To delineate the clinical spectrum and treatment choice of sacral fractures. [WT5”BX]Methods.[WT5”BZ] In this series, 39 sacral fractures were retrospectively reviewed and classified utilizing Denis′ classification...To delineate the clinical spectrum and treatment choice of sacral fractures. [WT5”BX]Methods.[WT5”BZ] In this series, 39 sacral fractures were retrospectively reviewed and classified utilizing Denis′ classification. There were 21 Zone Ⅰ fractures, 6 Zone Ⅱ fractures and 12 Zone Ⅲ fractures. Neurological deficits were present in seven patients. Thirty seven patients were treated conservatively and two underwent surgical management. [WT5”BX]Results.[WT5”BZ]Thirty eight patients were followed up for three months to 19 years. Thirty three have recovered, four improved, and one remained disabled. [WT5”BX]Conclusion.[WT5”BZ]The treatment of sacral fractures requires assessment of pelvic stability and existing nerve injury. The patients with pelvic ring instability and neurological deficits should be treated with fracture reduction and stability reconstruction. When the patients with pelvic fracture are complicated with neurological deficits, sacral fracture should be first suspected. Once the diagnosis of sacral fracture is made, fracture reduction should be indicated. Conservative treatment usually permits satisfactory results.展开更多
There are several well defined indications for surgical management of humeral shaft fractures.Operative procedures on the humerus are associated with their own complications.Iatrogenic brachial artery injury as a comp...There are several well defined indications for surgical management of humeral shaft fractures.Operative procedures on the humerus are associated with their own complications.Iatrogenic brachial artery injury as a complication of humeral shaft plating has not been reported previously.We report a case of a 48 years old femalewho received operation at a district hospital and was referred to us when the surgeon could not palpate the pulse.CT angiogram showed that there was segmental non-opacification of the brachial artery.There was distal reformation and the thrombosis was decided to be managed conservatively.We believe that the arterial injury was a result ofimproper surgical technique and the segmental block might be due to improper use of plate holding forceps.This case report makes us aware of a rare complication of operative management of humeral shaft fractures and that basic principles of surgery must be always followed to prevent such injuries.展开更多
Objective:: To explore the characteristics and treatment of temporal bone fractures and injuries in the medial-inner ear. Methods: The clinical data of 48 cases of temporal bone fractures admitted to our hospital from...Objective:: To explore the characteristics and treatment of temporal bone fractures and injuries in the medial-inner ear. Methods: The clinical data of 48 cases of temporal bone fractures admitted to our hospital from January 1989 to November 1999 were retrospectively analyzed. Results: Forty-eight patients with temporal bone fractures accounted for 17.00 % of the homochronous craniofacial fractures. Of the 48 cases, temporal bone fractures induced by traffic accidents accounted for 66.67 %, capillary fractures for 93.75 %, medial-inner ear injuries or craniocerebral injuries for 77.08 % and hearing loss or tinnitus for 48.00 %. The cerebrospinal fluid (CSF) otorrhea and facioplegia accounted for 36.70 % and 3.00 %, respectively, in the longitudinal fractures, while they were 25.00 % and 37.50 %, respectively, in the transversal fractures. Primary emergent operations were performed on 46 cases and neurosurgery accounted for 46.00 %. Secondary procedures accounted for 16.70 %. As a result, 43 cases survived ( 89.58 %) and 5 died ( 10.41 %). Conclusions: Traffic injury is the first high-dangerous factor for temporal bone fractures, which are often complicated with medial-inner ear or craniocerebral injury. The CSF otorrhea is common in the longitudinal fractures and facioplegia is common in the transversal fractures. The key step is to rescue the life, keep the airway unobstructed and maintain the circulation in the primary emergency treatment.展开更多
Objective： To explore the treatment methods and outcome of posterior wall fractures of the acetabulum. Methods： The data of 31 patients （25 males and 6 females, aged 19-59 years, mean： 40.5 years） with posterior ...Objective： To explore the treatment methods and outcome of posterior wall fractures of the acetabulum. Methods： The data of 31 patients （25 males and 6 females, aged 19-59 years, mean： 40.5 years） with posterior wall fractures of the acetabulum hospitalized in our department from 2002 to 2006 were analyzed retrospectively in this study. The types of fractures, number of fragments, combined dislocations, and sciatic nerve function were documented before admission. All the fractures were treated with open reduction and internal fixation. Based on the fracture type and site, either screws alone or reconstructive plates were used. The patients were immobilized for an average of 12 weeks before partial weight bearing was permitted. After follow-up for 12-70 months （43.6 months on average）, modified Merle d＇Aubigne score was adopted to evaluate the outcomes of the operations. Results： The percentages of the excellent, good, fair and poor results were 48.4%, 41.9%, 6.5%, and 3.3%, respectively, with a good to excellent rate of 90.2%. Idiopathic sciatic nerve injury occurred in only one case. Conclusions： The sciatic nerve should be routinely exposed and protected during the surgery. The type of fixation should be based on the fracture type and site. Prolonged immobilization may be helpful in improving the final outcomes.展开更多
文摘To delineate the clinical spectrum and treatment choice of sacral fractures. [WT5”BX]Methods.[WT5”BZ] In this series, 39 sacral fractures were retrospectively reviewed and classified utilizing Denis′ classification. There were 21 Zone Ⅰ fractures, 6 Zone Ⅱ fractures and 12 Zone Ⅲ fractures. Neurological deficits were present in seven patients. Thirty seven patients were treated conservatively and two underwent surgical management. [WT5”BX]Results.[WT5”BZ]Thirty eight patients were followed up for three months to 19 years. Thirty three have recovered, four improved, and one remained disabled. [WT5”BX]Conclusion.[WT5”BZ]The treatment of sacral fractures requires assessment of pelvic stability and existing nerve injury. The patients with pelvic ring instability and neurological deficits should be treated with fracture reduction and stability reconstruction. When the patients with pelvic fracture are complicated with neurological deficits, sacral fracture should be first suspected. Once the diagnosis of sacral fracture is made, fracture reduction should be indicated. Conservative treatment usually permits satisfactory results.
文摘There are several well defined indications for surgical management of humeral shaft fractures.Operative procedures on the humerus are associated with their own complications.Iatrogenic brachial artery injury as a complication of humeral shaft plating has not been reported previously.We report a case of a 48 years old femalewho received operation at a district hospital and was referred to us when the surgeon could not palpate the pulse.CT angiogram showed that there was segmental non-opacification of the brachial artery.There was distal reformation and the thrombosis was decided to be managed conservatively.We believe that the arterial injury was a result ofimproper surgical technique and the segmental block might be due to improper use of plate holding forceps.This case report makes us aware of a rare complication of operative management of humeral shaft fractures and that basic principles of surgery must be always followed to prevent such injuries.
文摘Objective:: To explore the characteristics and treatment of temporal bone fractures and injuries in the medial-inner ear. Methods: The clinical data of 48 cases of temporal bone fractures admitted to our hospital from January 1989 to November 1999 were retrospectively analyzed. Results: Forty-eight patients with temporal bone fractures accounted for 17.00 % of the homochronous craniofacial fractures. Of the 48 cases, temporal bone fractures induced by traffic accidents accounted for 66.67 %, capillary fractures for 93.75 %, medial-inner ear injuries or craniocerebral injuries for 77.08 % and hearing loss or tinnitus for 48.00 %. The cerebrospinal fluid (CSF) otorrhea and facioplegia accounted for 36.70 % and 3.00 %, respectively, in the longitudinal fractures, while they were 25.00 % and 37.50 %, respectively, in the transversal fractures. Primary emergent operations were performed on 46 cases and neurosurgery accounted for 46.00 %. Secondary procedures accounted for 16.70 %. As a result, 43 cases survived ( 89.58 %) and 5 died ( 10.41 %). Conclusions: Traffic injury is the first high-dangerous factor for temporal bone fractures, which are often complicated with medial-inner ear or craniocerebral injury. The CSF otorrhea is common in the longitudinal fractures and facioplegia is common in the transversal fractures. The key step is to rescue the life, keep the airway unobstructed and maintain the circulation in the primary emergency treatment.
文摘Objective： To explore the treatment methods and outcome of posterior wall fractures of the acetabulum. Methods： The data of 31 patients （25 males and 6 females, aged 19-59 years, mean： 40.5 years） with posterior wall fractures of the acetabulum hospitalized in our department from 2002 to 2006 were analyzed retrospectively in this study. The types of fractures, number of fragments, combined dislocations, and sciatic nerve function were documented before admission. All the fractures were treated with open reduction and internal fixation. Based on the fracture type and site, either screws alone or reconstructive plates were used. The patients were immobilized for an average of 12 weeks before partial weight bearing was permitted. After follow-up for 12-70 months （43.6 months on average）, modified Merle d＇Aubigne score was adopted to evaluate the outcomes of the operations. Results： The percentages of the excellent, good, fair and poor results were 48.4%, 41.9%, 6.5%, and 3.3%, respectively, with a good to excellent rate of 90.2%. Idiopathic sciatic nerve injury occurred in only one case. Conclusions： The sciatic nerve should be routinely exposed and protected during the surgery. The type of fixation should be based on the fracture type and site. Prolonged immobilization may be helpful in improving the final outcomes.
