Objective: To investigate the effectiveness of the plate screw internal fixation technique on the clinical outcomes of patients with traumatic fractures of long bones in the lower extremities. Methods: From January 20...Objective: To investigate the effectiveness of the plate screw internal fixation technique on the clinical outcomes of patients with traumatic fractures of long bones in the lower extremities. Methods: From January 2022 to December 2023, 70 patients with traumatic fractures of long bones in the lower extremities were admitted to the hospital and randomly divided into two groups: the control group and the observation group, each consisting of 35 cases. The control group underwent traditional closed interlocking intramedullary nailing, while the observation group received internal fixation with steel plates and screws. Relevant surgical indicators, treatment effectiveness, and postoperative complication rates were compared between the two groups. Results: The observation group exhibited significantly short surgical duration (80.65 ± 5.01 vs. 88.36 ± 5.26 minutes), fracture healing time (13.27 ± 0.32 vs. 15.52 ± 0.48 weeks), and hospitalization days (10.49 ± 1.13 vs. 16.57 ± 1.15 days) compared to the control group (P = 0.000). The effective treatment rate was significantly higher in the observation group (29/82.86%) than in the control group (21/60.00%), with a significant difference observed (χ2 = 4.480, P = 0.034). Additionally, the complication rate in the observation group (2/5.71%) was significantly lower than that in the control group (8/22.86%), with a correlated difference (χ2 = 4.200, P = 0.040). Conclusion: The plate screw internal fixation technique demonstrates significant clinical efficacy in treating traumatic fractures of long bones in the lower extremities. It improves the healing rate, reduces complications, and represents a safe and effective treatment strategy worthy of widespread use and application.展开更多
This study is aimed to explore the clinical application of the guiding template designed by three-dimensional printing data for the insertion of sacroiliac screws.A retrospective study of 7 cases (from July 2016 to De...This study is aimed to explore the clinical application of the guiding template designed by three-dimensional printing data for the insertion of sacroiliac screws.A retrospective study of 7 cases (from July 2016 to December 2016),in which the guiding template printed by the three-dimensional printing technique was used for the insertion of sacroiliac screws of patients with posterior ring injuries of pelvis,was performed.Totally,4 males and 3 females were included in template group,aged from 38to 65years old (mean 50.86±8.90).Of them,5 had sacral fractures (3 with Denis type Ⅰ and 2 with type Ⅱ)and 2 the separation of sacroiliac joint.Guiding templates were firstly made by the three-dimensional printing technique based on the pre-operative CT data. Surgical operations for the stabilization of pelvic ring by applying the guiding templates were carried out.A group of 8 patients with sacroiliac injuries treated by percutaneous sacroiliac screws were analyzed as a control group retrospectively.The time of each screw insertion,volume of intra-operative blood loss,and the exposure to X ray were analyzed and the Matta's radiological criteria were used to evaluate the reduction quality.The Majeed score was used to evaluate postoperative living quality.The visual analogue scale (VAS)was applied at different time points to judge pain relief of coccydynia.All the 7 patients in the template group were closely followed up radiographically and clinically for 14 to 20 months,mean (16.57±2.44)months.Totally 9 sacroiliac screws for the S 1 and S2 vertebra were inserted in the 7 patients.The time length for each screw insertion ranged from 450 to 870 s,mean (690.56±135.68)s,and the number of times of exposure to X ray were 4 to 8,mean (5.78±1.20).The intra-operative blood loss ranged from 45to 120 mL,mean (75±23.32)mL.According to Matta's radiology criteria,the fracture and dislocation reduction were excellent in 6cases and good in 1.The pre-operative VAS score ranged from 5.2 to 8.1,mean (7.13±1.00).The average one-week/six-month post-operative VAS was (5.33±0.78)and (1.33±0.66),respectively (P<0.05 when compared with pre-operative VAS).The 12-month post-operative Majeed score ranged from 86 to 92,mean (90.29±2.21).The three-dimensional printed guiding template for sacroiliac screw insertion,which could significantly shorten the operation time,provide a satisfied outcome of the stabilization of the pelvic ring,and protect doctors and patients from X-ray exposure,might be a practical and valuable new clinical technique.展开更多
Treatment of children with cervical spine disorders requiring fusion is a challenging endeavor for a variety of reasons. The size of the patients, the corresponding abnormal bony anatomy, the inherent ligamentous laxi...Treatment of children with cervical spine disorders requiring fusion is a challenging endeavor for a variety of reasons. The size of the patients, the corresponding abnormal bony anatomy, the inherent ligamentous laxity of children, and the relative rarity of the disorders all play a part in difficulty of treatment. The benefits of modern posterior cervical instrumentation in children, defined as rigid screw–rod systems, have been shown to be many including: improved arthrodesis rates, diminished times in halo-vest immobilization, and improved reduction of deformities. The anatomy of children and the corresponding pathology seen frequently is at the upper cervical spine and craniocervical junction given the relatively large head size of children and the horizontal facets at these regions predisposing them to instability or deformity. Posterior screw fixation, while challenging, allows for a rigid base to allow for fusion in these upper cervical areas which are predisposed to pseudarthrosis with non-rigid fixation. A thorough understanding of the anatomy of the cervical spine, the morphology of the cervical spine, and the available screw options is paramount for placing posterior cervical screws in children. The purpose of this review is to discuss both the anatomical and clinical descriptions re-lated to posterior screw placement in the cervical spine in children.展开更多
Objective: To investigate the clinical efficacy of the cement-screw technique in repairing tibial plateau bone defects in total knee arthroplasty (TKA) recipients and summarize the preoperative prehabilitation strateg...Objective: To investigate the clinical efficacy of the cement-screw technique in repairing tibial plateau bone defects in total knee arthroplasty (TKA) recipients and summarize the preoperative prehabilitation strategies for such surgeries. Methods: A total of 33 TKA recipients (45 knees) in our department underwent repair of unilateral or bilateral tibial defects using the cement-screw technique. The subjects were divided into two groups based on the differences in preoperative interventions. The control group received routine preoperative health education according to the consensus, while the observation group received instructive and standardized prehabilitation exercises for four weeks in addition to the routine education. Scale scores, intraoperative parameters, and postoperative recovery indicators were recorded at different time pointsand subjected to statistical analysis for intra-group and inter-group differences. All subjects underwent long-term follow-up for at least 24 months. Results: Within each group at different time points, there were statistically significant differences in VAS, ROM, and HSS scores (p Conclusions: Cement-screw technique for repairing tibial plateau bone defects in TKA recipients can significantly relieve pain, and improve joint function. Prehabilitation can improve preoperative rehabilitation reserves in these patients, accelerate postoperative recovery, and contribute to better short-term clinical outcomes.展开更多
To explore the value of helical CT volume rendering technique (VRT) in post-operative evaluation of screw fixation of axis fractures.Methods There were 21 cases of screw fixation of axis fractures between February 200...To explore the value of helical CT volume rendering technique (VRT) in post-operative evaluation of screw fixation of axis fractures.Methods There were 21 cases of screw fixation of axis fractures between February 2002 and May 2004 in the study including six cases with fractures on axis body,five on odontoid process and 10 on axis body and odontoid process.All cases received X-ray plain film,helical CT scanning,multi-planar reformatting(MPR) and VRT.Results Screw fixation through axis body and massa lateralis atlantis was performed in 10 cases and that through axis body and odontoid process in 11.VRT could clearly display full aperture of screw orbit,location of screw and angle of fixation and hence was superior to X-ray plain film and MPR.Multi-angle VRT displayed asymmetrical space of odontoid process and massa lateralis atlantis in four cases and medial deviation of 2～5 mm of half screw in screw fixation through axis body and massa lateralis atlantis in six.Conclusion VRT can eliminate false shadow of fixation screw,clearly display full aperture of screw orbit and hence supply improtant imaging evidence for post-operative evaluation of screw fixation of axis fractures.7 refs,1 fig,1 tab.展开更多
BACKGROUND The pedicle screw technique is widely employed for vertebral body fixation in the treatment of spinal disorders.However,traditional screw placement methods require the dissection of paraspinal muscles and t...BACKGROUND The pedicle screw technique is widely employed for vertebral body fixation in the treatment of spinal disorders.However,traditional screw placement methods require the dissection of paraspinal muscles and the insertion of pedicle screws at specific transverse section angles(TSA).Larger TSA angles require more force to pull the muscle tissue,which can increase the risk of surgical trauma and ischemic injury to the lumbar muscles.AIM To study the feasibility of zero-degree TSA vertical pedicle screw technique in the lumbosacral segment.METHODS Finite element models of vertebral bodies and pedicle screw-rod systems were established for the L4-S1 spinal segments.A standard axial load of 500 N and a rotational torque of 10 N/m were applied.Simulated screw pull-out experiment was conducted to observe pedicle screw resistance to pull-out,maximum stress,load-displacement ratio,maximum stress in vertebral bodies,load-displacement ratio in vertebral bodies,and the stress distribution in pedicle screws and vertebral bodies.Differences between the 0-degree and 17-degree TSA were compared.RESULTS At 0-degree TSA,the screw pull-out force decreased by 11.35%compared to that at 17-degree TSA(P<0.05).At 0-degree and 17-degree TSA,the stress range in the screw-rod system was 335.1-657.5 MPa and 242.8-648.5 MPa,separately,which were below the fracture threshold for the screw-rod system(924 MPa).At 0-degree and 17-degree TSA,the stress range in the vertebral bodies was 68.45-78.91 MPa and 39.08-72.73 MPa,separately,which were below the typical bone yield stress range for vertebral bodies(110-125 MPa).At 0-degree TSA,the load-displacement ratio for the vertebral bodies and pedicle screws was slightly lower compared to that at 17-degree TSA,indicating slightly lower stability(P<0.05).CONCLUSION The safety and stability of 0-degree TSA are slightly lower,but the risks of screw-rod system fracture,vertebral body fracture,and rupture are within acceptable limits.展开更多
文摘Objective: To investigate the effectiveness of the plate screw internal fixation technique on the clinical outcomes of patients with traumatic fractures of long bones in the lower extremities. Methods: From January 2022 to December 2023, 70 patients with traumatic fractures of long bones in the lower extremities were admitted to the hospital and randomly divided into two groups: the control group and the observation group, each consisting of 35 cases. The control group underwent traditional closed interlocking intramedullary nailing, while the observation group received internal fixation with steel plates and screws. Relevant surgical indicators, treatment effectiveness, and postoperative complication rates were compared between the two groups. Results: The observation group exhibited significantly short surgical duration (80.65 ± 5.01 vs. 88.36 ± 5.26 minutes), fracture healing time (13.27 ± 0.32 vs. 15.52 ± 0.48 weeks), and hospitalization days (10.49 ± 1.13 vs. 16.57 ± 1.15 days) compared to the control group (P = 0.000). The effective treatment rate was significantly higher in the observation group (29/82.86%) than in the control group (21/60.00%), with a significant difference observed (χ2 = 4.480, P = 0.034). Additionally, the complication rate in the observation group (2/5.71%) was significantly lower than that in the control group (8/22.86%), with a correlated difference (χ2 = 4.200, P = 0.040). Conclusion: The plate screw internal fixation technique demonstrates significant clinical efficacy in treating traumatic fractures of long bones in the lower extremities. It improves the healing rate, reduces complications, and represents a safe and effective treatment strategy worthy of widespread use and application.
文摘This study is aimed to explore the clinical application of the guiding template designed by three-dimensional printing data for the insertion of sacroiliac screws.A retrospective study of 7 cases (from July 2016 to December 2016),in which the guiding template printed by the three-dimensional printing technique was used for the insertion of sacroiliac screws of patients with posterior ring injuries of pelvis,was performed.Totally,4 males and 3 females were included in template group,aged from 38to 65years old (mean 50.86±8.90).Of them,5 had sacral fractures (3 with Denis type Ⅰ and 2 with type Ⅱ)and 2 the separation of sacroiliac joint.Guiding templates were firstly made by the three-dimensional printing technique based on the pre-operative CT data. Surgical operations for the stabilization of pelvic ring by applying the guiding templates were carried out.A group of 8 patients with sacroiliac injuries treated by percutaneous sacroiliac screws were analyzed as a control group retrospectively.The time of each screw insertion,volume of intra-operative blood loss,and the exposure to X ray were analyzed and the Matta's radiological criteria were used to evaluate the reduction quality.The Majeed score was used to evaluate postoperative living quality.The visual analogue scale (VAS)was applied at different time points to judge pain relief of coccydynia.All the 7 patients in the template group were closely followed up radiographically and clinically for 14 to 20 months,mean (16.57±2.44)months.Totally 9 sacroiliac screws for the S 1 and S2 vertebra were inserted in the 7 patients.The time length for each screw insertion ranged from 450 to 870 s,mean (690.56±135.68)s,and the number of times of exposure to X ray were 4 to 8,mean (5.78±1.20).The intra-operative blood loss ranged from 45to 120 mL,mean (75±23.32)mL.According to Matta's radiology criteria,the fracture and dislocation reduction were excellent in 6cases and good in 1.The pre-operative VAS score ranged from 5.2 to 8.1,mean (7.13±1.00).The average one-week/six-month post-operative VAS was (5.33±0.78)and (1.33±0.66),respectively (P<0.05 when compared with pre-operative VAS).The 12-month post-operative Majeed score ranged from 86 to 92,mean (90.29±2.21).The three-dimensional printed guiding template for sacroiliac screw insertion,which could significantly shorten the operation time,provide a satisfied outcome of the stabilization of the pelvic ring,and protect doctors and patients from X-ray exposure,might be a practical and valuable new clinical technique.
文摘Treatment of children with cervical spine disorders requiring fusion is a challenging endeavor for a variety of reasons. The size of the patients, the corresponding abnormal bony anatomy, the inherent ligamentous laxity of children, and the relative rarity of the disorders all play a part in difficulty of treatment. The benefits of modern posterior cervical instrumentation in children, defined as rigid screw–rod systems, have been shown to be many including: improved arthrodesis rates, diminished times in halo-vest immobilization, and improved reduction of deformities. The anatomy of children and the corresponding pathology seen frequently is at the upper cervical spine and craniocervical junction given the relatively large head size of children and the horizontal facets at these regions predisposing them to instability or deformity. Posterior screw fixation, while challenging, allows for a rigid base to allow for fusion in these upper cervical areas which are predisposed to pseudarthrosis with non-rigid fixation. A thorough understanding of the anatomy of the cervical spine, the morphology of the cervical spine, and the available screw options is paramount for placing posterior cervical screws in children. The purpose of this review is to discuss both the anatomical and clinical descriptions re-lated to posterior screw placement in the cervical spine in children.
文摘Objective: To investigate the clinical efficacy of the cement-screw technique in repairing tibial plateau bone defects in total knee arthroplasty (TKA) recipients and summarize the preoperative prehabilitation strategies for such surgeries. Methods: A total of 33 TKA recipients (45 knees) in our department underwent repair of unilateral or bilateral tibial defects using the cement-screw technique. The subjects were divided into two groups based on the differences in preoperative interventions. The control group received routine preoperative health education according to the consensus, while the observation group received instructive and standardized prehabilitation exercises for four weeks in addition to the routine education. Scale scores, intraoperative parameters, and postoperative recovery indicators were recorded at different time pointsand subjected to statistical analysis for intra-group and inter-group differences. All subjects underwent long-term follow-up for at least 24 months. Results: Within each group at different time points, there were statistically significant differences in VAS, ROM, and HSS scores (p Conclusions: Cement-screw technique for repairing tibial plateau bone defects in TKA recipients can significantly relieve pain, and improve joint function. Prehabilitation can improve preoperative rehabilitation reserves in these patients, accelerate postoperative recovery, and contribute to better short-term clinical outcomes.
文摘To explore the value of helical CT volume rendering technique (VRT) in post-operative evaluation of screw fixation of axis fractures.Methods There were 21 cases of screw fixation of axis fractures between February 2002 and May 2004 in the study including six cases with fractures on axis body,five on odontoid process and 10 on axis body and odontoid process.All cases received X-ray plain film,helical CT scanning,multi-planar reformatting(MPR) and VRT.Results Screw fixation through axis body and massa lateralis atlantis was performed in 10 cases and that through axis body and odontoid process in 11.VRT could clearly display full aperture of screw orbit,location of screw and angle of fixation and hence was superior to X-ray plain film and MPR.Multi-angle VRT displayed asymmetrical space of odontoid process and massa lateralis atlantis in four cases and medial deviation of 2～5 mm of half screw in screw fixation through axis body and massa lateralis atlantis in six.Conclusion VRT can eliminate false shadow of fixation screw,clearly display full aperture of screw orbit and hence supply improtant imaging evidence for post-operative evaluation of screw fixation of axis fractures.7 refs,1 fig,1 tab.
基金the institutional review board of Mingzhou Hospital of Ningbo(No.202208501).
文摘BACKGROUND The pedicle screw technique is widely employed for vertebral body fixation in the treatment of spinal disorders.However,traditional screw placement methods require the dissection of paraspinal muscles and the insertion of pedicle screws at specific transverse section angles(TSA).Larger TSA angles require more force to pull the muscle tissue,which can increase the risk of surgical trauma and ischemic injury to the lumbar muscles.AIM To study the feasibility of zero-degree TSA vertical pedicle screw technique in the lumbosacral segment.METHODS Finite element models of vertebral bodies and pedicle screw-rod systems were established for the L4-S1 spinal segments.A standard axial load of 500 N and a rotational torque of 10 N/m were applied.Simulated screw pull-out experiment was conducted to observe pedicle screw resistance to pull-out,maximum stress,load-displacement ratio,maximum stress in vertebral bodies,load-displacement ratio in vertebral bodies,and the stress distribution in pedicle screws and vertebral bodies.Differences between the 0-degree and 17-degree TSA were compared.RESULTS At 0-degree TSA,the screw pull-out force decreased by 11.35%compared to that at 17-degree TSA(P<0.05).At 0-degree and 17-degree TSA,the stress range in the screw-rod system was 335.1-657.5 MPa and 242.8-648.5 MPa,separately,which were below the fracture threshold for the screw-rod system(924 MPa).At 0-degree and 17-degree TSA,the stress range in the vertebral bodies was 68.45-78.91 MPa and 39.08-72.73 MPa,separately,which were below the typical bone yield stress range for vertebral bodies(110-125 MPa).At 0-degree TSA,the load-displacement ratio for the vertebral bodies and pedicle screws was slightly lower compared to that at 17-degree TSA,indicating slightly lower stability(P<0.05).CONCLUSION The safety and stability of 0-degree TSA are slightly lower,but the risks of screw-rod system fracture,vertebral body fracture,and rupture are within acceptable limits.
