Clinical Effectiveness of the Plate Screw Internal Fixation Technique in the Treatment of Patients with Traumatic Fractures of Long Bones in the Lower Extremities

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.

EFFECT OF INTERNAL FIXATION PLATES ON MICROCIRCULATION IN UNDER-PLATE CORTICAL BONES MICROANGIOGRAPHY AND SCANNING ELECTRONMICROSCOPY

To elucidate the effect of the internal fixation plates on the local bone blood sapply, we used microangiography and scanning electron microscopy to observe the morphological changes of microcirculation in the cortical bones obtained from intact rabbit tibiae on which plates of two different stiffness had been fixed for comparison. The results indicated that both rigid stainless steel plate and less rigid methyl methacrylate plate could induce the bone microcirculation under the plate to undergo a process from early depression to late reactive recruitment. The features of the microcircuiation recruitment such as vascular number, arrangement and dilatation varied with plates of different stiffness and were more obvious in the cortex fixed by rigid stainless steel plate.

A Biomechanical Comparison of Conventional versus an Anatomic Plate and Compression Bolts for Fixation of Intra-articular Calcaneal Fractures

The purpose of this study was to compare the biomechanical stability obtained by using our technique featured an anatomical plate and compression bolts versus that of the conventional anatomic plate and cancellous screws in the fixation of intraarticular calcaneal fractures.Eighteen fresh frozen lower limbs of cadavers were used to create a reproductive Sanders type-Ⅲ calcaneal fracture model by using osteotomy.The calcaneus fractures were randomly selected to be fixed either using our anatomical plate and compression bolts or conventional anatomic plate and cancellous screws.Reduction of fracture was evaluated through X radiographs.Each calcaneus was successively loaded at a frequency of 1 Hz for 1000 cycles through the talus using an increasing axial force 20 N to 200 N and 20 N to 700 N,representing the partial weight bearing and full weight bearing,respectively,and then the specimens were loaded to failure.Data extracted from the mechanical testing machine were recorded and used to test for difference in the results with the Wilcoxon signed rank test.No significant difference was found between our fixation technique and conventional technique in displacement during 20-200 N cyclic loading(P=0.06),while the anatomical plate and compression bolts showed a great lower irreversible deformation during 20-700 N cyclic loading(P=0.008).The load achieved at loss of fixation of the constructs for the two groups had significant difference:anatomic plate and compression bolts at 3839.6±152.4 N and anatomic plate and cancellous screws at 3087.3±58.9 N(P=0.008).There was no significant difference between the ultimate displacements.Our technique featured anatomical plate and compression bolts for calcaneus fracture fixation was demonstrated to provide biomechanical stability as good as or better than the conventional anatomic plate and cancellous screws under the axial loading.The study supports the mechanical viability of using our plate and compression bolts for the fixation of calcaneal fracture.

Small splints versus plate fixation for distal radius fractures: A meta- analysis and systematical analysis

Objective:Evaluate the efficacy,safety and economy of small splints and plate in the treatment of distal radius fractures(DRFs).Methods:Seven electronic databases,including PubMed,EMBASE,Cochrane Library,sinomed,CNKI,VIP and Wanfang,were searched for the original study.Literature was screened according to the inclusion and exclusion criteria,and the methodological quality of the included studies was evaluated by Cochrane risk bias assessment tool.The software Revman 5.4 was used for data analysis.Results:A total of 19 studies were included in the study.The clinical effective rate of the plate group[RR=0.96,95%CI(0.93,0.99),P=0.007],Radial inclination[MD=-1.85,95%CI(-2.93,-0.77),P=0.0008],Ulnar inclination[MD=-2.49,95%CI(-3.95,-1.04),P=0.0007],relative height of radius[MD=-1.63,95%CI(-2.40,-0.86),P<0.0001]were better than those in small splints group.There was no significant difference in fracture healing time[MD=-4.39,95%CI(-9.07,0.28),P=0.07]and complications[RR=1.57,95%CI(0.98,2.52),P=0.06]between the two groups.In terms of treatment cost[MD=-2.83,95%CI(-3.37,-2.30),P<0.00001],the small splint group was better than the plate treatment group.Conclusion:Compared with small splints therapy,plate internal fixation has advantages in clinical effective rate and imaging scores.There is no significant difference in fracture healing time and complications between the two groups.In terms of treatment cost,small splint therapy is better than plate therapy.Clinical treatment should be selected and formulated according to the individual situation,demands and clinical practice of patients.

Usage of buttress plate internal fixation associated with autografting of fibula and iliac bone for the treatment of distal femoral C_3 type fracture

To assess the effect of using buttress plate associated with antografting of fibula and iliac bone for the treatment of distal femoral C3 type fracture.Methods Seventeen cases of distal femoral C3 type fracture using buttress plate associated with antografting of fibula and iliac bone were analyzed retrospectively.Results All cases were followed up for an average of 24 months（8～55 months）.The average time of octets bridge forming were 4 months（3～5 months） while the average time for bone union were 8 months （6～14 months）.According to Shelbourne rating system,result of all 18 cases were excellent and no malunion,infection were found.Conclusion Buttress plate associated with antografting of fibula and iliac bone is an effective alternative for the treatment of distal femoral C3 type fracture.It can provide more stable fixation to the bone and earlier functional exercises can be achieved.5 refs,3 figs,1 tab.

Rib Osteosynthesis for Sub-Acute Management of a Flail Chest in a Tertiary Centre in a Low-Middle Income Country of Sub-Saharan Africa: Case Report at Douala Laquintinie Hospital

Background: Costal fracture surgical is still a debate, therefore we shall select between early and delay surgical management. Case Report: We are reporting two cases of post road traffic clash delay ribs fractures osteosynthesis involving a 63-year-old man with multistage fractures on the left and pulmonary pinning of one of the costal arches, complicated by a homolateral haemothorax and a 41-year-old man with a bilateral flail chest. Conclusion: The simple postoperative course and the immediate postoperative improvement in the patient’s clinical respiratory condition enabled us to discuss the time frame for management, in this case the indication for early or later surgery.

Neutralization versus Compression Plate on Lateral Malleolus Fracture:Is Lag Screw Necessary?

Introduction: Our aim was to compare clinical and radiological results of lateral malleolus fracture treated with neutralization and compression plate. Material and Methods: 54 patients with isolated lateral malleolus fractures treated between March 2012 and April 2015 at Fatih Sultan Mehmet Training and Research Hospital were evaluated with the Ankle-Hindfoot Scale of the American Orthopedic Foot and Ankle Society (AOFAS) score (excellent, ≥90;good, 75 - 89;acceptable, 50 - 74;poor, Results: There was no significant change in AOFAS, VAS, PSS and the union rates between two plating techniques. Conclusion: Similar results have shown both of two plating techniques were successful treating isolated lateral malleolus fracture.

Effect of Locking Compression Plate on the Treatment of Limb Fracture and the Effect of Operative Success Rate and Postoperative Recovery Time

Objective:To analyze the effect of locking compression plate on the success rate of operation and the time of postoperative recovery.Methods:120 patients with limb fractures from March 2018 to March 2020 were randomly divided into control group(60 cases)and observation group(60 cases).The control group was treated with plate screw internal fixation,The observation group used locking compression plate internal fixation,Compare the effect of treatment,the success rate of operation and the time of postoperative recovery.results:compared the effective rate of the two groups,the observation group(93.33%)was significantly higher than the control group(75.00%).Compared with the two groups,the success rate of operation and the time of postoperative recovery,the observed composition power was higher than that of the control group,and the postoperative recovery time was lower than that of the control group,P<0.05.Conclusion:The use of locking compression plate for the treatment of limb fracture can significantly increase the probability of successful operation,shorten the recovery time after operation,the overall curative effect is ideal,and the clinical popularization value is high.

Postoperative Fracture Healing Effects of Locking Compression Plate for the Treatment of Limb Fractures

Objectives To study the effects of applying locking compression plates in the treatment of patients with limb fractures on postoperative fracture healing.Methods:115 patients with limb fractures who were treated in our hospital from November 2019 to November 2020 were selected.In order to study the effective treatment method,the random-number table method was used in this study to divide the patients into two groups,namely the experimental group and the control group,and the locking compression plate treatment method and the pure plate and screw internal fixation treatment method were administered respectively to study their clinical application effects.Results:Compared with the control group,patients in the experimental group had a lower incidence of complications,shorter hospitalizations and shorter recovery time.Meanwhile,the experimental group had a better quality of recovery,and all data were significantly different from those of the control group,P<0.05,the intervention effect of the experimental group was better.Conclusion:The application of the locking compression plate in the treatment of patients with limb fractures is more conducive to promoting the postoperative healing of the patients'fractures,reducing the incidence of postoperative complications,and promoting the rapid recovery of patients,which has positive significance for clinical development.

Biomechanical comparison of locking plate and crossing metallic and absorbable screws fixations for intra-articular calcaneal fractures

The locking plate and percutaneous crossing metallic screws and crossing absorbable screws have been used clinically to treat intra-articular calcaneal fractures, but little is known about the biomechanical differences between them. This study compared the biomechanical stability of calcaneal fractures fixed using a locking plate and crossing screws. Three-dimensional finite-element models of intact and fractured calcanei were developed based on the CT images of a cadaveric sample. Surgeries were simulated on models of Sanders type III calcaneal fractures to produce accurate postoperative models fixed by the three implants. A vertical force was applied to the superior surface of the subtalar joint to simulate the stance phase of a walking gait. This model was validated by an in vitro experiment using the same calcaneal sample. The intact calcaneus showed greater stiffness than the fixation models. Of the three fixations, the locking plate produced the greatest stiffness and the highest von Mises stress peak. The micromotion of the fracture fixated with the locking plate was similar to that of the fracture fixated with the metallic screws but smaller than that fixated with the absorbable screws. Fixation with both plate and crossing screws can be used to treat intra-articular calcaneal fractures. In general, fixation with crossing metallic screws is preferable because it provides sufficient stability with less stress shielding.

Locking plate versus external fixation for type C distal radius fractures： A meta-analysis of randomized controlled trials

Purpose： Distal radial fracture is one of the most common fractures. Up to now, locking plates （LP） and external fixation （EF） are two conventional surgical approaches to type C radius fracture. Which method is superior has not yet reached a consensus. We try to assess the clinical effectiveness of the two in- terventions by this meta-analysis. Methods： We used network to search the PubMed, Embase, and Cochrane Medical Library of randomized controlled clinical trials about the type C distal radius fractures performed according to the search strategy mentioned in Cochrane Handbook 5.1.0 from Jan. 2005 to Jan. 2016. Patients in the experimental group were used LP, in the control group were included EF and other surgical approaches. Publication language was restricted to English. Studies that patient population and surgical indication did not define had been excluded. Studies must report at least one of the outcomes as follow： radial inclination, patmar tilt, ulnar variance, range of wrist flexion and extension, and range of wrist supination and pronation. The trials in which participants included children were excluded. We used Jadad study scores to appraise the study. Results： Seven studies included 162 patients （LP group） and 190 patients （EF group）. We compared the radial inclination, palmar tilt, ulnar variance, range of wrist flexion and extension, and range of wrist supination and pronation. The radial inclination were revealed a difference favoring LP over EF [WMD = 1.84, 95% CI （0.17, 3.50）, p = 0.03] and the palmar tilt and ulnar variance was no significant difference between the two groups [（WMD = 3.61, 95% CI （0.00, 7.23）, p = 0.05; WMD = 0.05, 95% CI （-0.99,1.09）, p = 0.93]. The functional activities of range of flexion and extension and range of supination and pronation between the two groups was no difference [WMD = 10.04, 95% CI （-6.88, 26.96）, p = 0.24; WMD = 12.53, 95% CI （-9.99, 35.06）, p = 0.28]. Conclusion： Locking plate and external fixation is feasible to heal radius type C fracture. We found the small difference between the two groups on imaging examination. The locking plate has the advantage on maintaining reduction, however no significant difference regarding outcomes has been found be- tween the two groups.

Quantitative Histological Study on Changes of the Cortical Bones after Internal Fixation with Plates of Different Rigidity

In an effect to explore the potemtial role of bone microcirculation causing plate-induced reginal osteoporosis

Treatment of intertrochanteric fractures of the femur with L trapezoid compression plate and its mechanical principles

Objective: To improve the results of the treatment of unstable types of intertrochanteric fractures of the femur (ITFF) by internal fixation. Methods: A L trapezoid compression plate system (L TCP) was designed and compared to the AO/ASIF angle plates of 95° and 130° (L AP) with mechanical tests. An Evans Type Ⅲ model was made, the simulation electrical test with loading on single and both legs were done. The results demonstrated that the stability of the L TCP fixation was significantly greater, and the stress concentration at the upper screw hole was relevantly smaller than that of L AP. From June 1986 to June 1998, 82 patients of ITFF were treated with L TCP fixation. The average age was 67.4 years old (26 91). Seventy four of those fractures were unstable. Fifty eight patients were treated with open reduction, and 24 cases were treated by closed reduction and limited open (only lateral aspect of upper femur was exposed) fixation with L TCP under X ray monitoring. Results: Sixty six patients were followed up for 6 69 months. Complications, including 3 wound infection, 1 non union, 3 coxa varus and 2 implant breakage (9 complications of 7 cases), all occurred in the open reduction group. No complication was found in the closed reduction group. Conclusions: In the treatment of ITFF, the results of closed reduction and limited open fixation with L TCP is significantly better than that of open reduction and fully exposed fixation.