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
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
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
目的评估后路寰枢椎椎弓根螺钉内固定系统在治疗青少年游离齿状突小骨伴寰枢椎脱位患者中的长期临床效果,并介绍一种针对难复性寰枢椎脱位的综合复位技术。方法回顾性研究2014年1月~2016年9月期间在笔者医院手术治疗的21例游离齿状突小...目的评估后路寰枢椎椎弓根螺钉内固定系统在治疗青少年游离齿状突小骨伴寰枢椎脱位患者中的长期临床效果,并介绍一种针对难复性寰枢椎脱位的综合复位技术。方法回顾性研究2014年1月~2016年9月期间在笔者医院手术治疗的21例游离齿状突小骨伴寰枢椎脱位的12~18岁青少年患者,所有患者均采用后路寰枢椎椎弓根螺钉复位固定系统治疗,对于5例术前通过颅骨牵引不能达到满意寰枢椎复位的患者应用了综合提拉复位的手术技术。通过术前术后颈椎过伸过屈位的影像学资料,测量以下指标:寰椎椎管内径(inner diameter of the atlantal ring,D atl)、椎管最小径(minimum diameter of the spinal canal,D min)、椎管最大径(maximum distance of the spinal canal,D max)、寰齿前间距(atlantodens interval,ADI)、延髓脊髓角(cervico-medullary angle,CMA)、C2~C7 Cobb角、并随访术前术后JOA和NDI评分。采用独立样本t检验比较患者术前术后各项指标。结果所有患者术后均获得满意的寰枢椎复位及神经症状改善,术中未发生神经损伤、椎动脉损伤等并发症,所有患者随访24~48个月,颈椎功能障碍指数(NDI)从17.4±6.7分改善为10.1±3.6分,JOA评分从11.2±1.9分提高到14.4±1.9分。术后随访影像学数据表明,C2~C7 Cobb角由术前25.4°±10.5°变为17.2°±6.4°。寰椎椎管内径从术前16.6±2.1mm变为16.7±2.4mm,椎管最小直径从9.1±2.4mm明显改善为15.3±1.9mm,寰齿前间距(ADI)由术前1.5±0.7mm变为术后1.5±0.6mm。延髓脊髓角(CMA)由术前135.2°±7.6°明显改善为152.0°±6.1°。结论后路寰枢椎椎弓根螺钉固定系统在治疗青少年游离齿状突畸形伴寰枢椎脱位中能够获得较满意的长期临床疗效。同时采用的综合提拉复位方法在难复性寰枢椎脱位的治疗中初步得到满意复位效果。展开更多
目的:比较大通道全内镜下椎间减压融合联合单侧椎弓根螺钉固定与双侧椎弓根螺钉固定治疗单节段腰椎退行性疾病的疗效。方法:回顾性分析2019年12月~2021年10月在我院行大通道全内镜下椎间减压融合内固定手术治疗的47例单节段腰椎退行性...目的:比较大通道全内镜下椎间减压融合联合单侧椎弓根螺钉固定与双侧椎弓根螺钉固定治疗单节段腰椎退行性疾病的疗效。方法:回顾性分析2019年12月~2021年10月在我院行大通道全内镜下椎间减压融合内固定手术治疗的47例单节段腰椎退行性疾病患者的临床资料,其中20例采用单侧椎弓根螺钉固定(单侧固定组),男5例,女15例,年龄39~69岁(54.1±9.6岁);27例采用双侧椎弓根螺钉固定(双侧固定组),男9例,女18例,年龄40~70岁(57.8±9.4岁)。两组患者的年龄、体重指数(body mass index,BMI)、性别、手术节段、疾病类型、随访时间等一般资料均无统计学差异(P>0.05)。比较两组患者手术时间、术中透视次数、住院费用、住院时间、手术前后的血红蛋白及变化值和并发症发生率;术前及术后3天、3个月、1年采用疼痛视觉模拟评分(visual analog scale,VAS)评价腰腿痛,术前及术后3个月、1年采用Oswestry功能障碍指数(Oswestry disability index,ODI)评价功能障碍情况;术后1年根据CT评价椎间融合情况,通过改良MacNab标准对临床疗效进行评价。结果:所有患者手术顺利,均获得1年及以上随访,双侧固定组手术时间、术中透视次数、住院费用、住院时间均显著性高于单侧固定组(P<0.05)。两组患者术前、术后血红蛋白值及血红蛋白变化值均无统计学差异(P>0.05)。两组患者术后3天、3个月、1年的VAS评分及术后3个月、1年的ODI均较术前明显下降(P<0.05);两组同时间点VAS评分及ODI比较均无统计学差异(P>0.05)。两组并发症发生率(单侧固定组10.0%vs双侧固定组11.1%)、术后1年融合率(单侧固定组90.0%vs双侧固定组92.6%)及改良MacNab优良率(单侧固定组90.0%vs双侧固定组88.9%)均无统计学差异(P>0.05)。结论:大通道全内镜下椎间减压融合联合单侧椎弓根螺钉固定与双侧椎弓根螺钉固定治疗单节段腰椎退行性疾病均安全有效,与双侧固定相比,单侧固定术中透视次数、手术时间、住院费用、住院时间更具有优势。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.
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.
文摘目的评估后路寰枢椎椎弓根螺钉内固定系统在治疗青少年游离齿状突小骨伴寰枢椎脱位患者中的长期临床效果,并介绍一种针对难复性寰枢椎脱位的综合复位技术。方法回顾性研究2014年1月~2016年9月期间在笔者医院手术治疗的21例游离齿状突小骨伴寰枢椎脱位的12~18岁青少年患者,所有患者均采用后路寰枢椎椎弓根螺钉复位固定系统治疗,对于5例术前通过颅骨牵引不能达到满意寰枢椎复位的患者应用了综合提拉复位的手术技术。通过术前术后颈椎过伸过屈位的影像学资料,测量以下指标:寰椎椎管内径(inner diameter of the atlantal ring,D atl)、椎管最小径(minimum diameter of the spinal canal,D min)、椎管最大径(maximum distance of the spinal canal,D max)、寰齿前间距(atlantodens interval,ADI)、延髓脊髓角(cervico-medullary angle,CMA)、C2~C7 Cobb角、并随访术前术后JOA和NDI评分。采用独立样本t检验比较患者术前术后各项指标。结果所有患者术后均获得满意的寰枢椎复位及神经症状改善,术中未发生神经损伤、椎动脉损伤等并发症,所有患者随访24~48个月,颈椎功能障碍指数(NDI)从17.4±6.7分改善为10.1±3.6分,JOA评分从11.2±1.9分提高到14.4±1.9分。术后随访影像学数据表明,C2~C7 Cobb角由术前25.4°±10.5°变为17.2°±6.4°。寰椎椎管内径从术前16.6±2.1mm变为16.7±2.4mm,椎管最小直径从9.1±2.4mm明显改善为15.3±1.9mm,寰齿前间距(ADI)由术前1.5±0.7mm变为术后1.5±0.6mm。延髓脊髓角(CMA)由术前135.2°±7.6°明显改善为152.0°±6.1°。结论后路寰枢椎椎弓根螺钉固定系统在治疗青少年游离齿状突畸形伴寰枢椎脱位中能够获得较满意的长期临床疗效。同时采用的综合提拉复位方法在难复性寰枢椎脱位的治疗中初步得到满意复位效果。
文摘目的:比较大通道全内镜下椎间减压融合联合单侧椎弓根螺钉固定与双侧椎弓根螺钉固定治疗单节段腰椎退行性疾病的疗效。方法:回顾性分析2019年12月~2021年10月在我院行大通道全内镜下椎间减压融合内固定手术治疗的47例单节段腰椎退行性疾病患者的临床资料,其中20例采用单侧椎弓根螺钉固定(单侧固定组),男5例,女15例,年龄39~69岁(54.1±9.6岁);27例采用双侧椎弓根螺钉固定(双侧固定组),男9例,女18例,年龄40~70岁(57.8±9.4岁)。两组患者的年龄、体重指数(body mass index,BMI)、性别、手术节段、疾病类型、随访时间等一般资料均无统计学差异(P>0.05)。比较两组患者手术时间、术中透视次数、住院费用、住院时间、手术前后的血红蛋白及变化值和并发症发生率;术前及术后3天、3个月、1年采用疼痛视觉模拟评分(visual analog scale,VAS)评价腰腿痛,术前及术后3个月、1年采用Oswestry功能障碍指数(Oswestry disability index,ODI)评价功能障碍情况;术后1年根据CT评价椎间融合情况,通过改良MacNab标准对临床疗效进行评价。结果:所有患者手术顺利,均获得1年及以上随访,双侧固定组手术时间、术中透视次数、住院费用、住院时间均显著性高于单侧固定组(P<0.05)。两组患者术前、术后血红蛋白值及血红蛋白变化值均无统计学差异(P>0.05)。两组患者术后3天、3个月、1年的VAS评分及术后3个月、1年的ODI均较术前明显下降(P<0.05);两组同时间点VAS评分及ODI比较均无统计学差异(P>0.05)。两组并发症发生率(单侧固定组10.0%vs双侧固定组11.1%)、术后1年融合率(单侧固定组90.0%vs双侧固定组92.6%)及改良MacNab优良率(单侧固定组90.0%vs双侧固定组88.9%)均无统计学差异(P>0.05)。结论:大通道全内镜下椎间减压融合联合单侧椎弓根螺钉固定与双侧椎弓根螺钉固定治疗单节段腰椎退行性疾病均安全有效,与双侧固定相比,单侧固定术中透视次数、手术时间、住院费用、住院时间更具有优势。
