Objective To investigate mechanism involved i n knee joint rehabilition by compreh ensive rehabilitation therapy foll owing com-minuted fracture of patella surgery.Method25patients suffered from comminute d fracture o...Objective To investigate mechanism involved i n knee joint rehabilition by compreh ensive rehabilitation therapy foll owing com-minuted fracture of patella surgery.Method25patients suffered from comminute d fracture of patella received rehabilitation training,drugs administration and physical therapy.Results Knee joint function was evaluated,e xcellent 22cases,good 2cases,favo rable 1case,good rate was 96%.Conclusion Rehabilitation of knee joint is satisfying in patients underwent compre hensive rehabilitation treatment.So,comprehensive rehabilitation treatment is valuable in clinic.展开更多
AIM To review and report functional outcomes, complications,and survivorship associated with total knee arthroplasty(TKA) in the treatment of post-traumatic arthritis(PTA).METHODS We conducted a systematic review acco...AIM To review and report functional outcomes, complications,and survivorship associated with total knee arthroplasty(TKA) in the treatment of post-traumatic arthritis(PTA).METHODS We conducted a systematic review according to the PRISMA guidelines. We searched PubMed, Cochrane Library, and SCOPUS in December 2015 for Englishlanguage clinical research studies, both prospective and retrospective, examining the use of TKA for the treatment of PTA. All relevant articles were accessed in full. The manual search included references of retrieved articles.We extracted data on patients' demographics and clinical outcomes, including preoperative diagnosis and pre- and post-operative functional scores. We summarized the data and reported the results in tables and text.RESULTS Sixteen studies, four prospective and ten retrospective,examined patients who underwent TKA for PTA due to fractures of the proximal tibia, patella, and/or distal femur. Eleven studies utilized the Knee Society Scores criteria to assess functional outcomes. All studies utilizing these criteria reported an improvement in functional and knee scores of patients following TKA. Further, studies reported an increased range of motion(ROM) and reduction of pain following surgery. The most commonly reported complications with TKA included infection, stiffness, wound complications, intraoperative rupture of tendons, and osteolysis/polyethylene wear. The overwhelming majority of these complications occurred within the first two years following surgery. Six studies examined the survivorship of TKA with subsequent revision for any reason as an endpoint. Compared to patients with osteoarthritis, patients with PTA required more revisions, the majority for polyethylene wear.CONCLUSION Although associated with higher complication rates,TKA is an effective treatment for PTA, as it improves ROM, pain and functional outcomes.展开更多
Bone graft may be needed to fill bone defect in elderly patients with a metaphyseal comminuted distal radius fracture. In this retrospective, nonrandomized, single-surgeon study, we evaluated the clinical and radiolog...Bone graft may be needed to fill bone defect in elderly patients with a metaphyseal comminuted distal radius fracture. In this retrospective, nonrandomized, single-surgeon study, we evaluated the clinical and radiologic outcomes of using both dorsal locking plates with or without augmentation with mineralized collagen （MC） bone graft for elderly patients with dorsally metaphyseal comminuted radius fractures. Patients in group 1 （n = 12） were treated with dorsal locking plates with MC bone graft application into the metaphyseal bone defect, and those in group 2 （n - 12） only with dorsal locking plates. Clinical and radiologic parameters were determined at three and 12 months after surgery. At final follow-up, no significant difference was noted between the 2 groups in terms of palmar tilt and radial inclination （p - 0.80）; however, ulnar variance increased significantly in the group 2 treated with dorsal locking plates without augmentation （p〈0.05）. Functionally, there was no significant difference between the groups. Our preliminary study suggests that combination of MC as bone-graft substitutes and dorsal locking plates may be a usefully alternative for elderly patients with metaphyseal comminuted distal radius fracture.展开更多
Purpose:Comminuted intraarticular distal radial fractures are difficult to treat conservatively and require operative treatment.This study compared the functional outcomes between variable angle volar plating and exte...Purpose:Comminuted intraarticular distal radial fractures are difficult to treat conservatively and require operative treatment.This study compared the functional outcomes between variable angle volar plating and external fixator with K-wire augmentation in open reduction and internal fixation.Methods:A total of 62 adult patients with comminuted intraarticular distal radius fracture were randomized into 2 groups:volar plate group and external fixator group.These patients aged between 18 and 60 years had unilateral fractures,and agreed to be included in the study.Patients with a history of fracture,bilateral fracture,associated other injuries,delayed injury for more than 2 weeks,open fracture,pre-existing arthrosis or disability,psychiatric illness and pathological fracture were excluded.Patients were followed up at 6 weeks,3 months,6 months and 1 year.The assessment of pain,functional activity,range of motion and grip strength was done at each stage of follow-up.The pain and functional activities were assessed by patient rated wrist evaluation(PRWE)score and disabilities of the arm,shoulder and hand(DASH)score.Results:Patients in volar plate group had superior PRWE score and DASH score at each stage of followup.At 1 year follow-up,the mean PRWE score were 7.48 for volar plate group and 7.35 for external fixator group;while the mean DASH score was 4.65 for volar plate group and 5.61 for external fixator group.They had better flexion and extension range of movement.They also had better pronation and supination range of motion at initial follow-up,however the difference get attenuated by 1 year.Volar plate group had significantly better grip strength than external fixator group.Complication rates were higher in external fixation group.Conclusion:Fixation with variable angle volar plate results in early wrist mobilization,better range of movement,less pain and disability and early return of function.展开更多
Background Double plate osteosynthesis is the standard treatment for intra-articular fractures of the distal humerus.However,there is still controversy concerning dual plate positions in terms of providing optimal sta...Background Double plate osteosynthesis is the standard treatment for intra-articular fractures of the distal humerus.However,there is still controversy concerning dual plate positions in terms of providing optimal stability.The purpose of this retrospective study was to compare the clinical outcomes in patients with type C intra-articular distal humeral fractures using perpendicular and parallel plating methods.Methods Between March 2008 and June 2011,a total of 45 patients with type C distal humerus fractures were treated using two different dual plating methods.Of them,24 patients were treated by perpendicular plating （group Ⅰ） and 21 patients were treated by parallel plating （group Ⅱ）.The surgical time,blood loss,and union time were compared between the two groups.The fiexion-extension arc,the total range of flexion and extension at the end of follow-up were compared between the two groups.The Mayo Elbow Performance Score （MEPS） was used to determine the elbow functional results.Results All patients were followed up.The mean duration of follow-up was 16 months （range 12-25 months） in group Ⅰ and 15.5 months in group Ⅱ （range 12-25 months）.There were no significant differences in the surgical time,blood loss,and the bone union time between the two groups.In group Ⅰ,the mean elbow flexion-extension arc was 101° and the mean MEPS was 85 points.The rate of excellent and good results was 87.5%.In group Ⅱ,the mean flexion-extension arc was 100° and the mean MEPS was 86.1 points.The rate of excellent and good results was 90.5%.There were no significant differences in the MEPS,flexion-extension arc,and the total range of flexion and extension between the two groups.Conclusions Perpendicular and parallel plate configurations with the appropriate surgical techniques can provide anatomical reconstruction and stable fixation of type C intra-articular distal humeral fractures and allow early mobilization of the elbow after an operation.The occurrence of post-operative elbow stiffness can be reduced and good outcomes can be obtained.展开更多
文摘Objective To investigate mechanism involved i n knee joint rehabilition by compreh ensive rehabilitation therapy foll owing com-minuted fracture of patella surgery.Method25patients suffered from comminute d fracture of patella received rehabilitation training,drugs administration and physical therapy.Results Knee joint function was evaluated,e xcellent 22cases,good 2cases,favo rable 1case,good rate was 96%.Conclusion Rehabilitation of knee joint is satisfying in patients underwent compre hensive rehabilitation treatment.So,comprehensive rehabilitation treatment is valuable in clinic.
文摘AIM To review and report functional outcomes, complications,and survivorship associated with total knee arthroplasty(TKA) in the treatment of post-traumatic arthritis(PTA).METHODS We conducted a systematic review according to the PRISMA guidelines. We searched PubMed, Cochrane Library, and SCOPUS in December 2015 for Englishlanguage clinical research studies, both prospective and retrospective, examining the use of TKA for the treatment of PTA. All relevant articles were accessed in full. The manual search included references of retrieved articles.We extracted data on patients' demographics and clinical outcomes, including preoperative diagnosis and pre- and post-operative functional scores. We summarized the data and reported the results in tables and text.RESULTS Sixteen studies, four prospective and ten retrospective,examined patients who underwent TKA for PTA due to fractures of the proximal tibia, patella, and/or distal femur. Eleven studies utilized the Knee Society Scores criteria to assess functional outcomes. All studies utilizing these criteria reported an improvement in functional and knee scores of patients following TKA. Further, studies reported an increased range of motion(ROM) and reduction of pain following surgery. The most commonly reported complications with TKA included infection, stiffness, wound complications, intraoperative rupture of tendons, and osteolysis/polyethylene wear. The overwhelming majority of these complications occurred within the first two years following surgery. Six studies examined the survivorship of TKA with subsequent revision for any reason as an endpoint. Compared to patients with osteoarthritis, patients with PTA required more revisions, the majority for polyethylene wear.CONCLUSION Although associated with higher complication rates,TKA is an effective treatment for PTA, as it improves ROM, pain and functional outcomes.
文摘Bone graft may be needed to fill bone defect in elderly patients with a metaphyseal comminuted distal radius fracture. In this retrospective, nonrandomized, single-surgeon study, we evaluated the clinical and radiologic outcomes of using both dorsal locking plates with or without augmentation with mineralized collagen （MC） bone graft for elderly patients with dorsally metaphyseal comminuted radius fractures. Patients in group 1 （n = 12） were treated with dorsal locking plates with MC bone graft application into the metaphyseal bone defect, and those in group 2 （n - 12） only with dorsal locking plates. Clinical and radiologic parameters were determined at three and 12 months after surgery. At final follow-up, no significant difference was noted between the 2 groups in terms of palmar tilt and radial inclination （p - 0.80）; however, ulnar variance increased significantly in the group 2 treated with dorsal locking plates without augmentation （p〈0.05）. Functionally, there was no significant difference between the groups. Our preliminary study suggests that combination of MC as bone-graft substitutes and dorsal locking plates may be a usefully alternative for elderly patients with metaphyseal comminuted distal radius fracture.
文摘Purpose:Comminuted intraarticular distal radial fractures are difficult to treat conservatively and require operative treatment.This study compared the functional outcomes between variable angle volar plating and external fixator with K-wire augmentation in open reduction and internal fixation.Methods:A total of 62 adult patients with comminuted intraarticular distal radius fracture were randomized into 2 groups:volar plate group and external fixator group.These patients aged between 18 and 60 years had unilateral fractures,and agreed to be included in the study.Patients with a history of fracture,bilateral fracture,associated other injuries,delayed injury for more than 2 weeks,open fracture,pre-existing arthrosis or disability,psychiatric illness and pathological fracture were excluded.Patients were followed up at 6 weeks,3 months,6 months and 1 year.The assessment of pain,functional activity,range of motion and grip strength was done at each stage of follow-up.The pain and functional activities were assessed by patient rated wrist evaluation(PRWE)score and disabilities of the arm,shoulder and hand(DASH)score.Results:Patients in volar plate group had superior PRWE score and DASH score at each stage of followup.At 1 year follow-up,the mean PRWE score were 7.48 for volar plate group and 7.35 for external fixator group;while the mean DASH score was 4.65 for volar plate group and 5.61 for external fixator group.They had better flexion and extension range of movement.They also had better pronation and supination range of motion at initial follow-up,however the difference get attenuated by 1 year.Volar plate group had significantly better grip strength than external fixator group.Complication rates were higher in external fixation group.Conclusion:Fixation with variable angle volar plate results in early wrist mobilization,better range of movement,less pain and disability and early return of function.
文摘Background Double plate osteosynthesis is the standard treatment for intra-articular fractures of the distal humerus.However,there is still controversy concerning dual plate positions in terms of providing optimal stability.The purpose of this retrospective study was to compare the clinical outcomes in patients with type C intra-articular distal humeral fractures using perpendicular and parallel plating methods.Methods Between March 2008 and June 2011,a total of 45 patients with type C distal humerus fractures were treated using two different dual plating methods.Of them,24 patients were treated by perpendicular plating （group Ⅰ） and 21 patients were treated by parallel plating （group Ⅱ）.The surgical time,blood loss,and union time were compared between the two groups.The fiexion-extension arc,the total range of flexion and extension at the end of follow-up were compared between the two groups.The Mayo Elbow Performance Score （MEPS） was used to determine the elbow functional results.Results All patients were followed up.The mean duration of follow-up was 16 months （range 12-25 months） in group Ⅰ and 15.5 months in group Ⅱ （range 12-25 months）.There were no significant differences in the surgical time,blood loss,and the bone union time between the two groups.In group Ⅰ,the mean elbow flexion-extension arc was 101° and the mean MEPS was 85 points.The rate of excellent and good results was 87.5%.In group Ⅱ,the mean flexion-extension arc was 100° and the mean MEPS was 86.1 points.The rate of excellent and good results was 90.5%.There were no significant differences in the MEPS,flexion-extension arc,and the total range of flexion and extension between the two groups.Conclusions Perpendicular and parallel plate configurations with the appropriate surgical techniques can provide anatomical reconstruction and stable fixation of type C intra-articular distal humeral fractures and allow early mobilization of the elbow after an operation.The occurrence of post-operative elbow stiffness can be reduced and good outcomes can be obtained.
