应用氨甲环酸分成对照组和治疗组,对照组(n = 74)予以治疗踝关节骨折切开复位钢板内固定术,治疗组(n = 104)在对照组治疗基础上加用氨甲环酸治疗,观察2组术前与术后第1天和第5天血常规指标(红细胞、血红蛋白、红细胞压积、血小板、红细胞平均体积和平均血红蛋白浓度),比较两组血清总蛋白、白蛋白和血清铁离子的变化。结果:① 术前资料:术前两组患者的年龄、性别构成、体质量指数、高血压、糖尿病、骨质疏松症、手术时间以及血红蛋白、血小板、红细胞平均体积、平均血红蛋白浓度、血清总蛋白和白蛋白指标进行比较,差异均无显著性意义(P > 0.05);② 两组患者术后第1,5天血小板和红细胞平均体积比,差异均无显著性意义(P > 0.05);术后第1,5天血红蛋白比,差异有显著性意义(P Objective: To investigate the clinical effectiveness of tranexamic acid in perioperative ankle fracture. Methods: According to the inclusion criteria, retrospective screening of 178 patients undergoing open reduction plate internal fixation of ankle fracture in the orthopedic department of the second people’s hospital of Kashgar Region from April 2021 to March 2023, according to the application of tranexamic acid during the perioperative period, the control group (n = 74) was treated with open reduction plate fixation, the treatment group (n = 104) added tranexamic acid to the control group, observe the 2 blood routine indexes (red blood cells, hemoglobin, hematocrit, platelet, red blood cell volume and mean hemoglobin concentration before and postoperative days 1 and 5), changes in serum total protein, albumin and serum iron ions were compared between the two groups. Results: ① Preoperative data: Age, sex composition, body mass index, hypertension, diabetes, osteoporosis, operation time, mean hemoglobin, platelet, red blood cell volume, mean hemoglobin concentration, serum total protein and albumin index of the two groups, no difference was significant (P > 0.05);② Aan volume ratio of platelets to red blood cells at 5 days, none of the differences were significant (P > 0.05);Postoperative number 1, the 5-day hemoglobin ratio, the difference was significant (P < 0.05);Hematocrit ratio on postoperative day 1 in both groups, the difference was significant (P < 0.05);Red blood BC, mean hemoglobin concentration, and total serum protein, albumin, and serum ferritin ratio, the difference was significant (P < 0.05). Conclusion: The results show that the treatment group showed effective hemostasis, and improved serum total protein, albumin and serum ferritin. Therefore, the author suggested that tranexamic acid was preferred as the hemostasis drug.
文摘Objective：Debate continues regarding the management of calcaneal fractures,between open reduction and internal fixation and closed treatment.Hence we aim at evaluating the radiological and functional outcomes of open reduction and internal fixation in displaced joint depression type of calcaneal fractures fixed with locking calcaneal plate.Methods：In this series,28 patients （26 unilateral and 2 bilateral） with joint depression type of calcaneal fractures as per Essex-Lopresti classification system were operated on with locking calcaneal plate within 3 weeks of injury.Patients were evaluated in terms of associated injuries and X-rays of anteroposterior,lateral and axial views of the calcaneum.CT scan was done to assess the amount ofcomminution and articular depression.Patients were followed up clinically and radiologically at least for 1 year.Radiological assessment was done by Bohler＇s angle and Gissane＇s angle along with measurement ofcalcaneal height and width.Functional outcome was assessed using the American Orthopaedics Foot and Ankle Society （AOFAS） scale.Results：At average follow-up of 14.5 months,average AOFAS score was 86.3 （range 66 to 97）,with 86% having excellent to good results and 2 （7.7%） and 1 （3.7%） having fair and poor results respectively.All patients had stable ankle joint with all having dorsiflexion and plantar flexion more than 30°.Average subtalar range of motion was 17°.The mean Bohler＇s angle,mean Gissane＇s angle,calcaneal height and width were 25.47°,121.3°,4.32 cm and 3.81cm respectively at final follow-up.Three patients had flap necrosis at incision site and one had superficial and deep infection.Subtalar arthritis was seen in 5 patients,whereas sural nerve hypoaesthesia in 1 patient.None of the patients had compartment syndrome,heel pad problems,peroneal tendinitis,reflex sympathetic dystropy or implant failure.Conclusion：Open reduction and internal fixation with locking calcaneal plate gives sound functional outcome,i.e.restoring anatomically reconstruction of height,width,Bohler＇s and Gissiane＇s angles of the calcaneum,and allowing early mobilization.
