Objective:To investigate the effect of locking compression plate internal fixation on the injury extent and bone metabolism of Robinson 2A and 2B middle clavicular fractures.Methods:Totally 80 cases of patients with R...Objective:To investigate the effect of locking compression plate internal fixation on the injury extent and bone metabolism of Robinson 2A and 2B middle clavicular fractures.Methods:Totally 80 cases of patients with Robinson 2A and 2B middle clavicular fractures admitted to our hospital between March 2017 and January 2019 were divided into the control group(n=41)receiving conventional kirschner wire internal fixation and the observation group(n=39)receiving locking compression plate internal fixation according to the operation plans.The differences in serum contents of inflammatory factors,oxidative stress indexes and bone metabolism indexes were compared between the two groups of patients before patients entered operating room,24 h after surgery and 48 h after surgery.Results:Before patients entered operating room,there were no statistically significant differences in the serum contents of inflammatory factors,oxidative stress indexes or bone metabolism indexes between the two groups(P>0.05).At 24 h and 48 h after surgery,serum inflammatory factors interleukin-1(IL-1),interleukin-17(IL-17),high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factorα(TNF-α)contents in the observation group were lower than those in the control group;serum reactive oxygen species(ROS)and lipid hydroperoxide(LHP)contents were lower than those in the control group,while catalase(CAT)and glutathione peroxidase(GSH-Px)contents were higher than those in the control group;serum N-terminal propeptide of procollagen type I(PINP),bone gla protein(BGP)and alkaline phosphatase(ALP)contents were higher than those in the control group,while N-telopeptide of typeⅠcollagen(NTX),C-telopeptide of typeⅠcollagen(CTX)and tartrate-resistant acid phosphatase 5b(TRACP5b)contents were lower than those in the control group(P<0.05).Conclusion:Locking compression plate internal fixation can reduce the postoperative trauma extent and help promote the fracture healing in patients with Robinson 2A and 2B middle clavicular fracture.展开更多
<b><span>Purpose</span></b><b><span>: </span></b><span>The purpose </span><span>of </span><span>this study was to define a treatment protoc...<b><span>Purpose</span></b><b><span>: </span></b><span>The purpose </span><span>of </span><span>this study was to define a treatment protocol in which a non-vascularized endosteal fibular strut graft, a corticocancellous grafts and a locking plate construct </span><span>are</span><span> used for stabilization of the delayed and neglected proximal humerus fractures and to report its outcome. </span><b><span>Patients & Methods</span></b><b><span>:</span></b><b><span> </span></b><span>Eleven patients (6 females and 5 males) with delayed, neglected proximal humerus fractures were included in this study,</span><span> </span><span>conducted between March 2015 </span><span>and </span><span>December 2019.</span><span> </span><span>Average age of the patients was 57 years (range: 41 to 67 yrs). All patients were treated with the debridement, decortication and shingling of the bone at the site of the fracture followed by using an endosteal fibular strut graft, corticocancellous bone grafts and stabilization with locking plate. The patients were followed</span><span> </span><span>up for a mean time of 16.3 months (range: 13 </span><span>to </span><span>40 months). The patient outcomes were evaluated using the Disabilities of the Arm, Shoulder, and Hand Questionnaire, and the modified scoring system of Constant and Murley. </span><b><span>Results</span></b><b><span>:</span></b><b><span> </span></b><span>Union at the fracture site was achieved in all patients at a mean </span><span>of </span><span>8.5 months (range: 6 to 11 months). The DASH score improved from an average pre-operative score of 71.1 (range: 64 to 78) to an average post-operative score of 25.2 (range: 21 to 35) at the final follow-up. Albeit with a small sample size of n</span><span> </span><span>=</span><span> </span><span>11, this difference was found to be statistically significant (p</span><span> </span><span><</span><span> </span><span>0.05). The CM score improved from an average pre-operative score of 33.2 (range: 20 to 48) to an average post-operative score of 66.8 (range: 59 to 72) at the final follow-up. This difference was also found to be statistically significant in this patient cohort (p</span><span> </span><span><</span><span> </span><span>0.05). The results were excellent in 3 patients, good in 6 and moderate in 2. </span><b><span>Conclusions</span></b><b><span>:</span></b><b><span> </span></b><span>An endosteal fibular strut, subperiosteally placed cortico-cancellous grafts with a locking plate fixation helps in biological healing of neglected fractures of proximal humerus.</span>展开更多
Objective:To compare the clinical therapeutic effect of bridge combined internal fixation system and locking compression plate internal fixation in the treatment of displaced midshaft clavicle fractures by emphaticall...Objective:To compare the clinical therapeutic effect of bridge combined internal fixation system and locking compression plate internal fixation in the treatment of displaced midshaft clavicle fractures by emphatically observing fracture healing and shoulder joint function.Methods:Totally 44 elderly patients with Robinson type 2B displaced midshaft clavicle fractures were included from the Department of Orthopaedics,Shenyang Fourth People's Hospital during February 2016 and December 2018,including 23 males and 21 females,mean age(69.8±10.2)years old.The patients were divided into a bridge combined internal fixation system group(bridge group,n=22)and a locking compression plate internal fixation group(plate group,n=22)according to the internal fixation methods.The operation time,intraoperative blood loss,fracture healing time,and postoperative complications were recorded.At 12 months after surgery,the shoulder joint Constant-Murley score and DASH score were used to assess the recovery of joint function.The serum levels of bone turnover biochemical markers procollagen I N-terminal peptide(P1NP),cross-linked Carboxy-terminal telopeptide of typeⅠcollagen(CTX-I),and osteoblast specific factor(OSF)were measured before and 3 months after surgery.Results:The operation time,intraoperative blood loss and fracture healing time of the bridge group were significantly shorter than those of the plate group(P<0.05).Constant scores and DASH scores in the bridge group were significantly better than those of the plate group at 12 months after surgery(P<0.05).Serum levels of CTX-I was significantly decreased,while the P1NP and OSF were significantly increased compared with before surgery in the both groups(P<0.05),and the changes were more obvious in the bridge group(P<0.05).The incidence of complications was similar between the two groups(P<0.05).Conclusion:Compared with the locking plate system,the bridge combined internal fixation system can effectively improve the operation efficiency,have more benefits on fracture healing,better promote the recovery of patients'function,and reduce the failure rate of internal fixation,thus providing a better choice to treat displaced midshaft clavicle fractures by intraoperative internal fixation.展开更多
基金Application and clinical characteristics of Ilizarov technique in the treatment of bone defect,No:20150802.
文摘Objective:To investigate the effect of locking compression plate internal fixation on the injury extent and bone metabolism of Robinson 2A and 2B middle clavicular fractures.Methods:Totally 80 cases of patients with Robinson 2A and 2B middle clavicular fractures admitted to our hospital between March 2017 and January 2019 were divided into the control group(n=41)receiving conventional kirschner wire internal fixation and the observation group(n=39)receiving locking compression plate internal fixation according to the operation plans.The differences in serum contents of inflammatory factors,oxidative stress indexes and bone metabolism indexes were compared between the two groups of patients before patients entered operating room,24 h after surgery and 48 h after surgery.Results:Before patients entered operating room,there were no statistically significant differences in the serum contents of inflammatory factors,oxidative stress indexes or bone metabolism indexes between the two groups(P>0.05).At 24 h and 48 h after surgery,serum inflammatory factors interleukin-1(IL-1),interleukin-17(IL-17),high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factorα(TNF-α)contents in the observation group were lower than those in the control group;serum reactive oxygen species(ROS)and lipid hydroperoxide(LHP)contents were lower than those in the control group,while catalase(CAT)and glutathione peroxidase(GSH-Px)contents were higher than those in the control group;serum N-terminal propeptide of procollagen type I(PINP),bone gla protein(BGP)and alkaline phosphatase(ALP)contents were higher than those in the control group,while N-telopeptide of typeⅠcollagen(NTX),C-telopeptide of typeⅠcollagen(CTX)and tartrate-resistant acid phosphatase 5b(TRACP5b)contents were lower than those in the control group(P<0.05).Conclusion:Locking compression plate internal fixation can reduce the postoperative trauma extent and help promote the fracture healing in patients with Robinson 2A and 2B middle clavicular fracture.
文摘<b><span>Purpose</span></b><b><span>: </span></b><span>The purpose </span><span>of </span><span>this study was to define a treatment protocol in which a non-vascularized endosteal fibular strut graft, a corticocancellous grafts and a locking plate construct </span><span>are</span><span> used for stabilization of the delayed and neglected proximal humerus fractures and to report its outcome. </span><b><span>Patients & Methods</span></b><b><span>:</span></b><b><span> </span></b><span>Eleven patients (6 females and 5 males) with delayed, neglected proximal humerus fractures were included in this study,</span><span> </span><span>conducted between March 2015 </span><span>and </span><span>December 2019.</span><span> </span><span>Average age of the patients was 57 years (range: 41 to 67 yrs). All patients were treated with the debridement, decortication and shingling of the bone at the site of the fracture followed by using an endosteal fibular strut graft, corticocancellous bone grafts and stabilization with locking plate. The patients were followed</span><span> </span><span>up for a mean time of 16.3 months (range: 13 </span><span>to </span><span>40 months). The patient outcomes were evaluated using the Disabilities of the Arm, Shoulder, and Hand Questionnaire, and the modified scoring system of Constant and Murley. </span><b><span>Results</span></b><b><span>:</span></b><b><span> </span></b><span>Union at the fracture site was achieved in all patients at a mean </span><span>of </span><span>8.5 months (range: 6 to 11 months). The DASH score improved from an average pre-operative score of 71.1 (range: 64 to 78) to an average post-operative score of 25.2 (range: 21 to 35) at the final follow-up. Albeit with a small sample size of n</span><span> </span><span>=</span><span> </span><span>11, this difference was found to be statistically significant (p</span><span> </span><span><</span><span> </span><span>0.05). The CM score improved from an average pre-operative score of 33.2 (range: 20 to 48) to an average post-operative score of 66.8 (range: 59 to 72) at the final follow-up. This difference was also found to be statistically significant in this patient cohort (p</span><span> </span><span><</span><span> </span><span>0.05). The results were excellent in 3 patients, good in 6 and moderate in 2. </span><b><span>Conclusions</span></b><b><span>:</span></b><b><span> </span></b><span>An endosteal fibular strut, subperiosteally placed cortico-cancellous grafts with a locking plate fixation helps in biological healing of neglected fractures of proximal humerus.</span>
文摘Objective:To compare the clinical therapeutic effect of bridge combined internal fixation system and locking compression plate internal fixation in the treatment of displaced midshaft clavicle fractures by emphatically observing fracture healing and shoulder joint function.Methods:Totally 44 elderly patients with Robinson type 2B displaced midshaft clavicle fractures were included from the Department of Orthopaedics,Shenyang Fourth People's Hospital during February 2016 and December 2018,including 23 males and 21 females,mean age(69.8±10.2)years old.The patients were divided into a bridge combined internal fixation system group(bridge group,n=22)and a locking compression plate internal fixation group(plate group,n=22)according to the internal fixation methods.The operation time,intraoperative blood loss,fracture healing time,and postoperative complications were recorded.At 12 months after surgery,the shoulder joint Constant-Murley score and DASH score were used to assess the recovery of joint function.The serum levels of bone turnover biochemical markers procollagen I N-terminal peptide(P1NP),cross-linked Carboxy-terminal telopeptide of typeⅠcollagen(CTX-I),and osteoblast specific factor(OSF)were measured before and 3 months after surgery.Results:The operation time,intraoperative blood loss and fracture healing time of the bridge group were significantly shorter than those of the plate group(P<0.05).Constant scores and DASH scores in the bridge group were significantly better than those of the plate group at 12 months after surgery(P<0.05).Serum levels of CTX-I was significantly decreased,while the P1NP and OSF were significantly increased compared with before surgery in the both groups(P<0.05),and the changes were more obvious in the bridge group(P<0.05).The incidence of complications was similar between the two groups(P<0.05).Conclusion:Compared with the locking plate system,the bridge combined internal fixation system can effectively improve the operation efficiency,have more benefits on fracture healing,better promote the recovery of patients'function,and reduce the failure rate of internal fixation,thus providing a better choice to treat displaced midshaft clavicle fractures by intraoperative internal fixation.
